METHODS: A systematic literature search was performed on five electronic databases from database inception to 3 November 2021. A two-step technique was used in the data synthesis process: (i) the barriers of LTBI management were identified using the COM-B model, followed by (ii) mapping of intervention functions from BCW to address the identified barriers.
RESULTS: Forty-seven eligible articles were included in this review. The findings highlighted the need for a multifaceted approach in tackling the barriers in LTBI management across the public, provider and system levels. The barriers were summarized into suboptimal knowledge and misperception of LTBI, as well as stigma and psychosocial burden, which could be overcome with a combination of intervention functions, targeting education, environment restructuring, persuasion, modelling, training, incentivization and enablement.
CONCLUSIONS: The remedial strategies using BCW to facilitate policy reforms in LTBI management could serve as a value-added initiative in the global tuberculosis control and prevention program.
METHODS: The following databases will be searched: Embase, MEDLINE, Emcare, EPPI-Centre database of health promotion research (BiblioMap) EPPI-Centre Database for promoting Health Effectiveness Reviews (DoPHER), Global Health, CINAHL, Joanna Briggs Institute EBP Database, Maternity and Infant Care Database, Education Resource Information Center, PsycINFO, Scopus, Web of Science and Global Index Medicus, which indexes Latin America and the Caribbean, Index Medicus for the South-East Asia Region, African Index Medicus, Western Pacific Region Index Medicus. Cochrane Central Register of Controlled Trials, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, conference proceedings, thesis and dissertations, policy and guidelines and their reference lists will also be searched. Two reviewers will independently screen titles and abstracts and full text based on predefined eligibility criteria. The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews using the Population, Concept and Context framework and the Template for Intervention Description and Replication checklist will be used to structure and report the findings.
ETHICS AND DISSEMINATION: Ethics permission to conduct the scoping review is not required as the information collected is publicly available through databases. Findings will be disseminated through a peer-reviewed publication and conference presentations.
METHOD: This cross-sectional survey was conducted among community pharmacists in all 14 states of Malaysia between November 2021 and July 2022. The self-administered survey was shared to relevant groups through various social media platforms.
RESULTS: A total of 312 community pharmacists were involved in the survey. Majority of the respondents were females (66%), with a mean age (SD) of 32.9 (8.4) years. Most of the respondents showed satisfactory practice for patient counselling, but improvements are needed particularly in risk assessment and collaborative care aspect. Most of them expressed their interest for dyslipidemia management training (89.4%). Lack of access to medical records (71.2%) and lack of CVD-related educational materials (70.8%) were the two main perceived barriers identified.
CONCLUSION: Community pharmacists in Malaysia provide a satisfactory role in the provision of cardiovascular disease-related health promotion activities, especially in providing patient counselling. Strengthening collaborative care is essential for providing comprehensive and patient-centered intervention in dyslipidemia management. This requires ongoing efforts to address and overcome existing barriers for effective teamwork and coordination among healthcare professionals.
OBJECTIVES: To perform a systematic review of clinical practice guidelines for falls prevention and management for adults 60 years or older in all settings (eg, community, acute care, and nursing homes), evaluate agreement in recommendations, and identify potential gaps.
EVIDENCE REVIEW: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-analyses statement methods for clinical practice guidelines on fall prevention and management for older adults was conducted (updated July 1, 2021) using MEDLINE, PubMed, PsycINFO, Embase, CINAHL, the Cochrane Library, PEDro, and Epistemonikos databases. Medical Subject Headings search terms were related to falls, clinical practice guidelines, management and prevention, and older adults, with no restrictions on date, language, or setting for inclusion. Three independent reviewers selected records for full-text examination if they followed evidence- and consensus-based processes and assessed the quality of the guidelines using Appraisal of Guidelines for Research & Evaluation II (AGREE-II) criteria. The strength of the recommendations was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation scores, and agreement across topic areas was assessed using the Fleiss κ statistic.
FINDINGS: Of 11 414 records identified, 159 were fully reviewed and assessed for eligibility, and 15 were included. All 15 selected guidelines had high-quality AGREE-II total scores (mean [SD], 80.1% [5.6%]), although individual quality domain scores for clinical applicability (mean [SD], 63.4% [11.4%]) and stakeholder (clinicians, patients, or caregivers) involvement (mean [SD], 76.3% [9.0%]) were lower. A total of 198 recommendations covering 16 topic areas in 15 guidelines were identified after screening 4767 abstracts that proceeded to 159 full texts. Most (≥11) guidelines strongly recommended performing risk stratification, assessment tests for gait and balance, fracture and osteoporosis management, multifactorial interventions, medication review, exercise promotion, environment modification, vision and footwear correction, referral to physiotherapy, and cardiovascular interventions. The strengths of the recommendations were inconsistent for vitamin D supplementation, addressing cognitive factors, and falls prevention education. Recommendations on use of hip protectors and digital technology or wearables were often missing. None of the examined guidelines included a patient or caregiver panel in their deliberations.
CONCLUSIONS AND RELEVANCE: This systematic review found that current clinical practice guidelines on fall prevention and management for older adults showed a high degree of agreement in several areas in which strong recommendations were made, whereas other topic areas did not achieve this level of consensus or coverage. Future guidelines should address clinical applicability of their recommendations and include perspectives of patients and other stakeholders.
OBJECTIVES: This paper aims to identify requirements in developing a breast examination awareness mobile app based on the component of the Health Belief Model (HBM) for integration in health promotion strategy.
METHODS: A qualitative approach using semi-structured in-depth interview was utilized in this study. A purposive sampling method was conducted among public women attending hospital services, software and content experts in a tertiary teaching hospital in the East coast of Peninsular Malaysia. These interviews were recorded, transcribed and organized using NVIVO 11. The main themes were identified through thematic analysis of the interview transcripts. Results: A total of 37 participants recruited in this study. The themes that emerged from the analysis are vulnerability, forecasting, reactive, influence, outcome and obstacles. The sub-themes findings supported the HBM's component in terms of the requirement for are an infographic risk factor, video (symptoms, self-examination), info (metastasis, survival, screening, triple assessment, treatment, myth and facts, benefit of early treatment, support groups), features (screening reminder, sharing button, prompt) and mobile app's design.
CONCLUSION: The research findings could provide a guide for future app development from public women, content and software experts. The information will be used to develop a breast examination awareness mobile app integrated with health theories.
METHODS: In this three-arm randomised controlled trial we recruited individuals in the USA using Facebook and multimedia advertisements. Included participants were 18 years or older, smoked at least weekly in the preceding year, and vaped at least weekly in the preceding month. We used computer generated randomisation with balanced-permuted blocks (block size 10, with 2-4-4 ratio) to allocate participants to assessment only (ASSESS group), generic smoking cessation self-help booklets (GENERIC group), or booklets targeting dual users (eTARGET group). Individuals in the generic or targeted intervention groups received monthly cessation materials for 18 months, with assessments every 3 months for 24 months. The main outcome was self-reported 7-day point-prevalence smoking abstinence at each assessment point. All randomly allocated participants were included in primary analyses using generalised estimating equations for each of 20 datasets created by multiple imputation. Analysis of the χ2s produced an F test. The trial is registered with ClinicalTrials.gov, NCT02416011, and is now closed.
FINDINGS: Between July 12, 2016, and June 30, 2017, we randomly assigned 2896 dual users (575 to assessment, 1154 to generic intervention, and 1167 to targeted self-help). 7-day point-prevalence smoking abstinence increased from 14% at 3 months to 42% at 24 months (F7,541·7=67·1, p<0·0001) in the overall sample. Targeted self-help resulted in higher smoking abstinence than did assessment alone throughout the treatment period (F1,973·8=10·20, p=0·0014 [α=0·017]). The generic intervention group had abstinence rates between those of the assessment and targeted groups, but did not significantly differ from either when adjusted for multiple comparisons (GENERIC vs eTARGET F1,1102·5=1·79, p=0·18 [α=0·05]; GENERIC vs ASSESS F1,676·7=4·29, p=0·039 [α=0·025]). Differences between study groups attenuated after the interventions ended.
INTERPRETATION: A targeted self-help intervention with high potential for dissemination could be efficacious in promoting smoking cessation among dual users of combustible cigarettes and e-cigarettes.
FUNDING: National Institute on Drug Abuse, National Cancer Institute.
