Health Promotion International, Vol. 18, No. 4, 361-371, December 2003
© Oxford University Press 2003 All rights reserved
What picture is worth a thousand words? A comparative evaluation of a burn prevention programme by type of medium in Israel
1The Center for Research and Development of Advanced Services in Plastic Surgery, The Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva and 2Israel National Center for Trauma and Emergency Medicine Research Unit, The Gertner Institute for Epidemiology and Health Policy Research. Sheba Medical Center, Tel-Hashomer, Israel
Address for correspondence: Dr Esther Shani, Plastic Surgery Department, Soroka University Medical Center, Beer-Sheva, Israel, E-mail: geshani{at}netvision.net.il
Burns are associated with longer hospital stay, permanent disfigurement and emotional stress disorders, and represent a health problem, especially among economically and socially deprived populations, such as the Bedouin population in Israel, hence the importance of intervention programmes. The objective of this research was to examine the extent to which the effect of a visual one-session burn prevention programme was determined by the type of medium used. We also examined the possibility that fear motivates action only when someone feels confident in his/her ability to control the threat. Data were based on the pre-/post-programme self-report questionnaires administered to a randomly selected three-group sample of 12- to 13-year-old Bedouin children (n = 179). All three sessions were identical, but differed in the type of medium used: slides (S), video (V), or slides and video consecutively (S + V). We measured health beliefs (perceived threat, internal/external control, self-efficacy) and sense of coherence (SOC), both before and 2 months after completion of the intervention. We also measured post-programme fear reaction and the improvement in burn-related knowledge, understanding and safety behaviour as the outcome measure. No significant post-programme differences between intervention groups were found, either in terms of outcome measure or in terms of health beliefs and SOC. However, within- person analysis indicated that the S group participants had the highest level of post-exposure fear and a decrease in luck control over injuries. The S + V group demonstrated the lowest within change. The hierarchical regression analysis revealed that self-efficacy, fear, higher socio-economic status and female gender predicted improvement. As hypothesized, the interaction between fear and self-efficacy added significantly to prediction. It seems that health beliefs and demographic characteristics were more powerful in predicting the effect of the intervention than the choice of medium per se. A multifaceted approach and more comprehensive interventions are needed in order to promote health among disadvantaged populations.
Key words: Bedouin children; burns; prevention