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Rating of perceived exertion as a tool for managing exercise intensity during pregnancy: a scoping review

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Objective

During pregnancy, international guidelines recommend ≥150 min of moderate-intensity aerobic physical activity per week, with an intensity perceived as fairly light to somewhat hard on the Borg Rating of Perceived Exertion (RPE) scale (ranging from 6 ‘no exertion’ to 20 ‘maximal exertion’, corresponding to 60% to 80% of maximum heart rate). However, the determination and monitoring of exercise intensity seem to be a particular source of confusion, and the most effective method to monitor exercise intensity remains uncertain. This study aimed to examine existing research on the correlation between the Borg RPE scale and maternal heart rate (MHR) for monitoring exercise intensity during pregnancy.

Design

Scoping review using the mixed methods appraisal tool (MMAT) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

Data sources

PubMed, Web of Science and SPORTDiscus were searched from 16–17 April 2023, with a subsequent search on 1 November 2023.

Eligibility criteria

We included studies investigating the correlation between perceived intensity on the Borg RPE scale (6–20) and MHR during exercise in pregnant individuals and written in English/Scandinavian language. There were no restrictions on publication year or study design.

Data extraction and synthesis

Two independent reviewers screened the articles based on title and abstract. Selected articles were read in full text and reference lists of screened articles were also checked. Out of 120 studies screened, six articles met the inclusion criteria after removing one duplicate. The results were qualitatively summarised to provide an overview of common themes and variations between studies. MMAT and GRADE assessed the risk of bias and the certainty of the evidence.

Results

The six studies involved a total of 260 healthy pregnant individuals (gestational week: from 16 to 38), with various exercise protocols (cycling, walking, running and resistance exercise) and intensities (from light to moderate). Three studies supported the Borg RPE scale to estimate exercise intensity during pregnancy, while three found no correlation between this scale and MHR. The certainty of the evidence was graded as low to moderate, with a potential risk of bias due to small sample sizes, incomplete outcome data and inconsistencies across studies.

Conclusion

The mixed results highlight the complexity of monitoring exercise intensity during pregnancy. Using both the Borg RPE scale and MHR might be better than using them separately for monitoring exercise intensity during pregnancy. Due to limited and inconsistent research, more extensive studies are needed.

Objective
During pregnancy, international guidelines recommend ≥150 min of moderate-intensity aerobic physical activity per week, with an intensity perceived as fairly light to somewhat hard on the Borg Rating of Perceived Exertion (RPE) scale (ranging from 6 ‘no exertion’ to 20 ‘maximal exertion’, corresponding to 60% to 80% of maximum heart rate). However, the determination and monitoring of exercise intensity seem to be a particular source of confusion, and the most effective method to monitor exercise intensity remains uncertain. This study aimed to examine existing research on the correlation between the Borg RPE scale and maternal heart rate (MHR) for monitoring exercise intensity during pregnancy.

Design
Scoping review using the mixed methods appraisal tool (MMAT) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

Data sources
PubMed, Web of Science and SPORTDiscus were searched from 16–17 April 2023, with a subsequent search on 1 November 2023.

Eligibility criteria
We included studies investigating the correlation between perceived intensity on the Borg RPE scale (6–20) and MHR during exercise in pregnant individuals and written in English/Scandinavian language. There were no restrictions on publication year or study design.

Data extraction and synthesis
Two independent reviewers screened the articles based on title and abstract. Selected articles were read in full text and reference lists of screened articles were also checked. Out of 120 studies screened, six articles met the inclusion criteria after removing one duplicate. The results were qualitatively summarised to provide an overview of common themes and variations between studies. MMAT and GRADE assessed the risk of bias and the certainty of the evidence.

Results
The six studies involved a total of 260 healthy pregnant individuals (gestational week: from 16 to 38), with various exercise protocols (cycling, walking, running and resistance exercise) and intensities (from light to moderate). Three studies supported the Borg RPE scale to estimate exercise intensity during pregnancy, while three found no correlation between this scale and MHR. The certainty of the evidence was graded as low to moderate, with a potential risk of bias due to small sample sizes, incomplete outcome data and inconsistencies across studies.

