Browsing by Person "Allotey, Pascale"

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34 Gender Difference in the Association between Handgrip Strength and Cognitive Performance of Older Adults in Rural Malaysia
(Oxford University Press, 2019-12-20) Moffat, Emily; Stephan, Blossom CM; Allotey, Pascale; Reidpath, Daniel
Introduction Handgrip strength is an easy and safe measurement to evaluate the physical functioning of older adults. Lower hand grip strength is associated with cognitive decline, and can be used as an effective method for early detection of cognitive impairment. Objective This study aimed to evaluate the gender differences in association between hand grip strength and cognitive performance among older adults in rural Malaysia Methods This was a cross-sectional study done among 200 community dwelling older adults (100 men and 100 women) aged ≥ 50 years. The study was embedded in the ongoing longitudinal study of South East Asia Community Observatory (SEACO) in Segamat district of Johor, Malaysia. Data was collected by trained data collectors during home visits. Cognitive performance was assessed using Mini Mental State Examination (MMSE). Hand grip strength was measured using digital grip dynamometer. Results The mean age of study participants was 61.5 years (SD= 8.4). Women had lower mean hand grip strength (19.8, SD=5.6) compared to men (33.4, SD= 8.2). The mean MMSE score for women and men were 23 (SD= 4.5) and 25.1(SD=3) respectively. Cognitive impairment was detected in 26% of men and 21% of women. Hand grip strength showed positive association with MMSE score, among women (ß coefficient= 0.302, p<0.001), but not among men (p= 0.077). Hand grip strength was significantly association with MMSE score among women (ß coefficient=0.162, 95% CI = 0.026- 0.298; p=0.02) after controlling for age, level of education and body mass index. Conclusion The study shows that lower hand grip strength is associated with poor cognitive performance among women, while hand grip strength is not associated with cognitive performance among men.
Adaptive invention: independence and mobility through modifications
(Taylor and Francis Group, 2017-08-24) Mairami, Fatima Fanna; Allotey, Pascale; Warren, Narelle; Mak, Jun Shin; Reidpath, Daniel
Background: Stroke is a leading cause of disability that limits everyday activities and reduces social participation. Provision of assistive devices helps to achieve independence and social inclusion. However, due to limited resources or a lack of suited objects for their needs, individuals with disabilities in low and middle income countries (LMIC) often do not have access to assistive devices. This has resulted in the creation of purpose built innovative solutions. Methodology and case content: This paper uses a single case derived from a larger ethnographic study of stroke survivors in rural Malaysia to demonstrate the role of assistive devices in shaping stroke recovery and how existing structures can be modified. Second, the concept of affordances in relation to structures within the environment, issues of affordability and accessibility of assistive devices for individuals in LMIC are discussed. Findings and conclusions: Stroke recovery involves adapting to new limitations and discovering the support necessary to live life. These changes are influenced by a range of environmental factors. Healthcare professionals need to support stroke patients in identifying challenges and work to find innovative ways to address them. Stroke survivors may benefit from the use of an assistive device beyond its clinical function to participate purposefully in activities of daily living. Implications for Rehabilitation Stroke is a cause of disability that limits everyday activities and reduces social participation. Assistive devices help achieve independence, social inclusion and shape stroke recovery. Individuals with disabilities in low and middle income countries often do not have access to assistive devices and resort to innovative solutions that are purpose built. Stroke recovery involves adapting to new limitations and discovering the support necessary to live life as best as possible.
Addressing cultural diversity in Australian health services
(2002-08-01) Allotey, Pascale; Reidpath, Daniel; Manderson, L
Issue addressed: Recent changes in the model of health service delivery in Australia have resulted in the attrition of ethnic specific health services and the expectation that patients from culturally and linguistically diverse backgrounds will present to mainstream health services for all health problems. Providers are often ill equipped to provide appropriate care and have expressed concerns with addressing the needs of people from increasingly diverse communities. Meanwhile, community groups and anthropologists have expressed their frustration with the stereotypic and essentialising tone of many of the guides and fact-files developed for use in clinical settings. Methods: Applied anthropological approaches were used to negotiate the style and content of a set of resource materials for health providers in community health and hospital settings. Results: Extensive consultation ensured that the resources met providers' needs and were acceptable to communities. Conclusion: The result provides a guide to best practice of clinical care, regardless of cultural or linguistic background. So what: Health services would be assisted by materials on ethnic cultural factors that avoided stereotyping and emphasised asking questions.
