针对荷兰学童开展的蜱虫叮咬及莱姆病预防教育：比较在线教育视频游戏与传单或无干预措施的效果。
Education on tick bite and Lyme borreliosis prevention, aimed at schoolchildren in the Netherlands: comparing the effects of an online educational video game versus a leaflet or no intervention.
作者信息
Beaujean D J M A, Gassner F, Wong A, Steenbergen J E, Crutzen R, Ruwaard D
机构信息
National Institute for Public Health and the Environment, Centre for Infectious Disease Control, P.O. Box 1, 3720, BA, Bilthoven, The Netherlands.
Department of Statistics, Informatics and Mathematical Modeling, National Institute for Public Health and the Environment, P.O. Box 1, 3720, BA, Bilthoven, The Netherlands.
出版信息
BMC Public Health. 2016 Nov 16;16(1):1163. doi: 10.1186/s12889-016-3811-5.
BACKGROUND
Lyme disease or Lyme borreliosis (LB) is the most common tick-borne disease both in the United States and Europe. Children, in particular, are at high risk of contracting LB. Since child-specific educational tools on ticks, tick bites and LB are lacking, we developed an online educational video game. In this study, we compared the effectiveness of an online educational video game versus a newly developed leaflet aimed to improve prevention of tick bites and LB among Dutch schoolchildren.
METHODS
A total of 887 children, aged 9-13 years and attending the two final years of primary schooling, were recruited from 25 primary schools in June and July 2012. They were assigned through cluster randomization to one of three intervention groups: 'game' (22.4%), 'leaflet' (35.6%) or 'control' (41.9%). Prior to and directly following intervention, the children were asked to complete a short questionnaire. The main outcome measures were knowledge, perception (perceived susceptibility and importance) and preventive behavior in relation to tick bites and LB. Generalized linear mixed models were used to analyze the data.
RESULTS
In the game group, the leaflet group and the control group, knowledge about ticks and tick bites improved significantly. The game was also an effective tool for improving preventive behavior; the frequency of checking for ticks increased significantly. However, there were no significant differences in knowledge improvement between the interventions. The game outperformed the leaflet in terms of improving preventive behavior, whereas the frequency of tick checks increased significantly. But this frequency didn't increase more than in the control group.
CONCLUSIONS
The positive knowledge effects observed in the control group suggests the presence of a mere measurement effect related to completion of the questionnaire. The game did not outperform the leaflet or control group on all outcome measures. Therefore, the game may be of value as a complementary role, in addition to other media, in child-specific public health education programs on ticks and LB. This trial was retrospectively registered on October 21, 2016 (trial registration number: ISRCTN15142369).
背景
莱姆病或莱姆疏螺旋体病（LB）是美国和欧洲最常见的蜱传疾病。尤其是儿童，感染莱姆病的风险很高。由于缺乏针对儿童的关于蜱虫、蜱虫叮咬和莱姆病的教育工具，我们开发了一款在线教育视频游戏。在本研究中，我们比较了一款在线教育视频游戏与一份新开发的传单在提高荷兰学童预防蜱虫叮咬和莱姆病方面的效果。
方法
2012年6月和7月，从25所小学招募了887名9至13岁、处于小学最后两年的儿童。通过整群随机化将他们分配到三个干预组之一：“游戏组”（22.4%）、“传单组”（35.6%）或“对照组”（41.9%）。在干预前和干预后，要求儿童完成一份简短问卷。主要结局指标是与蜱虫叮咬和莱姆病相关的知识、认知（感知易感性和重要性）以及预防行为。使用广义线性混合模型分析数据。
结果
在游戏组、传单组和对照组中，关于蜱虫和蜱虫叮咬的知识均有显著提高。该游戏也是改善预防行为的有效工具；检查蜱虫的频率显著增加。然而，各干预措施在知识改善方面没有显著差异。在改善预防行为方面，游戏的表现优于传单，蜱虫检查频率显著增加。但该频率的增加幅度并不比对照组更大。
结论
对照组中观察到的积极知识效应表明存在与完成问卷相关的单纯测量效应。该游戏在所有结局指标上并未优于传单组或对照组。因此，除其他媒体外，该游戏作为补充手段，在针对儿童的蜱虫和莱姆病公共卫生教育项目中可能具有价值。该试验于2016年10月21日进行回顾性注册（试验注册号：ISRCTN15142369）。
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