Lack Of Risk Perception Research Articles

Rain on the Parade of Influenza Vaccine Hesitancy

Abstract: Background: Following the protection motivation theory (PMT), a lack of risk perception is one of the reasons for differences in vaccine uptake ( Rogers, 1975 ). When the risk for diseases like seasonal influenza is underestimated, protective measures such as vaccination are used less. Aims: In this paper, we propose that the sequelae approach, which involves providing information about the severe complications of diseases, can influence people’s risk perceptions and their intention to vaccinate. This is in comparison to providing merely information about the disease itself. Method: Three preregistered online experiments (2017–2019) were conducted to examine whether risk perceptions and vaccination intentions increase when (1) information about sequelae is presented as statistical texts or narratives (vs. not presented at all), (2) known or unknown sequelae (myocardial infarction vs. sepsis), and (3) different target populations (e.g., health literacy) are considered. Results: An internal meta-analysis showed that the sequelae approach increases intentions ( SMD = .39[.20;.59]) but not risk perception ( SMD = .09[−.10;.27]). Unknown and known sequelae had an equal impact on vaccination intentions. None of the strategies (narratives vs. statistical texts, sequelae type) produced adverse reactions in people with low health literacy. In addition, no evidence was found for boomerang effects. Limitations: Even though our research was based on PMT, we cannot add evidence on self-efficacy or response efficacy as influential factors. Conclusion: Although increased risk perception is not the primary mechanism behind the sequelae approach, the results support the use of this strategy in educational interventions that target vaccine hesitancy.

Caregivers' understanding of childhood influenza vaccination during the epidemic in China. A mixed-methods study.

Influenza vaccination uptake among young children has been poor in China, but it is unclear how it changed during the COVID-19. This study aimed to investigate the uptake status and reasons of childhood influenza vaccination during the pandemic in China. A mixed-methods study combining a questionnaire survey and semi-structured interviews was conducted in Anhui, Shaanxi, and Guangdong provinces between September and November 2021. 2081 caregivers completed the valid questionnaire. 38 caregivers participated in interviews, and data were analyzed thematically, using deductive and inductive coding. A total of 2081 caregivers completed the valid questionnaire, and 38 caregivers participated in interviews. Among the caregivers, a total of 1796 were in the age group for high-risk groups in the 2019-2020 flu season, and 46.10% reported that their children received influenza vaccination in the 2019-2020 flu season; 43.63% said that they vaccinated their children against influenza in the 2020-2021 flu season. Many caregivers indicated that the adoption of nonpharmacologic interventions (NPIs) during COVID-19 reduced the risk of influenza infection for children. Most caregivers consider the severity of influenza to be low, and some confused the common cold with influenza. Meanwhile, some caregivers lack confidence in the vaccine's effectiveness and importance. They thought that vaccines are not effective in preventing the constantly mutating virus. Despite clear perceptions about the severity of influenza and the effectiveness of the vaccine, we found that most caregivers did not receive any relevant medical information, and the communication about vaccines between caregivers and professional information sources, such as healthcare workers, is inadequate. Hence, caregivers have no scientific evidence to back up their perceptions. In terms of access to vaccination service, caregivers reported conflicts between time of vaccination service and their schedule, and the need for vaccine prices to be reduced. Targeted interventions are needed to address caregivers' lack of risk perception on influenza during COVID-19 and promote communication between caregivers and professional information sources. Extending vaccination service hours and increasing the number of vaccine clinics close to residential areas and expansion of financing sources for self-paid vaccination could facilitate the access to influenza vaccination service.

Implementation of a group-based lifestyle intervention programme (Healthy Heart) in general practices in The Netherlands: a mixed-methods study.

Lifestyle intervention programmes target behavioural risk factors that contribute to cardiovascular diseases (CVDs). Unfortunately, sustainable implementation of these programmes can be challenging. Gaining insights into the barriers and facilitators for successful implementation is important for maximising public health impact of these interventions. The Healthy Heart (HH) programme is an example of a combined lifestyle intervention programme. To analyse the reach, adoption, and implementation of the HH programme. A mixed-methods study conducted in a general practice setting in The Netherlands. Quantitative data were collected from the Healthy Heart study (HH study), a non-randomised cluster stepped-wedge trial to assess the effect of the HH programme on patients at high risk of developing CVDs at practice level. Qualitative data were obtained through focus groups. Out of 73 approached general practices, 55 implemented the HH programme. A total of 1082 patients agreed to participate in the HH study, of whom 64 patients were referred to the HH programme and 41 patients participated. Several barriers for participation were identified such as time investment, lack of risk perception, and being confident in changing lifestyle on their own. Important barriers for healthcare providers (HCPs) to refer a patient were time investment, lack of information to sufficiently inform patients, and preconceived notions regarding which patients the programme was suitable for. This study has offered insights from a patient and HCP perspective regarding barriers and facilitators for implementation of the group-based lifestyle intervention programme. The identified barriers and facilitators, and the suggested improvements, can be used by others who wish to implement a similar programme.

Effect of risk perception and vulnerability on adaptive architecture in flood resilience: a case from Ratnapura, Sri Lanka

In the last few decades, the frequency and severity of floods in South Asia have vastly increased due to the increase in global surface temperature and change in rainfall patterns. The lack of risk perception, high vulnerability and lack of proper architectural adaptations have added to the negative consequences of disasters. This study discusses the effect of risk perception and vulnerability on flood resilient architecture. The research was conducted with 35 participants selected from the Mudduwa area in Rathnapura, Sri Lanka where the annual flood frequency and damage is very high. The collected data was analyzed using statistical software to calculate a composite mean score to each theoretical factor risk perception, vulnerability, and architectural adaptation. With assumptions, a non-parametric correlation test was carried out to identify the relationship between the three theoretical factors and their subsequent variables. The research findings concluded that risk perception has a positive correlation with architectural adaptation, but vulnerability demonstrates a negative correlation. According to the study, vulnerability acts as a resistance to the correlation between risk perception and architectural adaptation. In conclusion this study elaborates on the importance of a proper system of adaptation for vulnerable people living in flood prone areas.

Do factors associated with older pedestrian crash severity differ? A causal factor analysis based on exposure level of pedestrians

Objective Older pedestrians are more likely to have severe or fatal consequences when involved in traffic crashes. Identifying the factors contributing to the severity and possible interdependencies between factors in specific exposure areas is the first step to improving safety. Therefore, examining the causal factors’ impact on pedestrian-vehicle crash severity in a given area is vital for formulating effective measures to reduce the risk of pedestrian fatalities and injuries. Methods This study implements the Thiessen polygon algorithm deployed to define older pedestrians’ exposure influence area. Enabling trip characteristics and built environment information as exposure index settings for the background of the pedestrian severity causal analysis. Then, structural equation modeling (SEM) was applied to conduct a factor analysis of the crash severity in high- and low-exposure areas. The SEM evaluates latent factors such as driver risk attitude, risky driving behavior, lack of risk perception among older pedestrians, natural environment, adverse road conditions for driving or walking, and vehicle conditions. The SEM crash model also establishes the relationship between each latent factor. Results In total, drivers’ risky driving behavior (0.270, p < 0.05) in low-exposure areas significantly impacts older pedestrian crash severity more than in high-exposure areas. Lack of risk perception among older pedestrians (0.232, p < 0.05) is the most critical factor promoting crash severity in high-exposure areas. The natural environment (0.634, p < 0.05) in high-exposure areas positively influences older pedestrians’ lack of risk perception more than in low-exposure areas. Conclusions Significant group differences (p-values ∼ 0.001-0.049) existed between the causal factors of the high-exposure risk areas and the low-exposure risk factors. Different exposure intervals require detailed scenarios based on the critical risks identified. The crash severity promotion measures in different exposure areas can be focused on according to the critical causes analyzed. Those clues, in turn, can be used by transportation authorities in prioritizing their plans, policies, and programs toward improving the safety and mobility of older pedestrians.

Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals

BackgroundCervical cancer screening is a cost-effective method responsible for reducing cervical cancer-related mortality by 70% in countries that have achieved high coverage through nationwide screening strategies. However, there are disparities in access to screening. In Ecuador, although cervical cancer is the second most common cancer in women, only 58.4% of women of reproductive age have ever been screened for cervical cancer.MethodologyA qualitative study was performed to understand the current barriers to screening and to identify strategies that could increase uptake in Azuay province, Ecuador. Seven focus group discussions (FGDs) were conducted with under-screened women and health professionals (HPs). The FGDs were recorded and transcribed. Content analysis was done using the socio-ecological framework to categorize and analyse the data.ResultsOverall, 28 women and 27 HPs participated in the study. The two groups perceived different barriers to cervical cancer screening. The HPs considered barriers to be mainly at the policy level (lack of a structured screening plan; lack of health promotion) and the individual level (lack of risk perception; personal beliefs). The women identified barriers mainly at organizational level, such as long waiting times, lack of access to health centres, and inadequate patient–physician communication. Both groups mentioned facilitators at policy level, such as national campaigns promoting cervical cancer screening, and at community and individual level, including health literacy and women’s empowerment.ConclusionsThe women considered access to health services the main barrier to screening, while the HPs identified a lack of investment in screening programmes and cultural patterns at the community level as major obstacles. To take an integrated approach to cervical cancer prevention, the perspectives of both groups should be taken into account. Additionally, new strategies and technologies, such as self-administered human papillomavirus (HPV) testing and community participation, should be implemented to increase access to cervical cancer screening.

Disaster management in India’s construction industry during the Covid-19 pandemic

A biological disaster such as Covid-19 is unique in that, unlike other natural disasters, it does not engage the civil engineering community directly. Gaps in managing the pandemic exposed the lack of an institutional memory of handling pandemics, plus a lack of risk perception of ‘fat tail’ events. The impact on the construction sector was significant across the world, but different sections of the sector were affected differently. This paper documents and analyses these issues and concludes with a case study of how small and medium engineering practices endured the pandemic.

Barriers and Drivers of Public Preventive Behavioral Responses to COVID-19 Outbreak: Evidence from Iran

Background: When an epidemic outspreads, the society engagement seems essential to make sure of the population’s preparedness for taking individual precautions. Objectives: The primary objective of this study was to examine public’s preventive behavioral responses to protective behaviors during the COVID-19 pandemic to provide a description of conceptual frameworks for deeper understanding of these behaviors. Methods: A self-administrated questionnaire was used in this online survey through social networks during March 19th to 26th, 2020 (n = 2550). A Likert scoring scale was employed to investigate barriers and drivers affecting the participants’ preventive behaviors. Using personal protective equipment and good hand hygiene practices were identified as person-based measures. Social distancing and the restriction of social and economic activities during the past two months were determined as community-based measures. Univariate logistic regression and multiple - logistic regression were used to identify and assess influencing factors. Results: The study results indicated that 2426 (95.1%) of the participants intended to restrict their social and economic activities, and 1968 (72.2%), 1637 (64.2%), and 2492 (97.7%) persons intended to observe social distancing, use personal protective equipment, and have good hand hygiene, respectively. The most important barriers for preventive behaviors were the lack of risk perception, economic and financial barriers, lack of access, and cultural barriers, respectively. The perceived benefit was among the most significant driver. Intention for person-based measures was less affected by demographic and economic characteristics in comparison with community-based measures. Conclusions: Considering the substantial impact of preventive behaviors on managing COVID-19 epidemic, this study findings have remarkable implications for governments to manage future communications as well as interventions during this ongoing outbreak and subsequent national risk events.

