ADDING “NUDGE” TO CKD EDUCATION: BEHAVIORAL INTERVENTIONS TO IMPROVE CHILDREN'S HEALTH LITERACY

 

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https://storage.unitedwebnetwork.com/files/1099/4779925603acc5d54325d13349568219.pdf
ADDING “NUDGE” TO CKD EDUCATION: BEHAVIORAL INTERVENTIONS TO IMPROVE CHILDREN'S HEALTH LITERACY

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Junko
Nakamura
Junko Nakamura junko-nakamura@nuhw.ac.jp Niigata University of Health and Welfare Health and Nutrition Niigata Japan *
Ryohei Kaseda ryoheik@med.niigata-u.ac.jp Niigata University Graduate School of Medical and Dental Sciences Clinical Nephrology and Rheumatology Niigata Japan -
Shinichi Wada wada-nii@umin.net Sado General Hospital Nephrology and dialysis Niigata Japan -
Suguru Yamamoto yamamots@med.niigata-u.ac.jp Niigata University Graduate School of Medical and Dental Sciences Clinical Nephrology and Rheumatology Niigata Japan -
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Disease awareness education prior to adulthood is crucial for improving health literacy. Behavioral science methods using nudges are gaining attention as a way to encourage natural behavioral changes. The nudge approach can be implemented simply, in a short time, and at a low cost. It is also independent of the educational system and can be practiced in any region. In this study, we examined whether nudge theory-based interventions for children can influence their knowledge of chronic kidney disease (CKD) and their understanding of clinical test values, which could potentially lead to improved parental knowledge.

An intervention using nudges to improve health literacy regarding CKD was implemented for 107 second-year junior high school students between May 2023 and February 2024. Leaflets addressing children's health issues were distributed to the students every 2 months, for five times in total, with the fifth leaflet focusing on CKD. In September 2023, a single 10-minute lecture on CKD was presented during regular school classes. Questionnaire surveys were administered before and after the intervention to assess changes in children's knowledge about CKD and related clinical test values, as well as to evaluate improvements in parental understanding regarding this disease.

The junior high school students scored 19% for CKD knowledge before the intervention. This score increased to 50.8% after the intervention. Post-intervention CKD knowledge and knowledge of proteinuria (p < 0.01) correlated statistically significantly. However, students scored 22.0% for proteinuria knowledge and 1.7% for eGFR knowledge after the intervention. Thus, although CKD knowledge improved with the intervention, the understanding of more specialized content, such as clinical test values, did not deepen sufficiently. Furthermore, parents scored 62.7% for CKD knowledge before the intervention, which tended to increase to 71.2% after the intervention. This implied that, even in the context of relatively high levels of knowledge, approaches targeting children may have influenced parental CKD knowledge.

This study demonstrated that distributing leaflets and providing approximately 10 minutes of CKD education improved junior high school students' understanding. Future challenges include developing content that enhances children’s understanding of clinical test values and verifying the effectiveness of continuous educational interventions. Children’s CKD education within simple school programs is expected to be introduced widely and to be expanded as a new means of achieving public awareness and education.  

Kewords