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Abdullah SR, Azizul NH, Wan Mohd Zin RM, Sulaiman NS, Mustafa Khalid N, Mohd Salim Mullahi Jahn RJ, Khalil MKN, Abu Seman N, Zainal Abidin NA, Ali A, Tan YZ, Omar A, Johari MZ, Abdul Aziz NS, Baharudin A, Seman Z, Ibrahim Wong N, Md Rasip ML, Yusof HM, Md Noh MF. Cardiometabolic and Anthropometric Outcomes of Intermittent Fasting among Overweight and Obese Civil Servants in Malaysia (CAIFA): Study Protocol for A Non-Randomized Controlled Trial (Preprint). JMIR Res Protoc 2021; 11:e33801. [PMID: 35930331 PMCID: PMC9496805 DOI: 10.2196/33801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/14/2022] [Accepted: 05/11/2022] [Indexed: 11/21/2022] Open
Abstract
Background Overweight and obesity among adults are a growing global public health threat and an essential risk factor for various noncommunicable diseases. Although intermittent fasting is a generally new dietary approach to weight management that has been increasingly practiced worldwide, the effectiveness of 2 days per week dry fasting remains unclear. Objective The Cardiometabolic and Anthropometric Outcomes of Intermittent Fasting study aims to determine the cardiometabolic, anthropometric, dietary intake, and quality of life changes among civil servants with overweight and obesity, following combined intermittent fasting and healthy plate (IFHP) and healthy plate (HP) and explore the participants’ experiences. Methods We designed a mixed methods quasi-experimental study to evaluate the effectiveness of the IFHP and HP methods among adults with overweight and obesity. A total of 177 participants were recruited for this study, of which 91 (51.4%) were allocated to the IFHP group and 86 (48.6%) to the HP group. The intervention comprised 2 phases: supervised (12 weeks) and unsupervised (12 weeks). Data collection was conducted at baseline, after the supervised phase (week 12), and after the unsupervised phase (week 24). Serum and whole blood samples were collected from each participant for analysis. Data on sociodemographic factors, quality of life, physical activity, and dietary intake were also obtained using questionnaires during data collection. Results Most of the participants were female (147/177, 83.1%) and Malay (141/177, 79.7%). The expected outcomes of this study are changes in body weight, body composition, quality of life, physical activity, dietary intake, and cardiometabolic parameters such as fasting blood glucose, 2-hour postprandial blood glucose, hemoglobin A1c, fasting insulin, and lipid profile. Conclusions The Cardiometabolic and Anthropometric Outcomes of Intermittent Fasting study is a mixed methods study to evaluate the effectiveness of combined IFHP and HP interventions on cardiometabolic and anthropometric parameters and explore participants’ experiences throughout the study. Trial Registration ClinicalTrials.gov NCT05034653; https://clinicaltrials.gov/ct2/show/NCT05034653 International Registered Report Identifier (IRRID) RR1-10.2196/33801
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Affiliation(s)
- Shazana Rifham Abdullah
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Nur Hayati Azizul
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Ruziana Mona Wan Mohd Zin
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Nur Suffia Sulaiman
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Norhayati Mustafa Khalid
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Roshan Jahn Mohd Salim Mullahi Jahn
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Muhamad Khairul Nazrin Khalil
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Norhashimah Abu Seman
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Nur Azlin Zainal Abidin
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Azizan Ali
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - You Zhuan Tan
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Azahadi Omar
- Sector for Biostatistic and Data Repository, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Mohammad Zabri Johari
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Nur Shahida Abdul Aziz
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Azli Baharudin
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Zamtira Seman
- Sector for Biostatistic and Data Repository, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Norazizah Ibrahim Wong
- Sector for Biostatistic and Data Repository, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Mona Lisa Md Rasip
- Occupational Safety and Health Unit, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Hayati Mohd Yusof
- Faculty of Fisheries and Food Science, Universiti Malaysia Terengganu, Terengganu, Malaysia
| | - Mohd Fairulnizal Md Noh
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
