Effectiveness of Play-Based Nasal Hygiene Education in Preschool Children

NCT07654673 | Completed

• 1 other identifier: 2025/020-14
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

This study aimed to determine the effectiveness of a play-based nasal hygiene education program on nasal hygiene knowledge and skills among preschool children.

Conditions

Health Behavior; Nasal Hygiene; Respiratory Tract Infection Prevention; Preschool Children

Keywords

Nasal hygiene; Nose blowing; Preschool children; Play-based education; Health education; Cluster randomized controlled trial

Outcome Measures

Primary Outcomes (4)

• Change in Nasal Hygiene Knowledge Score

  Children's nasal hygiene knowledge was assessed using the Nasal Hygiene Knowledge Sequencing Test. The test consists of eight visual cards representing the steps of nasal hygiene. Children were asked to place the cards in the correct order. Each correctly ordered card was scored as 1 point and each incorrectly ordered card was scored as 0 points. Higher scores indicate a higher level of nasal hygiene knowledge.

  Baseline and two weeks after completion of the intervention

• Change in Nasal Air Pressure Performance

  Nasal air pressure performance was assessed using the Nasal Air Pressure Measurement Test. A lightweight paper strip was fixed to the child's nasal bridge, and the child was asked to blow through the nose with the mouth closed. Performance was evaluated based on the angle difference between the baseline position of the paper and the maximum elevation angle achieved during nasal blowing. Higher angle differences indicate better nasal air pressure performance.

  Baseline and two weeks after completion of the intervention

• Change in Nasal Airflow Performance

  Nasal airflow performance was assessed using the Nasal Airflow Performance Test. A lightweight pom-pom ball was placed inside a cardboard tube attached to a pediatric respiratory mask. Children were asked to blow through the nose with the mouth closed to move the pom-pom out of the tube. Performance was evaluated using two parameters: success in expelling the pom-pom from the tube and the time required to expel the pom-pom. Successful expulsion and shorter completion time indicate better nasal airflow performance.

  Baseline and two weeks after completion of the intervention

• Change in Nasal Hygiene Skill Score

  Children's nasal hygiene skills were assessed using the Nasal Hygiene Skill Assessment Checklist. The checklist evaluates children's performance of nasal hygiene steps in a simulated environment. Each skill step was scored as "performed" = 3 points, "partially performed" = 2 points, and "not performed" = 1 point. Higher scores indicate better nasal hygiene skill performance. The performance was video-recorded and evaluated by independent observers.

  Baseline and two weeks after completion of the intervention

Secondary Outcomes (1)

• Change in Parent-Rated Independent Nasal Hygiene Performance

  Baseline and four weeks after completion of the intervention

Study Arms (2)

Play-Based Nasal Hygiene Education Group

EXPERIMENTAL

Participants in the intervention group received a structured play-based nasal hygiene education program designed for preschool children. The program included visual educational materials, an animation-based educational video, and play-based skill development activities. The intervention aimed to improve children's nasal hygiene knowledge and performance, and hand hygiene after nasal cleaning.

Behavioral: Play-Based Nasal Hygiene Education Program

Control Group

NO INTERVENTION

Participants in the control group did not receive any nasal hygiene education during the data collection period. After completion of the post-test measurements, the nasal hygiene education program was also provided to the control group.

Interventions

Play-Based Nasal Hygiene Education Program BEHAVIORAL

The intervention consisted of a structured nasal hygiene education program developed for preschool children. The program included group-based education using visual educational materials, an animation-based educational video, and demonstration of nasal hygiene steps. It also included individual play-based practice stations: nasal air pressure development activities, nasal airflow performance activities, nasal hygiene sequencing cards, and a simulated nasal hygiene practice station. The program targeted both cognitive learning and psychomotor skill development.

Play-Based Nasal Hygiene Education Group

Eligibility Criteria

• Age: 5 Years - 6 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Being enrolled in the preschool/kindergarten class of the school where the study was conducted
• Being able to speak and understand Turkish
• Having written informed consent from a parent or legal guardian
• Being willing to participate in the study

You may not qualify if:

• Having an active disease that could affect nasal hygiene practice during data collection
• Having any chronic disease
• Having structural anomalies that may cause nasal obstruction
• Having a physical or cognitive impairment that prevents communication, watching the educational materials, or completing the measurement tools
• Having previously participated in a structured education program on nasal hygiene or nose-blowing skills
• Not having written informed consent from a parent or legal guardian
• Not being willing to participate in the study

Sponsors & Collaborators

• Istanbul Medeniyet University: lead

Study Sites (1)

Istanbul Medeniyet University

Istanbul, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Health Behavior; Health Education

Condition Hierarchy (Ancestors)

Behavior; Adherence Interventions; Medication Adherence; Patient Compliance; Patient Acceptance of Health Care; Treatment Adherence and Compliance

Study Officials

• Aynur Aytekin Özdemir, Professor

  İstanbul Medeniyet University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Due to the nature of the educational and play-based intervention, participants and the researcher delivering the intervention could not be blinded. However, performance-based assessments were video-recorded and evaluated by independent observers to reduce measurement bias.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: This study used a cluster randomized parallel-group design. Randomization was conducted at the classroom level to reduce the risk of contamination between children.

Study Record Dates

• First Submitted: June 12, 2026
• First Posted: June 17, 2026
• Study Start: November 1, 2025
• Primary Completion: January 16, 2026
• Study Completion: January 16, 2026
• Last Updated: June 17, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)