Overcoming health inequalities by using the Bug Busting 'whole-school approach' to eradicate head lice.
OBJECTIVE
The aim of this paper was to illustrate the socially inclusive nature of the Bug Busting 'whole-school approach' to head louse eradication.


BACKGROUND
In the UK, Belgium and Denmark, persistent head lice in families of all socio-economic status (SES) is a problem. Since 1995 in the UK and 1998 elsewhere, an educational programme intended to teach families how to detect and treat head lice by using the Bug Busting wet combing method has been organized in some areas. Local schools lead this community strategy for prevention, known as a 'whole-school approach' (UK).


METHODS
We describe five studies applying the Bug Busting approach, four set in districts where some disadvantaged families live (UK and Belgium) and a fifth set in Denmark. Feasibility and consumer satisfaction are examined. One UK study analyses data on area prescribing for head lice and the impact in a deprived locality of raising the profile of Bug Busting.


RESULTS
We find parental education in Bug Busting enables families of all SES to participate in a 'whole-school approach' to head lice. Best results are obtained when each family has a Bug Buster Kit. This provides all the combs necessary with full instructions on their use with ordinary shampoo and conditioner to detect lice, eradicate an infestation mechanically, or to check the success of any treatment. In the UK, the promotion of the Bug Busting approach is reducing primary care expenditure on treatment for head lice and professional time spent with worried parents. As a result, healthcare providers can give time to the few families who require one-to-one guidance.


CONCLUSIONS
Incorporation of the Bug Busting approach to head lice into clinical practice in school communities contributes to sustainable control whilst overcoming health inequalities in participating families.
Ibarra
Joanna
J
Community Hygiene Concern, Manor Gardens Centre, London, UK. joanna_ibarra@chc.org
Fry
Frances
F
Clarice
Wickenden
W
Olsen
Alice
A
Vander Stichele
Robert H
RH
Lapeere
Hilde
H
Maryan
Jenner
J
Franks
Andrea
A
Smith
Jane L
JL
D000293:Adolescent; D000818:Animals; D001294:Attitude to Health; D001530:Belgium; D002648:Child; D002675:Child, Preschool; D003718:Denmark; D005240:Feasibility Studies; D006266:Health Education / Q000458:organization & administration*; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D007300:Insect Control / Q000458:organization & administration; D010373:Lice Infestations / Q000175:diagnosis / Q000517:prevention & control*; D015403:Nursing Evaluation Research; D010290:Parents / Q000193:education / Q000523:psychology; D010374:Pediculus; D011320:Primary Health Care / Q000706:statistics & numerical data; D015397:Program Evaluation; D012536:Scalp Dermatoses / Q000175:diagnosis / Q000517:prevention & control*; D012572:School Health Services / Q000458:organization & administration*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom