Increase In Mean Knowledge Scores Research Articles

Focused Needs Assessment and Tailored Training Pilot for Emergency Care Providers in Rwanda

Introduction:In lower- and middle-income countries (LMIC), 45% of deaths could be prevented by implementation of emergency care systems. Prehospital care is critical for emergency medical services (EMS) worldwide, and basic affordable training improves EMS systems. This study conducted a needs assessment in addition to a tailored prehospital training intervention. Subsequent changes in prehospital care as well as patient outcomes were measured.Method:Thirty providers identified through the prehospital medical command office participated. A prospective, nonrandomized interrupted time-series approach was utilized for a needs assessment and training intervention. Data collected included age, gender, training level, and a knowledge assessment, and was used to create an 18-hour training, with immediate and 11-month posttests. Prehospital process indicators evaluated on-the-ground application of skills, including airway intervention, intravenous fluid administration, and glucose administration. Linked prehospital and hospital care datasets allowed for evaluation of patient outcomes.Results:Of 30 providers, 60% (n=18) female and 40% (n=12) male, 19 were nurses and 11 were nurse anesthetists. Median age was 36 and median years providing care was 10 (IQR: 7,11). 24 (80%) participants completed immediate and post-test assessments, showing a 56% (95%CI: 36.2, 75.8) relative increase in mean knowledge score across 12 core skills that was maintained across post-tests. 324 of 572 total patients transported to the ED during the study were transported during the pre-training period (56.4%). Prehospital oxygen administration for patients with a saturation level of <95% increased pre- to post-intervention (66.7% to 71.7%; Δ = 5.0%; Δ95%CI: 1.9, 8.1%).Conclusion:This study is the first LMIC-based prehospital provider training efficacy study that includes analysis of patient outcomes and clinical process indicators. Results offer important insights on Rwanda’s prehospital care system and demonstrate that affordable, tailored educational interventions targeting process indicators have positive impacts on provider knowledge and practice.

Effect of social marketing on the knowledge, attitude, and uptake of pap smear among women residing in an urban slum in Lagos, Nigeria

IntroductionNigeria has a low uptake of cervical cancer screening and is one of the five countries that represent over half of the global burden of deaths from cervical cancer. Social marketing principles can be used to design and implement interventions to increase uptake of cervical cancer screening. This study assessed the effect of a social marketing intervention on the knowledge, attitude, and uptake of pap smear among women residing in an urban slum in Lagos State, Nigeria.Materials and methodsThis was a quasi-experimental study. The intervention arm consisted of 140 women recruited from Ago-Egun Bariga community and the control arm consisted of 175 women recruited from Oto-Ilogbo extension community. Social marketing intervention was instituted in the intervention group. Data analysis was done using IBM SPSS Statistics version 20 and Stata version 16.0. Between groups comparisons and within groups comparisons were done using bivariate analysis with Chisquare, Students t test and Paired t test as appropriate.ResultsIn both the intervention and control groups, the mean knowledge score of cervical cancer was low at baseline (0.0 ± 0.3 and 0.1 ± 0.9 respectively). In the intervention group, there was a significant increase in mean knowledge score to 15.1 ± 3.7, post-intervention (p < 0.001). In both groups, the mean attitude score of cervical cancer was low at baseline (27.1 ± 0.8 in the intervention group and 27.2 ± 1.4 in the control group). In the intervention group, there was a significant increase in mean attitude score to 36.5 ± 4.8, post-intervention (p < 0.001). In both the intervention and control groups, uptake of pap smear was low at baseline (0.0% and 0.6%, respectively). In the intervention group, there was a significant increase in uptake of pap smear to 84.3%, post-intervention (p < 0.001). There was no statistically significant change in knowledge, attitude or uptake of pap smear in the control group, post-intervention.ConclusionThis study demonstrated that social marketing intervention can be successful in improving knowledge, attitude, and also the uptake of pap smear, even in settings where these are abysmally low. It is recommended that social marketing intervention be employed as a strategy for improving cervical cancer screening among women residing in slums.

