Medical students' improved attitudes toward prevention of cardiovascular diseases from entry to graduation. Preventive Cardiology Academic Cooperative Research Group of the National Heart, Lung, and Blood Institute.

First-year medical students have been previously reported to have positive attitudes about disease prevention, in general, and about cardiovascular disease prevention, in particular. Whether medical school experiences exert a positive, negative, or neutral effect on prevention-oriented attitudes in medical students is not known. We assessed attitudes toward heart disease prevention in 770 entering medical students enrolled at six selected American medical schools, each having some curricular emphasis on preventive cardiology, and repeated the attitude survey near graduation in the 750 fourth-year students enrolled in the six schools. Response rates were similar at each of the schools for each administration and averaged 88% in entering students and 74% in the graduating students. We used two mean attitude scores, ranging from 1.0 to 5.0 on a Likert scale, 5.0 representing the most positive attitude. The score treating the importance of primary prevention increased from 4.08 +/- 0.39 to 4.35 +/- 0.41. The attitude score concerning the importance of research in preventive cardiology also increased from 3.65 +/- 0.56 to 3.90 +/- 0.64 (P less than .0001 for both comparisons of first-year to fourth-year students). Analyses by school revealed similar increases, as did analyses for men, women, whites, and nonwhites. The results indicate that positive attitudes toward heart disease prevention can become even more positive during medical school. The perpetuation of positive attitudes should contribute to improved clinical prevention behaviors when these graduates embark on careers in medicine.     

What students bring to medical school: attitudes toward health promotion and prevention

INTRODUCTION: Health care providers' positive attitudes toward prevention and health promotion are important in achieving national health care goals. Limited studies of incoming medical students have been conducted that measure predictors of positive attitudes toward health promotion and prevention. METHODS: Data were obtained from a 1993 curriculum evaluation survey of first-year students at five different medical schools in California. Attitudes toward health promotion and prevention were measured using a nine-question Prevention Attitude Scale (PAS). We developed 2 multivariate linear regression models using demographics, education choices, and personal social values and beliefs to predict PAS scores. We also performed bivariate analysis. RESULTS: Five hundred ninety-nine completed surveys were analyzed, with a response rate of 95%. Mean PAS score was 36.47 +/- 3.7 on a 0 to 44 scale. Female gender, Democratic party preference, and a planned specialty choice in preventive medicine or primary care predicted the highest PAS scores on bivariate analysis (p < 0.002). Significant correlation ( p < 0. 001) was shown between PAS scores and 2 additional scales regarding beliefs in associations of social factors and illness and in the importance of caring for the poor. Linear regression model using personal social values and beliefs explained 34% of the variance, as opposed to the demographic model that explained only 9% of the variance. CONCLUSIONS: In the schools studied, participating first-year medical students had moderately positive attitudes toward health promotion and prevention, as measured by PAS scores. In designing curriculum to improve medical students' attitudes toward health promotion and prevention, medical educators may need to consider other personal and social values held by medical students and to address the "political" aspects of health promotion and prevention. Future studies are needed to longitudinally follow medical student attitudes.     

深圳市中学生预防艾滋病干预措施评价

目的 探索在中学开展预防艾滋病（AIDS）有效干预模式及其效果评价。方法 对深圳市10所中学初一、高一学生进行预防艾滋病健康教育干预前后相关知识、态度及行为的变化进行比较。结果 （1）知识方面：干预后,学生预防AIDS基本知识平均得分初一男生由7.47提高到10.21（满分为15）;初一妇生从7.17提高互10.21;高一男生从10.30提高到11.09;高一妇生从9.58提高到10.55。（2）态度方面:对待HIV/AIDS患采取正向态度明显提高,男生由22.6％上升到34.9%;女生由24.4%上升到41.5%。（3）行为方面：同学可以运用更多的信息来源获取有关知识。结论 学校预防AIDS教育干预措施以帮助学生增强抵御HIV／AIDS的能力,树立正向的态度,但要由知识转变行为还需要一定的时间、综合的干预和社会的多方支持。     

Attitudes towards community medicine: a comparison of students from traditional and community-oriented medical schools

OBJECTIVE: To compare the attitudes towards community medicine of first and final year students from two Australian medical schools. METHOD: In 1995, medical students from Newcastle University (a problem-based, community-oriented curriculum) and Adelaide University (a more traditional lecture-based curriculum) were asked to complete the Attitudes to Community Medicine questionnaire. This is a valid and reliable 35 item survey assessing six key domains of community medicine. The two medical schools differ in their methods of selection and curriculum delivery, and also in curriculum content. RESULTS: Response rates averaged 95% for first year and 81% for final year students. Students selected into both medical schools were found to have positive attitudes with respect to most aspects of community medicine. However, those entering Newcastle had more positive attitudes toward community medicine overall than their Adelaide counterparts. They also scored more positively on subscales relating to holistic care and evaluation of health care interventions. Students who were older and female scored more positively on some subscales, but correction for age and gender did not change the conclusions about medical school differences. CONCLUSION: This study suggests that selection criteria, and probably curriculum style and emphasis, have an influence on the attitudes that medical students possess and later develop toward community medicine.     

Evaluation of an educational program in preventive cardiology

In 1979, an educational program in preventive cardiology (PC), supported by the National Heart, Lung, and Blood Institute (NHLBI) was introduced into the medical school at the University of Tennessee, Memphis (UTM). This report evaluates that program from 1979 to 1984 in terms of student health behaviors, student attitudes toward PC, student knowledge of PC, and the impact of the program on continuing development of educational programs in PC. In 1981, using a 30% random sample, freshmen students in medicine and dentistry at UTM and medical students at a nearby state medical school similar to UTM were surveyed concerning health behaviors, attitudes, and knowledge. The surveys were repeated three years later. Analysis of the data from these pre- and postsurveys showed that UTM medical students improved (P less than .05) their attitudes about the preventability of heart disease and that their PC knowledge scores increased (P less than .0001). Personal health habits and health parameters were generally good and remained so. Although control medical students improved their PC knowledge, this change was not as great as in UTM medical students (P less than .05). The improved attitude toward PC in UTM medical students was not statistically different from changes in control students. Unfortunately, the statistical power of this analysis was low (less than 20%), and important differences between UTM medical students and controls were likely to have been missed. In addition to changes in students, considerable institutional change occurred at UTM as a direct result of this project, leading to the expansion of emphasis on PC (and prevention in general) in the five years since the completion of this NHLBI-funded program.     

Coaches’ Attitudes and Involvement in Alcohol Prevention Among High School Athletes

A total of 288 high school coaches completed a survey on their attitudes toward and involvement in alcohol prevention among male high school athletes. Results indicated that coaches felt alcohol use was less of a problem among high school student-athletes than high school students in general. Only one-third of coaches (39%) worked at a school requiring them to talk to their athletes about alcohol use. Coaches most likely to be involved in alcohol prevention were those who had attended an alcohol prevention class/workshop and those who worked for schools with strong alcohol prevention policies and schools that required them to talk with athletes about alcohol use.     

Preventive care attitudes of medical students

Presently developing attitudes of future physicians towards preventive medicine will likely provide either a major impetus for or barriers to the inclusion of preventive medicine content in medical school curricula and in other formats of physician education. In turn, attitudes about preventive care and its role in medical practice will continue to have a large influence on how much disease prevention and health promotion emphasis physicians provide in their practices. Consequently, it becomes important to study how medical students' attitudes evolve during the process of medical education. Furthermore, to the extent that we can better understand how desired attitudes can be developed and nurtured, the practice of preventive medicine may become more purposeful. Beginning and third-year medical students were surveyed with a 100-item questionnaire designed to assess their attitudes regarding: the relative importance of 20 specific preventive services to the practice of medicine and the adequacy of preclinical coursework for preparing them to offer preventive care in medical practice. The confidence of third year students' in the ability of primary care physicians to provide these specific services was also assessed. Preventive care service areas about which third-year students expressed high confidence in the ability of physicians to provide were: immunizations, health screening physicals, blood pressure control, cancer detection education, family planning, health counseling/education, and sexually transmitted disease prevention. Services that students had low confidence in the ability of physicians to provide were: smoking cessation, nutrition counseling/education and weight reduction.(ABSTRACT TRUNCATED AT 250 WORDS)     

