“A STUDY TO EVALUATE THE EFFECTIVENESS OF

STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE

REGARDING HEALTH PROMOTIVE SERVICES AMONG
PRIMARY SCHOOL TEACHERS IN A SELECTED SCHOOLS,
BENGALURU”

By

SHYNY S NAIR

Dissertation Submitted to the

Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka

In partial fulfillment of the requirements for the degree of

Master of Science
In
Community Health Nursing

Under the Guidance of

Prof. MUDHALIYAPPAN .R .MSc. (N)
Department of Community Health Nursing
Brite College of Nursing
Bengaluru
2013

i
 Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka

DECLARATION BY THE CANDIDATE

I hereby declare that this dissertation/thesis entitled “A STUDY TO EVALUATE

THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON
KNOWLEDGE REGARDING HEALTH PROMOTIVE SERVICES AMONG PRIMARY
SCHOOL TEACHERS IN A SELECTED SCHOOLS, BENGALURU.” is a bonafide and
genuine research work carried out by me under the guidance of Prof.
MUDHALIYAPPAN.R. M,Sc (N) HOD , Department of Community Health Nursing ,
Brite College of Nursing,Bengaluru.

Date : Ms. Shyny S Nair

Place : Bengaluru

ii
 CERTIFICATE BY THE GUIDE

This is to certify that the dissertation “A STUDY TO EVALUATE THE

EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE

REGARDING HEALTH PROMOTIVE SERVICES AMONG PRIMARY SCHOOL

TEACHERS IN A SELECTED SCHOOLS, BENGALURU” is a bonafide research work

done by Ms. Shyny S Nair in partial fulfilment of the requirement for the degree of Master of

Science in Community Health Nursing.

Date : Prof. Mr. Mudhaliyappan.R. M.Sc. (N),

Place : Bengaluru Head of the Department,

Department of Community Health Nursing,

Brite College of Nursing.

iii
 ENDORSEMENT BY THE HOD, PRINCIPAL / HEAD OF THE
INSTITUTION

This is to certify that the dissertation entitled “A STUDY TO EVALUATE THE

EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE

REGARDING HEALTH PROMOTIVE SERVICES AMONG PRIMARY SCHOOL

TEACHERS IN A SELECTED SCHOOLS, BENGALURU” is a bonafide research work

by Ms. Shyny S Nair under the guidance of Prof. Mudhaliyappan.R.

M,Sc (N), HOD, Department of Community Health Nursing, Brite College of Nursing.

Seal and Signature of the HOD Seal and Signature of the Principal

Prof. Mudhaliyappan.R. Prof. H.H. Dasegowdas,

Head of the Department, Principal,
Department of Community Health Nursing, Brite College of Nursing,
Brite College of Nursing, Bengaluru.
Bengaluru.

Date : Date :
Place : Bengaluru Place : Bengaluru

iv
 COPYRIGHT

DECLARATION BY THE CANDIDATE

I hereby declare that the Rajiv Gandhi University of Health Science, Karnataka shall have
the rights to preserve, use and disseminate this dissertation / thesis in print or electronic format
for academic / research purpose.

Date :

Place : Bengaluru Ms. Shyny S Nair

© Rajiv Gandhi University of Health Sciences, Bangalore Karnataka

v
 ACKNOWLEDGEMENT

“ I will extol thee , my God , O king ; and I will bless thy name forever and ever .
Everyday will I bless thee ; and I will praise thy name forever and ever”.
Psalms 145. Vs. 1-2

I hereby offer my heartfelt gratitude to the King of kings and the Lord of lords ,
the Almighty God who makes all things beautiful in His own time. His grace and
blessing was my strength throughout this study.

I extend my sincere thanks to Dr. Rajeev Kumar Rai, Chairman, AVK Group of
Institution, Bangaluru for their Constant Support.
My sincere thanks to Mr.Mathew Joseph, Director,Brite Group of Institution,

Bangaluru, and Mr.Shanthanu Kumar Rai, Administrator, Brite College of Nursing ,

Bangaluru, for all their valuable support.

I am deeply indebted to The Principal, Brite College of Nursing,

Prof.Dasegowdas for her valuable suggestions and support throughout my study.

This study has been completed under the guidance of Prof. Mudhaliyappan.R. M.Sc.
(N), Head of the Department, Community Health Nursing, Brite College of Nursing
Sciences. I express my sincere gratitude for the guidance, suggestions and
encouragement.

I also give thanks to Mrs.Shiline Kotian vice Principal, Brite College of Nursing,
Bangaluru for her valuable suggestions.

I am grateful to all the experts for their sincere efforts in validating my tool. I express my
sincere gratitude for their guidance and valuables suggestions.

vi
 My sincere thanks extended to Dr. K. P. Suresh, for their expert validation in the
statistical analysis procedures helped in great measure.

I acknowledge the positive response of the participants without whom this project would
have been next to nothing.

I have no words to pen the love, affection and inspiration by my loving parents. They
have expressed a true display of devotion. I owe a great deal to them.

I owe a great deal to my great friends and my lovely B.Sc, M.Sc. classmates, who were
a great help in making life a bit easier when one is strapped for time.

As a final note, my sincere thanks and gratitude to all those who directly or indirectly
helped in the successful completion of this thesis.

With a grateful heart...

Date : Ms. Shyny S Nair

Place : Bengaluru

vii
 LIST OF ABBREVATIONS USED

A.V.aids Audio visual aids

CF Cumulative Frequency

Dept. Department

df Degree of freedom

Fig Figure

HOD Head of the department

Min. Minute

N Number

Prof Professor

STP Structured teaching programme

SD Standard Deviation

Sl.No Serial number

USA United States of America

WHO World Health Organization

viii
 ABSTRACT

Background of the study

Decades of research has documented that promotive services has a crucial role in the
optimal growth, learning, and development of children from infancy through adolescence. Yet,
this need is being challenged, and so children are right to get all this services. The time has come
to advocate strongly in support of services for all children.
The aim of the study is “to assess the effectiveness of structured teaching programme on
knowledge regarding health promotive services among primary school teachers in a selected
schools, Bengaluru”.

Objectives of the study

1. To assess the pre existing knowledge among primary school teachers by pre test
Knowledge regarding health promotive services.

2. To assess the pre existing knowledge among primary school teachers by post test
Knowledge regarding health promotive services.

3. To evaluate the effectiveness of structured teaching programme among primary school

teachers by comparing pre and post test knowledge scores.

4. To find the association between pre test knowledge scores with selected demographic
variables.

Method
An evaluative approach with one group pre-test post-test design was used for the study.
The sample consisted of 50 school teachers, selected by non-probability convenient sampling
technique. Data was collected by structured knowledge questionnaire on health promotive
services. After collecting demographic data and conducting the pre-test, structured teaching
programme was given to the subjects. Seven days after structured teaching programme post-test
was conducted using the same structured knowledge questionnaire used for collecting the pre-
test. The collected data was analyzed by using descriptive and inferential statistics.

ix
Result
The result showed the significant difference suggesting that the STP was effective in
increasing the knowledge of the primary school teachers (t =29.67). The mean post-test
knowledge score was (24.18) higher than the mean pre-test knowledge scores (11.36). There was
no association between the pre-test knowledge scores and the selected demographic variables
like age, religion, educational level, experience, family income, type of family.
Interpretation and conclusion
The findings of the study showed that the knowledge of the school teachers was not
satisfactory before the introduction of structured teaching programme, and the structured
teaching programme helped them to learn more about health promotive services. The post-test
knowledge scores showed significant gain in knowledge. Hence the planed teaching programme
was an effective strategy for providing information and improving the knowledge of subjects.
Educating the primary school teachers will help them to improve the knowledge about health
promotive services and its importance in the life of their children.

Keywords
Effectiveness; structured teaching programme; health promotive services; Primary school
teachers.

x
 TABLE OF CONTENTS

Chapter
No. Title Page No.

1. Introduction 1-3

2. Objectives 4-12

3. Review of literature 13-21

4. Methodology 22-35

5. Results 36-61

6. Discussion 62-69

7. Conclusion 70-75

8. Summary 76-79

9. Bibliography 80-82

10. Annexures 83-121

xi
 LIST OF TABLES

Sl. Page
No Tables No

1 Frequency and percentage distribution of the characteristics 41

2 Distribution of pre-test knowledge score 48

3 Area wise pre-test mean knowledge score and percentage mean

50
knowledge score

4 Area wise post-test mean knowledge score and percentage mean

50
knowledge score

5 Frequency, cumulative frequency and percentage of pre-test and post-

52
test knowledge scores

6 Area-wise mean, standard deviation, and mean percentage of pre-test

54
and post test knowledge scores.

7 Area-wise mean percentage and mean gain and pre and post-test
56
knowledge scores

8 Mean, Mean difference and ‘t’ value of pre-test and post-test

58
knowledge score

9 Areawise mean percentage score, mean difference and ‘t’ value of

58
pre-test and post-test scores

10 Association between pre-test knowledge scores of school teachers

regarding health promotive services with selected demographic 59
variable

xii
 LIST OF FIGURES

Figure
No. Title Page No

1. Conceptual framework based on general system theory of 12

Von Bertalanffy’s

2. Pre test, post test research design 26

3. The schematic representation of the study design 28

4. Bar diagram showing distribution of samples in terms of age. 43

5. Bar diagram showing distribution of samples in terms of Sex 43

6. Bar diagram showing distribution of samples in terms of 44

religion

7. Cylindrical diagram showing distribution of samples in terms 44

of educational status

8. Doughnut diagram showing distribution of samples in terms 45

of experience

9. Bar diagram showing distribution of samples in terms of 46

monthly income.

10. Pie diagram showing distribution of samples in terms of 47

sources of information.

11. Bar diagram showing grading of pre-test and post-test 49

knowledge score

12. Ogive representing pre-test and post test knowledge scores 53

13. Bar diagram shows that distribution of mean percentage of 57

pre-test and post-test knowledge scores on health promotive
services

xiii
 LIST OF ANNEXURES

Annexure
No. Title Page No
1. Letter requesting permission to conduct pilot study 86

2. Letter granting permission to pilot study 87-89

3. Letter requesting permission to conduct Research study 90

4. Letter granting permission to conduct research work 91

5. Letter requesting consent of the subjects for the participation in 92

the study

6. Letter seeking consent to validate the research tool and health 93

education pamphlet.

7. Acceptance form for tool validation 94

8. List of Experts 95-96

9. Criteria checklist for validation of the tool 97

10. Criteria checklist for evaluation and validating lesson plan 98

11. Blue print of the knowledge questionnaire on health promotive 99

services

12. Description of tool (English) 100-108

13. Answer Key 109

14 Structured teaching programme on health promotive services 110-120

(English)

15 Statistical formulas used for analysis and interpretation 121

xiv
 1
Introduction

1
 1. INTRODUCTION

"Good health supports successful learning, successful learning supports health.

Education and health are inseparable. Worldwide as we promote health, we can see
our significant investment in education field the greatest benefits"

Health is a state of complete physical, mental, social and spiritual well being not
merely the absence of disease or infirmities by WHO. Health of the school children can
be ensured if all our school become health promoting school. In India , the school health
services started in 1909 as medical examination for school children. It is a highly
specialized service contributing to the process of eduction.1

The School Health Programme rolled out in the State from July ‘09 as a unique
joint venture of the Departments of Health, Education, Sports, Council and Local Self
Government aims to introduce a unique concept of a comprehensive Health card, the
‘School TC & Health Record’, for every student. The medical details and personal details
which have bearing upon the child’s health will be recorded in this Health Record named
“Minus 2 to Plus 2”. This Health Record will serve as a comprehensive document of each
student as the Transfer Certificate and Conduct Certificate are also incorporated into it.
Junior Public Health Nurses @ one for 2,500 students will be especially recruited and
specifically trained to attend to the health of the school goers. The benefits of the School
Health Programme will be extended to approximately 9.50 lakh students, both from
Government and aided sectors, in 992 schools across the State (one school representing
every Panchayat/ Municipality and 2-3 in the Corporation area) during the first phase.
Comprehensive health services including the services of specialist Doctors on fixed days
are planned as a part of this programme.2

The health of a nation means more than just the health of its population. It
concerns the planning for the health of its future population. Similarly, health status is not
just an assessment of a person at a point in time, but an ongoing and dynamic process.
Health of the future generations is primarily moulded by the quality of maternal health
and child health. Child health, in turn, is determined by various factors at home, school
and on the playground. Of these factors, most of an average child’s wakeful life is spent

2
in school and in academic activities, more than any other place. The school activities
expose the child to other children, and to public places, such as streets and buses. This
makes the child vulnerable to a set of medical issues, ranging from infectious diseases,
food poisoning, psycho-social issues and addictive behaviors, all of which are
preventable. School health service in India dates back to 1909, when for the first time,
medical examination of school children was carried out in Baroda City, Gujarat. After
independence, in the five year plans, many state governments have provided school
health and feeding programs to the students. But, efforts to improve school health have
not been up to our expectations. The reason may be due to the lack of initiative, resource
constrains and insufficient facilities. In Kerala, there was once a district school health
team comprising of doctors, nurses, attendants, and so on, under health services
department. Gradually the members of this team were redeployed for other duties and the
team became almost defunct.3

