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Rezaei F, Keyvanara M, Yarmohammadian MH. Participation' goals of Community- based organizations in the COVID-19 pandemic based on capacity gaps: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:336. [PMID: 36567999 PMCID: PMC9768742 DOI: 10.4103/jehp.jehp_1672_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/03/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND There have been criticisms that local authorities develop disaster planning independently, which led to less sensitiveness and responsibility of community-based organizations (CBOs). Disasters planning should incorporate into CBOs' management processes. This study aims to set goals of a community-based plan based on preparedness capacities that CBOs need to have in the COVID-19 pandemic. MATERIALS AND METHODS This cross-sectional study used a prevalidated and reliable questionnaire assessing (CBOs). The tool assesses preparedness in the field of planning, training, and infrastructure. Forty CBOs met the inclusion criteria as assisting or cooperating agencies during the COVID-19 pandemic. Then, key informants, who simultaneously have been working in the health system and CBOs, prioritized low-scale items that have shown capacity gaps according to effects on the vulnerable group, sustainability, and capability of the health system. Descriptive statistics performed using SPSS18 software (SPSS Inc., Chicago, USA). RESULTS The results showed that the preparedness of CBOs was weak in the field of planning, training, and infrastructure. Besides, overlaps of CBOs' resources and covering the clients' medical needs in the COVID-19 pandemic were the most priority that needs to be intervened. CONCLUSION Providing medical needs by CBOs require legal legitimacy assigned by health authority, especially in epidemic-prone diseases. In addition, assigning a coordinator to set a priority list and mutual agreements authoried by health departments can solve the problem of overlapped resources. Therefore, functional roles of CBOs in the pandemic should focus mostly on resource allocation and the medical needs of clients to set goals and functional objectives.
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Affiliation(s)
- Fatemeh Rezaei
- Department of Health in Disasters and Emergencies, Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmoud Keyvanara
- Department of Healthcare Management, Faculty of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad H Yarmohammadian
- Department of Health in Disasters and Emergencies, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Shahabi N, Kamalzadeh Takhti H, Hassani Azad M, Ezati Rad R, Ghaffari HR, Mohseni S, Aghamolaei T, Norozian F. Knowledge, attitude, and preventive behaviors of Hormozgan residents toward COVID-19, one month after the epidemic in Iran. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2021; 30:1565-1576. [PMID: 33432291 PMCID: PMC7788169 DOI: 10.1007/s10389-020-01454-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 12/02/2020] [Indexed: 12/30/2022]
Abstract
Aim COVID-19 has become prevalent in the world since December 2019. The further prevalence of the disease can be prevented by correct management of society and increasing knowledge, practices, and attitudes of the people. The present research aimed to evaluate the knowledge, attitudes, and preventive behaviors of people in Hormozgan in the south of Iran toward COVID-19. Subject and methods The present cross-sectional research was conducted over 2 months (March 2020–April 2020). The online questionnaire comprised four sections: demographic information, knowledge, attitude, and behavior toward COVID-19. Knowledge included 36 items, attitude eight items, and behavior ten items. The collected data were analyzed statistically using SPSS ver. 22. The split-half method was used to test the reliability of knowledge and the estimated value was 0.84. That of attitude and behavior was estimated via Cronbach’s alpha and was found to be 0.81 and 0.75, respectively. Results A total number of 2024 participants with an average age of 33.94 years took part in this research. Of all participants, 64.4% were female. According to the results, 65.8% enjoyed a good level of knowledge and 34.2% enjoyed an average level. In addition, 63.2% demonstrated a good attitude and 36.8% an average level. A large percentage of participants (90.6%) had good practices and only 9.4% had an average level of practices. Conclusion The present findings show that participants had a relatively good level of knowledge, positive attitude, and good behavior concerning COVID-19.
