Knowledge-attitude-practice Research Articles

Effect of a patient health engagement (PHE) model on rehabilitation participation in patients with acute myocardial infarction after PCI: a study protocol for a randomized controlled trial

BackgroundParticipation in cardiac rehabilitation is low in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Although existing rehabilitation methods have achieved certain results, patient participation in exercise rehabilitation is not ideal. The Patient Health Engagement (PHE) model is designed to ensure that patients improve their participation in cognitive, emotional, behavioral, and other aspects in all phases of exercise rehabilitation. The purpose of this study is to confirm whether the rehabilitation method based on the PHE model improves the rate of patient participation and enhances the rehabilitation effect during cardiac rehabilitation in patients with acute myocardial infarction compared with the traditional rehabilitation model.Methods/designThis is a single-center, double-blind, randomized, controlled trial that will enroll 128 patients. Patients with stable acute myocardial infarction after undergoing PCI who received cardiac rehabilitation and postoperative LVEF ≥ 40%, categorized into Killip class I ~ II and with age ≥ 18 years, will be included in the study. Exclusion criteria are mainly malignant arrhythmias, acute heart failure, congestive heart failure, and patients requiring intra-aortic balloon counterpulsation. Patients will be randomized in a 1:1 ratio to the intervention (1) and control (2) groups. Physicians, rehabilitation specialists, patients, and data collectors will be blinded during the study. A rehabilitator and a specialist nurse will conduct the cardiac rehabilitation. The specialist nurse will hand over the sealed bag containing patient information (group 1 or 2) to the physician. Group 1 will undergo cardiac rehabilitation through the PHE model, three times a week for 3 months. The rehabilitation program will be evaluated and adjusted in time from each period of the rehabilitation. Group 2 will be treated with routine cardiac rehabilitation. The rehabilitation participation rate of the two groups will be evaluated before and after 3 months of intervention. The primary outcome will be the level of patient participation in rehabilitation, and the secondary outcome will include general data of patients, postoperative rehabilitation indicators, cardiac rehabilitation knowledge–attitude–practice questionnaire, cardiovascular adverse events, and a brief mood scale.Expected outcomesWe expect improved cardiac rehabilitation participation rates and rehabilitation outcomes in patients with acute myocardial infarction after undergoing PCI using the PHE model.DiscussionThis approach may increase patient participation in rehabilitation, improve rehabilitation outcomes, and be widely implemented in hospitals and rehabilitation centers.Trial registrationClinicalTrials.gov identifier, ChiCTR2400085276 (Version 2.0 June 04, 2024), https://www.chictr.org.cn.Trial sponsorShandong Second Medical university, Weifang, Shandong. Contact name: Dechun Qin, Address: Shandong Second Medical university, Weifang Shandong. Email: 13562666589@163.com.

ESPRIT study, analysis of the results of the pre-intervention survey in upper secondary schools

Abstract Background Sexually transmitted infections are a major public health problem, and their number is increasing in Italy. However, affective sexuality education is not yet part of the curricula. Therefore, a project entitled ESPRIT was launched, involving 3 regions (Friuli-Venezia Giulia, Lazio and Sicily), the IRCSS ‘Burlo Garofolo’ and the Istituto Superiore di Sanità, and implemented with the technical and financial support of the Ministry of Health - CCM. Methods A multicenter prospective intervention study was designed involving public upper secondary school students (grade 10-11). All target groups completed a KAP (knowledge, attitude, practice) questionnaire before and after participation in the educational intervention to measure its effectiveness. The questionnaires from the first phase were collected between January and April 2024, and the results were analyzed using R statistical software. Results The analysis of the overall results (463 students in total; female 58%, male 39%, other 2%; FVG 49%, Lazio 25%, Sicily 26%) showed that the group of upper secondary school students, targeted by peer education answered the knowledge part correctly by 56.6±13.8% on average. Applying the Kruskal-Wallis test showed that the percentage was significantly higher for females than males (p-value=0.005) and for licei students compared to technical and vocational schools (p-value=0.000). In terms of to attitudes, only 17% of students talked at length about sexually transmitted infections, and in 86.6% of cases, the interlocutors were friends or peers. Conclusions The results of the first phase show differences between the sexes and between the different types of educational institutions. The current level of knowledge still leaves much room for intervention and improvement. Analyzing the results of the follow-up phase will allow us to understand the effectiveness of the peer education intervention. Key messages • Adolescents’ knowledge of sexually transmitted infections needs to be improved. • Gender and the type of school attended affect the level of knowledge.

