The Impact of Structured awareness programme on cancer prevention among Urban Population of Assam

Bandana Devi*

Principal, Arya Nursing College, Kamrup, Assam.

Ph D Scholar, Srimanta Sankaradeva University of Health Sciences, Guwahati, Assam.

*Corresponding Author E-mail: bandana_nst@yahoo.com

ABSTRACT:

Background: Cancer is a leading cause of death globally. According to Indian Council of Medical Research's latest report, fresh cases of cancer annually among men will increase from 4.47 lakh in 2008 to 5.34 lakh by 2020.¹ The national incidence of cancer is approximately 100 to 130 individuals per 1,00,000 but in the Northeast, according to the population-based cancer registry of Indian Council of Medical Research (ICMR), the incidence is highest with Assam alone adding roughly 26,000 new cancer patients every year.² Objectives: The present study aimed to assess baseline knowledge on risk factors of cancer and its preventive aspects followed by structured awareness programme and assessing the effectiveness of the programme among urban population of Assam. Method: A Quantitative evaluative research approach with an interventional pre experimental design (One Group Pre test Post Test Design) is adopted to assess the impact of structured awareness programme on cancer prevention among urban population of Assam. Total 177 samples were selected by using Multistage random sampling followed by purposive sampling technique. Structured interview questionnaire, Modified Cancer Prevention Module were used as tools to collect data. Content validity of the tool was obtained from 10 experts and reliability was determined by Internal consistency using Split Half method. Collected data were analysed by descriptive and inferential statistics. Results: The finding shows that before structured awareness program on cancer out of 177 selected urban population 39 (22.0%) had low, 115 (65.0%) had medium and 23 (13.0%) had high knowledge on risk factors of cancer. The finding shows that before structured awareness program on cancer out of 177 selected rural population 33 (18.6%) had low, 107 (60.5%) had medium and 37 (20.9%) had high knowledge on preventive aspects of cancer. Before structured awareness program on cancer, mean score for knowledge on risk factors were 14.2 whereas after structured awareness program on cancer, mean score for knowledge on risk factors were 38.68. Hence, before structured awareness program on cancer, mean score for knowledge on preventive aspects were 12.97 whereas after structured awareness program on cancer, mean score for knowledge on preventive aspects were 17.56. Before structured awareness program on cancer, mean score for knowledge on risk factors and preventive aspects were 27.17 whereas after structured awareness program on cancer, mean score for knowledge on risk factors and preventive aspects were 56.25. So, it is concluded that the structured awareness program on cancer improved the knowledge on risk factors and preventive aspects of cancer for urban population of Assam. There is significant increase of knowledge on risk factors of cancer (24.48±3.01, n=177), t (176)= 108.148, P=.001 and preventive aspects (4.60±2.20, n=177), t(176)= 27.800, P=.001after awareness program on cancer. It is concluded that there is significant increase of knowledge on risk factors and preventive aspects (29.08±3.80, n=177), t (176)= 101.699, P=.001 after awareness program on cancer. Finding suggests that there was no association between knowledge as a whole (on risk factors and preventive aspects) with age (Chi Sq=6.19; df=6; P=.402), gender (Chi Sq=1.14; df=2; P=.566), educational qualification(Chi Sq=5.07; df=6;P=.534) and occupation (Chi Sq=2.86; df=6; P=.826). Conclusion: It suggests that t- values are significant at P= <.001, so null hypothesis is rejected and concluded that the knowledge on risk factors and preventive aspects on cancer are increased among urban population after structured awareness program on cancer. So, it is concluded that there is significant impact of structured awareness program on cancer among urban population of Assam.

KEYWORDS: Impact, Structured awareness programme, Cancer, Prevention, Urban population.

