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Objective:To evaluate the effectiveness of a nutritional intervention to promote fruit and vegetable (FV) intake.Design:A randomised controlled community trial was conducted to evaluate the effectiveness of a 7-month nutritional intervention and to promote FV intake, separately and together. All participants attended physical exercise sessions. The intervention was based on the transtheoretical model and Paulo Freire’s pedagogy. The interventions included group educational sessions, motivational cards and informational materials. The primary outcome was a change in FV intake (g/d), and secondary outcomes included stages of change, self-efficacy, decisional balance and knowledge on FV. All data were collected face-to-face; and FV intake was assessed using a validated brief questionnaire.Setting:Health promotion services of Brazilian Primary Health Care.Participants:3414 users of Brazilian Primary Health Care (1931 in the control group and 1483 in the intervention group (IG)).Results:At baseline, the average daily FV intake was 370·4 g/d (95 % CI 364·2, 376·6). The increase in FV intake (23·4 g/d; 95 % CI 6·7, 40·0) and fruit intake (+17·3 g/d; 95 % CI 5·1, 29·4; P = 0·01) was greater in the IG among participants in the lowest baseline intake. Participants in the IG also showed progression in the stages of change (P < 0·001), increased self-efficacy (P < 0·001) and improved knowledge of FV crops (P < 0·001).Conclusions:The nutritional intervention was effective in increasing FV intake and fruits intake among individuals with a lower intake at baseline and in maintaining FV intake among those who reported consuming FV as recommended (400 g/d).

Objective To evaluate the effectiveness of two teaching strategies, both guided by the concept of dialogicity, on adolescents’ knowledge about schistosomiasis and adherence to diagnostic fecal testing. Methods Two teaching strategies related to schistosomiasis were developed, an educational video and group conversation, which were tested in two groups of students aged 10–15 years old. Before and after the intervention, a questionnaire was applied to assess participants' knowledge about schistosomiasis and, after the intervention, two fecal samples were requested from each participant. Comparisons were performed by paired t- and McNemar tests. Results Both strategies resulted in statistically significant improvements in knowledge between the pre- and post-tests. Students who watched the video had a higher return rate of fecal samples and percentage of correct questionnaire answers, mainly on questions about schistosomiasis infection. Conclusion Teaching strategies based on dialogue favored the construction of concepts about schistosomiasis that can influence the adoption of positives attitudes related to health. Practical implications Using teaching strategies based on the concept of dialogicity can favor the increase of knowledge of school age children about schistosomiasis and can influence behavioral change related to health.

[This corrects the article DOI: 10.1371/journal.pntd.0005574.].