Alcohol Consumption Patterns and Associated Risk Behaviors in Three Ethnic Groups of Malaysian Millennials
(Openventio Publishers, 2020-04-24) Singh, Sangeeta K.; Yap, Kwong H.; Natarajan, Peter; Allotey, Pascale; Reidpath, Daniel
Objectives To gain further insights into factors associated with harmful alcohol consumption patterns and other associated behaviours among Malaysians millennials. Methods The United States Centre for Disease, Control, and Prevention (CDC) Youth Risk Behaviour Survey was adapted and translated into Bahasa Malaysia language. The self-administered questionnaire collected information on socio-demographic characteristics and risk behaviours associated with alcohol consumption. Multi-facet sampling was used to recruit participants across six sites in the Klang Valley, Malaysia. There were 326 respondents: 103 Malays, 111 Chinese and 112 Indians; with 171 (52%) male and 155 (48%) female. Results Mean age of the respondents was 21-years. Twenty percent of the millennials surveyed were binge consumers: 79% of binge drinkers were male. More than half (54%) of the binge drinkers were Indians followed by Chinese at 39% and Malays at 8%. Binge consumers were at increased odds (OR=7.58: 95% CI=3.88-14.80) of driving a vehicle under the influence of alcohol and at increased odds (OR=6.88: 95% CI=3.40-13.90) of being driven by someone drunk. Those who were binge drinkers were also at higher odds than non-drinkers of being forced into sexual intercourse (OR=3.16: 95% CI=1.25-7.97) or other sexual acts (OR=3.84: 95% CI=1.74-8.47). Binge drinkers were also more prone to smoking compared to current drinkers (OR=10.82 9% CI=4.85-24.12). Conclusion Binge consumption among millennials was associated with a myriad of behavioural risk factors and harmful alcohol-related consequences. Multiple strategic approaches are needed that address respective cultural norms, enhancement of millennials socialisation and engagement skills within communities to improve the efficacy of preventive interventions.
Anthropometric and cardiometabolic risk factors in parents and child obesity in Segamat, Malaysia
(Oxford University Press, 2017-06-29) Partap, Uttara; Young, Elizabeth H.; Allotey, Pascale; Sandhu, Manjinder S.; Reidpath, Daniel
Background There is little evidence regarding risk factors for child obesity in Asian populations, including the role of parental anthropometric and cardiometabolic risk factors. We examined the relation between parental risk factors and child obesity in a Malaysian population. Methods We used data from health and demographic surveillance conducted by the South East Asia Community Observatory in Segamat, Malaysia. Analyses included 9207 individuals (4806 children, 2570 mothers and 1831 fathers). Child obesity was defined based on the World Health Organization 2007 reference. We assessed the relation between parental anthropometric (overweight, obesity and central obesity) and cardiometabolic (systolic hypertension, diastolic hypertension and hyperglycaemia) risk factors and child obesity, using mixed effects Poisson regression models with robust standard errors. Results We found a high burden of overweight and obesity among children in this population (30% overweight or obese). Children of one or more obese parents had a 2-fold greater risk of being obese compared with children of non-obese parents. Sequential adjustment for parental and child characteristics did not materially affect estimates (fully adjusted relative risk for obesity in both parents: 2.39, 95% confidence interval: 1.82, 3.10, P < 0.001; P for trend < 0.001). These associations were not modified by parental or child sex. We found no consistent evidence for associations between parental cardiometabolic risk factors and child obesity. Conclusions Parental obesity was strongly associated with child obesity in this population. Further exploration of the behavioural and environmental drivers of these associations may help inform strategies addressing child obesity in Asia.
