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PubMed2002

Knowledge of neonatal car seat location in a predominantly disadvantaged prenatal population.

In order to assess knowledge of correct car seat location in prenatal patients of predominant lower socioeconomic status, an anonymous survey was performed at 2 inner city obstetric clinics. The survey participants (n = 688) were asked to select from among 3 drawings the correct location of a neonatal car seat. The choices showed an infant facing backward in the rear seat, forward in the rear seat, and backward in the front seat. The correct location of the car seat was selected by 61% of the participating subjects. Knowledge of correct location was related to age (p = 0.047), race (p = 0.002), and parity (p = 0.001) on univariate analysis. Education, survey site, and attendance at prenatal classes did not significantly correlate with car seat knowledge. Multiple regression analysis revealed that Caucasian race compared to African-American race predicted correct knowledge of car seat location with an Odds Ratio of 2.11 (CI 1.38-3.24). Multiparous women were more likely to know where to install a car seat relative to nulliparous women with an Odds Ratio of 1.63 (CI 1.12-2.38). Age was not significantly correlated with car seat knowledge on multivariate analysis. Knowledge of neonatal car seat location was suboptimal in our predominantly disadvantaged population, particularly in nulliparous, African-American women. Further prenatal education is needed during pregnancy or before hospital discharge to address this knowledge deficit.

Adolescent↗
PubMed2001

A direct assessment of the relation between shared knowledge and communication in a referential communication task.

The present paper introduces a way to document quantitatively the changing relation between shared knowledge and communication over time. It is often assumed that people engaged in prolonged interaction come to share more knowledge over the course of interaction, and, further, it is assumed that this increase in shared knowledge enables them to communicate more efficiently with each other. In Experiments 1 and 2, this assumption was evaluated by monitoring the participants' knowledge of the experimental stimuli and their estimates about each other's knowledge periodically during several trials of a referential communication task. The results confirmed that participants developed more shared knowledge over the course of interaction, and that their estimates about shared knowledge become more accurate over successive trials. Experiment 3 was conducted in order to examine whether the use of intervening questionnaires in the earlier experiments prompted the participants to behave differently than they otherwise would. Although the use of the questionnaires encouraged a more active exchange of information, the overall pattern of behavior exhibited by the participants was not affected by this procedure.

Adult↗
PubMedDate not supplied

Predictors of diabetes-specific knowledge and treatment satisfaction among Costa Ricans.

PURPOSE: The purpose of this study was to identify predictors of disease-specific knowledge and patient satisfaction among adult Costa Ricans with type 2 diabetes. Knowledge differences between Costa Ricans and Spanish-speaking US Latinos also were tested. The psychometric viability of a Spanish-language diabetes knowledge and client satisfaction measure with Costa Ricans was reviewed. METHODS: The Diabetes Knowledge Questionnaire (DKQ) and the Client Satisfaction Questionnaire (CSQ) were administered to 162 Costa Rican adults with type 2 diabetes who were receiving services in the greater San Jose area. Sociodemographic, medical history, and anecdotal information also was collected. RESULTS: More years of education, younger age, longer diabetes duration, and home glucose monitoring predicted diabetes knowledge. Home glucose monitoring and treatment with only oral hypoglycemics predicted significantly lower patient satisfaction. Costa Ricans exhibited greater diabetes knowledge than respondents in an earlier study with Spanish-speaking Latinos. CSQ psychometric limitations with Costa Ricans were identified. CONCLUSIONS: The greater diabetes knowledge among Costa Ricans than US Latinos is likely due to more consistent, stable, and accessible care. Older, less educated, and newly diagnosed Costa Rican diabetes patients require more focused attention.

Adult↗
PubMedDate not supplied

Cancer genetics knowledge and beliefs and receipt of results in Ashkenazi Jewish individuals receiving counseling for BRCA1/2 mutations.

