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Four flipcharts were taught over 36 months to patients, community members, school children, and professionals, with surveys and a knowledge test before, after, and at follow-up.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/rheumatic-heart-disease-education-tools-integrated-into-a-screening-program-in-brazil-acceptability-and-knowledge-gain/418743/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/rheumatic-heart-disease-education-tools-integrated-into-a-screening-program-in-brazil-acceptability-and-knowledge-gain/418743.png","ImageObject",300,407,{"name":42,"@type":43},"Jordan Avery","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":33},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What was the purpose of the education tools in the Brazil screening program?","Question",{"text":62,"@type":63},"The flipcharts aimed to support communication about RHD prevention, recognition, and management in underserved high-burden areas.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"Who received the flipchart education and training?",{"text":67,"@type":63},"Patients, community members, school children, and healthcare and education professionals were taught using four low-literacy flipcharts, with in-person training and workshops for professionals.",{"name":69,"@type":60,"acceptedAnswer":70},"How was knowledge gain measured and when were assessments conducted?",{"text":71,"@type":63},"A knowledge test was given before training, after training, and at three-month follow-up; 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VINHAL CRAIG A. SABLE  CLARECI S. CARDOSO  LIESL ZÜHLKE  ALISON SPAZIANI LAYLAH RYKLIEF MARIA CARMO P. NUNES  \nISABELY KAROLINE S. RIBEIRO  \nREBECA PREVIERO LORENA R. SILVA  \nLUZ M. TACURI CHAVEZ KACIANE K. B. OLIVEIRA  \nINGRED BEATRIZAMARAL  \nLARISSA LEMOS JULLIANE S. CORREA CECÍLIA T. COELHO BRENNO A. SANTOS LUIZA H. DE PAULA ISADORA S. SOUZA MARIA LUIZA B. S.  \nSANTIAGO  \nBRUNA C. FREITAS  \nGABRIEL R. ANGELO  \nMATHEUS HENRIQUE P. NUNES  \nKLICIA J. PEREIRA ANTONIO LUIZ P.  \nRIBEIRO  \nBRUNO R. NASCIMENTO  \nON BEHALF OF THE PROVAR+ (PROGRAMADE RASTREAMENTODA VALVOPATIAREUMÁTICA  \nAND OTHER CARDIOVASCULAR DISEASES) INVESTIGATORS  \n*Author affiliations can be found in the back matter of this article  \nABSTRACT  \nBackground: Rheumatic heart disease (RHD) is a preventable cause of premature death among young individuals in low- and middle-income countries. Education is a key strategy to alleviate the burden of this disease. We aimed to assess the acceptability and knowledge gain of a series of low-literacy education flipcharts, presented during screening in high-burden areas of Brazil.  \nMethods: Four low-literacy flipcharts were developed over three years and taught over 36 months to patients, community, school children, and health and education professionals, mostly in the state of Minas Gerais. In-person training and education workshops were assessed through printed surveys. Post-education surveys (for patients and community members), and post-training surveys (for healthcare and education professionals) were conducted from January 2023 to December 2025. A knowledge test, delivered at pre-training, post-training and three-month follow-up, was incorporated from January 2024 to March 2025.  \nResults: Flipchart training was delivered to 1,317 healthcare and education professionals, while 1,292 patients and community members and 2,585 school students received education using the flipcharts. There was a statistically significant (p \u003C 0.01) improvement in knowledge about rheumatic fever (RF) and RHD among  \nORIGINAL RESEARCH  \nCORRESPONDING AUTHOR:  \nJessica Abrams  \nDivision of Paediatric Cardiology, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Reach, Cape Town, South Africa  \n[Jessica.abrams@uct.ac.za](Jessica.abrams@uct.ac.za)  \nKEYWORDS:  \nRheumatic Heart Disease; Education; Screening  \nTO CITE THIS ARTICLE:  \nAbrams J, Vinhal WC, Sable CA, Cardoso CS, Zühlke L, Spaziani A, Ryklief L, Nunes MCP, Ribeiro IKS, Previero R, Silva LR, Chavez LMT, Oliveira KKB, Amaral IB, Lemos L, Correa JS, Coelho CT, Santos BA, de Paula LH, Souza IS, Santiago MLBS, Freitas BC, Angelo GR, Nunes MHP, Pereira KJ, Ribeiro ALP, Nascimento BR, On behalf of the PROVAR+(Programa de RastreamentOda VAlvopatia Reumática and Other Cardiovascular Diseases) investigators. Rheumatic Heart Disease Education Tools Integrated Into a Screening Program in Brazil: Acceptability and Knowledge Gain. Global Heart. 2025; 20(1): 115. DOI:  \n[https://doi.org/10.5334/](https://doi.org/10.5334/)[ ](https://doi.org/10.5334/)[gh.1510](gh.1510)  \nhealthcare and education professionals participating in the pre- and post-training survey (n = 511): RF as the cause of RHD (64% vs 95%), use of benzathine penicillin G (43% vs 98%), and frequency of antibiotic prophylaxis (21% vs 77%). The improvement from baseline was sustained at follow-up. Over the entire study period, 98% of survey respondents (2,134) reported learning something new, and 94%(2,041) intended to share the learnings with their peers or community.  \nConclusion: Culturally adapted, low-literacy educational flipcharts were successfully integrated into an existing RHD screening program in Brazil. The tool was well accepted among people living with RHD, their providers, and at-risk communities, with si","cbCaijzXMCFzRfd2","https://ap.wps.com/l/cbCaijzXMCFzRfd2","pdf",638000,11,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction","[{\"question\":\"What was the purpose of the education tools in the Brazil screening program?\",\"answer\":\"The flipcharts aimed to support communication about RHD prevention, recognition, and management in underserved high-burden areas.\"},{\"question\":\"Who received the flipchart education and training?\",\"answer\":\"Patients, community members, school children, and healthcare and education professionals were taught using four low-literacy flipcharts, with in-person training and workshops for professionals.\"},{\"question\":\"How was knowledge gain measured and when were assessments conducted?\",\"answer\":\"A knowledge test was given before training, after training, and at three-month follow-up; it was incorporated from January 2024 to March 2025, alongside pre- and post-surveys from January 2023 to December 2025.\"}]","Rheumatic Heart Disease Education Tools Integrated Into a Screening Program in Brazil - Acceptability and Knowledge Gain | PDF",1790614186,28]