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National study of knowledge of AIDS, testing patterns, and self-assessed risk among health care workers.

We conducted a study to assess the level of AIDS knowledge, testing behavior patterns, and self-assessed risk of contracting AIDS for a representative sample of health care workers in the United States. The study was based on data collected in the 1989 AIDS Knowledge and Attitudes Supplement to the National Health Interview Survey. Health care workers in four occupational groups were compared with other members of the labor force and with one another. The survey included 1,620 respondents identified as health care workers and 25,217 respondents with occupations other than in health care. Health care workers were more knowledgeable about AIDS than were other workers; approximately 55% and 25%, respectively, reported knowing a lot about AIDS. They were also more likely to have been tested (34%) than other workers (24%) and to have done so voluntarily (28% versus 14%). Health care workers also believed they had higher risk of contracting AIDS (8% versus 3%), although they were about equally likely to report being in one of the six high-risk groups. Among health care workers, those in the health diagnosing occupations were the most knowledgeable about AIDS (74% reported knowing a lot) and were the most likely to have been tested (41% were tested at least once). Health service workers were the least knowledgeable; only 38% reported knowing a lot about AIDS and only 26% reported being tested.

Acquired Immunodeficiency Syndrome↗

Measuring beneficiary knowledge of the Medicare program: a psychometric analysis.

Reliable measures of Medicare beneficiaries' program knowledge are necessary for credible program monitoring, evaluation, and public accountability. This study developed and evaluated the psychometric properties of two possible measures of beneficiary knowledge. One measure was based on self-reported knowledge, the other was a true/false quiz which requires beneficiaries to demonstrate their knowledge. We used data from the 1998 and 1999 Medicare Current Beneficiary Survey (MCBS) to evaluate the reliability and construct validity of the indices. Overall, based on both content considerations and the psychometric analyses, the true/false quiz proved to be the more accurate and useful measure of beneficiaries' knowledge.

Health Education↗

Breast self-examination. Knowledge and behavior of Greek female health care professionals working in primary health care centers.

A comparative correlational study was conducted to examine the knowledge and frequency of breast self-examination (BSE) by Greek health care professionals. A total of 268 women working in primary health care centers constituted the sample. The women were 22-64 years of age. Subjects reported low levels of knowledge about BSE and facts related to breast cancer. Multiple regression analysis showed significant relationships between level of knowledge and profession, number of years of health-related education, and frequency of BSE. The sample's frequency of practice of BSE was limited. Only 34.7% of the participants claimed to practice BSE on a monthly basis. Multiple regression analysis revealed statistically significant correlations between BSE behavior and marital status, professional experience with breast cancer, and level of knowledge. The level of knowledge of the participants is considered to be inadequate, taking into account that they work in settings where primary health care is offered. Courses of preventive medicine and health education should be incorporated in medical and nursing curricula.

Adult↗

The knowledge, attitude and use of contraception among secondary school girls in Port Harcourt.

BACKGROUND: Sexual activity is on the increase among teenagers worldwide, with a trend towards early onset. These activities are often unplanned and may lead to unintended pregnancies and sexually transmitted diseases including AIDS. Teenagers in developing countries exhibit little knowledge, and exposure to contraceptives. This study was undertaken to describe the knowledge, attitude and use of contraception among female students in Port Harcourt. METHOD: A self-administered questionnaire was used for the study. Five hundred and thirty four students selected from a female only secondary school in Port Harcourt Local Government Area of Rivers State were studied. RESULTS: The students were aged 8-23 years (mean 15.6 years). Two hundred and sixty four (49.4%) were in junior classes (JSS1-3) and 270 (50.6%) in senior classes (SS1-SS3). Two hundred ninety five (55.2%) of the respondents had heard of at least one contraceptive method. Age and not the academic level significantly influenced the knowledge (p < 0.05). Condom was the commonest method known by the students. Few students (< 10%) had knowledge of the modern contraceptive methods. One hundred and thirty five (25.3%) students believed that contraceptives could be harmful. Among the sexually active girls, only 45.3% had ever used any method of contraception. The use of contraception was more among junior students than senior students (64.5% vs 35.5%) (p < 0.05). CONCLUSIONS: We therefore recommend formal sex education in secondary schools in Port Harcourt, in order to improve the reproductive health knowledge and contraceptive use of sexually active girls. The education program must address students' misconceptions about effective methods of contraception targeting the senior students specifically.