METHODS: Participants aged ≥40 years (n = 730) from randomly selected households in Selangor State Malaysia, completed interview-based assessments. Campaign reach was assessed in terms of responses to an adapted questionnaire that was used in evaluations in other countries. The impact of the campaign was assessed in terms of awareness, confidence to detect symptoms and self-efficacy to discuss symptoms with a doctor as captured by the Cancer Awareness Measure (CAM). CAM was administered before-and-after campaign implementation and responses by BCAC recognisers (i.e. participants who recognised one or more of the BCAC television, radio or print advertisements when prompted) and non-recognisers (i.e. participants who did not recognise any of the BCAC advertisements) were compared analytically. Logistic regression analysed comparative differences in cancer awareness by socio-demographic characteristics and recognition of the BCAC materials.
RESULTS: Over 65% of participants (n = 484) recognised the BCAC-CRC. Campaign-recognisers were significantly more likely to be aware of each CRC symptom at follow-up and were more confident about noticing symptoms (46.9% vs 34.9%, p = 0.018) compared to non-recognisers. There was no difference between groups in terms of self-efficacy to see a doctor about symptoms. Improved symptoms awareness at follow-up was lower for Indians compared to Malays (adjusted odds ratio (OR) 0.53, 95% Confidence Interval (CI): 0.34, 0.83, p = 0.005). Health service use data did not indicate an increase in screening activity during or immediately after the campaign months.
CONCLUSION: Overall, the findings of the evaluation indicated that the culturally adapted, evidence-based mass media intervention improved CRC symptom awareness among the Malaysian population; and that impact is more likely when a campaign operates a differentiated approach that matches modes of communication to the ethnic and social diversity in a population.
METHODS AND ANALYSIS: Arksey and O'Malley's scoping review methodology framework will guide the conduct of this scoping review. The search strategy will involve electronic databases including PubMed, Excerpta Medica Database, Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Google Scholar and ScienceDirect, in addition to grey literature sources and hand-searching of reference lists. Two reviewers will independently screen all abstracts and full-text studies for inclusion. Data will be charted and sorted through an iterative process by the research team. The extracted data will undergo a descriptive analysis and simple quantitative analysis will be conducted using descriptive statistics. Engagement with relevant stakeholders will be carried out to gain more insights into our data from different perspectives.
ETHICS AND DISSEMINATION: Since the data used are from publicly available sources, this study does not require ethical approval. Results will be disseminated through academic journals, conferences and seminars. We anticipate that our findings will aid technology developers and health professionals working in the area of ageing and rehabilitation.
DESIGN: Randomized-controlled study.
SETTING: Two internal medicine wards of a public, university-affiliated, tertiary-care hospital in Malaysia.
METHODS: We randomly allocated 2 wards to hand hygiene promotion delivered either by PICAs (study arm 1) or by MSCAs (study arm 2). The primary outcome was hand hygiene compliance using direct observation by validated auditors. Secondary outcomes were hand hygiene knowledge and observations from ward tours.
RESULTS: Mean hand hygiene compliance in study arm 1 and study arm 2 improved from 48% (95% confidence interval [CI], 44%-53%) and 50% (95% CI, 44%-55%) in the preintervention period to 66% (63%-69%) and 65% (60%-69%) in the intervention period, respectively. We detected no statistically significant difference in hand hygiene improvement between the 2 study arms. Knowledge scores on hand hygiene in study arm 1 and study arm 2 improved from 60% and 63% to 98% and 93%, respectively. Staff in study arm 1 improved hand hygiene because they did not want to disappoint the efforts taken by the PICAs. Staff in study arm 2 felt pressured by the MSCAs to comply with hand hygiene to obtain good overall performance appraisals.
CONCLUSION: Although the attitude of PICAs and MSCAs in terms of leadership, mode of action and perception of their task by staff were very different, or even opposed, both PICAs and MSCAs effectively changed behavior of staff toward improved hand hygiene to comparable levels.
METHODS/DESIGN: This quasi-experimental study aimed to evaluate the effectiveness of the SNP between intervention and comparison groups before and after the SNP, and after a 3-month follow-up. The SNP consisted of two main components, whereby three nutrition education sessions were implemented by trained teachers using three standardised modules, and healthy school food environment was implemented by the canteen food handlers with the provision of healthy menu to children during school recess times. Children from intervention group participated in the SNP, in addition to the standard Physical and Health Curriculum. The comparison group attended only the standardised Physical and Health Curriculum and the school canteen food handlers were reminded to follow the standard canteen guidelines from the Ministry of Education Malaysia. The assessment parameters in evaluating the effectiveness of the programme were knowledge, attitude and practice on nutrition, eating behaviours, physical activity, body composition, psychological distress, cognitive performance and health-related quality of life. Assessments were conducted at three time points: pre-intervention, post-intervention and 3-month follow-up.
