Evaluation of the effectiveness of tuberculosis health education and behavioral intervention based on the PDCA cycle theory

doi:10.19983/j.issn.2096-8493.20260054

Abstract

Abstract:

Objective: To evaluate the effect of Plan-Do-Check-Act (PDCA) cycle-based health education on pulmonary tuberculosis (PTB) prevention and control knowledge and behaviors among students in Tianjin. Methods: A repeated cross-sectional survey design was adopted. Using cluster sampling, 9 schools with relatively high PTB epidemic in Tianjin were selected to carry out PDCA cycle-based health education. Questionnaire surveys were conducted in September 2021 (pre-intervention) and March 2023 (post-intervention), with 9606 and 8936 valid questionnaires collected respectively. Meanwhile, information on student PTB patients and their contacts from November 2017 to December 2023 was collected. Independent samples chi-square test or Fisher’s exact test was used to analyze the differences before and after the intervention. Results: After the intervention, the overall awareness rate of core PTB knowledge (92.71% (74558/80424)) and the full awareness rate of core PTB knowledge (66.55% (5947/8936)) were significantly higher than those before the intervention (88.73% (76712/86454) and 47.37% (4550/9606), respectively), with statistically significant differences (χ²=776.34 and 693.69, both P<0.001). Compared with pre-intervention, the overall awareness rate of supplementary PTB knowledge (76.31% (150027/196592) vs. 57.12% (120715/211332)) and the full awareness rate of supplementary PTB knowledge (28.59% (2555/8936) vs. 0 (0/9606)) were significantly improved after the intervention (χ²=16807.96 and 3183.11, both P<0.001). Among them, students still had insufficient cognition of latent tuberculosis infection and anti-tuberculosis preventive treatment. After the intervention, the standardized screening rate of PTB contacts (90.61% (3378/3728)), anti-tuberculosis preventive treatment rate (11.79% (31/263)) and PTB treatment completion rate (96.67% (30/31)) were significantly higher than those before the intervention (79.66% (13223/16599), 1.43% (25/1742) and 80.00% (20/25), respectively), with statistically significant differences (χ²=243.83, 90.19 and 4.07, all P<0.05). While the proportion of epidemiologically linked cases (4.17% (3/72)) was lower than that before the intervention (22.64% (72/318)), with a statistically significant difference (χ²=12.90, P<0.001). Conclusion: The preliminary results indicate that PDCA cycle-based health education can effectively improve students’ cognition and behavioral levels of tuberculosis. However, further strengthening of publicity and education on latent tuberculosis infection and anti-tuberculosis preventive treatment among students is needed.

Key words: Tuberculosis, Students, Health education, Comparative study

CLC Number:

R52
R179

Yu Yanming, Zhang Xiaomeng, Wan Ying, Zhang Guoqin, Zhang Fan. Evaluation of the effectiveness of tuberculosis health education and behavioral intervention based on the PDCA cycle theory[J]. Journal of Tuberculosis and Lung Disease , 2026, 7(4): 480-486. doi: 10.19983/j.issn.2096-8493.20260054

Figures/Tables 3

内容	干预前组(9606名)		干预后组(8936名)		χ²值	P值
内容	知晓人次数	知晓率 (%)	知晓人次数	知晓率 (%)	χ²值	P值
核心知识
结核病是严重危害人民群众身体健康的慢性传染病(信息1)	6388	66.50	7211	80.70	477.17	<0.001
肺结核主要是通过呼吸道传播,人人都有可能被感染(信息2)	18287	95.19	17361	97.14	95.11	<0.001
咳嗽、咳痰2周以上,应当怀疑得了结核病,要及时就诊(信息3)	8491	88.39	8372	93.69	157.66	<0.001
不随地吐痰,咳嗽、打喷嚏时掩口鼻,戴口罩可以减少肺结核的传播(信息4)	8778	91.38	8476	94.85	86.33	<0.001
规范治疗,绝大多数患者可以治愈,还可以避免传染他人(信息5)	7990	83.18	7967	89.16	137.94	<0.001
出现肺结核可疑症状或被诊断为肺结核后,应当主动向学校报告,不隐瞒病情、不带病上课(信息6)	9144	95.19	8705	97.41	63.67	<0.001
养成开窗通风的习惯(信息7)	9101	94.74	8586	96.08	18.91	<0.001
保持充足的睡眠,合理膳食,加强体育锻炼、提高抵御疾病的能力(信息8)	8533	88.83	7880	88.18	1.91	0.170
总知晓	76712	88.73	74558	92.71	776.34	<0.001
全部知晓	4550	47.37	5947	66.55	693.69	<0.001
补充知识
传播	14438	75.16	15464	86.53	767.23	<0.001
发病	13719	47.61	19143	71.41	3254.58	<0.001
世界防治结核病日	7036	73.25	8172	91.45	1039.07	<0.001
治疗	20517	71.20	21883	81.63	833.63	<0.001
营养支持	13288	69.17	15098	84.48	1208.49	<0.001
潜伏感染	8846	46.04	10646	59.57	679.15	<0.001
预防性治疗	1230	12.80	3781	42.31	2043.87	<0.001
潜伏感染筛查	160	1.67	2104	23.55	2067.49	<0.001
就诊信息提供	414	4.31	8673	97.06	15931.59	<0.001
病后防控	16947	88.21	16852	94.29	424.25	<0.001
常规防控措施	15123	78.72	15794	88.37	622.72	<0.001
卡介苗	8997	46.83	12417	69.48	1946.25	<0.001
总知晓	120715	57.12	150027	76.31	16807.96	<0.001
全部知晓	0	0.00	2555	28.59	3183.11	<0.001

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项目	干预前组(9606名)		干预后组(8936名)		χ²值	P值
项目	人数(名)	构成比(%)	人数(名)	构成比(%)	χ²值	P值
年龄组(岁)					364.67	<0.001
<18	2866	29.83	1828	20.46
18~<22	6553	68.22	6585	73.69
≥22	187	1.95	523	5.85
性别					<0.01	0.960
男性	5134	53.45	4779	53.48
女性	4472	46.55	4157	46.52
学校类型					0.02	0.990
中等职业教育	2416	25.15	2243	25.10
高等职业教育	2874	29.92	2681	30.00
普通高等教育	4316	44.93	4012	44.90
生源地区域					0.03	0.990
天津	3560	37.06	3303	36.96
结核病高流行地区	1731	18.02	1618	18.11
其他	4315	44.92	4015	44.93
既往参加结核病宣传活动(次)					1397.47	<0.001
0	2469	25.70	1292	14.46
1	3119	32.47	1988	22.25
2	1592	16.57	1337	14.96
3	1250	13.01	1351	15.12
≥4	1176	12.25	2968	33.21