Status of self-medication and the relevant factors regarding drug efficacy and safety as important considerations among adolescents aged 12-18 in China: a cross-sectional study

The objective of this study was to investigate self-medication behavior among Chinese adolescents aged 12-18 years and explore the factors associated with whether adolescents prioritize drug efficacy or safety when engaging in self-medication behavior. In 2021, a questionnaire investigation was conducted in the Chinese mainland using a multi-stage sampling approach. After a statistical description, logistic regression was used to analyze the factors associated with considering drug efficacy and safety. The self-medication rate among Chinese adolescents aged 12-18 years was 96.61%. Of these, 65.84% considered drug safety to be essential, while 58.72% prioritized drug efficacy. Regression analysis showed that individuals with better healthcare were more likely to consider drug efficacy an important factor. Additionally, those with a healthier family lifestyle were more likely to prioritize efficacy. When individuals engage in self-medication, those residing in urban areas and possessing advanced preventive health literacy and ample family health resources tend to prioritize drug safety to a greater extent. Conversely, those with higher monthly household incomes and only children exhibit a decreased inclination towards prioritizing safety during self-medication. Self-medication is a frequently observed practice among Chinese adolescents aged 12-18. Several factors, such as demographic and sociological characteristics, health literacy, and family health status, have been found to be associated with the extent to which adolescents prioritize medication safety and efficacy when engaging in self-medication practices. Higher levels of health literacy and better family health status were positively correlated with considering both the efficacy and safety of drugs as important factors when self-medicating.

Reaching Out-of-school Adolescent Girls and Young Women at Risk for HIV Through Their Social Networks

Out-of-school adolescent girls/young women (AGYW) in Africa are at increased risk for HIV and are underserved by HIV prevention interventions. Identifying social networks of out-of-school AGYW may be a strategic approach for reaching them. A sequential mixed methods study design was used. The PLACE (Priorities for Local AIDS Control Efforts) methodology, implemented in one ward of Dar es Salaam, Tanzania, identified 69 networks of AGYW. We randomly selected 28 networks and conducted surveys and network assessments with 80.9% (n = 310) of the members. On average, the networks consisted of 13.7 members, and had a density of 0.65 and a transitivity of 0.80, indicating high cohesion. The networks were mostly female (92%). On average, 67% of network membership were AGYW aged 15-24 years, of whom 70% were out-of-school and 67% were sexually active. Among sexually active AGYW aged 15-24, self-reported HIV seropositivity was 12.2%. We then conducted focus group discussions with 6 purposively selected networks. AGYW described their networks as sources of support and advice. Social norms supported AGYW engaging in transactional sex to alleviate life's hardships; it was the easiest way to earn income without "sweating". AGYW discussed IPV as a common experience, and social norms stigmatized AGYWs' use of condoms. AGYW were largely unaware of pre-exposure prophylaxis. The self-reported HIV prevalence rates of this cohort were higher than national averages, suggesting we tapped into high-risk networks. Social norms promoted transactional and unprotected sex. Social networks are an acceptable channel for HIV prevention intervention delivery to out-of-school AGYW.

The OCCHLTH Mnemonic-Construction and Content of a Tool for Increasing Awareness of Occupational Illness and Injury

INTRODUCTION

Unidentified or nonmitigated occupational illnesses and injuries can complicate disease management. The "occupational health" (OCCHLTH) mnemonic aims to raise awareness of work-related exposures and associated illnesses and injuries.

METHODS

Occupational safety and health history-taking elements were combined with peer-reviewed information [from the PubMed database (first review January 1, 2000, to February 8, 2016; updated to February 8, 2021)] about workplace exposure-outcome associations to create the mnemonic.

RESULTS

Seven components constitute the OCCHLTH mnemonic. Literature results support its categories and subcategories. Three components represent symptom onset and health conditions. Four represent occupational exposures. Evaluating published occupational illness cases explored mnemonic applicability.

CONCLUSIONS

Awareness of occupational risk factors can affect clinical decision-making. The OCCHLTH mnemonic encourages consideration of occupational causes of illness and injury to optimize patient care. Further evaluation of the utility of the OCCHLTH mnemonic is needed.

Knowledge, attitudes and practices regarding zoonotic diseases among cat and dog owners in Bangladesh

The close relationship between human and companion animals like cats and dogs raises public health concerns regarding the potential transmission of zoonotic diseases in Bangladesh. The study aimed to evaluate the cat and dog owners' knowledge, attitudes, practices, and risk perception concerning zoonotic diseases for designing effective interventions and reducing disease transmission. A cross-sectional survey was conducted among 480 pet owners in various region of Bangladesh. For data collection, a structured, closed-ended questions were implemented. The data collection was anonymous and individuals were chosen through a random selection method. Responses were classified to evaluate comprehensive knowledge, using a threshold value of ≥65%. Quantitative score was created to measure Knowledge, Attitudes, and Practices, and these scores were divided into categories of good and poor knowledge, positive and negative attitudes, as well as correct and incorrect practices. The analysis included the application of both descriptive statistics and logistic regression analysis. The findings showed that females made up more than half of the survey participants (55.2%), with the predominant pet owned being cats (73.1%). Overall, only a small portion (21.25%) of the survey respondents demonstrated good knowledge about the topic as measured by a dichotomous outcome. A larger proportion of participants (84.58%) exhibited a positive attitude towards zoonotic diseases. However, when it came to correct practices, about one-third (29.79%) of performed satisfactorily. It is noteworthy that 90.4% of the participants exhibited a high level of understanding regarding the transmission of rabies through dog bites. The knowledge and practices of owners were markedly impacted by their education, occupation, and geographic location. Furthermore, 48.1% identified 'social media' as their primary source of information, and 80.0% regarded vaccination as a preventive measure. The study reveals gaps in knowledge and practices of risks regarding zoonotic diseases among pet owners in Bangladesh. It is crucial to implement focused educational initiatives and preventative measures to effectively tackle gaps in knowledge concerning zoonotic diseases and to avert potential infections.

Oral manifestations of syphilis: Knowledge and skills of senior dental students and newly graduated dentists

OBJECTIVES

To evaluate the knowledge of senior dental students and newly graduated dentists about the prevention, diagnosis and treatment of oral manifestations of syphilis.

MATERIALS AND METHODS

A 32-question questionnaire was designed with three domains: (I) demographic, academic and professional data of the participants, (II) attitudes, practices and self-perception regarding training about syphilis and (III) knowledge about syphilis. All knowledge responses were classified as correct or incorrect. Scores ranging from 1 to 14 were calculated, and grades were assigned to each participant according to their level of knowledge.

RESULTS

The sample comprised 408 dental students and 339 newly graduated dentists. The mean score was 7.70 ± 3.35 for undergraduates and 9.09 ± 3265 for dentists. The highest frequency of correct answers (>70%) was attributed to questions about the aetiology, transmission and treatment of syphilis. The questions with the lowest frequency of correct answers (<50%) were about the identification of oral manifestations and stages of syphilis.

CONCLUSIONS

The knowledge of dental practitioners and academics about the oral manifestations of syphilis was unsatisfactory. The lack of understanding of these aspects can delay the diagnosis and treatment of patients with this disease, which is concerning given the steady increase in cases in recent years.

An Integrated Health Belief Model: Predicting Uptake of the First COVID-19 Booster Vaccine

Public health campaigns have turned to the Health Belief Model (HBM) as a guiding framework for the past six decades. Carpenter's 2010 HBM meta-analysis revealed important shortcomings as well as a path forward that has largely been ignored by recent COVID-19 research using this framework. Consistent with Carpenter's recommendations, this study on the uptake of the first COVID-19 booster vaccine focused on the overlooked interactional processes of the original HBM founders. Our study used SEM and Hayes's PROCESS 4.1 to explore the possibilities of the interdependent nature of the core three beliefs to form a model that is integrated. The study indicated that the core variables of the original HBM were significant predictors of the intent to take the first COVID-19 booster vaccine when considered in an interactional process framework. Our study results have implications for those designing public health advocacy campaigns regarding COVID-19 as it enters an endemic stage with future vaccines and medications.

Cell Phones in the OR: A Cross-Sectional Study of Norwegian Perioperative Nurses' Knowledge, Practice, and Attitudes

Few studies have focused on the use of cell phones in the OR. In Norway, researchers sought to assess perioperative nurses' knowledge, practice, and attitudes associated with cell phone use in the OR and distributed a nationwide questionnaire via a social media platform. More than 80% of the 332 respondents thought that cell phones were contaminated and that pathogens could contaminate hands. Almost all respondents brought their phone to work; approximately 61% of respondents carried it in their pocket in the OR. Responses to questions about phone cleaning showed that 39 (11.7%) of the respondents routinely cleaned their phone before entering the OR and 33 (9.9%) of the respondents cleaned it when leaving the OR. Less than 20% of respondents indicated their facility had guidelines for cleaning personal cell phones. Opportunities for improvement in cell phone cleaning in ORs exist and additional research involving all perioperative team members is needed.

