Hypertension-Related Knowledge, Attitudes, and Behaviors among Community-Dwellers at Risk for High Blood Pressure in Shanghai, China

Determinants of hypertension-related knowledge, attitude, and practices (KAP) among caregivers in Neno, rural Malawi: A cross-sectional study

Background

Hypertension, a significant health concern, increases the risk of cardiovascular disease and premature mortality. Caregivers play a crucial role in ensuring optimal care for hypertensive patients and reducing associated complications. Caregivers' basic knowledge, good attitude, and relevant practices are necessary to ensure high-quality care for patients with hypertension. However, there is no research conducted in Malawi that investigated the knowledge, attitude, and practices of caregivers towards hypertension prevention and management.

Objective

The study aimed to assess knowledge, attitude, and practices towards hypertension and their determinants among caregivers of hypertensive patients in Neno, Malawi.

Methods

Our study, conducted in Neno, Malawi, involved 422 caregivers of hypertensive patients. We used a cross-sectional study design. Data was collected through a structured questionnaire and analyzed using SPSS Version 22.0.

Results

The participants had a mean age of 44.94 years (SD = 9.889), with 63.3 % being female. The mean KAP scores were 38 %, 93.3 %, and 78.7 %, respectively. Positive correlations were found between knowledge and practice (r = +0.252; p < 0.001) and knowledge and attitude (r = +0.255; p < 0.001). However, no significant relationship was observed between attitude and practice (r = +0.064; p = 0.190). Age showed a strong correlation with attitude (r = +0.233; p < 0.001) but not with knowledge or practice. On the other hand, occupation, education level, and caregiver-patient relationship significantly influenced knowledge and attitude but not practice. Gender also demonstrated a notable association with KAP regarding hypertension.

Conclusion

Caregivers demonstrated poor knowledge but engaged in good practices. Despite their limited understanding, they maintained an excellent attitude towards hypertension. This highlights the necessity for increased prevention, and control strategies within communities, emphasizing health education on lifestyle modifications and to address the gaps identified in caregivers' understanding in the prevention and management of hypertension.

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

BACKGROUND

Researchers have paid little attention to the safety of drug use among community residents (CRs). Irrational use of drugs can lead to health risks. We investigated the situation of knowledge-attitude-practices (KAP) of CRs in Shenzhen (China) for safe use of drugs, and analyzed the main factors influencing drug use.

METHODS

A multi-stage, random sampling method was used. We used a validated questionnaire to conduct an online questionnaire survey on the demographic characteristics and KAP of safe use of drugs of CRs in 10 administrative districts of Shenzhen City. The KAP score of safe use of drugs of CRs was analyzed. Influencing factors were identified using a single-factor chi-squared test and binary logistic regression analysis.

RESULTS

A total of 7269 valid questionnaires were collected. The average scores of knowledge, attitude, and behavior were (9.08 ± 1.49) (possible range: 0-10), (37.82 ± 3.96) (possible range: 8-40), and (35.82 ± 4.56) (possible range: 8-40), respectively, indicating that they had a better grasp of safe use of drugs. Logistic regression analysis showed that sex, age, education level, occupation, monthly household income per capita, marital status, health status, and different sources of information were the main factors affecting the knowledge and behavior of safe use of drugs of CRs. In addition to the marital status variable, other variables also have a significant impact on attitude towards safe use of drugs of CRs.

CONCLUSIONS

Male sex, lower education level, lower income level, average/poor self-rated health status, and single source of drug-use information were the main factors affecting safe use of drugs based on KAP theory. The government and medical workers should carry out various forms of drug-education activities for people with different needs, encourage CRs to learn safe use of drugs, and promote safe use of drugs by CRs through diverse information sources.

Factors associated with knowledge of hypertension risk factors and symptoms among Gambian women: A cross-sectional study based on the Gambia Demographic and Health Survey

Background

We examined the factors associated with knowledge of hypertension risk factors and symptoms among Gambian women.

Methods

This cross-section study was based on 11, 865 female participants (aged 15-49 years) of The Gambia Demographic and Health Survey 2019-2020. We performed descriptive statistics, and multivariate-adjusted logistic regression models.

