Knowledge, Attitude, and Practices of Dentists in Caribbean Countries during the COVID-19 Pandemic: A Multicenter Cross-Sectional Study

Background: The COVID-19 pandemic has affected dentists globally, both financially and mentally. This study aimed to determine the knowledge, attitude, and practices of dentists in Caribbean countries during the COVID-19 pandemic. Methods: A non-probability sample was obtained from dentists in more than ten different Caribbean countries. They were invited to complete a self-reported questionnaire, which was conducted from December 2020 to March 2021. Ethics approval was sought and an exemption was received from the UWI ethics committee. Results: One hundred and fifty-two dentists responded. More than one-third (38.8%) were in the >35­45 age group, and 58.6% were females. Most (84.9%) were general dentists and 75% were stressed by the COVID-19 situation with 80.9% being affected financially. The majority, 94.7%, believed that the highest risk of transmission of COVID-19 was via aerosol-generating procedures and 87.5% were worried about contracting it clinically. The majority (69.1%) were willing to receive the vaccine, the main reason reported for vaccine hesitancy was due to the possible side effects (35.3%). Most (75%) consumed alcohol. When the locus of control was determined, 54.6% felt they were in control of protecting themselves while 52% felt that external factors controlled their lives. Conclusions: The findings suggest that most dentists in the Caribbean were knowledgeable about COVID-19 and followed current guidelines in their practice and were willing to receive the vaccine.

Knowledge, Attitudes and Practices of Drivers towards Road Traffic Regulations in Trinidad, West Indies

This study aims to test the knowledge, practices & attitudes of drivers in Trinidad through issuing a questionnaire based on driving practices in relation to seat belt use, alcohol consumption, fatigue & distraction, and a quiz, which focuses on road regulations. The information obtained from this study can be used to prevent accidents by identifying: poor knowledge, driving practices and attitudes in the driving population of Trinidad.

An investigation on the knowledge, attitudes and practice towards vaginal candidiasis amongst women of reproductive age attending the University of the West Indies, St. Augustine Campus

From 20th century, our views, understanding and treatment of pathogenic infections have drastically changed. Pathogenic organisms were discovered, classified and treatments were subsequently implemented. Candidiasis spp. was discovered and linked to the condition; Vulvovaginal Candidiasis (VVC), commonly known as yeast infection, which affects the female lower genital tract, vulva and vagina. Symtoms of such an infection include itching, burning, soreness and a creamy vaginal discharge. Given the nature, location and symptoms of such an infection, individuals are often self-conscious and hesitant to discus it or seek medical attention until symptoms become unbearable. VVC is one of the most common infections in reproductive age females with 75% of women experiencing infection at least once in their lives. Due to the qualitative gap in literature toward women affected by VVC in our country, this study aimed to highlight the knowledge, attitudes and practices towards VVC among reproductive age in Trinidad and Tobago.

Getting to zero HIV in The Bahamas: Physicians’ attitudes and practice regarding male circumcision

OBJECTIVE: We proposed that physicians in The Bahamas may favour and participate in a national policy advocating circumcision and conducted a study on the attitudes and practices of Bahamian physicians related to male circumcision(MC). SUBJECTS AND METHODS: Sample size was estimated using information on physicians’ recommending or practising MC in the United States of America (USA). Bahamian physicians were randomly selected. A standardized questionnaire adapted from the Joint United Nations Programme on HIV and AIDS/World Health Organization(UNAIDS/WHO) was used. Trained medical students conducted the face-to-face interviews. The study was approved by the Research Ethics Board of the Universityof Ontario Institute of Technology (UOIT) and the National Ethics Committee of The Bahamas. Data analysis was done in SPSS. RESULTS: A total of 196 questionnaires were analysed. Over 62% of the sample was between 25 and 49 years ofage; 53% was male. Sixty-one per cent of the sample would recommend MC, 27% were undecided and 12% would not recommend MC. Asked if they would perform MC, 63% reported that they would need additional training. However, if an MC programme was promoted in The Bahamas, 52% would not be willing to provide the service. CONCLUSION: Our study indicates that, in The Bahamas, more than half the physicians would support a policy recommending male circumcision. Education and training programmes would likely be beneficial in promoting this practice as half reported being unwilling to provide the service of MC.

