Knowledge, attitudes, and practices associated with influenza vaccine uptake among healthcare personnel in Israel during three influenza seasons, 2016-2019.

INTRODUCTION: Despite a longstanding Israel Ministry of Health recommendation that all healthcare personnel (HCP) receive a seasonal influenza vaccine, vaccine uptake among HCP remains below the country's target of 60% coverage. To understand factors related to vaccine hesitancy, we used data from a prospective three-year (2016-2019) influenza vaccine effectiveness study among Israeli HCP to examine knowledge, attitudes, and practices (KAP) about influenza vaccination and their association with vaccine uptake. METHODS: At the start of each influenza season, all participating HCP completed a questionnaire that included questions about socio-demographic and occupational characteristics, health status, and KAP related to seasonal influenza vaccination. We extracted vaccination history from electronic medical records and employee vaccination registries. We used logistic regression models to identify demographic and occupational factors, and KAP about influenza vaccination, associated with receipt of vaccination. RESULT: A total of 2,126 HCP were enrolled and had available data on vaccination history. Their median age was 42 years [IQR 35-52], and 73 % self-identified as female. Influenza vaccine uptake in 2016, 2017 and 2018 was 46 %, 48 % and 47 %, respectively. Overall, 36 % of HCP had received an influenza vaccine in ≥ 4 of the eight years prior. HCP aged 35-49 years were less likely to receive influenza vaccine compared to HCP aged ≥ 50 years (OR: 0.81 [95 % CI: 0.67-0.98]). Nurses and allied personnel were less likely to receive influenza vaccine compared to physicians (OR: 0.63 [95 % CI: 0.50-0.78] and OR: 0.53 [95 % CI: 0.40-0.70], respectively). The emotional benefit of vaccination (e.g., anticipating regret if not vaccinated) and the perception of vaccine safety were factors associated with vaccine uptake (OR: 7.60 [95 % CI: 6.27-9.22] and OR: 3.43 [95 % CI:2.91-4.03], respectively). CONCLUSION: Among HCP at two hospitals in Israel, less than half received an annual influenza vaccine. Older HCP, physicians, and those who reported the emotional benefit of vaccination or agreed that influenza vaccines are safe were more likely to be vaccinated. Future influenza vaccination campaigns could focus on these demographic groups and tailor messages emphasizing the emotional benefits of vaccination and vaccine safety to increase seasonal influenza vaccine uptake among HCP in Israel.

Psychometric evaluation of a novel tool for assessing gestational diabetes and hypertension care: knowledge, attitudes, and practices of midwives and nurses.

While standardized assessment of knowledge, attitudes, and practices (KAP) related to gestational diabetes and hypertension is possible with a valid tool, existing research remains limited. This prospective validation study aimed to develop and validate a novel tool to assess the KAP of midwives and obstetric nurses. We included 125 midwives and obstetric nurses who routinely care for patients with gestational diabetes and hypertension. The tool demonstrated good internal consistency (Cronbach's alpha): knowledge (0.729, 95% CI, 0.654-0.776), attitude (0.756, 95% CI, 0.690-0.814), and practices (0.925, 95% CI, 0.905-0.943). Difficulty indices (d) ranged from 0.38 to 0.99 (knowledge), 0.41 to 0.99 (attitudes), and 0.41 to 0.93 (practices), indicating appropriate item difficulty. Discrimination indices (D) confirmed items could differentiate between respondents with low and high knowledge levels (D range: 0.02-0.77 for knowledge, 0.06-0.64 for attitudes, 0.20-0.84 for practices). The robust psychometric properties of this tool support its use in future research on KAP related to diabetes and gestational hypertension management in midwives and nurses. This instrument has the potential to be valuable in various settings, including baseline assessment before educational programs or evaluation of learning outcomes after interventions.

Knowledge, attitudes, and practices of veterinary professionals towards ticks and tick-borne diseases in Illinois.

Objective: A lack of standardized surveillance or reporting of tick-borne diseases (TBDs) in Illinois creates uncertainty for veterinarians regarding TBDs occurring within their practice geography or which TBDs may be encroaching on their area from neighboring territories. Therefore, the objective of this study was to gauge the knowledge, attitudes, and practices of veterinary professionals in Southern and Central Illinois to establish a foundation for targeting educational and outreach programs that address knowledge gaps. Sample: 72 veterinary professionals in Central and Southern Illinois. Procedures: An online knowledge, attitudes, and practices survey was distributed to veterinary professionals in Southern and Central Illinois. Poisson regression analyses were conducted to determine factors associated with knowledge scores and the estimated number of TBD cases diagnosed. Results: Knowledge scores were significantly higher among veterinary practitioners with recent (within the last 5 years) training on TBD. The number of cases of TBD diagnosed was higher among those reporting concern about TBD, and among those who routinely test for TBDs. The types of diseases diagnosed were heavily influenced by the diagnostic method used. Clinical relevance: This study paints a cohesive picture of human factors associated with diagnosing veterinary diseases and TBD prevalence in Southern and Central Illinois. Our results highlight the importance and practical value of veterinary continuing education on ticks and TBDs for both companion animals and public health. Building capacity for training veterinarians in parasitology using partnerships between academia and industry may strengthen the knowledge and understanding of ticks and tick-borne pathogens in the veterinary community.

