Effect of Community-Based Education on Knowledge and Prevention of Communicable Diseases Among Adolescents

Main Article Content

Haifa Arain
Shah Fahad
Ghazal Ismail
Rizwan Ali Tunio
Murtaza Bacha
Zahid Iqbal Awan

Abstract

Background: Communicable diseases remain common in Pakistan, particularly where overcrowding, unsafe water, poor sanitation, and limited health literacy affect preventive behaviour. Adolescents are an important group for disease prevention because they interact across home, school, hospital, and community environments and may transfer health messages to families. Objective: To assess short-term changes in adolescents’ knowledge, attitudes, and preventive practices regarding communicable diseases after a structured hospital-based community health education intervention. Methods: This quasi-experimental one-group pre-test and post-test study included 120 adolescents aged 10–19 years at a tertiary-care hospital in South Punjab, Pakistan. Participants were recruited through non-probability convenient sampling. Data were collected using a structured KAP questionnaire before the intervention and two weeks after a 30–40-minute education session using discussion, pictorial charts, local examples, and handwashing demonstration. Data were analyzed using SPSS version 26, and paired sample t-test was used for pre–post comparisons. Results: The mean age was 15.4 ± 2.1 years. Knowledge score increased from 12.6 ± 3.4 to 21.8 ± 2.7, attitude score from 18.4 ± 4.1 to 24.7 ± 3.3, practice score from 14.1 ± 3.9 to 20.9 ± 3.6, and overall KAP score from 45.1 ± 9.8 to 67.4 ± 8.2, with all comparisons showing p < 0.001. Good knowledge increased from 24.2% to 71.7%. Conclusion: The intervention was associated with significant short-term improvement in communicable disease-related KAP among adolescents.

Article Details

Section

Articles

How to Cite

1.
Arain H, Shah Fahad, Ghazal Ismail, Rizwan Ali Tunio, Murtaza Bacha, Zahid Iqbal Awan. Effect of Community-Based Education on Knowledge and Prevention of Communicable Diseases Among Adolescents. JHWCR [Internet]. 2026 Mar. 14 [cited 2026 Jul. 4];4(5):1-12. Available from: https://jhwcr.com/index.php/jhwcr/article/view/1868

References

1. GBD 2019 Child and Adolescent Communicable Disease Collaborators. The unfinished agenda of communicable diseases among children and adolescents before the COVID-19 pandemic, 1990–2019: a systematic analysis of the Global Burden of Disease Study 2019. Lancet. 2023;402(10398):313-335. doi:10.1016/S0140-6736(23)00860-7.

2. Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, et al. Our future: a Lancet Commission on adolescent health and wellbeing. Lancet. 2016;387(10036):2423-2478. doi:10.1016/S0140-6736(16)00579-1.

3. Baird S, Viner R, Patton G, Sawyer S, Azzopardi P, et al. A call to action: the second Lancet Commission on adolescent health and wellbeing. Lancet. 2025. doi:10.1016/S0140-6736(25)00503-3.

4. Indravudh PP, Sibanda EL, d’Elbée M, et al. Community-led strategies for communicable disease prevention and control in low- and middle-income countries: a systematic review. PLOS Glob Public Health. 2025;5(4):e0004304. doi:10.1371/journal.pgph.0004304.

5. Wang M, Han X, Fang H, Xu C, Lin X, Xia S, et al. Impact of health education on knowledge and behaviors toward infectious diseases among students in Gansu Province, China. Biomed Res Int. 2018;2018:6397340. doi:10.1155/2018/6397340.

6. Wang X, Liu J, Zhang L, et al. Effectiveness of health education on infectious disease knowledge and behaviours among school students: a national multicenter school-based trial. BMC Public Health. 2023. doi:10.1186/s12889-023-16000-3.

7. Pradhan NA, Haider F, Khudadad U, Zahidie A, Asim M, Ladak AA, et al. Intervention to improve children’s hygiene in urban squatter settlement schools in Pakistan. Environ Health Insights. 2025;19:11786302241306288. doi:10.1177/11786302241306288.

8. Pradhan NA, Haider F, Khudadad U, Zahidie A, Asim M, Ladak AA, et al. Gaps in hygiene promotion at schools in Pakistan: qualitative descriptive research. Health Promot Int. 2023;38(3):daac046. doi:10.1093/heapro/daac046.

