Using the PRECEDE Model to Determine Junior High School Students'' Knowledge, Attitudes, and Beliefs about AIDS

The effectiveness of a one-period school-based AIDS education program on an adolescent population of seventh and eighth grade students (N = 585) was determined. An instrument based on the PRECEDE model was used to assess program effectiveness. Three-way analysis of variance indicated significant differences (p v .01) between pretest to posttest scores for knowledge, attitude, and beliefs for those who received the program versus those who did not by grade and gender of students. The intervention group scored significantly higher than the comparison group on knowledge gain for both seventh and eighth grade students and for males and females. On attitude items, a significant increase occurred from pretest to posttest for eighth grade students who received the program, but not for seventh grade students. The experimental group of eighth grade students scored higher on the attitudes component than the comparison of eighth grade students on the posttest. When attitudes were examined by gender for females in the educational intervention, an increase occurred in attitude scores from pretest to posttest. While belief scores increased significantly from pretest to posttest for the experimental seventh and eighth grade students, significant increases occurred only for experimental group females. Findings support the contention that a one-class period AIDS education program can affect more than just knowledge since attitudes and beliefs also were partially affected.     

Knowledge and psychosocial effects of the film super size me on young adults

The prevalence of overweight and obesity has risen dramatically over the past 2 decades. Among the many contributing factors is increased consumption of fast foods. Mass media outlets have cited the potential of the film Super Size Me to alter this behavior. The purpose of this study was to determine the effect of this film on young adults' fast-food knowledge and psychosocial measures (ie, attitudes, self-efficacy, healthy weight locus of control, and stage of change) and evaluate the effectiveness of this film as a form of emotional arousal and consciousness-raising. A pretest-posttest follow-up control group design with random assignment was used. Young adults (n=135; 54% female) completed the pretest; approximately 10 days later viewed a film then completed the posttest; and about 9 days later completed the follow-up test. The experimental group (n=80) viewed Super Size Me. The control group (n=55) viewed an unrelated film. Unpaired t tests revealed that the study groups did not differ significantly (P>0.05) at pretest on any measure. Analysis of covariance, with pretest score as the covariate, revealed the experimental group scored substantially better than the control group at posttest on knowledge and nearly all psychosocial measures. In addition, the experimental group continued to score substantially higher than the control group at follow-up on knowledge, stage of change, and consciousness-raising and lower on external: chance health locus of control. Super Size Me represents a potentially powerful tool for nutrition education. Nutrition practitioners should consider using Super Size Me as a consciousness-raising and emotional arousal change process with patients in pre-action stages of change for reducing fast-food intake.     

Reproductive Health Service Preferences And Perceptions of Quality Among Low‐Income Women: Racial,Ethnic and Language Group Differences

CONTEXT: Eliminating racial and ethnic disparities in health care is an important national priority. Despite substantial research documenting such disparities, this topic has received limited attention in the reproductive health field. METHODS: Logistic regression was used to test for group differences in three service delivery preferences and five service quality perceptions among a nationally representative sample of 1,741 low‐income black, Latina and white women aged 18–34; the data were collected in 1995 and represent the most recent data available for looking at these issues. RESULTS: English‐speaking Latinas and Spanish‐speaking Latinas were more likely than whites to prefer a female clinician at their visits (odds ratios, 1.8 and 3.6, respectively) and to highly value clinician continuity (1.7 and 2.2). English‐speaking Latinas and blacks were more likely than whites to prefer receiving reproductive health care at a site delivering general health care (1.5 and 1.6). Both groups of Latinas were less likely than whites to give the facility environment or the patient‐centeredness at their most recent reproductive health visit the highest rating (0.3–0.5). Blacks were more likely than whites to report ever having been pressured by a clinician to use contraceptives (2.3). CONCLUSIONS: Efforts to reduce racial, ethnic and language group differences in clients’ perceptions of reproductive health service quality should focus on improving client‐clinician communication, the service environment and contraceptive counseling. Future research should continue to assess group differences and try to determine their underlying causes.     

