Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
PLoS One. 2013 Aug 12;8(8):e70654. doi: 10.1371/journal.pone.0070654. eCollection 2013.
Ingestion of contaminated water or food is a major contributor to childhood diarrhea in developing countries. In Vietnam, the use of community-based information, education and communication (IEC) activities could be a sustainable strategy to improve food hygiene and food safety behaviors. This study thus examined the long-term impact of community-based IEC activities on food hygiene and food safety behaviors.
In this longitudinal study, we interviewed caregivers of children aged between six months and four years in suburban Hanoi. Baseline data were collected in January 2006 (n = 125). After conducting IEC interventions, we collected a 1(st) set of evaluation data in January 2007 (n = 132). To examine the long-term impact of the interventions, we then collected a 2(nd) set of evaluation data in January 2008 (n = 185). Changes in childhood diarrhea prevalence, IEC coverage, and food hygiene and food safety behaviors were assessed over a two-year period using bivariate and logistic regression analyses. Effective IEC channels were determined through multiple linear regression analysis.
Childhood diarrhea was significantly reduced from 21.6% at baseline to 7.6% at the 1(st) post-intervention evaluation (P = 0.002), and to 5.9% at the 2(nd) evaluation. Among 17 food hygiene and food safety behaviors measured, a total of 11 behaviors were improved or maintained by the 2(nd) evaluation. Handwashing after toilet use was significantly improved at both evaluation points. Overall, 3 food safety behaviors and 7 food hygiene behaviors were found to have significantly improved at the 1(st) and at the 2(nd) evaluations, respectively. Flip chart communication administered by community groups was identified to be the most effective IEC channel for effecting behavior change (P = 0.018).
Flip chart communication administered by community groups is effective for improving multiple food hygiene and food safety behaviors in sustainable ways, and should be included in water and health promotion programs.
在发展中国家，饮用水或食物污染是导致儿童腹泻的主要原因。在越南，采用以社区为基础的信息、教育和通讯（IEC）活动可能是改善食品卫生和食品安全行为的可持续战略。本研究因此检验了以社区为基础的 IEC 活动对食品卫生和食品安全行为的长期影响。
在这项纵向研究中，我们对河内郊区 6 个月至 4 岁儿童的照顾者进行了访谈。基线数据于 2006 年 1 月收集（n=125）。在进行 IEC 干预后，我们于 2007 年 1 月收集了第一组评估数据（n=132）。为了检验干预的长期影响，我们随后于 2008 年 1 月收集了第二组评估数据（n=185）。在两年期间，使用双变量和逻辑回归分析评估儿童腹泻患病率、IEC 覆盖率以及食品卫生和食品安全行为的变化。通过多元线性回归分析确定有效的 IEC 渠道。
儿童腹泻率从基线时的 21.6%显著降低到第一次干预评估时的 7.6%（P=0.002），并在第二次评估时降低到 5.9%。在测量的 17 种食品卫生和食品安全行为中，有 11 种行为在两次评估中都得到了改善或保持。便后洗手的行为在两次评估中都显著改善。总体而言，有 3 种食品安全行为和 7 种食品卫生行为在第一次和第二次评估中均得到显著改善。由社区团体管理的翻页图表沟通被确定为最有效的 IEC 渠道，能够有效改善行为（P=0.018）。
由社区团体管理的翻页图表沟通对于以可持续的方式改善多种食品卫生和食品安全行为是有效的，应纳入水和健康促进计划。