Adolescent↗

Factors associated with palliative care knowledge among internal medicine house staff.

PURPOSE: To assess knowledge and associated factors in palliative care. METHODS: Self-administered survey of 88 internal medicine house officers in 1996. RESULTS: Twenty-one interns and 36 residents completed the survey for a response rate of 65%. Most house officers reported 1-5 hours of prior formal training in palliative care, 1-5 hours in pain management, and 6-20 hours in ethics. The mean knowledge score was 75% correct (SD = 8); pain management scores were lowest (70%). Overall, interns had a significantly lower mean score than residents (70% vs. 77%; p = 0.001). In multivariate analysis, only the year of residency was significantly associated with knowledge score; prior formal training in palliative care, pain management, or ethics was not. One third of house officers rated themselves as "not at all" or "only slightly" at ease in caring for a dying patient. These self-ratings were not associated with prior training or knowledge, but were higher in residents compared to interns. CONCLUSIONS: Palliative care knowledge and ease with dying patients were higher in later years of residency but were not associated with prior formal palliative care training. These data highlight the continued need to evaluate and improve training in palliative care and pain management.

Adult↗

[Couples' knowledge and attitudes regarding the practice of family planning in the jungle of Peru].

OBJECTIVE: To assess the association of knowledge and attitudes about family planning (FP) with its practice in couples of the Peruvian jungle region. MATERIAL AND METHODS: A cross-sectional study was carried out in the jungle region in Peru (Pucallpa and Tarapoto), among 600 couples. Males were > or = 15 years old and females between 15 and 49 years old, who had resided in the area for at least two years. A questionnaire was used to determine FP practices (defined as the use of modern contraceptive methods (MCM) for > or = 12 months), as well as attitudes and knowledge regarding FP. Frequencies were compared using the chi-squared test. Logistic regression was used to assess the association between demographic variables and MCM knowledge as well as MCM utilization. The association between sociodemographic variables and attitudes toward MCM was assessed with linear regression models. RESULTS: Males with primary education or with no formal education were twice as likely to have no knowledge about MCM compared with males with professional education (OR: 2.18, 95% CI: 1.05, 4.50). Females with a catholic partner were more likely to know about MCM than those whose partners did not practice any religion (OR: 0.60, 95% CI: 0.37, 0.97). Partner's lower education, older age of women, and rural background of males were all factors associated with a less favorable attitude toward FP practices. Couples in which the man did not know about contraceptive methods were more likely not to use MCM than couples where the man knew about MCM (OR: 1.57, 95% CI: 1.07, 2.30). Couples where the man had an intermediate level of acceptance towards FP were more likely not to use MCM than those where the man had a high level of acceptance (OR: 1.90, 95% CI: 1.03, 3.48). The strength of association was higher when the man had a low level of acceptance toward PF (OR: 2.23, 95% CI: 10, 4.51). CONCLUSIONS: Knowledge of contraceptive methods and attitudes toward FP among men are associated with the practice of FP by couples. Study findings show that male acceptance of MCM and FP is a necessary, important, and influential factor in FP promotion and practice. The English version of this paper is available at:http://www.insp.mx/salud/index.html.

Adolescent↗

[Awareness of HIV/AIDS hazards in the youth from Southern Podlasie compared with the state of knowledge in the general population of Poland].

Southern Podlasie is a specific region as regards HIV/AIDS hazards for its geographical position (border zone) as well as social problems (high level of unemployment). The aim of the research was to find out the level of knowledge of rural youth on the subject of risk factors and ways of spreading HIV as well as AIDS clinic. 405 students aged 15-17 (197 males and 208 females) that attend chosen rural schools on the territory of Southern Podlasie were questioned. The method of diagnostic poll was employed in the research using the questionnaire "HIV/AIDS knowledge and beliefs" from international studies on school youth health preservation (HBSC)--the supervisor of the project in Poland is professor B. Woynarowska). The research has shown different levels of knowledge of rural youth on the subject of HIV/AIDS. There were still many false opinions among the people questioned about the ways of HIV infection. Despite considerable knowledge about the ways of reducing the risk of HIV infection, there was low level of knowledge concerning AIDS treatment compared with the results of nationwide survey, there were fewer correct answers in our study group. It is the duty of schools, parents and mass media to provide the youth with relevant information on the subject of HIV/AIDS. Only systematic education in this domain can protect the infected persons and their partners or children against the consequences of ignoring the disease.

