Effect of a health education program on teachers' practices regarding Helicobacter pylori prevention among basic school teachers in Koya district

Background and aim Helicobacter pylori infection remains a major public health concern, particularly in developing countries where poor hygiene facilitates transmission. Teachers serve as community role models; however, their preventive behaviors toward H. pylori infection are often insufficiently addressed. This study aimed to assess the association between a health education program and teachers' preventive practices regarding H. pylori infection among basic school teachers in Koya District, Erbil City, Iraq. Method This quasi-experimental study was conducted from September 1st, 2024, to June 1st, 2025, across 10 basic schools in Koya District using a multistage sampling technique (cluster-based school selection from five geographical zones followed by random teacher selection). Data were collected from 104 teachers (52 intervention, 52 control) using a structured questionnaire developed from published guidelines and validated through expert panel review (S-CVI = 0.91). Statistical analyses included chi-square, t -tests, multiple linear regression, binary logistic regression, and mixed-effects regression. Results Significant improvements were observed in the intervention group, particularly in filtered water use (Δ = 0.46, p < 0.01), clean water tank maintenance (Δ = 0.23, p = 0.03), and regular health check-ups (Δ = 0.58, p < 0.01). The intervention was associated with higher post-test practices scores (Adjusted R 2 = 0.39, p < 0.001). Intervention participants were nearly four times more likely to demonstrate significant improvement (adjusted OR = 3.89, p = 0.003). Conclusions The health education program was associated with improved teachers' preventive practices toward H. pylori infection. These findings suggest that structured, school-based health education may enhance hygiene practices, though confirmation through randomized multi-site studies with objective outcome measures and longer follow-up is warranted.