Necator americanus Glutathione-S-Transferase-1 (Na-GST-1) plays a role in the digestion of host hemoglobin by adult N. americanus hookworms. Vaccination of laboratory animals with recombinant Na-GST-1 is associated with significant protection from challenge infection. Recombinant Na-GST-1 was expressed in Pichia pastoris and adsorbed to aluminum hydroxide adjuvant (Alhydrogel) according to current Good Manufacturing Practice. Two Phase 1 trials were conducted in 142 healthy adult volunteers in the United States and Brazil, first in hookworm-naïve individuals and then in residents of a N. americanus endemic area in Brazil. Volunteers received one of three doses of recombinant Na-GST-1 (10, 30, or 100 μg) adjuvanted with Alhydrogel, adjuvanted with Alhydrogel and co-administered with an aqueous formulation of Glucopyranosyl Lipid A (GLA-AF), or the hepatitis B vaccine. Vaccinations were administered via intramuscular injection on days 0, 56, and 112. Na-GST-1/Alhydrogel was well tolerated in both hookworm-naïve and hookworm-exposed adults, with the most common adverse events being mild to moderate injection site pain and tenderness, and mild headache and nausea; no vaccine-related severe or serious adverse events were observed. Antigen-specific IgG antibodies were induced in a dose-dependent fashion, with increasing levels observed after each vaccination in both trials. The addition of GLA-AF to Na-GST-1/Alhydrogel did not result in significant increases in specific IgG responses. In both the US and Brazil studies, the predominant IgG subclass induced against Na-GST-1 was IgG1, with lesser amounts of IgG3. Vaccination of both hookworm-naïve and hookworm-exposed adults with recombinant Na-GST-1 was safe, well tolerated, and resulted in significant antigen-specific IgG responses. Based on these results, this vaccine will be advanced into clinical trials in children and eventual efficacy studies. Trial registration ClinicalTrials.gov (NCT01261130 for the Brazil trial and NCT01385189 for the US trial), Author summary Hookworm infection caused by Necator americanus is a major neglected tropical disease with significant associated morbidity. New tools, such as vaccines, are needed due to the inadequacy of current control strategies. Glutathione-S-Transferase-1 of N. americanus (Na-GST-1) is one of the lead hookworm vaccine candidates; antibodies induced by this vaccine are postulated to interfere with the digestion of host hemoglobin by adult N. americanus hookworms, thereby impairing their development and survival. We conducted two Phase 1 trials of recombinant Na-GST-1 adjuvanted with Alhydrogel in 142 healthy adults living in the United States and Brazil. Each participant received three vaccinations every 2 months by intramuscular injection of the vaccine administered with or without an aqueous solution of the Toll-like receptor-4 agonist, Glucopyranosyl Lipid A (GLA-AF). Na-GST-1/Alhydrogel was well tolerated in both hookworm-exposed and hookworm-naïve adults; no vaccine-related severe or serious adverse events were observed. Antigen-specific IgG antibodies were induced in a dose-dependent fashion with increasing levels observed after each vaccination. The addition of GLA-AF to the vaccine did not result in significantly higher antibody responses. Based on these results, the vaccine will be advanced into clinical trials in children and eventual efficacy studies.

Apresentamos o relato de proposta da disciplina Teoria do Conhecimento e da Educação nas Práticas Educativas em Saúde, do curso de pós-graduação em Enfermagem da Universidade Federal de Minas Gerais. Trata-se de uma experimentação inspirada nos pressupostos de Gaston Bachelard, que abordou a doação de órgãos e os transplantes buscando produzir conhecimentos e engendrar acontecimentos. O artigo está dividido em oito momentos, equivalentes aos que Bachelard compreende como necessários para chegar ao conhecimento, indo da desconstrução gradativa do senso comum à afirmação científica. A criação de um ambiente de dúvidas e inquietações sobre a temática foi a matéria para a experimentação e a atualização de acontecimentos. Dessa matéria, demasiadamente viva, insurgiram acontecimentos capazes de inaugurar variações, conexões e proliferações no pensamento, além de situações marcadas pela captura do instituído e por processos de subjetivação fechados sobre si mesmos.

Objetivou-se avaliar as potencialidades de um jogo de Role Playing Game como estratégia pedagógica na Graduação em Enfermagem, com ênfase em suas implicações subjetivas na compreensão sobre aspectos da profissão. Estudo qualitativo, realizado por meio de pesquisa avaliativa, do tipo análise da implantação. Participaram alunos do 3º período de Enfermagem. O instrumento de coleta foram Memórias de Jogo, relatos elaborados pelos alunos após sessões do jogo. O jogo constituiu uma estratégia pedagógica não tradicional que favoreceu aos alunos a aproximação com a prática profissional, a participação ativa, a autorreflexão e a reflexão sobre a atuação profissional. Essa estratégia favoreceu processos de singularização, permitindo ao aluno vivenciar situações semelhantes às da prática do enfermeiro e exercitar habilidades como trabalho em equipe e criatividade. A ampliação dos estudos que abordam os processos subjetivos no ensino superior, por meio de jogos de simulação, pode contribuir para melhor delineamento dos processos formativos em saúde.