Effects of a structured educational program on nursing students' level of knowledge and awareness toward child neglect and abuse: A quasi-experimental evaluation

BACKGROUND

Nurses have a key role in the recognition, reporting, and channelization of child abuse and neglect. Nurses should have sufficient knowledge about the presentation of child abuse and neglect. They also need to understand their role in reporting any instance where they detect cases of abuse and neglect.

PURPOSE

The aim of this study is to determine the effect of a structured Child Neglect and Abuse Educational Program (CNaA-EP) on the level of knowledge and awareness of nursing students about child neglect and abuse.

METHODS

This study conducted with nursing students used a pretest-post-test quasi-experimental design. The third-year nursing students were divided into two groups: experimental (n = 25) and control groups (n = 30). The intervention group received CNaA-EP. In both groups, pretests were performed using the "Child Abuse and Neglect Awareness Scale," and "Child Abuse and Neglect Knowledge Test" The posttest was conducted 1 week after the 14-week CNaA-EP course was completed. Numbers, percentages, chi-square test, t-test, Kolmogorov-Smirnov test, Fisher's exact test were conducted using SPSS 22.00 software.

RESULTS

The education group's scores of child abuse/neglect awareness (t = -2.768 p < 0.05) and child abuse/neglect knowledge (t = -12.416 p < 0.01) were significantly higher than those of the control group. After the education program, a significant difference was found between the education and control groups on the core measures.

CONCLUSION

A child neglect and abuse education program was an effective method of educating nursing students on knowledge and awareness of child abuse and neglect. For this reason, education programs should be planned and implemented to increase awareness about abuse and neglect problems that threaten children's health and development.

The effectiveness of visualising plaque on cardiac computed tomography in modifying risk factors for cardiovascular disease: A systematic review

Cardiovascular disease (CVD) is the leading cause of disease burden worldwide, with a significant proportion of cases and deaths attributable to modifiable risk factors. Recent interest has emerged in using cardiac computed tomography (CT) imaging as a tool to enhance motivation and drive positive behavioural changes. However, the impact of providing visual feedback of plaque from CT on risk factor control and individual health behaviours remains understudied. This study aimed to assess the effects of visual feedback from cardiac CT imaging on health-related behaviours and risk factor control. A systematic search of electronic databases was conducted, yielding nine studies (five randomised controlled trials and four observational studies) for analysis. The results varied, but based on the limited low-quality data, CT imaging appears to have short-term favourable effects on cholesterol levels and systolic blood pressure reductions, and positive dietary behavioural changes. Further research is warranted to better understand the long-term impact of cardiac CT imaging on health behaviours and risk factor modification.

Knowledge and approach towards Helicobacter pylori diagnosis and management among primary care physicians in Cameroon: a cross-sectional study

BACKGROUND

Low- and middle-income countries have a high prevalence of Helicobacter pylori infection (HPI). In Cameroon, the majority of HPIs are diagnosed and treated by primary care physicians (PCPs). We sought to assess the knowledge and practices of PCPs in the diagnosis and management of HPI in Cameroon.

METHODS

A hospital-based cross-sectional study was carried out in four randomly selected regions of Cameroon from November 2021 to June 2022. In each of the selected regions, PCPs were recruited by non-probability convenience sampling and interviewed using a pre-structured questionnaire. Chi-squared, Fisher's exact and Student's t-tests were performed for descriptive analyses. Multivariable logistic regression was used to examine associations between knowledge and practice, with the model adjusted by age of the PCP, geographic region, number of patients and years in practice. Analysis was performed in SAS version 9.4 (SAS Institute, Cary, NC, USA).

RESULTS

A total of 382 PCPs were included in the analysis. The majority (60.0%) were males between the ages of 20-29 y (64.1%). Most PCPs (80.9%) reported that HPI is the cause of gastroesophageal reflux disease and 41.8% reported that HPI is the main cause of dyspeptic symptoms. The dominant diagnostic tests used for HPI were serology (52.8%) and stool antigen (30.9%). The most frequently used first-line therapies were amoxicillin (AMX), clarithromycin (CLA), metronidazole (MNZ) and proton pump inhibitor (PPI) concomitant therapy (32.2%), AMX-CLA-PPI triple therapy (18.6%) and AMX-MNZ-PPI triple therapy (13.1%). Half of the practitioners (48.6%) treat HPI empirically, without positive H. pylori testing. About half of the PCPs (48%) do not request laboratory confirmation of H. pylori eradication following treatment.

CONCLUSIONS

There is inadequate knowledge and significant differences in the clinical approach towards HPI among PCPs in Cameroon. We recommend more teaching programs and continuous medical education on HPI.

A cross-sectional survey on university students' knowledge, attitudes, and behaviors regarding organ, tissue, and body donation

PURPOSE

Body donors continue to have an important role in anatomy education in medical schools. Furthermore, the demand for organ transplantation is increasing as life expectancy increases. In Turkey, there are efforts to enable both donations to be made through a single system. These issues were addressed together, and it was aimed to evaluate the level of knowledge and attitudes of medical and law students regarding tissue-organ and body donation.

METHODS

A questionnaire consisting of 29 questions was administered to 693 individuals to measure these aspects. Data were analyzed using a one-way analysis of variance with Bonferroni correction. Categorical data collected during the study were summarized in terms of frequency and percentage.

RESULTS

When asked about their willingness to donate their bodies, 39.4% answered no, 29.5% responded yes, and 31.1% were undecided. Regarding organ donation, 61.8% of the participants expressed willingness, 22.8% were undecided, and 15.4% declined. Notably, there was a significant difference between those who had prior knowledge of organ tissue and body donation and those who did not (p < 0.001).

CONCLUSION

The findings of our research indicate that knowledge about organ tissue and body donation, as well as the inclination to donate, increased as medical education progressed into clinical practice. Additionally, the level of knowledge among university students on this subject was found to be correlated with whether they had received prior training on the topic. It was observed that there is a need to provide more education for students to understand the importance of organ and body donation.

Improving Parental Knowledge of Medically Complex Neonates Through Scheduled Conferences

Reports of parental dissatisfaction from incomplete or inconsistent information led to a quality improvement (QI) project to establish planned family conferences at 10 days and 1 month of life, for 50% of the medically complex neonates admitted to a neonatal intensive care unit within 1 year. A QI team instituted a system in which social workers scheduled family conferences and a neonatologist conducted the conferences. Team members tracked measures using statistical process control charts over 21 months. The QI team scheduled conferences for greater than 80% of eligible families, with an 86% completion rate on days 10 and 30, exceeding project goals of 50%. The majority of the families surveyed were satisfied with the meetings. Only 2% of parents surveyed found meetings burdensome, compared to 14% of physicians. A sustainable method for scheduling meetings and preparation for conferences, including the use of a template led to success.

Development and validation of a French questionnaire that assesses knowledge, attitude, and practices toward Marburg diseases in sub-Saharan African countries

OBJECTIVES

Marburg virus, previously referred to as Marburg hemorrhagic fever, is a highly severe and frequently fatal illness that affects humans. This study aimed to develop and validate a French questionnaire to assess knowledge, attitude, and practice toward Marburg virus disease (FKAP-MVD).

STUDY DESIGN

An anonymous online survey was used, which was distributed through various platforms and emails. Data were collected from Burkina Faso, Guinea, the Democratic Republic of Congo, and Senegal.

METHODS

To conduct the study, an anonymous online survey was used, which was distributed through various platforms such as Facebook, Twitter, WhatsApp, and emails. The survey was uploaded onto a Google form to facilitate data collection. Data were collected from Burkina Faso, Guinea, the Democratic Republic of Congo, and Senegal.

RESULTS

Of the total sample of 510 participants, 60.0% were male, their mean age was 28.41 ± 6.32 years, 38.0% were married, 86.6% resided in urban areas and 64.1% had a university education. The questionnaire had good internal consistency; Cronbach's alpha was 0.87. The correlation between knowledge and attitude was 0.002, the correlation between knowledge and practice was 0.204, and the correlation between practice and attitude was relatively weak and negative at -0.060. This indicates the divergent validity of the questionnaire. The KMO value of 0.91 indicates a high level of adequacy, suggesting that the data are suitable for factor analysis. The Bartlett test of Sphericity yielded an approximate χ2 value of 4016.890 with 300 degrees of freedom and a P-value of 0.0001. The confirmatory factor analysis revealed 25 questions in three domains. The normed chi-square value is 1.224. The goodness of Fit Index (GFI) is 0.902, the Comparative Fit Index (CFI) is 0.982, the Root Mean Square Error of Approximation (RMSEA) is 0.033, and the Root Mean Square Residual (RMR) is 0.062. These values indicate a good fit of the model to the data.

