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Influenza as an issue on the agenda of health care workers: what can we do? What do we need?

Vaccine, 2006 Nov 10;24(44-46):6791-2.
PMID: 17167887

ESWI recommends that the 25 European Union nations strive to vaccinate one-third of their collective population every year by 2010. This translates into an annual vaccine usage of 150 million doses for a population of 455 million. However, the current vaccine usage in Europe is 79 million doses, meaning that only 40% of ESWI's recommended target population is being vaccinated in the EU-25. Indeed, the EU's current risk groups equal about 28% of its population, but it is estimated that less than 62% are being vaccinated with the current vaccine supply--the equivalent of 17% of the total population. Clearly, as ESWI noted in its concluding position paper at the Malta conference, "a large proportion of those traditionally assumed to be at most risk from influenza are not being vaccinated." How to change this and minimize the consequences of a pandemic? "It's very interesting how the arithmetic works, given the goal of immunizing 75 percent of Europe's high-risk group, " said Dr K.Nichol of the University of Minnesota Medical Center who chaired the session. "If you go from a trivalent vaccine to a monovalent one, then you triple the number of doses you can manufacture. Thus, you could produce enough doses for the entire population of the EU." However, there is no coordinated approach in Europe, meaning such an optimistic scenario is unlikely in the medium-term. For the time being, emphasis must be on raising public awareness and raising vaccination rates at the local level, starting with health care workers themselves. Here the role and attitude of health policy officials and--critically--health care workers are crucial. These front-line policy and healthcare professionals constitute both the problem and the solution to a more effective influenza vaccine effort in Europe: they know first-hand the institutional obstacles blocking progress--i.e., lack of resources, poorly focused public information campaigns, etc.--but their own work practices and attitudes can be misdirected, too. To identify the issues and help the participants produce a set of recommendations, ESWI brought in Penny Lawson from to facilitate Dr.K. Nichol to steer this session's workshop debate. The participants were a diverse group of 35 health care workers from Australia, Finland, France, Germany, Malaysia, Malta, Netherlands, Norway, Poland, Portugal, Spain, Sweden and the UK.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
Challenges to health workers and their opinions about parents' refusal of oral polio vaccination in the Khyber Pakhtoon Khawa (KPK) province, Pakistan

Khan TM, Sahibzada MU

Vaccine, 2016 Apr 19;34(18):2074-81.
PMID: 26993330 DOI: 10.1016/j.vaccine.2016.03.008

A qualitative study design was adapted to explore the challenges faced by health workers (HWs) during the polio health campaign. In addition, HWs' opinions about the factors causing parents to refuse oral polio vaccination (OPV) were also explored. Four focus group discussions (FGDs) were held (from 1st January 2015-31st March 2015) with the HWs who participated in the OPV campaigns in the polio red zones of Khyber Pakhtoon Khawa (KPK) province of Pakistan, namely Kohat (FG 1), Domel and Bannu (FG 2), Hangoo (FG 3), and Peshawar (FG 4). A total of N=42 HWs (10-11 in each FG) agreed to participate in this study. Overall, HWs disclosed that public attitude and harsh behaviour towards the HWs and security threats are the two main challenges they face. Common issues hindering parents' willingness to vaccinate their children against OPV are: OPV is seen as haram and not permitted in Islam, it is said to contain the blood of pigs (Khinzir) and monkeys, and parents are afraid that it is done to induce sterility among their children. HWs also shared that parents have a strong belief in the conspiracies that are associated with OPV, i.e. the USA and CIA, are spying on us and our government is helping them to achieve their agenda. Furthermore, HWs revealed that frequent visits may further strengthen parents' perceptions and make them more resistant to OPV. The common side effects of OPV reported by parents were mainly gastro-intestinal problems and in some cases mild to moderate fever with some respiratory symptoms. There is a great need to improve the logistics and facilities for HWs assisting in vaccination programmes. Furthermore, it is necessary to improve education, so people understand the basic concept of revaccination and booster doses, thereby assisting in creating a basic understanding of vaccinations, which may trigger changes in attitudes and make people believe in the benefits of OPV rather than following the conspiracies that lead them to refuse it.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
Vaccine hesitancy towards childhood immunisation amongst urban pregnant mothers in Malaysia

Kalok A, Loh SYE, Chew KT, Abdul Aziz NH, Shah SA, Ahmad S, et al.

