Displaying publications 61 - 80 of 91 in total

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  1. Fulltext Is the right to health compatible with sustainability?
    Reidpath DD, Gruskin S, Allotey P
    J Glob Health, 2015 Jun;5(1):010301.
    PMID: 25734001 DOI: 10.7189/jogh.05.010301
  2. Fulltext Addressing non-communicable diseases in Malaysia: an integrative process of systems and community
    Mustapha F, Omar Z, Mihat O, Md Noh K, Hassan N, Abu Bakar R, et al.
    BMC Public Health, 2014;14 Suppl 2:S4.
    PMID: 25080846 DOI: 10.1186/1471-2458-14-S2-S4
    The prevalence of non-communicable diseases (NCDs) and NCD risk factors in Malaysia have risen substantially in the last two decades. The Malaysian Ministry of Health responded by implementing, "The National Strategic Plan for Non-Communicable Diseases (NSP-NCD) 2010-2014", and the "NCD Prevention 1Malaysia" (NCDP-1M) programme. This paper outlines the primary health system context in which the NCDP-1M is framed. We also discuss the role of community in facilitating the integration of this programme, and outline some of the key challenges in addressing the sustainability of the plan over the next few years. The paper thus provides an analysis of an integration of a programme that involved a multi-sectoral approach with the view to contributing to a broader discourse on the development of responsive health systems.
  3. Does one cigarette make an adolescent smoker, and is it influenced by age and age of smoking initiation? Evidence of association from the U.S. Youth Risk Behavior Surveillance System (2011)
    Reidpath DD, Davey TM, Kadirvelu A, Soyiri IN, Allotey P
    Prev Med, 2014 Feb;59:37-41.
    PMID: 24270054 DOI: 10.1016/j.ypmed.2013.11.011
    OBJECTIVES: Evidence that age of smoking initiation represents a risk factor for regular smoking in adolescence is complicated by inconsistencies in the operational definition of smoking initiation and simultaneous inclusion of age as an explanatory variable. The aim of this study was to examine the relationship between age, age of smoking initiation and subsequent regular smoking.
    METHODS: A secondary analysis was conducted of the U.S. Youth Risk Behavior Survey 2011. A sex stratified multivariable logistic regression analysis was used to model the likelihood of regular smoking with age and age of smoking initiation as explanatory variables and race/ethnicity as a covariate.
    RESULTS: After controlling for race/ethnicity, age and age of smoking initiation were independently associated with regular smoking in males and females. Independent of age, a one year's decrease in the age of smoking initiation was associated with a 1.27 times increase in odds of regular smoking in females (95% CI: 1.192-1.348); and similar associations for males (OR: 1.28; 95% CI: 1.216-1.341).
    CONCLUSION: While the majority of high school students do not become regular smokers after initiating smoking, earlier initiation of smoking is associated with subsequent regular smoking irrespective of sex or race/ethnicity. These findings have potentially important implications for intervention targeting.
    KEYWORDS: Adolescent; Epidemiology; Smoking
  4. How much energy is locked in the USA? Alternative metrics for characterising the magnitude of overweight and obesity derived from BRFSS 2010 data
    Reidpath DD, Masood M, Allotey P
    Int J Public Health, 2014 Jun;59(3):503-7.
    PMID: 24045784 DOI: 10.1007/s00038-013-0510-1
    OBJECTIVES: Four metrics to characterise population overweight are described.

    METHODS: Behavioural Risk Factors Surveillance System data were used to estimate the weight the US population needed to lose to achieve a BMI 

