Predictors of Intention to use Health Literacy Strategies in Patient Education among Health Care Professionals at Public Hospitals of Bahir Dar City: Application of Theory of Planned Behavior.

PURPOSE: Health literacy strategies were using plain language, using visual aids, using the teach-back method, limiting the number of items provided, and providing culture-sensitive care. This study aimed to assess predictors of intention to use health literacy strategies in patient education among healthcare professionals. DESIGN: An institutional-based cross-sectional study, theory of planned behavior. SETTING: Bahir Dar, Northwest Ethiopia, from March 10 to April 10, 2023. SUBJECTS: 422 healthcare professionals. MEASURES: Six items with a response range from 1 = strongly disagree to 5 = strongly agree each item was summed on a five-point Likert scale and its score range (6-30). ANALYSIS: Linear regression, SPSS version 25. RESULTS: A total of 389 healthcare professionals participated with a response rate of 92.18%. The overall mean intention towards health literacy strategies score was 24.02 with (SD ± 3.84). Subjective norm [(ß, .231; 95% CI: .129, .333)], attitude [ß, .162; 95% CI: .072, .252], perceived behavioral control [(ß, .121; 95% CI: .022, .221)], having got training [(ß, .125; 95% CI: .348, .530)] and knowing health literacy [(ß, .251; 95% CI: .131, .371)] were factors. CONCLUSION: The mean score of intention to use health literacy strategies was very low. Attitude, subjective norm, perceived behavioral control, training, and knowledge of health literacy strategies were predictors. Therefore, different strategies should be applied to increase the utilization of health literacy strategies.

Lived Experience of Adult With Heart Failure at Tibebe Ghion Specialized Teaching Hospital Northwest Ethiopia, Qualitative Phenomenological Study.

Background: Heart failure is major public health problem that affects many people worldwide. It affects all aspects of patients' lives, leading to extreme physical, social, and functional restriction and increasing psychological distress. The purpose of this study was to explore the lived experience of adult patient with heart failure at Tibebe Ghion Specialize Hospital, Ethiopia, 2022. Method: Qualitative Phenomenological study design was conducted at Tibebe Ghion Specialized Referral Hospital, from November 10 to December 15, 2022. Heterogenous purposive sampling technique was used to select 11 study participants. Data were collected through in-depth interviews guides and observational checklist. The rigor and trustworthiness of the study were maintained by transferability, dependability, credibility, and conformability. Thematic analysis method was used for the development of codes and themes using ATLAS. ti.7 software for analysis. Result: Five main themes and eleven subthemes were developed that explore the lived experience of adults with heart failure. Impact of heart failure on daily life, psychological and spiritual experiences, financial experiences, experiences related to hospital service, and challenges to getting treatment are major themes. Unavailability of medicine, lab investigations, and the inaccessibility of cardiac centers were the main challenges during their treatment. Conclusion: This study explored that lived experience of adult HF patients were addressed in in terms of Physical, Psychological and Spiritual, financial, hospital service and challenges to get treatment. Therefore, we recommended providing psychological and economical support for HF patients and in addition to accessing medication and medical care centers.

Mothers' intention to vaccinate their daughters against human papillomavirus in NorthWest Ethiopia, using the theory of planned behavior.

Human papillomavirus (HPV) is the second most common cause of cancer worldwide among females. HPV vaccination is highly protective against HPV infection and can reduce 56% of HPV infections. Therefore, the study aims to assess mothers' intention to vaccinate their daughters aged 9-14 years old against human papillomavirus in Debre Tabor town, Northwest Ethiopia, using the theory of planned behavior. A community-based cross-sectional study design was employed using the theory of planned behavior from November 1 to 30, 2022, in Northwest Ethiopia. A total sample of 449 study participants was enrolled. The study participants were selected using a multi-stage random sampling technique. Data was collected using an interview-administered questionnaire. The data was entered into EPI data version 4.6 and then, exported to SPSS version 23 for analysis. Those variables with a p-value <.05 with 95% CI were considered significant predictors. Mothers' positive intention to vaccinate their daughters aged 9-14 years against HPV was 67.5%. Attitude, perceived behavioral control, and subjective norm were significant predictors with (AOR = 10.09, 95% CI = 6.23-16.32), (AOR = 4.12, 95% CI = 2.71-6.26), and (AOR = 16.397, 95% CI = 9.69-27.748), respectively. Only two-thirds of mothers have a positive intention to vaccinate their daughters against human papillomavirus. Attitude, perceived behavioral control, and subjective norm were predictors. Therefore, it is better to do community mobilization toward the advantage of HPV vaccination.