NEED FOR THE STUDY

"Children will master their experiences through continual play, which is

actually most intensive and fruitful learning in their whole life cycle"
(Frank, 1968)
The School Health Program is now being redesigned for more benefits for the
students, renovated according to the changed times and repackaged in a user friendly
manner. This fresh program is undertaken as a joint venture by the Health Services
Department, National Rural Health Mission and the Education Department.4
School health services are services from medical, teaching and other professionals
applied in or out of school to improve the health and well-being of children and in some
cases whole families. These services have been developed in different ways around the
globe but the fundamentals are constant: the early detection, correction, prevention or
amelioration of disease, disability and abuse from which school aged children can suffer.5
A study was conducted Knowledge and attitude of Jordanian school health
teachers with regards to emergency management of dental trauma, The purpose of this

3
study was to assess, by means of a self administered structured questionnaire, the level of
knowledge of school health teachers in northern Jordan with regards to the immediate
emergency management of dental trauma. The sample consisted of all school health
teachers in northern Jordan (220) who attended an oral health education course held by
the Jordanian dental association. Only 190 were included in the survey. Sixty-three
percent were females, 44% were in their twenties, and 43% in their forties. Their school
health teaching experience ranged from 1 to 7 years. Only 20% were officially trained in
school health. Less than half of the teachers received first aid training only once in their
teaching career, not necessarily as part of school health training. Only 10 teachers were
trained in dental first aid, and more than half had a previous experience with handling
dental trauma in children. Overall the teachers' knowledge with regards to the emergency
management of the trauma cases presented in the report was deficient. Chi-square test
showed that, the difference in their responses to the knowledge part of the questionnaire
was not statistically significant with regards to age, gender, years of teaching experience,
first aid training, or number of seen trauma cases. Generally, the attitude was positive,
most teachers wanting further education on the topic, however those who were trained in
first aid, thought they were able to give proper action when needed in cases of trauma (P
= 0.026). Most teachers were unsatisfied with their level of knowledge, and only 30%
knew of the availability of after hour emergency services for dental trauma. The present
report indicated the gross lack of knowledge among school health teachers with regards
to dental trauma emergency management. Educational programs to improve the
knowledge and awareness of this group of adults, who are usually the first line of advice
in case of dental trauma in schools, are mandatory. These programs should be properly
designed to insure that proper information is retained with a positive effect on attitude,
and self assessed competence.6

Above studies shows that there is close relation between teacher’s knowledge and
health promotive services and teachers are care givers of children in school settings. So
teachers should have adequate knowledge about relationship between health and health
promotive services of child and hence there is need to conduct a study and to share
information of health promotive services.

4
 2
Objectives

5
 2.OBJECTIVES

Objectives provide the investigator with some clear criteria against which the
proposed research method can be assessed. For the present study review of literature,
discussion with experts, and personal experience of the investigator gave a basis for the
selection of the problem.7
This chapter deals with statement of problem, objectives of the study and
conceptual framework.

Statement of the problem

“A study to evaluate the effectiveness of structured teaching programme on

knowledge regarding health promotive services among primary school teachers in a
selected schools, Bengaluru”

Objectives of the study

1. To assess the pre existing knowledge among primary school teachers. by pre-test
knowledge regarding health promotive services.

2. To assess the pre existing knowledge among primary school teachers. by post-
test knowledge regarding health promotive services.

3. To evaluate the effectiveness of structured teaching programme regarding health

promotive services among primary school teachers by comparing pre and post test
knowledge scores.

4. To find the association between pre test knowledge scores with selected
demographic variables.

Operational definitions

1. Effectiveness: In this effectiveness refers to the extent to which the structured teaching
program on health promotive services have achieved the desired effect in improving the
knowledge of school teachers as evidence by gain in post test score.

6
2. Planned teaching program: In this study it refers to systematically developed
instructional program designed for school teachers to provide information regarding
health promotive services.
3. School: In this study the school refers to the educational institution where group of
pupils pursue defined studies at defined levels, receive instruction from one or more
teachers.
4. Primary school teachers: In this study primary school teacher refers to person who
have completed teachers training course to teach children and are working in a selected
primary school.
5. School health services: In this study, school health services refers to a need based
comprehensive services rendered to pupils, teachers and other personal in the school to
promote and protect their health, prevention and control diseases.
6. Structured teaching programme: In this study structured teaching programme refers
to the systematically developed health educational programme, instructions and teaching
aids to provide the information about health promotion..

Assumption:

The investigator assumes that:

1. The teachers from selected school will have lack of knowledge regarding the
health promotive services.
2. Structured teaching programme will increase the primary school teachers
knowledge regarding health promotive services.

Delimitations:
The study will be delimited to:
1. The investigation is limited to a selected schools.
2. The study is delimited to the teachers of primary schools.
3. The teachers who are available at the time of data collection.

7
Hypothesis
H 1: There will be significant difference between pre test and post test knowledge
scores regarding health promotive services among primary school teachers.
H 2: There will be a significant association between pre test knowledge score and
selected demographic variables.

Conceptual framework
Every study has a framework. A clearly expressed framework is one indication of
a well developed study. Conceptual framework acts as a building block for the research
study. The overall purpose of framework is to make scientific findings meaningful and
generalized. It provides a certain framework of reference for clinical practice, research
and education. They also give direction for relevant question to practical problems.20
The present study aimed to evaluate the effectiveness of structured teaching
programme on knowledge regarding health promotive services among primary school
teachers in a selected schools.
The conceptual framework of this study was based on the General Systems
Theory developed by Von Bertalanffy with input, process, output and feedback in 1968.
According to systems theory a system is a group of elements, individuals and their
environment. An individual is capable of taking energy and information as input from the
environment and release them to the environment. This input, when processed, provides
an output and continues to be so, as long as these four parts keep interacting. If there is
change in any of the parts, there will be changes in all the parts. This system is cyclical in
nature that interacts with one another in order to achieve the goal. Feedback within the
system or from the environment provides the information, which helps the system to
determine whether it meets its goal.8
In this study, these concepts can be explained as follows.
Input: It refers to the process by which the system receives energy and information from
the environment. These inputs include 'learners' background, level of knowledge and
interest.7
In this study input refers to the teachers. The influencing demographic factors are
age, sex, religion, education work experience, monthly income, sources of knowledge

8
and assessment of existing knowledge by administering structured knowledge
questionnaire.
Process: It refers to the actions needed to accomplish the desired task, i.e. energy and
information for the maintenance of homeostasis of the system. Through dynamic
interaction with the environment, the system changes information indifferent forms such
as verbal and behavioral communication.7
In this study, process refers to the development and administration of structured
teaching programme. Following this, knowledge will be assessed again by using the same
structured knowledge questionnaire to know the gain.
Out put: output refers to the product of the process. After processing the input, the
system releases the energy and information to the environment as output.7
In the present study, output refers to the evaluation of the effectiveness of
structured teaching programme on health promotive services that may also be regarded as
the product of the process.
Feedback: Feedback refers to the process by which information is received at each stage
of the system and the feedback as input to guide/direct in its evaluation. It is the process
that provides information about the systemic output.20 Accordingly, the higher knowledge
scores obtained by the teachers in the post test indicate that the STP was effective in
increasing the knowledge of school teachers on health promotive services. Lower scores
indicate structured teaching programme was not effective in increasing their knowledge.
Hence, alternative measures should be taken to improve their knowledge.
Environment: The individuals are fixed constraint that may influence the effectiveness
of STP. In the present study, the environment may be considered as selected schools in
Bengaluru.

9
 3
Conceptual
Framework

10
 CONCEPTUAL FRAMEWORK

ENVIRONMENT

INPUT PROCESS OUTPUT

Gain in STP
Characteristics of school teachers  Assessment of knowledge effective
 Age existing knowledge scores
 Religion of school teachers
 Education by administering
 Work experience structured
 Monthly income knowledge
 Sources of information questionnaire
 Administration of No gain in STP not
STP knowledge effective
 Evaluation by post- scores
test after 7 days

Key:
STP : Structured teaching programme Feed-back
----- : Not included in the study

Figure 1: Conceptual framework based on general system theory of Von Bertalanffy’s for evaluating the
effectiveness of STP on health promotive services
11
 4
Review of Literature

12
 4. REVIEW OF LITERATURE

“Think about yourself in general including everything you are and

everything you do and say which of the following overall evaluations best describes

your feelings about yourself”.

(Walsh and Taylor, 1980).

Review of literature is an important step in the development of a research project.

Literature review refers to the activities involved in identifying and searching for
information on a topic, and developing a comprehensive picture of the state of the
knowledge on the topic.7
This chapter presents review of literature to the present study. A review is related
to research and theory on topic has become a standard and virtually an essential activity
of scientific research projects. Literature review is a critical summary of research on a
topic of interest often prepared to put a research problem in content or as the basis for an
implementation project.
In this study the literature reviewed is been presented under the following
heading.
 Review of literature related to health of school children.
 Review of literature related to health promotive services.

Review of literature related to health of school children.

A study was conducted Questionnaire for teachers changes the outcome of
school entrance medical examinations. The objective of the study is to evaluate the
impact of a teachers' questionnaire on the outcome of school entrance medical
examinations (SEMs). Method used is Retrospective audit. Routine SEMs in 17 primary
schools before and after the introduction of the questionnaire. Result found was Primary
outcome was teachers' concerns known to school doctors, which increased from 2% of
pupils to 27% (P < 0.001). Secondary outcome measures increased significantly: new
diagnoses made by school doctors (22-31%, P = 0.038) and follow-ups arranged (8-15%,
P = 0.034). Medical or educational intervention was required in 17% of pupils identified

13
by teachers' concerns over the subsequent 3 years. Used as an adjunct for selection for
SEMs, the questionnaire would have reduced the number of children with problems
overlooked by 60%.9

A study was conducted Knowledge and perception of professionals towards

school injuries. All physicians and nurses were included in this survey. In addition, a
teacher or a social worker was randomly selected from the same school. They were
requested to fill in a questionnaire to collect relevant information. Findings indicate that
school injury is not perceived as a priority problem by all social workers and 68.5% of
teachers. Moreover, its economic burden was not perceived by one third of physicians
and nurses. Regarding associated risk factors, more than 80% of the surveyed
professionals recognized nine out of the 16 stated factors as a risk for school injuries.
However, less than 80% viewed that the risk of school injury is higher in technical
schools, schools which include more than one educational stage as well as in the evening
shift. Moreover, less than 80% of nurses recognized that a higher risk is associated with
poorly kept school building, primary schools and methods of transportation. Furthermore,
less than 80% of teachers recognized that boys are at a much higher risk of injuries.
Surveyed professionals ranked increase supervision, continuous maintenance of school
building as well as health education activities as priority preventive strategies. Mass
media was the method of health education that received the highest priority while the
least were pupils' activities and the organization of an injury prevention day.10
A study was conducted School teachers can effectively manage primary
prevention of adult cardiovascular disease. To determine whether school teachers
educated about Primary Prevention of Adult Cardiovascular Disease (PPCVD) could help
their students improve their blood lipid profile. Five teachers voluntarily received training
about PP-CVD. Thirteen classes of a single high school in Stradella (north Italy) were
randomized to receive a 2-month course on PP-CVD (PP-classes; 150 pupils) by their
teachers or to a control group (control classes; 130 pupils) during 2004. In all students
body weight and fasting venous blood concentrations of total cholesterol (TC), HDL-
CHOL, LDL-CHOL, and triglycerides were determined before and 6 months after the
completion of the PP-CVD course. Six months after the PP-CVD course, males had
significant improvements of all baseline lipid parameters whereas females had improved
14
HDL-CHOL and TC/HDL ratio. No improvements were observed in the control class
students. Body weight was unchanged in both groups of students 6 months after the PP-
CVD course or the control course.11

A study was conducted Teaching school teachers to recognize respiratory distress

in asthmatic children. To demonstrate that school teachers can be taught to recognize
respiratory distress in asthmatic children. Forty-five school teachers received a one-hour
educational session on childhood asthma. Each education session consisted of two
portions, video footage of asthmatic children exhibiting respiratory distress and didactic.
Pre- and posttests on general asthma knowledge, signs of respiratory distress on video
footage and comfort level with asthma knowledge and medications were administered.
General asthma knowledge median scores increased significantly, pre = 60% correct, post
= 70% (p < 0.0001). The ability to visually recognize respiratory distress also
significantly improved (pre-median = 66.7% correct, post = 88.9% [p < 0.0001]).
Teachers' comfort level with asthma knowledge and medications improved.12