The Impact of Short-Form Video and Optimistic Bias on Engagement in Oral Health Prevention: Integrating a KAP Model.

College students are recognized as a demographic particularly susceptible to higher oral health risks due to irregular and unhealthy habits. While previous research has underscored these risks through descriptive studies within this group, a significant gap persists in the literature regarding the impact of contemporary media, specifically oral-health-related content, on the engagement in oral health prevention among Chinese college students. To address this gap, this study, guided by the extended knowledge-attitude-practice (KAP) theory model, explores the direct, mediated, and serially mediated mechanisms through which exposure to oral health short-form videos on Douyin influences their participation in oral health prevention. An empirical cross-sectional online survey was conducted, with valid data (N = 421) analyzed using descriptive statistics and hierarchical regression. Mediation and serial mediation analyses were also performed using SPSS version 25.0. The analysis revealed that exposure to oral health short-form videos had a positive direct effect on both oral health knowledge and the reduction of optimistic bias among Chinese college students. Furthermore, a significant serial mediation effect of oral health knowledge and oral health attitude was identified. The findings underscore the substantial applicability and explanatory power of the extended KAP theory model in understanding engagement in oral health prevention.

CORRELATION OF COMMUNITY PHARMACIST KNOWLEDGE, ATTITUDES, AND PRACTICES IN THE DETECTION OF TUBERCULOSIS CASES IN WEST JAVA PROVINCE

Tuberculosis (TB) control is hampered by suboptimal case detection and treatment delays. Pharmacies are reported as a first-aid treatment for patients with TB. Therefore, researchers analyzed knowledge, attitudes, and practices (KAP) regarding TB case detection among community pharmacists, aiming to find innovative strategies to involve community pharmacists in TB case detection. The research aims to determine the level of knowledge, attitudes, and practices, and the relationship between knowledge and attitude, knowledge-practice, and attitude-practice of community pharmacists in detecting tuberculosis cases in West Java Province. This research uses a descriptive observational method with 419 pharmacists who practice pharmacies. The results showed that pharmacists had a sufficient level of knowledge (14.94 ± 1.99), an adequate level of attitude (63.58 ± 9.12), and a sufficient level of practice (20.58 ± 8.55) regarding TB case detection. There is a very low relationship between knowledge and attitude (p-value 0.024<0.05), knowledge and practice ( p-value 0.018>0.05), and attitude and practice ( p-value 0.000< 0.05). This study concluded that community pharmacists in West Java Province have sufficient knowledge, attitudes, and practices in detecting TB cases, but the level of relationship between knowledge attitude and detecting TB cases, and the level of association between knowledge attitude and knowledge practice was very low, while the relationship between attitude practice was low. Keywords: Pharmacist, Knowledge, Practice, Attitude, Tuberculosis

Development and validation of a knowledge, attitude, and practice questionnaire regarding exercise and exergames for obese patients with gout

The Knowledge-Attitude-Practice (KAP) Questionnaire could help investigate whether there are misconceptions, positive attitudes, and adequate practice in people with gout about exercise and exergames. The study aims to develop and validate the KAP questionnaire regarding exercise and exergames for obese patients with gout to understand gout ‘patients’ awareness level of exercise and perception of exergames. The development and validation of the questionnaire involved two phases: (1) development of the instrument and (2) judgment of the instrument through calculating the content validity by the expert panel and using SPSS version 28 to examine the test-retest reliability, internal consistency, and structural validity of the instrument. After the first phase of instrument development, an initial questionnaire consisting of six parts with 35 items was identified. After the content validation of the second phase, 11 items with a content validity ratio (CVR) value below 0.99 were eliminated, 3 items were rephrased, 2 items that mixed two statements were divided, and 15 items were added based on the original instrument. In addition, in the factor analysis, five items within the knowledge domain with factor loadings below 0.4 were removed. The final questionnaire was examined and demonstrated acceptable content validity, test-retest reliability, internal consistency, and construct validity.

