Extending and validating a human papillomavirus (HPV) knowledge measure in a national sample of Canadian parents of boys

As the human papillomavirus (HPV) vaccine is now recommended for males, a reliable, comprehensive HPV knowledge measurement tool which addresses issues relevant to males is needed. We aimed to replicate, validate and test the comprehensiveness of an existing general HPV and an HPV vaccination knowledge scale in English and French. We also measured parental HPV knowledge and changes over time. An online questionnaire was administered in February (Time 1; T1) and November 2014 (Time 2; T2) to a nationally representative sample of Canadian parents of boys. Dimensionality, internal consistency and model fit were evaluated at both time points and separately in English and French sub-samples. Differences in knowledge scores were measured. Analyses were performed on 3117 participants at T1 and 1427 at T2. The 25-item HPV general knowledge and an 11-item HPV vaccination scale were unidimensional, showed high internal consistency (α>0.87, α>0.73) and had good model fit. Both general HPV and vaccine-specific knowledge significantly increased over time in both languages, but remained low at T2, with only about half of the items being answered correctly. Correct responses at T2 are best explained by correct responses at T1, with some small changes from 'Don't know' at T1 to correct at T2. The extended general and vaccine-specific knowledge scales are valid, reliable and comprehensive, and could be used among parents of boys, in both English and French. Educational interventions could target specific knowledge gaps and focus on providing information rather than correcting misconceptions

Knowledge of human papillomavirus (HPV) and HPV vaccination: an international comparison.

Since vaccination against human papillomavirus (HPV) became available, awareness of HPV has dramatically increased. Implementation of a vaccine program varies internationally yet no studies have explored the influence this has on the public's knowledge of HPV. The present study aimed to explore differences in awareness of HPV and HPV knowledge across three countries: The US, UK and Australia. Participants (n=2409) completed a validated measure of HPV knowledge as part of an online survey. There were higher levels of HPV awareness among men and women in the US than the UK and Australia. Being male and having a lower educational level was associated with lower HPV awareness in all three countries. Awareness of HPV vaccine was higher in women from the US than the UK and Australia. Women in the US scored significantly higher on general HPV knowledge (on a 15-item scale) than women in the UK and Australia, but there were no between country differences in HPV vaccine knowledge (on a 6-item scale). When asked about country-specific vaccine availability, participants in the US were less able to identify the correct answers than participants in the UK and Australia. More than half of participants did not know: HPV can cause genital warts; most sexually active people will get HPV at some point in their life; or HPV doesn't usually need treatment. Pharmaceutical advertising campaigns could explain why awareness of HPV and HPV vaccine is higher in the US and this has helped to get some important messages across. Significant gaps in HPV knowledge remain across all three countries

Validation of a measure of knowledge about human papillomavirus (HPV) using item response theory and classical test theory.

Public understanding of HPV is important to ensure informed participation in cervical cancer prevention programmes. While many studies have measured HPV knowledge, none has developed a validated measure for use across countries. We aimed to develop and validate such a measure

Virtual discussions to support climate risk decision making on farms

Climate variability represents a significant risk to farming enterprises. Effective extension of climate information may improve climate risk decision making and adaptive management responses to climate variability on farms. This paper briefly reviews current agricultural extension approaches and reports stakeholder responses to new web-based virtual world ‘discussion-support’ tools developed for the Australian sugar cane farming industry. These tools incorporate current climate science and sugar industry better management practices, while leveraging the social-learning aspects of farming, to provide a stimulus for discussion and climate risk decision making. Responses suggest that such virtual world tools may provide effective support for climate risk decision making on Australian sugar cane farms. Increasing capacity to deliver such tools online also suggests potential to engage large numbers of farmers globally

Knowledge of human papillomavirus (HPV) testing in the USA, the UK and Australia: an international survey.

To measure knowledge and awareness of human papillomavirus (HPV) testing in the USA, the UK and Australia

Can digital discussion support tools provide cost-effective options for agricultural extension services?

