A systematic review of health promotion interventions to increase breast cancer screening uptake: from the last 12 years.

Background: The outcome of breast cancer treatment largely depends on the timing of detection. The health promotion interventions have an immense contribution to early detection and improved survival. Therefore, this review aimed to provide evidence on the efficacy of the health promotion interventions to increase the uptake of breast cancer screening and to develop effective interventions targeting women. Methods: Online databases (PubMed/MEDLINE/PubMed Central, Ovid/MEDILINE, EMBASE, Web of Science and Google Scholar) were searched for studies published between January 2005 and January 2017. A quality coding system was assessed using Cochrane checklists for randomized controlled trial (RCT) and Downs and Black checklists for non-RCT. The score was rated for the included articles by each researcher independently and the average score is given accordingly. This study was registered in PROSPERO as [PROSPERO 2017: CRD42017060488]. Results: The review dovetailed 22 studies. Thirteen studies (59.10%) were conducted in the Unite States, 4 in Iran (18.18%), 2 in India (9.09%) and 1 each in Turkey, Saudi Arabia and Israel. The interventions were classified as 'individual-based', 'community-based', 'group-based teachings and training' and 'behavioral model based'. The majority of the studies showed favorable outcomes after health promotion interventions, including improvements in women's view of breast screening, breast self-examination and knowledge of breast screening. Conclusion: The review confirmed that most of the health promotion interventions targeting women boosted the breast screening in one or another way. However, the limited quality of the included studies showed that further research is needed to improve the trials in the next future.

A systematic review of the effectiveness of health education interventions to increase cervical cancer screening uptake.

Background: Cervical cancer screening reduced cancer morbidity and mortality in developed countries. Health education interventions are expected to enhance screening and early detection. Thus, this review is aimed to see the effectiveness of the interventions in cervical cancer screening uptake. Methods: Online databases (PubMed/MEDLINE/PubMed Central, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar) were searched for all published eligible research articles in the past 12 years (as of January 2005-2017). A total of 17 research articles were included. The interventions were classified as 'individual level', 'community level' and 'cultural sensitive educations' which contains various interventions in their content as compared with usual care. A quality coding system was assessed using Cochrane checklists and rated by each researcher independently and the average score was given accordingly. This study was registered in PROSPERO 2017: CRD42017060405. Results: The review dovetailed 17 studies. Ten studies (58.82%) were conducted in the United States, three in Iran (17.65%) and one each in Malaysia, China, Cameroon and Nigeria (23.53%). Almost all levels of the interventions boosted the screening uptake and the Pap test. However, the individual level health education interventions were prioritized in many of the studies. Conclusion: The review indicated that health education interventions have immense contributions in boosting the screening uptake. However, the effectiveness varies with study setting, populations and the way of delivery. Therefore, the limited quality of the studies indicated that further research is required to develop a simple and effective intervention to boost cervical cancer screening uptake.

Patient Satisfaction with Antiretroviral Therapy Services in Hadiya Zone, Central Ethiopia Using the Donebidean Model: A Time-Motion Study.

Background: A time-motion study is a scientific method for recording time spent on various tasks in a narrow range of specialized work settings, beginning with initial enrollment in ART provision. Therefore, the study aimed to assess the time motion of patient satisfaction with antiretroviral therapy services in Central Ethiopia. Methods: A facility-based cross-sectional study was conducted on a sample of 422 patients from June 14 to July 30, 2021. We used a simple random sampling technique to select the participants. Structural input-related qualitative data were collected using an in-depth interview and used for concurrent triangulation with quantitative. Quantitative data were collected using a standardized and pre-tested questionnaire and analyzed using SPSS version 24.0. Bivariate and multivariable logistic regressions were used to identify independent predictors of time motion and patient satisfaction. The degree of association between the outcome and independent variables was assessed by using an odds ratio with a 95% CI. Results: The time motion of patient satisfaction study found that 53.1% (224/422) of the study participants were satisfied. As independent predictors, time spent (time motion) waiting to be seen by a health professional (AOR = 0.228, 95% CI = 0.079-0.661), patient-provider interaction (AOR = 3.72, 95% CI = 2.111-5.771), perceived privacy (AOR = 2.912, 95% CI = 1.76-2.78), sex (AOR = 2.499, 95% CI = 1.556-4.009), and income class (AOR = 0.228, 95% CI = 0.073-0.707) were associated with outcome variable. Conclusion: The study found low patient satisfaction with ART services, indicating the need for further improvement to enhance patient-centered services with the given time motion. Therefore, further research is needed to assess the intensity and reach of the information through an analysis of pre- and post-intervention that provides a complete picture of conceptualizations of time motion studies.

