Change In Attitude Scores Research Articles

Impact of iron tablet administration and nutritional counseling: Hemoglobin level improvement in anemic pregnant women

Background: According to the 2013 Riskesdas, the prevalence of anemia in Indonesia was 37.1%. Data from the Pariaman City Health Office showed that the prevalence of anemia in 2014 was 43.1%. This study aims to determine the effect of iron (Fe) tablets and nutritional counseling on hemoglobin levels in pregnant women with anemia in the Pariaman City area in 2016. Methods: This study is a quantitative study using a quasi-experimental design. The study population consisted of third-trimester pregnant women with anemia, divided into two groups: the Fe tablet group (n=20) and the Fe tablet plus nutritional counseling group (n=20). Data analysis was performed using univariate and bivariate analysis with the Dependent T-Test statistical test. Findings: The results showed that the average knowledge score in the Fe group was 0.3, while in the Fe plus nutritional counseling group it was 1.4. The average change in knowledge scores between the two groups showed a significant increase (p=0.002). The average attitude score in the Fe group was 2.15, while in the Fe plus nutritional counseling group it was 2.75. The average change in attitude scores between the two groups was not significant (p=0.205). The average action score in the Fe group was 1.050, while in the Fe plus nutritional counseling group it was 2.7. The average change in action scores between the two groups showed a significant increase (p=0.002). The average difference in hemoglobin levels in the Fe group was 0.280, while in the Fe plus nutritional counseling group it was 0.690. The average change in hemoglobin levels between the two groups showed a significant increase (p=0.008). Conclusion: It can be concluded that the provision of Fe supplementation and nutritional counseling results in a higher increase in hemoglobin levels compared to Fe tablets alone. It is hoped that nutritionists in the field will be more active in providing nutritional counseling to pregnant women with anemia to increase their knowledge about anemia. Novelty/Originality of this article: This study proposes an integrated nutritional intervention model combining Fe tablets with a community-based interactive nutritional counselling program. This model can increase the effectiveness of anaemia control programs in pregnant women by combining supplementation and education.

Can interprofessional education change students’ attitudes? A case study from Lebanon

BackgroundInterprofessional collaboration is key to improving the health of individuals and communities. It is supported by provision of Interprofessional education (IPE) which has recently emerged in the Middle East region. This study investigated changes in healthcare students’ attitudes towards interprofessional collaboration after undertaking the Interprofessional Education and Collaboration (IPEC) course.MethodsA paper-based anonymous survey using the Interprofessional Attitude Scale (IPAS) was administered to a sample of 346 health students (nursing, medicine, and public health) pre/post undertaking the IPEC course. Less than half of the students provided a post response, with pre/post survey results of 111 pairs subsequently matched and analyzed.ResultsResults showed elevated pre-course scores, an improvement in students’ attitudes towards the interprofessional biases domain of the IPAS, and a slight decline in their scores in the remaining 4 domains (team roles and responsibilities, patient centeredness, community centeredness, and diversity and ethics). These changes were not statistically significant, except for the patient centeredness domain (p = 0.003**).ConclusionsThe study provided important results about attitudes towards interprofessional collaboration. These findings are essential because our institution is one of few in Lebanon that provides this mandatory course to a large group of health professionals. Future studies should investigate these changes in attitude scores in a larger sample size, and how these attitudes would influence collaboration post-graduation.

An evaluation of mental health capacity building among Community Rehabilitation Officers in Malawi: A mixed-methods case study