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Perialathan K, Johari MZ, Jaafar N, Yuke Lin K, Lee Lan L, Sodri NA, Mohd Yunus SNN. Enhanced Primary Health Care Intervention: Perceived Sustainability and Challenges Among Implementers. J Prim Care Community Health 2021; 12:21501327211014096. [PMID: 33966530 PMCID: PMC8114286 DOI: 10.1177/21501327211014096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: This study aimed to assess and explore perceived sustainability and challenges of the intervention among Health Care Providers (HCPs) who were involved. Methods: The study applied mixed-method embedded design to analyze both quantitative and qualitative data. Quantitative approach was used to evaluate sustainability perception from 20 intervention clinics via self-reported assessment form whereas qualitative data were obtained through in-depth interview (IDI) and focus group discussions (FGDs) 14 health care professionals participated in IDI session and were either care coordinators, liaison officers (LOs)/clinic managers, or medical officers-in-charge for the clinic’s intervention. Nine FGDs conducted comprised 58 HCPs from various categories. Results: HCPs from all the 20 clinics involved responded to each listed Enhanced Primary Healthcare (EnPHC) intervention components as being implemented but the perceived sustainability of these implementation varies between them. Quantitative feedback showed sustainable interventions included risk stratification, non-communicable disease (NCD) screening form, referral within clinics and hospitals, family health team (FHT), MTAC services and mechanisms and medical adherence status. Qualitative feedback highlighted implementation of each intervention components comes with its challenges, and most of it are related to inadequate resources and facilities in clinic. HCPs made initiatives to adapt based on clinical setting to implement the interventions at best level possible, whereby this seems to be one of the core values for sustainability. Conclusion: Overall perceptions among HCPs on sustainability of EnPHC interventions are highly influenced by current experiences with existing resources. Components perceived to have inadequate resources are seen as a challenge to sustain. It’s crucial for stakeholders to understand implications affecting implementation process if concerns raised are not addressed and allocation of needed resources to ensure overall successfulness and long term sustainability.
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Affiliation(s)
| | | | | | - Kong Yuke Lin
- Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Low Lee Lan
- Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
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Jaafar N, Perialathan K, Zulkepli MZ, Mohd Zin Z, Jonoi PE, Johari MZ. Patients' Perception Towards Health Education Services Received at the Enhanced Primary Healthcare Facilities: A Qualitative Exploration. J Prim Care Community Health 2021; 11:2150132720980629. [PMID: 33300405 PMCID: PMC7734550 DOI: 10.1177/2150132720980629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The present Malaysian healthcare system is burdened with increasing cases of non-communicable diseases (NCDs) and its risk factors. Health care providers (HCPs) have to provide both treatment and health education to ensure optimal outcome. Health education is a vital component in addressing and managing chronic diseases. This study intends to explore patient's perspective on health education services received from HCPs, focusing at the secondary triage in government primary healthcare facilities. METHODS This qualitative exploratory study focused on the health education component derived from a complex enhanced primary health care intervention. Participants were purposively selected from patients who attended regular NCD treatment at 8 primary healthcare facilities in rural and urban areas of Johor and Selangor. Data collection was conducted between April 2017 and April 2018. Individual semi-structured interviews were conducted on 4 to 5 patients at each intervention clinic. Interviews were transcribed verbatim, coded and analyzed using a thematic analysis approach. RESULTS A total of 35 patients participated. Through thematic analysis, 2 main themes emerged; Perceived Suitability and Preferred HCPs. Under Perceived Suitability theme, increased waiting time and unsuitable location emerged as sub-themes. Under Preferred HCPs, emerging sub-themes were professional credibility, continuity of care, message fatigue, and interpersonal relationship. There are both positive and adverse acceptances toward health education delivered by HCPs. It should be noted that acceptance level for health information received from doctors are much more positively accepted compared to other HCPs. CONCLUSION Patients are willing to engage with health educators when their needs are addressed. Revision of current location, process and policy of health education delivery is needed to capture patients' attention and increase awareness of healthy living with NCDs. HCPs should continuously enhance knowledge and skills, which are essential to improve development and progressively becoming the expert educator in their respective specialized field.