Student nurse opinions about the importance of health promotion practices

Senior nursing students (N=505) attending 13 schools in the NY metropolitan area were administered a questionnaire to assess their beliefs about the importance of health promotion behaviors to the average person. Respondents rated 23 health promotion practices on a Likert scale. The five most important items concerned: knowledge of drug contents and their side effects; the elimination of cigarette and cigar smoking; eating a balanced diet; and using a seat belt. The least important item concerned having an annual exercise test. These results were similar to those found for other health care providers, including physicians, dieticians, and pharmacists. Further, the results were similar to those found in an earlier survey of student nurses. Nurses' attitudes and beliefs seem supportive of health promotion and disease prevention. These attitudes also seem associated with the nurse's role as health promoter. Positive nurse attitudes/beliefs toward health promotion are posited as precursors to the alteration of patient behaviors, although further exploration in this area is needed.Sherri Sheinfeld Gorin, Ph.D. is Associate Professor, School of Social Work, Adelphi University, Garden City, New York.This research was supported by National Cancer Institute Grant No. CA41621 and No. CA16713. The author thanks all participating Nursing Schools: Adelphi Marion A. Buckley School of Nursing; The City College-The City University of New York College of Nursing; Columbia University College of Nursing; State University of New York College of Technology at Farmingdale; Hunter College Bellevue School of Nursing; County College of Morris Nursing Department; College of New Rochelle School of Nursing; New York Technical College Nursing Department; The State University of New Jersey-Rutgers College of Nursing; Wagner College Department of Nursing; Westchester Community College Nursing Department; Mt. Vernon Hospital School of Nursing; and St. Vincent's School of Nursing.The author wishes to thank the following who contributed to the study: Drs. Jacqueline Royce and Mario Orlandi of the American Health Foundation, New York, N.Y.     

An evaluation of a school-based AIDS/HIV education program for high school students.

The effect of a 1-hr school-based AIDS/HIV education program on the knowledge and attitudes of high school students was evaluated with a modified version of the Centers for Disease Control Health Risk Survey. One urban and one suburban school each were randomly assigned to an educational intervention (n = 535) or a control group (n = 659). All students received a posttest 2 weeks after the intervention. Knowledge was based on responses to 12 true-false questions (pretest alpha = .76, posttest alpha = 0.81). Principal components analysis was used to develop three attitude scales and risk-taking behavior was assessed by self-report. Data were analyzed with Kruskall-Wallis analysis of variance (ANOVA) and multivariate ANOVA. The groups did not differ in knowledge level at pretest. At posttest the education group had significantly (p < or = 0.006) higher knowledge even after controlling for the effects of previous AIDS education (p < or = 0.019), gender (p < or = 0.007), and Hispanic ethnicity (p < or = 0.048). After the education program, students were less worried about exposure to the AIDS virus, but were more worried (p < or = 0.048) about AIDS acquisition during their adult life. Although single school-based AIDS/HIV education programs may increase knowledge, more extensive education may be needed to change the behavior and attitudes of older high school students.     

Do experiences of racial discrimination predict cardiovascular disease among African American men? The moderating role of internalized negative racial group attitudes

Studies examining associations between racial discrimination and cardiovascular health outcomes have been inconsistent, with some studies finding the highest risk of hypertension among African Americans who report no discrimination. A potential explanation of the latter is that hypertension and other cardiovascular problems are fostered by internalization and denial of racial discrimination. To explore this hypothesis, the current study examines the role of internalized negative racial group attitudes in linking experiences of racial discrimination and history of cardiovascular disease among African American men. We predicted a significant interaction between reported discrimination and internalized negative racial group attitudes in predicting cardiovascular disease. Weighted logistic regression analyses were conducted among 1216 African American men from the National Survey of American Life (NSAL; 2001–2003). We found no main effect of racial discrimination in predicting history of cardiovascular disease. However, agreeing with negative beliefs about Blacks was positively associated with cardiovascular disease history, and also moderated the effect of racial discrimination. Reporting racial discrimination was associated with higher risk of cardiovascular disease among African American men who disagreed with negative beliefs about Blacks. However, among African American men who endorsed negative beliefs about Blacks, the risk of cardiovascular disease was greatest among those reporting no discrimination. Findings suggest that racial discrimination and the internalization of negative racial group attitudes are both risk factors for cardiovascular disease among African American men. Furthermore, the combination of internalizing negative beliefs about Blacks and the absence of reported racial discrimination appear to be associated with particularly poor cardiovascular health. Steps to address racial discrimination as well as programs aimed at developing a positive racial group identity may help to improve cardiovascular health among African American men.     

