In this review, we have summarized the findings of fifteen studies of knowledge of stroke warning signs and risk factors in both high- and low-risk populations. In general, there appears to be low levels of knowledge of both risk factors and stroke warning signs among the communities studied. Using free recall, between 20% and 30% of respondents could not name a single risk factor, and between 10% and 60% could not name a single warning sign of stroke. Providing survey respondents with a list of potential warning signs substantially improved the identification of warning signs. Respondents in older age groups and having lower levels of educational attainment tended to have less knowledge of risk factors and warning signs of stroke than those in younger age groups and those with more education. Public campaigns to improve stroke knowledge are needed, particularly in the older age groups where the risk of stroke is greater.
stroke; awareness; risk factors; knowledge; survey
Objectives. To determine the awareness of the warning signs, risk factors, and treatment of tuberculosis among urban Nigerians. Methods. This was a cross-sectional survey among 574 adults in Ilorin, Nigeria. Semistructured questionnaire was administered by trained interviewers to obtain information about awareness of tuberculosis warning signs, risk factors, and treatment. Results. Majority of the subjects (71.4%) were aware of at least one warning sign of tuberculosis. Cough (66.2%), weight loss (38.0%), and haemoptysis (30.7%) were the most identified warning signs. The predictors of awareness of warning sign were increasing age (r + 0.12), higher family income (r + 0.10), higher level of education (r + 0.10), and belonging to Christian faith (r + 0.11). Awareness of risk factors for tuberculosis was higher for tobacco smokers (77.0%) and history of contact with a case of TB (76.0%). Less than half were aware of HIV infection (49.8%), alcohol consumption (42.5%), chronic kidney disease (40.4%), extremes of ages (39.4%), cancers (36.9%), and diabetes mellitus (27.5%) as risk factors for TB. Tuberculosis was reported to be curable by 74.6% of the subjects and 67.9% knew that there are medications for treatment of tuberculosis, while 11.5% knew the duration of treatment. Conclusion. This study has revealed that the awareness of HIV and noncommunicable diseases as risk factors for TB is poor. This study has therefore demonstrated the need for health education programs that will emphasize recognition, identification, and modification of risk factor for TB.
Little is known about ethnic differences in awareness of cancer-warning signs or help-seeking behaviour in Britain. As part of the National Awareness and Early Diagnosis Initiative (NAEDI), this study aimed to explore these factors as possible contributors to delay in cancer diagnosis.
We used quota sampling to recruit 1500 men and women from the six largest minority ethnic groups in England (Indian, Pakistani, Bangladeshi, Caribbean, African and Chinese). In face-to-face interviews, participants completed the newly developed cancer awareness measure (CAM), which includes questions about warning signs for cancer, speed of consultation for possible cancer symptoms and barriers to help seeking.
Awareness of warning signs was low across all ethnic groups, especially using the open-ended (recall) question format, with lowest awareness in the African group. Women identified more emotional barriers and men more practical barriers to help seeking, with considerable ethnic variation. Anticipated delay in help seeking was higher in individuals who identified fewer warning signs and more barriers.
The study suggests the need for culturally sensitive, community-based interventions to raise awareness and encourage early presentation.
ethnicity; cancer awareness; cancer symptoms; anticipated delay; help seeking
To assess public awareness of cancer warning signs, anticipated delay and perceived barriers to seeking medical advice in the British population.
We carried out a population-based survey using face-to-face, computer-assisted interviews to administer the cancer awareness measure (CAM), a newly developed, validated measure of cancer awareness. The sample included 2216 adults (970 males and 1246 females) recruited as part of the Office for National Statistics Opinions Survey using stratified probability sampling.
Awareness of cancer warning signs was low when open-ended (recall) questions were used and higher with closed (recognition) questions; but on either measure, awareness was lower in those who were male, younger, and from lower socio-economic status (SES) groups or ethnic minorities. The most commonly endorsed barriers to help seeking were difficulty making an appointment, worry about wasting the doctor's time and worry about what would be found. Emotional barriers were more prominent in lower SES groups and practical barriers (e.g. too busy) more prominent in higher SES groups. Anticipated delay was lower in ethnic minority and lower SES groups. In multivariate analysis, higher symptom awareness was associated with lower anticipated delay, and more barriers with greater anticipated delay.