9. Malik FR, Ali S, Waseem S, et al. Intestinal parasites and hygiene practices among schoolchildren in Karachi. J Pak Med Assoc. 2022;72(4):664-668. doi:10.47391/JPMA.2051.

10. Khan S, Ashraf H, Iftikhar S, Baig-Ansari N. Impact of hand hygiene intervention on hand washing ability of school-aged children. J Family Med Prim Care. 2021;10(2):642-647. doi:10.4103/jfmpc.jfmpc_1906_20.

11. Smith L, Butler L, Tully MA, Jacob L, Barnett Y, López-Sánchez GF, et al. Hand-washing practices among adolescents aged 12–15 years from 80 countries. Int J Environ Res Public Health. 2021;18(1):138. doi:10.3390/ijerph18010138.

12. Almoslem MM, Alshehri TA, Althumairi AA, Aljassim MT, Hassan ME, Berekaa MM. Handwashing knowledge, attitudes, and practices among students in Eastern Province schools, Saudi Arabia. J Environ Public Health. 2021;2021:6638443. doi:10.1155/2021/6638443.

13. Willmott M, Nicholson A, Busse H, MacArthur GJ, Brookes S, Campbell R. Effectiveness of hand hygiene interventions in reducing illness absence among children in educational settings: a systematic review and meta-analysis. Arch Dis Child. 2016;101(1):42-50. doi:10.1136/archdischild-2015-308875.

14. Randle J, Metcalfe J, Webb H, Luckett JCA, Nerlich B, Vaughan N, et al. Impact of an educational intervention upon the hand hygiene compliance of children. J Hosp Infect. 2013;85(3):220-225. doi:10.1016/j.jhin.2013.07.014.

15. Younie S, Mitchell C, Bisson MJ, Crosby S, Kukona A, Laird K. Improving young children’s handwashing behaviour and understanding of germs: the impact of A Germ’s Journey educational resources in schools and public spaces. PLoS One. 2020;15(11):e0242134. doi:10.1371/journal.pone.0242134.

16. Ismail SR, Zulkifli A, Ahmad N, et al. The effects of school-based hygiene intervention programme on hygiene knowledge and practices among schoolchildren. PLoS One. 2024;19(8):e0308390. doi:10.1371/journal.pone.0308390.

17. Itrat A, Khan A, Javaid S, Kamal M, Khan H, Javed S, et al. Knowledge, awareness and practices regarding dengue fever among the adult population of dengue hit cosmopolitan. PLoS One. 2008;3(7):e2620. doi:10.1371/journal.pone.0002620.

18. Siddiqui TR, Ghazal S, Bibi S, Ahmed W, Sajjad SF. Use of the Health Belief Model for the assessment of public knowledge and household preventive practices in Karachi, Pakistan, a dengue-endemic city. PLoS Negl Trop Dis. 2016;10(11):e0005129. doi:10.1371/journal.pntd.0005129.

19. Noreen K, Rubab ZE, Umar M, Rehman R, Baig M, Baig F. Knowledge, attitudes, and practices against the growing threat of COVID-19 among medical students of Pakistan. PLoS One. 2020;15(12):e0243696. doi:10.1371/journal.pone.0243696.

20. Salman M, Mustafa ZU, Asif N, Zaidi HA, Hussain K, Shehzadi N, et al. Knowledge, attitude and preventive practices related to COVID-19: a cross-sectional study in two Pakistani university populations. Drugs Ther Perspect. 2020;36:319-325. doi:10.1007/s40267-020-00737-7.

21. Raza S, Rasheed MA, Rashid MK, et al. A cross-sectional survey of knowledge, attitude, and practices related to COVID-19 among students in Lahore, Pakistan. Front Public Health. 2021;9:697686. doi:10.3389/fpubh.2021.697686.

22. Faisal S, Khotib J, Zairina E. Knowledge, attitudes, and practices towards COVID-19 among university students in Pakistan: a cross-sectional study. J Basic Clin Physiol Pharmacol. 2021;32(4):681-686. doi:10.1515/jbcpp-2020-0436.

23. Fatmi Z, Mahmood S, Hameed W, Qazi I, Siddiqui M, Dhanwani A, et al. Knowledge, attitudes and practices towards COVID-19 among Pakistani residents: information access and low literacy vulnerabilities. East Mediterr Health J. 2020;26(12):1446-1455. doi:10.26719/emhj.20.133.