A study was conducted An oral health promotion program for the prevention of
complications following avulsion: the effect on knowledge of physical education
teachers. One hundred and twenty-six teachers completed the first questionnaire, 2
months before the seminar. One hundred teachers completed the second questionnaire 10
months after the seminar. Of these, 70 attended the seminar and 30 did not. Thirty-two
teachers who attended the seminar had completed both questionnaires. The percentage of
teachers who provided expected 'correct' answers in the first questionnaire (11% and
16%) was significantly lower than that in the second questionnaire (23% and 68%). The
percentage of teachers who provided correct answers in the second questionnaire among
those who attended the seminar (24% and 69%) was not significantly different from those
who did not attend the seminar (20% and 66%). An educational campaign in the
community with a seminar targeted towards a cohort of physical education teachers can
improve the knowledge of the teachers, even those who did not attend the seminar,
probably by means of a contamination effect. Despite the improvement, which was
found, the level of knowledge after the campaign remained low and more public health
promotion efforts are indicated.13
15
 A study was conducted an oral health education programme based on the National
Curriculum. The aim of this study was to develop and evaluate a teaching programme
based on the national curriculum for use in a primary school setting. National Curriculum
guidelines were combined with oral health education messages to draw up lesson plans
for teachers to deliver. A questionnaire was used to demonstrate children's oral health
knowledge prior to the teaching programme, and at 1 and 7 weeks following the
programme. The study took place in inner-city, state-run primary schools in Manchester
and North London, UK. The subjects were children between the ages of 7 and 8 years
from Manchester (n = 58) and North London (n = 30). The main outcome measure was
change in knowledge attributable to a newly developed teaching programme. The
children in Manchester had a higher level of knowledge prior to the teaching programme.
Following the teaching programme, children in both schools showed a significant
improvement in dental health knowledge (P < 0.001). Seven weeks later, the Manchester
children showed no significant loss of knowledge (P < 0.001).14

A study was conducted Effect of training programme on secondary schools

teachers' knowledge and attitude towards reproductive health education in rural schools
Ile-Ife, Nigeria. This study assessed the effect of training programme on teachers'
knowledge of and attitude towards reproductive health education /sexuality education
[RHE/SE] in five randomly selected rural schools in Ife-North local government area
[IFLGA], Southwest, Nigeria. All the 84 teachers in the selected schools in the LGA
were recruited for the study. They [84 teachers] were all given training in RHE/SE for
one month. Their knowledge and attitude towards RHE/SE were assessed pre-and post-
training programme. The results show a significant increase in percentage of those who
had good knowledge in general areas of RHE/SE at post-training assessment compared
with pre-training assessment[from 14.3% to 53.6%, p=0.0001].Also, pre-post attitudinal
disposition assessments show that there was an increase in percentage of those who were
favourably disposed to the teaching of RHE/SE in Nigeria Schools at post-training
assessment [from 17.9% to 45.2%, p=0.0011]. The study suggests that RHE/SE should be
included and made compulsory in all training programme for all teachers in Nigeria.15

16
 A study was conducted a pilot project testing the feasibility of schools adopting
and delivering healthy messages during the school day. Goal was to determine the
feasibility of school staff voluntarily adopting strategies to deliver health-promotion
messages to primary and middle school students during the school day. During the 2006-
2007 school year, we provided a resource kit with strategies for promoting physical
activity and healthy eating through use of the 5-2-1-0 message (encouraging > or =5
servings of fruits and vegetables daily, limiting screen time to < or =2 hours per day,
promoting > or =1 hour of physical activity daily, and avoiding sugar-sweetened
beverages) to 7 primary schools and 2 middle schools in southern Maine. Teachers and
administrators voluntarily implemented resource-kit strategies in classrooms and schools.
Eighty percent of the teachers who reported using the resource kit found it easy or
extremely easy to use. Ninety percent of the teachers reported that they would be willing
to continue implementing strategies in the future; of those who would not, a lack of time
was cited as the reason. All administrators reported that the project had been worthwhile
for their district. Parents were less aware of the message than teachers and administrators;
2 in 5 parents reported receiving educational handouts. Most students responded
positively to the messages.16

Review of literature related to health promotive services.

A study was conducted on School health services: parents' and teachers' opinions.
To study parents' and teachers' knowledge about the content of SHS, their use and
importance, and their preferred way of delivering these services. From December 2006 -
January 2007, teachers (n=304) of 2nd-12th-grade pupils and the pupils' parents (n=808)
in state schools of the Hebrew education system (both secular and religious) were
interviewed by phone. Parents were located by random dialing (response rate 63%), and
the teachers from a Ministry of Education list (response rate 70%). About 70% of
parents and teachers knew that SHS provide immunizations; 70% and 80% respectively,
reported they provided first aid. Only 8% of the parents and 13% of the teachers reported
that a nurse came at least three days a week to the school and most of them preferred that
the nurse should come every day. Most respondents said that the SHS did important
work. About a third of parents and 40% of teachers preferred that all health care services
17
be provided in the schools by doctor and nurse; 40% of parents and teachers wanted the
nurse to provide counseling and that the rest of SHS content be provided by the regular
primary health care providers; 20% of parents and 14% of teachers preferred other
options.17

A study was conducted Alcohol carousel and children's school drawings as part of
a communityeducational strategy. Within a community action research program,
messages for the community population can be conveyed through already existing
channels (newspapers, magazines, TV, radio) or special tools can be created. As part of
the Rifredi Health District (16,900 inhabitants), Florence, Italy, Community Alcohol
Action Research Project, 5,500 alcohol carousels (translated and adapted from the
Stockholm carousel) were distributed during 1996 in the project's area where they were
freely available. Two samples, one of a consumers' association (response rate 26%) and
the other of school parents, employed a questionnaire. A few local key people underwent
a qualitative interview. In all circumstances the carousel proved to be understandable,
useful, and able to elicit discussions about alcohol issues. In 1996-97, after a 2-year
training program in communication skills and alcohol prevention, 13 teachers in local
preschools, elementary schools, and middle schools planned and implemented a health
education program on the issues of alcohol and food. One outcome was nine drawings
produced by the school children. The drawings were exhibited in some schools and
supermarkets, and were hung in city buses.18

A study was conducted Knowledge and attitudes towards attention deficit

hyperactivity disorder among elementary school teachers. Attention deficit/hyperactivity
disorder (ADHD) is one of the most common psychiatric disorders in child and
adolescent psychiatry. ADHD children are at risk for academic and psychological
difficulties. One hundred and ninety six elementary school teachers in Shiraz, Iran,
anonymously completed a self-report questionnaire on ADHD. Knowledge about ADHD
was relatively low. 46.9% of respondents agreed that ADHD is due to biological and
genetic vulnerabilities and causation. 53.1%of all the teachers considered ADHD to be
the result of parental spoiling. The attitude score towards ADHD children was also low.
64.8% agree that the same disciplinary rules used for all students should also be applied
18
to ADHD children. 77.6% believe that ADHD students experience difficulties in their
relations with their classmates. There was a significant correlation between teachers'
knowledge of ADHD and their attitude. The main sources of knowledge about ADHD
were: Television and radio; friends and relatives; periodical, newspapers and
magazines.19

A study was conducted School climate and teachers' beliefs and attitudes
associated with implementation of the positive action program: a diffusion of innovations
model. Were specified in two cross-sectional mediation models of program
implementation. Implementation was defined as the amount of the programs' curriculum
delivered (e.g., lessons taught), and use of program-specific materials in the classroom
(e.g., ICU boxes and notes) and in relation to school-wide activities (e.g., participation in
assemblies). Teachers from 10 elementary schools completed year-end process evaluation
reports for year 2 (N = 171) and 3 (N = 191) of a multi-year trial. Classroom and school-
wide material usage were each favorably associated with the amount of the curriculum
delivered, which were associated with teachers' attitudes toward the program which, in
turn, were related to teachers' beliefs about SACD. These, in turn, were associated with
teachers' perceptions of school climate. Perceptions of school climate were indirectly
related to classroom material usage and both indirectly and directly related to the use of
school-wide activities.20

A study was conducted evaluating first-aid knowledge and attitudes of a sample

of Turkish primary school teachers. The goal of this study was to determine the
knowledge and attitudes of a sample of Turkish teachers regarding the administration of
first aid. Three hundred twelve teachers took part in this study to evaluate knowledge and
attitudes of teachers in primary schools about first aid. Data were obtained using a
questionnaire. It included 30 questions that help identify the teachers and determine their
knowledge and attitudes about first aid. Data were analyzed by chi-square test. In this
study, it was determined that most of the teachers do not have correct knowledge and
attitudes about first aid. For example, 65.1% of teachers gave incorrect answers regarding
epistaxis, 63.5% for bee stings, and 88.5% for abrasion. It was found out that as the age
of the teachers increases, appropriate first-aid practice becomes more and more
unlikely.21
19
 A study was conducted Students' special needs and problems as reasons for the
adaptation of substance abuse prevention curricula in the nation's middle schools. In this
study we estimate the proportion of the nation's middle school teachers who have adapted
substance abuse curricula in response to their students' special problems or needs. We
also explore a variety of characteristics associated with schools, teachers, and the
curricula implemented that are associated with adaptations made in response to the most
prevalent of these student problems or needs. Study data were collected in 1999 from a
representative sample of lead substance abuse prevention teachers in the nation's public
and private schools. We found that 79.8% of respondents report adapting their prevention
curricula in response to at least one of the dozen student problems and needs specified.
The problems cited most frequently, by slightly more than half of all respondents, relate
to the needs of students who are sexually active or have discipline problems. Associated
most strongly with adaptations for these two reasons were teachers who were recently
trained in their curricula, and substance abuse prevention lessons that could readily be
integrated into the school's overall curriculum. We discuss the need for curriculum
developers to recognize the frequency with which, and reasons for which, teachers are
adapting their curricula, and to include appropriate optional content that addresses
students' needs.22
A study was conducted Effects of a School-based Intervention Program for
Middle School Adolescent Girls with Depression: As Part of the School Health Services.
The purpose of this study was to evaluate the effects of a school-based intervention
program for middle school adolescent girls with depression. The study was a pretest-
posttest repeated-measure design with a nonequivalent control group. Fifty eight students
with depressive symptoms were recruited from two middle schools in Seoul, Korea. The
data were collected from the intervention (n=30) and the comparison group (n=28). The
research instrument was Reynolds Adolescent Depression Scale. The intervention group
greatly improved from baseline to 10 weeks and then saw a slight positive change
between 10 and 13 weeks. The results of this research show that depression intervention
programs are effective for young female adolescents. Thus the investigation has
important school-based treatment implications, and should be integrated into school
curriculums by school health nurses for early intervention of depressive symptoms in
middle school adolescent girls.23
20
 A study was conducted Presence of medical home and school attendance: an
analysis of the 2005-2006 national survey of children with special healthcare needs. The
purpose of this study was to examine the association between presence of medical home
and missed school days among CSHCN. A secondary analysis of cross-sectional data
from the 2005 National Survey of Children With Special Healthcare Needs (NS-CSHCN)
was conducted. Multivariate ordinal logistic regression was done to analyze the
relationship between presence of a medical home and number of missed school days. The
presence of a medical home among CSHCN was associated with being in the highest
category of missed school days. The adjusted odds ratios for the number of missed school
days, after adjustment for poverty, metropolitan statistical area status, education in the
household, age, race and ethnicity, demonstrated that access to a medical home does not
decrease school absences.24

21
 5
Research
Methodology

22
 5. METHODOLOGY

Research method refers to steps, procedures and strategies for gathering analyzing
data in a research involved. Research methodology is a way to systematically solve the
research problem. It is science of studying how research is done scientifically.7
This chapter describes the methodology adopted for evaluating the STP on health
promotive services. The methodology includes research approach, research design,
setting sample and sampling techniques, instrument for data collection and development
of teaching programme on health promotive services, pilot study and plan for data
analysis.
RESEARCH APPROACH:

An evaluative research is an applied form of research, that involves finding out

how well a programme, practice, procedure or policy is working. The main goal is to
evaluate the success of the programme.25
In the present study, the research aim is to determine the effectiveness of
structured teaching programme on knowledge regarding health promotive services among
primary school teachers in a selected schools using evaluative approach.
RESEARCH DESIGN:

A research design is the plan structure and strategy of investigations of answering

the research questions, is the overall plan of blue print, the researcher select to carry out
the study.26
One group pre test post test design with pre - experimental approach was adopted
for this study. In this design, the variable is measured before the introduction of the
treatment. The treatment is then introduced and the dependent variable is measured again
after the treatment.

Subjects Pre-test Administration of Post-test

STP

50 primary school teachers O1 X O2

Figure 2: Pre test, post test design.

23
O1: Administration of structured knowledge questionnaire on health promotive services.
X: Conducting structured teaching programme on health promotive services for the
teachers on the same day.
O2: Administration of structured knowledge questionnaire on health promotive services
on 7th days after STP.

24
 The schematic representation of study design is presented in 3- phase
Phase I Phase II Phase III
Population Sample and Variable Tool Tool O1 X O2
sampling construction
technique
Primary 50 primary Dependent Demographic Review of Assessing the Administration Post test Descriptive
school school variable proforma literature knowledge of of STP after knowledge statistics.
teachers teachers by knowledge structured discussion teachers on pretest assessment on To assess the
from a non of teachers knowledge with experts Day I using 7th day after knowledge of
selected probability on health questionnaire on blue print structured administration teachers by
schools at convenient promotive health promotive preparation of knowledge of STP by using mean,
Bengaluru sampling services services structured questionnaire using same mean
Independent knowledge tool percentage
variables questionnaire frequency and
STP on development standard
health of STP deviation
promotive content
Inferential
services validity
statistics
Extraneous pretesting
paired ‘t’ test
variable reliability of
to find out the
Age tool pilot
effectiveness
study
Sex of STP
Religion Chi square test
Education to find out
association
Work
between pre
experience
test score and
Monthly the selected
income demographic
Sources of variable
information

Figure 3 : The schematic representation of the study design.

