A COMPARATIVE STUDY ON THE EFFECT OF ACTION

SONGS VERSUS ACTION SONGS AIDED WITH

PICTURES ON THE ENHANCEMENT AND
RETENTION OF KNOWLEDGE ON
INTESTINAL PARASITISM

A research paper presented

To the faculty of
Ateneo de Zamboanga University School of Medicine

In Partial Fulfillment
Of the Requirement for the Degree of
DOCTOR OF MEDICINE

Submitted by:

MERRY ANN S. TEUS

April 2005
 APPROVAL SHEET

This research entitled “A COMPARATIVE STUDY ON THE EFFECT OF

ACTION SONGS VERSUS ACTION SONGS AIDED WITH PICTURES ON THE
ENHANCEMENT AND RETENTION OF KNOWLEDGE ON INTESTINAL
PARASITISM”, prepared and submitted by Merry Ann Sabang Teus, in partial
fulfillment for the degree of Doctor of Medicine, is hereby accepted.

__________________
Dr. Roesmin S. Edding
Adviser

Approved by the Oral Examination Committee with a grade of PASSED

____________________ ___________________________
Dr. Ernesto G. Florendo Dr. Analisa Pureza A. Santamaria
Member Member

____________________ ___________________________
Dr. Samuel L. Cristobal Dr. Bernadette C. Chua
Member Member

____________________ ___________________________
Dr. Ricardo N. Angeles Dr. Hazel Eiza C. Soriano
Member Member

ACCEPTED in partial fulfillment of the requirements for the degree of DOCTOR OF

MEDICINE.
____________________
Dr. Mario R. Arciaga
Associate Dean for Research
Ateneo de Zamboanga University School of Medicine

i
 TABLE OF CONTENTS

PAGE

APPROVAL SHEET i
TABLE OF CONTENTS ii
ACKNOWLEDGEMENT iv
LIST OF FIGURES AND TABLES v
ABSTRACT vi
CHAPTER I INTRODUCTION
Background of the Study 1
Statement of the Problem 2
Conceptual Framework 4
Hypotheses 5
Significance of the Study 5
Scope and Limitations of the Study 5
Definition of Terms 6

CHAPTER II REVIEW OF RELATED LITERAURE 8

CHAPTER III METHODOLOGY
Research Design 13
Research Setting 13
Selection of Respondents 14
Variables of the Study 14
Research Instrument 15
Data Gathering Procedures 16
Statistical Treatment 19

CHAPTER IV RESULTS AND INTERPRETATION 20

CHAPTER V DISCUSSION 25
CHAPTER VI CONCLUSION AND RECOMMENDATIONS 29

ii
BIBLIOGRAPHY 30
APPENDICES
A QUESTIONNAIRE 32
B THE SONGS 36
C THE PICTURES 40
CURRICULUM VITAE

iii
 ACKOWLEDGEMENT
The researcher would like to extend her utmost gratitude to the following

individual who had been a blessing to her for they had played a great role in the

accomplishment of this research paper.

Her parents, brothers, sister & nephew for the prayers, inspiration, and love.

Her research adviser, Dr.Roesmin Edding, for the patience, time & enduring
kindness.

The ADZU-SOM research panel, for the constructive criticisms and for the patience.

Dr. Ricardo Angeles, for teaching her how to do the statistical analysis for this study.

Dr. Ervina Jalali, for her very creative study which paved a way for this study.

The Faculty, staff, & the grade 3&4 pupils of De Venta Perla Elem. School and San
Jose Elem. School for being very supportive & cooperative.

Zamboanga City Alliance Evangelical Church Praise & Worship Team members
headed by Pastor Bacabac & Hope, for helping in the recording of the songs.

Lloyd, Tin, & Norvie for the creation of the pictures which were used in this study.

Her research assistant, Ate Rose & survey assistant, Ate Fe for the unselfish support.

Manang Hasle & Manong Edward for a friendship that had helped her become a
better person; for the prayers, words of wisdom and for the “package deal” love.

Christine & Jayson for the best friendship ever; for being one of God’s greatest
blessings to her. The times of laughter when problems come, the times wherein
victories & fun were celebrated together, they will never be forgotten.

Juby, Patty, Ivie & Charlie– for being around back in the mountains. The great times
the group had spent together had really compensated the hardships that the group had
endured altogether.

Dr. Kunting & his family for the support, hospitality, & friendship.

The Magallanes family for treating the Venus group like a real family.

Lastly, to the Lord God Almighty, her greatest friend & Saviour. Indeed, his
faithfulness, mercy & love know no bounds. His grace is beyond description.

iv
 LIST OF FIGURES
Figures Page

1. Conceptual Framework 3

2. Graph: Knowledge Scores of the Experimental groups 1 & 2 22

LIST OF TABLES

Tables Page

1. Demographic Profile of the Respondents 19

2. Pre-intervention & 1st Post-intervention Knowledge Mean Scores of the

Experimental Group1 20

3. 1st Post-intervention & 2nd Post-intervention Knowledge Mean Scores of the

Experimental Group1 20

4. Pre-intervention & 1st Post-intervention Knowledge Mean Scores of the

Experimental Group2 21

5. 1st Post-intervention & 2nd Post-intervention Knowledge Mean Scores of the

Experimental Group2 21

6. Knowledge Mean Scores of the Experimental Groups 1 & 2 23

v
 “A COMPARATIVE STUDY ON THE EFFECT OF ACTION SONGS VERSUS
ACTION SONGS AIDED WITH PICTURES ON THE ENHANCEMENT AND
RETENTION OF KNOWLEDGE ON INTESTINAL PARASITISM”
by Merry Ann Sabang Teus
ABSTRACT