BackgroundThe World Health Organisation's Mental Health Gap Action Programme (mhGAP) training has been delivered throughout sub-Saharan Africa to enhance health workers' capacity to provide mental health care. mhGAP training evaluations typically assess one or two soft skills, namely trainee confidence to identify, manage, and refer people with mental illness, and their attitudes towards people with mental illness. This research expands on these evaluations by assessing changes in Community Rehabilitation Officers' (CROs) knowledge and self-efficacy to identify, manage, and refer people with mental illness, in addition to their confidence and attitudes. The relationship between changes in CROs' attitudes and changes in their knowledge, confidence, and self-efficacy, and perceptions of CROs' capacity in delivering community mental health care are also explored. Material and methodsIn this mixed-methods study, fifty-seven CROs who participated in mhGAP training in Malawi were assessed on knowledge, confidence, and self-efficacy in delivering mental health care and their attitude towards mental illness. Two programme managers and seven facilitators were interviewed to investigate their perception of CROs' mental health care delivery capacity post-training. ResultsOnly CROs' confidence and self-efficacy scores improved post-training. No relationship was found between changes in attitude scores and knowledge, confidence, and self-efficacy scores. Programme managers and facilitators identified instances where training positively impacted CROs’ delivery of mental health care. However, they questioned its long-term sustainability. ConclusionsmhGAP training was found to enhance CRO confidence and self-efficacy in Malawi. Thus, mhGAP training may help in improving the confidence and self-efficacy of non-specialist health workers in this context. How mhGAP training impacts changes in knowledge and attitudes towards mental health requires further exploration. CROs' sustainable provision of mental health care in resource-constrained contexts needs to be addressed. Findings add to the evidence on the impact of mhGAP training in building health workers’ mental health care delivery capacity.

The Effect of Assistance for Pregnant Women on Attitudes and Behavior Changes in Stunting Prevention

Background: East Kotawaringin and Pulang Pisau Regency have highest prevalence of stunting, respectively, in Central Kalimantan Province. One of the efforts made through the assistance to improve the knowledge and skills of pregnant women. The study was aimed at analyzing the effectiveness of assistance on behavior and attitudes among pregnant women in the Pulang Pisau Regency. It also aimed to analyze the behavior of pregnant women shifting upon stunting.Method: It is a quasi-experimental study (n = 60), with pre-posttest group comparison. There are two groups, namely conventional (n = 30) and assisted through pocket book (n = 30). Socio-economic data was collected to draw the characteristics of the study subjects through questionnaire. A 2x2 chi-square and paired t-test was run in SPSS v. 18 for Windows.Results: The characteristics of the study respondents did not show any significant differences in attitudes and behaviors of stunting prevention in the Pulang Pisau district. The average change in attitude score shows a significant difference in the assisted group with a pretest of 65.8 ± 7.8, increased during the post-test of 75.7 ± 2.7. It is also an increase in understanding (n = 21). We concluded that pocket-book treatment is more effective in improving the attitude of pregnant women towards preventing stunting.

Knowledge about antibiotic resistance among dental students in Chengalpattu district, Tamil Nadu – A cross-sectional study

Objectives: Antibiotic resistance is rising to dangerously high levels in all parts of the world. New resistance mechanism is emerging and spreading globally, threatening our ability to treat common infectious diseases. Dentists prescribe about 9–11% of all common antibiotics. The aim of this study was to assess the knowledge and attitude of antibiotic resistance among graduating dental students. Materials and Methods: A cross-sectional study was conducted among 294 participants between November 2019 and December 2019. A structured questionnaire consisting of 14 questions was administered to the dental students. Descriptive analysis of demographic variables was done and knowledge score and attitude score were performed using Kruskal–Wallis H test. Results: About 85% of the participants suggested amoxicillin as the choice of antibiotic. Among the four domains suggesting the solution for antibiotic resistance, 48% of the final year students suggested avoiding self-medication as a solution, 34% of interns suggested avoiding over dosage, and 48% of the 3rd year students suggested completing the course of antibiotics. A majority of (87%) of the final year students suggested the usage of prophylactic antibiotics in patients with infective endocarditis. The difference in mean change in attitude scores among the groups was statistically significant (P = 0.028). Conclusion: The research showed variable levels of knowledge and attitude about antibiotic resistance among the students of different year of study. The study result insists the need to educate the dental students more regarding antibiotics and their proper use.