  5. Fulltext Validity of self-measured waist and hip circumferences: results from a community study in Malaysia
    Reidpath DD, Cheah JC, Lam FC, Yasin S, Soyiri I, Allotey P
    Nutr J, 2013;12:135.
    PMID: 24093886 DOI: 10.1186/1475-2891-12-135
    BACKGROUND: Measures of central adiposity are better predictors of adverse health events than BMI. Nonetheless, BMI is more widely used in health research. One reason for this may be the limited research supporting the self-measurement of waist and hip circumference. The lack of validity studies is particularly acute in Asia. The main objective was to establish the validity of self-measurement of waist and hip circumference in a community setting and the correlation of those measures with BMI, blood pressure, and blood glucose levels.
    METHODS: A community based, cross-sectional survey. A "healthy living expo" at a shopping mall in a rural town on peninsular Malaysia One hundred and thirty six (136) individuals volunteered to participate in the study, 125 of whom met the inclusion criteria. The ethnic distribution of the participants was 80% Chinese, 17% Malay and 3% Indian. Most participants were female (60%), with participants' ages ranging from 18 to 78 years (mean, 47.2). Self and assisted measurements of waist and hip were taken. Blood pressure, non-fasting blood glucose, height, and weight were also measured. Bland Altman plots and Lin's concordance coefficient were used to measure agreement between self and assisted measures. Pearson's correlation was used to examine the association of self and assisted measures with blood pressure, blood glucose, and BMI.
    RESULTS: There was a downwards bias in self measured waist (-0.81 cm) and hip (-1 cm) circumferences compared with assisted measures. The concordance for the self and assisted measures of waist, hip and the ratio of the two were, respectively, .96, .93 , and .84. The correlation between measures of central adiposity and BMI, blood pressure and blood glucose were similar for self and assisted measures.
    CONCLUSION: The results provide additional support for the use of self-measurement of waist and hip circumference studies of central adiposity, but is limited by the specificity of the setting.
  6. Fulltext Community-based blood pressure measurement by non-health workers using electronic devices: a validation study
    Reidpath DD, Ling ML, Yasin S, Rajagobal K, Allotey P
    Glob Health Action, 2012;5:14876.
    PMID: 22761601 DOI: 10.3402/gha.v5i0.14876
    INTRODUCTION: Population monitoring and screening of blood pressure is an important part of any population health strategy. Qualified health workers are expensive and often unavailable for screening. Non-health workers with electronic blood pressure monitors are increasingly used in community-based research. This approach is unvalidated. In a poor, urban community we compared blood pressure measurements taken by non-health workers using electronic devices against qualified health workers using mercury sphygmomanometers.
    METHOD: Fifty-six adult volunteers participated in the research. Data were collected by five qualified health workers, and six non-health workers. Participants were randomly allocated to have their blood pressure measured on four consecutive occasions by alternating a qualified health worker with a non-health worker. Descriptive statistics and graphs, and mixed effects linear models to account for the repeated measurement were used in the analysis.
    RESULTS: Blood pressure readings by non-health workers were more reliable than those taken by qualified health workers. There was no significant difference between the readings taken by qualified health workers and those taken by non-health workers for systolic blood pressure. Non-health workers were, on average, 5-7 mmHg lower in their measures of blood pressure than the qualified health workers (95%HPD: -2.9 to -10.0) for diastolic blood pressure.
    CONCLUSION: The results provide empirical evidence that supports the practice of non-health workers using electronic devices for BP measurement in community-based research and screening. Non-health workers recorded blood pressures that differed from qualified health workers by no more than 10 mmHg. The approach is promising, but more research is needed to establish the generalisability of the results.
    KEYWORDS: Malaysia; blood pressure; community workers; hypertension; measurement; screening
    Study site: urban, low-income community, of the Klang Valley near Kuala Lumpur, Malaysia
    Device: Mercury sphygmomanometers (Spirit brand, model number CK-101C), electronic, automatic blood pressure monitors (Omron brand model HEM-7203)
  7. Fulltext The fallacy of the equity-efficiency trade off: rethinking the efficient health system
    Reidpath DD, Olafsdottir AE, Pokhrel S, Allotey P
    BMC Public Health, 2012;12 Suppl 1:S3.
    PMID: 22992346 DOI: 10.1186/1471-2458-12-S1-S3