This study aims to compare the effect of action songs with pictures and action
songs alone in the enhancement and retention of knowledge regarding intestinal
parasitism among elementary students. A total of 101 respondents were included in this
study, 53 in the experimental group1 and 48 in the experimental group2. The
experimental group1 are the grade 3 & 4 students of San Jose Elementary School, and
the experimental group2 are the grade 3 & 4 students of De Venta Perla Elementary
School. A pre-intervention examination was conducted to ensure that both groups were
comparable in terms of their baseline knowledge regarding intestinal parasitism.
Afterwards, the 4-weeks intervention was conducted, two sessions per week, 30 minutes
per session, all scheduled in the morning. Action songs alone were the health teaching
tool being introduced to the experimental group1, while action songs with pictures were
the health teaching tool being introduced to the experimental group2. The first post-
intervention exam was given to both groups a day after the last day of the intervention.
Results showed that the experimental group2 has a significantly higher mean score
compared to that of the experimental group1. Thus the pictures had helped enhance the
students’ knowledge regarding intestinal parasitism. Two months after the first post-
intervention exam, a second post-intervention exam was given to both groups. Results
showed that there was knowledge decay in the experimental group1, but not in the
experimental group2. When both groups were compared in terms of their second post-
intervention mean scores, the experimental group2 still had a significantly higher
knowledge mean score than the experimental group1. Indeed, the action songs plus the
pictures had really helped in the enhancement and retention of the students’ knowledge
regarding intestinal parasitism.

vi
 CHAPTER I
INTRODUCTION

Background of the study

In the Philippines, parasitic infection is highly prevalent, and the most common

are the Soil-Transmitted Helminths. These parasites have a higher prevalence and

intensity of infection among children than adults due to lack of personal hygiene in

children and they have more frequent contact with soil (Del Mundo, 2000).

A study was done by Dr. Jalali (2004) using action songs as an educational

intervention, which aims to enhance the knowledge as well as increase knowledge

retention regarding intestinal parasitism among school children. The result of the said

study revealed that the action songs had helped enhance the knowledge of the school

children regarding intestinal parasitism immediately after the intervention. However, two

months after the intervention was done, the knowledge mean score of the respondents had

decreased significantly, indicating knowledge decay.

The health intervention done by Dr. Jalali (2004) was very promising. But the

problem of knowledge decay should be addressed. According to Woolfolk (Educational

Psychology, 1998), information is being stored in the long-term memory as either visual

images, or verbal units, or both. But information coded both visually and verbally is

easiest to learn and retrieve. A health teaching that uses both songs and pictures best

demonstrate a learning process wherein the information being grasped will be verbally

and visually encoded.

1
 Several studies found in the internet (medscape) had used pictures as an additional

material to other health teaching mediums. It had been used together with a lecture, with

songs and stories, with game cards, and with videos. All these studies showed that the

pictures had helped increase knowledge retention among the different respondents even

months after the different interventions were done. Thus, the author of this study came up

with the idea of supplementing the action songs used by Jalali with pictures to be able to

minimize knowledge decay.

Statement of the problem

Will action songs aided with pictures be more effective compared to action songs

alone in the enhancement and retention of knowledge regarding intestinal parasitism

among elementary students?

General Objective:

To compare the effect of action songs versus action songs aided with pictures as

an educational intervention in the enhancement and retention of knowledge regarding

intestinal parasitism among elementary pupils in Barangay De Venta Perla, Polanco and

in Barangay San Jose, Sergio Osmeña, Zamboanga del Norte.

Specific Objectives:

1. To determine the pre-intervention knowledge of the group where action songs with

pictures (experimental group2), and the group where action songs alone (experimental

group1) were used as a health education tool regarding intestinal parasitism.

2
2. To determine the knowledge of the experimental group1 and experimental group2

immediately after the intervention (first post-intervention examination) and two months

after the intervention (second post-intervention examination).

3. To compare the first post-intervention and second post-intervention knowledge mean

scores regarding intestinal parasitism of the experimental group1 and experimental

group2.

3
Conceptual Framework

Inadequate knowledge
regarding intestinal
parasitism.

ACTION SONGS
+
PICTURES

Knowledge enhancement and

increase knowledge retention

Figure 1: Conceptual Framework

This figure presents the theory in question, that is, knowledge regarding intestinal

parasitism. Action songs alone had caused knowledge decay as shown in the study

conducted by Dr. Jalali (2004). This study hopes to enhance the knowledge and increase

the level of retention of this knowledge by adding pictures to the action songs used in the

above-mentioned study.

4
Hypothesis

There is a significant difference between action songs and action songs

aided with pictures as an educational intervention on the enhancement and retention of

knowledge regarding intestinal parasitism among elementary students from De Venta

Perla Elementary School and San Jose Elementary School.

Significance of the Study

Despite causing knowledge decay two months after the intervention, the previous

study done by Dr. Jalali (2004) still yielded a very significant result in terms of

enhancement of knowledge of the school children regarding intestinal parasitism. Thus,

the researcher thought that it would a big help if such intervention will be improved for it

to be more effective as a health teaching medium among school children.

If this study can prove that the pictures could help minimize knowledge decay,

then it can be recommended as an alternative tool in teaching children regarding

intestinal parasitism.

Scope and Delimitations of the Study

Action songs aided with pictures and action songs alone were the two forms of

educational intervention used. Topics included were limited to hookworms, pinworms,

whipworms, and roundworms - their mode of transmission, effects in the human body,

and prevention of infection by these parasites. The knowledge that was assessed was also

limited to these topics.

5
 One limitation of this study is a lesser number of respondents compared to the

previous study done by Dr. Jalali (2004). Her study had included 156 respondents, while

this study only had 101.

Definition of Terms

1. Action songs – the health teaching tool recorded in audio tapes with the tunes of

certain known nursery rhymes but the lyrics were changed into information about the

mode of transmission and effects in the human body of soil-transmitted helminthiases

namely pinworms, hookworms, whipworms, and roundworms, as well as how to prevent

being infected by these worms. The lyrics were originally written by Dr. Jalali. Actions

will accompany the songs, which will be demonstrated by the researcher to the students,

and it shall depict the same message with the songs. The songs are the following:

Intestinal Worms with the tune of “Ten Little Indian”

Parasites with the tune of “Mary had a little lamb”

Bad for the health with the tune of “Are you sleeping”

Hands patterned from the tune of “Row, row your boat”

This is the way with the tune of “Here we go round the Mulberry bush”

To keep worms away with the tune of “London Bridge”

2. Action songs with pictures – the same action songs namely (1) Intestinal Worms (2)

Parasites (3) Bad for the health (4) Hands (5) This is the way and (6) To keep worms

away. The action songs have corresponding pictures, one picture per song, with a total of

six pictures as well. Each picture depicted the same message with its corresponding song.

There were 5 colored pictures and 1 black & white picture, each the size of a cartolina

6
paper. It was conceptualized by the author and drawn in a short-sized bond paper by a

cartoonist. Then it was scanned, edited in the computer, and then reproduced by printing

into a cartolina size. It was presented in the form of a flip chart wherein it was

simultaneously shown to the students. The pictures could also be easily reproduced by

manual sketching using pencils, cartolina or illustration boards, plastic cover, and an

expert hand. It is thus very affordable. But due to limited time, the author opted to have

the pictures printed rather than manually done.

7
 CHAPTER II

REVIEW OF RELATED LITERATURE

The highest percentage of people infected with Soil Transmitted Helminthiasis

(STH) is found in the age ranging from 3-18 years old. Children carry the heaviest worm

and egg burden because of their unhygienic practices. They are the principal

disseminators of infection. High prevalence rate in the younger age groups generally

indicates intense transmission, and special attention should therefore be given to children

(Casinillo, 2001). Thus, we should teach the children regarding intestinal parasites since

they are the most common victim.

According to Piaget’s Theories of Cognition, the third period of cognition, which

he labeled as “Concrete Operational Period”, occurs at age 7-11 years old. At this stage,

thinking is logical and there is an ability to relate external event to each other without

being egocentric. The child can understand classes and relation and can handle numbers.

Intellectual development also proceeds rapidly during this period, as well as conceptual

characteristics. This, coupled with the data in the first paragraph, are the reasons why the

researcher choose the grades 3 & 4 students, who belong to the age bracket 8-11 years

old, as the subjects.

The first step in learning is paying attention (Woolfolk, Educational Psychology,

1998). But the attention span of children is relatively short. It is therefore necessary to

teach children in such a way that their attention will be kept in focus. This is where the

issue of creativity sets in. There are many ways to be creative when it comes to teaching

children. One of this is the use of songs, and this has been proven as an effective

8
educational tool for children as reflected in the study done by Dr. Jalali (2004) wherein

after her one-month intervention, the knowledge of her respondents had significantly

increased. Although two months since the intervention was implemented, it was noted

that there was decay in the knowledge of the students.

Another creative way of teaching children is by using pictures. In the study done

by Shu, et. al (Public Health, 1999) entitled Health Education to School Children in

Okpatu, Nigeria: Impact on Onchocerciasis-related Knowledge, aside from the health

education given through lecture, illustrated picture materials were used to support and

enhance their understanding of the subject matter. This was done for three months, two

sessions per week, and 45 minutes per session. After the intervention, a significantly

higher proportion of these children knew about onchocerciasis, its causative agent,

clinical manifestations, treatment and prevention. It was concluded that the school-based

health education done showed an increase in knowledge about onchocerciasis.

The above-mentioned studies had separately proven the effectiveness of songs as

well as pictures respectively in enhancing the knowledge of children. However, despite

vigorous effort in looking for studies that used both songs and pictures as an educational

intervention, either in books, previous studies, on the internet using the medscape and

mednet search engine, none was found. But there was a study found in the internet in

which songs, pictures, and stories were used. This was done by Lansdown, et.al (Health

Education Research, 2002) entitled Schistosomiasis, Helminth Infection & Health

Education in Tanzania: Achieving Behavioral Changes in Primary Schools. In this study;

songs, stories, and pictures were used for four months as an educational tool among the

schools. Then, an evaluation was done five months and fifteen months after the

9
intervention. Accordingly, the children in the intervention area had a better knowledge

regarding the topics that were included as compared to the comparison group in which

only a lecture was done (p-0.000). Such study was almost similar with this study except

that in this study, stories were not part of the health education tool being used, only songs

and pictures.

Two more studies were found in the internet in which, pictures were used together

with other educational tool(s) as a health education medium. One is a study done by

Akogun, O.B., (Journal of the Royal Society of Health, 1992) entitled The Effect of

Selected Health Education Schemes on Knowledge & Attitude of the Kanuri towards

Certain Parasitic Diseases. There were three group of respondents, the third being the

control group. For the first group, health education tools used were still pictures and

game cards. While drama, songs, story-telling and discussions were the health education

tools being used for the second group. When a series of evaluation was conducted, the

first and second groups showed a significant improvement in terms of their knowledge

and attitude towards the given topics. Another is a study entitled Improving Compliance

with Quinine plus Tetracycline for Treatment of Malaria: Evaluation of Health

Education Interventions in Cambodian Villages by Denis,M.B., et.al. (Bulletin: WHO,

1998). To improve compliance with a 7-day quinine and tetracycline regimen against

malaria, two health education interventions were tested for ten weeks. Posters and videos

were used for the first group, while posters alone were used for the second group. Result

of the study showed that for the group wherein posters and videos were used, the

compliance rate increases from 0.5% to 20% with a p-value of 0.0004. The other group,

on the other hand, increased from 6% to 11%, with a p-value of 0.09. These figures

10
clearly show that the first group has a significantly higher compliance rate after the

intervention.

Several articles and arguments by some authors were also found which supports

the idea of using songs and pictures simultaneously. Such are:

First, Woolfolk (Educational Psychology, 1998) who says, “How then can we

make the most effective use of our practically unlimited capacity to learn and remember?

The way we learn information in the first place- the way we process it at the outset-

seems to affect its recall later .Information is being stored in the long-term memory as

either visual images or verbal units, or both. But information coded both visually and

verbally is easiest to learn and retrieved”.

Second, Barbara Fulk in her article 20 Ways to Make Instructions Memorable

(Intervention in Schools and Clinic Journal, 2000) gave twenty instructional strategies

which, can be used simultaneously and are designed to maintain student’s interest,

maximize student engagement, and optimize the memory of content information over

time. Among the 20 strategies she mentioned, the following were being utilized in this

study: (1) Grab their attention, (2) let students do it together, (3) take aim, (4) keep it

visual, (5) stress relationships using graphics to visually display links between different

ideas, (6) show them how (7) keep the action going, (8) employ constant practice among

themselves, and (9) refresh their memories. One message is very clear from this article –

be very creative, utilize the different senses, and encourage student’s participation.

Third, on another article written by Robin Salazar (2001) entitled Teaching

Methods- New Ideas, he stressed out that variety in teaching methods is very important,

may it be an adult class or a pre-school class. According to this article, there are seven

11
types of Multiple Intelligence, namely (1) visual/spatial, (2) verbal/linguistics, (3)

logical/mathematical, (4) bodily/kinesthetic, (5) musical/rhythmic, (6) interpersonal, and

(7) intrapersonal. In a certain class, we cannot expect everybody to be good at

memorizing dance steps alone, or singing alone, or reasoning out alone. Each member of

a class has his/her own strengths and weaknesses when it comes to learning. Some learn

easily through verbal lectures (verbal/linguistic learners), some through the teacher’s

body language and facial expression, pictures and diagrams (visual/spatial learners), and

others through hands-on approach (bodily/kinesthetic learners), etc. In this study, four of

these seven types of Multiple Intelligence were tapped. These are the visual/spatial,

verbal/linguistics, bodily/kinesthetic, and musical/rhythmic.

Based on the literatures mentioned above, the researcher came to a conclusion

that using the action songs used by Dr. Jalali, coupled with pictures as visual aids could

also be one creative way, and may even be more effective, in teaching children about

intestinal parasitism.

12
 CHAPTER III

METHODOLOGY

Research Design

This study is a quasi-experimental study.

Research Setting

This study was conducted in two different barangays, namely Barangay San Jose,

Sergio Osmeña, Zamboanga del Norte, the experimental group1, and Barangay De Venta

Perla, Polanco District II, the experimental group2.

Barangay San Jose is situated on the southern part of the municipality of Sergio

Osmeña, more than 9 km away from the town proper which is Poblacion Alto. It is very

hilly, situated on a higher altitude than the other part of the municipality, and could be

reached mainly by riding a “habal-habal” or motorcycle.

Polanco District II on the other hand is a neighbor municipality of Sergio Osmeña

situated on its northern part. Barangay De Venta Perla, the barangay of Polanco II nearest

to Sergio Osmeña, is also situated on the northern part of the Municipality of Sergio

Osmena and is around 9 km away from Poblacion Alto. It is situated along the highway,

and could be reached via bus traveling from Molave to Dipolog City.

13
Selection of Respondents

All grade 3 & 4 students of De Venta Perla Elementary School and San Jose

Elementary School were included in this study. For every examination that was

conducted, all of the students were allowed to take the examination. However, only the

knowledge mean scores of those students who were able to take the three examinations

namely pre-intervention, first post-intervention and second post-intervention

examinations were included in the final analysis of data. There were 6 pupils from San

Jose Elementary School who failed to take the first post-intervention examination, thus

they were no longer included.

Inclusion Criteria:

o Elementary students from Grades 3 & 4 regardless of their age.

Drop-out Criteria:

o Students who missed any of the three exams – the pre-intervention exam, the

first post-intervention exam and the second post-intervention exam.

Variables of the Study

Independent Variables

Six action songs regarding intestinal parasitism namely (1)Intestinal Worms sung

from the tune of “Ten Little Indian”, (2) Parasites with the tune of “Mary had a little

lamb” (3) Bad for the health with the tune of “Are you sleeping, (4) Hands patterned

from the tune of “Row, row your boat”, (5) This is the way with the tune of “Here we go

round the Mulberry bush”, and (6) To keep worms away with the tune of “London

Bridge”.

14
 Another are the six colored pictures which are also entitled (1) Intestinal Worms,

(2) Parasites, (3) Bad for the health, (4) Hands, (5) This is the way, and (6) To keep

worms away. The pictures were of the size of one cartolina paper each and these were

used together with the action songs for the experimental group.

Dependent Variables

The dependent variables will be the knowledge mean scores of the respondents

regarding intestinal parasitism.

Research Instruments

Questionnaire

The formulated, self-administered questionnaire from the previous study was used

in gauging knowledge enhancement and retention regarding intestinal parasitism for both

the experimental group1 and experimental group2. It is a 19-item questionnaire which

focuses mainly on the mode of transmission, effects in the human body, and prevention

of infection of hookworms, pinworms, whipworms, and roundworms.

Action songs

These were the set of songs originally written by Dr. Jalali (2004), which she

also used in her study, namely:

o Intestinal Worms sung from the tune of “Ten Little Indian”

o Parasites with the tune of “Mary had a little lamb”

o Bad for the health with the tune of “Are you sleeping

o Hands patterned from the tune of “Row, row your boat”

o This is the way with the tune of “Here we go round the Mulberry bush”

15
 o To keep worms away with the tune of “London Bridge”.

Colored pictures

The colored pictures were used as a visual aid in the form of flip charts which

were presented to the experimental group2 while they were performing the action songs.

The pictures were visual counterpart of the songs, thus the topics it portrayed were the

same as that of the action songs. Thus, the pictures were also entitled (1) Intestinal

Worms, (2) Parasites, (3) Bad for the health, (4) Hands, (5) This is the way, and (6) To

keep worms away. For every action song that the children sung, its corresponding picture

was shown to them.

Data Gathering Procedure

Pre-Intervention

Questionnaires were used to gauge the baseline knowledge of the students

regarding intestinal parasitism. It was given out to the respondents and they were given a

maximum of 30 minutes to answer all items. These were distributed in two separate days,

one day per school. For De Venta Perla Elementary School, it was done last October 20,

2004. San Jose Elementary School, on the other hand, was last October 22, 2004.

Intervention

The entire length of the intervention for both groups was conducted last

November 04 until December 03, 2004. It lasted for four weeks. The researcher

personally conducted and led the singing in each session for both the experimental

group1 and experimental group2. Per group were allotted two sessions per week and it

16
was done on Tuesdays and Fridays for the experimental group1 and on Mondays and

Thursdays for the experimental group2. Every session lasted between 30-40 minutes.

