Academic literature on the topic 'Suboptimal Health Status Questionnaire-25'

Background: Suboptimal health status (SHS) measurement has now been recognized as an essential construct in predictive, preventive, and personalized medicine. Currently, there are limited tools, and an ongoing debate about appropriate tools. Therefore, it is crucial to evaluate and generate conclusive evidence about the psychometric properties of available SHS tools. Objective: This research aimed to identify and critically assess the psychometric properties of available SHS instruments and provide recommendations for their future use. Methods: Articles were retrieved by following the guidelines of the PRISMA checklist, and the robustness of methods and evidence about the measurement properties was assessed using the adapted COSMIN checklist. The review was registered in PROSPERO. Results: The systematic review identified 14 publications describing four subjective SHS measures with established psychometric properties; these included the Suboptimal Health Status Questionnaire-25 (SHSQ-25), Sub-health Measurement Scale Version 1.0 (SHMS V1.0), Multidimensional Sub-health Questionnaire of Adolescents (MSQA), and the Sub-Health Self-Rating Scale (SSS). Most studies were conducted in China and reported three reliability indices: (1) the internal consistency measured by Cronbach’s α value ranged between 0.70 and 0.96; (2) the test–retest reliability; and (3) the split-half reliability coefficient values ranged between 0.64 and 0.98, and between 0.83 and 0.96, respectively. For the values of validity coefficients in the case of SHSQ-25 > 0.71, the SHMS-1.0 ranged from 0.64 to 0.87, and the SSS ranged from 0.74 to 0.96. Using these existing and well-characterized tools rather than constructing original tools is beneficial, given that the existing choice demonstrated sound psychometric properties and established norms. Conclusions: The SHSQ-25 stood out as being more suitable for the general population and routine health surveys, because it is short and easy to complete. Therefore, there is a need to adapt this tool by translating it into other languages, including Arabic, and establishing norms based on populations from other regions of the world.

The patient, who has risk factors but considers himself / herself to be healthy, does not consult a doctor, but is in a suboptimal status. The study of the patient’s health at different levels of physical activity is an important issue of preventive medicine.Material and methods. 351 people (133 men and 218 women) aged 18 to 75 years after obtaining voluntary informed consent to the study were examined. Patients were divided into 8 groups according to the international physical activity questionnaire (IPAQ). In addition to the classic clinical and laboratory examination, patients were interviewed using questionnaires: suboptimal health status (SHSQ-25), hospital anxiety and depression scale (HADS), stress susceptibility questionnaire (PSS). Statistical processing was carried out by programs Microsoft Excel 2010 and Statistica 10,0.Research result. When studying the values of discovering the fact of the differences in some indicators: increase of arterial pressure in 3 and 4 group physical activity, age of women, increasing of body mass in the 2, 3, 5 and 8 groups physical activity that proves the relationship of the presence of risk factors and physical activity level of the patient. Significant differences between the actual values of the mean age and the alarm level in groups with high and low suboptimal status were revealed. Significant differences in suboptimal status were revealed, which reflected the presence of risk factors for chronic noncommunicable diseases in groups with different physical activity (age of women over 45 years old, overweight, monthly use of alcohol, the presence of hypercholesterinemia and high level of depression). Significant differences in groups with high and low indicators of suboptimal status in the presence of risk factors for chronic noncommunicable diseases are revealed: age over 45 years, increased systolic and diastolic blood pressure, high levels of anxiety. Significantly differed in the indicators of suboptimal status of the group of physical activity: 2, 3, 6 and 7.Conclusion. In groups of patients who consider themselves healthy and do not see a doctor for 3 months or more, the risk factors of chronic non-communicable diseases, more common in groups of patients who are not engaged in physical activity, were identified. Differences in indicators of suboptimal health status in the presence of risk factors of chronic noncommunicable diseases are revealed. The SHSQ-25 questionnaire objectively reflected the main screening indicators of chronic disease risk factors, it is simple to use in primary health care, it is an economical and effective tool for screening subclinical, reversible stages of chronic diseases.

The problem of prevention of chronic non-communicable diseases continues to be relevant. It is a promising non-invasive integration of new screening methods to assess the patient's health system. The goal was to establish the relationship of vascular endothelial function parameters with indicators of suboptimal health status and the factors of cardiovascular risk. Materials and methods. A total of 327 residents of Samara, who had no history of disease and did not receive treatment in the last 3 months. We used a questionnaire diagnostic screening suboptimal health status SHSQ-25, the risk factors of cardiovascular diseases, endothelin-1, human blood index of endothelial function was determined by computer photopletismography. Results and discussion. Suboptimal health status is associated with the prevalence and severity of cardiovascular risk factors, smoking, overweight, total cholesterol, glucose, blood endothelin, vascular endothelium reactivity, indicating that their dominant influence on the quality of life in a population of healthy individuals. Vascular reactivity non-invasively evaluated in terms of endothelial function in the sample with ischaemia of the upper limb by computer photopletismography reflects systemic vascular endothelial function as a negative associated with endothelin blood and the main factors of cardiovascular risk: age, male gender, body mass index, the nature of work activity, blood pressure value.

Background: Low vitamin D status, adiposity, and at-risk lipid profile are associated with adverse health consequences. This study aimed to assess serum 25(OH)D concentration of Indigenous (Orang Asli) adults and to determine the associations between serum 25(OH)D with adiposity and lipid profile, respectively. Methods: This cross-sectional study was conducted among 555 (164 men, 391 women) Orang Asli adults aged 18–65 years of Jah Hut sub-tribe in Krau Wildlife Reserve (KWR), Peninsular Malaysia. Demographic and socio-economic information were obtained using interviewer-administered questionnaire. Participants were also assessed for serum 25-hydroxyvitamin D (25(OH)D) concentration, adiposity indices (BMI, WC, WHtR, WHR, %BF) and lipid parameters (TC, LDL-C, HDL-C, TG). Data were analyzed using binary logistic regression via SPSS. Results: The prevalence of suboptimal 25(OH)D concentration was 26.3%, comprising 24.9% insufficiency (50 to <75 nmol/L) and 1.4% deficiency (<50 nmol/L). While men (14–30.5%) were associated with a more proatherogenic lipid profile than women (6.1–14.3%), more women were with central obesity (M: 19.5–46.3%; F: 34.5–49.1%) and suboptimal (<75 nmol/L) vitamin D status (M: 11.6%; F: 32.4%). While suboptimal 25(OH)D concentration was significantly associated with higher odds of at-risk LDL-C (p < 0.01) and obesity (WC, WHtR) (p < 0.05) in men, no significant association was observed for women. Nonetheless, it should be noted that there were only 19 men with suboptimal (<75 nmol/L) vitamin D status. Conclusions: While suboptimal vitamin D status was relatively low in Orang Asli adults, the prevalence of obesity and undesirable serum lipids were relatively high. The sex-specific associations between vitamin D status with adiposity indices and serum lipids warrant further investigation.

ObjectivesThe study aimed to develop and validate a model to measure psychosocial factors at work among medical staff in China based on confirmatory factor analysis (CFA). The second aim of the current study was to clarify the association between stress-related psychosocial work factors and suboptimal health status.DesignThe cross-sectional study was conducted using clustered sampling method.SettingXuanwu Hospital, a 3A grade hospital in Beijing.ParticipantsNine hundred and fourteen medical staff aged over 40 years were sampled. Seven hundred and ninety-seven valid questionnaires were collected and used for further analyses. The sample included 94% of the Han population.Main outcome measuresThe Copenhagen Psychosocial Questionnaire (COPSOQ) and the Suboptimal Health Status Questionnaires-25 were used to assess the psychosocial factors at work and suboptimal health status, respectively. CFA was conducted to establish the evaluating method of COPSOQ. A multivariate logistic regression model was used to estimate the relationship between suboptimal health status and stress-related psychosocial work factors among Chinese medical staff.ResultsThere was a strong correlation among the five dimensions of COPSOQ based on the first-order factor model. Then, we established two second-order factors including negative and positive psychosocial work stress factors to evaluate psychosocial factors at work, and the second-order factor model fit well. The high score in negative (OR (95% CI)=1.47 (1.34 to 1.62), P<0.001) and positive (OR (95% CI)=0.96 (0.94 to 0.98), P<0.001) psychosocial work factors increased and decreased the risk of suboptimal health, respectively. This relationship remained statistically significant after adjusting for confounders and when using different cut-offs of suboptimal health status.ConclusionsAmong medical staff, the second-order factor model was a suitable method to evaluate the COPSOQ. The negative and positive psychosocial work stress factors might be the risk and protective factors of suboptimal health, respectively. Moreover, negative psychosocial work stress was the most associated factor to predict suboptimal health.

Objectives: Presently, limited data are available on dietary supplements (DSs) and their associated effects on health status although the consumption of DS continues to expand. This study is aimed to explore the possible relationship between DSs consumption and suboptimal health status (SHS) in Dubai, United Arab Emirates (UAE). Methods: This study was a cross-sectional research held among a sample of citizens and residents in the Emirate of Dubai in the UAE using a well-structured, self-administered, anonymous survey. Frequency tables, odds ratios, and confidence intervals were generated during the data analysis using SPSS version 23. Results: A total of 618 participants were enrolled in this study and fully completed the questionnaire. In this study, 317 participants (51.3%) (95% CI: 47.3%-55.3%) reported the use of DS products. A significant association between DS consumption and suboptimal health status was detected ( P < .001). DS consumers had a 1.5-fold increased odds of suboptimal health status when compared with non-DS consumers (95% CI 1.4-1.7). Conclusion: The findings of this study suggest a need to develop policies and programs that will help minimize the risk of possible adverse events that are associated with the utilization of DSs.

The earliest correction of behavioral risk factors for chronic non-communicable diseases will reduce the rates of premature mortality of the population. Currently, the relationship between the altered spectrum of intestinal microflora in various indicators of suboptimal health status and body mass index is not sufficiently studied. When they are in a state of suboptimal health status, patients consider themselves healthy and do not go to the doctor for a long time, which makes it difficult to implement early preventive measures in this group of patients. Goal. To determine the qualitative and quantitative composition of the intestinal microflora before and 1 month after taking a metaprebiotic complex containing dietary fiber (inulin) and oligosaccharides (oligofructose) in outpatient patients who consider themselves healthy, have behavioral risk factors for chronic non-communicable diseases or chronic non-communicable diseases in remission, and/or do not consult a doctor within the last 3 months. Materials and methods. Outpatient patients were examined (114 people: 36 men, 78 women aged 18 to 72 years). A survey was conducted, including a detailed active collection of complaints (including using the international SHSQ-25 questionnaire) and anamnesis, as well as a thorough physical examination with an anthropometric study. Using the MALDI-ToF mass spectrometry method, the degree of microbiotic disorders, the structure of the intestinal microflora were determined with the identification of microorganisms isolated from feces before and after taking the course of the metaprebiotic complex with various indicators of suboptimal status and body mass index. Results. New data were obtained on the intestinal biocenosis of patients who consider themselves healthy at different levels of suboptimal status. When using a metaprebiotic complex containing inulin and oligofructose, an improvement in the composition of the intestinal microflora was found due to a decrease in the frequency of release of conditionally pathogenic enterobacteria and other gram-negative microorganisms (median degree of contamination: from 0.45 (0.3-0.98) to 0.3(0.21-0.7) at low suboptimal status and from 0.5(0.7-1.7) to 0.31 (0.2-1.3) at high) and increase the frequency of enterococcal excretion (median degree of contamination: from 5,58 (4,16-7,0) tо 6,3 (4,8-7,8) at low suboptimal status and from от 4,5 (2,8-6,3) tо 5,1 (3,8-6,4) at high). Conclusion. The importance of studying the microbiotic complex of the intestine in increasing the indicators of suboptimal health status and body mass index in patients who consider themselves healthy is proved, which will allow for the earliest detection and rational individual prevention of chronic non-communicable diseases.

Purpose: To assess the response to information about vitamin D status by participants enrolled in employer-sponsored wellness programs. Design: A self-reported health risk assessment questionnaire was used to categorize vitamin D supplementation. Participants: A total of 50 209 participants of 12 employer-sponsored wellness programs that included vitamin D testing and services provided by Quest Diagnostics in 2014 and 2015. Measures: Vitamin D status based on laboratory testing results and responses to vitamin D supplementation in a health risk assessment questionnaire for initial and subsequent years. Results: Among 50 209 participants, 29% had deficient and 37% had suboptimal levels of vitamin D. Many participants appeared to act counter to their informed vitamin D status by starting supplements when vitamin D level was initially optimal (20%) or discontinuing supplements when vitamin D level was initially deficient (36%). Three-quarters of participants who had deficient or suboptimal vitamin D levels and were not taking supplements in 2014 continued not taking supplements in 2015. Conclusion: Deficient and suboptimal vitamin D levels remain prevalent in a working-age population. Many participants do not seem to be taking appropriate actions after receiving vitamin D testing results. Accordingly, employer-sponsored wellness programs have an opportunity to better educate participants.

The increased frequency and intensity of forest fires have been concerning populations particularly in countries typically affected by this natural disaster. Portugal has been harshly afflicted by wildfires specially in the north and central regions. In the frontline of forest fire combat there is one of the riskiest occupations in the world – firefighters. Firefighting involves high physical and psychological demanding activities typically performed in hostile environments. The proximity to fire exposes them not only to high temperatures but also to high concentrations of hazardous pollutants, most of which are listed as probable or known carcinogens. Given the above, IARC classified occupational firefighting activity as possibly carcinogenic to humans. However, it is still among the least studied occupations, existing very little information on exposure induced mechanisms that lead to health diseases. Thus, the general aim of Bio4FOX study is to identify a set of (bio)markers for the surveillance of Portuguese Wildland firefighters’ occupational exposure during three phases, pre-, during and post- fire season. Here, we aim to describe the preliminary data on sociodemographic and occupational context of the Bio4Fox study population in the pre-fire season. For the 1st phase of the study were enrolled around 173 wildland firefighters from 14 fire stations located in the northern region of Portugal. Information on sociodemographic data, health status, lifestyle and occupational exposure were obtained via a comprehensive questionnaire. The study group was composed by 144 men and 29 women; the mean age of the group was 37.88±10.82. Most of the firefighters reported to be voluntary (83%; n=144) beginning their activities at young ages; more than half (n=93) started within 17 - 22 years old and 8% (n=14) of the individuals attended firefighters’ activities at earlier ages (12-16 years old). The average length of service as firefighter was 15.87±10.17 years. Around 46% (n=79) claimed to spend more than 10 hours in their duties, while 34% (n=58) and 12% (n=21) spend 8-9hours and < 8 hours, respectively. Concerning their risk perception related to exposure to hazard contaminants, 79% (n=136) believed to be exposed to smoke, gases, and/or particles and 15% (n=25) to solvents (e.g., combustible). Self-reported symptoms (of last 30 days, not related with cold/flu) were: expectoration (14%; n=24), tiredness (13%; n=22), breath difficulty (9%; n=16), cough (8%; n=13) and wheezing (6%; n=10). Our preliminary data describes the sociodemographic factors and occupational activities of a group of Portuguese firefighters before the fire-season. This data will be integrated together with the biological and environmental findings collected over different time points of a wildfire season. Bio4FOX will contribute to the establishment of recommendations/good practices to improve firefighters’ working conditions, as well support the definition of better policies/prevention strategies highly needed in this sector.

ABSTRACT Background: Good nutrition and adequate stimulation for early learning are estimated as essential components for child development. The purpose of this study was to determine nutritional factors associated with child development aged 3-6 years. Subjects and Method: A cross sectional study was carried out at 25 preschools in Tanjung Jabung Timur, Jambi, Indonesia, from September to October 2019. A sample of 200 children aged 3-6 years was selected by stratified random sampling. The dependent variable was child development. The independent variables were child nutritional status, dietary pattern, exclusive breastfeeding, maternal education, maternal employment, and family income. Child development was measured by early childhood developmental screening. The other variables were collected by questionnaire. The data were analyzed by a multiple logistic regression. Results: Child development improved with good nutritional status (b= 1.86; 95% CI= 0.54 to 3.19; p= 0.006), exclusive breastfeeding (b= 0.58; 95% CI= -0.67 to 1.84; p= 0.363), good dietary pattern (b= 1.55; 95% CI= 0.31 to 2.79; p= 0.014), maternal education ≥Senior high school (b= 2.27; 95% CI= 0.98 to 3.55; p= 0.001), and family income ≥Rp 2,840,000 (b= 1.84; 95% CI= 0.34 to 3.33; p= 0.016). Child development decreased with mother working outside the house (b= -1.31; 95% CI= -2.42 to -0.19; p=0.021). Conclusion: Child development improves with good nutritional status, exclusive breastfeeding, good dietary pattern, maternal education ≥Senior high school, and family income ≥Rp 2,840,000. Child development decreases with mother working outside the house Keywords: child development, nutritional status, exclusive breastfeeding Correspondence: Dinda Septiani Hardilla. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: dindaseptianihardilla15@-gmail.com. Mobile: 082373568987 DOI: https://doi.org/10.26911/the7thicph.03.88

ABSTRACT Background: Health-related quality of life (HRQoL) is a commonly used measure of health outcome. It reflects several dimensions of health, including physical, psychological, social, cognitive function, as well as general well-being, including in elderly population. The association between social capital and HRQoL in elderly has been rarely studied in Indonesia. The purpose of this study was to investigate the biopsychosocial factors influencing the quality of life of elderly using path analysis. Subjects and Method: A cross sectional study was conducted in Surakarta, Central Java, in December 2019. A sample of 200 elderly was selected by simple random sampling. The dependent variable was quality of life. The independent variables were education, income, marital status, body mass index (BMI), physical activity, locus of control, family support, peer support, social capital. The data were collected by questionnaire and analyzed by path analysis run on Stata 13. Results: Quality of life in elderly was directly increased by high physical activity (b= 2.01; 95% CI= 0.55 to 3.45; p= 0.007), education ≥Elementary school (b= 2.38; 95% CI= 0.79 to 3.97; p= 0.003), BMI 18.5 to 25 (b= 3.45; 95% CI= 1.60 to 5.30; p<0.001), income ≥Rp 1,800,000 (b= 2.96; 95% CI= 1.33 to 4.59; p<0.001), strong social capital (b= 2.01; 95% CI= 0.56 to 3.44; p= 0.006), married (b= 2.15; 95% CI= 0.63 to 3.67; p= 0.005), and internal locus of control (b= 2.29; 95% CI= 0.69 to 3.90; p= 0.005). Quality of life in elderly was directly increased by physical activity, education, peer support, social capital, and marital status. Conclusion: Quality of life in elderly is directly increased by high physical activity, education ≥Elementary school, BMI 18.5 to 25, income ≥Rp 1,800,000, strong social capital, married, and internal locus of control. Quality of life in elderly is directly increased by physical activity, education, peer support, social capital, and marital status. Keywords: quality of life, biopsychosocial, path analysis, elderly Correspondence: Dwi Tour Kumalasari. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: kumalasari.azzah-ra@gmail.com. Mobile: +6281216417536. DOI: https://doi.org/10.26911/the7thicph.01.41

Abstract Introduction The global threat caused by COVID-19 pandemic and the unprecedented lockdown imposed had created emotional stress among the breast cancer patients with dilemma regarding risk of progression of cancer due to interruptions of standard medical care and panic about acquiring the COVID-infection during their frequent visits to the hospital. Objectives We conducted a questionnaire-based study to assess the psychological impact in this situation affecting their quality of life and their perspective in this current situation. Materials and Methods Breast cancer patients who had been recently diagnosed, those who were on chemotherapy and visited our OPD in the month of July during the COVID-19 pandemic were assessed for their treatment-related perspectives with a questionnaire. Psychological status was analyzed with GAD-7 (generalized anxiety disorder questionnaire) and PHQ-9 (patient health questionnaire). Results A total of 202 breast cancer patients were included when lockdown was relaxed after a period of 3 months and COVID-19 status was still up trending. The clinical profile and patient-related information were collected from the medical records. Of them, 55.4% (112 patients) were within the city, 35.1% (71 patients) were from suburban areas of the city, and 9.4% (19 patients) were from adjacent districts/rural areas. Also, 56% were educated. Of these, 87% wanted to continue treatment and did not bother about the spread of the infection, while remaining patients’ main concern was to avoid infection than to get oncological management. Also, 76% were aware about the COVID-19 infection and sequelae. A total of 80% patients were aware of the consequences due to delay in cancer treatment. Of these patients, 51%, 42% and 7% had mild, moderate, and severe anxiety respectively and 69%, 25% and 6% had mild, moderate, and severe depression respectively. The severe anxiety and depression correlated with metastatic breast cancer and educated patients. Conclusion This study reflected that the breast cancer patients were more bothered to continue the treatment in spite of the existing pandemic.

ABSTRACT Background: Tuberculosis (TB) disease in children under 15 years (pediatric TB) is a public health problem of special significance because it is a marker for recent transmission of TB. This study aimed to analyze biological, social, and economic risk factors of child TB. Subjects and Method: A case control study was carried out at 25 villages in Surakarta, from August to September 2019. A sample of 200 chilren aged 0-18 years was selected by fixed disease sampling. The dependent variable was TB. The independent variables were birthweight, BCG immunization, exclusive breastfeeding, nutritional status, family income, smoke exposure, family history of TB. Data on TB cases were obtained from medical record. The other variables were collected by questionnaire. The data were analyzed by a multiple logistic regression. Results: The risk of TB increased with poor house sanitation (OR= 4.50; 95% CI= 1.18 to 17.12; p= 0.027), smoke exposure (OR= 4.13; 95% CI= 1.05 to 16.22; p= 0.042), and had history of TB (OR= 5.54; 95% CI= 1.49 to 20.61; p= 0.011). The risk of TB decreased with normal birthweight ≥2,500 g (OR= 0.18; 95% CI= 0.05 to 0.57; p= 0.003), BCG immunization (OR= 0.18; 95% CI= 0.06 to 0.58 p= 0.004), exclusive breastfeeding (OR= 0.11; 95% CI= 0.02 to 0.55; p= 0.006), good nutritional status (OR= 0.10; 95% CI= 0.02 to 0.48; p= 0.004), and family income ≥Rp1,802,700 (OR= 0.09; 95% CI= 0.02 to 0.36; p= 0.001). Conclusion: The risk of TB increases with poor house sanitation, smoke exposure, and had history of TB. The risk of TB decreases with normal birthweight ≥2,500 g, BCG immunization, exclusive breastfeeding, good nutritional status, and high family income. Keywords: Tuberkulosis, biological, sosial dan ekonomi. Correspondence: Dyah Ayu Saputri. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: ayusaputridyah7@gmail.com. Mobile: 081353236388. DOI: https://doi.org/10.26911/the7thicph.01.45

Background: Adolescents living in institutional settings are more susceptible to the EBPs than others as they are deprived of a family's love, support, attachment and care. Objective: To assess the prevalence of EBPs among adolescents and explore the perceptions of caretakers living in children’s home. Method: A mixed method, descriptive cross-sectional study among 134 adolescents from 5 children’s homes of Gokarneshwor Municipality, was done. All the adolescents from 10-19 years living in the children’s home were assessed using a self-administered questionnaire, Youth Self-Report (YSR-11/18) 2001, developed by Achenbach System of Empirical Based Assessment and self-developed socio- demographic questionnaires. Data was coded and analyzed using SPSS (25). Descriptive statistics and Chi square were used to analyze the quantitative data, while narrative summary was used for qualitative through IDI. Results: Prevalence of EBPs was 48.5% among the adolescents. While the EBPs factors prevalence was found to be anxious depression (46.3%), withdrawn depressed (46.3%), attention problems (46.3%), somatic complaints (50.7%), social problems (42.5%), thought problems (38.8%), attention problems (46.3%), rule breaking behaviour (41%) and aggressive problems (50%). The occurrence of EBPs was significantly associated with status of adolescent (ꭓ2=6.015, p=0.014, df=1). Similarly, there was the significant association between dependent variable (prevalence of EBPs and EBP variables such as anxious depressed (ꭓ2=20.078, p<0.001, df=1), withdrawn depressed (ꭓ2=38.616, p<0.001, df=1), social problems (ꭓ2=32.678, p<0.001, df=1), attention problems (ꭓ2=30.479, p<0.001, df=1), rule breaking behavior (ꭓ2=25.322, p<0.001, df=1), thought problems (ꭓ2=31.14, p<0.001, df=1), somatic complaints (ꭓ2=20.248, p<0.001, df=1) and aggressive problem (ꭓ2=32.536, p<0.001, df=1). Conclusion: EBPs are a serious mental health concern among adolescents and especially living in children’s homes. The provision of the appropriate counseling, life skill educations and ECAs engagements help to address the EBP factors. Keywords: Adolescents, EBPs, Children’s home, YSR, Gokarneshwor Municipality, Nepal.

ABSTRACT Background: Non-Communicable Diseases (NCDs) is the leading cause of death worldwide and a serious threat to health in low and middle income countries. This can be prevented by early detection and monitoring of NCDs risk factors. This study aimed to investigate the contextual effect of the integrated health post on the use of non- communicable disease screening service. Subjects and Method: A cross sectional study was carried out at 25 integrated health posts (posbindu) in Kapuas Hulu, West Kalimantan, Indonesia, from August to October 2019. A sample of 200 study subjects was selected by fixed disease sampling. The dependent variable was the use of NCD screening service. The independent variables were subjective norm, health information, family support, cadre support, health beha-vior, health status, attitude, and intention. The data were collected by questionnaire and analyzed by a multiple multilevel logistic regression run on Stata 13. Results: The use of NCD screening service increased with supportive subjective norm (b= o.88; 95% CI= 0.01 to 1.75; p= 0.045), high health information exposure (b= 1.10; 95% CI= 0.18 to 2.02; p= 0.019), strong family support (b= 0.94; 95% CI= 0.05 to 1.83; p= 0.037), strong cadre support (b= 0.87; 95% CI= 0.01 to 1.73; p= 0.047), health behavior (b= 1.39; 95% CI= 0.49 to 2.30; p= 0.002), had NCD (b= 1.30; 95% CI= 0.19 to 2.41; p= 0.021), positive attitude (b= 0.98; 95% CI= 0.12 to 1.84; p= 0.025), and strong intention (b= 1.14; 95% CI= 0.26 to 2.01; p= 0.010). Posbindu had negligible contextual effect on the use of NCD screening service with intra-class correlation (ICC)= 7.1%. Conclusion: The use of NCD screening service increases with supportive subjective norm, high health information exposure, strong family support, strong cadre support, health behavior, had NCD, positive attitude, and strong intention. Posbindu has negligible contextual effect on the use of NCD screening service. Keywords: non-communicable disease, screening service, integrated health post Correspondence: Riza Firdaus. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutarmi 36A, Surakarta 57126, Central Java, Indonesia. Email: rizafirdaus88@yahoo.-co.id. Mobile: 08565056311. DOI: https://doi.org/10.26911/the7thicph.04.38

Background An estimated 292 million people are living with chronic hepatitis B virus (HBV) infection globally, including 223,000 people in Australia. HBV diagnosis and linkage of people living with HBV to clinical care is suboptimal in Australia, with 27% of people living with HBV undiagnosed and 77% not receiving regular HBV clinical care. This systematic review aimed to characterize population-level interventions implemented to enhance all components of HBV care cascade and analyse the effectiveness of interventions. Review questions Question 1: What population-level interventions, programs or policy approaches have been shown to be effective in reducing the incidence of hepatitis B; and that may not yet be fully rolled out or evaluated in Australia demonstrate early effectiveness, or promise, in reducing the incidence of hepatitis B? Question 2: What population-level interventions and/or programs are effective at reducing disease burden for people in the community with hepatitis B? Methods Four bibliographic databases and 21 grey literature sources were searched. Studies were eligible for inclusion if the study population included people with or at risk of chronic HBV, and the study conducted a population-level interventions to decrease HBV incidence or disease burden or to enhance any components of HBV care cascade (i.e., diagnosis, linkage to care, treatment initiation, adherence to clinical care), or HBV vaccination coverage. Studies published in the past 10 years (since January 2012), with or without comparison groups were eligible for inclusion. Studies conducting an HBV screening intervention were eligible if they reported proportion of people participating in screening, proportion of newly diagnosed HBV (participant was unaware of their HBV status), proportion of people received HBV vaccination following screening, or proportion of participants diagnosed with chronic HBV infection who were linked to HBV clinical care. Studies were excluded if study population was less than 20 participants, intervention included a pharmaceutical intervention or a hospital-based intervention, or study was implemented in limited clinical services. The records were initially screened by title and abstract. The full texts of potentially eligible records were reviewed, and eligible studies were selected for inclusion. For each study included in analysis, the study outcome and corresponding 95% confidence intervals (95%CIs) were calculated. For studies including a comparison group, odds ratio (OR) and corresponding 95%CIs were calculated. Random effect meta-analysis models were used to calculate the pooled study outcome estimates. Stratified analyses were conducted by study setting, study population, and intervention-specific characteristics. Key findings A total of 61 studies were included in the analysis. A large majority of studies (study n=48, 79%) included single-arm studies with no concurrent control, with seven (12%) randomised controlled trials, and six (10%) non-randomised controlled studies. A total of 109 interventions were evaluated in 61 included studies. On-site or outreach HBV screening and linkage to HBV clinical care coordination were the most frequent interventions, conducted in 27 and 26 studies, respectively. Question 1 We found no studies reporting HBV incidence as the study outcome. One study conducted in remote area demonstrated that an intervention including education of pregnant women and training village health volunteers enhanced coverage of HBV birth dose vaccination (93% post-intervention, vs. 81% pre-intervention), but no data of HBV incidence among infants were reported. Question 2 Study outcomes most relevant to the HBV burden for people in the community with HBV included, HBV diagnosis, linkage to HBV care, and HBV vaccination coverage. Among randomised controlled trials aimed at enhancing HBV screening, a meta-analysis was conducted including three studies which implemented an intervention including community face-to-face education focused on HBV and/or liver cancer among migrants from high HBV prevalence areas. This analysis demonstrated a significantly higher HBV testing uptake in intervention groups with the likelihood of HBV testing 3.6 times higher among those participating in education programs compared to the control groups (OR: 3.62, 95% CI 2.72, 4.88). In another analysis, including 25 studies evaluating an intervention to enhance HBV screening, a pooled estimate of 66% of participants received HBV testing following the study intervention (95%CI: 58-75%), with high heterogeneity across studies (range: 17-98%; I-square: 99.9%). A stratified analysis by HBV screening strategy demonstrated that in the studies providing participants with on-site HBV testing, the proportion receiving HBV testing (80%, 95%CI: 72-87%) was significantly higher compared to the studies referring participants to an external site for HBV testing (54%, 95%CI: 37-71%). In the studies implementing an intervention to enhance linkage of people diagnosed with HBV infection to clinical care, the interventions included different components and varied across studies. The most common component was post-test counselling followed by assistance with scheduling clinical appointments, conducted in 52% and 38% of the studies, respectively. In meta-analysis, a pooled estimate of 73% of people with HBV infection were linked to HBV clinical care (95%CI: 64-81%), with high heterogeneity across studies (range: 28-100%; I-square: 99.2%). A stratified analysis by study population demonstrated that in the studies among general population in high prevalence countries, 94% of people (95%CI: 88-100%) who received the study intervention were linked to care, significantly higher than 72% (95%CI: 61-83%) in studies among migrants from high prevalence area living in a country with low prevalence. In 19 studies, HBV vaccination uptake was assessed after an intervention, among which one study assessed birth dose vaccination among infants, one study assessed vaccination in elementary school children and 17 studies assessed vaccination in adults. Among studies assessing adult vaccination, a pooled estimate of 38% (95%CI: 21-56%) of people initiated vaccination, with high heterogeneity across studies (range: 0.5-93%; I square: 99.9%). A stratified analysis by HBV vaccination strategy demonstrated that in the studies providing on-site vaccination, the uptake was 78% (95%CI: 62-94%), significantly higher compared to 27% (95%CI: 13-42%) in studies referring participants to an external site for vaccination. Conclusion This systematic review identified a wide variety of interventions, mostly multi-component interventions, to enhance HBV screening, linkage to HBV clinical care, and HBV vaccination coverage. High heterogeneity was observed in effectiveness of interventions in all three domains of screening, linkage to care, and vaccination. Strategies identified to boost the effectiveness of interventions included providing on-site HBV testing and vaccination (versus referral for testing and vaccination) and including community education focussed on HBV or liver cancer in an HBV screening program. Further studies are needed to evaluate the effectiveness of more novel interventions (e.g., point of care testing) and interventions specifically including Indigenous populations, people who inject drugs, men who have sex with men, and people incarcerated.