Knowledge attitude practice among oncologists and health care workers during COVID19 pandemic

IntroductionHealthcare providers should be well prepared to fight the COVID-19 pandemic and protect their patients and themselves as frontline workers. The aim of this study was to assess oncologists’ and health care workers (HCWs) knowledge, attitude, and practice in response to the COVID-19 pandemic and its impact on them.Material and methodsThis cross-sectional study was conducted among Egyptian oncologists and HCWs in the oncology department at Suez Canal University Hospitals, Egypt. Participants were reached through a Google Form questionnaire. The questionnaire was shared on social media (Facebook, Twitter, and WhatsApp) over four months, from June 1st to September 30, 2022. All physicians and HCWs in the oncology department were invited to participate in the survey. Researchers intended to enroll all physicians and HCWs within the study period.ResultsOut of the 110 participants included in the study, there was a female predominance, and the majority were oncology nurses and clinical oncologists. Knowledge with significant participants’ characteristics showed that knowledge significantly varied by age. The level of knowledge was significantly higher among participants between 30 and 40 years old (OR = 5.111; 95% CI, 1.202–21.738; P = 0.027). 65.5% of the participants had poor knowledge, with a mean ± SD of 4.9 ± 1.4. About 43.6% of the participants experienced more burnout than before the COVID-19 pandemic, with a negative emotional impact. 63.7% reported a negative financial impact due to the pandemic. 62.7% had support from their family, even though their job increases their risk of infection. 7.3% only reported a positive impact regarding their friend’s relationship.ConclusionCOVID-19 pandemic has a negative impact on oncologists' personal and professional lives. Interventions should be implemented to lessen the negative impact and better prepare oncologists to handle future crises with greater efficiency and resilience.

The Effectiveness of a Self-Management and Multifactorial Program for Blood Pressure Control Among Older Home-Based Workers in Urban Bangkok, Thailand

Older adults aged between 50-65 years old have a high risk of hypertension. With the growing numbers of home-based workers among adults and older adults in Thailand, this study aimed to evaluate the effectiveness of self-management with a multifactorial program to control blood pressure among older adults. A randomized controlled trial was conducted. Participants who worked as home-based workers aged between 50-65 years old were recruited from a community in the western area of Bangkok. Approximately 70 participants were randomly and equally assigned to the intervention and control groups (35 participants in each group). Participants in the intervention group received the program that consisted of education regarding food selection, work time management and arm swinging; a practical protocol, an exercise program, a heart rate monitor, a recorded book for facilitating participants’ progress to ensure their safety and efficiency in a health professional manner for a week/month. While those in the control group received usual care. A Knowledge Attitude Practice questionnaire was utilized to assess their knowledge, attitude, and practice, which demonstrated a content validity index and Cronbach alpha of 0.80, respectively. The Citizen CH-403C was utilized to measure blood pressure and heart rate. Two-way Repeated Measures ANOVA was employed to analyze the differences in outcome scores at baseline, 3-month after program, and 6-month follow up. The results showed a significant increase in participant’s knowledge, attitudes, and behaviors toward hypertension and a decrease in blood pressure to nearly normal after 3months following the completion of the program and 6-month follow-up. Therefore, the self-management and multifactorial program could be an effective preventive intervention for older adults with pre-hypertension conditions to offer them valuable knowledge on work-life balance as well as to help prevent hypertension, and related stroke complications.

Exploring menopausal symptoms, attitudes, and behaviors among menopausal women in China: an online research perspective.

The number of perimenopausal women in China is rising, but the population's concept of menopausal hormone therapy (MHT) is still relatively outdated. In this study, we used the Knowledge-Attitude-Practice (KAP) theory and collected online questionnaires from 1,100 women aged 40 to 60 years nationwide to find out their menopausal symptom profiles; to learn about their perceptions, attitudes, and behaviors toward menopause and MHT; to explore the factors influencing the acceptance of hormone treatments; and to look for better ways to promote the dissemination of menopausal knowledge. The results revealed that among women aged 40 to 60 years, 82.36% experienced possible menopausal symptoms, with hot flushes/sweating, sleep disorders, mood disorders, and fatigue being the most prevalent; 55.90% reported moderate to severe symptoms, but only 46.99% of them sought healthcare services. Among those who sought medical care, 16.00% had their first visit to climacteric clinics/gynecological endocrinology, and 5.66% accepted MHT. Furthermore, 77.82% of participants never heard of MHT or were unaware of its existence. The healthcare-seeking behavior of menopausal women in response to symptoms and their willingness to accept MHT were found to be closely associated with their level of self-care. The prevalence of menopausal symptoms is higher in China than previous research findings, but due to a lack of relevant knowledge, the rate of seeking treatment from the appropriate medical department and accepting MHT is relatively low. Enhancing physicians' knowledge of the menopausal transition and using Internet tools might help improve Chinese women's knowledge of menopause and help them pass through this period smoothly.

