Complex relation among Health Belief Model components in TB prevention and care.

OBJECTIVES: This study aims to explore the relationships among components of the Health Belief Model, tuberculosis (TB) preventive behavior, and intention of seeking TB care. STUDY DESIGN: Cross section study. METHODS: Using convenience sampling, 1154 rural-to-urban migrant workers were selected between the ages of 18-50 years in six urban areas of three provinces in China. The survey was conducted by individual, face-to-face interviews with a standardized questionnaire. Lisrel 8.7 was used to conduct path analysis. RESULTS: The knowledge and benefits components of the Health Belief Model predicted preventive behaviors: cover nose/mouth when coughing or sneezing (ß = 0.24, 0.33 respectively), evade others' coughs (ß = 0.13, 0.25) and also predicted seeking TB care (ß = 0.27, 0.19). Susceptibility and severity also predicted seeking TB care (ß = 0.12, 0.16). There were also important relationships among model components. Knowledge of TB predicted both susceptibility (ß = 0.32-0.60) and severity (ß = 0.41-0.45). Further, each of susceptibility (ß = 0.30) and severity (ß = 0.41) predicted perceived benefits of preventive care. CONCLUSION: Thus, a path from knowledge, through severity and susceptibility, and then through benefits predicted prevention and TB care seeking behaviors.

Public awareness of tuberculosis in China: a national survey of 69 253 subjects.

OBJECTIVE: To investigate the level of awareness about tuberculosis (TB) in the public and associated factors in China. METHODS: Participants were recruited from 60 counties in 19 provinces and interviewed using a structured questionnaire. Questions asked covered the following areas: 1) overall TB awareness, 2) signs/symptoms of TB, 3) mode of TB transmission, 4) TB dispensaries, 5) free TB detection/treatment policy, 6) TB curability and 7) stigma attached to TB. Factors associated with TB awareness were examined using logistic regression. RESULTS: A total of 69 253 respondents aged 12-65 years were interviewed, revealing an overall TB awareness rate of 89.0% (95%CI 88.8-89.3). The awareness rates for TB symptoms, TB dispensaries and the free TB detection/treatment policy were respectively 15.1% (95%CI 14.8-15.4), 41.9% (95%CI 41.6-42.3) and 44.7% (95%CI 44.3-45.0). Approximately 71.9% (95%CI 71.6-72.3) had some extent of stigma towards patients with TB. People in the farming industry and those with low educational levels had poorer knowledge of all aspects of TB knowledge and were more likely to stigmatise TB. CONCLUSIONS: Future TB control programmes in China should emphasise TB symptoms, TB dispensaries and its free TB detection/treatment policy to increase public TB awareness, and should target farm workers and people with low educational levels.