INTRODUCTION:

The world at present is heading towards various types of non communicable diseases which are also known as modern epidemics. Among the modern epidemics cancer is second largest non-communicable disease and it has a sizable contribution in the total number of deaths. The World Health Organization documents that cancer rates are set to increase at an alarming rate globally and it is projected that cancer burden would increase to 20 million by 2020 with 70% in the developing world.³

The burden of cancer is increasing in developing countries as people in the developing countries adopt Western lifestyles such as cigarette smoking, higher consumption of saturated fat and calorie-dense foods and reduced physical activity. It is estimated that there are 2 million cancer patients in India with 0.7 million new cases each year. Cancer is the third greatest cause of death with 0.4 million deaths per annum, and is thus a major public health problem in India. Facilities for screening and proper management of cancer patients are grossly limited in developing countries and also more than two third of cancer patients are already in advanced and incurable stage at the time of diagnosis.³

Cancer burden is increasing worldwide. The number of cancer cases is increasing by the day in the state, a study conducted by B Barooah Cancer Institute (BBCI) revealed. Assam is the worst-affected state in the northeast. In 2011-12, the maximum number of cancer cases in the hospital has been reported from Kamrup, Nagaon and Dhubri districts. In 2011-12 the number of patients has gone up to 8,708. The number of deaths was 55 in 2001-02 and it has more than doubled to 129 in 2011-12. In 2011-12, maximum number of cases have been reported from Kamrup (986), followed by Nagaon (483) and Dhubri (239). Among all the other states of NE, Assam has the highest incidence of cancer with 4,443 cases, next is Meghalaya with 101 cases, Manipur with 38 cases, Mizoram with 59 cases, Nagaland with 84 cases, Arunachal with 65 cases and Tripura with 14 cases in 2011-12. Even though rate of cancer cases are increasing at an alarming rate, the level of awareness remains very low. Eighty per cent patients come to the hospital at a very late stage, when there are no chances of recovery. So awareness on cancer is on great need in Assam.⁴

The researcher felt the urgent need for improving knowledge and bringing awareness on cancer among people and planned for providing structured awareness programme on cancer prevention to bring about a change in the knowledge and preventive practices of people.

PROBLEM STATEMENT:

“The Impact of Structured Awareness Programme on Cancer Prevention among Urban Population of Assam”.

OBJECTIVE(S):

General Objective:

To assess baseline knowledge on risk factors of cancer and its preventive aspects followed by structured awareness programme and assessing the effectiveness of the programme among urban population of Assam.

Specific Objectives:

1. To assess baseline knowledge on risk factors of cancer among urban population of Assam.

2. To assess knowledge on preventive aspects of cancer among urban population of Assam.

3. To organize structured awareness programme on cancer prevention by using Modified Cancer Prevention Module (with reference to WHO Cancer module⁵ and “What you need to know about cancer”⁶ by National Cancer Institute, U.STo assess the impact of the structured awareness programme on cancer prevention.

4. To recommend the further implementation of suitable awareness programme on cancer prevention

5. To associate knowledge and preventive aspects of cancer with certain demographic variables like age, sex, educational status and occupation.

HYPOTHESIS:

1. There will be no significant difference in knowledge on risk factors of cancer and its preventive aspects after structured awareness programme among urban population of Assam.

2. There will be no association of knowledge on risk factor and preventive aspects of cancer with certain demographic variables like age, sex, educational status and occupation.

MATERIAL AND METHODS:

Research Approach:

A Quantitative evaluative research approach is adopted to assess the impact of structured awareness programme on cancer prevention among urban population of Assam.

Research Design:

An interventional pre experimental (One Group Pre test Post Test) design is adopted to assess the impact of structured awareness programme on cancer prevention among urban population of Assam.

Setting of the study:

Due to feasibility of the study and availability of the sample, the present study was conducted in urban areas of Kamrup and Darrang District of Assam.

Population of the study:

In the present study the target population comprises of all adult (20-60 years of age) of Kamrup and Darrang District of Assam

Sample:

In this study the sample were the adults (20-60 years of age) attending the CHC and Urban Health Centres of Kamrup and Darrang District of Assam?

Sample size:

The total sample size is 177 (One hundred seventy seven).