25
The schematic representation of the study design presented the three phases.
Phase I :
1.Preparation of structured knowledge questionnaire and STP based on the
i. Review of literature
ii. Discussion with experts
2. Preparation of the blue print to determine the areas of the questionnaire
3. Tool and STP content were validated by experts
4. Testing the tool for its reliability
Phase II
1. Pre-test to assess the knowledge of teachers by a structured knowledge questionnaire prior to
STP
2. Administration of prepared STP to the samples after the pre-test.
3. Post-test knowledge assessment on the 7th day by the same questionnaire
Phase III
1. Comparison of pre-test and post-test knowledge scores by analyzing and interpretation
of the collected data.
2. Comparison of pre-test and post-test scores
3. Testing of Hypothesis testing
4. Interpretation of the data with diagram
Population:
Population is the aggregate of cases about which research would like to make
generalization.20
The population of the present study consisted of primary school teachers from selected
schools Bangaluru.
Sample and sampling techniques:
Sample refers to a subset of population selected to participate in the research study
sampling refers to the process of selecting a portion of population to represent the entire
population. The sample in this study comprised of 50 primary school teachers from selected
schools Bangaluru. In this study, the investigator used the non-probability convenient sampling
technique to draw the samples.7

26
Criteria for selection of sample:
Inclusion criteria:
1. Primary school teachers aged less than 50 years.
2. Teachers who are able to read and write in English.
3. Teachers who have completed teachers training course.
Exclusion criteria:
1. Teachers who are not willing to participate in the study
2. Teachers who are undergone same type of study.
Variables
Variables are the qualities, properties or characteristics of persons, things or situations
that change or vary.7
Three types of variables were used in the study.
1. Independent variable
2. Dependent variable
3. Extraneous variable.
Independent variable:
Independent variable is the variable, which is believed to cause or influence the
dependent variable.27
In the present study, independent variable was structured teaching programme on health
promotive services for the teachers.
Dependent variable:
The presumed effect is referred to as the dependent variable.27
In this study, dependent variable was the knowledge of teachers on health promotive
services as measured by structured knowledge questionaire.
Extraneous variables:
A controlled variable is which greatly influence the results of the study.27
In this study, extraneous variable refers to age, religion, work experience, monthly
income, and sources of information.
Setting of the study:
The setting refers to the physical location and condition in which data collection takes
place in the study. 7

27
 The study was conducted in selected schools which involves Sri Vani, Embessy,
Prajwal Schools Bengaluru.
Data collection instruments:
Data collection tools are the procedure or instruments, used by researcher to observe or
measure the key variables in the research problem.28
The following instruments were developed by the researcher for the present study.
Part 1: Demographic proforma.
Part 2: Structured knowledge questionnaire on health promotive services.
Development of instrument:
Instrument is the written device that a researcher uses to collect data. It includes the
questionnaire, tests, observation, schedules and scales. The researcher developed the tools from
the reviewed literature and the items that were relevant to the study were selected. The tool was
developed in order to attain the objectives of the study. The researcher adopted the following
steps in the development of the instrument.
 Personal experience and discussion with experts
 Development of blueprint of the structured knowledge questionnaire.
 Structured knowledge questionnaire
 Construction of demographic proforma and structured knowledge questionnaire
 Content validity.
 Pre - testing of the tool / pilot study.
 Reliability.
A structured knowledge questionnaire was developed to assess the knowledge of
teachers on health promotive services. The tools were developed after review of literature on
relevant to topic and in consultation with subject experts.

Preparation of blue print:

A blue print was prepared prior, to the construction of structured knowledge
questionnaire on health promotive services. It included domains, namely, knowledge,
comprehension and application. The knowledge domain consisted of 15 items (50%)
comprehension 13 items (43.3%), and application 2 (6.7%) items. The items were distributed
according to the content area.

28
Testing the tool:
Validity is the degree to which an instrument measures what it is suppose to measure.7
Content validity:
It refers to the degree to which the items in an instrument adequately represent the
universe of content.7
The prepared tool, along with the objectives, blue print, structured teaching programme
and criteria rating scale were given to 11 experts, of which seven were from the department of
nursing and two were doctors for establishing content validity, two were health personnels.
The experts were requested to give their opinion regarding adequacy, relevance and
appropriateness of content against the criterion rating scale which had column ‘agree’,
'disagree' and 'remarks'. There was 100% agreement on the content area of the blue print.
Thus the final draft of the tool consisted of 7 items on structured knowledge
questionnaire to collect the demographic data and 30 questions on structured knowledge
questionnaire to assess the knowledge on health promotive services.
Pre testing of the tool:
Pre test is the trial administration of newly developed instrument to identify plans or
assess time requirement.29
The tool was pre - tested by administrating it to ten subjects who fulfilled the inclusion
criteria. The respondents clearly understood the language of the tool. The average time taken to
complete the knowledge questionnaire was 30-35 minutes and one hour for planned teaching
programme, which was acceptable by the subjects. No changes were made in the tool.
Reliability of the tool:
The reliability of an instrument is the degree of consistency with which it measure the
attribute it is suppose to be measuring.7
The reliability of the instrument was established by administering the tool to 10 primary
school teachers in a selected schools which involves Sri Vani, Embessy, Prajwal schools
Bengaluru.
Reliability of the tool was tested by using Karl Pearson's correlation Formula (r=0.85).
The tool was found reliable.

29
Description of the final tool:
The final tool for assessing the knowledge of teachers on health promotive services
consisted of two parts.
Part I: Demographic profoma to collect the demographic data (7 item) It include the
identification data such as age, sex, religion, education work experience, monthly income,
sources of information.
Part II: Structured knowledge questionnaire to assess the knowledge of teachers on health
promotive services (50 items). It included the various items on health promotive services under
the following areas:
Section A: General information regarding health promotive services
Section B: Important of health promotive services
Section C: Process of health promotive services
Section D: Teachers responsibility in health promotive services.

Development of planned teaching programme:

The structured teaching programme was developed for teachers. It was prepared based
on extensive review of literature and experts opinion from the related field.
Pilot study:
Pilot study is a small scale version or trail run, done in preparation for a major study.7
The purpose of the Pilot study is to find out the feasibility of the study, clarity of
language in tool and finalise the plan for analysis.
Written permission to conduct the study was obtained from the school head master. The
tool was administered to 10 teachers in respected schools Sri Vani, Embessy, Prajwal Schools
from 19-9-2012 to 26-09-2012.
The tool was found to be feasible and practicable and no modification was made. Data
analysis was done using descriptive and inferential statistics. The findings revealed that
structured teaching programme was effective in increasing the knowledge of teachers on health
promotive services.

30
Process for data collection:
The investigator obtained written permission from Head Master, prior to data
collection. The investigator assured the confidentiality to the subjects and to their responses
and consent was obtained. The pre test was conducted on 50 primary school teachers using
structured knowledge questionnaire which was prepared in English. The time taken to conduct
the pre test was nearly 30-35 minutes. The structured teaching programme was conducted on
the same day respectively. The duration of each session was one hour. On seventh day, after
STP, post test was conducted for primary school teachers using the same structured knowledge
questionnaire to evaluate the effectiveness of planned teaching programme. The average time
taken for post test was 30-35 minutes. The data collection was terminated by thanking each
primary school teachers for their participation and cooperation. The data collected was
compiled for data analysis.
Plan for data analysis:
Data analysis is the systematic organization and synthesis of research data and testing
of the research hypothesis using those datas.7
Data was planned to be analysed on the basis of objectives and hypothesis.
The plan for data analysis is as follows:
1. The data obtained will be plotted in master sheet
2. Demographic variables will be described in terms of frequency and percentage.
3. Level of knowledge regarding health promotive services would be analysed by
frequency percentage and mean percentage.
4. The pre test and post test knowledge scores will be expressed by mean and standard
deviation.
5. Area -wise mean percentage of pre test and post test knowledge scores.
6. Paired 't' test will be computed to determine the significance of difference between
mean post test and pre test knowledge scores of the subjects.

31
SUMMARY:
The chapter dealt with the methodology adopted for the study. This included the
research approach, research design, variables, and setting of the study, sample, sampling
technique, and development of tool, description of the tool, and development of STP, Pilot
study, and method of data collection and plan for data analysis. The analysis and interpretation
of the same are presented in the following chapter.

32
 6
Results

33
 6. RESULTS

Processing the data implies editing, coding classification and tabulation of

collected data. So that they are amenable to analysis. The term analysis refers to the
computation of certain measures along with searching for pattern of relationship that exist
among data groups.
This chapter describes the analysis and interpretation of the data collected
through structured knowledge questionnaire from 50 teachers before and after the
administration of STP on health promotive services.
The objectives of the study were

1. To assess the pre existing knowledge among primary school teachers by pre test

Knowledge regarding health promotive services.

2. To assess the pre existing knowledge among primary school teachers by post test

Knowledge regarding health promotive services.

3. To evaluate the effectiveness of structured teaching programme among primary

school teachers by comparing pre and post test knowledge scores.

4. To find the association between pre test knowledge scores with selected

demographic variables.

Organization of the findings

The data collected were organized and presented in four parts.
Part I: Description of sample characteristics
Part II : Analysis of pre-test and post- test knowledge scores of teachers on health
promotive services.
Section A: Assessment of the level of knowledge
Section B: Pre test and post test mean, SD and mean percentage of knowledge scores
Part III: Evaluation of the effectiveness of structured teaching programme on
health promotive services.
Section A: Quartile distribution of the pre -test and post-test knowledge scores.
Section B: Area-wise effectiveness of structured teaching programme

34
Section C: Area-wise comparison of pre –test and post-test knowledge scores of
teachers on health promotive services.
Section D: Testing of hypothesis
Part IV: Association between pre-test knowledge scores of teachers on health
promotive services with selected demographic variables

Part I: Description of Sample Characteristic

The samples were selected through non probability convenient sampling
technique. The sample size consisted of 50 primary school teachers. The frequency and
percentage of the demographic characteristic of the sample has been presented in table 1.

Table 1 : Frequency and percentage distribution of the characteristics

N=50
Sl. No. Variables Frequency Percentage (%)

1 Age (in years)

A Above 20 10 20

B 21-24 years 25 50

C 25-30 years 11 22

D 31 and above 4 8

2 Sex

A Male 10 20

B Female 40 80

3 Eductation

A PUC + D.Ed 14 28

B SSLC + D.Ed 8 16

C D.Ed + B.Ed 12 24

D B. Ed 16 32

35
 4 Religion

A Hindu 24 48

B Muslim 17 34

C Christians 9 18

D Any other 0 0

5 Work experience

A Below 1yrs 4 8

B 2 to 3 yrs 15 30

C 4 to 5 yrs 11 22

D Above 6rys 20 40

6 Monthly income

A <3000 14 28

B 3001-6000 13 26

C 7001-10000 12 24

D ≥10001 11 22

7 Sources of information

A Colleague and higher authority 34 68

B Health personals 11 22

C Mass media 5 10

The data presented in table 1 depicts the distribution of respondents according to

their age, sex, religion, education, work experience, monthly income, sources of
information in terms of frequency and percentage.

36
1. Age

Figure 4: Bar diagram showing distribution of samples in terms of age.

With regard to age group, majority of the primary school teachers50% were in the
age group of 21 to 24years, 22% were in the age group of 25-30 years, 20% were above
20 years of age, and 8% (4) were above 31 years of age.

II. Sex

Figure 5: Pai diagram showing distribution of samples in terms of sex.

With regard to sex, majority of the primary school teachers80% were in females,
and 20% were in males.
37
III. Religion

Figure 6: Cylinder diagram showing distribution of samples in terms of religion.

With regard to Religion 48% were belongs to Hindus, 34% were belongs
to Muslim, 18% were belongs to Christians and, (0%) none of them were belongs to
other castes.

IV. Education

Figure 7: Cylindrical diagram showing distribution of samples in terms of

Education.

38
 With regard to education, majority of the primary school teachers32% were

completed B.Ed, 28% were completed PUC+D.Ed, 24% were completed D.Ed+ B.Ed,

and 16% were completed SSLC+D.Ed.

V. Work experience

Figure 8: Cone diagram showing distribution of samples in terms of work

experience.

With regard to work experience , majority of the primary school teachers 40%

having above 6 years experience, 22% having 4 to 5 years, 30% having 2 to 3 years and

8% having below 1 year experience.

39
VI. Income

Figure 9: Cone diagram showing distribution of samples in terms of monthly

income.

With regard to the monthly income, majority of the teachers 8% had

monthly income of below Rs. 3000, 30% had a monthly income of Rs. 3001-6000, 22%

had monthly income of Rs. 7001-10000, and 40% had a monthly income above

Rs. 10001.

40
VII. Sources of information

Figure 10: Pie diagram showing distribution of samples in terms of sources of

information.

