Cross-sectional survey on protective behaviors against COVID-19 among 25,170 pupils
ZHANG Ya-li1, WANG Lei1, PEI Ying-xin1, LIU Hui-hui1, ZHANG Li- jie1, LI Yuan2, CHEN Hui3, GUO Li- chun4, LUO Hui-ming1, MA Hui-lai1
1. Chinese Center for Disease Control and Prevention, Beijing 100050, China; 2. Bao'an District Center for Disease Control and Prevention, Shenzhen, Guangdong 518101, China; 3. Center for Disease Control and Prevention of Xinjiang Production and Construction Corps, Urumqi, Xinjiang 830022, China; 4. Xiqing District Center for Disease Control and Prevention, Tianjin 300393, China Author contributions: ZHANG Ya-li and WANG Lei contributed equally to this paper
Abstract:Objective To investigate the protective behaviorsamong primary school students during thecoronavirus disease 2019 (COVID-19) epidemic. Methods The electronic questionnaire was issued using WeChat public account of Chinese Center for Disease Control and Prevention, and data were collected from parents in 31 provinces (autonomous regions and municipalities) in China in April 2020. Post-stratification weights were obtained according to the 2019 national education statistics on primary school students by province and the location of residence (urban or rural areas). The complex survey procedures in SPSS 27.0 were used toestimate the adjusted 1-week prevalence (95%CI) of protective behaviors among primary school students, and chi-square test within the complex survey module was used to compare the prevalence by genders, grades, urban versus rural residence, and regions with different levels of emergency response to COVID-19. Results Among the 25,170 primary school students, the protective behaviors with best compliance were to avoid taking public transportation (96.1% (95%CI: 92.8%-97.9%)) and not scheduled to attend a gathering or dining event (90.9% (95%CI: 87.3%-93.6%)). However, only 64.4% of the pupils (95%CI: 59.1%-69.5%) observed the respiratory etiquette, 36.8% (95%CI: 31.8%-42.0%) took at least 20 seconds or more to wash hands, and16.8% (95%CI: 13.1%-21.2%) performed physical activities for 1 hour or more during a 24-hour period. No statistically significant difference was foundin the prevalence of protective behaviors against COVID-19between male and female students. Pupils from lower grades were less likely to be able to avoid playing with other children (76.8% vs. 85.4%; χ2=293.89, P<0.05). The proportions of rural students wearing a medical or N95 facemask when going out (72.1% vs. 83.3%; χ2=131.24, P<0.05) and washing hands first when returning home (77.9% vs. 90.2%; χ2=228.27, P<0.01) were lower. There was a statistically significant difference in the prevalence of taking hand sanitizer or disinfecting wipes when going out among pupils from regions with different levels of emergency response to COVID-19 (χ2=244.16, P<0.01). Conclusion The pupils had good compliance with protective behaviors against COVID-19. COVID-19 health education and behavioral intervention programs for primary school students should focus on respiratory etiquette, hand hygiene, and physical activities. Protective behaviors show differences among pupils from different grades and betweem rural and urban areas; and hence, specific interventions should be tailored accordingly.
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