Sampling technique:

The samples were selected based on availability and fulfillment of criteria. The technique employed for selection of the subjects was Multistage random sampling followed by purposive sampling.

Criteria for sample selection:

Inclusion criteria:

In this study, the samples selected were only:

1. Age group of samples was 20-60 years.

2. Those are willing to participate in the study.

Exclusion criteria:

The samples excluded were:

1. Diagnosed case of Cancer.

Tools and Technique:

The tools used for the present study were Structured Interview Questionnaire to assess knowledge on risk factors and preventive aspects of Cancer and Modified Cancer Prevention Module to conduct structured awareness programme on cancer.

Interview schedule and self reporting was used to assess knowledge on risk factors and preventive aspects of cancer among urban population of Assam.

Validity of the tool:

Content validity of the tool was obtained from 10 (ten) experts from the field of Nursing, Medicine and Community Medicine. Reliability was determined by internal consistency using Split Half method. Here reliability coefficient obtained was 0.84 for knowledge on risk factors of cancer and 0.88 for knowledge on preventive aspects of cancer. Since the calculated value was above the stated reliability coefficient, the tool was found to be statistically reliable.

Data Collection process:

Permission was obtained from the Joint Director of Health Services of Kamrup (Metro) and Darrang District. Prior to data collection permission was obtained from Medical Superintendent and Health Officer i/c of various Urban Health Centre and CHC. The samples were then informed about the nature of the study. Written consent was obtained from the selected samples. The samples were interviewed and the responses given were recorded simultaneously against structured questionnaire on knowledge on risk factors and preventive aspects on cancers. After assessing the pre-existing knowledge, the structured awareness programme on cancer was carried out with the help of modified cancer prevention module. The investigator also distributed the module among the samples. After 15 days the samples were interviewed again on the same parameters and responses were simultaneously noted.

RESULTS:

Section I: Frequency and Percentage distribution of demographic data

Table 1: Frequency and Percentage distribution of demographic data N=177

Age	20 – 30 years	34 (19.21%)
	30 – 40 years	57 (32.2%)
	40 – 50 years	68 (38.42%)
	50 - 60 years	18 (10.17%)
Gender	Male	109 (61.58%)
Gender	Female	68 (38.42%)
Marital Status	Married	121 (68.36%)
	Unmarried	38 (21.47%)
	Widow	18 (10.17%)
	Divorce	0 (0%)
Educational Qualification	Primary	3 (1.69%)
	Secondary	13 (7.34%)
	Graduate	75 (42.37%)
	Post Graduate	86 (48.59%)
Occupation	Govt–service	43 (24.29%)
	Private–service	59 (33.33%)
	Self employed	46 (25.99%)
	Unemployed	29 (16.38%)
Area of work	Office	109 (61.58%)
	Field work	43 (24.29%)
	Industries	14 (7.91%)
	Others	11 (6.21%)
Monthly income	< Rs 3000	14 (7.91%)
	Rs 3000 - 6000	18 (10.17%)
	Rs 6000 - 9000	49 (27.68%)
	> Rs 9000	96 (54.24%)
Diet	Vegetarian	11 (6.2%)
Diet	Non- Vegetarian	166 (93.8%)
Smoking	Yes	96 (54.2%)
Smoking	No	81 (45.8%)
Alcohol	Yes	102 (57.6%)
Alcohol	No	75 (42.4%)
Tobacco	Yes	103 (58.2%)
Tobacco	No	74 (41.8%)
Family history of cancer	Yes	9 (5.1%)
Family history of cancer	No	168 (94.9%)
History of hospitalization	Yes	30 (16.9%)
History of hospitalization	No	147 (83.1%)

Section II: Analysis of knowledge on risk factors of cancer among urban population N=177

Fig. 1: Pre test knowledge on risk factors on cancer

The findings suggest that before structured awareness program on cancer prevention out of 177 selected urban population 39 (22.0%) had low, 115 (65.0%) had medium and 23 (13.0%) had high knowledge on risk factors of cancer.