With regard to the sources of information, majority of the teachers 68% getting

information from the colleague and higher authority, 22% getting from health personals

and 10% belong to mass media.

Part II : Assessment of pre-test and post-test knowledge scores of teachers on health

promotive services.

Section A: Assessment of level of knowledge

The pre-test level of knowledge was assessed before and the post-test level of

knowledge was assessed after the administration of planned teaching programme. The

knowledge scores obtained by the respondents were tabulated in master sheet. The data

was analyzed in terms of frequency and percentage. The findings are presented in table 2.

41
Table 2: Distribution of pre-test and post-test knowledge score of teachers on health

promotive services:

N=50

Level of Range of Percentage No. of respondents Percentage

knowledge scores of scores (%)
Pre-test Post-test Pre-test Post-
test
Poor 0-10 0-33% 25 0 50 -

Moderate 11-20 34-67% 25 0 50 -

Good 21-30 68-100% - 50 - 100

Total 50 50 100 100

Maximum Score = 30
Minimum score = 0
The data presented in table 2 displays the frequency distribution of teachers

according to their pre-test and post-test knowledge scores The scores ranged from 0-10,

11-20 and 21-30 were the maximum possible score was 30. Further data showed 50%

(25) teachers scored 0-10, 50% (25) teachers scored 11-20 and no teachers scored 21-30

in pre-test whereas in the post-test all teachers (100%) scored 21-30.

42
 Figure 11: Cylindrical diagram showing grading of pre-test and post-test

knowledge score of primary school teachers

Section B : Pre -test and post-test mean, SD, and mean percentage of knowledge

scores

The pre-test knowledge scores were obtained in relation to four areas namely,

characteristics types and classification related with health promotive services.

Table 3 : Area wise pre-test mean knowledge score and percentage mean knowledge

score of teachers on health promotive services.

N = 50
Maximum
Sl Standard Mean
Knowledge areas possible Mean score
No. deviation percentage
scores
1 General information
regarding health 11 4.74 1.626 43.09
promotive services
2 Important of health
promotive services 3 1.28 0.701 42.67
3 Process of health
promotive services 5 2.08 0.829 41.60
4 Teachers
responsibility in 11 3.26 1.337 29.64
health promotive
services

Total 30 11.36 4.493 39.25

43
 The mean percentage of total knowledge scores of the pre-test was 39.25% with mean ±

SD of 11.36±4.493. Area wise mean percentage of knowledge score was 43.09% in the

area of " General information regarding health promotive services ", with a mean±SD of

4.74±1.626. In the area of " Important of health promotive services " the mean percentage

was 42.67% with an area wise mean ±SD of 1.28±0.701. In the area of “Process of health

promotive services”, the mean percentage was 41.60% with a mean ±SD of 2.08±0.829

and in the area of “Teachers responsibility in health promotive services” the mean

percentage was 29.64% with a mean ±standard deviation of 3.26 ±1.337. This reveals

that teachers had inadequate knowledge regarding health promotive services.

Table 4 : Area wise post-test mean knowledge scores and percentage mean

knowledge scores of teachers on health promotive services

N =50
Sl. Knowledge Maximum Mean score Standard Mean
No areas possible deviation percentage
scores
General
1
information 11 9.68 0.794 88
regarding
health
promotive
services

2 Important of
health 3 2.26 0.443 75.33
promotive
services

3 Process of
health 5 3.54 0.503 70.80
promotive
services

44
 4 Teachers
responsibility 11 8.70 1.233 79.0
in health
promotive
services

Total 30 24.18 2.973 78.28

The mean percentage of total knowledge scores of the post-test was 78.28% with

mean ± SD of 24.18±2.973. Area wise mean percentage of knowledge score was 88% in

the area of " General information regarding health promotive services ", with a mean±SD

of 9.68±0.794. In the area of "Important of health promotive services " the mean

percentage was 75.33% with an area wise mean ±SD of 2.26±0.443. In the area of

“Process of health promotive services”, the mean percentage was 70.80% with a mean

±SD of 3.54±0.503 and in the area of “Teachers responsibility in health promotive

services” the mean percentage was 79.09% with a mean ±standard deviation of

3.70±1.233. This reveals that teachers had adequate knowledge regarding health

promotive services after the administration of STP.

45
Part III: Evaluation of the effectiveness of STP on health promotive services

Section A: Quartile distribution of pretest and post test knowledge scores

Table 5 : Frequency, cumulative frequency and percentage of pre-test and post-test

knowledge scores of teachers on health promotive services

N =50

Pre-test Post-test

Knowledge
scores
Frequency Cumulative Percentage Frequency Cumulative Percentage
frequency frequency

0-6 - - - - - -

7-8 8 8 16 - - -

9-10 17 25 34 - - -

11-12 3 28 6 - - -

13-14 15 43 30 - - -

15-16 7 50 14 - - -

17-18 - - - - - -

19-20 - - - - - -

21-22 - - - 14 14 28

23-24 - - - 11 25 22

25-26 - - - 19 44 38

27-28 - - - 6 50 12

29-30 - - - - - -

46
 60

50

40

Pre-test
30
Post-test

20

Median = 24.5
Median = 11

10

0
6 8 10 12 14 16 18 20 22 24 26 28 30

Figure 12: Ogive representing pre-test and post test knowledge scores of teachers on
health promotive services

The data presented in the ogive shows that there was an increase in the knowledge

scores of the primary school teachers after the administration of STP. In the pre test

maximum number of teachers 34% (17) were in the category of knowledge between 9-

10; where in the post-test the maximum number of teachers 38% (19) scored between 25-

26 By graphical method the pre - test median score was 11 where as the post-test

median score was 24.5. The ogive plotted shows that the post-test median was higher

than the pre - test median. It revealed that higher effectiveness of STP. So the ogive

indicated that there was a significant increase in the knowledge of primary school

teachers after STP.

47
Section B: Area-wise effectiveness of the STP

Table 6: Area-wise mean, standard deviation, and mean percentage of pretest and

post test knowledge scores of teachers in selected area of health promotive services.

Area Maximum Pre-Test (X) Post-Test (Y) Effectiveness (Y-X)

possible
Mean ±SD Mean Mean ±SD Mean Mean ±SD Mean
score
% % %

General
information 11 4.74 ±1.626 43.09 9.68±0.794 88 4.94±1.70 44.91
regarding
health
promotive
services

Important of
health 3 1.28±0.701 42.67 2.26±0.443 75.33 0.98±0.71 32.66
promotive
services

Process of
health 5 2.08±0.829 41.60 3.54±0.503 70.80 1.46±0.93 29.2
promotive
services

Teachers
responsibility 11 3.26±1.337 29.64 8.70±1.233 79.09 5.44±1.79 49.45
in health
promotive
services

Total 30 11.36±4.493 39.25 24.18±2.973 78.28 12.82±1.52 39.03

48
 The data presented in the table 6 shows the mean percentage of the knowledge

scores of the pre-test and post- test. It reveals an increase of 39.03% in the total mean

percentage of knowledge scores of the teachers regarding health promotive services.

Comparison of area-wise mean and SD of knowledge scores shows that in the are of

“General information regarding health promotive services” pre-test mean percentage of

knowledge score was 43.09% with a mean and SD of 4.741.626; where as the post-test

mean percentage of knowledge score was 88% with a mean and SD of 9.680.794;

showing 44.91% effectiveness of STP. With regard to “Important of health promotive

services” the pre-test mean percentage of knowledge score was 42.67% with a mean and

SD of 1.28  0.701; where as post-test mean percentage of knowledge score was 75.33%

with a mean and SD of 2.26  0.443; showing 32.66% of the effectiveness of STP. In the

area of “Process of health promotive services”, the pre-test mean percentage of

knowledge score was 41.6% with a mean and SD of 2.080.829; where as the post-test

mean percentage of knowledge score 70.80% with a mean and SD of 3.540.503;

showing 29.2% of effectiveness of STP. With regard to area “Teachers responsibility in

health promotive services” the pre-test mean percentage of knowledge score was 29.64%

with a mean and SD of 3.26 1.337; whereas the post mean percentage of knowledge

score 79.09% with a mean and SD of 8.70  1.233; showing 49.45% of effectiveness of

STP. This shows that the STP was effective in enhancing the knowledge of teachers

regarding health promotive services.

Section C: Area-wise comparison of pre-test post-test knowledge scores of teachers

on health promotive services.

Area-wise mean and percentage of mean knowledge score and the difference in

the mean was computed as data presented in table 6.

49
Table 7: Area-wise mean percentage and mean gain and pre and post-test

knowledge scores

Areas Percentage mean knowledge Effectiveness

scores of STP

Pre-test Post-test

Section A: General information 43.09 88 44.91

regarding health promotive
services

Section B: Important of health 42.67 75.33 32.66

promotive services

Section C: Process of health 41.60 70.80 29.20

promotive services

Section D: Teachers 29.64 79.09 49.45

responsibility in health promotive
services

50
 Figure 13: Cylindrical diagram shows that distribution of mean percentage of pre-
test and post-test knowledge scores on health promotive services

The data in the table 7 shows that, mean percentage scores of pretest was highest

(4309%) in section A and least (29.64%) in the section D area; where as mean post-test

score was highest (88%) in Section A and least (70.80%) in Section C. Mean gain shows

that post-test knowledge score was higher than pre-test knowledge score in all areas.

Thus the findings suggested that STP was effective.

Section D: Testing the hypotheses

To evaluate the effectiveness of STP, a research hypothesis was framed

H1: The mean post test knowledge scores will be significantly higher than the mean pre-

test knowledge scores.

Paired ‘t’ test was used to analyse the difference in knowledge scores of teachers

in pre-test and post-test.

51
Table 8: Mean, Mean difference and ‘t’ value of pre-test and post-test knowledge

score of teachers on health promotive services

N = 50
Mean Mean difference ‘t’ value

Pre-test 11.36
12.82 29.67*
Post-test 24.18

(table value of ‘t’ at 0.05 level with 49 df = 1.680) * significant

The data presented n the table 8 shows that the mean post-test knowledge scores

of the teachers was significantly higher than their mean pre-test knowledge score

(t49=29.67). Hence the research hypothesis accepted and that the structured teaching

programme on health promotive services was an effective method of increasing

knowledge of teachers. Further, area wise analysis was to find out the difference between

mean pre-test and post-test scores, and paired ‘t’ test was computed. The data is presented

in table 9.

Table 9: Areawise mean percentage score, mean difference and ‘t’ value of pre-test

and post-test scores of teachers on health promotive services.

Sl. Areas Mean percentage score Mean ‘t’ value

No. difference
Pre-test Post-test

1. General information
regarding health 43.09 88 4.94 20.61
promotive services

2. Important of health
promotive services 42.67 75.33 0.98 9.71

3. Process of health
promotive services 41.60 70.80 1.46 11.10

52
 4. Teachers responsibility in
health promotive services 29.64 79.09 5.44 21.54

Total 39.25 78.28 12.82 29.67*

The data presented in table 8 shows that the mean post-test knowledge score of

the teachers on health promotive services was significantly higher than their mean pre-

test knowledge score. This shows that there was significant gain in knowledge on health

promotive services. Therefore, the structured teaching programme has been an effective

method in increasing the knowledge of primary school teachers.

percentage should be written above

Section IV: Association between pre-test knowledge scores of teachers on health

promotive services with selected demographic variables.

Table 10: Association between pre-test knowledge scores of teachers regarding

health promotive services with selected demographic variable

N = 50
Sl. Variables < Median ≥ Median 2 value Inferences
No.
1 Age (in years)-teacher
A Above 20 5 5 Not
B 21-24 years significant
12 13 0.107
C 25-30years 6 5
D 31 and above 3 1
2 Sex
A Male 6 4 Not
B Female 0.945 significant
22 18
3 Education
A PUC + D.Ed
10 14

53
 B SSLC + D.Ed 3 5 6.77 Significant
C D.Ed + B.Ed 4 8
D B. Ed 8 8
4 Religion
A Hindu 12 12 Not
B Muslim 0.874 significant
10 7
C Christians 5 4
D Any other - -
5 Work experience
A Below 1year 1 3
B 2 to 3 year 7 8 3.365 Significant
C 4 to 5 year 5 6
D Above 6 year 8 12
6 Monthly income
A <3000 7 7 Not
B 3001-6000 0.168 significant
6 7
C 7001-10000 6 6
D ≥10001 6 5
7 Sources of information
A Colleague and higher 14 11 Not
authority significant
0.720
B Health personals 9 11
C Mass media 2 3

Inference:

Chi-square test was computed to find the association between the pre-test

knowledge level and selected demographic variables. The findings showed that there was

no significant association between pre-test knowledge level of teachers on health

promotive services and their demographic variable such as age,sex,education,religion,

54
monthly income, and sources of information. There is a significant association between

knowledge and their demographic data like work experience

Summary:

This data was described the interpretation of data using descriptive and inferential

statistics. To determine the effectiveness of structured teaching programme, paired ‘t’ test

was computed and was found to be highly significant. Chi-square was computed to

determine the significance of association between pre-test knowledge scores and selected

demographic variables like work experience were found to be significant.

