{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:04:44Z","timestamp":1781071484597,"version":"3.54.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background and aim<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      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\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection are often insufficiently addressed. This study aimed to assess the association between a health education program and teachers' preventive practices regarding\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection among basic school teachers in Koya District, Erbil City, Iraq.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      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,\n                      <jats:italic>t<\/jats:italic>\n                      -tests, multiple linear regression, binary logistic regression, and mixed-effects regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant improvements were observed in the intervention group, particularly in filtered water use (\u0394 = 0.46,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.01), clean water tank maintenance (\u0394 = 0.23,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03), and regular health check-ups (\u0394 = 0.58,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.01). The intervention was associated with higher post-test practices scores (Adjusted R\n                      <jats:sup>2<\/jats:sup>\n                      = 0.39, p &amp;lt; 0.001). Intervention participants were nearly four times more likely to demonstrate significant improvement (adjusted OR = 3.89,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The health education program was associated with improved teachers' preventive practices toward\n                      <jats:italic>H. pylori<\/jats:italic>\n                      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.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1830639","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:41:51Z","timestamp":1781070111000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of a health education program on teachers' practices regarding Helicobacter pylori prevention among basic school teachers in Koya district"],"prefix":"10.3389","volume":"14","author":[{"given":"Rukhosh","family":"Ishaq Mikha","sequence":"first","affiliation":[{"name":"Community Health Nursing Department, College of Nursing, Hawler Medical University","place":["Erbil, Iraq"]},{"name":"Nursing Department, Koya Technical Institute, Erbil Polytechnic University","place":["Erbil, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kareem","family":"Fattah Aziz","sequence":"additional","affiliation":[{"name":"Community Health Nursing Department, College of Nursing, Hawler Medical University","place":["Erbil, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"191","DOI":"10.3390\/antibiotics12020191","article-title":"Helicobacter pylori infection: current status and future prospects","volume":"12","author":"Elbehiry","year":"2023","journal-title":"Antibiotics."},{"key":"B2","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/S2468-1253(23)00070-5","article-title":"Global prevalence of Helicobacter pylori infection between 1980 and 2022","volume":"8","author":"Li","year":"2023","journal-title":"Lancet Gastroenterol Hepatol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.3390\/children9091359","article-title":"Worldwide prevalence and risk factors of H","volume":"9","author":"Borka Balas","year":"2022","journal-title":"pyloriChildren."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e73873","DOI":"10.7759\/cureus.73873","volume":"16","author":"Saeed","year":"2024","journal-title":"Cureus"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2149","DOI":"10.3390\/ijerph20032149","article-title":"Early gastric cancer: update on prevention, diagnosis and treatment","volume":"20","author":"Conti","year":"2023"},{"key":"B6","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1111\/den.14063","article-title":"Endoscopic screening for gastric cancer in Japan","volume":"34","author":"Mabe","year":"2022","journal-title":"Dig Endosc."},{"key":"B7","author":"Li","year":"","journal-title":"Regional Variation, Lifestyle Determinants, and Household Clustering of Helicobacter pylori in Coastal Southern China: A Multicenter, Population-Based Cross-Sectional Study."},{"key":"B8","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1038\/s41575-025-01098-0","article-title":"Rethinking gastric cancer prevention through an immigrant health lens","volume":"22","author":"Hyun","year":"2025","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"4325","DOI":"10.3390\/foods14244325","article-title":"On the role of food in the transmission of Helicobacter pylori infection: a narrative review","volume":"14","author":"Schuppler","year":"2025","journal-title":"Foods."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e064207","DOI":"10.1136\/bmjopen-2022-064207","article-title":"School-based Hygiene Intervention to Prevent HelicObacter Pylori infection among childrEn (SHIP HOPE): protocol for a cluster-randomised controlled trial","volume":"12","author":"Zhou","year":"2022","journal-title":"BMJ Open."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e943666","DOI":"10.12659\/MSM.943666","article-title":"Machine learning-based prediction of H","volume":"30","author":"Liu","year":"2024","journal-title":"pyloriMed Sci Monit."},{"key":"B12","doi-asserted-by":"publisher","first-page":"55","DOI":"10.21608\/ejnhs.2025.456098","article-title":"Knowledge and health beliefs regarding H pylori prevention among nursing students Egypt","volume":"6","author":"Abdelwahab","year":"2025","journal-title":"J Nurs Health Sci"},{"key":"B13","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1053\/j.gastro.2021.10.048","article-title":"How we approach difficult to eradicate H","volume":"162","author":"Argueta","year":"2022","journal-title":"pylori. 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