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Affiliation(s)
- Nahid Shahabi
- Student Research Committee, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hesamaddin Kamalzadeh Takhti
- Department of Community Medicine, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Hassani Azad
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Roghayeh Ezati Rad
- Student Research Committee, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hamid Reza Ghaffari
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Fatemeh Norozian
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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A Review of Mobile Health Applications in Epidemic and Pandemic Outbreaks: Lessons Learned for COVID-19. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2020. [DOI: 10.5812/archcid.103649] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Context: Using smart mobile devices, called mobile health (mHealth), facilitates providing health services, speeds up the process, and reduces the costs and complications of direct services. Also, mHealth has many capabilities and applications in epidemic and pandemic outbreaks. This study aimed to identify mHealth applications in epidemic/pandemic outbreaks and provide some suggestions for tackling COVID-19. Methods: To find the relevant studies, searches were done in PubMed and Scopus by related keywords during 2014 - 2020 (March 10). After selecting the studies based on the inclusion and exclusion criteria, data were collected by a data-gathering form. Results: Of the 727 retrieved studies, 17 studies were included. All studies emphasized the positive effect of mHealth for use in epidemic/pandemic outbreaks. The main applications of mHealth for epidemic/pandemic outbreaks included public health aspects, data management, educational programs, diagnosis, and treatment. Conclusions: mHealth is an appropriate method for encountering epidemic/pandemic outbreaks due to its extensive applications. In the pandemic outbreak of COVID-19, mHealth is one of the best choices to use in the patient-physician relationship as tele-visits, using in fever coach, providing real-time information for healthcare providers, population monitoring, and detecting the disease based on obtained data from different locations.
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Huang Y, Wu Q, Wang P, Xu Y, Wang L, Zhao Y, Yao D, Xu Y, Lv Q, Xu S. Measures Undertaken in China to Avoid COVID-19 Infection: Internet-Based, Cross-Sectional Survey Study. J Med Internet Res 2020; 22:e18718. [PMID: 32396516 PMCID: PMC7219722 DOI: 10.2196/18718] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/09/2020] [Accepted: 04/29/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND In early 2020, over 80,000 cases of coronavirus disease (COVID-19) were confirmed in China. Public prevention and control measures, along with efforts from all sectors of society, were undertaken to control and eliminate disease transmission. OBJECTIVE This paper describes Chinese citizens' response to the epidemic, the preventive measures they implemented to avoid being infected, and the public strategies that were carried out by the government, health workers, etc. We also discuss the efficacy of these measures in controlling the epidemic in China. METHODS Information on the responses and behaviors of Chinese citizens were collected through a cross-sectional, internet-based survey using Dingxiang Doctor's public account on WeChat. Information on public strategies implemented by all sectors of society to control the epidemic and data on new COVID-19 cases were collected from the internet, mainly from government websites. Standard descriptive statistics and multivariate logistic regression analyses were conducted to analyze the data. RESULTS A total of 10,304 participants responded to the survey, with 10,198 valid responses; 74.1% (n=7557) were female and 25.9% (n=2641) were male. Overall, 98.2% (n=10,013) of participants paid high or very high attention to the epidemic, with WeChat being their main information source (n=9400, 92.2%). Over half the participants (n=5878, 57.7%) were confident that the epidemic could be curbed in China; 92.4% (n=9427) opened windows for ventilation more frequently than usual; 97.9% (n=9986) used masks in public; 95.7% (n=9759) avoided large crowds and stayed at home as much as possible; and 97.9% (n=9988) washed their hands more often than usual. Women were more likely to practice these behaviors than men (P<.001). With a series of strict public control measures, like nationwide health education campaigns, holiday extensions, the Examine and Approve Policy on the resumption of work, close management of working and living quarters, a health QR (Quick Response) code system, community screening, and social distancing policies, the number of new cases have decreased dramatically since February 12, 2020. CONCLUSIONS The methods employed by Chinese citizens and authorities have effectively curtailed the spread of COVID-19, demonstrating that this pandemic can be brought under control as long as the right measures are taken.
