Nutrition-Related Knowledge, Attitudes, and Practices (KAP) among Kindergarten Teachers in Chongqing, China: A Cross-Sectional Survey

Relationships among health-related social media use, knowledge, worry, and cervical cancer screening: A cross-sectional study of US females

OBJECTIVE

This study aimed to explore the relationship between health-related social media use and HPV-related health knowledge, attitudes, and practices (KAP).

METHOD

Data were derived from a subset of the national cohort from the 2022 Health Information National Trends Survey (HINTS 6), including only women aged 21 to 65 years old (n = 2013). Ordinary least squares regression and structural equation modeling were used to answer the research question and test hypotheses.

RESULTS

Participants with a family history of cancer, higher education, and White showed more HPV knowledge. Older females were associated with lower HPV knowledge, less worry and fewer timely cervical cancer screening. Additionally, HPV knowledge positively predicted worry and cervical cancer screening. Health-related social media use positively predicted HPV knowledge, worry, and cervical cancer screening.

CONCLUSION

This study identified populations with HPV knowledge and hesitated cervical cancer screening and tested hypothesized models that combine social media use with the KAP survey.

PRACTICE IMPLICATIONS

Future health interventions should strategically leverage the role of social media to enhance public awareness of HPV knowledge and cancer concerns. By promoting HPV knowledge and awareness, such interventions can subsequently encourage timely cervical cancer screening.

Vitamin A-related nutrition knowledge gaps and predictors among caregivers of preschool children in Eastern Uganda: a cross-sectional study

BACKGROUND

Vitamin A (VA) remains a core micronutrient as VA Deficiency (VAD) in children has persisted as a public health problem in parts of Africa with adverse effects. Caregivers of children are essential in the control of VAD; however, there is a paucity of data on their knowledge of VA, dietary sources, and VAD. This study sought to assess the level of VA-related nutrition knowledge (VANK) and its predictors among caregivers of preschool children in Eastern Uganda.

METHODS

A cross-sectional analytical design was used. Both socio-demographic and knowledge and attitude (KA) data were collected using a structured questionnaire partly adapted from the FAO model Knowledge, Attitude and Practice (KAP) questionnaire. A sample size of 256 was used. Caregivers of 24-59 months-old children were selected from Bukwo District in Eastern Uganda using purposive and random sampling methods. Knowledge scores (%) based on responses to ten questions were determined and eventually classified as low (≤ 40%) and moderate or high (˃40%). Descriptive and inferential statistics were computed using SPSS (version 24). Logistic regression was used to identify predictors with p < 0.05 considered significant.

RESULTS

The study had 247 caregivers with a mean age of 30.9 ± 7.7 years. The majority were female (90%), married, subsistence crop farmers and had primary-level education or lower. The mean VANK score was 18.9 ± 24.7%. Overall, most of the caregivers had low VANK as only about 20% had moderate or high. The proportions that knew the different aspects of VANK were correspondingly small. About half of the caregivers (46.6%) knew VA itself and only 27% knew any of its sources. Those who knew VAD, its causes, signs/symptoms and prevention measures were 31, 22, 13 and 24% respectively. The caregivers' VANK was significantly associated with their overall VA-related attitude, age and level of education. However, education and age were the significant predictors.

CONCLUSION

Caregivers had very low VANK. They barely knew VA and its food sources or VAD. The main predictors of VANK were caregiver age and level of education. The study recommends education of caregivers about VA for effective VAD control which contributes to achievement of the Sustainable Development Goal (SDG) 2.

Nutritional knowledge, attitudes, and practices among residents in the Northeast areas of China during the COVID-19 epidemic

Background

The coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 infection continues to affect the daily life of communities worldwide. Nutrition is a vital determinant of overall health. Given the lack of specific drugs for COVID-19 and incomplete vaccination coverage, optimizing nutrition appears to be one of the most cost-effective means of enhancing immunity. Therefore, this study was designed to evaluate nutrition-related knowledge, attitudes, and practices (KAP) to offer insights into the personal determinants of dietary behavior during COVID-19 pandemic in four major cities within the Northeast region.

