Community Health Education Programs Research Articles

Assessment of knowledge, attitude, and practices towards canine visceral leishmaniasis based on the one health concept in Weliso and Ejaji Towns, Oromia, Ethiopia

Canine visceral leishmaniasis (CVL) is a significant vector-borne Meta zoonotic disease caused by agents of the L. donovani complex. The disease is transmitted by the bite of phlebotomine female sandflies of the genera Phlebotomus and Lutzomyia in the old and new worlds, respectively. This study was conducted to assess the knowledge, attitude, and practices of the residents about CVL based on the One Health concept in two towns of the Oromia Region, Ethiopia. A community-based cross-sectional study was conducted between October 2019 and September 2020, using an interview questionnaire as the study instrument. The study participants were selected through a simple random sampling method. Pearson’s Chi-square and logistic regression tests were used to evaluate the association between the study participants’ knowledge, attitude, and practices toward CVL and possible risk factors. The study included a total of 400 participants, and the results indicated that 77.25% had good knowledge, 60.5% had a favorable attitude, and 59.25% had good practices toward CVL. The town of Ejaji and dog ownership were significantly associated with good knowledge (p = 0.001), and attitude (p = 0.001) towards CVL, while having a dog (p = 0.001), having a diploma (p = 0.019) or degree and above (0.018), being divorced or widowed (0.012), and being Oromo (p = 0.013) were all significantly associated with good CVL practice. Most participants in both study areas had good knowledge but moderate attitudes and practices toward CVL. Therefore, it is crucial to undertake comprehensive community health education and awareness programs of zoonotic visceral leishmaniasis and its vectors based on the One Health concept through various means.

Illuminating the Shadows: Exploring the Causes, Overcoming Challenges, and Advancing Solutions for Skin Cancers in Pakistan

Skin cancer poses a significant and growing public health concern in Pakistan, with rising incidence rates and a burden that weighs heavily on individuals, families, and healthcare systems. Understanding the causes, addressing the challenges, and implementing effective solutions are critical steps in combating this escalating issue.1 In this editorial, we shed light on the complexities of skin cancers in Pakistan, exploring the underlying causes, the challenges faced, and the pathways to advancing solutions for prevention, early detection, and treatment. The primary cause of skin cancers, including melanoma and non-melanoma types, is excessive and prolonged exposure to ultraviolet (UV) radiation from the sun1. Pakistan's geographical location, with abundant sunshine and a predominantly sunny climate, places its population at a heightened risk of developing skin cancers. Cultural practices, such as limited sun protection measures and a preference for fair skin, further contribute to increased UV exposure and vulnerability to skin cancers.1 Public awareness campaigns and education on the importance of sun protection practices, such as wearing protective clothing, using sunscreen, and seeking shade during peak sun hours, are crucial for reducing UV-related risks. Another significant challenge in combating skin cancers in Pakistan is the lack of comprehensive and consistent data on the incidence, prevalence, and mortality rates. Limited national registries and fragmented data collection systems impede accurate assessment and hinder evidence-based decision-making.2 Strengthening surveillance mechanisms, establishing cancer registries, and promoting data sharing and collaboration among healthcare institutions and researchers are pivotal in obtaining a comprehensive understanding of the burden and trends of skin cancers. Access to healthcare services, particularly in rural areas, poses a significant obstacle to early detection and timely treatment of skin cancers. Limited healthcare infrastructure, inadequate training of healthcare professionals and financial constraints restrict access to dermatological expertise, specialized diagnostics, and appropriate treatment modalities. Investment in dermatology services, the training of healthcare professionals, and the establishment of skin cancer centers can enhance early detection, diagnosis, and treatment accessibility for all individuals across Pakistan.3 Community engagement and health education programs play a pivotal role in raising awareness about skin cancers, dispelling misconceptions, and encouraging early detection behaviors4. Collaboration with community leaders, schools, and local organizations can facilitate the dissemination of information on risk factors, warning signs, and the importance of regular self-examinations4. By empowering individuals to recognize suspicious lesions and seek timely medical attention, we can promote early diagnosis and improve treatment outcomes.4 Furthermore, innovative technological solutions, such as telemedicine and mobile health applications, have the potential to bridge the geographical gaps and improve access to dermatological expertise in remote areas. Telemedicine platforms enable dermatologists to remotely assess and diagnose skin lesions, providing guidance on further evaluation and treatment options. Integrating these digital solutions into the healthcare system can greatly enhance dermatology services and improve outcomes for individuals with skin cancers.5 Collaborative research efforts and partnerships between academia, healthcare institutions, and governmental bodies are vital in advancing the understanding of skin cancers in Pakistan.6 Research studies focused on epidemiology, genetic factors, environmental influences, and treatment outcomes can provide valuable insights into the unique characteristics of skin cancers in the Pakistani population. These insights can inform the development of tailored prevention strategies, treatment guidelines, and targeted interventions. In conclusion, addressing the rising burden of skin cancers in Pakistan requires a multifaceted approach that encompasses awareness, prevention, early detection, treatment accessibility, and research collaboration. By illuminating the shadows cast by skin cancers, we can create a comprehensive framework that combines public education, healthcare infrastructure development, technological innovations, and research advancements. Together, we can combat this growing epidemic and improve the lives of individuals affected by skin cancers in Pakistan.7-10 How to Cite This: Rani B. Illuminating the Shadows: Exploring the Causes, Overcoming Challenges, and Advancing Solutions for Skin Cancers in Pakistan. Isra Med J. 2023; 15(1):35-36. DOI: https://doi.org/10.55282/imj.ltr35