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Affiliation(s)
- Yu Huang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Qingqing Wu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ping Wang
- Jiashan Prefectural Center for Disease Control and Prevention, Jiashan, China
| | - Yan Xu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Lei Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yusui Zhao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Dingming Yao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yue Xu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Qiaohong Lv
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Shuiyang Xu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Zhou X, Zhang Y, Shen C, Liu A, Wang Y, Yu Q, Guo F, Clements ACA, Smith C, Edwards J, Huang B, Soares Magalhães RJ. Knowledge, attitudes, and practices associated with avian influenza along the live chicken market chains in Eastern China: A cross-sectional survey in Shanghai, Anhui, and Jiangsu. Transbound Emerg Dis 2019; 66:1529-1538. [PMID: 30891947 DOI: 10.1111/tbed.13178] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/11/2019] [Accepted: 03/09/2019] [Indexed: 12/01/2022]
Abstract
The avian influenza (AI) virus of the H7N9 subtype emerged in China in 2013. Live bird markets (LBMs) selling live meat chickens were indicated to present a high-risk of the virus dissemination. This study aimed to quantify the level of knowledge, attitudes, and practices (KAP) on AI and to measure the associated risk factors among different actors along the live chicken market chain within H7N9-affected Eastern provinces in China. A cross-sectional survey was conducted in these provinces from June to July 2014. Structured questionnaires about KAP on AI were delivered to chicken farmers, chicken vendors, and consumers in LBMs. Multivariable generalized least squares regression models were developed to identify predictors of KAP scores among different actors. Our results indicate that KAP scores of chicken farmers were generally higher than those of chicken vendors. Chicken farmers who worked for more than 15 years had significantly lower total KAP scores than those who worked for less than 6 years. Chicken farmers who worked more than 15 hrs in a day had significantly lower attitude scores than those who worked less than 6 hrs. For chicken vendors, females and individuals > 35 years old had significantly lower knowledge scores compared to the reference categories. Practice scores were significantly higher in female vendors and those vendors who also conducted slaughter compared to males and vendors who did not conduct slaughter. Consumers who bought chicken at least once every month had better risk awareness compared to those who bought chicken at least once every week. In addition, female consumers had significantly better practice scores than male consumers. In conclusion, risk-based health promotion interventions should be developed and implemented by animal health agencies (targeting farmers and vendors) and public health agencies (targeting frequent and male consumers) to prevent transmission of H7N9 along the market chain in China.
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Affiliation(s)
- Xiaoyan Zhou
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - Yi Zhang
- Department of Epidemiology Survey, China Animal Health and Epidemiology Centre, Ministry of Agriculture, Qingdao, PR China
| | - Chaojian Shen
- Department of Epidemiology Survey, China Animal Health and Epidemiology Centre, Ministry of Agriculture, Qingdao, PR China
| | - Ailing Liu
- Department of Epidemiology Survey, China Animal Health and Epidemiology Centre, Ministry of Agriculture, Qingdao, PR China
| | - Youming Wang
- Department of Epidemiology Survey, China Animal Health and Epidemiology Centre, Ministry of Agriculture, Qingdao, PR China
| | - Qi Yu
- Beijing Centre for Animal Disease Prevention and Control, Beijing, PR China
| | - Fusheng Guo
- Food and Agriculture Organization of the United Nations (FAO), Bangkok, Thailand
| | - Archie C A Clements
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Carl Smith
- School of Business, The University of Queensland, Brisbane, Queensland, Australia
| | - John Edwards
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia.,Department of Epidemiology Survey, China Animal Health and Epidemiology Centre, Ministry of Agriculture, Qingdao, PR China.,School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
| | - Baoxu Huang
- Department of Epidemiology Survey, China Animal Health and Epidemiology Centre, Ministry of Agriculture, Qingdao, PR China
| | - Ricardo J Soares Magalhães
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia.,UQ Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
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Hou Y, Tan YR, Lim WY, Lee V, Tan LWL, Chen MIC, Yap P. Adequacy of public health communications on H7N9 and MERS in Singapore: insights from a community based cross-sectional study. BMC Public Health 2018; 18:436. [PMID: 29609573 PMCID: PMC5879609 DOI: 10.1186/s12889-018-5340-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 03/20/2018] [Indexed: 12/21/2022] Open
Abstract
Background Singapore remains vulnerable to worldwide epidemics due to high air traffic with other countries This study aims to measure the public’s awareness of the Middle East Respiratory Syndrome (MERS) and Avian Influenza A (H7N9), identify population groups who are uninformed or misinformed about the diseases, understand their choice of outbreak information source, and assess the effectiveness of communication channels in Singapore. Methods A cross-sectional study, comprising of face-to-face interviews, was conducted between June and December 2013 to assess the public’s awareness and knowledge of MERS and H7N9, including their choice of information source. Respondents were randomly selected and recruited from 3 existing cohort studies. An opportunistic sampling approach was also used to recruit new participants or members in the same household through referrals from existing participants. Results Out of 2969 participants, 53.2% and 79.4% were not aware of H7N9 and MERS respectively. Participants who were older and better educated were most likely to hear about the diseases. The mean total knowledge score was 9.2 (S.D ± 2.3) out of 20, and 5.9 (S.D ± 1.2) out of 10 for H7N9 and MERS respectively. Participants who were Chinese, more educated and older had better knowledge of the diseases. Television and radio were the primary sources of outbreak information regardless of socio-demographic factors. Conclusion Heightening education of infectious outbreaks through appropriate media to the young and less educated could increase awareness.
