Knowledge and attitudes about otitis media risk: Implications for prevention

Objectives. To investigate maternal knowledge and attitudes about otitis media (OM) risk, to estimate the prevalence of risk factors in the first year of life, and to identify barriers to the reduction of risk factors leg, formula feeding, day care attendance, and exposure to passive smoke). Methods. Questionnaires mailed to a systematic sample of 504 Minnesota women greater than or equal to 18 years old identified through 1994 birth certificates. Results. Eighty percent returned a completed survey. According to maternal report, 29% of infants (age 8 to 13 months) had recurrent OM (greater than or equal to 3 episodes) and 2% had tympanostomy tubes. Forty-six percent attended day care, 29% had greater than or equal to 1 smoking parent, and 49% breastfed for less than or equal to 2 months. Women were more knowledgeable-about OM signs and symptoms than about risk factors. Mean OM knowledge score (the sum of correct true-false responses) was 7.0 (standard deviation = 1.6). Using multiple linear regression, knowledge score was significantly related to marital status, education, age, area of residence, breastfeeding (months), and number of cigarettes smoked per day by the mother, but not to infant or sibling OM history or day care attendance (R-2 =.23). Infant history of OM (odds ratio, 1.9; 95% confidence interval, 1.1 to 3.2) and white race (odds ratio, 0.3; 95% confidence interval, 0.1 to 0.8), but not the presence of risk factors, were significantly related to having received clinicians' advice about OM prevention advice. Conclusion. OM education and prevention programs should target pregnant women and new mothers with OM risk factors, and Chose who are young, single, and less educated.