The effect of a video-assisted health education program sequenced by peer education on the health literacy of COVID-19 and other infectious diseases among school children: a randomized controlled trial (Preprint)

Abstract

To improve the engagement and effectiveness of traditional health programs, it is necessary to explore alternative models of health education including video-assisted lectures and peer education.

The present study aimed to evaluate the effects of a combination of video-assisted lecture and peer education on the health literacy of pupils related to infectious diseases.

Third-grade classes from 11 pilot schools in Longgang district of Shenzhen, China were randomized to the intervention and control groups with a ratio of 1:1. In the intervention group, a video-assisted interactive health education program was conducted twice over a time-span of five months. Each of the two sessions included a 40-minute lecture on COVID-19 and other common infectious diseases in schools and a 5-minute science video. In addition, five “little health supervisors” at the end of the first session were elected in each class, who were responsible for helping class members to learn health knowledge and develop good hygiene habits. Students answered the same quiz before the first and after the second session. Models based on item response theory (IRT) were constructed to score the students’ knowledge of infectious diseases based on the quiz.

Fifty-two classes and 2526 students (1311 in the intervention group and 1215 in the control group) were enrolled. Responses of the baseline survey were available for 2177 (86.2%; 1306 in the intervention group and 871 in the control group) students and the post-intervention survey were 1862 (73.7%; 1187 in the intervention group and 675 in the control group). There were statistically significant cross-group differences in the rates of correctly answering questions about influenza symptoms, transmission and its preventive measures, chickenpox symptoms, norovirus diarrhea symptoms, mumps symptoms, and COVID-19 symptoms. Average IRT scores of questions related to infectious diseases in the intervention and control groups were, respectively, -0.0375 (SD 0.7784) and 0.0477 (SD 0.7481) before the intervention (P=0.010), suggesting better baseline knowledge among the control group. After the intervention, the average scores of the intervention and control groups were 0.0543 (SD 0.7569) and -0.1115 (SD 0.7307), respectively (P<0.001), suggesting not only significantly better scores but also greater improvement among the intervention group.

After the health education project, the correct answer rate of infectious disease questions in the intervention group was improved compared with the control group, which indicates significant effects of the combination of video-assisted lectures and peer education for the promotion of health literacy. In addition, the intervention effect of the first session persisted for at least four months up to the second session. As such, the proposed program was effective at improving the health literacy of school children related to infectious diseases and should be considered for massive health promotion campaigns during pandemics.