Browsing by Subject "Knowledge"
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Item Assessing the LGBT cultural competency of dementia care providers(Wiley, 2021-02-14) Nowaskie, Dustin Z.; Sewell, Daniel D.; Psychiatry, School of MedicineIntroduction: Although dementia risk factors are elevated in lesbian, gay, bisexual, and transgender (LGBT) older adults and are perpetuated by a lack of cultural competency, no known studies have quantified LGBT cultural competency among dementia care providers. Methods: Dementia care providers (N = 105) across the United States completed a survey consisting of the 7-point Likert LGBT-Development of Clinical Skills Scale. Results: Dementia care providers reported very high affirming attitudes (M = 6.67, standard deviation [SD] = 0.71), moderate knowledge (M = 5.32, SD = 1.25), and moderate clinical preparedness (M = 4.93, SD = 1.23). Compared to previously published data, they reported significantly lower knowledge than medical students. There were no differences compared to psychiatry residents. Discussion: The current state of dementia care providers' LGBT cultural competency has significant, yet modifiable, gaps. Better education, including more LGBT patient exposure, is necessary to improve the care being provided to members of the LGBT community impacted by dementia illness.Item How much is needed? Patient exposure and curricular education on medical students’ LGBT cultural competency(BMC, 2020-12-04) Nowaskie, Dustin Z.; Patel, Anuj U.; Psychiatry, School of MedicineBackground: For medical students, providing exposure to and education about the lesbian, gay, bisexual, and transgender (LGBT) patient population are effective methods to increase comfort, knowledge, and confidence in caring for LGBT people. However, specific recommendations on the number of patient exposures and educational hours that relate to high LGBT cultural competency are lacking. Methods: Medical students (N = 940) at three universities across the United States completed a survey consisting of demographics, experiential variables (i.e., number of LGBT patients and LGBT hours), and the 7-point Likert LGBT-Development of Clinical Skills Scale (LGBT-DOCSS). LGBT-DOCSS scores were stratified by 1-point increments, and experiential variable means were computed per each stratification to characterize the mean LGBT patients and hours of medical students with higher scores and those with lower scores. Results: Medical students reported caring for some LGBT patients annually (M = 6.02, SD = 20.33) and receiving a low number of annual LGBT curricular hours (M = 2.22, SD = 2.85) and moderate number of annual LGBT extracurricular hours (M = 6.93, SD = 24.97). They also reported very high attitudinal awareness (M = 6.54, SD = 0.86), moderate knowledge (M = 5.73, SD = 1.01), and low clinical preparedness (M = 3.82, SD = 1.25). Medical students who cared for 35 or more LGBT patients and received 35 or more LGBT total hours reported significantly higher preparedness and knowledge. Conclusions: Medical students have shortcomings in LGBT cultural competency and limited LGBT patient exposure and education. To improve LGBT cultural competency, medical schools and accrediting bodies should consider providing medical students with at least a total of 35 LGBT patient contacts and 35 LGBT education hours (10 h of required curricular education and 25 h of supplemental education).Item Investigation of Indiana tennis coaches' knowledge of disordered eating and nutrition and their confidence in such knowledge(2015-12-11) Reagan, Brian Patrick; Bahamonde, Rafael; Morrone, Anastasia; Pierce, David; Beekley, MattIt is well documented that a variety of sports coaches lack nutrition knowledge. However, few studies explore their knowledge of appropriate weight loss methods, macronutrient intake, or disordered eating. Unfortunately, both college and high school coaches disseminate inaccurate nutrition and weight loss counsel to their respective athletes who are just as unknowledgeable. Further, there is little research, which only focuses on coaches of a specific sport (e.g. tennis). Thus, the primary purpose of this study was to assess high school tennis coaches' knowledge of macronutrients and disordered eating (e.g. symptoms and prevention). Other purposes included identifying confidence in knowledge and any differences between the participating coaches' knowledge and demographic variables. To address these purposes, the 27-question Nutrition and Eating Disorders in Tennis ("NET") Survey was created (and validated). The study design involved a one-time, voluntary assessment of the Indiana coaches' demographic variables, knowledge, sources of knowledge, and level of confidence (e.g. Not At All or Very Confident). Overall, the results revealed that the coaches lacked knowledge. The average score was 70.6%, which was below the criterion for adequate knowledge. Furthermore, the coaches lacked adequate knowledge in three of the five knowledge domains: Treatment and Prevention of