BACKGROUND: Genetic counseling for BRCA1 and BRCA2 mutations (mutations associated with increased risk of breast-ovarian cancer) endeavors to communicate information that will help individuals make informed decisions regarding genetic testing. METHODS: This repeated-measures study examined cancer genetics knowledge and beliefs before and after counseling and their relationship to receipt of results for BRCA1/2 mutations in 120 highly educated Ashkenazi Jewish individuals. RESULTS: A repeated-measures analysis examined change in knowledge and beliefs regarding personal behavior, mechanisms of cancer inheritance, meaning of a positive result, practitioner knowledge, frequency of inherited cancer, and meaning of a negative result from pre- to post-counseling with the between subjects variables of education (with/without graduate training) and personal history of breast or ovarian cancer (yes/no), and risk of having a mutation entered as a covariate. Mechanisms of cancer inheritance, meaning of a positive result, and practitioner knowledge increased from pre- to post-counseling. Those with graduate training had higher ratings of mechanisms of cancer inheritance ratings and lower ratings of frequency of inherited cancers than those without. Mann-Whitney U tests found those testing had higher ratings in mechanisms of cancer inheritance, specifically in the association of multiple primary cancers with hereditary cancer, than those not testing. CONCLUSIONS: Genetic counseling is helpful in improving overall knowledge of cancer genetics even for highly educated individuals. Particular areas of knowledge improvement should be explored in relation to receipt of results, especially to further elucidate the relationship of knowledge of the association of multiple primary cancers with hereditary cancer to receipt of test results.

Adult↗
PubMed2006

Knowledge of breast cancer and its early detection measures among rural women in Akinyele Local Government Area, Ibadan, Nigeria.

BACKGROUND: Breast cancer is the commonest cancer among women in Nigeria and globally. In Nigeria, late presentations of breast cancer cases have also been consistent for three decades. In an environment where there is no established national screening program for breast cancer, it is pertinent to assess the knowledge of breast cancer and its early detection measures. The objective of this study therefore, was to assess rural women's level of knowledge of breast cancer and its early detection measures. METHODS: The knowledge of various aspects of breast cancer; etiology, early warning signs, treatment modes and early detection measures; was assessed among women in two randomly selected health districts in Akinyele Local Government in Ibadan. The assessment was performed with the use of a self-structured validated questionnaire administered by trained interviewers to 420 women randomly selected from the two health districts. The various aspects of facts about breast cancer were scored and added together to determine respondents' level of knowledge RESULTS: The mean score of knowledge of breast cancer was 55.4 SD 5.4 (range of scores obtainable was 26-78), while the mean score for knowledge of early detection of breast cancer was 24.8 SD 2.3 (range of scores obtainable was 12-36). The leading source of information about breast cancer was "elders, neighbors and friends" and 63(15.4%) acknowledged this source, while only 18 (4.4%) respondents acknowledged health workers as source. Only 54 (13.3%) claimed to have heard about breast self- examination (BSE) however, and the leading source of information about BSE were health workers. Nine (2.2%) of respondents claimed this source. CONCLUSION: This study revealed that respondents lacked knowledge of vital issues about breast cancer and early detection measures. It also revealed that health workers were not forthcoming with information to the public thereby constituting a challenge to community health nurses and other health workers, to provide vital information to the public.

Adult↗
PubMed2005

A gap between acceptance and knowledge of herbal remedies by physicians: the need for educational intervention.

BACKGROUND: The unprecedented global increase in the use of herbal remedies is set to continue apace well into the foreseeable future. This raises important public health concerns, especially as it relates to safety issues including adverse effects and herb-drug interactions. Most Western-trained physicians are ignorant of the risks and benefits of this healthcare modality and assessment of acceptance and knowledge would identify appropriate intervention strategies to improve physician-patient communication in this area. METHODS: A cross-sectional survey was done using an interviewer-administered pilot tested de novo questionnaire at six public hospitals in Trinidad between May-July 2004. The questionnaire utilized weighed questions to quantify acceptance (maximum score = 14 points) and knowledge (maximum score = 52 points). Acceptance and knowledge scores were analyzed using the ANOVA and Tukey's tests. RESULTS: Of 192 physicians interviewed, most (60.4%) believed that herbal remedies were beneficial to health. Respondents had relatively high acceptance levels (mean = 5.69 +/- 0.29 points or 40% of total possible score) and poor knowledge (mean = 7.77 +/- 0.56 points or 15% of total possible score). Seventy-eight physicians (40.6%) admitted having used herbs in the past, and 60 of these (76.9%) were satisfied with the outcome. Although 52 physicians (27.1%) recommended the use of herbs to their patients only 29 (15.1%) were able to identify at least one known herb-drug interaction. CONCLUSION: The use of herbal remedies is relatively high in Trinidad, as throughout the world, and most patients self-medicate with or without the knowledge of their attending physician. Surprisingly, we demonstrated relatively high acceptance levels and use of herbs among physicians in Trinidad. This interesting scenario of high acceptance levels and poor knowledge creates a situation that demands urgent intervention. We recommend educational intervention to narrow the gap between acceptance and knowledge so that physicians would be adequately equipped to communicate with their patients on this modality. The integration of herbal medicine into the curriculum of medical schools, continuing education programs and the availability of reputable pharmacopoeias for referencing at public health institutions are useful instruments that can be used to close this gap and promote improved physician-patient communication.

