Suchergebnisse

Purpose.Environmental conditions often serve as critical enabling factors for health promotion. This article describes the effect of a preschool hygiene intervention program on classroom environmental conditions.Design.Cluster randomized trial, with randomization at the level of the preschool.Setting.State-run preschools in Jerusalem.Subjects.Forty secular and religious Jerusalem preschools (including 1029 children).Intervention.A multidisciplinary hygiene intervention that included changes to the preschool environment.Measures.Presence of soap, soap dispenser, paper towel, paper towel dispenser, cloth towels, communal cup, or personal cups.Analysis.Generalized estimating equations and Fisher's exact test were used to estimate the effect of the intervention program on environmental conditions.Results.Information was obtained from most (97.9%) visits. Baseline environmental hygienic conditions were poor. Relative to the control group, the following environmental conditions were better in the intervention group after program implementation: soap (odds ratio [OR] = 14.7; p < .01), paper towels (OR = 13.5; p < .01), communal cups (OR = .05; p < .01), soap dispensers (secular preschools only, p < .01), individual cups (secular, p < .01; religious, OR = 18.7; p < .02).Conclusions.Environmental hygiene in the Israeli preschools studied was deficient at baseline but amenable to change. Improvement in environmental conditions was a necessary enabling factor for the changes in hand-washing behavior that were observed among the children. Sustained environmental change is possible in the preschool environment. (Am J Health Promot 2011;25[4]:248–256.)

Among the challenges presented by the SARS-CoV2 pandemic are those related to balancing societal priorities with averting threats to population health. In this exceptional context a group of Israeli physicians and public health scholars (multidisciplinary academic group on children and coronavirus [MACC]) coalesced, examining the role of children in viral transmission and assessing the necessity and consequences of restricted in-class education. Combining critical appraisal and analytical skills with public health experience, MACC advocated for safe and monitored school re-opening, stressing the importance of education as a determinant of health, continuously weighing this stance against evolving COVID-19-risk data. MACC's activities included offering research-based advice to government agencies including Ministries of Health, Finance, and Education. In a setting where government bodies were faced with providing practical solutions to both decreasing disease transmission and maintaining society's vital activities, and various advisors presented decision-makers with disparate views, MACC contributed epidemiological, clinical and health policy expertise to the debate regarding school closure as a pandemic control measure, and adaptations required for safe re-opening. In this paper, we describe the evolution, activities, policy inputs and media profile of MACC, and discuss the role of academics in advocacy and activism in the midst of an unprecedented public health crisis. A general lesson learned is that academics, based on the rigor of their scientific work and their perceived objectivity, can and should be mobilized to pursue and promote policies based on shared societal values as well as empiric data, even when considerable uncertainty exists about the appropriate course of action. Mechanisms should be in place to open channels to multidisciplinary academic groups and bring their input to bear on decision-making.