Intention to comply with solid waste management practices among households in Butajira town, Southern Ethiopia using the theory of planned behavior.

BACKGROUND: One of the world's most serious environmental issues is solid waste management. It is critical for researchers to understand the intention to comply with solid waste management. Thus, we aim to determine the intention to comply with solid waste management practice among households in Butajira Town using the Theory of Planned Behavior. METHOD: A community-based cross-sectional study was conducted on a sample of 422 households in Butajira from June 1 to June 30, 2020. The constructs and principles of the theory of planned behavior (TPB) were measured. We selected using a systematic sampling method and collected data by using a structured interviewer-administered questionnaire. Data was analyzed using SPSS version 25.0. The predictors of intention to practice solid waste management were identified using a multivariable linear regression model. A P-value of less than 5% was considered to declare a significant association. RESULTS: The findings demonstrated that intention to practice solid waste management explained 86% of the variance explained by all predictors. The perceived behavioral control construct had the greatest impact on households' behavioral intentions to comply with solid waste management practice (ß = 0.16; CI (0.14, 0.18), followed by attitude (ß = 0.15; CI (0.11, 0.21) and subjective norms (ß = 0.12; CI (0.06, 0.17). CONCLUSION: Our study also found that intention has a substantial influence on the behavior of solid waste management practices. Therefore, there is a need to enhance service utilization for solid waste management and to improve outdoor solid waste dropping behavior through door-to-door collection services by municipality. Furthermore, further longitudinal research should be done through intervention mapping.

Perception towards cardiovascular diseases preventive practices among bank workers in Hossana town using the health belief model.

BACKGROUND: Cardiovascular diseases (CVD) are becoming a public health problem in Ethiopia, especially among those who have limited physical activity. Although bank workers are at an increased risk of contracting CVD, their participation in CVD preventive activities is not studied in Ethiopia. Therefore, this study aimed to assess the perception of bank workers towards CVD preventive behaviors and associated factors in Hossana town. METHODS: A cross-sectional study was conducted on a sample of 258 participants from February 11 to 30/2020. A simple random sampling method was used to select study participants from the enumerated list of staff. Data was collected using a self-administered structured questionnaire and the collected data was entered and analyzed using SPSS version 20 software. Descriptive statistics and logistic regression analysis were done. A p-value less than 0.05 with 95% CI was considered to declare an association between independent and dependent variables. RESULTS: A total of 253 respondents with response rate of 98.0% were participated. The study revealed that the likelihood of performing CVD preventive behaviors is 62.0%. Moreover, the study found that bank workers' exposure to passive smoking [AOR = 0.5; 95% CI: 0.23-0.98], level of alcohol consumed [AOR = 0.5; 95% CI: 0.01-0.54], regularly consuming fruit and vegetable in daily meal [AOR = 0.16; 95% CI: 0.03-0.80], perceived severity[AOR = 0.1;95% CI: 0.01-0.68], and cues to take action [AOR = 0.12;95% CI: 0.02-0.73] were identified as predictors of perception to engage in CVD preventive behaviors. CONCLUSION: The level of bank workers' perception of engaging in CVD preventive behavior was in a considerable state to design and implement intervention strategies. Behavior change communication should be strengthened to improve their knowledge and perception of the severity of CVD and barriers so as to improve the likelihood of taking action.

Atazanavir / ritonavir versus Lopinavir / ritonavir-based combined antiretroviral therapy (cART) for HIV-1 infection: a systematic review and meta-analysis.

BACKGROUND: This systematic review and meta-analysis was conducted to evaluate the safety and effectiveness of Atazanavir/ritonavir over lopinavir/ritonavir in human immunodeficiency virus-1 (HIV-1) infection. METHODS: Clinical trials with a head-to-head comparison of atazanavir/ritonavir and lopinavir/ritonavir in HIV-1 were included. Electronic databases: PubMed/Medline CENTRAL, Embase, Scopus, and Web of Science were searched. Viral suppression below 50 copies/ml at the longest follow-up period was the primary outcome measure. Grade 2-4 treatment-related adverse drug events, lipid profile changes and grade 3-4 bilirubin elevations were used as secondary outcome measures. RESULTS: A total of nine articles from seven trials with 1938 HIV-1 patients were included in the current study. Atazanavir/ritonavir has 13% lower overall risk of failure to suppress the virus level < 50 copies/ml than lopinavir/ritonavir in fixed effect model (pooled RR: 0.87; CI: 0.78, 0.96; P=0.006). The overall risk of hyperbilirubinemia is very high for atazanavir/ritonavir than lopinavir/ritonavir in the random effects model (pooled RR: 45.03; CI: 16.03, 126.47; P< 0.0001). CONCLUSION: Atazanavir/ritonavir has a better viral suppression at lower risk of lipid abnormality than lopinavir/ritonavir. The risk and development of hyperbilirubinemia from atazanavir-based regimens should be taken into consideration both at the time of prescribing and patient follow-up.

