Rheumatic fever in Samoa: education as prevention.

The incidence of acute rheumatic fever (ARF) and its sequela rheumatic heart disease (RHO) is disproportionately high among the children of Western Samoa. Basic symptoms of ARF include fever, joint pain, and a sore throat. The condition of strep throat, if left untreated, may initiate an immune response which can damage the heart and become RHD. Primary prevention currently consists of educating locally trained nurses to detect strep throat and dispense antibiotics as necessary. The concept of targeting proximal caregivers with prevention information has not been explored. Health behavior theories offer methodology for the development, implementation, and evaluation of health promotion programs. This study incorporates the interpersonal level of the ecological model (EM) in conjunction with the four elements of the social change model (SCM) which are critical thinking, fundamental skills, cultural sensitivity, and action. The purpose of this study was to test the hypothesis that an educational prevention program can be effective in disseminating pertinent information regarding ARF prevention. This study followed a matched-pairs, same subject design, using a pre-/post-survey as the observational tool in which to measure the effectiveness of the presentation. The question that targeted trust of health care workers showed a statistically significant increase (p = < .0001) from approximately 50% in the pre-survey to 73% in the post-survey. The question regarding antibiotic treatment was slightly significant for the pre-survey (p = 0.0428), but showed increased statistical significance for the post-survey (p -< 0.0001). Responses targeting the contagious factor changed in significance between the pre- and post-survey from p = .009 to p = < .001. The response change for the question targeting the possibility of a child contracting a sore throat as school changed from p = .0123 to p = < < .0001. These findings support the use of a basic and inexpensive educational prevention program.