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Affiliation(s)
- Norrafizah Jaafar
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Komathi Perialathan
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Mohamad Zaidan Zulkepli
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Zaikiah Mohd Zin
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Patricia Elisha Jonoi
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Mohammad Zabri Johari
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
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Yong TSM, Panting AJ, Juatan N, Perialathan K, Ahmad M, Ahmad Sanusi NH, Hassan L, Jahis R, Shamsudin N, Yap SL, Norshamsul NI, Pisol M, Johari MZ. Development and validation of a cognitive, affective and behaviour questionnaire on pet-associated zoonotic diseases (CAB-ZDQ). Vet Med Sci 2021; 7:1558-1563. [PMID: 34137200 PMCID: PMC8464282 DOI: 10.1002/vms3.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Zoonoses among household pets are recognized as disease and infections transmitted between animals and humans. World Health Organization‐estimated zoonotic diseases have contributed about one billion cases of illness and millions of mortalities every year. Despite the emerging and re‐emerging zoonotic disease, most pet owners are unaware of the risks posed by their pets. As there are a lack of studies assessing infections at home, this study aimed to develop and validate a cognitive, affective and behaviour questionnaire (CAB‐ZDQ) to assess household pets’ zoonotic diseases. Methods This paper covers detailed explanation on the various developmental and validation process stages of the CAB zoonotic disease questionnaire development. The development phase comprised thorough literature search, focus group discussion, expert panel assessment and review. The validation process included pre‐test and pilot testing, data analysis of results, analysis of internal consistency and the development of the final version of the questionnaire. Participants selected represented main ethnicities, gender, levels of education and population type (urban/rural) in the Klang Valley area. Results The items in the questionnaire has undergone various changes in structurally and linguistically. The final refined CAB questionnaire consists of 14 items cognitive (no items removed at pilot phase), nine items affective (one item removed at pilot phase) and five items behaviour (no items removed from pre‐test phase), respectively. Reliability analysis revealed Cronbach's alpha values were 0.700 (cognitive) and 0.606 (affective) which indicated good internal consistency after item reduction. Conclusions The developed questionnaire has proved its feasibility in assessing the Malaysian general population cognitive, affective and behavior regarding the household pets’ zoonotic diseases. This article detailed the process of development and validation of a questionnaire used to assess Cognitive, Affective and Behaviour for humans in relation to zoonotic diseases for pets at home.
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Affiliation(s)
- Teresa Sui Mien Yong
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Albeny Joslyn Panting
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Nurashma Juatan
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Komathi Perialathan
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Masitah Ahmad
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Nor Haryati Ahmad Sanusi
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Latiffah Hassan
- Faculty of Veterinary, Universiti Putra Malaysia, Selangor, Malaysia
| | - Rohani Jahis
- Zoonosis Control Sector, Disease Control Division, Ministry of Health Malaysia, Selangor, Malaysia
| | - Norita Shamsudin
- Zoonosis Control Sector, Disease Control Division, Ministry of Health Malaysia, Selangor, Malaysia
| | - Siew Lee Yap
- Zoonosis Control Sector, Disease Control Division, Ministry of Health Malaysia, Selangor, Malaysia
| | - Nur Izzati Norshamsul
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Maryam Pisol
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Mohammad Zabri Johari
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
