Knowledge, Attitude and Practice of Diabetes among School Teachers in Upper Siang District of Arunachal Pradesh: A Cross-sectional Study
Correspondence Address :
Dr. Obang Perme,
J Kena Apartment, E sector, Naharlagun-791100, Arunachal Pradesh, India.
Introduction: Diabetes is a global problem and expected to affect around 300 million adults all over the world and around 57 million in India by year 2025. Studies indicate that the awareness of diabetes among general population in Arunachal Pradesh is low. School teachers form the backbone of a society and are entrusted with the work of spreading knowledge and awareness among children and youths on many topics including health. School teachers also act as community leaders and shape the public perception.
Aim: To assess the Knowledge, Attitude and Practice (KAP) of diabetes among school teachers in Upper Siang district of Arunachal Pradesh, India.
Materials and Methods: The present cross-sectional study was carried out in all the five high and higher secondary schools in headquarter region of Upper Siang district of Arunachal Pradesh, India. Data was collected from February to May 2018. In each school, 22 randomly selected teachers from staff register were interviewed regarding KAP of diabetes using predesigned questionnaire. Data was descriptively analysed in form of frequencies and percentages and presented in form of tables.
Results: A total of 110 school teachers were interviewed. Majority 108 (98.18%) had knowledge about condition called diabetes. About 96 (87.27%) thought more and more people are getting affected from diabetes. However, only 4 (3.63%) of the respondents had knowledge that diabetes can impact younger people also. According to the responses, renal 63 (57.27%) and ocular 46 (41.82%) involvement were the two most common organs involved in diabetes. Almost half of the respondents felt that family history of diabetes, 54 (49.09%) was the most important risk factor for development of diabetes. Almost onethird, 34 (30.91%) of the respondents did not feel eating healthy and regular blood sugar 103 (93.64%) checking is important in diabetes. About 44 (40%) responding negative to the practice of morning walk for diabetes control.
Conclusion: Among school teachers in Arunachal Pradesh majority had a knowledge about diabetes as an entity but there was a significant lacuna in attitude and practices towards diabetes which needs to be inculcated as a means for better education for the teachers and transition of knowledge to students.
Diabetes mellitus, Health, High school
Diabetes is a global problem and is expected to affect around 300 million adults all over the world and around 57 million in India by year 2025 (1),(2). India with 65.1 million people with diabetes in 2013 was the second highest burden country after China which had 98.4 million people with diabetes (3). Increase in incidence and prevalence of diabetes has been attributed to the changes in lifestyle from more physically active to sedentary lifestyle pattern with improvement of socio-economic condition, which can be prevented by adopting healthy lifestyle [2,4]. A study done in West Bengal, reported low awareness of diabetes in both rural and urban communities (5). Overall, in India, 43.2% of the adult population had heard about a condition called diabetes (6). Knowledge on diabetes was reported to be low in rural areas of India (7). Another study from Tripura, a North Eastern state reported low knowledge and awareness about diabetes among adult population (8).
The literature review for studies about the KAP on diabetes from Arunachal Pradesh revealed only a single study. In the study done in Kameng District of Arunachal Pradesh among adults aged 25 years and above, only 21% had showed awareness of diabetes (9). Schools have been widely recognised as an important platform for delivering health promotion interventions particularly in context of non communicable diseases (10),(11). School teachers form the backbone of a society and are entrusted with the work of spreading knowledge and awareness among children and youths on many topics including health. School teachers also act as community leaders and can shape public perception. They can play a major role in improving knowledge and awareness about diabetes among the communities they serve.
There have been no studies on KAP of diabetes among school teachers of the North Eastern state of Arunachal Pradesh. So, the aim of this study was to assess the KAP of diabetes among school teachers in Upper Siang district of Arunachal Pradesh, India.
The present cross-sectional study was carried out among teachers of schools in Upper Siang district of Arunachal Pradesh, India. Study was approved by Institutional Ethical Committee (IEC) of TRIHMS Naharlagun, Arunachal Pradesh, India (No.TRIHMS/ ETHICS/01/2019-20/39). All interviews were conducted after taking informed written consent. Privacy and confidentiality was maintained during the interviews. This study included teachers of high school and higher secondary schools headquarter region of the district and data was collected between February to May 2018.
Inclusion criteria: All school teachers aged above 18 years of age were included in the study.
Exclusion criteria: Those not willing or refusal for participating in the study were excluded from the study.
Sample size calculation: No previous studies on KAP of diabetes among school teachers in Arunachal Pradesh were available, so considering 50% prevalence to get maximum sample size and taking 10% error and 95% confidence interval, sample size was calculated as 96. Taking a non response rate of 5%, sample size was calculated as 101 and this was rounded off to 110 (12).
