Intervenção educativa para prevenção e controle da Covid-19 com adolescentes em situação de acolhimento à luz do modelo transteórico: estudo quase experimental

Abstract

Educational interventions, when appropriate to the reality of the adolescent, favor the construction of knowledge and the reduction of the vulnerabilities observed, demonstrating adequacy to health promotion actions. The transtheoretical model (TTM) can be seen as a promising theoretical framework to promote behavior change. The study aimed to analyze the effect of an educational intervention on the behavior change of adolescents in foster care for adherence to COVID-19 prevention and control measures, in the light of MTT. This is a quasi-experimental study, of the before-after type, carried out in four shelters linked to the Municipality of Fortaleza-Ceará. The initial population of the study consisted of 65 adolescents. However, in view of the losses that occurred along the way, a total of 37 (57.0%) were effectively worked. The study was conducted in July 2023. The data were entered into an Excel database (Microssoft Office), and then exported to the Statistical Package for the Social Sciences (SPSS), version 25, for analysis. Statistical measures frequency, mean and standard deviation were calculated. For the analysis of associations between the independent variables and the outcome, the McNemar test was used, onsidering a significance level of 0.05. The research was submitted to the Research Ethics Committee of the Federal University of Ceará, and was approved under number: 6.066.807 (68410923.8.0000.5054). The sociodemographic characterization showed that 22 (59.5%) are men; 16 (43.3%) were in the age group between 14 and 15 years, with a mean age of 14.7 years; 19 (51.4%) consider themselves to be brown; 29 (78.4%) were heterosexual; 17 (45.9%) had no religion; 17 (45.9%) had been schooling for 7-9 years, with a mean of 8.1 years; and 24 (64.9%) were without a partner. The clinical characterization showed that 29 (78.4%) did not have COVID-19. However, of the eight (21.6%) who were affected by the disease, two (5.4%) needed to be hospitalized; and six (16.2%) had sequelae/complications of the "shortness of breath" type. Among the four shelters visited, 16 (43.2%) adolescents had been in foster care between 1 and 4 years, with an average of 3.6 years; 20 (54.1%) were in the shelter 1 to 2 times; and, 11 (29.7%) were admitted to the shelter, mainly due to family instability and contact with drugs, among other reasons. The adolescents were in the "maintenance stage" in relation to adherence to all COVID-19 prevention and control measures, both before and after the educational intervention. When comparing the stages of behavior change for adherence to COVID-19 prevention and control measures, before and after the educational intervention, it was found that there was no effect. However, there was an improvement in adherence of 17.8% and 8.1% to physical distancing; and hand hygiene, respectively; a worsening of 2.7% and 5.4% in relation to adherence to respiratory etiquette and vaccination, respectively; maintaining the same percentage in relation to the use of masks. It is concluded that the educational intervention did not influence the change in behavior of adolescents in foster care to adhere to COVID-19 prevention and control measures, in the light of the MTT, but it raised reflections that implied in the improvement of the practice of some measures and the maintenance of others.