Objective: To evaluate the effect of health awareness on health values such as dietary structure and choices. To evaluate the effect of health awareness levels on the presence of Chronic Noncommunicable Diseases in St. Vincent and the Grenadines. Results: Participants with high awareness levels have higher educational levels and lower incidences of non-communicable diseases than individuals with low awareness levels. Chi square test gave a p value less than 0.00001 for the association between awareness level and disease. The relationship between awareness level and education, yielded a p value of 0.000088.

1. Health Awareness as a Predictor of Chronic Non-Communicable
Diseases in St. Vincent and the Grenadines
Supervisor: Dr. Daphne Santhosh & Co-Supervisor: Dr. Maxim Crasta
Research Scholars: Jodean Campbell, Dovounne Green, Wilbert Alceus, Brian Kim

2. Chronic Noncommunicable Diseases (CNCDs) in St. Vincent & the
Grenadines
CNCDs are the leading causes of death in St. Vincent and the Grenadines (Javid).
Highest disease burden for CNCDs in the Organization of the Eastern Caribbean States
(The World Bank).
The top seven causes of death were CNCDs, which accounted for 74% of all deaths (Pan
American Health Organization).
The top five causes of morbidity are neoplasms, ischemic heart disease, hypertensive
heart disease, cerebrovascular disease, and diabetes mellitus (Pan American Health
Organization).

3. Rationale
To examine health
awareness levels of the
population in St. Vincent &
the Grenadines.
To examine the effect of
health awareness levels on
dietary habits.
To evaluate if health
awareness levels could be a
predictor of the presence of
CNCDs
To evaluate the factors
affecting dietary habits in the
population
To evaluate the public health
implications of these findings
and make appropriate
recommendations

4. Methods Duration
• The study took place between
June 2015 – November 2015
Questionnaire: Design 15
Question Survey
• Demographics
• Health Awareness: General knowledge
of diet & nutrition
• Dietary Structure & Health-Centered
Behaviors
• Presence of CNCDs
Participants: 126
• 38 (30.2%) males
• 80 (63.5%) females
• 8 (6.3%) unspecified/not
reported
Statistical Analysis:
• Descriptive Statistics
• Likert Scale Analysis
• Multivariate Linear
Regression

5. Health Awareness: The Knowledge or Perception of Factors
Contributing to One’s Health Status
The statistical
approach
implemented for
analyzing
awareness
amongst
responders was
the Likert Scale
Analysis.
Responses to key
survey questions
(5, 6, 7, 8, 9 and
17) were coded
using numerical
figures to quantify
response.
Responses for
each question
was given a value
from 1 to 5, with 5
being the highest
health awareness
score.
Means of coding
values were used
as the level of
awareness
Levels of
awareness were
compared amongst
the different group,
as it relates to
dietary structure.
There is little research on the effect of health awareness on health predicting
behaviors, such as dietary choices, and the non-socioeconomic factors
influencing them

6. ~88% of the Population Scored at Least Mid-level Health
Awareness Scores
12%
62%
26%
POPULATION DISTRIBUTION BY AWARENESS LEVELS
low awareness levels mid awareness levels high awareness levels

7. Health Awareness Levels Appears to be Impartial to Age
or Sex
• Health awareness appears to not
be biased by age or sex, though
women tended to have slightly
higher health awareness scores.
• As age increased, health
awareness also increased.
However this relationship is weak,
as the p =0.984.
0
0.5
1
1.5
2
2.5
3
3.5
4
20 & under 21-30 31-40 40+
AWARENESSSCORES
AGE
AWARENESS LEVEL BY AGE AND SEX
Male Female

8. Higher Health Awareness May Be Closely Associated
with Higher Education Levels
• 22.4% of mid aware individuals have
grad degree, 41.2% have college
degree, 33.8% high school and 2.6% no
education.
• All individuals with low health
awareness had either no education or
just a high school education. This is
significant with a p value of less than
0.00088.
-40
-20
0
20
40
60
80
100
120
None High School College Graduate
PERCENTAGEOFINDIVIDUALS
EDUCATION LEVEL
HIGHLY HEALTH AWARE INDIVIDUALS HAVE HIGHER
EDUCATIONAL LEVELS THAN THOSE WITH LOWER HEALTH
AWARE SCORES
Low Awareness Level Mid Awareness Level High Awareness Level

9. Health Awareness May Be a Good Predictor for the Presence of
Chronic Noncommunicable Disease in Saint Vincent and the
Grenadines
-20
0
20
40
60
80
100
120
low mid high
PERCENTAGEOFINDIVIDUALS
AWARENESS LEVEL
INDIVIDUALS WITH HIGHER HEALTH AWARENESS
SCORES HAVE LESS PREVALENCE OF DISEASE
THAN THOSE WITH LOWER SCORES
No Disease Disease
• There was a statistically significant difference
(p<0.00001) between the presence of chronic
noncommunicable diseases in low and high
awareness groups.
• It should be noted that presence of disease is
low amongst all participants.
• This may be due to the iceberg effect, a
phenomenon where participants have disease
but are unaware.
• Other factors such irregular medical/physical
examinations or response biases may
account for this observation.

