Evaluation of the intervention effect of an online prize-winning quiz on residents’ core knowledge of pulmonary tuberculosis prevention and control

doi:10.19982/j.issn.1000-6621.20260278

Abstract

Abstract:

Objective: To evaluate the intervention effect of online prize-winning quiz activities on residents’ awareness rate of core knowledge on pulmonary tuberculosis (PTB) prevention and control, and to provide evidence for optimizing TB health education strategies. Methods: Two rounds of online prize-winning quizzes on PTB prevention and control knowledge were released via the official WeChat public account of Changsha Center for Disease Control and Prevention in 2022 and 2023, with online questionnaire surveys conducted among all residents. Propensity score matching was applied to control for confounding factors. Among participants of the 2023 activity, those who had joined the 2022 activity were assigned to the intervention group (n=6638), and those who had not were assigned to the control group (n=6638). The differences in the overall awareness rate and item-specific awareness rate of core PTB prevention and control knowledge in the 2023 activity were compared between the two groups. Meanwhile, changes in the overall awareness rate of core PTB prevention and control knowledge within the intervention group were compared between 2022 (pre-intervention) and 2023 (post-intervention). The log-binomial regression model based on generalized estimating equations was used to calculate the risk ratio (RR) and ratio of risk ratios (RRR). Results: Cross-sectional comparison showed that the overall awareness rate reached 89.18% (29598/33190) in the intervention group and 81.38% (27009/33190) in the control group; the overall awareness rate of the intervention group was 1.10 times (95%CI: 1.09-1.10) that of the control group. Subgroup analysis revealed that the intervention effect was optimal among populations aged under 20 years (RR=1.37, 95%CI: 1.23-1.53). Among all core information items, the second core item (“Pulmonary tuberculosis is mainly transmitted through the respiratory tract, and everyone is susceptible to infection”) achieved the best intervention effect (RR=1.14, 95%CI: 1.12-1.16), while the third core item (“Those with cough and expectoration for more than 2 weeks should be suspected of pulmonary tuberculosis and seek medical care promptly”) had a relatively lower intervention effect (RR=1.06, 95%CI: 1.05-1.07). The overall awareness rate of the intervention group in 2023 (89.18%) was steadily elevated compared with its baseline level in 2022 (86.39%, 28674/33190)(RR=1.03, 95%CI: 1.03-1.04). The improvement magnitude was correlated with the number of quiz attempts and total quiz duration: participants with ≥2 attempts and cumulative quiz duration ≥2 minutes presented better improvement in awareness rate. Conclusion: Participation in online prize-winning quiz activities exerts a significant enhancement effect on residents’ mastery of core knowledge on PTB prevention and control. It is recommended to incorporate online prize-winning quizzes into routine TB health education approaches, adopt differentiated designs for different populations, and guide participants to take quizzes repeatedly and extend effective learning time to deepen the intervention effect.

Key words: Tuberculosis, Health education, Questionnaires, Intervention studies

CLC Number:

Xie Cifu, Song Lixin, Yin Pengliang, Xiong Zi. Evaluation of the intervention effect of an online prize-winning quiz on residents’ core knowledge of pulmonary tuberculosis prevention and control[J]. Chinese Journal of Antituberculosis, 2026, 48(9): 1356-1363. doi: 10.19982/j.issn.1000-6621.20260278