Effectiveness of Structured Teaching Programme on Knowledge and Attitude Regarding Prevention and Control of Alcohol Use among Undergraduate College Students

Introduction: Use of alcohol among college students is a worldwide problem. Alcoholism is gradually tearing down the college students irrespective of gender. Incidents of many diseases are preventable through changes in health behavior by adopting health education strategies for educating the students. Objectives: The objectives of the study were to evaluate the effectiveness of the structured teaching program (STP) on knowledge and attitude regarding prevention and control of alcohol use among undergraduate college students. Materials and Methods: One group pre-test and post-test design was used on 163 undergraduate college students at Shekhawati P.G. College Kanwat, Sikar (Rajasthan), using Stratified random sampling. STP, structured knowledge questionnaire and attitude scale were used to collect the data. Results: Study found a statistically significant (t = 41.60, df = 162, P = 0.0153) increase in mean knowledge score (mean difference of 9.57) from mean pre-test knowledge score of 10.14, SD ± 2.09 to post-test knowledge score of 19.71, SD ± 2.18 after administration of the STP. Similarly, post-exposure to the STP a statistically significant (t = 19.47, df = 162, P = 0.0326) improvement in attitude score, from pre-test attitude scores of 68, SD ± 8, to mean post-test attitude score 77.97, SD ± 5.78, was found with mean difference of 9.97. It shows that STP was effective in enhancement of knowledge and attitude of undergraduate college students. The post-test knowledge and attitude score showed statistically significant correlation (r = 0.73, df = 161, P = 0.00001). Conclusion: Systematically prepared STP on prevention and control of alcohol use was effective in improving the knowledge and attitude of undergraduate college students.

Co-Learning Curriculum in Quality Improvement for Surgical Residents– Five-Year Experience from the University of Toronto

We describe our five-year experience with a novel co-learning curriculum in quality improvement (CCQI)1 for the largest reported cohort of surgical residents. The program introduces trainees to principles of quality improvement (QI)2 and empowers them to complete collaborative projects with mentorship from faculty experts. Each iteration consists of three interactive seminars. Residents are required to complete and present a QI project in the third seminar. To assess the impact of the program, graduates of the 2020-2021 iteration were surveyed using validated tools to examine changes in confidence and knowledge of QI principles. Department of Surgery, University of Toronto, Toronto, ON, Canada. Participation ranged from 57 to 63 residents yearly, from diverse surgical disciplines including General Surgery, Plastic Surgery, Obstetrics and Gynecology, amongst others. Multiple small groups consisted of 4-6 residents from each speciality, mentored by a faculty lead from the same specialty. Approximately 300 first-year surgical residents have participated in the CCQI since 2015, with over 60 completed QI projects. A total of 41(66%) and 51(82%) residents completed the survey in its pre- and post-course administration in 2020-2021, respectively. There was a significant increase in confidence scores with respect to describing a QI issue, building a team, and testing the change, amongst other aspects. There was also a statistically significant increase in mean knowledge scores for both scenarios of the Quality Improvement Knowledge Application Tool. 69% and 73% of residents reported "some improvement" in their knowledge, and confidence in applying QI principles to patient care, respectively. A majority of residents (73%) found the QI curriculum somewhat valuable, with 23% reporting it to be very valuable to their residency and future surgical career. We describe successful long-term implementation of a novel co-learning curriculum in quality improvement. Residents derive value from this curriculum with a meaningful increase in confidence and knowledge of QI as an integral part of surgical practice.

Effect of health education on knowledge and awareness of sickle cell disease among adolescents

Introduction: Majority of Nigerians are not aware of their personal genotype, and the knowledge about sickle cell disease is quite low. We hypothesize that health education will improve the knowledge and awareness of sickle cell genotype among adolescents. This study aimed to determine the effect of health education on knowledge and awareness of sickle cell genotype among adolescents. Materials and Methods: Adolescent students of Federal Government College were recruited, and necessary data on sociodemography, knowledge, and awareness of sickle cell were obtained through a pretested sickle cell knowledge assessment questionnaire. Following health education, the same questionnaire was re-administered to the participants for assessment of any change in knowledge. Results: Majority (58.1%) of the respondents heard about sickle cell during lessons in class, while mass media was the next common source (16.5%) of knowledge and awareness. Following health education, there was an improvement in all the specific knowledge questions, especially the prevalence of sickle cell trait in Nigeria (28.1% vs. 75.2%) and the probability of carrier couple having a child with sickle cell anemia (SCA) (10.3% vs. 48.2%). There was a statistically significant increase in mean knowledge score (t = −14.203, P