High school students’ attitudes towards SARS-CoV-2 pandemic: an online cross-sectional survey

BackgroundAdolescents play a major role in SARS-CoV-2 spread. The study objective was to assess COVID-19 attitudes among Polish final year high school students.MethodsAn online cross-sectional survey was conducted between December 2020-March 2021; 24 high schools were randomly selected in Lubuskie region, followed by a random selection of 51 classes. Students' attitudes were assessed by an anonymous questionnaire before an online lecture on SARS-CoV-2.ResultsResponse rate was 72%, 638 students responded (360 females, mean age 18.4±0.6 years); 438 attended schools in towns with <100,000 inhabitants; 201 were in the science program; 7.4% reported past SARS-CoV-2 infection (5% females vs 10.8% males; p = 0.006). 52.2% believed COVID-19 is a serious disease (more females, those in larger cities and in the science program, p = 0.02; p < 0.001; p < 0.001 respectively). However, 71.3% were not afraid of getting SARS-CoV-2 infection (more males and those not in the science program, p = 0.0007; p = 0.01 respectively); 59.1% were concerned that their parents and 68.7% their grandparents will get COVID-19 (more females, those in larger cities and in the science program, both: p = 0.0004; p = 0.004; p = 0.0005 respectively). Only 16.5% believed that government recommendations effectively control the epidemic (more in the science program; p = 0.01); 44.6% supported lockdown as an effective strategy (more those in larger cities and in the science program; both: p < 0.001).ConclusionsThe findings show low awareness of SARS-CoV-2 infection risk, deficiencies in appropriate attitudes and lack of trust regarding the epidemic management among the high school students. Given attitudes determine people's actions, to limit SARS-CoV-2 transmission and strengthen positive attitudes further investigation into the factors underlying the lack of risk perception is warranted.Key messages The study provides perspectives of youth for policymakers that should be taken into account while implementing educational programs related to COVID-19.We recommend implementing COVID-19 knowledge into school curricula to improve students’ risk perception and attitudes.

Factors Associated with Condom Use in Anal Intercourse Among Spanish Men Who Have Sex with Men: Proposal for an Explanatory Model.

Men who have sex with men (MSM) account for more than half of the new HIV diagnoses in Spain. This study aims to carry out a descriptive analysis of the sexual practices and frequency of condom use of MSM and identify the variables that explain inconsistent condom use during anal intercourse. The sample consists of 405 men between 18 and 60years of age (M = 28.94; SD = 9.35). The results indicate that the percentage of consistent condom use is 72.9% for anal intercourse. Lack of risk perception, high self-esteem, and greater sensation-seeking are risk factors for risky sexual behavior. In contrast, high levels of sexual assertiveness and self-efficacy are protective factors. The proposed model explains between 33.8 and 49.2% of the variance. These findings highlight the importance of designing and implementing condom promotion programs for MSM who engage in anal intercourse with specific sections that consider the acquisition of assertive skills and reduce the risks associated with a perceived invulnerability to HIV.

Barriers and facilitators for colorectal cancer screening in a low-income urban community in Mexico City

BackgroundColorectal cancer (CRC) incidence and mortality are increasing in many low- and middle-income countries (LMICs), possibly due to a combination of changing lifestyles and improved healthcare infrastructure to facilitate diagnosis. Unfortunately, a large proportion of CRC cases in these countries remain undiagnosed or are diagnosed at advanced stages, resulting in poor outcomes. Decreasing mortality trends in HICs are likely due to evidence-based screening and treatment approaches that are not widely available in LMICs. Formative research to identify emerging opportunities to implement appropriate screening and treatment programs in LMICs is, therefore, of growing importance. We sought to identify potential barriers and facilitators for future implementation of fecal immunochemical test (FIT)-based CRC screening in a public healthcare system in a middle-income country with increasing CRC incidence and mortality.MethodsWe performed a qualitative study with semi-structured individual and focus group interviews with different CRC screening stakeholders, including 30 lay people at average risk for CRC, 13 health care personnel from a local public clinic, and 7 endoscopy personnel from a cancer referral hospital. All interviews were transcribed verbatim for analysis. Data were analyzed using the constant comparison method, under the theoretical perspectives of the social ecological model (SEM), the PRECEDE-PROCEED model, and the health belief model.ResultsWe identified barriers and facilitators for implementation of a FIT-based CRC screening program at several levels of the SEM. The main barriers in each of the SEM levels were as follows: (1) at the social context level: poverty, health literacy and lay beliefs related to gender, cancer, allopathic medicine, and religion; (2) at the health services organization level: a lack of CRC knowledge among health care personnel and the community perception of poor quality of health care; and (3) at the individual level: a lack of CRC awareness and therefore lack of risk perception, together with fear of participating in screening activities and finding out about a serious disease. The main facilitators perceived by the participants were CRC screening information and the free provision of screening tests.ConclusionsThis study’s findings suggest that multi-level CRC screening programs in middle-income countries such as Mexico should incorporate complementary strategies to address barriers and facilitators, such as (1) provision of free screening tests, (2) education of primary healthcare personnel, and (3) promotion of non-fear-based CRC screening messages to the target population, tailored to address common lay beliefs.

