This paper describes an interdisciplinary, variable credit-bearing university course on acquired immunodeficiency syndrome (AIDS) that enrolled 429 students. Pre- and post-course questionnaries were used to assess knowledge and attitudes relative to AIDS and these were compared to National Health Interview Survey findings. Considerable cognitive and attitudinal changes occurred over the course period. University courses, taught annually, were found to be an efficient mechanism for educating large numbers of future community leaders and professionals about AID

Corless, I B

Dennis, B H

Luckey, J W

Strauss, R P

van der Horst, C M

English

PubMed

Carolina Digital Repository

Public Health Briefiseroconversion, particularly if there hasbeen a substantial lag since the most re-cent negative test. []AcknowledgentsThis work was supported by grants from theCommonwealth ofMassachusetts, Departmentof Public Health, and the National Institute onDrug Abuse (RO1-DA05615-OlA2).The authorswish to thank the membersof the Worcester AIDS Consortium for theirsupport in this effort, especially the interview-ers and the field coordinators for collecting thedata used in this study; and Joan Landon,MPH, who assisted with the analysis.References1. Centers for Disease Control. Coordinatedcommunity programs for HIV preventionamong intravenous drug users-California,Massachusetts. MMWR 1989;38:369-374.2. McCuskerJ, Koblin B, Lewis BF, Sulivan J.Demographic characteristics, risk behavior,and IHV seroprevalence among intravenousdrug users by site of contact: results from acommunity-wide HIV surveillance project.AmiJPublic Heath 199,80:1062-1067.3. Koblin BA, McCusker J, Lewis BF, Sulli-van JL. Racial/ethnic differences in HIV-1seroprevalence and risky behaviors amongintravenous drug users in a multi-site study.Am JEpidemioL 1990;132:837-8.4. Mausner JS, Kramer S. Epidemiology AnIntrodcory Tex. 2nd ed. Philadelphia, Pa:WB Saunders Co; 1985:chap 9.5. Harrel AV. Validation of self-report: the re-search record. In: Self-repot Measues ofEsim ting Drug Use. Rockville, Md: USDept of Health and Human Services; 1985.NIDA Research Monograph 57: 12-21.6. Stephens R. The truthfulness of addict re-spondents in research projects. IntlAddct.1972;7:549-558.7. Bonito AJ, Nurco DN, Shaffer JW. Theveridicality of addicts' self-reports in socialresearch. IntJAddict. 1976;11:719-724.8. Smart RG, JarvisGK Do self-report studiesof drug use really give dependable results?Can J Crimnology. 1981;23:3-12.............................. ............................ I..... ........... ...................................................................... ........................ .............. ........................................... ..................... ................................................................................ ... ..... ....................... ... ........ .........e.............................. ..... ..................... ..... ............ ww k Vo........................................................... .... .. .. ... II .......d :M.- aSir ........................ ... ... ...... .. .... ... .....Cognitive and Attitudinal Impactsof a University AIDS Course:Interdisciplinary Education asa Public Health InterventionRonald P. Strauss, DMD, PhD, Inge B. Corless, RN., PhD, James W.Luckey, PhD, Charles M. van der Horst MD, and Betty H. Dennis,PhannD, MStS... .. .. -:e.:.... ....f:S:: .:' .: S ................. .... ::S .......... ...- . > .. f s.s :. .sA s s .r^. ssfa .:a.. SS s .- a..- a ..-s--- .....s fs -e -. . .-. ' eX ' s:S f *'_- D _ ~ ~ ~~~~~ ~~~~~~~...........~~~~~~~~~~~~~~~~~....-.oS.o.e....i....ig.~~~~~~~~~~~~~...... mf.. ......'S SS ff...................