Conclusion
The mixed results highlight the complexity of monitoring exercise intensity during pregnancy. Using both the Borg RPE scale and MHR might be better than using them separately for monitoring exercise intensity during pregnancy. Due to limited and inconsistent research, more extensive studies are needed.

High-load strength training compared with standard care treatment in young adults with joint hypermobility and knee pain: study protocol for a randomised controlled trial (the HIPEr-Knee study)

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Introduction

Patients with generalised joint hypermobility, including knee hypermobility (GJHk), often experience knee pain and are typically managed with low-intensity strength training and/or proprioceptive training as part of standard care. However, not all patients experience satisfactory outcomes. High-load strength training may offer additional benefits, such as increased muscle cross-sectional area, neural drive and tendon stiffness, which may reduce pain and improve active knee joint stability during movement tasks and daily activities. So far, no randomised controlled trials (RCTs) have compared high-load strength training with traditional treatment strategies (standard care) for this patient group.

Methods and analysis

In this RCT, we aim to recruit patients with GJHk and knee pain from primary care physiotherapy clinics in the Region of Southern Denmark and via social media. Patients with competing injuries or experience with high-load strength training will be excluded. Patients will be randomised (1:1 ratio) to either 2 weekly sessions of high-load strength training or standard care for 12 weeks. The primary outcome is self-reported knee pain during an activity nominated by the patient as the most aggravating for their present knee pain measured using the Visual Analogue Scale for Nominated Activity (VASNA, 0–100; 0=no pain and 100=worst imaginable pain). This will be collected at baseline, 6 weeks, 12 weeks and 12 months. Secondary outcomes include self-reported knee function and adverse events (collected at baseline, 12 weeks and 12 months), objective measurements including a 5-repetition maximum single-leg press, proprioception and single-leg-hop for distance (collected at baseline and 12 weeks), and a range of other outcome measures such as fear of movement, tendon stiffness and global perceived effect. We aim to recruit 90 patients in total to detect a 10 mm group difference in the primary outcome with 80% power.

Ethics and dissemination

This study was funded by Independent Research Fund Denmark (grant number 2034-00088B) on 14 June 2022; the Regional Committees on Health Research Ethics for Southern Denmark approved it (S-20230050) on 30 August 2023. The first recruitment site opened on 15 February 2024, and the final results will be submitted to a peer-reviewed journal to inform rehabilitation strategies for symptomatic GJHk.Protocol version 1, dated 4 July 2024.

Trial registration number

NCT06277401.

Introduction
Patients with generalised joint hypermobility, including knee hypermobility (GJHk), often experience knee pain and are typically managed with low-intensity strength training and/or proprioceptive training as part of standard care. However, not all patients experience satisfactory outcomes. High-load strength training may offer additional benefits, such as increased muscle cross-sectional area, neural drive and tendon stiffness, which may reduce pain and improve active knee joint stability during movement tasks and daily activities. So far, no randomised controlled trials (RCTs) have compared high-load strength training with traditional treatment strategies (standard care) for this patient group.

Methods and analysis
In this RCT, we aim to recruit patients with GJHk and knee pain from primary care physiotherapy clinics in the Region of Southern Denmark and via social media. Patients with competing injuries or experience with high-load strength training will be excluded. Patients will be randomised (1:1 ratio) to either 2 weekly sessions of high-load strength training or standard care for 12 weeks. The primary outcome is self-reported knee pain during an activity nominated by the patient as the most aggravating for their present knee pain measured using the Visual Analogue Scale for Nominated Activity (VASNA, 0–100; 0=no pain and 100=worst imaginable pain). This will be collected at baseline, 6 weeks, 12 weeks and 12 months. Secondary outcomes include self-reported knee function and adverse events (collected at baseline, 12 weeks and 12 months), objective measurements including a 5-repetition maximum single-leg press, proprioception and single-leg-hop for distance (collected at baseline and 12 weeks), and a range of other outcome measures such as fear of movement, tendon stiffness and global perceived effect. We aim to recruit 90 patients in total to detect a 10 mm group difference in the primary outcome with 80% power.