Acquired Immunodeficiency Syndrome↗

[Maternal health knowledge and its use in pediatrics in primary care].

OBJECTIVE: To find the nature of the relationship between the general level of mothers' health knowledge and the over-use of paediatric facilities at the Primary Care level. DESIGN: A crossover study with a control group. SITE. Zaidin-Sur Health Centre (Granada). PATIENTS OR OTHERS PARTICIPANTS: We selected all the over-users (69) of a Paediatric office and compared them to a random sample, grouped by age, of normal users (82); n = 151. MAIN MEASUREMENTS AND RESULTS: To control confusion, we measured a total of 31 variables, grouped as to need, predisposition and expediting factors. After validating the scales, the average scores for general health understanding and the score for clinical attitudes and knowledge were significantly lower in the over-user group (p = 0.017 and p = 0.000). The scale for attitudes to and knowledge of prevention did not attain any importance (p = 0.104). We worked out a model of multiple logistical regression which included in the equation the scale of clinical attitudes and knowledge (p less than 0.005). CONCLUSIONS: We emphasised the importance of mothers' health knowledge to the question of over-use of paediatric facilities. It is desirable to attempt to intervene on this question in order to lessen excessive use of health facilities.

Health Knowledge, Attitudes, Practice↗

Knowledge and attitudes towards cardiopulmonary resuscitation in the community.

AIMS: This study examined basic aspects of knowledge and attitudes towards resuscitation in a New Zealand urban community. METHODS: Using a telephone survey, we questioned 400 subjects aged (over 17 years of age), on their prior training, knowledge, and attitudes towards resuscitation. RESULTS: Seventy-four percent of subjects had previously been taught cardiopulmonary resuscitation (CPR). Of these, 12% had been taught during the previous year, and 63% over 5 years previously. Older subjects were less likely to have learnt CPR than younger subjects. Seventy-three percent of those surveyed desired to know more about resuscitation (than they currently did) and 70% thought that resuscitation should be a compulsory component of the New Zealand Driver's Licence test. Sixty-three percent said they would be willing to perform mouth-to-mouth ventilation on a stranger. CPR knowledge was poor, however, with only 4% knowing an acceptable rate at which to perform chest compressions, and only 9% knowing the correct compression-to-ventilations ratio for adult CPR. Overall knowledge was highest for those taught in the previous year, and for those persons aged between 26 and 45 years. CONCLUSIONS: Although attitudes of the community toward CPR are positive, theoretical knowledge relating to basic CPR is poor. This suggests that present community CPR educational strategies have limited efficacy.

Adult↗

Cancer of the cervix: knowledge, beliefs and screening behaviours of health workers in Mudzi District in Mashonaland East Province, Zimbabwe.

OBJECTIVE: To assess the knowledge, beliefs and screening behaviours on cervical cancer among health workers in Mudzi District. DESIGN: Cross sectional survey. SETTINGS: Mudzi District Hospital and all the 20 rural health centres in Mudzi District of Mashonaland East. SUBJECTS: Sixty health workers in Mudzi District. MAIN OUTCOME MEASURES: Knowledge of cervical cancer risk factors, screening methods and treatment options. Beliefs and screening behaviours. RESULTS: The knowledge levels were lower for many of the predisposing factors of cervical cancer except for the use of vaginal herbs or chemicals, which 85% of the health workers knew. Though 50% of the respondents knew of the Pap smear as a screening method for cervical cancer, 86.6% did not know the human papiloma virus screening and 90% did not know of the visual inspection of the cervix using acetic acid. There were also very low knowledge levels for most of the treatment options for pre-cancer with all health workers not knowing the leep and the Laser options. The majority 73.3% believed that they where not at risk of developing cervical cancer. Most of the respondents, 81.7%, had not undergone any form of cervical cancer screening. However, the main reason for non screening was that there were no cervical cancer screening facilities in Mudzi District. CONCLUSION: The study revealed low knowledge levels, negative beliefs about the risk of developing cervical cancer and poor screening behaviours among health workers in Mudzi District. Training in cervical cancer is, therefore, recommended for the health workers. However, the training should be combined with setting up facilities for cervical cancer screening.

