Frequent mental distress, chronic conditions, and adverse health behaviors in the Behavioral Risk Factor Surveillance Survey, Jordan, 2007.

INTRODUCTION: Recent evidence indicates that chronic diseases and mental illness are associated. In the Middle Eastern country of Jordan, chronic diseases and frequent mental distress (FMD) are increasing; however, the capacity for mental health care is limited. The objective of this study was to determine the association between FMD, chronic conditions, and adverse health behaviors in Jordan. METHODS: The third cycle of the Jordan Behavioral Risk Factor Surveillance Survey (2007) served as the data source for this study. The sample consisted of 3,612 noninstitutionalized Jordanian adults aged 18 years or older. Logistic regression was used to obtain odds ratios for the association between chronic conditions, health behaviors, and FMD adjusted for age, sex, marital status, education, income, and employment. RESULTS: In the adjusted models, people with hypertension (adjusted odds ratio [AOR], 2.0; 95% confidence interval [CI], 1.6-2.7), high cholesterol (AOR, 2.3; 95% CI, 1.6-3.2), diabetes (AOR, 1.6; 95% CI, 1.1-2.4), and asthma (AOR, 2.2; 95% CI, 1.5-3.1) and smokers (AOR, 1.5; 95% CI, 1.1-2.0) were more likely to have FMD than people without each of these conditions. Adults who reported vigorous physical activity were less likely to have FMD (AOR, 0.6; 95% CI, 0.4-0.9) than their less active counterparts. CONCLUSIONS: In Jordan, FMD was associated with several chronic conditions. As a result, we suggest additional research to examine the complex relationship between FMD and chronic conditions. More doctors in the primary health care system should be trained in mental health.

Prevalence of selected chronic, noncommunicable disease risk factors in Jordan: results of the 2007 Jordan Behavioral Risk Factor Surveillance Survey.

INTRODUCTION: Noncommunicable diseases (NCDs) are the leading cause of illness and death in Jordan. Since 2002, the Jordan Ministry of Health, in cooperation with the World Health Organization and the Centers for Disease Control and Prevention, established the Jordan Behavioral Risk Factor Surveillance Survey to collect information on many of the behaviors and conditions related to NCDs. The objectives of this study were to describe the prevalence of selected NCD risk factors and the relationship between body mass index and selected health conditions among a nationally representative sample of Jordanian adults aged 18 years or older. METHODS: We used a multistage sampling design to select 3,688 households, from which we randomly selected and interviewed 1 adult aged 18 years or older. A total of 3,654 adults completed the survey. We randomly selected a subsample of 889 interviewed adults and invited them to visit local health clinics for a medical evaluation; we obtained measurements, including fasting blood glucose and blood lipids, from 765 adults. Data were collected between June 1, 2007, and August 23, 2007. RESULTS: Nearly one-third of participants smoked cigarettes, 18% reported having been diagnosed with high blood pressure, and 10% reported frequent mental distress. Compared with survey participants who did not participate in the medical evaluation, those who participated were more likely to self-report high blood pressure, high blood cholesterol, and diabetes and report lower levels of health-related quality of life. Among participants of the medical evaluation, an estimated 11% reported they had been diagnosed with diabetes by a health professional, and 19% were diagnosed with diabetes according to laboratory testing. Approximately one-third of participants of the medical evaluation were either overweight (30%) or obese (36%). In the fully adjusted model, obese participants of the medical evaluation were nearly 3 times as likely to have high blood pressure and more than 2 times as likely to have high blood cholesterol as normal-weight participants. CONCLUSION: Diabetes, high blood pressure, high cholesterol, and obesity are a public health concern in Jordan. Adequate and continuous monitoring of NCD risk factors in Jordan is needed, and the surveillance findings should be used in health promotion and disease prevention activities.

Pharmacists-physicians collaborative intervention to reduce vaccine hesitancy and resistance: A randomized controlled trial.

PURPOSE: Given their negative influence on community health, vaccine hesitancy and resistance are emerging challenges that require healthcare intervention. Therefore, this study aimed to assess the impact of physician-pharmacist collaborative health coaching on rates of hesitancy and resistance for a COVID-19 vaccine. METHODS: After an initial assessment of rates of hesitancy and resistance for a COVID-19 vaccine was conducted, hesitant and resistant participants were approached, recruited, and randomized into an active and control group. Pharmacists-physicians collaborative coaching intervention was delivered to active group subjects over two months through Facebook live sessions. The outcome measures were assessed in both groups before coaching, directly after coaching, and a month after coaching. RESULTS: The proportions of hesitancy and resistance for a COVID-19 vaccine among subjects in the active group were significantly reduced from 64.3% and 35.7% before coaching to 20.1% and 7.8% directly after coaching, respectively. These proportions were further reduced to 11.1% and 3.3% a month after coaching, respectively. Furthermore, the mean scores for knowledge on, and attitude towards COVID-19 vaccine were significantly increased from 4.6 ± 1.8 and 4.1 ± 1.7 before coaching to 7.5 ± 3.1 and 8.9 ± 3.8 directly after coaching, respectively. However, the change in mean score of beliefs about COVID-19 vaccines among active group subjects was not significant. CONCLUSION: High rates of hesitancy and resistance for a COVID-19 vaccine were found in Jordan. These rates can be significantly reduced through online pharmacists-physicians collaborative coaching, which can also improve knowledge of and attitude towards COVID-19 vaccines.

