Assessing the Impact of Health Education on Physical Measurements of Children in Bangladesh: A Non-Randomized Controlled Trial.

Abstract

Children remain vulnerable to several diseases posing a significant threat to their lives, while inequitable access to regular physical measurement, healthcare services and resources is unsteady. Therefore, this study aims to evaluate the physical measurements and effects of health education on changes in the physical measurements of children in Bangladesh. A non-randomized controlled trial and pre- and post-test design, conducted in Chandpur, Bangladesh, from September 2021 to September 2022. The school-aged children were enrolled and allocated into the intervention group (IG) and control group (CG), while the IG received 9 months of school nurse-based health education. Data were collected by a questionnaire and physical measurements such as vital signs, height, weight, body mass index, mid-upper arm circumference measurement, triceps and subscapular skinfold, vision screen, and blood test. A total of 455 children completed the study. Among them, 107 (53.2%) and 94 (46.8%) were 7 to 8 years old in IG and CG, respectively. In IG, 140 (53.2%) and in CG 123 (46.8%) children were female. Since several physical assessments differed at baseline, repeated measures ANCOVA was performed with endline data as the dependent variable, group as a fixed factor, and baseline data as a covariate. The mean of the participants' body height, weight, BMI, MUAC and skinfolds were greater among IG than the CG, which were statistically significant (P < .001). Systolic blood pressure was significantly lower in the IG than in the CG (P = .023), while diastolic blood pressure did not differ significantly (P = .120). Integrating regular physical assessments and evidence-based health education by school nurses can reduce health challenges. For the sustainability of school-based health initiatives, establishing a continuous monitoring system and engaging parents, teachers, and local health authorities is needed to assess whether these health benefits persist over time.