There are five high school and higher secondary schools in the district headquarter region of Upper Siang district of Arunachal Pradesh, India. All five schools were included in the study. In each school 22 teachers were interviewed. The interviewers first approached the principal of the school for permission to conduct the study and explained the purpose of the study. After obtaining permission, the 22 teachers were chosen randomly from the staff register and approached at a convenient time during the day. If a chosen teacher was absent on the day of visit, another visit was made after consultation with the teacher. The data was collected by interview method using a predesigned and pretested questionnaire encompassing KAP related to diabetes. The questionnaire was prepared based on previous published studies (13),(14). The study questionnaire was prepared in english. Pilot testing of the questionnaire was done among a few teachers in the district. These interviews were not kept for analysis [Annexure].
Descriptive data was expressed as numbers and percentages. All calculations were done using Microsoft excel and Statistical Package for the Social Sciences (SPSS) version 18.0.
The baseline characteristics of the study population is shown in (Table/Fig 1). A 60 (54.55%) of the population were male and a majority 57 (51.82%) had an educational qualification of Bachelor of Arts (B.A). The knowledge domain of the respondents is shown in (Table/Fig 2). Majority had a knowledge about diabetes as an entity and the rising incidence of the disease. However, only 4 (3.63%) of the respondents had knowledge that diabetes can impact younger people also. According to the responses renal 63 (57.2%) and ocular 46 (41.8%) involvement were the two most common organs involved in diabetes. Almost half the respondents felt that family history of diabetes 54 (49.09%) was the most important risk factor for development of diabetes. The (Table/Fig 3) shows the attitude domain results. Importantly almost one-third 34 (30.91%) of the respondents did not feel eating healthy and regular blood sugar checking is important in diabetes. The practice responses are shown in (Table/Fig 4) with more than one-third 41 (37.27%) reporting it is not important to regularly check blood sugar and 44 (40%) responding negative to the practice of morning walk for diabetes control. About 69 (62.73%) subjects responded that they would visit a doctor, if they ever had diabetes.
The KAP about diabetes among the population is important for prevention as well as proper treatment and control of diabetes. The current study was done to assess KAP about diabetes of school teachers of Upper Siang district of Arunachal Pradesh, India. Teachers in a community are among the educated persons and are an influential role models for students and a source of knowledge on many topics including health related issues like diabetes. Schools have been widely recognised as an important platform for delivering health promotion interventions particularly in context of non communicable diseases (10),(11). Understanding the gap in KAP of diabetes among school teachers would help in health education activities focusing on the identified gap areas.
In this study, 108 (98.18%) of respondents had heard about condition called diabetes which was higher than earlier studies reported from other parts of India, albeit from diverse population (7),(9),(15). Overall level of knowledge of diabetes was high which was expected given the background educational qualifications of the population.
Most of the respondents 103 (93.64%) agreed that getting blood sugar checked regularly was important. However, a substantial part of the respondents did not agree that healthy eating as a preventive measure of diabetes which has also been observed in previous studies (7),(9),(15). These can have important implications for future programmes aimed at raising awareness about the link between diet, healthy lifestyle and diabetes prevention among teachers of this region.
Among the study participants practice of taking low calorie diets was observed in only 58 (52.73%). Such a practice again hints at the overall lack of information diet and diabetes interactions among respondents from this region. Another important aspect was that around half of the respondents were not agreeing on the importance of practice of morning walk for diabetes prevention. World Health Organisation (WHO) has revised its recommendations on physical activity in 2020 and stated that adults should undertake 150-300 minutes of moderate-intensity, or 75-150 minutes of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week (16). While multiple reasons like inherently active nature of the local community without a diurnal preference of activity may influence this practice, there needs to be further impetus on the encouragement towards an increased physical activity among teachers with the ultimate goal of percolating the knowledge to students.
This study forms the first study from Arunachal Pradesh as well as from the region focussed on school teachers and highlights further need of spreading education about diabetes among school teachers.
The study findings are based on the memory of the respondent and are subjected to recall bias. Practices of the respondent were not observed.
Among school teachers in Arunachal Pradesh majority had knowledge about diabetes as an entity but there was significant lacuna in attitude and practices towards diabetes which emphasises the need for increasing diabetes awareness activities among school teachers which will in turn increase diabetes knowledge among students.
Date of Submission: Jun 14, 2022
Date of Peer Review: Jul 13, 2022
Date of Acceptance: Sep 14, 2022
Date of Publishing: Oct 01, 2022
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
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