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Community outreach: a call for community action.

For a variety of reasons, end-stage renal disease disproportionately affects minority populations. Factors such as socioeconomic status, cultural differences, and genetic variations, are all involved. In addition, there are often real and perceived barriers for these patient groups in fully accessing the healthcare system. Thus, there is a real need for the development of specific outreach programs that target these high-risk communities. In developing such programs, it is important to realize that there is not a homogeneous 'ethnic community', but rather, like any large demographic grouping, a diverse population. These differing communities will all have different requirements and needs and, thus, outreach programs need to be wide-ranging and adapted for individual, local communities, to ensure that all target audiences are reached. The core aims for these outreach programs must be raising disease awareness and education among minority patients. To achieve this goal, a wide range of organizations need to be actively involved, including national and--importantly--local, community-based patient organizations, and hospital management corporations, as well as local radio and television companies to advertise the outreach initiatives. However, any outreach campaign will need to be combined with policy changes and further research into kidney disease among minority groups if real improvements in outcomes are to be achieved.

Community-Institutional Relations↗

Knowledge on AIDS among female adolescents in Bangladesh: evidence from the Bangladesh demographic and health survey data.

To assess the knowledge on acquired immunodeficiency syndrome (AIDS) among female adolescents in Bangladesh, this study used data extracted from the Bangladesh Demographic and Health Survey (BDHS) 1996-1997. Of 1,446 ever-married women included in the study, most were currently married (96%), Muslims (92%) and from rural areas (91%). Only one in six adolescents had ever heard of AIDS. Of them, 57% reported AIDS as a fatal disease almost always, while only 22% believed that AIDS could be avoided. Multivariate analysis revealed that knowledge on AIDS was strongly and positively associated with education of female adolescents and their husbands and varied significantly across different parts of the country. Knowledge on AIDS was higher among relatively older and urban residents who had access to television or radio and whose husbands were using condom. Strong efforts are needed to improve awareness and to clarify misconceptions about AIDS. Improved access to education, mass-media, and promotion of condom use could prevent AIDS among female adolescents in Bangladesh.

Acquired Immunodeficiency Syndrome↗

UK information service relaunched.

The nationwide public and professional information service operated by the FPA (Family Planning Association) in association with the UK health promotion agencies since 1977 is relaunched this year under the new name of the Contraceptive Education Service (CES). The service is offered in England, Scotland, Wales and Northern Ireland with some variations to meet specific local needs, but containing the same key elements. These are: 1) a nationwide telephone, postal and personal enquiry service on contraception, for both the public and professionals including details about local family planning clinics. This service is available Mondays to Fridays from 9 am to 5 pm, from the FPA national helpline 071-636-7866. A local service is also available from FPA Scotland, FPA Wales, and FPA N. Ireland; 2) public education leaflets on contraception and family planning, of which over 4 million are distributed a year via health promotion units throughout the UK; 3) professional information provided through factsheets on 21 key topics in family planning, contraception and sexual health and through Family Planning Today; 4) press and media publicity which helps to publicize the CES services and to spread information about contraception and family planning issues through articles and coverage on radio and television.

Communication↗

Iran records lower growth rate.

The population growth rate in the Islamic Republic of Iran has fallen to 1.8%, according to the Deputy Minister of Health, Treatment and Medical Training, Dr. H. Malek Afzali. The country's total population exceeds 64 million, with a population growth rate of 3%, according to the 1994 ESCAP Population Data Sheet. Dr. Malek Afzali said that, in 50,000 families surveyed from 22 May to 21 June 1994, the birth rate stood at 23 per 1000 and the mortality rate at 5 per 1000. He added that the number of births throughout the country in the year that ended on 21 March stood at 1,385,000, down from 2.2 million in the years before 1993. He said that the only thing to worry about in the growth of the country's population is the high number of people under 15 years of age, which is about 26 million. The present population under the age of 15 would make up 13 million couples within the next few years and, if they choose to have two children each, the country's population will increase by 26 million, he said. The Deputy Health Minister proposed that, in order to tackle the problem, training courses in family planning be set up for the young population. Later, on the occasion of World Population Day (11 July), the Director of the Islamic Republic of Iran Broadcasting, Dr. Ali Larijani, emphasized the important role that radio and television could play to increase public knowledge and awareness through broadcasting programs on population growth and family planning.