Likelihood of Breast Screening Uptake among Reproductive-aged Women in Ethiopia: A Baseline Survey for Randomized Controlled Trial.

BACKGROUND: Breast cancer is the most devastating public health problem affecting women in developed and developing world. Therefore, this study was aimed to assess the likelihood of taking breast self-examination as a breast screening behavior among reproductive age women. METHODS: A community based cross-sectional study was conducted on 810 reproductive-age women. Intervieweradministered questionnaires were used to collect data. Study participants were selected using systematic sampling method. Data were analyzed using SPSS version 24.0. RESULTS: The likelihood of performing breast self-examination was 54.3%. However, the comprehensive knowledge of the participants was 11.5%. As independent predictors, perceived severity of breast cancer [AOR (95%CI) = 2.05 (1.03 to 1.07)] and self-efficacy [AOR (95%CI) = 2.97(0.36-0.99)] were positively associated with the likelihood of performing breast self-examination whereas districts [AOR (95%CI) = 0.58 (0.37 to 0.91)] and place of residence [AOR (95%CI) = 0.69 (0.51 to 0.93)] were negatively associated with the likelihood of performing breast selfexamination. The HBM Model explained 64.2% of the variance in this study. CONCLUSION: Although the likelihood of performing breast selfexamination was relatively good, the comprehensive knowledge of the women was very low. Therefore, breast cancer screening education must address knowledge and socio-cultural factors that influence breast screening through awareness creation using appropriate behavioral change communication strategies.

How do reproductive age women perceive breast cancer screening in Ethiopia? A qualitative study.

BACKGROUND: Breast cancer remains one of the deadliest non-communicable diseases in the world. In Ethiopia, breast cancer accounts for 33.4% of total cancer diagnosis in women. OBJECTIVE: This study aims to explore perception about breast screening behavior among reproductive age women. METHODS: This qualitative study was conducted as a baseline to identify gaps to design interventions that will enhance breast screening uptake among reproductive age women. Six focus group discussions and 9 in-depth interviews were conducted with women and health workers respectively. Semi-structured questions were used. Data analysis was analyzed by Atlas.ti. 7 and the ideas were put in direct quotation and narration. RESULTS: Lack of awareness is the preceding problem for self-susceptibility to breast cancer as well as for having breast screening. Majority of women thought that the cause of breast cancer was a sin (supernatural power). Self-efficacy and cues to action were the most important correlates of the perception owing to fear of socio-cultural stigma and discrimination. CONCLUSION: All health belief model constructs identified a critical problem for adaptation of behavior. Therefore, this gives the opportunity to design and develop community-based intervention and explore new intervention mechanism with an accurate method.

Application of Kingdon and Hall Models to Review Environmental Sanitation and Health Promotion Policy in Ethiopia: A Professional Perspective as a Review.

BACKGROUND: In the world, many countries, including Ethiopia, are framing policies to roll back the problem of the sanitation. For this, the Kingdon and Hall models are the two distinct models formed to articulate the policy agenda to the health problem. The Kingdon model includes problem, policy and politics streams whereas the Hall model includes legitimacy, feasibility and support of the health policies. Therefore, this review aims to integrate the two models with diseases prevention and health promotion policies of Ethiopia. METHODS: We used the existing frameworks of the models as a guiding principle. Then, we applied the frameworks of the two models as an important consideration to interlink policy agenda to a given health problem. We also described the existing scientific literature about the sanitation and health promotion. After thoroughly reviewing, possible policy inputs and country setups were included with a brief discussion by comparing different kinds of literatures. RESULTS: The two models are recognized as an opportunity to get an essential sanitation policy. The government settled and has closed links to the new innovation as an emerged discourse. Therefore, the two model streams came together for setting sanitation problem on the policy agenda. The technical feasibility, public acceptability and congruence with existing values were all judged to be favorable. CONCLUSION: The integration of policies within the policy frameworks has very important outputs in various countries. Therefore, the field specialists should figure out the problem of policy integration through policy evaluation researches.

