Effect of using an interactive booklet about childhood respiratory tract infections in primary care consultations on reconsulting and antibiotic prescribing: a cluster randomised controlled trial Infection prevention at day-care centres: Feasibility and possible effects of intervention The impact of fever health education on clinic utilization. Management of minor illness. The effect of educational program on knowledge, attitude and practice of mothers regarding prevention of febrile seizure in children More physician consultations and antibiotic prescriptions in families with high concern about infectious illness--adequate response to infection-prone child or self-fulfilling prophecy? Effect of a URI-Related Educational Intervention in Early Head Start on ED Visits Mothers' benefit of a self-care booklet and a self-care educational session at child health centres. Minor illness education for parents of young children. Fever therapy: an educational intervention for parents. The prevalence of symptoms and consultations in pre-school children in the Avon Longitudinal Study of Parents and Children (ALSPAC): a prospective cohort study. Respiratory illness in children: what makes parents decide to consult? Development and randomized controlled trial of a booklet of advice for parents.
Objective To establish whether an interactive booklet on  respiratory tract infections in children reduces reconsultation for the same illness episode , reduces antibiotic use , and affects future consulting intentions , while maintaining parental satisfaction with care . Design Pragmatic cluster r and omised controlled trial . Setting 61 general practice s in Wales and Engl and . Participants 558 children ( 6 months to 14 years ) presenting to primary care with an acute respiratory tract infection ( 7 days or less ) . Children with suspected pneumonia , asthma or a serious concomitant illness , or needing immediate hospital admission were excluded . Three withdrew and 27 were lost to follow-up , leaving 528 ( 94.6 % ) with main outcome data . Interventions Clinicians in the intervention group were trained in the use of an interactive booklet on respiratory tract infections and asked to use the booklet during consultations with recruited patients ( and provide it as a take home re source ) . Clinicians in the control group conducted their consultations as usual . Main outcome measures The proportion of children who attended a face-to-face consultation about the same illness during the two week follow-up period . Secondary outcomes included antibiotic prescribing , antibiotic consumption , future consulting intentions , and parental satisfaction , reassurance , and enablement . Results Reconsultation occurred in 12.9 % of children in the intervention group and 16.2 % in the control group ( absolute risk reduction 3.3 % , 95 % confidence interval −2.7 % to 9.3 % , P=0.29 ) . Using multilevel modelling ( at the practice and individual level ) to account for clustering , no significant difference in reconsulting was noted ( odds ratio 0.75 ; 0.41 to 1.38 ) . Antibiotics were prescribed at the index consultation to 19.5 % of children in the intervention group and 40.8 % of children in the control group ( absolute risk reduction 21.3 % , 95 % confidence interval 13.7 to 28.9 ) , P<0.001 ) . A significant difference was still present after adjusting for clustering ( odds ratio 0.29 ; 0.14 to 0.60 ) . There was also a significant difference in the proportion of parents who said they would consult in the future if their child developed a similar illness ( odds ratio 0.34 ; 0.20 to 0.57 ) . Satisfaction , reassurance , and parental enablement scores were not significantly different between the two groups . Conclusions Use of a booklet on respiratory tract infections in children within primary care consultations led to important reductions in antibiotic prescribing and reduced intention to consult without reducing satisfaction with care . Trial registration Current Controlled Trials IS RCT Objective . To study the effect of an educationally oriented intervention programme , with the recommendations from the National Board of Health and Welfare as a base . Design . A prospect i ve intervention study . Setting . Six day-care centres in Växjö , Sweden . Three centres comprised the  intervention group and three constituted the control group .  Subjects and main outcome measures . The parents and personnel completed a question naire on their views concerning information about infectious diseases . During a nine-month period , parents of all children reported every episode of absence , the number of days absent , the cause of absence , and any contact with doctors or prescription of antibiotics . Results . The guidelines were implementable in routine child day-care . Parents found regular information valuable and felt better informed about infectious diseases . Multilevel analyses showed no statistically significant results of the intervention . “ Infection-prone ” children had more sickness absence , doctor 's consultations , and antibiotic prescriptions than those not “ infection-prone ” . Conclusion . It is possible to implement an educationally oriented intervention programme directed against infectious diseases in child day-care . No significant effect of the intervention was found , which is why a larger intervention study is needed We evaluated the ability of an office health education program to ( 1 ) increase  parental knowledge about fever in children , ( 2 ) improve parental satisfaction with services , and ( 3 ) affect the number of fever-associated clinic visits .  