# Situation: Before the rainy season, the municipal health office asks the public health nurse to lead a dengue prevention campaign in several barangays using information, education, and communication (IEC) materials. Three months after the campaign, which finding BEST shows that residents changed their practices?

> source: MyMerci (mymerci.kr)  
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> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: Before the rainy season, the municipal health office asks the public health nurse to lead a dengue prevention campaign in several barangays using information, education, and communication (IEC) materials.

Three months after the campaign, which finding BEST shows that residents changed their practices?

## 보기

1. Fewer dengue cases were reported than in the previous year
2. More households had covered or emptied containers on inspection **✔ 정답**
3. Leaflets reached nine out of ten households in the barangays
4. Most residents scored higher on a post-test about dengue

**정답: 2**

## 해설

A change in practice is a behavior change, part of impact evaluation, and it is shown best by direct observation: more households with covered or emptied water containers on inspection. Higher test scores show knowledge, not behavior; leaflet coverage is a process measure; and fewer dengue cases are an outcome that also depends on rainfall, virus circulation, and other factors.

## 심화 해설

Behavior change is shown by observed practice
The question asks for the finding that best shows residents changed their practices. A change in practice is a behavior change, which is measured in impact evaluation. The strongest evidence of behavior is direct observation of the behavior or its results. Finding more households with covered or emptied water containers on inspection shows that residents are actually doing what the campaign taught. Observed covered or emptied containers are the direct sign that dengue prevention practices changed.

Levels of evaluation for an IEC campaign
Health education campaigns are evaluated at several levels. Process evaluation asks whether the campaign was delivered as planned, for example how many leaflets reached households or how many sessions were held. Impact evaluation looks at immediate effects on knowledge, attitudes, and behavior. Outcome evaluation looks at longer-term health results, such as changes in disease rates. Each level answers a different question, so the measure chosen must match what the evaluator wants to know.

| Finding | Evaluation level | What it shows |
| --- | --- | --- |
| Leaflets reached nine of ten households | Process | The campaign was delivered |
| Higher post-test scores | Impact (knowledge) | Residents learned facts |
| More covered or emptied containers | Impact (behavior) | Residents changed practices |
| Fewer dengue cases | Outcome | Health status changed, many causes |

Why the other findings fall short
Higher post-test scores show a gain in knowledge, but knowing that containers breed mosquitoes does not mean a household acts on it. Leaflet coverage shows that the campaign reached people, not that they did anything differently. Fewer dengue cases is an outcome influenced by many factors beyond household practice, including rainfall, the circulating virus serotypes, and vector control by the local government, so it cannot by itself prove that practices changed. Watch out! Disease reduction is the ultimate goal, but it is the weakest evidence of behavior change because of its many causes.

Exam takeaway
Match the evaluation measure to the question: delivery is process, knowledge and behavior are impact, and disease rates are outcome. For dengue prevention, barangay health workers can conduct house-to-house container inspections before and after the campaign, using the same checklist, to measure the change in practice. Combining these observations with case data over several seasons gives a fuller picture of the campaign's effect.

## 임상 시나리오

Evaluating an IEC CampaignEvidence of changed practices
A change in practice is behavior change, part of impact evaluation, best shown by direct observation.

More households with covered or emptied containers on inspection directly show changed dengue prevention practices.

Leaflet coverage is process evaluation; post-test scores show knowledge; fewer cases are an outcome with many causes.

CautionKnowledge gain does not equal behavior change, and fewer cases cannot alone prove that practices changed.

## 핵심 개념

- **IEC** — Information, education, and communication: health messages and materials designed to inform and change behavior.
- **Process evaluation** — Evaluation of whether a program was delivered as planned, such as materials distributed.
- **Impact evaluation** — Evaluation of immediate effects of a program on knowledge, attitudes, and behavior.
- **Container inspection** — House-to-house checking of water containers for mosquito larvae and protective practices.

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