Contextualizing Ottawa Charter Frameworks for Type 2 Diabetes Prevention: A Professional Perspective as a Review.

BACKGROUND: Type 2 Diabetes remains one of the deadliest non-communicable diseases in the world. Systematically articulating the health issues with emerging policies is very important in preventing chronic diseases like diabetes. This article aims to integrate Ottawa Charter frameworks in prevention of Type 2 diabetes and the way the charter's application should bring amicable changes if applied as planned. METHOD: We used the aim of the study as a method derivative. Then, we applied the five actions of Ottawa Charter frameworks. We also described and stated the existing scientific literature (knowledge) about the prevention of diabetes. After thoroughly reviewing, possible intervention strategies were included with a brief discussion by comparing different literatures. In our case, diabetes prevention is facilitated by those actions and conditions. EVIDENCE: Setting appropriate goals, lifestyle modifications, appropriate self-monitoring of blood glucose, medications, regular monitoring for complications, and laboratory assessment are important factors to be endorsed within Ottawa Charter five actions. Lifestyle interventions and physical activities are the most important factors recommended in different reviews and interventions. However, none of the studies had integrated disease prevention with existing policy. CONCLUSION: Type 2 Diabetes directed health promotion interventions implemented in various countries were not integrated into Ottawa charter frameworks. As field experts, we believe that applying all the basic principles of health promotion and the idea of Ottawa Charter articulation is very important in disease prevention and behavioral change. Therefore, field specialists should figure out the problem of policy integration through policy evaluation researches.

Discourses on Sexuality and Sexual Health Perspectives among Wachemo University Students, Ethiopia: A Qualitative Study.

BACKGROUND: Sexuality is a central aspect of being human throughout life. Discourse analysis is used to understand discussion, conversation, talk, dialogue, debate, consultation and chat in the people perception and language. Therefore, this study aims to explore sexuality and sexual health perspectives among Wachemo University students in Ethiopia. METHODS: This qualitative study was conducted in Hosanna Town among Wachemo University students. A criterion related sampling (purposive sampling) was used to select a variety of young people. Eight focus group discussions and four in-depth interviews were used to collect data. Data was transcribed first and translated from Amharic into English. Atlas ti.7 software was used to analyze data. Then, their discourses were stated in narration and direct quotation. RESULT: Discursive explanation of words and languages differ in different sub-cultures and societies. Languages and vocabularies were mostly attached to sexual relationships, love, affiliation and intention to be intimate with the opposite sex on a campus. This affiliation is known as "campus life". The students' perspectives of what constitutes sexuality and sexual health were quite consistent. However, approaching opposite sex with unique languages and words depends on individual talents. CONCLUSION: Discursive expressions of sexuality issues are becoming complex than ever in this generation. Therefore, further research is needed to reach this group with a variety of interventions through concurrent triangulation of qualitative research and longitudinal studies.

Testing Psychometrics of Healthcare Empowerment Questionnaires (HCEQ) among Iranian Reproductive Age Women: Persian Version.

BACKGROUND: Producing high quality data needs an accurate measurement in any fields of study. This study aimed to test psychometrics of the Persian version Healthcare Empowerment Questionnaire (HCEQ) in relation to personal care among Iranian reproductive age women and to validate the instrument for future use. METHODS: A cross-sectional study was conducted on 549 reproductive age women in a health centers affiliated to Tehran University of Medical Sciences producing a response rate of 100%. Content validity was established using translation and backtranslation procedures, pilot testing, and getting views of expert panel. Construct validity was measured using explanatory factor analysis. Cronbach's alpha was used to measure internal consistency, and intra-class correlation coefficients were used to confirm stability. RESULTS: The results indicated that explanatory factor analysis of 10 items in three dimensions explained 63.2% of the total variance. Validity and reliability of the 10-items of HCEQ with two response scales (perception of control and motivation of being empowered) assessed for internal quality showed the reliability of internal consistency (α=0.70; range=0.62-0.76). The correlation between convert (10 items) and apparent (3 factors) variables was 0.5 times higher than the revealed convergent validity. CONCLUSION: The findings of this study supported the reliability and validity of the Persian version of HCEQ to assess the degree of individual empowerment in relation to personal healthcare and services among reproductive age women. Therefore, the HCEQ-Persian version could be a useful, comprehensive, and culturally sensitive scale for assessing healthcare empowerment among reproductive age women.