Este estudo discute a forma como os profissionais da equipe de saúde da família pensam e representam a educação em saúde e a prática educativa que realizam. Os sujeitos da pesquisa (n=248) - médico, enfermeiro, auxiliar de enfermagem e agente comunitário de saúde de 20 unidades básicas de saúde de Belo Horizonte - foram entrevistados mediante a utilização da técnica de evocação livre e da teoria das representações sociais. Solicitou-se aos sujeitos que verbalizassem cinco palavras que lhes ocorressem imediatamente em relação à educação em saúde, classificando-as em positiva ou negativa. Utilizou-se o software Evoc e calculou-se a frequência simples de ocorrência, a média ponderada de ocorrência em função da ordem de evocação e a média das ordens ponderadas do conjunto dos termos evocados. Construiu-se o quadro de quatro casas composto do núcleo central, elementos de contraste e periféricos da representação. Médicos e enfermeiros compartilham conteúdos representacionais entre si, expressando representações sociais similares, ao apresentarem nos possíveis núcleos centrais 'capacitação' e 'prevenção'. Auxiliares de enfermagem e agentes comunitários de saúde se assemelham por meio dos possíveis elementos centrais 'educação' e 'prevenção'. O foco recai na transmissão de orientações com o objetivo de persuadir os indivíduos à adoção de modos de vida saudáveis.

Objective: To verify whether what users of soup kitchens in Belo Horizonte, Minas Gerais, Brazil, think about a healthy diet and the challenges they face to eat healthy are associated with their household food security status. Methods: This cross-sectional study included 1,656 users of soup kitchens in Belo Horizonte. Socioeconomic and household food security data, and healthy-eating discourses were collected by a semi-structured questionnaire. The data were submitted to descriptive analyses for constructing frequency distribution tables, and to univariate analysis. Discourse analysis was based on the social representation theory. Results: To cut, reduce, avoid, not eat, eat less, and decrease carbohydrates, salt, meats, various beverages, and other foods are the most frequent changes (71.4%) that food-secure users have made or intend to make. Food-insecure users intended to eat more fruits, non-starchy vegetables, and other foods (34.4%). The main obstacles food-secure and food-insecure users face to adopt a healthier diet are lack of time (82.9%) and low income (53.5%), respectively (p

The aim of this study was to analyze the social representations of the diets 34 patients of the Brazilian public primary care service diagnosed with type- 2 diabetes mellitus, according to how they represent their identity. Free association of words was used with responses to questions to survey social representations of food. Representations of identity were adopted from a previous study with the same participants. Normal participants eat healthily, eat little, eat greens and vegetables, avoid sweets, have positive attitudes, and maintain healthy eating habits and regular blood glucose levels. Participants who accept having the disease do not eat a lot, do not eat everything, avoid sweets, have an attitude of acceptance, and maintain inadequate eating habits and uncontrolled blood glucose. Participants with difficulties do not eat everything, do not eat a lot, do not follow the diet and eat vegetables and fruits, and have negative attitudes and altered blood glucose. info:eu-repo/semantics/publishedVersion

OBJECTIVE To investigate the relationship between hookworm and Ascaris lumbricoides infection and performance on three subsets of the Wechsler Intelligence Scale for Children - third edition (WISC-III) (Digit Span, Arithmetic and Coding) and Raven Colored Progressive Matrices. METHODS Cross-sectional study of 210 children between the ages of 6 and 11 years in Americaninhas, Minas Gerais, Brazil. Separate proportional odds models were used to measure the association between the intensity of helminth infections and poor performance on each of the four cognitive tests. RESULTS After adjusting for sex, age, socioeconomic status and other helminth infections, moderate-to-high-intensity hookworm infection was associated with poor performance on the WISC-III Coding subtest [OR = 3.20; 95% confidence interval (CI) = 1.43-7.17], low intensity of hookworm infection was associated with poor performance on the WISC-III Coding subtest [odds ratio (OR) = 3.71; 95% CI = 1.80-7.66] and moderate-to-high-intensity A. lumbricoides infection was associated with poor performance on the Raven test (OR = 2.03; 95% CI = 1.04-3.99), all in comparison with uninfected children. Children co-infected with A. lumbricoides infection and hookworm infection had greater odds of poor performance on some WISC-III subtests than children with only A. lumbricoides infection. CONCLUSIONS These findings suggest that hookworm infection may be associated with poorer concentration and information processing skills, as measured on the WISC-III Coding subtest, and that A. lumbricoides infection may be associated with poorer general intelligence, as measured through the Raven Colored Progressive Matrices. This study also presents evidence that polyparasitized children experience worse cognitive outcomes than children with only one helminth infection.