Abstract 1918: Reducing human papillomavirus associated cancers and disparities among Hispanics/Latinos through the adapted NCI NON CHE (National Outreach Network Community Health Education) program

Abstract While HPV vaccination has dramatically reduced HPV-related cancer incidences in certain demographic groups, it continues to disproportionately affect Hispanics/Latinos. The NON CHE program at (USC), (NCCC), aims to understand the gaps in Human Papillomavirus (HPV) knowledge and vaccination uptake, cervical cancer screenings, and addresses the barriers to participating in clinical trials (CT) by conducting culturally-sensitive educational workshops to the community. Methods: Materials such as a PowerPoint presentation and Human Papillomavirus Vaccination (HPV) infographics were adapted by the NCI to ensure the message can influence the target audience. Educational workshops were conducted via Zoom. Recruitment of participants were facilitated by partnering with community organizations across Los Angeles County (LAC) which is NCCC’s catchment area. The effectiveness of the workshops was assessed by delivery of pre and post surveys that captured demographics and a series of true and false questions that measured HPV knowledge. 3- and 6-month follow-up surveys are distributed among participants of those of age 18 - 26 and to parents of children 9 - 18 years of age to assess vaccination intake. Results: A total of 1,515 people have been reached during educational workshops, health fairs, and outreach events from October 2021 to September 2022. Our results demonstrate that the 236 participants, (55.6%) Spanish-speaking and (26.9%) English-speaking had not heard of HPV indicating the sparse availability and accessibility of information contributing to parents’ unfamiliarity of the HPV vaccine (79.5%) between the two groups. However, there was a positive distribution of likely to get vaccine (72.88%) and likely to vaccinate their children (47.88%.) Their lack of awareness stemmed from lack of provider motivation (44.2%) and limited health education (39.5%.) Conclusion: Conducting culturally tailored educational workshops to disseminate information on Human Papillomavirus (HPV) has helped Hispanics/Latinos understand what HPV is and reduce the stigma. Effective dissemination of HPV education requires it to be inclusive, concise, and engaging to motivate community members to seek preventive care. Citation Format: Alejandra Ramos, Carolina Aristizabal, Lourdes Baezconde-Garbanati. Reducing human papillomavirus associated cancers and disparities among Hispanics/Latinos through the adapted NCI NON CHE (National Outreach Network Community Health Education) program [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1918.

Multifaceted community health education programs as powerful tools to mitigate snakebite-induced deaths, disabilities, and socioeconomic burden.