R and omly selected experimental and control groups differed only in that the former group viewed a slide-tape presentation . Testing of population sample s before and after the presentation disclosed a highly significant improvement in knowledge about fever in the experimental population that persisted for almost 6 months . Monitoring of subsequent clinic visits revealed a 30 % to 35 % decrease in visits for fever and a 20 % to 25 % decrease in all visits for acute problems . These findings suggest that an audiovisual health education intervention can significantly improve patient confidence in managing fever as reflected by decreased clinic visits . This program is potentially useful in both the office and clinic in a health maintenance organization setting Department of Health and Social Security . Report on confidential enquiries into maternal deaths in Engl and and Wales 1973 - 5 . London : HMSO , 1979 . ( Reports on health and social subjects No 14 . ) 2 Ministry of Health . Report on confidential enquiries into maternal deaths in Engl and and Wales 1961 - 3 . London : HMSO , 1966 . ( Reports on public health and medical subjects No 115 . ) 3 And erson JR . Too few necropsies . Br MedJ3 1979 ; ii : 932 . 4 Cameron HM , McGoogan E , Clark J , Wilson BA . Trends in hospital necropsy rates in Scotl and 1961 - 74 . Br MedJ 1977;i:1577 - 80 . 5 Editorial . Reviving the hospital necropsy . Br MedJ3 1977;i:1560 . 6 Sheehan HL . Post-partum necrosis of the anterior pituitary . 3rournal of Pathology and Bacteriology 1937;45:189 - 214 . 7 Robertson WB , Brosens I , Dixon HG . The pathological response of the vessels of the placental bed to hypertensive pregnancy . Journal of Pathology and Bacteriology 1967;93 : 581 - 92 . 8 Whittington RM , Robinson JS , Thompson JM . Fatal aspiration ( Mendelson 's ) syndrome despite antacids and cricoid pressure . Lancet 1979 ; ii : 228 - 30 . 9 Claireaux A. Stillbirths and first week deaths . In : British births 1970 . Vol I. The first week of life . London : Heinemann , 1975 . 10 McWeeny PM , Emery JL . Unexpected postnatal deaths ( cot deaths ) due to recognizable disease . Arch Dis Child 1975;50:191 - 6 Background : Febrile convulsion is one of the most common problems in children aged 5 months to 6 years . The aim of this study was to explore the effectiveness of an educational program on mothers  for prevention of febrile seizure in children . Material s and Methods : In this clinical trial study , 88 mothers were chosen who were divided into intervention and control groups , r and omly . Data of the control and intervention groups were collected in two stages , before intervention and 1 month after intervention , by a vali date d and reliable question naire . The intervention consisted of three educational sessions , each one lasting for 60 min . Data were analyzed using chi-square , t-test and paired t-test . Findings : Age average of subjects in the intervention group and in the control group was 26.75 and 26.84 years , respectively . The results showed a significant increase in the knowledge ( P < 0.001 ) , attitude ( P = 0.04 ) and practice ( P = 0.01 ) in the intervention group 1 month after intervention compared with that before intervention , while such an increase was not seen in the control group . Conclusion : This study confirmed the efficiency of educational interventions in improving mother 's knowledge , attitude and practice regarding prevention of febrile seizure in children BACKGROUND Respiratory tract infections ( RTI ) in children is the most common cause of prescription of antibiotics . It is important to describe and analyse non-medical factors in order to develop more rational use of antibiotics . OBJECTIVES To compare families with high and low concern about infectious illness with regard to social variables , perception of infection proneness and beliefs in antibiotics  and to relate the concern for infectious illness to reported morbidity , physician consultations and antibiotic prescriptions for the 18-month-old child in the family . METHODS A prospect i ve , population -based survey was performed . During 1 month , all infectious symptoms , physician consultations and antibiotic treatments for 18-month-old children were noted . The 818 families also answered questions about their socio-economic situation , illness perception and concern about infectious illness . RESULTS High concern about infectious illness was associated with more frequent physicians consultations and more prescriptions of antibiotics . There was no significant difference in reported days with symptoms of RTI , but the parents more often experienced their children with RTI without fever as being ill . The variables of infection proneness in the child , inadequate beliefs in antibiotics and the factor of being the only child were important explanatory factors for concern about infectious illness . CONCLUSIONS High concern about infectious illness is an important determining factor for physician consultations and antibiotic prescription for small children . An adequate consultation , where the doctor deals with the parents ' worries and gives appropriate information about symptoms and disease , might contribute to less antibiotic prescribing with preserved parental