Ethics and dissemination
This study was funded by Independent Research Fund Denmark (grant number 2034-00088B) on 14 June 2022; the Regional Committees on Health Research Ethics for Southern Denmark approved it (S-20230050) on 30 August 2023. The first recruitment site opened on 15 February 2024, and the final results will be submitted to a peer-reviewed journal to inform rehabilitation strategies for symptomatic GJHk.Protocol version 1, dated 4 July 2024.

Trial registration number
NCT06277401.

Cryptosporidiosis in individuals with inflammatory bowel disease: a scoping review protocol

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Introduction

Cryptosporidiosis is a leading cause of moderate-to-severe diarrhoea globally, and, while it is often self-limited, in immunocompromised individuals, the infection can be associated with significant morbidity and mortality. Diagnosis might be missed or delayed in patients with inflammatory bowel disease (IBD) due to similar presentation, and these patients may also be on immunosuppressive therapies, increasing their risk of infection. Additionally, gastrointestinal infection and dysbiosis may be a risk factor for IBD. Diagnosis, presentation and treatment of cryptosporidiosis in individuals with IBD, as well as any epidemiologic correlations between the two diseases, will be investigated.

Methods and analysis

MEDLINE, Embase, Cochrane Library, CINAHL, Dissertations and Theses Global and grey literature will be searched. Joanna Briggs Institute (JBI) methodology for scoping reviews was used for the protocol and will be for the review. Two reviewers will independently screen studies and extract data. The evidence and presentation of the results will be analysed with input from the review team. Studies of cryptosporidiosis in patients with IBD will be included. Paediatric, adolescent and adult studies in all patient environments will be included. Cases in which Crohn’s disease does not affect the intestine and cases in which cryptosporidial infection is not in the intestine will be excluded.

Ethics and dissemination

Published clinical literature will be systematically reviewed, and this work does not directly involve patients. Consequently, ethical review by an institutional review board is not required. Data will be presented at academic conferences, and a culminating report will be published in a peer-reviewed journal.

Open Science Framework registration

https://osf.io/j47mb.

Introduction
Cryptosporidiosis is a leading cause of moderate-to-severe diarrhoea globally, and, while it is often self-limited, in immunocompromised individuals, the infection can be associated with significant morbidity and mortality. Diagnosis might be missed or delayed in patients with inflammatory bowel disease (IBD) due to similar presentation, and these patients may also be on immunosuppressive therapies, increasing their risk of infection. Additionally, gastrointestinal infection and dysbiosis may be a risk factor for IBD. Diagnosis, presentation and treatment of cryptosporidiosis in individuals with IBD, as well as any epidemiologic correlations between the two diseases, will be investigated.

Methods and analysis
MEDLINE, Embase, Cochrane Library, CINAHL, Dissertations and Theses Global and grey literature will be searched. Joanna Briggs Institute (JBI) methodology for scoping reviews was used for the protocol and will be for the review. Two reviewers will independently screen studies and extract data. The evidence and presentation of the results will be analysed with input from the review team. Studies of cryptosporidiosis in patients with IBD will be included. Paediatric, adolescent and adult studies in all patient environments will be included. Cases in which Crohn’s disease does not affect the intestine and cases in which cryptosporidial infection is not in the intestine will be excluded.

Ethics and dissemination
Published clinical literature will be systematically reviewed, and this work does not directly involve patients. Consequently, ethical review by an institutional review board is not required. Data will be presented at academic conferences, and a culminating report will be published in a peer-reviewed journal.

Open Science Framework registration
https://osf.io/j47mb.

‘Cold’ Letby initially failed final student placement

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The post ‘Cold’ Letby initially failed final student placement appeared first on Nursing Times.

Lucy Letby failed her final student placement because her assessor found her to be “cold” and lacking the attributes needed to be a children’s nurse.
The post ‘Cold’ Letby initially failed final student placement appeared first on Nursing Times.

Level of eye healthcare utilisation and associated factors in Gamo and Gofa Zones, Southern Ethiopia: a community-based, cross-sectional study

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Objective

About 90% of eye health problems are preventable or curable with existing cost-effective interventions. There is limited evidence on eye healthcare utilisation (ECU) and the factors influencing it in the study area. This study aimed to determine the level of ECU and the associated factors in Southern Ethiopia.