    In the health systems literature one can see discussions about the trade off between the equity achievable by the system and its efficiency. Essentially it is argued that as greater health equity is achieved, so the level of efficiency will diminish. This argument is borrowed from economics literature on market efficiency. In the application of the economic argument to health, however, serious errors have been made, because it is quite reasonable to talk of both health equity being a desirable output of a health system, and the efficient production of that output. In this article we discuss notions of efficiency, and the equity-efficiency trade off, before considering the implications of this for health systems.
  8. Fulltext The burden is great and the money little: Changing chronic disease management in low- and middle-income countries
    Reidpath DD, Allotey P
    J Glob Health, 2012 Dec;2(2):020301.
    PMID: 23289072 DOI: 10.7189/jogh.02.020301
  9. Fulltext Behaviour Change in Public Health: Evidence and Implications
    Pokhrel S, Anokye NK, Reidpath DD, Allotey P
    Biomed Res Int, 2015;2015:598672.
    PMID: 26380284 DOI: 10.1155/2015/598672
  10. Fulltext Reframing non-communicable diseases
    Vijayasingham L, Allotey P
    Lancet Glob Health, 2017 11;5(11):e1070.
    PMID: 29025625 DOI: 10.1016/S2214-109X(17)30326-1
  11. Fulltext The problem of 'trickle-down science' from the Global North to the Global South
    Reidpath DD, Allotey P
    BMJ Glob Health, 2019;4(4):e001719.
    PMID: 31406597 DOI: 10.1136/bmjgh-2019-001719
  12. Ethics of care and selective organisational caregiving by private employers for employees with chronic illness in a middle-income country
    Vijayasingham L, Jogulu U, Allotey P
    Soc Sci Med, 2021 01;269:113608.
    PMID: 33360218 DOI: 10.1016/j.socscimed.2020.113608
    For people with chronic illnesses in low-and-middle-income countries, access to enabling resources that contribute to health, economic and social resilience such as continued employment, often fall outside the health sector's remit or delivery of national structural protection. In the absence of sufficient laws and policies that mitigate discrimination and enhance reasonable work modifications, private employers have a high degree of agency and discretion in how they hire, manage, or terminate employees with chronic illnesses (ECI). There is a scarcity of research on how employers make decisions under these conditions. Using a constructivist grounded theory approach, we interviewed and analysed data from 30 human resource (HR) professionals and decision-makers within private organisations in Klang Valley, Malaysia (June 2015-September 2016). In this paper, we use 'ethics of care' as an analytic, and moral lens to present HR's decision-making rationales in caring for and managing ECI. Respondents described the positive influence of international practices, including through parent company policies, as a reference for best practice. While overt bias and discriminatory perceptions were predictably described, participants also discussed care as relational organisational culture, and strategy, albeit selectively. Apart from illness factors such as duration and severity, descriptions of 'selective caregiving' included considerations of an employee's duration in organisations, the perceived value of the employee to employers, organisation size, ethos, resources and capabilities, and how organisations managed the uncertainty of illness futures as a potential risk to organisation outcomes. Selective caregiving can contribute to social, economic and health inequalities in populations with chronic illness. Nevertheless, global health actors can use the problems identified by participants, as entry points to engage more closely with employers and the broader private and commercial sectors in LMICs, to facilitate more inclusive care, and care-based intersectoral work to address the social and economic determinants of health.
  13. Fulltext Navigating paradox in self-care
    Christofield M, Moon P, Allotey P
    BMJ Glob Health, 2021 06;6(6).
    PMID: 34140304 DOI: 10.1136/bmjgh-2021-005994
  14. Fulltext Single, community-based blood glucose readings may be a viable alternative for community surveillance of HbA1c and poor glycaemic control in people with known diabetes in resource-poor settings
    Reidpath DD, Jahan NK, Mohan D, Allotey P
    Glob Health Action, 2016;9:31691.
    PMID: 27511810 DOI: 10.3402/gha.v9.31691
    BACKGROUND: The term HbA1c (glycated haemoglobin) is commonly used in relation to diabetes mellitus. The measure gives an indication of the average blood sugar levels over a period of weeks or months prior to testing. For most low- and middle-income countries HbA1c measurement in community surveillance is prohibitively expensive. A question arises about the possibility of using a single blood glucose measure for estimating HbA1c and therefore identifying poor glycaemic control in resource-poor settings.

