家庭参与式洗手行为干预在幼托机构传染病防控中效果分析

Effects of family-involved hand washing intervention on prevention of infectious diseases among children in kindergartens

目的探讨家庭参与式洗手行为干预在改善幼托机构儿童洗手行为及预防急性传染病的效果。方法于2018年3—6月,在广东省广州市4所幼儿园的16个小班开展研究,采用整群随机分组,干预组(n=247)和对照组(n=243)各8个班级;对照组接受常规健康教育,干预组在此基础上开展家庭参与式洗手行为干预,比较2组儿童、父母的洗手行为及儿童急性传染病的发生率。结果干预后2组儿童的各种洗手行为存在差异(b=–0.207、–0.106、–0.149、–0.113,均P<0.05),干预组在干预后2个月的餐前、便后、外出后洗手及七步洗手法,4个月的餐前洗手,6个月的餐前洗手及七步洗手法优于对照组(均P<0.05);干预后2个月干预组家长的各种洗手行为均优于对照组(χ2=8.750、7.243、15.557,均P<0.05);干预12个月内干预组儿童以消化道、呼吸道传播为主的急性传染病发生率为9.3%,低于对照组的16.0%(χ2=5.031,P=0.025)。结论家庭参与式洗手行为干预有助于降低幼托机构儿童急性传染病的发病率,并改善儿童及家长的洗手行为,对于幼托机构急性传染病的预防管理具有积极意义。

Objective To determine the efficacy of a family-involved hand washing intervention on the improvement of hand hygiene of children and the prevention of infectious diseases among children in kindergartens. Methods A clusterrandomized controlled trial was conducted among 490 children(averagely aged 4.28 ± 0.33 years) and their parents at16 classes from 4 kindergartens in Guangzhou city from March to June in 2018, and there were 8 classes in each group by randomization. Totally 247 children and their families were enrolled in the intervention group with family-involved hand washing intervention, and 243 children and their families in the control group with regular health education. The behavior of hand washing among the children and their parents and the incidence of infectious diseases of children between the two groups were compared. Results Hand washing behaviors of the children were significantly different between the two groups after the intervention(hand washing before eating [b =-0.207], after toilet use [b =-0.106], after going out [b =-0.149],and with seven-step procedure [b =-0.113];all P < 0.05). The hand washing before eating, after toilet use and going out,and with seven-step procedure 2 months after the intervention, the hand washing before eating 4 months after the intervention, and the hand washing before eating and with seven-step procedure 6 months after the intervention were significantly better among the children of intervention group than among those of the control group(all P < 0.05). The hand washing of the parents in the intervention group were significantly better than that of parents in the control group 2 months after the intervention(hand washing before eating [χ2 = 8.750], after toilet use [χ2 = 7.243], after going out [χ2 = 15.557];all P < 0.05). The cumulated incidence of acute gastrointestinal and respiratory infections was significantly lower among the children in the intervention group than among those in the control group(9.3% vs. 16.0%, χ2 = 5.031;P = 0.025) during the12-month follow-up. Conclusion The family-involved hand washing intervention is effective in improving hand hygiene behaviors among kindergarten children and their parents and reducing infectious diseases in the children, suggesting that the intervention is of significance for infectious disease prevention in kindergartens.