Design

A community-based, cross-sectional study was conducted in Southern Ethiopia from 1 June to 15 July 2023. Data were analysed using SPSS V.27.

Setting

Two selected districts (Dita and Uba Debretsehay) in Southern Ethiopia.

Participants

Permanent residents living in randomly selected kebeles.

Outcome measure

The level of ECU was the outcome measure. A binary logistic regression model was used to check the association between explanatory variables and the dependent variable. To avoid many variables and unstable estimates and to control for possible confounders in the subsequent model, only variables that reached a p value of less than 0.25 on binary analysis were used in the multivariate logistic regression analysis to identify factors independently associated with ECU.

Results

992 respondents participated in this study, with a response rate of 95.4%. The prevalence of ECU within the past 2 years was 21.6% (95% CI 19.0, 24.3). The reported barriers to ECU were lack of awareness (123, 40.6%) and lack of money (58, 19.2%). Age <30 years (adjusted OR (AOR)=2.7; 95% CI 1.5, 4.6), being male (AOR=2.2; 95% CI 1.4, 3.6), shorter travel time (AOR=2.0; 95% CI 1.3, 3.1), undergoing regular vision check-ups (AOR=5.4; 95% CI 3.47, 8.37), history of eye diseases (AOR=4.8; 95% CI 2.5, 9.1) and having trichiasis (AOR=1.5; 95% CI 1.1, 2.3) were positively associated with eye care service utilisation. Low wealth quantile (AOR=0.62; 95% CI 0.39, 0.98) and poor knowledge (AOR=0.26; 95% CI 0.16, 0.44) were negatively associated with eye care service utilisation.

Conclusions

The ECU within the past 2 years was a quarter. Socioeconomic factors, disease-related factors and respondent knowledge are independently associated with ECU. Designing strategies that can improve the capacity of healthcare facilities and patient awareness is important in order to reduce barriers and improve service utilisation. Researchers interested in working in the area should focus on community-specific approaches that can improve community health literacy by using stronger study designs.

Objective
About 90% of eye health problems are preventable or curable with existing cost-effective interventions. There is limited evidence on eye healthcare utilisation (ECU) and the factors influencing it in the study area. This study aimed to determine the level of ECU and the associated factors in Southern Ethiopia.

Design
A community-based, cross-sectional study was conducted in Southern Ethiopia from 1 June to 15 July 2023. Data were analysed using SPSS V.27.

Setting
Two selected districts (Dita and Uba Debretsehay) in Southern Ethiopia.

Participants
Permanent residents living in randomly selected kebeles.

Outcome measure
The level of ECU was the outcome measure. A binary logistic regression model was used to check the association between explanatory variables and the dependent variable. To avoid many variables and unstable estimates and to control for possible confounders in the subsequent model, only variables that reached a p value of less than 0.25 on binary analysis were used in the multivariate logistic regression analysis to identify factors independently associated with ECU.

Results
992 respondents participated in this study, with a response rate of 95.4%. The prevalence of ECU within the past 2 years was 21.6% (95% CI 19.0, 24.3). The reported barriers to ECU were lack of awareness (123, 40.6%) and lack of money (58, 19.2%). Age <30 years (adjusted OR (AOR)=2.7; 95% CI 1.5, 4.6), being male (AOR=2.2; 95% CI 1.4, 3.6), shorter travel time (AOR=2.0; 95% CI 1.3, 3.1), undergoing regular vision check-ups (AOR=5.4; 95% CI 3.47, 8.37), history of eye diseases (AOR=4.8; 95% CI 2.5, 9.1) and having trichiasis (AOR=1.5; 95% CI 1.1, 2.3) were positively associated with eye care service utilisation. Low wealth quantile (AOR=0.62; 95% CI 0.39, 0.98) and poor knowledge (AOR=0.26; 95% CI 0.16, 0.44) were negatively associated with eye care service utilisation.

Conclusions
The ECU within the past 2 years was a quarter. Socioeconomic factors, disease-related factors and respondent knowledge are independently associated with ECU. Designing strategies that can improve the capacity of healthcare facilities and patient awareness is important in order to reduce barriers and improve service utilisation. Researchers interested in working in the area should focus on community-specific approaches that can improve community health literacy by using stronger study designs.

