Abstract 18513: School-based Rheumatic Heart Disease Education Results in Improved Knowledge - Data From the PROVAR Study
Introduction: Rheumatic Heart Disease (RHD) remains an important cause of morbidity and mortality in Brazil and other low- and middle-income countries (LMIC). Lack of public awareness of the causes and prevention of RHD limit the efficacy of primary and secondary prevention programs. Objectives: To evaluate the efficacy of knowledge transfer that results from a structured public-school educational program on RHD. Methods: A prospective, cohort study was conducted over 7 months (9/2014-3/2015) in 5 randomly selected low-income public schools in Belo Horizonte, Brazil. All enrolled and present students received education. A nurse and an imaging technician utilized two custom structured educational curriculums, targeting children in grades 6 - 11 (aged 11-17). Pre-tests, taken immediately prior to educational curriculum queried students’ knowledge of the causes, prevention, diagnosis, and treatment of RHD. Post-tests, 1-3 weeks following education assessed the efficacy of knowledge transfer and retention. Results: The educational curriculum was delivered to 3200 students. One-third of these (1025) were randomly selected to participate in pre- and post-testing including 403 (39%) in 6th/7th grades (G1), 360 (35%) in 8th/9th (G2), and 261 (26%) of in 10th/11th grades (G3). The mean interval between pre-test and post-test was 10±10 days. Prior to the intervention, general knowledge regarding RHD was universally low (median score 46.7%, 40.0-60.0). Children in higher grades (G3) knew more about RHD than those in lower grades (60% vs. 40.0% G1/46.7% G2), p<0.001. Children showed significant gains in the post-test, raising the median score by 20 percent (60%, 40.0-73.3). Again, children in the higher grades showed higher overall scores (73%, 60.0-80.0 G3; 56.7%, 40.0-73.3 G2; 53.3%, 33.3-66.7 G1), p<0.001. However, the percent increase was similar between groups (6.8% G1, 6.8% G2, 8.5% G3), p=0.47. Conclusions: School-based RHD education resulted in consistent but modest gains in knowledge. Novel educational techniques and use of technology to engage young learners may lead to improved knowledge gains and retention. Further studies are needed to determine if increased knowledge leads to behavioral changes that could decrease the burden of RHD in LMIC.