Methods

This cross-sectional study was conducted between January and December 2022 using a self-administered questionnaire. The data were entered in EpiData V-3.02 and analyzed using SPSS version 26. Binary logistic regression analysis was also employed to examine the association between dependent and independent variables.

Results

A total of 4,092 respondents were included in the study. Most of the respondents demonstrated had inadequate nutrition knowledge, 26% of them provided ≥60% of correct answers. About one-third of the respondents were knowledgeable about the daily levels of oil, salt, milk, water, vegetables and fruits for adults. Furthermore, our results showed that 60.6% of participants held positive attitudes toward healthy eating. Additionally, only 54.6% of the participants have heathy dietary practices during COVID-19 pandemic. Binary logistic regression analysis showed that the following characteristics were associated with displaying unhealthy dietary behaviors: being men, having a lower education level, having a family income of 10,000-19,999 and more than 20,000, being resided in Harbin, Shenyang, and Changchun. Importantly, the strongest associations were observed between poor dietary knowledge and unhealthy eating behaviors. Similarly, dietary attitudes were strongly associated with healthy dietary behaviors when the effects of other factors were excluded; responders with negative attitudes were more likely to exhibit unhealthy eating behaviors.

Conclusion

Our findings suggest that residents in the Northeast China possessed a relatively low level of nutritional knowledge, which directly influenced their dietary practices during the COVID-19 pandemic. This study provides valuable insights into the cross-sectional description and key factors related to nutrition-related KAP, serving as a basis for future policymaking to respond more effectively to health crises.

Addressing schoolteacher food and nutrition-related health and wellbeing: a scoping review of the food and nutrition constructs used across current research

BACKGROUND

Teachers form a large and essential workforce globally. Their wellbeing impacts personal health-related outcomes with flow on effects for the health, and wellbeing of their students. However, food and nutrition (FN) interventions that include teachers, typically neglect the impact of personal FN factors on a teachers' ability to achieve optimal nutrition-related health and wellbeing, and successfully fulfil their professional FN roles as health promoters, gate keepers, educators', and role models. The aim of this review was to scope FN constructs that have been studied internationally regarding teacher FN-related health and wellbeing.

METHODS

Six databases were searched, and papers extracted in June/July 2021. Eligibility criteria guided by the population, concept, context mnemonic included studies published after 2000, in English language, with an aspect of personal FN-related health and wellbeing, among in-service (practising) and pre-service (training), primary, and secondary teachers. Screening studies for inclusion was completed by two independent researchers with data extraction piloted with the same reviewers and completed by lead author, along with complete descriptive and thematic analysis.

RESULTS

Ten thousand six hundred seventy-seven unique articles were identified with 368 eligible for full text review and 105 included in final extraction and analysis. Sixty-nine descriptive studies were included, followed by 35 intervention studies, with the main data collection method used to assess both personal and professional FN constructs being questionnaires (n = 99 papers), with nutrition knowledge and dietary assessment among the most commonly assessed.

CONCLUSION

FN constructs are used within interventions and studies that include teachers, with diversity in constructs included and how these terms are defined. The evidence from this scoping review can be used to inform data collection and evaluation in future epidemiological and interventional research that addresses teacher FN-related health and wellbeing.

Dietary Pattern, Nutrition-Related Knowledge and Attitudes of Working Women in Western Province, Sri Lanka