OBJECTIVE To investigate the concept understood by Family Healthcare Strategy (ESF) professionals of knowledge, education and subjects participating in learning activities. METHOD Qualitative study carried out with the ESF professionals with university degree, members of the healthcare staff who undertook educational health group activities at Basic Healthcare Units (UBS) in Belo Horizonte. The following triangulation techniques were used: participant observation, photos and field notes; interviews with professionals; and document analysis. RESULTS We identified three interaction patterns that are different from each other. Firstly, the professional questions, listens and provides information to users, trusting in the transmission of knowledge; secondly, the professional questions and listens, trusting that users can learn from each other; thirdly, the professional questions, listens, discusses and produces knowledge with users, both teaching and learning from each other. CONCLUSION There are educational practices that include unique methods capable of creating a militant space for citizenship engagement. OBJETIVO Investigar la concepción de los profesionales acerca de la Estrategia Salud de la Família (ESF) con respecto al conocimiento, la educación y los sujetos que participan de acciones pedagógicas. MÉTODO Estudio cualitativo realizado con profesionales de la ESF, de nivel superior, integrantes del equipo de asistencia y quienes llevaron a cabo acciones educativas grupales de salud en Unidades Básicas de Salud (UBS) de Belo Horizonte. Se utilizó la triangulación de las técnicas; observación participante, fotografía y diario de campo; entrevista con los profesionales y análisis documental. RESULTADOS Se identificaron tres estándares de interacción, diferentes entre sí. En el primero, el profesional cuestiona, oye y facilita informaciones a los usuarios, creyendo en la transmisión de conocimientos; en el segundo, cuestiona y oye, fiándose de que los usuarios aprenden los unos con los otros; en el tercero, cuestiona, oye, problematiza y produce conocimientos con los usuarios, ambos enseñando y aprendiendo. CONCLUSIÓN Existen prácticas educativas que incluyen métodos singulares capaces de convertirse en espacio de militancia a favor de la ciudadanía. OBJETIVO Investigar a concepção de profissionais da Estratégia Saúde da Família (ESF) em relação ao conhecimento, à educação e aos sujeitos que participam de ações pedagógicas. MÉTODO Estudo qualitativo realizado com profissionais da ESF, de nível superior, integrantes da equipe de assistência e que realizaram ações educativas grupais de saúde em Unidades Básicas de Saúde (UBS) de Belo Horizonte. Utilizou-se a triangulação das técnicas: observação participante, fotografia e diário de campo; entrevista com os profissionais; e análise documental. RESULTADOS Identificaram-se três padrões de interação, diferentes entre si. No primeiro, o profissional questiona, ouve e fornece informações aos usuários, acreditando na transmissão de conhecimentos; no segundo, questiona e ouve, confiando que os usuários aprendem uns com os outros; no terceiro, questiona, ouve, problematiza e produz conhecimentos com os usuários, ambos ensinando e aprendendo. CONCLUSÃO Há práticas educativas que incluem métodos singulares capazes de se transformar em espaço de militância em favor da cidadania.