Snakebite envenoming (SBE) predominantly affects rural impoverished communities that have limited access to immediate healthcare. These communities often hold numerous myths/misbeliefs about snakes and SBE. Moreover, healthcare professionals who practice in rural regions often work in unstable situations with limited medical infrastructure and therefore, lack sufficient knowledge/experience and confidence in the clinical management of SBE. Due to the lack of reliable statistics on the true burden of SBE, developing health policies for this condition by relevant authorities may be difficult. Hence, it is critical to improve awareness about SBE among rural communities, healthcare professionals and health authorities using robust multifaceted community health education approaches. Here, we describe the design, development, implementation, and impact of distinctive community health education approaches that we used in India and Brazil. A wide range of educational tools including information leaflets, posters, pocket guides, learning materials for healthcare professionals and short/long video documentaries were developed in local languages and used to engage with target communities through direct assemblies as well as mass/traditional and social media. Notably, we used diverse methods to determine the impact of our programs in improving awareness, treatment-seeking behaviour, and clinical practice. The people-centred approaches that we used were inclusive and highly impactful in instigating fundamental changes in the management of SBE among rural communities. The resources and approaches presented in this article can be easily adapted for wider use in other countries in order to collectively reduce SBE-induced deaths, disabilities and socioeconomic ramifications.

Supporting Faith-Based Communities Through and Beyond the Pandemic.

The COVID-19 pandemic brought widespread and notable effects to the physical and mental health of communities across New York City with disproportionate suffering Black/African American and Hispanic/Latino communities alongside additional stressors such as racism and economic hardship. This report describes the adaptation of a previously successful evidence-based community engagement health education program for the deployment of resilience promoting workshop program in faith-based organizations in BIPOC communities in New York City. From June 2021 to June 2022, nine faith-based organizations implemented 58 workshops to 1,101 non-unique workshop participants. Most of the workshops were delivered online with more women (N = 803) than men (N = 298) participating. All organizations completed the full curriculum; the workshop focused on self-care and physical fitness was repeated most frequently (N = 13). Participants in the workshops ranged from 4 to 73 per meeting and were largely female. The Building Community Resilience Project is an easy and effective way to modify an existing, evidence-based community health education program to address new and relevant health needs such as resilience and stress amidst the COVID-19 pandemic among faith communities serving BIPOC populations. More research is needed regarding the impact of the workshops as well as adaptability for other faith traditions.

CHALLENGES OF ADHERING TO HAND WASHING PROTOCOLS AS A COVID-19 PREVENTION MEASURE AMONG SLUM DWELLERS IN NAIROBI, KENYA

In an effort to mitigate the outbreak of COVID-19, many countries have imposed drastic lockdown, movement control, or shelter-in-place orders on their residents. The effectiveness of these mitigation measures is highly dependent on the cooperation and compliance of all members of society. The knowledge, attitudes, and practices people hold toward the disease play an integral role in determining a society’s readiness to accept behavioral change measures from health authorities. Urban informal settlements are characterized by large populations occupying a small land area. Housing in informal settlements is close to each other with most households making do with poor quality and erratic water supply. How challenges of sanitation in slum dwellings in Kenya affect the spread of COVID-19 is not known. Social distancing, wearing masks and hand washing among other measures are known to reduce the spread of COVID-19. Although access to hand-washing facilities with soap and water is nearly universal in high-income countries, the same is not true for low-income countries. The purpose of this survey was to assess the challenges of hand washing as a COVID-19 prevention measure among urban slum populations in Kenya. Key information of practices on hand-washing practices among this sub-population will inform the ministry of health, its collaborators, and interested health sectors, on areas of improvement. A descriptive cross-sectional survey for quantitative data was used. Solvins formula for the calculation of sample size was used. A properly designed data collection tool was used in collecting the primary data on hand washing to prevent transmission of COVID-19 with a combination of face-to-face interviews. A pre-test of the data collection tool prior to pilot data collection was performed to ascertain validity and reliability. Data was analyzed using descriptive statistics such as frequencies, mean and standard deviation and displayed using tables and figures. Inferential statistics for predictive associations between variables was performed. In the analysis, data was combined to allow reporting on an array of issues. The results indicate salient challenges on hand-washing and show an acceptable level of knowledge in mitigating COVID-19 through hand-washing and hygiene and, highlight the importance of consistent messaging from local health authorities and the government as well as the need for tailored community health education and sensitization programs to improve levels of knowledge, attitudes, and practices mostly on handwashing as this pandemic may be there for some time or there could be a possible upsurge in future.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0202/a.php" alt="Hit counter" /></p>

Breakfast Skipping and Determinant Factors among Moroccan School Adolescents (12–19 Years): The Case of Beni Mellal City