Applied social sciences for public health (‎ASSPH)‎ : higher degree training for implementation research on tropical diseases
(World Health Organization, 2007) Gouda, Hebe; Fox-Rushby, Julia; Heald, Suzette; Helman, Cecil; Parker, Melissa; Pokhrel, Subhash; Skelly, Chris; Reidpath, Daniel; Allotey, Pascale
Understanding and monitoring the dynamic nature of a population’s health is critical for successful health promotion, disease prevention and disease control. It necessarily involves a multidisciplinary and interdisciplinary endeavour. Many of the research techniques and tools to facilitate this are available across the range of social sciences. However, as a result of economic and other factors, building and retaining of research capacity in applied social sciences for public health (ASSPH) in resource-poor countries has been a challenge. There is therefore a serious lack of ASSPH researchers and consequently an ongoing dearth in high quality research that involves social, economic and behavioural aspects of tropical disease control despite the clear need for evidence in this area. This need was identified in the TDR review of research capacity strengthening in 1999 (TDR, 2000). However, seven years later, the problem remains critical. A further need has been identified for applied social science research in the process of implementation of disease control programmes – i.e. for ‘implementation research’. Over the last 30 years, TDR and other medical research institutions have invested substantial funds in the development of interventions for the management of tropical diseases. However, in the absence of capacity and understanding in how to engage with communities and ensure their participation, and of the ability to adapt research methods and health technologies to local contexts, the uptake, effectiveness and sustainability of these interventions remains limited. The lack of high quality social science research expertise to combine an understanding of tropical diseases with the ability to work with and understand the local community is chronic. Further expertise is also required to integrate this knowledge with institutional and organizational structures that support the successful and sustained uptake of new technologies. This present initiative draws on existing capacity in sub-Saharan Africa (SSA) with support from Southern and Northern partners to develop high quality, internationally recognized, higher degree interdisciplinary and multidisciplinary research training that is grounded in theoretical and applied social science and public health disciplines and relevant to local contexts. These programmes will be offered through regional centres of excellence. As background to the initiative, this report is a compilation of three independent but inter-related documents presenting background information on ASSPH and a strategy for building capacity in subSaharan Africa. The specific focus is on training a workforce for implementation research at Master’s and potentially PhD level. The report presents: • A background on the training needs in ASSPH in sub-Saharan Africa and an overview of related courses and programmes available locally and internationally. • A strategic vision for capacity building in ASSPH based on consultations with stakeholders in the region and in related disciplines. • A review of current training capacity and proposed training programmes in Ghana and Kenya for Anglophone countries in West and East Africa respectively.
Behaviour Change in Public Health: Evidence and Implications
(BMC, 2015-08-25) Pokhrel, Subhash; Anokye, Nana K.; Reidpath, Daniel; Allotey, Pascale
Breast Cancer Screening in Semi-Rural Malaysia: Utilisation and Barriers
(MDPI, 2021-11-23) Mohan, Devi; Su, Tin Tin; Donnelly, Michael; Hoe, Wilfred Mok Kok; Schliemann, Désirée; Tan, Min Min; Reidpath, Daniel; Taib, Nur Aishah; Allotey, Pascale
Breast cancer (BC) is the commonest cancer in Malaysia. Delayed diagnosis is a significant cause of BC mortality in the country. Early diagnosis and screening are vital strategies in mortality reduction. This study assessed the level of utilisation and barriers for breast self-examination (BSE), clinical breast examination (CBE) and mammogram in a semi-rural population in Malaysia and compared these across the different ethnic groups. This cross-sectional study was conducted among women aged 40 years and above, embedded within a health and demographic surveillance site (HDSS) in Segamat, Malaysia. Trained data collectors collected data on screening and barriers during home visits. Study participants (n = 250) were aged 59.4 ± 10.9 years and represented Malaysia’s three major ethnic groups. Practice of regular BSE, CBE uptake (ever) and mammogram (ever) was 23.2%, 36% and 22.4%, respectively. Regular BSE practice was highest in the Malay ethnic group and least among the Chinese. Regular CBE was very low in all ethnic groups (<5%). Mammogram uptake was highest among Chinese (34.4%), followed by Indians (30.4%) and Malays (16.6%). After adjusting for other socio-demographic variables, Malay ethnicity was positively associated with regular BSE (adjusted OR = 5.26, 95% CI 2.05, 13.50) and negatively associated with having had a mammogram (adjusted OR = 0.3, 95% CI 0.15, 0.57). Lower education was negatively associated (adjusted OR = 0.36, 95% CI 0.17, 0.74) with mammogram attendance (ever). Emotional and financial barriers were the most reported types of barriers, specifically, fear of diagnosis (74.8%), cost of diagnosis (69.6%) and fear of losing a breast (66.4%). Malay women more commonly reported most barriers compared to other ethnic groups. Screening uptake was low among semi-rural women in Malaysia. Implementing culturally appropriate interventions that consider ethnic differences is crucial to empowering women to engage in BC screening initiatives in these communities.
