COVID-19 control school-based interventions: characteristics and impact of a national-level educational programme in Italy
Keywords:
School, COVID-19, prevention, hygiene, health education, infection, hand hygieneAbstract
Objective: to report on the characteristics and impact of “Igiene Insieme”, a school-based national-level educational programme designed and implemented in Italy to promote hygiene and sanitation in schools, stimulate healthy behaviors in teachers, students and their families, and ultimately fight COVID-19.
Methods: the project targeted kindergartens and primary schools and included three components: the design and delivery of innovative health education interventions to i) students and ii) teachers, and iii) the provision of sanitation products in schools. Here we describe the intervention, report on the project penetration and evaluate its impact. First, a survey was conducted on a convenience sample of 1,005 teachers to evaluate the project at the national level, then a retrospective analysis was conducted in the Lombardy region comparing SARS-CoV-2 infection incidence rate in schools participating to the project with regional burden data.
Results: Over 8,000 Italian schools joined the project, for a total of 32,000 teachers and 1.1 million students. Survey respondents rated the educational interventions and the provision of sanitation products as excellent (66.6% and 82.5%, respectively) and reported the project to have greatly impacted on students’ health behaviors. In the Lombardy region, 271 primary schools (11%) joined the project and 140 (52%) provided COVID-19 burden data. Over the study period, SARS-CoV-2 infection incidence rate in schools participating in the project was 14% lower as compared to regional-level data (643 per 100,000 vs. 747 per 100,000).
Conclusions: We raise awareness on the importance of promoting health education and infectious diseases primary prevention in schools, and to plan, implement and monitor student-centred interventions during and beyond COVID-19 times.
References
COVID-19 in children and the role of school settings in transmission - first update [Internet]. European Centre for Disease Prevention and Control. 2020 [citato 4 luglio 2021]. Disponibile su: https://www.ecdc.europa.eu/en/publications-data/children-and-school-settings-covid-19-transmission
Signorelli C, Scognamiglio T, Odone A. COVID-19 in Italy: impact of containment measures and prevalence estimates of infection in the general population. Acta Biomed. 10 aprile 2020;91(3-S):175–9.
Viner RM, Russell SJ, Croker H, Packer J, Ward J, Stansfield C, et al. School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review. Lancet Child Adolesc Health. maggio 2020;4(5):397–404.
Levinson M, Cevik M, Lipsitch M. Reopening Primary Schools during the Pandemic. N Engl J Med. 3 settembre 2020;383(10):981–5.
Signorelli C. High seroprevalence of SARS_COV-2 in Bergamo: evidence for herd immunity or reason to be cautious? :3.
Considerations for school-related public health measures in the context of COVID-19 [Internet]. [citato 4 luglio 2021]. Disponibile su: https://www.who.int/publications-detail-redirect/considerations-for-school-related-public-health-measures-in-the-context-of-covid-19
Gray DJ, Kurscheid J, Mationg ML, Williams GM, Gordon C, Kelly M, et al. Health-education to prevent COVID-19 in schoolchildren: a call to action. Infect Dis Poverty. dicembre 2020;9(1):81.
CDC. Hand Hygiene at School [Internet]. Centers for Disease Control and Prevention. 2021 [citato 31 agosto 2021]. Disponibile su: https://www.cdc.gov/handwashing/handwashing-school.html
Signorelli C, Fara GM. COVID-19: Hygiene and Public Health to the front. Acta Biomed. 2020;91(Suppl 3):7–8.
Chen X, Ran L, Liu Q, Hu Q, Du X, Tan X. Hand Hygiene, Mask-Wearing Behaviors and Its Associated Factors during the COVID-19 Epidemic: A Cross-Sectional Study among Primary School Students in Wuhan, China. Int J Environ Res Public Health. aprile 2020;17(8):2893.