Introduction: Breakfast skipping is an unhealthy eating behavior reportedly common among adolescents. The aim of the present study was to determine the prevalence and factors associated with breakfast skipping among schoolchildren aged 12–19 years in Beni Mellal city, Morocco, and to assist in the design of interventions to improve breakfast consumption habits of school-aged children in this region. Methods: A school-based cross-sectional study was carried out. A total of 550 children were included in the study. Multivariable logistic regression analysis was used to identify factors associated with skipping breakfast consumption. The association between dependent and independent variables was assessed using an odds ratio (OR) with a 95% confidence interval and p value <0.05 was considered statistically significant. Results: Among 550 Moroccan adolescents evaluated, 25.6% reported not consuming breakfast every day. Breakfast eating was statistically associated with gender (OR = 7.13 [95% CI 1.32–3.84], p = 0.008); mother’s low educational level (OR = 2.86 [95% CI 1.89–4.71], p = 0.091); nonworking mothers (OR = 13.71 [95% CI 1.16–5.29], p < 0.001); not eating between meals (OR = 15.49 [95% CI 2.15–5.49], p < 0.001); eating dinner regularly each day (OR = 17.79 [95% CI 2.81–8.01], p = 0.005); eating vegetables 1–3 times per week (OR = 10.21 [95% CI 1.44–4.67], p = 0.001); consuming milk and dairy product 1–3 times per week (OR = 13.88 [95% CI 1.59–5.56], p < 0.001); and never consuming sodas and soft drink in week (OR = 3.12 [95% CI 1.90–4.50], p = 0.003). Conclusions: This study revealed that the prevalence of skipping breakfast consumption among school-aged children in Beni Mellal city was high. Thus, the findings suggest a community health education program, conducted by school nurses, nutritionists, and other health professionals, is needed.

Community Knowledge, Perceptions and Experiences on Healthcare Services for Malaria Prevention and Treatment in the Okavango Delta, Botswana.

This paper analyses community knowledge, perceptions, and experiences of effectiveness of healthcare service provision on malaria prevention/treatment in two disease-endemic villages of the Okavango Delta panhandle in northern Botswana. A stratified random sampling of 355 households was conducted in October-November 2015. Follow-up retrospective cohort interviews were undertaken in August 2016 from 79 households that reported malaria incidences during the household survey. Data were also collected from 16 key informant interviews and 2 focus group discussions participants. Descriptive statistics and content analyses were used to summarise quantitative and qualitative data, respectively. Results indicate that communities in the study sites had positive perceptions about efficiency of health services based on availability, accessibility and utilization, adequacy of prevention and treatment interventions. Local health clinics were crucial information channels used by respondents. Additionally, factors related to acceptability, availability and accessibility are likely to contribute to perceived effectiveness of the interventions provided by healthcare service providers. Affirmation of efficiency health service provision against malaria has public health implications for adherence to treatment/prevention and participation in community health education campaigns and program implementation in the Okavango Delta region.

Gender differences in the association between oral health literacy and oral health-related quality of life in older adults

BackgroundPoor oral health affects quality of life; oral health literacy studies are increasing as it plays an essential role in promoting oral health. However, little is known regarding the gender differences in oral health literacy and oral health-related quality of life (OHRQoL) among older adults. This study aimed to explore the gender differences in oral health literacy and OHRQoL among community-dwelling older adults in Taiwan.MethodsA cross-sectional study design with convenience sampling was undertaken to recruit participants at two community service centres. Data were collected using a structured survey consisted of the demographic characteristics, instrumental activities of daily living, nutrition assessment, oral health literacy and OHRQoL. The logistic regression was used to examine the gender differences in the relationship between oral health literacy and OHRQoL.ResultsA total of 202 participants completed the survey. Of which 56.4% (n = 114) were female. Logistic regression analyses showed that after controlling for age, instrumental activities of daily living, nutrition, education level, and average monthly income, better oral health literacy was associated with better oral health quality of life (p = 0.006) in men.ConclusionsThe relationship between oral health literacy and OHRQoL was only significant for men. No significant relationship between women’s oral health literacy and their OHRQoL. However, good OHRQoL is an integral part of overall health, but it is affected by differences in oral health and the accessibility of healthcare services. We suggest that gender-specific oral health literacy education should be offered through community health-education programs.