Análisis del consumo de sustancias e indicadores de salud física y psicológica en hombres y mujeres jóvenes

La salud es una experiencia biopsicosocial que se relaciona con ciertos aspectos como los estilos de vida y el bienestar. Sin embargo, esta perspectiva no siempre se ha estudiado atendiendo tanto al género como a indicadores de salud física y mental. Objetivo: analizar la relación entre hábitos de salud específicos (tabaco, alcohol y consumo de sustancias) y la percepción subjetiva de bienestar físico y mental, teniendo en cuenta las diferencias de género. Método: 600 universitarios (50% hombres; 50% mujeres) completaron un cuestionario online sobre Estilos de Vida y Salud (Giménez-García Ballester-Arnal, 2017). Resultados: el 13,5% reporta una mala salud física (14% hombres y 13% mujeres) y el 17,7% una mala salud mental (18,3% hombres y 17% mujeres).En cuanto al consumo de sustancias tóxicas, el 14,7% de la muestra fuma, el 47% se ha emborrachado bastantes-muchas veces y el 34,2% ha consumido otras sustancias. Más hombres que mujeres se han emborrachado muchas veces (X2= 10,13; p= .017) y han consumido otras sustancias alguna vez (X2=8,08; p= ,004). En general, no existe una asociación entre el consumo y abuso de tabaco, alcohol y otras sustancias con la percepción de salud mental ni física por parte de los jóvenes. Así, aunque en teoría debería existir cierta relación entre estilos de vida como el consumo de sustancias y la salud mental y física, gran parte de estos resultados no han sido significativos. Dado que se ha evaluado percepción subjetiva de salud mental y física y no indicadores objetivos, esto puede deberse a la baja percepción de riesgo de los jóvenes, lo que les lleva a la realización de conductas no saludables sin por ello ser conscientes de las consecuencias no fácilmente reconocibles a corto plazo. En los programas de prevención es fundamental considerar esta falta de percepción de riesgo entre los jóvenes.

Barriers to the safe use of chemical household products: A comparison across European countries

Chemical household products, such as cleaning and washing products or pest control and garden chemicals, are frequently involved in poisonings in private households. Consumer research has identified a number of barriers that impede the safe use of these products, ranging from unfamiliarity, to misconceptions and a lack of risk perception, to behavioural or situational barriers. This study aimed at investigating these barriers for consumers in eight European countries. Participants from eight European countries were recruited and asked to fill out an online questionnaire on their familiarity with hazard pictograms, perceptions and self-reported behaviour (Total: N = 5631, Austria: N = 731, Switzerland: N = 698, Germany: N = 711, France: N = 708, Italy: N = 695, Poland: N = 693, Sweden: N = 682, UK: N = 713). Across all countries, the lowest consumer familiarity was found for the meaning of the pictogram for “health hazard” (65% indicated having never seen it before). Small-sized differences between the eight countries were observed regarding people’s familiarity, perceptions and self-reported behaviour. The results suggest that people apply hazard-related as well as product- and marketing-related strategies to judge the dangerousness of a chemical household product. These findings suggest a number of starting points for risk regulation and communication regarding hazardous household chemical products. Further, the results suggest that positive outcome expectancies and rules of thumb for judging the risks of a chemical household product are particularly relevant for people’s self-reported safe use of chemical household products.

Application of the HIV prevention cascade to identify, develop and evaluate interventions to improve use of prevention methods: examples from a study in east Zimbabwe.