Disordered Eating (63.6% ± 22.9%), Disordered Eating Signs and Symptoms (60.0% ± 21.7%), and Macronutrients (57.0% ± 22.4%). The latter was further substantiated through the responses to scenario questions (Part 3). Specifically, the tennis coaches demonstrated a significant knowledge deficiency of carbohydrates, energy needs, and appropriate scope of practice. There was no significant difference between coaches' education level, gender, or type and knowledge. However, there was in experience; the more years coached, the lower the scores. Moreover, there was a trend of overconfidence in the most missed questions. This dissertation's data can provide basis for coaches' educational programs.Item Knowledge and Awareness Among Patients with Chronic Kidney Disease Stage 3(American Nephrology Nurses Association, 2016) Welch, Janet L.; Bartlett Ellis, Rebecca J.; Perkins, Susan M.; Johnson, Cynthia S.; Zimmerman, Lani M.; Russell, Cynthia L.; Richards, Christine; Guise, David M.; Decker, Brian S.; School of NursingKnowledge is a prerequisite for changing behavior, and is useful for improving outcomes and reducing mortality rates in patients diagnosed with chronic kidney disease (CKD). The purpose of this article is to describe baseline CKD knowledge and awareness obtained as part of a larger study testing the feasibility of a self-management intervention. Thirty patients were recruited who had CKD Stage 3 with coexisting diabetes and hypertension. Fifty-four percent of the sample were unaware of their CKD diagnosis. Participants had a moderate amount of CKD knowledge. This study suggests the need to increase knowledge in patients with CKD Stage 3 to aid in slowing disease progression.Item Knowledge of Cervical Cancer and Acceptability of Prevention Strategies Among Human Papillomavirus-Vaccinated and Human Papillomavirus-Unvaccinated Adolescent Women in Eldoret, Kenya(Mary Ann Liebert, 2019-08-20) Mburu, Anisa; Itsura, Peter; Mabeya, Hillary; Kaaria, Alice; Brown, Daaron R.; Medicine, School of MedicineCervical cancer is a critical public health concern in sub-Saharan Africa. Adolescents are key targets in primary prevention strategies. Following a human papillomavirus (HPV) vaccination initiative (Gardasil) in Eldoret, Kenya, the knowledge and source of information of cervical cancer and acceptance of prevention strategies among vaccinated and unvaccinated adolescents were evaluated. A cross-sectional comparative study enrolled 60 vaccinated and 120 unvaccinated adolescent women. Institutional ethical approval was obtained and signed consent was obtained from the parents. Data collection was performed using interviewer-administered questionnaires derived from factual statements based on information from print material used for community sensitization on cervical cancer. The median age of the participants was 14.0 years (interquartile range [IQR] = 13.0-15.0). Of 60 vaccinated adolescents, 56 (93.3%) had heard of the HPV vaccine compared with 6 (5%) of unvaccinated participants (p < 0.001). Of 60 vaccinated participants, 58 (96.7%) had heard of cervical cancer compared with 61 (50.8%) unvaccinated participants (p < 0.001). Both cohorts identified the school as the main source of information for cervical cancer. The two groups also showed similarity in their selection of cervical cancer prevention strategies acceptable to them such as delaying sexual debut, limiting number of sexual partners, and use of condoms for protection against sexually transmitted infections. Of 120 unvaccinated participants, 63.7% expressed willingness to be vaccinated. Exposure to the HPV vaccine was associated with a higher knowledge of cervical cancer. The adolescents predominantly rely on the school for health information. Both cohorts of adolescents showed remarkable acceptability for cervical cancer prevention strategies.Item Refining a questionnaire to assess breast cancer knowledge and barriers to screening in Kenya: Psychometric assessment of the BCAM(BioMed Central, 2017-02-03) Wachira, J.; Busakhala, A.; Chite, F.; Naanyu, V.; Kisuya, J.; Otieno, G.; Keter, A.; Mwangi, A.; Inui, T.; Department of Medicine, IU School of MedicineBackground Our study objective was to determine the validity and reliability of the breast module of a cancer awareness measure (BCAM) among adult women in western Kenya. Methods The study was conducted between October and November 2012, following three breast cancer screening events. Purposive and systematic random sampling methods were used to identity 48 women for cognitive focus group discussions, and 1061 (594 who attended vs. 467 who did not attend screening events) for surveys, respectively. Face and psychometric validity of the BCAM survey was assessed using cognitive testing, factor analysis of survey data, and correlations. Internal reliability was assessed using Cronbach’s alpha. Results Among survey participants, the overall median age was 34 (IQR: 26–44) years. Compared to those women who did not attend the screening events, women attendees were older (median: 35 vs. 32 years, p = 0.001) more often married (79% vs. 72%, p = 0.006), more educated (52% vs. 46% with more than an elementary level of education, p = 0.001), more unemployed (59% vs. 11%, p = 0.001), more likely to report doing breast self-examination (56% vs. 40%, p = 0.001) and more likely to report having felt a breast lump (16% vs. 7%, p = 0.001). For domain 1 on knowledge of breast cancer symptoms, one factor (three items) with Eigen value of 1.76 emerged for the group that did not attend screening, and 1.50 for the group that attended screening. For both groups two factors (factor 1 “internal influences” and factor 2 “external influences”) emerged among domain 4 on barriers to screening, with varied item loadings and Eigen values. There were no statistically significant differences in the factor scores between attendees and non-attendees. There were significant associations between factor scores and other attributes of the surveyed population, including associations with occupation, transportation type, and training for and practice of breast self-examination. Cronbach’s alpha showed an acceptable internal consistency. Conclusion Certain subpopulations are less likely than others to attend breast screening in Kenya. A survey measure of breast cancer knowledge and perceived barriers to screening shows promise for use in Kenya for characterizing clinical and community population beliefs, but needs adaptation for setting, language and culture.Item Self-management interventions in stages 1 to 4 chronic kidney disease: an integrative review(SAGE, 2015-05) Welch, Janet L.; Johnson, Michelle; Zimmerman, Lani; Russell, Cynthia L.; Perkins, Susan M.; Decker, Brian S.; IU School of NursingThe prevalence, effect on health outcomes, and economic impact of chronic kidney disease (CKD) have created interest in self-management interventions to help slow disease progression to kidney failure. Seven studies were reviewed to identify knowledge gaps and future directions for research. All studies were published between 2010 and 2013; no investigations were conducted in the United States. Knowledge gaps included the focus on medical self-management tasks with no attention to role or emotional tasks, lack of family involvement during intervention delivery, and an inability to form conclusions about the efficacy of interventions because methodological rigor was insufficient. Educational content varied across studies. Strategies to improve self-management skills and enhance self-efficacy varied and were limited in scope. Further development and testing of theory-based interventions are warranted. There is a critical need for future research using well-designed trials with appropriately powered sample sizes, well-tested instruments, and clear and consistent reporting of results.Item U.S. pregnant women's knowledge and attitudes about behavioral strategies and vaccines to prevent Zika acquisition(Elsevier, 2018-01-02) Fraiz, Lauren Dapena; de Roche, Ariel; Mauro, Christine; Catallozzi, Marina; Zimet, Gregory D.; Shapiro, Gilla K.; Rosenthal, Susan L.; Pediatrics, School of MedicineINTRODUCTION: Zika virus infection during pregnancy can cause significant infant morbidity. Little is known about pregnant women's attitudes regarding behavioral strategies and hypothetical vaccination to prevent Zika infections and sequelae. METHODS: Pregnant women across the United States (N = 362) completed an online questionnaire regarding attitudes about Zika, including six behavioral prevention strategies (i.e., abstaining from sex, using condoms, not traveling to an area with Zika, their partner not traveling into an area with Zika, using mosquito repellant, wearing long pants and sleeves) and vaccination. RESULTS: Most women (91%) were married/living with the baby's father, 65% were non-Hispanic White, and 71% had been pregnant. Seventy-four percent were worried about Zika, while 30% thought they were knowledgeable about Zika. The mean knowledge score was 5.0 out of 8 (SD = 2.09), and the mean behavioral strategies score was 4.9 out of 12 (SD = 3.7) with a range of 0 (none would be hard to do) to 12 (all would be hard to do). In a multivariable model, having had a sexually transmitted infection, living/traveling in an area with Zika, and worrying about Zika were significantly related to reporting behavioral strategies as hard to do. Seventy-two percent would be willing to be vaccinated. In the multivariable model, living/traveling in an area with Zika, believing they knew a lot about Zika, worrying about Zika, and considering Zika vaccine development as important were significantly associated with willingness to get vaccinated. CONCLUSIONS: Pregnant women were worried about Zika, yet had gaps in their factual knowledge. Most women reported they would get vaccinated if a vaccine was available. Pregnant women who reported themselves as vulnerable (being worried, having lived in or traveled to a Zika area) were more likely to view behavioral strategies as hard to do and to accept vaccination.