Application of Mindsets to Health Education and Behavior Change Programs

Successful health promotion programs are characterized in part, by the willingness of audiences to engage, participate, and adopt healthier behaviors. But presentation of messages that reach and resonate with the intended audience remains challenging. This is due in part to the variety of mindsets—viewpoints, attitudes, and beliefs—within a population. These mindsets play an essential role in understanding and predicting behaviors and lifestyle factors associated with health or chronic diseases. The purpose of this study is to demonstrate how a specific survey-based method of mindset segmentation can distinguish predominant mindsets and then be used to create, adapt, and/or market health programs to appeal to these mindsets. Steps in survey construction, distribution, and analysis are described. Interpretation of the results, yielding three primary mindsets, is the critical outcome of this segmentation method. The applications of this interpretation to community health education programs are suggested. This approach has potential to inform, enhance, or customize programs, tailoring activities, methods, and messages to the preferences of the community.

Nurses' and midwives' views on male partner involvement in maternity care in Imo, Nigeria

Background/Aims In 2015, the World Health Organization recommended male partner involvement in maternal and child health as an effective strategy to combat maternal and child health in pregnancy. Healthcare practitioners' acceptance of male partners in maternal and child healthcare is likely to improve provider and patient satisfaction. The main objective of the study was to assess nurses' and midwives' perceptions of male partner involvement in maternity care, and their willingness and constraints to performing it in selected hospitals in Imo, Nigeria. Methods A mixed-method approach was used to gather data from nurses and midwives in the antenatal care, labour and postnatal care wards of selected hospitals. A semi-structured questionnaire and interview guide were used to collect data assessing the participants' perceptions of male partner involvement in maternity care and of the barriers to it. Quantitative data were analysed through bivariate analysis, using the Chi squared test, and key quotes were extracted from qualitative data to illustrate relevant points. Results The majority (57%) of the respondent had a good perception of the concept of male partner involvement. The ward that a participant worked in significantly affected their perception (P=0.01). Respondents were willing to accept male partners in maternity care through education and providing more male-friendly services. However, sociocultural, hospital policy and structural factors restricted acceptance of men in the wards. Conclusions Nurses and midwives in all wards should be educated on the importance of male partner involvement in maternity care. Nurses and midwives need to engage in community health education programmes that will modify cultural constraints to male partner involvement and facilities should modify their structure and policies to be more male-friendly.

Integrating dermatology services into a social pediatrics network: 8 years of experience in the RICHER (Responsive, Interdisciplinary/Intersectoral, Child/Community, Health, Education and Research) program.

Social pediatric initiatives aim to improve health outcomes for vulnerable children by working in the community to empower families, to enhance protective factors that mitigate adverse childhood experiences (ACEs), and to deliver place-based health care. In 2012, pediatric dermatology was added as a component of the Responsive, Interdisciplinary Intersectoral Child and Community Health Education and Research (RICHER) social pediatric program in Vancouver, BC. We share our experience with inclusion of pediatric dermatology in a well-established social pediatric program as well as lessons we have learned in the first 8years of our partnership. Partnership, bridging trust, knowledge sharing, empowerment, consistency, and flexibility were found to be central elements in the success of this endeavor.

Malaria prevalence, knowledge, attitude, and practice among febrile patients attending Chagni health center, Northwest Ethiopia: a cross-sectional study

