title: Knowledge, attitudes, and practices of nonpharmaceutical interventions following school dismissals during the 2009 Influenza A H1N1 pandemic in Michigan, United States.
abstract: BACKGROUND
  Many schools throughout the United States reported an increase in dismissals due to the 2009 influenza A H1N1 pandemic (pH1N1). During the fall months of 2009, more than 567 school dismissals were reported from the state of Michigan. In December 2009, the Michigan Department of Community Health, in collaboration with the United States Centers for Disease Control and Prevention, conducted a survey to describe the knowledge, attitudes, and practices (KAPs) of households with school-aged children and classroom teachers regarding the recommended use of nonpharmaceutical interventions (NPIs) to slow the spread of influenza.
  
  
  METHODS
  A random sample of eight elementary schools (kindergarten through 5th grade) was selected from each of the eight public health preparedness regions in the state. Within each selected school, a single classroom was randomly identified from each grade (K-5), and household caregivers of the classroom students and their respective teachers were asked to participate in the survey.
  
  
  RESULTS
  In total, 26% (2,188/8,280) of household caregivers and 45% (163/360) of teachers from 48 schools (of the 64 sampled) responded to the survey. Of the 48 participating schools, 27% (13) experienced a school dismissal during the 2009 fall term. Eighty-seven percent (1,806/2,082) of caregivers and 80% (122/152) of teachers thought that the 2009 influenza A H1N1 pandemic was severe, and >90% of both groups indicated that they told their children/students to use NPIs, such as washing hands more often and covering coughs with tissues, to prevent infection with influenza.
  
  
  CONCLUSIONS
  Knowledge and instruction on the use of NPIs appeared to be high among household caregivers and teachers responding to the survey. Nevertheless, public health officials should continue to explain the public health rationale for NPIs to reduce pandemic influenza. Ensuring this information is communicated to household caregivers and teachers through trusted sources is essential.
authors.affiliation: Eagle Medical Services, San Antonio, Texas, United States of America.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Shi
authors.affiliation: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Atlanta, Georgia, United States of America.
authors.forename: Rashid
authors.initials: R
authors.lastname: Njai
authors.affiliation: University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America.
authors.forename: Eden
authors.initials: E
authors.lastname: Wells
authors.affiliation: Michigan Department of Community Health, Bureau of Epidemiology, Lansing, Michigan, United States of America.
authors.forename: Jim
authors.initials: J
authors.lastname: Collins
authors.affiliation: Michigan State University Program in Public Health, East Lansing, Michigan, United States of America.
authors.forename: Melinda
authors.initials: M
authors.lastname: Wilkins
authors.affiliation: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Atlanta, Georgia, United States of America.
authors.forename: Carrie
authors.initials: C
authors.lastname: Dooyema
authors.affiliation: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Atlanta, Georgia, United States of America.
authors.forename: Julie
authors.initials: J
authors.lastname: Sinclair
authors.affiliation: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Atlanta, Georgia, United States of America.
authors.forename: Hongjiang
authors.initials: H
authors.lastname: Gao
authors.affiliation: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Atlanta, Georgia, United States of America.
authors.forename: Jeanette J
authors.initials: JJ
authors.lastname: Rainey
mesh_terms: D002648:Child; D002675:Child, Preschool; D003142:Communication; D003625:Data Collection; D005191:Family Characteristics; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000502:physiology*; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D008824:Michigan / Q000453:epidemiology; D058873:Pandemics / Q000517:prevention & control*; D011634:Public Health; D012574:Schools / Q000706:statistics & numerical data*
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