Vaccine, 2020 02 24;38(9):2183-2189.
PMID: 32001070 DOI: 10.1016/j.vaccine.2020.01.043

BACKGROUND: Vaccine hesitancy is a complex behaviour which involves various degrees of indecision about specific vaccines or vaccination uptake. Access to antenatal care had been associated with positive vaccine behavior.
OBJECTIVE: To determine the prevalence of vaccine hesitancy towards childhood immunisation amongst urban pregnant mothers and the associated socio-demographic factors.
METHODS: A cross-sectional study was conducted among 1081 women who received antenatal care at a teaching hospital in Kuala Lumpur. Vaccine hesitancy was assessed using the Parent Attitudes about Childhood Vaccines (PACV) Survey in both English and validated Malay versions. The sociodemographic data of the mothers and their partners, source of vaccine information and reasons for hesitancy were analysed.
RESULTS: Eighty-six (8.0%) pregnant mothers were vaccine hesitant. Ethnicity, religion, number of children, educational level and employment status were significantly associated with vaccine hesitancy. Multivariable analysis showed that a low level of education was the most significant risk factor (p Health professionals was the main source of information about vaccine. The non-vaccine hesitant women were more likely to seek information from health professionals, and health books and magazine. Fear of adverse side effects of vaccines was the predominant concern for all participants (58%) whilst fear of vaccination pain, preference for alternative medicine and lack of trust in the pharmaceutical industry were significant reasons given by the vaccine hesitant group. Partners' ethnicity, a low educational level and a low income were significantly associated with vaccine hesitancy amongst pregnant mothers.
CONCLUSION: Prevalence of vaccine hesitancy amongst urban Malaysian pregnant women was relatively low. Muslim mothers are less likely to be vaccine hesitant. Educational level of mothers and their partners are the common determinant of vaccine hesitancy amongst antenatal mothers.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
Vaccine hesitancy among parents in a multi-ethnic country, Malaysia

Mohd Azizi FS, Kew Y, Moy FM

Vaccine, 2017 05 19;35(22):2955-2961.
PMID: 28434687 DOI: 10.1016/j.vaccine.2017.04.010

BACKGROUND: Vaccine hesitancy is a threat in combating vaccine-preventable diseases. It has been studied extensively in the Western countries but not so among Asian countries.
OBJECTIVES: To assess the test-retest reliability of the Parent Attitudes about Childhood Vaccines (PACV) questionnaire in Malay language; to determine the prevalence of vaccine hesitancy among parents and its associations with parents' socio-demographic characteristics.
METHODS: Forward and backward translation of PACV in Malay language was carried out. The reliability of the Malay-PACV questionnaire was tested among parents with children. The same questionnaire was used to study vaccine hesitancy among parents in a tertiary hospital in Kuala Lumpur. Information pertaining to socio-demographic characteristics, sources of information regarding vaccination and vaccine hesitancy were collected. Associations between vaccine hesitancy with socio-demographic factors were tested using Multivariable Logistic Regression.
RESULTS: The Spearman correlation coefficient and Cronbach alpha for total PACV was 0.79 (p<0.001) and 0.79 respectively. The intra-class correlation coefficients of the subscales ranged from 0.54 to 0.90 demonstrating fair to excellent reliability. A total of 63 (11.6%) parents were noted to be vaccine hesitant. In the univariate analyses, vaccine hesitancy was associated with unemployed parents, parents who were younger, had fewer children and non-Muslim. In the multivariate model, pregnant mothers expecting their first child were four times more likely to be vaccine hesitant compared to those who already had one or more children (aOR: 3.91, 95% CI: 1.74-8.79) and unemployed parents were also more likely to be vaccine hesitant (aOR: 1.97, 95% CI: 1.08-3.59). The internet (65.6%) was the main source of information on vaccination followed by brochures (56.9%).
CONCLUSION: The Malay-PACV questionnaire is reliable to be used. The prevalence of vaccine hesitancy among the multi-ethnic Malaysians was comparable with other populations. Pregnant mothers expecting their first child and unemployed parents were found to be more vaccine hesitant.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Influenza in the Asia-Pacific region: Findings and recommendations from the Global Influenza Initiative

Cowling BJ, Caini S, Chotpitayasunondh T, Djauzi S, Gatchalian SR, Huang QS, et al.