Increasing physician involvement In cholesterol-lowering practices: The role of knowledge,attitudes and perceptions

The study evaluated a multifaceted educational intervention systematically designed to increase physician involvement in cholesterol-lowering practices. We hypothesized that knowledge, perceptions and behaviours would be enhanced in participating physicians, compared with controls. Method: Fifty-one family physicians were assigned randomly to three groups; the two experimental groups attended a training workshop, received physician and patient education materials and ongoing consultant support. One experimental group also received a “cuing” intervention. The control group received no interventions. Outcome measures included knowledge and attitude scores, self-efficacy perceptions, and physician dietary counselling behaviour. Measures were taken at pretest, 6 weeks and 15 months later. Results: Intervention group physicians achieved significantly higher knowledge scores than the control group at the six-week test; the differences disappeared at 15 months. Attitudes, self-reported practices and overall self-efficacy scores were similar across groups. Within group variation was highly significant. Physician dietary counselling scores were significantly higher in the intervention groups (p = 0.0001). Some associations were seen among knowledge, attitude, self-efficacy and dietary counselling scores. Conclusion: Physician behaviour change in cholesterol reduction may not depend entirely upon knowledge, attitudes and perceptions. This revised version was published online in June 2006 with corrections to the Cover Date.     

AIDS/HIV Articles Published in Selected Professional Health Journals: 1981–1990

ABSTRACT: Journals from five professional associations were reviewed to determine the response to AIDS/HIV in their journal: Association for the Advancement of Health Education (AAHE) and Journal of Health Education; American College Health Association (ACHA) and Journal of American College Health; American Public Health Association (APHA) and American Journal of Public Health; American School Health Association (ASHA) and Journal of School Health, and the Society for Public Health Education (SOPHE) and Health Education Quarterly. The project posed the following questions: 1) How many articles on AIDS/HIV were published in the selected journals during the 10-year period from 1981 through 1990? 2) What types of articles were published during the period, such as editorials, recommendations, guidelines, and research? and 3) What approaches were shown effective in changing knowledge, attitudes, and behavior? The first article appeared in 1984; 239 articles were published in the five journals reviewed. Each journal devoted at least one entire issue to AIDS/HIV. The articles were categorized as either applied (43.9%) or data-based (56.1 %). Since most articles with a research focus did not include pretest and posttest measurements, it proved difficult to determine the most effective methods for changing knowledge, attitudes, and behavior. Evaluation methods that assess the effectiveness of interventions in changing knowledge, attitudes, and behavior are needed.     

Multi-school collaboration to develop and test nutrition computer modules for pediatric residents