Empowering AYUSH health professionals on oral health promotion in a tertiary care dental hospital in India: An interventional study

BackgroundThe extensive reach of AYUSH health professionals allows them to provide profound quality care to the unreachable. These professionals from the traditional system of medicine form fundamental part of the health care system. If adequately trained on oral health they can play a remarkable role in oral health promotion and prevention of oral diseases. ObjectiveA training strategy was thus chalked out and this study was conducted to assess the knowledge of AYUSH health professionals on oral health and the impact of this training intervention in improving their knowledge. Materials and methodsAn interventional study via self structured pre and post questionnaire on 49 participants assessed the knowledge of participants on oral health promotion. The needs assessment revealed that all the AYUSH health practitioners felt the need to participate in oral health promotion training. ResultsA significant increase in mean knowledge scores from 12.56 ± 2.26 to 15.26 ± 1.40 of AYUSH professionals was seen after a one day training programme. ConclusionThe study concluded that the utilization of AYUSH health professionals for oral health promotion and education can aid as a valuable tool for population based oral health promotion approaches.

Effectiveness of self-instructional module on awareness on screening regarding breast cancer with Intelligent Breast Examination among primary schoolteachers in Karad.

As Breast cancer is most common in developed and developing world. Despite of seriousness & importance of breast cancer the awareness is low. This Study highlights the primary screening of breast cancer with the device Intelligent Breast Examination. The objectives of this study are to assess the knowledge regarding awareness on screening of breast cancer with Intelligent Breast Examination (IBE), to develop a self-instructional module (SIM) on awareness on screening regarding breast cancer with IBE, and to assess its effectiveness on awareness about screening breast cancer with IBE. Evaluative research approach was used. The study used preexperimental research design. The samples (60 primary schoolteachers) were selected by the use of two sampling techniques, i.e., random sampling (for schools) and purposive sampling (study participants). Data were collected in two phases (pre and post) using structured questionnaire followed by the administration of SIM. The results revealed a significant increase in mean knowledge scores (mean pre 11.16 standard deviation [SD] = 2.631 to mean post 21.2 SD = 1.842) regarding awareness on screening of breast cancer with IBE. The calculated paired t value (23.902) is greater than the table value ( t = 1.67) at 0.05 level of significance. The study concluded that the SIM prepared proved to be effective in increasing the awareness regarding screening with IBE in breast cancer.

The effectiveness of WhatsApp video to increase knowledge of pneumonia early detection among mothers of children under five years

Background and purpose: Number of people in Indonesia who have access to smartphones is quite high, but their use for health education media specifically for the detection of pneumonia is still limited. This study aims to determine the effectiveness of use of video information through the WhatsApp (WA) application compared to leaflets in order to increase maternal knowledge about early detection of pneumonia among under-five children.Methods: A pretest-posttest randomized control trial was conducted in three of the six sub-villages (called banjar) in the Gelgel Village, Klungkung District. Banjar was selected purposively by considering the distance between banjar. As many as 30 mothers were selected as samples from around 45-50 mothers of children under five in each banjar. The intervention was conducted randomly where one banjar was given intervention with videos through WA, one banjar with leaflets and one banjar as a control group. The intervention was carried out for three weeks (August-September 2018). Data were collected before and after the intervention through face-to-face interviews with the mothers in their homes which included social demographics, mother's knowledge about pneumonia detection and educational media preferences. Bivariate data analysis was conducted with paired t-test and multivariate analysis with General Linear Model.Results: Characteristics of respondents in all three groups were similar in terms of age, education, employment and parity. The results of interviews on educational media choices showed that most respondents (64%) preferred WA media. The increase in mean knowledge score after the intervention was significantly higher in the WA group which was 6.93 (95%CI: 6.38-7.49) and leaflet 5.90 (95%CI: 5.49-6.44) compared to the control group 1.87 (95%CI: 1.26-2.47). There was no significant difference between the WA and the leaflet group. The results of multivariate analysis showed that educational media (F=110.99; p&lt;0.001) and education (F=16.69: p&lt;0.001) were significantly associated with the increase in knowledge after adjustments were made based on age, employment and parity.Conclusion: WA videos and leaflets were found to be effective in increasing maternal knowledge about early detection of pneumonia in under-five children. Because the use of WA application is increasing, efforts to increase health knowledge with WA videos need to be enhanced.