Behavioral Responses for Face Cleanliness Message to Prevent Trachoma Among Mothers Having Children Age 1-9 Years Old, in Fogera District, Northwest Ethiopia: An Application of Extended Parallel Process Model.

Background: Trachoma is an eye disease caused by bacteria called Chlamydia trachomatis. This infection causes papillary and/or follicular inflammation of the tarsal conjunctiva referred to as active trachoma. Active trachoma prevalence among 1 to 9 years old children is 27.2% in Fogera district (study area). Many people still require the implementation of the face cleanliness components of the SAFE strategy. Even if face cleanness is an important component to prevent trachoma, there is limited research done on this area. Therefore, the purpose of this study is to assess behavioral responses to face cleanliness messages to prevent trachoma among mothers having children aged 1 to 9 years old. Methods: A community-based cross-sectional study was conducted with the guidance of an extended parallel process model in Fogera District from December 01 to December 30, 2022. A multi-stage sampling technique was used to select 611 study participants. Interviewer administered questionnaire was used to collect the data. Bivariable and multivariable logistic regression analysis was done to identify predictors of behavioral responses using SPSS V.23 significant variables were declared by AOR at a 95% confidence interval and a p-value <0.05. Result: Among the total participants, 292 (47.8%) were in danger control. Residence [AOR = 2.91; 95% CI: (1.44-3.86)], marital status [AOR = 0.79; 95% CI: (0.667-0.939)], level of education [AOR = 2.74; 95% CI: (1.546-3.65)], family size [AOR = 0.57; 95% CI: (0.453-0.867)], round trip to collect water [AOR = 0.79; 95% CI: (0.423-0.878)], having information about face washing [AOR = 3.79; 95% CI: (2.661-5.952)], Source of an information health facility [AOR = 2.76; 95% CI: (1.645-4.965)], school [AOR = 3.68; 95% CI: (1.648-7.530)], health extension workers [AOR = 3.96; 95% CI: (2.928-6.752)], Women development army [AOR = 2.809; 95% CI: (1.681-4.962)], knowledge [AOR = 2.065; 95% CI: (1.325-4.427)] self-esteem [AOR = 1.013; 95% CI: (1.001-1.025)], self-control [AOR = 1.132; 95%CI: (1.04-1.24)], and future orientation [AOR = 2.16; 95% CI: (1.345-4.524)] were found to be statistically significant predictors of behavioral response. Conclusion: Less than half of the participants were in the danger control response. Residence, marital status, level of education, family size, face-washing information, source of information, knowledge, self-esteem, self-control, and future orientation were independent predictors of face cleanliness. Strategies of face cleanliness messages should give high attention to perceived efficacy with consideration of perceived threat.

Lived experience of young people with epilepsy in Bahir Dar city government hospitals, Ethiopia, a qualitative interview study.