DISCUSSION: It was hypothesised that the SNP would be effective in promoting healthy lifestyle among school children, and further contributes in preventing malnutrition problem, enhancing cognitive performance and improving health-related quality of life among school children. Findings of the present study can be expanded to other schools in future on ways to improve nutrition education and healthy school food environment.
TRIAL REGISTRATION: UMIN Clinical Trial Registration UMIN000032914 (Date of registration: 7th June 2018, retrospectively registered).
PROTOCOL VERSION: 16th September 2019 & Version 4.
METHODS: An overview of reviews was conducted. A systematic search was performed on four databases up to March 2018. Included systematic reviews were analysed for quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR).
RESULTS: A total of 2187 articles were identified after removing duplicates. Ultimately, 58 systematic reviews were identified that yielded 641 instruments. From those, 45 instruments were selected for appraisal as they met the inclusion criteria of being developed mainly by occupational therapists and were recommended in the summarised findings from the systematic reviews. The instruments were classified according to the following occupation domains: (i) multidimensional, (ii) activities of daily living, (iii) productivity, (iv) social, (v) sleep/rest, (vi) sexuality and (vii) spirituality. No systematic review was identified that specifically focussed on occupations related to school/education, leisure and play.
DISCUSSION: Certain occupation domains such as activities of daily living, social and sleep/rest received high attention amongst researchers. There is a need for systematic reviews of instruments to measure education/school, play and leisure. Limited numbers of instruments were developed by occupational therapists outside the occupation domain of activities of daily living, and in areas of practice other than children and older people. Nevertheless, this overview can give some guidance for occupational therapists in selecting a suitable occupational therapy instrument for practice.
DESIGN: Individual in-depth, semistructured interviews were audio-taped, then verbatim transcribed and translated when necessary. The data were first independently coded and then collectively discussed for emergent themes using the Straussian grounded theory method.
PARTICIPANTS AND SETTING: Fifty-seven current smokers were recruited from a previous smoking related study carried out in a primary care setting in Malaysia. Current smokers with at least one failed quit attempts were included.
RESULTS: A five-theme model emerged from this grounded theory method. (1) Personal and lifestyle factors: participants were unable to resist the temptation to smoke; (2) Nicotine addiction: withdrawal symptoms could not be overcome; (3) Social cultural norms: participants identified accepting cigarettes from friends as a token of friendship to be problematic; (4) Misconception: perception among smokers that ability to quit was solely based on one's ability to achieve mind control, and perception that stopping smoking will harm the body and (5) Failed assisted smoking cessation: smoking cessation services were not felt to be user-friendly and were poorly understood. The themes were organised into five concentric circles based on time frame: those actionable in the short term (themes 1 and 2) and the long term (themes 3, 4, 5).
CONCLUSIONS: Five themes of specific beliefs and practices prevented smokers from quitting. Clinicians need to work on these barriers, which can be guided by the recommended time frames to help patients to succeed in smoking cessation.
METHODS: The review was conducted according to a predefined protocol. Medline, EMBASE, CINAHL, Web of Science, Cochrane Library, and Google Scholar were searched in September 2017, and data extraction and rating of methodologic study quality (according to Joanna Briggs Institute rating procedures) were performed independently by reviewers.
RESULTS: Twenty-two studies (reported across 24 papers) met the inclusion criteria. Most studies (n = 21) were conducted in high or upper-middle income countries; targeted breast (n = 11), cervical (n = 7), colorectal (n = 3), or oral (n = 2) cancer; and used small media either alone (n = 15) or in combination with mass media and other components (n = 5). Studies regarding cancer screening uptake were of medium to high quality and mainly reported positive outcomes for cervical cancer and mixed results for breast and colorectal cancer. The methodologic strength of research that investigated change in cancer-related knowledge and the cost effectiveness of interventions, respectively, were weak and inconclusive.
CONCLUSION: Evidence indicated that small media campaigns seemed to be effective in terms of increasing screening uptake in Asia, in particular cervical cancer screening. Because of the limited number of studies in Asia, it was not possible to be certain about the effectiveness of mass media in improving screening uptake and the effectiveness of campaigns in improving cancer-related knowledge.