CONCLUSIONS

In general, the developed questionnaire has significant potential to inform public health initiatives and interventions related to MVD.

Human papillomavirus vaccination and contributing factors of vaccination intention among adolescents and young adults in China from a socio-ecological perspective: A cross-sectional study

OBJECTIVES

Adolescents and young adults are the main target population for human papillomavirus (HPV). The study aimed to investigate school students' HPV vaccination intentions and explore the contributing factors from a socio-ecological perspective.

DESIGN

A questionnaire survey was conducted in three secondary schools and three colleges in China.

SAMPLE

A total of 1756 students aged 14-22 years participated in this study. Among the 1756 participants, 182 students have received the HPV vaccine. For the remaining 1574 students, we analyzed their HPV vaccination intentions and the influencing factors.

MEASUREMENTS

Survey items for sociodemographics, knowledge and awareness of HPV, sexual intercourse and sexual knowledge, subjective socioeconomic status, self-efficacy, eHealth literacy, perceived social support from family, and the availability of HPV vaccine information were measured.

RESULTS

Only 182 (10.4%) had received the HPV vaccine among the 1756 participants. Among the remaining 1574 students, the majority of the students (1403, 89.1%) were willing to receive the HPV vaccine. Binary logistic regression analysis showed that students who were female, had lower self-efficacy, scored higher on sexual knowledge, believed vaccination preventing related diseases, worried about side effects after vaccination, thought oneself at risk of contracting HPV, had higher family support, knew the availability of the HPV vaccine in Mainland China from healthcare institutions, and with family residence in rural areas were more willing to receive the HPV vaccine.

CONCLUSIONS

Students had high HPV vaccination intentions while had low vaccination rate. Intrapersonal, interpersonal and institutional or community factors predicted HPV vaccination intention. Public health nurses in communities and schools could target the modifiable factors to promote students' HPV vaccine uptake.

'I think we could probably do more': an interview study to explore community pharmacists' experiences and perspectives of frailty and optimising medicines use in frail older adults

BACKGROUND

Community pharmacists potentially have an important role to play in identification of frailty and delivery of interventions to optimise medicines use for frail older adults. However, little is known about their knowledge or views about this role.

AIM

To explore community pharmacists' knowledge of frailty and assessment, experiences and contact with frail older adults, and perceptions of their role in optimising medicines use for this population.

METHODS

Semi-structured interviews conducted between March and December 2020 with 15 community pharmacists in Northern Ireland. Interviews were transcribed verbatim and analysed thematically.

RESULTS

Three broad themes were generated from the data. The first, 'awareness and understanding of frailty', highlighted gaps in community pharmacists' knowledge regarding presentation and identification of frailty and their reluctance to broach potentially challenging conversations with frail older patients. Within the second theme, 'problem-solving and supporting medication use', community pharmacists felt a large part of their role was to resolve medicines-related issues for frail older adults through collaboration with other primary healthcare professionals but feedback on the outcome was often not provided upon issue resolution. The third theme, 'seizing opportunities in primary care to enhance pharmaceutical care provision for frail older adults', identified areas for further development of the community pharmacist role.

CONCLUSIONS

This study has provided an understanding of the views and experiences of community pharmacists about frailty. Community pharmacists' knowledge deficits about frailty must be addressed and their communication skills enhanced so they may confidently initiate conversations about frailty and medicines use with older adults.

How do primary care clinicians approach the management of frailty? A qualitative interview study

BACKGROUND

Around 15% of adults aged over 65 live with moderate or severe frailty. Contractual requirements for management of frailty are minimal and neither incentivised nor reinforced. Previous research has shown frailty identification in primary care is ad hoc and opportunistic, but there has been little focus on the challenges of frailty management, particularly within the context of recent introduction of primary care networks and an expanding allied health professional workforce.

AIM

Explore the views of primary care clinicians in England on the management of frailty.

DESIGN AND SETTING

Semi-structured interviews were conducted with clinicians across England, including general practitioners (GPs), physician associates, nurse practitioners, paramedics and clinical pharmacists. Thematic analysis was facilitated through NVivo (Version 12).

RESULTS

A total of 31 clinicians participated. Frailty management was viewed as complex and outside of clinical guidelines with medication optimisation highlighted as a key example. Senior clinicians, particularly experienced GPs, were more comfortable with managing risk. Relational care was important in prioritising patient wishes and autonomy, for instance to remain at home despite deteriorations in health. In settings where more formalised multidisciplinary frailty services had been established this was viewed as successful by clinicians involved.

CONCLUSION

Primary care clinicians perceive frailty as best managed through trusted relationships with patients, and with support from experienced clinicians. New multidisciplinary working in primary care could enhance frailty services, but must keep continuity in mind. There is a lack of evidence or guidance for specific interventions or management approaches.

Peer-to-Peer Chain Recruitment for Enrolling Young South African Women into an HIV Pre-exposure Prophylaxis (PrEP) Intervention Study: How Did It Perform?

Peer-to-peer chain recruitment has been used for descriptive studies, but few intervention studies have employed it. We used this method to enroll sexually active women ages 18 to 25 into an online Pre-Exposure Prophylaxis (PrEP) information and motivation intervention pilot in eThekwini (Durban), South Africa. Seeds (N = 16) were recruited by study staff and randomized to Masibambane, Ladies Chat, a Gender-Enhanced group-based WhatsApp Workshop (GE), or Individual-Access (IA), a control condition that provided participants with online information/motivation materials only. Each seed could recruit up to three women to participate in the same study condition, with an incentive for each enrolled woman; participants in subsequent waves could choose to recruit or not. We evaluated if peer-to-peer recruitment was self-sustaining and resulted in enrolling women who, in subsequent waves, had less contact with the health care system and less knowledge about PrEP than the initial seeds. Over three recruitment waves beyond the seeds, 84 women were recruited. Almost 90% of women became recruiters, with each recruiting on average 1.90 women and 1.26 eligible enrolled women. The approach was successful at reaching women with less education but not women with less health system contact and PrEP knowledge across waves. IA participants had a slightly higher, though non-significantly different, percentage of individuals who became Peer Health Advocates (PHAs) than GE participants and, on average, they recruited slightly more women who enrolled. Our findings demonstrated that peer-to-peer recruitment is a feasible and self-sustaining way to recruit SA young women into a PrEP intervention study.

When describing harms and benefits to potential trial participants, participant information leaflets are inadequate

BACKGROUND

Providing informed consent for trials requires providing trial participants with comprehensive information about the trial, including information about potential risks and benefits. It is required by the ethical principle of respecting patient autonomy. Our study examines the variation in the way information about potential trial benefits and harms is shared in participant information leaflets (PILs).

METHODS

A total of 214 PILs and informed consent forms from clinical trials units (CTUs) and Clinical Research Facilities (CRFs) in Ireland and the UK were assessed by two authors independently, to check the extent to which they adhered to seven recently developed principles. Discrepancies were resolved by a third.

RESULTS

Usage of the seven principles varied widely between PILs regardless of the intended recipient or trial type. None of the PILs used more than four principles, and some (4%) used none. Twenty-seven per cent of PILs presented information about all known potential harms, whereas 45% presented information on all known potential benefits. Some PILs did not provide any potential harms or potential benefits (8%). There was variation in the information contained in adult and children PILs and across disease areas.

CONCLUSION

Significant variation exists in how potential trial benefits and harms are described to potential trial participants in PILs in our sample. Usage of the seven principles of good practice will promote consistency, ensure informed ethical decision-making and invoke trust and transparency. In the long term, a standardised PIL template is needed.

Integration of Total Worker Health ® Training for Occupational Health and Safety Professionals With Efforts to Promote Worker Health, Safety, and Well-being in Mexico

OBJECTIVE

We sought to test whether a 2-week Total Worker Health (TWH) training mapped to TWH education competencies could be administered to a Mexican audience of occupational safety and health professionals and could lead to positive changes to knowledge and behaviors.

METHODS

This study used robust program evaluation methods collected before and after each of the nine training days and at the end of the course.

RESULTS

Overall course quality received a mean score of 4.6 (SD = 0.6) and 98.8% of participants agreed that their TWH knowledge increased. All participants intended to make at least one change to their professional practice, most frequently helping companies assess their organizational culture to support health, safety, and well-being.

CONCLUSIONS

This TWH training was well received and led to positive self-reported increase in knowledge and abilities to influence workers' health, safety, and well-being.