The burden is great and the money little: Changing chronic disease management in low– and middle–income countries
(International Society of Global Health, 2012-12) Reidpath, Daniel; Allotey, Pascale
Can national research assessment exercises be used locally to inform research strategy development? The description of a methodological approach to the UK RAE 2008 results with a focus on one institution
(Springer, 2009-10-17) Reidpath, Daniel; Allotey, Pascale
National mechanisms for comparing the research profiles of higher education institutions (HEIs) have become increasingly common. Probably the best known of these is the Research Assessment Exercise (RAE) conducted in the United Kingdom, and used as the basis for the allocation of research funding. Such exercises are expensive. They would have additional value if the data could be used by HEIs to inform the development of their research strategies. In this paper we use publicly available RAE outcome data to demonstrate this potential. We contrast the two units’ research profiles with other units of assessment within the HEI, with other like-units nationally, and finally we examine the relative performance of all the HEI’s units of assessment against their national counter-parts. Finally we discuss the kinds of insights these data may offer in the development of research strategy at the level of the institution, and at the level of the School or Department.
Challenges and opportunities for breast cancer early detection among rural dwelling women in Segamat District, Malaysia: A qualitative study
(Public Library of Science, 2022-05-20) Schliemann, Désirée; Hoe, Wilfred Mok Kok; Mohan, Devi; Allotey, Pascale; Reidpath, Daniel; Tan, Min Min; Taib, Nur Aishah Mohd; Donnelly, Michael; Su, Tin Tin
Introduction Breast cancer patients in low- and middle-income countries often present at an advanced stage. This qualitative study elicited views regarding the challenges and opportunities for breast cancer screening and early detection among women in a low-income semi-rural community in Segamat district, Malaysia. Methods Individual semi-structured interviews with 22 people (health professionals, cancer survivors, community volunteers and member from a non-governmental organization) and four focus group discussions (n = 22 participants) with women from a local community were conducted. All participants were purposively sampled and female residents registered with the South East Asia Community Observatory aged ≥40 years were eligible to participate in the focus group discussions. Data were transcribed verbatim and analyzed using thematic analysis. Results The thematic analysis illuminated barriers, challenges and opportunities across six domains: (i) personal experiences and barriers to help-seeking as well as financial and travel access barriers; (ii) primary care challenges (related to delivering clinical breast examination and teaching breast-self-examination); (iii) secondary care challenges (related to mammogram services); (iv) disconnection between secondary and primary care breast cancer screening pathways; and (v) opportunities to improve breast cancer early detection relating to community civil service society activities (i.e. awareness raising, support groups, addressing stigma/embarrassment and encouraging husbands to support women) and vi) links between public healthcare personnel and community (i.e. improving breast self-examination education, clinical breast examination provision and subsidised mammograms). Conclusion The results point to a variety of reasons for low uptake and, therefore, to the complex nature of improving breast cancer screening and early detection. There is a need to adopt a systems approach to address this complexity and to take account of the socio-cultural context of communities in order, in turn, to strengthen cancer control policy and practices in Malaysia.
Challenges and Research Priorities for Dementia Care in Malaysia from the Perspective of Health and Allied Health Professionals
(MDPI, 2021-10-20) Rosli, Roshaslina; Goodson, Michaela; Tan, Maw Pin; Mohan, Devi; Reidpath, Daniel; Allotey, Pascale; Kamaruzzaman, Shahrul; Chin, Ai-Vyrn; Robinson, Louise
Few studies to date have evaluated dementia care in Malaysia, and the focus of studies has primarily been on epidemiological and laboratory research. In this study, we aimed to identify potential challenges for the delivery of dementia care in Malaysia and priorities for research and enhancing existing dementia care. This study used thematic analysis to evaluate the open and focus group workshop discussions guided by semi-structured questions. Triangulation of the collected data (sticky notes, collated field notes, and transcripts of discussions) was achieved through stakeholder consensus agreement during a workshop held in 2017. Five main themes as priorities for dementia care were identified: (1) availability of a valued multi-disciplinary care service, (2) accessibility of training to provide awareness, (3) the functionality of the governance in establishing regulation and policy to empower care services, (4) perceived availability and accessibility of research data, and (5) influence of cultural uniqueness. The findings of this study seek to enhance existing dementia care in Malaysia but have potential application for other low and middle-income countries with a similar social and health care set up. The constructed relationship between themes also tries to tackle the challenges in a more efficient and effective manner, as none of these aforementioned issues are standalone challenges. In addition, we demonstrated how a carefully constructed workshop with defined aims and objectives can provide a useful analysis tool to evaluate health and social care challenges in a multidisciplinary forum.