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Yong TSM, Perialathan K, Ahmad M, Juatan N, Abdul Majid L, Johari MZ. Perceptions and Acceptability of a Smartphone App Intervention (ChildSafe) in Malaysia: Qualitative Exploratory Study. JMIR Pediatr Parent 2021; 4:e24156. [PMID: 34061039 PMCID: PMC8207251 DOI: 10.2196/24156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/14/2020] [Accepted: 03/11/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Home is a vulnerable place for accidental child injuries. Unintentional injuries are a leading cause of death, hospitalization, and disabilities. These injuries are considered preventable and if not tackled, they will continue to be a persisting problem. Smartphones have become increasingly important in our everyday life and is an important tool not only for communication but also for other purposes-they have apps that can be used for various purposes. Therefore, an app-based intervention (ChildSafe) was developed to assess and reduce child injury at home. OBJECTIVE This study aimed to evaluate the acceptance of the ChildSafe smartphone app intervention by parents/guardians. METHODS This study was conducted using a qualitative exploratory approach on selected participants of the ChildSafe intervention app study. A total of 27 semistructured in-depth interviews were carried out among parents or guardians who have at least one child between the age of 0 and 59 months in the area of Sungai Buloh, Selangor, between November 2017 and March 2018. Interview questions were developed from the consolidated framework for implementation research (CFIR). Interviews were recorded, transcribed verbatim, and data were thematically analyzed guided by CFIR. RESULTS The study revealed users' perception on usability, feasibility, and acceptability toward the ChildSafe app. Three CFIR domains were identified: intervention characteristics, inner setting, and characteristics of individuals. A total of 5 constructs were revealed under intervention characteristics: evidence strength and quality, relative advantage, adaptability, trialability, and design quality and packaging; 2 under inner setting: implementation climate and readiness for implementation; and 4 under characteristics of individuals: knowledge and beliefs about the intervention, self-efficacy, individual stage of change, and other personal attributes. In general, participants felt the app is extremely useful and effective, easy to use, and purposeful in achieving home safety assessment via reminders. The app replaces the need for participants to search for information on home safety and dangers, as the app itself was designed as a tool to assess for this specific purpose. Even at the nascent stage and despite its limitations, the app has prompted users to consider and make changes around their own home. However, future versions of the app should be expanded to make it more attractive to users as it lacks interactive feedback and additional features. CONCLUSIONS Parents/guardians are accepting the use of the ChildSafe app to prevent child injury at home. However, further expansion and improvements are needed to increase the acceptability of this app by parents/guardians.
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Affiliation(s)
- Teresa Sui Mien Yong
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Komathi Perialathan
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Masitah Ahmad
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Nurashma Juatan
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Liana Abdul Majid
- Institute of Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Mohammad Zabri Johari
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
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Abdullah Z, Lan LL, Rahim IA, Azam S, Johari MZ, Nasir NH. Exploring Communication Processes in Referral Pathways for Chronic Disease Management: Malaysian Public Primary Health care Experiences. Glob J Health Sci 2020. [DOI: 10.5539/gjhs.v12n13p115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND: Referrals are a two-way communication between healthcare facilities to enable information transfer for the continuity of patient care. The Enhanced Primary Healthcare (EnPHC) initiative, a complex intervention package to improve non-communicable disease (NCD) management, introduced improvements to the NCD’s referral mechanism from primary healthcare clinics to the hospital. This study explores the communication process between the Malaysian public primary healthcare and hospital for chronic care management.
METHOD: A qualitative exploratory study using purposive sampling was done in all twenty EnPHC intervention clinics. In-depth interviews and focus group discussions were carried out among all healthcare providers working in EnPHC clinics. The 47 interview sessions were audio-recorded, transcribed verbatim, and analyzed thematically.
RESULTS: A total of 97 healthcare providers participated. Three main themes of the communication process between the primary health care and hospital during the implementation of EnPHC intervention emerged from the analysis. These are; (1) structured information relay, (2) no show appointment tracking via various communication devices has strengthened the mechanism to monitor the referred patient appointment scheduling and their adherence to the appointment, and (3) inter-facility networking facilitated the implementation of EnPHC’s referral mechanism.