~ ~ ~ ~ ~~~~~.................................':- ::::': :: '- '' :gy ~~~~~~~~~~~.InroductonThe onset and spread of human im-munodeficiency virus (HIV) infection hasraised many social, ethical, and clinicalissues that are of importance to individu-als fromvaried backgrounds.A universitycourse that provides a detailed educationabout HIV infection and acquired immu-nodeficiency syndrome (AIDS) serves todevelop expertise in future communityand professional leaders, and may en-lighten society's response to this healthcare and social crisis. The educational top-ics incorporated in a disease-specific ed-ucational offering are applicable beyondthe focus on AIDS. AIDS was dealt within this course not only as a disease, butalso as a case study of how societies dealwith contagion, stigma, disability, death,social stratification, and access to scarceresources.Ronald P. Strauss is with the School of Den-tistry, Inge B. Corless is with the School ofNursing, James W. Luckey is with the Schoolof Public Health, Charles M. van der Horst iswith the School ofMedicine, and BettyH. Den-nis is with the School of Pharmacy at the Uni-versity of North Carolina at Chapel Hill.Requests for reprints should be sent to Dr.Ronald P. Strauss, University of North Caro-lina School of Dentistry, CB #7450, ChapelHill, NC 27599.This paper was submitted to the JournalApril 2, 1991, and accepted with revisions No-vember 27, 1991.American Journal of Public Health 569Public Health BriiefsUniversities in the United Stateshave responded to AIDS by incorporatingrelevant information into courses cur-rently offered to students and by develop-ing new courses.1A Cross-sectional sur-veys and other reports have defined gapsin HIV-related knowledge and attitudesamong college students.527 However, theliterature on the impact of AIDS educa-tion suggests that knowledge and attitudechanges do occur over the course of ed-ucational programs.1-3.28-31This paper describes a study of anAIDS course as a public health interven-tion and examines cognitive and attitudi-nal changes that occurred in students overthe course period.The course, "AIDS: Principles,Practices and Politics," combined facultyand resources from health and social sci-ence disciplines. One faculty memberfrom the Schools of Dentistry, Medicine,Nursing, Pharmacy, and Public Healthparticipated in organizing and teachingthe course, thus exemplifying the inter-disciplinary approach necessary to pro-vide care and resolve the AIDS crisis.Students, whowere drawn from everyschool on the university campus, includedundergraduates (69%), professional/graduate students (28%), and others (3%).Offered at one to three credit levels, thecourse involved weekly lectures, readings,and a graduate seminar. Enrollment be-tween 1989 and 1992 has varied fiom 250 to550 studentsper semester, with 429 enrolledin 1989.MetodsIn 1989, an anonymous precoursequestionnaire was administered to stu-dents to examine their risk factors, knowl-edge, and attitudes. Three hundred andthirty-nine students took the pretest, andtheir responses were compared with thoseof the 245 students who took the posttest.The data were treated in the aggregate, asthe anonymity of the instrument pre-cluded matching individual precourse andpostcourse questionnaires. Some of thequestions were drawn from the NationalHealth Interview Survey (NHIS),32 andfindings include comparisons with thesenational data. Postcourse test mean re-sponses were compared with precoursemeans using t tests and chi-square.ResmltsStudent knowledge about the riskfactors for infection with the AIDS virusare displayed in Table 1. When comparedwith national surveys ofUS persons aged18 to 29, from the same time period(NHIS, January to March 1989),32 it is ev-ident that our sample of university stu-dents was less concerned about casualHIV transmission.Students starting this course weremore educated and accurate about risk fac-tors for H1V infection than those in thenational sample. Though students ex-pressedno concern about living near, shak-ing hands with, touching, kissing on thecheek, or attending school with persons in-fected with the AIDS virus, the precoursesurvey showed some concern about otherforms of casual contagion. These includedsharing eating utensils (7%), eating in a res-taurant where the cook has the virus (6%),and being coughed or sneezed on by aninfected person (8%). There was also someconcern about mosquitoes and other in-sects (10%). The relatively low level ofpre-course concem or misinformation was re-duced during the course.April 1992, Vol. 82, No. 4570 American Journal of Public