The Impacts Of Peer Education Based On Adolescent Health Education On Resilience Of Left-Behind Children In China

ObjectiveTo explore the association between adolescence-related knowledge,attitude and practice(KAP)and resilience in Chinese left-behind children,and verify the effect of peer education based on adolescent health education on resilience of left-behind children.MethodsAt baseline survey,a multiple-stage stratified cluster sampling method was conducted involving 4 schools(2 primary schools and 2 middle schools)with 1244 left-behind children from grades 3 to 9.The self-designed KAP Questionnaire and Resilience Scale for Chinese Adolescents was used to collect data.At intervention survey,the 4 schools were assigned into intervention group and control group randomly.The intervention group accepted peer education based on adolescent health education and control group acceptednothing.In study regarding effect of intervention on Pubertal KAP,students belonging to grades 3-4 in primary school and grade 7 in middle school were included,and students belonging to grade 4 in primary school and grade 7 in middle schools participated in research of effect of intervention on QoL.During intervention,we conduct supervision twice every semester,with solving the problems of peer educators,and we followed up these students every half year to collect these similar data as baseline.ResultsBaseline:Regarding the association between adolescent KAP and resilience in left-behind children,Pearson correlation analysis found that adolescent KAP was related to target concentration,emotional control,positive cognition,family support,interpersonal assistance and total resilience of left-behind children positively,with Pearson coefficient of 0.220,0.164,0.336,0.242,0.256,and 0.365 respectively(P<0.001).And multiple line regression showed that adolescent KAP had positive prediction on target concentration(B=0.104,SE=0.012,P<0.001),emotional control(B=0.065,SE=0.013,P<0.001),positive cognition(B=0.091,SE=0.010,P<0.001),family support(B=0.053,SE=0.011,P<0.001),interpersonal assistance(B=0.091,SE=0.014,P<0.001)and total resilience(B=0.403,SE=0.036,P<0.001)of left-behind children.After intervention:Regarding the effect of peer educators training,the correct rate of knowledge and attitude about physiological and psychological development were increased significantly(P<0.001),proving that peer educators had enough ability to perform intervention activities.The average number of activities per class was 14.81,ranging from 10 to 29.Each class consisted of 4.38 posters averagely,with minimum values of 2 posters and maximum values of 8 posters per class.With respect of the impacts of intervention on adolescence-related KAP of left-behind children,after half year of intervention,the scores of knowledge,attitude and total KAP was increased significantly in both intervention and control groups(P<0.001),but practice dimension had no significant increase(P=0.072);after 1 year and 1.5 years of intervention,significant increases of knowledge,attitude,practice and total KAP were found in both groups(P<0.001).Repeated measures variance analysis revealed that the increases of knowledge,attitude and total KAPin intervention group were greater than in control group(P<0.01).,but no effect in practice dimension(P=0.357).Regarding the effect of intervention on resilience of left-behind children,after half year of intervention,the scores of emotional control,interpersonal assistance and total resilience declined significantly in controlgroup(P<0.05),significant increase was found in positive cognition(P<0.05),but target concentration and family support had no significant change(P>0.05);no significant changes were found in every dimensions and total resilience for intervention group(P>0.05).1 year later,significant decreases of target concentration,emotional control,interpersonal assistance and total resilience were found in control group(P<0.05),but no significant decrease in positive cognition and family support(P>0.05);in intervention group,emotional control(P=0.010)was increased significantly,but there were no significant changes in other dimensions and total resilience(P>0.05).After 1.5 years,there were significant decreases in interpersonal assistance of control group(P<0.001),significant increase was found in positive cognition(P<0.05),but no significant changes in others(P>0.05);every dimension and total resilience had no significant changes in intervention group(P>0.05).Repeated measures variance analysis showed that the increases of emotional control,interpersonal assistance and total resilience in intervention group were greater than in control group(P<0.05),but no effective in target concentration,positive cognition and family support(P>0.05).ConclusionsThe resilience of left-behind children during adolescence was associated with adolescent KAP positively,and the peer education based onadolescent health education was effective in improvement of adolescent KAP and resilience of left-behind children.Therefore,more attention should be paid into adolescent health education for left-behind children.