A combination of public education about symptoms and empowerment to seek medical advice, as well as support at primary care level, could enhance early presentation and improve cancer outcomes.
cancer awareness; symptom awareness; anticipated delay; barriers; cancer warning signs
This study investigated the self-reported awareness of the presence of product warning messages and signs among random samples of Hispanics in San Francisco surveyed in 1990 and in 1991. The messages that were tested related to cigarettes, alcoholic beverages, and other consumer products. A random sample of 1,204 Hispanics (43.5 percent males) were interviewed by telephone in 1990. The corresponding figure for the second survey in 1991 was 1,569 Hispanics (41.1 percent males). In general, respondents reported low levels of awareness of the presence of product warning messages and signs. The exception was warning messages on cigarette packets which approximately 70 percent of the respondents reported having seen within the 12 months before the survey. There was an increase from 1990 to 1991 in the reported awareness of warning messages for wine, beer, and cigarettes. Smokers and drinkers of alcoholic beverages reported the highest levels of awareness of the relevant warning messages and signs. Length of exposure to warning messages and multiplicity of sources (for example, advertisements and products) seem to produce greater levels of awareness of the presence of product warning messages. Less acculturated, Spanish-speaking Hispanics are less likely to report being aware of the warnings, particularly those that appear only in English (for example, alcoholic beverages).
Rapid identification and treatment of ischemic stroke can lead to improved patient outcomes. Public education campaigns in selected communities have helped to increase knowledge about stroke, but most data represent large metropolitan centers working with academic institutions. Much less is known about knowledge of stroke among residents in rural communities.
In 2004, 800 adults aged 45 years and older from two Montana counties participated in a telephone survey using unaided questions to assess awareness of stroke warning signs and risk factors. The survey also asked respondents if they had a history of atrial fibrillation, diabetes, high blood pressure, high cholesterol, smoking, heart disease, or stroke.
More than 70% of survey participants were able to correctly report two or more warning signs for stroke: numbness on any side of the face/body (45%) and speech difficulties (38%) were reported most frequently. More than 45% were able to correctly report two or more stroke risk factors: smoking (50%) and high blood pressure (44%) were reported most frequently. Respondents aged 45 to 64 years (odds ratio [OR] 2.44; 95% confidence interval [CI], 1.78–3.46), women (OR 2.02; 95% CI, 1.46–2.80), those with 12 or more years of education (OR 1.96; 95% CI, 1.08–3.56), and those with high cholesterol (OR 1.68; 95% CI, 1.17–2.42) were more likely to correctly identify two or more warning signs compared with respondents without these characteristics. Women (OR 1.48; 95% CI, 1.07–2.05) and respondents aged 45 to 64 years (OR 1.35; 95% CI, 1.01–1.81) were also more likely to correctly identify two or more stroke risk factors compared with men and older respondents.
Residents of two rural counties were generally aware of stroke warning signs, but their knowledge of stroke risk factors was limited.
We aimed to develop and validate a measurement tool to assess cancer awareness in the general population: the cancer awareness measure (CAM).
Items assessing awareness of cancer warning signs, risk factors, incidence, screening programmes and attitudes towards help seeking were extracted from the literature or generated by expert groups. To determine reliability, the CAM was administered to a university participant panel (n=148), with a sub-sample (n=94) completing it again 2 weeks later. To establish construct validity, CAM scores of cancer experts (n=12) were compared with those of non-medical academics (n=21). Finally, university students (n=49) were randomly assigned to read either a cancer information leaflet or a leaflet with control information before completing the measure, to ensure the CAM was sensitive to change.
