Zhang Jing, Lin Dandan, Hu Fei, Li Dong, Chen Junjiang, Xie Hua, Li Yifeng, Ding Sheng
Jiangxi Provincial Institute of Parasitic Diseases, Nanchang, Jiangxi, P.R. China.
PLoS Negl Trop Dis. 2025 Aug 6;19(8):e0013388. doi: 10.1371/journal.pntd.0013388. eCollection 2025 Aug.
Schistosomiasis remains a critical public health challenge in endemic regions, particularly among school-aged children. Despite global efforts, conventional health education approaches show limited success in translating knowledge into sustained practices change. This study evaluates the efficacy of two innovative educational approaches-curriculum-integrated infiltration and stepwise progressive approaches-compared to traditional methods in enhancing schistosomiasis-related knowledge, attitudes, and practices (KAP) among students. A school-based intervention was conducted in Duchang County's Zhouxi township, with is an area afferted by schistosomiasis in China. Sixth-grade students (n ≈ 300) were divided into three groups: a traditional intervention group receiving standard WHO-aligned lectures, an infiltration group with cross-disciplinary curriculum integration, and a stepwise group with modular, tiered content. KAP outcomes were assessed via validated questionnaires at baseline and post-intervention. Both intervention groups demonstrated significant knowledge gains compared to traditional intervention (post-intervention accuracy: infiltration 89.67%, stepwise 91.10%, traditional intervention 86.50%; P < 0.001). Practices knowledge showed the most significant improvement (41.47% increase in the infiltration group vs. 22.38% in traditional intervention). The stepwise approaches achieved the highest overall accuracy (91.10%) but showed no statistically significant advantage over the infiltration approach (P > 0.05). Attitudinal improvements were consistent across groups, with high baseline rates limiting further gains (post-intervention: 95.60-96.68%). Curriculum-integrated and stepwise approaches effectively address the knowledge-practices gap in schistosomiasis education. The infiltration strategy, requiring minimal resources, is ideal for practices reinforcement in low-resource settings, while the stepwise approach suits rapid knowledge dissemination in well-resourced areas. These findings advocate for context-adaptive, multisectoral frameworks to optimize school-based interventions, aligning with WHO goals for neglected tropical disease elimination.
血吸虫病在流行地区仍然是一项严峻的公共卫生挑战，尤其是在学龄儿童中。尽管全球都在努力，但传统的健康教育方法在将知识转化为持续的行为改变方面成效有限。本研究评估了两种创新教育方法——课程整合渗透法和逐步递进法——与传统方法相比，在提高学生与血吸虫病相关的知识、态度和行为（KAP）方面的效果。在中国受血吸虫病影响的都昌县周溪乡开展了一项基于学校的干预措施。六年级学生（n≈300）被分为三组：接受符合世卫组织标准讲座的传统干预组、进行跨学科课程整合的渗透组和采用模块化分层内容的逐步递进组。在基线和干预后通过经过验证的问卷对KAP结果进行评估。与传统干预组相比，两个干预组均显示出显著的知识增长（干预后准确率：渗透组89.67%，逐步递进组91.10%，传统干预组86.50%；P<0.001）。行为知识显示出最显著的改善（渗透组增加41.47%，而传统干预组增加22.38%）。逐步递进法总体准确率最高（91.10%），但与渗透法相比无统计学显著优势（P>0.05）。各组态度改善情况一致，基线率较高限制了进一步提高（干预后：95.60 - 96.68%）。课程整合法和逐步递进法有效地解决了血吸虫病教育中的知识 - 行为差距。渗透策略所需资源最少，是在资源匮乏地区强化行为的理想方法，而逐步递进法适合在资源丰富地区快速传播知识。这些发现倡导采用因地制宜的多部门框架来优化基于学校的干预措施，以符合世卫组织消除被忽视热带病的目标。