BackgroundEthiopia has achieved considerable progresses in the prevention and control of malaria in the past decades; hitherto it is a formidable health concern and socio-economic impediment. This study aimed at assessing the magnitude, knowledge, attitudes and practices towards malaria among febrile patients attending Chagni health center, northwest Ethiopia.MethodsHealth facility-based cross-sectional study was conducted to estimate the prevalence of malaria and KAP towards malaria among febrile patients at Chagni health center in Chagni Town during September 2017 to February 2018. In order to determine the magnitude of malaria, finger prick blood samples were collected and thick and thin smears were prepared and microscopically examined for the presence of malaria parasites. A pre-tested structured questionnaire was also applied to assess KAP of suspected malaria patients, attending the health center. Data were analyzed using SPSS version 20.0.ResultsPrevalence of malaria among febrile patients, who visited the sampled health facility, was 7.3%. Of these, Plasmodium falciparum, P. vivax, and mixed infections accounted for 55, 44.3 and 0.7% of the cases, respectively. This study also revealed that 97% of the respondents had ever heard about malaria and recognized it as a serious health problem. Mosquito bite was identified as the main malaria transmission. Taking drug (86.3%), use of mosquito nets (73.3%), drain stagnated water (68%), and house spay with insecticides (66%) were mentioned as the main malaria prevention methods. Mosquito net coverage and utilizations in the prior night were 98 and 75%, respectively. Indoor residual spraying (IRS) coverage was 99%, of which 77.5% of study participants’ houses have been sprayed in the last 6 months.ConclusionsThe current study revealed that prevalence of malaria among febrile illnesses in the study area was relatively low (7.3%) with a high proportion of P. falciparum. Besides, participants had adequate knowledge, encouraging attitudes, and good practices about prevention and control of malaria. However, some misconceptions on malaria disease, its transmission, and prevention have been noted that actually require due attention by the concerned stakeholders. The findings of this study could be used as important inputs for the implementation of effective malaria prevention and control methods, including community health education programs, and scaling up coverage of evidence-based interventions.

Birth Preparedness Practice: Profiling Determining Factors for Male Involvement in Southern Nigeria

Maternal mortality remains high in most African countries including Nigeria. Delays in seeking care for normal delivery and obstetric emergencies are the major determinants of maternal mortality. Birth Preparedness (BP) has been found to be very effective in reducing these delays. Females have always been focused on birth preparedness studies. This study was however designed to investigate male involvement in the practice of birth preparedness in Southern, Nigeria. This was a descriptive study design using a validated structured interviewer-administered questionnaire. A multistage sampling technique was used to select 302 married men in the community. Knowledge on BP was measured on a 48-point knowledge scale and a 30-point practice scale was used to determine male involvement in BP. Data were analysed using descriptive and inferential statistics at p&lt;0.05. The mean age of the respondents was 38.0 ± 8.6 years. Majority (59.9 %) of the respondents had good knowledge on birth preparedness. Mean score for level of involvement was 21.52±5.4 and 43.0% of the respondents had good score. Identified factors militating against male involvement in birth preparedness include low socioeconomic status, busy work schedule, cultural belief, and poor attitude of health workers. There was significant association between knowledge of birth preparedness and religion as well as level of male involvement in BP (p=0.018; 0.001 respectively). This study showed low level of male involvement in birth preparedness. Several factors were identified to be responsible for this. There is therefore the need for sustainable community health education programmes to motivate and encourage male involvement in birth preparedness. Keywords: Birth preparedness, Knowledge, Male involvement, Practices

Data utilisation and factors influencing the performance of the health management information system in Tanzania

BackgroundHealth Management Information System (HMIS) is a set of data regularly collected at health care facilities to meet the needs of statistics on health services. This study aimed to determine the utilisation of HMIS data and factors influencing the health system’s performance at the district and primary health care facility levels in Tanzania.MethodsThis cross-sectional study was carried out in 11 districts and involved 115 health care facilities in Tanzania. Data were collected using a semi-structured questionnaire administered to health workers at facility and district levels and documented using an observational checklist. Thematic content analysis approach was used to synthesise and triangulate the responses and observations to extract essential information.ResultsA total of 93 healthcare facility workers and 13 district officials were interviewed. About two-thirds (60%) of the facility respondents reported using the HMIS data, while only five out of 13 district respondents (38.5%) reported analysing HMIS data routinely. The HMIS data were mainly used for comparing performance in terms of services coverage (53%), monitoring of disease trends over time (50%), and providing evidence for community health education and promotion programmes (55%). The majority (41.4%) of the facility’s personnel had not received any training on data management related to HMIS during the past 12 months prior to the survey. Less than half (42%) of the health facilities had received supervisory visits from the district office 3 months before this assessment. Nine district respondents (69.2%) reported systematically receiving feedback on the quality of their reports monthly and quarterly from higher authorities. Patient load was described to affect staff performance on data collection and management frequently.ConclusionInadequate analysis and poor data utilisation practices were common in most districts and health facilities in Tanzania. Inadequate human and financial resources, lack of incentives and supervision, and lack of standard operating procedures on data management were the significant challenges affecting the HMIS performance in Tanzania.

