AIMS AND METHODS: This study explored male smokers' knowledge, beliefs, and behaviors related to SHS exposure and smoking in the home, to guide future intervention development. Twenty-four men who smoked and lived in Klang Valley, Kuantan, or Kuala Terengganu took part in semi-structured interviews which explored knowledge and beliefs regarding SHS in the home, and associated home-smoking behaviors. Data were managed and analyzed using the framework approach.
RESULTS: There was limited knowledge regarding the health risks associated with SHS: the smell of SHS in the home was a more prominent concern in most cases. Many had no rules in place restricting home smoking, and some suggested that smoking in specific rooms and/or near windows meant SHS was not "shared" with other household members. A few fathers had created but not maintained a smoke-free home prior to and/or after their children were born. Desire to smoke in the home conflicted with men's sense of responsibility as the head of the household to protect others and set a good example for their children.
CONCLUSIONS: Men's home-smoking behaviors are shaped by a lack of understanding of the health risks associated with SHS exposure. Gaining a broader understanding of the factors that shape men's decisions to create a smoke-free home is important to facilitate the development of culturally appropriate interventions that address their responsibility to protect other household members from SHS exposure.
IMPLICATIONS: Our findings highlight the need for public information campaigns in Malaysia to educate men who smoke regarding the health harms associated with SHS in the home and the ways in which SHS travels and lingers in household air. This is important given men's concerns about SHS often focus on the smell of cigarette smoke in the home. Our findings suggest a number of potential avenues for future intervention development, including household and community-level initiatives that could build on men's sense of responsibility as the head of the household and/or their general desire to protect their families.
METHODS: A prospective cross-sectional study was conducted where 443 caregivers, of 508 children with active TB receiving treatment, were interviewed using a structured questionnaire. Logistic regression analysis was used to examine the risk factors for TB.
RESULTS: A total of 2397 family members at the median of 5 persons were recorded. Of these, 223 (9.3%) were screened on symptoms basis and 35 (15.7%) of these contacts were diagnosed with TB. Multivariate analysis revealed HHC with TB (OR = 15.288, 95% CI: 5.378-43.457), HHC with smoking (OR = 7.094, 95% CI: 2.128-23.648), and contact of > 18 h with TB individual (OR = 4.681, 95% CI: 1.198-18.294) as statistically significant risk factors of TB among the HHC.
CONCLUSION: With the current system of contact screening for TB, only 9.3% of all HHC were screened. The low rates of contacts screened are possibly a repercussion of the passive nature of the program, which mainly depend on distinctive clinical symptoms being experienced by the contacts. Strategies are required to certify adherence with contact screening among children with active TB and to critically consider the factors responsible for TB transmission.
OBJECTIVE: This study assessed the diet quality of households by their type of engagement in homestead aquaculture and/or horticulture. Socio-demographic determinants of diet quality were also studied.
METHOD: Diet quality was assessed using a nutrient adequacy ratio (NAR), based on the preceding 7 days' dietary recall at the household level. Adult male equivalent units (AMEs) were used for age- and sex-specific intra-household distribution of household intakes. Mean adequacy ratios (MAR) were computed as an overall measure of diet quality, using NAR.
RESULTS: Better diet quality (mean ± SD) was associated with households engaged in both homestead aquaculture and horticulture (0.43 ± 0.23; p < 0.001) compared to only one type of agriculture (0.38 ± 0.20) or none (0.36 ± 0.20). Tukey's post-hoc test confirmed significant differences in diet quality between both and either engagement (0.05 ± 0.01, p < 0.001), both and no engagement (0.07 ± 0.01, p < 0.001), and either and no engagement households (0.02 ± 0.01, p < 0.001). Beyond farm production of nutrient-rich foods, generalized estimating equations showed that diet quality was influenced by the higher educational level and occupation of adult household members, higher daily per capita food expenditure, sex, family size and region.
CONCLUSIONS: Projects that promote and support household engagement in both homestead aquaculture and horticulture have the potential to improve the diet quality of households.