Factors influencing safe use of drugs among community residents: a cross-sectional study

BackgroundResearchers have paid little attention to the safety of drug use among community residents (CRs). Irrational use of drugs can lead to health risks. We investigated the situation of knowledge–attitude–practices (KAP) of CRs in Shenzhen (China) for safe use of drugs, and analyzed the main factors influencing drug use.MethodsA multi-stage, random sampling method was used. We used a validated questionnaire to conduct an online questionnaire survey on the demographic characteristics and KAP of safe use of drugs of CRs in 10 administrative districts of Shenzhen City. The KAP score of safe use of drugs of CRs was analyzed. Influencing factors were identified using a single-factor chi-squared test and binary logistic regression analysis.ResultsA total of 7269 valid questionnaires were collected. The average scores of knowledge, attitude, and behavior were (9.08 ± 1.49) (possible range: 0–10), (37.82 ± 3.96) (possible range: 8–40), and (35.82 ± 4.56) (possible range: 8–40), respectively, indicating that they had a better grasp of safe use of drugs. Logistic regression analysis showed that sex, age, education level, occupation, monthly household income per capita, marital status, health status, and different sources of information were the main factors affecting the knowledge and behavior of safe use of drugs of CRs. In addition to the marital status variable, other variables also have a significant impact on attitude towards safe use of drugs of CRs.ConclusionsMale sex, lower education level, lower income level, average/poor self-rated health status, and single source of drug-use information were the main factors affecting safe use of drugs based on KAP theory. The government and medical workers should carry out various forms of drug-education activities for people with different needs, encourage CRs to learn safe use of drugs, and promote safe use of drugs by CRs through diverse information sources.

Knowledge Attitude Practice of Malaria Preventive Measures Amongst Attendees of ESUT Teaching Hospital, Parklane Enugu

Aims: To determine the knowledge of malaria and its preventive measures among antenatal attendees of ESUT Teaching Hospital,to determine the preventive measures taken to prevent malaria,To determine the factors that influence their preventive practices towards malaria.  Study Design: This is a descriptive cross-sectional study which was conducted using interviewer-administered questionnaire.  Place and Duration of Study: The study area is antenatal ward situated in ESUT Teaching Hospital, which is located in Parklane GRA, Enugu, Nigeria, between June and July 2019.  Methodology: We included willing antenatal attendees of ESUT Teaching Hospital from the age of 15 irrespective of their gestational age of pregnancy. A total of 360 pregnant women participated in the study.  Results: Out of 355 questionnaires that were distributed only 323 were recovered, giving a response rate of 90.99%.The overall knowledge of the cause of malaria was relatively good, as 310 (96%) respondents believed that it was caused by mosquito bite, while only a few 38 (14.5%) did not know the cause.Also,more younger respondents 156 (90.7%) were knowledgeable about the use of Insecticides Treated Nets (ITNs) and Intermittent Preventive Therapy(IPT)in the prevention of malaria with p = 0.031 and p=0.001 respectively.  Conclusion: We were able to deduct that majority of the pregnant women who participated in the study had a good knowledge of cause of malaria and it's effect on the unborn child,however the practice varies amongst individual and dependents on various factors including age,educational level,occupation and religious beliefs. Thus, we are recommending the government to make insecticide treated nets and insecticides readily accessible, in addition, health care providers should reinforce their health talks on the need to use insecticide treated nets while pregnant.

Research Status of the Knowledge-Attitude-Practice Theory Model in Gastric Cancer Prevention.