Informed consent is one of the principal ethical requirements of conducting clinical research, regardless of the study setting. Breaches in the quality of the informed consent process are frequently described in reference to clinical trials conducted in developing countries, due to low levels of formal education, a lack of familiarity with biomedical research, and limited access to health services in these countries. However, few studies have directly compared the quality of the informed consent process in developed and developing countries using the same tool and in similar clinical trials. This study was conducted to compare the quality of the informed consent process of a series of clinical trials of an investigational hookworm vaccine that were performed in Brazil and the United States. A standardized questionnaire was used to assess the ethical quality of the informed consent process in a series of Phase 1 clinical trials of the Na-GST-1/Alhydrogel hookworm vaccine that were conducted in healthy adults in Brazil and the United States. In Brazil, the trial was conducted at two sites, one in the hookworm non-endemic urban area of Belo Horizonte, Minas, and one in the rural, resource-limited town of Americaninhas, both in the state of Minas Gerais; the American trial was conducted in Washington, DC. A 32-question survey was administered after the informed consent document was signed at each of the three trial sites; it assessed participants’ understanding of information about the study presented in the document as well as the voluntariness of their decision to participate. 105 participants completed the questionnaire: 63 in Americaninhas, 18 in Belo Horizonte, and 24 in Washington, DC. Overall knowledge about the trial was suboptimal: the mean number of correct answers to questions about study objectives, methods, duration, rights, and potential risks and benefits, was 45.6% in Americaninhas, 65.2% in Belo Horizonte, and 59.1% in Washington, DC. Although there was no difference in the rate of correct answers between participants in Belo Horizonte and Washington, DC, there was a significant gap between participants at these two locations compared to Americaninhas (p = 0.0002 and p = 0.0001, respectively), which had a lower percentage of correct answers. Attitudes towards participating in the clinical trial also differed by site: while approximately 40% had doubts about participating in Washington, DC and Belo Horizonte, only 1.5% had concerns in Americaninhas. Finally, in Belo Horizonte and Washington, high percentages cited a desire to help others as motivation for participating, whereas in Americaninhas, the most common reason for participating was personal interest (p = 0.001). Understanding of information about a Phase 1 clinical trial of an experimental hookworm vaccine following informed consent was suboptimal, regardless of study site. Although overall there were no differences in knowledge between Brazil and the US, a lower level of understanding about the trial was seen in participants at the rural, resource-limited Brazilian site. These findings demonstrate the need for educational interventions directed at potential clinical trial participants, both in developing and developed countries, in order to improve understanding of the informed consent document., Author Summary Informed consent is an essential element of the ethical conduct of clinical trials of new vaccines, regardless of the study setting. However, the quality of informed consent is often suboptimal. Some research has suggested that the quality of the informed consent process may be reduced in resource-limited areas compared to developed country settings. To test this, we conducted a study of the quality of the informed consent process in two similar Phase 1 clinical trials of the Na-GST-1/Alhydrogel hookworm vaccine that were conducted in healthy adult volunteers in Brazil and in the United States. In Brazil, the trial was conducted at two sites, one a large urban area (Belo Horizonte), and the other a rural, resource-limited region of the state of Minas Gerais; in the United States, the trial was conducted in Washington, DC. A structured questionnaire was administered after the informed consent document was signed at each of the three clinical trial sites, which tested understanding about the information contained in the document and attitudes toward the volunteers’ participation in the clinical trial. The results indicate that there were no substantial differences between the overall quality of the informed consent obtained from participants in the United States and in Brazil. However, a significant association was found between the particular site where the trial was conducted and the quality of the informed consent process, with residents of the site in rural Brazil having the lowest percentage of correct answers on the informed consent questionnaire. The informed consent process should therefore take into account the specific characteristics of the population in which the trial is being conducted.

Background In order for Informed Consent to be ethical and valid each clinical trial participant must be able to make a voluntary decision to participate, free from pressure or coercion. Nonetheless, many factors may influence the decision reached, and such influences may be different for male and female volunteers. Being aware of these differences may help researches develop better processes for obtaining consent that safeguard the right of autonomy for all participants. The goal of this study was to evaluate potential gender-based differences in the factors influencing clinical trial participation. Methods This cross-sectional study was conducted in the Northeast region of Minas Gerais, Brazil, in October 2011. A structured questionnaire was administered to 143 volunteers (48 male, 95 female) screened for participation in a clinical study of an investigational functional food with potential anthelminthic properties. Answers regarding their decision to participate in the study were compared, by gender, using chi-square and Mann Whitney tests. Odds ratios (OR) was used to measure association. Results A majority of subjects (58% of males, 59% of females) listed the desire to collaborate with the development of a product against parasitic worms as their main reason for participation. Females were significantly more likely to report a decision influenced by friends, family, or researchers (OR 3.14, 3.45, and 3.46 respectively, p