55
 7
Discussion

56
 7. DISCUSSION

The present study was conducted to evaluate the effectiveness of structured

teaching progamme on health promotive services. In order to achieve the objectives of

the study, one group pre-test, post-test with pre-experimental approach was adopted. Non

probability convenient sampling technique was used to select the sample. The data was

collected from fifty primary school teachers before and after the administration of the

structured teaching programme.

A number of events have been organized to help create awareness about health

promotive services for teachers. In view of this a study looking into the knowledge

regarding health promotive services for teachers was conducted which led the following

findings which have been discussed with reference to the objectives and hypothesis

stated in the initial chapters.

Part 1: Description of sample characteristics:

Age: With regard to the age group majority of the primary school teachers50% (25) were

within the age group of 21-24 years. 22%(11) were in the age group of 25-30 years and

8%(4) were above 31 years of age.

Religion: With regard to the religion, maximum number of teachers of under five

children 48%(24) were Hindu, 34%(17) were Muslim and 18%(9) were Christian.

Work experience: With regard to the educational status majority of the teachers 40%

had above 6 years experience, 30% had 2 to 3 years experience, 22% had 4 to 5 years

work experience, 8% had below 1 year experience.

57
Income: With regard to the income, majority of the teachers of under five children 8%

(14) had a monthly income below Rs. 3000, 306% (13) had a monthly income of Rs.

3001-6000, 22% (12) had monthly income of the Rs. 7001-10000 and 40%(11) had

monthly income above Rs. 10001.

Sources of information: With regard to the sources of information, majority of the

teachers 68% getting information from the colleague and higher authority, 22% getting

from health personals and 10% belong to mass media.

Part II: Analysis of pre - test knowledge scores of health promotive services

Section A: Assessment of the level of knowledge:

Assessment of the level of knowledge of the primary school teachers revealed that

50% (25) teachers scored 0-10, 50% (25) teachers scored 11-20 and no teachers scored

21-30 in pre-test whereas in the post-test all teachers (100%) scored 21-30.

Section B: Area wise - pre - test mean. SD and mean percentage of knowledge

scores.

The mean percentage of total knowledge scores of the pre-test was 39.25% with

mean ± SD of 11.36±4.493. Area wise mean percentage of knowledge score was 43.09%

in the area of "General information regarding health promotive services ", with a

mean±SD of 4.74±1.626. In the area of " Important of health promotive services " the

mean percentage was 42.67% with an area wise mean ±SD of 1.28±0.701. In the area of

“Process of health promotive services”, the mean percentage was 41.60% with a mean

±SD of 2.08±0.829 and in the area of “Teachers responsibility in health promotive

services” the meaercentage was 29.64% with a mean ±standard deviation of 3.26 ±1.337.

This reveals that teachers had inadequate knowledge regarding health promotive services.

58
Section C: Area-wise post-test mean, SD and mean percentage of knowledge scores.

The mean percentage of total knowledge scores of the post-test was 78.28% with

mean ± SD of 24.18±2.973. Area wise mean percentage of knowledge score was 88% in

the are of " General information regarding health promotive services ", with a mean±SD

of 9.68±0.794. In the area of " Important of health promotive services " the mean

percentage was 75.33% with an area wise mean ±SD of 2.26±0.443. In the area of

“Process of health promotive services”, the mean percentage was 70.80% with a mean

±SD of 3.54±0.503 and in the area of “Teachers responsibility in health promotive

services” the mean percentage was 79.09% with a mean ±standard deviation of

3.70±1.233. This reveals that teachers had adequate knowledge regarding health

promotive services after the administration of STP.

Part III: Evaluation of the effectiveness of structured teaching programme on

health promotive services

Section A: Quartile distribution of the pre - test and post - test knowledge scores.

The data presented in the form of Ogives shows significant difference between

pre-test and post-test knowledge scores. By graphical method the pre - test median score

was 11 where as the post-test median score was 24.5. The ogive plotted shows that the

post-test median was higher than the pre - test median. It revealed that higher

effectiveness of STP. So the ogive indicated that there was a significant increase in the

knowledge of primary school teachers after STP.

59
Section B: Area - wise effectiveness of planned teaching programme:

Comparison of area - wise mean and SD of the knowledge score in the area of

"General information regarding health promotive services " shows that the pre-test mean

of the knowledge score was 43.09% (4.74±1.626) whereas post - test mean knowledge

score was 88% (9.68±0.794). This shows an increase of 44.91% in the mean knowledge

score of teachers.

The area of knowledge on "Important of health promotive services " shows that

the pre-test mean knowledge score was 42.67% (1.28±0.701) whereas the post test

knowledge score was 75.33% (2.26±0.443). This shows an increase of 32.66% in the

mean knowledge scores of teachers.

In the area of knowledge on " Process of health promotive services " shows that,

the pre - test knowledge score was 41.60% (2.08±0.829) whereas the post test knowledge

score was 78.80% (3.54±0.503). This shows an increase of 29.20% in mean knowledge

scores of teachers.

In the area of knowledge on “Teachers responsibility in health promotive

services” shows that the pre-test score was 29.64%(3.26±1.337), where as pot test

knowledge score was 79.09% (8.70±1.233). This shows an increase of 49.45% in mean

knowledge teachers.

The overall findings revealed that the percentage of post-test knowledge score

was more, the STP was effective in enhancing the knowledge of teachers on health

promotive services.

60
Section C: Area-wise comparison of pre-test, post-test knowledge scores of teachers

on health promotive services.

The data presented in the form of cylindrical diagram shows that the data in table
7 shows that, mean percentage scores of pretest was highest (43.9%) in section A and
least (29.64%) in the section D. area; where as mean post-test score was highest (88%) in
Section A and least (70.80%) in section C . Mean gain shows that post-test knowledge
score was higher than pre-test knowledge score in all areas. Thus the findings suggest
that STP was effective. The overall findings reveal that the percentage of post - test
knowledge score was more, hence, the STP was effective in enhancing the knowledge of
teachers on health promotive services.

Section D: Testing of hypothesis:

Findings revealed that the mean post test knowledge score of primary school
teachers was significantly higher than the mean pre-test score. The calculated 't' value
was greater than the table value at 0.05 level of significance. Hence, the research
hypothesis was accepted. Therefore, it is concluded that the gain in knowledge of
teachers through structured teaching programme on health promotive services was highly
significant.

Part IV: Association between pre test knowledge scores of teachers regarding health
promotive services with selected demographic variables.
Chi - square test was computed to find the association between the pre-test
knowledge level and selected demographic variables. The findings showed that there was
no significant association between pre - test knowledge level of teachers on health
promotive services and their demographic variable such as age, sex, education, religion,
monthly income and sources of information. It is significant with work experience of the
teachers.

61
 8
Conclusion

62
 8. CONCLUSION

Assessment of the level of knowledge of teachers regarding health promotive

services revealed that highest percentage 54% of the respondents had average knowledge.

Area-wise anlaysis showed that post-test knowledge score was more (88%) in the

area of "General information regarding health promotive services " and least (70.80%) in

the area of “Important of health promotive services ". Mean percentage of knowledge

score in pre-test was 39.25% with mean±SD of 11.36±4.493. which increased after

administration of STP with mean percentage of knowledge score in post-test by 78.28%

with mean±SD of 24.18±2.973. Mean percentage of effectiveness was found to be 43%

with mean and SD of 12.82±3.06.

Based on the findings of the study the following conclusions were drawn:

The difference between pre-test and post - test knowledge score indicated a

significantly high post-test score. Hence, the modified gain score was consistently high in

all the areas and sub areas included in the study. The 't' test computed between mean

post-test knowledge in all areas. It was concluded that there was true gain in the

knowledge and teaching programme was effective as a method to improve knowledge.

From the analysis of the effectiveness of structured teaching programme on health

promotive services. It can be concluded that the structured teaching programme was

effective in terms of improving the knowledge of teachers regarding health promotive

services. Thus it is concluded that the teaching programme on health promotive services

was effective.

63
 Further the study indicated that all the primary school teachers did not have 100%

knowledge. They required teaching because all of them needed to know everything about

the health promotive services.

Demographic variables also play a role in improving the knowledge. From the

findings of the study it can be concluded.

Implications

The findings of this study have implications for nursing practice, nursing

education, nursing administration, and nursing research.

Implication to nursing practice

 Health education is an important tool for health care. It is one of the most cost

effective interventions. It is concerned with promoting health as well as

prevention of disease

 The extended and expanded role of professional nurse emphasizes more about the

preventive and promotive aspects of the health

 Education programmes with effective teaching strategies, will motivate people to

follow healthy practices in day-to-day life, including their changes in life style.

 The present study would help the nurse to develop an understanding about the

knowledge of teachers regarding health promotive services.

 The nurses could further impart knowledge to the teachers regarding health

promotive services.

64
Implications to nursing education

 The present health care delivery system emphasizes more on preventive rather

than the curative aspect.

 Nursing students should be made aware of their role in health promotion and

disease prevention for the present and their future, which may help in achieving

the goal of ‘health for all’.

 The nursing student can improve the knowledge on health promotive services.

 The student nurse can engage in providing education and conduct awareness

programmes among teachers regarding health promotive services.

Implications to nursing research

 The emphasis on research and clinical status is to improve the quality of nursing

care. Nurses need to engage in multidisciplinary research so that it will help to

improve their knowledge and skill while applying it into practice, many health

problems can be solved.

 The nurses should conduct research on various aspects of health promotive

services, which provides more scientific data and adds more scientific body of

information to the nursing profession.

 Innovative methods and techniques of teaching and learning have to be

implemented in education, as well as clinical research, which is a challenging task

in the era of improved technology

 Nurse researcher should be aware of the health care system and formulating new

theories. Researchers can improve the knowledge, skill and attitude of nurses and

ultimately can improve the status and standards of nursing profession.

65
  The nurse researchers can further plan, implement and evaluate a planned

awareness programmes among teachers regarding health promotive services.

Implications to nursing administration

 The knowledge of the nurses may be updated through in-service education and

refresher courses regarding health promotive services.

 The nurse administrator can organize community level programmes to increase

awareness on health promotive services.

 The nurse administrators can collaborate with the other health care providers to

organize education programs.

Limitations

 The study was limited to primary school teachers.

 The study was limited to the selected schools in Bangaluru.

Recommendations

Having become familiar with the problems faced during the study and keeping the

limitations in view, the following recommendations are offered for further research.

 The study can be replicated among rural areas.

 A comparative study can be conducted to assess the knowledge of rural and

urban teachers of primary school.

 A large scale study needs to be carried out to generalize the findings.

 A similar study may be replicated with a control group and on a larger

population.

 A survey to assess the knowledge, beliefs and practices of primary school

teachers regarding health promotive services may be undertaken.

66
 A follow up study may be conducted to determine the effectiveness of the

structured teaching programme in terms of change in health promotive services

in those subjects who were administered the structured teaching programme.

 A study can be conducted to assess the knowledge of staff nurses regarding

school health services.

67
 9
Summary

68
 9. SUMMARY

This chapter presents a brief summary of research study. This chapter also

includes recommendations for future research and limitations of the study.

The main aim of the study was to determine the effectiveness of structured

teaching programme on health promotive services among primary shool teachers in a

selected schools Bengaluru.

Objectives of the study

The objectives of the study are :

1. To assess the pre existing knowledge among primary school teachers by pre test

knowledge regarding health promotive services.

2. To assess the pre existing knowledge among primary school teachers by post test

knowledge regarding health promotive services.

3. To evaluate the effectiveness of structured teaching programme regarding health

promotive services among primary school teachers by compairing pre and post

test knowledge scores.

4. To find the association between pre test knowledge scores with selected

demographic variables.

Assumptions

The investigator assumes that:

1. The teachers from selected school will have lack of knowledge regarding the health

promotive services.

2. Planned teaching program will increase the primary school teachers knowledge on

health promotive services.

69
Hypothesis

The hypothesis will be tested at 0.05 level of significance.

H 1: The mean post test knowledge scores of teachers regarding health promotive

services will be significantly higher than the mean pre-test knowledge scores.

H 2: There will be a significant association between the teachers knowledge with

selected demographic variables.

Variables

The independent variables was the planned teaching programme on health

promotive services and the dependent variable was the knowledge of teachers regarding

health promotive services.

Conceptual framework adopted for the study

The study was based on 'General Systems Theory" which emanates from three,

structural cognitive operations, i.e., input, which includes primary school teachers and

their age,sex,education, religion, work experience, income, and sources of information,

knowledge of teachers on health promotive services which is assessed by using structured

knowledge questionnaire. Process, which refers to the administration of structured

teaching programme and output, which is the ultimate knowledge gained by the primary

school teachers in terms of post-test scores.

Research methodology of the study

The research design consisted of an evaluated approach with pre-experimental

one group pre-test post-test design. The population selected for the study consisted of

70
teachers at selected primary schools Bengaluru. Fifty subjects were selected using non-

probability convenient sampling technique. The data was collected using a structured

knowledge questionnaire. Content validity of the questionnaire was Pre-testing and the

reliability of the questionnaire were done. The tool was found to be reliable (r=0.85).

The structured teaching programme was developed from the available literature.

A criterion checklist was developed for evaluating the structured teaching programme by

nine experts. Modifications were done according to their suggestions.