Healthy eating behaviour of women is critical not only for their health but also for their children's health and well-being. The present study examined the dietary pattern, nutrition-related knowledge, and attitudes of working women in Western Province, Sri Lanka. In addition, this study identified the factors associated with dietary diversity score (DDS). A cross-sectional study was conducted among 300 working women, aged 20-60 years, in Western Province, Sri Lanka. The data on socio-demography, dietary patterns, and nutrition-related knowledge and attitudes were collected. Overall, 38% of the women were overweight and 13% were obese. The median frequency of intake of chicken, fish, eggs, milk and milk products, green leafy vegetables, and fruits were 2, 5, 2, 9, 5, and 10 respectively, per week. A large majority of the women (70%) had tea/coffee with sugar and snacks (60%) at least four times a week. Only a third of the women met the minimum DDS, while more than half of the women had good nutrition-related knowledge and attitudes. Women with good nutrition-related knowledge were more frequent consumers of roots/tubers, shellfish, vegetables, fruit, fruit juice, nuts and oils, and fast food. Women with good nutrition-related attitudes had a significantly lower frequency of consumption of soya meat, while having a higher frequency of consumption of fast food. Multiple regression analysis showed that age and household income were significantly independently related to DDS, while attitudes were negatively associated. While there was a trend, the association of nutrition-related knowledge with DDS was not statistically significant (p = 0.057). The overall F ratio (8.46) was highly significant (p = 0.001) and the adjusted R² was 0.093. The results demonstrate that a significant proportion of working women have good basic nutrition-related knowledge and attitudes, while two-thirds of them do not meet the minimum DDS. Furthermore, age, family income, and knowledge were positively associated with DDS, while attitudes were negatively associated. Before designing any intervention, further research is needed using a qualitative approach to understand how nutrition knowledge and eating behaviour are related in this population group.

Food knowledge level among Tanzanian women of childbearing age: developing a score for the food knowledge questionnaire

Food knowledge (FK) is one of the factors that contribute to malnutrition conditions in developing countries, together with food safety, food security and food access. FK is defined as ‘the competence to understand healthy nutrition concepts’; it impacts individuals’ life due to its relationship with food behaviour and eating habits. Therefore, acting on FK can represent a starting point for improving the health status of vulnerable populations. The authors present a total score of an FK questionnaire (FKQ) and its relation to the socio-demographic characteristics of a specific target population: Tanzanian women of childbearing age. The results of the manuscript complement evidence of construct validity of the FKQ by providing an algorithm to compute a total score as a measure of FK. The strength of this tool, and its score, lies in the fact that the questionnaire has been validated and is easy to administer.

Association Between Nutritional Knowledge, Dietary Regimen, and Excess Body Weight in Primary School Teachers

Introduction

Peru is one of the developing countries with the highest prevalence of overweight and obesity in Latin America and Caribbean region. Primary school teachers are identified as a high-risk group for overweight and obesity. However, studies conducted in this population group are limited. This study evaluated the association between nutritional knowledge, dietary regimen, and excess body weight in primary school teachers.

Methods

This was a cross-sectional study that included 151 teachers from two state schools in the eastern region of Lima, Peru. The level of nutritional knowledge was assessed using a validated questionnaire. Dietary regimen was also determined. The body mass index (BMI) was determined through self-reported weight and height. Logistic regression analysis was used to assess the association between possible risk factors with excess body weight among teachers.

Results

Inadequate nutritional knowledge level (AOR = 5.21, 95% CI: 1.31–20.93), being male teachers (AOR = 2.25, 95% CI: 1.13–4.45), and being married (AOR = 2.49, 95% CI: 1.17–5.30) were the significant predictors of excess body weight. In contrast, vegetarian teachers were less likely to have excess body weight (AOR = 0.35, 95% CI: 0.47–0.97).

Conclusion

Future intervention programs should include improving nutritional knowledge with greater attention to male and married teachers to decrease the risk of excess body weight.

Attitude towards the Promotion of Healthy Eating among Secondary School Teachers—Construction and Validation of a Questionnaire

Health promotion activities in secondary schools are scarce and have little involvement of the teaching staff. Most often, activities are developed from the curriculum that appears in school materials, with little capacity for adaptation and innovation. The aim of this study was to construct and validate a tool to find out teachers’ attitudes towards activities to promote healthy eating in secondary schools. For this purpose, a descriptive study was conducted. The total sample of the study consisted of 200 teachers from secondary schools. Internal consistency was determined by Cronbach’s alpha coefficient globally and by dimension, and with the corrected item–test correlation. The construct validity of the questionnaire was assessed by means of an exploratory factor analysis, for which the principal components method with Varimax rotation was used. A Likert-type scale with nine items and four response options about attitude was designed. The exploratory factor analysis showed a nine-factor solution, of which two had eigenvalues greater than 1. These two factors explained 63.4% of the variance. The Cronbach’s alpha internal consistency index obtained for the global scale was 0.81, and 0.75 and 0.85 for each component. The results obtained with this structure confirmed an adequate reliability and validity of the questionnaire.