Challenges for Diagnostic Clarity for Post-stroke Cognitive Impairment and Behavioural Issues in Middle-Income Countries: Case Studies From Malaysia
(Frontiers Media, 2021-06-02) Yap, Kwong Hsia; Warren, Narelle; Allotey, Pascale; Reidpath, Daniel
Following stroke, individuals require ongoing screening, diagnosis and monitoring for cognitive impairment. Services and policies around these vary widely between settings, and reports from many countries highlight persistent under-diagnosis of cognitive impairment in the months and years after stroke. Missed and delayed diagnosis of post-stroke cognitive impairment, including dementia, are important factors in shaping the experiences of people so affected and their family members, especially in low- and middle-income countries. Drawing upon ethnographic research conducted in Malaysia, this article draws upon three case studies to examine the continued health-seeking behaviour after the appearance of salient cognitive and behavioural symptoms that occurred after stroke. Findings highlight the challenges in getting formal diagnostic clarity for cognitive and behavioural symptoms in a rural setting within a middle-income country. No study participants sought help for memory or cognitive problems, partly due to limited lay awareness of cognitive impairment but more significantly due to health service factors. Despite their elevated risk for dementia, participants were not monitored for cognitive impairment during any follow-up care in various health facilities. Furthermore, caregivers' attempts to seek help when behavioural issues became untenable were met with multiple health system barriers. The journey was complicated by the meanings attached to the reactions towards cognitive symptoms at the community level. We suggest that strategies seek to increase the awareness of post-stroke cognitive and behavioural symptoms, and incorporate clear treatment pathways into the long-term care plans of community-dwelling stroke survivors.
Characterisation and correlates of stunting among Malaysian children and adolescents aged 6–19 years
(Cambridge University Press, 2019-03-04) Partap, Uttara; Young, Elizabeth H.; Allotey, Pascale; Sandhu, Manjinder S.; Reidpath, Daniel
Background Despite emerging evidence regarding the reversibility of stunting at older ages, most stunting research continues to focus on children below 5 years of age. We aimed to assess stunting prevalence and examine the sociodemographic distribution of stunting risk among older children and adolescents in a Malaysian population. Methods We used cross-sectional data on 6759 children and adolescents aged 6–19 years living in Segamat, Malaysia. We compared prevalence estimates for stunting defined using the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) references, using Cohen's κ coefficient. Associations between sociodemographic indices and stunting risk were examined using mixed-effects Poisson regression with robust standard errors. Results The classification of children and adolescents as stunted or normal height differed considerably between the two references (CDC v. WHO; κ for agreement: 0.73), but prevalence of stunting was high regardless of reference (crude prevalence: CDC 29.2%; WHO: 19.1%). Stunting risk was approximately 19% higher among underweight v. normal weight children and adolescents (p = 0.030) and 21% lower among overweight children and adolescents (p = 0.001), and decreased strongly with improved household drinking water sources [risk ratio (RR) for water piped into house: 0.35, 95% confidence interval (95% CI) 0.30–0.41, p < 0.001). Protective effects were also observed for improved sanitation facilities (RR for flush toilet: 0.41, 95% CI 0.19–0.88, p = 0.023). Associations were not materially affected in multiple sensitivity analyses. Conclusions Our findings justify a framework for strategies addressing stunting across childhood, and highlight the need for consensus on a single definition of stunting in older children and adolescents to streamline monitoring efforts.
Chronic disease profiles of subjective memory complaints: a latent class analysis of older people in a rural Malaysian community
(Taylor and Francis Group, 2018-12-27) Yap, Kwong Hsia; Warren, Narelle; Allotey, Pascale; Reidpath, Daniel
Background: Subjective memory complaints (SMC) are common in the elderly and have been suggested as the first subtle sign of decline which can predict dementia. Cognitive decline is thought to be related to inflammatory processes similarly found in other chronic diseases and conditions such as stroke, heart disease and arthritis. This study aimed to examine the association of SMC with chronic diseases and the profile of these health conditions reported by a group of older adults. Methods: Data from a cross-sectional survey conducted from August 2013 and March 2014 was drawn from 6179 individuals aged 56 years and above. Multivariable logistic regression analyses were used to examine SMC’s relationship with individual chronic diseases (asthma, kidney disease, heart disease, stroke, arthritis, hypertension and diabetes) and multimorbidity. Latent class analysis (LCA) was used to identify the profile of health conditions. The effect of SMC was estimated in a multinomial logistic regression as part of the latent class model. Results: SMC was statistically significant in its association with asthma, stroke, heart disease, arthritis and multimorbidity in the fully controlled multivariable logistic regression models. Three health profiles were identified: low comorbidity (n = 4136, low rates in all health conditions), arthritis group (n = 860) and diabetes and hypertension group (n = 1183). SMC was associated with arthritis group (OR = 2.04, 95% CI = 1.51–2.75) and diabetes and hypertension group (OR = 1.22, 95% CI = 1.03–1.46). Conclusion: Adapting a combination of analytical approaches allows a better understanding in the assessment of SMC’s relationship with chronic diseases and the patterns of distribution of these health conditions.