Comparing ChatGPT and Bing, in response to the Home Blood Pressure Monitoring (HBPM) knowledge checklist

High blood pressure is one of the major public health problems that is prevalent worldwide. Due to the rapid increase in the number of users of artificial intelligence tools such as ChatGPT and Bing, it is expected that patients will use these tools as a source of information to obtain information about high blood pressure. The purpose of this study is to check the accuracy, completeness, and reproducibility of answers provided by ChatGPT and Bing to the knowledge questionnaire of blood pressure control at home. In this study, ChatGPT and Bing's responses to the HBPM 10-question knowledge checklist on blood pressure measurement were independently reviewed by three cardiologists. The mean accuracy rating of ChatGPT was 5.96 (SD = 0.17) indicating the responses were highly accurate overall, with the vast majority receiving the top score. The mean accuracy and completeness of ChatGPT were 5.96 (SD = 0.17) and 2.93 (SD = 0.25) and in Bing were 5.31 (SD = 0.67), and 2.13 (SD = 0.53) Respectively. Due to the expansion of artificial intelligence applications, patients can use new tools such as ChatGPT and Bing to search for information and at the same time can trust the information obtained. we found that the answers obtained from ChatGPT are reliable and valuable for patients, while Bing is also considered a powerful tool, it has more limitations than ChatGPT, and the answers should be interpreted with caution.

Didactic and narrative persuasion: An experiment to promote colorectal cancer screening

We tested whether a didactic and a narrative video (i.e. educational content and personal stories versus irrelevant information) could boost colorectal cancer (CRC) screening intention directly and through cognitive predictors of CRC screening behavior. We also tested whether exposure to a story changed participants' affective forecasting, reducing the perception of negative emotions associated with CRC screening (disgust, embarrassment, and fear). The study was conducted online with a between-participants design and recruiting a convenience sample (N = 375). We found that, compared with watching the control video, being exposed to the narrative video about CRC screening was indirectly associated with greater screening intention via vicarious experience and positive attitudes, whereas watching the didactic video was positively associated with CRC screening intention only among participants who had received an invitation letter but did not get screened, and among those yet to receive an invitation to screen. In the latter group, screening intention was boosted through positive attitudes. Our findings do not confirm that stories change affective forecasting, but narration likely fosters messages acceptance through vicarious experience. We also found support for the effectiveness of physicians' recommendations in promoting CRC screening, an intervention that might be effectively administered through a generalized, cost-effective video.

Social and structural factors associated with interest in HIV preexposure prophylaxis among Black women in the United States

In a nationwide sample of cisgender Black women in the US, we assessed the associations between social and structural factors and interest in using HIV preexposure prophylaxis (PrEP). Among 315 respondents, 62.2% were interested in PrEP if it were provided for free. Positive social norms surrounding PrEP, including injunctive norms (perceived social acceptability of PrEP use) and descriptive norms (perceived commonality of PrEP use), were positively associated with interest in using PrEP. Concerns about HIV infection, recently visiting a health care provider, and comfort discussing PrEP with a provider were also positively associated with interest in using PrEP. Anticipating PrEP disapproval from others was negatively associated with interest in PrEP. Although PrEP can promote autonomy and personal discretion, Black women's PrEP-related decisions occur in a complex social environment. Black women may benefit from interventions to promote positive norms and attitudes surrounding PrEP at the community level and empower them in discussions with their providers about PrEP.

Malnutrition care in hospitalized pediatric inpatients: comparison of perceptions and experiences across two pediatric academic health sciences centres

Malnutrition affects up to one in three Canadian children admitted to hospital. Awareness among pediatric healthcare providers (HCPs) of the prevalence and impacts of hospitalized malnutrition is critical for optimal management. The purpose of this study was to determine perceptions of malnutrition among pediatric HCP across two major academic health sciences centres, and to determine how the use of a standardized pediatric nutritional screening tool at one institution affects responses. Between 2020 and 2022, 192 HCPs representing nursing, dietetics, medicine, and other allied health were surveyed across McMaster Children's Hospital and The Hospital for Sick Children. 38% of respondents from both centres perceived rates of malnutrition between approximately one in three patients. Perceptions of the need for nutritional screening, assessment, and management were similar between centres. All respondents identified the need for better communication of hospitalized malnutrition status to community providers at discharge, and resource limitations affecting nutritional management of pediatric inpatients. This study represents the largest and most diverse survey of inpatient pediatric HCPs to date. We demonstrate high rates of baseline knowledge of hospital malnutrition, ongoing resource challenges, and the need for a systematic approach to pediatric nutritional management.

A survey of skin failure perceptions amongst pressure injury management staff in China: A cross-sectional study

This study sought to evaluate the perceptions of pressure injury (PI) management staff regarding skin failure (SF). Additionally, an analysis of influencing factors based on the collected data was conducted to establish a foundation for targeted SF training. A descriptive, cross-sectional survey was undertaken in October-November 2023, utilising a convenience sampling method involving selected management staff of PI from 16 provinces in China. A total of 501 nursing participants were included, exhibiting an overall perception level that was moderately low. Although the majority were aware of the possibility of SF (n = 417, 83.23%), only 60% reported an understanding of the fundamentals of SF, with the lowest level of comprehension observed in differentiating between SF and PI (n = 212, 42.31%). Overall attitudes were generally positive. Regarding behaviour, active learning was more prevalent (n = 340, 67.86%), but training is less (n = 287, 57.29%). Family education (n = 401, 80.04%) and nursing record monitoring (n = 426, 85.03%) demonstrated better behaviour. Further analysis revealed that training (t = 13.937, p < 0.001) and professional title (F = 4.681, p = 0.010) had a significant effect on participants' perceptions. These findings underscore that there remains a substantial lack of perception about SF amongst participants. Overall, participants exhibited a positive attitude towards SF, highlighting the need for future improvements in SF training.

Perceptions of TB-HIV comorbidity among the Nomads in Adamawa State, Nigeria

The recalcitrance of Mycobacterium tuberculosis (MTB) to eradication was related to achieving a nonreplicating (dormant) state and the increasing global burden of HIV coinfection. Consequently, understanding the knowledge and perception of the population at risk of tuberculosis-HIV infection is essential to designing a strategy of intervention embraced by the target population. A cross-sectional study was conducted among Nomads in Adamawa State, Nigeria. A multistage sampling technique was employed to recruit consented participants. Self-administered questionnaires were used to gather the required information from 4 nomadic schoolteachers in each selected school. Data were entered into a Microsoft Excel sheet where trends and tables of collated data were developed. The findings show that only 13.5% of the participants expressed the correct perceptions of the complementary relationship between HIV and TB. More people in government employment (35%) understand the coexisting relationship of TB-HIV infections. At the same time, cattle herders and crop farmers who practice the prevalent occupation lack knowledge of TB-HIV relatedness. Across gender, only a proportion of males (14.8%) than females (10.5%) were more likely to show an understanding of the complementary association of HIV and TB, and this difference showed statistical significance (p = 0.0001). In conclusion, male gender, education at a degree or professional level, and employment with the government are factors associated with positive perceptions of TB/HIV relatedness. Thus, there is a need to intensify communication to educate Nomads on HIV and TB-related issues.

Implementing a whole-of-service stepped care approach to personality disorder treatment: Impact of training and service redesign on clinician attitudes and skills

Personality disorders are a highly prevalent mental health condition. Historically, clinician attitudes have been negative, and only a small number have specialised training. This study evaluated clinician attitudes and confidence in working with people with personality disorder following the combination of training and implementation of a stepped care whole-of-service approach. A total of 102 multidisciplinary mental health clinicians were trained to implement the stepped care approach, and completed surveys prior to implementation and at 12 months follow up. Clinicians delivered manualised structured psychological therapy as part of the model. Measures assessed changes in attitudes and confidence, and impact of the service changes and therapy approach. Qualitative responses elucidated core themes. Evaluation at 12 months post training and service redesign showed improvements in clinician skills, confidence, theoretical knowledge and attitudes. Qualitative thematic analysis found core themes of improved understanding, clinical skills and improvements in the accessibility and timeliness of treatment. Implementing a whole-of-service model featuring stepped care therapies enhanced clinician attitudes, confidence, skills and knowledge in working with people with personality disorders. Clinicians identified that the whole-of-service model also improved accessibility to treatment, and quality of clinical care to the consumer and their carers.

An osteoporosis knowledge assessment instrument - development and validation

INTRODUCTION

The consequences of osteoporotic fractures are extremely detrimental to the individual as well as to society. Adopting effective preventative measures is a top public health priority.

Explaining the barriers faced by veterinarians against preventing antimicrobial resistance: an innovative interdisciplinary qualitative study

BACKGROUND

Considering the significance of increased antimicrobial resistance (AMR) and its adverse effects on individual and social health and the important and effective role that veterinarians play in controlling this growing issue worldwide, it is essential to have effective preventive control programs. To this aim, the first step is to identify the factors behind the prevalence of AMR in Iran and the barriers veterinarians face to controlling this problem. Thus, the present study was conducted to explain the barriers veterinarians faced in the prevention of AMR from an Iranian veterinarian's perspective.

METHODS

The present research was done in three cities in Iran in 2021. The data were collected through in-depth interviews with 18 veterinarians selected through purposive and snowball sampling and analyzed using conventional qualitative content analysis.