Figures/Tables 4

特征	干预组^a	对照组^a	RR^b (95%CI)值	Z值	P值	RRR^b (95%CI)值	Z值	P值
性别
男性	88.32 (14220/16100)	79.62 (12943/16255)	1.11 (1.10~1.12)	16.899	<0.001	参照组	参照组	参照组
女性	89.98 (15378/17090)	83.06 (14066/16935)	1.08 (1.07~1.09)	14.800	<0.001	0.98 (0.96~0.99)	-3.022	<0.003
年龄组(岁)
<20	86.34 (354/410)	63.08 (287/455)	1.37 (1.23~1.53)	5.613	<0.001	参照组	参照组	参照组
20~39	89.48 (26848/30005)	82.22 (24556/29865)	1.09 (1.08~1.10)	20.225	<0.001	0.80 (0.71~0.89)	-4.087	<0.001
40~59	86.18 (2232/2590)	75.20 (2038/2710)	1.14 (1.11~1.18)	8.252	<0.001	0.84 (0.75~0.94)	-3.066	<0.002
≥60	88.65 (164/185)	80.00 (128/160)	1.11 (0.96~1.27)	1.430	0.153	0.81 (0.68~0.96)	-2.376	0.018
文化程度
小学及以下	87.06 (1097/1260)	75.97 (961/1265)	1.15 (1.09~1.21)	5.154	<0.001	参照组	参照组	参照组
初中	88.38 (3862/4370)	79.73 (3512/4405)	1.11 (1.08~1.14)	7.805	<0.001	0.97 (0.91~1.02)	-1.164	0.245
高中	88.92 (7812/8785)	81.83 (7361/8995)	1.09 (1.07~1.11)	10.715	<0.001	0.95 (0.90~1.00)	-1.870	0.061
本科及以上	89.62 (16827/18775)	81.92 (15175/18525)	1.09 (1.08~1.10)	17.454	<0.001	0.95 (0.91~1.01)	-1.727	0.084
职业
农牧渔船民	86.31 (889/1030)	79.63 (864/1085)	1.09 (1.04~1.14)	3.581	<0.001	参照组	参照组	参照组
机关/事业单位	87.40 (4702/5380)	81.32 (4363/5365)	1.08 (1.05~1.10)	7.072	<0.001	0.99 (0.94~1.04)	-0.400	0.689
医务人员	88.65 (6454/7280)	78.84 (6130/7775)	1.12 (1.10~1.14)	11.900	<0.001	1.03 (0.98~1.08)	1.217	0.224
企业	91.05 (10566/11605)	83.23 (9230/11090)	1.09 (1.08~1.11)	13.806	<0.001	1.01 (0.96~1.06)	0.263	0.793
商业/服务业	88.78 (5593/6300)	82.78 (5244/6335)	1.07 (1.06~1.09)	8.334	<0.001	0.99 (0.94~1.04)	-0.448	0.654
在校学生	89.56 (806/900)	78.74 (689/875)	1.14 (1.09~1.19)	5.654	<0.001	1.05 (0.98~1.12)	1.435	0.151
军人	90.00 (45/50)	90.00 (36/40)	1.02 (0.81~1.30)	0.194	0.846	0.94 (0.74~1.20)	-0.482	0.630
离退休	84.55 (93/110)	81.05 (77/95)	1.04 (0.87~1.24)	0.418	0.676	0.96 (0.80~1.15)	-0.496	0.620
其他	84.11 (450/535)	70.94 (376/530)	1.19 (1.10~1.28)	4.235	<0.001	1.09 (1.00~1.20)	1.877	0.060
合计	89.18 (29598/33190)	81.38 (27009/33190)	1.10 (1.09~1.10)	22.499	<0.001	-	-	-

