Theses (MSc. Public Health)

Dyslipidaemia is a highly prevalent and asymptomatic disorder that warrants blood lipid screenings to identify at-risk individuals and to prevent the development of vascular diseases. Various predisposing, enabling and need factors have been described in literature to elucidate the inclination of an individual to perform medical screenings. The objectives of this study were to determine the level of knowledge about dyslipidaemia, to determine the association between the level of knowledge about dyslipidaemia and the frequency of lipid testing, and to determine the personal and healthcare related factors in relation to predisposing, enabling and need factors that are associated with the frequency of lipid testing among adults aged 30 and above, residing in Taman Selatan, Klang, Selangor, Malaysia. Methods: A cross-sectional survey was carried out amongst 314 residents of Taman Selatan from September 2022 to October 2022. Participants were selected via systematic random sampling and were administered a paper-based 42-item bilingual questionnaire, that assessed the predisposing, enabling and need factors, in terms of the respondent’s sociodemographic characteristics, knowledge about dyslipidaemia, belief and attitude towards screening, and healthcare related factors that may influence lipid testing practice, as measured by the lipid testing frequency of Malaysian adults aged 30 and above, residing in Taman Selatan, in the past year. Results: Out of the 314 residents approached, 271 responded to the questionnaire yielding a response rate of 86.31%. The median and interquartile range for total dyslipidaemia knowledge score was found to be 5 and 1 respectively. A medium positive correlation was identified between total dyslipidaemia knowledge score and frequency of blood lipid testing (r=0.447, p<0.001). Four variables, namely total knowledge score (OR=1.385, 95% CI = 1.112, 1.726), respondent’s belief and attitude, in terms of fatalistic attitudes, fear and perception of good health (OR=0.276, 95% CI = 0.132, 0.575), ethnicity, specifically Chinese (OR=0.458, 95% CI = 0.225, 0.933), and lower income group (OR=3.428, 95% CI = 1.379, 8.525) were found to be statistically significantly associated with the frequency of lipid testing. Conclusion: The sample had below average knowledge level about dyslipidaemia. Higher knowledge score and low monthly income were associated with frequent lipid testing. Higher fatalistic attitudes, fearfulness and perception of good health correlated to a decrease in lipid testing frequency. Respondents of Chinese ethnicity were found to be associated with a lower lipid testing frequency. Key words: Dyslipidaemia, knowledge, lipid testing, practice, frequency.

Background: Drug abuse is a significant social problem and public health concern. A change in philosophy and direction to make drug abuse a medical problem is needed. It should start with positive change of mindset of the healthcare providers. Accurate information must be cascaded to communities to fill the great gap between scientific evidence and perception on drug abuse and addiction. Objectives: To determine the medical student's beliefs, attitudes, and agreement with treatment towards drug abuse. Their beliefs and attitudes may influence their perceptions of individual with drug use disorders, ability to use specific intervention techniques, and likelihood of consenting to treatment strategies. Materials and Methods: This is a cross-sectional study carried out in the International Medical University, using self-administered questionnaire. Samples were selected by simple random sampling using Microsoft Excel. Section A consists of four demographics items. Section B comprised of 12-items of attitude subscales questionnaire, Section C comprised of 7-items of belief subscales questionnaire, and Section D comprised of 5-items on agreement to treatment questionnaire. The independent variable is agreeing to drug abusers deserve treatment. The dependent variable is disease and psychosocial model beliefs. Statistical Analysis: Data was analysed using Statistical Packages for the Social Sciences (SPSS). Demographics data were analysed for frequency, percentage, mean, and standard deviation (SD). PROCESS macro for SPSS was utilised for mediation analysis. Results: 95 medical students participated. Scores for beliefs in disease and psychosocial models, and attitudes towards drug abuse were middling-to-high. Relationship between beliefs and outcome of agreeing to drug abusers deserving treatment was mediated by attitudes towards drug abusers. More exposures in clerking and observing drug abuse cases leads to less negative attitudes towards the abusers Conclusions: Medical students in clinical year of the IMU is not ready to be the change agent to promote drug abuse and addiction as a medical disease. More teaching and learning activities with additional clinical contact hours will help to build positive attitudes among these medical students. Key Words: Substance use disorders, Substance abuse, Drug dependence, Disease model, Psychosocial model

INTRODUCTION: The Orang Asli peoples have lived in Peninsular Malaysia for at least 5,000 years, making them the region's oldest population. Orang Asli has the worst health conditions among the population in Malaysia. Due to their superstitions that illnesses are associated with supernatural forces rather than scientifically explainable natural one, has a profound impact on their health-seeking behavior, which now places more of a focus on traditional and explicitly spiritual healing methods rather than on treatments that have been shown to be effective via scientific research. The aim of this research was to investigate the health seeking behavior among adult Orang Asli living in Cameron Highlands. METHODOLOGY: Quantitative research was carried out involving 225 adult Orang Asli (n = 225) from 11 villages in Cameron Highlands. RESULT: It was found that out of 225 adult Orang Asli interviewed, 132 people (58.7%) had appropriate health seeking behavior while 93 others (41.3%) did not display an appropriate health seeking behavior. It was also found that the health seeking behavior of the adult Orang Asli was associated with gender, age, occupation, distance from health facility, current health status as well as the severity of the disease. It was found that the majority of the adult Orang Asli who do seek healthcare service, are more inclined to seek medical treatment preferring medical doctors (including specialists) that are available at hospitals and clinics. The researcher also managed to gain some valuable knowledge in terms of reasons for not seeking treatment, medication or advice among the adult Orang Asli living in Cameron Highlands. Work commitment, transportation issues, perceived inadequate knowledge of the healthcare professionals in treating the patients, do not require treatment because can heal by meditation and not being sick enough to seek healthcare service are among the reasons identified for the refusal of Orang Asli in seeking healthcare service. CONCLUSION: As the aim of this research was set to study the healthcare seeking behavior for common illnesses among adult Orang Asli in Cameron Highlands, it was revealed that health seeking behavior of the adult Orang Asli was associated with gender, age, economic status, distance from health facility, current health status as well as the severity of the disease. Keywords: Health utilization, aboriginal, acute illness, knowledge, treatment, advice, healthcare professionals, beliefs

Background: Despite the well-documented benefits of work health promotion programmes (WHPPs) in reducing non-communicable diseases and their risk factors, the services are under-utilised. The study assesses private university employees’ awareness, perception and utilisation of WHPP and identifies the factors influencing WHPP utilisation. Methods: A cross-sectional study was conducted among employees of five private universities using an online self-administered questionnaire. The independent variables were predisposing factors (age, gender, marital status, race, education, job classification and years of working), enabling factors (awareness, perception, financial and organisational factors) and need factors (perceived, evaluated health status and health risk factors) while the dependent variable was WHPP utilisation. Results were analysed using IBM SPSS Version 28. Results: The proportion of 161 respondents with high WHPP awareness, positive perception and high utilisation was respectively 57.8%, 55.0% and 50.9% . Education level (OR: 0.428, 95%CI: 0.214-0.860), awareness (OR: 6.13, 95%CI: 3.060-12.281) and no transportation (OR: 5.286, 95%CI: 1.7-16.433) were associated with utilisation. Awareness (OR: 5.953, 95%CI: 2.859-12.396) and no transportation (OR: 5.286, 95%CI: 1.7 - 16.433) best predicted WHPP utilisation. Conclusion: The actual employees’ WHPP utilisation was low despite having a high level of WHPP awareness and positive perception. Enabling factors were the predictors of WHPP utilisation. Keywords: knowledge, attitude, engagement, occupational health services