Student-Led Health Education Intervention Package Enhanced Tuberculosis Prevention in Colleges: A Quasi-Experimental One-Group Pre-Test/Post-Test Study

Xinyi Chen,1,2,* Min Wang,3,* Liai Peng,4,* Lin Zhou,1,2 Fei Wang,1 Zhipeng Zu,1 Ying Peng,1,2 Yinan Wang,5 Bin Chen1,2 1Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, People’s Republic of China; 2Zhejiang Key Laboratory of Vaccine, Infectious Disease Prevention and Control, Hangzhou, Zhejiang, People’s Republic of China; 3Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, People’s Republic of China; 4Department of Tuberculosis Control and Prevention, Shenzhen Baoan Center for Chronic Diseases Control, Shenzhen, Guangdong, People’s Republic of China; 5Department of Chronic Diseases Control and Prevention, Yuhuan Center for Disease Control and Prevention, Taizhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Bin Chen, Email bchen@cdc.zj.cnObjective: Tuberculosis (TB) remains a major public health threat, and colleges are crucial yet challenging settings for sustainable TB control. This study evaluated a standardized, student-led, multi-component intervention package designed to improve TB-related knowledge, attitudes, and practices (KAP) among college students in Zhejiang Province, China.Methods: Conducted across 20 colleges from March 2022 to June 2023, this quasi-experimental one-group pre-test/post-test design study implemented a novel health education intervention package that integrated five activities. KAP data were collected using an electronic questionnaire at baseline and post-intervention. Data on TB patients and delays were collected through the Tuberculosis Information Management System. The Mann–Whitney U-test was used for delay time analysis.Results: Valid responses included 4414 pre- and 4133 post-intervention. Overall, core knowledge of TB increased from 81.6% to 83.4% (P < 0.001). Significant improvements were seen in symptom recognition and care-seeking intent (P < 0.05). Regarding beliefs, the proportion who considered TB health education in schools “very necessary” increased from 53.5% to 57.8% (P = 0.001), while the proportion willing to proactively share knowledge with others rose from 90.9% to 92.5% (P = 0.007). Regarding behaviors, the proportion of current smokers decreased from 3.3% to 2.2% (P = 0.002), and the proportion of students frequently resting after 11 p.m. decreased from 70.2% to 64.3% (P < 0.001). Voluntary care-seeking among TB patients increased from 69.1% to 76.6%, while median patient delay decreased from 3 days to 0 (P < 0.001).Conclusion: This report adds to the literature by demonstrating the effectiveness of a participatory, multi-faceted health education model within the college population. The findings provide a replicable example for campus-based health promotion and offer clear implications for strengthening institutional public health strategies.