Agricultural extension that delivers timely, targeted, and cost-effective support to farmers will help ensure the sustainability and adaptive capacity of agriculture, enhancing both food security and environmental security. Leveraging advances in agriclimate science and adult education, innovative digital technologies offer significant new opportunities to engage with farmers and to support decision making. In this study, animated video clips (machinimas), developed using the Second LifeTM virtual world gaming platform, model conversations around climate risk and critical on-farm decisions in the Australian sugarcane farming industry. Early evaluation indicates that this is an engaging format that promotes discussion by leveraging farmers’ natural modes of information gathering and social learning. Comparison with conventional extension practices indicates that these discussion support tools may be a cost effective addition to existing approaches. The format’s flexibility means machinimas are readily updated with new information and customized to meet the needs of different farmer groups. Rapid growth in digital access globally and the scalability of such approaches promise greater equity of access to high-value information, critical to better risk management decision making, at minimal cost, for millions of farmers

The Development of Virtual World Tools to Enhance Learning and Real World Decision Making in the Australian Sugar Farming Industry

In farming, the outcome of critical decisions to enhance productivity and profitability and so ensure the viability of farming enterprises is often influenced by seasonal conditions and weather events over the growing season. This paper reports on a project that uses cutting-edge advances in digital technologies and their application in learning environments to develop and evaluate a web-based virtual ‘discussion-support’ system for improved climate risk management in Australian sugar farming systems. Customized scripted video clips (machinima) are created in the Second Life virtual world environment. The videos use contextualized settings and lifelike avatar actors to model conversations about climate risk and key farm operational decisions relevant to the real-world lives and practices of sugarcane farmers. The tools generate new cognitive schema for farmers to access and provide stimuli for discussions around how to incorporate an understanding of climate risk into operational decision-making. They also have potential to provide cost-effective agricultural extension which simulates real world face-to-face extension services but is accessible anytime anywhere

The association of health literacy with adherence in older 2 adults, and its role in interventions: a systematic meta-review

Background: Low health literacy is a common problem among older adults. It is often suggested to be associated with poor adherence. This suggested association implies a need for effective adherence interventions in low health literate people. However, previous reviews show mixed results on the association between low health literacy and poor adherence. A systematic meta-review of systematic reviews was conducted to study the association between health literacy and adherence in adults above the age of 50. Evidence for the effectiveness of adherence interventions among adults in this older age group with low health literacy was also explored. Methods: Eight electronic databases (MEDLINE, ERIC, EMBASE, PsycINFO, CINAHL, DARE, the Cochrane Library, and Web of Knowledge) were searched using a variety of keywords regarding health literacy and adherence. Additionally, references of identified articles were checked. Systematic reviews were included if they assessed the association between health literacy and adherence or evaluated the effectiveness of interventions to improve adherence in adults with low health literacy. The AMSTAR tool was used to assess the quality of the included reviews. The selection procedure, data-extraction, and quality assessment were performed by two independent reviewers. Seventeen reviews were selected for inclusion. Results: Reviews varied widely in quality. Both reviews of high and low quality found only weak or mixed associations between health literacy and adherence among older adults. Reviews report on seven studies that assess the effectiveness of adherence interventions among low health literate older adults. The results suggest that some adherence interventions are effective for this group. The interventions described in the reviews focused mainly on education and on lowering the health literacy demands of adherence instructions. No conclusions could be drawn about which type of intervention could be most beneficial for this population. Conclusions: Evidence on the association between health literacy and adherence in older adults is relatively weak. Adherence interventions are potentially effective for the vulnerable population of older adults with low levels of health literacy, but the evidence on this topic is limited. Further research is needed on the association between health literacy and general health behavior, and on the effectiveness of interventions

Virtual Discussions to Support Climate Risk Decision Making on Farms

Climate variability represents a significant risk to farming enterprises. Effective extension of climate information may improve climate risk decision making and adaptive management responses to climate variability on farms. This paper briefly reviews current agricultural extension approaches and reports stakeholder responses to new web-based virtual world ‘discussion-support’ tools developed for the Australian sugar cane farming industry. These tools incorporate current climate science and sugar industry better management practices, while leveraging the social-learning aspects of farming, to provide a stimulus for discussion and climate risk decision making. Responses suggest that such virtual world tools may provide effective support for climate risk decision making on Australian sugar cane farms. Increasing capacity to deliver such tools online also suggests potential to engage large numbers of farmers globally