The Institute for Global Health and Development
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Item Religiosity and Spirituality and the Intake of Fruit, Vegetable, and Fat: A Systematic Review(Hindawi, 2013-11-10) Tan, Min Min; Chan, Carina KY; Reidpath, DanielObjectives. To systematically review articles investigating the relationship between religion and spirituality (R/S) and fruit, vegetable, and fat intake. Methods. PubMed, CINAHL, and PsycInfo were searched for studies published in English prior to March 2013. The studies were divided into two categories: denominational studies and degree of R/S studies. The degree of R/S studies was further analyzed to (1) determine the categories of R/S measures and their relationship with fruit, vegetable, and fat intake, (2) evaluate the quality of the R/S measures and the research design, and (3) determine the categories of reported relationship. Results. Thirty-nine studies were identified. There were 14 denominational studies and 21 degree of R/S studies, and 4 studies were a combination of both. Only 20% of the studies reported validity and 52% reported reliability of the R/S measures used. All studies were cross-sectional, and only one attempted mediation analysis. Most studies showed a positive association with fruit and vegetable intake and a mixed association with fat intake. Conclusion. The positive association between R/S and fruit and vegetable intake may be one possible link between R/S and positive health outcome. However, the association with fat intake was mixed, and recommendations for future research are made.Item Faith, Food and Fettle: Is Individual and Neighborhood Religiosity/Spirituality Associated with a Better Diet?(MDPI, 2014-08-14) Tan, Min Min; Chan, Carina KY; Reidpath, DanielDiet is an important contributor to many non-communicable diseases. Religion and spirituality (R/S) has a salutary effect on physical health, and one of the possible links between R/S and positive health outcomes is a better diet. Religious neighborhoods might also play a role in influencing the adoption of a healthier diet. Suggestions for future research in R/S and diet are included.Item Religiosity, dietary habit, intake of fruit and vegetable, and vegetarian status among Seventh-Day Adventists in West Malaysia(Springer, 2016-03-24) Tan, Min Min; Chan, Carina KY; Reidpath, DanielReligion has been shown to be salutary on health, and a possible link between religion and positive health outcomes is diet. Research has shown that religiosity is associated with better diet but most studies were conducted in a multi-denominational context, which might be confounded with theological differences. This study examined the relationship between religiosity and diet within a homogenous group of believers. Data from survey of 574 Seventh-Day Adventists residing in West Malaysia, aged 18–80, were analyzed using multiple regressions. While none of the religious variables were significantly associated with fruit and vegetable intake, a higher level of religiosity was associated with a better dietary habit and vegetarian status. The mixed relationship between religiosity and diet suggest that further research is needed to explore how religion might influence the diet of adherents.Item Does the social gradient remain in the dietary habits of a health-conscious population? A study of Seventh-Day Adventists in West Malaysia(Oxford University Press, 2016-10-13) Tan, Min Min; Chan, Carina KY; Reidpath, DanielBackground Socioeconomic status (SES) is a strong predictor of health, and individuals with higher SES generally have better health than those with lower SES. One of the pathways that SES influences health is through health behaviors, such as dietary intake, and a higher SES has been associated with a better diet. The purpose of this study was to determine whether there was a social gradient in dietary habits among the Seventh-Day Adventists, a group of conservative Christians, where healthy eating is part of the doctrinal teaching. Methods Data from a survey of 574 Adventists residing in West Malaysia, aged 18–80 years, were analyzed. Dietary habits were measured using the Nutrition subscale of Health Promoting Lifestyle Profile II. Results Education and income were significantly associated with dietary habits before and after controlling for demographics. There was a gradient of association; a higher level of education and higher income were associated with better dietary habits. However, only education remained significantly associated with dietary habits when the other two socioeconomic variables were included. Employment was not significantly associated with dietary habits before or after controlling for demographic variables and the other two sociodemographic variables. Conclusions This study showed that education is the strongest predictor of healthy diet, and a social gradient in dietary habits still exists even among health-conscious population.Item Religion and mental health among older adults: ethnic differences in Malaysia(Taylor and Francis Group, 2020-08-03) Tan, Min Min; Su, Tin Tin; Ting, Rachel Sing-Kiat; Allotey, Pascale; Reidpath, DanielObjectives Religion and spirituality gain importance as a person ages. Research has shown that religion has a salutary effect on mental health, and it is associated with health differently across ethnic groups. The current study examined ethnic differences in the association between religion and mental health among older adults in a predominantly Muslim population and multicultural setting. Methods Data of 7068 participants (4418 Malays, 2080 Chinese and 570 Indians) aged ≥55 years that were collected as part of the community health survey conducted in 2013 in the South East Asia Community Observatory (SEACO) were analyzed using bivariate and multiple regressions. Analyses were stratified by ethnicity. Results The importance of having an enriched religious/spiritual life was associated with higher scores of depression, anxiety and stress among Chinese and higher score of depression among Malays, while belief in a higher power was associated with better mental health among Malays, Chinese and Indians. Conclusion