CONCLUSION: The EnPHC referral mechanism created a platform for PHC clinics and hospitals to communicate and build rapport to help ensure care continuity for NCD patients. The traditional method of communication between healthcare facilities should change and instead start using the newest or most current, advanced technology.
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Abdullah Z, Abdul Aziz SH, Sodri NA, Mohd Hanafiah AN, Ibrahim NI, Johari MZ. Issues and Challenges in Implementing Care Coordinator in Primary Healthcare in Malaysia: A Qualitative Study. J Prim Care Community Health 2020; 11:2150132720956478. [PMID: 33089737 PMCID: PMC7585891 DOI: 10.1177/2150132720956478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Primary healthcare is the earliest gateway for patient care, and improvisations are often needed to accommodate the ever-increasing demand in public health. The Enhanced Primary Healthcare (EnPHC) initiative is aimed at improving such needs, and one core intervention is the introduction of a care coordinator (CC). The purpose of this study was to identify barriers and facilitators in implementing a new intervention in primary healthcare clinics. METHODS This qualitative exploration study. All healthcare providers who were involved in EnPHC at the intervention clinics were selected as participants. In-depth interviews and focus group discussions were carried out among healthcare providers working in the intervention clinic. Thematic analysis was used to categorize data, based on the consolidated framework for implementation research (CFIR) theoretical framework domains. RESULTS A total of 61 healthcare providers participated. All 5 domains with 19 CFIR constructs emerged from the analysis. Inner setting played a significant role in facilitating CC intervention, in which culture, networking, and collaboration and leadership engagement played an essential role in supporting CC activities. Although CC tasks are complex, concerns of losing clinical skill and resource constraints were identified as potential barriers in CC implementations. Criteria for appointing new CCs emerged from the characteristics of individual constructs, in which the individual must be familiar and interested in community health, have good communication skills, and at least 3 years' experience in the primary healthcare setting. CONCLUSION The implementation of the CC intervention faces varying challenges in different settings. This is partially resolved through teamwork, guidance from mentors, and support from superiors. The complexity of the responsibility of the CC intervention is perceived as both a validation and a burden. Above all, it is seen as paramount in EnPHC intervention.
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Affiliation(s)
- Zalilah Abdullah
- Institute for Health System's Research, National Institute of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Siti Hajar Abdul Aziz
- Institute for Health System's Research, National Institute of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Nur Aliyah Sodri
- Institute for Health System's Research, National Institute of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Ainul Nadziha Mohd Hanafiah
- Institute for Health System's Research, National Institute of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Nor Idawaty Ibrahim
- Family Health Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Mohammad Zabri Johari
- Institute for Health Behavioural Research, National Institute of Health, Ministry of Health Malaysia, Selangor, Malaysia
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Johari MZ, Wee LH, Nudin SSH, Ujang E, Roslan NM, Omar B, Chinna K. High Risk Health Behavior among Malaysian Adolescents: A Comparison between Gender. Glob J Health Sci 2020. [DOI: 10.5539/gjhs.v12n11p152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE: The main objective was to study health risk behaviours, knowledge and perception amongst Malaysian adolescents aged between 13-17 years of age.
METHODS: Modified version of Youth Behaviour Risk Factor Surveillance System (YBRFSS) was used in this nationwide cross-sectional study involving 5,000 students enrolled from 50 selected schools, by adopting multi-stage sampling with randomization of schools and classes from all states in Malaysia. Descriptive data for behaviours, knowledge and perception were also compared between genders.
RESULTS: Overall, 72.6% and 21.1% adolescents were found to not perform adequate exercise or did not perform any exercise, respectively. Majority of them also (81.8%) spent time watching TV beyond one hour per day. Although overall compliance to meal timings showed better result for girls (89.2%) than boys (84.8%); non-compliance to breakfast timing was the most frequent (74.7%) compared to other meal timings. Signs of continuous sadness ranked highest (21.3%), followed by signs of depression (9.4%) and suicidal ideation (7.8%). Girls suffered worse than boys for signs of continuous sadness (25.4% vs. 16.2%) and suicidal ideation (10.4% vs. 4.5%). In terms of perception, only 50.1% responded favourably to managing their anger. Boys were more satisfied with their own body weight and body shapes compared with the girls (43.3% vs. 34.7%; 45.3% vs. 37.9%, respectively).