Closing the prevention of mother-to-child transmission gap in Nigeria: an evaluation of service improvement intervention in Nigeria
(AOSIS, 2014-08-15) Chabikuli, ON; Gwarzo, U; Olufunso, A; Reidpath, Daniel; Allotey, Pascale; Ibrahim, M; Hamelmann, C
Objectives: The objective was to assess improvement, or lack thereof, in the uptake of prevention of mother-to-child transmission (MTCT) services at selected sites supported sites by the Global HIV/AIDS Initiative Nigeria (GHAIN). Design: The study used aggregated monthly service statistics to evaluate service improvement efforts that were conducted before and after these were undertaken between July 2007-June 2008. Settings and subjects: The service improvement efforts took place in 60 public healthcare facilities. Outcome measures: The study measured changes in the number of pregnant women who attended antenatal clinics for the first time, the number of pregnant women tested for human immunodeficiency virus (HIV), the number of HIV-positive women receiving antiretroviral (ARV) prophylaxis, and the service ratio, an indicator of the relative uptake of ARV prophylaxis. An estimate of MTCT events that were averted through ARV prophylaxis taken by the pregnant women was also calculated. Results: One hundred and twenty thousand, five hundred and thirty-seven women attended an antenatal clinic (ANC) for the first time. There was an average of 167.4 monthly attendances per facility. ANC attendance increased per facility by 11.1 women monthly post-intervention (p-value < 0.01). The uptake of HIV testing was 87%, with a monthly average increase of 17.8 women tested per facility (p-value < 0.01). ARV prophylaxis uptake rose from 3.3–5.4 women per facility per month (p-value < 0.01). The service ratio per facility improved from 5.3 women receiving ARVs to 6.5 for every 10 women who tested positive for HIV (p-value < 0.01). Applying risk reduction estimates of different ARV regimens, it was estimated that between 88–169 MTCT events were averted pre-intervention, and 143–276 events, post-intervention. Conclusion: Service improvement intervention improved the utilisation of PMTCT services. It should be a key intervention that is used to close the PMTCT gap in Nigeria.
Cohorts and community: a case study of community engagement in the establishment of a health and demographic surveillance site in Malaysia
(Taylor and Francis Group, 2014-05-06) Allotey, Pascale; Reidpath, Daniel; Devarajan, Nirmala; Rajagobal, Kanason; Yasin, Shajahan; Arunachalam, Dharma; Imelda, Johanna Debora; Soyiri, Ireneous; Davey, Tamzyn; Jahan, Nowrozy; The Seaco Team
Background Community engagement is an increasingly important requirement of public health research and plays an important role in the informed consent and recruitment process. However, there is very little guidance about how it should be done, the indicators for assessing effectiveness of the community engagement process and the impact it has on recruitment, retention, and ultimately on the quality of the data collected as part of longitudinal cohort studies. Methods An instrumental case study approach, with data from field notes, policy documents, unstructured interviews, and focus group discussions with key community stakeholders and informants, was used to explore systematically the implementation and outcomes of the community engagement strategy for recruitment of an entire community into a demographic and health surveillance site in Malaysia. Results For a dynamic cohort, community engagement needs to be an ongoing process. The community engagement process has likely helped to facilitate the current response rate of 85% in the research communities. The case study highlights the importance of systematic documentation of the community engagement process to ensure an understanding of the effects of the research on recruitment and the community. Conclusions A critical lesson from the case study data is the importance of relationships in the recruitment process for large population-based studies, and the need for ongoing documentation and analysis of the impact of cumulative interactions between research and community engagement.