Knowledge, attitudes and practices towards Evidence-Based-Dentistry regarding dental practitioner: A cross-sectional study.

Introduction: Dental practice experienced two important evolutions: the development of the concept of evidence-based dentistry (EBD) and the changes in the relationship between dentists and patients. Thus, the practitioner is invited nowadays to give a treatment that reflects the best available evidence.The purpose of this study is to explore knowledge, attitudes, and practices of dentists toward the concept of EBD. Methods: This is a cross sectional study that was conducted among dentists in public and private sector in Morocco. A self-administered questionnaire with 27 questions was delivered to practitioners. The comparison was carried out using the Khi2 test or Fisher's exact test, t-test or the Mann-Whitney. Logistic regression was performed to assess factors associated with the application of EBD. Linear regression was also performed to identify factors that impact knowledge, attitude and practice score. Results: A total of 209 responses was received. 58% of the participants were in the private sector, and 32.7% were academics. The main reported obstacles were the lack of time 44% and lack of training on critical appraisal 60.3%. Knowledge of PICO question formulation and previous EBD training was significantly related to the implementation of EBD in multivariate analysis in logistic regression (OR = 8.163- CI95%: 2.095-31.80 and OR = 12.79- CI95%: 2.868-57 respectively). The total score of surveyed dentists was affected by the knowledge of PICO question formulation and the knowledge of relevant information sources (PubMed/Medline, the Cochrane library) (ß = 3.04- CI95%: 0.411-5.66, ß = 6.29- CI95%: 2.92-9.66 and ß = 8.35- CI95%: 5.89-10.81 respectively). Conclusion: Based on the findings of this study, application of EBD was associated with knowledge of PICO question formulation and previous EBD training. The lack of time was the most common obstacles identified by the participants applying EBD. Therefore, EBD educational programs should be developed for dental practitioners to enhance their knowledge and skills.

Knowledge, attitudes, and practices of Illinois medical professionals related to ticks and tick-borne disease.

Background: The rising incidence of tick-borne disease (TBD) underscores the importance of proficiency in TBD diagnosis. Clinicians' knowledge about vector ticks and TBDs in their area may influence whether patients are questioned about potential tick exposure and the consideration of diagnostic testing for TBDs. Objective: Our objective was to assess the knowledge, attitudes, and practices of Illinois clinicians towards ticks and TBDs. The study aimed to 1) identify predictors associated with knowledge, 2) identify knowledge gaps, and 3) evaluate attitudes and practices related to TBDs. Methods: A web-based knowledge, attitudes, and practices survey about Illinois ticks and TBDs was disseminated to physicians, mid-level practitioners, and nurses between August 2020 and February 2022. Poisson regression analysis was conducted to identify predictors of higher scores. Results: Of 346 respondents, 80% correctly identified Lyme disease as endemic to Illinois, and 95% were familiar with diagnostic testing for Lyme. Knowledge of other TBDs present in the state was highest among physicians, yet only 26% of physicians believed Rocky Mountain spotted fever (RMSF) to be present in Illinois, and only 17% believed ehrlichiosis to be endemic. Only 32% of physicians knew the cause of Alpha-gal syndrome and fewer than 18% were aware of available diagnostic testing. Tick or TBD-related education within the past two years was the most significant predictor of higher scores, increasing overall knowledge scores by 26% (RR 1.26, 95% CI 1.13-1.41) and increasing scores specific to TBDs by 42% (RR 1.42, 95% CI 1.19-1.69). Conclusion: Illinois clinicians were informed about Lyme disease but lacked knowledge of other TBDs endemic to the state, including RMSF, ehrlichiosis, and Alpha-gal syndrome. The strongest predictor of knowledge was tick/TBD training in the previous two years, highlighting the importance of frequent region-specific training on ticks and TBDs.

Rabies research in Ethiopia: A systematic review.

