Knowledge, attitudes, and information needs regarding norovirus infection among parents of primary school students directly affected by outbreaks: a cross-sectional study in Hangzhou, China.

Abstract

Background: Norovirus outbreaks are prevalent in primary schools; however, few studies have specifically examined the parents directly impacted by these events.

Methods: A cross-sectional survey was conducted between January 2025 and March 2026. Parents from seven primary schools affected by norovirus outbreaks in Hangzhou, China, were invited to complete a self-administered online questionnaire. Data were collected on sociodemographic characteristics, knowledge of norovirus pathogenesis, attitudes toward prevention and control, and information needs.

Results: A total of 322 valid responses were obtained (response rate 82.14%). Among respondents, 83.85% reported awareness of norovirus. The mean knowledge score regarding norovirus pathogenesis was 6.43 ± 1.91 out of 11 (58.45% correct), with only 14.07% attaining a "good" knowledge level (≥9 points). Attitude scores were high, with a rate of 88.22% of the maximum. Multivariable logistic regression identified educational attainment (bachelor's degree or higher: OR = 6.27, 95% CI: 1.75-52.28), residence type (detached house: OR = 5.76, 95% CI: 1.48-6.18), and active information-seeking (OR = 24.60, 95% CI: 11.28-53.66) as factors independently associated with good knowledge level.

Conclusion: Parents directly affected by norovirus outbreaks demonstrated inadequate knowledge but held positive attitudes. Proactive information-seeking was the strongest predictor of good knowledge. Targeted health education, particularly through WeChat parent groups, is urgently required to bridge knowledge gaps and foster active learning.