Vaccine, 2017 Feb 07;35(6):856-864.
PMID: 28081970 DOI: 10.1016/j.vaccine.2016.12.064

The fourth roundtable meeting of the Global Influenza Initiative (GII) was held in Hong Kong, China, in July 2015. An objective of this meeting was to gain a broader understanding of the epidemiology, surveillance, vaccination policies and programs, and obstacles to vaccination of influenza in the Asia-Pacific region through presentations of data from Australia, Hong Kong, India, Indonesia, Malaysia, New Zealand, the Philippines, Taiwan, Thailand, and Vietnam. As well as a need for improved levels of surveillance in some areas, a range of factors were identified that act as barriers to vaccination in some countries, including differences in climate and geography, logistical challenges, funding, lack of vaccine awareness and education, safety concerns, perceived lack of vaccine effectiveness, and lack of inclusion in national guidelines. From the presentations at the meeting, the GII discussed a number of recommendations for easing the burden of influenza and overcoming the current challenges in the Asia-Pacific region. These recommendations encompass the need to improve surveillance and availability of epidemiological data; the development and publication of national guidelines, where not currently available and/or that are in line with those proposed by the World Health Organization; the requirement for optimal timing of vaccination programs according to local or country-specific epidemiology; and calls for advocacy and government support of vaccination programs in order to improve availability and uptake and coverage. In conclusion, in addition to the varied epidemiology of seasonal influenza across this diverse region, there are a number of logistical and resourcing issues that present a challenge to the development of optimally effective vaccination strategies and that need to be overcome to improve access to and uptake of seasonal influenza vaccines. The GII has developed a number of recommendations to address these challenges and improve the control of influenza.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
Attitudes towards Zika screening and vaccination acceptability among pregnant women in Malaysia

Wong LP, Alias H, Hassan J, AbuBakar S

Vaccine, 2017 10 13;35(43):5912-5917.
PMID: 28886944 DOI: 10.1016/j.vaccine.2017.08.074

The aim of this study was to examine the willingness of pregnant women to have prenatal screening for the Zika virus (ZIKV). Secondly, the study also assessed the acceptability of a hypothetical Zika vaccination and its association with the health belief model (HBM) constructs. A cross-sectional study was conducted from 4th October to 11th November 2016, among pregnant women who attended antenatal care at the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. The majority (81.8%) was willing to be tested for ZIKV and 78% felt that their spouse would be willing to be tested for ZIKV. A total of 94% expressed a willingness to receive a Zika vaccination if available. The participants expressed high perceived benefits of a ZIKV vaccination. Although many have a high perception of the severity of ZIKV, the proportion with a strong perception of their susceptibility to ZIKV was low. In the multivariate analysis of all the HBM constructs, cue-to-action, namely physician recommendation (odds ratio [OR]=2.288; 95% confidence interval [CI] 1.093-4.793) and recommendation from friends or relatives (OR=4.030; 95% CI 1.694-9.587), were significantly associated with a willingness to be vaccinated against ZIKV. The favourable response to a Zika vaccination implies that more research attention has to be given to develop a vaccine against ZIKV. Should the vaccine be available in the future, publicity and healthcare providers would play a vital role in ensuring vaccine uptake among pregnant women.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
Determinants of Willingness to Become Organ Donors among Dialysis Patients' Family Members

Tumin M, Mohd Satar NH, Zakaria RH, Raja Ariffin RN, Soo-Kun L, Kok-Peng N, et al.