    DESIGN: Using data from the 2011-2012 US National Health and Nutrition Examination Surveys, we examined the relationship between HbA1c and a single fasting measure of blood glucose in a non-clinical population of people with known diabetes (n=333). A linear equation for estimating HbA1c from blood glucose was developed. Appropriate blood glucose cut-off values were set for poor glycaemic control (HbA1c≥69.4 mmol/mol).

    RESULTS: The HbA1c and blood glucose measures were well correlated (r=0.7). Three blood glucose cut-off values were considered for classifying poor glycaemic control: 8.0, 8.9, and 11.4 mmol/L. A blood glucose of 11.4 had a specificity of 1, but poor sensitivity (0.37); 8.9 had high specificity (0.94) and moderate sensitivity (0.7); 8.0 was associated with good specificity (0.81) and sensitivity (0.75).

    CONCLUSIONS: Where HbA1c measurement is too expensive for community surveillance, a single blood glucose measure may be a reasonable alternative. Generalising the specific results from these US data to low resource settings may not be appropriate, but the general approach is worthy of further investigation.

  15. Shisha (waterpipe) smoking initiation among youth in Malaysia and global perspective: a scoping review (2006-2015)
    Singh SK, Enzhong L, Reidpath DD, Allotey P
    Public Health, 2017 Mar;144:78-85.
    PMID: 28274388 DOI: 10.1016/j.puhe.2016.11.022
    OBJECTIVE: To explore the initiating factors of waterpipe tobacco smoking (WTS) among youth.

    STUDY DESIGN: The analytic framework for this scoping review was performed using the methodology outlined by Arksey and O'Malley, which includes identification of the research question, study selection, charting the data, collating, summarizing and reporting the results that were primarily guided by the research question; 'what is known about the initiation of shisha smoking among youth?'

    METHODS: Electronic databases such as Cochrane, MEDLINE and PsycINFO were used to search for relevant articles. Articles included were all in English and published within the year of 2006 to 2015. Inclusion criteria; i) age range of 10 to 29 years; ii) examined the reasons why youth started or tried WTS; iii) in full text. Therefore, 26 articles were included in this scoping review.

    RESULTS: This review has identified and classified the initiating factors of WTS among youth in four subtopics: individual factors, interpersonal influences, cigarettes and alcohol use, and media influences. Individual factors and interpersonal influences played an important role in initiation factors of WTS among youth.

