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Table of Contents
ORIGINAL ARTICLE
Year : 2021  |  Volume : 7  |  Issue : 2  |  Page : 38-42

Knowledge and attitude regarding noncommunicable diseases among school-going girls in Ghaziabad: An interventional study


Department of Community Medicine, Santosh Medical College, Santosh Deemed to be University, Ghaziabad, Uttar Pradesh, India

Date of Web Publication6-Dec-2021

Correspondence Address:
Anupama Singh
Department of Community Medicine, Santosh Medical College, Santosh Deemed to be University, Ghaziabad - 201 009, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2455-1732.331786

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  Abstract 


Introduction: Noncommunicable diseases (NCDs) are chronic health conditions that do not spread from person to person. Once considered the epidemic of the affluent, now they are gripping low- and middle-income countries. Disability caused by NCDs has risen from 21% of the total disease burden in 1990 to 34% by 2019. Major causes include poor nutrition, physical inactivity, unregulated usage of tobacco and alcohol, inaccessible healthcare, and unhealthy environment. Therefore, giving the correct information about the long-term effects of adopting unhealthy habits should be emphasized among adolescents.
Objectives: The objective is to study the impact of awareness session on knowledge and attitude regarding NCDs among school-going girls in Ghaziabad city.
Materials and Methods: A School-based intervention study was conducted in a selected Government School in Ghaziabad city. A predesigned, semi-structured questionnaire was administered to the students to assess their baseline knowledge and attitude. After the awareness session, the same questionnaire was administered again. The data were compiled and analyzed using MS Excel 2016, and appropriate statistical method like McNemar's test was applied.
Results: Among the 216 study participants, 75.9% could differentiate between Communicable and NCDs correctly which increased to 89.8% after the session. Regarding the identification of major NCDs pre- and post-session proportions were 59% and 68%, respectively. The attitude of majority of the students (99%) remained positive from the starting. They believed that these diseases are preventable and lifestyle modifications are protective.
Conclusion: Considerable improvement was observed in the awareness levels of the school students regarding NCDs after attending the health awareness session. When correct information is imparted, students develop a positive attitude and are encouraged to develop a healthy lifestyle. Hence, it is recommended that regular awareness sessions should be organized in schools to build a healthy nation.

Keywords: Adolescent, alcohol, attitude, awareness, chronic, impact, knowledge, noncommunicable diseases, school-going, tobacco


How to cite this article:
Jetli N, Agrawal D, Kumar A R, Singh A, Gaur A, Gupta GK. Knowledge and attitude regarding noncommunicable diseases among school-going girls in Ghaziabad: An interventional study. Santosh Univ J Health Sci 2021;7:38-42

How to cite this URL:
Jetli N, Agrawal D, Kumar A R, Singh A, Gaur A, Gupta GK. Knowledge and attitude regarding noncommunicable diseases among school-going girls in Ghaziabad: An interventional study. Santosh Univ J Health Sci [serial online] 2021 [cited 2022 Sep 25];7:38-42. Available from: http://www.sujhs.org/text.asp?2021/7/2/38/331786




  Introduction Top


Noncommunicable diseases (NCDs) include chronic, long-term illnesses such as diabetes, hypertension, stroke, cardiovascular diseases, chronic respiratory diseases, and cancer.[1] Once considered the epidemic of the affluent, now they are gripping low and middle-income countries. Disability caused by NCDs has risen from 21% to 34% in the past decade.[2] Most of them are caused by a combination of genetic, physiological, environmental, and behavioral factors. Unhealthy diet, sedentary lifestyle, tobacco use, and excess alcohol consumption are major modifiable risk factors for NCDs.[3],[4]

The development of habits and behavioral patterns during the adolescent period makes a great impact on the lifestyle adopted by an individual. Adolescence being an impressionable age makes teenagers vulnerable to developing unhealthy habits. Therefore, imparting the right knowledge about NCDs and their risk factors are important for community-based prevention strategy. NCDs are responsible for 60% of all deaths in India.[5] Health education has always been the hallmark for the prevention of NCDs. Therefore, this study was undertaken to assess the impact of awareness session on knowledge and attitude regarding NCDs through a pre- and post-session assessment among school-going students in Ghaziabad city.


  Materials and Methods Top


A school-based interventional study was planned in the Department of Community Medicine, Santosh Medical College, and conducted in the Government Girls Senior Secondary School in Urban Field practice area of the Department of Community Medicine, Santosh Medical College, Ghaziabad, UP. The study population consisted of students in classes 9–11.

Sample size:



Where Z is 1.96 at 5% level of significance (95% confidence interval) and taking 50% (P) as general awareness regarding NCDs[6] with relative precision (L) of 15% of P and 10% nonresponse, the total sample size was calculated to be 188.

