Effectiveness of Behavior Change Communication (BCC) on maintenance of positive health among the students of Rural Higher Primary Schools

 

Gurupada K P1, David A Kola2

1Staff Nurse, Kodagu Institute of Medical Sciences and Teaching Hospital, Madikeri, Karnataka.

2Principal and Head, Dept of Community Health Nursing, SDM Institute of Nursing Science, Dharwad, Karnataka.

*Corresponding Author E-mail: gurupada.kp@gmail.com

 

ABSTRACT:

Children’s well-being is the fundamental concern of every one. A healthy child brings eternal joy to the family and thrill to the society and hope to the nation. Children are the builders of the future of any nation “Children Health- Tomorrows wealth”. This can be achieved by imparting knowledge regarding health to bring positive changes in health behavior of the children which may help them to maintain positive health throughout the lifetime. A pre- experimental one group pre-test post-test design with evaluative approach was taken to evaluate the effectiveness of Behavior Change Communication (BCC) on maintenance of positive health among the students of Rural Higher Primary Schools Dharwad Taluk. Sixty samples were selected by using simple random sampling technique and pre-test was conducted by using structured knowledge questionnaire and attitude scale which of five domains i.e. concept of health, physical health, psychosocial health, spiritual health and environmental health. BCC on maintenance of positive health was given and post-test was conducted after seven days of BCC by using the same instrument. Data collected were analyzed using appropriate descriptive and inferential statistics. The results revealed that there was a significant difference between pre-test knowledge score (27.3±10.2), pre-test attitude score (20.7±9.5) and post-test knowledge score (44.2±10.1), post-test attitude score (31.7±7.7) as assessed by the paired t-test values 17.7(Knowledge) and 19.2 (Attitude) at p≤ 0.05. There was significant association between monthly income and pre-test attitude score at p value less than 0.05. Hence the study concludes that BCC was effective in maintenance of positive health among rural higher primary school students.

 

KEYWORDS: Positive health; Behavior Change Communication; Rural Higher Primary School Students.

 

 


INTRODUCTION:

“To keep the body in good health is a duty... otherwise we shall not be able to keep our mind strong and clear”.

-                                                                        Buddha

 

Good health, longevity and happiness- these have been the aspirations and dreams of mankind.1 The future of the world depends on how well it cares for its youth. Focusing on the health needs of children increases the chances that future adults will value and practice healthy life style.2 A healthy child can lead a physically active life even after growing old. Children’s health and learning are unquestionably linked. Healthy children are more able to learn and achieve academic success.1

Promoting health through schools is a ‘life-course’ approach to promote healthy behavior among children. Many of today’s and tomorrow’s leading causes of death, disease and disability can be significantly reduced by preventive behavior that is initiated during youth, through behavior change communication, health education, understanding and motivation.3

 

Behavior Change Communication is a process of working with individuals through different communication channels to promote positive health behaviors and support them to maintain positive health behaviors taken on. For successful Behavior Change, people must move from awareness to action by motivating them to believe that health benefits will be obtained by changing behavior and by increasing individuals’ sense of control over his own health behavior choices.

 

OBJECTIVES OF THE STUDY:

1.     To assess the pre-test knowledge and attitude of Rural Higher Primary School students on maintenance of positive health.

2.     To determine the effectiveness of Behavior Change Communication on maintenance of positive health.

3.     To find the association between pre-test scores of knowledge and attitude with selected socio-demographic variables of the students.

 

Hypotheses:

H1:   The mean post-test Behavior Change Communication scores of rural higher primary school students on maintenance positive health will be significantly higher than the mean pre-test score at 0.05 level of significance.

H2:   There is an association between pre-test knowledge, attitude scores of Rural Higher Primary School Students on maintenance of positive health with selected socio-demographic variable.

 

Conceptual framework:

The conceptual framework selected for this study was based on Modified Health Belief Model (HBM) (Rosenstock et al 1994) and Theory of Planned Behavior (TPB) (Ajzen 1991, 2002).

 

METHODOLOGY

Research Approach:

A quasi- experimental non-equivalent control group pre-test post-test design was adopted.

 

Variables under study:

Dependent variable:

The knowledge and attitude of the Rural Higher Primary School students regarding maintenance of positive health.