Urol J, 2015 Sep 04;12(4):2245-50.
PMID: 26341766

PURPOSE: This study explores the factors affecting the willingness of dialysis patients' family members to become involved in living and deceased organ donation.
MATERIALS AND METHODS: We utilize cross sectional data on 350 family members of dialysis patients collected through self-administered survey from June to October 2013. The factors affecting willingness to become deceased and living organ donors among respondents were identified by running logistic regressions.
RESULTS: The findings reveal that ethnicity, education and role in family are significant factors explaining willingness for living donation, while ethnicity, knowledge of organ donation and donor age drive willingness for deceased donation. We also find that the reasons of respondents being unwilling to donate center on the lack of information and family objections for deceased donation, while being medically unfit, scared of surgery and family objections are the reasons for unwillingness to donate living organs.
CONCLUSION: In light of our findings, educational efforts are suggested to decrease the reluctance to become involved in living and deceased donation.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
Prostate cancer screening perspective, Malaysia

Sothilingam S, Sundram M, Malek R, Sahabuddin RM

Urol Oncol, 2010;28(6):670-2.
PMID: 21062649 DOI: 10.1016/j.urolonc.2009.12.014

The incidence of prostate cancer in Malaysia is still low compared to the west. This may be due to a true low incidence or lower detection rates. Prostate Awareness Campaigns are held on a yearly basis to educate and encourage males over the age of 50 years to have their prostate examined. Such a campaign was organized in 2005 at the national level involving 12 district hospitals. A total of 2770 participants attended the campaign. 38.7% had no urinary symptoms and attended out of curiosity. Among the symptomatic patients, nocturia was the most bothersome in the majority. 84.6% of the participants also had some degree of erectile dysfunction based on the IIEF questionnaire. 10.4% of participants had a PSA > 4 ng/mL. Malay participants had the highest mean PSA level (2.32 ng/mL) and Indian participants the lowest (1.30 ng/mL). 408 participants were called back for biopsy but only 183 agreed to the biopsy. 30 cancers were detected. At present Malaysia will benefit most by continuing to conduct these awareness programmes to educate the public on prostate disease and hopefully in future patients will be less reluctant to have prostate biopsies taken when indicated.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Prostatitis-like symptoms: diagnosis and management in a Malaysian primary care population

Lee SW, Liong ML, Yuen KH, Leong WS, Khan N, Cheah PY, et al.

Urol Int, 2009;82(1):32-7.
PMID: 19172094 DOI: 10.1159/000176022

BACKGROUND: Little is known about how primary care physicians (PCPs) in Asia diagnose and manage prostatitis-like symptoms. This study investigated the clinical diagnosis of and care provided for prostatitis-like symptoms by PCPs in a Malaysian population, and compared these findings to reports from other areas.
METHODS: All members of the Penang Private Medical Practitioners' Society were asked to complete a self-administered survey. Nonresponders were contacted after 3 weeks and received a telephone request after 6 weeks.
RESULTS: Of the 786 practitioners contacted, 669 considered themselves to be PCPs, including 279 (42%) who responded to the survey. Adult males with prostatitis-like symptoms typically constitute <1% of the patients seen by PCPs. Most PCPs (72%) believe that prostatitis-like symptoms are caused by bacterial infection. 61% of PCPs base their diagnosis of prostatitis-like symptoms on clinical history, a physical examination and dipstick urinalysis. Standard management was to prescribe 1 or 2 courses of antimicrobials.
CONCLUSIONS: Despite the 8.7% prevalence found in a previous survey in this population, prostatitis remains underdiagnosed in Malaysia. In contrast to many other clinical settings, urologists in Malaysia see a large proportion of newly diagnosed and treatment-naive prostatitis patients, providing an opportunity for clinical diagnostic and treatment studies.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
Fulltext Tobacco use, knowledge and attitude among Malaysians age 18 and above

Lim KH, Sumarni MG, Amal NM, Hanjeet K, Wan Rozita WM, Norhamimah A

Trop Biomed, 2009 Apr;26(1):92-9.
PMID: 19696733 MyJurnal

This study aims to determine the level of knowledge and to understand their attitude towards smoking and secondly to determine how sociodemographic background, smoking status and knowledge on the health risks of smoking contribute toward the development of such attitude. A total of 10,545 respondents age 18 years and above across Malaysia were interviewed. Results indicated that level of knowledge and attitude varied by gender, education level, smoking status, age, ethnicity and smoker category. Smokers' low education, poor knowledge on the dangers of smoking and being males had more positive or greater impact on their attitudes towards smoking. Formulation and implementation of a holistic programme aimed at increasing knowledge and attitude change that accounts for sociodemographic background of the population is recommended in order to bring down smoking rates and thus reduce smoking related health problems in this country.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext Preliminary evaluation of STRIDE programme in primary schools of Malaysia

