● Article
WANG Ruolin, ZHANG Yi, XIONG Yanle, WU Shuangsheng, YIN Ziguang, YUN Hong, DENG Lu, TANG Jia, LIU Yan, SHEN Guangdong, DU Liyong, ZHANG Lihua, ZHANG Xiuhong, WU Ming, ZHANG Yidun, YANG Junfen, LI Yan, QIU Aiming, ZHAO Zhigang, ZHAO Haiping, ZHAO Wei, GAO Aiyu, KOU Chunmei, Liang Jinghong, DONG Yanhui, MA Jun
Objective To understand the current status and differences in related Knowledge, Attitudes, and Practices (KAP) regarding influenza prevention and control among parents of students and school health management personnel, and examine the associations between knowledge, attitude, and prevention and control practice behaviors, thereby providing evidence for improving school-based influenza prevention and control strategies. Methods A cross-sectional survey was conducted in 16 cities in China in 2025. The participants included students’ parents and school health management personnel. The questionnaire collected information on demographic characteristics and KAP related to influenza prevention and control. Knowledge and attitude scores were classified as qualified or unqualified based on the predefined thresholds. Based on vaccination or implementation of prevention and control work and the corresponding intentions, practice behaviors were uniformly categorized into three ordered stages: no intention or hesitation, intention without action, and action. Chi-square tests were used to compare the qualification rates of knowledge and attitude across groups with different characteristics. Multivariate logistic regression models were constructed to identify the influencing factors associated with knowledge and attitude qualification. Ordinal logistic regression models were further used to examine the associations of knowledge and attitude with the stages of prevention and control practice behavior in both populations. Results A total of 4 763 parents of students and 6 865 school health management personnel were included. School health management personnel had higher knowledge and attitude scores than students’ parents (P<0.001). The distribution of practice behavior stages differed significantly between the two groups (P<0.001). Most school health management personnel were predominantly in the “action” stage, whereas a relatively high proportion of students’ parents remained in the “no intention or hesitation” or “intention without action” stages. Multivariate analysis showed that among parents, those with higher educational attainment were more likely to achieve qualified knowledge and attitudes. Among school health management personnel, higher educational attainment and specific job positions were associated with higher knowledge and attitude qualification levels. Ordinal logistic regression showed that among parents of students, higher attitude scores were associated with being in a more advanced stage of prevention and control practice, whereas the influence of knowledge scores on the behavioral stage was relatively weaker. Among school health management personnel, higher knowledge scores were associated with being in a more advanced practice stage, whereas no significant association was found between attitude scores and the stage of prevention and control practice behavior. Conclusions There are marked differences between parents of students and school health management personnel in terms of influenza prevention and control knowledge, attitude, and practice behavior stages. Moreover, the patterns through which knowledge and attitude influence prevention and control behaviors differ between the two populations. Campus influenza prevention and control interventions should simultaneously address both the family and school dimensions, optimizing health education content, training mechanisms, and organizational support measures according to the characteristics of different groups, so as to facilitate the effective implementation of prevention and control behaviors.
Editor-in-Chief: Ma Jun
