Study protocol for a nationwide Knowledge, Attitudes and Practices (KAP) survey on diabetes in Singapore’s general population

Asharani, P. V.; Abdin, Edimansyah; Roystonn, Kumarasan; Kumar, Fiona Devi Siva; Shafie, Saleha; Jeyagurunathan, Anitha; Chua, Boon Yiang; Vaingankar, Janhavi Ajit; Fang, Sum Chee; Lee, Eng Sing; Dam, Rob M. van; Chong, Siow Ann; Subramaniam, Mythily

doi:10.1136/bmjopen-2020-037125

Cited by 39 publications

(49 citation statements)

References 24 publications

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“…The methodology of this cross-sectional study, including detailed information on the sample size calculations, sampling, survey methodology and questionnaires used, was reported elsewhere [29].…”

Section: Methodsmentioning

confidence: 99%

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Health Literacy and Diabetes Knowledge: A Nationwide Survey in a Multi-Ethnic Population

Asharani

Lau

Roystonn

et al. 2021

IJERPH

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Health literacy is a key determinant of the public health and health climate of the nation. This study examined the functional health literacy of the nation, factors associated with health literacy, and its relationship with diabetes recognition. This cross-sectional survey recruited participants (N = 2895) who were 18 years and above from a population registry through disproportionate stratified sampling. The Brief Health Literacy Screen and other questionnaires were administered through face-to-face interviews, in one of the four national languages (English, Chinese, Malay or Tamil). The majority (80.5%) had adequate functional health literacy and were able to recognise symptoms of diabetes correctly (83.5% overall; 83.7% and 82.2% in those with adequate and inadequate health literacy, respectively). Those with inadequate health literacy had a higher incidence of chronic conditions (p < 0.001) compared to those with adequate health literacy in bivariate analysis. The majority of the sample had sufficient levels of physical activity (83.3%), and more than half reported an unhealthy lifestyle (57.4%). Older age, Chinese ethnicity, those who were employed, with lower education (secondary or below), and were married had significantly higher odds of inadequate health literacy. Health literacy was not associated with lifestyle, physical activity, chronic conditions and diabetes recognition. Health literacy interventions should focus on the disadvantaged social groups for improving their health literacy.

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Section: Methodsmentioning

confidence: 99%

“…The details of the sampling, sample size and procedures of the survey were published elsewhere [29]. Briefly, the sample size was calculated for the prevalence of knowledge on diabetes and its risk factors among the general public.…”

Section: Sample Sizementioning

confidence: 99%

Health Literacy and Diabetes Knowledge: A Nationwide Survey in a Multi-Ethnic Population

Asharani

Lau

Roystonn

et al. 2021

IJERPH

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“…For the results to be representative of the Singapore population, all estimates were analyzed using survey weights to adjust for age and ethnicity post-stratification, oversampling, and nonresponse. The protocol of the study methodology has been published in an earlier article (AshaRani et al, 2020).…”

Section: Sample Size Calculation and Samplingmentioning

confidence: 99%

“…Against this backdrop, the current study examines the extent of social stigma toward diabetes among Singapore's general population and whether this differs for socio-demographic subgroups. We used data from a nationwide study that examined the knowledge, attitudes, and practices regarding diabetes (AshaRani et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Correlates of Social Stigma Toward Diabetes: Results From a Nationwide- Survey in Singapore