IntroductionThe HIV prevention cascade could be used in developing interventions to strengthen implementation of efficacious HIV prevention methods, but its practical utility needs to be demonstrated. We propose a standardized approach to using the cascade to guide identification and evaluation of interventions and demonstrate its feasibility for this purpose through a project to develop interventions to improve HIV prevention methods use by adolescent girls and young women (AGYW) and potential male partners in east Zimbabwe.DiscussionWe propose a six‐step approach to using a published generic HIV prevention cascade formulation to develop interventions to increase motivation to use, access to and effective use of an HIV prevention method. These steps are as follows: (1) measure the HIV prevention cascade for the chosen population and method; (2) identify gaps in the cascade; (3) identify explanatory factors (barriers) contributing to observed gaps; (4) review literature to identify relevant theoretical frameworks and interventions; (5) tailor interventions to the local context; and (6) implement and evaluate the interventions using the cascade steps and explanatory factors as outcome indicators in the evaluation design. In the Zimbabwe example, steps 1‐5 aided development of four interventions to overcome barriers to effective use of pre‐exposure prophylaxis (PrEP) in AGYW (15‐24 years) and voluntary medical male circumcision in male partners (15‐29). For young men, prevention cascade analyses identified gaps in motivation and access as barriers to voluntary medical male circumcision uptake, so an intervention was designed including financial incentives and an education session. For AGYW, gaps in motivation (particularly lack of risk perception) and access were identified as barriers to PrEP uptake: an interactive counselling game was developed addressing these barriers. A text messaging intervention was developed to improve PrEP adherence among AGYW, addressing reasons underlying lack of effective PrEP use through improving the capacity (“skills”) to take PrEP effectively. A community‐led intervention (community conversations) was developed addressing community‐level factors underlying gaps in motivation, access and effective use. These interventions are being evaluated currently using outcomes from the HIV prevention cascade (step 6).ConclusionsThe prevention cascade can guide development and evaluation of interventions to strengthen implementation of HIV prevention methods by following the proposed process.

Education-based disparities in knowledge of novel health risks: The case of knowledge gaps in HIV risk perceptions.

Risk perception is a key determinant of preventive health behaviour, but when asked, some individuals indicate they do not know their health risk. Low education is associated with both lack of knowledge about health risk and with the persistence and exacerbation of gaps in knowledge about health issues. This study uses the context of an emerging infectious disease threat to explore the hypothesis that the education-don't know risk relation results from differences in knowledge about the health issue of interest. Specifically, we examine whether patterns of change over time follow theoretical predictions that disparities in risk knowledge would increase over time in less educated sectors of the population (knowledge gap hypothesis). Secondary analysis of population-representative behavioural surveillance survey. We analysed data from the 1993 to 2000 Behavior Risk Factor Surveillance System surveys, which measured education and perceived HIV/AIDS risk in a population sample collected separately in each survey year; don't know responses were coded. In each year, individuals with higher education were less likely to respond don't know. The absolute prevalence of don't know responding dropped over time; nonetheless, there was an increase over time in the magnitude of the pattern of lower education being associated with greater don't know responding. We found support for the knowledge gap hypothesis. Over time, populations with greater education gained more knowledge about their HIV risk than populations with lower education. Results highlight the need to carefully consider health communication strategies to reach and address those individuals with low education and health knowledge. Statement of contribution What is already known on this subject? A meaningful potion of the population answers 'don't know' when asked to report their risk for health problems, indicating a lack of risk perception in the domain. Previous studies have shown that level of education is associated with don't know responding - those with lower educational attainment are more likely to respond don't know. The education-don't know responding relation suggests that lack of health information and health domain knowledge might be a factor in lacking risk perception, but this mechanism has not been previously tested. What does this study add? Patterns of changes in don't know responding over time as population-level knowledge of a health risk increase are consistent with the health information/health knowledge hypothesis outlined above. As population knowledge of HIV/AIDS risk in the United States increased over time (indicated by declining overall rates of don't know responses), the relation of education level to don't know responding actually became stronger. The pattern of change over time is the classic 'knowledge gap hypothesis' pattern, which has not been previously demonstrated for knowledge of personal health risk. The knowledge gap response pattern supports the health information/health knowledge hypothesis.