The pilot study was conducted on ten primary school teachers at selected schools

Bengaluru, and the study was found to be feasible.

Pre-test was given on the first day followed by administration of structured

teaching programme; post- test was done on the seventh day.

Results

The analysis of the data was based on the objectives and hypotheses. Both

descriptive and inferential statistics were used for data analysis. Descriptive statistics

used were mean, standard deviation with tabular presentation of the data. Paired 't' test

was computed to test the significant difference in the man pre-test and post-test of

knowledge scores.

The study findings revealed that majority of the teachers 50% (25) in age group

of 21 to 24 years. The mean pre-test knowledge score was 11.36 and that of post-test was

24.16. Among the four areas of health promotive services the highest (43.09%) mean

percentage knowledge score was found in the area of “General information regarding

health promotive services” and the lowest (29.64%) was found in the area of “Teachers

71
responsibility in health promotive services ". The maximum post-test mean percentage

score was in the area " General information regarding health promotive services " (88%).

The mean post test knowledge score (24.18%) was higher than the pre -test scores

(11.36). The 't' value showed the significant difference in the post-test (t=29.67,

P <0.05).

Interpretation and conclusion

The study findings showed that there was a significant increase in the knowledge

of primary school teachers after administration of the structured teaching programme on

health promotive services. Hence, it was concluded that the structured teaching

programme was effective in increasing the knowledge of primary school teachers.

72
 10
Bibliography

73
 REFERENCES

1. Isenberg J, Quisenberg N. Health promotive services: A necessity for all children

A position, Oleny, MD: Association for Childhood Education International ;

1998. Available online: http://www.ncbi.nlm.nih.gov/pubmed/

2. Frost J, Bowers L, Worthham S. The state of American Health promotive

services. Journal of Physical Education, Recreation and Dance. 1996; 61(8): 18-

23.

3. Delborah JL. Early childhood today. American Journal of Pediatrics. 2005; 20(1):

6-7.

4. Frombay DP. Play issues in early childhood education. 2nd ed. Columbus; 1998.

5. Goleman D. Emotion intelligence. New York; 1995. Available online:

http://www.ncbi.nlm.nih.gov/pubmed/

6. Isenberg JP, Jalongo MR. Health promotive services. 3rd edition, 2000.

7. Pilot DF, Beck JC. Nursing research, principles and methods. 7th ed. Lippincott

Williams and Wilkins Publishers. Philadelphia. 2004.

8. Hughes F. Major trends and issues in early childhood education: Challenges,

controversies and insights. 2nd ed. 1999.

9. Johnson J, Christie J, Yankey T. Play and early childhood development. 2nd ed.

New York: Longman; 1999.

10. McCune L, Janes M. Learning, attention and play. Psychological perspectives in

early childhood education; 2001; 81(5):. 92-106.

11. Miller TR, Spincer RS. How safe our school ? American Journal of Public Health.

1998; 88: 413-418.

74
12. Uma H, et al. Health promotive services. Indian Journal of Community Healths;

2001; 59(4): 417-422

13. Sue Barton, Tammy Rhine. Online article on summary of the meta analytic

findings. US Public health services; 2000. Available online:

http://www.ncbi.nlm.nih.gov/pubmed/

14. Tamis-Lemonda, et al. Article on “teachers knowledge about Health promotive

services: Short term stability and interrelations”. Developmental psychology”.

Jan. 1998; 34(1): 115-124.

15. Dr. Somasundaran. Report on “The Hindu”; Monday, Jan. 02, 2006.

16. Yo Jackson, et al. “Outcome of a Health promotive services”. Developmental

Psychology. 2000; 35 (2): 110-113.

17. Panicker AS, et al. “Health promotive services”. Indian Journal of Clinical

Psychology. 2004; 31 (6): 151-156.

th
18. Aggarwal JC. Teacher and education in developing society.5 ed.New Delhi.

Vikas Publishing House; 1996.

19. Ramji S. National family health survey. Journal of Indian Pediatrics. 1981-89;

34(3):413-15.

20. James HB, et al. “T Health promotive services”. Journal of early development of

parenting. December 1996; 5 (4) : 185-194.

21. Taneja V, et al. “Health promotive services”. Journal on Child: care, health,

development. 2002; 28(1): 95-100.

22. Lisa M. Noll, Carol Gibb Harding. “School health programme”. Journal of

Counseling Psychology. 2000; 36(2); 80-95.

75
23. Aggarwal R et al. “School health programme”. Journal on Child: care, health,

development. 2005; 30(1): 91-95.

24. Renuka Dutta, Manju Mehta. “Children’s health”. Journal of Indian Association

of Child Adolescent Mental Health. 2006; 2(3): 85-88.

25. Talbot LA. Principles and practice of nursing research. Philadelphia; Mosby;

1992.

26. Basavantappa BT. Nursing research, 1st ed, New Delhi; Jaypee, 1998.

27. Treece EW, Treece JW. Elements of research in nursing. 2nd ed. London: Mosby;

1999.

28. Robert C, Bruke S. A quantitative and qualitative approach, 1st ed. Borton: James

Barett; 1989.

29. Abdellah FG, Levine E. Better patient care through nursing research. New York:

MacMillan; 1996.

30. Kerlinger FN. Foundation of behavioural research. 2nd ed. Holt Rineart and

Winston; 1973

76
 11

Annexure

77
 Annexure 1
Letter requesting permission to conduct Research study

From,

Shyny S Nair
2nd year MSc Nursing
Brite College of Nursing
Bengaluru.
To,
Medical officer
Malleswaram PHC
Bengaluru.

Forwarded through,
Prof. HH. DASEGOWDAS, M Sc (N)
Principal
BRITE College of Nursing sciences
Bengaluru

Respected sir /madam,

Subject: Permission to conduct research study

I, Shyny S Nair student of BRITE College of Nursing sciences have selected the
below mentioned topic for research study, which is to be submitted to Rajiv Gandhi
University of health sciences, Bangalore as a part of partial fulfillment of the course.
Topic: “A study to evaluate the effectiveness of structured teaching programme
on knowledge regarding health promotive services among primary school
teachers in a selected schools, Bengaluru”.
Data will be collected using a structured knowledge questionnaire All information
obtained will be used only for research purpose and will kept confidential.
I request you to grant me permission to conduct the research study.
Thanking you,
Yours truly
Place: Bengaluru
Date: (Shyny S Nair)

78
 Annexure 2

Letter granting permission to Research study

79
Letter granting permission to Research study

80
Letter granting permission to Research study

81
 Annexure 3

Letter requesting permission to conduct Research study

From,

Shyny S Nair
2nd year MSc Nursing
Brite College of Nursing
Bengaluru.
To,
Medical officer
Malleswaram PHC
Bengaluru.

Forwarded through,
Prof. Mr. HH. Dasegowdas, M Sc (N)
Principal
BRITE College of Nursing sciences
Bengaluru

Respected sir /madam,

Subject: Permission to conduct research study

I, Shyny S. Nair, student of BRITE College of Nursing sciences have selected the
below mentioned topic for research study, which is to be submitted to Rajiv Gandhi
University of health sciences, Bangalore as a part of partial fulfillment of the course.

Topic: “A study to evaluate the effectiveness of structured teaching programme

on knowledge regarding health promotive services among primary school
teachers in a selected schools, Bengaluru”.
Data will be collected using a structured knowledge questionnaire All information
obtained will be used only for research purpose and will kept confidential.
I request you to grant me permission to conduct the research study.
Thanking you,
Yours truly
Place: Bengaluru
Date: (Shyny S. Nair)

82
 Annexure 4

Letter seeking consent to validate the research tool.

From,
Shyny S Nair
IInd year MSc Nursing
BRITE College of Nursing sciences
Bengaluru.

To,

Respected sir /madam,

Subject: Requisition for acceptance to validate the research tool.

I, Shyny S Nair, II year MSc Nursing student (Community Health Nursing) of the
above mentioned institution kindly request you to give consent to validate the tool on

Topic: “A study to evaluate the effectiveness of structured teaching

programme on knowledge regarding health promotive services among
primary school teachers in a selected schools, Bengaluru”.
I would be highly obliged if you kindly give your acceptance. The acceptance
form is enclosed here with for your kind perusal.

Thanking you,

Place: Bengaluru Yours sincerely,

Date:

(Shyny S Nair)

83
 Annexure 5

Letter requesting consent of the subjects for the participation in the study

Dear respondent

I am a postgraduate student of Brite College of Nursing sciences, Bengaluru. As a

partial fulfillment of Master of Nursing Degree I am conducting a research study

“A study to evaluate the effectiveness of structured teaching programme on

knowledge regarding health promotive services among primary school teachers in a

selected schools, Bengaluru.”

Purpose of my study is to assess school teacher’s knowledge regarding the health

promotive services. Therefore I request you to respondent to the questionnaire. Your

answers will be kept confidential and will be used only for the purpose of the study.

Thanking you in participation

Yours faithfully

Date: (Shyny S Nair)

84
 Annexure 6

Letter seeking consent to validate the research tool.

From,
Shyny S Nair
IInd year MSc Nursing
BRITE College of Nursing sciences
Bengaluru.

To,

Respected sir /madam,

Subject: Requisition for acceptance to validate the research tool.

I, Shyny S Nair, II year MSc Nursing student (Community Health Nursing) of the
above mentioned institution kindly request you to give consent to validate the tool on

Topic: “A study to evaluate the effectiveness of structured teaching

programme on knowledge regarding health promotive services among
primary school teachers in a selected schools, Bengaluru”.
I would be highly obliged if you kindly give your acceptance. The acceptance
form is enclosed here with for your kind perusal.

Thanking you,

Place: Bengaluru Yours sincerely,

Date:
(Shyny S Nair)

85
 Annexure 7

Acceptance form for tool validation

Name:

Designation:

Name of the college:

Statement of acceptance or non-acceptance

I hereby accept/reject to validate your tool

Topic: “A study to evaluate the effectiveness of structured teaching programme

on knowledge regarding health promotive services among primary school
teachers in a selected schools, Bengaluru”.

Place:

Date:
Signature of Expert

86
 Annexure 8

List of Experts

1. Theresa L.M
Professor
Department of Community Health Nursing
Laxmi Memorial College of Nursing
Bengaluru.

2. Mrs. Veena
Professor and HOD
Department of Community Health Nursing
Masood College of Nursing
Bengaluru

3. Prof. Stella Sagaya Mary J.

Principal
Karavali College of Nursing Sciences
Bengaluru

4. Ms. R. Priyavadhana
Associate Professor
Sridevi College of Nursing
Bengaluru

87
5. Mrs. Renilda Shanthi Lobo
Head of the Department
Department of Community Health Nursing
City College of Nursing,
Bengaluru

6. Mrs. Chitra
Head of the Department
Department of Community Health Nursing
Unity College of Nursing
Bengaluru

7. Mr. Vishwanath Shetty

Consultant Community Healthian
Vishal Clinic
Bengaluru

8. Mr. Anil Shetty

Consultant Community Healthian
Vishal Clinic
Bengaluru

88
 Annexure 9

Evaluation Criteria Checklist for Validation of Tool

Instructions
1. The expert is request you to give your expert comments and suggestions.
2. There are 3 columns given for responses place a tick (  ) mark in the
appropriate column and give your remarks in the columns.
Interpretation of columns:
 Column I completely meets the criteria.
 Column II partially meets the criteria.
 Column III does not meet the criteria.
 Remarks.
3. Your expert opinion and kind co-operation will be highly appreciated and
gratefully acknowledged.
Thanking you in anticipation.
Sl.
Evaluation Criteria I II III Remarks
No.
1 Part I: Demographic data.
The items on socio-demographic
information cover all aspects
necessary for the study
2 Part II: Questionnaire to assess the
knowledge regarding health promotive
services among the primary school
teachers in selected schools.

Date:
Place: Signature of the Valuator

89
 Annexure 10

Content Validity Certificate

This is to certify that the tool developed by Ms. Shyny S Nair, II year M.Sc.
Nursing student of Brite College of Nursing,No.69,BWSSB Colony, Pipe Line Road,
Chikkagollahatti, Magadi Main Road, Bangalore-560091 (Affiliated Rajiv Gandhi
University of Health Sciences) is validated by the undersigned and can proceed to
conduct the main study for dissertation entitled “A study to evaluate the effectiveness
of structured teaching programme on knowledge regarding health promotive
services among primary school teachers in a selected schools, Bengaluru.”

Place: (Signature of the Valuator)

Date: (Designation & Address)

90
 Annexure -11

Blue print of the knowledge questionnaire on health promotive services

Content Knowledge Comprehension Application Total Percentage

General
information 1,3,4 2,5,6,7,8,9,10,11 11 36.7
regarding health
promotive
services

Important of
health 12,13,14 3 10
promotive
services

Process of
health 15, 18 19 16, 17 5 16.7
promotive
services

Teachers
responsibility in 20,22,23, 21,26,27,28 11 36.7
health
24,25,29,30
promotive
services.

