PDF(Pubmed)
Abstract：
UNASSIGNED: Parental health literacy is important to children\'s health and development, especially in the first 3 years. However, few studies have explored effective intervention strategies to improve parental literacy.
UNASSIGNED: This study aimed to determine the effects of a WeChat official account (WOA)-based intervention on parental health literacy of primary caregivers of children aged 0-3 years.
UNASSIGNED: This cluster randomized controlled trial enrolled 1332 caregiver-child dyads from all 13 community health centers (CHCs) in Minhang District, Shanghai, China, between April 2020 and April 2021. Participants in intervention CHCs received purposefully designed videos via a WOA, which automatically recorded the times of watching for each participant, supplemented with reading materials from other trusted web-based sources. The contents of the videos were constructed in accordance with the comprehensive parental health literacy model of WHO (World Health Organization)/Europe (WHO/Europe). Participants in control CHCs received printed materials similar to the intervention group. All the participants were followed up for 9 months. Both groups could access routine child health services as usual during follow-up. The primary outcome was parental health literacy measured by a validated instrument, the Chinese Parental Health Literacy Questionnaire (CPHLQ) of children aged 0-3 years. Secondary outcomes included parenting behaviors and children\'s health outcomes. We used the generalized linear mixed model (GLMM) for data analyses and performed different subgroup analyses. The β coefficient, risk ratio (RR), and their 95% CI were used to assess the intervention\'s effect.
UNASSIGNED: After the 9-month intervention, 69.4% (518/746) of caregivers had watched at least 1 video. Participants in the intervention group had higher CPHLQ total scores (β=2.51, 95% CI 0.12-4.91) and higher psychological scores (β=1.63, 95% CI 0.16-3.10) than those in the control group. The intervention group also reported a higher rate of exclusive breastfeeding (EBF) at 6 months (38.9% vs 23.44%; RR 1.90, 95% CI 1.07-3.38) and a higher awareness rate of vitamin D supplementation for infants younger than 6 months (76.7% vs 70.5%; RR 1.39, 95% CI 1.06-1.82). No significant effects were detected for the physical score on the CPHLQ, breastfeeding rate, routine checkup rate, and children\'s health outcomes. Furthermore, despite slight subgroup differences in the intervention\'s effects on the total CPHLQ score and EBF rate, no interaction effect was observed between these subgroup factors and intervention factors.
UNASSIGNED: Using a WHO literacy model-based health intervention through a WOA has the potential of improving parental health literacy and EBF rates at 6 months. However, innovative strategies and evidence-based content are required to engage more participants and achieve better intervention outcomes.
UNASSIGNED: This study aimed to determine the effects of a WeChat official account (WOA)-based intervention on parental health literacy of primary caregivers of children aged 0-3 years.
UNASSIGNED: This cluster randomized controlled trial enrolled 1332 caregiver-child dyads from all 13 community health centers (CHCs) in Minhang District, Shanghai, China, between April 2020 and April 2021. Participants in intervention CHCs received purposefully designed videos via a WOA, which automatically recorded the times of watching for each participant, supplemented with reading materials from other trusted web-based sources. The contents of the videos were constructed in accordance with the comprehensive parental health literacy model of WHO (World Health Organization)/Europe (WHO/Europe). Participants in control CHCs received printed materials similar to the intervention group. All the participants were followed up for 9 months. Both groups could access routine child health services as usual during follow-up. The primary outcome was parental health literacy measured by a validated instrument, the Chinese Parental Health Literacy Questionnaire (CPHLQ) of children aged 0-3 years. Secondary outcomes included parenting behaviors and children\'s health outcomes. We used the generalized linear mixed model (GLMM) for data analyses and performed different subgroup analyses. The β coefficient, risk ratio (RR), and their 95% CI were used to assess the intervention\'s effect.
UNASSIGNED: After the 9-month intervention, 69.4% (518/746) of caregivers had watched at least 1 video. Participants in the intervention group had higher CPHLQ total scores (β=2.51, 95% CI 0.12-4.91) and higher psychological scores (β=1.63, 95% CI 0.16-3.10) than those in the control group. The intervention group also reported a higher rate of exclusive breastfeeding (EBF) at 6 months (38.9% vs 23.44%; RR 1.90, 95% CI 1.07-3.38) and a higher awareness rate of vitamin D supplementation for infants younger than 6 months (76.7% vs 70.5%; RR 1.39, 95% CI 1.06-1.82). No significant effects were detected for the physical score on the CPHLQ, breastfeeding rate, routine checkup rate, and children\'s health outcomes. Furthermore, despite slight subgroup differences in the intervention\'s effects on the total CPHLQ score and EBF rate, no interaction effect was observed between these subgroup factors and intervention factors.