CONCLUSION: Although adolescents in Malaysia had good overall knowledge and perception on the healthy habits, they still practiced risky behaviours which may lead to early morbidity and mortality among adolescence.
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Johari MZ, Abdullah Z, Mohd Hanafiah AN, Mohammed Nadzri NI, Razli SA, Kong YL. Can patients make heads or tails of enhanced primary health care (EnPHC)? Experience through their own journey. BMC Fam Pract 2020; 21:182. [PMID: 32887562 PMCID: PMC7487683 DOI: 10.1186/s12875-020-01254-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 08/27/2020] [Indexed: 12/14/2022]
Abstract
Background Implementation of the new Enhanced Primary Health Care (EnPHC) intervention aims to improve service quality and experience at primary healthcare clinics; especially to newly diagnosed patients. This was achieved by restructuring and improving existing services to better manage non-communicable diseases amongst patients. Objectives of this study are to explore patients’ experiences of the EnPHC intervention, to document their feedback and to determine effects of EnPHC intervention on patients. Methods This phenomenological qualitative study focussed on patients’ experiences in relation to EnPHC interventions. Participants were purposely selected from a group of patients who attended the eight intervention primary healthcare clinics in Johor and Selangor regularly for treatment. Data collection was conducted between April to July 2018. Semi-structured interviews were conducted at average an hour per interview for four to five patients per clinic. Interviews were audio recorded, transcribed verbatim, coded and analysed using a thematic analysis approach. Results A total of 35 patients participated. Analysis revealed five main themes about patient experiences receiving the EnPHC intervention. These are: (1) health assessment in disease progress monitoring, (2) patient-doctor relationship and continuity of care, (3) professionalism in service delivery, (4) ensuring compliance in achieving health targets and (5) communication skills. Each theme represents an important aspect of the service, how it should be delivered within the patient expectations and how it can improve patient’s health through their lens. Conclusion Even though patients were not able to exactly identify the EnPHC intervention components implemented, they are able to describe the process changes that occurred; enabling them to improve their healthcare status. Engagement is necessary to better inform patients of the EnPHC intervention, its purpose, mechanisms, changes and importance for healthcare. It would reduce resistance and increase awareness amongst patients at the clinic.
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Affiliation(s)
- Mohammad Zabri Johari
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, No: 1, Block B3, Jalan Setia Murni U13/52, 40170, Shah Alam, Selangor, Malaysia.