satisfaction OBJECTIVES : To evaluate the effectiveness of an educational intervention to decrease pediatric emergency department ( PED ) visits and adverse care practice s for upper respiratory infections ( URI ) among predominantly Latino Early Head Start ( EHS ) families . METHODS : Four EHS sites in New York City were r and omized . Families at intervention sites received 3 1.5-hour education modules in their EHS parent-child group focusing on URIs , over-the-counter medications , and medication management . St and ard curriculum families received the st and ard EHS curriculum , which did not include URI education . During weekly telephone calls for 5 months , families reported URI in family members , care sought , and medications given . Pre- and post-intervention knowledge-attitude surveys were also conducted . Outcomes were compared between groups . RESULTS : There were 154 families who participated ( 76 intervention , 78 st and ard curriculum ) including 197 children < 4 years old . Families were primarily Latino and Spanish-speaking . Intervention families were significantly less likely to visit the PED when their young child ( age 6 to < 48 months ) was ill ( 8.2 % vs 15.7 % ; P = .025 ) . The difference remained significant on the family level ( P = .03 ) . These families were also less likely to use an inappropriate over-the-counter medication for their < 2-year-old child ( odds ratio , 0.29 ; 95 % confidence interval , 0.09–0.95 ; 12.2 % vs 32.4 % , P = .034 ) and /or incorrect dosing tool for their < 4-year-old child ( odds ratio , 0.24 ; 95 % confidence interval , 0.08–0.74 ; 9.8 % vs 31.1 % ; P < .01 ) . The mean difference in Knowledge-Attitude scores for intervention families was higher . CONCLUSIONS : A URI health literacy-related educational intervention embedded into EHS decreased PED visits and adverse care practice Mothers ' benefit of a mass-distributed self-care booklet and a self-care educational session about young children 's minor illnesses were investigated . The following questions were studied : ( 1 ) Do mothers of infants read and benefit from a self-care booklet ? ( 2 ) Is the mothers ' knowledge about self-care improved more if the booklet is supplemented by a self-care educational session ? 265 ( 92 % ) of 288 r and omly sample d Swedish mothers whose first child was 6 - 12 months of age were interviewed regarding their knowledge about self-care . Shortly thereafter a self-care booklet was mailed to all households in Uppsala county and 6.5 months later a new group of 572 mothers was r and omly sample d. Among the 572 mothers , 332 ( 58 % ) were r and omized to a self-care session organized at child health centres and 240 ( 42 % ) were not invited to a session . Of the 572 mothers , 530 ( 93 % ) were later interviewed about the booklet , the session and their knowledge about self-care . 69 % participated among the mothers r and omized to the session . Among these mothers , 99 % recalled the booklet and 96 % had read the child care section . Among the mothers not invited to the session , 68 % recalled the booklet and 60 % had read the child care section . The mothers who had read the child care section would follow the recommendations about when to seek ( and not to seek ) medical care significantly better than those who had not read it ( P less than 0.003 ) . ( ABSTRACT TRUNCATED AT 250 WORDS BACKGROUND A number of previous studies on minor illness have concentrated on nurse-led clinics and the role of nurse practitioners . This study examines the effect of a minor illness education programme which aim ed to increase  parents ' confidence and knowledge in managing childhood illnesses . AIM The primary aim of this study was to evaluate the effectiveness of a home visit and booklet in providing education to parents about minor infant illnesses . DESIGN A r and omized controlled trial was conducted . The intervention involved a home visit to discuss parents ' concerns and provide advice and information , and a booklet advising parents what to do and when to consult about infant illnesses . METHOD A total of 120 parents of 6 week old babies were identified over a 6 month period , using health visitors ' caseloads , and r and omized to an intervention group ( 60 ) , that received a visit and a booklet , or a control group ( 60 ) that received st and ard care .  Groups were compared on entry to the study and at 7 months , in terms of parental knowledge and confidence about childhood illnesses , the intended use of home care activities , intention to consult professionals and actual use of health services . Data were collected by self-completed question naire and case note review . FINDINGS The educational intervention result ed in a reduction in visits to the child health clinic but had little effect on use of other services . Parents in the intervention group showed a general trend towards greater certainty about the home care options they would choose , and a reduction in intention to consult a doctor . However , they also indicated a feeling of reduced confidence and knowledge . CONCLUSION The trial showed no effect on use of services but did demonstrate reduction in parents ' intentions to consult a doctor , which appeared to be because of increased certainty about home care . However , it is of concern that they indicated feeling less confident and knowledgeable . It is not possible to clarify whether this represented anxiety that was