HealthPublic Health BriefsAt the start of the course, 18% of thestudents indicated that their blood hadbeen tested for HIV (Table 2); this wasless than NHIS cohort findings (26%among 18- to 29-year-olds). Over the pe-riod of the course, an additional 5% weretested. Most students reported that HIVtesting had occurred through a blood do-nation, with fewer than a third specificaLlyseeking a blood test voluntarily. Whenpresented with a list of risk factors beforethe course, 6% of the students identifiedthemselves as members of a high-riskgroup. Thiswas twice the rate reported forthe 18- to 29-year-old cohort in the NHS.At the end ofthe course, an additional 3%(amounting to a postcourse total of 9.5%)rated themselves as having behaviors thatmight place them at risk forHIV infection.Attitudes toward the rights of healthworkers to refuse to care for persons in-fected with HIV changed over the courseperiod (Table 3). There was a significantreduction in the percentage of those whoindicated that physicians (-13.7%) andnurses (-13.5%) had such a right. Attitudechangeswere found, demonstratingby thecourse end increased understanding andtolerance for persons who are HIV posi-tive.Anonymous course evaluation formswere distributed after the final class ses-sions. Students largely rated the courseand the lectures as good or excellent. Theclass most highly ranked was "The Hu-man Side of AIDDS," a panel of personswith AIDS. Ninety-five percent ofthe stu-dents would have recommended thecourse to others.DiuscionThis initiative in university interdis-ciplinary course development shows thatlarge numbers of university students willAmerican Journal of Public Health 571Aprfl 1992, Vol. 82, No. 4Public Health Briefsenroll in a credit-bearing course onAIDS. Variable-credit course optionswill attract undergraduate lecture coursestudents as well as graduate seminar stu-dents.This project indicates that many andsignificant changes occur in studentknowledge and attitudes about AIDSover the period of a university course onAIDS. It suggests that other universitiesmight use this interdisciplinary educa-tional approach and public health initia-tive to educate students-our futurecommunity leaders and professionals-about AIDS. Health sciences profes-sional schools are in a unique position tobegin similar campuswide educationalprograms that demonstrate in educationthe interdisciplinary nature of the workrequired in practice. ElAcknowledgmentsThis research and educational initiative wassupported by a grant from the Pew-RockefellerHealth of the Public Program, the UNC Centerfor Health Promotion and Disease Prevention.This paper was presented in part at the SixthInternational Conference on AIDS on June 21,1990, in San Francisco, CA. Itwas also partiallyincluded in a presentation at the annual meetingof the Association of American Medical Col-leges on October 21, 1990, in San Francisco.Special appreciation goes to Dr. H. Gar-land Hershey (vice chancellor ofHealth Affairsand vice provost, University ofNorth Carolinaat Chapel Hill) and the Lupton OpportunityFund for their support of this project.References1. Johnson JA, Campbell AE, Toewe CH H,Bell BJ. Knowledge and attitudes aboutAIDS among first- and second-year medi-cal students. AIDS Educ Prev. 1990;2:48-57.2. Goldman JD. An elective seminar to teachfirst-year students the social and medicalaspects of AIDS. J Med Educ. 1987;62:557-561.3. Hale PJ. An elective course on AIDS. JNurs Educ. 1989;28:232-234.4. Dommeyer CJ, Marquard JL, Gibson JE,Taylor RL. The effectiveness of an AIDSeducation campaign on a college campus.JAm Coil Health. 1989;38:131-135.5. Strunin L, Hingson R. Acquired immuno-deficiency syndrome and adolescents:knowledge, beliefs, attitudes, and behav-iors. Pediatrics. 1987;79:825-828.6. Hingson R, Strunin L, Berlin B. Acquiredimmunodeficiency syndrome transmis-sion: changes in knowledge and behaviorsamongteenagers, Massachusetts statewidesurveys, 1986 to 1988. Pediatrics. 