Manchester mental health staff strike over ‘unsafe’ staffing

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The post Manchester mental health staff strike over ‘unsafe’ staffing appeared first on Nursing Times.

Nurses are among a group of mental health workers in Manchester who are striking today over “unsafe” staffing levels.
The post Manchester mental health staff strike over ‘unsafe’ staffing appeared first on Nursing Times.

Association between peripheral venous catheter failure and care complexity factors in emergency department: a cross-sectional study

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Objective

The objective was to determine the prevalence of peripheral venous catheter (PVC) failure and its association with care complexity individual factors (CCIFs) in emergency department (ED) patients.

Design

A cross-sectional, descriptive-correlational study was performed.

Methods

All patients with a PVC inserted in the ED of a tertiary hospital were included. The period of study was from June 2021 to June 2022. The main outcomes were PVC failure (phlebitis, extravasation/infiltration, dysfunction/occlusion and dislodgement/involuntary withdrawal) and 26 CCIFs categorised into 5 domains (psycho-emotional, mental-cognitive, sociocultural, developmental and comorbidity/complications). Other secondary variables were also collected, such as level of triage or nursing care plan. All data were collected retrospectively from the electronic health records. A descriptive and inferential analysis was performed.

Results

A total of 35 968 patients with one or more PVC inserted during their ED visit were included in the study. The prevalence of PVC failure was 0.9% (n=316). The statistically significant CCIFs associated with PVC failure were: incontinence, haemodynamic instability, transmissible infection, vascular fragility, anxiety and fear, impaired adaptation, consciousness disorders, lack of caregiver support and agitation. In addition, we identified that patients with a higher number of CCIFs were more frequently experienced PVC failure.

Conclusion

This study identified a prevalence of PVC failure in the ED of around 1%. The most prevalent complication was dysfunction, followed by extravasation and dislodgement. In addition, PVC failure was associated with comorbidity/complications, psycho-emotional and mental-cognitive CCIFs domains.

Objective
The objective was to determine the prevalence of peripheral venous catheter (PVC) failure and its association with care complexity individual factors (CCIFs) in emergency department (ED) patients.

Design
A cross-sectional, descriptive-correlational study was performed.

Methods
All patients with a PVC inserted in the ED of a tertiary hospital were included. The period of study was from June 2021 to June 2022. The main outcomes were PVC failure (phlebitis, extravasation/infiltration, dysfunction/occlusion and dislodgement/involuntary withdrawal) and 26 CCIFs categorised into 5 domains (psycho-emotional, mental-cognitive, sociocultural, developmental and comorbidity/complications). Other secondary variables were also collected, such as level of triage or nursing care plan. All data were collected retrospectively from the electronic health records. A descriptive and inferential analysis was performed.

Results
A total of 35 968 patients with one or more PVC inserted during their ED visit were included in the study. The prevalence of PVC failure was 0.9% (n=316). The statistically significant CCIFs associated with PVC failure were: incontinence, haemodynamic instability, transmissible infection, vascular fragility, anxiety and fear, impaired adaptation, consciousness disorders, lack of caregiver support and agitation. In addition, we identified that patients with a higher number of CCIFs were more frequently experienced PVC failure.

Conclusion
This study identified a prevalence of PVC failure in the ED of around 1%. The most prevalent complication was dysfunction, followed by extravasation and dislodgement. In addition, PVC failure was associated with comorbidity/complications, psycho-emotional and mental-cognitive CCIFs domains.

Impact of primary care and public health integration of chronic conditions in China: a protocol for a prospective multicentre cohort study

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Introduction

The prevalence of chronic conditions is increasing. Given that the majority of chronic patients are managed by primary healthcare providers, there is a need to integrate primary care with public health to address the prevailing situation and enhance patient outcomes. The purpose of this study is to establish, implement and evaluate an integrated primary care and public health model in China for patients with chronic conditions.

Methods

This prospective, multicentre and observational study will be conducted at 12 township hospitals on patients (n=7200) diagnosed with chronic conditions (hypertensive, diabetic or stroke). Participants were divided into two groups: pilot areas and mainstream areas follow-up groups. The primary outcome will be the difference in the proportion of controlled chronic conditions among the two groups. Secondary outcomes will be the differences in mean change in diastolic and systolic blood pressures, fasting glucose, total cholesterol and triglyceride, death from any cause and participant-reported physical and psychological health status.