| | - Zalilah Abdullah
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, No: 1, Block B2, Jalan Setia Murni U13/52, 40170, Shah Alam, Selangor, Malaysia
| | - Ainul Nadziha Mohd Hanafiah
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, No: 1, Block B2, Jalan Setia Murni U13/52, 40170, Shah Alam, Selangor, Malaysia
| | - Nur Izzati Mohammed Nadzri
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, No: 1, Block B2, Jalan Setia Murni U13/52, 40170, Shah Alam, Selangor, Malaysia
| | - Siti Aisyah Razli
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, No: 1, Block B2, Jalan Setia Murni U13/52, 40170, Shah Alam, Selangor, Malaysia
| | - Yuke Lin Kong
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, No: 1, Block B2, Jalan Setia Murni U13/52, 40170, Shah Alam, Selangor, Malaysia
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Mohd Hanafiah AN, Johari MZ, Azam S. A qualitative study on the implementation of family health team: the perspectives of providers and patients. BMC Fam Pract 2020; 21:162. [PMID: 32772931 PMCID: PMC7416414 DOI: 10.1186/s12875-020-01217-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/10/2020] [Indexed: 11/16/2022]
Abstract
Background Malaysia has committed to the global call to achieve universal health coverage, and with the adoption of Sustainable Development Goals, is further strengthening the health system through the primary health care services, particularly the family doctor concept. The Enhanced Primary Health Care (EnPHC) initiative was implemented to address the worrying upward trend of non-communicable disease prevalence, and incorporates the Family Health Team (FHT) concept. The aim of this paper is to describe the implementation of the FHT as part of the EnPHC intervention. Methods In-depth interviews and focus group discussions were conducted with the intervention design team, healthcare providers and patients in two rounds during the implementation period. A total of 121 individuals in the two rounds, split into different groups, where some of the participants of the FGD were also interviewed individually. Data were analysed using a thematic analysis, with codes being organised into larger themes. Results Themes that emerged from the data were around the process of FHT implementation and the advantages of the FHT, which included continuity of health care and improved quality of care. Patients and health care providers were receptive to the FHT concept, and took the effort to adapt the concept in the local settings. Conclusions The FHT concept implemented at 20 public primary health clinics has benefits appreciated by health care providers and patients. Addressing the viable shortcomings would better prepare the current primary healthcare system to scale up the FHT concept nationwide and enhance its feasibility and sustainability. Trial registration The study is registered with the National Medical Research Register, Ministry of Health Malaysia (NMRR-17-295-34711).
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Affiliation(s)
- Ainul Nadziha Mohd Hanafiah
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.
| | - Mohammad Zabri Johari
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Syafinas Azam
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
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Low LL, Ab Rahim FI, Johari MZ, Abdullah Z, Abdul Aziz SH, Suhaimi NA, Jaafar N, Mohd Hanafiah AN, Kong YL, Mahmud SH, Zulkepli MZ, Perialathan K, Muharam N, Zainudin NH, Mohd Zin Z, Mohd Roslan N, Aris T, Murad S. Assessing receptiveness to change among primary healthcare providers by adopting the consolidated framework for implementation research (CFIR). BMC Health Serv Res 2019; 19:497. [PMID: 31311538 PMCID: PMC6636000 DOI: 10.1186/s12913-019-4312-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 07/01/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Amid the current burden of non-communicable (NCD) diseases in Malaysia, there is a growing demand for more efficient service delivery of primary healthcare. A complex intervention is proposed to improve NCD management in Malaysia. This exploratory study aimed to assess primary healthcare providers' receptiveness towards change prior to implementation of the proposed complex intervention. METHOD This study was conducted using an exploratory qualitative approach on purposely selected healthcare providers at primary healthcare clinics. Twenty focus group discussions and three in-depth interviews were conducted using a semi-structured interview guide. Consent was obtained prior to interviews and for audio-recordings. Interviews were transcribed verbatim and thematically analysed, guided by the Consolidated Framework for Implementation Research (CFIR), a framework comprised of five major domains promoting implementation theory development and verification across multiple contexts. RESULTS The study revealed via CFIR that most primary healthcare providers were receptive towards any proposed changes or intervention for the betterment of NCD care management. However, many challenges were outlined across four CFIR domains-intervention characteristics, outer setting, inner setting, and individual characteristics-that included perceived barriers to implementation. Perception of issues that triggered proposed changes reflected the current situation, including existing facilitating aspects that can support the implementation of any future intervention. The importance of strengthening the primary healthcare delivery system was also expressed. CONCLUSION Understanding existing situations faced at the primary healthcare setting is imperative prior to implementation of any intervention. Healthcare providers' receptiveness to change was explored, and using CFIR framework, challenges or perceived barriers among healthcare providers were identified. CFIR was able to outline the clinics' setting, individual behaviour and external agency factors that have direct impact to the organisation. These are important indicators in ensuring feasibility, effectiveness and sustainability of any intervention, as well as future scalability considerations.