Turn off the TV?: attitudes towards TV-viewing and childhood obesity in Jamaican mothers

OBJECTIVE: TV-viewing has been associated with childhood obesity and reducing screen time might help address this epidemic in Caribbean children. We explored the attitudes and beliefs of Jamaican mothers on the impact of television viewing on childhood obesity. DESIGN AND METHODS: Community health aides recruited mothers, 18 years and older with children aged 6-24 months, from four primary care clinics in Jamaica. Four focus group discussions (2 rural and 2 urban) were conducted using a semi-structured interview guide. Audio recordings and field notes from discussions were collected by field investigators. Transcripts were reviewed by study investigators and immersion/crystallization techniques were used to identify emerging themes. RESULTS: the mothers had a mean age of 28.26 ñ 6.25 years and 63% were unemployed. Parenting decisions were made based on instinct developed through experience, example and external input (friends, family, community and media) and information not consistent with this instinct was not readily accepted. Among the risk factors for obesity identified by mothers, TV-viewing was not perceived as important. The causal link between TV-viewing and obesity in young children was unclear to mothers. The perceived benefits from TV-viewing on their child’s development outweighed any potential harm and strong evidence would be required to convince them otherwise. CONCLUSION: Jamaican mothers may not easily accept obesity interventions that discourage TV-viewing. Incorporating evidence from credible sources, and interventions focused on healthy growth and development using examples of children developing optimally without the aid of TV, may overcome this perception.

Grenadian doctors’ perceptions on abortion

OBJECTIVE: To assess perceptions of Grenadian physician on abortion. DESIGN AND METHODS: An online survey was created and emailed to all doctors registered to practice in Grenada. Once the data was collected, it was analyzed using SPSS. RESULTS: A response rate of 58% (45 out of 78 physicians) took part in this study. Almost all physicians (93%) indicated that they were personally aware of unsafe abortions being performed in Grenada. The three main complications physicians reported as arising out of unregulated abortion procedures were bleeding (18%), infection (17%), and uterine perforation (17%). Health education was identified by 93% of physicians as the best solution to preventing unsafe abortions. CONCLUSIONS: Almost all local physicians reported that unsafe abortions are taking place in Grenada and that the best solutions to this problem would be to provide health education along with use of modern contraception and the use of legalized and regulated abortion services. Specifically, the implementation of school-based health education program could prove effective in minimizing the conditions that lead to women being placed in a position where they feel that they have to resort to unsafe abortion procedures.

Local public knowledge of blood donation systems in Trinidad and Tobago and in other places

OBJECTIVE: To investigate the Trinidad and Tobago (TRT) public’s knowledge of donation procedures locally and in the United States (USA) and United Kingdom (UK) and its effect on willingness to donate blood locally. DESIGN AND METHODS: A cross sectional study was conducted on a convenience sample from adults in TRT concerning knowledge and attitudes towards blood donation. Data was collected using an interviewer-administered questionnaire. 529 responses were received. Analysis was performed using SPSS Statistics 21. Chi-squared testing was done to determine statistical significance. RESULTS: Of 529 respondents, 141 (26.7%) had donated previously, 34 (6.4%) had been excluded and 354 (66.9%) had never donated. 76.8% of those who had donated did so for a friend or family member. 53.6% of respondents rated their knowledge of TRT’s system, and 86.2% rated that of the US and UK, as ‘poor’ or ‘very poor’. Knowledge of the local system was directly correlated to willingness to donate blood in TRT (p<0.001). No relation was found concerning knowledge of the foreign systems and local willingness to donate (p=0.423). Factors deemed most ‘likely’ or ‘very likely’ to influence people to donate included: if donation was for an ill family member (87.7%) or friend (77.9%); if the blood donation system in place was a replacement system (70.9%) and if more information was given to the public about blood donation (67.3%). CONCLUSION: Public knowledge of the blood donation system of TRT affected willingness to donate while knowledge of the US and UK systems had no effect.

Attitude toward older people taking the HIV-test among a sample of middle-aged and older people in the British Virgin Islands

OBJECTIVE: This study focuses on middle-aged and older people’s attitude toward older people taking the HIV-test by examining the effect of sociodemographic and HIV-related factors on their agreement with the statement “There is no reason for older people to take the HIV-test because younger ones are more likely to be infected than older ones”. DESIGN AND METHODS: Descriptive, bivariate and multivariate statistics were used to analyse the data. Binary logistic regression analysis was used to examine the effect of sociodemographic and HIV/AIDS related factors on attitude toward older people taking the HIV-test. RESULTS: 64.4% of the participants were born in the Virgin Islands; the average age is 65.3 years; 49.7% had at least a secondary level education; 62.5% were married or in a cohabiting relationship; 63.8% lived in male-headed households. 54.8% strongly disagreed with the notion that older people do not have to be tested because younger ones are more at risk for infection. Bivariate examination showed a significant association between attitude toward older people taking the HIV-test and place of birth; age; education; age of head of the household; religious participation, type of relationship; employment status and number of children; as well as HIV/AIDS-related factors. In binary logistic regression analysis, the two most important influences in attitude toward older people taking the HIV-test were education and agreement with the idea that HV can be prevented by always using condoms with a person who is not your spouse. CONCLUSION: There may be a need to scale up HIV services for the older adult.

