A Study on the Effectiveness of a Health Education Intervention Combining an Online Digital App for HFMD with Offline Health-themed Cultural and Creative Products

Luyao Pan; Wanting Lin; Yue Qian

doi:10.71204/7ezdf635

Authors

Luyao Pan Wenzhou Medical University Author
Wanting Lin Wenzhou Medical University Author
Yue Qian Wenzhou Medical University Author

DOI:

https://doi.org/10.71204/7ezdf635

Keywords:

HFMD, Health Education, Virtual Simulation APP, Health-Themed Cultural and Creative Products, Health Literacy, Childcare and Early Years Population

Abstract

Hand-foot-mouth disease (HFMD) is a Class C infectious disease prevalent among infants and toddlers under 5 years old. There are no specific antiviral drugs available for its treatment, making health education a core strategy for prevention and control. To develop a tiered and fully inclusive popular science model for HFMD prevention, this study recruited 318 primary caregivers of young children and 216 kindergarten staff in Wenzhou as research subjects. A self-designed questionnaire covering HFMD awareness and health behaviors was compiled, and two types of publicity carriers—an immersive virtual simulation education APP and daily-use health cultural and creative products—were developed for a 3-month combined intervention. Paired t-tests, chi-square tests and binary logistic regression were adopted to analyze intervention effects. The results indicated that after intervention, the awareness rate of HFMD knowledge among both groups and the compliance rate of healthy behaviors among family caregivers increased significantly (P < 0.05). Both the APP and health cultural and creative products acted as independent positive protective factors for improving disease prevention awareness. The online APP suits young and middle-aged populations, while offline cultural and creative products can reach elderly caregivers with low digital literacy; the integration of the two eliminates coverage gaps in health education. This study verifies that the integrated publicity model combining digital online tools and daily cultural and creative products can effectively improve the infectious disease health literacy of populations related to preschool childcare, and provides practical solutions for routine health education in communities and kindergartens.

References

Andreoni, A. R., & Colton, A. S. (2017). Coxsackievirus B5 associated with hand-foot-mouth disease in a healthy adult. JAAD Case Reports, 3(2), 165–168. https://doi.org/10.1016/j.jdcr.2017.01.026

Chen, W., Weng, Y. W., He, W. X., Zhang, Y. J., Yang, X. H., Meng, H., Xie, J. F., Wang, J. Z., Zheng, K. C., & Yan, Y. S. (2014). Molecular epidemiology of HFMD-associated pathogen coxsackievirus A6 in Fujian Province, 2011-2013. Chinese Journal of Virology, 30(6), 624–629.

Gao, Q. (2021). Meteorological factors influencing the incidence of hand, foot, and mouth disease and their application in early warning and prediction [Master's thesis, Shandong University]. https://link.cnki.net/doi/10.27272/d.cnki.gshdu.2021.002074

Gonzalez, G., Carr, M. J., Kobayashi, M., Hanaoka, N., & Fujimoto, T. (2019). Enterovirus-associated hand-foot and mouth disease and neurological complications in Japan and the rest of the world. International Journal of Molecular Sciences, 20(20). https://doi.org/10.3390/ijms20205201

Guidelines for prevention and control of hand, foot and mouth disease (2009 edition). (2010). Chinese General Practice Clinical and Education , 8(2), 125–127+133. https://doi.org/10.13558/j.cnki.issn1672-3686.2010.02.039

Hu, J., Tian, X. Y., Ren, X. F., Cheng, Y. L., Di, Z. Q., Chen, J. B., He, J. Z., & Jin, F. F. (2019). Confirmatory factor analysis of the Infectious Disease Health Literacy Scale for Chinese residents. Chinese Journal of Public Health, 35(3), 313–316.

Huang, L. J., Yang, J. J., Fu, T., & Li, J. S. (2014). Risk factors for silent infection among medical staff in hand-foot-mouth disease wards and prevention strategies. Laboratory Medicine and Clinic, 11(7), 916–917.

Jin, F. F., Tian, X. Y., Di, Z. Q., Cheng, Y. L., Ren, X. F., Chai, Y., Ding, F., Chen, J. B., Cui, Z. W., Hu, X. Q., Xu, J. D., Xu, S. Y., & Qian, G. H. (2016). Development and validation of the Infectious Disease Health Literacy Scale for Chinese residents. Chinese Journal of Public Health, 32(12), 1651–1655.

Li, G. B., Wang, J. X., Shen, L. L., & Shi, F. J. (2021). Epidemiological characteristics of hand, foot and mouth disease in Wuwei City, 2011–2020. Bulletin of Disease Control and Prevention, 36(5), 54–56. https://doi.org/10.13215/j.cnki.jbyfkztb.2104001

Li, J. L., Wei, Y. J., Dong, B. Q., Chen, M. M., Chen, M., Li, H., Su, Y. J., & Li, R. X. (2022). Trend of incidence and mortality of hand, foot and mouth disease in China, 2008–2017. Disease Surveillance, 37(2), 233–240.

Li, Y. T. (2008). Epidemiological characteristics and prevention of hand-foot-mouth disease. Shanghai Journal of Preventive Medicine, (6), 316–317. https://doi.org/10.19428/j.cnki.sjpm.2008.06.027

Qin, F. H., Zhu, L. H., & Ma, M. M. (2020). Application of "Internet+" family-centered health education in parents of outpatients with hand-foot-mouth disease. Journal of Logistics University of PAP (Medical Sciences) , 29(10), 71–73. https://doi.org/10.16548/j.2095-3720.2020.10.019

Shi, J. Q., Gong, M. W., & Wu, J. (2024). Research progress on the relationship between hand, foot and mouth disease epidemics and meteorological factors. Preventive Medicine Tribune, 30(5), 397–400. https://doi.org/10.16406/j.pmt.issn.1672-9153.2024.5.015

Su, Z. R., Li, W. A., He, Z. J., Guo, H. J., & Zhou, L. (2021). Evaluation of clinical nursing pathway for children with hand-foot-mouth disease. Chinese School Doctor, 35(6), 412–414+477.

Wen, Y. Y. (2009). Application of health education in family members of children with hand-foot-mouth disease. Nursing Practice and Research, 6(12), 114–115.

Wu, Y. F., Chen, X. G., Liu, D. M., Li, J. S., Tan, X. H., & Yang, F. (2022). Epidemiological characteristics of hand, foot and mouth disease caused by coxsackievirus A6 in Guangdong Province, 2017–2019. Disease Surveillance, 37(3), 361–366.

Yuan, X. X., Liu, H. Y., You, Y. H., & Bai, J. L. (2015). Application of health education in nursing care of children with hand-foot-mouth disease. Journal of Clinical Rational Drug Use , 8(4), 172–173. https://doi.org/10.15887/j.cnki.13-1389/r.2015.04.105

Zhang, W. X., & Liu, J. (2021). Advances in epidemiology of hand, foot and mouth disease caused by coxsackievirus A6. Chinese Journal of Disease Control and Prevention, 25(5), 605–611. https://doi.org/10.16462/j.cnki.zhjbkz.2021.05.020