The provision of essential nutrition-related content in US medical education has been deficient, despite efforts of the federal government and multiple professional organizations. Novel and efficient approaches are needed. A multi-department project was developed to create and pilot a computer-based compact disc instructional program covering the nutrition topics of oral rehydration therapy, calcium, and vitamins. Funded by an internal medical school grant, the content of the modules was written by Department of Pediatrics faculty. The modules were built by School of Informatics faculty and students, and were tested on a convenience sampling of 38 pediatric residents in a randomized controlled trial performed by a registered dietitian/School of Health and Rehabilitation Sciences Master's degree candidate. The modules were reviewed for content by the pediatric faculty principal investigator and the registered dietitian/School of Health and Rehabilitation Sciences graduate student. Residents completed a pretest of nutrition knowledge and attitude toward nutrition and Web-based instruction. Half the group was given three programs (oral rehydration therapy, calcium, and vitamins) on compact disc for study over 6 weeks. Both study and control groups completed a posttest. Pre- and postintervention objective test results in study vs control groups and attitudinal survey results before and after intervention in the study group were compared. The experimental group demonstrated significantly better posttrial objective test performance compared to the control group (P=0.0005). The study group tended toward improvement, whereas the control group performance declined substantially between pre- and posttests. Study group resident attitudes toward computer-based instruction improved. Use of these computer modules prompted almost half of the residents in the study group to independently pursue relevant nutrition-related information. This inexpensive, collaborative, multi-department effort to design a computer-based nutrition curriculum positively impacted both resident knowledge and attitudes.     

An evaluation of AIDS education: a quasi-experimental exploration.

This study reports on a quasi-experimental study designed to evaluate the relationship between receiving classroom instruction and subsequent AIDS knowledge, behavior, and attitudes. Survey information was gathered from 61 students enrolled in an AIDS course and 68 students enrolled in "control" courses. Both groups were pretested at the beginning of the semester and again at the end of the semester concerning AIDS knowledge, behavior, and attitudes. The results obtained indicated that there was a widespread acceptance of the conventional wisdom concerning AIDS in both the experimental and control groups prior to the study. Few behavior changes were observed as a result of the AIDS curriculum. Three empirically distinct factors, "interaction," "constraint," and "testing," emerged from the attitude measures. Respondents were more accepting of interacting with persons with AIDS across time. Moreover, respondents in the experimental group were more reticent to advocate mandatory AIDS testing vis-à-vis those in the control group across time.     

Evaluation of an affective-based adult nutrition education program

Nutrition educators have had limited success using cognitive approaches to effect behavior change. This study evaluated the effectiveness of an affective-based program in changing the nutrition attitudes and behavior of a group of adults, using pre-, post-, and retention test measures of nutrition knowledge, attitudes, and dietary behavior. The sample consisted of a treatment group (n = 59) and a control group (n = 58). The treatment group participated in a five-week nutrition course offered at a public health unit. At the conclusion of the program the respondents had improved nutrition knowledge, maintained positive attitudes, and improved reported nutrition behavior. Nutrition knowledge scores rose significantly from the pretest to posttest situations for both groups. However, only the treatment group showed a rise in knowledge scores from the pretest to the retention test. No significant changes in scores occurred on the attitude scale, which measured flexibility-rigidity in nutrition attitudes. Pretest scores were very high for both treatment and control groups, suggesting a possible ceiling effect. Nutrition behavior was measured by 24-hour recalls which were scored qualitatively. The mean behavior scores rose significantly from pretest to posttest and pretest to retention test for the treatment group only.     

护士学校学生艾滋病相关知识调查

目的了解护士学校学生关于预防艾滋病知识和有关态度的情况,为更好开展艾滋病健康教育提供依据。方法自行编写调查问卷,采用整群抽样的方法,对北京一所护校二年级3个班级的学生进行问卷调查。结果护士学校学生对艾滋病传播途经知晓率较高,达到95%以上;对感染艾滋病的非危险因素的知识比较缺乏;对自身健康行为的态度调查中“我不反对婚前性行为”肯定回答者占24.2%;大多数学生表示对艾滋病病人抱以关心、同情,并愿意将来从事其护理工作。结论护士学校学生中对艾滋病的主要传播途经和预防措施有一定程度的了解,但部分学生对艾滋病病人有恐惧,甚至歧视的态度。在学校健康教育中,应加强艾滋病的有关知识、危险因素的教育以及学生的护理职业道德教育。     

Reductions in HIV risk-associated sexual behaviors among black male adolescents: effects of an AIDS prevention intervention.

