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Limitations in knowledge of HIV transmission among HIV-positive patients accessing case management services in a resource-poor setting.

HIV has increasingly become an infection of poverty. Adequate HIV transmission knowledge among HIV-positive patients is necessary to reduce the risk of secondary infection and protect those who are uninfected from transmission. This study was conducted among individuals enrolled in a program that serves impoverished HIV patients in the Boston area. Although the mean HIV transmission knowledge score was 80% for this group, a significant proportion of patients demonstrated limitations in knowledge of HIV transmission. Highly vulnerable patients, such as those who reported not accessing HIV medications, a history of sexual abuse, or problems getting clothing, had lower levels of HIV knowledge. This paper hopes to alert providers that their most vulnerable patients may be at an increased risk of re-infection or transmission due to limited HIV knowledge. Programs that serve HIV-positive patients coping with poverty and other serious problems need to ensure adequate knowledge of HIV transmission to reduce the overall burden of HIV in resource-poor settings.

Adaptation, Psychological↗

Knowledge and practices of a control authority: impact on the environment and food safety.

This study investigates the practices and knowledge of a Control Authority dealing with the environment and the safety and control of hawker foods. Experience and background education are used as likely determinants of food safety practices and knowledge of the control authority. A total of 60 questionnaires were distributed to the Health Inspectors (HIs) in the Hawkers' and Health Departments, City Hall, Kuala Lumpur. The return rate was 93%. The structured questionnaire contained 14 main food safety practices and knowledge constructs. Significance was found pertaining to knowledge of HIs with different experience backgrounds but experience was not demonstrated to impact on practices of HIs. However, education was noted to have significantly but inconsistently influenced certain Practices and Knowledge scores of HIs. A Pearson bivariate coefficient characterised an association between food safety practices and knowledge of the control authority. The findings: (1) highlight the actual shortcomings in the staff resources relating to environmental health, food safety, foodborne illnesses and their control, and (2) provide information on the control aspect within the hawker micro-industry with the view of protecting the public from health hazards arising from the hawkers' practices and consumption of hawker foods.

Food Contamination↗

The knowledge of healthcare professionals with regard to the treatment and prevention of head lice.

This study examined the knowledge and practice of healthcare professionals regarding the prevention and treatment of head lice 18 months after dissemination of local guidelines. A self-administered postal questionnaire was sent to all primary healthcare professionals (general practitioners and practice nurses), community healthcare professionals (community paediatricians, health visitors and school nurses) and pharmacists in South Staffordshire health district, UK. The overall response rate was 48% (range 24-63%). Compared to other groups: community healthcare professionals were more likely to refer to the guidelines and have adequate knowledge of treatment and prevention; pharmacists were least likely to refer to the guidelines; and primary healthcare professionals were most likely to have poor knowledge about prevention and treatment. Overall, healthcare professionals' knowledge regarding prevention methods was significantly better than their knowledge of treatment methods (63% vs. 5%, P <0.00001). In conclusion, the results of this study suggest that healthcare professionals' knowledge of control methods for head lice varies widely and is sub-optimal and may contribute to ineffective head lice control.

Adult↗

The nature and predictors of stroke knowledge amongst at risk elderly persons in Brisbane, Australia.

PURPOSE: The aim of the study was to investigate the nature, extent, and predictors of stroke knowledge amongst people at risk of stroke. METHOD: A total of 273 questionnaires were distributed to three types of sites in metropolitan Brisbane (retirement villages, senior citizens and bowls clubs), and this strategy yielded a response rate of 37%. Of the surveys returned, 75 were retained in this study on the basis that: (a) participants met our criteria for being at risk of stroke (i.e., they reported one or more modifiable stroke risk factor, such as hypertension), and (b) they returned a completed Stroke Knowledge Test (SKT). RESULTS: Descriptive analyses revealed the overall level of stroke knowledge in this group was fair (approximately 50% of SKT items answered correctly, on average). SKT performance trends showed that participants did not have misconceptions about stroke but that more than 50% of the sample did not know the answer to seven out of 20 SKT items. Some overlap was identified regarding the issues about which participants in this and other previously researched groups admit they lack knowledge, such as the extent of increased stroke risk associated with smoking; however, the number of knowledge gaps identified in this sample was almost double that reported previously amongst stroke survivors and the general community. Analyses undertaken to explore determinants of stroke knowledge revealed age and education but not risk factor variables as significant predictors. CONCLUSION: Overall, findings suggest that it is presently difficult to predict an individual's understanding of stroke and that there is a need to increase stroke education, especially if this can address issues that people at risk of stroke admit they do not understand.