For the first session conducted among the experimental group1 during the first

week, lyrics of the songs which were written in manila paper were shown to the students

using a flipchart, and then they were asked to sing it along with the recorded songs. They

were able to sing each song three times. On the second session, they were asked again to

sing along with the recorded songs, with the lyrics of the songs shown to them. This time

the actions were also shown to them by the researcher. They were asked to follow the

actions while singing. For this session, they were able to sing each song two times. Just

like in the experimental group1, the lyrics of the songs were also shown to the

experimental group2 during the first session, and they were also asked to sing it along

with the recorded songs. The pictures were still not shown to them since it was the first

day and the researcher wanted the pupils to first familiarize with the different songs.

They were also able to sing each song three times. On the second session, they were

asked again to sing along with the recorded songs, with the lyrics of the songs being

shown to them. The actions were also shown to them by the researcher and they were

asked to follow while singing. Then, from the very first song that they sung until the last

song, the corresponding pictures of the songs were also shown to them. A research

assistant was the one assigned to change the pictures that were shown. The songs they

were singing and the picture being shown should match. For this session, they were also

able to sing each song two times.

For the next two sessions during the second week, the lyrics of the songs were still

being shown to both groups while the students sung and perform the action songs. This

17
time, each group was able to sing each song three times per session. The pictures were

also continually presented to the experimental group2 in the manner that it was being

presented during the first week of the intervention.

On the third week, the lyrics were no longer shown to the students from both the

experimental group1 and experimental group2. They were just asked to sing along with

the recorded songs. But the pictures were still continually shown to the experimental

group2. Still, both groups were able to sing each song three times per session.

Finally, on the last two sessions during the fourth week, the pupils were just asked

to sing the songs and perform the actions of the songs without the lyrics and without the

recorded songs, but still with the pictures for the experimental group2. Each song was

again sung three times in every session.

Post- Intervention

The first post-intervention examination on both groups was done after the last day

of the intervention using the same questionnaire that was used during the pre-intervention

survey.

Two months after the first post-intervention examination, a second examination

was again given to both groups using the questionnaire.

During the second post-intervention exam, the teachers of the respondents

reported to the researcher that during time between the first post-intervention exam and

the second post-intervention exam, the students from both groups do perform the songs

during their early morning opening class programs. They do it once to twice a week. The

pictures, on the hand were no longer shown to the students from the experimental group2

during this period of time.

18
Statistical Treatment

Independent sample T-test was used to assess if the pre-intervention exam scores

of the two groups were comparable. The same test was also used to compare the first

post-intervention mean scores of the two groups, as well as their second post-intervention

mean scores.

To compare the pre-test with the first post test, and the first post test with the

second post test in each group, ANOVA for repeated measure was used.

19
 CHAPTER IV
RESULTS AND INTERPRETATION

Demographic Profile of the Respondents

Initially, this study has employed a total of 107 pupils as respondents. Forty eight

(48) of these are from the experimental group2 and fifty nine (59) are from the

experimental group1. However, 6 respondents from the experimental group1 were

dropped-out because they were not able to take the first post-intervention examination.

Thus, at the end of this study, there were only a total of 101 respondents, 53 from the

experimental group1 and 48 from the experimental group2.

The mean age of each group shows that the age distributions of both groups are

just almost the same. The distributions of the grade 3 and 4 pupils between the two

groups are also within the same range.

Table 1: Demographic Profile of the Respondents

Sex Mean Age
GROUP (years) Grade 3 Grade 4
Male Female

EXPERIMENTAL 22 31 10 29 24
GROUP 1 (N=53)
EXPERIMENTAL 30 18 10.10 23 25
GROUP 2 (N=48)

20
Results of the Pretest, First Post test and Second Post test

Table 2 shows the comparison of the pre-intervention and first post-intervention

knowledge mean scores of the respondents in the experimental group1 one-month after

the intervention. The comparison gives a p-value of 0.000 which means that there is a

significant increase of their knowledge.

Table 2: Pre-intervention & 1st Post-intervention Knowledge Mean Scores of the Experimental
Group1 with its Corresponding ANOVA p-value
EXPERIMENTAL GROUP 1 (SAN JOSE ELEM. SCHOOL)

Pre-intervention 1st post-intervention Gain Score p-value

6.53 13.11 6.58 0.000

P-value ≺ 0.05 is significant

Table 3, on the other hand, shows the difference of the knowledge mean scores

between the first post-intervention and second post-intervention knowledge mean scores

of the experimental group1. It has a p-value of 0.004, which means that the decrease from

13.11 to 11.85 is also significant, indicating knowledge decay.

Table 3: 1st Post-intervention & 2nd Post-intervention Knowledge Mean Scores of the
Experimental Group1 with its Corresponding ANOVA p-value
EXPERIMENTAL GROUP 1 (SAN JOSE ELEM. SCHOOL)

1st post- 2nd post-

Gain Score p-value
intervention intervention

13.11 11.77 1.34 0.028

P-value ≺ 0.05 is significant

21
 Table 4 shows the pre-intervention and first post-intervention exam knowledge

mean scores of the experimental group2. It has a p-value of 0.000, which means that

there was a significant increase of knowledge one-month after the intervention.

Table 4:Pre-intervention & 1st Post-intervention Knowledge Mean Scores of the Experimental
Group2 with its Corresponding ANOVA p-value.
EXPERIMENTAL GROUP 2 (DE VENTA PERLA ELEM. SCHOOL)

Pre-intervention 1st post-intervention Gain Score p-value

6.06 15.02 8.96 0.000

P-value ≺ 0.05 is significant

Table 5 shows the comparison between the first post-intervention exam and
second post-intervention exam, which is not significant (p-value of 0.087). This means
that there was no significant decrease in the knowledge of the respondents even if two
months had already passed since the intervention was done. Thus, there was retention of
knowledge regarding intestinal parasitism among this group.