Correlates of compliance with lifestyle modifications among hypertensive patients in Mazowe District, Zimbabwe

Non-compliance with lifestyle modifications is one of the most important reasons for uncontrolled blood pressure and hypertension complications among hypertensive patients. Our study sought to determine factors affecting compliance with recommended lifestyle modification among hypertensive patients (N = 290). A mixed methods design was adopted which involved both quantitative and qualitative data collection techniques. Data were collected through interviewer administered questionnaires, review of medical records and four focus group discussions. The prevalence of non-compliance with recommended lifestyle modifications ranged from 8.6% for non-compliance with limiting alcohol intake, to 89.6% for non-compliance with increased fruit consumption. Female patients were more likely to be compliant with reducing dietary salt [odds ratio (OR): 0.5; 95% confidence interval (95% CI): 0.25–0.93]. Patients aged 70 years and above were more likely to be non-compliant with engaging in regular physical activity (OR: 5.8; 95% CI: 3.32–10.51). Patients who bought vegetables from the local markets were more likely to be non-compliant with increasing vegetable consumption (OR: 7.8; 95% CI: 2.60–23.58) compared with those who obtained vegetables from their own gardens. Patients who did not perceive themselves to be at risk of hypertension complications were more likely to be non-compliant with reducing fat intake (OR: 4.4: 95% CI: 2.38–7.9). There was high prevalence of non-compliance with recommended lifestyle modifications among hypertensive patients. Factors that negatively affected compliance with recommended lifestyle modifications were lack of family support to modify lifestyle, lack of written advice that supplement verbal advice given at health centres, being aged 70 years and above, presence of co-morbidities, not having attended school, being unemployed and lack of risk perception.

Patterns of Sexual Mixing and STIs in Intimate Partner Relationships among Female Sex Workers in Nepal

Background and objective: Varying degrees of sexual mixing in an intimate partner relationship which provides emotional support and social security, in addition to the economic benefits to female sex workers (FSWs)—often results in risky sexual behaviour (for example, unprotected sex), hence increasing the vulnerability of FSWs to sexually transmitted infections (STIs). This paper analyses the pattern of sexual mixing and the major covariates of STIs in intimate partner sexual relationships among FSWs in Nepal. Method: The findings are based on information collected from 2901 FSWs, selected by using the modified timelocation cluster sampling as part of mapping and size estimation of MARPs across different districts of Nepal in year 2010-11. Results: Findings reveal that almost 40 percent or two-fifths of FSWs in Nepal have commercial as well as noncommercial sexual partners. Further, 5.2 percent of the FSWs reported having more than one non-commercial partner along with commercial partners. Half of the FSWs in intimate partner relationships reported their last sexual encounter as unprotected, which was further lower among those currently married. Adjusted effects of socio-demographic and behavioural correlates portray that being married (p<0.01) and having a higher client load—a proxy of poverty and powerlessness (p<0.05)—are significant determinants of unprotected sex, which may also be attributed to a lack of risk perception in intimate relationships. A higher incidence of unprotected sex further leads to substantially higher prevalence of STIs (35%), which is disproportionately higher among those aged 30 and above, and among those having no formal education. Conclusion: Findings of this study highlight the requirement of strategies to address sexual rights of FSWs within intimate partner relationships, in addition to the need for occupational empowerment of FSWs in order to combat prevalence of STIs and improving their quality of life.

Differences in the risk profiles and risk perception of flammable liquid hazards in San Luis Potosi, Mexico

The pace of urbanization and industrialization in developing countries is rapidly increasing. Unfortunately, regulatory and private-sector control of hazards has not always kept pace. This work identifies the level of emergency preparedness in chemical industries and evaluates the spatial distribution of hazards using a worst-case release scenario. Consequently, we identified potentially exposed urban communities and evaluated the social perception of a hazard. This research characterizes risk scenarios in a case study of the industrial area in San Luis Potosi, Mexico. Intervention zones of major concern are recognized when deficiencies in emergency preparedness join a poor social perception of hazards in communities that are potentially exposed. The worst-case scenario radii of flammable chemicals range from 425m to 733m. Potentially exposed communities have a limited perception of chemical risk and no training in emergency response. Proximity to an industrial area influences communities towards a better recognition of hazards. However, communities far from the industrial area have higher exposure to low preparedness worst-case scenarios for flammable chemicals and have a larger level of vulnerability because of their lack of risk perception.