Hanjeet K, Wan Rozita WM, How TB, Santhana Raj L, Baharudin O

Trop Biomed, 2007 Dec;24(2):15-21.
PMID: 18209703 MyJurnal

The Students' Resilience and Interpersonal Skills Development Education (STRIDE) is a preventive drug education programme. The rational of this programme is that preventive drug education has to begin early in age, before the development of social attitudes and behaviour of students. A pre and a post intervention surveys were performed to evaluate the impact of this programme. Nine schools from three states were identified to participate in the intervention. These schools were selected based on their locations in high-drug-use areas (where the prevalence of drug use exceeds 0.5% of the student population). The new intervention curriculum was put into practice for three months in the nine schools. The overall scores obtained by each respondent to assess their knowledge on drugs and its implications were analysed. The results showed that the programme made a positive impact from the pre to post intervention programme by using the Wilcoxon Signed Rank Test (p < 0.05). A high percentage of the questions showed significant evidence through the McNemar matched pair Chi-Squared test with Bonferonni correction that there were positive shifts in the answers by comparing the pre and post intervention results (p < 0.05). Recommendations have been discussed with the Ministry of Education to integrate this programme into the national primary school curriculum.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
The health burden of malaria and household choices regarding treatment and prevention in Pakistan

Khan M, Mahmood HZ, Noureen S, Muhmood K, Husnain MIU, Hameed Khaliq I

Trop Biomed, 2019 Sep 01;36(3):664-676.
PMID: 33597488

The extent of the economic burden of malaria and its imposed mechanisms are both relevant to public policy. This paper investigates the economic burden of malaria and household behaviour in relation to the treatment and prevention of the illness in Pakistan. In this regard, data were collected from a randomly selected sample of 360 households using structured questionnaires. The survey results indicate that 23.4% of household members contracted malaria during the three-month reference period. The average per person cost of malaria is estimated at 3116 Pakistani rupees (PKR) (USD 32). The estimated cost of the illness was found to be equivalent to, on average, 6.7% of monthly household income. Although high-income households face a higher financial burden due to better preventive and mitigation measures, the negative consequences hit low-income households harder due to liquidity constraints and poor access to effective treatment. We recommend that malaria control policies be integrated into development and poverty reduction programs.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
Knowledge, attitude and health seeking practice on bats-borne diseases among residents of Tioman Island, Malaysia

Mohamed NA, Said MH, Mohd Rani MD, Ramli S, Isahak I

Trop Biomed, 2019 Sep 01;36(3):709-717.
PMID: 33597493

Bats are slowly gaining recognition as a potential reservoir for viruses harmful to human (Smith and Wang, 2013). Bats are reservoir to viruses causing Ebola virus diseases (EBV) (Leroy et al., 2005), Nipah Encephalitis (NiV) (Chua et al., 2002), SARS(Li et al., 2005) and MERS-CoV (Yang et al., 2015) being the latest one making headlines. About 18 years ago, a major outbreak of Nipah virus encephalitis occurred in Peninsular Malaysia resulted in the deaths of 105 persons and the slaughter of approximately 1.1 million pigs. In 2006, a novel bat orthoreovirus was found to be associated with acute respiratory syndrome in Malaysia. Following that incidents, many studies have been done on bats, particularly to determine their species, behaviour, and antibody level and there were also studies in human on antibody prevalence to batsrelated viruses e.g. Nipah and Hendra and PRV. Humans may become infected with viruses from bats through intermediate host (swine, horse) or through aerosol or direct contact with bats. Communities living adjacent to bat roosts should aware of possible risk of infection transmission from bats. An earlier study in Guatemala demonstrated that risk of exposure to bats in communities near bats roosts was common, but recognition of the potential for disease transmission from bats was low (Moran et al., 2015). Surprisingly, there is no local published data on public awareness towards bats-related infection despite potential risk of getting the infection. This study aimed to determine knowledge and awareness on bat-related infections, attitudes towards bats and practices related to health-seeking behaviours following exposure to bats.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Post-era mass drug administration: an update on intestinal parasitic infections in urban poor communities in Peninsular Malaysia

