Impact of the educational program “Igiene Insieme”in 1,991 Italian primary schools: student behavior and incidence of SARS-CoV-2
Keywords:
school, COVID-19, hand-hygiene, health education, SARS-CoV-2 incidence, prevention, school education programme, infection preventionAbstract
Objective: To evaluate the impact of the health educational program “Igiene Insieme 2021/2022” on Italian primary school children’s knowledge, attitudes and practice of hygiene and sanitation and to compare incidence of SARS-CoV-2 in schools participating the project with regional data of Lombardy and Apulia. Methods: Participating schools were provided with a hygiene kit containing educational material for teachers and sanitizing products for students. We conducted a pre-post evaluation administering a questionnaire before and after the intervention. In addition, we compared SARS-CoV-2 incidence of the participating primary schools (225 in Lombardy and 120 in Apulia) to regional-level data. We tested the differences between groups by using the Chi-squared test. Results: Of 1,991 schools, 472 responded to both questionnaires for a total of 16,988 students. 17.3% of the students learned the importance of handwashing in preventing infections, 22.6% when to wash hands, 18.5% the existence of alternative solutions in absence of soap and water, 23.2% how to correctly wash hands. A lower incidence of SARS-CoV-2 infections was recorded in primary schools participating in the project as compared to the average regional incidence in Lombardy (9.6% vs.14.8%) and Apulia (10.7% vs.12.0%) for the same age group. Conclusions: We report an overall positive effect of health education interventions in primary schools. Although the limitations in the study design, our findings are important to inform planning, implementation and monitoring of health promotion campaigns in young generations so as to contribute to limit the risk of infection spread at the community level
References
WHO guidelines on hand hygiene in health care: a summary. World Health Organization; 2009. Report No. WHO/IER/PSP/2009.07.
Kingston L, O’Connell NH, Dunne CP. Hand hygiene-related clinical trials reported since 2010: a systematic review. J Hosp Infect. 2016;92(4):309–20. doi: 10.1016/j
.jhin.2015.11.012.
Von Lengerke T, Lutze B, Krauth C, et al. Promoting Hand Hygiene Compliance: PSYGIENE—a Cluster-Randomized Controlled Trial of Tailored Interventions. Dtsch Arztebl Int. 2017; 114(3):29-36. doi:10.3238
/arztebl.2017.0029.
Best M, Neuhauser D. Ignaz Semmelweis and the birth of infection control. Qual Saf Health Care. 2004;13(3):233–4. doi:10.1136/qhc.13.3.233.
Curtis V, Danquah L, Aunger R. Planned, motivated and habitual hygiene behaviour: An eleven country review. Health Educ Res. 2009;24:655–73. doi:10.1093/her/cyp002.
WHO UNICEF Joint Monitoring Programme for Water Supply and Sanitation Global water supply and sanitation assess-ment 2000 report. Switzerland; 2000 p.80 ISBN: 9241562021
Lee RL, Loke AY, Wu CS, et al. The lifestyle behaviours and psychosocial well-being of primary school students in Hong Kong. J Clin Nurs. 2010;19(9–10):1462–72. doi:10.1111/j.1365-2702.2009.03057.x.
Jatrana S, Hasan MM, Mamun AA, et al. Global Variation in Hand Hygiene Practices Among Adolescents: The Role of Family and School-Level Factors. Int J Environ Res Public Health. 2021;18(9):4984. doi: 10.3390/ijerph18094984
Mbakaya BC, Kalembo FW, Zgambo M. Use, adoption, and effectiveness of tippy-tap handwashing station in promoting hand hygiene practices in resource-limited settings: a systematic review. BMC Public Health.2020;20(1):1005. doi:10.1186/s12889-020-09101-w.
Lau CH, Springston EE, Sohn MW, et al. Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort study. BMC Pediatr.2012;12(1):52. doi: 10.1186/1471-2431-12-52.
Nandrup-Bus I. Mandatory handwashing in elementary schools reduces absenteeism due to infectious illness among pupils: A pilot intervention study. Am J Infect Control. 2009;37(10):820– 6. doi: 10.1016/j.ajic.2009.06.012.
Klar K, Knaack D, Kampmeier S, et al. Knowledge about Hand Hygiene and Related Infectious Disease Awareness among Primary School Children in Germany. Children(Basel). 2022;9(2):190. doi:10.3390/children9020190.