The Role of Poverty in Risk Perception Among Developing Nations' Workforce

A lack of risk perception, poverty, education, and culture play important roles in workers' lives or other people's lives when they are exposed to hazardous risks. In developing nations, the perceptions of risks are influenced by a number of outside factors. There is currently insufficient data and a fewstudies that address the relationship between risk perception and risk rec- ognition in developing nations, especially those nationsthat lack basic human needs such as clean and fresh water, nutrition, health care, education, clothing, and shelter. Risk perception is also a difficult proposition in developing countries because of cultural barriers that impede the understanding of the perceptual indicators of danger. Risk perception in this research means the measure of how effectively people see risk in their environment. Hence, this study aims at examining cultural risk perception and risk recognition in developing countries using pictorial evidence to ascertain the type of cultural risk perception and the prevalent rate at which it, or the lack of it, breeds unsafe conditions.

HIV and syphilis seroprevalence and associated factors in pregnant women and their couples in 6 Amazonian indigenous populations in Peru 2007-2008

Background: HIV and Syphilis magnitude information in Amazonian indigenous population is scarce. In 2004-2006, HIV/AIDS cases have been reported from periurban indigenous population. Methods: From June 2007 to december 2008 a seroprevalence study was conducted in 6 Amazonian indigenous populations: Shispibo-Konibo, Ashaninka, Kandozi, Shapra, Chayahuita, Matsigenka. Objective: to determine the magnitude of HIV and Syphilis and factors associated. Blood samples and written surveys were obtained. Informed consent was obtained from National, Regional and local Community leaders and participants. For HIV testing, Elisa and immunefluorescence tests were used; for Syphilis, RPR and MTPHA. Results: 1274 pregnant women and 721 male couples were surveyed. HIV positive results: 2 women (0.16% [95%CI: 0.02 - 0.58]) and 2 males (0.28% [95%IC: 0.03 – 1.02]). Syphilis positive results: 20 women (1.60% [95%CI: 0.98% – 2.46%]) and 17 males (2.41% [95%CI: 1.41% – 3.83%]). Only 14.3% and 29.6% of women and males, referred having used condoms sometime. Sexual transmitted infections (HIV and Syphilis - STI) in pregnant women were associated to: 1) Male couple STI: OR = 14.10 (95%CI: 2.73 – 65.21; p = 0.003); 2) Vaginal secretion: OR = 2.87 (95%CI: 1.15 – 7.14; p = 0.021); 3) women Anti-HBc positivity OR = 2.82 (IC95%: 1.13 – 7.23; p = 0.013); 4) > 1 sexual partner in last 12 months OR = 2.96 (IC95%: 1.07 – 8.18; p = 0.045); 5) >5 sexual partners in lifetime OR = 3.50 (IC95%: 1.10 – 9.62; p = 0.017). Sexual transmitted infections in males were associated to: 1) history of sexual relations with another male in lifetime OR = 5.9 (IC95%: 1.82 – 19.12; p = 0.010); 2) sexual relations with another male in last 12 months OR = 11.9 (IC95%: 3.01 – 47.26; p = 0.005); 3) More than 10 sex partners in lifetime OR = 3.29 (IC95%: 1.29 – 8.36; p = 0.015). Conclusion: HIV in Amazonian indigenous populations studied may be in a concentrated level (high risk groups information still needed). Syphilis triples national prevalence. Data suggests that transmission of these diseases to women is mediated by their couples. Lack of risk perception, poor STI knowledge, limited access to treatment and preventive measures, are other determinants identified. The development of a national plan of STI prevention and control is urgently needed in the Amazonian indigenous population in Peru. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive