Little Doctors: Agents of change in Indian rural communities.

The child-to-child approach to health advocacy is one that draws on the strengths and agency of children to make a positive impact within their communities. The approach has been popularly used for health education in low- and middle-income countries. This article describes the 'Little Doctors' program that implemented the child-to-child approach in the towns of KC Patty and Oddanchatram, located in remote hilly regions of Tamil Nadu, India starting in 1986 to train middle- and high school children to respond to diseases prevalent in their communities along with practices for preventative measures. The program involved sessions that used a combination of creative instructional methods to engage students and provided take-home messages for them to act on with their families and community. The program was successful in creating a creative learning environment for children, offering a shift from the traditional methods of classroom instruction. Students who successfully completed the program were awarded certificates as 'Little Doctors' in their communities. Although the program did not conduct formal evaluations of the program effectiveness, students reported successfully recalling complex topics such as early signs of diseases like tuberculosis and leprosy that were prevalent in the community during the time. The program experienced several challenges and had to be discontinued despite its continued benefits to the communities.

Reconsidering Reconciliation Within Families of Youth Who Sexually Offend.

Research on youth sexual offending has focused primarily on its prevalence, risk factors, treatment interventions, and recidivism rates. Thus, there is a need to develop better understandings of the processes towards reconciliation (or the lack thereof) that occur in the context of the collateral consequences of such harm-generating behavior. This qualitative study presents parents' perspectives on the benefits and challenges associated with the implications and outcomes of reconciliation, and of its deprivation among sexually offending youth, victims and their relatives. We analysed in-depth, semi-structured interview data among 16 parents from 10 families in Canada using thematic coding procedures. The findings reveal that in the absence of reconciliation, both relationship repair and rehabilitation are hindered by miscommunication, bitterness, and confusion. By contrast, when meaningful reconciliation occurs, offending youth are better able to take responsibility for their actions, which in many cases led to victim validation and relationship restoration among all affected parties, including immediate and extended relatives. Our research points to the importance of restorative practices in both formal and informal attempts towards accountability, reconciliation, rehabilitation, victim redress, as well as family and community reintegration.

Caregivers' Considerations of Remorse and Responsibility Among Youth Who Sexually Offend.

When a youth sexually offends, most of the reactions and repercussions that follow are understandably negative. However, there is limited research about mixed reactions involving remorse and responsibility on the part of the adolescent who offended and their relatives. Based on qualitative interviews with 16 caregivers among 10 families in Canada, this article presents the parents' perspectives on the various processes, benefits, challenges, and outcomes related to expressions of remorse and experiences of responsibility among youth who sexually offended, their victims, and their parents. This study sheds particular light on how adolescent perpetrators of sexual harm and especially their caregivers do feel deeply remorseful and responsible for the impacts of sexual offending behavior, which is contrary to public scrutiny that negatively projects responsibility onto youth offenders and their parents. Thus, our findings emphasize the constructive and considerate ways in which remorse is felt and responsibility is assumed; and by extension, they point to the importance of restorative practices in efforts toward reconciliation and accountability.

Economic Benefit in Treatment of Unintentional Childhood Injuries by Implementation of Child-To-Child Approach.

BACKGROUND: Childhood injury has been recognized as a major threat to child survival and health, as well as economic burden, which includes the cost to government and out-of-pocket expenses (OOPE) to families. Child-To-Child Approach is an innovative technique to reduce childhood injuries and expenses on their treatment. OBJECTIVES: To assess economic benefit in the treatment of unintentional childhood injuries, including OOPE by families, by the implementation of the child-To-Child approach. MATERIALS AND METHODS: The present study is part of a quasi-experimental before-and-after intervention study conducted in the rural area of Delhi for the prevention of childhood injuries through intervention by the child-To-Child approach. Cost of injury treatment, including travel and accommodation expenses, and wage loss were noted. The projected gain in the total cost and out-of-pocket expenditure on injury treatment throughout 20 years of childhood and adolescence were calculated. RESULTS: Both incidences of injuries and total expenditure for treatment of injuries had decreased during the postintervention period in the intervention group, against a rise in the control group. The proportion of OOPE for availing private health care facilities for treatment of injuries, which was more than one-fourth of total expenses, also had decreased in the intervention group during the postintervention period. On economic analysis, it is projected that there will be enormous gain in cost by the implementation of child-To-Child approach in the study area in 20 years, along with saving of OOPE of the families. CONCLUSION: Child-To-Child approach is effective in preventing childhood injuries and reducing the cost of treatment of injuries.

Immunization coverage among under-five children living along a school student through child-to-child and child-to-parent information, education and communication strategy.

BACKGROUND: In spite of being a principal producer and exporter of vaccines and billions spent over decades, India is home to one-third of the world's under-five children (U5C) with no immunization. OBJECTIVES: The objective of this study was to find the outcome of child-to-child and child-to-parent Information, Education and Communication (IEC) strategy on the current percentage of immunization coverage (IC). METHODS: A mixed design research with multilevel concurrent sampling was conducted in Pune. Based on school students' households, 44 clusters having U5C were divided randomly into 11 experimental/control groups each. IEC strategy to students was independent variable and IC among U5C was dependent variable. Data were collected from 1092 students and 2352 U5C parents over 6 years. Vaccination card and Bacillus Calmette-Guérin mark were considered as evidence to conclude on full, partial and no IC. Change in knowledge quotient (KQ) among students/parents and U5C IC before and after IEC strategy assessed. RESULTS: Rural/urban age-appropriate full IC of U5C was 51% and 67% before and 88% and 85% in post-IEC, respectively. The mean KQ change score of 8-12/20 in students is likely to increase full IC by 37% and 18%, decrease partial coverage at 14% and 12%, and improve none coverage at 23% and 16%, from its existing level positively in experimental groups. Numerous factors discouraged parents to pursue their U5C immunization. CONCLUSIONS: Advocacy through school students can be an economically viable alternative marketing strategy for inadequate U5C IC than billions spent on treating vaccine-preventable diseases and impractical options.

Comparison of effectiveness of two methods of health education on cancer awareness among adolescent school children in a rural area of Southern India.

INTRODUCTION: Cancer is a major public health problem worldwide. There is an urgent need for a reinvigorated and tailored approach to promote cancer prevention and treatment-related health education, especially among the youth. OBJECTIVE: (1) To assess the knowledge and awareness of the students of adolescent age group about cancer. (2) To compare two methods of health education on improving awareness about cancer among these students. METHODOLOGY: We conducted an interventional study among students (both male and female) of adolescent age group (10-19 years) who attend Government school (Lakkur and Kugur) in Sarjapur PHC between May and September 2014. A standard pretested validated questionnaire-adopted from Cancer Awareness Measure-translated into Kannada was used. After pretest, health education was given by two modes: in Lakkur - child to child, and Kugur - routine (lecture). Following 2 days of health education, an immediate posttest was conducted. After 2 weeks, the second posttest was conducted. RESULTS: In Kugur School, 96 students and Lakkur School, 104 students participated. The mean age group of students in both the schools was 14 years. The preexisting knowledge scores between both the schools were not statistically significant. There was a significant increase in knowledge of the posttest scores in all three domains of cancer questionnaire in both the schools. Child to child program in Lakkur School was found to be more effective in increasing the knowledge scores. CONCLUSION: To increase the awareness of cancer among schools using child to child method for health education. School curriculum should include sessions on cancer education and reinforced to students periodically. To sustain this measure, school teachers could be trained in nuances of cancer prevention and treatment.