Aged↗

The association between knowledge and attitudes about genetic testing for cancer risk in the United States.

Attitudes about genetic testing are likely to be an important determinant of uptake of predictive genetic tests among the general public. Several prior studies have suggested that positive attitudes about genetic testing may be inversely related to knowledge about genetic testing. We conducted a random-digit-dialing (RDD) telephone survey of 961 adults in the continental United States to determine the associations among knowledge of, attitudes about, and perceptions of eligibility for genetic testing for cancer risk. Knowledge about genetic testing for cancer risk was generally high, with a mean accuracy score of 72%. Attitudes about genetic testing for cancer risk were also generally positive, with 87% of respondents reporting genetic testing for cancer risk would be used to help doctors manage their health care and 85% to help scientists find cures for diseases. In contrast, 58% of respondents thought genetic testing for cancer risk would be used to prevent them from getting health insurance and 31% to allow the government to label groups as inferior. Twenty-nine percent of respondents thought they were currently eligible for testing. After adjustment for sociodemographic characteristics and family cancer history, higher knowledge was correlated with more positive attitudes about testing, but not with negative attitudes or perceptions of testing eligibility. Family history was positively associated with perceptions of eligibility (OR 3.49, 95% CI 2.36-5.18), and higher levels of education were inversely associated with perceptions of eligibility (OR 0.55, 95% CI 0.32-0.94 for comparison of college or higher vs. less than high school). These results suggest that most members of the general public are knowledgeable and have positive attitudes about genetic testing for cancer risk and that greater knowledge is correlated with more positive attitudes about the benefits of testing.

Adolescent↗

Cancer knowledge and disparities in the information age.

Increasing information flow often leads to widening gaps in knowledge between different socioeconomic status (SES) groups as higher SES groups are more likely to acquire this new information at a faster rate than lower SES groups. These gaps in knowledge may offer a partial but robust explanation for differential risk behaviors and health disparities between different social groups. Drawing on the Health Information National Trends Survey (HINTS 2003), a national survey of communication behaviors conducted by the National Cancer Institute (NCI), we examine the relationship between publicity and knowledge gaps on two cancer topics that received different levels of publicity: knowledge about tobacco and sun exposure and their respective links to cancer. Analyses of the HINTS 2003 data suggest that differential knowledge levels of causes of cancer between SES groups are one potential explanation of cancer disparities that have been extensively reported in the literature. It is evident that high income and high education are associated with awareness about causes of major cancers such as lung and skin, and may allow people to protect themselves and minimize their risks. The data also show that heavier media attention could attenuate the knowledge gaps though moderate publicity or lack of news coverage may actually widen them. Last, the findings in this article suggest that it is necessary to take into account the SES variation within different racial and ethnic groups rather than mask them by treating the groups as one.

Adult↗

AIDS knowledge gaps: results from the first decade of the epidemic and implications for future public information efforts.

Throughout the first decade of AIDS, certain populations have been disproportionately affected by its spread, particularly men, blacks, Hispanics, and the young. Just as there are population differences in the spread of the disease, there are differences in knowledge about the disease as well. This article applies the knowledge gap framework to examine the nature and magnitude of gaps in knowledge among different populations. The analysis shows that persons of low education lag behind other groups in true-transmission knowledge (i.e., knowledge about ways in which HIV/AIDS actually is transmitted) and false-transmission knowledge (i.e., misconceptions about how the disease is spread).

Acquired Immunodeficiency Syndrome↗

How does individual smoking behaviour among hospital staff influence their knowledge of the health consequences of smoking?

AIMS: This study examined associations between individual smoking habits among hospital staff and their knowledge of the health consequences of smoking and passive smoking. The a priori hypothesis was a higher level of knowledge among non-smokers compared with smokers. METHODS: A survey was undertaken, based on self-administered questionnaires at a Danish hospital (Frederikssund Hospital) in the Copenhagen area. Descriptive statistics, chi-square test and multiple logistic regression analyses were used. A backward stepwise elimination of variables at a 5% level of significance was performed and 95% confidence intervals were calculated. Main outcome measures were knowledge of the health consequences of smoking, passive smoking and other lifestyle factors. RESULTS: A total of 445 of 487 employees (91%) from all professional groups returned the questionnaire. Compared with ex- and never smokers, smokers systematically underestimate the health consequences of smoking and passive smoking independent of profession, department, sex, and age. There is no consistent association between knowledge of the health consequences of smoking and profession and department. There are significant inverse associations between smoking and knowledge of the health effects of excess use of alcohol and lack of physical activity. CONCLUSION: Individual smoking habits among hospital staff strongly influence smoking-related knowledge. No other variables are of consistent importance. These findings are supported by the literature. The validity of the study is good, but a similar study in a bigger population would strengthen the evidence.