Sahimin N, Abd Khalil NS, Lewis JW, Mohd Zain SN

Trop Biomed, 2020 Jun 01;37(2):363-371.
PMID: 33612805

The health impact of a Malaysian national helminth control program which provided school-based anthelmintic chemotherapy from 1974 to 1983 was re-visited after three decades post MDA and associated risk factors amongst urban poor communities identified. Stool samples collected were screened using the formalin ethyl-acetate concentration technique recovered at least one species of helminth and/or protozoan. Despite a steady decline observed between 1974-1983 however, post MDA infections continue to persist in pockets of communities moderately (18.9%; n=39/206) with higher infection recorded amongst PPR flat residents (22.5%, n=16/71). Among risk factors identified, waste management method was the primary factor for Ascaris lumbricoides infections (n=33; 16.0%), whereas age, education, employment and source of drinking water were significant risk factors for cryptosporidiosis. Despite the government's efforts to improve health through the provision of basic amenities to the general public, higher prevalence values amongst PPR flat dwellers suggests the need to implement targeted chemotherapeutic treatment of, once a year deworming as recommended by World Health Organization when the baseline prevalence of soil-transmitted helminth infections in the community is over 20%, in addition to preventive measures though improvements in health awareness programs and improved waste management methods.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
Assessment of knowledge, attitude, and practice on livestock traceability among cattle farmers and cattle traders in peninsular Malaysia and its impact on disease control

Salina AB, Hassan L, Saharee AA, Jajere SM, Stevenson MA, Ghazali K

Trop Anim Health Prod, 2020 Nov 19;53(1):15.
PMID: 33211198 DOI: 10.1007/s11250-020-02458-5

The ability to trace the movement of animals and their related products is key to success in animal disease control. To ensure that a traceability system is optimized, livestock farmers and traders must have good appreciation and understanding about animal tracing. The present study examined the traceability of cattle in Malaysia vis-à-vis the domains of knowledge, attitude, and practice among cattle farmers and traders. A total of 543 farmers and traders in Peninsular Malaysia were interviewed. The results revealed that over 60% of the respondents had satisfactory knowledge and attitude about cattle movement and traceability. A lower proportion of the respondents (49%) were involved in appropriate practice that facilitated traceability of cattle. We found that the type of husbandry system and stakeholders' participation in livestock management-specific short courses were positively associated with satisfactory knowledge, attitude, and practice. A structured education and training program should be formulated to improve these domains so that the benefit of traceability becomes clear, paving the way to a successful traceability program.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext Knowledge, attitude and practice (KAP) survey of osteoporosis among students of a tertiary institution in Malaysia

Khan YH, Sarriff A, Khan AH, Mallhi TH

Tropical Journal of Pharmaceutical Research, 2014;13(1):155-62.
DOI: 10.4314/tjpr.v13i1.22

Purpose: To evaluate knowledge and perceptions of osteoporosis among university students in Malaysia belonging to different age groups, gender and ethnicity.
Methods: Using convenience sampling method, current study was conducted among students of University Sains Malaysia (USM), Pulau Penang, Malaysia. A pre-validated self-administered questionnaire was used to carry out the study.
Results: The mean age of the participants was 24.61 ± 5.51 years. A majority, 401 (87 %), identified osteoporosis correctly as a disease that makes bones weak and fragile. Lack of milk and dairy products were identified by majority of participants (74 %) as a risk factor for osteoporosis while being petite (24 %) and family history (34.5 %) were the least identified risk factors. Female showed statistically higher knowledge score than males (243.89 versus 216.12, p = 0.02). Ethnicity (Malay: 228.32, Chinese: 264.46, Indian: 194.04, Others: 236.94, p = 0.00) and type of education (Hybrid: 225.99, Arts: 182.21, Science: 286.23, p = 0.00) were factors that correlated significantly with knowledge and perceptions of osteoporosis.
Conclusion: This study demonstrates an urgent need for the implementation of educational and awareness programs for university students belonging to various age groups. Such programs should be designed on the basis of the parameters of health belief model. © Pharmacotherapy Group, Faculty of Pharmacy, University of Benin, Benin City, 300001 Nigeria. All rights reserved.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
Fulltext Evaluation of an intensive education program on the treatment of tobacco-use disorder for pharmacists: a study protocol for a randomized controlled trial

El Hajj MS, Awaisu A, Kheir N, Mohamed MHN, Haddad RS, Saleh RA, et al.