10. Health Awareness Scores May Influence Health Driven
Activities
Individuals with
higher health
awareness
scores, placed
less importance
on all factors
influencing food
purchase
(Calories, brand,
Ingredients,
Nutritional Costs
and Cost).
However people
with higher
health
awareness
scores were
associated with
higher rates of
keeping track of
nutritional facts.
This finding was
not significant
(p=0.36).
These two
observations
appear to be
contraindicative
and might be
explained due to
response or
statistical
analysis
biases/errors.

11. Higher Health Awareness Maybe Associated with
Increased Health Directed Activity
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Calories Brand Ingredients Nutritional
Facts
Cost
IMPORTANCEOFFACTORSAFFECTINGFOODPURCHASES
FACTORS
FACTORS AFFECTING FOOD PURCHASE BY
AWARENESS LEVELS
Low Awareness Level Mid Awareness Level High Awareness Level
-10
0
10
20
30
40
50
60
70
80
Never Sometimes Always
PERCENTAGEOFINDIVIDUALS
TRACK KEEPING
INDIVIDUALS WITH HIGHER HEALTH AWARENESS
SCORES KEEP TRACK OF NUTRITIONAL FACTS
MORE THAN THOSE WITH LOWER AWARENESS
SCORES
Low Awareness Level Mid Awareness Level High Awarenes Level

12. Cost and Brand were Identified as the Most Significant Factor in the Purchase
of Food, with Calories and Nutritional Facts having Lower Influences on Food
Purchases
0
10
20
30
40
50
60
Not important Little Importance Moderate Some what important Very Important
PERCENTAGEOFINDIVIDUALS
LEVEL OF IMPORTANCE
IMPORTANCE OF SEVERAL FACTORS ON THE PURCHASE OF FOOD
Calories Brand Ingredients Nutritional Facts Cost

13. Time and Lack of Knowledge are the Main Barriers to
Committing to a Healthier Diet
15%
26%
59%
BARRIERS TO A HEALTHIER DIET
Lack of Knowledge Hectic/Work Life Balance Insufficient Time
• Consumer habits suggested
people perceived healthy
eating as time consuming
with 85% of them reporting
they had little time to invest in
preparing healthy meals. The
other 15% reported they
didn’t know how to prepare
heathy meals.

14. Recommendations
Utilizing health
awareness levels
as a predictor for
risk factors
associated with
noncommunicable
diseases.
Implementing
Public Health
campaigns aimed at
educating the
population about
how to prepare
quick healthy
meals.
Establishing
nationwide high
quality
occupationally
based health
promotion
programs.
Promoting public
health campaigns
emphasizing the
many benefits; i.e.
sustainability,
environmental,
economical, of
backyard farming.

15. ConclusionCNCDsIndicator
Health awareness
levels may have
potential benefit as a
tool for evaluating
and predicting the
development of
chronic non
communicable
disease in St. Vincent
and the Grenadines.
PublicHealth
Public health campaigns
focusing on the ease of
cooking healthy meals
and the cost/health
benefits of backyard
farming, as well as
occupationally-based
health promotion
programs, may be highly
beneficial in increasing
healthier behaviors within
the population of Saint
Vincent’s and the
Grenadines.
MovingForward
It is recommended
that a more
structured study be
conducted with a
larger sample size
and a well-developed
standardized
instrument for the
evaluation of health
awareness.