The effectiveness of WhatsApp video to increase knowledge of pneumonia early detection among mothers of children under five years

Background and purpose: Number of people in Indonesia who have access to smartphones is quite high, but their use for health education media specifically for the detection of pneumonia is still limited. This study aims to determine the effectiveness of use of video information through the WhatsApp (WA) application compared to leaflets in order to increase maternal knowledge about early detection of pneumonia among under-five children. Methods: A pretest-posttest randomized control trial was conducted in three of the six sub-villages (called banjar) in the Gelgel Village, Klungkung District. Banjar was selected purposively by considering the distance between banjar. As many as 30 mothers were selected as samples from around 45-50 mothers of children under five in each banjar. The intervention was conducted randomly where one banjar was given intervention with videos through WA, one banjar with leaflets and one banjar as a control group. The intervention was carried out for three weeks (August-September, 2018). Data were collected before and after the intervention through face-to-face interviews with the mothers in their homes, which included social demographics, mother's knowledge about pneumonia detection and educational media preferences. Bivariate data analysis was conducted with paired t-test and multivariate analysis with General Linear Model. Results: Characteristics of respondents in all three groups were similar in terms of age, education, employment, and parity. The results of interviews on educational media choices showed that most respondents (64%) preferred WA media. The increase in mean knowledge score after the intervention was significantly higher in the WA group which was 6.93 (95%CI: 6.38-7.49) and leaflet 5.90 (95%CI: 5.49-6.44) compared to the control group 1.87 (95%CI: 1.26-2.47). There was no significant difference between the WA and the leaflet group. The results of multivariate analysis showed that educational media (F=110.99; p&lt;0.01) and education (F=16.69; p&lt;0.01) were significantly associated with the increase in knowledge after adjustments were made based on age, employment and parity. Conclusion: WA videos and leaflet were found to be effective in increasing maternal knowledge about early detection of pneumonia in under-five children. Because the use of WA application is increasing, efforts to improve health knowledge with WA videos need to be enhanced.

Values clarification workshops to improve abortion knowledge, attitudes and intentions: a pre-post assessment in 12 countries

BackgroundWomen’s access to abortion care is often denied or hampered due to a range of barriers, many of which are rooted in abortion stigma. Abortion values clarification and attitude transformation (VCAT) workshops are conducted with abortion providers, trainers, and policymakers and other stakeholders to mitigate the effects of abortion stigma and increase provision of and access to abortion care. This study assesses changes in knowledge, attitudes, and behavioral intentions of VCAT workshop participants.MethodsPre- and post-workshop surveys from 43 VCAT workshops conducted in 12 countries in Asia, Africa, and Latin America between 2006 and 2011 were analyzed to assess changes in three domains: knowledge, attitudes and behavioral intentions related to abortion care. A score was created for each domain (range: 0-100), and paired t-tests or Wilcoxon matched-pairs signed-ranks tests were used to test for significant differences between the pre- and post-workshop scores overall and by region and participant type (providers, trainers, and policymakers/other stakeholders). We also assessed changes in pre- and post-workshop scores for participants with the lowest knowledge and negative attitudes on the pre-workshop survey.ResultsOverall, the mean knowledge score increased significantly from 49.0 to 67.1 (p < 0.001) out of a total possible score of 100. Attitudes and behavioral intentions showed more modest, but still statistically significant improvements between the pre- and post-workshop surveys. The mean attitudes score increased from 78.2 to 80.9 (p < 0.001), and the mean behavioral intentions score rose from 82.2 to 85.4 (p = 0.03). Among participants with negative attitudes pre-workshop, most shifted to positive attitudes on the post-workshop survey, ranging from 35.2% who switched to supporting unrestricted access to second-trimester abortion to 90.9% who switched to feeling comfortable working to increase access to contraceptive services in their country. Participants who began the workshop with the lowest level of knowledge experienced the greatest increase in mean knowledge score from 20.0 to 55.0 between pre- and post-workshop surveys (p < 0.001).ConclusionsVCAT workshop participants demonstrated improvements in knowledge, attitudes, and behavioral intentions related to abortion care. Participants who entered the workshops with the lowest levels of knowledge and negative attitudes had the greatest gains in these domains.