Adult↗

Changes in knowledge and attitudes of folate, and use of dietary supplements among women of reproductive age in Norway 1998-2000.

AIMS: From March 1998, Norwegian nutrition authorities have recommended that women consume a folic acid supplement before and early in pregnancy to prevent neural tube defects. The authors wished to establish Norwegian data on knowledge of, use of, and attitudes to folic acid supplement and dietary supplements before and after implementing national information campaigns on folate and pregnancy. METHODS: Telephone surveys were carried out in late 1998 and in late 2000 among, respectively, 1,146 and 1,218 Norwegian women of reproductive age. RESULTS: Overall, 50% of the women in 1998 and 60% of the women in 2000 had heard about folate, 33% and 46% knew about its role in pregnancy, and 9.5% and 21% knew that it may prevent a congenital malformation. Only 4.0% and 8.5% of the women, respectively, knew that the critical period for folic acid supplement to reduce the risk of neural tube defect is before and early in pregnancy. Knowledge and increase in knowledge between the two surveys were highest among women close to pregnancy (woman planning pregnancy, pregnant women, or women who had given birth within the last 12 months), and among women with high education. Among the 54 women in 1998 and the 55 women in 2000 whose last birth was within the previous year, use of a folic acid supplement before or early in the last pregnancy was reported by 10% (95% confidence interval (CI) 5-21%) and by 47% (95% CI 35-60%), respectively. Among women close to pregnancy, 76% in 1998 and 87% in 2000 stated that they would use a folic acid supplement in a future pregnancy. CONCLUSIONS: Knowledge and use of folate among Norwegian women increased from 1998 to 2000. Future information strategies on folate and pregnancy should in particular aim at increasing women's knowledge on the critical period for folic acid supplementation, as well as reducing socio-demographic differences in use and knowledge of folate.

Adolescent↗

HIV/AIDS knowledge and condom use among Somali and Sudanese immigrants in Denmark.

AIMS: This study explores the knowledge, attitudes and practices among Somali and Sudanese immigrants in Denmark with regard to HIV/AIDS and condom use. MATERIAL AND METHODS: A 78-item questionnaire, divided into five thematic sections, was given to 192 purposively selected Sudanese and Somalis of both sexes, aged 18-49, who had lived in Denmark for one or more years. It was administered in Arabic and Somali in four locations and supplemented by 13 semi-structured interviews. RESULTS: Education, sex, and nationality, but not length of residence in Denmark, were positively associated with knowledge about HIV/AIDS. Less than half of both men and women scored more than 70% on the knowledge portion of the questionnaire, while Sudanese knew more than Somalis. Men had a more negative attitude towards condoms than women, but greater knowledge about them. One-third of the women reported never having seen or heard of a condom, and almost half had never received information about condoms. Both sexes preferred receiving such information from the TV or friends instead of family doctors or HIV-positive individuals. CONCLUSIONS: This study suggests that knowledge about HIV/AIDS is low in these two Danish immigrant groups, both of which are characterized by reported incidence rates that are higher than the national average. The groups receive little information, while condom knowledge is particularly low among poorly educated women, and men have a negative attitude to condom use. The findings indicate a need for targeted, culturally sensitive HIV/AIDS information and advice.

Acquired Immunodeficiency Syndrome↗

Knowledge of tuberculosis and associated health-seeking behaviour among rural Vietnamese adults with a cough for at least three weeks.

