Knowledge, attitudes, behavioral and organizational factors of health professions students for a competent smoking cessation practice: An instrument adaptation and psychometric validation study in Spanish and English samples.

BACKGROUND: To improve smoking cessation, training of health professions students is essential. However, no specific instrument is available to assess factors that may affect students' learning about smoking cessation practice. AIM: To adapt and validate the Knowledge, Attitudes, Behaviors and Organization questionnaire in the population of undergraduate health professions students. DESIGN: Methodological research. METHODS: The researchers conducted this study with 511 Spanish and 186 English health professions students from four different universities. We used a four-step approach: 1) adaptation of the items to the target population and validation of the content by a panel of experts; 2) a pilot study to test face validity; 3) linguistic adaptation of the Spanish version to English; and 4) the psychometric assessment based on construct validity, criterion validity and internal consistency. RESULTS: Exploratory factor analysis revealed four subscales for the Spanish version, namely 'Individual knowledge and skills', 'Individual attitudes and beliefs', 'Organizational support' and 'Organizational resources', which accounted for 85.1% of the variance. Confirmatory factor analysis in the holdout Spanish and English samples revealed adequate goodness-of-fit values, supporting the factor structure. Hypotheses testing demonstrated significant differences by capacitation in smoking cessation interventions and degree courses, providing further evidence regarding construct validity. All the subscales correlated positively with the criterion variables (5 A's smoking cessation model), except for the 'Organizational resources' subscale, which was not significantly correlated with the 5 A's. The overall Cronbach's alpha was.83 for the Spanish version and.88 for the English one. CONCLUSIONS: Our results provide empirical support for the use of the Knowledge, Attitudes, Behaviors and Organization questionnaire for Students as a reliable and valid instrument to assess knowledge, attitudes, behaviors and organization perceptions in health professions students, which is essential for competent smoking cessation practice. Interestingly, 'Organizational resources' subscale presented the lowest correlations among factors and did not correlate with any component of the 5 A's, suggesting the need of enhancing students' responsibility and involvement during their internships, as well as the interest of some organizations.

Health promotion and lifestyle advice in a general practice: what do patients think?

BACKGROUND/RATIONALE: Since 1990 health promotion and lifestyle advice has been integrated in general practice and has been mainly undertaken by practice nurses. However little is known about patients' views of the service provided. AIMS OF THE STUDY: To examine patients' recall and perceptions of lifestyle counselling received from practice nurses in a general practice in the North-east of England. To investigate the extent to which patients' needs are met. To assess the main sources of health information sought by patients. DESIGN/METHODS: Cross-sectional descriptive survey. A total of 512 patients were sent a postal questionnaire about current lifestyle, recall of lifestyle advice received and perceptions of the advice provided. FINDINGS: A response rate of 64% was achieved. Questionnaire analysis revealed unhealthy lifestyles among the population studied that could be addressed through health promotion, e.g. 25% were smokers; 44% exercised occasionally; 40% had a body mass index >25 kg/m2. Advice received on diet was reported by 6% of patients; on exercise by 4%; on smoking by 4% and on alcohol consumption by 2%. Patients were willing to receive more health promotion in areas such as stress, exercise and weight reduction. Magazines (67%) and TV (47%) were selected as the main sources for health promotion information. CONCLUSIONS: Health needs to be promoted. The low rate of lifestyle advice reported by the patients implies that more preventive advice should be provided in primary care settings. More effective health promotion should be planned according to the needs of the practice population.