Adolescents' understanding of the Nepalese version of HLS-CHILD-Q15: qualitative pre-testing in ninth-graders.

INTRODUCTION: Research on health literacy is still at an early stage, lacking a dedicated measurement instrument for assessing children's and adolescents' health literacy. Such tools are necessary to generate the evidence required for informed intervention development. This study translated the validated German HLS-Child-Q15 into the Nepalese context, creating the HLS-Child-Q22-NEP. METHODS: The research team initially created the HLS-Child-Q22-NEP using an additional item pool. We conducted thirteen one-on-one cognitive interviews with adolescent students from community schools in three districts of Nepal during the pre-test. We employed verbal probing techniques and deductively analysed the interviews based on Tourneau's model, uncovering four main themes: (1) comprehension (with the two sub-categories: a) item comprehension and b) word comprehension); (2) retrieval; (3) judgement; and (4) response. RESULTS: Overall, participants responded positively to the HLS-Child-Q22-NEP. However, this study revealed comprehension challenges such as unfamiliarity, misunderstandings, and translation issues. Additionally, the study identified retrieval challenges and poor judgement, indicating limitations in the assessment. Participants experienced varying levels of difficulty with some items, emphasising the need for revised instructions. Subsequent revisions, guided by pretest insights, led to the development of the HLS-Child-Q24-NEP. CONCLUSION: The development of the HLS-Child-Q22-NEP is a significant step in addressing Nepali adolescents' lack of health literacy measurement. Despite its generally positive reception, this study encountered challenges in comprehending the scale, prompting enhancements, and developing the HLS-Child-Q24-NEP. Further research, both qualitative and quantitative, is necessary to evaluate the validity and reliability of the modified items.

Improving adolescent health literacy through school-based health literacy intervention: a mixed-method study protocol.

BACKGROUND: Health-promoting actions might benefit from adolescent health literacy (AHL), however, there is scant research on it in Nepal. This study identifies adolescent students' health literacy (HL) needs and trials an intervention to improve their HL and intention to take health-promoting actions. METHODS: This study employs a pre-and post-test mixed-method intervention involving three phases. First, we will conduct a formative and summative evaluation to identify participants' HL needs and design an intervention using quantitative and qualitative methods. Second, the intervention will be administered to the intervention group. Finally, formative and summative post-tests will be conducted to assess the effectiveness of the intervention. We will select four community schools from Birendranagar municipality based on random sampling. In quantitative research, data will be collected from adolescents selected through a census with standardized scales such as the HLS-Child-Q15, self-efficacy, social support, and health-promoting actions. A framework analysis was conducted to analyze qualitative data collected from focus group discussions with purposively chosen adolescents and key informant interviews with Health and Physical Education teachers and school nurses. The difference in difference approach will be used to analyze the intervention's outcome, i.e., the participants' improved HL, and health-promoting actions. DISCUSSION: This is one of the first studies to explore HL in this group in Nepal. This study will provide the first insights into the overall level of AHL, potential AHL determinants, and the relationship between AHL and the intention to participate in health-promoting activities. The data can then be used to inform health promotion and health literacy initiatives.

Factors associated to acceptance and willingness to pay for COVID vaccine in Nepal.

Introduction: Corona virus disease (COVID-19) remains pandemic globally. Vaccination is considered one of the best means to control both morbidity and mortality of COVID-19. The study aims to find out the people's acceptance and willingness to pay for it. Methods: The study used cross-sectional survey design. Data were collected using a survey questionnaire from 1072 respondents (age 20-60 years) from 14 districts of Nepal. Socio-demographic characteristics of the respondents were independent and acceptance of vaccine was the dependent variable. Results: The study found that 84% of the respondents accepted the COVID vaccine. Only one out of six did not accept the COVID vaccine while 16% of the respondents stated that they would like to pay for the COVID vaccination. The average willingness to pay (WTP) for vaccination was NRs. 1053 (US$ 9) while median and mode remained the same NRs. 500. The middle age groups (30-49 years), respondents belonged to Madhesi, business people in terms of occupation and the respondents who had completed school level education had a higher acceptance rate than other categories. It was observed that place of residence in terms of provinces or districts, age group, caste/ethnicity, and educational level of the respondents were significantly associated with the acceptance of the COVID vaccine. Moreover, respondents residing from Lumbini Province, age group of 30-39 years, and having secondary or higher education were noticed as more likely to accept the COVID vaccine than the respective compared groups. Conclusion: Appropriate information, education and communication needs to disseminate to minimize the misinformation about the COVID and lack of trust in vaccine that may lead to low acceptance and poor WTP for vaccine. These findings could be considered while making COVID and the COVID vaccine-related interventions.

Evaluation of teachers' self-efficacy on integration of eye health education and promotion at basic schools in Solukhumbu district, Nepal: A cross-sectional study.

INTRODUCTION: Many studies have shown that eye health services in Nepal are still far behind in reaching schools. Therefore, the aim of this study is to examine the teacher's self-efficacy for the incorporation of eye health promotion activities. MATERIALS AND METHODS: A cross-sectional study design was applied with a self-administrated questionnaire. A total of 292 teachers were randomly selected for this study. RESULTS: Male (153.38) older-aged and Dalit ethnic group (159.81) teachers, as well as teachers who had participated (146.85) in the program, had higher self-efficacy to conduct school eye health-promoting activities than non-participants in schools. But, teaching experience is not determined to get self-efficacy for testing of visual acuity. Teachers with higher qualifications are found to be skillful. CONCLUSION: The school's eye health program has not been superseded by any relevant legislation. As a result, it's critical to concentrate on provisions that may be included in the school curriculum.