Impact of multifaceted health education on influenza vaccination health literacy in primary school students: a cluster randomized controlled trial.

IF 7 1区医学 Q1 MEDICINE, GENERAL & INTERNAL

BMC Medicine Pub Date : 2025-06-04 DOI:10.1186/s12916-025-04156-1

Jingyi Chen, Weiguang Xie, Xuehua Huang, Anzhong Huang, Tingyu Lu, Ruihang Zhang, Jingyi Xiao, Shaoyi He, Jiao Wang, Lin Xu

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引用次数: 0

Abstract

Background: Influenza remains a significant public health concern globally. We assessed the impact of multifaceted health education on influenza vaccination rates and health literacy among primary school students in China.

Methods: This cluster randomized controlled trial enrolled fourth- and fifth-grade students from 20 primary schools in Dongguan, China. Schools were randomly allocated (1:1) by a computer program to either the intervention group, receiving multifaceted health education, or the control group, receiving standard health education. Data were collected at baseline and post-intervention. The primary outcome was influenza vaccination rate. Secondary outcomes included health literacy, influenza incidence, influenza-like illness incidence, and influenza vaccine protection rate. Both intention-to-treat (ITT) and per-protocol (PP) analyses were performed.

Results: A total of 3463 students (1544 [44.6%] females; mean [SD] age, 9.9 [0.7] years) were enrolled. The ITT analysis included 3463 participants (control group [n = 1811]; intervention group [n = 1652]) while the PP analysis included 3275 participants (control group [n = 1717]; intervention group [n = 1558]). The influenza vaccination rate was significantly higher in the intervention group than the control group (ITT: 173 [10.9%] vs 130 [7.4%], adjusted risk ratios 1.54 [95% CI, 1.23-1.93], P < 0.001; PP: 165 [10.6%] vs 116 [6.8%], adjusted risk ratios 1.61 [95% CI, 1.27-2.03], P < 0.001). The knowledge component of children's health literacy scores significantly increased in the intervention group post-intervention (ITT: mean differences 0.12 [95% CI 0.04-0.20], P < 0.01; PP: mean differences 0.12 [95% CI 0.04-0.21], P < 0.01). No significant differences were observed for other secondary outcomes.

Conclusions: The multifaceted health education significantly enhanced influenza vaccination uptake in primary school students. However, the increase was modest, indicating that more effective school-based influenza prevention programs are urgently needed to improve vaccine uptake in children.

Trial registration: Registered at ClinicalTrials.gov on 09/08/2023 (registration number: NCT06048406).

查看原文本刊更多论文

多层面健康教育对小学生流感疫苗接种健康素养的影响：一项聚类随机对照试验。

背景：流感仍然是全球重大的公共卫生问题。我们评估了多方面健康教育对中国小学生流感疫苗接种率和健康素养的影响。方法：采用整群随机对照试验，选取东莞市20所小学的四、五年级学生为研究对象。通过计算机程序将学校随机（1:1）分配到接受多方面健康教育的干预组和接受标准健康教育的对照组。在基线和干预后收集数据。主要结局是流感疫苗接种率。次要结局包括健康素养、流感发病率、流感样疾病发病率和流感疫苗保护率。进行了意向治疗（ITT）和方案分析（PP）。结果：在校学生3463人，其中女生1544人，占44.6%；平均[SD]年龄，9.9[0.7]岁)。ITT分析纳入3463名参与者(对照组[n = 1811]；干预组[n = 1652])， PP分析纳入3275名参与者(对照组[n = 1717]；干预组[n = 1558])。干预组流感疫苗接种率显著高于对照组(ITT: 173 [10.9%] vs 130[7.4%]，校正风险比1.54 [95% CI, 1.23-1.93]， P结论：多层面健康教育显著提高小学生流感疫苗接种率。然而，这一增长幅度不大，这表明迫切需要更有效的以学校为基础的流感预防计划，以提高儿童的疫苗接种率。试验注册：于2023年8月9日在ClinicalTrials.gov注册（注册号：NCT06048406）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Medicine 医学-医学：内科

CiteScore

13.10

自引率

1.10%

发文量

435

审稿时长

4-8 weeks

期刊介绍： BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.