Gastric cancer, as a malignant tumor with high morbidity and mortality, poses a serious threat to people's health. The knowledge-attitude-practice (KAP) theory model shows important value in gastric cancer prevention by improving health knowledge, changing health attitudes or beliefs, and guiding healthy practice. At present, the application of this model in gastric cancer prevention has gradually received attention. This article reviews the current application status of the KAP theory model in gastric cancer prevention and analyzes the challenges, countermeasures, and development prospects in order to provide a reference for gastric cancer prevention.

Evaluation of a knowledge-attitude-practice model based narrative life education program for community-dwelling older adults: a mixed-methods feasibility study

BackgroundThe global aging population presents challenges that are particularly acute in China. Older Chinese adults’ attitudes towards death significantly impact their quality of life. Death education is crucial for promoting positive perspectives on life and death. Narrative education offers a promising approach to facilitating death education. Integrating the Knowledge-Attitude-Practice (KAP) model into death education will enhance the feasibility and acceptability of death education programs.MethodsThis mixed-methods feasibility study included a quasi-experimental trial and semi-structured interviews. Older adults in the intervention group (N = 27) received a 6-week KAP-based narrative life education program in addition to standard community health education; participants in the control group (N = 20) received only the normal community health education. In both groups, attitudes toward death and the meaning of life were assessed at baseline and immediately after the intervention. A post-intervention semi-structured interview and satisfaction survey were also conducted for the intervention group.ResultsForty out of 47 older adults completed the program for an 85.1% retention rate. All of the older adults in the experiment were very satisfied and satisfied with the life education program, and no adverse events were reported. Compared to the control group, participants in the intervention group had a significant decrease in the fear of death (P = 0.028), and substantial improvement in their value of life (P = 0.031), goal of life (P = 0.035), freedom of life (P = 0.003), and the total score for purpose in life (P = 0.017). The qualitative results yielded four themes: profound recognition of life and death, contradiction between thoughts and action, conflict between one’s acceptance and others’ avoidance, and evaluation of the life education program.ConclusionsThe KAP-based narrative life education program is feasible and acceptable for older Chinese community-dwelling adults. It is also potentially effective in improving attitudes toward death attitudes and the meaning of life in this cohort.Trial registrationThis study was retrospectively registered at China Clinical Trial Registry as ChiCTR2300069551 on 2023-03-20. URL of registration: https://www.chictr.org.cn/showproj.html?proj=183176.

Survey of public knowledge, attitudes, and practices regarding personal protection against COVID-19 in the post-pandemic era.

In the emerging post-pandemic era (the 'wavelet' era), humans must coexist with viruses for the foreseeable future, and personal protective behaviors will largely replace national-level preventive measures. In this new normal, encouraging the public to implement proper personal protective behaviors against the coronavirus disease (COVID-19) is vital to the sustainable development of cities and communities. This knowledge-attitude-practice (KAP) survey conducted in Chengdu (N = 900) narrowed the knowledge gap regarding post-pandemic public practices of protective behavior. Findings show that:(1) approximately 1/3 of the respondents are currently not concerned about COVID-19 at all; (2) respondents with different demographics and individual COVID-19-related factors showed significant differences in practice behaviors indoors and outdoors; (3) vulnerable groups performed better in practice behavior indoors/outdoors; (4) because the public may relax their vigilance outdoors, public places may become a transmission threat in the next outbreak; (5) attitudes are important, but limited incentives for practice; and (6) when knowledge increases beyond a threshold (68.75-75% in this study), protective behaviors decrease. Our results suggest that authorities must continue to educate and motivate the public, extending measures to cover personal protective practices, and have targeted policies for specific demographics to ensure equity in healthcare in the event of another pandemic (COVID-19 and alike crisis). Besides, comparing the results of the current study with similar studies conducted in other parts of the world can provide insights into how different populations respond to and adopt COVID-19 protective behaviors. The epidemiologists can use the data collected by this and other KAP surveys to refine epidemiologic models, which can help predict the spread of the virus and the impact of interventions in different settings.