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Affiliation(s)
- Yan'an Hou
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore.,Epidemiology Unit, Division of Infectious Diseases, Department of Medicine, National University Hospital Singapore, Singapore, Singapore
| | - Yi-Roe Tan
- Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Wei Yen Lim
- Research and Development Office, Agency for Integrated Care, Singapore, Singapore
| | - Vernon Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Linda Wei Lin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Mark I-Cheng Chen
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore. .,Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore.
| | - Peiling Yap
- Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore
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Chen E, Wang MH, He F, Sun R, Cheng W, Zee BCY, Lau SYF, Wang X, Chong KC. An increasing trend of rural infections of human influenza A (H7N9) from 2013 to 2017: A retrospective analysis of patient exposure histories in Zhejiang province, China. PLoS One 2018; 13:e0193052. [PMID: 29447278 PMCID: PMC5814046 DOI: 10.1371/journal.pone.0193052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/02/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although investigations have shown that closing live poultry markets (LPMs) is highly effective in controlling human influenza A (H7N9) infections, many of the urban LPMs were shut down, but rural LPMs remained open. This study aimed to compare the proportional changes between urban and rural infections in the Zhejiang province from 2013 to 2017 by analyzing the exposure histories of human cases. METHODS All laboratory-confirmed cases of H7N9 from 2013 (the first wave) to 2017 (the fifth wave) in the Zhejiang province of China were analyzed. Urban and rural infections were defined based on the locations of poultry exposure (direct and indirect) in urban areas (central towns) and rural areas (towns and villages on the outskirts of cities). A Chi-square trend test was used to compare the proportional trend between urban and rural infections over time and logistic regression was used to obtain the odds ratio by years. RESULTS From 2013 to 2017, a statistically significant trend in rural infections was observed (p <0.01). The incremental odds ratio by years of rural infections was 1.59 with 95% confidence intervals of 1.34 to 1.86. Each year, significant increases in the proportion of live poultry transactions in LPMS and poultry processing plants were detected in conjunction with an increased proportion of urban and rural infections. CONCLUSION The empirical evidence indicated a need for heightened infection control measures in rural areas, such as serving rural farms and backyards as active surveillance points for the H7N9 virus. Other potential interventions such as the vaccination of poultry and extending the closure of LPMs to the provincial level require further careful investigations.
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Affiliation(s)
- Enfu Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Binjiang District, Hangzhou, Zhejiang, China
| | - Maggie H. Wang
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Fan He
- Zhejiang Provincial Center for Disease Control and Prevention, Binjiang District, Hangzhou, Zhejiang, China
| | - Riyang Sun
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Wei Cheng
- Zhejiang Provincial Center for Disease Control and Prevention, Binjiang District, Hangzhou, Zhejiang, China
| | - Benny C. Y. Zee
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Steven Y. F. Lau
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiaoxiao Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Binjiang District, Hangzhou, Zhejiang, China
- * E-mail: (KCC); (XW)
| | - Ka Chun Chong
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
- * E-mail: (KCC); (XW)
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Impact of an intervention programme on knowledge, attitudes and practices of population regarding severe fever with thrombocytopenia syndrome in endemic areas of Lu'an, China. Epidemiol Infect 2017; 146:125-136. [DOI: 10.1017/s0950268817002679] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
SUMMARYKnowledge, attitudes and practices (KAP) of the population regarding severe fever with thrombocytopenia syndrome (SFTS) in endemic areas of Lu'an in China were assessed before and after an intervention programme. The pre-intervention phase was conducted using a sample of 425 participants from the 12 selected villages with the highest rates of endemic SFTS infection. A predesigned interview questionnaire was used to assess KAP. Subsequently, an intervention programme was designed and applied in the selected villages. KAP was re-assessed for each population in the selected villages using the same interview questionnaire. Following 2 months of the programme, 339 participants had completed the re-assessed survey. The impact of the intervention programme was evaluated using suitable statistical methods. A significant increase in the KAP and total KAP scores was noted following the intervention programme, whereas the proportion of correct knowledge, the positive attitudes and the effective practices toward SFTS of respondents increased significantly. The intervention programme was effective in improving KAP level of SFTS in populations that were resident in endemic areas.