Medical student attitudes toward the doctor-patient relationship

CONTEXT: Medical educators have emphasized the importance of teaching patient-centred care. OBJECTIVES: To describe and quantify the attitudes of medical students towards patient-centred care and to examine: (a) the differences in these attitudes between students in early and later years of medical school; and (b) factors associated with patient-centred attitudes. METHODS: We surveyed 673 students in the first, third, and fourth years of medical school. Our survey utilized the Patient-Practitioner Orientation Scale (PPOS), a validated instrument designed to measure individual preferences towards various aspects of the doctor-patient relationship. Total PPOS scores can range from patient-centred (egalitarian, whole person oriented) to disease- or doctor-centred (paternalistic, less attuned to psychosocial issues). Additional demographic data including gender, age, ethnicity, undergraduate coursework, family medical background and specialty choice were collected from the fourth year class. RESULTS: A total of 510 students (76%) completed data collection. Female gender (P < 0.001) and earlier year of medical school (P = 0.03) were significantly associated with patient-centred attitudes. Among fourth year students (n = 89), characteristics associated with more patient-centred attitudes included female gender, European-American ethnicity, and primary-care career choice (P < 0.05 for each comparison). CONCLUSION: Despite emphasis on the need for curricula that foster patient-centred attitudes among medical students, our data suggest that students in later years of medical school have attitudes that are more doctor-centred or paternalistic compared to students in earlier years. Given the emphasis placed on patient satisfaction and patient-centred care in the current medical environment, our results warrant further research and dialogue to explore the dynamics in medical education that may foster or inhibit student attitudes toward patient-centred care.     

Effects of School Health Nursing Education Interventions on HIV/AIDS-Related Attitudes of Students in Akwa Ibom State,Nigeria

PurposeOne of the greatest challenges facing school nurses is that of identifying and using appropriate strategies to meet the health education needs of adolescents in regard to prevention of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). This study examined the effects of HIV/AIDS preventive health education with parental involvement on students’ attitude toward HIV/AIDS prevention in Akwa Ibom State, Nigeria.MethodsThe study population comprised students from three of nine secondary schools in the study area. The three schools were randomly assigned as Intervention Group 1 (IG1), involving nurses only; Intervention Group 2 (IG2), involving both nurses and parents (IG2); and a control group. A pretest/post-test intervention design was used. A 29-item, validated questionnaire was the instrument for data collection. Sampling involved multistage and stratified random technique to select 120 subjects from each of the three selected schools, with a total of 360 subjects representing 8.3% of the study population. From this number, 339 (94.2%) provided sufficient data for analysis. Data analysis involved analysis of covariance and the Scheffé post hoc test determined at the .05 significance level.ResultsResults show significant effect of intervention on students attitudes toward preventive measures (F = 234.27, p < .0011). The intervention that involved nurses only was found to be a more potent strategy in providing favorable attitudes toward HIV/AIDS prevention (IG1 mean, 20.59; IG2 mean, 19.20; control mean, 12.34). Attitudes were influenced by older age but not by gender.ConclusionHealth education efforts aimed at improving HIV/AIDS-related attitudes should not only focus on children but also on parents so that they in turn could assist to improve on health workers’ efforts in educating the children.     

Parental influences on students' aggressive behaviors and weapon carrying.

This article describes the association between four family constructs (family structure, relationship with parents, parental monitoring, and perception of parental attitudes toward fighting) and aggressive behaviors and weapon carrying among middle school students. Results are based on a cross-sectional survey of 8,865 6th, 7th, and 8th graders from eight urban schools in Texas (88.5% response rate). The sample was ethnically diverse. An inverse relationship was observed between aggression scores, fighting, injuries due to fighting, and weapon carrying and the family variables: parental monitoring, a positive relationship with parents, and the lack of parental support for fighting. Students who lived with both parents were less likely to report aggression than students in other living arrangements. These four family constructs accounted for almost one-third of the total variance in the aggression score. The perception of parents' attitudes toward fighting was the strongest predictor of aggression. Results provide support for including a strong parental component in the development of violence prevention programs for young people.     

The association between Colombian medical students' healthy personal habits and a positive attitude toward preventive counseling: cross-sectional analyses

Background  

Physician-delivered preventive counseling is important for the prevention and management of chronic diseases. Data from the U.S. indicates that medical students with healthy personal habits have a better attitude towards preventive counseling. However, this association and its correlates have not been addressed in rapidly urbanized settings where chronic disease prevention strategies constitute a top public health priority. This study examines the association between personal health practices and attitudes toward preventive counseling among first and fifth-year students from 8 medical schools in Bogotá, Colombia.     