Ethics and dissemination

Ethics approval was obtained from the Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology. We plan to publish the results of this study in a peer-reviewed journal article.

Introduction
The prevalence of chronic conditions is increasing. Given that the majority of chronic patients are managed by primary healthcare providers, there is a need to integrate primary care with public health to address the prevailing situation and enhance patient outcomes. The purpose of this study is to establish, implement and evaluate an integrated primary care and public health model in China for patients with chronic conditions.

Methods
This prospective, multicentre and observational study will be conducted at 12 township hospitals on patients (n=7200) diagnosed with chronic conditions (hypertensive, diabetic or stroke). Participants were divided into two groups: pilot areas and mainstream areas follow-up groups. The primary outcome will be the difference in the proportion of controlled chronic conditions among the two groups. Secondary outcomes will be the differences in mean change in diastolic and systolic blood pressures, fasting glucose, total cholesterol and triglyceride, death from any cause and participant-reported physical and psychological health status.

Ethics and dissemination
Ethics approval was obtained from the Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology. We plan to publish the results of this study in a peer-reviewed journal article.

Advancing health equity and the role of digital health technologies: a scoping review protocol

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Introduction

Healthcare systems around the world exhibit inherent systemic inequities that disproportionately impact marginalised populations. Digital health technologies (DHTs) hold promising potential to address these inequities and to play a pivotal role in advancing health equity. However, there is a notable gap regarding a comprehensive and structured overview of existing frameworks and guidelines on advancing health equity and a clear understanding of the potential of DHTs in their implementation. To this end, our primary objectives are first to identify prevalent frameworks and guidelines that promote health equity and second to pinpoint the contemporary role of DHTs as an avenue for implementing these frameworks and guidelines. This synthesis will guide future DHTs, ensuring equitable accessibility and effectiveness and ultimately contributing to enhancing health equity among marginalised populations.

Methods and analysis

This work adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Reviews. To identify pertinent evidence, we will employ seven electronic databases (PubMed, EMBASE, Cochrane, PsycINFO, Scopus, Web of Science and WISO) encompassing the fields of medicine, healthcare and social sciences. Moreover, selected grey literature will be considered. We will include primary and secondary studies published in English between 2010 and 2023 that focus on (technology and non-technology-based) frameworks and guidelines for health equity improvement. Each article will undergo an independent assessment for eligibility, followed by the extraction of pertinent data from eligible sources. Subsequently, the extracted data will be subjected to qualitative and quantitative analyses, and findings will be presented using narrative and descriptive formats.

Ethics and dissemination

Ethical approval is deemed unnecessary for this scoping review, as it involves synthesising existing knowledge. The findings from this study will be disseminated through peer-reviewed publications.

Protocol registration

https://osf.io/94pht.

Introduction
Healthcare systems around the world exhibit inherent systemic inequities that disproportionately impact marginalised populations. Digital health technologies (DHTs) hold promising potential to address these inequities and to play a pivotal role in advancing health equity. However, there is a notable gap regarding a comprehensive and structured overview of existing frameworks and guidelines on advancing health equity and a clear understanding of the potential of DHTs in their implementation. To this end, our primary objectives are first to identify prevalent frameworks and guidelines that promote health equity and second to pinpoint the contemporary role of DHTs as an avenue for implementing these frameworks and guidelines. This synthesis will guide future DHTs, ensuring equitable accessibility and effectiveness and ultimately contributing to enhancing health equity among marginalised populations.

Methods and analysis
This work adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Reviews. To identify pertinent evidence, we will employ seven electronic databases (PubMed, EMBASE, Cochrane, PsycINFO, Scopus, Web of Science and WISO) encompassing the fields of medicine, healthcare and social sciences. Moreover, selected grey literature will be considered. We will include primary and secondary studies published in English between 2010 and 2023 that focus on (technology and non-technology-based) frameworks and guidelines for health equity improvement. Each article will undergo an independent assessment for eligibility, followed by the extraction of pertinent data from eligible sources. Subsequently, the extracted data will be subjected to qualitative and quantitative analyses, and findings will be presented using narrative and descriptive formats.