Total 15 13 2 30

Percentage 50 43.3 6.7 100.00

91
 Annexure – 12
Description of tool (English)

DEMOGRAPHIC DATA
Instruction : Place tick mark () against the space provided in the following brackets
which applicable to you.
1. Sample No. [ ]

2. Age of the teachers (in years)

a. > 20 years [ ]

b. 21-24 years [ ]

c. 25-30 years [ ]

d. 31 and above [ ]

3. Sex
a. Male [ ]

b. Female [ ]

4. Education
a. PUC + D.Ed [ ]

b. SSLC + D.Ed [ ]

c. D.Ed + B.Ed [ ]

d. B. Ed + other [ ]

92
5. Religion
e. Hindu [ ]

f. Muslim [ ]

g. Christian [ ]

h. Others [ ]

6. Work experience years

a. 1 year [ ]

b. 2 to 3years [ ]

c. 4 to 5 years [ ]

d. >6 years [ ]

7. Monthly income of the family

a. <3000 [ ]
b. 3001-6000 [ ]
c. 7001-10000 [ ]
d. ≥10001 [ ]

8. Sources of information
a. Colleague& higher authority [ ]
b. Health personals [ ]
c. Mass media [ ]

93
PART – II : GENERAL INFORMATION REGARDING HEALTH PROMOTIVE
SERVICES
1. Health promotive services for

a. Improve the health [ ]

b. Maintenance of health [ ]

c. Prevention of disease [ ]

2. In schools health monitoring is responsibility of

a. Teacher [ ]

b. Head teacher [ ]

c. Management [ ]

3. Implementation of school health program is done by

a. Government [ ]

b. Management [ ]

c. Teachers [ ]

4. Implementation of health programme

a. Improve the health of the children [ ]

b. Improve the school attendance [ ]

c. Improve the school income [ ]

5. Health promotive services also includes

a. Education services [ ]

b. Nutritional services [ ]

c. Transport services [ ]

94
6. Health promotive services will be recorded in

a. Books [ ]

b. Attendance [ ]

c. School health records [ ]

7. Nutritional problem can be prevented by

a. Mid-day meal programme [ ]

b. Mid-day milk programme [ ]

c. Mid-day egg programme [ ]

8. Prevention of communicable disease can be done by

a. Medical treatment [ ]

b. Vaccination [ ]

c. Early detection [ ]

9. Immunization is part of

a. Nutritional programme [ ]

b. School health programme [ ]

c. Mental health programme [ ]

10. Following are the types of games except

a. Formal games [ ]

b. Imitative games [ ]

c. Informal games [ ]

95
 11. Hygiene means

a. Hair combing [ ]

b. Nail cutting [ ]

c. Personal hygiene [ ]

SECTION B : IMPORTANT OF HEALTH PROMOTIVE SERVICES

12. Important of Health promotive services is

a. Improve the health status of the children [ ]

b. Improve the growth and development of the children [ ]

c. All of above [ ]

13. Health promotive services will help

a. Skill development [ ]

b. Socialization [ ]

c. Awareness about the health [ ]

14. Health promotive services is also promote

a. Educational research [ ]

b. Kowledge [ ]

c. School attendance [ ]

96
SECTION C : PROCESS OF HEALTH PROMOTIVE SERVICES
15. Health appraisal will be

a. Only for student [ ]

b. Only for staff [ ]

c. Both staff and student [ ]

16. Medical examination will be monitored by

a. School health committee [ ]

b. Management committee [ ]

c. Staff committee [ ]

17. Mid-day meal programme contain

a. Only Protein [ ]

b. Only calcium [ ]

c. Necessary all nutrition [ ]

18. Which is the international organization started applied nutritional programme

a. WHO [ ]

b. UNICEF [ ]

c. UNESCO [ ]

19. St. John ambulance given equippement for

a. Eye health [ ]

b. Mental health [ ]

c. First aid [ ]

97
SECTION D : TEACHERS RESPONSIBILITY IN HEALTH PROMOTIVE
SERVICES
20. Maintains of school health records done by

a. Nurses [ ]

b. Teachers [ ]

c. Doctor [ ]

21. Teachers also responsible for

a. Awakening the health consciousness [ ]

b. Improving the result [ ]

c. Follow the committee order [ ]

22. Teachers update their knowledge by

a. Regular class [ ]

b. Regular meeting [ ]

c. Refer medias [ ]

23. Healthful school environment can be done by

a. Government [ ]

b. Staff committee [ ]

c. Teachers [ ]

24. Another responsibility of the teachers in school is

a. Periodic health checkup [ ]

b. Report to health committee [ ]

c. All of above [ ]

98
25. Nutritional programme will be successful

a. Efficient management [ ]

b. Efficient government [ ]

c. Efficient teacher [ ]

26. Teacher give importance during the health checkup is

a. Dental problem [ ]

b. Hygiene [ ]

c. Progress of child [ ]

27. Teachers responsibility in case of illness in child is

a. Send for better treatment [ ]

b. Continues observation [ ]

c. All of above [ ]

28. For health guidance and club in schools done by

a. Doctors [ ]

b. Nurses [ ]

c. Teachers [ ]

29. Mental problem easily identified by teachers because

a. Teachers will be have good knowledge [ ]

b. Children’s are available more time with teachers [ ]

c. Children will tell problem with teachers [ ]

99
30. Children health can be assessed and monitored and promoted in schools by

a. Mother [ ]

b. Nurses [ ]

c. Teacher [ ]

100
 Annexure -13

Answer Key

Q. No. Answer Q. No. Answer

1. B 16. c
2. B 17. c
3. C 18. a
4. B 19. b
5. B 20. c
6. A 21 a
7. B 22. a
8. B 23. b
9. A 24. c
10. C 25. a
11. B 26. c
12. A 27. a
13. C 28. b
14. A 29. a
15. A 30. b

101
 Annexure -14

10
A LESSON PLAN ON STRUCTURED TEACHING
PROGRAMME ON
HEALTH PROMOTIVE SERVICES
 TEACHING PLAN ON HEALTH PROMOTIVE SERVICES

Topic : Health promotive services

Group : Primary school teachers
Place : Selected schools at Bengaluru
Duration : 45 minutes
Method of teaching : Lecture cum discussion.
General objective : On the completion of structured teaching programme, the primary school teachers will gain knowledge regarding
health promotive services and will be able to apply this knowledge into practice.

SPECIFIC OBJECTIVE
On the completion of teaching programme, the primary school teachers.
1. define health promotive services

2. list down the Guidelines of the Health Promotive services

3. explain the Process of Health Promotive services

4. enumerate the important of Health Promotive services

5. explain the teachers responsibility in health Promotive services

Specific Content Time Teachers Learners AV Evalua
objective activity activity aids tion
Introduction:
3 min Teacher Listening
Health promotive services is a program for school introduces
the topic
health service under National Rural Health Mission, which has
been necessitated and launched in fulfilling the vision of
NRHM to provide effective health care to population
throughout the country It also focuses on effective integration
of health concerns through decentralized management at
district with determinant of health like sanitation, hygiene,
nutrition, safe drinking water, gender and social concern.

Definition:
3 min Defines Listening Flash Define
The health promotive services service is defined as "the
To define Health cards Health
Health school procedures that contribute to the maintenance and promotive promot
promotive services ive
improvement of the health of pupils and school personnel
services service
including health services healthful living and health s
education."
 Guidelines of the Health Promotive services

10min List down Listening Flash List

To List Guidelines of the Health Promotive services include:
the and cards down
down the
 The School Health Programme intends to cover 12,88,750 Guidelines clarifying the
Guidelines
of the doubt Guideli
of the Government and private aided schools covering around 22 Health nes of
Health
Crore students all over India. Promotive the
Promotive
services Health
services  The School health programme is the only public sector Promot
programme specifically focused on school age children. ive
service
 The programme at the national level has been developed to s
provide uniformity/guidance to States who are already
implementing or plan to implement their own versions of
programme and to give guidance in proposing a coherent
strategy for school health programme in next year’s NRHM
PIP to those States who have not yet started their
programme.
 The decentralized framework of implementation under
NRHM has enabled various states to devise and implement
their own version of School Health Programme.
 Various options of implementation have been suggested
under the programme based on the assessment of various
on-going school health programmes in various States.
  These management committees have been proposed in a
manner that they bring in convergence between related
departments/organizations.

Process of Health Promotive services

5mts Explain the Explaining Flash Explain

To Explain The health appraisal should cover not only the students but also and card
Process of the
the Process the teachers and other school personnel. Health appraisal clarifying
Health Process
of Health consists of periodic medical examinations and observation of
Promotive of
Promotive children by the class teacher.
services Health
services
The School Health Committee in India, recommended medical Promot
examination of children at the time of entry and thereafter ive
every four years. So one of the most important means of taking service
care of the physical well being of the school children is s
through systematic medical inspection of schools.

Generally it is seen that most of the students in the school

suffer from many preventable diseases such as defective teeth,
bad sight, deafness, anemia etc. but such diseases adversely
affect the learning capacity of the students and cause ill health.

Medical inspection is only the initial step in a great scheme of

progress which involves the improvement of not only the
physical but the mental and moral development of the children.
Although the system of school medical inspection has been in
existence for a number of years, yet the outcome of the result
have not been satisfactory for the following reasons as pointed
out by Secondary Education commission.

(i) The medical inspection has been done in a perfunctory

manner;

(ii) The defects that have been brought out even by this type of
examination have not been remedied because the remedial
measures suggested are often not carried out;

(iii) There is no follow-up, even in the case of those who have

been declared as defective;

(iv) Effective co-operation has not been established between

the school authorities and the parents, either due to ignorance
or due to lack of financial resources or reports of the school
medical officers.

Unless and until the present system is improved considerably,

it would be a mere waste of time and money to continue this
type of medical inspection in the urban areas in most schools
there is provision for medical inspection of students.

But in rural areas no such provision is available for students. In

Western countries, the medical inspection of children is a
regular feature of the school. However for making the medical
inspection meaningful the following factors should be taken in
to account:

(i) A thorough medical examination of all pupils and necessary

follow-up and treatment where necessary, should be carried out
in all schools;

(ii) Pupils with serious defects and those who suffer from
severe illness should be examined more frequently;

(iii) Medical examination should be given to teachers and other

school personnel as they form a part of the environment to
which the child is exposed;

(iv) The teacher is in a unique position to carry out the 'daily

inspection' as he is familiar with the children and can detect
changes in the child appearance or behavior that suggest illness
 or improper growth or development;

Important of Health Promotive services

10mts Enumerate Enumeratin Flash Enume

To 1.Developing schools in India as ‘Health Promoting Schools’. the important g and card rate
of Health clarifying the
enumerate
Promotive doubt importa
2. Implementing Comprehensive School Health Programme
the services nt of
(CHSP) in schools. Health
important
Promot
of Health ive
3. Promotion of research and development in the field of service
Promotive
school health and student well-being. s
services
4. Creation of awareness among school children about healthy
living.

5. Enhancement of the skills of school teachers in handling

health and developmental problems among children.

6. To promote life skill education and personal development in

schools.

7. To provide guidance for the establishment and maintenance

of Health Clubs in schools.

8. Provision of Preventive Health Services to Schools.

9. To identify and correct psychosocial problems among school

children, including substance abuse.

10. To provide counseling and guidance services to children

with special problems.

11. To develop and distribute health education materials and

media to schools.

12. Promotion of Educational Research.

13. To co-operate with governments and health agencies in the

formulation, implementation and evaluation of school health
policies and programs.

14. To set up and run establishments/institutions, that may help

in furthering the objectives.

15. To bring out newsletters, pamphlets and other

informational materials, that may help in furthering the
 objectives.

16. To formulate and implement any other activity as may be

necessary or is conducive to the attainment of the above
objectives.

Teachers responsibilities in health promotive services :

To Explain  Health appraisal of school children and school 8mts Explain the Explain the Flash Explain
cards
the personnel; teachers teachers the
teachers  Co-operation with the home and the community; responsibilit responsibilit teacher
responsibil  Healthful school environment; y in health y and s
ity in  Prevention of communicable diseases; Promotive discussing respons
health  Nutritional services; services ibility
Promotive  First aid and emergency care; in
services  Psychological services; health
 Use of school health records; Promot
 Remedial measures and follow up; ive
 Health instruction; service
 The promotion of positive health;
 The prevention of diseases;
  Early diagnosis, treatment and follow up of defects;

 Awakening health consciousness in children:

Summary:
Health promotive services in school is one of the most 3 min Summarize Listening Summa
rize the
important masseurs to restore the health of the children in topic
school age, it will help the children to re gain there earlier
condition and to maintain the health condition.

Conclusion:
Restoration of the health will be done only through 3 min Concluded Listening Conclu
de the
proper health promotive services, this required advanced topic
teachers knowledge. This will help the children to regain
health.
 Annexure -14

Statistical formulas used for analysis and interpretation

1. Karl – Pearson’s coefficient of correlation

n xy – (x) (y)

r=
[n (x2 – (x)2] [n (y2 – (xy)2]

2. Spearman – Brown Prophecy formula

2r
1 =
r
1+r

3. Chi- square test with 2x2 contigency table

N (ab – bc)2
X2 =

(a+b) (c+d) (a+c) (b+d)

4. Paried ‘t’ test

d d
t= d= d =  (d- d)2
 d2 n n
n