Results

Only 34.89 % and 36.82 % of the participants knew at least one risk factor and symptom of hypertension, respectively. Women who had never measured their blood pressure had a reduced odds of knowing a hypertension risk factor (OR = 0.68; 95 %CI: 0.60---0.77; P < 0.01) and symptom (OR = 0.56; 95 %CI: 0.49---0.64; P < 0.01). Compared to women with higher education, those with no education had a lower odds of knowing a hypertension risk factor (OR = 0.18; 95 %CI: 0.12---0.27; P < 0.01) and symptom (OR = 0.32; 95 %CI: 0.23---0.45; P < 0.01). Similarly, women who never used the internet had reduced odds of mentioning a hypertension risk factor (OR = 0.55; 95 %CI: 0.48---0.61; P < 0.01) and symptom (OR = 0.61; 95 %CI: 0.54---0.69; P < 0.01). Those who never watched television had decreased odds of knowing a hypertension risk factor (OR = 0.74; 95 %CI: 0.63--0.86; P < 0.01) and symptoms (OR = 0.68; 95 %CI: 0.58---0.80; P < 0.01). Conclusion: Fewer women could mention at least one hypertension risk factor and symptom. We also found that knowledge of hypertension risk factors and symptoms was associated with education level and socio-economic status.

Willingness to be tested for a secondary cause of hypertension: a survey of the Australian general community

BACKGROUND

Primary aldosteronism (PA) represents the most common and potentially curable cause of secondary hypertension. However, PA is not commonly screened for, and up to 34% of patients who screen positive do not complete the full diagnostic process. This suggests that the diagnostic process may pose a barrier to patients and may contribute to the under-diagnosis of PA.

AIMS

To evaluate the willingness of the Australian general public to undergo testing for secondary causes of hypertension and identify enablers or barriers to testing from the patients' perspective.

METHODS

An online survey containing questions on knowledge and attitudes towards hypertension, willingness to be tested and enablers/barriers towards testing was distributed to the Australian community.

RESULTS

Of 520 adult respondents (mean age 50.4 years, SD 27.3 years; 28.8% hypertensive; 56.0% female), the majority of non-hypertensive and hypertensive respondents (82.7% vs 70.0%; P = 0.03) were willing to undergo testing for a secondary cause of hypertension that involved blood and urine tests. Greater knowledge of hypertensive risk modification strategies and complications was predictive of willingness to be tested, whereas age, sex, education level, geographic location, socio-economic status and cardiovascular comorbidities were not. The top three barriers to testing included fear of a serious underlying condition, lack of belief in further testing and increased stress associated with further testing.

CONCLUSION

A high proportion of patients are willing to engage in testing for a secondary cause of hypertension. Education about the risks associated with hypertension and the testing process may overcome several barriers to testing.

Effectiveness of an integrative programme in reducing hypertension incidence among the population at risk for hypertension: A community-based randomized intervention study in Shanghai, China

Background

We aimed to evaluate the effectiveness of a community-based integrative programme in reducing hypertension incidence among populations at high risk for hypertension in Shanghai, Eastern China.

Methods

We conducted a cluster-randomized intervention trial with a total of 607 participants (intervention, n = 303; control, n = 304) between October 2019 and October 2020. A total of 605 participants (intervention, n = 302; control, n = 303) completed the follow-up survey. The intervention group received an integrative programme that included health education, physician follow-up, and self-management, while the control group received usual care only. We used questionnaires to investigate risk factors, knowledge, attitudes, and behaviours regarding hypertension prevention for all participants at baseline and follow-up. We measured the incidence of hypertension according to the predefined protocol based on the national definition during the four follow-ups (only applicable to the intervention group) and the physical examination at the end of the intervention/programme/study. The difference-in-difference (DID) effects of the intervention were estimated using Generalized Estimating Equations.

