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Uses of formal and informal knowledge in the comprehension of instructions for oral rehydration therapy in Kenya.
Social Science and Medicine. 1987; 25(11):1225-34.Information for using pre-mixed oral rehydrations salts solutions which have been made widely available in rural Kenya is normally printed on the packets in English, along with illustrations, and is either read or explained to the purchaser. This report found that comprehension of these directions could be improved with simple changes in the printed text that would reinforce prior knowledge and increase the effectiveness of the illustrations. The larger issue at stake is the need to develop long term health care remedies such as education and literacy, as well as short term. Oral rehydration therapy (ORT) was adopted as a short term way of combatting infant mortality due to diarrhea with explanation of ORT becoming the responsibility of village level health workers. This study suggests, however, that education including literacy, knowledge of environmental and biological causes of disease, and the ability to comprehend treatments is essential to long term health care goals.
Drug Intelligence and Clinical Pharmacy. 1984 Sep; 18(9):730-5.The distribution of the patient package insert (PPI) by pharmacists is at best controversial. Although most health professionals agree that the patient has the right to receive information about drugs, they disagree on the best way to provide that information. Since the oral contraceptive (OC) PPI has been in routine use for approximately 10 years, a large data base exists that can be used to determine not only patient acceptance of the PPI, but also knowledge, feelings, and behavior secondary to the PPI. In this study, 50 women of childbearing age completed a questionnaire, and it was learned that 84% had taken or were currently taking OCs, and 90% of those received a PPI; however, only 61% of these women read all of it. The women performed poorly on the knowledge exam (mean +or- SD, 44.5 +or- 21.2, range 0-83%); those who read all of the PPI or who were white had higher scores (P0.02 and P0.001). 38% of the women thought that the PPI information was inadeqaute, suggesting that it needs to be rewritten and/or supplemented with information from pharmacists. After reading the PPI, 12% contacted their pharmacist for additional information. Pharmacists are in a unique position to provide OC information that enables women to make informed judgments regarding benefit: risk ratios on a personal basis. (author's)
[Unpublished] 1982 Feb 22. 16 p.Family of the Future (FOF) conducted between December 14 1981 and January 7 1982 interviews with 394 people at 10 pharmacies and 3 clinics, to determine awareness of family planning methods. Among the 394 people interviewed 100 did not use contraception, 98 were condom users, 100 were oral contraceptive (OC) users, and 96 were vaginal foaming tablet users. Mean age of males was 34.7, and mean age of OC users was 31, of foaming tablet users was 30, and of nonusers was 28. In general, men were better educated than women. 44% of condom users said they liked them because of lack of side effects; 1/3 said the condom reduced sensitivity; 90% of users knew the Tops brand, followed by the Tahiti brand. 99% bought condoms at a pharmacy; 7 out of 10 would buy Tops; 4 out of 10 said they first bought a condom under advice of the pharmacist. 76% preferred the inner package to be covered on both sides; 2/3 of respondents said they had seen advertisements about Tops. 49% of OC users thought it was the most effective method; mean duration of pill use was 5.3 years. 33% had first heard of OCs from a doctor; 90% of users took the pill correctly and the most common side effect was headache. 50% of women said neither a doctor nor a pharmacist had ever discussed side effects with them. Anovlar was the best known brand, and 95% of users were satisfied with the brand they used. Users of tablets liked the lack of side effects best, although 6 out of 10 did not like the bubbly, warm, and burning sensation after insertion; 4 out of 10 users said their husbands could feel the tablet during intercourse. 90% of users had heard of the Amaan brand, and 82% currently used it. 9 out of 10 users bought the tablets at a pharmacy, and 90% said they had read the instructions; 4 out of 10 had heard of the tablets from a doctor. Among nonusers of contraception 3 out of 10 were pregnant, 2 out of 10 were breastfeeding, and 2 out of 10 said they wanted more children. 6 out of 10 had previously used the pill, 1/4 the IUD, and 20% the condom. Nonusers reported that they would start family planning in about 1 year. 6 out of 10 said they would use the IUD, 3 out of 10 the pill, and less than 10% the tablet. The pill was chosen because of its effectiveness, but prospective users knew they would experience some side effects. 90% of prospective IUD users also were expecting side effects. The IUD was chosen mostly because of its effectiveness and because it does not need sustained motivation. Over 90% of users would like more information about family planning methods; about 7 out of 10 respondents knew of FOF.
[Unpublished] . 17,  p.The Social Marketing Project (SMP) of Bangladesh developed an illustrated Maya (a regular dose oral contraceptive) packet insert of instructions for use and information on potential side effects and what to do about them. Later, the pictures were further clarified by adding a simple text for women who could read and also for those illiterate women who would be interested to have it read by someone else if they had difficulty in understanding the message. The desired material was prepared during 1980 and printed in early 1981. SMP has considered printing it on a large scale, but first wants to determine if this pamphlet is really useful to the Maya consumers. PIACT International agreed to fund a project in Bangladesh to evaluate this pamphlet. Objectives of the evaluation were to learn if the pamphlet is understood by Maya consumers and to compare knowledge of proper use of Maya, its side effects, and what to do about them between the consumers who received and those who did not receive the pamphlet along with the Maya pill packet. 4 markets from the district of Dacca were chosen: Manikogonj, Tongi, Joydebpur, and Norsingdi. From each market, a number of pharmacies were chosen. The selected pharmacies in each market were divided into 2 groups: 1 group of pharmacies was provided a number of pamphlets depending on their Maya sales of the preceding month; pharmacies in the other group were supplied only the forms to record the addresses of the illiterate Maya consumers during a 1-month period. 200 illiterate Maya consumers were randomly selected and interviewed from each of the study and control groups. A majority of the pamphlet recipients understood the messages in the pamphlets. The illustrated support material was more effective than the text material in communicating messages. Clarification of the pictures by adding simple text was found to be useful. The recipients of the pamphlet possessed better knowledge than the nonrecipients of the pamphlet with regard to proper use of Maya, its side effects, and what to do about the side effects. The SMP should use the illustrative support material of Maya as an insert in the Maya packet. In the future, the SMP should use only the pamphlet as an insert in the Maya packet. Some additional information should be added, such as the irregularity of menses due to the use of Maya and the benefits of the use of Maya for other than birth control.