The objectives of hygiene education of children, adolescents and youth as one of the areas of the public health system multidimensional activity are shaping the healthy lifestyle and improvement of the hygiene skills aimed at health promotion [1–4].
The health-preserving technologies as a component of educational environment intended to reduce the negative impact of various factors are characterized by indiscriminate use of methods [5–7].
The issue of improving motivation to participate in the hygiene education programs and stimulation of interest to healthy lifestyle using the activity elements popular among students are discussed in the scientific literature [8–11].
Educational institutions play a vital part in the issues related to the health of children and adolescents. That is why it is important to bring the proven technologies that contribute to health preservation in children, adolescents and youth, the effectiveness of which is scientifically grounded, to the work of the institutions.
The study was aimed to develop and test the technology for hygiene training of students.

METHODS

In 2017–2019, we tested the “Habit Trackers — Checklists” technology in dynamics within the framework of the hygiene training of schoolchildren in the Moscow and Astrakhan regions. In 2021–2023, the technology was tested among college and university students. The study involved 502 schoolchildren attending various schools of the Astrakhan region (gymnasiums, lyceums, secondary schools); 234 college students studying in various areas of training (Tourism and Hospitality, Hair Styling Technology and Makeup Design, Economics and Accounting, Information Systems and Programming, Cookery and Confectionery); 429 university students (Pirogov Russian National Research Medical University).
Inclusion criteria: age 7–20 years; belonging to the group of students; availability of the informed consent. Exclusion criteria: another age group; not belonging to the group of students; no informed consent available.
Statistical processing of the data obtained was performed using the Statgraphics (Statgraphics Technologies; USA), Microsoft Office Excel (Microsoft; USA), Statistica 13 PL (StatSoft; USA) software packages. The Student's t-test for independent samples was used to assess the significance of differences between the mean values. When testing the statistical hypotheses, the significance level was set as p ≤ 0.05.

RESULTS

Various preventive, health-improving and health-preserving technologies are quite often used in educational institutions, however, the use of such technologies is haphazard, and the measures are often selected based on the teacher’s subjective beliefs. There is usually no verification of the effectiveness of implementation of such technologies.

In the Astrakhan region, we tested a comprehensive multidisciplinary approach proposed by the Ministry of Education of the Astrakhan Region and the Department of Hygiene of the Faculty of Preventive Medicine, Astrakhan State Medical University, considering the regional particularities and environmental factors influencing children. The “Habit Trackers – Checklists” technology was developed and tested, the instructional materials for implementation of the technology were prepared. The habit tracker is a tool that helps develop good habits. This may be in the form of a paper notebook, leaflet or a healthy lifestyle smartphone application. It is used to record the habit and the days of the task completion. The tracker helps incorporate new good habits and get rid of old ones. It is believed that on average, a habit takes 30 days to develop. Checklists are the lists of tips and actions widely used in the modern education system, i.e. represent the format that can be understood by today’s schoolchildren. The checklists developed for schoolchildren provide simple and easily achievable recommendations on shaping adherence to healthy lifestyle in school students. Thus, the checklist for schoolchildren contained the following recommendations:
– take a break or take a walk before doing homework;
– fine-tune the amount of light and sit down so that the light falls from the left (from the right if you are a left-hander);
– alternate between writing and oral tasks;
– at school and at home try to maintain a correct sitting position with your back and head straight, legs bent at the knees, feet flat on the floor or footrest;
– do not do your homework lying down on the sofa or in the armchair;
– do not use a tablet or smartphone holding it close to your eyes;
– check the time on your electronic device.

To provide the hygiene training of schoolchildren, educational institutions themselves developed a visual guide in the form of booklets containing information about the main components of daily routine and principles of healthy eating. The booklets were posted on the websites of the educational institutions taking part in the study, and the hard copies were distributed during the parents' meetings. The materials developed turned out to be in demand, these were used in the practice of the Regional Center for Public Health and Medical Prevention of the Astrakhan region (fig. 1).

The proposed approach showed its effectiveness: in educational institutions, where the hygiene training was conducted, the number of schoolchildren with the diseases of the musculoskeletal system and connective tissue decreased by 1.4 times, and the number of students with eye diseases decreased by 2.6 times compared to other educational institutions of the Astrakhan region.

Later the technology was tested for college and university students. The technology made it possible to improve the students’ awareness of the issues related to healthy lifestyle and the degree of adherence to the principles of healthy living.

Almost all students (95.0%) learned how to use the health smartphone applications and started to monitor their physical activity and other parameters (fig. 2). During their hygiene training 90.0% of students subscribed for various Internet resources provided by the medical institutions engaged in preventive work among the population.

During the technology testing the students chose the habit they wanted to develop themselves and created a specific habit tracker. The vast majority of students (85.5%) focused on the habit tracker for improvement of the levels of physical activity and chose the checklist for improvement of physical activity among the checklists developed within the framework of the checklist-based technology methodological support.

The materials developed turned out to be in demand, these were used in the practice of the Regional Center

for Public Health and Medical Prevention of the Yamal-Nenets Autonomous Area, being the leader in the field of preventive work among the population (fig. 3).

The proposed approach showed its effectiveness: the number of students having medium and high levels of physical activity increased from 46.0% (before the hygiene training) to 72.0% (after the hygiene training) (p ≤ 0.05).

DISCUSSION

The importance of health protection in children and adolescents is determined by the fact that deterioration of health in this population group can worsen unfavourable demographic situation, reduce the country’s labor, defense and intellectual potential [12, 13].

The students’ vision of the healthy lifestyle is on a tabloid level, it implies mainly the lack of harmful habits. Many schoolchildren and students do not realize that the key roles are also played by healthy eating, restful sleep, sufficient physical activity, coping skills, skills of proper spare time management. This suggests their insufficient awareness and insufficient adherence to the principles of healthy living [14–19].

However, the literature describes not all the techniques for hygienic training of students that contribute to formation of health-preserving skills, proper assessment of the risk of eye diseases, disorders of the musculoskeletal system, etc.

Useful skills can be applied via the habit tracker applications allowing one to develop a good habit within a certain time period [20].

Checklists are an essential component of the process of useful skill development and preparation of the hygiene training materials. The practical significance of checklists has been proven when using these for consolidation of acquired skills in the youth and skills training. The checklist is a memo used to note important moments and subsequently applied during activities. It may look like a mini plan or algorithm of actions for prevention of problems related to vision, stress, etc. [21].

Testing and assessment of the efficiency of the proposed technology suggest the increase in the students’ awareness of the health risk factors, preventive measures, healthy lifestyle basics, and learning health-preserving skills in daily life.

CONCLUSIONS

The findings allow us to recommend replicating the proposed technology as one of the practices used for effective hygiene training of students of all skill levels.