Trials, 2019 Jan 08;20(1):25.
PMID: 30621772 DOI: 10.1186/s13063-018-3068-7

BACKGROUND: Tobacco use is presently responsible for the death of over seven million people across the world. In Qatar, it is one of the main causes of premature deaths and preventable diseases. To reduce tobacco use, Qatar has ratified the World Health Organization (WHO)'s Framework Convention on Tobacco Control (FCTC) and has implemented many tobacco-control initiatives. In spite of these measures, tobacco use is still considered a public health threat in Qatar. Pharmacists practicing in retail/community pharmacy settings are often the first port of call for individuals requiring general health advice. Evidence has proven that they have a pivotal role in health promotion and disease prevention including tobacco cessation. However, pharmacists in Qatar are not actively involved in tobacco control and many have not received any education or training about smoking cessation counseling in the past. In an effort to build the capacity of pharmacists towards tobacco control in Qatar, the aim of the proposed study is to design, implement, and evaluate an intensive education program on tobacco dependence treatment for pharmacists in Qatar.
METHODS/DESIGN: The study will be a prospective randomized controlled trial comparing an intensive tobacco-related education program versus non-tobacco-related training on pharmacists' tobacco-use-related knowledge, attitudes, self-efficacy, and skills. Community pharmacists practicing in Qatar will be eligible for participation in the study. A random sample of pharmacists will be selected for participation. Consenting participants will be randomly allocated to intervention or control groups. Participants in the intervention group will receive an intensive education program delivered by a multi-disciplinary group of educators, researchers, and clinicians with expertise in tobacco cessation. A short didactic session on a non-tobacco-related topic will be delivered to pharmacists in the control group. The study has two primary outcomes: post-intervention tobacco-related knowledge and post-intervention skills for tobacco cessation assessed using a multiple-choice-based evaluation instrument and an Objective Structured Clinical Examination (OSCE), respectively. The secondary study outcomes are post-intervention attitudes towards tobacco cessation and self-efficacy in tobacco-cessation interventions assessed using a survey instrument. An additional secondary study outcome is the post-intervention performance difference in relation to tobacco-cessation skills in the practice setting assessed using the simulated client approach.
DISCUSSION: If demonstrated to be effective, this education program will be considered as a model that Qatar and the Middle East region can apply to overcome the burden of tobacco-use disorder.
TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03518476 . Registered on 8 May 2018. Version 1/22 June 2018.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
Fulltext Effectiveness and sustainability of a structured group-based educational program (MEDIHEALTH) in improving medication adherence among Malay patients with underlying type 2 diabetes mellitus in Sarawak State of Malaysia: study protocol of a randomized controlled trial

Ting CY, Ahmad Zaidi Adruce S, Hassali MA, Ting H, Lim CJ, Ting RS, et al.

Trials, 2018 Jun 05;19(1):310.
PMID: 29871651 DOI: 10.1186/s13063-018-2649-9

BACKGROUND: Amidst the high disease burden, non-adherence to medications among patients with type 2 diabetes mellitus (T2DM) has been reported to be common and devastating. Sarawak Pharmaceutical Services Division has formulated a pharmacist-led, multiple-theoretical-grounding, culturally sensitive and structured group-based program, namely "Know Your Medicine - Take if for Health" (MEDIHEALTH), to improve medication adherence among Malay patients with T2DM. However, to date, little is known about the effectiveness and sustainability of the Program.
METHODS/DESIGN: This is a prospective, parallel-design, two-treatment-group randomized controlled trial to evaluate the effectiveness and sustainability of MEDIHEALTH in improving medication adherence. Malay patients who have underlying T2DM, who obtain medication therapy at Petra Jaya Health Clinic and Kota Samarahan Health Clinic, and who have a moderate to low adherence level (8-item Morisky Medication Adherence Scale, Malaysian specific, score <6) were randomly assigned to the treatment group (MEDIHEALTH) or the control group. The primary outcome of this study is medication adherence level at baseline and 1, 3, 6 and 12 months post-intervention. The secondary outcomes are attitude, subjective norms, perceived behavioural control, intention and knowledge related to medication adherence measured at baseline and 1, 6 and 12 months post-intervention. The effectiveness and sustainability of the Program will be triangulated by findings from semi-structured interviews with five selected participants conducted 1 month after the intervention and in-depth interviews with two main facilitators and two managerial officers in charge of the Program 12 months after the intervention. Statistical analyses of quantitative data were conducted using SPSS version 22 and Stata version 14. Thematic analysis for qualitative data were conducted with the assistance of ATLAS.ti 8.
DISCUSSION: This study provides evidence on the effectiveness and sustainability of a structured group-based educational program that employs multiple theoretical grounding and a culturally sensitive approach in promoting medication adherence among Malays with underlying T2DM. Both the quantitative and qualitative findings of this study could assist in the future development of the Program.
TRIAL REGISTRATION: National Medical Research Register, NMRR-17-925-35875 (IIR). Registered on 19 May 2017. ClinicalTrials.gov, NCT03228706 . Registered on 25 July 2017.