    CONCLUSION: This study concludes that public health professionals within the Southeast Asia region need to promote innovative preventive measures through peer-to-peer led interventions that are also easily assessable on social media platforms. The public health messages need to address the misconceptions of risk associated to WTS use.
  16. Chronic illness and sustainable careers: How individuals with multiple sclerosis negotiate work transitions in a middle-income country
    Vijayasingham L, Jogulu U, Allotey P
    Soc Sci Med, 2020 01;245:112699.
    PMID: 31785425 DOI: 10.1016/j.socscimed.2019.112699
    Reports of work change and transitions are common amongst individuals with chronic illnesses such as multiple sclerosis (MS). However, there is little research on the lived experience of these work transitions. The scarcity of this research is particularly evident within low-and-middle-income countries, where protection laws and resources such as anti-discrimination laws and reasonable work modifications may not exist or be well enforced. In this paper, we explore how and why individuals with MS seek and achieve work transitions in the structural context of Malaysia. We interviewed ten working individuals with MS (July-december 2015) using a joint hermeneutic phenomenology and constructivist grounded theory approach. Using a broad conceptual lens of 'sustainable careers', we examine their careers as a series of experiences, decisions, and events, paying attention to the influences of context, time, their personal levels of agency and sense of meaning. Participants described work transitions as early as within the first year of diagnosis, that were prompted by voluntary, involuntary and semi-voluntary reasons. Key aspects of the process of seeking new roles included an exploration of alternative roles and paths, and then acquiring, trialing/adapting and remaining engaged in their new roles. Participants identified the perception and experience of 'being unemployable', based on how their diagnosis and short-term symptoms were responded to by employers. Nevertheless, participants used various strategies and career resources to obtain and maintain meaningful work roles. However, success in obtaining or maintaining new roles were not equally achieved. This research draws attention to the cumulative economic disadvantage of a chronic illness diagnosis, even at milder and episodic stages. Furthermore, it reiterates the need for cohesive structural protection in low-and-middle-income countries to facilitate a more equal ability to remain economically resilient and capable of engaging in meaningful long-term careers when living with a chronic illness.
  17. Fulltext Interpretations of self-rated health in stroke survivors from a semi-rural community in South East Asia
    Yap KH, Warren N, Reidpath DD, Allotey P
    Int J Qual Stud Health Well-being, 2019 Dec;14(1):1613875.
    PMID: 31120385 DOI: 10.1080/17482631.2019.1613875
    Purpose: Stroke survivors report poorer self-rated health (SRH) compared to the general population but there is limited understanding on what contributes to SRH. This ethnographic study examined the individual and contextual factors that shape stroke survivors' SRH in a rural middle income country situated in South East Asia. Methods: Ethnographic methods which encompasses various data collection methods from different data sources were used in this study to describe the socio-cultural context of 16 stroke survivors living in a rural village. Within this context, the experiences of these participants were then interpreted in terms of what contributed to their perception of health and recovery, juxtaposed with objectively measure physical and cognitive states. Results: SRH reflected the post stroke adjustment of stroke survivors. Better SRH was influenced by good post-stroke adjustment that was achieved by a combination of physical functioning, cognitive functioning, emotional well-being and family support. Poorer SRH appear to reflect poor post-stroke adjustment regardless of the objective physical and cognitive states of the stroke survivors. It was also observed that cognitive deficits, though its presence was acknowledged by participants, were usually not taken into account when rating SRH. However, while physical functioning was perceived by participants to directly impact SRH, the presence of cognitive deficits (often in tandem with depressive symptoms) indirectly complicated the recovery of physical functions treasured by participants. Conclusion: Stroke survivors reporting poorer SRH warrant further attention and intervention from health practitioners supporting the longer-term needs of stroke survivors in similar settings.
  18. Fulltext Restrictive migration policies in low-income and middle-income countries
    Vijayasingham L, Rhule E, Asgari-Jirhandeh N, Allotey P
    Lancet Glob Health, 2019 07;7(7):e843-e844.
    PMID: 31200884 DOI: 10.1016/S2214-109X(19)30196-2
  19. Fulltext Breast Cancer Screening in Semi-Rural Malaysia: Utilisation and Barriers
    Mohan D, Su TT, Donnelly M, Hoe WMK, Schliemann D, Tan MM, et al.
    Int J Environ Res Public Health, 2021 11 23;18(23).
    PMID: 34886015 DOI: 10.3390/ijerph182312293
    Breast cancer (BC) is the commonest cancer in Malaysia. Delayed diagnosis is a significant cause of BC mortality in the country. Early diagnosis and screening are vital strategies in mortality reduction. This study assessed the level of utilisation and barriers for breast self-examination (BSE), clinical breast examination (CBE) and mammogram in a semi-rural population in Malaysia and compared these across the different ethnic groups. This cross-sectional study was conducted among women aged 40 years and above, embedded within a health and demographic surveillance site (HDSS) in Segamat, Malaysia. Trained data collectors collected data on screening and barriers during home visits. Study participants (n = 250) were aged 59.4 ± 10.9 years and represented Malaysia's three major ethnic groups. Practice of regular BSE, CBE uptake (ever) and mammogram (ever) was 23.2%, 36% and 22.4%, respectively. Regular BSE practice was highest in the Malay ethnic group and least among the Chinese. Regular CBE was very low in all ethnic groups (<5%). Mammogram uptake was highest among Chinese (34.4%), followed by Indians (30.4%) and Malays (16.6%). After adjusting for other socio-demographic variables, Malay ethnicity was positively associated with regular BSE (adjusted OR = 5.26, 95% CI 2.05, 13.50) and negatively associated with having had a mammogram (adjusted OR = 0.3, 95% CI 0.15, 0.57). Lower education was negatively associated (adjusted OR = 0.36, 95% CI 0.17, 0.74) with mammogram attendance (ever). Emotional and financial barriers were the most reported types of barriers, specifically, fear of diagnosis (74.8%), cost of diagnosis (69.6%) and fear of losing a breast (66.4%). Malay women more commonly reported most barriers compared to other ethnic groups. Screening uptake was low among semi-rural women in Malaysia. Implementing culturally appropriate interventions that consider ethnic differences is crucial to empowering women to engage in BC screening initiatives in these communities.
  20. Fulltext Designing the next generation of implementation research training for learners in low- and middle-income countries
    Penkunas MJ, Chong SY, Rhule ELM, Berdou E, Allotey P
    Global Health, 2021 06 21;17(1):63.
    PMID: 34154605 DOI: 10.1186/s12992-021-00714-3
    Efficacious health interventions tested through controlled trials often fail to show desired impacts when implemented at scale. These challenges can be particularly pervasive in low- and middle-income settings where health systems often lack the capacity and mechanisms required for high-quality research and evidence translation. Implementation research is a powerful tool for identifying and addressing the bottlenecks impeding the success of proven health interventions. Implementation research training initiatives, although growing in number, remain out of reach for many investigators in low- and middle-income settings, who possess the knowledge required to contextualize challenges and potential solutions in light of interacting community- and system-level features. We propose a realigned implementation research training model that centers on team-based learning, tailored didactic opportunities, learning-by-doing, and mentorship.
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