AIMS: Good general lay knowledge of tuberculosis (TB), its cause and treatment is considered important for both prompt healthcare seeking and adherence to treatment. The main aim of this study was to describe the knowledge of TB among med and women with a cough for more than three weeks and to see how their health seeking related to TB knowledge. METHODS: A population-based survey was carried out within a demographic surveillance site in Vietnam. The study population included 35,832 adults aged 15 years or over. Cough cases were identified at household level and structures interviews were carried out with all cases of cough in person. RESULTS: A total of 559 people (1.6%) reported coughing with a duration of three weeks or longer (259 men and 300 women). A large proportion of individuals with a cough for more than three weeks had limited knowledge of the causes, transmission modes, symptoms, and curability of TB. Men had a significantly higher knowledge score than women (3.04 vs 2.55). Better knowledge was significantly related to seeking healthcare and seeking hospital care. More men than women did not take any health care action at all. DISCUSSION: Health education for TB thus seems to be useful, but efforts must be made to ensure that both men and women in different socioeconomic contexts can access the information.

Adolescent↗

Attitudes and knowledge about nicotine and nicotine replacement therapy.

Nicotine replacement therapies (NRTs) represent an effective means of promoting smoking cessation, but they remain underutilized. Negative attitudes and false beliefs about nicotine and nicotine replacement may cause NRT underutilization. In a randomized, controlled, single-blind study of nicotine gum, 97 smokers were assessed on their attitudes and knowledge about nicotine, nicotine replacement, and smoking cessation therapy. Information from these self-report measures was used in an intervention that provided tailored, brief feedback to promote positive attitudes and accurate knowledge about NRT. Considerable variability in pretreatment attitudes and knowledge was observed across individuals. Moreover, attitudes and knowledge showed a consistent pattern of intercorrelation and were systematically related to smoking characteristics (e.g., prior use of NRT, nicotine dependence, treatment completion). The brief feedback intervention led to a significant global elevation in attitudes about nicotine, NRT, and assisted cessation but not knowledge about nicotine. Changes in attitudes and knowledge were not significantly related to gum use or smoking cessation. Recommendations for the appropriate application of brief feedback are offered.

Adult↗

Knowledge of standard and isolation precautions in a large teaching hospital.

OBJECTIVE: To assess the level of knowledge regarding and attitudes toward standard and isolation precautions among healthcare workers in a hospital. METHOD: A confidential, self-administered questionnaire survey was conducted in a random sample of 1500 nurses and 500 physicians in a large teaching hospital. RESULTS: A total of 1,241 questionnaires were returned (response rate, 62%). The median age of respondents was 39 years; 71.9% were women and 21.2% had senior staff status. One-fourth had previously participated in specific training regarding transmission precautions for pathogens conducted by the infection control team. More than half (55.9%) gave correct answers to 10 or more of the 13 knowledge-type questions. The following reasons for noncompliance with guidelines were judged as "very important": lack of knowledge (47%); lack of time (42%); forgetfulness (39%); and lack of means (28%). For physicians and healthcare workers in a senior position, lack of time and lack of means were significantly less important (P < .0005). On multivariate linear regression, knowledge was independently associated with exposure to training sessions (coefficient, 0.33; 95% confidence interval, 0.08 to 0.57; P = .009) and less professional experience (coefficient per increasing professional experience, -0.024; 95% confidence interval, -0.035 to -0.012; P < .0005). CONCLUSIONS: Despite a training effort targeting opinion leaders, knowledge of transmission precautions for pathogens remained insufficient. Nevertheless, specific training proved to be the major determinant of "good knowledge".

Adult↗

Knowledge, attitude, and practices regarding contact precautions among Iranian physicians.

OBJECTIVE: To assess the knowledge, attitudes, and practices of Iranian physicians regarding contact isolation precautions. DESIGN: Data were collected between May and November 2002 using a cross-sectional survey design. SETTING: Teaching hospitals in Shiraz, Iran. PARTICIPANTS: A total of 155 physicians: 78 attending clinicians and 77 resident physician surgeons or internists. RESULTS: The mean scores for knowledge and attitude were acceptable, with 71% of physicians scoring the maximum for knowledge and 65% achieving the maximum scores for attitude, whereas the mean score for practice was low, with only 26% achieving the maximum score. A good level of knowledge be associated with a good attitude (odds ratio [OR], 68.4 [95% confidence interval {CI}, 20.0-285.6]; P<.001), good practices were associated with good knowledge (OR, 22.5 [95% CI, 7.1-91.3]; P<.001), and a good attitude was associated with good practice (OR, 20.0 [95% CI, 5.7-105.2]; P<.001). CONCLUSION: Although strong associations were found among knowledge, attitude, and practice, the level of compliance with precautions was not nearly as high as it should be.

Adult↗

Knowledge of menopause and hormone replacement therapy use in low-income urban women.