Results

There were no significant differences in age group, gender, and educational level between intervention and control groups at baseline. The integrative programme reduced the incidence of hypertension in the intervention group compared to the control group (odds ratio (OR) = 0.27, 95% confidence interval (CI) = 0.12-0.61). The DID analysis found that the one-year intervention has improved the level of hypertension-related knowledge and attitudes regarding diagnostic criteria, complications of hypertension, and lifestyle modification (P < 0.05). The intervention was also associated with a 3.7% increase in the behaviour change rate of "not smoking" (OR = 2.50, 95% CI = 1.45-4.30) and a 34.8% increase in the rate of "monitoring blood pressure regularly" (OR = 29.61, 95% CI = 13.02-67.35).

Conclusions

The integrative programme could reduce the risk for hypertension and improve the level of hypertension-related knowledge and attitudes, affecting the formation of healthy behaviours in high-risk populations. The community-based management for high-risk groups should be scaled up and incorporated into national hypertension control programmes, which may potentially reduce the substantial burden of hypertension and cardiovascular disease in China.

Registration

ISRCTN registration number: ISRCTN74154693.

Health motivations and perceived barriers are determinants of self-care behaviour for the prevention of hypertension in a Malaysian community

INTRODUCTION

Self-care behaviour is fundamental in preventing hypertension in the general population. According to the Health Belief Model, health beliefs and perceptions influence the success in adopting disease prevention strategies. While factors influencing hypertension self-care behaviour have been examined previously in patient populations, they have not been assessed in the general community.

METHODS

This was a cross-sectional study conducted between 12 June 2020 to 26 July 2021. An online survey was administered via email and social media to Malaysians in the Selangor and Kuala Lumpur communities. Respondents were over 18 years old, without a formal diagnosis of hypertension. The survey evaluated hypertension knowledge, Health Belief Model constructs, self-care behaviour frequency, and motivators and barriers to self-care behaviour. Multiple linear regression was performed to determine the main predictors of self-care behaviour, and descriptive statistics were used to characterise motivators and barriers of each self-care behaviour.

RESULTS

Only health motivations (β = 0.217, p < 0.001) and perceived barriers (β = 0.571, p < 0.001) significantly influenced self-care behaviour. Maintaining a healthy diet, regular physical activity and blood pressure checks need to be improved in the community, particularly in reducing salt and calorie intake. Lack of time, limited choices and laziness are the biggest challenges that need to be tackled in adopting a healthy diet and an active lifestyle in the community. Many are ignorant towards their health status, therefore, do not prioritize blood pressure screenings, suggesting a need to enhance community blood pressure checks for early diagnosis of hypertension.

CONCLUSION AND IMPLICATIONS

Motivations and barriers were the main determinants of self-care behaviour in the Selangor and Kuala Lumpur community. Targeting these aspects of self-care behaviour should be considered when developing interventions and education programmes tailored to local cultural, environmental and personal factors, to more effectively reduce the hypertension prevalence and burden.

Diet-related knowledge, attitudes, and behaviors among young and middle-aged individuals with high-normal blood pressure: A cross-sectional study in China

Background

Dietary modifications play an important role in the prevention and management of high-normal blood pressure (BP). The aim of this study was to investigate diet-related knowledge, attitudes, and behaviors, and the socio-demographic determinants of these, among young and middle-aged Chinese individuals with high-normal BP.

Methods

Data from the 2015 China Health and Nutrition Survey (CHNS) were analyzed in this study. A total of 1,756 subjects with high-normal BP were included. A chi-square test and binary logistic regression analysis were conducted to identify the risk factors toward diet-related knowledge, attitudes, and behaviors.