Attitudes towards dog ownership on St. Kitts, West Indies.

A structured face-to- face interview was held with 64 arbitrarily selected local people attending a vegetable market in the capital of St. Kitts on a Saturday morning. Most (67%) respondents liked dogs and many (57%) owned one (41%) or two (29%) for protection (67%) and as a pet (65%). The main reason people disliked dogs were because they feared them (56%) and because they created a mess (50%). Generally people had purebred (40%) male (56%) dogs which were always outside (50%), in fenced yards (43%), on chains (34%) or running free (22%). All owners fed their dogs, mainly on table scraps (44%) or commercial dog food (39%). Only 16% of animals were neutered and many had puppies (range 3-11) and there was a high mortality rate (>2 puppies in 73% of litters). Only 24% of the dogs were over 4 years. Relatively few owners (55%) took their dogs to the veterinarian, principally for vaccination and checkups (85%) but when their animal was ill (24%). Most people (54%) used insecticides for external parasites on their dogs and some (44%) dewormed their animals. Many people (24%) had been bitten by a dog but 64% did not believe people could acquire diseases from dogs. Only 6% of respondents thought there were too many dogs on the island.

Attitudes towards dog ownership on St. Kitts, West Indies.

A structured face-to- face interview was held with 64 arbitrarily selected local people attending a vegetable market in the capital of St. Kitts on a Saturday morning. Most (67%) respondents liked dogs and many (57%) owned one (41%) or two (29%) for protection (67%) and as a pet (65%). The main reason people disliked dogs were because they feared them (56%) and because they created a mess (50%). Generally people had purebred (40%) male (56%) dogs which were always outside (50%), in fenced yards (43%), on chains (34%) or running free (22%). All owners fed their dogs, mainly on table scraps (44%) or commercial dog food (39%). Only 16% of animals were neutered and many had puppies (range 3-11) and there was a high mortality rate (>2 puppies in 73% of litters). Only 24% of the dogs were over 4 years. Relatively few owners (55%) took their dogs to the veterinarian, principally for vaccination and checkups (85%) but when their animal was ill (24%). Most people (54%) used insecticides for external parasites on their dogs and some (44%) dewormed their animals. Many people (24%) had been bitten by a dog but 64% did not believe people could acquire diseases from dogs. Only 6% of respondents thought there were too many dogs on the island.

Attitudes of Jamaicans in Kingston and St.Andrew towards homosexuality [abstract]

OBJECTIVE: Jamaica has long been considered to be a homophobic society. The aim of this survey was to examine the attitudes of the Jamaican populance towards homosexuality, thus shedding light on the important issue of homosexuality, disclosure of one's sexual preference and the relationship to the HIV/AIDS epidemic. METHODS: There have been several subjective reports on the issue of homosexuality in Jamaica. Many of these reports have suggested that Jamaica is not truly a homophobic society. No objective study on attitudes towards homosexuality in Jamaica has been done to date; this is an attempt in that regard. A survey was conducted in the Kingston and St.Andrew region. A questionnaire consisting of 17 knowledge and attitude items with six items to determine demographic data was prepared. This was administered to every third person in 6 designated areas, ensuring that equal numbers of males and females aged 16 years and over were polled. RESULTS: The analysis indicates that the majority of those surveyed thought that the homosexuality lifestyle was unaccepatable. Of significance, views varied depending on the level of educational attainment: 100 percent of persons with primary level education found homosexuality unacceptable in contrast with 76 percent of those with teritiary level education with a similar opinion (p=0.028). There was a generally negative attitude towards befriending an acknowledged homosexual or having such persons in positions of authority. Many participants agreed that homosexual partners should have access to social services, including insurance plans, with 37 percent in outright agreement and 21 percent remaining neutral. There was a dramatic decrease in the number of persons who believed that HIV was solely a homosexual disease (13 percent) in contrast with the results of a 1989 survey conducted by the Ministry of Health (81 percent). CONCLUSION: Despite changing global opinions of the homosexual lifestyles, several biases still remain within the Jamaican society. These conditions force homosexuals to remain ensconced within the cloak of the more acceptable heterosexual lifestyle, which may have significant social and health implications. (AU)