Permission was sought from the school authorities to conduct the study among the students of classes 9–11. The total number of students enrolled in these classes 9–11 was 2600. We randomly selected the students who consented to participate. Therefore, 216 students were included in this study.

A self-administered pre-designed, pretested semi-structured questionnaire in Hindi (which is the local language here) was administered to assess the baseline knowledge and attitude before and after the awareness session to the same students of classes 9–11 willing to participate in the study.

The questionnaire was explained to the students beforehand, and it consisted of questions pertaining to the awareness of common NCDs such as diabetes mellitus, hypertension, obesity, cancer, cardiovascular disease, stroke, accidents, and their risk factors. Anonymity of the study subjects was maintained throughout.

The data were compiled and analyzed using MS Excel 2016, and appropriate statistical method like McNemar's test was applied.


  Results Top


In the present study, a total of 216 students participated. All of them were 12–18 of years. Majority 173 (80%) students were of 14–16 years, 22 (10.2%) students were below 14 years of age, and 21 (9.8%) students were above 14 years [Figure 1].
Figure 1: Age-wise distribution of study population

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Before the awareness session, 75.9% knew the difference between communicable and NCDs; after the session, this number increased to 89.8%. Among the study population, 38.9% correctly knew the cause of maximum mortality worldwide to be cardiovascular disease, which increased to 52.3%. The correct cause of NCDs being poor lifestyle choices was known to a mere 30.1% of students whereas, after the awareness session, more than double (64.8%) students answered correctly. The awareness level among the students after the intervention was found to be significantly higher for all the variables (P values ranging from 0.0000 to 0.0233) [Table 1].
Table 1: Knowledge about noncommunicable diseases among study subjects

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Attitudes of the students regarding NCDs were positive from the beginning itself as almost all of them believed that these diseases are preventable and that their contribution is necessary in controlling them [Table 2].
Table 2: Attitude about noncommunicable diseases among study subjects

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The students were asked to identify major NCDs from a list of diseases, 59% could correctly identify 5–7 of major NCDs before the awareness session and 68% after it [Table 3].
Table 3: Students who could identify major noncommunicable diseases

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  Discussion Top


Adolescence is an age of mental as well as physical transition thus, making it a vulnerable age group. Experimentation is common, and the chances of adopting habits which can predispose to developing chronic illnesses are high. Hence, creating awareness and knowing the attitudes of teenagers regarding NCDs and their risk factors is important. Repeated interventions in the form of imparting correct information regarding healthy lifestyle choices is important as health education is the cornerstone of long-term prevention of chronic diseases.

In this study, 59% of students were aware of 5–7 major NCDs such as hypertension, diabetes, obesity, cardiovascular diseases, cancer, cerebrovascular disorders, and accidents. This was similar to the findings of Goel and Singh[7] who found knowledge about hypertension and diabetes being NCDs in 65.3% and 58.3% of their study subjects, respectively. However, Shivalli et al.[8] found one-fourth (27.3%) and one-third (30.5%) students were aware of hypertension and diabetes to be NCDs in rural Varanasi. This difference in the knowledge levels about NCDs may be due to the urban-rural divide among adolescents.

After the awareness session, 13.9% more students could differentiate between Communicable and NCDs. A similar jump of 10% was seen in students correctly knowing the most common cause of mortality among women worldwide being cardiovascular disorders. A massive increase of 34.7% of students knowing the correct causes of NCDs was seen after the intervention.

Before the awareness session, 28.2% of the study subjects considered NCDs to be of public health importance, but once the correct knowledge was imparted, this number rose to 40.8%. However, in the study done by Gupta et al[3] in rural adolescents of North west India, 83.95% of study participants considered NCDs to be of public health importance. This shows a considerable lack of knowledge among the urban adolescents of Ghaziabad regarding the importance of NCDs in public health.

All the students knew about the ill effects of alcohol, and 97% considered smoking to be injurious to health and a risk factor for the development of these chronic conditions; thus, consumption of tobacco and related products was also negligible among the study participants. In the study done by Shivalli et al.,[8] only 10% of the study subjects considered alcohol to be the risk factor for diabetes. A study done by Batlish et al.[9] also reported low awareness of risk factors of NCDs in adolescents in Pune. This difference in the findings may be due to the increased use of social media among the urban adolescents in the present times.

In contrast to the good knowledge about healthy habits among more than 70% of the study subjects, only 53.7% responded correctly for the lifestyle changes they can further adopt for prevention of these diseases. Only 18% of students were having a physical activity routine, and others were not very keen on taking up daily exercises. Taha[10] also reported in a Saudi Arabian study among male school students that <50% were aware of the beneficial effects of regular physical exercise for the prevention of NCDs. Similarly, Chaudhari et al.[11] and Ade et al.[12] also reported low levels of awareness about preventive measures regarding NCDs.

