School-based health education intervention to increase knowledge on rheumatic heart disease: the provar study

• Autor(a) principal: Andrea Beaton
• Data de Publicação: 2016
• Outros Autores: l. Barros, Craig Sable, B.r. Nascimento, Maria do Carmo Pereira Nunes, K.b. Oliveira, Antônio Luiz Pinho Ribeiro, C.m. Oliveira, Graziela Chequer, V.m. Rezende, a. Lauar, A.l.m. Costa
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: http://hdl.handle.net/1843/54843; https://orcid.org/0000-0002-7539-4994
• topic: Rheumatic Heart Disease; Brazil; Middle countries; Cardiopatia Reumática; Brasil; Países em Desenvolvimento

Introduction: Rheumatic Heart Disease (RHD) remains an important cause of morbidity and mortality in Brazil and other low- and middle-income countries (LMIC). Lack of public awareness of the causes and prevention of RHD limit the efficacy of primary and secondaryprevention programs. Objectives: To evaluate the efficacy of knowledge transfer that results from a structured public-school educational program on RHD. Methods: A prospective, cohort study was conducted over 8 months (9/2014-4/2015) in 6 randomly selected low-income public schools in Belo Horizonte, Brazil. All enrolled and present students received education. A nurse and an imaging technician utilized 2 custom educational curriculums, targeting children in grades 6 - 11 (aged 11-17). Pre-tests, taken immediately prior to educational curriculum queried students’ knowledge of the causes, prevention, diagnosis, and treatment of RHD. Post-tests, 1-3 weeks following education assessed the efficacy of knowledge transfer and retention. Results: Education was delivered to 3700 students. Of these, 1176 were randomly selected to participate in pre- and post-testing including 404 (34%) in 6th/7th grades (G1), 511 (44%) in 8th/9th (G2), and 261 (22%) of in 10th/11th grades (G3). The mean interval between pre and post-tests was 1010 days. Prior to the intervention, general knowledge regarding RHD was universally low (median score 46.7%, 40.0-60.0). Children in higher grades (G3) knew more about RHD than those in lower grades (60% vs. 43.3% G1/46.7% G2), p<0.001.Children showed significant gains in the post-test, raising the median score by 20% (60%, 40.0-73.3). Again, children in higher grades showed higher overall scores (73.3%, 60.0-80.0 G3; 60%, 40.0-73.3 G2; 53.3%, 33.3-66.7 G1), p<0.001. However, the percent increase was similar between groups (6.9% G1, 7.9% G2, 8.5% G3), p¼0.53. Conclusion: School-based RHD education resulted in consistent but modest gains in knowledge. Novel educational techniques and use of technology to engage young learners may lead to improved knowledge gains and retention. Further studies are needed to determine if increased knowledge leads to behavioral changes that could decrease theburden of RHD in LMIC.