Miller GF, Greening B, Rice KL, Arifkhanova A, Meltzer MI, Coronado F. Modeling the Transmission of Covid-19: Impact of Mitigation Strategies in Prekindergarten-Grade 12 Public Schools, United States, 2021. J Public Health Manag Pract. 30 aprile 2021;
CDC. COVID-19 ARCHIVED WEBPAGE [Internet]. Centers for Disease Control and Prevention. 2020 [citato 31 agosto 2021]. Disponibile su: https://www.cdc.gov/coronavirus/2019-nCoV/index.html
Handwashing to Prevent Illness at School [Internet]. [citato 31 agosto 2021]. Disponibile su: https://www.doh.wa.gov/CommunityandEnvironment/Schools/EnvironmentalHealth/handwashing
Toney-Butler TJ, Gasner A, Carver N. Hand Hygiene. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [citato 31 agosto 2021]. Disponibile su: http://www.ncbi.nlm.nih.gov/books/NBK470254/
Flasche S, Edmunds WJ. The role of schools and school-aged children in SARS-CoV-2 transmission. Lancet Infect Dis. marzo 2021;21(3):298–9.
The Lancet Child & Adolescent Health. Pandemic school closures: risks and opportunities. The Lancet Child & Adolescent Health. maggio 2020;4(5):341.
Edmunds WJ. Finding a path to reopen schools during the COVID-19 pandemic. Lancet Child Adolesc Health. novembre 2020;4(11):796–7.
Ismail SA, Saliba V, Lopez Bernal J, Ramsay ME, Ladhani SN. SARS-CoV-2 infection and transmission in educational settings: a prospective, cross-sectional analysis of infection clusters and outbreaks in England. Lancet Infect Dis. marzo 2021;21(3):344–53.
Coronavirus (COVID-19) Infection Survey, UK: 13 November 2020 - Office for National Statistics [Internet]. [citato 9 settembre 2021]. Disponibile su: https://www.ons.gov.uk/releases/coronaviruscovid19infectionsurveyuk13november2020
TFC: Children and transmission, 4 November 2020 [Internet]. GOV.UK. [citato 9 settembre 2021]. Disponibile su: https://www.gov.uk/government/publications/tfc-children-and-transmission-4-november-2020
Ferguson N, Laydon D, Nedjati Gilani G, Imai N, Ainslie K, Baguelin M, et al. Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand [Internet]. Imperial College London; 2020 mar [citato 9 settembre 2021]. Disponibile su: http://spiral.imperial.ac.uk/handle/10044/1/77482
Lee J. Mental health effects of school closures during COVID-19. Lancet Child Adolesc Health. giugno 2020;4(6):421.
S.r.l CC. Igiene Insieme [Internet]. Igiene Insieme. [citato 24 settembre 2021]. Disponibile su: https://www.igieneinsieme.it
Signorelli C, Odone A, Gianfredi V, Bossi E, Bucci D, Oradini-Alacreu A, et al. The spread of COVID-19 in six western metropolitan regions: a false myth on the excess of mortality in Lombardy and the defense of the city of Milan. Acta Biomed. 2020;91(2):23–30.
Odone A, Delmonte D, Scognamiglio T, Signorelli C. COVID-19 deaths in Lombardy, Italy: data in context. Lancet Public Health. giugno 2020;5(6):e310.
Paakkari L, Okan O. COVID-19: health literacy is an underestimated problem. Lancet Public Health. maggio 2020;5(5):e249–50.
Colao A, Piscitelli P, Pulimeno M, Colazzo S, Miani A, Giannini S. Rethinking the role of the school after COVID-19. Lancet Public Health. luglio 2020;5(7):e370.
CDC, CDC. Community, Work, and School [Internet]. Centers for Disease Control and Prevention. 2021 [citato 9 settembre 2021]. Disponibile su: https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/index.html
Gurdasani D, Alwan NA, Greenhalgh T, Hyde Z, Johnson L, McKee M, et al. School reopening without robust COVID-19 mitigation risks accelerating the pandemic. The Lancet. 27 marzo 2021;397(10280):1177–8.
Panovska-Griffiths J, Kerr CC, Stuart RM, Mistry D, Klein DJ, Viner RM, et al. Determining the optimal strategy for reopening schools, the impact of test and trace interventions, and the risk of occurrence of a second COVID-19 epidemic wave in the UK: a modelling study. Lancet Child Adolesc Health. novembre 2020;4(11):817–27.
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