Awareness and attitude towards major non-communicable diseases among undergraduate students in Dhaka, Bangladesh: a cross-sectional study

Abstract

Background: Non-communicable diseases (NCDs) are a major public health challenge in Bangladesh, and many modifiable risk factors begin during adolescence and early adulthood. Undergraduate students are therefore an important group for early health promotion. This study assessed awareness and attitude toward major NCDs among undergraduate students in Dhaka, Bangladesh. Methods: A descriptive cross-sectional study was conducted among undergraduate students from Jagannath University and Bangladesh Maritime University. A total of 421 valid completed responses were analyzed. Data were collected using a semi-structured, self-administered Google Forms questionnaire covering sociodemographic characteristics, 12 awareness items, and 12 attitude statements. Awareness was scored from 0 to 12 and categorized as low, moderate, or high. Attitude was measured on a five-point Likert scale; seven negatively worded items were reverse-coded before calculating the global attitude score. Data were analyzed using SPSS version 25 with descriptive statistics, chi-square tests, ANOVA, correlation, and regression analyses. Results: The mean awareness score was 7.58±2.65 out of 12. Low, moderate, and high awareness were observed in 56 (13.3%), 185 (43.9%), and 180 (42.8%) students, respectively. Correct awareness was highest for smoking as an NCD risk factor (87.6%), dietary risk for obesity and type 2 diabetes (83.6%), sugary drink-related health risk (79.6%), and cardiovascular disease definition (79.3%). Important gaps remained for WHO physical activity recommendations (27.8%), organ involvement in type 2 diabetes (35.4%), and identification of malaria as not being an NCD (41.3%). The mean attitude score was 3.55±0.49 out of 5; 52 (12.4%) students had low, 308 (73.2%) moderate, and 61 (14.5%) high attitude scores. Awareness and attitude were positively associated; mean attitude increased from 3.03±0.48 in the low-awareness group to 3.77±0.37 in the high-awareness group (p<0.001), and the awareness-attitude correlation was moderate and positive (r=0.543, p<0.001). Conclusions: Undergraduate students demonstrated moderate-to-high awareness and generally favorable attitudes toward NCD prevention, but important knowledge gaps and perceived behavioral barriers remained. The positive association between awareness and attitude supports university-based NCD education, but interventions should also address motivation, perceived barriers, and supportive campus environments.