Health Behavior, Nasal Hygiene, Preschool Children, Respiratory Tract Infection Prevention
Conditions
Keywords
Nasal hygiene, Nose blowing, Preschool children, Play-based education, Health education, Cluster randomized controlled trial
Brief summary
This study aimed to determine the effectiveness of a play-based nasal hygiene education program on nasal hygiene knowledge and skills among preschool children.
Detailed description
This completed cluster randomized controlled trial evaluated the effectiveness of a play-based nasal hygiene education program on nasal hygiene knowledge and skills among preschool children. The study was conducted in the kindergarten level of a public primary school in Istanbul, Türkiye. Two preschool classrooms were randomly assigned to the intervention and control groups. The intervention group received a structured nasal hygiene education program including visual educational materials, an animation-based video, and play-based skill practice activities, while the control group received no education during the data collection period. Outcomes were assessed at baseline and two weeks after completion of the intervention using performance-based and video-recorded assessments. After post-test measurements, the education program was also provided to the control group.
Interventions
BEHAVIORALPlay-Based Nasal Hygiene Education Program
The intervention consisted of a structured nasal hygiene education program developed for preschool children. The program included group-based education using visual educational materials, an animation-based educational video, and demonstration of nasal hygiene steps. It also included individual play-based practice stations: nasal air pressure development activities, nasal airflow performance activities, nasal hygiene sequencing cards, and a simulated nasal hygiene practice station. The program targeted both cognitive learning and psychomotor skill development.
Sponsors
Istanbul Medeniyet University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
Due to the nature of the educational and play-based intervention, participants and the researcher delivering the intervention could not be blinded. However, performance-based assessments were video-recorded and evaluated by independent observers to reduce measurement bias.
Intervention model description
This study used a cluster randomized parallel-group design. Randomization was conducted at the classroom level to reduce the risk of contamination between children.
Eligibility
Sex/Gender
ALL
Age
5 Years to 6 Years
Healthy volunteers
Yes
Inclusion criteria
* Being enrolled in the preschool/kindergarten class of the school where the study was conducted * Being able to speak and understand Turkish * Having written informed consent from a parent or legal guardian * Being willing to participate in the study
Exclusion criteria
* Having an active disease that could affect nasal hygiene practice during data collection * Having any chronic disease * Having structural anomalies that may cause nasal obstruction * Having a physical or cognitive impairment that prevents communication, watching the educational materials, or completing the measurement tools * Having previously participated in a structured education program on nasal hygiene or nose-blowing skills * Not having written informed consent from a parent or legal guardian * Not being willing to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Nasal Hygiene Knowledge Score | Baseline and two weeks after completion of the intervention | Children's nasal hygiene knowledge was assessed using the Nasal Hygiene Knowledge Sequencing Test. The test consists of eight visual cards representing the steps of nasal hygiene. Children were asked to place the cards in the correct order. Each correctly ordered card was scored as 1 point and each incorrectly ordered card was scored as 0 points. Higher scores indicate a higher level of nasal hygiene knowledge. |
| Change in Nasal Air Pressure Performance | Baseline and two weeks after completion of the intervention | Nasal air pressure performance was assessed using the Nasal Air Pressure Measurement Test. A lightweight paper strip was fixed to the child's nasal bridge, and the child was asked to blow through the nose with the mouth closed. Performance was evaluated based on the angle difference between the baseline position of the paper and the maximum elevation angle achieved during nasal blowing. Higher angle differences indicate better nasal air pressure performance. |
| Change in Nasal Airflow Performance | Baseline and two weeks after completion of the intervention | Nasal airflow performance was assessed using the Nasal Airflow Performance Test. A lightweight pom-pom ball was placed inside a cardboard tube attached to a pediatric respiratory mask. Children were asked to blow through the nose with the mouth closed to move the pom-pom out of the tube. Performance was evaluated using two parameters: success in expelling the pom-pom from the tube and the time required to expel the pom-pom. Successful expulsion and shorter completion time indicate better nasal airflow performance. |
| Change in Nasal Hygiene Skill Score | Baseline and two weeks after completion of the intervention | Children's nasal hygiene skills were assessed using the Nasal Hygiene Skill Assessment Checklist. The checklist evaluates children's performance of nasal hygiene steps in a simulated environment. Each skill step was scored as "performed" = 3 points, "partially performed" = 2 points, and "not performed" = 1 point. Higher scores indicate better nasal hygiene skill performance. The performance was video-recorded and evaluated by independent observers. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Parent-Rated Independent Nasal Hygiene Performance | Baseline and four weeks after completion of the intervention | Parents evaluated children's independent nasal hygiene performance using a visual analog scale. Higher scores indicate a higher level of independent nasal hygiene performance. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORAynur Aytekin Özdemir, Professor
İstanbul Medeniyet University
Outcome results
None listed