Dissemination of a Child Passenger Safety Program Through Trauma Center-Community Partnerships.

Improper child passenger restraint use contributes to higher pediatric motor vehicle collision morbidity and mortality among cultural minority populations. Child passenger safety education improves caregiver knowledge of restraint use, but effective interventions require culturally specific programming. The purpose of this study was to evaluate the effectiveness of a child passenger safety education program culturally adapted through a pediatric trauma center's community partnerships. A nonexperimental observational cohort study using program evaluation data for the child passenger safety education programs during a 24-month period. Paired pretest/posttest self-reported survey responses measured changes in caregiver knowledge and self-efficacy of restraint use. Data were analyzed by class location and by caregiver language using a paired t test and Wilcoxon's signed ranks test. A total of 1,795 paired survey responses were collected in English, Spanish, or Russian. An increase in mean knowledge scores occurred overall, with a difference in mean of 0.565 (SE = 0.022, 95% CI [0.521, 0.607]). Stratification by class site and by language reflected significant increases in median scores, but findings were variable by study group. Pretest median scores for self-efficacy of restraint use were high for all groups, but the increases in posttest medians were also significant across groups (p ≤ .001). Caregiver knowledge and self-efficacy for child passenger restraint use increased after participation in the community classes. The pediatric trauma center's community partnerships facilitated uptake and adaption of the child passenger safety education programs and increased the injury prevention outreach to minority communities.

Education and process change to improve skin health in a residential aged care facility.

We report on an intervention and evaluation in relation to changes in staff knowledge, time spent on healing and wound prevention and proportion of wounds in the facilities before and after. A rapid review of recent peer-reviewed literature (2006-2016) found 14 education-based intervention articles and provided the background and context for this intervention. A cohort of 164 nurses and personal care workers and 261 residents at two aged care-approved facilities contributed to this intervention on the effect of education, mentoring and practice change on staff knowledge and wound prevalence between 2015 and 2016. There was a significant decrease in pressure injury prevalence and an increase in the early identification of potential wounds between phase 1 and 3 across the two facilities. Overall, registered nurses and enrolled nurses showed significant increase in mean knowledge scores. There was a reorganisation of time spent on various wound care and prevention strategies that better represented education and knowledge. Wound management or prevention education alone is not enough; this study, using an educational intervention in conjunction with resident engagement, practice change, mentorship, onsite champions for healthy skin and product choice suggestions, supported by an organisation that focuses on a healthy ageing approach, showed improvement across two residential sites.

A study on knowledge and awareness about tuberculosis in senior school children in Bangalore, India

BackgroundTuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (M. tuberculosis), commonly affecting the lungs. All health care professionals including the pharmacists provide a valuable public health role in promoting community awareness of TB particularly in reducing stigma attached to TB. Thus, creating awareness at a community level could play a vital role in control and prevention of TB. ObjectivesTo determine whether educational intervention would affect the level of TB awareness among students of selected schools and pre-university colleges (PUCs) in Bangalore urban and Bangalore rural regions. MethodologyThe present study was conducted among the students of 8th, 9th, 10th and PUC in Bangalore rural and urban jurisdiction (n=2635). A questionnaire was designed in English and Kannada language, consisting of 20 questions with multiple-choice answers. A 30-minute visual health education was given on TB in English, followed by general pictorial presentation, and the data were collected as pre-test and post-test. ResultsData collected from 2635 participants during pre- and post-education session revealed that mean score improved from 8.77±2.59 to 14.95±1.99. Impact of the education session showed a significant knowledge improvement about TB from 1.59% (pre-education) to 49.67% (post-education). ConclusionThe present study clearly demonstrated that a simple, 30-minute health education session did have a positive impact on knowledge and awareness about TB among school children as observed with increase in mean knowledge score from pre-test to post-test, indicating that empowerment of students could guide the community on various aspects of TB.