Cognitive interviewing indicated that the CAM was being interpreted as intended. Internal reliability (Cronbach's α=0.77) and test–retest reliability (r=0.81) were high. Scores for cancer experts were significantly higher than those for non-medical academics (t(31)=6.8, P<0.001). CAM scores were higher among students who received an intervention leaflet than the control leaflet (t(47)=4.8, P<0.001).
These studies show the psychometric properties of the CAM and support its validity as a measure of cancer awareness in the general population.
cancer awareness; measurement; psychometrics
Studies have shown limited awareness about cancer risk factors among hospital-based staff. Less is known about general cancer awareness among community frontline National Health Service and social care staff.
A cross-sectional computer-assisted telephone survey of 4664 frontline community-based health and social care staff in North West England.
A total of 671 out of 4664 (14.4%) potentially eligible subjects agreed to take part. Over 92% of staff recognised most warning signs, except an unexplained pain (88.8%, n=596), cough or hoarseness (86.9%, n=583) and a sore that does not heal (77.3%, n=519). The bowel cancer-screening programme was recognised by 61.8% (n=415) of staff. Most staff agreed that smoking and passive smoking ‘increased the chance of getting cancer.' Fewer agreed about getting sunburnt more than once as a child (78.0%, n=523), being overweight (73.5%, n=493), drinking more than one unit of alcohol per day (50.2%, n=337) or doing less than 30 min of moderate physical exercise five times a week (41.1%, n=276).
Cancer awareness is generally good among frontline staff, but important gaps exist, which might be improved by targeted education and training and through developing clearer messages about cancer risk factors.
neoplasms; health knowledge, attitudes, practice; staff development; risk factors; early detection of cancer
Studies of stroke awareness suggest that knowledge of early warning signs of stroke is low in high-risk groups. However, little is known about stroke knowledge among individuals with a history of prior stroke who are at significant risk for recurrent stroke.
Data from 2,970 adults with a history of prior stroke from the 2003 Behavioral Risk Factor Surveillance System were examined. Recognition of the five warning signs of stroke and appropriate action to call 911 was compared across three racial/ethnic groups: non-Hispanic white, non-Hispanic black, and Hispanic/other. Multiple logistic regression analyses were used to: (1) determine the association between race/ethnicity and recognition of multiple stroke signs and appropriate first action and (2) identify independent correlates of recognition of multiple stroke signs and taking appropriate action to seek treatment among individuals with prior stroke.
Recognition of all five signs of stroke and taking appropriate action to call 911 was lowest among the non-Hispanic black group (22.3%) and Hispanic/other group (16.7%). In multivariate models, Hispanic/other (odds ratio [OR] 0.42 [0.25, 0.71]), age 50–64 (OR 0.64 [0.43, 0.97]), age ≥65 (OR 0.36 [0.23, 0.55]), and >high school education (OR 1.79 [1.22, 2.63]) emerged as independent correlates of recognition of all five signs of stroke and first action to call 911.
Less than 35% of people with prior stroke can distinguish the complex symptom profile of a stroke and take appropriate action to call 911. Targeted educational activities that are sensitive to differences in race/ethnicity, age, and education levels are needed for individuals with prior stroke.
There is a lack of evidence around the effectiveness of school-based interventions designed to raise adolescents’ cancer awareness. To address this deficit this study assessed the impact of an intervention delivered in the United Kingdom by Teenage Cancer Trust on: recall (open question) and recognition (closed question) of cancer warning signs; knowledge of common childhood, teenage, male and female cancers; awareness of the relationship between cancer and age; anticipated medical help-seeking delay; perceived barriers to seeking medical advice about cancer; and examined variation of intervention effect by gender and whether adolescents reported that they knew someone with cancer.
The Cancer Awareness Measure (CAM) was completed by 422 adolescents (male: 221, 52.4%) aged 11-17 years old (mean age=13.8, standard deviation=1.26) two weeks before and two weeks after the intervention in three schools, and on two occasions four weeks apart in a fourth (control) school. Intervention schools were followed-up 6-months post-intervention.