BACKGROUND. The number of reported cases of acquired immune deficiency syndrome (AIDS) is increasing disproportionately among Blacks in the United States. The relatively high incidence of sexually transmitted diseases among Black adolescents suggest the need for AIDS prevention programs to reduce their risk of sexually transmitted human immunodeficiency virus (HIV) infection. METHODS. Black male adolescents (n = 157) were randomly assigned to receive an AIDS risk reduction intervention aimed at increasing AIDS-related knowledge and weakening problematic attitudes toward risky sexual behavior, or to receive a control intervention on career opportunities. RESULTS. The adolescents who received the AIDS intervention subsequently had greater AIDS knowledge, less favorable attitudes toward risky sexual behavior, and lower intentions to engage in such behavior than did those in the control condition. Follow-up data collected 3 months later revealed that the adolescents who had received the AIDS intervention reported fewer occasions of coitus, fewer coital partners, greater use of condoms, and a lower incidence of heterosexual anal intercourse than did the other adolescents. CONCLUSIONS. These results suggest that interventions that increase knowledge about AIDS and change attitudes toward risky sexual behavior may have salutary effects on Black adolescents' risk of HIV infection.     

Racial and ethnic differences in men's knowledge and attitudes about contraception

BackgroundLittle is known about racial/ethnic differences in men's contraceptive knowledge and attitudes.Study DesignWe used multivariable logistic regression to examine racial/ethnic differences in contraceptive knowledge and attitudes among 903 men aged 18–29 in the 2009 National Survey of Reproductive and Contraceptive Knowledge.ResultsBlack and Hispanic men were less likely than Whites to have heard of most contraceptive methods, including female and male sterilization, and also had lower knowledge about hormonal and long-acting reversible methods. They were less likely to know that pills are ineffective when 2–3 pills are missed [Blacks: adjusted odds ratio (aOR)=0.42; Hispanics: aOR=0.53] and that fertility was not delayed after stopping the pill (Blacks: aOR=0.52; Hispanics: aOR=0.27). Hispanics were less likely to know that nulliparous women can use the intrauterine device (aOR=0.47). Condom knowledge was similar by race/ethnicity, but Blacks were less likely to view condoms as a hassle than Whites (aOR=0.46).ConclusionsEfforts to educate men, especially men of color, about contraceptive methods are needed.     

Efficacy of a video for teaching patients about prostate cancer screening and treatment

PURPOSE: To test the effectiveness of a video to teach patients about prostate cancer screening and treatment in a clinic setting. METHODS: A staged, two-group, pretest-posttest quasi-experimental design was used. Questionnaires were completed before and after a routine doctor's appointment in a Veteran's Administration clinic. The experimental group (n = 52) viewed the video, and the control group (n = 52) received usual care only. The two groups were similar in age, education, race, and quality of life. RESULTS: Knowledge increased significantly from pretest to posttest for the experimental group, but not for the control group (p < .001). More patients in the experimental group changed their preference for prostate-specific antigen (PSA) screening (31% experimental vs. 2% control, p = .002), indicating the patients were impacted by the information presented. Viewing the video did not stimulate increased discussion with the physician or lengthen appointment time. CONCLUSION: The video was effective in improving knowledge about a complex topic and changing some patients' preference for PSA testing without frightening or confusing patients.     

Rural School Nurses'Attitudes about AIDS and Homosexuality

ABSTRACT: The AIDS epidemic has spread to rural areas of the United States. Conservative rural communities are facing the challenge of having children with HIV entering school. School nurses, as the only health care providers in the schools, are in a strong position to facilitate the education of children with HIV and to provide AIDS education to students, faculty, and parents. School nurses' knowledge and attitudes about AIDS and people with AIDS influence their effectiveness in prevention activities and care of HIV-infected children. This study examined the relationship between specific demographic, practice, and cultural variables and rural school nurses' attitudes about AIDS and homosexuality. Sixty-nine school nurses responded to a mailed questionnaire as part of a larger study of rural nurses. Results indicate attitudes about homosexuality were related to nurses' homosexual knowledge and religious beliefs while attitudes about AIDS were related to nurses' willingness to care for people with AIDS and feeling prepared to do so.(J Sch Health. 1997;67(8):341–347)     

Correlates of breast cancer screening among low-income, low-education Latinas.