Awareness of Premarital Screening and Genetic Counseling among Saudis and its Association with Sociodemographic Factors: a National Study.

BackgroundPremarital screening and genetic counseling (PMSGC) is compulsory in Saudi Arabia and aims to identify and decrease the prevalence of some genetic and sexually transmitted infectious diseases. However, there are little data on community awareness about PMSGC. This study assessed knowledge levels, attitudes, and behaviors associated with PMSGC in the general Saudi Arabian population and their associations with sociodemographic characteristics.MethodsThis was a cross-sectional, population-based study of 6263 participants randomly selected from all 20 health regions in Saudi Arabia, stratified according to age and fulfilling predefined selection criteria. Trained data collectors used a comprehensive pretested questionnaire to collect data. Data were collected in March and April 2019. Univariable and multivariable associations between sociodemographic characteristics and knowledge levels, attitudes, and behaviors were examined.ResultsWhile all 6263 study participants had heard about PMSGC, only 575 (9.2%) participants had satisfactory knowledge, while 3283 (52.4%) participants had fair knowledge. Predictors of high knowledge scores were university or higher education level (aOR=2.06; 95% CI: 1.80–2.36), positive medical history of PMSGC-screened disease (aOR=2.02; 95% CI: 1.51–2.69), family income ≥3000 SR/month (aOR=1.70; 95% CI: 1.50–1.93), being married/previously married (aOR=1.46; 95% CI: 1.25–1.70), female gender (aOR=1.25; 95% CI: 1.12–1.40), and age >18 years (aOR=1.25; 95% CI: 1.06–1.48). The majority of participants (5246, 83.8%) had positive attitudes towards the importance of PMSGC, the burden of screened genetic and infectious diseases on the family, and that marrying was inadvisable with incompatible results. Of the 3986 engaged or married participants, 2911 (73.0%) had undertaken premarital screening, of whom 360 (12.4%) had incompatible results; 98 (37.1%) married despite this information.ConclusionDespite advances in public healthcare measures in Saudi Arabia, gaps remain in the knowledge, beliefs, and behaviors associated with PMSGC. Culturally specific community health education programs for PMSGC must be devised that emphasize the risks associated with consanguineous marriage.

Health literacy needs among migrant populations in France: validity testing and potential contribution of the Health Literacy Questionnaire (HLQ)

Health literacy is a potential factor contributing to health disparities in migrant groups. This exploratory work sought to investigate the validity of the health literacy questionnaire (HLQ) in exploring the health literacy needs of migrant people in a vulnerable borough of Montpellier, France. The multidimensional HLQ was administered, together with cognitive interviews, to 17 persons with varying French language skills benefiting from a community health education program. The great majority of HLQ items were understood as intended in this sample, with markedly heterogenous health literacy profiles. Participants with the lowest education found some words or concepts difficult to understand, but the endorsed response options were consistent with their narrative during qualitative interviews. This study adds to the growing body of evidence ensuring the cross-cultural validity of the HLQ lying on culturally generic translated item concepts. This is of importance for the exploration of both health literacy strengths and weaknesses, which provides critical insights into potentially relevant responsiveness to the needs of vulnerable persons experiencing the complex challenges of migration.

A randomized control trial of activity scheduling to reduce the impact of the caring role on older adults with dementia