Recognition of nine common cancer warning signs significantly increased two weeks after the intervention (4.6 to 6.8, p<0.001) and was maintained at 6-month follow-up (6.2, p<0.001). Endorsement of emotional barriers to help-seeking ‘not confident to talk about symptoms’ (53% to 45%, p=0.021) and ‘worried about what the doctor might find’ (70% to 63%, p=0.021) significantly decreased two weeks after the intervention but changes were not maintained at 6-months. The intervention had a greater impact on females and those who knew someone with cancer.
The intervention is an effective way to raise adolescents’ cancer awareness, especially of cancer symptoms. Further development and evaluation is required to maximise intervention impact, particularly on barriers to help-seeking behaviour.
Effective stroke intervention and risk reduction depend on the general public's awareness and knowledge of stroke. In Korea, where both traditional Oriental medicine and Western medicine are practiced, estimates of the general public's awareness and knowledge of stroke are poor. The present study sought to describe the inception cohort of the Ansan Geriatric Study (AGE study) and to determine baseline stroke awareness and preferred medical treatment for stroke in this Korean sample.
A total of 2,767 subjects selected randomly from the Ansan Geriatric Study in South Korea were questioned about stroke. Their answers were compared with their sociodemographic data and other variables.
Only 44.8% of participants correctly identified stroke as a vascular disease in the human brain. Sudden numbness or weakness was the most frequently identified stroke warning sign (60.2%). Hypertension (66.7%) and mental stress (62.2%) were most frequently identified as stroke risk factors. The contributions of diabetes mellitus and cardiovascular disease to stroke were underestimated; they were identified as risk factors by 28.3% and 18.6% of participants, respectively. The predictors for poor knowledge of stroke warning signs and risk factors were similar irrespective of preference for Western or Oriental medical treatment, and included those with lower levels of education and inaccurate definition of stroke. Television and radio (40.3%) were the most frequent sources of stroke information for both groups.
This study shows that knowledge of stroke is similar among Koreans with preferences for either Western or Oriental medical treatment and that misunderstandings about stroke are common among the Korean elderly. In order to prevent and manage stroke effectively, public health education regarding basic concepts of stroke is necessary. This should target those with a lower level of education and a misunderstanding of the definition of stroke.
There are several problems associated to the management of patients with phenylketonuria (PKU). Social status could be one of the affecting factors on dietary adherence in these patients. The aim of this study was to evaluate family social status and dietary adherence of PKU patients in Iranian population.
In a cross-sectional study, we studied 105 Iranian PKU patients (born 1984 to 2010), treated and followed at Mofid Children's Hospital, Tehran. Social status was defined by number of children in family, number of affected children in family, maternal and paternal education, marital and employment status of the parents. Age at diagnosis and duration of treatment were also recorded. Mean plasma phenylalanine level was considered as a sign of dietary adherence in PKU patients and was calculated considering the phenylalanine measurements throughout at least one year.
Mean plasma phenylalanine concentration was 5.9±3.6 mg/dl in patients <12 years old and 13.1±3.9 mg/dl in patients >12 years old. Blood phenylalanine concentrations in 47.6% of patients were in normal age-related reference range. There was a significant association between divorced and unemployed parents, and higher levels of blood phenylalanine concentration (P=0.02 and P=0.03 respectively). There was a significant positive correlation between number of affected children in the family (r=0.43, P<0.001), age at diagnosis (r=0.2, P=0.03), treatment duration (r=0.7, P=<0.001) and blood phenylalanine concentrations. There was no significant relation between parental education, family size and dietary adherence.
Social status affects dietary adherence to some extent. We suggest exploring care-givers dietary knowledge as the next step to improve dietary compliance in these patients.