16. Objective: To evaluate the effect of health awareness on Chronic
Noncommunicable Diseases in St. Vincent and the Grenadines, and to evaluate
the relationship between health awareness and health values such as dietary
structure and choices.
Methods: For this study, a cross-sectional analysis was conducted amongst 126
participants. A 20 item survey was used to gather information on demographics,
socioeconomic status, dietary structure and health awareness.
Results: Participants with high awareness level have higher educational levels
and lower incidences of non-communicable diseases than individuals with low
awareness levels. Chi square test gave a p value less than 0.00001 for the
association between awareness level & disease, and yielded a p value of
0.000088 for the association between health awareness & education.
Conclusion: Health awareness is linked to chronic non-communicable diseases
such as cancer, cardiovascular disease, hypertension, diabetes and stroke (p-
value< 0.00001). There is a positive correlation between higher awareness and
higher education levels, this difference is shown with a p value of 0.000088. There
is no significant difference in factors that affect the purchase of foods amongst all
awareness groups. Cost and brand were identified as the most significant factor in
the purchasing food. Calories and nutritional facts seem to have a lower
influences on food purchase.
ABSTRACT
Health awareness can be defined as the knowledge or perception of factors
contributing to one’s health status. From observation of societal trends, health
awareness seem to be influenced more by personal values and cultural norms,
rather than variables of socioeconomic status. Health awareness has a very
powerful influence on industry and cultural norms. In the past decade, there has
been a nationally observable increase in health awareness among various
populations. People of all societal strata are sharing a vested interest in factors
affecting their health, including policies affecting the regulation of their health and
consumption products. The ‘organic food craze’ has now crossed-over from being a
fad to being the new dietary gold standard of society (Chaker, 2013).
There is little research on the effect of health awareness on dietary choice and
diseases. Awareness is a rather abstract concept which is very difficult to
standardize for measurement. To date no study has attempted to evaluate the
effects of health awareness on the dietary habits of a population.
In this study, we attempt to demonstrate that overall health values, including dietary
structure are directly influenced by health awareness. Health awareness, thus, may
represent an acceptable predictive value for the development of Chronic
Noncommunicable diseases in St. Vincent and the Grenadines.
INTRODUCTION
Figure 6. Health directed activity by awareness level. Increased
health directed activity is associated with higher health
awareness.
RESULTS
DISCUSSION & RECOMMENDATIONS
Of the 126 participants, 30.2% were males, 63.5% females and 6.3% unspecified.
Age was appropriately distributed with 80% being at least over the age of 20. 22.04%
of mid aware individuals have grad degree, 44.2% have college degree, 33.8% high
school and 2.6% no education. These findings are suggestive that high levels of
health awareness may be closely associated to educational levels (Figure 5). All
individuals with low health awareness had either no education or just a high school
education. This is significant with a p value of less than 0.0001. Health awareness
appears to not be biased by age or sex, though women tended to have slightly
higher health awareness scores (Figure 4). There was a statistically significant
difference between the presence of chronic noncommunicable diseases in low and
high awareness groups. Suggesting that the level of health awareness may be a
good predictor for the presence of chronic noncommunicable disease in Saint
Vincent and the Grenadines. However, it should be noted that presence of disease
is low amongst all participants. This may be due to the iceberg effect in which
participants have disease and don’t know it, not getting regular physical
examinations from a physician or response bias. We recommend creating health
campaigns to educate the population about preparing quick healthy meals and the
many benefits of backyard farming. We also recommend the implementation of
work-place based health and wellness program.
REFERENCES
ACKNOWLEDGEMENTS
1. Chaker, Anne Marie. "Wall Street Journal: Backyard Farming Gets Fancy."City Farmer News RSS. Micheal Levenston, 30 June 2013. Web. 25 Nov. 2015.
2. "Consumer Trends: Increasing Health Awareness Boosts Organic Market." Food Manufacturing. 23 Oct. 2013. Web. 23 Nov. 2015. <http://www.foodmanufacturing.com/news/2013/10/consumer-trends increasing-health-awareness-
boosts-organic-market>.
3. Curl, Cynthia L., Shirley A. A. Beresford, Anjum Hajat, Joel D. Kaufman, Kari Moore, Jennifer A. Nettleton, and Ana V. Diez-Roux. "Associations of Organic Produce Consumption with Socioeconomic Status and the Local Food
Environment: Multi-Ethnic Study of Atherosclerosis (MESA)." PLoS ONE (2013). PLOS ONE. PLOS ONE. Web. 24 Nov. 2015.
4. “Noncommunicable Diseases.” WHO. WHO, 2015 Web.23 Nov. 2015. <http://www.who.int/mediacentre/factsheets/fs355/en/>
5. Pan American Health Organization. "Saint Vincent and the Grenadines."Health in the Americas, 2012 Edition: Country Volume. Pan American Health Organization, 2012. Web. July 2015.
6. Roberts, Javid. "CNCDs – The LeadingCause of Death in SVG." NBC Radio. NBC SVG, 19 Mar. 2014. Web. July 2015.
7. Rongen, A., and SK Robroek. "Workplace Health Promotion: A Meta-analysis of Effectiveness."American Journal of Preventative Medicine 44.4 (2013): 406. PMC. Web. 26 Nov. 2015.
8. "The Newest Vital Sign." Pfizer. Pfizer. Web. 26 Nov. 2015.
9. “"Saint Vincent and the Grenadines Demographics Profile 2014."Mundi. IndexMundi. Web. 26 Nov. 2015. http://www.indexmundi.com/saint_vincent_and_the_grenadines/demographics_rofile.html>.
10. "Socio-economic Disadvantage and Health." Authoritative Information and Statistics to Promote Better Health and Wellbeing (AIHW). Australian Institute of Health and Welfare. Web. 26 Nov. 2015. <http://www.aihw.gov.au/socio-
economicdisadvantage-and-health/>.
11. Zoellner, Jamie, Wen You, Carol Connell, Renae Smith-Ray, Kacie Allen, Katherine Tucker, Brenda Davy, and Paul Estabrooks. "Health Literacy Is
Associated with Healthy Eating Index Scores and Sugar-Sweetened Beverage Intake: Findings from the Rural Lower Mississippi Delta." Journal of the American Dietetic
Association. U.S. National Libraryof Medicine, 1 July 2012. Web. 26 Nov. 2015. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3160591/>.
The research scholars of this paper are thankful to our Projects Supervisor, Dr.
Daphne Santhosh, co-supervisor, Dr. Maxim Crasta, Dean of student affairs and
Professor, and Dr. Zeine.
Health Awareness as a Predictor of Chronic Non-Communicable Diseases in St.
Vincent and the Grenadines
Research Scholars: Jodean Campbell, Dovounne Green, Wilbert Alceus, Brian Kim
Supervisor: Dr. Daphne Santhosh & Co-Supervisor: Dr. Maxim Crasta
Figure 4. Effect of age on health awareness. There is not clear effect on age and
sex on health awareness.
Figure 2. Awareness level of respondents. 62% of respondents have
mid level health awareness. 26% scored high awareness level.
Figure 8. Factors affecting the purchase of foods by health awareness levels.
All levels of health awareness seem to place similar significanceon calories,
brand, ingredients and cost.
Figure 3. Social Barriers affecting Diet. Time seems to be the
most significant barrier to eating a balanced diet.
Figure 7. Importance of factors in the purchase of food.
Figure 5. Effect of education on health awareness. There is a strong
link between education level and high awareness level. This finding is
significant with a p value of 0.000088.
Figure 9. Increase in health awareness is associated with better
health.
Instrument: A 20 item survey
Inclusion/Exclusion Criteria: Vincentians 18 years or older, without intellectual
disabilities.
Statistical Analysis: The statistical approach implemented for analyzing awareness
amongst responders was the Likert Scale Analysis. Responses to key questions (5, 6, 7, 8,
9 and 17) were coded using numerical figures to quantify response. Response for each
question was given a value from 1 to 5, with 5 being the highest. Means of coding values
were used as the level of awareness. Levels of awareness were compared amongst the
different group, as it relates to dietary structure. Chi square test was done to measure the
significance of findings. The p value then determined the acceptance of the hypothesis.
Also, charts were used for better understanding of recommendations to improve diet, as
well as, the demographic information of respondents. We defined high awareness as a
score of 3.6 and over, mid awareness, a score from 3.5 to 2, and low awareness a score of
1.9 and under.
Statistics: Categorical data were analyzed using the Microsoft Excel software. Data were
considered significant if the p-value ≤0.05 using the Chi-squared test.
METHODS
Figure 1. Demographics of Participants
DEMOGRAPHICS

