Effectiveness of a continuous handwashing education program with multiple activities at a Japanese kindergarten school.

Formation of proper handwashing techniques and habits from childhood is important for disease prevention. However, there are few studies that comprehensively and longitudinally evaluate the effectiveness of handwashing education for kindergarteners. This study aims to evaluate the effectiveness of continuous handwashing education using multiple activities to improve handwashing practices and skills among first- to third-grade students at a kindergarten in central Japan. A quasi-experimental one group pre- and post-test design was used. The education program consisted of three activities: (i) a 1-day teaching session by a researcher in January 2021, (ii) a 1-month follow-up activity led by kindergarten teachers and (iii) a 1-month follow-up activity led by parents at home, both occurring from late January to late February 2021. The study used questionnaires and handwashing skill experiments to investigate the kindergarteners' handwashing practices and comprehensive handwashing skills (handwashing steps, handwashing time, rinsing time and areas of the hands left unwashed) before and after Activities 1, 2 and 3. Data were obtained from 56 kindergarteners (64.4%). Second and third graders showed a significant improvement in their handwashing practices after coughing or sneezing. With the exception of rinsing time, handwashing skills significantly improved in all grades after the 1-day teaching session. After 1-month follow-up activities, the number of areas left unwashed by first graders significantly decreased, and the score for handwashing steps significantly improved. This study indicated that continuous handwashing education is partially effective at improving and maintaining handwashing practices and skills, except for rinsing time, among kindergarteners of all grades.

Lessons learned from health education in Japanese schools.

INTRODUCTION: A qualitative improvement in school health education is required to improve health for school-aged children in developing countries. This study aimed to clarify the factors that enable the provision of comprehensive and consistent health education in Japan. METHODS: We reviewed health education in Japanese schools and the feature of curriculum revision, and clarified the factors that enable the provision of comprehensive and consistent health education. RESULTS: We identified nine points as enabling factors: (i) clear description of the purpose of health education; (ii) clear provision of teaching content and adequate time allocation; (iii) comprehensive school health framework and clarification of the position of the health education; (iv) systems for surveying and screening children's health problems; (v) regular revising of the Courses of Study; (vi) well trained teachers responsible for health education; (vii) health education specialists in higher education facilities; (viii) various materials related to health education; and (ix) collaboration with related health workers. CONCLUSIONS: We proposed measures to enhance health education in developing countries: (i) clarifying the role of health education toward achieving goals set out in laws and policies related to education; (ii) providing appropriate learning content and time allocation; (iii) establishing a comprehensive school health framework; (iv) establishing a system that continuously monitors children's health issues; (v) identifying the person responsible for health education in a school and establishing a training system; (vi) providing a teacher's guide and teaching materials to facilitate child participatory learning, and (vii) collaborating with guardians, community members, and local health workers.

Health screening system to ensure children's health and development in Japan.

BACKGROUND: The establishment of health screening systems for children is important, however, such systems are not always well-established in developing countries. This study aimed to improve child health screening systems in developing countries by analyzing the factors that contribute to enabling continuous and proper screenings at various governmental levels in Japan. METHODS: We reviewed the history of child health and development screening systems in Japan and examined factors that enabled their regular and nationwide implementation. RESULTS: We identified the six enabling factors: (i) the existence of relevant laws and regulations in health and education systems for health checkups, (ii) mandated and detailed conditions for health checkups within both school and community health, (iii) the provision of guidelines and manuals for health checkups, (iv) a sufficient number of professionals to carry out the health checkups, (v) clear criteria for evaluating and interpreting the checkup results, and (vi) understanding among teachers, children, and guardians of the importance of health checkups. CONCLUSION: We proposed the following six requirements to the governments in developing countries for establishing their own health screening programs: (i) a clear description of the need for regular and continuous health checkups in the relevant laws, regulations, and policies, (ii) mandate as essential activity and detailed requirements of the screening activities, (iii) provision of relevant manuals for health workers and teachers, (iv) provision of enough well-trained professionals and a training system, (v) studying growth and development curves for children, and (vi) promoting understanding among stakeholders about the importance of health checkups.