Hormone replacement therapy (HRT) can have significant long-term health benefits in postmenopausal women, yet rates of HRT use are low, especially in low-income urban women. Previous research has revealed that knowledge of menopause is a key predictor of HRT use in this population. A descriptive cross-sectional survey of 215 perimenopausal and postmenopausal low-income urban women was carried out to characterize knowledge of menopause and HRT and factors associated with knowledge level. Sociodemographic characteristics, patterns of HRT use, and knowledge about menopause and HRT were collected through a structured interview. Results revealed a general lack of knowledge about menopause and HRT, particularly relative to heart disease and the role of HRT in prevention. Major independent predictors of increased knowledge (R2 = 0.31) were having talked with a healthcare provider about HRT, having at least a high school education, and being less than 60 years of age. These findings emphasize the key role of providers in educating this vulnerable population about menopause and HRT and the potential subsequent impact on HRT use.

Cross-Sectional Studies↗

Cardiovascular disease risk factor knowledge in young adults and 10-year change in risk factors: the Coronary Artery Risk Development in Young Adults (CARDIA) Study.

This study's objective was assessment of cardiovascular disease (CVD) risk factor knowledge in young adults, its association with 10-year changes in risk factor levels, and variables related to risk factor knowledge. A total of 4,193 healthy persons (55% female, 48% Black; mean age=30 years) from four urban US communities were queried about risk factor knowledge in 1990-1991 and were reexamined in 2000-2001. Of six risk factors considered (hypertension, hyperlipidemia, smoking, overweight, sedentary lifestyle, and unhealthy diet), participants mentioned a mean of two; more than 65% were not aware of any risk factors, and less than 35% recognized being overweight as a risk factor. After adjustment, variables associated with mentioning more than two CVD risk factors versus one or fewer were Black race (OR=0.52, 95% confidence interval (CI): 0.44, 0.61), having a high school education or less (OR=0.88, 95% CI: 0.80, 0.95), having one or two (vs. zero) risk factors (OR=1.27, 95% CI: 1.05, 1.53), and having three or more (vs. zero) risk factors (OR=1.79, 95% CI: 1.35, 2.38). More knowledge was marginally associated with less increase in body mass index 10 years later (p=0.06) but was unrelated to other risk factor changes. Knowledge of CVD risk factors was very low in these young adults but increased with the presence of risk factors. Knowledge alone did not predict 10-year changes in risk factors.

Adult↗

Knowledge and attitudes of economically disadvantaged women regarding exposure to environmental tobacco smoke: a Michigan, USA study.

BACKGROUND: Exposure to environmental tobacco smoke (ETS) is a global public health problem which is particularly acute in groups where smoking rates are higher than in the general population. A study was undertaken to investigate knowledge, attitudes and preventive efforts with regard to exposure to ETS in a sample of economically disadvantaged women residing in Michigan, USA. METHODS: Analysis-of-variance techniques were used to investigate how knowledge, attitudes and preventive efforts regarding exposure to ETS relate to demographic variables such as smoking status, ethnicity, education, employment, and income; and analysis-of-covariance techniques were applied to determine the degree to which knowledge, attitudes, age, smoking status, ethnicity, education, employment, income and home environment predict these women's preventive efforts regarding exposure to ETS. RESULTS: Generally, women with no high school diploma and women who were smokers were less knowledgeable about the adverse health effects of exposure to ETS, had worse attitudes concerning exposure to ETS and were less likely to take preventive steps to limit their exposure to ETS than were women who had more formal education or who were nonsmokers, respectively. The primary predictors of preventive efforts were knowledge, attitudes and smoking status. CONCLUSIONS: The results suggest that educational efforts focusing on increasing knowledge and improving attitudes regarding exposure to ETS, as well as providing practical strategies for limiting exposure to ETS, should be developed and delivered to at-risk populations.

Adult↗

Demographic variation in nutrition knowledge in England.

This paper describes a nutrition knowledge survey carried out on a cross-section of the adult population of England (n = 1040), looking at knowledge relating to current dietary recommendations, sources of nutrients, healthy food choices and diet-disease links. Serious gaps in knowledge about even the basic recommendations were discovered, and there was much confusion over the relationship between diet and disease. Significant differences in knowledge between socio-demographic groups were found, with men having poorer knowledge than women, and knowledge declining with lower educational level and socio-economic status. Possible reasons for these differences and implications for public education campaigns and socio-economic inequalities in health are discussed.

Adult↗