RESULTS

The data analysis results were classified into 4 main categories and 44 subcategories. The former included: educational factors, administrative/legal factors, client-related factors, and veterinarian-related factors.

CONCLUSIONS

The increased AMR can be approached from multiple aspects. Considering the different factors that affect the increased AMR, it is necessary to consider them all through effective planning and policy-making at multi-level and multidisciplinary dimensions. There is special attention needed to scientific and practical interventions at the individual, interpersonal, social, and even political levels. At the same time, measures should be taken to rehabilitate and maintain the health of society to strengthen supervision and attract the full participation of interested organizations.

Effectiveness of the Integrated Dengue Education and Learning (iDEAL) module in improving the knowledge, attitude, practice, environmental cleanliness index, and dengue index among schoolchildren: A randomised controlled trial protocol

BACKGROUND

Dengue is a mosquito-borne disease caused by four distinct, closely related dengue viruses (DENV). Global dengue incidence has markedly increased in the past decades. The World Health Organization reported that cases increased from 505,430 in 2000 to 5.2 million in 2019. Similarly, the total dengue cases in Malaysia increased from 7,103 in 2000 to a peak of 130,101 in 2019. Knowledge, attitude, and practice (KAP) remain the most effective dengue prevention and control tools. Furthermore, school-based health education is key to enhancing knowledge and raising awareness of the seriousness of dengue among schoolchildren and transferring knowledge and practice from classrooms to homes. Thus, it is necessary to plan an integrated module for the primary prevention of dengue infection, specifically among schoolchildren.

AIMS

The present study intends to develop, implement, and evaluate the effectiveness of a theory-based integrated dengue education and learning (iDEAL) module in improving the KAP, environmental cleanliness index, and dengue index among schoolchildren in Selangor and Kuala Lumpur.

METHODS

This study is a single-blinded, cluster randomised controlled trial to be conducted from 1 September 2023 to 31 August 2025. The study will involve 20 primary and 20 secondary schools in Selangor and Kuala Lumpur. The 1600 participants will be randomly allocated to intervention and control groups based on selected clusters to avoid contamination. A cluster is a comparable school that fulfils the inclusion and exclusion criteria. The intervention group will receive the iDEAL module, while the control group will receive standard education. The iDEAL module will be developed following a systematic procedure and delivered in-person by trained researchers to the participants. The outcome will be measured using validated, self-administered questionnaires at baseline (T0), immediately (T1), one month (T2), and three months (T3) post-intervention to measure the intervention module effectiveness. The data will be analysed using IBM Statistical Package for Social Science (SPSS) version 28 and descriptive and inferential statistics. Within-group changes over time will be compared using one-way repeated measure analysis of variance for continuous and normally distributed variables. Within-group analysis of categorical data will use Cochran's Q test. The main effect and interaction between and within the intervention and control groups at T0, T1, T2, and T3 will be tested using the generalised linear mixed model (GLMM). Hypothetically, the KAP, environmental cleanliness index, and dengue index among the intervention group will be significantly improved compared to the control group. The hypothesis will be tested using a significance level with a p-value of 0.05 and a confidence interval of 95%.

CONCLUSIONS

The study protocol outlines developing and testing an iDEAL module for schoolchildren in Selangor and Kuala Lumpur, with no socio-demographic differences expected. The intervention aims to improve KAP, environmental cleanliness index, and dengue index, potentially reducing dengue risk. Results could inform public health policies, emphasizing school-based interventions' importance in combating diseases like dengue.

Co-design and mixed methods evaluation of an interdisciplinary digital resource for undergraduate health profession students to improve the prevention, recognition, and management of delirium in Ireland: a study protocol

BACKGROUND

Delirium is a common symptom of acute illness which is potentially avoidable with early recognition and intervention. Despite being a growing concern globally, delirium remains underdiagnosed and poorly reported, with limited understanding of effective delirium education for undergraduate health profession students. Digital resources could be an effective approach to improving professional knowledge of delirium, but studies utilising these with more than one profession are limited, and no evidence-based, interdisciplinary, digital delirium education resources are reported. This study aims to co-design and evaluate a digital resource for undergraduate health profession students across the island of Ireland to improve their ability to prevent, recognise, and manage delirium alongside interdisciplinary colleagues.

METHODS

Utilising a logic model, three workstreams have been identified. Workstream 1 will comprise three phases: (1) a systematic review identifying the format, methods, and content of existing digital delirium education interventions for health profession students, and their effect on knowledge, self-efficacy, and behavioural change; (2) focus groups with health profession students to determine awareness and experiences of delirium care; and (3) a Delphi survey informed by findings from the systematic review, focus groups, and input from the research team and expert reference group to identify resource priorities. Workstream 2 will involve the co-design of the digital resource through workshops (n = 4) with key stakeholders, including health profession students, professionals, and individuals with lived experience of delirium. Lastly, Workstream 3 will involve a mixed methods evaluation of the digital resource. Outcomes include changes to delirium knowledge and self-efficacy towards delirium care, and health profession students experience of using the resource.

DISCUSSION

Given the dearth of interdisciplinary educational resources on delirium for health profession students, a co-designed, interprofessional, digital education resource will be well-positioned to shape undergraduate delirium education. This research may enhance delirium education and the self-efficacy of future health professionals in providing delirium care, thereby improving practice and patients' experiences and outcomes.

TRIAL REGISTRATION

Not applicable.

The knowledge about long-term consequences of preterm birth among health professionals, educational professionals, and parents in Slovenia

AIM

To assess the knowledge about the long-term consequences of preterm birth and the need for training and information among various professionals working with preterm children and parents of preterm children.

METHODS

In February and March 2018, physicians, psychologists, special education needs teachers, teachers, preschool teachers, and parents (N=488) filled in the Preterm Birth-Knowledge Scale and a survey regarding their perceptions and attitudes toward working with preterm children.

RESULTS

Physicians and psychologists were most knowledgeable among the groups about the long-term consequences of preterm birth. Teachers, preschool teachers, and parents had significantly lower knowledge (F=23.18, P<0.001). The majority of professionals indicated that they did not feel adequately equipped to support the learning and development of preterm children and that they had not received sufficient training in this area. More than half indicated that they had received no formal training. In general, the participants tended to underestimate the long-term problems of preterm children.

CONCLUSION

The findings underscore the importance of integrating the issue of the long-term outcomes of preterm birth and working with preterm children into formal education, and in other forms of educational activities.

Shared decision-making needs, barriers, and facilitators of patients with newly diagnosed advanced cancer in the hospital: a multi-level, mixed-methods study

PURPOSE

Little is known about the shared decision-making (SDM) needs, barriers, and facilitators of patients with newly diagnosed advanced cancer in the hospital. Understanding this may improve SDM and cancer care quality in this vulnerable population.

METHODS

A single-site, mixed-methods study of hospitalized patients with newly diagnosed advanced cancer, caregivers, and oncologists was conducted. After discharge, patient ± caregiver semi-structured interviews exploring SDM needs, barriers, and facilitators regarding their most important upcoming cancer-related decision were conducted. Oncologists were surveyed about patient knowledge and SDM needs using closed- and open-ended questions, respectively. Thematic analysis was performed for qualitative data with a focus on themes unique to or amplified by hospitalization. Descriptive statistics and the Chi-squared test were performed for quantitative data.

RESULTS

Patients and caregivers reported high SDM needs surrounding treatment and prognostic information, leading to decisional conflict. Eight themes emerged: anticipated cancer treatment decisions, variable control preferences in decision-making, high cancer-related information needs and uncertainty, barriers and facilitators to information gathering during and post hospitalization, and decision-making facilitators. Among 32 oncologists, most (56%) reported patients were poorly informed about treatment and prognosis. Oncologists reported variable expectations about patient knowledge after hospitalization, facilitators to patient decision-making, and patient uncertainty while awaiting an outpatient oncologist appointment.

CONCLUSION

Patients newly diagnosed with advanced cancer in the hospital have high SDM needs and experience decisional conflict. This may be due to barriers unique to or exacerbated by hospitalization. Further research is needed to develop strategies to address these barriers and enhance the facilitators identified in this study.

Prevalence of modern contraceptive discontinuation and associated factors among married reproductive age group women in Debre Berhan town, Ethiopia: a community-based cross-sectional study

OBJECTIVE

To assess the prevalence of modern contraceptive discontinuation and associated factors among married reproductive age (15-49 years) group women.

STUDY DESIGN, SETTING AND PARTICIPANTS

A community-based cross-sectional study was conducted in Debre Berhan town among 500 reproductive age group women. Study participants were selected using two-stage sampling procedures. Data were collected using a semistructured face-to-face interview questionnaire. The data were entered in EpiData V.4.2.0 and then exported to SPSS V.25 software for data analysis. Descriptive statistics such as mean, per cent and frequency were used to summarise women's characteristics. Binary logistic regression analysis was used to identify predictors' variables with modern contraceptive discontinuation and p<0.05 was used to declare association.