Adult↗

Using Rasch models to reveal contours of teachers' knowledge.

Teachers' knowledge is usually categorised into subject matter (SMK) and pedagogical content knowledge (PCK). Previously, measurement instruments and consequent cognitive scales have been developed to assess students' and teachers' subject knowledge. A number of qualitative studies have explored teachers' pedagogical content knowledge. This study developed a means to investigate one aspect of PCK--teachers' awareness of their students' knowledge--using a combination of measurement and qualitative interpretation. We asked teachers to estimate on a Likert scale (and also describe qualitatively) the difficulty their pupils would have with test items which we had already scaled using data from their pupils. We then constructed, using various models, a "Teacher's collective Perception of Item Difficulty" (TPID) scale and contrasted this with the student's ability scale by comparing the two sets of item-difficulty parameters. The results were triangulated with qualitative data. We suggest the methodology is best supported by an Inverse Partial Credit Model (IPCM) but we compare the results across alternative Rasch models.

Child↗

AIDS knowledge and attitudes among injection drug users: the issue of reliability.

Among injection drug users (IDUs), AIDS-related knowledge and attitudes have not consistently predicted AIDS risk behavior. This may be due in part to the limited reliability of indexes used to measure drug users' AIDS knowledge and attitudes. In addition, the substantive interpretation of findings is confounded if index reliability is lower for particular demographic groups (e.g., ethnic populations and women). This report is based on 8 measures of AIDS-related knowledge and attitudes in a sample of 332 injection drug users in Los Angeles. The reliability of knowledge and attitude indexes for the overall sample is generally acceptable for the purpose of group comparison (average alpha = .60). But reliability is consistently lower for respondents who are Hispanic (average alpha = .49) and respondents with less formal education (alpha = .56). The reliability of 2 measures of sex-related attitudes is lower for female respondents. It is therefore important that the reliability of knowledge and attitude indexes be assessed not just for drug-user samples as a whole, but also within demographic groups of substantive interest.

Acquired Immunodeficiency Syndrome↗

Knowledge and beliefs of international travellers about the transmission and prevention of HIV infection.

OBJECTIVES: To measure the perceived risk of acquired immunodeficiency syndrome (AIDS) among international travellers, to measure their knowledge of the transmission and prevention of HIV infection abroad and to identify some of the determinants of this knowledge. DESIGN: Survey. SETTING: Travellers' immunization clinic providing mostly primary preventive care to international travellers. PARTICIPANTS: All clients aged 18 to 50 years seen at the clinic between Oct. 2 and Dec. 21, 1989, before their departure. MAIN OUTCOME MEASURES: Sixteen statements measured knowledge of transmission and prevention of HIV infection. Standardized scales measured health beliefs. RESULTS: The response rate was 81% (331/409). Compared with other diseases AIDS was perceived to be associated with a low risk except by those travelling to countries with a high prevalence of AIDS. Most of the clients were found to have a good knowledge of HIV transmission to travellers, although some myths remained popular and some real routes of transmission, especially blood, remained underrated. In all, 70% of the subjects believed in the efficacy of condoms when used with local people, as compared with 79% when used with other tourists; this difference was greatest among travellers who perceived AIDS as being particularly severe but difficult to prevent. The determinants of the knowledge of HIV transmission and prevention were a high level of education, a mother tongue other than French, unmarried status, a high prevalence of AIDS at the destination, the duration of the trip and a high perceived risk of HIV infection. CONCLUSIONS: Counselling should teach travellers (a) not to underestimate their risk of HIV infection during their trip, (b) to decrease the risk of requiring health care in developing countries and (c) to rely on their own prudent sexual behaviour rather than on their assessment of the level of risk posed by the environment.