24. Rozi S, Khowaja MA, Qamar S, Hashmi M, Rehman N, Jamal WZ, et al. Understanding of adolescents’ knowledge, attitudes, and prevention practices toward COVID-19 using a web-based cross-sectional study. Sci Rep. 2025;15(1). doi:10.1038/s41598-024-78999-8.

25. Rehman R, Jawed S, Ali R, et al. COVID-19 pandemic awareness, attitudes, and practices among the Pakistani population. Front Public Health. 2021;9:588537. doi:10.3389/fpubh.2021.588537.

26. Hatabu A, Mao X, Zhou Y, Kawashita N, Wen Z, Ueda M, et al. Knowledge, attitudes, and practices toward COVID-19 among university students in Japan and associated factors. PLoS One. 2020;15(12):e0244350. doi:10.1371/journal.pone.0244350.

27. Hasan H, Raigangar V, Osaili T, Neinavaei NE, Olaimat AN, Aolymat I, et al. A cross-sectional study on university students’ knowledge, attitudes, and practices toward COVID-19 in the United Arab Emirates. Am J Trop Med Hyg. 2021;104(1):75-84. doi:10.4269/ajtmh.20-0857.

28. Dkhar SA, Quansar R, Saleem SM, Khan SMS. Knowledge, attitude, and practices related to COVID-19 pandemic among social media users in Jammu and Kashmir, India. Indian J Public Health. 2020;64(Suppl):S205-S210. doi:10.4103/ijph.IJPH_469_20.

29. Mohammed EA, Alotaibi HA, Alnemari JF, Althobiti MS, Alotaibi SS, Ewis AA, et al. Assessment of knowledge, attitude, and practice towards tuberculosis among Taif University students. Healthcare. 2023;11(20):2807. doi:10.3390/healthcare11202807.

30. Terry AF, Etikan I. Evaluating the knowledge, attitude, and practice of tuberculosis among health sciences students. Healthcare. 2025;13(13):1534. doi:10.3390/healthcare13131534.

31. Luby SP, Agboatwalla M, Feikin DR, Painter J, Billhimer W, Altaf A, Hoekstra RM. Effect of handwashing on child health: a randomised controlled trial. Lancet. 2005;366(9481):225-233. doi:10.1016/S0140-6736(05)66912-7.

32. Aiello AE, Coulborn RM, Perez V, Larson EL. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health. 2008;98(8):1372-1381. doi:10.2105/AJPH.2007.124610.

33. Curtis V, Cairncross S. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis. 2003;3(5):275-281. doi:10.1016/S1473-3099(03)00606-6.

34. Freeman MC, Stocks ME, Cumming O, Jeandron A, Higgins JP, Wolf J, et al. Hygiene and health: systematic review of handwashing practices worldwide and update of health effects. Trop Med Int Health. 2014;19(8):906-916. doi:10.1111/tmi.12339.

35. Ejemot-Nwadiaro RI, Ehiri JE, Arikpo D, Meremikwu MM, Critchley JA. Hand washing promotion for preventing diarrhoea. Cochrane Database Syst Rev. 2021;12:CD004265. doi:10.1002/14651858.CD004265.pub4.

36. Chirgwin H, Cairncross S, Zehra D, Sharma Waddington H. Interventions promoting uptake of water, sanitation and hygiene for preventing disease: evidence and gap map. Campbell Syst Rev. 2021;17(4):e1194. doi:10.1002/cl2.1194.

37. Talaat M, Afifi S, Dueger E, El-Ashry N, Marfin A, Kandeel A, et al. Effects of hand hygiene campaigns on incidence of laboratory-confirmed influenza and absenteeism in schoolchildren, Cairo, Egypt. Emerg Infect Dis. 2011;17(4):619-625. doi:10.3201/eid1704.101353.

38. Mbakaya BC, Lee PH, Lee RLT. Hand hygiene intervention strategies to reduce diarrhoea and respiratory infections among schoolchildren in developing countries: a systematic review. Int J Environ Res Public Health. 2017;14(4):371. doi:10.3390/ijerph14040371.

39. Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies. Health Promot Int. 2000;15(3):259-267. doi:10.1093/heapro/15.3.259.

40. Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. doi:10.1186/1471-2458-12-80.