Implementing an mhGAP-based training and supervision package to improve healthcare workers\u2019 competencies and access to mental health care in Malawi

BackgroundIt is now well established that the integration of mental health care into primary care is one of the most effective ways of reducing the substantial treatment gap for mental disorders which exists in most low- and middle-income countries. This study set out to determine whether a Mental Health Gap Action Programme (mhGAP) training and supervision package could be contextualised and implemented within the existing health care system in five districts in Southern Malawi. In addition, the study assessed the feasibility of holding community awareness events and establishing peer support groups in each district to further improve the access of the population to evidence-based mental health care.MethodsA lead training team of experienced Malawian mental health professionals was appointed and mhGAP training materials were contextualised for use in Malawi. The lead team delivered a 4-day training package to district mental health teams in five districts covering three core conditions: psychosis, moderate-severe depression, and alcohol and substance use disorders. District mental health teams then delivered a 2-day training package and provided monthly supervision for 3 months to 500 non-specialist healthcare workers. Paired sample t-tests were used to compare knowledge, confidence and attitude scores before and immediately after training, and after 6 months in two districts. Case detection rates measured pre- and post-training in the pilot district were compared using Wilcoxon Rank Sum Test. Community awareness events were held and peer support groups were established in each of the five districts. The acceptability of the package was assessed through focus group discussions involving specialist and non-specialist healthcare workers, users and carers.ResultsNon-specialist healthcare workers’ knowledge and confidence scores significantly increased immediately after training in comparison to pre-training. These scores were maintained at 6 months. However, no statistically significant change in attitude scores was detected. Case detection rates increased immediately after the training in comparison to pre-training. Responses from focus group discussion participants illustrated the programme’s acceptability.ConclusionsThis study demonstrated that, with minimal additional funding and working within existing structures, an mhGAP based training at primary and secondary health care levels is feasible in Southern Malawi.

Effectiveness of a structured teaching program (STP) on cessation of tobacco chewing, on knowledge and attitude among female hospital housekeeping personnel - a pilot study.

To evaluate the effectiveness of a structured teaching program (STP) on: a) improving knowledge of female hospital housekeeping personnel regarding harmful impact of tobacco chewing and how to quit, and b) fostering an unfavorable attitude toward tobacco chewing. The STP focused on adverse health effects of tobacco chewing, myths and facts, and tobacco cessation. It was administered in regional language to female hospital housekeeping personnel (N=35) over three days. Post-assessments were conducted at 4 weeks following the last session of the STP. Current tobacco use was reported by 26% of the sample. Tobacco chewers (vs. non-chewers) were more likely to be significantly older, have elementary education, belong to nuclear family, have lesser knowledge regarding harmful effects, and have a more favorable attitude toward the practice of tobacco chewing. At the end of 4 weeks following the STP, participants significantly improved their knowledge regarding the harmful health impact of tobacco chewing and how to quit (p=0.001), and showed a significantly less favorable attitude toward tobacco chewing (p=0.001). Change in participants' knowledge scores was found to be negatively correlated with change in attitude scores, implying that increase in knowledge was associated with less favorable attitude toward tobacco chewing (r=-0.427, p=0.011). Findings provide preliminary evidence for the effectiveness of health education on harmful impact of tobacco chewing and how to quit, delivered through a STP, in improving knowledge and fostering an unfavorable attitude toward tobacco chewing, among female hospital housekeeping personnel.

The Effects of an Early Observational Experience on Medical Students’ Attitudes Toward End-of-Life Care

End-of-life care is paramount in maintaining the quality of life of the terminally ill, protecting them from unnecessary treatment, and controlling costs incurred in their care. Training doctors to be effective end-of-life caregivers begins in medical school. A survey design was used to collect data from 166 first-year medical students before and after exposure to hospice or palliative care through an early clinical exposure program. Data demonstrated that students had a significant change in attitude scores after the observational experience (P < .05). Providing students with the opportunity to observe and participate in end-of-life care has a positive effect on attitudes toward the care of dying persons. We recommend that direct exposure to end-of-life care practices be incorporated early in the medical school curriculum.

Baby Milk Challenge: Changing secondary school student?' attitudes to breastfeeding

Interventions to improve breastfeeding rates are aimed primarily at couples in the perinatal period. However, many parents make decisions on infant feeding before pregnancy. In this study, a school-based intervention is evaluated for its effect on attitudes to breastfeeding in male and female secondary school students in single-sex and mixed-sex groups. After a period of qualitative feedback and intervention adjustment, significant changes in attitude scores were seen in both single-sex and mixed-sex groups, with the students’ attitudes becoming more positive towards breastfeeding. The author recommends that this intervention should be used as part of a longer-term public health strategy to improve rates of breastfeeding initiation, taught by facilitators confident with the material and experienced in breastfeeding interventions.