WhatsApp-based intervention to promote tea consumption and healthy lifestyle in Indonesian’s adult

<p><em><strong><span lang="EN-US">Background: </span></strong></em><em><span lang="EN-US">Tea flavonoids have been shown to reduce Cardiovascular Disease (CVD) risks, and tea consumption might help reduce the problem in the community. Meanwhile, tea consumption among Indonesian people is still rare and in small quantities.</span></em></p><p><em><strong><span lang="EN-US">Objectives: </span></strong></em><em><span lang="EN-US">This research aimed to evaluate the effect of a WhatsApp-based education intervention, "HaH (Heart at Home)," a program that aims to increase KAP (Knowledge, Attitude, Practice) to prevent CVD by practicing a healthy lifestyle and encouraging tea consumption.</span></em></p><p><em><strong><span lang="EN-US">Methods: </span></strong></em><em><span lang="EN-US">Subjects were women/men who are married, members of IHF (Indonesia Heart Foundation), aged 25-50 years old, own and used a smartphone in their daily life. A total of 80 adults was participated in this study. The study design was pre-post intervention conducted online using WhatsApp for 21 days. The intervention included videos/ picture posts and online discussion through WhatsApp. Wilcoxon and McNemmar tests were used to examine the differences in subjects' KAP before and after the intervention.</span></em></p><p><em><strong><span lang="EN-US">Results: </span></strong></em><em><span lang="EN-US">Most subjects were women (96.3%) aged 25-40 years (78.8%) and housewives (67.5%). The knowledge score increased by about 17.5% (p<0.05). More than 10% of subjects increased their knowledge of CVD risk. Almost all subjects already had a positive attitude at baseline (94%) and was slightly increased to 97.0% (p<0.05). After the intervention, positive health practices such as exercise, consuming vegetables, relaxation, and sleep were increased. In contrast, harmful practices such as smoking, stress symptoms, and consuming high-cholesterol food were decreased.</span></em></p><p><em><strong><span lang="EN-US">Conclusions: </span></strong></em><em><span lang="EN-US">The present study showed that an online program effectively increases the KAP of subjects, although this can be maximized by having more interaction with subjects.</span></em></p>

Knowledge, attitudes, and practices of primary healthcare practitioners regarding pharmacist clinics: a cross-sectional study in Shanghai

BackgroundPharmacist clinics offer professional pharmaceutical services that can improve public health outcomes. However, primary healthcare staff in China face various barriers and challenges in implementing such clinics. To identify existing problems and provide recommendations for the implementation of pharmacist clinics, this study aims to assess the knowledge, attitudes, and practices of pharmacist clinics among primary healthcare providers.MethodsA cross-sectional survey based on the Knowledge-Attitude-Practice (KAP) model, was conducted in community health centers (CHCs) and private hospitals in Shanghai, China in May, 2023. Descriptive analytics and the Pareto principle were used to multiple-answer questions. Chi-square test, Fisher’s exact test, and binary logistic regression models were employed to identify factors associated with the knowledge, attitudes, and practices of pharmacist clinics.ResultsA total of 223 primary practitioners participated in the survey. Our study revealed that most of them had limited knowledge (60.1%, n = 134) but a positive attitude (82.9%, n = 185) towards pharmacist clinics, with only 17.0% (n = 38) having implemented them. The primary goal of pharmacist clinics was to provide comprehensive medication guidance (31.5%, n = 200), with medication education (26.3%, n = 202) being the primary service, and special populations (24.5%, n = 153) identified as key recipients. Logistic regression analysis revealed that education, age, occupation, position, work seniority, and institution significantly influenced their perceptions. Practitioners with bachelor’s degrees, for instance, were more likely than those with less education to recognize the importance of pharmacist clinics in medication guidance (aOR: 7.130, 95%CI: 1.809–28.099, p-value = 0.005) and prescription reviews (aOR: 4.675, 95% CI: 1.548–14.112, p-value = 0.006). Additionally, practitioners expressed positive attitudes but low confidence, with only 33.3% (n = 74) feeling confident in implementation. The confidence levels of male practitioners surpassed those of female practitioners (p-value = 0.037), and practitioners from community health centers (CHCs) exhibited higher confidence compared to their counterparts in private hospitals (p-value = 0.008). Joint physician-pharmacist clinics (36.8%, n = 82) through collaboration with medical institutions (52.0%, n = 116) emerged as the favored modality. Daily sessions were preferred (38.5%, n = 86), and both registration and pharmacy service fees were considered appropriate for payment (42.2%, n = 94). The primary challenge identified was high outpatient workload (30.9%, n = 69).ConclusionsAlthough primary healthcare practitioners held positive attitudes towards pharmacist clinics, limited knowledge, low confidence, and high workload contributed to the scarcity of their implementation. Practitioners with diverse sociodemographic characteristics, such as education, age, and institution, showed varying perceptions and practices regarding pharmacist clinics.