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特征	干预组(6638名)	对照组(6638名)	合计(13276名)	χ²值	P值
性别				0.290	0.590
男性	3251(49.0)	3220(48.5)	6471(48.7)
女性	3387(51.0)	3418(51.5)	6805(51.3)
年龄组(岁)				1.439	0.696
<20	91(1.4)	82(1.2)	173(1.3)
20~39	5973(90.0)	6001(90.4)	11974(90.2)
40~59	542(8.1)	518(7.8)	1060(8.0)
≥60	32(0.5)	37(0.6)	69(0.5)
文化程度				0.861	0.835
小学及以下	253(3.8)	252(3.8)	505(3.8)
初中	881(13.3)	874(13.2)	1755(13.2)
高中	1799(27.1)	1757(26.5)	3556(26.8)
本科及以上	3705(55.8)	3755(56.5)	7460(56.2)
职业				6.419	0.600
农牧渔船民	217(3.3)	206(3.1)	423(3.2)
机关/事业单位	1073(16.2)	1076(16.2)	2149(16.2)
医务人员	1555(23.4)	1456(21.9)	3011(22.7)
企业	2218(33.4)	2321(35.0)	4539(34.2)
商业/服务业	1267(19.1)	1260(19.0)	2527(19.0)
在校学生	175(2.6)	180(2.7)	355(2.7)
军人	8(0.1)	10(0.2)	18(0.1)
离退休	19(0.3)	22(0.3)	41(0.3)
其他	106(1.6)	107(1.6)	213(1.6)

题目	干预组 (6638名)^a	对照组 (6638名)^a	RR^b (95%CI)值	Z值	P值	RRR^b (95%CI)值	Z值	P值
第1项	5034(75.84)	4612(69.48)	1.09(1.07~1.11)	8.226	<0.001	参照组	参照组	参照组
第2项	5896(88.82)	5168(77.85)	1.14(1.12~1.16)	16.950	<0.001	1.05(1.02~1.07)	3.651	<0.001
第3项	6480(97.62)	6112(92.08)	1.06(1.05~1.07)	14.322	<0.001	0.97(0.95~0.99)	-2.653	0.008
第4项	5853(88.17)	5376(80.99)	1.09(1.07~1.10)	11.331	<0.001	1.00(0.97~1.02)	-0.212	0.832
第5项	6335(95.44)	5741(86.49)	1.10(1.09~1.12)	17.822	<0.001	1.01(0.99~1.03)	0.972	0.331

项目	干预后 (2023年)^a	干预前 (2022年)^a	RR^b (95%CI)值	Z值	P值	RRR^b (95%CI)值	Z值	P值
答题次数(次)
1	93.77 (4032/4300)	93.07 (4002/4300)	1.00 (0.99~1.01)	-0.522	0.602	参照组	参照组	参照组
2	90.87 (6638/7305)	90.09 (6581/7305)	1.04 (1.02~1.05)	5.962	<0.001	1.04 (1.02~1.05)	4.782	<0.001
3	89.17 (5952/6675)	86.55 (5777/6675)	1.04 (1.02~1.05)	5.434	<0.001	1.04 (1.02~1.06)	4.666	<0.001
4	88.07 (3985/4525)	83.36 (3772/4525)	1.06 (1.04~1.08)	6.340	<0.001	1.06 (1.04~1.08)	5.705	<0.001
≥5	86.58 (8991/10385)	82.25 (8542/10385)	1.06 (1.04~1.07)	7.559	<0.001	1.06 (1.04~1.08)	6.408	<0.001
累计答题时间(min)
<1	91.08 (7687/8440)	91.33 (7708/8440)	1.01 (0.99~1.02)	1.159	0.246	参照组	参照组	参照组
1~<2	90.30 (6574/7280)	87.23 (6350/7280)	1.01 (1.00~1.02)	1.547	0.122	1.00 (0.98~1.02)	0.136	0.892
2~<3	87.88 (5866/6675)	84.60 (5647/6675)	1.03 (1.02~1.04)	4.511	<0.001	1.02 (1.00~1.04)	2.423	0.015
3~<4	88.94 (3442/3870)	84.16 (3257/3870)	1.06 (1.04~1.07)	6.587	<0.001	1.05 (1.03~1.07)	4.504	<0.001
≥4	87.06 (6029/6925)	82.48 (5712/6925)	1.05 (1.04~1.06)	8.633	<0.001	1.04 (1.03~1.06)	4.996	<0.001
合计	89.18 (29598/33190)	86.39 (28674/33190)	1.03 (1.03~1.04)	10.795	<0.001	-	-	-