constructive , enhancing decision-making or was destructive . Further work into the role of education in parental decision-making , anxiety levels and enhancement of confidence is required Fever in children is a common problem , but one which often alarms parents . Parental misconceptions often lead them to unnecessarily aggressive and inappropriate management of fever in their children . A prospect i ve controlled trial of an educational intervention to improve parental underst and ing and management of fever , involving the parents of 108 children , aged 6 months to 4 years , was performed in a private group practice . Although the majority of these patients were well educated , most were found to be misinformed about many aspects of the seriousness of fever and its management . Parents in the intervention group received a st and ardized interview in which the management of fever was discussed , demonstrated , and practice d. In addition , they received a printed information sheet for reinforcement 2 months after the initial interview . Parents in both the control group and intervention group revealed an increase in knowledge about fever over time , but only in the intervention group were inappropriate physician contacts and medication errors reduced . The effectiveness of an active learning approach to anticipatory guidance for the management of transient febrile illness was documented and it is suggested that extension of this approach to other common problems in the private practice setting be examined BACKGROUND Pre-school children are frequent users of health services , but little contemporary data are available describing their symptoms or why they consult . OBJECTIVE To describe symptom and consultation prevalence in pre-school children and to identify the socio-demographic factor or factors associated with consultations for those symptoms . METHODS Prospect i ve cohort study of 13,617 pre-school children living in south-west Engl and . Parents completed question naires asking about symptoms and consultations for those symptoms at six , 18 , 30 , 42 and 57 months . RESULTS During the pre-school years , all children experienced one or more symptoms , most commonly cold , cough , high temperature , vomiting or diarrhoea . Ninety seven percent consulted a doctor at least once , most commonly for cough , high fever and /or earache . Lower parity was most strongly and consistently associated with higher consultation rates . CONCLUSIONS Fever , respiratory and gastro-intestinal symptoms are a normal part of pre-school life . Research of acute conditions in young children could focus on the most common symptoms leading to consultation , namely cough , fever and earache . Efforts to support parents ' help seeking decision making might usefully be targeted at first time parents Parents of a stratified r and om sample of 234 children from 21 training practice s in north east Engl and were interviewed at home . All these children had been reported in a postal question naire as having had a cough between six and 10 weeks before the interview . Interviews covered social characteristics of the family , the severity of the child 's cough and the child 's previous respiratory history . These data were analysed using the statistical technique of logistic regression . This produced a good model of consulting behaviour . The model showed that a doctor was likely to be consulted if the child had severe symptoms , or if the cough affected the child 's behaviour . This suggests that most parents deciding whether to consult the doctor make careful decisions based on what they see as objective criteria . No social characteristic had a significant influence on the decision to consult the doctor over and above the influence of the characteristics and effect of the cough itself A booklet was developed in the author 's practice that provided advice for parents on the home management of cough , fever , sore throat , diarrhoea and vomiting in children , and included specific recommendations about when to seek medical help . The effect of distributing this booklet on the frequency of parent-initiated consultations was evaluated in a r and omized , controlled trial . The overall effect of the booklet was a statistically non-significant reduction in consultations for the symptoms that it addressed ( ' booklet symptoms ' ) . However , this finding masked a statistically significant reduction in daytime home visits for booklet symptoms ( especially for cough , fever and sore throat ) and a significant increase in out of hours consultations ( for fever , diarrhoea and vomiting ) . Had all the households in the practice been sent a copy of the booklet then it was estimated that over the following year some 28 % fewer home visits and some 173 % more out of hours consultations would have been undertaken for booklet symptoms than if none of the households had been sent a copy
Background Fever is common in preschool children and is often caused by benign self-limiting infections .
Parents ' lack of knowledge and fever phobia leads to high healthcare consumption .
Objective To systematic ally review the effect of providing educational interventions about childhood fever and common infections in well-child clinics ( WCCs ) , prior to illness episodes , on parental practice s : healthcare-seeking behaviour ( frequency of physician consultations , appropriateness of consultations ) and medication management .