EXTENSION CASE STUDY: WHY PADDY FARMERS ARE NOT INCLINED TO USE A DRONE AS PART OF MECHANISATION FOR PADDY CULTIVATION

Drone technology is emerging as a pivotal component in the agricultural sector, particularly in the context of Agricultural Industrial Revolution 4.0 (IR4.0). Its application, especially in activities such as fertiliser and crop protection chemical spraying in the Kemubu Agricultural Development Authority (KADA) granary areas, can significantly enhance the farmers’ yields. Despite the positive reception of drone technology, there is a growing phenomenon of technology rejection that requires further exploration. This research aims to investigate farmers’ acceptance of drones as a mechanisation tool for paddy cultivation in the Jajahan Bachok, Kelantan granary areas within KADA authority. A structured questionnaire, based on the knowledge, attitude, practice (KAP) model, was administered to 82 farmers surrounding Jajahan Bachok through purposive sampling. Data analysis using SPSS version 26.0 involved Descriptive statistics, Spearman’s Correlation, and Reliability tests. The study reveals that paddy farmers exhibit acceptance of drone technology, albeit with a slow adoption rate. The correlations between knowledge, attitude, and practice with drone mechanisation acceptance are significant but negligible at levels of 0.253, 0.866, and 0.69, respectively. This research is vital for both agency and drone vendors to comprehend the factors influencing drone technology acceptance among paddy farmers. Understanding these factors can contribute to enhance the application and adoption rate of drone as next important mechanisation for paddy farming activities among farmers especially in the KADA granary areas. Keywords: Drone, paddy, acceptance, KAP model, KADA.

Socioeconomic and cultural factors associated with pap smear screening among French women living in Réunion Island

BackgroundRéunion Island is a French overseas territory located in the southern Indian Ocean, with a challenging socioeconomic and multicultural context. Compared to mainland France, Réunion has an overincidence and overmortality of cervical cancer. In order to investigate these two issues, it is important to evaluate the barriers and potential levers to Pap smear screening among female inhabitants of the island. We aimed to identify the specific socio-demographic factors, cultural factors, and living conditions associated with Pap smear screening in Réunion, with a view to increasing uptake.MethodsWe conducted a Knowledge Attitude Behavior and Practices (KABP) survey on cervical cancer screening practices among women aged between 25 and 65 years old living in Réunion Island, selected using random digit dialing sampling. Data were collected using Computer Assistant Telephone Interviews. Weighted chi-squared tests and Student’s t-tests were used to compare women who had up-to-date Pap smear screening with women who did not. Weighted logistic models were used to identify the factors associated with not having up-to-date screening.ResultsA total of 1000 women were included in the study. Of these, 88.1% had a Pap smear test during the previous three years. Factors independently associated with not being up to date were as follows: aged over 55 (AOR 2.3 [1.2–4.3]), no children (AOR 2.5 [1.4–4.3]), having free universal health coverage (AOR 1.7 [1.1–2.7]), an income per unit consumption lower than 1500€ per month (AOR 2.0 [1.1–3.7]), low health literacy (AOR 2.7 [1.7–4.1]), not consulting a general practitioner in the prior 12 months (AOR 3.6 [2.0-6.5]), and a BMI > 30 (AOR 2.6 [1.5–4.4]).ConclusionsThis is the first large-scale survey focusing on recommended Pap smear screening uptake in Réunion Island. Although self-reported screening incidence was higher than in mainland France, national screening policies must take into account the island’s diverse social and cultural characteristics (e.g., an ageing population, low health literacy), while implementing actions to fight against poverty and increase general access to healthcare.