Access to Information↗
PubMed2006

Knowledge and attitudes about health research amongst a group of Pakistani medical students.

BACKGROUND: Health research training is an important part of medical education. This study was conducted to assess the level of knowledge and attitudes regarding health research in a group of Pakistani medical students at Aga Khan University, Karachi. METHODS: It was a cross-sectional pilot study conducted among a group of Pakistani medical students. Through stratified random sampling, a pre-tested, structured and validated questionnaire was administered to 220 medical students. Knowledge and attitudes were recorded on a scale (graduated in percentages). RESULTS: Mean scores of students were 49.0% on knowledge scale and 53.7% on attitude scale. Both knowledge and attitudes improved significantly with increasing years of study in medical college [Regression coefficient 4.10 (p-value; 0.019) and 6.67 (p-value; < 0.001) for knowledge and attitudes, respectively]. CONCLUSION: Medical students demonstrate moderate level of knowledge and attitude towards health research. Intensive training in this regard is associated with significant improvement in knowledge and attitudes of students towards health research.

Adult↗
PubMed2004

The effect of breast cancer screening messages on knowledge, attitudes, perceived risk, and mammography screening of African American women in the rural South.

PURPOSE/OBJECTIVES: To determine the effect of three types of breast cancer screening messages (positive/upbeat, neutral/cognitive, and negative/fear) on knowledge, attitudes, perceived risk for breast cancer, and mammography screening of African American women. DESIGN: Repeated measures intervention. SETTING: Three rural counties in the South. SAMPLE: 450 African American women aged 45-65 who had not received a mammogram in the past 12 months. METHODS: Following completion of pretest knowledge and attitude surveys, the women participated in a 60-minute breast health intervention session that included watching one of three videos with varied affective tones (positive/upbeat, neutral/cognitive, negative/fear). Data on knowledge, attitudes, perceived risk for breast cancer, and mammography screening were collected before, after, and 12 months following the intervention. MAIN RESEARCH VARIABLES: Knowledge, attitudes, perceived risk for breast cancer, and mammography screening. FINDINGS: No significant difference was found among video groups on mammography screening and knowledge of and attitudes about breast cancer over the three measurement periods. CONCLUSIONS: The affective tone of the educational videos did not make a difference in mammogram screening, attitudes, and knowledge of breast cancer screening. More women received a mammogram 12 months postintervention than prior to the intervention; however, the influence of the intervention on this outcome is uncertain. IMPLICATIONS FOR NURSING: Nurses and health communication experts should design interventions that foster positive attitudes, increase knowledge about breast cancer screening, and stimulate women to participate in breast cancer screening as outlined by the American Cancer Society. These interventions need to be done in the context of the cultural norms and the education levels of the target population.

Black or African American↗
PubMed2005

Oral cancer knowledge and experience: a survey of South Carolina medical students in 2002.

