The incidence of acute rheumatic fever (ARF) and its sequela rheumatic heart disease (RHD) is disproportionately high among the children of Western Samoa (Samoa). Basic symptoms of ARF include fever, joint pain, and sore throat. The condition of strep throat, if left untreated, may initiate an immune response that can damage the heart and become RHD. Primary prevention currently consists of educating locally trained nurses to detect strep throat and dispense antibiotics as necessary. The concept of targeting proximal caregivers with prevention information has not been explored.The purpose of this study was to test the hypothesis that an educational prevention program can be effective in disseminating pertinent information with regard to ARF prevention. This study followed a matched-pairs, same-subject design, using a presurvey and postsurvey as the observational tool with which to measure the effectiveness of the presentation.The question that targeted trust of health-care workers showed a statistically significant increase in trusting health-care workers (p = .0001) from approximately 50% in the presurvey to 74% in the postsurvey. The question with regard to antibiotic treatment was slightly significant for the presurvey (p = 0.0428) but showed increased statistical significance for the postsurvey (p = 0.0001). Responses targeting the contagious factor changed in significance between the presurvey and postsurvey from p = .009 to p = 0. The response change for the question targeting the possibility of a child contracting a sore throat at school changed from p = .0123 to p = .0001. These findings support the use of a basic and inexpensive educational prevention program.Efforts are currently underway to incorporate basic educational materials to proximal caregivers in Samoa through mobile nurse educators.Health behavior theories offer methodology for the development, implementation, and evaluation of health promotion programs. This study incorporated the interpersonal level of the ecological model in conjunction with the four elements of the social change model, which are critical thinking, fundamental skills, cultural sensitivity, and action. These constructs guided the development of an oral/visual prevention presentation targeting factors associated with ARF, and the associated surveys were developed to measure the effectiveness of the presentation.
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