BACKGROUND: Epilepsy is the most common neurological disorder, which is characterized by persistent derangement of the nervous system due to an abrupt excessive discharge of the group of neurons from the cerebrum. For developing young people with epilepsy coping with the challenges of living with epilepsy and adjusting normative tasks associated with adolescence is stressful in all domains of the lives of young people with epilepsy. But in Ethiopia, published literature regarding the lived experience of young people with epilepsy is lacking. OBJECTIVES: This study aims to explore lived experience of young people with epilepsy. METHODS: A qualitative interview study was conducted in Bahir Dar city government specialized and referral Hospitals, from February to April, 2021. Using the rule of saturation, a total of 11 study participants (age 12-24) were selected using hetrogenious types of purposive sampling technique. The data were collected through semi structured interviews technique with the aid of audio recorder. Semi-structured interview guide and observation checklist for care context in health facilities were used. The collected data was transcribed word by word and translated conceptually. The Data were analyzed using thematic approach. The credibility, dependability, Conformability and transferability of the study were assured using different techniques such as peer debriefing, member checking; audit Trail, thick description and purposeful sampling. Atlas- ti version7 software was used to facilitate data analysis. RESULTS: The participants' narratives revealed two main themes: 'experiences due epilepsy' and 'coping strategies to wards epilepsy'. Experience due to epilepsy' was described by young people with epilepsy in terms of psychosocial, physical, economical and health care related experiences. They described coping strategies towards epilepsy in terms of finding support from family and society as well as religious institutions and other traditions as copping strategy. CONCLUSION: Even though young people with epilepsy had suffered a lot of hurtful experiences, they reported coping strategies towards epilepsy that include support from various sources. These types of findings have implications for social work interventions for young people living with epilepsy.

Application of the integrated behavioral model to identify the predictors of toothbrushing practices among primary school children at Bahir Dar city, Ethiopia.

Knowing the level of behavioral intention and tooth-brushing practices is crucial for the implementation of the intervention. However, such studies are too limited in Ethiopia. The current study employed a health behavior model to identify predictors that can serve to support primary school children's attitudes, intentions, knowledge, environmental constraints, and practices of tooth brushing. Thus, this study aimed to assess tooth brushing practices and their predictors among primary school children in Bahir Dar city, Ethiopia. An Institutional based cross-sectional study was conducted among primary school children in Bahir Dar city. A multi-stage sampling technique was used to select 610 participants. Data were collected using pre-tested interviewer-administered questionnaires. Questionnaires adapted from items' previous literature were used for integrated behavioral model constructs incorporated with elicitation study results. Data were entered into Epi data and then analyzed by Stata. Descriptive statistics were done. Confirmatory factor analysis was performed to check the convergent validity of the measurement. The Internal reliability of the items was also checked using composite reliability. Multivariable logistic regression was used to predict the role of independent variables in toothbrushing practices. Moreover, path analysis was performed to check the causal effect of integrated behavioral model constructs on toothbrushing practices. The goodness of fit of the final model was checked using the Hosmer and Lemeshow test of best fit with a large p value = 0.97 and Area under receiver operating characteristics curve = 0.98. The overall prevalence of the current practice of toothbrushing among the respondents was 45.4%. The prevalence of brushing frequency was 243 (89.01%), 27 (9.89%), and 3 (1.09%) brushed once a day, twice a day, and more than twice a day respectively. Female child's [AOR 3.23, 95% CI 1.48-7.02], mothers' education [AOR 4.6; 95% CI 1.22-17.44], past experience of toothbrushing [AOR 0.042; CI 0.018-0.101], knowledge about tooth brushing practices [AOR 1.3; 95% CI 1.09-1.60], behavioral intention [AOR 2.01; 95% CI 1.74-2.32], experiential attitude [AOR 1.09; 95% CI 1.01-1.17],instrumental attitude [AOR 1.02; 95% CI 1.01-1.03], and descriptive norm [AOR 1.07; 95% CI 1.01-1.14] were predictors of toothbrushing practices. The findings indicate that the practice of toothbrushing practices among primary school students was low. Sex, mother's education, knowledge, intention, experience, experiential attitude, instrumental attitude, and descriptive norm, have significant effects on toothbrushing practices; indicating that the integrated behavioral model showed adequate utility in predicting toothbrushing practices in the study area. School-based toothbrushing practices change interventions such as communication strategy.