Ethics and dissemination
Ethical approval is deemed unnecessary for this scoping review, as it involves synthesising existing knowledge. The findings from this study will be disseminated through peer-reviewed publications.

Protocol registration
https://osf.io/94pht.

Status and influencing factors of knowledge, attitudes and practices relating to screening for breast and cervical cancer among rural women aged 40-65 years in China: a cross-sectional study

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Objectives

The objectives are to investigate the status of knowledge, attitudes and practices (KAP) and to identify factors related to KAP towards breast and cervical cancer screening among rural Chinese women aged 40–65 years.

Design and setting

This cross-sectional study was conducted from July to September 2020 in rural areas of eastern China.

Participants

This study involved 301 rural women aged 40–65 years.

Variables and outcomes

The questionnaire included demographic information and the KAP related to breast and cervical cancer screening. Multivariate linear regression analysis was used for the multifactor analysis.

Results

A total of 301 rural women aged 40–65 years participated in the survey. The overall score of KAP was (62.41±11.24), and the scores of each KAP domain relating to screening for breast and cervical cancer among participants in rural areas were (1.82±0.97), (44.52±7.20) and (16.06±4.56), respectively. The following factors were significantly associated with the total KAP Score relating to breast and cervical cancer screening among rural women aged 40–65 years, explaining 35% of the variance (p<0.001): aged 50–54 (β=–0.160, 95% CI –7.403 to –0.794), aged 55–59 (β=–0.266, 95% CI –10.763 to –3.757), aged 60–65 (β=–0.243, 95% CI –12.504 to –4.331), junior high school (β=0.186, 95% CI 1.287 to 7.064), housewife (β=0.172, 95% CI 0.849 to 6.868), other work (β=0.171, 95% CI 3.818 to 15.044), annual household income ranging from 50 000 to 79 999 (β=0.281, 95% CI 3.887 to 10.458) and annual household income≥80 000 (β=0.330, 95% CI 4.735 to 11.554).

Conclusions

The status of KAP related to breast and cervical cancer screening still requires improvement. Measures to enhance the participation of the two-cancer screening should be provided to rural women aged between 50 and 65 years with lower education level and lower annual household income, especially women who are farmers.

Objectives
The objectives are to investigate the status of knowledge, attitudes and practices (KAP) and to identify factors related to KAP towards breast and cervical cancer screening among rural Chinese women aged 40–65 years.

Design and setting
This cross-sectional study was conducted from July to September 2020 in rural areas of eastern China.

Participants
This study involved 301 rural women aged 40–65 years.

Variables and outcomes
The questionnaire included demographic information and the KAP related to breast and cervical cancer screening. Multivariate linear regression analysis was used for the multifactor analysis.

Results
A total of 301 rural women aged 40–65 years participated in the survey. The overall score of KAP was (62.41±11.24), and the scores of each KAP domain relating to screening for breast and cervical cancer among participants in rural areas were (1.82±0.97), (44.52±7.20) and (16.06±4.56), respectively. The following factors were significantly associated with the total KAP Score relating to breast and cervical cancer screening among rural women aged 40–65 years, explaining 35% of the variance (p<0.001): aged 50–54 (β=–0.160, 95% CI –7.403 to –0.794), aged 55–59 (β=–0.266, 95% CI –10.763 to –3.757), aged 60–65 (β=–0.243, 95% CI –12.504 to –4.331), junior high school (β=0.186, 95% CI 1.287 to 7.064), housewife (β=0.172, 95% CI 0.849 to 6.868), other work (β=0.171, 95% CI 3.818 to 15.044), annual household income ranging from 50 000 to 79 999 (β=0.281, 95% CI 3.887 to 10.458) and annual household income≥80 000 (β=0.330, 95% CI 4.735 to 11.554).

Conclusions
The status of KAP related to breast and cervical cancer screening still requires improvement. Measures to enhance the participation of the two-cancer screening should be provided to rural women aged between 50 and 65 years with lower education level and lower annual household income, especially women who are farmers.

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