Independent variable:

Behavior Change Communication which is the process of instructional interventions used to improve knowledge and attitude towards maintenance of positive health behavior.

 

Research setting:

The study is conducted in a selected school in field practice area of Rural Health Training Centre (RHTC) (SDM College of Medical Sciences and Hospital and SDM Institute of Nursing Sciences, Manjushree Nagar, Dharwad) Yadwad, Dharwad Taluk.

 

Research population:

Boys and Girls studying in VI, VII and VIII Standard of RHPS.

 

Sample and sample technique:

Simple random sampling technique was used for the selection of the sample, the details are as follows. Sample comprised of 60 Rural Higher Primary School students studying VI, VII and VIII standard.

1    The field practice area comprised of 12 villages and 12 higher primary schools having one school in each village. The school from Yadwad village was selected for study purpose since this village is almost central in the field practice area.

2    List of the boys and girls from class VI, VII, VIII was prepared.

3    Proportionate samples were drawn through lottery method from each class.

 

Sampling criteria:

Inclusion criteria:

1    Studying in VI, VII, VIII standard, both boys and girls.

2    Willing to participate in the study.

3    Available at the time of data collection.

 

Exclusion criteria:

1    The students who were physically challenged and free from any chronic ailments.

 

Data collection tools:

Structured knowledge questionnaire and Attitude scale was developed by the researcher. Content validity was done by 10 experts from the field of Nursing, Community Medicine and Psychology. The reliability of the instrument was established by using split half technique, coefficient (r) of internal consistency for structured knowledge questionnaire and attitude scale were 0.8 and 0.7 respectively, which indicates that the tool is reliable.

 

Description of tool:

The instrument used for the present study had following three sections:

 

Section-A:

Consisted of baseline Performa on variables

 

Section-B:

Structured knowledge questionnaire on maintenance of positive health. The questionnaire consisted 60 items of 5 sub-sections, referred as domains namely concept of health, physical health, psychosocial health, spiritual health and environmental health.

 

Section-C:

To assess the attitude towards the maintenance of positive health a structured attitude scale was constructed having 20 items indicated by the three point likert scale, 50% items were positive and negative.

 

Preparation of the Behavior Change Communication (BCC):

The teaching material for BCC was developed by the researcher; the content of the Behavior Change Communication was grouped under subsections as mentioned in the tool. It was sent for content validation along with Instrument.

 

Data collection procedure:

After obtaining a formal permission from the Block Education Officer (BEO), School Master and Parent. Pre-test was conducted and Behavior Change Communication (BCC) was administered. The formal class room teaching was given to the students in two sessions with the gap of one hour between two sessions. The investigator kept personal contact with individual student till the post test, providing explanations and demonstration. Clearing their doubts and bringing changes in their health behavior. The post-test of the study was conducted on 7 days of intervention, using the same tool as the pretest. The both pre and post-test data collected was then tabulated and analyzed and interpreted using descriptive and inferential statistics.

 

RESULTS:

Findings of the present study shows that majority of the subjects 20 (33.3%) belonged to the age of 13 years. Maximum subjects 23(38.3%) were studying in VIII standard. Majority of the subjects 42 (70%) belonged to Hindu religion. Maximum parents did not have formal education. Majority of the fathers 19 (31.6%) were unskilled workers and 6 (10%) were government employees.

 

The analysis of the findings reveals that the mean post-test knowledge scores (Fig-1) were (73.7%) and the mean pre-test scores were (45.5%) mentioning the impact of BCC in the improvement of the knowledge. The mean post-test attitude scores (Fig-2) were (79.4%) while the mean pre-test score (51.9%), indicating that BCC was effective in changing the attitude of the students in positive direction.

 

Fig-1: Cylindrical diagram shows the mean percentage of Pre and Post-test knowledge scores

 

Fig-2: Cone diagram shows the mean percentage of Pre and Post-test attitude scores

 

Findings in the tables 1 and 2 describes that the pre-test knowledge and attitude scores of each domains were proportionately higher than the mean post-test scores and obtained ‘t’ value under the each domains shows significant at 0.05 level, clearly indicating that the behavior change communication was effective in maintenance of positive health among Rural Higher Primary School students.


