[Prevention of hepatitis B in juveniles. Effect of a medical health education lesson in school].
BACKGROUND
In recent years, a dramatic rise in the incidence of sexually transmitted hepatitis B in youth and adolescence has been observed, with a doubling of the incidence during the 1990s; in particular, young females have a fourfold increased risk of infection, compared with the general population. The responsible mechanisms in this age group include a general change of sexual behavior as well as insufficient knowledge, and thus underestimation, of the disease. Improved primary prevention requires a more effective and broader health education, but reliable data on extent and duration of such educational interventions are lacking.


METHODS
In a prospective, randomized, controlled trial of 1,911 children (6th grade, n = 881) und adolescents (9th grade, n = 1,030), the increment in the specific knowledge of hepatitis B (intervention group; n = 1,123) persisting for 14 days, as effected with a single, medical, focused health education lesson given by physicians, in comparison with a control group (n = 788; without health education lesson) was investigated. The questions included basic facts on crucial mechanisms of hepatitis B transmission. In parallel, the participants evaluated the subjectively perceived relevance and acceptance of the topic. Interventions were integrated in routine class lessons.


RESULTS
Prior to intervention, both groups had an identical rate of correct answers (34-60% and 32-66%, respectively). The rates remained unchanged in the control group over the 2-week observation period. By contrast, in the intervention group the proportion of correct answers increased (to 68-88%; p < 0.0001). In parallel, subjective relevance and acceptance increased significantly. Moreover, lesson acceptance rates and objective knowledge increments were significantly correlated (p < 0.0001).


CONCLUSIONS
These results demonstrate for the first time the effect of a focused, medical health education lesson in juvenile age groups prior to, and in, a period of life with an increased risk for hepatitis B infection. A preventive impact can be expected not only due to a markedly improved specific knowledge, but also due to a significant increase in the acceptance of the topic, including the importance of hepatitis B vaccination programs.
Layer
Cordula
C
Arztliche Gesellschaft zur Gesundheitsförderung der Frau e. V. (AGGF), Hamburg. c.layer@ik-h.de
Gille
Gisela
G
Klapp
Christine
C
Ravens-Sieberer
Ulrike
U
D000293:Adolescent; D002648:Child; D003479:Curriculum; D005260:Female; D005858:Germany; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006509:Hepatitis B / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D008297:Male; D010819:Physician's Role; D011446:Prospective Studies