BACKGROUND: Compared to the U.S. states and District of Columbia, the adult population in South Carolina ranks in the high five in oral cavity and pharynx cancer mortality rate and top ten for incidence rate. Previous studies revealed a lack of knowledge related to the diagnosis of oral cancer among health professionals in the USA. This study assessed the oral cancer knowledge and experience of medical students in an academic setting. METHODS: This IRB approved cross-sectional survey used a self-administered pilot-tested questionnaire and the census of the Medical University of South Carolina medical students. Data were summarized by frequencies and chi-square comparisons of pre-clinical (first and second year) and clinical (third and fourth year) students. RESULTS: The overall response rate was 79% (450/571 students), range 61-91% by year. Significant (p < 0.001) differences were found between pre-clinical and clinical students for knowledge of risk factors, signs and symptoms of oral cancer, and tobacco cessation techniques; with clinical students more knowledgeable but at less than 78% accuracy. All students were in high agreement of the role and responsibility of physicians in tobacco cessation, and in medical history taking. Four students had seen or been instructed on how to perform an oral biopsy. Most (75%) of fourth year students felt adequately trained to palpate neck lymph nodes. However, less than 7% of all students perceived they were adequately trained to examine patients for oral cancers. CONCLUSIONS: Results suggest that these students may not receive adequate exposure to oral cancer prevention and detection knowledge and practices. Additional training to increase knowledge of risk factors and cessation counseling, and knowledge of signs and symptoms and examination skills may improve oral cancer prevention and detection. The implication is that additional education for the medical students in prevention and detection may lead to improvements in South Carolina oral cavity and pharyngeal cancer incidence and mortality rates.

Adult↗
PubMed2003

Development of a framework for knowledge translation: understanding user context.

OBJECTIVE: To develop a framework that researchers and other knowledge disseminators who are embarking on knowledge translation can use to increase their familiarity with the intended user groups. METHODS: The framework was derived from a review and analysis of the knowledge translation literature and from the authors' own experience with a variety of user groups. RESULTS: The framework consists of five domains: the user group, the issue, the research, the knowledge translation relationship, and dissemination strategies. Within each domain, the framework includes a series of questions. The questions provide the researcher with a way of organizing what he or she already knows about the user group and the knowledge translation project, of identifying what still is unknown, and of flagging what is important to learn. CONCLUSIONS: Most researchers wishing to engage in knowledge translation are moving out of their own familiar contexts. By using this framework, researchers will learn about the new contexts in which they find themselves. The insights they gain will increase their familiarity with the user group, thus aiding in the implicit goal of the interactive model of knowledge translation: making the researcher a part of the user group context.

Evidence-Based Medicine↗
PubMed2003

Sharing and expanding academic and practitioner knowledge in health care.

The purpose of this paper is to expand understanding of academic-practitioner knowledge-sharing in the service of enhanced knowledge creation in health care. To this end, we describe the tacit and explicit knowledge of academics and practitioners and how this knowledge exists within their communities of practice. We also discuss benefits of, difficulties with, and some underlying dynamics of academic-practitioner knowledge-sharing. We then propose what might be done, based on appreciation of these dynamics, to foster joint knowledge-sharing and knowledge creation. We illustrate our arguments with examples from health care settings.

Cooperative Behavior↗
PubMed2005

Demystifying knowledge translation: learning from the community.

OBJECTIVES: While there is increasing interest in research related to so-called Knowledge Translation, much of this research is undertaken from the perspective of researchers. The objective of this paper is to explore, through the participatory evaluation of Manitoba's The Need to Know Project, the characteristics of effective knowledge translation initiatives from the perspective of community partners. METHODS: The multi-method evaluation adopted a utilization-focused approach, where stakeholders participated in identifying evaluation questions, and methods were made transparent to participants. Over 100 open-ended, semi-structured interviews were conducted with project stakeholders over the first three years of the project. These interviews explored the perspectives of participants on all aspects of project development. Formal feedback processes allowed further refinement of emerging theory. RESULTS: This research suggests that there has been insufficient emphasis on personal factors in knowledge translation. The themes of 'quality of relationships' and 'trust' connected many different components of knowledge translation, and were essential for collaborative research. Organizational barriers and lack of confidence in researchers present greater challenges to knowledge translation than individual interest or community capacity. The costs of participation in collaborative research for community partners and the benefits for researchers, also require greater attention. CONCLUSIONS: Participation of community partners in The Need to Know Project has provided unique perspectives on knowledge translation theory. It has identified limitations to the common interpretations of knowledge translation principles and highlighted the characteristics of collaborative research initiatives that are of greatest importance to community partners.