17. Acknowledgements
The Research Scholars of this paper are thankful to the following individuals:
• Project Supervisor, Dr. Daphne Santhosh, Associate Professor, Department of
Microbiology, St. James School of Medicine, St. Vincent and the Grenadines
• Co-supervisor, Dr. Maxim Crasta, Dean of student affairs and Professor,
Department of Physiology, St. James School of Medicine, St. Vincent and the
Grenadines
• Research Methods III Instructor, Dr. Rana Zeine, Associate Professor,
Department of Pathology, St. James School of Medicine, St. Vincent and the
Grenadines

18. References
• Pan American Health Organization. "Saint Vincent and the Grenadines." Health in the
Americas, 2012 Edition: Country Volume. Pan American Health Organization,
2012. Web. July 2015.
• Roberts, Javid. "CNCDs – The Leading Cause of Death in SVG." NBC Radio. NBC
SVG, 19 Mar. 2014. Web. July 2015.
• The World Bank. "The Growing Burden of Noncommunicable Diseases in the Eastern
Caribbean." The World Bank. Human Development Unit Caribbean Country
Management Unit Latin America and the Caribbean Region, 2013. Web. July
2015.
• The World Health Organization. "The Global Burden of Disease." World Health
Organization WHO Library Cataloguing-in-Publication Data (2008): The World
Health Organization. Web. July 2015.