Phenylketonuria; Mental Retardation; Marital status; Hyperphenylalaninaemia; PKU
It has been noted that the African American population in the U.S. bears disproportionately higher cancer morbidity and mortality rates than any racial and ethnic group for most major cancers. Many studies also document that decreased longevity is associated with low educational attainment and other markers of low socioeconomic status (SES), both of which are prevalent in African American communities across the nation. Evidence suggests that this phenomenon may be due to attitudes that reflect a lack of knowledge surrounding facts about cancer awareness and prevention. This study was designed to yield data concerning the general population's attitudes toward cancer, taking into consideration racial and/or socioeconomic differences in the population studied.
Two hundred and fifteen subjects participated in the survey, of which 74% (159/215) defined themselves as African-American, 20% were White, and 6% were of other races. While only 38% of the study population was able to identify at least 5 risk factors associated with cancer, a lower proportion of African Americans identified at least 5 risk factors than whites (34% vs. 53%, p = 0.03). In addition, a slightly higher percentage of African Americans (10%) were not aware of the definition of a clinical trial when compared to whites (8%, p > 0.1). Of those aware of the definition of a clinical trial, African Americans were more reluctant to participate in clinical trials, with 53% answering no to participation compared to 15% of whites (p = 0.002).
When comparing results to a similar study conducted in 1981, a slight increase in cancer knowledge in the African American population was observed. Our results suggest that while knowledge of cancer facts has increased over the years amongst the general population, African Americans and lower income populations are still behind. This may affect their risk profile and cancer early detection.
Stroke is a leading cause of death and functional impairment. While older people are particularly vulnerable to stroke, research suggests that they have the poorest awareness of stroke warning signs and risk factors. This study examined knowledge of stroke warning signs and risk factors among community-dwelling older adults.
Randomly selected community-dwelling older people (aged 65+) in Ireland (n = 2,033; 68% response rate). Participants completed home interviews. Questions assessed knowledge of stroke warning signs and risk factors, and personal risk factors for stroke.
Of the overall sample, 6% had previously experienced a stroke or transient ischaemic attack. When asked to identify stroke risk factors from a provided list, less than half of the overall sample identified established risk factors (e.g., smoking, hypercholesterolaemia), hypertension being the only exception (identified by 74%). Similarly, less than half identified established warning signs (e.g., weakness, headache), with slurred speech (54%) as the exception. Overall, there were considerable gaps in awareness with poorest levels evident in those with primary level education only and in those living in Northern Ireland (compared with Republic of Ireland).
Knowledge deficits in this study suggest that most of the common early symptoms or signs of stroke were recognized as such by less than half of the older adults surveyed. As such, many older adults may not recognise early symptoms of stroke in themselves or others. Thus, they may lose vital time in presenting for medical attention. Lack of public awareness about stroke warning signs and risk factors must be addressed as one important contribution to reducing mortality and morbidity from stroke.
During the last decades, global migration has increased and many immigrant groups have a higher prevalence than the native born population of several cardiovascular disease risk factors, including poor dietary habits. However, it is uncertain if dietary habits in immigrant populations reflect dietary habits in their country of origin or if the current diet is a consequence of the migration and possible change of dietary habits. The aim of this study was to examine possible dietary differences between elderly Iranians living in Stockholm, Sweden with elderly Iranians living in Tehran, Iran, taking into account sex, age, marital status, and education.
Dietary intakes were assessed by semi - quantitative food frequency questionnaire in a cross-sectional study of 121 Iranians living in Stockholm and 52 Iranians living in Tehran, aged 60-80. Differences in dietary habits between the two groups was analysed by bootstrapped regression analyses with 1000 replications.
Iranians living in Sweden had significantly higher intake of protein, total fat, fiber than Iranians living in Iran, but lower consumption of carbohydrates. The observed differences in intake of macronutrients were reflected in consumed amount of all food items, which were higher among Iranians living in Iran with the exception of bread and grain consumption which was lower.
There are general differences in dietary habits between Iranians living in Iran and Iranians living in Sweden. Parts of observed differences in dietary habits may reflect a favourable adoption process to the Swedish dietary habits after migration. Meanwhile other differences are point of concern in light of the high prevalence of overweight, among Iranians living in Sweden and can have unfavourable impact in particular in the context of cardiovascular health.
