Methods: This study, stratified in pre-, during, and post-intervention periods, was conducted between February 2017 and March 2018 in two wards at a tertiary care hospital in Malaysia. Hand hygiene promotion was facilitated either by PICAs (study arm 1) or MSCAs (study arm 2), and the two wards were randomly allocated to one of the two interventions. Outcomes were: 1) perceived leadership styles of PICAs and MSCAs by staff, vocalised during question and answer sessions; 2) the social network connectedness and communication patterns between HCWs and change agents by applying social network analysis; and 3) hand hygiene leadership attributes obtained from HCWs in the post-intervention period by questionnaires.
Results: Hand hygiene compliance in study arm 1 and study arm 2 improved by from 48% (95% CI: 44-53%) to 66% (63-69%), and from 50% (44-55%) to 65% (60-69%), respectively. There was no significant difference between the two arms. Healthcare workers perceived that PICAs lead by example, while MSCAs applied an authoritarian top-down leadership style. The organisational culture of both wards was hierarchical, with little social interaction, but strong team cohesion. Position and networks of both PICAs and MSCAs were similar and generally weaker compared to the leaders who were nominated by HCWs in the post-intervention period. Healthcare workers on both wards perceived authoritative leadership to be the most desirable attribute for hand hygiene improvement.
Conclusion: Despite experiencing successful hand hygiene improvement from PICAs, HCWs expressed a preference for the existing top-down leadership structure. This highlights the limits of applying leadership models that are not supported by the local organisational culture.
METHODS: A sample of 758 adolescents aged 12-18 years were recruited from private and public schools in Tehran. Information about socio-demographic background and body change techniques were collected via a self-administered questionnaire.
RESULTS: A high percentage of adolescents used body change techniques frequently to alter their body appearance. Girls changed normal eating pattern significantly (p=0.007) to lose weight more frequently than boys while boys used this method significantly (p=0.01) to gain weight more frequently than girls. Overweight/obese adolescents exercised significantly to change muscle size (p=0.03) and changed normal diet to lose weight (p<0.001) more frequently than normal weight adolescents. The relation between sex and body weight status with body change techniques (p<0.0) implied that male and female adolescents especially overweight/obese adolescents were frequently trying to change their body appearance.
CONCLUSION: Significant differences existed in using body change techniques according to sex and body weight status and these should be considered in obesity prevention programs for adolescents.
MATERIALS AND METHOD: The Family Diet Study was conducted with urban Malay families and included a child aged 8-12 years and their main carer(s). Seven domains of parent-child feeding practices were assessed using the child feeding questionnaire and familial demographics, including socio-economic status, child anthropometry and dietary intake were collected. Inferential statistics were used to explore the relationships between variables.
RESULTS: Of the 315 families enrolled, 236 completed all measures, with the majority of parent-reporters being mothers (n = 182). One-third of the children were classified as overweight/obese. Three domains of parent-child feeding practices had median scores of 4.0 out of 5.0 [concern about child overweight (CCO) (Interquartile range (IQR): 3.3, 4.7); pressure-to-eat (PTE) (IQR: 3.3, 4.5) and food monitoring (IQR: 3.0, 5.0)]. The domain of 'perceived child overweight' was positively associated with child age (r = 0.45, p