Table 5:1st Post-intervention & 2nd Post-intervention Knowledge Mean Scores of the
Experimental Group2 with its Corresponding ANOVA p-value.
EXPERIMENTAL GROUP 2 (DE VENTA PERLA ELEM. SCHOOL)

2nd post-intervention Gain Score p-value

1st post-intervention
15.02 14.29 0.73 0.260

P-value ≺ 0.05 is significant

22
 16

14
Knowledge Mean Scores

12

10
experimental 2
8
experimental 1
6

0
Pre-intervention First Post Exam Second Post
exam Exam
Figure 2: Graphical Representation of the knowledge Mean Scores between the Experimental
group1 and Experimental group2

Figure2 shows the graphical comparison of the knowledge mean scores of the two
groups during the pre-intervention, first post and second post examinations. The graph
clearly shows the trend of the difference of the mean scores of the two groups. The
experimental group1 has a slightly higher pre-intervention mean score compared to
experimental group2. But during the two post examinations, the trend shows that the
experimental group2 had gained a significantly higher mean scores compared to
experimental group1.

23
 Table 6 shows the pre-intervention, first post and second post-intervention exams
knowledge mean scores of the experimental group1 and experimental group2. The T-test
p-value of the pre-intervention mean scores is 0.432 which means that despite the little
difference in the mean scores of the two groups, the difference is not significant. Thus,
the two groups were comparable. First post-intervention exam knowledge mean scores of
both the experimental groups 1 & 2 shows a p-value of 0.024, which means that the mean
score of the experimental group2 is significantly higher than that of the experimental
group1. The knowledge mean scores during the second post-intervention exam, with a p-
value of 0.007, also shows a significant difference which means that the experimental
group2 still has a significantly higher knowledge mean score compared with the
experimental group1, even after two months after the interventions were being
implemented. But in totality, both first & second post-intervention exams show a
significantly higher knowledge mean scores from that of the pre-intervention exam man
scores.

Table 6: Knowledge Mean Scores between the Experimental group1 and Experimental group2
and its corresponding Independent Sample T-test p-value
EXPERIMENTAL EXPERIMENTAL
EXAM P-value
GROUP1 GROUP2
Pre-intervention
6.53 6.06 0.432
Exam
First post-
13.11 15.02 0.024
intervention exam
Second post-
11.77 14.29 0.007
intervention exam
p-value ≺ 0.05 is significant

24
 CHAPTER V
DISCUSSION

Initially, a pre-intervention examination was conducted among the two groups

using the questionnaire being used in the previous study done by Jalali (2004) to ensure

that both groups were comparable in terms of their baseline knowledge regarding

intestinal parasitism. The result revealed a mean score of 6.53 for the experimental

group1 and 6.06 for the experimental group2 with a p-value of 0.432 (table 6). The

difference in their knowledge mean scores was insignificant, making both groups the

final respondents for this study.

The intervention in this study also lasted for four weeks, just like in the study

done by Jalali (2004). There were also two sessions per week for every group which

lasted at an average of 30 minutes per session. The experimental group1 in this study

was the group wherein the intervention received was similar with the experimental group

in Jalali’s study. The way of conducting the intervention was also similar for both studies,

except that in this study, the recorded songs were used only up to the third week for both

the experimental groups 1 & 2 because the students had already memorized the songs.

While in the intervention done by Jalali, the recorded songs were used up to the fourth

week of intervention for both the control and experimental group. But despite this

difference, the results of both studies had similarly showed that action songs alone can

really enhance the knowledge of the students after the one-month intervention, but not

two months after because knowledge decay was both noted in Jalali’s experimental group

and the experimental group1 in this study. This will be further elaborated in the

succeeding paragraphs below.

25
 After the last day of the 4-weeks intervention, an immediate post-intervention

examination was conducted. Results showed a mean score of 15.02 for the experimental

group2 and 13.11 for the experimental group1, with a p-value of 0.024 (table 6). The

experimental group2 had a significantly higher mean score compared to the experimental

group1. This result had supported John Bradford (2000) in saying that “in enhancing a

child’s memory, we should allow the child to use more of his/her senses in such a way

that the child has visual memory of the topic(s), auditory memory, kinetic (body

movements) memory and tactile memory”. The action songs had helped the students

anchor a kinetic and auditory memory of the topics while the pictures had helped

facilitate their visual memory, thus enhancing the storage and retrieval of the knowledge

they had recently acquired. It was a creative way of teaching them regarding intestinal

parasitism, its mode of transmission, its effects in the body, and prevention of being

infected by it. The sessions conducted were something new for the students and they

enjoyed it immensely. It was very inspiring that they were really looking forward to

every session being scheduled for them during the entire length of the intervention. Even

the researcher also had a great time teaching the students those action songs.

The concept of John Bradford also applies even among the experimental group1

respondents because their first post-intervention exam knowledge mean score which was

13.11 is still significantly higher from the pretest mean score of 6.53, with a p-value of

0.000 (table 2). In the study done by Jalali (2004), the experimental group (action songs

only) had also a significant increase in their knowledge after the entire length of the

intervention done. They had a pre-intervention knowledge mean score of 6.66 and 14.70

26
for the first post-intervention exam, with a p-value of 0.000. The action songs had helped

enhance their auditory and kinetic memory.

These two groups wherein action songs were used had both proven that action

songs can really increase the knowledge of elementary students regarding intestinal

parasitism one month after the intervention.

Two months after the intervention was conducted, a second post-intervention

exam was given to all the respondents who were able to take the pre-intervention and first

post-intervention exams. This is to assess the level of knowledge retention regarding the

topics being incorporated in the action songs and the pictures to both groups. For the

experimental group2, from a first post test mean score of 15.02, it became 14.29 during

the second post test with a p-value 0.087 (table 5). This value means that there is no

significant difference in the knowledge of the experimental group2 even if two months

had already passed since the intervention was implemented. Thus, there was no

knowledge decay. Indeed, the ideas of Barabara Fulk (2000) in her article 20 Ways to

Make Instructions Memorable holds true – be very creative, utilize the different senses,

and encourage student’s participation. For the experimental group1, their first post-

intervention exam knowledge mean score of 13.11 decreased to 11.77 during the second

post-intervention exam, with a p-value of 0.004 (table 3). The difference is significant

and this means that there was knowledge decay among the experimental group1. Thus,

the hypothesis of this study is proven true. The pictures can help in the enhancement as

well as in retention of knowledge among elementary pupils regarding intestinal

parasitism.