Matched MeSH terms: Health Knowledge, Attitudes, Practice
Fulltext A complex behavioural change intervention to reduce the risk of diabetes and prediabetes in the pre-conception period in Malaysia: study protocol for a randomised controlled trial

Skau JK, Nordin AB, Cheah JC, Ali R, Zainal R, Aris T, et al.

Trials, 2016;17(1):215.
PMID: 27117703 DOI: 10.1186/s13063-016-1345-x

Over the past two decades, the population of Malaysia has grown rapidly and the prevalence of diabetes mellitus in Malaysia has dramatically increased, along with the frequency of obesity, hyperlipidaemia and hypertension. Early-life influences play an important role in the development of non-communicable diseases. Indeed, maternal lifestyle and conditions such as gestational diabetes mellitus or obesity can affect the risk of diabetes in the next generation. Lifestyle changes can help to prevent the development of type 2 diabetes mellitus. This is a protocol for an unblinded, community-based, randomised controlled trial in two arms to evaluate the efficacy of a complex behavioural change intervention, combining motivational interviewing provided by a community health promoter and access to a habit formation mobile application, among young Malaysian women and their spouses prior to pregnancy.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
The effectiveness of pharmacist-led educational model in adult patients with allergic rhinitis: a single-center randomized control trial protocol (AR-PRISE RCT)

Chew CC, Lim XJ, Letchumanan P, George D, Rajan P, Chong CP

Trials, 2024 Apr 25;25(1):279.
PMID: 38664701 DOI: 10.1186/s13063-024-08111-y

BACKGROUND: Allergic rhinitis is a chronic respiratory disorder that significantly impacts patients' quality of life (QoL) and work performance. Pharmacists are recognized as suitable professionals to provide patient education and pharmaceutical care for managing allergic rhinitis patients. However, local clinical practice guidelines, particularly regarding pharmaceutical care in public healthcare institutions, are lacking. This study protocol outlines a randomized controlled trial (RCT) designed to evaluate the effectiveness of a pharmacist-led educational model (AR-PRISE Model) in managing allergic rhinitis in adult patients compared to standard pharmaceutical care. The AR-PRISE model delivers patient educational material and a pharmaceutical care algorithm.
METHOD: This is a 6-month, single-center, prospective, randomized, two-arm, and parallel-group controlled trial. The trial recruits patients attending the otorhinolaryngology clinics of a tertiary referral hospital. Participants are randomized into control or intervention groups in a 1:1 ratio using permuted block randomization. The total number of participants estimated is 154, with each group requiring 77 participants. The control group receives standard pharmaceutical care, while the intervention group receives pharmacist-led education according to the AR-PRISE model. Both groups are assessed for middle turbinate endoscopy findings, disease severity, knowledge level, symptom control, medication adherence, and QoL at baseline and the end-of-study follow-up (day 180 ± 7). Depending on feasibility, intermediate follow-ups are conducted on days 60 ± 7 and 120 ± 7, either virtually or face-to-face. During intermediate follow-ups, participants are assessed for symptom control, medication adherence, and QoL. The intention-to-treat analysis includes all participants assigned to each group. An independent T-test compares the mean difference in knowledge level between the two groups. A two-way repeated measures ANOVA analysis is employed to determine between-group differences for scores of symptom control, adherence rate, and QoL. A P-value

Matched MeSH terms: Health Knowledge, Attitudes, Practice

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