Assessing students’ environmental literacy on sustainability through Knowledge -Attitude-Practice (K-A-P) approach in the Ecosystem Discovery Journey (EDJ) Programme

A successful transition towards sustainability in the university context requires incorporation of three important aspects based on knowledge, beliefs, values and actions among all stakeholders, particularly students, through environmental education and literacy. Hence, this study aims to assess the level of environmental literacy, encompassing knowledge, attitude and practice (KAP) of undergraduate students enrolled in the LMCP1522: Ecosystem Discovery Journey (EDJ) course in Universiti Kebangsaan Malaysia. A quantitative study was conducted, involving a survey and structured questionnaires completed by 108 students, also known as Eco-volunteers (Ekorelawan). The collected data were analysed by applying the descriptive and inferential statistics. The findings showed a high level of environmental knowledge (94.4%), positive environmental attitude (56.5%) and fair/moderate environmental practice (69.5%) among students. The study also found positive and significant relationships between environmental knowledge, attitude and practice among the students through Spearman correlation test. The analysis discovered that students acquired environmental knowledge through electronic media, particularly social media as their primary source. The findings of the study illustrated a general depiction of environmental literacy level among students and provided general direction for policy discussion with respect to environmental education in Malaysian higher education institutions.

A method to enhance drivers' hazard perception at night based on “knowledge-attitude-practice” theory

During nighttime driving, the inherent challenges of low-illuminance conditions often lead to an increased crash rate and higher fatalities by impairing drivers' ability to recognize imminent hazards. While the severity of this issue is widely recognized, a significant research void exists with regard to strategies to enhance hazard perception under such circumstances. To address this lacuna, our study examined the potential of an intervention grounded in the knowledge-attitude-practice (KAP) framework to bolster nighttime hazard detection among drivers. We engaged a cohort of sixty drivers split randomly into an intervention group (undergoing specialized training) and a control group and employed a holistic assessment that combined eye movement analytics, physiological response monitoring, and driving performance evaluations during simulated scenarios pre- and post-intervention. The data showed that the KAP-centric intervention honed drivers' visual search techniques during nighttime driving, allowing them to confront potential threats with reduced physiological tension and ensuring more adept vehicle handling. These compelling findings support the integration of this methodology in driver training curricula and present an innovative strategy to enhance road safety during nighttime journeys.

Nutrition and physical activity in schools in Pacific Island Countries

The increasing rates of obesity among children and adolescents are significant issues worldwide and in the Pacific Island Nations(1). An energy imbalance between calorie intake and expenditure is linked to overweight and obesity for children and adolescents. Epidemiological, nutritional, and technological changes are linked to altered eating habits, including an increase in energy consumption. Conversely, technological advancements and market globalization are responsible for declines in physical activity (PA)(2). During COVID-19 outbreak a more sedentary lifestyle than before the outbreak has been adopted by children and adolescents as a result of lockdown measures, which include shutting of schools, restrictive travel outside the home, and limiting social interactions has made the issue worse(3). Studies have shown that 40% to 70 % of obese children become obese adults(4). Since children spend a large portion of their day in school and eat their main meals there, school settings are suitable for interventions aimed at preventing childhood obesity. Additionally, school environments will reduce the number of dropouts brought on by problems with accessibility or transit(5). The selection of primary school children is important for interventions as the dietary and physical activity habits acquired at this age are ingrained in children and continue into adulthood. So, it is important to have a robust nutrition and physical activity curriculum in all the primary schools. There are many challenges faced by the governments in implementing such curriculum which includes lack of trained in country staff, limited infrastructures in schools for physical activity, culturally relevant information which can be easily understood by local populations, proper monitoring, and evaluation of the existing guidelines. Community engagement and partnership with local health ministries and departments are crucial for the success of these curriculum (6). To fill this gap robust evidence on effectiveness and implementation of school-based wellness intervention programs in primary schools are in dire needs in Pacific Island nations. Given this, the project titled “Healthy Child Promising Future-Promoting health in primary school settings was conducted in all schools in Wallis & Futuna and piloted in one urban school in Fiji. A knowledge, attitude, practice (KAP) questionnaire was used to evaluate the effectiveness of the intervention which was conducted for all the children (7-9 years) and their care takers. Intervention was conducted on 15 pre identified themes by face-to-face sessions every week and 30 minutes physical activity session was conducted every day in all the schools for children. For caretakers intervention was conducted around 5 themes. In both the countries the intervention had shown significant improvement in KAP scores both for caretakers and children related to the healthy diet consumption and promotion of physical activity. The results indicate that the developed intervention package had a positive impact on KAP.