Informing tobacco control policy in Jordan: assessing the effectiveness of pictorial warning labels on cigarette packs

The Role of Pharmacists and Community Pharmacies in the Screening, Knowledge, and Awareness of Diabetes Mellitus Type 2 in Jordanian People Visiting Community Pharmacies

BACKGROUND

According to the International Diabetes Federation (IDF), diabetes is increasing exponentially worldwide and will become more prevalent than ever in the Middle East by 2045, with a 110% increase. This study aims to clarify the role of pharmacists and community pharmacies in the screening, knowledge, and awareness of Type 2 diabetes among Jordanian people who visit community pharmacies in Amman, Jordan.

METHODS

Study design: This was a cross-sectional prospective study that was conducted from September to December 2021 in Amman, Jordan. Data were collected using a standardized questionnaire that was composed of multiple parts. The first part collected information on demographics, residence, educational level, and insurance status; the second part was composed of 14 knowledge assessing questions; the last part was composed of the American Diabetes Association (ADA) diabetes risk score card test. Additionally, after confirming that each participant had returned their completed sheets, participants who scored greater than 5 had their blood sugar levels checked using a finger-prick blood test. The questionnaire was administered in person by a trained researcher. Using Slovin's formula, a 95% confidence interval (CI), and a 0.05 margin of error, the sample size was determined to be 267 participants. The study included 305 participants. Descriptive and regression analyses were performed by using the Statistical Package for Social Science (SPSS) with a significance level of p < 0.05.

RESULTS

A significant relationship was found between specialty (medical education) and the knowledge of risk factors for Type 2 diabetes mellitus (T2DM), (p < 0.012). In terms of knowledge, from a total of 13 correct knowledge points (13 marks for correct answers out of 14), some subjects scored slightly higher than others (n = 175; 57.4% of participants scored above 7, nearly over half of the correct answers, compared to n = 130; 42.6% scoring below 7). We found 132 individuals (44%) with risk scores of five or above (high risk for developing T2DM according to ADA). Smokers comprised n = 138, 45%, and nonsmokers comprised n = 148, 48%. Although 50.5% of the participants (n = 154) held a bachelor's, master's, or doctorate degree, these degrees did not improve the participants' overall general knowledge levels. The association was tested using chi-squared analysis, but no significance was found.

CONCLUSIONS

Random visitors to Jordanian community pharmacies are expected to benefit from awareness and educational campaigns. These test results revealed a lack of knowledge, indicating the need for education to dispel myths and highlight the serious risks associated with T2DM. The study discovered that participants' understanding of diabetes disease prevention through lifestyle and dietary changes was inadequate. A specialist-led educational program may increase knowledge among visitors who participate. In order to prevent the spread of diabetes, more campaigns and health-promoting and prevention educational activities are required.

Knowledge, attitude, practice and perceived barriers towards smoking cessation services among community pharmacists

Introduction

With more than one billion current smokers, 80% of them living in low and middle-income countries, tobacco smoking is considered a global public health problem. Jordan has one of the highest estimate rates of tobacco use in the region and world. Still, tobacco use interventions, that could significantly reduce the number of smoking-related diseases and reduce health care costs, are scarce. While such interventions could be carried out by community pharmacists, given their unique position to counsel patients and provide effective cessation interventions, the role of community pharmacists in tobacco control services in Jordan has never been fully investigated.

Objective

This study aimed at assessing the community pharmacists' knowledge, attitudes, and practice towards smoking cessation and identifying their perceived barriers for smoking cessation counselling utilizing a sample of community pharmacists in Northern Jordan.

Method

A cross-sectional study was conducted among community pharmacies in Irbid city, North of Jordan, between April and August 2018. A random sample of 95 pharmacies was selected using the multistage random sampling technique. A structured English questionnaire, consisting of 5 parts, was used. The Survey assessed pharmacists' socio-demographics, knowledge, attitude, practice and perceived barriers related to tobacco use cessation services.

Results

One hundred and fifty pharmacists completed the survey. Their mean age was 30.71±10.10 years. The mean of pharmacists' knowledge score was 3.74±0.38, while their positive and negative attitude were 3.87±0.43 and 3.18±0.66 respectively. Pharmacists' mean smoking cessation practice was 2.01+0.64. Barriers to providing cessation interventions included the lack of training on nicotine replacement therapy products (86%), the lack of smoking cessation programs (84%) and low demands from smokers (83.3%).

Conclusion

While knowledge related to tobacco use cessation services among the community pharmacists was sub-optimal, a good positive attitude and a low practice levels were observed. The lack of educational materials, low patients' demand, knowledge deficits, low training and the lack of cessation programs have been identified as barriers hindering the provision of smoking cessation services. Furthermore, the study identified factors that will increase community pharmacists' participation in smoking cessation, help in raising pharmacists' awareness of smoking as a public health problem and the importance of their role.