The need for information on nutrition among adolescents and adult knowledge regarding food consumption recommendations

OBJECTIVES

The eating habits of most Lithuanian people do not adhere to the recommendations for a healthy diet. If children and adolescents were provided with the relevant information, it would not only improve their nutritional knowledge, but also their eating habits in adulthood and the subsequent health of their children. The objective of this study was to determine the need for information on nutrition among Lithuanian adolescents, the current knowledge of adults regarding recommendations for the consumption of various food groups, and the factors that influence both the need for information and the current knowledge.

METHODS

Two cross-sectional studies were conducted, consisting of 3,574 adolescents aged 14-18 years and 1,007 adults aged 18-75 years. Logistic regression models with confidence intervals of 95% were used to determine the influence of various socio-demographic factors on the adolescent need for information on nutrition and the adult knowledge of nutrition.

RESULTS

A total of 66.7% of adolescents stated that they need information regarding nutrition, whereas 29.8% indicated that they lack such information. Significantly more girls than boys, and more students from schools in urban areas than students from schools in rural areas, expressed their need for information on nutrition. Lithuanian adults lacked knowledge of recommendations for the consumption of various food groups. Women and respondents with higher education degrees were found to have more knowledge on recommendations of the consumption of various food groups compared to men and respondents of other levels of education respectively.

CONCLUSIONS

The results of this study demonstrate that the required information on nutrition must be continuously provided via various channels to both adolescents and adults, and socio-demographic factors must be taken into account when planning public health intervention measures.

Knowledge, attitude, and practice of healthy eating among public school teachers in Kuwait

Background: Healthy food is essential for strengthening the body and protecting it from diseases. Conversely, unhealthy food can cause severe diseases in children and adolescents. The present study aimed to assess the level of knowledge, attitude, and practice among teachers about healthy food and to examine the associated factors.

Design and methods: A cross-sectional study was conducted using a questionnaire distributed to 300 teachers in the Hawalli and Al-Jahra educational areas in Kuwait over approximately six months in 2019.

Results: Those who participated in a course had significantly greater knowledge than those who did not (p=0.005). The respondents in Hawalli had a significantly lower mean attitude than Al- Jahrah teachers (7.9±1.5 vs 8.2±1.5, respectively; p=0.03).

Conclusions: Limited knowledge combined with a low level of positive attitude suggests an ongoing educational workshop should be established to promote healthy nutrition.

Knowledge, attitudes and practices related to WG consumption among college students: a cross-sectional study in Chongqing, China

OBJECTIVES

This work aimed to investigate WG (WG)-related knowledge, attitudes, practices (KAPs) and factors affecting WG consumption among college students in Chongqing, China.

STUDY DESIGN

A cross-sectional study was performed among 2500 students from six universities using a self-administered questionnaire.

METHODS

The chi-squared test and binary logistic regression were used for data analysis.

RESULTS

Only 14.7% of the participants were aware of WG, 57.1% supported the consumption of WG, and only 8.5% consumed WG regularly in the last month. Participants with poor knowledge of WG were about 2 times more likely to not concern about chronic diseases (CDs) than concern about CDs (odds ratio [OR] = 2.241, 95% confidence interval [CI], 1.030-4.877). Women were less likely to have a poor attitude to WG compared with men (OR = 0.682, 95% CI, 0.529-0.878), whereas women were more likely to have a poor WG practice (OR = 2.335, 95% CI, 1.327-4.111).