Attitudes of patients and staff to the implementation of an open door policy in a psychiatric unit of a general hospital [Abstract]

OBJECTIVE: To document the changing attitudes of staff and patients to the implementation of an open door policy (ODP) in the custodial psychiatry unit at the University Hospital of the West Indies. METHOD: The implementation of the changing therapeutic activities between October 2000 and January 2001 was followed using qualitative methods. Patients, their relatives and staff were interviewed around the time of implementation of each changing activity, and their attitudes documented. Patients attitudes to the transformed ward were sampled from May 2001 using the Verona Satisfaction Scale. The ODP had five separate components. The first was the opening of the main gate of the ward, which took place in October 2000. This was followed by a rationalization in stages of patients clinical status and their assignment to specific therapeutic activities. The implementation of daily therapeutic community group meetings was followed shortly afterwards by the implementation of an art therapy programme and other occupational activities. The opening of the Occupational Centre was the final phase of the programme in June 2001. RESULTS: The initial response of staff members to the opening of the main gate was angry and hostile with acts of passive resistance. Patient response was cautious but favourable, and they soon took advantage of leaving the ward unacompanied. Demarcation of the patients into groups of clinical severity soon allowed the staff to rationalize therapuetic activities for the patients. Both staff and patients were cooperative to this change. Implementation of the therapuetic community group meetings had a profound resocializing effect on patients and staff. Finally, the implementation of the art and activity therapy was warmly received by the patients, and proudly acclaimed by the staff. Analysis of the Verona Satisfaction Scores indicated a general acceptance and appreciation by the patients. CONCLUSIONS: The general consensus has been that the ward atmosphere was positively transformed by the ODP with patients being more satisfied with their care and being less hostile in their interactions with staff. Staff have cooperated with the changes, and have expressed appreciation of the benefits derived from the process. (AU)

Concepts of obesity among outpatients of a Jamaican hospital

Obesity is an important risk factor for the development of chronic non-communicable diseases such as diabetes and hypertension, which affects large numbers of Caribbean people. There is a perception that Caribbean culture is not only tolerant of obesity but actually encourages this state, especially among women. We carried out a survey among normal-weight and overweight adults in order to investigate their attitudes to obesity. Three hundred adults (245 women and 55 men) present at the Casualty department at the University Hospital during the study period were asked to participate. A questionnaire was given, and heights and weights were measured to determine Body Mass Index (BMI). The relation between BMI and attitudes to obesity was explored. Forty percent of the respondents agreed that fatness was a sign of happiness, 15 percent thought it represented wealth, and 10 percent thought it represented health. Just over half (58 percent) of the women who were overweight perceived themselves to be fat, while of the overweight men (42 percent) thought themselves fat. Fifty-six percent of the men, and 38 percent of the women preferred a slim partner. Most respondents were aware of the diseases associated with obesity and could name foods which contributed to obesity e.g. fried foods and sweets. These data suggest that obesity is viewed favourably, or not unfavourably, by nearly half of the sample, or the converse, over half of the respondents did not view obesity favourably. Although the problems of obesity are recognized, overweight people are not necessarily aware that they are in fact overweight and at risk. Health promotion efforts should take this into account. (AU)

A study of the Knowledge, attitudes and practices of primary health care workers in the South-East region of Jamaica concerning the DOTS strategy for the control of tuberculosis

Tuberculosis is an infectious disease caused by the micro-organism Mycobacterium tuberculosis. This micro-organism can be found in about one third of the world population and causes more deaths than any other infectious agent globally. To control this deadly disease, persons ill witH TB need to take a combination of medications for a period of 6 to 8 months. Most of those suffering from TB find this difficult, and to aid in the adequate treatment of persons with the disease and protect others from it, the World Health Organisation along with others concerned about the situation, developed the directly observed treatment, short-course (DOTS) strategy. This cost effective method of treatment requires that health workers world wide observe infected persons while they take their tablets. The aim of this study was to assess the knowledge, attitudes and practices of primary health care workers about the treatment and control of TB using the directly observed treatment, short-course (DOTS) strategy. Data were collected using a questionnaire administered to a sample of selected categories of health workers in the study area. Additionally, three selected key informants from the Jamaican health services were interviewed. One hundred and seventy respondents from five categories, (medical officers, nurses, public health inspectors, community health aids and contact investigators) completed questionnaires. The study found that primary health care workers in Jamaica are very willing to participate in this global effort. They feel confident that once they are given the right tools to work with they can contribute ... The study recommends a review of the progress of the implementation program, preparation of a revised plan of action will all involved in TB control activities and institution of training programs throughout the health service on this "health breakthrough of the 1990's" (AU)

