Intervention effect of hand washing behavior in primary and secondary schools in Shanghai by non-participatory observation

Abstract

Objective To assess the changes of students' hand washing behaviors after implementing comprehensive interventions, and to provide the reference for hand-washing promotion among students.

Methods The implementation of comprehensive intervention projects had been carried out in three aspects: hardware transformation, system establishment, health management and health education. A randomized controlled trial method was used to select each one primary and secondary school in 2016 from 17 districts in Shanghai, and 17 intervention schools and 17 control schools were taken as object. Non-participant observation was used for students' hand washing behaviors for 4 times during May, 2016 to May, 2017. Descriptive analysis and chi square test were used to analyze the data.

Results Compared with the control group, the hand washing rate of the intervention group was lower than that of the control group at baseline. The intervention group has got a higher rate than that of the control group in the evaluation of 1, the assessment 2 and the assessment 3 after intervention. The difference was statistically significant (χ ² = 7.70, 24.23, 38.88, 21.71, P<0.05). Compared with the control group, the hand washing rate of the intervention group after class was lower than that of the control group. After the intervention, the rate of the intervention group was higher than that of the control group in the evaluation 1, the assessment 2 and the assessment 3 after the intervention. The difference was statistically significant ( χ ² = 8.52, 33.79, 54.64, 13.99, P<0.05). Compared with the control group, there was no difference between the baseline intervention group and the control group before meals. The intervention group after intervention was higher than the control group in the evaluation of 1, evaluation 2 and evaluation 3. The difference was statistically significant ( χ ² =45.01, 42.19, 27.82, P<0.05).

Conclusion After comprehensive intervention, the effect was significant under different temperature conditions, and the effect of intervention lasted for one year.

Abstract

【摘要】 目的 评估实施综合干预措施后学生洗手行为的改变, 为促进学生形成良好的洗手行为提供参考。 方法 采用随机对照试验方法于 2016 年上海市 17 个区各选择 1 所中小学作为干预校, 并同时各选择 1 所学校作为对照, 共有 17 所干预学校和 17 所对照学校, 每所学校分别观察 20 名学生。干预学校从硬件改造、制度的建立和卫生管理、健康教育 3 个方面开展干预。用非参与式观察法观察学生的洗手行为并记录, 分别在 2016 年 5, 11, 12 月和 2017 年 5 月开展 4 次观察 (分别视为基线、评估 1、评估 2、评估3)。采用描述性分析和; χ ²检验对结果进行统计分析。 结果 基线时干预组便后洗手 率低于对照组, 干预后干预组在评估 1、评估 2、评估 3 时便后洗手率均髙于对照组, 差异均有统计学意义 (χ ² 值分别为 7.70, 24.23, 38.88, 21.71, P值均<0.05)。基线时干预组在体育课或课外活动后洗手、课后洗手率低于对照组, 干预后干预 组在评估 1、评估 2、评估 3 时课后洗手率均髙于对照组, 差异均有统计学意义(χ ² 值分别为8.52, 33.79, 54.64, 13.99, P值均 <0.05)。基线时干预组与对照组饭前洗手率差异无统计学意义, 干预后干预组在评估 1、评估 2、评估 3 时饭前洗手率均髙 于对照组, 差异均有统计学意义 (χ ² 值分别为 45.01, 42.19, 27.82, P值均<0.05.)。 结论 综合干预之后在不同的季节干预 效果显著, 并且干预的效果持续 1 年之后仍有意义。