CONCLUSIONS

Although results showed low levels of WG knowledge and practices, this study still supports positive attitudes to acquire WG-related knowledge among college students in Chongqing, China.

Knowledge of Child Health and Affecting Factors Among Preschool Teachers: A Cross-Sectional Study in Chongqing, China

Aim

This research aims to explore the health knowledge mastery of preschool teachers in Chongqing.

Methods

A cross-sectional questionnaire survey of preschool teachers in Chongqing was conducted by random sampling. A total of 399 preschool teachers were included in this research. Multiple linear regression analysis was conducted to explore the influencing factors on preschool teachers’ mastery of preschool child health knowledge.

Results

This research found that the average score of preschool teacher’s knowledge of preschool children was only 34.01±0.78, and the accuracy of the knowledge points of continuous short-distance eye use time was the lowest, at less than 5%. The conducting of eye exercises by the kindergarten and the scores of preschool teachers were negatively correlated (β=−0.257, p<0.001); the score of health knowledge of preschool teachers of the kindergarten whose screen time met the standard was lower (β=−0.113, p=0.017); whether the time and frequency for outdoor activities of the kindergarten met the standards and the health knowledge score of preschool teachers was positively correlated (β=0.130, p<0.001 vs β=0.163, p<0.001). Male preschool teachers and teachers overweight according to BMI had higher scores for preschool health knowledge (β=−0.114, p=0.016 vs β=0.099, p=0.034).

Conclusion

Preschool teachers in Chongqing had a poor grasp of knowledge regarding preschool children’s health, and in particular, knowledge of children’s exercise and eye use. Educational background and work experience may no longer indicate preparedness for teaching these topics, and suggests that supportive measures can also be directly provided at the kindergarten level in the future to increase the health knowledge of preschool teachers.

Reliability and validity of Arabic version of revised general nutrition knowledge questionnaire on university students

OBJECTIVE

The current study evaluated the reliability and validity of the Arabic version of the revised general nutrition knowledge questionnaire (GNKQ-R) for adults.

DESIGN

The eighty-eight-item English GNKQ-R was adapted into an eighty-six-item Arabic version. Four validation studies were conducted for internal (n 805) and external (n 106) reliability, construct validity between participants with (n 84) and without (n 88) nutrition background, convergent validity for associations between nutrition knowledge and demographic characteristics (n 750) and responsiveness to online nutrition information (n 55).

SETTING

United Arab Emirates University in United Arab Emirates and Hashemite University in Jordan.

PARTICIPANTS

Undergraduate students aged 18 years and above, enrolled in any programme at the two universities, were recruited.

RESULTS

Overall, internal reliability (Cronbach's α = 0·91) and external reliability (P = 0·350; intra-class correlation coefficient = 0·84) were high. Significantly higher GNKQ-R scores of students with (66·0 (10·6)) v. without (38·0 (10·7), P < 0·001; d = 2·6) nutrition background indicated high construct validity. Significantly higher GNKQ-R scores among females v. males, older and senior students v. younger and junior students and students in health discipline v. non-health discipline reflected good convergent validity. Significant differences in GNKQ-R scores with nutrition information (time 1 = 37·8 (10·5) and time 2 = 47·7 (9·1), P < 0·001; d = 1·0) indicated high responsiveness to nutrition intervention.

CONCLUSIONS

The Arabic GNKQ-R showed high reliability and validity in the young adult Arab population. Besides the reliability of the overall questionnaire, each section demonstrated adequate reliability. Further studies are warranted to establish the generalisability and applicability of the Arabic GNKQ-R in older adults and in different middle-eastern Arab countries.