27
 As for the comparison among the two groups in terms of their second post-

intervention knowledge mean scores, the mean score of the experimental group2 was

14.29 and 11.77 for the experimental group1, with a p-value of 0.007. It shows that the

experimental group2’s mean score is still significantly higher than that of the

experimental group1, and so is their knowledge retention regarding intestinal parasitism.

This result strongly supports the statement of Woolfolk (1998) wherein she said that

information is being stored in the long-term memory as either visual images or verbal

units, or both. But information coded both visually and verbally is easiest to learn and

retrieved. The experimental group was able to utilize their visual and verbal senses in

encoding the new knowledge they had acquired into their long-term memory, while the

control group only utilizes their verbal sense.

The intervention done in the experimental group2 was also able to address more

Multiple Intelligence types (Salazar, 2001) compared to the intervention done among the

experimental group1. The pictures were able to address those pupils who are

visual/spatial learners. The action songs, on the other hand, were useful to those who

were bodily/kinesthetic learners, the verbal/linguistic learners as well as those who were

musical/rhythmic learners.

Woolfolk was also right in stressing out the necessity to be very creative in

teaching, especially among children for this will help them learn fast. Learning in

different ways would make the children realize that there are many ways to approach

anything that they need to learn

28
 CHAPTER VI

CONCLUSION AND RECOMMENDATIONS

Conclusion

The study done by Jalali (2004) utilized action songs as a health education tool.

The result of her study showed that the knowledge of the students had increase after the

one month intervention. But there was knowledge decay two months after.

In this study, pictures were being used together with the action songs and indeed,

adding the pictures to the action songs had enhance the knowledge and had increased the

level of retention of such knowledge among the elementary students regarding intestinal

parasitism.

Recommendations

Based on the results of this study, the following are recommended. First, the

action songs coupled with the pictures can be recommended as an alternative educational

tool among school children. Second, each action song should be sung and performed at

least once a day. Third, the pictures may be placed in the walls of the classrooms so that

even without singing the songs, the pupils will frequently remember the topics being

incorporated in the action songs and pictures. Fourth, aside from the knowledge, further

study which will assess the attitudes and practices may also be done.

29
 BIBLIOGRAPHY

Akogun, O.B. The Effect of Selected health education Schemes on Knowledge and

Attitude of the Kanuri Towards Certain Parasitic Diseases (Journal of the

Royal Society of Health). 1992. hubley.co.uk/infectdis.htm

Bradford,John. Using Multi-Sensory Teaching Methods. 2000. dyslexia-

teacher.co.uk/t6.htm

Casinillo, Noemi Ann. Effect of Community-Based Health Education Strategy on the

Control of Intestinal Parasitism in School Children Aged 8-13 Years in

Grades 3-5 in Dumalinao Pilot Elementary School in Barangay Paglaum,

Dumalinao, ZDS. 2001

Del Mundo, et.al. Textbook of Pediatrics and Child Health. JMC Press, Inc. 4th ed.

2000

Denis, M.B. Improving Compliance with Quinine plus Tetracycline for Treatment of

Malaria: evaluation of health Education Interventions in Cambodian Villages

(Bulletin:WHO). 1998. hubley.co.uk/infectdis.htm

Fulk, Barbara. Make Instructions More Memorable. 2000.

hubley.co.uk/infectdis.htm

30
Jalali, Ervina. The Effect of Action Songs on the Enhancement and Retention of

Knowledge Regarding Intestinal Parasitism Among Elementary Pupils in

barangay Polo. 2004

Lansdown, et.al. Schistosomiasis, Helminth Infection and Health Education in

Tanzania: Achieving Behavioral Changes in Primary Schools. 2002.

hubley.co.uk/infectdis.htm

Salazar, Robin. Teaching Methods-New Ideas.2001. bellaonline.com

Shu, et.al. Health Education to School Children in Okpatu, Nigeria: Impact on

Onchocersiasis-related Knowledge. 1999. hubley.co.uk/infectdis.htm

Woolfolk, Anita. Educational Psychology. Allyn & Bacon A. Simon & Schuster Co.

7th ed. 2001

31
 APPENDIX A
QUESTIONNAIRE

Name: Age:
Grade: Address:
Section: Sex:

1. What is an intestinal worm?

a. Bacteria
b. Virus
c. Protozoa
d. Parasite

2. Identify the correct statement regarding intestinal worms

a. Intestinal worms are bad for our health
b. Intestinal worms are good for our health
c. Intestinal worms can make us fat
d. None of the above

3. Identify the correct statement regarding parasite

a. A parasite is good for our body
b. A parasite can make us healthy
c. A parasite lives and feeds on us
d. A parasite can make us smart

4. What are the intestinal worms?

a. Roundworms, pinworms, hookworms, and whipworms
b. Earthworms, fruitworms, and toothworms
c. Silkworms, seaworms, and footworms
d. None of the above

32
5. Which of the following statement is correct?
a. Some eggs of intestinal worms can be swallowed thru dirty hands
b. Some eggs of intestinal worms can be swallowed thru clean hands
c. Some eggs of intestinal worms can be swallowed by eating fruits after
washing them
d. None of the above

6. Some intestinal worms can go inside our body by passing through what way?
a. Passing through eyes
b. Passing through skin
c. Passing through ears
d. Through the bites of mosquitoes

7. If some intestinal worms eat our food inside our body, what can other worms do
inside our body?
a. Some intestinal worms suck our blood inside our body
b. Some intestinal worms stay inside our body and do nothing
c. Some intestinal worms inside our body create vitamins that can make us
strong
d. None of the above

8. Why do we need to avoid intestinal worms?

a. Intestinal worms can make us angry
b. Intestinal worms can make us sad
c. Intestinal worms can make us sick
d. None of the above
9. What should we do to keep our nails short and clean?
a. Suck our nails
b. Trim our nails
c. Press our nails
d. None of the above