et al. 2021

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Aims: To examine the extent of social stigma toward diabetes among Singapore's multi-ethnic general population and determine whether this differs across socio-demographic sub-groups.Methods: Data for this study came from a nationwide cross-sectional study. A diabetes stigma questionnaire comprising Social Distance Scale and Negative Attitudes and Stereotyping Scale was administered to those respondents who had not been diagnosed with diabetes. Exploratory factor analysis was conducted to determine the dimensionality of the instruments and validated using confirmatory factor analysis. Multiple linear regression analysis was conducted to examine associations between socio-demographic factors and measures of diabetes stigma.Results: In all, 2,895 participants were recruited from the general population giving a response rate of 66.2%. Factor analyses found that a one-factor model resulted in an acceptable fit for both stigma scales, which measured social distance and negative attitudes and stereotyping, respectively. Multiple linear regression analyses identified Indian ethnicity (vs. Chinese), higher personal income (≥SGD2000 vs. < SGD 2000) and having close friends or family members who had been diagnosed with diabetes to be significantly associated with lower social distance scores while those aged 50–64 years and those with secondary and vocational education (vs. degree and above) were significantly associated with higher social distance scores. Those with a personal income of SG$2,000–3,999 and SGD $6,000 and above, and those with close friends or family members diagnosed with diabetes were significantly associated with lower negative attitudes and stereotyping scores. In contrast those aged 35 years and above, those with primary education and below, and those of Malay ethnicity were significantly associated with higher negative attitudes and stereotyping scores.Conclusions: The study found a relatively low level of stigma toward diabetes in the general population of Singapore, although some stigmatizing beliefs emerged. While greater knowledge of diabetes could reduce stigma, anti-stigma messaging should be incorporated into the “War on Diabetes” programme in Singapore.

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“…Statistical power calculations for binary proportions post-adjusted for design effects determined sample sizes for population prevalence estimate, as well as for subgroup (age and ethnicity) estimates, with overall precision of 2.5%. [19] Using 20% as a prevalence estimate based on previously reported prevalence rates of diabetes knowledge in Singapore,[17] a total sample size of 3000 was estimated to be adequate to determine the general knowledge of diabetes in the population. The margin of error for the overall prevalence estimate was found to be 2.5%, while that of the subgroups by age and ethnicity ranged from 4.5% to 5%.…”

Section: Methodsmentioning

confidence: 99%

Recognition of Diabetes in a Multi-ethnic Population: Results from a Nationally Representative Population-Based Study

Roystonn¹,

Lau²,

Asharani³

et al. 2021

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Background The prevalence of diabetes is on the rise in developed countries. Yet discrepancies exist in reports regarding the level of knowledge of diabetes. This study evaluates the recognition of diabetes among residents in the Singapore population. Sociodemographic characteristics associated with the ability to correctly recognise diabetes were also examined. Methods This was a nationwide cross-sectional vignette-based study. Data were collected from 2895 residents aged 18 years and above through face-to-face interviews, of which 436 are persons with diabetes. Descriptive statistics, chi-square tests, and binary logistic regression were used in the analyses. Results In total, 82.7% (2418/2895) of respondents recognised diabetes correctly. In adjusted models, correct recognition was significantly higher among respondents aged 35-49 years (OR, 1.85; 95% CI, 1.15 to 2.98; P= 0.01), 50-64 years (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.19 to 3.56; P= 0.01), ethnic Malays (OR, 1.39; 95% CI, 1.02 to 1.89; P= 0.04) (vs. Chinese) and persons with diagnosed diabetes (OR, 2.64; 95% CI, 1.38 to 5.08; P < 0.01). Being male (OR, 0.64; 95% CI, 0.46 to 0.90; P < 0.01), ethnic Others (OR, 0.59; 95% CI, 0.37 to 0.93; P < 0.01), and being unemployed (OR, 0.48; 95% CI, 0.25 to 0.92; P= 0.03), were significantly associated with poor recognition of diabetes. Conclusion Overall public recognition of diabetes is high, but the significant gaps in knowledge in certain demographic groups are of concern. Public health interventions aimed at preventing and controlling diabetes should continue to target all members of the population with accurate and appropriate information. Ongoing efforts of diabetes awareness and educational programs need to be improved, particularly for young adults, males, and the unemployed.

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Study protocol for a nationwide Knowledge, Attitudes and Practices (KAP) survey on diabetes in Singapore’s general population

Cited by 39 publications

References 24 publications

Health Literacy and Diabetes Knowledge: A Nationwide Survey in a Multi-Ethnic Population

Health Literacy and Diabetes Knowledge: A Nationwide Survey in a Multi-Ethnic Population

Prevalence and Correlates of Social Stigma Toward Diabetes: Results From a Nationwide- Survey in Singapore

Recognition of Diabetes in a Multi-ethnic Population: Results from a Nationally Representative Population-Based Study

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