Community Health Services↗
PubMedDate not supplied

New Mexico pharmacists' knowledge, attitudes, and beliefs toward prescribing oral emergency contraception.

OBJECTIVE: To describe New Mexico pharmacists' knowledge, attitudes, and beliefs toward the prescribing of oral emergency contraception (EC) in their practices. DESIGN: Cross-sectional study. SETTING: New Mexico in January through March 2004. POTENTIAL PARTICIPANTS: New Mexico pharmacists. INTERVENTIONS: Questionnaire containing 74 items. MAIN OUTCOME MEASURE(S): Mean scores were calculated for individual knowledge items, overall knowledge scores, and attitude/belief items. Knowledge and attitude/belief scores were compared across demographic variables using t tests, ANOVA, and chi-square analyses. RESULTS: Of 1392 deliverable questionnaires, 555 (40%) were returned and 523 (38%) were usable; 136 contained written comments. Pharmacists had overall knowledge scores of 71.2% +/- 11.3%. Pharmacists who had participated in a state-approved EC prescribing training program and had time in their practice setting to prescribe EC had significantly higher knowledge scores. Mean scores indicated that pharmacists have positive attitudes and beliefs toward prescribing EC. Overall, 40% of respondents indicated that they would like to become certified to prescribe EC. Pharmacists who agreed that they would like to be certified to prescribe EC were significantly more likely to be male, non-Hispanic, non-Christian, to have liberal or moderate political views, and to indicate that they had employer/manager approval, time, and privacy in their practice setting to prescribe EC. CONCLUSION: New Mexico pharmacists have positive attitudes/beliefs toward EC prescribing; however, their knowledge in this area is average. Although religious, moral, and political views influence pharmacists' willingness to prescribe EC, factors such as education and practice environment must be addressed if more pharmacists are to accept this EC prescriptive authority.

Contraception, Postcoital↗
PubMed2005

Effects of a national health education program on the medication knowledge of the public in Taiwan.

BACKGROUND: The inappropriate use of medication and inadequate medication knowledge among the general population has long been a concern in Taiwan. One reason for the deficiencies might be the lack of an active role of pharmacists in educating the public. To rectify the situation, in 2002, the Bureau of Pharmaceutical Affairs, Department of Health of Taiwan, began to sponsor a national effort, titled Community Education Program on Medication Use, to involve the expertise of pharmacists in public education. OBJECTIVE: To evaluate the effects of this education program by analyzing the changes in knowledge of drug therapy among the participating public. METHODS: This was a single-group pre- and post-comparison study. Between September 2003 and January 2004, a total of 955 community residents enrolled in the pharmacist-facilitated education program offered at 31 community universities. The medication knowledge of the participants was evaluated before and after the program. Demographic variables that might affect the education outcomes of the program were also examined. RESULTS: Medication knowledge at baseline was positively correlated with education level and negatively correlated with age. Females were more aware of drug-related information than were males. The participants showed a significant improvement in medication knowledge (p < 0.001) at the end of the program. The baseline knowledge score was the most important determinant of the improvement of the posttest score. CONCLUSIONS: A national education program facilitated by pharmacists can improve the medication knowledge of the participants. Pharmacists should be encouraged to play a proactive role in large-scale health education programs.

Adolescent↗
PubMed2006

Internal migration and contraceptive knowledge and use in Guatemala.

CONTEXT: Levels of modern contraceptive knowledge and use among people living in rural areas of Guatemala differ substantially from those of people living in urban areas. Understanding the pace and extent of rural-to-urban migrants' adoption of urban contraceptive practices is important in determining if there is a strong need for migrant-focused reproductive health programs. METHODS: Bivariate and multivariate analyses of data on 971 married male and female respondents in the 1999 Guatemalan Migration and Reproductive Health Survey were used to examine how migration status and duration of residence in an urban area are associated with knowledge of modern contraceptive methods and current contraceptive use. RESULTS: Migrants' contraceptive knowledge was positively associated with the number of years they had lived in an urban area. Mayan migrants in Guatemala City did not accumulate contraceptive knowledge at the same rate as non-Mayan migrants, perhaps due to cultural and linguistic barriers to obtaining knowledge of and access to contraceptives. Rural-to-urban migrants eventually achieve a level of modern contraceptive use slightly below that of urban nonmigrants, with the level of contraceptive knowledge being an important factor associated with use of modern methods. CONCLUSIONS: Migrants possess limited knowledge of modern contraceptive methods and, therefore, may experience unmet need for contraception or may have a limited choice of modern contraceptive methods during their first years in an urban destination. Programs designed to raise contraceptive awareness and use should target recent migrants--particularly indigenous Mayans--in urban areas.