A Health Promoting Schools (HPS) program among primary and secondary school children in Southern Province, Sri Lanka: A qualitative study on the program’s effects on the school children, parents, and teachers / 国際保健医療

  A Health Promoting Schools (HPS) program was conducted among primary and secondary school children in Southern Province, Sri Lanka. The HPS program included implementation of health education and workshops, as well as publication of school newsletters that communicated the material the children discussed and learned in school to their families. The study aimed to determine whether the HPS program had any effects on the health of the school children, their parents and teachers.<BR>  A total of 22 adults (nine parents, nine school teachers, and four school principals) were invited for in-depth individual interviews and reported their views on changes after the implementation of the project. The interviewees reported that the school children substantially improved their behaviors regarding dietary habits, basic hygiene, lifestyle, and exercise. They also expressed that the school environment improved. They indicated direct and indirect changes in their own awareness and attitudes, as well as in other family members.<BR>  After the implementation of the HPS program, improved health behaviors and subsequent improved health across two generations were observed. Beyond providing students with health knowledge, more emphasis on motivating children to spread their health knowledge in their communities will make a more effective health intervention.

Child-to-child training for prevention of school injuries in Odemis, Turkey.

Students encounter many risks for injury, which can impact their health and educational success; prevention of these injuries are paramount for school nurses. These article report results of a study conducted to determine the efficacy of training given to children regarding prevention of school injuries and to compare the effectiveness of instructor-to-child training to that of the child-to-child training method in affecting student attitudes toward the prevention of school injuries. An interventional teaching program was developed with the objective of positively impacting students' attitudes toward preventing school injuries. The health care training using instructor-to-child and child-to-child training produced a similar effect in changing the attitudes of students with respect to preventing school injuries. Given the high ratio of children to school nurses within the school systems in Turkey, nurses could consider the use of child-to-child training to supplement their own health care training to support changes in students' attitudes toward prevention of school injuries.

Application of the child-to-child strategy to change health awareness and behavior among school children and community dwellers in Sri Lanka / 国際保健医療

<B>Introduction</B><br>Recently, the increasing prevalence of chronic and lifestyle-related diseases has become the most crucial global health issue, even in low- and middle-income countries. However, current health systems are often unable to address the large burden of such diseases because of their poor capacity. In Sri Lanka, a country facing such issues, we implemented a school initiative project, the effect of which expanded beyond the school to the student's family as well as the local community. The project was aimed at prevention of chronic and lifestyle-related diseases among adults through school children's activities.<br><B>Activities</B><br>Major interventions such as workshops and regular publication of newsletters including the results of the workshops were implemented at four selected primary and secondary schools in the Southern Province of Sri Lanka. The newsletters the children brought home facilitated their communication with the parents regarding health issues. All the schools conducted health camps, which children planned and managed themselves, and incentive funds were offered to support the children's activities.<br><B>Results</B><br>Through discussion and learning at the workshops, children's self-confidence and self-reliance might be enhanced, particularly in regard to developing their health literacy. The health camps and incentive funds helped promote children's autonomy and capability. The attendance rate of the students at the four schools has increased since the inception of the project, while a questionnaire survey showed that the proportion of parents who smoked has decreased.<br><B>Conclusion</B><br>The trial suggested that school children have the potential not only to improve their own health but also to help their parents and the broader community adopt a healthier lifestyle. Application of the child-to-child strategy may be useful to deal with chronic and lifestyle-related diseases of adulthood as it expands to the child-to-parents and the child-to-community approach.

APPLICABILITY STUDY OF DEVELOPING NUTRITIONAL EDUCATION THROUGH CHILD-TO-CHILD APPROACH AMONG THE PRIMARY SCHOOL STUDENTS / 营养学报

Objective:To explore the feasiblility and impact in developing school-based nutritional education through child-to-child approach. Method : Using controlled-comparison quasi-experiment approach, the intervention of nutrition education was implemented based on the Child-to-Child model among more than 3000 primary school students in Shanxi and Zhejiang Province. Results:The knowledge, attitude and practice of students from pilot schools were improved significantly after intervention (P