Acquired Immunodeficiency Syndrome↗

A comparison of nutrition knowledge and attitudes, dietary practices, and bone densities of postmenopausal women, female college athletes, and nonathletic college women.

This study evaluated the nutrition knowledge and attitudes, dietary practices, and bone densities of four groups of women: 18 postmenopausal women, 14 college-aged dancers, 13 members of a college track team, and 14 nonathletic college women. Subjects completed a personal information questionnaire, a 24-hour food recall, a food frequency questionnaire, a nutrition knowledge test, and an attitude survey; measurements of the subjects' spinal bone density were also taken. The mean (+/- 0.5 standard error [SEM]) nutrition knowledge score of the dancers (22.5) was significantly lower than the mean scores of the postmenopausal women (28.5), the nonathletes (29.7), and the track team members (26.5). Dancers also reported eating fewer mean (+/- 4.0 SEM) servings of high-calcium foods per month (43) than did postmenopausal women (77), nonathletes (66), or track team members (73). Track team members had a significantly higher mean (+/- 0.2 SEM) anorexia/bulimia score (3.7) than did postmenopausal women (2.5), nonathletes (2.1), or dancers (2.2). There were no significant differences in bone mineral density among the four groups. The number of servings of high-calcium foods eaten was significantly correlated with nutrition knowledge scores (r = .38) and attitude scores (R = .32), but nutrition knowledge and attitude scores were not significantly correlated with each other. The track team members exercised significantly more than women in all other groups--mean (+/- 40 SEM) minutes exercise time was 700 minutes/week for track team members, 79 minutes/week for postmenopausal women, 92 minutes/week for nonathletes, and 500 minutes/week for dancers--and also experienced the most amenorrhea.

Adolescent↗

Cardiovascular secondary prevention: patients' knowledge of cardiovascular risk factors and their attitude to reduce the risk burden, and the practice of family doctors. The "Help Your Heart Stay Young" study.

BACKGROUND: Whether the practice of family doctors of assessing the global cardiovascular risk profile improves the knowledge of cardiovascular risk factors and the attitude to lifestyle change in patients' secondary cardiovascular prevention is unknown. METHODS: We evaluated subjects who visited their family doctors and those with self-reported cardiovascular disease in the urban area of Naples, Italy. Patients self-administered a simple standard questionnaire to evaluate their knowledge of cardiovascular risk factors and of simple lifestyle modifications to reduce the cardiovascular risk burden. For each participant, family doctors, blinded to the information provided by patients, had to provide a global coronary risk based on the risk factors recorded in their electronic database, or report the missing information. RESULTS: The study sample comprised 560 subjects, 61% male, with mean age 60 +/- 9 years. Angina pectoris (49%) and myocardial infarction (40.9%) were the most frequently self-reported cardiovascular diseases in the study sample. The self-reported data revealed that 46% of the sample was overweight and an additional 20% overtly obese. Among those who self-reported arterial hypertension, approximately 11% admitted that they were unaware of their blood pressure, and 26% believed that they were normotensive but reported a recently detected blood pressure > 140/90 mmHg. Approximately 8% were not aware of whether they had high cholesterol levels, and among those who declared having normal cholesterol levels, 9% referred levels > 200 mg/dl. Of the sample, 22% self-reported diabetes, but 7% did not know whether they were diabetic or not. Thirty percent of the sample were smokers and among these, 40% smoked > 20 cigarettes/day. A low level of education was reported in 66% of the study sample. Women were more frequently obese, more often reported high cholesterol levels, had a low level of education and achieved a lower score from the questionnaire on knowledge of cardiovascular risk factors than men. Patients > 55 years more often reported an elevated blood pressure among those who defined themselves as normotensive, and achieved a lower score from the questionnaire on knowledge of cardiovascular risk factors than younger patients. CONCLUSIONS: With regard to secondary cardiovascular prevention, the study population was found to have insufficient knowledge of cardiovascular risk factors and of the correct approach to reduce their global risk despite the fact that the attitude of their family doctors in detecting and recording risk factors was above average.

Adult↗

Knowledge, attitude and practices regarding Crimean-Congo haemorrhagic fever among healthcare workers in Balochistan.

