Factors Associated with Health-Seeking Preference Among People Who Were Supposed to Cough for More Than 2 Weeks: A Cross-Sectional Study in Southeast China

Abstract

Background: The health-seeking preference of people with a cough >2 weeks had not been extensively researched in southeast China. The study aimed to explore factors associated with health-seeking preference, which could provide more evidence to improve individuals' appropriate health-seeking behavior.

Materials and methods: From October 2018 to December 2018, this cross-sectional study was conducted in Zhejiang, China. A questionnaire was used to collect information on sociodemographic characteristics, knowledge of tuberculosis (TB), and health-seeking preference. The chi-square test and multivariable logistic regression were performed to evaluate factors associated with health-seeking preference.

Results: Of the 7174 participants, 3321 (46.3%) were men, 6148 (85.7%) were married, and 6013 (83.8%) knew about TB. Appropriate health-seeking preference was reported by 6229 (86.8%) participants. Respondents knowing about TB were more likely to seek appropriate care than those did not (89.6% vs 72.4%, p<0.001). Of the 6013 participants knowing about TB, respondents with higher scores on five key items of TB knowledge were more likely to get appropriate health-seeking preference. About 805 (96.6%) participants with 5 scores on TB knowledge had appropriate care preference. Only 97 (72.4%) participants with a score of 0 reported an appropriate preference. Multivariable logistic regression showed residence, marital status, education level, occupation, and awareness of TB knowledge were predictors of appropriate health-seeking preference. Compared to participants with a score of 0 on five TB key knowledge, participants with a score of 5 were 8.57 times more likely to have appropriate health-seeking preference (95% confidence interval [CI]: 4.97-14.78), followed by a score of 4 (odds ratio [OR]=5.99, 95% CI, 3.23-8.03); 3 (OR=3.74, 95% CI, 2.44-5.74); 2 (OR=1.99, 95% CI, 1.30-3.02) and 1 (OR=1.17, 95% CI, 0.76-1.80).

Conclusion: Participants with little knowledge of TB had a low level of appropriate health-seeking preference. Appropriate health-seeking preference of the participants improved with increased key knowledge level of TB.

Keywords: cough; health care-seeking behavior; tuberculosis.

Figure 1

The association between knowledge of TB and health-seeking behavior among participants who knew about TB in Zhejiang, China (n=6013). Notes: 1) When residence, education, marriage, and occupation were adjusted for, participants with higher scores based on correct answers on five items of key information were more likely to get appropriate health-seeking preference. 2) Compared to participants with a score of 0, participants with a score of 5 were 8.57 times more likely (95% CI, 4.97–14.78) to have appropriate health-seeking preference, followed by participants with a score of 4 (OR=5.99; 95% CI, 3.23–8.03), a score of 3 (OR=3.74; 95% CI, 2.44–5.74); a score of 2 (OR=1.99; 95% CI, 1.30–3.02); and a score of 1 (OR=1.17; 95% CI, 0.76–1.80). 3) Appropriate health-seeking preference of the participants increased as the key knowledge scores increased.