INTRODUCTION: The aim of this study was to evaluate the effect of health education in learning and cognitive development of children infected, previously treated in an endemic area for helminthiasis. METHODS: It is a longitudinal, experimental, with random allocation of participants. The study included 87 children of both sexes enrolled in the school hall of Maranhão, State of Minas Gerais, Brazil, and divided into two groups: intervention and control. Initially the children were submitted to the parasitological fecal examination for infection diagnosis and, when positive, they were treated. For the data collection, a structured questionnaire and the psychological tests Raven, Wisc-III and DAP III were applied, before and after the educational intervention. For the group comparison, the Mann Whitney test was used, and established significance level of 5%. RESULTS: It was found that previously infected children who received the educational intervention, children showed higher performance than the control group in strutured questionnaire (p

Background Obtaining informed consent for clinical trials is especially challenging when working in rural, resource-limited areas, where there are often high levels of illiteracy and lack of experience with clinical research. Such an area, a remote field site in the northeastern part of the state of Minas Gerais, Brazil, is currently being prepared for clinical trials of experimental hookworm vaccines. This study was conducted to assess whether special educational tools can be developed to increase the knowledge and comprehension of potential clinical trial participants and thereby enable them to make truly informed decisions to participate in such research. Methodology/Principal Findings An informational video was produced to explain the work of the research team and the first planned hookworm vaccine trial, using a pedagogical method based on analogies. Seventy-two adults living in a rural community of Minas Gerais were administered a structured questionnaire that assessed their knowledge of hookworm, of research and of the planned hookworm vaccine trial, as well as their attitudes and perceptions about the researchers and participation in future vaccine trials. The questionnaire was administered before being shown the educational video and two months after and the results compared. After viewing the video, significant improvements in knowledge related to hookworm infection and its health impact were observed: using a composite score combining related questions for which correct answers were assigned a value of 1 and incorrect answers a value of 0, participants had a mean score of 0.76 post-video compared to 0.68 pre-video (p = 0.0001). Similar improvements were seen in understanding the purpose of vaccination and the possible adverse effects of an experimental vaccine. Although 100% of participants expressed a positive opinion of the researchers even before viewing the film and over 90% said that they would participate in a hookworm vaccine trial, an increase in the number who expressed fear of being vaccinated with a novel vaccine was seen after viewing the video (51.4% post-video versus 29.2% pre-video). Increases were also seen in the proportion who thought that participation in a vaccine trial would be inconvenient or disrupt their daily activities. Conclusions/Significance Even in rural, resource-limited populations, educational tools can be specially designed that significantly improve understanding and therefore the likelihood of obtaining truly informed consent for participation in clinical research. The observed changes in the knowledge and perceptions of the research participants about hookworm infection and the experimental hookworm vaccine demonstrate that the video intervention was successful in increasing understanding and that the subjects acquired knowledge pertinent to the planned research., Author Summary Conducting clinical trials of new vaccines in rural, resource-limited areas can be challenging since the people living in these areas often have high levels of illiteracy, little experience with clinical research, and limited access to routine health care. Especially difficult is obtaining informed consent for participation in this type of research and ensuring that potential participants adequately understand the potential risks and benefits of participation. The researchers have been preparing a remote field site in the northeastern part of the state of Minas Gerais, Brazil, for clinical trials of experimental hookworm vaccines. A special educational video was designed based on the method of analogies to introduce new scientific concepts related to the researchers' work and to improve knowledge of hookworm, a disease that is highly prevalent in their community. A questionnaire was administered both before and after the video was shown to a group of adults at the field site, which demonstrated the effectiveness of the video in disseminating knowledge about hookworm infection and about the vaccine being developed. Therefore, even in a rural, resource-limited area, educational tools can be specially designed that significantly improve understanding and therefore the likelihood of obtaining truly informed consent for participation in clinical research.