Behavioral responses for facemask use messages to prevent COVID-19 among residents of Bahir Dar City, Ethiopia: an application of extended parallel process model.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic causes major morbidity and mortality in the world. Timely behavioral response assessment of the community is important to shape the next effective interventions and risk communication strategies to adopt preventive behavior. Hence, this study aimed to assess behavioral responses for facemask-use messages to prevent COVID-19 and its predictors among residents of Bahir Dar City, Ethiopia, 2021 by using the Extended Parallel Process Model.  METHODS: A community-based cross-sectional study was conducted with the guide of the Extended Parallel Process Model in Bahir Dar city from March 9 to April 9, 2021. A multistage sampling technique was used, and data was collected through a face-to-face interviewer-administered questionnaire using Epicollect5. Descriptive statistics and Binary logistic regression were computed using SPSS V.25. Variable with P < 0.25 in the bivariable analysis was a candidate for multivariable analysis to control confounding effect. In multivariable analysis, variables with P < 0.05 were considered statistically significant and the result was presented using an adjusted odd ratio (AOR) with a 95% confidence interval (CI). RESULTS: A total of 616 participants with a response rate of 97.1% were included. Of the total participants, 229(37.2%) were in the danger control response. The behavioral response was affected by Occupational status [AOR (95%CI) 3.53(1.67-7.46)], the number of people living together [AOR (95%CI) 2.62(1.28-5.39)], self-control [AOR (95%CI) 1.14(1.05-1.25)], a friend for the preferred source of information [AOR (95%CI) 5.18(3.22-8.33)] and printed materials for the preferred channel [AOR (95%CI) 2.14(1.35-3.43)]. CONCLUSION: Above one-third of the participants were in the danger control response. Occupational status, number of people living together, self-control, a friend for the preferred source of information, and printed materials for the preferred channel were independent predictors of resident behavioral response to the use of facemasks. Policymakers should consider students and people who live alone. Message developers should use a friendly person to transmit messages and should prepare printed materials. Activities and strategies should also focus on self-control and perceived efficacy without ignoring the perceived threat.

Self-care practice, lived experience of type 1 diabetes mellitus patients at Kemisse General Hospital, North Eastern Ethiopia: Phenomenological study.

Objectives: To explore self-care experience of type 1 diabetes mellitus patients at Kemisse General Hospital, North east Ethiopia. Methods: A phenomenological study was conducted to explore self-care experience of type 1 diabetes mellitus patients at Kemisse General Hospital from 28 February 2020 to 15 March 2020. Participants were selected using a heterogeneous type of purposive sampling technique. Data were collected using in-depth interviews and observation with the aid of an audio recorder and interview guide by the principal investigator. The thematic analysis approach was used to analyze the data. To facilitate the data analysis process, Atlas. ti software version 7 was used. Results: The six interconnected themes that were emerged from the analysis are: (1) physical exercise, (2) dietary practice, (3) medication adherence, (4) self-monitoring of blood sugar, (5) problem-solving skill during hypoglycemia and hyperglycemia, and (6) diabetic foot care. Conclusion: The study described that type 1 diabetic patients at Kemisse general hospital faced difficulty in self-care practice, which were difficulty in medication adherence; foot care was neglected diabetes self-care, did not practice diabetes recommended dietary plan and lack of regular physical exercises. In addition to this, self-monitoring of blood sugar was not practiced regularly due to the absence of glucometer machine and financial constraints to buy test strips. In addition to diabetic patient's role to manage hyperglycemia and hypoglycemic episode, family support was crucial to managing hypoglycemia because most of the respondent's experience loss of consciousness during a hypoglycemic attack.

Voluntary Blood Donation Among Bahir Dar University Students: Application of Integrated Behavioral Model, Bahir Dar, Northwest Ethiopia, 2020.