RESULTS

The prevalence of modern contraceptive discontinuation among married reproductive age group women was 35.2% with a mean duration of use of 2.6±2.1 months. This study also revealed that the discontinuation rate was 12.6% within the first year of use. In the current study, those living with their husband (adjusted OR (AOR)=3.81, p<0.001), experiencing side effects while using modern contraceptives (AOR=2.45, p=0.02), getting counselling service (AOR=5.51, p<0.001) and respondent husband acceptance of her modern contraceptive use (AOR=3.85, p=0.01) were significantly associated with modern contraceptive discontinuation.

CONCLUSION

The findings of this study showed that the prevalence of modern contraceptive discontinuation rate of all methods among married reproductive age group women was 35.2%. To reduce modern contraceptive discontinuation, mutually, it is important to create community awareness about the importance of the continued use of modern contraceptives, improve the quality of family planning service in the health institution, strengthen family planning counselling service and give adequate counselling on details of effectiveness and side effects.

Examining Women's HIV Protective Behaviors in Nepal

Women's autonomy in decision making has important sexual and reproductive health implications. This study uses a nationwide analysis in Nepal to examine women's autonomy, attitude toward intimate partner violence (IPV) behaviors, and HIV-related knowledge in the execution of HIV protective behaviors such as having one sexual partner or getting an HIV test to prevent HIV transmission. Secondary data analysis was conducted using the nationally represented Nepal Demographic and Health Survey (2016-2021) dataset. The sample included 9,904 women ages 15 to 49 who self-identified as ever married. Factor analysis for women's autonomy, attitude toward IPV behaviors, and HIV-related knowledge were conducted based on social dominance theory. Structural equation modeling was conducted, and the results indicated that higher autonomy decreased the risk of HIV infection through having one sexual partner. Factors related to multiple sex partners included unemployment, religious affiliation, and age. Similarly, higher autonomy, HIV-related knowledge, having a formal job, and urban residence increased women's likelihood of taking an HIV test. Women's higher education, greater wealth, religious affiliation, and youth also correlate with HIV testing. Future HIV prevention interventions should include strategies that support women's social and economic empowerment and enhance women's ability to make informed choices about their health and risks.

Understanding facilitators and barriers to COVID-19 vaccination in the Zimbabwean population: a qualitative analysis

BACKGROUND

Vaccines are effective biological interventions that reduce health burdens. However, during the COVID-19 pandemic, there were concerns about varying levels of COVID-19 vaccination coverage in the Zimbabwean population. This study aimed to understand facilitators and barriers to COVID-19 vaccine uptake in the Zimbabwean population.

METHODS

In September-October 2023, key informant interviews (KIIs) and focus group discussions (FGDs) were conducted with a sample comprising health workers, village health workers, church leaders, traditional healers, teachers, youth leaders and the general population selected across the country. At each site, the participant sample was homogeneous. Data were collected using audiotapes, transcribed verbatim, and translated into English. Data were analysed manually using thematic analysis.

RESULTS

Ten FGDs and 30 KIIs were conducted across the country. Among the facilitators of COVID-19 vaccine uptake were the perceived benefits of COVID-19 vaccination, such as protection from infection, severe disease and death. People also complied with COVID-19 vaccination because of the government's call for mandatory vaccination, travel restrictions, restrictions when entering some premises for services, visiting, working, learning and functions. Barriers to COVID-19 vaccine uptake included low-risk perception, negative attitudes emanating from concerns about the origins of the vaccines, COVID-19 cases or death of vaccinated people, negative peer influence, religious doctrines, cultural beliefs and misconceptions circulating through social media. Other barriers included knowledge gaps on COVID-19 vaccines, safety, effectiveness, side effects, access-related challenges to COVID-19 services and concerns over the changing policy on COVID-19 vaccination.

CONCLUSIONS

The study has shown the importance of community engagement and data-driven public health communication strategies to facilitate behaviour change for increased uptake of a vaccine. In future epidemics, public health campaigns should focus on the timely provision of information explaining the benefits of an intervention, addressing safety concerns more effectively. To build trust and hence improve vaccine uptake by the public, there is a need for continuous engagement with people and to provide platforms for dialogue to address issues contributing to low vaccine uptake.

Strengthening care for emergencies: what is the level of awareness and utilization of Emergency Medical Services (EMS) in FCT, Nigeria?

BACKGROUND

As part of the Federal Government of Nigeria's desire to increase medical coverage among the citizenry, the National Emergency Medical Service and Ambulance Scheme (NEMSAS) was set up and piloted in the FCT in 2022. To gauge the progress so far, this study sought to assess the level and determinants of public awareness and utilization of Emergency Medical Services (EMS) among residents of the Federal Capital Territory, Abuja.

METHODS

A cross-sectional study was conducted in June 2023 among 1177 respondents residing in FCT Abuja at the time of the survey. Data was collected by trained research assistants using an interviewer-administered questionnaire and purposive sampling was adopted. The level of awareness and the socio-demographic determinants of the level of awareness in the FCT were assessed. Logistic regression was used to find predictors of EMS awareness and utilization.

RESULTS

57.8% of respondents are aware of EMS, while 42.2% are not. 62.7% are uncertain about the source of information for EMS with only a minority relying on word of mouth (17.7%), traditional media (11.1%), or social media (8.5%). 91.4% have not accessed or utilized EMS via the toll-free emergency line, while only 8.6% reported doing so. There are median EMS awareness and utilization differences across gender, age, location, and employment status of the respondents. Additionally, the multivariate logistic regression showed that age, location, and employment status are significant predictors of EMS awareness and utilization. Males have lower odds of awareness and utilization of EMS compared to females. Furthermore, there was a significant relationship between EMS access and utilization (Chi-square = 80.748, p < 0.001). However, awareness did not necessarily translate to utilization.

CONCLUSION

The relationship between EMS awareness and utilization and the unmasked predictors in this paper should be factored into the design of interventions to increase access and utilization of EMS in Nigeria.

Breast density knowledge and willingness to delay treatment for pre-operative breast cancer imaging among women with a personal history of breast cancer

BACKGROUND

Following a breast cancer diagnosis, it is uncertain whether women's breast density knowledge influences their willingness to undergo pre-operative imaging to detect additional cancer in their breasts. We evaluated women's breast density knowledge and their willingness to delay treatment for pre-operative testing.

METHODS

We surveyed women identified in the Breast Cancer Surveillance Consortium aged ≥ 18 years, with first breast cancer diagnosed within the prior 6-18 months, who had at least one breast density measurement within the 5 years prior to their diagnosis. We assessed women's breast density knowledge and correlates of willingness to delay treatment for 6 or more weeks for pre-operative imaging via logistic regression.

RESULTS

Survey participation was 28.3% (969/3,430). Seventy-two percent (469/647) of women with dense and 11% (34/322) with non-dense breasts correctly knew their density (p < 0.001); 69% (665/969) of all women knew dense breasts make it harder to detect cancers on a mammogram; and 29% (285/969) were willing to delay treatment ≥ 6 weeks to undergo pre-operative imaging. Willingness to delay treatment did not differ by self-reported density (OR:0.99 for non-dense vs. dense; 95%CI: 0.50-1.96). Treatment with chemotherapy was associated with less willingness to delay treatment (OR:0.67; 95%CI: 0.46-0.96). Having previously delayed breast cancer treatment more than 3 months was associated with an increased willingness to delay treatment for pre-operative imaging (OR:2.18; 95%CI: 1.26-3.77).

CONCLUSIONS

Understanding of personal breast density was not associated with willingness to delay treatment 6 or more weeks for pre-operative imaging, but aspects of a woman's treatment experience were.

CLINICALTRIALS

GOV : NCT02980848 registered December 2, 2016.

Residents' KABP and Social Support Statuses Under Normalized COVID-19 Pandemic Prevention and Control: A Cross-Sectional Study

OBJECTIVES

To investigate the status quo of residents' knowledge, attitude, belief, and practice (KABP) and social support and the correlation of KABP with social support under normalized coronavirus disease (COVID-19) pandemic prevention and control.

METHODS

A questionnaire was designed based on the KABP model, and an online survey was conducted among residents in September 2022. SPSS software (version 25.0) was used to analyze the data. Two independent sample t-tests, one-way analysis of variance (ANOVA), multivariate linear regression analysis, and Pearson's correlation analysis were conducted.

RESULTS

In total, 326 valid questionnaires were obtained. The scoring rates of residents' KABP and social support were 68.1%, 92.2%, 89.3%, 75.3%, and 62.6%, respectively. Main factors influencing residents' knowledge included gender, nationality, education level, practice, and social support; those influencing attitude were belief and practice; those influencing belief were place of residence, attitude, and practice; those influencing practice were knowledge, attitude, belief, and social support; and those influencing social support were marital status, place of residence, knowledge, and practice. Social support was positively correlated with knowledge and practice.