A surveillance summary of smoking and review of tobacco control in Jordan.

The burden of smoking-related diseases in Jordan is increasingly evident. During 2006, chronic, noncommunicable diseases (NCDs) accounted for more than 50% of all deaths in Jordan. With this evidence in hand, we highlight the prevalence of smoking in Jordan among youth and adults and briefly review legislation that governs tobacco control in Jordan. The prevalence of smoking in Jordan remains unacceptably high with smoking and use of tobacco prevalences ranging from 15% to 30% among students aged 13-15 years and a current smoking prevalence near 50% among men. Opportunities exist to further reduce smoking among both youth and adults; however, combating tobacco use in Jordan will require partnerships and long-term commitments between both private and public institutions as well as within local communities.

Estimated burden of human Salmonella, Shigella, and Brucella infections in Jordan, 2003-2004.

BACKGROUND: There is limited information on the disease burden due to foodborne pathogens in the eastern Mediterranean region. This study estimates the burden of disease in Jordan for Salmonella, Shigella, and Brucella during 1 year. METHODS: Nationwide population and laboratory surveys were conducted during September 2003 and May 2004, and burden of disease estimates were calculated. A validation study was conducted prospectively from August to September 2003 to provide an estimate of the internal validity of burden estimates. RESULTS: Each year in Jordan there are about 4.4 million episodes of diarrhea among persons >1 year of age and about 1.3 million persons seek medical care for diarrhea. For each person with laboratory-confirmed Shigella or Salmonella infection there are about 273 infected persons in the community. There are approximately 1.1 million episodes of fever and 0.7 million persons >1 year of age seeking medical care for fever each year. For each person with serological confirmed Brucella infection there are about 31 infected persons in the community. There are at least 16,260 Shigella, 6612 Salmonella, and 6912 Brucella cases yearly. CONCLUSION: This study provides baseline information of the burden of selected foodborne pathogens for 1 year in Jordan and indicates significant underreporting and under-diagnosis of Shigella and Salmonella infections.

Obesity and diabetes in Jordan: findings from the behavioral risk factor surveillance system, 2004.

INTRODUCTION: Chronic diseases are the leading cause of morbidity and mortality in Jordan. The Jordanian Ministry of Health, in collaboration with the Centers for Disease Control and Prevention, established a behavioral risk factor surveillance system to monitor the behavioral risk factors associated with chronic diseases. METHODS: We used a multistage sampling design to select households from which we then randomly selected and interviewed one adult aged 18 years or older. A random subsample of the adults interviewed were then invited to visit the local health clinic, where we obtained medical measurements, including blood lipids (low-density lipoprotein, high-density lipoprotein, and triglycerides) and fasting blood glucose. RESULTS: Approximately 9% of the participants in the subsample who underwent medical testing reported having been diagnosed with diabetes previously, compared with 16.9% diagnosed in our laboratory testing. About 12.3% of the participants were glucose intolerant, and about 35% were obese. Obesity was significantly associated with diabetes, high blood pressure, high cholesterol, and asthma. Compared with adults of normal weight, obese adults had an adjusted odds ratio of 3.27 (95% CI, 1.58-6.76) for diabetes, 3.69 (95% CI, 2.13-6.39) for high blood pressure, 3.45 (95% CI, 1.68-7.10) for high cholesterol, and 5.12 (95% CI, 1.53-17.19) for asthma. DISCUSSION: Obesity, poor diet, and physical inactivity create a major chronic disease burden in Jordan that is likely to increase substantially in the next few years. Our findings argue for establishment of a more preventive orientation in health care and public health systems in Jordan.

Health related quality of life measures by demographics and common health risks, Jordan 2004.

OBJECTIVE: To measure health-related quality of life (HRQOL) in Jordan. METHODS: A multi-stage sampling design was used to select households where an adult 18 years of age or older, selected at random, was interviewed. Four HRQOL questions, initially developed by the U.S. CDC, related to mental and physical health were included in the questionnaire and overall unhealthy days were calculated. HRQOL measures were compared to selected chronic conditions and risk factors. RESULTS: Older adults (aged 65 and over), females, persons who were illiterate or with only primary education, and persons with monthly income less than $ 140 reported the highest percentage of fair or poor health and > or =14 overall unhealthy days compared to persons without these characteristics. A high percentage of persons with asthma (33 %), hypertension (37 %), high blood cholesterol (37 %), and diabetes (47 %) also reported fair and poor health. CONCLUSION: Demographic characteristics, the presence of a chronic condition or a chronic disease risk factor are important determinants of mental and physical well-being in Jordan and should be taken into account when planning public health interventions or prevention and promotion programs.