To promote awareness of primary immunodeficiency (PID), the "10 warning signs" of PID and an immunodeficiency-related (IDR) score were developed. However, their efficiency in identifying PID cases was not sufficiently evaluated in clinical practice. The objective of this study was to test the validity of the 10 warning signs and IDR score in identifying PID among children with recurrent infections at a tertiary pediatric hospital in Egypt.
A retrospective analysis of the medical records of 204 patients was performed. Of these patients, 92 had defined PID diseases and 112 were considered non-PID cases because investigations were inconclusive.
Demonstrating two warning signs and an IDR score of 6 led to sensitivities of 94 and 66%, respectively, and specificities of 64 and 75%, respectively, in identifying PID cases. The strongest predictor of PID was family history that, if combined with the need for intravenous antibiotics, recurrent deep-seated infections, and failure to thrive, could identify 81% of PID patients. A family history of PID, sibling death, and/or parental consanguinity would predict 92% of combined immunodeficiencies, 92% of phagocyte defects, 87% of well-identified immunodeficiency syndromes, and 84% of antibody deficiency if the need for intravenous antibiotics is considered in the latter.
The 10 warning signs and IDR score do not aid in an early diagnosis of severe PID. Educational campaigns should target pediatricians aiming to increase PID awareness and to address family history of PID, parental consanguinity, and previous sibling death as key predictors of PID in communities with a high prevalence of consanguineous marriages.
Children; Egypt; immunodeficiency disease-related score; primary immunodeficiency diseases; recurrent infection; ten warning signs
India is a significant contributor to the world’s total burden of deafness. Out of all causes, almost 50% of the causes of decreased hearing are preventable. With the launch of the National Programme for Prevention and Control of Deafness, the need for an effective information, education and communication (IEC) campaign was felt. There is negligible information available about the status of awareness levels of the community about the various aspects of hearing loss. We carried out this research with the objective of getting to know the existing awareness related to hearing loss in the community to generate an evidence base for formulating various messages to be incorporated in IEC materials for dissemination in the community. We also asked the participants about their suggestions for the various information resources so that an IEC campaign could be designed accordingly.
Materials and Methods:
We carried out 10 focus group discussions among various groups of population and analyzed the discussion.
A descriptive analysis of the observations regarding the awareness about deafness in the community and prevalent myths and suggested information resources is presented.
We highlight the lacunae in the existing awareness of various causes of deafness and the preventive measures that could be taken to prevent hearing loss. The evidence generated was used to formulate relevant messages for the various target groups, which were then incorporated in development of the IEC materials for the dissemination in the community.
Deafness; focus group discussions; IEC resources
The aim of this study was to elicit the level of breast cancer awareness in older women. A cross-sectional study-specific questionnaire survey of 712 British women aged 67–73 years (response rate 83.8%), assessing knowledge of symptoms and risk and confidence to detect a change, was conducted. Over 85% of respondents were aware that a lump was a symptom of breast cancer but knowledge of non-lump symptoms was limited. Knowledge of risk was poor; 50% believed that the lifetime risk of developing breast cancer was less than 1 in 100 women and 75% were not aware that age is a risk factor. Thirty-one percent of women reported low levels of confidence to detect a breast change and 19% rarely or never checked their breasts. Those with fewer educational qualifications had poorer knowledge of symptoms, less awareness of lifetime and age-related risks, but were more likely to check their breasts than more highly educated women. This national survey demonstrates a significant lack of the prerequisite knowledge and confidence to detect a breast change. Raising breast cancer awareness and promoting early presentation among older women is important, as they are more at risk of breast cancer and more likely to delay seeking help with breast cancer symptoms than younger women.
breast cancer; older women; cancer awareness
Background and aims
Since most orthodontic patients are children and adolescents, it is believed that teachers can help find these patients and make them aware of their orthodontic problems. Therefore, teachers are expected to have proper knowledge about these problems. The aim of this study was to determine teachers’ awareness about orthodontic treatments in Tabriz and Saqqez and compare it in different educational levels.