Section III: Analysis of knowledge on preventive aspects of cancer among urban population N=177

Fig. 2: Pre test knowledge on preventive aspects of cancer

The findings shows that before structured awareness program on cancer prevention out of 177 selected urban population 33 (18.6%) had low, 107 (60.5%) had medium and 37 (20.9%) had high knowledge on preventive aspects of cancer.

There was significant increase of knowledge on risk factors of cancer among urban population of Assam as obtained D±SDD = 24.48±3.01, (n=177), t- value= 108.148, df= 176, P=<.001 after structured awareness program on cancer prevention. There was significant increase of knowledge on preventive aspects of cancer among urban population of Assam as obtained D±SDD = 4.60±2.20 (n=177), t- value = 27.800, df=176, P=<.001 after awareness program on cancer prevention. It is concluded that there was significant increase of knowledge on risk factors and preventive aspects among urban population of Assam after awareness program on cancer prevention as obtained D±SDD = 29.08±3.80 (n=177), t- value = 101.699, df= 176, P=<.001.

Section V: Analysis to associate knowledge on cancer and preventive aspects of samples with certain demographic variables by λ²test:

Finding suggests that there was no association between pre test knowledge as a whole (risk factors and preventive aspects) with age (Chi Sq=6.19; df=6; P=.402), gender (Chi Sq=1.14; df=2; P=.566), educational qualification (Chi Sq=5.07; df=6; P=.534) and occupation (Chi Sq=2.86; df=6; P=.826).

DISCUSSION:

The objective of the study was to assess baseline knowledge on risk factors of cancer and its preventive aspects followed by structured awareness programme and assessing the effectiveness of the programme among urban population of Assam. The finding shows that the structured awareness program on cancer improved the knowledge on risk factors and preventive aspects of cancer among urban population of Assam. There is significant increase of knowledge on risk factors and preventive aspects of cancer (29.08±3.80, n=176), t(176)= 101.699, P=<.001 after awareness program on cancer prevention among urban population of Assam. It suggests that t- values are significant at P= <.001, so null hypothesis is rejected and concluded that the knowledge on risk factors and preventive aspects of cancer are increased among urban population of Assam after structured awareness program on cancer.

CONCLUSION:

The study findings showed that the structured awareness program on cancer improved the knowledge on risk factors and preventive aspects of cancer among urban population of Assam. So, it is concluded that there is significant impact of structured awareness program on cancer among urban population of Assam.

REFERENCES:

1. Kounteya Sinha. India sitting on a cancer bomb.Times of India 2009 Oct 3; TNN.

2. Mation, Northeast Cancer Awareness Programme Guwahati: Concert to uproot cancer from North-East India. Indian Express 2008 Oct Available from http://www. Indianxpress.com.

3. Puri S. Mangat C. Bhatia V. Kaur AP. Kohli DR. Knowledge of cancer and its risk factors in Chandigarh, India. The Internet Journal of Epidemiology 2010;8(1): p.1-7.

4. Celebration of world cancer day by Dr B Borooah Cancer Institute, Guwahati (http://www.bbcionline.org/press.htm)

5. WHO. Planning cancer control knowledge into action WHO guide for effective programmes. Switzerland: World Health Organization; 2006.

6. National Institute of Health. What you need to know about cancer. U.S department of Health and Human Services.2006.

Received on 19.08.2020 Modified on 28.09.2020

Int. J. Nur. Edu. and Research. 2021; 9(1):9-13.

DOI: 10.5958/2454-2660.2021.00003.X

Knowledge on	Test	Mean±SD	D±SDD	t-value	Df	P-value
Risk factors	Pre Test	14.20±1.97	24.48±3.01	108.148	176	<.001**
	Post Test	38.68±2.82
Preventive aspects	Pre Test	12.97±2.7	4.60±2.20	27.8	176	<.001**
	Post Test	17.56±2.69
Knowledge (risk factors and preventive aspects)	Pre Test	27.17±3.37	29.08±3.80	101.699	176	<.001**
	Post Test	56.25±3.95