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Affiliation(s)
- Lee Lan Low
- Institute for Health Systems Research, National Institute of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Fathullah Iqbal Ab Rahim
- Institute for Health Systems Research, National Institute of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Mohammad Zabri Johari
- Institute for Behavioural Research, National Institute of Health, Ministry of Health Malaysia, Block B3, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Zalilah Abdullah
- Institute for Health Systems Research, National Institute of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Siti Hajar Abdul Aziz
- Institute for Health Systems Research, National Institute of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Nur Ajeerah Suhaimi
- Institute for Health Systems Research, National Institute of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Norrafizah Jaafar
- Institute for Behavioural Research, National Institute of Health, Ministry of Health Malaysia, Block B3, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Ainul Nadziha Mohd Hanafiah
- Institute for Health Systems Research, National Institute of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Yuke Lin Kong
- Institute for Health Systems Research, National Institute of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Siti Haniza Mahmud
- Institute for Health Systems Research, National Institute of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Mohamad Zaidan Zulkepli
- Institute for Behavioural Research, National Institute of Health, Ministry of Health Malaysia, Block B3, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Komathi Perialathan
- Institute for Behavioural Research, National Institute of Health, Ministry of Health Malaysia, Block B3, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Norazlin Muharam
- Department of Statistics, Block C6, Complex C, Federal Government Administrative CentrE, 62514 Putrajaya, Malaysia
| | - Nur Hani Zainudin
- Institute for Health Systems Research, National Institute of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Zaikiah Mohd Zin
- Institute for Behavioural Research, National Institute of Health, Ministry of Health Malaysia, Block B3, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Norazilah Mohd Roslan
- Family Health Development Division, Putrajaya, Ministry of Health Malaysia, Block E1, E3, E7 & E10, Complex E, Federal Government Administrative Centre, 62590 Putrajaya, Malaysia
| | - Tahir Aris
- Institute for Public Health, National Institute of Health, Ministry of Health Malaysia, Block B5, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor Malaysia
| | - Shahnaz Murad
- Office of Deputy Director General of Health (Research and Technical Support), Ministry of Health Malaysia, Block E1, E3, E7 & E10, Complex E, Federal Government Administrative Centre, 62590 Putrajaya, Malaysia
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Farhana Harun SN, Sahani M, Johari MZ. Factors Affecting the Decision Making of HPV Vaccination Uptake Among Female Youth in Klang Valley (Influencing Factors): A Qualitative Study. Glob J Health Sci 2018. [DOI: 10.5539/gjhs.v11n1p36] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION: Cervical cancer is estimated to affect 500 000 women each year globally, whereby 80% of the cases are in developing nations. Almost all cervical cancer cases were attributed to Human Papilloma Virus (HPV) infection.
AIM: To identify factors influencing the decision-making of HPV vaccination uptake as prevention for cervical cancer among female youth in the Klang Valley
METHODS: This study used in-depth interview; purposive sampling and snowball sampling method. The questionnaire was based on the Health Belief Model, which consist of perceived susceptibility, severity, benefit, barrier and cues to action. NVivo 7 software was used to process, transcribe and analyse the data from interview sessions.
RESULT: This study found that the key driving factors that encouraged female youth to get vaccinated were due to the role of family members and friends, concerns on contracting HPV related illness, free/discounted priced vaccination, recommendation from health care personnel, government’s policy, and benefit (believe in the effectiveness of vaccination). Meanwhile, deterring factors which prevented the uptake of HPV vaccination were lack of knowledge and awareness, costs, healthcare provider and services, time constraint and perceived not at risk.
CONCLUSION: Factors leading to the uptake of the HPV vaccine should be seen in a transparent manner to ensure the success of the HPV vaccination program in this country.
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Ng LO, Wee LH, Lee JK, Johari MZ, Hassan Nudin SS, Omar B. Developing a Malaysian Psychotic Symptom Screening Inventory: an exploratory study. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/17542863.2013.835329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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