The current study showed that there were ethnic variations in the associations between religion and mental health, and the associations depended on the religious variable included in the analysis. The findings of this study showed that religion could be another potential channel to improve mental health among older adults by accommodating and understanding their religious beliefs.Item 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, PascaleBreast 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.Item Religiousness and Quality of Life Among Older Adults of Different Ethnic Groups in Malaysia: A Five-Year Follow-up Study(Springer, 2021-07-29) Tan, Min Min; Reidpath, Daniel; Ting, Rachel Sing-Kiat; Allotey, Pascale; Su, Tin TinResearch has shown that religion is associated with a better quality of life (QoL). This study aims to examine ethnic differences in the association between religion and the QoL of older adults in a predominantly Muslim population within a multicultural setting. Two-wave data of 3,810 participants consisting of mostly Muslims and older adults aged ≥ 55 years were collected as part of the community health surveys conducted in 2013 and 2018 in the South East Asia Community Observatory (SEACO). Both cross-sectional analyses of baseline data and prospective analyses of longitudinal data were conducted. The associations between religiosity and quality of life were mainly positive in the cross-sectional analysis. In the two-wave analysis, religious importance was negatively associated with QoL among the Malays (B = − 1.103, SE B = 0.029, p < .001) and the Chinese (B = − 0.160, SE B = 0.043, p < .001), and a belief in a higher power control was associated with better QoL among the Malays (B = 0.051, SE B = 0.022, p < .005) and poorer QoL domains among the Indians (physical health: B = − 5.412, SE B = 1.382, p < .001; psychological: B = − 3.325, SE B = 1.42, p < .001; social relationship: B = − 5.548, SE B = 1.616, p < .001; environment: B = − 2.586, SE B = 1.288; p < .05). Our study's mixed results suggest that religiosity is positively associated with quality of life in cross-sectional analyses. However, in longitudinal analyses, the results are different. Conclusions with regard to causality based on cross-sectional analyses may be misleading. Health promotion programs should continue to examine the effect of religiousness on health outcomes over time among aging populations across different ethnic groups.Item 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 TinIntroduction 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.Item Hypertension care in demographic surveillance sites: a cross-sectional study in Bangladesh, India, Indonesia, Malaysia, Viet Nam.(2022-08-22) Geldsetzer, Pascal; Tan, Min Min; Dewi, Fatwa St; Quyen, Bui Tt; Juvekar, Sanjay; Hanifi, Sayed Ma; Roy, Sudipto; Asgari-Jirhandeh, Nima; Reidpath, Daniel; Su, Tin TinTo determine the proportion of adults with hypertension who reported: (i) having been previously diagnosed with hypertension; (ii) taking blood pressure-lowering medication; and (iii) having achieved hypertension control, in five health and demographic surveillance system sites across five countries in Asia. Data were collected during household surveys conducted between 2016 and 2020 in the five surveillance sites in Bangladesh, India, Indonesia, Malaysia and Viet Nam. We defined hypertension as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg or taking blood pressure-lowering medication. We defined hypertension control as systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg. We disaggregated hypertension awareness, treatment and control by surveillance site, and within each site by sex, age group, education, body mass index and smoking status. Of 22 142 participants, 11 137 had hypertension (Bangladesh: 211; India: 487; Indonesia: 1641; Malaysia: 8164; and Viet Nam: 634). The mean age of participants with hypertension was 60 years (range: 19-101 years). Only in the Malaysian site were more than half of individuals with hypertension aware of their condition. Hypertension treatment ranged from 20.8% (341/1641; 95% CI: 18.8-22.8%) in the Indonesian site to 44.7% (3649/8164; 95% CI: 43.6-45.8%) in the Malaysian site. Less than one in four participants with hypertension had achieved hypertension control in any site. Hypertension awareness, treatment and control were generally higher among women and older adults. While hypertension awareness and treatment varied widely across surveillance sites, hypertension control was low in all sites. [Abstract copyright: (c) 2022 The authors; licensee World Health Organization.]Item Mental distress along the cascade of care in managing hypertension.(2022-09-23) Ang, Chiew Way; Tan, Min Min; Bärnighausen, Till; Reininghaus, Ulrich; Reidpath, Daniel; Su, Tin TinHypertension might be a contributing factor of mental illness. The aim of this study was to investigate the association between different levels of hypertension care and mental distress among hypertensive individuals in Malaysia. We constructed a hypertension care cascade using data of 6531 hypertensive individuals aged ≥ 35 years that were collected as part of the community health survey conducted in 2013 in the South East Asia Community Observatory. We examined the association between the status of hypertension care and mental distress using multiple logistic regressions. Respondents who had not been screened for hypertension and those who had uncontrolled blood pressure (BP) had higher odds of depression, anxiety and, stress compared to those who had been screened and those who had controlled BP, respectively. Respondents who were not taking antihypertensive medication had lower odds of depression and anxiety compared to those who were on medication. There was an association between different levels of hypertension care and mental distress. The application of a hypertension care cascade may help improve the provision of mental health support in primary care clinics. Specific mental health interventions could be provided for patients with particular needs along the cascade. [Abstract copyright: © 2022. The Author(s).]