Adolescent↗
PubMedDate not supplied

Correlates of parental antibiotic knowledge, demand, and reported use.

BACKGROUND: Clinicians cite parental misconceptions and requests for antibiotics as reasons for inappropriate prescribing. AIMS: To identify misconceptions regarding antibiotics and predictors of parental demand for antibiotics and to determine if parental knowledge and attitudes are associated with use. METHODS: Survey of parents in 16 Massachusetts communities. Domains included antibiotic-related knowledge, attitudes about antibiotics, antibiotic use during a 12-month period, demographics, and access to health information. Bivariate and multivariate analyses evaluated predictors of knowledge and proclivity to demand antibiotics. A multivariate model evaluated the associations of knowledge, demand, and demographic factors with parent-reported antibiotic use. RESULTS: A total of 1106 surveys were returned (response rates: 54% and 32% for commercially-insured and Medicaid-insured families). Misconceptions were common regarding bronchitis (92%) and green nasal discharge (78%). Two hundred sixty-five (24%) gave responses suggesting a proclivity to demand antibiotics. Antibiotic knowledge was associated with increased parental age and education, having more than 1 child, white race, and receipt of media information on resistance. Factors associated with a proclivity to demand antibiotics included decreased knowledge, pressure from day-care settings, lack of alternatives offered by clinicians, and lack of access to media information. Among all respondents, reported antibiotic use was associated with younger child age and day-care attendance. Among Medicaid-insured children only, less antibiotic knowledge and tendency to demand antibiotics were associated with higher rates of antibiotic use. CONCLUSIONS: Misconceptions regarding antibiotic use are widespread and potentially modifiable by clinicians and media sources. Particular attention should be paid to Medicaid-insured patients in whom such misconceptions may contribute to inappropriate prescribing.

Adult↗
PubMed2000

Preparing for motherhood: authoritative knowledge and the undercurrents of shared experience in two childbirth education courses in Cagliari, Italy.

This article compares the social settings and teaching organization of two differently structured childbirth education courses in Cagliari, Italy, in order to understand how social processes and contexts work to negotiate authoritative knowledge. Although the explicit goal of both courses was to transmit biomedical knowledge, knowledge based in women's experience nonetheless dominated some course sessions. Thus, I examine the social processes and interactions that enabled women's experiential knowledge to dominate discussions and subsequently share in the authority of biomedical knowledge in some situations. Because few existing studies do so, this article also addresses a gap in our current understanding by exploring not only how experiential knowledge comes to share authority with biomedical knowledge, but also, why it is important that it does. Focusing on the efficacy of differently structured courses, this article informs the planning of future childbirth education courses in similar settings.

Female↗
PubMed2004

"Who is sitting across from me?" Immigrant mothers' knowledge of parenting and children's development.

OBJECTIVE: Although parents' knowledge about child development and child rearing is relevant to pediatric practice, very little is known about immigrant parents' knowledge. To fill this gap in research, this study investigated parenting knowledge in 2 groups of mothers who had immigrated to the United States. DESIGN: Japanese and South American immigrant mothers of 2-year-olds completed a standardized survey of parenting knowledge and provided information about sociodemographic and infant health status. Their data were compared with European American mothers in the United States. RESULTS: Immigrant mothers scored approximately 70% on the evaluation of parenting knowledge, significantly lower than multigenerational US mothers. The majority of immigrant mothers did not know correct answers for 25% of the items, and their incorrect answers were mostly to questions about normative child development. CONCLUSIONS: Parents' knowledge is relevant to pediatricians' evaluations of the health and welfare of children as understood by their parents. Gaps in parenting knowledge have implications for clinical interactions with parents, child diagnosis, pediatric training, and parent education.

Acculturation↗