CONCLUSIONS

This study provides a scientific foundation for the current normalized prevention and control of COVID-19 and is conducive to health managers to better carry out prevention and control related health education for specific groups.

Curriculum-based sexual and reproductive health education: revealing its relevance for risky sexual behaviors among secondary school students in Mwanza, Tanzania

BACKGROUND

Secondary school students are vulnerable to risky sexual behaviors (RSBs) which may lead to adverse health consequences, such as teenage pregnancies and sexually transmitted diseases (STDs), including HIV/AIDS. In Tanzania, the burden of teenage pregnancy was reported to be 27% in 2016. The integration of sexual and reproductive health (SRH) education into the school curriculum is one of the proven crucial interventions. However, there is limited information on the extent to which curriculum-based SRH education is relevant for fostering good practices for coping with RSBs. This study sought to describe students' and teachers' perceptions of the relevance of curriculum-based SRH education.

METHODS

A qualitative study was conducted from May to June 2020 (involving 5 secondary schools in Ilemela district, Mwanza, Tanzania). In-depth interviews (30) were conducted among secondary school students and 10 interviews for teachers. The data were collected in Swahili and then transcribed and translated into English after which thematic content analysis was performed.

RESULTS

The majority (56%) of secondary school students were revealed to have a limited understanding of curriculum-based SRH education, which was limited to a few aspects of health that involved married people and pregnant women. Teachers of different subjects had different perceptions about the relevance of curriculum-based SRH education. Civics teachers had the perception that it was relevant and enough, while Biology teachers thought that it was not enough. Students reported utilizing the information taught in class to manage and navigate RSBs. Moreover, they expressed a need for additional delivery strategies to be used for a comprehensive understanding of sexual and reproductive health.

CONCLUSION

Despite the identified gaps in providing a comprehensive knowledge that builds on the appropriate attitudes and skills, the existing curriculum-based SRH education in secondary schools was utilized to help students in addressing and managing RSBs. However, there is a need for more comprehensive information and an improved delivery approach for SRH to equip students with the necessary skills when faced with RSBs.

Comparison of knowledge, awareness, and behaviors toward oral cancer among dental students and dentists: an online cross-sectional questionnaire in Türkiye

OBJECTIVE

This cross-sectional online questionnaire-based study evaluated the knowledge, awareness, and behaviors of dentists and senior dental students regarding oral cancer (OC).

MATERIALS AND METHODS

This study included 168 dentists and senior dental students who had completed all theoretical educations and clinical practices. An online survey was administered to all participants to assess their awareness of the risk factors for OC, clinical knowledge, and behaviors. The participants' demographic characteristics and knowledge of OC were analyzed.

RESULTS

Of the participants, 48.8% were female and 51.2% were male. Their mean age was 27.04 ± 5.56 years (range: 21-51). In addition, 59.5% were dentists, and 40.5% were senior dental students. The dentists' mean time since graduation was 6.38 ± 5.64 years (range: 1-27). Routine oral mucosa examination for OC was significantly more frequent among the dentists than the senior dental students (p < 0.05). Among all participants, 33% of dentists and 51.5% of senior dental students had poor knowledge of OC-related or possibly predisposing factors. Routine evaluation of OC-related and predisposing risk factors, including human papillomavirus infection, smoking, alcohol use, trauma-related non-healing oral lesions caused by long-term incompatible prostheses, and poor oral hygiene, was significantly more frequent among the dentists than the senior dental students (p < 0.05).

CONCLUSION

Educating dental students about a more comprehensive oral examination and early diagnosis of OC would help overcome the current lack of adequate knowledge and attitudes in OC prevention and early detection. A core curriculum compatible with the global standards on OC should be provided to dental students.

Knowledge of and Attitudes Toward Clinical Trials: A Questionnaire-Based Study of 179 Male Third- and Fourth-Year PharmD Undergraduates from Riyadh, Saudi Arabia

BACKGROUND Clinical Trials (CTs) are essential for the formation of a new medicine. This questionnaire-based study included 179 male third- and fourth-year PharmD undergraduate students from Riyadh, Saudi Arabia, between 18 and 23 years of age, was conducted in 2022, and aimed to evaluate student knowledge and attitudes toward CTs. MATERIAL AND METHODS A cross-sectional study was conducted using self-administered questionnaires. The data was collected using convenience sampling. Part 1 of the study collected demographics, with 6 items; part 2 measured knowledge about CTs (9 items); part 3 measured attitudes (5 items) measured on a 5-point Likert scale. A score of 1 was given for correct, and a score of 0 for each incorrect response. Multiple linear regression was used to evaluate the determinants of knowledge and attitudes about CTs. RESULTS A total of 108 (60.3%) undergraduates reported having heard about CTs, 15% of undergraduates had heard about institutional review boards, while 74.3% of the undergraduates believed that CTs have direct benefits to society. The mean knowledge score of the CTs among the students was 5.75±2.32 (median 6.00), while the mean attitude score of CTs was 16.45±4.56 (median 16.00). However, the results of the simple regression model revealed that age, year of study, and chronic disease status were not predictors of the knowledge and attitude score (P>0.05). CONCLUSIONS This study indicated that half of undergraduates were aware of CTs, were knowledgeable, and showed positive attitudes. Furthermore, the study identified potential misunderstandings about the benefits of CTs.

Factors influencing breast cancer screening practices among women worldwide: a systematic review of observational and qualitative studies

BACKGROUND

The variation in breast cancer incidence rates across different regions may reflect disparities in breast cancer screening (BCS) practices. Understanding the factors associated with these screening behaviors is crucial for identifying modifiable elements amenable to intervention. This systematic review aims to identify common factors influencing BCS behaviors among women globally.

METHODS

Relevant papers were sourced from PubMed, Scopus, Embase, and Google Scholar. The included studies were published in English in peer-reviewed journals from January 2000 to March 2023 and investigated factors associated with BCS behaviors.

RESULTS

From an initial pool of 625 articles, 34 studies (comprising 29 observational and 5 qualitative studies) with 36,043 participants were included. Factors influencing BCS behaviors were categorized into nine groups: socio-demographic factors, health status history, knowledge, perceptions, cultural factors, cues to action, motivation, self-efficacy, and social support. The quality appraisal scores of the studies ranged from average to high.

CONCLUSIONS

This systematic review highlights factors pivotal for policy-making at various levels of breast cancer prevention and assists health promotion professionals in designing more effective interventions to enhance BCS practices among women.

Knowledge, attitudes and perceptions of Latin American healthcare workers relating to antibiotic stewardship and antibiotic use: a cross-sectional multi-country study

BACKGROUND

The burden of antimicrobial resistance (AMR) in Latin America is high. Little is known about healthcare workers' (HCWs) knowledge, attitudes, and perceptions of antimicrobial stewardship (AS), AMR, and antibiotic use (AU) in the region.

METHODS

HCWs from 42 hospitals from 5 Latin American countries were invited to take an electronic, voluntary, anonymous survey regarding knowledge, attitudes, and perceptions of AS, AMR, and AU between March-April 2023.

FINDINGS

Overall, 996 HCWs completed the survey (52% physicians, 32% nurses, 11% pharmacists, 3% microbiologists, and 2% "other"). More than 90% of respondents indicated optimizing AU was a priority at their healthcare facility (HCF), 69% stated the importance of AS was communicated at their HCF, and 23% were unfamiliar with the term "antibiotic stewardship". Most (> 95%) respondents acknowledged that appropriate AU can reduce AMR; however, few thought AU (< 30%) or AMR (< 50%) were a problem in their HCF. Lack of access to antibiogram and to locally endorsed guidelines was reported by 51% and 34% of HCWs, respectively. Among prescribers, 53% did not consider non-physicians' opinions to make antibiotic-related decisions, 22% reported not receiving education on how to select antibiotics based on culture results and 60% stated patients and families influence their antibiotic decisions.

CONCLUSIONS

Although HCWs perceived improving AU as a priority, they did not perceive AU or AMR as a problem in their HCF. AS opportunities include improved access to guidelines, access to AMR/AU data, teamwork, and education on AS for HCWs and patients and families.