AbstractBackgroundParticipating in meaningful activities is important to an individual’s wellbeing. Activity scheduling enables older adults with dementia and their spouse caregivers to structure their activities consistently in the directions they value.MethodThis was a 12‐week single‐blinded randomized control trial using a parallel group experimental design study. Community‐dwelling older adults with mild to moderate dementia and their spouses received the community health education program during the first two‐weeks. Then the participants were randomly assigned to one of the two groups for the following 10 weeks. In the control group, participants received 10 weekly education sessions on dementia care education. In the experimental group, participants received the same dementia care education program plus activity scheduling offered by occupational therapists with the intervention focused on scheduling events that are pleasant and improving communication.ResultFrom August 2018 to August 2019, 50 couples completed the intervention. The activity scheduling showed improvements with respect to alleviating the impact of the caregiving role, reducing the behavioural and psychological symptoms of dementia, decreasing the caring demand and generally improving the quality of life. A significant difference between the two groups was shown regarding the impact of the caring role, and the alleviation of disruption and depression behavior, with an effect size of .61 (95% CI = .39‐.67), .45 (95% CI = .35‐.71) and .50 (95% CI = .35‐.71) respectively. The differences between the groups indicated the experimental group showed an improvement over time in alleviating the role of caring, with Cohen’s d = .64 (95% CI : .38 to .78), and alleviating disruption and depression behavior, with an effect size of .45 (95% CI = .38‐.52) and .50 (95% CI = .43‐.59) respectively. Moreover, the number of caring hours needed, dropping from 6.98 to 5.98 hours in the experimental group.ConclusionActivity Scheduling is straightforward to administer and personalized in nature. There were significant reductions in caregiving demand. Through proper coaching and regular facilitation, AS can help caregivers create pleasant events in their daily living and quality of life of people receiving care can be much enhanced.

Enhancing Knowledge in Informal Settlements: Assessing Health Beliefs and Behaviors in Nigeria: A cross-sectional survey assessment of perceptions, practices, and resources in underserved urban communities in Lagos.

Background:Community Health Education (CHE) programs have been shown to be effective in relieving the burden on healthcare systems in Sub-Saharan Africa.Objective:This project aimed to determine the baseline level of health literacy, behavioral practices, and accessibility to resources in a set of 16 informal settlements located around Lagos, Nigeria in order to identify topics that should be emphasized in a new teaching curriculum directed at local Community Health Educators.Methods:In June of 2017, a unique cross-sectional survey composed of 37 questions was conducted in informal settlements around Lagos. Sites selected were areas in which future CHE trainings were planned to take place and survey participants were chosen by trained community health educators based on convenience sampling with snowball effect. Survey questions included both multiple-choice and open-ended questions and were asked in the local language. We collected demographic information and assessed health literacy, health behaviors, and community practices. Results were analyzed using descriptive statistics to assess for differences between demographic groups.Findings:Our survey collected 348 total responses. Respondents displayed a high level of knowledge regarding the benefits of hand washing (97.1%) and childhood immunizations (81.0%). Knowledge around infectious diseases and reproductive health was lower, including a large proportion of people (50%) incorrectly indicating that HIV could be spread through a mosquito bite. Malaria was reported to be the most prevalent disease affecting both adults (40.0%) and children (58.3%). Health access was limited, with most people not reporting access to a nearby health center (55.8%).Conclusions:Areas of knowledge that should be emphasized in future versions of CHE training curricula include infectious diseases, reproductive health, and reinforcement of the importance of sanitation and clean water. The curriculum should address the reality of limited health access and develop strategies to improve this.

Risk reduction of diarrhea and respiratory infections following a community health education program - a facility-based case-control study in rural parts of Kenya

BackgroundDiarrheal and acute respiratory infections remain a major cause of death in developing countries especially among children below 5 years of age. About 80% of all hospital attendances in Kenya can be attributed to preventable diseases and at least 50% of these preventable diseases are linked to poor sanitation. The purpose of this study was to assess the impact of a community-based health education program, called Familia Nawiri, in reducing the risk of diarrhea and respiratory infections among people living in three rural Kenyan communities.MethodsCases were defined as patients attending the health facility due to diarrhea or a respiratory infection while controls were patients attending the same health facility for a non-communicable disease defined as an event other than diarrhea, respiratory infection. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a logistic regression model to assess the risk of diarrheal or respiratory infection in association with exposure to the health education program.ResultsThere were 324 cases and 308 controls recruited for the study with 57% of the cases and 59% of the controls being male. Overall, 13% of cases vs. 20% of control patients were exposed to the education program. Participants exposed to the program had 38% lower odds of diarrhea and respiratory infections compared to those not exposed to the program (adjusted OR 0.62, 95% CI 0.41–0.96). A similar risk reduction was observed for participants in the study who resided in areas with water improvement initiatives (adjusted OR 0.65, 95% CI 0.47–0.90). Variables in the adjusted model included water improvement projects in the area and toilet facilities.ConclusionFindings from this study suggest participants exposed to the education program and those residing in areas with water improvement initiatives have a reduced risk of having diarrhea or respiratory infection.