Assessing public health knowledge and perceptions of pharmacy students before and after completion of didactic and experiential public health coursework

ObjectivesTo characterize baseline public health knowledge and to evaluate changes in pharmacy student performance after participation in one semester of didactic and experiential public health coursework. MethodsThird-year professional students were surveyed before and after fall semester 2013, a semester in which they completed two public health courses. ResultsTotal public health knowledge score increased from 61.5% to 65.2% (p = 0.006). An increase in mean knowledge score was significant for the domains of social and behavioral science, and epidemiology, but not for the domains of biostatistics, environmental health, and health policy. Students initially perceived the pharmacy curriculum to do the best at preparing them in epidemiology, but this perception changed to social and behavioral science after taking the public health courses. ConclusionA semester of focused public health exposure increased knowledge scores in public health topics by 3.7%. Perceptions about public health education in the pharmacy curriculum were also changed.

Knowledge change associated with participation in prenatal education programs in Ontario: A cohort study.

The primary objective was to examine how participation in prenatal programs delivered by Ontario public health units influences pregnant women's pregnancy-related knowledge. Secondary objectives were to examine the socio-demographic characteristics of women participating in these programs and assess program satisfaction. A cohort study was conducted of 511 adult pregnant women who were registered for a prenatal program within one of seven Ontario public health units. Participants completed a pre-program survey, which examined socio-demographic and pregnancy characteristics, and baseline pregnancyrelated knowledge. After finishing the program, participants completed a post-program survey investigating pregnancy-related knowledge and program satisfaction. Pregnancy-related knowledge was assessed using the Healthy Pregnancies Knowledge Survey, which captures knowledge within three subtopic areas: healthy pregnancies, healthy lifestyles and breastfeeding. Participants demonstrated a significant increase in mean knowledge scores, both overall and across each subtopic area. Most participants reported that their program satisfied their questions either mostly or very well across all content areas examined. This study is the first large-scale effort to examine the ability of prenatal programs offered through Ontario public health units to influence clients' pregnancy-related knowledge. These findings contribute to the evidence base for prenatal education program planning.

Vivir Con Un Corazón Saludable: a Community-Based Educational Program Aimed at Increasing Cardiovascular Health Knowledge in High-Risk Hispanic Women.

Hispanic women suffer from high rates of cardiometabolic risk factors and an increasingly disproportionate burden of cardiovascular disease (CVD). Particularly, Hispanic women with limited English proficiency suffer from low levels of CVD knowledge associated with adverse CVD health outcomes. Thirty-two predominantly Spanish-speaking Hispanic women completed, Vivir Con un Corazón Saludable (VCUCS), a culturally tailored Spanish language-based 6-week intensive community program targeting CVD health knowledge through weekly interactive health sessions. A 30-question CVD knowledge questionnaire was used to assess mean changes in CVD knowledge at baseline and postintervention across five major knowledge domains including CVD epidemiology, dietary knowledge, medical information, risk factors, and heart attack symptoms. Completion of the program was associated with a statistically significant (p < 0.001) increase in total mean CVD knowledge scores from 39 % (mean 11.7/30.0) to 66 % (mean 19.8/30.0) postintervention consistent with a 68 % increase in overall mean CVD scores. There was a statistically significant (p < 0.001) increase in mean knowledge scores across all five CVD domains. A culturally tailored Spanish language-based health program is effective in increasing CVD awareness among high CVD risk Hispanic women with low English proficiency and low baseline CVD knowledge.

Promoting Colorectal Cancer Screening through Group Education in Community-Based Settings

National colonoscopy adherence rates near 65% and New York City (NYC) colonoscopy rates approach 69%. Despite an overall increase in national colorectal cancer (CRC) screening rates, rates of CRC screening among Blacks and Latinos are lower than non-Latino Whites. We developed two group level, culturally targeted educational programs about CRC for Blacks and Latinos. One hour programs included education about screening, peer testimony given by a colonoscopy-adherent person, and pre- and post-knowledge assessment. From 2010 to 2012, we conducted 66 education programs in NYC, reaching 1,065 participants, 62.7% of whom were 50 years of age or older identified as Black or Latino and provided information about colonoscopy history (N = 668). Colonoscopy adherence in the sample was 69.3%. There was a significant increase in mean knowledge score about CRC and CRC screening from pretest to posttest. Sixty-eight percent of attendees without prior colonoscopy reported intent to schedule a colonoscopy as a result of attending the program. Culturally targeted education programs with peer testimony are a valuable way to raise awareness about CRC and colonoscopy and can influence intent to screen among nonadherent persons. Additional research is needed to establish group level education as an effective means of promoting CRC screening.