Results

A total of 37.4% of the participants knew about the Chinese Food Pagoda (CFP) or the Dietary Guidelines for Chinese Residents (DGCR). Overall, 39.8% of the subjects were classified as having adequate diet-related knowledge literacy, 27.8% reported positive diet-related attitudes to healthy eating, and 35.3% reportedly looked for nutrition knowledge. Of note, 72.4% and 80.1% of the participants reported liking to eat fruits and vegetables, respectively. Individuals with a middle school education [odds ratio (OR) = 1.784, 95% CI = 1.236-2.576], high school/vocational education (OR = 1.944, 95% CI = 1.305-2.896), and college degree or above (OR = 2.089, 95% CI = 1.341-3.322), who were living in a rural area (OR = 1.311, 95% CI = 1.048-1.639), proactively looking for nutrition knowledge (OR = 1.529, 95% CI = 1.227-1.906), and reported liking to eat vegetables (OR = 1.939, 95% CI = 1.409-2.688), were more likely to have sufficient dietary knowledge literacy. Managers (OR = 1.655, 95% CI = 1.039-2.635) were more likely to have positive dietary attitudes. Female gender (OR = 1.396, 95% CI = 1.089-1.790), high school/vocational school education (OR = 2.071, 95% CI = 1.269-3.379), college degree and above (OR = 2.207, 95% CI = 1.262-3.862), knowledge about the CFP or DGCR (OR = 8.138, 95% CI = 6.326-10.468), and sufficient dietary knowledge literacy (OR = 1.338, 95% CI = 1.050-1.705) were associated with an increased likelihood of looking for nutrition knowledge.

Conclusion

Individuals with high-normal BP, predominantly males, living in rural area, with lower education, farmers, workers, service workers, and workers in the non-government employment unit may have poor diet-related knowledge, attitudes, and behaviors.

Development and Validation of a Risk Score Screening Tool to Identify People at Risk for Hypertension in Shanghai, China

Purpose

This study aimed to develop a screening tool based on a risk scoring approach that could identify individuals at high risk for hypertension in Shanghai, China.

Methods

A total of 3147 respondents from the 2013 Shanghai Chronic Disease and Risk Factor Surveillance were randomly divided into the derivation group and validation group. The coefficients obtained from multivariable logistic regression were used to assign a score to each variable category. The receiver operating characteristic (ROC) curve was used to find the optimal cut-off point and to evaluate the screening performance.

Results

Age, family history of hypertension, having diabetes, having dyslipidemia, body mass index, and having abdominal obesity contributed to the risk score. The area under the ROC curve was 0.817 (95% CI: 0.797–0.836). The optimal cut-off value of 20 had a sensitivity of 83.4%, and a specificity of 64.3%, demonstrating good performance.

Conclusion

We developed a simple and valid screening tool to identify individuals at risk for hypertension. Early detection could be beneficial for high-risk groups to better manage their conditions and delay the progression of hypertension and related complications.

Parents' attitudes as mediators between knowledge and behaviours in unintentional injuries at home of children aged 0-3 in Shanghai, Eastern China: a cross-sectional study

OBJECTIVE

Parental behaviours are important in preventing unintentional injury at home among young children. Previous research showed an inconsistent relationship between knowledge and behaviours, indicating that the mechanisms may vary for different behaviours. This study aimed to examine the mediating roles of different attitudes in the mechanism of knowledge acting on different behaviours.

DESIGN

Cross-sectional study.

SETTING

Eastern China.

PARTICIPANTS

Participants were recruited using stratified community-based sampling. A total of 488 parents of children aged 0-3 years participated in the study and 476 (97.5%) valid questionnaires were recovered.

PRIMARY OUTCOME MEASURES

Parents' knowledge, attitudes (including injury attribution, preventability and responsibility) and behaviours (including supervision behaviours, risky behaviours and providing a safe home environment).

RESULTS

The results of mediation analysis showed that the mediator variables were different for different behaviours and that all associations were positive. Parents' knowledge (β 0.19, 95% CI 0.13 to 0.24) and attitude of injury attribution (β 0.37, 95% CI 0.21 to 0.46) were directly associated with risky behaviours. Attitude of preventability was directly associated with parents' supervision behaviour (β 0.27, 95% CI 0.14 to 0.40). Parents' attitude of preventability mediated the positive association between knowledge, attitudes of injury attribution and responsibility, and supervision behaviours, as well as providing a safe home environment. In addition, the occurrence of child injuries at home was directly associated with home environment (β -0.41, 95% CI -0.82 to -0.01).

CONCLUSIONS

The current findings confirm that attitudes play varying mediating roles between knowledge and different behaviours. An important recommendation is that parents' attitudes, especially towards preventability and responsibility, need to be considered when health providers develop health education programmes targeted at improving parental supervision behaviours and providing a safe home environment.