Abstract: Objective　To compare the changes of knowledge, attitude and practice (KAP) related to taeniasis and cysticercosis among primary school students before and after health education interventions in disease⁃elimination pilot areas of Henan Province, so as to evaluate the effectiveness of health education interventions. Methods　A primary school was selected from each of Dushu, Bowang and Yangji townships, Fangcheng County, Henan Province from 2017 to 2019; then, 2 to 3 classes were randomly selected from grade 4 to 6 in each primary school, and finally, all students in these classes were enrolled as study subjects. A thematic health education lecture pertaining to taeniasis and cysticercosis was given once each year by means of “health education in class”. The KAP towards taeniasis and cysticercosis was investigated among primary school students using self⁃filled structured questionnaires, and the changes of awareness of taeniasis and cysticercosis control knowledge and percentage of healthy behaviors formation were compared in primary school students among years and following various frequencies of health education interventions. Results　More than 10 thousand person⁃time primary school students received health education interventions during the period from 2017 to 2019, and a total of 1 223 person⁃time primary school students were investigated during the 3⁃year study period, including 633 person⁃time men and 590 person⁃time women and 88.55% of primary school students at ages of 10 to 12 years. The proportion of households raising pigs and using dry toiliets decreased from 5.30% (24/453) and 18.10% (82/453) in 2017 to 3.60% (13/361) and 11.08% (40/361) in 2019, respectively. The awareness rate of taeniasis and cysticercosis control knowledge increased significantly from 0.22% (1/453) in 2017 to 62.59% (256/409) in 2018 and 76.73% (277/361) in 2019 ([χ2] = 567.60, P < 0.001), and the awareness rate was 85.25% (104/122) among primary school students attending the thematic special health education courses for successive three times. The awareness rates of taeniasis and cysticercosis control knowledge were 0.44% (1/225), 58.00% (116/200) and 71.63% (149/208) among male students and 0 (0/338), 66.99% (140/209) and 83.66% (128/153) among female students from 2017 to 2019, and there was a significant difference in the awareness of taeniasis and cysticercosis control knowledge between male and female students in 2019 ([χ2] = 7.14, P = 0.01). On⁃site teaching by doctors was the students’ favorite way to receive health education interventions (70.07%, 857/1 223), followed by watching health education videos (58.63%, 717/1 223) and seeing parasite specimens (48.9%, 598/1 223). The proportion of students’ families who used cutting boards for raw and cooked food separately increased from 7.28% (33/453) in 2017 to 47.37% (171/361) in 2019, was 67.21% (82/122) among students attending the health education courses for successive three times. The proportion of students who frequently washed their hands before meals and after using toilet increased from 71.96% (324/453) in 2017 to 89.47% (319/361) in 2019 and was 95.90% (117/122) among students attending the health education courses for successive three times. In addition, the percentage of students washing hands frequently in families using dry toilets was significantly lower in those who did not use dry toilets ([χ2] = 9.21, P = 0.002), and the proportion of students with a habit of eating raw or undercooked meat decreased significantly from 35.76% (162/453) in 2017 to 6.65% (24/361) in 2019 ([χ2] = 69.11, P < 0.01). Conclusion　The thematic health education activity of “health education in class” contributes greatly to the increase in the awareness of taeniasis and cysticercosis control knowledge and the rate of healthy behaviors formation among primary school students in disease⁃elimination pilot areas of Henan Province.

Key words: Taeniasis, Cysticercosis, Health education, Effect evaluation, Knowledge, attitude, practice (KAP), Questionnaire survey, Primary school student, Fangcheng County

摘要： 目的　了解河南省消除试点地区健康教育干预前后小学生带绦虫病和囊尾蚴病相关知识、态度和行为变化情况，评估健康教育效果。方法　2017—2019年在河南省方城县独树镇、博望镇和杨集乡各选择一所小学，在每所小学4～6年级中随机整群抽取2～3个班级小学生作为调查对象，每年开展1次带绦虫病和囊尾蚴病“防治知识进课堂”专题健康教育。采用自填结构式问卷对干预小学生进行带绦虫病和囊尾蚴病知识、态度和行为调查，比较不同年份、接受不同健康教育频次后小学生带绦虫病和囊尾蚴病防治知识知晓率、健康行为形成率等主要指标变化。结果　2017—2019年，通过带绦虫病和囊尾蚴病健康教育累计干预小学生1万余人·次。3年累计调查小学生1 223人·次，其中男生633人·次、女生590人·次，10～12岁学生占88.55%。家庭养猪和使用旱厕小学生比例从2017年的5.30%（24/453）和18.10%（82/453）分别降至2019年的3.60%（13/361）和11.08%（40/361）。2017年开展健康教育前，带绦虫病和囊尾蚴病防治知识知晓率为0.22%（1/453），2018、2019年分别升至62.59%（256/409）和76.73%（277/361），3年知晓率差异有统计学意义（[χ2] = 567.60，P < 0.01）；连续参与3次专题健康教育的小学生带绦虫病和囊尾蚴病防治知识知晓率达85.25%（104/122）。2017—2019年，男生带绦虫病和囊尾蚴病防治知识知晓率分别为0.44%（1/225）、58.00%（116/200）和71.63%（149/208），女生知晓率分别为0（0/338）、66.99%（140/209）和83.66%（128/153），2019年男、女生知晓率差异有统计学意义（[χ2] = 7.14，P = 0.01）。“听医生讲”是学生最喜欢的健康教育方式（70.07%，857/1 223），其次是“看健康教育视频”（58.63%，717/1 223）和“看虫体标本”（48.9%，598/1 223）。做到生熟砧板分开的学生家庭比例从2017年的7.28%（33/453）升至2019年的47.37%（171/361）；参与3次专题健康教育的小学生中，该比例升至67.21%（82/122）。饭前便后经常洗手的小学生比例从2017年的71.96%（326/453）升至2019年的89.47%（319/361），参与3次专题健康教育的学生比例升至95.90%（117/122）。家庭使用旱厕的小学生经常洗手率低于使用非旱厕的学生（[χ2] = 9.21，P = 0.002），有生食/半生食肉类习惯的学生比例从2017年的35.76%（162/453）降至2019年的6.65%（24/361）（[χ2] = 69.11，P < 0.01）。结论　“防治知识进课堂”专题健康教育活动对促进河南省消除试点地区小学生带绦虫病和囊尾蚴病防治知识知晓率提升和相关健康行为形成有显著效果。

关键词: 带绦虫病, 囊尾蚴病, 健康教育, 效果评价, 知识、态度、行为, 问卷调查, 小学生, 方城县