Nutrition Knowledge and Perspectives of Physical Activity for Pre-Schoolers amongst Early Childhood Education and Care Teachers

Caregivers’ nutrition and physical activity knowledge is recognised as being important for children’s health and body size. Identifying knowledge gaps amongst caregivers may inform professional development and obesity-prevention strategies in childcare settings. This cross-sectional validated online questionnaire aimed to measure current early childhood education and care (ECEC) teachers’ nutrition knowledge for pre-schoolers (2–5-year-olds) and related perspectives. Teachers’ (n = 386) knowledge of nutrition was lacking: The overall score was 22.56 ± 2.83 (mean ± SD), or 61% correct. Increased years of experience significantly predicted an increase in knowing that national nutrition and physical activity guidelines exist (B = 0.02 [95% CI, 0.00–0.03], r² = 0.13, p = 0.033). Teachers’ increased agreement in feeling they were confident talking about nutrition to parents significantly predicted an increase in overall nutrition knowledge scores (B = 0.34 [95% CI, 0.06–0.63], r² = 0.15, p = 0.019). The belief that ECEC teachers play a vital role in promoting pre-schoolers’ healthy eating and physical activity was widespread. Common knowledge barriers included a lack of staff training, confidence, and resources. ECEC teachers may lack nutrition knowledge for pre-schoolers, particularly in regard to basic nutrition recommendations (servings, food/beverage choices, and portion sizes).

The Development of a Psychometrically Valid and Reliable Questionnaire to Assess Nutrition Knowledge Related to Pre-Schoolers

With rising childcare enrollments, caregivers have a unique opportunity to promote children’s nutrition education and healthy eating. Accurately identifying nutrition knowledge gaps amongst caregivers is necessary for professional development planning. Our aim was to design an early childhood education and care (ECEC) teacher nutrition knowledge questionnaire that satisfies psychometric criteria of validity and reliability. Items were based on the New Zealand Ministry of Health dietary guidelines, literature and expert advice. University students in their final year of a Bachelor of Science (BSc) in Human Nutrition (n = 40), and students with no nutrition background (n = 51) completed the questionnaire to assess construct validity; 35 BSc nutrition students completed the questionnaire two weeks later to assess reliability. The Mann-Whitney-U test and a median-split table assessed construct validity; Pearson’s product-moment correlation assessed test-retest reliability. Nutrition students achieved higher total and subcategory scores (p < 0.01). All nutrition students scored above the median of the combined group; 82% of non-nutrition students scored below the median. In testing reliability, first and second administration median scores for total and subcategories were significantly correlated (r = 0.43–0.78; p < 0.01). The questionnaire achieved construct validity and test-retest reliability and measured ECEC teachers’ nutrition knowledge for preschoolers.

Food and Nutrition-Related Knowledge, Attitudes, and Practices among Reproductive-Age Women in Marginalized Areas in Sri Lanka

Nutrient deficiencies are a public health problem in Sri Lanka. Achieving food security is a major challenge due to unhealthy eating patterns. The nutritional status of a woman and her knowledge is a powerful indicator of the nutritional security of her children and household food security. Nutrition-related knowledge and attitude are necessary for dietary changes towards a healthier dietary pattern. For that reason, food and nutrition-related Knowledge, Attitude and Practice (KAP) is one of the key factors to achieving household food and nutritional security. The main objective of this study is to assess the food and nutrition-related KAP among reproductive-age women and understanding of household food and nutritional security in Sri Lanka as an example for marginalized societies. Thus, a cross-sectional survey was conducted using the KAP model questionnaire administered on 400 reproductive age women (18-49 Years) in marginalized areas in Sri Lanka. Data were collected using a random sampling method. The research results clearly showed that the reproductive age women have a low level of nutritional knowledge in the areas being investigated. Most women have a positive attitude towards receiving nutritional knowledge but have low-level practice about a healthy diet. Furthermore, knowledge, practices, and attitudes of women largely affect their BMI status, as well as household food security. Multiple linear regression analysis was used to analyze the influential factors. There was a highly significant positive correlation between nutritional knowledge, attitude score, and BMI level and a significant difference was found in the area, age, family size, monthly income, educational level, attitudes towards nutrition, food and nutrition practices across the reproductive women (R2:467, p < 0.01). The research results showed that KAP largely determines women's nutrition and household food security. Based on the results of this research, there is a need to enhance nutritional education in reproductive-age women in marginalized areas in Sri Lanka.