 

Table 1: Domains wise distribution of mean percentage and mean difference of Pre-test and Post-test knowledge scores and ‘t’ value of students on maintenance of positive health.

Domains

Mean percentage score

Mean difference

't' value

‘p’ value

Pre-test

Post-test

Concept of health

37.0

70.8

33.7

8.0

0.00001*

Physical health

46.5

74.9

28.4

14.8

0.00001*

Psycho-social health

48.1

71.2

23.1

8.4

0.00001*

Spiritual health

43.3

70.5

27.2

5.5

0.00001*

Environmental health

39.5

71.2

31.6

7.9

0.00001*

n=60

 

Table 2: Domains wise distribution of mean percentage and mean difference of Pre and Post-test attitude scores and t value of students on maintenance of positive health.

Domains

Mean percentage score

Mean difference

't' value

‘p’ value

Pre-test

Post-test

Concept of health

79.1

94.5

15.4

4.8

0.00001*

Physical health

35.2

72.8

37.5

19.5

0.00001*

Psycho-social health

70.6

85.2

14.5

4.7

0.00001*

Spiritual health

59.5

79.5

20.0

3.7

0.00004*

Environmental health

62.9

85.8

22.9

6.1

0.00001*

n=60

 


Fig. 3 depicted that in the post test 18(30%) students had good knowledge and 39(65%) students had moderate knowledge while in the pre-test 34(56.7%) students had poor level of knowledge and 13 (21.7%) students had moderate knowledge. Fig. 4 shows that majority of the students 27 (45%) had unfavorable attitude in pre-test Where as in post-test majority of the students 59 (98.3%) had favorable attitude towards maintenance of positive health.

 

 

Fig: 3 cylindrical diagrams shows the classification of knowledge scores

 

The study findings also proved in Fig: 4 that majority of the students 27 (45%) had unfavorable attitude in pre-test Where as in post-test majority of the students 59 (98.3%) had favorable attitude towards maintenance of positive health. The significant association only in the dietary pattern and pre-test knowledge scores at 0.05 level of significance.

 

Fig: 4 Pyramid diagram shows the classification of attitude scores

 

DISCUSSION:

Healthy children make healthy generation. There is a close relationship between unhealthy children to a worsened future of the nation.4 The children constitute one third of the population of the country.5 In this regards, the pre-test out of 60 subjects selected from the school 34 (56.6%) had poor and 13(21.7%) had moderate level of knowledge, while as many as thirty three (55%) subjects had favorable attitude on maintenance of positive health. After exposure to BCC the post-test scores showed reversal trend of remarkable enhancement in the knowledge and attitude of the students, i.e. 30% good knowledge, 65% moderate level of knowledge and 98% favorable attitude towards maintenance of positive health. It confirms that BCC has made true difference in enhancing the knowledge and changing the attitude of the school students in the maintenance of positive health.

 

CONCLUSION:

School population is a sizeable population segment, willing for a change, and valuable national assets hence they need to be molded to build a strong nation by giving them authentic information, education and motivation.5 Behavior Change Communication proved to be effective and appropriate method for delivering health message to school children, which can be incorporated by community health nurse in their school regular health program.

 

REFERENCES:

1.      Soni R. Health education and administration. Delhi: Atlantic publishers and distributors (P) Ltd; 2012.p.3,13

2.      Marcia S, Jeanette L. Community & Public health nursing. 6th ed. Missouri: Mosby; 2000. p.616.

3.      Health and life skills kindergarten to grade 9. Report. Canada: Alberta Learning; 2002. Available from URL:http://education.alberta.ca/media/313382/health.pdf

4.      Comprehensive School Health Teachers Activity Manual. School Health Manual: New Delhi: 2010. Available from URL: http://home.myplaycity.Com

5.      ULR http://censusindia.gov.in/2011-common/census_inschool.html

 

 

 

 

Received on 25.06.2019          Modified on 18.07.2019

Accepted on 08.08.2019     © A&V Publications all right reserved

Int. J. Nur. Edu. and Research. 2019; 7(4): 535-538.

DOI: 10.5958/2454-2660.2019.00118.2