Energy drinks in Tamale: Understanding youth perceptions, consumption patterns, and related factors

Energy drinks (EDs) have become a popular choice for young people seeking physical and cognitive boosts, with ingredients such as caffeine, taurine, and B vitamins aimed at improving academic, athletic, and alertness levels. However, the popularity of these drinks is also driven by low prices, taste, brand loyalty, and gendered marketing, with boys being more likely to consume them. Despite the supposed benefits, EDs have been associated with high-risk behaviours, deaths, and adverse health effects, especially those related to cardiovascular risk. Meanwhile, in Ghana, the use of EDs is on the rise. Hence, this study aimed to examine the prevalence and consumption patterns, perceptions, and factors associated with ED consumption among the youth of the Tamale Metropolis. The study was cross-sectional, consisting of 541 participants. The group consisted of 340 males and 201 females, between the ages of 15 and 45. A questionnaire was utilized to obtain data on the respondents' consumption patterns and perceptions of EDs, as well as their socio-demographic characteristics. The results of the study indicated that a large percentage of the respondents, 98.7%, had consumed EDs before, while 78.7% currently consume them. Respondents believed that EDs provided additional energy (81.00%) and reduced stress (62.30%). However, they also perceived side effects such as insomnia (60.60%) and restlessness (51.40%). Also, the highest proportion of respondents (83.4%) had poor knowledge of EDs. They were unaware of the classification of EDs and their ingredients, side effects, and benefits. Age, marital status, level of education, work intensity, EDs served at gatherings, and knowledge of EDs was significantly associated with ED consumption (p < .05). Consumption was higher among those aged 26 to 35 years, singles, individuals with no formal education, and those with high work intensity. The high consumption was also associated with low knowledge levels. It is recommended that public health and nutrition professionals engage in further advocacy efforts to improve the youth's knowledge and perception of EDs in a positive manner. In addition, lawmakers should use legislation to influence consumption rates and safeguard the health of consumers.

Shining a spotlight on the inclusion of disabled participants in clinical trials: a mixed methods study

BACKGROUND

It is crucial to include a wide range of the population in clinical trials for the outcome to be applicable in real-world settings. Existing literature indicates that under-served groups, including disabled people, have been excluded from participating in clinical trials without justification. Exclusion from clinical trials exacerbates disparities in healthcare and diminishes the benefits for excluded populations. Therefore, this study was conducted to investigate potential obstacles that prevent disabled people from participating in clinical trials in the United Kingdom (UK).

METHODS

The study was carried out through an explanatory sequential mixed methods design. The Imperial Clinical Trials Unit devised and implemented an online questionnaire-based survey (with open/closed-ended questions) and an online focus group discussion. The target population were disabled people, family members/carers of disabled people and staff involved in clinical trials, whereupon the sample was recruited by convenience sampling methods via posters and emails through various networks. The Qualtrics XM survey system was used as the host platform for the online survey, and Microsoft Teams was used for an online focus group discussion. The focus group discussion was conducted to gain a deeper understanding of the themes identified from the survey responses. We analysed responses to the survey via descriptive analysis and used thematic analysis to synthesise the free-text answers from the survey and focus group discussion.

RESULTS

We received 45 responses to the survey questionnaire and 5 disabled people took part in a focus group discussion. Our findings highlighted the differences between the perspectives of researchers and those "being researched" and different types of barriers experienced by disabled people: opportunity barriers (inadequate recruitment strategy and ambiguous eligibility criteria), awareness barriers (perception of disability) and acceptance/refusal barriers (available support and adjustment, and sharing of trial results).

CONCLUSION

Our findings support perspectives drawn from the Ford Framework regarding the need to consider all barriers, not just up to the point of enrolment into trials but also beyond the point of inclusion in clinical trials. We support calls for the introduction of legislation on including disabled people in clinical trials, implementation of industry/community-wide participatory approaches and the development of guidelines, a combined public-private approach.

Knowledge, attitudes and demographic drivers for COVID-19 vaccine hesitancy in Malawi

This study assessed the association among knowledge, attitudes and uptake of COVID-19 vaccine in Malawi, examining demographic factors influencing these variables. The study employed a quantitative research design. It thus sampled 394 participants from Malawi's three districts of Zomba, Dowa and Nkhatabay. Results showed that 163 (41.4%) participants had low levels of knowledge of COVID-19 vaccine, 231 (58.6%) had high levels of knowledge, 237 (60.2%) had a positive attitude, and 156 (39.8%) had a negative attitude towards the COVID-19 vaccine. On vaccine uptake, the study found that only 29 (17%) male and 52 (23%) female participants had received the vaccine. Further, participants with low levels of knowledge and a positive attitude towards the vaccine were 5.9 times more likely (p-value = 0.001) to be vaccinated than those with low levels of knowledge and negative attitudes towards the vaccine. On the other hand, those with high knowledge and a positive attitude towards the vaccine were 8.2 times more likely (p-value < 0.001) to be vaccinated compared to those with low knowledge and negative attitudes towards the vaccine. The findings highlight the importance of vaccine-related knowledge and attitudes in shaping uptake and reveal disparities across demographic groups. To improve vaccination coverage in Malawi, targeted interventions focusing on enhancing COVID-19 vaccine knowledge, addressing attitudinal barriers, and countering misinformation are needed. Strategies should be tailored to reach populations with lower uptake, such as males, younger adults, and those with lower education levels. Strengthening public health messaging, engaging community leaders, and building trust in healthcare systems are crucial for promoting widespread acceptance and uptake of COVID-19 vaccines in Malawi.

Dental practitioners' knowledge, management practices, and attitudes toward collaboration in the treatment of temporomandibular joint disorders: a mixed-methods study

BACKGROUND

Temporomandibular joint disorders (TMDs) are a variety of conditions that affect different parts of the temporomandibular joints (TMJ) and can cause orofacial pain and functional impairment. This study aims to investigate dental practitioners' knowledge and management of Temporomandibular Joint Disorders (TMDs), particularly their knowledge of the role physical therapy plays in TMD treatment.

METHODS

A mixed-methods approach was adopted to provide a comprehensive view of current knowledge, management practices, and attitudes toward collaboration among dental practitioners in treating TMD. Data were collected from a convenience sample of 335 dentists in Karachi using a detailed questionnaire to assess their knowledge of the role of physical therapy in the treatment of TMD. Twenty dentists were chosen for face-to-face, in-depth interviews to explore their experiences and challenges in managing TMDs based on their responses to the administered questionnaire.

RESULTS

The cumulative quantitative and qualitative findings of the study revealed a landscape marked by individualized approaches to referral practices and significant gaps in interdisciplinary collaboration. Most practitioners holding a bachelor's degree predominantly used medication (65.2%) and cause-specific treatment (65.3%) for TMD treatment. Thematic analysis of clinical efficacy and practitioner challenges in managing TMD revealed significant issues faced by dental professionals.

CONCLUSIONS

The study successfully validated a questionnaire to understand dental practitioners' knowledge regarding physical therapy in TMD treatment. The study identified significant gaps in knowledge and a lack of collaboration between dentists and physiotherapists. The limited referral practices highlighted in the study, along with insights from dentist interviews, emphasize the need for improved interdisciplinary approaches to managing TMDs within dental practice.

Community Health workers United to Reduce Colorectal cancer and cardiovascular disease among people at Higher risk (CHURCH): study protocol for a randomized controlled trial

BACKGROUND

Colorectal cancer (CRC) is the second most lethal cancer in the United States (U.S.) with the highest incidence and mortality rates among African Americans (AAs) compared to other racial groups. Despite these disparities, AAs are the least likely to undergo CRC screening, have precancerous colorectal polyps removed, and have CRC detected at stages early enough for curative excision. In addition, compelling evidence links inflammatory dietary patterns to increased CRC and cardiovascular disease risk. Studies show that AA churches can successfully engage in health promotion activities including those related to cancer control. The current study seeks to leverage church-placed Community Health Workers (CHWs) to increase CRC screening and reduce CRC risk.

DESIGN AND METHODS

We aim to (1) increase guideline concordant CRC screening uptake using church-placed CHWs trained in screening with a validated instrument, Brief Intervention using Motivational Interviewing, and Referral to Treatment (SBIRT); and (2) reduce dietary risk factors (inflammatory dietary patterns) linked to CRC. The latter will be addressed by culturally adapting an existing, web-based lifestyle program called Alive!. Using a Hybrid Type 1 Implementation-Effectiveness cluster randomized design, we will randomize 22 AA churches into either the dual intervention arm (CHW-led SBIRT intervention plus Alive!) or a usual care arm comprised of CRC prevention educational pamphlets and a list of CRC screening sites. We will recruit 440 subjects and evaluate the effects of both arms on screening uptake (colonoscopy, fecal DNA) (primary outcome) and dietary inflammation score (secondary outcome) at 6-month follow-up, and Life Simple7 (LS7)-a cardiovascular disease (CVD) risk score-at 6 months and 1 year (secondary outcome). Finally, guided by a racism-conscious adaptation of the Consolidated Framework for Implementation Research (CFIR), we will conduct a mixed-methods process evaluation with key stakeholders to understand multi-level influences on CRC screening and CVD risk behaviors.

DISCUSSION

Church-placed CHWs are trusted influential connectors between communities and health systems. Studies have shown that these CHWs can successfully implement health prevention protocols in churches, including those related to cancer control, making them potentially important community mediators of CRC screening uptake and CRC/CVD risk reduction.

TRIAL REGISTRATION

NCT05174286; clinicaltrials.gov; August 31st, 2023.