Materials and methods
A questionnaire was given to 384 teachers (204 in Tabriz and 180 in Saqqez) in randomly selected schools of different levels. The questionnaire had 17 questions in 3 sections, including general information, age, and costs of orthodontic treatments. The teachers’ awareness in two cities was analyzed with independent t-test and in edu-cational levels with one-way ANOVA.
About 94% of the participants believed orthodontic treatment consisted of arrangement of teeth with special braces. However, there was no significant difference between the two cities in general information (p=0.23) and the age suitable for orthodontic treatment (p=0.53). The differences in the teachers’ awareness in three educational levels were not statistically significant between the two cities (p=0.23).
Awareness of teachers about orthodontic treatment in Saqqez and Tabriz was not sufficient and different; 75% of the participants believed that high cost of orthodontic treatment is the main problem.
Awareness; orthodontic treatment; teachers
The objective of this research was to compare the response of adult smokers in Malaysia to newly proposed pictorial cigarette warnings against the current text-only warnings. The study population included 140 adult male smokers who were enrolled in a randomized trial to view either the new pictorial warnings (intervention) or the old text-only warnings (control). Participants completed pre-exposure and post-exposure questionnaires that assessed their awareness of the health risks of smoking, response to the package warnings, and interest in quitting smoking. Exposure to the pictorial warnings resulted in increased awareness of the risks of smoking, stronger behavioral response to the warnings and increased interest in quitting smoking. The new warnings in Malaysia will increase smokers’ knowledge of the adverse health effects of smoking and have a positive effect on interest in quitting.
pictorial cigarette package warning labels; smoking behavior; awareness of health risk; interest in quitting; Malaysia; adult smokers; randomized trial; questionnaire; knowledge score
Methods: Women attending a well woman clinic were asked to complete a questionnaire assessing HPV awareness and specific knowledge about the virus.
Results: Questionnaires were completed by 1032 women, of whom 30% had heard of HPV. Older women, non-smokers, and those with a history of candida, genital warts, or an abnormal smear result were more likely to have heard of HPV. Even among those who had heard of HPV, knowledge was generally poor, and fewer than half were aware of the link with cervical cancer. There was also confusion about whether condoms or oral contraceptives could protect against HPV infection.
Conclusions: In this relatively well educated sample, awareness and knowledge of HPV were poor. Public education is urgently needed so that women participating in cervical cancer screening are fully informed about the meaning of their results, especially if HPV testing is soon to be introduced.
To assess the awareness and knowledge levels about glaucoma and its determinants in an urban population of Chennai in south India.
Materials and Methods:
Chennai glaucoma study (CGS) was a population based prevalence study to estimate the prevalence of glaucoma in a rural and urban south Indian population. A total of 3850 subjects aged 40 years or above participated in the urban arm of CGS. A systematic random sample of 1926 (50.0%) subjects completed a questionnaire that assesses their awareness and knowledge level of glaucoma. Respondents “having heard of glaucoma” even before they were contacted/recruited for the study were defined as “aware” and respondents having some understanding of the eye disease were defined as “knowledgeable”.
Overall 13.5% were aware of glaucoma, the age-gender adjusted rate for awareness was 13.3% (95% CI: 11.57 to 15.03). Two clinicians graded knowledge on glaucoma, based on the subject's knowledge of risk factors, definitions and treatment aspects of glaucoma. Overall 8.7% had some knowledge about glaucoma. Among those who had knowledge 0.5% had good knowledge about glaucoma, 4% had fair knowledge and 4.2% had poor knowledge. We observed a very good agreement between the clinicians in grading knowledge (k =0.92). Determinants of glaucoma awareness and knowledge were higher levels of education, females, age, religion and family history of glaucoma.
Awareness and knowledge about glaucoma was very low among the urban population of Chennai. We have found that younger subjects and men were less aware of glaucoma. Subjects with lower levels of education were less aware and knew less about glaucoma than their counterparts. The study findings stress the need for health education for effective prevention of blindness due to glaucoma.