UNASSIGNED: Using a WHO literacy model-based health intervention through a WOA has the potential of improving parental health literacy and EBF rates at 6 months. However, innovative strategies and evidence-based content are required to engage more participants and achieve better intervention outcomes.
摘要：
■父母的健康素养对儿童的健康和发展很重要，尤其是头三年。然而,很少有研究探索有效的干预策略来提高父母的识字能力。
■本研究旨在确定基于微信公众号（WOA）的干预措施对0-3岁儿童主要照顾者父母健康素养的影响。
■这项集群随机对照试验招募了闵行区所有13个社区卫生中心（CHC）的1332个照顾者-儿童双子体，上海,中国,2020年4月至2021年4月。干预CHC的参与者通过WOA收到了有目的地设计的视频，自动记录每个参与者的观看时间，补充了来自其他受信任的基于网络的来源的阅读材料。视频的内容是根据WHO（世界卫生组织）/欧洲（WHO/欧洲）的全面父母健康素养模型构建的。对照CHC的参与者接受了与干预组相似的印刷材料。所有参与者均随访9个月。两组都可以在随访期间像往常一样获得常规的儿童保健服务。主要结果是通过经过验证的仪器测量的父母健康素养，中国父母健康素养问卷（CPHLQ）0-3岁儿童。次要结果包括育儿行为和儿童健康结果。我们使用广义线性混合模型（GLMM）进行数据分析，并进行了不同的亚组分析。β系数，风险比(RR)，他们的95%CI用于评估干预效果。
■经过9个月的干预后，69.4％（518/746）的护理人员观看了至少1个视频。干预组患者CPHLQ总分(β=2.51,95%CI0.12~4.91)和心理评分(β=1.63,95%CI0.16~3.10)均高于对照组。干预组还报告了6个月时纯母乳喂养（EBF）的发生率更高（38.9％vs23.44％；RR1.90，95％CI1.07-3.38），并且6个月以下婴儿对维生素D补充的知晓率更高（76.7％vs70.5％；RR1.39，95％CI1.06-1.82）。对CPHLQ的身体评分没有检测到显著影响，母乳喂养率,常规检查率,和儿童的健康结果。此外，尽管干预对总CPHLQ评分和EBF率的影响有轻微的亚组差异，在这些亚组因素和干预因素之间未观察到交互作用.
■通过WOA使用基于WHO扫盲模型的健康干预措施有可能在6个月时提高父母的健康素养和EBF率。然而,需要创新的策略和基于证据的内容，以吸引更多的参与者，并实现更好的干预效果。
■本研究旨在确定基于微信公众号（WOA）的干预措施对0-3岁儿童主要照顾者父母健康素养的影响。
■这项集群随机对照试验招募了闵行区所有13个社区卫生中心（CHC）的1332个照顾者-儿童双子体，上海,中国,2020年4月至2021年4月。干预CHC的参与者通过WOA收到了有目的地设计的视频，自动记录每个参与者的观看时间，补充了来自其他受信任的基于网络的来源的阅读材料。视频的内容是根据WHO（世界卫生组织）/欧洲（WHO/欧洲）的全面父母健康素养模型构建的。对照CHC的参与者接受了与干预组相似的印刷材料。所有参与者均随访9个月。两组都可以在随访期间像往常一样获得常规的儿童保健服务。主要结果是通过经过验证的仪器测量的父母健康素养，中国父母健康素养问卷（CPHLQ）0-3岁儿童。次要结果包括育儿行为和儿童健康结果。我们使用广义线性混合模型（GLMM）进行数据分析，并进行了不同的亚组分析。β系数，风险比(RR)，他们的95%CI用于评估干预效果。
■经过9个月的干预后，69.4％（518/746）的护理人员观看了至少1个视频。干预组患者CPHLQ总分(β=2.51,95%CI0.12~4.91)和心理评分(β=1.63,95%CI0.16~3.10)均高于对照组。干预组还报告了6个月时纯母乳喂养（EBF）的发生率更高（38.9％vs23.44％；RR1.90，95％CI1.07-3.38），并且6个月以下婴儿对维生素D补充的知晓率更高（76.7％vs70.5％；RR1.39，95％CI1.06-1.82）。对CPHLQ的身体评分没有检测到显著影响，母乳喂养率,常规检查率,和儿童的健康结果。此外，尽管干预对总CPHLQ评分和EBF率的影响有轻微的亚组差异，在这些亚组因素和干预因素之间未观察到交互作用.
■通过WOA使用基于WHO扫盲模型的健康干预措施有可能在6个月时提高父母的健康素养和EBF率。然而,需要创新的策略和基于证据的内容，以吸引更多的参与者，并实现更好的干预效果。