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Huang Y, Xu S, Wang L, Zhao Y, Liu H, Yao D, Xu Y, Lv Q, Hao G, Xu Y, Wu Q. Knowledge, Attitudes, and Practices Regarding Zika: Paper- and Internet-Based Survey in Zhejiang, China. JMIR Public Health Surveill 2017; 3:e81. [PMID: 29084711 PMCID: PMC5684512 DOI: 10.2196/publichealth.7663] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 08/30/2017] [Accepted: 09/16/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As public access to the Internet increases, many health workers prefer to carry out health education online, reducing the use of traditional community-based health education methods. Since March 2016, four Zika cases have been confirmed in Zhejiang, China. Rapid assessment of people's knowledge, attitudes, and practices (KAP) regarding Zika is crucial to its prevention and control. Web-based surveys to assess public KAP may be a growing trend; however, we had little experience with this method. OBJECTIVES The aim of this study was to explore KAP regarding Zika in residents of Zhejiang using both traditional paper- and innovative Internet-based investigations. METHODS A questionnaire was designed by Zhejiang Provincial Center for Disease Control and Prevention. A paper-based version of the survey was used in a cross-sectional community study following multistage cluster random sampling, and an Internet-based survey was promoted through a local health education site. Data were interpreted via univariate and multivariate analyses. RESULTS A total of 447 community residents participated in the paper-based survey, with a response rate of 89.4% (447/500), and 621 eligible Internet users participated in the Internet-based survey, with a response rate of 36.92% (621/1682). Age, education level, and occupation differed significantly between participants in the paper- and Internet-based surveys. Participants completing the Internet-based survey were much younger (χ22=144.7, P<.001) and had a higher level of education (χ22=423.5, P<.001) than those completing the paper-based survey. Among participants completing the paper-based survey, there were more farmers, housewives, and unemployed people (χ23=413.7, P<.001). Overall, 83.52% of participants (892/1068) knew the transmission route for Zika, 76.12% (813/1068) knew that pregnant women were at high risk of severe complications, 66.39% (709/1068) knew that contracting Zika during pregnancy could lead to newborn babies with microcephaly, and 98.88% (1056/1068) knew places where mosquitos could usually be found. After controlling for sociodemographic variables, participants completing the Internet-based survey were more likely to know the transmission route of Zika (odds ratio [OR]=5.0, 95% CI 3.0-8.0), the association between pregnant women with Zika and newborn babies with microcephaly (OR 2.1, 95% CI 1.4-3.0), and that pregnant women were at high risk for Zika (OR 5.5, 95% CI 3.5-8.4) than those completing the paper-based survey. They were less likely to worry about contracting Zika (OR 0.6, 95% CI 0.4-0.9) and more likely to actively seek information about Zika than participants completing the paper-based survey (OR 3.3, 95% CI 2.0-5.6). CONCLUSIONS Participants completing the Internet-based survey had a higher level of basic knowledge and more positive attitudes and behaviors than participants completing the paper-based survey. In addition to providing Web-based health information, the government should ensure sufficient access to health information for the elderly and less educated people in the community to improve health equity.
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Affiliation(s)
- Yu Huang
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Shuiyang Xu
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Lei Wang
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yushui Zhao
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - He Liu
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Dingming Yao
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yue Xu
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Qiaohong Lv
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Gang Hao
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yan Xu
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Qingqing Wu
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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