Awareness; glaucoma; knowledge; India; population-based study
BACKGROUND: New health warnings and contents labelling on tobacco products were introduced in Australia in 1995. OBJECTIVE: To assess awareness of the new warnings at a time when a mix of packs with old and new warnings were being sold and on changes in relevant knowledge and attitudes from shortly before the implementation of the new warnings. DESIGN AND SUBJECTS: Approximately 500 smokers and 500 non- smokers were surveyed in December 1994, before implementation of the new warnings. Similar numbers were also surveyed in May 1995, part-way through implementation. Respondents were selected by random-digit dialling of telephone numbers in Australia. Smokers were oversampled. In addition, 243 smokers from the initial survey were re-surveyed in May 1995. MAIN OUTCOME MEASURES: Awareness of change to health warnings, knowledge of health warnings and tobacco smoke constituents, beliefs about the health effects of smoking, and perceived impact of the warnings. RESULTS: There was high awareness of the new warnings, particularly among smokers, with the increased size of the new warnings being the most salient feature. More than a third of smokers reported being affected by the warnings, with reductions in consumption and talking about warnings being the most common effects. Among smokers, there was an increase in knowledge about the main constituents of tobacco smoke. The number of types of health effects mentioned also increased as did the number of warnings correctly recalled. Overall beliefs about the six warning statements became stronger. Few changes were found for non-smokers. The knowledge and recall effects were replicated in the re-contact subsample, but the belief changes were not. CONCLUSIONS: These results suggest the new health warnings are resulting in better informed smokers and thus suggest that informative health warnings can play an important role in better informing consumers.
The aims of this study are to assess the awareness and intention to use maternity services. This was a multicentric study involving 800 women. Educational status was the best predictor of awareness of birth preparedness (P = 0.0029), but not a good predictor of intention to attend four antenatal clinic sessions (P = 0.449). Parity was a better predictor of knowledge of severe vaginal bleeding as a key danger sign during pregnancy than educational level (P = 0.0009 and P = 0.3849, resp.). Plan to identify a means of transport to the place of childbirth was related to greater awareness of birth preparedness (χ2 = 0.3255; P = 0.5683). Parity was a highly significant predictor (P = 0.0089) of planning to save money. Planning to save money for childbirth was associated with greater awareness of community financial support system (χ2 = 0.8602; P = 0.3536). Access to skilled birth attendance should be promoted.
Knowledge and awareness about childhood autism is low among health workers and the general community in Nigeria and other Sub-Saharan African countries. Poor knowledge and awareness about childhood autism, especially among health workers can compromise early recognition and interventions which had been known to improve prognosis in children with autism. In formulating policy and designing interventions for these children, there is need to develop a reliable tool that can be used in assessing baseline knowledge about childhood autism among health workers and the impact that future continued education and awareness campaign may have on such baseline knowledge. Knowledge about childhood autism among health workers (KCAHW) questionnaire was designed for this purpose.
The KCAHW questionnaire is a nineteen (19) item self-administered questionnaire that is divided into four domains. KCAHW questionnaires were distributed to fifty (50) psychiatric nurses involved in community mental health services in South-Eastern Nigeria to complete. After two weeks period, the KCAHW questionnaires were re-administered to the same fifty (50) psychiatric nurses to assess their knowledge about childhood autism and to assess the test-retest reliability and internal consistency of this questionnaire.
KCAHW questionnaire showed good test-retest reliability when the mean domain and total scores at first and second time administration were compared. The four mean domain scores and the mean total scores at first and second time administration were significantly correlated. The questionnaire also had a good overall internal consistency when the mean scores of the four domains were correlated with mean total scores (Cronbach's alpha = 0.97).
The KCAHW questionnaire is a reliable tool for assessing knowledge of health workers about childhood autism. It would be a useful tool in improving early recognition of features of autism among affected children in Sub-Saharan African and other developing countries of the world where knowledge and awareness about childhood autism is low.