Two-year effects of a school-based prevention programme on adolescent cigarette smoking in Guangzhou, China: a cluster randomized trial

The prevalence of adolescent smoking has been increasing rapidly in China. Theory-based smoking prevention programmes in schools may be an effective approach in preventing smoking among Chinese adolescents. A school-level cluster randomized controlled trial was conducted among 7th and 8th grade students (N = 2343) in four junior high schools in southern China during 2004-06. The theory-based, multi-level intervention was compared with the standard health curriculum. Outcome measures comprised changes in students' smoking-related knowledge, attitudes and behaviour. The mean knowledge scores from baseline to the 1- and 2-year follow-ups increased more in the intervention group than in the control group, whereas there was little change in attitude scores. At the 1-year follow-up (the total sample), the interventions reduced the probability of baseline experimental smokers' escalating to regular smoker [7.9 vs 18.3%; adjusted odds ratio (OR) 0.34, 95% confidence interval (CI) 0.12-0.97, P = 0.043], but did not reduce the probability of baseline non-smokers' initiating smoking (7.9 vs 10.6%; adjusted OR 0.86, 95% CI 0.54-1.38, P = 0.538). At the 2-year follow-up (only 7th grade students), similar proportions of baseline non-smokers initiated smoking in the intervention group and the control group (13.5 vs 13.1%), while a possibly lower proportion of baseline experimental smokers escalated to regular smoking in the intervention group than the control group (22.6 vs 40.0%; adjusted OR 0.43, 95% CI 0.12-1.57, P = 0.199). This multi-level intervention programme had a moderate effect on inhibiting the escalation from experimental to regular smoking among Chinese adolescents, but had little effect on the initiation of smoking. The programme improved adolescents' smoking-related knowledge, but did not change their attitudes towards smoking.

Are they just lazy? Student teachers' attitudes about dyslexia

It is highly likely that teachers' abilities in dealing with different forms of learning difficulties will be affected by their knowledge about and attitudes towards those difficulties. Ajzen's Theory of Planned Behaviour (TPB) provides a useful framework within which to explore such attitudes and was used as the starting point for investigating trainee teachers' attitudes towards aspects of dyslexia. It is assumed that new teachers will enter the profession with a set of intentions according to personal beliefs, normative views within the teaching profession and the sense of competence and power they feel in dealing with dyslexic difficulties. The purpose of this study was to probe student teachers' attitudes at a prestigious School of Education in the Southwest of England. Four hundred and eight primary and secondary Post Graduate Certificate in Education (PGCE) students responded to a survey asking about their attitudes toward dyslexia. The student teachers expressed strongly positive attitudes toward the construct of dyslexia, with the majority expressing confidence in their ability to support dyslexic pupils. Females held significantly more positive attitudes toward dyslexia than males, but there were no significant differences according to PGCE course subject. Students who took the survey before and after teaching practice demonstrated some small but significant changes in attitude scores over that time. It is proposed that a new breed of teachers may be entering the teaching profession with positive beliefs about their ability to help dyslexic pupils, but who remain unclear as to how this can be accomplished. Some implications for action and suggestions for future research are provided.

The Effect of the Geriatrics Education for Emergency Medical Services Training Program in a Rural Community

The Geriatrics Education for Emergency Medical Service (EMS) (GEMS) course provides continuing education for EMS providers. This study evaluated the effect of the course on EMS providers in a rural county by performing a prospective cohort study using a pre-postsurvey design. The Geriatric Attitude Scale, the GEMS knowledge posttest, a class satisfaction survey, and a survey evaluating EMS providers' comfort in caring for older adults were used to measure the classes' effect. Eighty-eight EMS providers participated. All passed the course and were very satisfied with it. Follow-up was completed with 77 (80%). No significant change in attitude score was identified (P=.09). Median comfort scores significantly increased for the domains of communications, medical care, abuse evaluation, and falls evaluation. Providing the GEMS course to EMS providers in a rural community resulted in students passing a posttest evaluating their knowledge regarding caring for older adults and resulted in an increase in their comfort level for the care of older adults. The effect of the training on patient outcomes needs to be identified.