Age Distribution↗

PVO / NGO initiatives, Africa. Society for Women and AIDS in Africa (SWAA), Mauritania.

Society for Women and AIDS in Africa (SWAA), Mauritania, uses a multi-sectoral approach to raise awareness of the HIV/AIDS pandemic and provide assistance when needed. SWAA believes that in order to have an impact on women and development in their country they must address issues of health, education, and society. To these ends they have created a special center to provide health care and counseling to HIV-positive women and their children; they conduct health and general education sessions geared towards women; and they have formed local chapters of SWAA throughout Mauritania to provide support and information to women within their own communities. SWAA has also taken on a mass education campaign which includes the production of flyers, educational materials, and public service announcements for radio and television. For more information, please contact Mme. Sana Mint Abass, President, SWAA/Mauritanie, BP 118, Nouakchott, Mauritanie; tel: +222 564 69 (office), +222 524 04 (home); fax: +222 599 26.

Adolescent↗

Children and media.

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Adolescent↗

Knowledge on, and attitude toward, HIV/AIDS among staff of an international organization in Bangladesh.

Two hundred and ninety-three randomly-selected members of the staff of ICDDR,B: Centre for Health and Population Research were surveyed anonymously in June 1998, using a pre-tested and self-administered questionnaire, to assess their knowledge on, and attitude toward, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). All except 4 (1.4%) heard of AIDS. Main sources of information were radio and television (93%), newspapers and magazines (84.8%), posters and leaflets (70.2%), and friends (59.2%). About 94% of the respondents believed that HIV might spread in Bangladesh. Only 61.6% knew about the causative agent for AIDS. More than 96% had knowledge that HIV could be detected through blood test. The respondents were aware that unprotected sexual intercourse (92%), transfusion of blood and blood components (93.8%), sharing unsterile needles for injections (94.1%), and delivery of babies by infected mothers (82.7%) could transmit HIV. Similarly, the respondents had the knowledge that HIV infection could be prevented by using condom during sexual intercourse (85.5%), having sex only with an HIV-negative faithful partner (87.2%), avoiding transfusion of blood not screened for HIV (88.9%), and taking injections with sterile needles (86.5%). However, only 33.0% had the knowledge that HIV-infected persons can look healthy, and 56.4% were unaware of transmission through breastmilk. Most members of the staff, particularly at lower level, had misconceptions about transmission and prevention of HIV/AIDS. More than 40% of the respondents had the attitude that HIV-infected persons should not be allowed to work, while another 10% did not have any idea about it. The findings of the study suggest that the members of the Centre's staff have a satisfactory level of essential knowledge on HIV/AIDS, although half of them have poor attitudes toward persons with HIV/AIDS. Therefore, preventive strategy for the staff should be directed toward behaviour change communication.

Acquired Immunodeficiency Syndrome↗

Georgia Hospital Association leads long-term staff recruiting effort. Reaches wide target audience through innovative media use.

The Georgia Hospital Association (GHA), faced with a critical healthcare workforce shortage, created a long-term response to the problem by creating a Workforce Shortage Media Campaign. Its single purpose was to encourage Georgians to pursue careers in healthcare. The four-week campaign took six months to develop and included print, radio and television.

Career Choice↗

[Cognitive-behavioral therapy in obesity and activities of the STOB (Stop to Obesity) society].

STOB Society (STop to OBesity) was founded in the Czech Republic in 1991. It joins together psychologists, medical doctors, instructors of appropriate physical exercises and other professionals whose aim is to help obese people in the struggle with their excess weight. Activities of STOB Society are based on the method of cognitive behavioural psychotherapy, it proceeds from the assumption that inappropriate habits are learnt and so with a help of various techniques they can be also unlearnt. The aim is to induce desirable changes in behaviour, that is in eating and physical activity habits, and at the same time to get rid of the emotions and thoughts that lead to an inappropriate behaviour. The basis of cognitive-behavioural therapy is described. STOB Society popularizes appropriate and healthy way of weight reduction through articles in newspapers and journals, through programmes in radio and television and through brochure, audio and wide tapes, calendar etc. STOB Society organizes national campaigns in which it prompts thousands of obese people in the Czech Republic to appropriate eating and physical activity habits. It organizes "Weight reduction courses" in 70 towns in the Czech Republic.

Cognitive Behavioral Therapy↗

Cross-cultural variations in dental knowledge among antenatal mothers.