BACKGROUND: The objective of this study was to determine the knowledge, attitude and practices regarding Crimean-Congo Haemorrhagic Fever (CCHF) among healthcare workers at a tertiary care referral hospital in Balochistan. METHODS: A cross-sectional survey was conducted in April-May 2000 among the doctors, nurses and laboratory technicians of Sandeman Provincial Teaching Hospital, Quetta, Balochistan. A questionnaire was formulated which included the demographic data of the respondents and their knowledge, attitude and practices towards CCHF. RESULTS: A total of 235 healthcare personnel including 150 (63.8%) doctors, 50 (21.2%) nurses and 35 (15%) laboratory technicians were interviewed during the survey. Seventy percent (164) of the subjects were males while 30% (71) were females. One fifty-five (66%) of the total respondents claimed to know what CCHF was. By designation 120 (80%) of doctors, 30 (60%) of nurses and 5 (14%) of laboratory technicians had a prior knowledge about CCHF. One twenty (80%) of the doctors knew the most common presentations of CCHF. All categories of the respondents had a poor knowledge regarding the burial procedure of dead patients. CONCLUSION: This study was an indicator of the poor level of knowledge of healthcare workers regarding the clinical presentations and the modes of spread of CCHF. It is the dire need of the time to educate the healthcare workers about the common preventive measures of this disease, which has resulted in the loss of several important lives in the past in this region.

Attitude of Health Personnel↗

Long-term effect of an oral hygiene training program on knowledge and reported behavior.

PURPOSE: To evaluate the long-term effect upon oral health knowledge and reported behavior of a comprehensive and a less comprehensive preventive program given to 13-16-year-old children 5 years after the termination of the programs. MATERIALS AND METHODS: 186 Brazilian schoolchildren, randomly assigned to two test groups and a control group were originally enrolled in a 3-year preventive program. The comprehensive program included active participation of the students and their parents. The time resources invested in this program were approximately 5 times that of the less comprehensive program, which mainly consisted of instruction in oral hygiene procedures. RESULTS: At the end of the program, a questionnaire was filled in by the participants showing a significant effect upon both knowledge and reported behavior of both programs; the comprehensive program displaying the better results. Five years later, the same variables were re-examined through a structured telephone interview with 103 of the original participants. Significant differences in knowledge among the three groups were still observed, but not in reported behavior. In all groups the reported daily users of dental floss increased with time and the number of daily in-between-meal consumers of sugar decreased. Females reported more frequent daily use of dental floss than did males five years after the termination of the program, but this was not evident immediately after the experimental period. After 5 years, the correlation between knowledge and reported behavior was no longer significant. CONCLUSION: Other factors than knowledge are of importance for behavior, and favorable behavior in early adulthood may be achieved independent of implementation of programs for teenagers.

Adolescent↗

An evaluation of post-campaign knowledge and practices of exclusive breastfeeding in Uganda.

Despite the benefits of exclusive breastfeeding for the health of mothers and children, its practice has markedly declined throughout the developing world. Mass media-communication programmes could play an important role in reversing this trend. This study evaluated the extent to which exposure to behaviour change communication (BCC) messages in the media determined recent improvements in exclusive breastfeeding knowledge and practices in areas targeted by the Delivery of Improved Services for Health (DISH) Project of Uganda. Data were drawn from the 1999 DISH Evaluation Survey. The survey collected information from representative samples of women and men of reproductive age. Multiple logistic regressions were used for assessing the independent influences of BCC exposure on breastfeeding knowledge and practices, controlling for several confounding factors. The results indicated that the exposure to BCC messages was strongly associated with women's knowledge of six months as the ideal duration for exclusive breastfeeding. Positive influences on knowledge of men were also found. Media effects on women's current practice of exclusively breastfeeding their infants up to six months were less conclusive, possibly because of the short interval between the launch of the BCC campaign and survey implementation. While there was some evidence of bias of self-reported exposure, results of exploratory analysis of the indirect effects of communication campaigns suggest that impacts may be compounded as overall awareness is increased at the community level eventually leading to improved knowledge among individuals.

Adolescent↗