In this study, 24% of study subjects considered adding extra salt to their cooked food as normal practice, and only 76% considered it harmful for health. Similarly, in a study by Gupta et al.,[3] 86.68% students considered avoiding excess salt consumption as a preventive measure.

Majority of the students (71%) got their information regarding these noninfectious diseases from television and print media. Only 33% stated their information source to be local doctors and ASHA workers. Gupta et al.[3] had similar findings with 60.18% of the study subjects getting the information from media sources.

Attitudes of the students regarding NCDs were positive from the beginning thus, emphasizing on the fact that repeated interventions at this stage of life can prevent adoption of unhealthy habits such as consumption of alcohol, smoking, and also attitude toward healthy eating can be easily developed.

The improvements in the awareness levels of students regarding NCDs and their risk factors after the awareness session can be attributed to the fact that students are more open to accepting correct information and also keen toward adopting healthy habits not only for themselves but also for their family members. Therefore, it is important to influence their young minds towards healthy living and for that such interventions are necessary.


  Conclusion Top


Considerable improvement was observed in the knowledge levels of the students regarding NCDs after attending health awareness session. Since students have a positive attitude towards NCDs, they are willing to adopt a healthy lifestyle. As it has been well established that risk factors for NCDs are of multifactorial nature, the need is to promote community-based behavioral and lifestyle-related interventions. Hence, it is recommended that regular awareness sessions should be organized in schools to build a healthy nation.

Limitations

The study was limited to adolescents from one school in the urban area of district Ghaziabad only. A study involving more school students from both rural and urban areas would give us a better idea on the baseline awareness and attitudes about NCDs for a better preventive approach.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Jeeman P, Mathews E, Jha V. “Non Communicable Diseases: A Modern Condition?” 14 May 2019. Available from: https://www.natureasia.com/en/nindia/article/10.1038/nindia. 2019.60. [Last accessed on 2020 Oct 10].  Back to cited text no. 1
    
2.
Mahapatra R. Global Burden of Diseases: Non-Communicable Diseases Bigger Burden than Early Deaths. 16 October 2020. Available from: https://www.downtoearth.org.in/news/health/global-burden-of-diseases-non-communicable-diseases- bigger-burden- than-early-deaths-73826. [Last accessed on 2020 Nov 05].  Back to cited text no. 2
    
3.
Gupta RK, Kumari R, Hussain S, Raine SK, Langer B, Parveen Z. A cross sectional study to evaluate awareness about non communicable diseases among rural adolescents in North West India. J Dent Allied Sci 2018;7:60-4.  Back to cited text no. 3
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Shayo FK. Co-occurrence of risk factors for non-communicable diseases among in-school adolescents in Tanzania: An example of a low-income setting of sub-Saharan Africa for adolescence health policy actions. BMC Public Health 2019;19:972.  Back to cited text no. 4
    
5.
Nethan S, Sinha D, Mehrotra R. Non communicable disease risk factors and their trends in India. Asian Pac J Cancer Prev 2017;18:2005-10.  Back to cited text no. 5
    
6.
Divakaran B, Muttapillymyalil J, Sreedharan J, Shalini K. Lifestyle riskfactors of noncommunicable diseases: Awareness among school children. Indian J Cancer 2010;47 Suppl 1:9-13.  Back to cited text no. 6
    
7.
Goel S, Singh A. Health awareness of high school students. Indian J Community Med 2007;32:192-4.  Back to cited text no. 7
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8.
Shivalli S, Gupta MK, Mohapra A, Srivastava RK. Awareness of non-communicable diseases and their risk factors among rural school children. Indian J Community Health 2012;24:332-5.  Back to cited text no. 8
    
9.
Batlish R, Jadhav SL, Banerjee A. Coronary heart disease: Awareness of risk factors and lifestyle among school-going adolescents. Indian J Med Sci 2007;61:474-6.  Back to cited text no. 9
[PUBMED]  [Full text]  
10.
Taha AZ. Self-reported knowledge and pattern of physical activity among male school students and their teachers in Al Khobar, Saudi Arabia. J Fam Com Med 2005;12:19-25.  Back to cited text no. 10
    
11.
Chaudhari AI, Rami K, Thakor N. Awareness regarding NCDs among adolescents. Int J Med Sci Public Health 2016;5:115-8.  Back to cited text no. 11
    
12.
Ade A, Chethana KV, Mane A, Hiremath SG. Non-communicable diseases: Awareness of risk factors and lifestyle among rural adolescents. Int J Biol Med Res 2014;5:3769-71.  Back to cited text no. 12
    


    Figures

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    Tables

  [Table 1], [Table 2], [Table 3]



 

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