Women's knowledge, practices and attitudes to breast self-examination

This is an interventional study that used a pre-test, post-test control group design to measure the effect of a nurse-led culture based intervention on rural women's knowledge, attitude and practice of breast self-examination (BSE) in Ibadan, Nigeria. Preintervention reports showed that most of the participants were not informed about timing of BSE. However post-intervention data indicated that 95 (44.8%) in the experimental group and only two participants in the control indicated correctly the timing for BSE. There was a significant increase in mean knowledge score of early detection measures from 24.95 SD (2.4) to 29.60 (4.3) p= 0.000000 in the experimental group. In the control group the pre-intervention score was 24.69 SD (2.3) and post intervention 24.68 SD p= 0.63. The findings of this study suggested that the nurse-led culture based intervention significantly improved both knowledge and self-reported practice of breast self-examination among the women.

Changes in Consumer Knowledge and Behavioral Intention Toward Genetically Engineered (GE) Foods

The main objective of this study is to assess change in the average American consumer's behavioral intention (BI) toward the avoidance of GE foods in the marketplace as a function of change in the consumer's level of knowledge about these foods. Thirty adult mainstream grocery store shoppers participated in this randomized, controlled educational intervention study. Participants completed demographic, knowledge, and BI questionnaires both before and after an educational intervention about GE foods in the marketplace. The questionnaire and educational materials were worded for neutrality – that is, to emphasize neither the pros nor the cons of GE foods. Student's t‐Test and Mann‐Whitney's U test were used and statistical significance defined as p&lt;0.05. The experimental group showed a statistically significant (p&lt;0.001) pre/post increase in knowledge score as compared to the control group. There were no statistically significant pre/post changes in BI scores between the two groups. Within groups, there was a statistically significant (p&lt;0.001) increase in mean knowledge score for the experimental group and a statistically significant (p&lt;0.05) decrease in mean knowledge score for the control group. No statistically significant correlations were found between changes in knowledge and BI scores. The results of this study indicate that neutral information may have little effect on consumer BI toward GE foods.

Making Choices for Childbirth: A Randomized Controlled Trial of a Decision‐aid for Informed Birth after Cesareana

Decision-making about mode of birth after a cesarean delivery presents challenges to women and their caregivers and requires a balance of risks and benefits according to individual circumstances. The study objective was to determine whether a decision-aid for women who have experienced previous cesarean birth facilitates informed decision-making about birth options during a subsequent pregnancy. A prospective multicenter randomized controlled trial of 227 pregnant women was conducted within 3 prenatal clinics and 3 private obstetric practices in New South Wales, Australia. Women with 1 previous cesarean section and medically eligible for trial of vaginal birth were recruited at 12 to 18 weeks' gestation; 115 were randomized to the intervention group and 112 to the control group. A decision-aid booklet describing risks and benefits of elective repeat cesarean section and trial of labor was given to intervention group women at 28 weeks' gestation. Main outcome measures included level of knowledge, decisional conflict score, women's preference for mode of birth, and recorded mode of birth. Women who received the decision-aid demonstrated a significantly greater increase in mean knowledge scores than the control group (increasing by 2.17 vs 0.42 points on a 15-point scale) (p < 0.001, 95% CI for difference = 1.15-2.35). The intervention group demonstrated a reduction in decisional conflict score (p < 0.05). The decision-aid did not significantly affect the rate of uptake of trial of labor or elective repeat cesarean section. Preferences expressed at 36 weeks were not consistent with actual birth outcomes for many women. A decision-aid for women facing choices about birth after cesarean section is effective in improving knowledge and reducing decisional conflict. However, little evidence suggested that this process led to an informed choice. Strategies are required to better equip organizations and practitioners to empower women so that they can translate informed preferences into practice. Further work needs to examine ways to enhance women's power in decision-making within the doctor-patient relationship.