This study evaluates the level of dental knowledge among 328 antenatal mothers from different ethnic groups and ascertains the importance of the various sources of dental information. The mothers were interviewed based on a structured questionnaire. Most mothers knew about the number of sets of teeth they possessed throughout their life. This was most evident among the Chinese and least among the Malays. Only 42.7% of the mothers interviewed were positive about the preservation of their teeth throughout life. This belief was highest among the Chinese followed by the Indians. However about 40% of the Chinese believed that tooth decay is hereditary. Generally the principal sources of dental information cited by most mothers were television or radio followed by dentists, school and family. This order of importance was similarly observed among the Malays and Chinese. However, among Indians, family members represent the second most important source of dental information. The implications of these findings are discussed.

Attitude to Health↗

Bone and joint diseases around the world. France: rheumatoid polyarthritis, chronic juvenile idiopathic arthritis, and ankylosing spondylitis. A public health priority.

Since its creation, the Association française des Polyarthrites is doing everything possible to come to the aid of people with polyarthritic diseases and to help medical research make advances against this illness. Each year, with the help of sponsors, we organize a national information campaign with first-hand accounts and presentations by sufferers on radio and television stations, so that polyarthritis should be better understood by the general public. Last year, together with other associations, we asked the Minister of Health about the barriers to receiving innovative treatment for polyarthritis because of the cost. Because of this action, the Minister has made additional funds available so that more sufferers can benefit from new treatment. Recently, several associations dealing with chronic and serious inflammatory rheumatic illnesses who came together as an action group presented a text to the Minister of Health about the urgent need to make these illnesses a public health priority. Working sessions between the Minister, patient associations, and rheumatologists to consider how to implement a public health plan are in progress.

Arthritis, Juvenile↗

Beliefs about smoking and health and attitudes toward tobacco control measures.

The opinions of a representative sample of adult South Africans about the effects of smoking on health and their attitudes toward tobacco control measures were surveyed by means of an interviewer-administered questionnaire. Seventy-five per cent of the respondents were black and 55.3% were female. More than 50% of blacks and Asians (61.7% and 53.2%) were non-smokers, whereas 52.1% of 'coloureds' were current smokers and 23.8% of whites ex-smokers. The majority of smokers (68.5%) acknowledged the harmful effects of direct smoking and a larger percentage of non- and ex-smokers (79.7% and 77% respectively) shared this view. A similar trend was observed in beliefs about passive smoking. Seventy-five per cent of participants felt that tobacco sales to minors should be banned and 55.8% thought that taxes on tobacco products should be increased. There was substantial white opposition to measures that prohibit tobacco companies from sponsoring sporting events. Most respondents felt that tobacco advertising should be banned on television (59.7%), radio (60.1%), in newspapers (58.4%), on billboards (58.7%) and in cinemas (59.3%). The results indicate that in the main the public supports the introduction of the measures proposed in the draft Tobacco Products Control Act and even more extensive legislation to control tobacco consumption. This augurs well for future strategies aimed at tobacco control in South Africa.

Adolescent↗

A survey of knowledge, attitude and practice of the prevention of dengue hemorrhagic fever in an urban community of Thailand.

To evaluate the effect of a health education program on the prevention and control of dengue hemorrhagic fever (DHF) in the municipality of Mae Sot, Tak Province, a survey of adult residents, mainly housewives, was conducted in late April 1990 to assess their knowledge of DHF and practice of preventive methods. A total of 417 respondents from 417 households selected by a systematic-cluster sampling method were interviewed. More than 90% of them knew that the disease is transmitted by Aedes mosquitos and indicated water jars and water retention in the houses as the common breeding places. However, the other two common breeding places, ant-traps and cement baths, were less frequently mentioned. This finding was consistent with the greater proportion of respondents who reported no larval control methods for these two kinds of containers than for the others. Covering water containers was the most common practice to prevent mosquito breeding in drinking-water containers whereas addition of abate (temephos sand granules) or changing stored water frequently was commonly used for non-drinking water storage. Larval control for ant-traps was mainly accomplished by the addition of chemicals, including abate, salt, oil or detergent. Health education efforts in this area could induce the majority of respondents to accept themselves as responsible for the Aedes control program. Health education by health personnel played an important role in disseminating DHF information and prevention methods. Radio and television were the main effective mass media for public health education on DHF in this area.

Adult↗