Primary Grade Teachers' Knowledge and Perceptions of Head Lice. (Research Papers)

By Kirchofer, Gregg M.; Price, James H. et al. | Journal of School Health, November 2001 | Go to article overview

Primary Grade Teachers' Knowledge and Perceptions of Head Lice. (Research Papers)


Kirchofer, Gregg M., Price, James H., Telljohann, Susan K., Journal of School Health


Management of head lice has stumped parents, health professionals, and teachers for years. Infestation of head lice can affect the child and the family financially, educationally, and psychologically. Education, recognition, communication, and early treatment all play a major role in controlling head lice transmission and infestation. In the past, diagnosis and education about head lice was considered the role of the school nurse.

Each year approximately 6 to 12 million Americans are infested with head lice, and the incidence rates of those affected continue to rise. (1) Most of those infested with head lice are school children between ages 5 to 12. (2) At present, no compulsory national reporting system exists for head lice, but outbreaks among elementary school students are frequently reported. (3) According to Surveillance Data Inc., (4) nearly 80% of school districts had at least one lice outbreak in 1997. An estimated 6 million elementary students, one in four, were infested in 1997. (4)

Head lice is an equal opportunity parasite because it exists all around the world and in every socioeconomic group. (5) Lice are most commonly found in young school-aged children because of the close physical contact with playmates. (6) Infestations from head lice have become more of the norm than the exception in elementary schools, child-care centers, and day camps. (4) "Prevalence of head louse infestation among school-aged children is usually reported as under 10% but may be as high as 40% in certain circumstances and locations." (6) (p 183)

Individuals at highest risk for infestation are White girls between ages 3 and 12. (5) Risk for this group has little to do with age or hygiene, but rather behaviors. Girls are often contaminated from shared use of fomites such as personal hair care items. Lice are more common among Whites than African-Americans because of the oval shape of their hair shafts. (7) The oval shape makes it more difficult for the lice to cling and secure their eggs to the hair shaft. (7)

Prevention is important when trying to limit the spread of head lice. There are four steps in the prevention process. (3) First, disclosure and communication are important in limiting the spread of lice from student to student and classroom to classroom. Communication is often difficult because of the stigma associated with head lice that prevents students and parents from coming forward. An atmosphere needs to be established which does not place the blame on one individual.

Second, teaching good habits is important. In most schools, the nurse is responsible for education of faculty, staff, parents, and students; however, classroom teachers should encourage practices that reduce the chance of transmission in the classroom. Classroom practices include placing personal belongings in individual lockers, discouraging mixture of outer clothing, and stressing the importance of good hygiene.

Third, educating individuals on how to provide proper treatment is important. The proper treatment process includes use of a pediculicide, nit removal, and cleaning the environment. Fourth, appropriate follow-up procedures are important in cases of chronic infestations. Parents should perform repeated head checks every two weeks until the school and home are clear of lice.

Prevention of head lice infestation and transmission can be accomplished with the cooperation of primary care providers, school health personnel, parents, and students. (3) Education, recognition, communication, and early treatment all play a role in controlling head lice transmission and infestation. In the past, this responsibility was left to the school nurse. However, elementary teachers also need to help in this effort. (8) A review of literature failed to find any studies that examined the knowledge and needs of elementary school teachers in regard to head lice prevention and education. This study assessed primary grade teachers' knowledge, perceived self-efficacy in dealing with head lice, and preferred resources for additional information on head lice. …

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