Background: The COVID-19 pandemic has had monumental effects on the mental health of populations worldwide. Previous research indicated that programs and interventions using social networks can play a positive role in promoting mental health. Nevertheless, current evidence is largely derived from high-income regions, reflecting an urgent need for more studies in low- and middle-income settings.Objectives: This paper aims to (a) describe the potential value of a hybrid health carnival in promoting mental health and increasing access to screening services; (b) assess the level of community engagement with the digital platform.Methods: A mental health carnival was conducted with the theme of “Mind Your Mental Health” (Cakna Kesihatan Mental) in conjunction with the World Mental Health Day in Malaysia. This was a hybrid carnival that combined elements of face-to-face interactions and virtual learning. Free online therapy sessions were offered to high-risk groups identified during the screening process. Social media metrics were utilized to report the levels of community engagement and participants completed pre-and post-assessments to measure the program's impact on their knowledge.Results: The carnival was attended by 515 participants (78.8% virtual participants). Social media metrics reported more than 5,585 reaches on Facebook for all the activities held throughout the event. Results from pre-and post-assessments showed significant improvement in the mean knowledge scores (p < 0.05).Conclusion: This digital approach will continue to evolve by releasing new features and tools as a new frontier for high-risk populations and all individuals seeking mental health support and treatment.
BACKGROUND In type 2 diabetes (T2D) adults, weight loss can improve hemoglobin A1c, blood pressure, triglycerides, quality of life, and reduce the frequency of medications needed. Unfortunately, there is a large proportion of T2D adults who are not ready to change for weight loss. Over decades, web-based health technologies are increasingly used as a delivery mode for health promotion and prevention for obesity. However, evidence of their effectiveness for initializing and maintaining healthy behavior, particularly among T2D adults, is still scarce. OBJECTIVE This study aims to develop, validate, and determine the effectiveness of a web-based intervention called “Chance2Act” among T2D adults with obesity to act for weight loss. METHODS A web-based intervention will be developed based on the Transtheoretical Model targeting T2D adults with obesity who are not ready to change for weight loss. Phase 1 will involve the development and validation of the web-based health intervention module. In phase 2, a quasi-experimental study will be conducted in two government health clinics selected by the investigator. This is an unblinded study with a parallel assignment (i.e. intervention vs. control (usual care) with an allocation ratio of 1:1). 124 study participants will be recruited, of which 62 participants will receive the Chance2Act intervention in addition to the usual care. The primary outcome is the changes of the stages of change to lose weight. The secondary outcomes include changes in self-efficacy, decisional balance, family support for weight loss, BMI, waist circumference, and body fat composition. RESULTS We hypothesize that the Chance2Act intervention will elicit significant behavioral changes for weight loss among the participants (i.e. readiness to change, self-efficacy, and decisional balance), cause meaningful improvement in family support for weight loss, and significantly reduce the BMI as well as the body fat composition among the participants. CONCLUSIONS The Chance2Act intervention is expected to yield new knowledge on the effects of a theory-based digital intervention targeting behavior change from an individual perspective. It is hoped that the evidence obtained from this study will enhance the delivery of obesity care among T2D adults in primary care settings. CLINICALTRIAL U.S. Clinical Trial Register NCT05736536; https://beta.clinicaltrials.gov/study/NCT05736536
Background: Recommendations from WHO regarding the comprehensive ban on tobacco advertisements, promotions and scholarships (TAPS) have recently caused tobacco companies in shifting their market strategies to focus on promoting unregulated devices such as electronic cigarettes (ECs) and vapes. Aim: This study aims to explore the motivations of EC use among dual users and its associations with sociodemographic factors and smoking related characteristics under different regulatory environments in Malaysia. Methods: A total of 5823 dual users was collected using a multistage sampling study design. Data collection was conducted through intercept face-to-face interviews within 3 waves; wave 1 (May-September 2016), wave 2 (December 2016 - April 2017) and wave 3 (May-August 2017). The samples were drawn from 5 streets randomly (two in hotspot and three in nonhotspot locations) within stratified urban and rural areas in 14 states of Malaysia. Every fifth person passing an interview station in each street was approached. All statistical tests were conducted using PASW 18. Results: The top four self-reported motivations of using EC by dual users included “tasted better than conventional cigarettes” (85.1%), “to reduce the number of cigarettes smoked” (72.9%), “to quit smoking” (63.5%) and “increase price of cigarette taxes” (62.9%). Based on a multivariate analysis, respondents from states that have no current restrictions toward the sale and usage of ECs and who use ECs less than weekly (Adj.OR=2.54; 95% CI=1.93-3.34), weekly (Adj.OR=2.22; 95% CI=1.72-2.85) and daily users (Adj.OR= 1.77; 95% CI=1.36-2.31) were more likely to use ECs due to its better taste as compared with those who use ECs less than once a month. In states that have banned the sales and usage of ECs, there was a significant association between daily users of ECs and the four primary motivations. It was found that an increasing amount of cigarettes smoked per day (Adj.OR=2.46; 95% CI=1.59-3.81) had significantly influenced smokers in these states to more likely use ECs due to the increase price of cigarette tax. Conclusion: This study was conducted to show associations between smoking characteristics, EC use and self-reported motivations under different regulatory environments in Malaysia. Frequency of EC use was significantly associated with these self-reported motivations. Further research should be conducted to monitor EC use by Malaysians as well as to contribute to the formulation of EC policy in Malaysia.
Background: In many parts of the world, E-cigarette (EC) devices are becoming popular and an increasing trend in its usage especially among young people and adult smokers. Aim: To examine the self-reported awareness, trial and current use of ECs among current smokers and to determine the predictors associated with the outcomes. Methods: A total of 40,000 current smokers aged 18 years and above were recruited through intercept face-to-face interview in wave 1 (May-September 2016), wave 2 (December 2016-April 2017) and wave 3 (May-August 2017). The samples were drawn from 5 streets randomly (two in hotspot and three in nonhotspot) within stratified urban and rural areas in 14 states of Malaysia. Respondents were recruited using systematic sampling. Every fifth person passing an interview station in each street was approached. Descriptive analysis and multivariate logistic regression were applied by using PASW 18. Results: Overall, 93% were aware of ECs, 19.9% were ECs trials and 14.6% were current users. Multivariate logistic regression shows that those states with no ban of ECs sales were more likely and significantly associated with these outcomes compared with those in states that this device has already been banned. Those who believe that ECs are “less harmful” (AOR=6.28; 95% CI=5.79-6.81, P < 0.001; AOR=4.84; 95% CI=4.12-5.69, P < 0.001) and “equally harmful” (AOR=2.06; 95% CI=1.91-2.22, P < 0.001; AOR=2.25; 95% CI=1.93-2.62, P < 0.001) were significantly associated with EC trials and current use of ECs respectively. In addition, intention to quit smoking (AOR=2.91; 95% CI=2.72-3.13) was also directly associated with EC trials. Conclusion: Awareness, trials and current use of ECs are likely due to the banning regulation implemented in specific states and strong belief that ECs is less harmful to health. Hence, this should be considered in the formulation of ECs policy in Malaysia.
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