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Public Health Concerns, Risk Perception and Information Sources in Cameroon

초록/요약

Abstract Objectives: Sampling public perception regarding health risks may cut across different factors ranging from; if the risk in question evokes feelings of dread, if the issue is well understood, whether it involve uncertainty, if it is a subject of personal control, or familiarity and media courage. Considering that, public perception on health risks could aid in shaping the way experts assess and direct decisions regarding health risk factors, it is of importance to closely examine their views. This study was designed to investigate the degree of public perception associated with various health risk factors, their information sources and the confidence on the sources of information to Cameroonians nationwide. The results are aimed towards contributing to a better understanding of perceived health risk factors and health status profile of Cameroonians, which could allow for the development or re-enforcement of health prevention/promotion programs of the nation. Methods: This was a national population-based cross-sectional survey that was conducted using a self-administered questionnaire designed to sample public perceptions on different health risk factors amongst Cameroonians. Based on the 2010 national population census, proportional quota sampling were used to ensure that respondents were demographically representative of the general population, with quotas based on gender and regions. Cameroonians adults of both sexes with age ≥ 20 years took part in the survey. A total of 1,067 Cameroonians were sampled within the 10 regions of the nation taking into account the proportional quotas based on gender. Descriptive statistical analyses were performed to illustrate the levels of risk perceived according to differences in mean score values as “high health risk” with respect to gender, age, education, income and region of location. Factors analysis was used to reduce the dimensions of common attributes of the risk factors into simpler dimensions using principal component and Varimax rotation methods. Independent two sample t-test was performed to examine the group differences in perceived risk for each hazard based on gender. ANOVA analysis was also performed to analyse the differences in risk perception through a comparison of the different issues with age, education, income and geographic differences. Statistical significance tests was at p˂0.05. Results: Public health concerns of twenty-five selected health risk factors to Cameroonians were analyzed and ranked according to mean score values perceived to be a “high health risk”. HIV/AIDS was perceived as posing the greatest personal health risk with a mean score of 6.58 ± 1.12 within the population. By combining the psychometric variables to determine the overall mean scores, terrorism was perceived as the greatest health risk factor with mean score value of 5.82 ± 0.51 to the nation. Natural disasters, unprotected sex, unemployment, drinking alcohol, cigarette smoking, poverty, malaria, and cholera were also among the leading perceived health risk factors to the population. Women perceived selected health risk factors more than men. The greatest perceived gender mean score difference of 0.51 was observed for unemployment. There was a great significant differences between perceived health risk factors based on regional location. All perceived risk factors were statistically significant across the different regions at (p˂0.05). Also, poverty, high voltage power lines and influenza had high mean score differences for age groups, educational and income levels respectively. Statistically significant differences were observed for poverty and measles based on income at (p˂0.05). Using factor analysis to reduce the dimensions of common attributes among the risk factors to simpler ones based on gender, knowledge and dread factors for perceived health risks were ranked differently. For the analyses based on knowledge, women and men ranked natural disaster (flood, landslide, eruption etc), and terrorism as the highest risk factors respectively. With regards to dread, terrorism was ranked the highest for both women and men. Conclusion: The present large scale survey of public opinions among Cameroonians provided some valuable information on their perception regarding selected health risk factors, information sources and the level of confidence on the information sources in Cameroon. Generally, the risk factors presented in this study were scored as posing a potential “high health risk” to the population. Experts and managers interested in population health may want to consider taking some measures that will address these issues, in order to effectively communicate and control the consequences that may emanate from their accidents. Although this study sampled public views limited to Cameroon, it could stand as a guide on public perception regarding health risk factors in a developing setting such as those of Sub-Saharan Africa where there is a dearth of information in this area of research. HIV/AIDS and terrorism that were perceived to be beyond individual control as the highest perceived health risk factors among others in Cameroon, the government may want to consider public views and take inclusive measures that will properly identify and address the issues that may result to further complications arising from their effects within the nation. Also, the results obtained from this study should be carefully interpreted, and policies directed towards the effective communication of health risk management strategies within the communities aimed at the development of health prevention/promotion programs of the nation should be encouraged.

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Table of contents
Abstract…...................................................................................................... i
I. Introduction….…………………………………………………………...1
1. Research background and significance……...…………………………1
2. Research purpose……..……………………………………………….7
II. Methods……………………………………………………………..9
1. Research area and subjects………………….............................................9
2. Research methods….…..……………………………………………….11
1) Content and methods of survey…….…………………………………11
2) Sample collection and procedure…….………………………….....13
3) Ethics statement……………………………………………………...15
4) Data analysis…………………………………………………………26
III. Results……………………………………………………………17
1. Characteristics of research subjects………………………………………17
2. General perceived health risk factors to Cameroonians...............………19
3. Perceived health risk differences based on gender…...……………….21
4. Perceived health risk differences based on age groups……….........23
5. Perceived health risk differences based on education…….….......25
6. Perceived health risk differences based on regional location….….27
7. Perceived health risk differences based on income……………30
8. Ranking of 25 health risk factors with respect to knowledge and dread based on gender………………………………………………………….32
9. Risk cognitive map of the 25 health risk factors based on gender…….……................................................................................36
10. Sources of information and confidence in information sources of health risk factors……………………………………………………38
IV. Discussion……………………………………………………………..40
Limitations ………………………………………………………...………49
V. Conclusion……………………………………………………….…...51
References……………………………………………………………….…53
Acknowledgement………………………………………………………58
Questionnaires………………………….…………………………………59

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