Rabies is an important zoonosis in Ethiopia, where lack of research is cited as a constraint to implementation of the national rabies control strategy. We conducted a systematic review of publications and theses on rabies in Ethiopia, to document research gaps and areas of knowledge saturation in relation to geographic and species focus, methods and findings. We also examined funding sources and extent of local researcher participation. After screening titles and abstracts, the full text of 119 publications was included in data extraction. More than 40% of publications involved data collection in one region (Oromia); no publications reported findings from Benishangul-Gumuz, Dire Dawa or Gambella. Dogs and wildlife (especially Canis simensis) were the focus of research in 45% and 24% publications, respectively. Descriptive epidemiology (N = 39 publications), ethno-medicine/-pharmacology (N = 17) and knowledge, attitude, and practice surveys (KAP, N = 15) were amongst the most common study designs, while studies involving economic methods (N = 3) and experimental epidemiology to test interventions (N = 3) were under-represented. Incidence surveys (N = 9) commonly used post-exposure prophylaxis administration in humans as a proxy for exposure without laboratory confirmation of the rabies status of the animal. KAP surveys tended to highlight reasonable levels of knowledge of rabies and poor practices, including overreliance on medicinal plants. International researchers were the first or last (senior) author on 42% and 58% of publications, respectively, most of which were funded by international organizations (45/72 publications reporting funding source). Based on this systematic review, we suggest more applied research is needed to address gaps in laboratory surveillance (including in humans, domestic and wild animals); identify effective ways to overcome socio-cultural and other barriers to accessing effective rabies treatments; inform best approaches to incentivizing mass dog vaccination programs; and generate local estimates of the cost-benefit and cost-effectiveness of different control strategies to improve financing and political buy-in for rabies control in Ethiopia.

Effect of nutrition behaviour change communication delivered through radio on mothers' nutritional knowledge, child feeding practices and growth.

Childhood undernutrition coupled with poor feeding practices continues to be public health problems in many parts of the world and efforts to address them remain elusive. We tested the hypothesis that women who are exposed to radio health/nutrition education will demonstrate greater nutrition and health knowledge, positive attitudes towards preventive health and better dietary diversity practices for improved child growth. We used a two-arm, quasi-experimental, non-equivalent comparison group design with pre- and post-test observations to evaluate the intervention. The study population comprised 712 mothers with children aged 6-36 months who were randomly selected from five intervention districts and one comparison district in Northern Ghana. Difference-in-difference (DID) analysis was performed to assess study outcomes. After 12-month implementation of intervention activities, the minimum dietary diversity and the minimum acceptable diet improved significantly (DID 9⋅7 percentage points, P 0⋅014 and DID 12⋅1 percentage points, P 0⋅001, respectively) in the intervention study group, compared with the comparison group. Mothers in the intervention communities had a nutrition-related knowledge, attitudes and practices score that was significantly higher than their colleagues in the comparison communities (DID 0⋅646, P < 0⋅001). The intervention did not have significant effects on the nutritional status as measured by height-for-age Z-score or weight-for-height Z-score. The data provide evidence that health and nutrition education using radio drama significantly increased health-/nutrition-related knowledge but had little effect on nutritional status.

Establishing research priorities to improve the One Health efficacy of Australian general practitioners and veterinarians with regard to zoonoses: A modified Delphi survey.

While general medical practitioners (GPs) and veterinarians are often the first line responders in the face of a disease outbreak, pathways to improving the One Health efficacy of these clinicians remain unclear. A two-phase modified Delphi survey of professionals with known expertise in One Health ('expert panel') was used to 1) identify key knowledge, attitudes and practices (KAPs) of GPs and veterinarians that would be consistent with a One Health approach to zoonoses; and 2) determine priorities for future surveys with Australian GPs and veterinarians to identify important gaps that impede effective diagnosis and management of zoonoses. A list of 13 topics/sub-topics, as well as a list of 25 specific zoonotic diseases/agents emerged from the first phase of the survey. In the second phase the expert panel identified general knowledge of the clinical aspects and epidemiological aspects of zoonoses, as well as risk management practices, as the most important KAPs and research priorities for both GPs and veterinarians. In terms of diseases, the expert panel regarded knowledge of Hendra virus, Q fever, Australian bat lyssavirus (ABLV), anthrax and Brucella suis most important for veterinarians, whilst for GPs, Q fever, gastrointestinal/foodborne diseases, influenza, ABLV and local vector-borne diseases were found to be most important by the expert panel. Some differences were noted in terms of prioritization of topics/sub-topics and diseases/agents according to expert background (veterinary and non-veterinary). The Delphi survey technique enabled efficient collection of data from a diverse range of One Health 'experts'/specialists and provided clear priorities for proposed future research, and potentially for educational interventions to improve One Health efficacy of clinicians.