The Middle of the Road: Results from the Aging Semantic Differential with Four Cohorts of Medical Students

To explore the presence of negative stereotypical attitudes among medical students and the extent to which attitudes changed over time. Analysis of pre- and postexperience administration of attitude measures to four cohorts of medical students (two cohorts as quasi-controls and two cohorts as curriculum "treatment" groups). The curriculum of a community-based medical school in the United States. Four sequential cohorts of medical students. Experience in a required comprehensive vertically integrated curriculum. The Aging Semantic Differential (ASD), using an 85-year-old woman as the cue image. The reliability scores for all administrations were acceptable. The two control cohorts demonstrated no change in attitude scores, whereas the treatment cohorts reflected a slight shift toward more-positive scores. However, all cohorts had scores for all sittings that were in the neutral range; on average students routinely scored 70% of the 32 items neither positively nor negatively. These students seemed not to hold negative stereotypes as measured using the ASD. Although two of the 32 items prompted negative stereotyping, and six items elicited positive stereotyping, attitudes were neutral about older adults. Characteristics of the ASD itself or of the response set used in this study may have affected the results.

Impact of a traffic light nutrition tool in a primary school

To evaluate the impact of a school traffic light nutrition tool on the knowledge, attitude and behaviour of Key Stage 1 children (aged five to seven years). A school traffic light nutrition tool is created, adopting the principles advocated by the House of Commons Health Select Committee on Obesity, which seeks to encourage children to freely eat green food, eat amber food in moderation and stop and think before eating red food. A single sample pre- and post-test design is used to measure changes in children's knowledge, attitude and behaviour. A state primary school in the UK, located in an area of mixed private and social housing, with a non-selective admission policy is the setting for the study. In total 69 children, aged five to seven, were tested three weeks before and three weeks after nutrition education. Knowledge improved significantly following nutrition education. Positive attitude scores and asking behaviour for red food decreased, but disappointingly positive feelings and asking behaviour for green food also diminished. Children's refusing behaviour for red food increased. Beneficial changes in knowledge, attitude and behaviour were observed, but negative changes in attitude scores and behaviour towards green food suggested that children misunderstood some nutritional messages. A lack of wider school involvement and only the partial support of parents weakened the effectiveness of this approach. The nutrition tool is cost neutral and may have applicability in other settings.

Attitude change during medical school: a cohort study.

Attitudes influence behaviour. Developing and maintaining proper attitudes by medical students can impact on the quality of health care delivered to their patients as they assume the role of doctors. There is a paucity of longitudinal research reports on the extent to which students' attitude scores shift as they progress through medical school. This study examined the change in attitude scores of a large student cohort as they progressed through medical school. Whether student gender is related to attitude change was also investigated. Medical students from 3 consecutive classes (1999-2001) participated in this study. Students completed 2 instruments that included the Attitudes Toward Social Issues in Medicine and an in-house tool referred to as the Medical Skills Questionnaire. The instruments were administered at 3 milestones during the course of medical school training (entry, end of preclinical training and end of clerkship). Reliability estimates for total (0.82-0.91) and subscale (0.41-0.81) attitudinal scores were in the acceptable range. Multivariate analyses of variance of mean attitudinal scores indicated a persistent decline in several attitude scores as students progressed through the medical educational programme. Females demonstrated higher attitude scores than males. As students progress through medical school their attitude scores decline. The reasons for the shift in attitude scores are not clear but they may relate to a ceiling of high attitude scores at entry, loss of idealism and the impact of the unintended curriculum. Further study of the impact of medical education on student attitudes is warranted.