The distribution and determinants of seat belt use in Kingston and St. Andrew

The consequences of road traffic accidents in Jamaica are of great public health concern. There is a high fatality rate, increasing morbidity and high cost associated with these accidents. In an effort to decrease these outcomes, legislation has been passed that will require mandatory seat belt use as of June 1, 1999. A cross-sectional study was conducted at 10 randomly selected gas stations in Kingston and St. Andrew to identify the distribution of seat belt use, to assess the knowledge of drivers, their attitude and subjective social norms to seat belt use. Data were collected by observation, questionnaire and focus group discussion. The observed prevalence of seat belt use among drivers was 16.8 percent, among front seat passengers 11.1 percent and among back seat passengers 6.6 percent. Seat belt use of drivers was significantly associated with gender, category of driver (taxi and private passenger vehicle) and educational level. Knowledge of the benefits of seat belts (p<0.01), subjective social norms (p<0.00001) and attitude towards seat belt use (p<0.0001) significantly influenced seat belt use. Passengers of drivers who wore seat belts were significantly more likely to wear seat belts than passengers of drivers who did not. Male drivers were significantly less likely to wear seat belts than female drivers, and had significantly lower subjective social norm score and attitude score. Compared to private passenger vehicle drivers, taxi drivers were significantly less likely to wear seat belts, and had significantly lower subjective social norm score and attitude score. The public health implication of the study is the need for the mandating of seat belt use accompanied by effective public education. The study's findings can be used to inform strategies for public and health education programmes. In addition, it may give valuable information to the lawmakers in equitably enforcing the law.(Au)

Cross-cultural differences in maternal evaluation of children's body shapes

OBJECTIVE: This study investigated cultural variation in mothers attitudes to children's body shape. METHOD: One hundred and thirty-one mothers from five cultural groups attending a pediatric clinic were approached, and data obtained from 114. Background information was obtained, including weight and height for themselves and their children. Mothers completed the Eating Attitudes Test (EAT-26) and rated drawings of children for attractiveness and health, using Likert scales, scored 1-7. RESULTS: Mothers from the different cultural groups and their children had similar average body weight. However, UK mothers found slimmer girls attractive compared to mothers from South Asia, the Mediterranean or the Caribbean regions, and sub-Saharan Africa (P<.05). The differences occurred within the mid-range (median scores for all ethnic groups 4-5). South Asian mothers presented to the pediatric clinic with more worries about their children not gaining weight and growth (p>.01). DISCUSSION: These findings have implications for understanding cultural variation in the acquisition of attitudes to body shape, and these attitudes influence medical seeking help (AU).

Abnormal eating attitudes and behaviours in two ethnic groups from a female British urban population

African-Caribbean (N=136) and White British (N=192) female family planning clinic attenders were administered the Bulimic Investigatory Test, Edinburgh (BITE) and the General Health Questionnaire (GHQ-28). A proportion of the participants were subsequently interviewed. The African-Caribbeans were found to have both significantly more disordered eating attitudes and a significantly higher level of abnormal eating behaviour than the White British. Although the African-Caribbean group had a significantly higher mean Body Mass Index this did not mediate the difference in levels of eating attitudes. When compared with the White British group more African-Caribbean women reported feelings of failure, guilt, abnormality and self consciousness concerning their eating habits. The results indicate that eating problems may be highly prevalent in this ethnic minority population and suggest that there may be differences in the nature of eating disorder psychopathology between ethnic groups. (AU)

Gender perception of stress: a comparative study between male and female physicians - abstract

Practising physicians of varied disciplines in Trinidad and Tobago, were studied to determine whether there was any gender difference in the perception of stress. A total of 50 physicians (25 male and 25 female), were selected on the basis of: urban locality of practice, and a workday minimum of five hours. They were asked to complete a questionnaire involving four major sections: (i) general biodata (ii) social activities (iii) lifestyle and (iv) work attitudes. Results indicated that the female physicians perceived significantly more stress than their male counterparts in most of the areas studied (AU)

Fear obstructs battle for safe sex in Barbados

Reports on the prevalent attitude towards HIV and AIDS in Barbados, which is obstructing the battle against the disease. HIV-positive individuals' nondisclosure of their condition to their sex partner; Men as the worst offenders; Swiss tourist scandal; Examples of anecdotal evidence; Need for AIDS education