This article examines changing common knowledge of elementary school children to scientific knowledge related to the relationship between water characteristics and the transmission of schistosomiasis through health education. A review of the literature and two case studies from rural elementary schools in Brazil show how the prevailing concept of dirty and polluted water, which has operated as an epistemological obstacle for acquiring scientific knowledge, may be related to symbolic thought and cultural parameters. Through an educational intervention not commonly applied to health programs involving elementary school students in two schistosomiasis-endemic rural communities in Brazil this paper describes the difficulties researchers encountered in changing the prevailing perception that very dirty and polluted water provides optimal conditions for schistosome transmission, to the scientifically accepted view that transmission occurs most often in visually clean, although fecally contaminated water. This conceptual difficulty may be largely explained in terms of the symbolism involved in clean and dirty water and the life-giving quality of water. Based on our results, we recommend that knowledge about water-related beliefs and concepts among school children should be considered in school-based health education programs in areas of endemic schistosomiasis and possibly other intestinal infections.

The objective of this study was to analyse the effect of using two health education approaches on knowledge of transmission and prevention of schistosomiasis of school children living in a rural endemic area in the state of Minas Gerais, Brazil. The 87 children participating in the study were divided into three groups based on gender, age and presence or absence of Schistosoma mansoni infection. In the first group the social representation model and illness experience was used. In the second group, we used the cognitive model based on the transmission of information. The third group, the control group, did not receive any information related to schistosomiasis. Ten meetings were held with all three groups that received a pre-test prior to the beginning of the educational intervention and a post-test after the completion of the program. The results showed that knowledge levels in Group 1 increased significantly during the program in regard to transmission (p = 0.038) and prevention (p = 0.001) of schistosomiasis. Groups 2 and 3 did not show significant increase in knowledge between the two tests. These results indicate that health education models need to consider social representation and illness experience besides scientific knowledge in order to increase knowledge of schistosomiasis transmission and prevention.

A study to determine the sociocultural factors influencing knowledge, attitudes, and practices of individuals from a small community toward Schistosoma mansoni infection was carried out in an endemic area in the State of Minas Gerais, Brazil. The study used qualitative approaches to collect data from school-aged children and teachers. Specific findings were that the individuals interviewed were aware of the disease, but also held inaccurate popular beliefs about transmission. Misconceptions coexisted with accurate knowledge both in children and teachers. The disease was not seen as a major health problem and did not affect their activities since it did not cause severe symptoms in most of the individuals. Although the majority of the participants related transmission to water and lack of sanitation, they did not take any preventive measures since their subsistence is highly dependent on irrigation, farming, fishing, and other essential work that is directly related to water activities. The authors discuss the development of a health education program based on the knowledge and perception of individuals about the disease and its determinants as being important for the context and behavioral change. Este estudo foi realizado em área endêmica do Estado de Minas Gerais, Brasil, com o objetivo de determinar os fatores sócio-culturais que influenciam o conhecimento, as atitudes e práticas dos indivíduos da comunidade em relação a esquistossomose mansoni. Os resultados mostraram que tanto crianças quanto professores conhecem a doença e possuem concepções corretas e incorretas sobre a transmissão. A doença não é vista como um problema importante de saúde pública e não afeta as atividades pelo fato de não causar sintomas graves na maior parte da população. Apesar da maioria dos entrevistados relacionar a transmissão da doença à água e falta de saneamento básico, não utiliza nenhuma medida preventiva para evitar a infecção, tendo em vista que sua subsistência depende em grande parte da agricultura, pesca e outras atividades relacionadas à água. Neste trabalho, os autores discutem o desenvolvimento de um programa de educação em saúde baseado na percepção e conhecimento dos indivíduos sobre a doença e seus determinantes como sendo de utilidade para a modificação não só do seu comportamento mas também do contexto.