Theory of reasoned Action and its integration with economic reasoning in linking farmers' attitudes and adoption behaviour - an illustration from the analysis of the uptake of livestock technologies in the South-West of England

The behavioural intentions of a sample of livestock farmers in the south-west of England towards new technologies were analysed within a Theory of Reasoned Action (TORA) framework, in order to explore reasons for the apparently low rate at which research-based knowledge is being transferred to the livestock industry. Correlations between components of attitudes (outcome beliefs and evaluations), subjective norms (normative beliefs and motivation to comply) and behavioural intentions were integrated with Positivistic Mathematical Programming (PosMP) to create a set of farm type models, which can predict the potential rate and equilibrium level of uptake of different kinds of technologies. Data relating to techniques for oestrus detection in dairy cows are used to illustrate the analysis and to show how this approach can help improve the targeting of knowledge and technology transfer strategies. Linking the Theory of Reasoned Action findings with the Positivistic Mathematical Programming approach identified where there is a realistic prospect for increasing or accelerating the uptake of a technology, thus helping an agency charged with knowledge and technology transfer to decide where investment in communication is likely to pay off. In the case of MDC observation times, even a 20% change in attitude score among hill and upland dairy farmers would have minimal impact on the numbers adopting; while a similar change among mixed farms would lead to a greater increase. Targeting mixed farms with this particular technology would make more sense than promoting it among upland farmers. The overall findings reinforce the importance of understanding and addressing the prevailing beliefs and values within the objective population.

Statistical methods and the evaluation of school-based AIDS education in Africa (reply)

We are grateful for the opportunity to re-analyze our data as suggested by Kinsman et al. and we apologize if the P values quoted in our paper appear to claim unwarranted precision. A paired t-test approach weighting the mean % scores proportionately to the differing numbers of students involved gave the following results. As expected this analysis gives results that have a higher P value than in the original analysis. The differences between changes in knowledge scores become of borderline significance but between changes in attitude scores are still highly significant. The behavior score changes still do not differ by more than could easily be explained by chance. So the conclusions in their paper remain substantially unchanged but may now be assigned a higher validity. Bearing in mind the limitations of our study we hope that these results will provide encouragement to those responsible for AIDS education programs in Africa. (full text)

Changes in Attitudes of Medical Students Toward Psychiatry: An Evaluation of a Clerkship in Psychiatry

Four categories of medical student attitudes were measured: attitudes toward psychiatry and psychiatrists; treatability of psychiatric patients; likeability of psychiatric patients; attitudes toward the medical profession. Albert Einstein College of Medicine (AECM) students showed preto post-clerkship positive attitude change in their attitude toward psychiatry and psychiatrists and treatability of psychiatric patients. Ben-Gurion University (Israel) students showed no changes in attitude scores. Analysis of 14 items considered especially relevant to the clerkship experience indicated that the clerkship tended to strengthen pre-existing positive attitudes with no change in negative attitudes.

Relationships between attitude and achievement among college biology students

AbstractThe purposes of this study were to (1) study changes in attitude toward science, school, and academic self among college biology students, and (2) to examine relationships between attitudes and achievement in an introductory college course in biology. The three attitude variables were assessed at the beginning and end of the study. Each of the three constructs was measured by the semantic differential and one additional instrument. One cognitive measure, biology achievement, was taken at the beginning and end of the study. This was accomplished by using the Nelson Biology Test. Another cognitive measure, grade in the course, as given by the instructor, was recorded at the end of the course. Normative data and correlation coefficients among pre‐ and postadministrations were calculated for each institution and the composite sample as well. An analysis of variance showed that while gains in scores on the Nelson Biology Test were significant beyond the 0.01 level of probability, changes in attitude scores were not. Correlations were calculated between the attitude and cognitive variables in this study. Relationships between academic self‐concept and achievement in biology were the strongest. Data from this study show that while student cognitive behavior was changed during an introductory college biology course, selected attitudes either stayed the same or became slightly more negative. Affective as well as cognitive gains would appear to be desirable goals in college courses. As we learn more about relationships that exist between cognition and affect, science educators at all levels will become better equipped to improve learning in science.

Training Teachers in Human Sexuality: Effect on Attitude and Knowledge

The current study investigated the extent to which a 9-wk. course on human sexuality for teachers changed their knowledge and attitudes. Significant changes were found from the pre- to post-course assessment on both measures of knowledge. The only significant change in attitude scores, however, was on the Autoeroticism Attitude Scale. This pilot program encourages further exploration of the differences in methodological approaches and the long-term effects of training on specific attitudes and knowledge.