title: Effectiveness of a multicentre nasopharyngeal carcinoma awareness programme in Indonesia.
abstract: OBJECTIVE
  To evaluate the effectiveness of a nasopharyngeal carcinoma (NPC) awareness programme on the short-term and long-term improvement of knowledge and referral of patients with NPC by primary healthcare centres (PHCCs) staff in Indonesia.
  
  
  METHODS
  The NPC awareness programme consisted of 12 symposia including a Train-The-Trainer component, containing lectures about early symptoms and risk factors of NPC, practical examination and the referral system for NPC suspects. Before and after training participants completed a questionnaire. The Indonesian Doctors Association accredited all activities.
  
  
  METHODS
  1 representative general practitioner (GP) from each PHCC attended an NPC awareness symposium. On the basis of the Train-The-Trainer principle, GPs received training material and were obligated to train their colleagues in the PHCC.
  
  
  RESULTS
  703 GPs attended the symposia and trained 1349 staff members: 314 other GPs, 685 nurses and 350 midwives. After the training, respondents' average score regarding the knowledge of NPC symptoms increased from 47 points (of the 100) to 74 points (p<0.001); this increase was similar between symposium and Train-The-Trainer component (p=0.88). At 1½ years after the training, this knowledge remained significantly increased at 59 points (p<0.001).
  
  
  CONCLUSIONS
  The initial results of this NPC awareness programme indicate that the programme effectively increases NPC knowledge in the short and long term and therefore should be continued. Effects of the improved knowledge on the stage at diagnoses of the patients with NPC will still need to be scrutinised. This awareness programme can serve as a blueprint for other cancer types in Indonesia and for other developing countries.
authors.affiliation: Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Renske
authors.initials: R
authors.lastname: Fles
authors.affiliation: Department of Otorhinolaryngology, Dr. Sardjito General Hospital, Faculty of Medicine Gadjah Mada University, Yogyakarta, Indonesia.
authors.forename: Sagung R
authors.initials: SR
authors.lastname: Indrasari
authors.affiliation: Department of Otorhinolaryngology, Dr. Sardjito General Hospital, Faculty of Medicine Gadjah Mada University, Yogyakarta, Indonesia.
authors.forename: Camelia
authors.initials: C
authors.lastname: Herdini
authors.affiliation: Department of Public Health, Airlangga University, Surabaya, Indonesia.
authors.forename: Santi
authors.initials: S
authors.lastname: Martini
authors.affiliation: Department of Public Health, Airlangga University, Surabaya, Indonesia.
authors.forename: Atoillah
authors.initials: A
authors.lastname: Isfandiari
authors.affiliation: Department of Otorhinolaryngology, Dr. Soetomo Hospital, Faculty of Medicine Airlangga University, Surabaya, Indonesia.
authors.forename: Achmad C
authors.initials: AC
authors.lastname: Romdhoni
authors.affiliation: Department of Otorhinolaryngology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine University of Indonesia, Jakarta, Indonesia.
authors.forename: Marlinda
authors.initials: M
authors.lastname: Adham
authors.affiliation: Department of Otorhinolaryngology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine University of Indonesia, Jakarta, Indonesia.
authors.forename: Ika D
authors.initials: ID
authors.lastname: Mayangsari
authors.affiliation: Department of Biometrics, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: van Werkhoven
authors.affiliation: Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Maarten A
authors.initials: MA
authors.lastname: Wildeman
authors.affiliation: Department of Otorhinolaryngology, Dr. Sardjito General Hospital, Faculty of Medicine Gadjah Mada University, Yogyakarta, Indonesia.
authors.forename: Bambang
authors.initials: B
authors.lastname: Hariwiyanto
authors.affiliation: Department of Otorhinolaryngology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine University of Indonesia, Jakarta, Indonesia.
authors.forename: Bambang
authors.initials: B
authors.lastname: Hermani
authors.affiliation: Department of Otorhinolaryngology, Dr. Soetomo Hospital, Faculty of Medicine Airlangga University, Surabaya, Indonesia.
authors.forename: Widodo A
authors.initials: WA
authors.lastname: Kentjono
authors.affiliation: Department of Histology, Cell and Tumour Biology, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia.
authors.forename: Sofia M
authors.initials: SM
authors.lastname: Haryana
authors.affiliation: Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Marjanka K
authors.initials: MK
authors.lastname: Schmidt
authors.affiliation: Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands Department of Otorhinolaryngology, Dr. Sardjito General Hospital, Faculty of Medicine Gadjah Mada University, Yogyakarta, Indonesia Department of Oral and Maxillofacial Surgery, Academic medical Centre, Amsterdam, The Netherlands.
authors.forename: I Bing
authors.initials: IB
authors.lastname: Tan
mesh_terms: D002277:Carcinoma; D003906:Developing Countries; D058005:General Practitioners / Q000193:education* / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007214:Indonesia; D016015:Logistic Models; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000453:epidemiology*; D011320:Primary Health Care / Q000458:organization & administration*; D012017:Referral and Consultation; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: MEDICAL EDUCATION & TRAINING; awareness; nasopharyngeal carcinoma