Injury-prevention counseling among residents of internal medicine

BACKGROUND: The U.S. Preventive Service Task Force's Guide to Clinical Preventive Services and Healthy People 2000 recommend that physicians participate in various counseling activities, including injury prevention. Despite recommendations, rates of physician counseling, particularly injury prevention, are low. This study assessed clinical preventive services and attitudes among physicians. Furthermore, the study illustrates how physicians prioritize injury-prevention counseling relative to other prevention recommendations. METHODS: Personal characteristics (i.e., demographics, specialty orientation, attitudes toward prevention, and personal health behaviors) of the residents were collected by a self-administered survey. We performed a 12-month retrospective chart review of 184 new doctor-patient encounters to determine rates of clinical preventive services that included four injury-prevention services: the use of seatbelts, helmets, and smoke detectors; and the safe storage of firearms. RESULTS: Overall, attitudes toward injury prevention in the context of other clinical preventive services were low. Seatbelt counseling was the only injury-prevention service documented in the charts, and was performed at only one of four clinic sites. CONCLUSIONS: Clinic site as a key predictor of preventive practice may be suggestive of the importance of organizational priorities and professional norms. Future injury-prevention education efforts must aim at improving attitudes of current and future physicians to facilitate positive professional norms.     

A survey on attitudes and practice concerning International Health

OBJECTIVE: A survey was conducted to help understanding of the attitudes and practice of Japanese medical students concerning "International Health". MATERIALS AND METHODS: One thousand seven hundred and ninety six students from eleven medical schools responded in the questionnaire study. One thousand and ninety seven were males and 699 were females with average ages of 22 and 21 years, respectively. RESULTS: 32.3% of the students answered that they have/had an interest in "International Health". About half of the students answered that they wanted to have a lecture on "International Health" and they also had a willingness to engage in activities for "International Health" someday. Further, 4% of the students had experience of participation in activities related to "International Health". Female students showed that they have a stronger willingness to take part in the "International Health activities" than males. CONCLUSION: Human resources that can work in the field of international cooperation are required because ODA from Japan has ranked first in the world for nine years in succession. However, the willingness to participate in "International Health activities" among students decreased conversely with their years of learning in medical school. This result might be a basic material when we look at the education toward "International Health" in the medical school.     

Improvement in attitudes toward influenza vaccination in medical students following an integrated curricular intervention

Introduction

Vaccination of health care workers (HCW) reduces transmission of influenza among patients, yet uptake of vaccination remains low. If vaccination education is integrated into the early medical school curriculum, will student attitudes toward the vaccine change? The objectives of the study were to: (1) Determine influenza vaccination rates among entering medical students; (2) Assess the attitudes toward influenza vaccination; (3) Evaluate the effects of a multifaceted educational intervention on attitudes to vaccination.

Methods

Entering medical students were surveyed before and after an intervention at the beginning of the influenza season. This intervention provided by an inter-professional team, included education about influenza, importance of vaccination for HCWs, followed by vaccination administration practice, and ended with students vaccinating consenting classmates.

Results

The pre-intervention surveys and intervention were completed by 124 of 125 (99%) students. Pre-intervention survey revealed 60 (48%) of students had been previously vaccinated. Of the vaccinated students 91% had been recommended vaccination by their healthcare provider compared to 43% of non-vaccinated students. More positive attitudes were noted in the vaccinated students compared to non-vaccinated students: importance of vaccination (p < 0.01); HCWs should be vaccinated (p < 0.01); recommendation of vaccine to family and friends (p < 0.01). 97 (78%) students completed post-intervention surveys. Significant improvement in these attitudes was noted post-intervention compared to pre-intervention: importance of vaccination 93% versus 71% (p < 0.01); HCWs should be vaccinated 95% versus 83% (p < 0.01); recommendation to family and friends 93% versus 73% (p < 0.01); comfort with vaccine counseling 92% versus 41%; comfort with vaccine administration 84% versus 22% (p < 0.01).

Conclusion

Educating medical students and promoting the importance of vaccination early in a medical student's career using such an intervention is relatively simple and easily integrated into the curriculum. This intervention was successful in vaccinating all students, and demonstrated a marked positive shift in attitudes toward influenza vaccination.     

高中生以生活技能为基础的艾滋病教育效果评估

目的 了解项目学校开展的以生活技能为基础的参与式预防艾滋病教育活动的效果以及目前高中生艾滋病相关的知识、态度和技能现状,以更好地促进学校预防艾滋病工作的开展.方法 采用封闭式问卷,于2008年6-7月对随机分层整群抽取的8个项目省的18所高中共2 280人进行调查.结果 项目学校高中生的“大众艾滋病基本知识知晓率调查”中的8条核心指标知晓率为78.8％,明显高于非项目校学生的61.0％;项目学校高中生对艾滋病病人不歧视态度拥有率为83.5％,明显高于非项目校学生的67.7％.从项目学校总体的现况来看,以知识、态度、技能总分的60％作为衡量学生合格与否的标准,项目学校高中学生技能的平均合格率较低,仅为68.4％.结论 以生活技能为基础的参与式预防艾滋病教育活动的效果明显,但技能发展不足,提示今后的项目工作应该有针对性地提高学生的生活技能.     