Guinan M, McGuckin M, Ali Y. The effect of a comprehensive handwashing program on absenteeism in elementary schools. Am J Infection Control. 2002;30(4):217–20. doi: 10.1067/mic.2002.120366.
Hammond B, Ali Y, Fendler E, et al. Effect of hand sanitizer use on elementary school absenteeism. Am J Infect Control. 2000;28(5):340–6. doi: 10.1067/mic.2000.107276.
Azor-Martinez E, Cobos-Carrascosa E, Seijas-Vazquez ML, et al. Hand Hygiene Program Decreases School Absenteeism Due to Upper Respiratory Infections. J Sch Health. 2016;86(12):873–81. doi: 10.1111/josh.12454.
Chittleborough CR, Nicholson AL, Young E, et al. Implementation of an educational intervention to improve hand washing in primary schools: process evaluation within a randomised controlled trial. BMC Public Health.2013;13(1):757. doi: 10.1186/1471-2458-13-757.
Odone A, Bricchi L, Signorelli C. COVID-19 control school-based interventions: characteristics and impact of a national-level educational programme in Italy. Acta Biomed. 2021;92(S6): e2021495–e2021495. doi: 10.23750
/abm.v92iS6.12327.
Celik LA, Pancoe DL. Healthy school environment: effectiveness of hand washing instruction in an elementary school set-ting. NASN Sch Nurse.2012;27(4):194–6. doi: 10.1177/1942602X12444451.
Crosby S, Laird K, Younie S. Interactive health-hygiene education for early years: the creation and evaluation of learning re-sources to improve understanding of handwashing practice. International Journal of Early Years Education. 2019;27(4):374–90 . doi: 10.1080/09669760.2019.1628010.
Lehotsky Á, Falus A, Lukács Á, et al. Orvosi Hetilap
.2018;159(12):485–90. [Hungarian] doi: 10.1556/650.
31031.
Randle J, Metcalfe J, Webb H, et al. Impact of an educational intervention upon the hand hygiene compliance of children. J Hosp Infect.2013;85(3):220–5. doi: 10.1016/j.jhin.2013.07.013
Bloomfield SF, Aiello AE, Cookson B, et al. The effectiveness of hand hygiene procedures in reducing the risks of infections in home and community settings including handwashing and alcohol-based hand sanitizers. Am J Infect Control. 2007;35(10):S27–64. doi: 10.1016/j.ajic.2007.07.001
Rutter S, Macduff C, Stones C, et al. Evaluating children’s handwashing in schools: an integrative review of indicative measures and measurement tools. Int J Environ Health Res. 2021;31(1):1–19. doi: 10.1080/09603123.2019.1625032.
Rohde J, Sadjimin T. Elementary-school pupils as health educators: role of school health programmes in primary health-care. Lancet.1980;315(8182):1350–2. doi: 10.1016
/s0140-6736(80)91797-3.
Garg A, Taneja DK, Badhan SK, et al. Effect of a school-based hand washing promotion program on knowledge and hand washing behavior of girl students in a middle school of Delhi. Indian J Public Health. 2013;57(2):109–12. doi: 10.4103/0019-557X.115009.
Pulimeno M, Piscitelli P, Colazzo S, Colao A, Miani A. School as ideal setting to promote health and wellbeing among young people. Health Promot Perspect.2020;
(4):316–24. doi: 10.34172/hpp.2020.50.
Scott E, Bloomfield SF, Exner M, et al. Prevention of the spread of infection: the need for a family-centered approach to hygiene promotion. Am J Infect Control. 2010;38(1):1–2.
doi: 10.1016/j.ajic.2009.11.001.
Bloomfield SF, Signorelli C, Fara G. Developing and promoting hygiene in the home and community. Ann Ig. 2010;22(1):1–8.
Riccò M, Vezzosi L, Gualerzi G, Signorelli C. Knowledge, attitudes and practices (KAP) towards vaccinations in the school settings: an explorative survey. J Prev Med Hyg. 2017;58(4): e266–78. doi:10.15167/2421-4248
/jpmh2017.58.4.673.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Lucia Bricchi, Carlo Signorelli, Anna Odone, Danilo Cereda, Lucia Bisceglia, Pier Luigi Lopalco
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