Combating infectious diseases of poverty: a year on
(BMC, 2013-11-18) Xia, Shang; Allotey, Pascale; Reidpath, Daniel; Yang, Pin; Sheng, Hui-Feng; Zhou, Xiao-Nong
The Infectious Diseases of Poverty journal, launched a year ago, is a platform to engage outside the traditional disciplinary boundaries, and disseminate high quality science towards the improvement of health. This paper reviews the milestone achievements during its first year of operation. The journal has filled an important niche, addressing some of the main priorities in the Global Report for Research on Infectious Diseases of Poverty. Highlights include the publication of three thematic issues on health systems, surveillance and response systems, as well as co-infection and syndemics. The thematic issues have foregrounded the importance and innovation that can be achieved through transdisciplinary research. The journal has been indexed by PubMed since April 2013, with the publication of a total of 38 articles. Finally, the journal is delivering to wider range readers both in developing and developed countries with sustained efforts with a focus on relevant and strategic information towards elimination of infectious diseases of poverty.
Coming of age, becoming obese: a cross-sectional analysis of obesity among adolescents and young adults in Malaysia
(BMC, 2016-10-13) Pell, Christopher; Allotey, Pascale; Evans, Natalie; Hardon, Anita; Imelda, Johanna D; Soyiri, Ireneous; Reidpath, Daniel; SEACO Team
Background Malaysians have become increasingly obese over recent years. The transition from adolescence to early adulthood is recognized as critical for the development of eating and activity habits. However, little obesity-related research focuses on this life stage. Drawing on data from a health and demographic surveillance site in Malaysia, this article describes obesity and overweight amongst adolescents and young adults in a multi-ethnic population. Methods Data were collected at the South East Asia Community Observatory (SEACO) in Segamat District, Johor. In this dynamic cohort of approximately 40,000 people, 5,475 were aged 16–35 in 2013–2014. The population consists of Malay, Chinese, Indian and Indigenous (Orang Asli) families in proportions that reflect the national ethnic diversity. Data were collected through health profiles (Body Mass Index [BMI] measurements in homes) and self-report questionnaires. Results Age and ethnicity were associated with overweight (BMI 25.0–29.9Kg/m2) and obesity (BMI ≥ 30Kg/m2). The prevalence of overweight was 12.8 % at ages 16–20 and 28.4 % at ages 31–35; obesity was 7.9 % and 20.9 % at the same age groups. The main ethnic groups also showed varied patterns of obesity and overweight at the different age groups with Chinese at lowest and Orang Asli at highest risk. Level of education, employment status, physical activity and frequency of eating out were poorly predictive of overweight and obesity. Conclusion The pattern of overweight and obesity in the 16–35 age group further highlights this as a significant period for changes in health-related behaviours. Further longitudinal research is however needed to confirm the observed pattern and investigate causal factors.
Community-based blood pressure measurement by non-health workers using electronic devices: a validation study
(Taylor and Francis Group, 2012-06-27) Reidpath, Daniel; Ling, MeiLee; Yasin, Shajahan; Rajagobal, Kanason; Allotey, Pascale
Introduction Population monitoring and screening of blood pressure is an important part of any population health strategy. Qualified health workers are expensive and often unavailable for screening. Non-health workers with electronic blood pressure monitors are increasingly used in community-based research. This approach is unvalidated. In a poor, urban community we compared blood pressure measurements taken by non-health workers using electronic devices against qualified health workers using mercury sphygmomanometers. Method Fifty-six adult volunteers participated in the research. Data were collected by five qualified health workers, and six non-health workers. Participants were randomly allocated to have their blood pressure measured on four consecutive occasions by alternating a qualified health worker with a non-health worker. Descriptive statistics and graphs, and mixed effects linear models to account for the repeated measurement were used in the analysis. Results Blood pressure readings by non-health workers were more reliable than those taken by qualified health workers. There was no significant difference between the readings taken by qualified health workers and those taken by non-health workers for systolic blood pressure. Non-health workers were, on average, 5–7 mmHg lower in their measures of blood pressure than the qualified health workers (95%HPD: −2.9 to −10.0) for diastolic blood pressure. Conclusion The results provide empirical evidence that supports the practice of non-health workers using electronic devices for BP measurement in community-based research and screening. Non-health workers recorded blood pressures that differed from qualified health workers by no more than 10 mmHg. The approach is promising, but more research is needed to establish the generalisability of the results.