Knowledge, Information Sources, and Preventive Measures in response to the Infectious Diseases in Chinese Children and Adolescents: A national Cross-sectional Study (Preprint)

BACKGROUND Infectious diseases are a priority in public health. Improving the knowledge and preventive measures of children and adolescents is important for disease prevention. Information sources play a crucial role in delivering disease-related knowledge. However, there is limited national-level evidence of the knowledge, information sources, and preventive measures in response to infectious diseases in Chinese children and adolescents. OBJECTIVE The aim of this study was to investigate the characteristics and interrelationships of knowledge, preventive measures of infectious diseases, and the information sources among Chinese children and adolescents. METHODS Participants in this cross-sectional study were embedded in a baseline survey of a national multi-centered cluster randomized controlled trial in seven provinces in China, using questionnaires to evaluate their level of knowledge and prevention measures, and the main source of information on infectious diseases. RESULTS A total of 30,287 children aged 6-17 years were enrolled. The mean scores of knowledge and preventive measures for infectious diseases were 2.35(SD=0.93) and 12.16 (SD=2.52), respectively. The majority of children and adolescents received information of infectious diseases through school (86.7%) and related groups (86.5%), followed by electronic media (73.4%). The results indicated that there were significant differences in knowledge and preventive measures among children and adolescents with different gender, age, children situation, living situation, residence, region, parents’ age and education level (P<0.05). In addition, multiple linear regression analysis showed that gender, age, living situation, residential area, region, mother's age, father's education level, knowledge score and main information source could better predict the score of preventive measures. Living with parents (vs Not living with parents; β=0.055 P<0.001), household income of 5000-10000 yuan (vs. Less than 5000 yuan; 0.024, P<0.001), south areas (vs. North: β=0.021), mother's age>35 years (vs.≤35years; 35-45 years: β=0.020, P=0.008; ≥45 years: β=0.022, P=0.005), father's education in high school/vocational school (vs. Junior high school and below; β=0.024, P=0.001), and high knowledge score (β=0.102, P<0.001) were more likely to have a high infectious disease prevention measures score(P<0.05). On the contrary, males (vs Females; β=-0.003, P<0.001), older (vs. 6-8 years; 12-14 years: β=-0.130, P<0.001;15-17years: β=-0.253, P<0.001), rural areas (vs. Urban; β=-0.023, P=0.001), central areas (vs. North; β=-0.036, P<0.001), and fathers aged 35-45 years (vs. ≤35 years; β=-0.021, P=0.009) were significantly associated with low infectious disease prevention measure scores(P<0.05). Interestingly, children or adolescents who accept information about infectious diseases through schools (vs. No; Yes: β=0.054, P<0.001) and paper media (vs. No; Yes: β=0.054, P<0.001) tend to score higher on measures to prevent infectious diseases(P<0.001). CONCLUSIONS The national survey provides an overview of knowledge, information sources, and preventive measures in response to infectious diseases in Chinese children and adolescents. The research findings add values to the future intervention and policy-making for promoting the preventive measures of infectious diseases in children and adolescents.