Strict and Comprehensive Tobacco Control Policy is Needed: A Qualitative Study Exploring How People Responding a New Policy of Pictorial Health Warning on Cigarette Package in Indonesia

BACKGROUND: Little is known about the process on how smoker and nonsmoker responses to a Pictorial Health Warning (PHW) which is important for policy improvement. AIM: We aim to explore the nature of the reaction and the extent of impact of the PHW implementation on smoking habit in Indonesia. METHODS: We collected the data among adult aged 18+ years in Sleman District, Yogyakarta, Indonesia, involving 45 informants in in-depth interviews and 22 informants in four Focus Group Discussions, selected using the maximum variation sampling according to smoking status and area of residence. We discussed with respondents about the meaning of the PHWs, how they felt when seeing the PHWs, how those feelings emerged when seeing the PHWs, and the impact of seeing the PHWs. We analyzed the data using the content analysis. RESULTS: PHWs raised the intended negative emotional response, that wearing out over time. However, for smokers, the disease threat in the message was less obvious than to defeat smoking addiction. Smokers tried to manage their risk of illness themselves. Among non-smokers, they were more confident in being non-smokers. Both smokers and non-smokers thought that Government is half-hearted in controlling the smoking problem. Smokers were grateful, but non-smokers were sorry for this. CONCLUSIONS: The application of PHW threatens smokers but does not make them quit smoking because of the fear of defeating cigarette dependence. For non-smokers, they feel more confident to be a smoker-free. Respondents claim the government is not serious about controlling smoking.

Awareness and Perceptions on Health Warning Labels on Cigarette Packs among Smokers: A Cross-Sectional Study

Backgrounds

Tobacco use is the leading preventable cause of premature deaths. Tobacco control remains a top priority, and health warning labels (HWLs) are one of the recommended methods. This study is aimed at examining the awareness and perceptions of HWLs on cigarette packs among smokers.

Methods

A cross-sectional study was conducted among 240 smokers who were randomly recruited from three townships in Mandalay in 2018. A face-to-face interview was done using a questionnaire. Multivariate logistic regression was used to analyse the data.

Results

About half were 18-40 years old; the majority were males (96.3%) and smokers (93.4%). Nearly all respondents noticed both pictorial warning and text messages, and about half could identify the current size of HWLs. Most of the smokers generally had positive perceptions and opinions on HWLS, and they strongly supported it. About 75% intended to reduce the number of cigarettes, and 18% were willing to quit within 6 months. Those who desired to reduce the number of cigarettes were more likely to quit within 6 months (aOR = 7.6, 95% CI 1.6-35.9 and aOR = 19.6, 95% CI 13.0-294.7 for those who had a little and strong desire, respectively).

Conclusion

Awareness status and perceptions of the respondents were acceptable, and HWLs have motivated smokers to quit smoking. The Tobacco Control Program needs to strengthen the tobacco control law that prohibits selling loosies in order to maximize the benefits of HWLs.

Reasoning Abilities and Potential Correlates Among Jordanian School Children

Objectives To investigate factors related to reasoning skills in 434 school children aged 5-9 years. Methods The Leiter International Performance Scale-Revised was used to assess reasoning skills. Demographic, work and family income data, information on child's daily behavior and school academic achievement were provided by the participating children's parents. Results Reasoning scores increased by 4.56 points with increasing subject's age, 1.71 points with increasing level of father's occupation, 1.86 points with each increase in the subject's GPA, 1.13 points with consumption of breakfast at home and 1.81 points when child slept more hours. Having a father who smoked and living in a rural area decreased scores in reasoning. Conclusions for Practice Screening of reasoning and associated factors is essential for a comprehensive and accurate understanding of the child's abilities and limitations. Understanding the child's reasoning abilities is critical for establishing intervention goals and planning therapeutic activities.

Knowledge, Attitudes, and Practices of Women Toward Prenatal Genetic Testing

Objectives:

We aim to address public knowledge, attitudes, and practices relative to prenatal genetic testing as a starting point for policy development in Jordan.

Study design:

We conducted a cross-sectional prenatal genetic testing knowledge, attitudes, and practices survey with 1111 women recruited at obstetrics and gynecology clinics nationwide. Data were analyzed using a variety of descriptive and inferential statistical tests.

Results:

The overwhelming majority (>94%) of participants considered prenatal genetic testing, particularly non-invasive prenatal genetic screening, procedures to be good, comfortable, and reasonable, even when the non-diagnostic nature of non-invasive prenatal genetic screening was explained. Likewise, 95% encouraged the implementation of non-invasive prenatal genetic screening within the Jordanian health system, but most preferred it to remain optional. However, women in higher-risk age brackets, in consanguineous marriages, and with less education were significantly less interested in learning about non-invasive prenatal genetic screening. Only 60% of women interviewed were satisfied with the services provided by their obstetric/gynecologist. The more satisfied the women were, the more they are likely to adapt non-invasive prenatal genetic screening.

Conclusions:

In sum, although the data support the receptivity of Jordanian women to national implementation of non-invasive prenatal genetic screening, such policies should be accompanied by health education to increase the genetic literacy of the population and to engage high-risk populations. Thus, this offers rare insight into the readiness of 1 particular Arab population to adapt non-invasive prenatal genetic screening technologies.

Memory and potential correlates among children in Jordan

BACKGROUND

Cognitive functioning hugely affects the performance of tasks of different complexity. Memory, one of the most important cognitive skills, allows children to practice and acquire necessary skills and knowledge and interact with the surrounding environment. Therefore, it is crucial to study the factors that influence the memory of children. The main purpose of his study was to investigate different variables related to memory in school aged children (5-9 years, N = 434).

METHODS

Parents of the participants provided information about child's daily behavior, child's school academic achievement, work and family income data and demographics. Memory skills in children were assessed by using the Leiter International Performance Scale -Revised.

RESULTS

The score of memory increased 2.53 points with upsurge in maternal occupation level, 3.08 points when the child ate breakfast and 4.51 points when the child daily slept nine hours and more. By contrast, increased family income and smoking by father resulted in decreased scores in memory.

CONCLUSION

Screening for and understanding of memory and relevant factors are vital for broad understanding of children's capabilities and weaknesses as well as for developing appropriate interventions.