33
10. How do we wash our hands to keep worms away from our body?
a. Wash hands for 10 minutes with clean water only
b. Scrub them well with lots of soap and rinse it
c. Wash hands thoroughly in the river
d. Wash hands with warm seawater

11. Your two years old cousin loves to play with the soil, after playing what should
you do to keep worms away from your cousin’s body?
a. Wash hands with soap and water
b. Wash her hands with water only
c. Wipe her hands with tissue paper
d. Leave your cousin alone

12. What should you do after throwing the garbage?

a. Scrub our hands well with lots of soap and rinse it
b. Wipe our hands using our clean shirt
c. Wash our hands thoroughly with clean water
d. None of the above

13. What should we do after using the bathroom?

a. Wipe our hands with a clean rag
b. Scrub our hands well with lots of soap and rinse it
c. Wash our hands with clean water only
d. None of the above

14. Your mother bought fruits from the market and you saw your small brother pick
one and was about to eat the fruit. What should you do?
a. Call mother
b. Leave him alone
c. Tell him to wash the fruits before eating
d. None of the above

34
15. You love to eat guava, and your friend gave you one on your way home from
school. Before eating the guava, what should you do?
a. Wash the guava
b. Clean the guava with tissue paper
c. Clean the guava with a rag
d. Wipe the guava with your own shirt

16. Which of the following is the right way to do to keep worms away from our
body?
a. Always wear our new dress
b. Always wear our sunglasses everytime we go out
c. Wear slippers/shoes everytime we go out
d. Always wear clothes that smell good

17. Why do you think you should wear shoes/slippers when you go out of the house?
a. To keep worms away
b. To kill worms by stepping on them with our shoes/slippers
c. To make us look neat and tidy
d. None of the above
18. Your small sister was about to go outside the house and play, what should you tell
her?
a. Tell your small sister to bring a raincoat
b. Tell your small sister to wear her new shirt
c. Tell your small sister to wear shoes/slippers
d. None of the above
19. Where should you defecate?
a. To our neighbor’s backyard, where we could dig a hole and use it
everytime we defecate
b. To a place with potty or bowl and use it everytime we defecate
c. Near the river, where other people cannot see us
d. None of the above

35
 APPENDIX B
THE SONGS:

1.) INTESTINAL WORMS

(“ten little indian’)

1 little 2 little 3 little roundworms

4 little 5 little 6 little pinworms
7 little 8 little 9 little hookworms
10 little parasite whipworms
These are the intestinal worms

2.) PARASITE
(“Mary had a little lamb”)

Intestinal worms are parasite, parasite, parasite

Intestinal worms are parasite that lives and feeds on us.

Some suck our blood, some eat our food

Suck our blood, eat our food
Some suck our blood, some eat our foor
Inside our body.

Intestinal worms can make us sick,

Make us sick, make us sick
Intestinal worms can make us sick
That’s why we have to avoid them.

36
 3.) BAD FOR OUR HEALTH
(“Are you sleeping”)

Intestinal worms (2x)

Bad for our health (2x)
Some of their eggs can be swallowed
Through dirty hands, dirty foods.

Intestinal worms (2x)

Bad for our health (2x)
Some of them can go inside the body
Pass through skin, pass through skin.

4.) HANDS
(“Row, row your boat’)

Wash, wash, wash your hands

Wash the worms away
Scrub them well with lots of soap
Do it several times a day.

Rinse, rinse, rinse your hands

Rinse the worms away
Scrub them well with lots of soap
After throwing the garbage.
REPEAT STANZA 2

Wash, wash, wash your hands

Wash the worms away
Scrub them well with lots of soap
After using the bathroom
REPEAT STANZA 2

37
 5.) THIS IS THE WAY
(“Here we go ‘round the Mulberry bush”)

This is the way we wash our hands,

Wash our hands
Wash our hands
This is the way we wash our hands
To keep worms away from our body.

This is the way we trim our nails,

Trim our nails
Trim our nails
This is the way we trim our nails
To keep it short and clean.

This is the way we take a bath

Take a bath
Take a bath
This is the way we take a bath
Every early morning.

This is the way we wash the fruits

Wash the fruits
Wash the fruits
This is the way we wash the fruits
Everytime we eat them.

This is the way we wear the shoes

Wear the shoes
Wear the shoes.
This is the way we wear the shoes
Everytime we go.

This is the way we use potty

Use potty
Use potty
This is the way we use potty
Everytime we defecate.

38
 6.) TO KEEP WORMS AWAY
(“London bridge is falling down”)

Mother, Father look what I do

Look what I do,look what I do
Mother, Father look what I do
To keep worms away.

I take a bath everyday, everyday, everyday

I take a bath everyday
To keep worms away.

When I go out I wear my shoes

Wear my shoes, wear my shoes
When I go out I wear my shoes
To keep worms away.

REPEAT STANZA 1

I wash my hands everyday

Everyday, everyday
I wash my hands everyday
To keep worms away.

I wash the fruits when I eat

When I eat, when I eat
I wash the fruits when I eat
To keep worms away.

39
 APPENDIX C

THE PICTURES

40
41
42
43
44
45
46
 CURRICULUM VITAE

PERSONAL INFORMATION

Name : Merry Ann Sabang Teus

Age : 25
Sex : Female
Civil Status : Single
Date of Birth : November 19, 1979
Address : GMV Drive, Gov. Camins Avenue
Religion : Evangelical Christian
Father : P/Inspt Diomedes Buay Teus
Mother : Mrs. Wilma Sabang Teus

EDUCATIONAL BACKGROUND

GRADUATE:
Degree : Medicine
School : Ateneo de Zamboanga Univ. – School of Medicine
Place : Zamboanga City
Year (Graduation) : 2005
COLLEGE:
Degree : BS Biology
School : University of the Philippines Cebu College
Place : Cebu City
Year (Graduation) : 2000
HIGH SCHOOL : Lapuyan National High School
Year (Graduation) : 1996

ELEMENTARY : Lapuyan Central Elementary School

Year (Graduation) : 1992