Efficacy of a food safety comic book on knowledge and self-reported behavior for persons living with AIDS.

INTRODUCTION: Persons living with AIDS are highly vulnerable to foodborne enteric infections with the potential for substantial morbidity and mortality. Educational materials about foodborne enteric infections intended for this immunocompromised population have not been assessed for their efficacy in improving knowledge or encouraging behavior change. METHODS/RESULTS: AIDS patients in four healthcare facilities in Chicago, New Orleans, and Puerto Rico were recruited using fliers and word of mouth to healthcare providers. Those who contacted research staff were interviewed to determine food safety knowledge gaps and risky behaviors. A food safety educational comic book that targeted knowledge gaps was created, piloted, and provided to these patients who were instructed to read it and return at least 2 weeks later for a follow-up interview. The overall food safety score was determined by the number of the 26 knowledge/belief/behavior questions from the survey answered correctly. Among 150 patients who participated in both the baseline and follow-up questionnaire, the intervention resulted in a substantial increase in the food safety score (baseline 59%, post-intervention 81%, p<0.001). The intervention produced a significant increase in all the food safety knowledge, belief, and behavior items that comprised the food safety score. Many of these increases were from baseline knowledge below 80 percent to well above 90%. Most (85%) of the patients stated they made a change to their behavior since receiving the educational booklet. CONCLUSION: This comic book format intervention to educate persons living with AIDS was highly effective. Future studies should examine to what extent long-term behavioral changes result.

Food Safety Knowledge, Beliefs and Behavior of Persons with AIDS: A Multicenter Study.

Persons living with AIDS are highly vulnerable to foodborne enteric infections including recurrent Salmonella septicemia and toxoplasmosis of the brain with the potential for substantial morbidity and mortality. Patients with immunologic AIDS in Chicago, New Orleans, and Bayamon were interviewed to determine gaps in food safety knowledge and prevalence of related behaviors in order to create targeted educational material for this population. A food safety score was calculated based on responses to 40 knowledge, belief, and behavior questions. Among 268 AIDS patients interviewed, the overall food safety score was 63% (range 28% to 93%). Many patients believed it was okay to eat higher risk food (38% for eating eggs served loose or runny, 27% for eating store-bought hot dogs without heating them first), 40% did not know that eating unpasteurized cheese may get germs inside their body that could cause hospitalization and possibly death, and 40% would not throw away salad that had been splashed with a few drops of raw chicken juice. These data demonstrate substantial knowledge gaps and behavioral risk related to acquisition of foodborne disease among AIDS patients. Healthcare providers should incorporate education regarding foodborne disease risk into routine outpatient discussion of improving and maintaining their health.

Assessment of perceived cost to the patient and other barriers to clinical trial participation.

PURPOSE: Less than 5% of patients with cancer participate in trials. Few studies have specifically addressed the role of cost to the patient as an influence on trial participation. Our main purpose was to determine the importance of added cost as a barrier to clinical trial participation in the community setting. Our secondary goal was to determine the most prevalent barriers to trial participation for patients. PATIENTS AND METHODS: Four community practices in New England issued surveys to consecutive cohorts of patients with cancer. Patients were assessed for eligibility for clinical trials at their practice site. Trial-eligible patients who declined participation were asked to select reasons that contributed to their decision. RESULTS: Surveys were issued to 1,755 patients. Seventy-one percent of all trial-eligible patients returned surveys. Forty-four percent of nonparticipating trial-eligible patients did not recall hearing about clinical trials from their provider. The most common reasons cited by trial-eligible patients for declining trial participation were fear of adverse effects (50%) and discomfort with random assignment (44%). Twenty-eight percent cited concerns about added cost, and 12% noted cost as the most important factor in their decision. CONCLUSION: Concerns about adverse effects and random assignment were the most common reasons cited by patients declining trial participation in four community oncology practices in New England. Cost considerations were important for a significant proportion of these patients. Many patients eligible for trial participation were not informed by their provider about the availability of research trials.