丹东市高中生性观念和性行为调查

目的 了解高中生性观念、性态度及性行为的状况,分析其影响因素,为学校有针对性地开展性健康教育提供依据.方法 采用随机整群抽样的方法,抽取本市区重点高中、普通高中及职业高中各4所共12所2979名高中学生进行问卷调查.结果 80％的高中学生对恋爱持认同态度,约21％的高中生有恋爱经历,74％的学生对婚前性行为持包容态度;超过80％学生认为爱情是性的前提,性行为发生比例趋于升高（5.1％）;在发生性行为的学生中,近半数学生在性行为时未采取任何避孕措施,而在采取措施的学生中,2种以上（含2种）措施混用最多（26.3％）.职业高中学生性观念、性态度较重点和普通高中学生开放,早恋和性行为发生率也高于重点和普通高中学生.结论 重点高中、普通高中与职业高中学生性观念、性态度及性行为均有显著性差异,要对不同学校学生采取有针对性的教育方法,在高中学生中加强性健康教育非常重要.     

Factors influencing physicians' preventive practices

We used data on a stratified random sample of 809 Quebec physicians to determine the extent to which the integration of prevention into medical practice was related to physicians' sociodemographic background, area of specialization, medical practice characteristics, and professional attitudes. Among factors positively associated with physicians' preventive practices were favorable attitudes toward prevention, patient education and patient-oriented activities, being in primary care medicine or in a medical specialty such as cardiology, gastroenterology, or pneumology, practicing in a public community health center on a salary basis, working in a group practice, having an office-based practice, devoting time to research activities, being older, and being a woman. Specialization in neurology, hematology, dermatology, nephrology, obstetrics-gynecology, and most notably surgery was negatively associated with preventive practices, as was working in an emergency room. Overall, the study variables explained 33% of the variance in physicians' preventive practices. The study underlines the prevailing role of attitudes in predicting physicians' preventive practices.     

Factors influencing physicians' orientation toward prevention

We examined the influence of various background characteristics as well as other variables such as personal health practices, specialty choice, and political orientation, on the attitudes of medical graduates toward the physician's role in prevention. The study was part of a 1979 survey conducted in three U.S. medical schools. The results revealed that graduates who believed more strongly in the physician's role in prevention tended to be in primary care training, had a more liberal political orientation, and came more often from physician families. These graduates also believed more strongly that physicians ought to be role models for their patients in health habits. However, they did not manifest better personal health practices than physicians less oriented toward prevention. There was also a medical school effect, although it could not be determined whether this represented the influence of the curriculum or of the selection process into medical school.     

Information technology in medical education: a nationwide project on the opportunities of the new technology

CONTEXT: The aim of the national "IT Culture in Medical Education" project in Finland is to enhance the opportunities new technology may provide for medical education. The project focuses on attitudes towards information technology (IT) and on its current use among teachers and students. METHOD: This survey was part of a Finnish nationwide project in medical education. Data were collected by means of a questionnaire designed to gather information about IT use in medical education, sent to teachers and students. The questions were 5-point Likert-type. The participants were medical teachers (n=196) and medical students (n=392) at two medical schools. RESULTS: In both universities, it appeared that medical teachers and students had a very positive attitude toward the advances in modern technology. In addition to the favourable attitudes, computer-related technology was also widely applied. Teachers, however, used information technology more in their research work than in teaching. CONCLUSIONS: The results pose challenges to medical education and underline the importance of educational and psychological knowledge in combination with new technical skills.     

高中生乙型肝炎预防知识认知现状调查

目的了解高中生对乙型肝炎预防的认知水平,为制定乙型肝炎的防治措施提供科学依据。方法对唐山市4所高中学校共505名在校学生进行问卷调查,利用SPSS13.0软件进行分析。结果高中生对乙型肝炎预防措施了解程度较低,农村学生低于城镇学生。结论应通过多种途径对高中生进行相关知识教育,减少乙型肝炎在学校人群中的传播。