1990;85:24-29.7. Koopman C, Rotheram-Borus MJ, Hen-derson R, Bradley JS, Hunter J. Assess-ment of knowledge of AIDS and beliefsabout AIDS prevention among adoles-cents. AIDS Educ IPv. 1990;2:58-70.8. Royse D, Dhooper SS, Hatch LR. Under-graduate and graduate students' attitudestowards AIDS. Psychol Rep. 1987;60:1185-1186.9. Royse D, Birge B. Homophobia and atti-tudes toward AIDS patients among medi-cal, nursing, and paramedical students.Psychol Rep. 1987;61:867-870.10. Katzman EM, Mholland M, SutherlandEM. College students and AIDS: a prelimi-nary surveyof knowledge, attitudes, and be-havior.JAm Coll Heath 1988;37:127-130.11. Lester LB, Beard BJ. Nursing students'attitudes toward AIDS. J Nurs Educ.1988;27:399-404.12. Strader MK, Beaman ML. College stu-dents' knowledge about AIDS and atti-tudes toward condom use. Pubic HealthNurs. 1989;6:62-66.13. Thomas SB, Gilliam AG, Iwrey CG.Knowledge about AIDS and reported riskbehaviors among Black college students.JAm Coll Healkth 1989;38:61-66.14. Kinnick BC, Smart DW, Bell DA, BlankWR, GrayTR, SchoberJL. An assessmentof AIDS-related knowledge, attitudes, andbehaviors among selected college and uni-versity students. AIDS Public Policy J.1989;4:112-119.15. GainesJ, IglarAF, Michal ML, Patton RD.Attitudes toward AIDS. Health Values.1988;12:53-60.16. Crawford J. Attitudes of undergraduatestudents towards AIDS. Psychol Rep.1990;66:11-16.17. Hernandez JT, Smith FJ. Inconsistenciesand misperceptions putting college stu-dents at risk of HIV infection. JAdolescHealth Care. 1990;11:295-297.18. Lesnick H, Pace B. Knowledge of AIDSrisk factors in South Bronx minority col-lege students. JAIDS. 1990;3:173-176.19. MacDonald NE, Wells GA, Fisher WA, etal. High-nsk STD/HV behavior among col-lege students.JAMA 1990;263:3155-3159.20. Thurman QC, FranklinKM. AIDS and col-lege health: knowledge, threat, and preven-tion at a northeastem university.JAm CoilHealth. 1990;38:179-184.21. Carroll L. Concem with AIDS and the sex-ual behavior of college students. J Mar-iage Far. 1988;50:405-411.22. Sy FS, Freeze-McElwee Y, Garrison CZ,Jackson KL. Knowledge, perceived risk,and beliefs about AIDS among high schooland college students in South Carolina.JSC MedAssoc. 1989;85:481-487.23. Kelly JA, St Lawrence JS, Smith S Jr,Hood HV, Cook DJ. Medical students' at-titudes toward AIDS and homosexual pa-tients. JMed Educ. 1987;62:549-556.24. Manning D, Balson PM, Barenberg N,Moore TM. Susceptibility to AIDS: whatcollege students do and don't believe.JAmColl Health 1989;38:67-73.25. Kegeles SM, Adler NE, Irwin CE. Sexu-ally active adolescents and condoms:changes over one year in knowledge, atti-tudes and use. Am J Public Health.1988;78:460-461.26. Keeling RP.AIDSon the College Campus.Rockville, Md: American College HealthAssociation; 1986. Special Report.27. Health Resources and Services Adminis-tration. Proceedings of the Multidis-ciplinary Curriculum Development Con-ference on HIV Infection. Public HealthSeIvice; Department ofHealth and HumanServices publication HRP0907199. Wash-ington, DC. 1987.28. Wertz DC, Sorenson JR, Liebling L, Kes-sler L, Heeren TC. Knowledge and atti-tudes ofAIDS health care providers beforeand after education programs. PublicHealth Rep. 1987;102:248-254.29. Miller TE, Booraem C, Flowers JV,Iversen AE. Changes in knowledge, atti-tudes, and behavior as a result of a com-munity-based AIDS prevention program.AIDS Educ P,ev. 1990;2:12-23.30. Lawrence SA, Lawrence RM. Knowl-edge and attitudes about acquired immu-nodeficiency syndrome in nursing andnonnursing groups. J Prof Nurs. 1989;5:92-101.31. Bell RA, Feldman TB, Grissom S, et al.Evaluating the outcomes of AIDS educa-tion. AIDS Educ Prev. 1990;2:70-83.32. Dawson DA. AIDS knowledge and atti-tudes for January-March 1989, provisionaldata from the National Health InterviewSurvey (advance data). Vtal and HealthStatistics. National Center for Health Sta-tistics; 1989;176:1-12.572 American Journal of Public Health April 1992, Vol. 82, No.4

Cognitive and attitudinal impacts of a university AIDS course: interdisciplinary education as a public health intervention.

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Cognitive and attitudinal impacts of a university AIDS course: interdisciplinary education as a public health intervention.

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