INTRODUCTION: This paper discusses the factors associated with breast cancer screening among low-education, low-income Latinas. BACKGROUND: These data were collected as part of a breast cancer educational intervention study aimed at this population. The objective of the larger study was to evaluate multimedia methods as an appropriate medium for educating this population of Latinas about breast cancer. METHODS: The study was designed as a field experiment with a pre and posttest design. A total of 1,197 individuals participated in the study, and these were all self-identified Latinas above the age of 40 years who fit the screening criteria of low income and education levels. Of these, 583 individuals provided the baseline (pretest) data on mammogram attitudes, knowledge, and intentions analyzed in this paper. RESULTS: Our results indicate that breast cancer screening knowledge and having a regular doctor were significant factors in ever having had a mammogram and having had a recent mammogram in this sample of low-income, low-education Latinas. Age affected the odds of ever having had a mammogram, but not a recent mammogram. CONCLUSION: Attitudes toward mammography, insurance status, and demographic factors such as foreign birth were not significant predictors of mammography screening in this study.     

Racial/ethnic differences in the risk of AIDS in the United States.

We analyzed the variation in the risk of AIDS in US Blacks, Hispanics, and other racial/ethnic groups relative to that in Whites (non-Hispanic) by geographic area and mode of acquiring HIV infection, based on data reported between June 1, 1981 and January 18, 1988 to the Centers for Disease Control and 1980 US census data. Relative risks (RRs) in Blacks and Hispanics were highest in the northeast region, and higher in suburbs than in central cities of metropolitan areas. RRs in Blacks and Hispanics were greatest for AIDS directly or indirectly associated with intravenous-drug abuse by heterosexuals (range: 5.7-26.9) and were also high for AIDS associated with male bisexuality (range: 2.5-4.8), suggesting that these behaviors may be more prevalent in Blacks and Hispanics than in Whites. Prevention strategies should take into account these racial/ethnic differences.     

HIV/AIDS knowledge and attitudes among alcohol and drug abusers in Egypt

The aim of this study was to assess knowledge, attitudes and practice towards HIV/AIDS among alcohol and drug abusers and the effect of health education (HE) on their knowledge and attitudes. Participants were 265 substance abusers, recruited from 8 addiction rehabilitation centers. A base line study preceding HE was done using a questionnaire composed of five sections. Three scores were developed to assess HIV/AIDS related knowledge. The base line study indicates that addicts with good knowledge scores > or =75%) regarding modes of transmission were significantly higher among males than females. About 70% of the addicts had negative attitudes towards dealing with HIV/AIDS patients, while 55.5% felt sympathy for them. Eleven percent of the injection drug abusers were sharing needle with others, while 38% of the participating females were previously convicted of prostitution. Logistic analysis showed that high level of education was the best predictive variable for good knowledge scores (> or =75%). Evaluation of the health education program revealed a highly significant increase in the knowledge scores among both males and females compared to the pretest scores. An increase in the percentages of male and female addicts with improved attitudes towards HIV/AIDS patients was also noted after HE. So, HE was found to be a successful tool in improving the knowledge and attitudes of substance abusers towards HIV/AIDS.     

An Experimental Study of an Empowerment‐Based Intervention for African American Head Start Fathers

This study examined the effects of an empowerment intervention, Men as Teachers, on African American Head Start fathers. Fathers were randomly assigned to the empowerment program or to a control group in which participants viewed a five‐part videotape series on parenting. The results revealed a significant improvement in fathers' attitudes about their ability to teach their preschool‐age children for the experimental group only. There was no significant improvement in these fathers' attitudes about racial oppression socialization practices. Resident fathers in the experimental group showed significant gains in self‐esteem and parenting satisfaction.