INTRODUCTION: The World Health Organization recommends that 1% to 3% of a country's population should donate blood to meet its demand and should focus on young people to achieve 100% voluntary blood donation. The aim of this study was to assess voluntary blood donation among Bahir Dar University students by using an integrated behavioral model. METHODS: An institution-based cross-sectional study was conducted on Bahir Dar University students from March 1-21, 2020. A multi-stage sampling technique was applied to select 625 study participants. Data were entered in Epi data version 3.1 and then exported to SPSS version 23.0 for analysis. Path analysis was done using Stata 15 to check the causal effect of the integrated behavioral model constructs on voluntary blood donation. Internal consistency and validity of constructs were checked using Cronbach's alpha and exploratory factor analysis, respectively. Multivariable linear and logistics regression were used to predict independent predictors on intention and voluntary blood donation, respectively. The significant independent predictor was declared at 95% confidence interval and P-value < 0.05. RESULTS: One hundred and four (16.8%) university students donated blood voluntarily. Being female (AOR = 1.92 (1.15-3.22)), being third year (AOR = 2.88 (1.55-5.35)), knowledge (AOR = 1.53 (1.32-1.77)), descriptive norm (AOR = 1.10 (1.01-1.12)) and intention (AOR = 1.42 (1.28-1.57)) were positively associated with blood donation. Injunctive norm (B = 0.06) and self-efficacy (B = 0.36) have significant association with intention. Intention, descriptive norm and knowledge have significant effect on blood donation with path coefficient 0.0, 0.09 and 0.48, respectively. CONCLUSION: The magnitude of voluntary blood donation was low as compared to other similar studies. Descriptive norm, intention, knowledge, sex, year of study were significant predictors associated with voluntary blood donation. Therefore, behavioral change health communication strategies should develop to address these factors among the students. Researchers should conduct prospective analytical study design to examine the causal relationship of constructs of the model to develop better interventional strategy.

Postabortion contraceptive use in Bahir Dar, Ethiopia: a cross sectional study.

BACKGROUND: Although promoting postabortion family planning is very important and effective strategy to avert unwanted pregnancy, less attention was given to it in Ethiopia. Thus, this study aimed to assess contraceptive use and factors which are affecting it among women after abortion in Bahir Dar town. METHODS: Facility based cross-sectional study was conducted in Bahir Dar town. The data was collected using structured interviewer administered questionnaire from women who obtain the abortion services. Bivariable and multivariable logistic regression was used to evaluate the association that demographic factor and reproductive characteristics have with postabortion contracetive use. Findings with p-value of < 0.05 at 95% CI were considered as statistically significant. RESULTS: A total of 400 women who received abortion service were participated in this study. The proportion of postabortion contraceptive use is 78.5%. Single women are 7.2 times more likely use contraceptive after abortion as compared to their counterpart. Contraceptive use is 2 times higher among women who have previous history of abortion as compared to their counterpart. Women who used contraceptive previously and who used contraception for index pregnancy are 4.73 and 2.64 times more likely to use contraceptive after abortion as compared to their counterpart respectively. CONCLUSION: Postabortion contraceptive use is associated with age, marital status, having previous history of abortion, previous contraceptive use and using contraception for index pregnancy. Greater emphasis should be given on providing postabortion contraceptive counselling to increase utilization of postabortion contraceptive use.

Epidemiology of multidrug-resistant tuberculosis (MDR-TB) in Ethiopia: a systematic review and meta-analysis of the prevalence, determinants and treatment outcome.

INTRODUCTION: The emergence of MDR-TB remained a major public health threat particularly in developing countries. With increased prevalence and complexity of treatment, the burden of MDR-TB challenged the country. It is of an important; the epidemiology of drug resistant TB is not well understood. There are few studies conducted to assess the prevalence, determinants and treatment outcome of MDR-TB with inconclusive finding. Therefore, we aimed to conduct a systematic review and meta-analysis on Epidemiology of MDR-TB in Ethiopia, So that policy makers and other stalk holders could have pooled evidence on the problem to make a decision. METHODS: The review was conducted through a systematic literature search of articles published between 1997 and 2017. Five bibliographic databases and libraries: PubMed/Medline, Global Health Database, Embase, the Cochrane Library, and African Index Medicus were used. After cleaning and sorting, analysis was performed using STATA version 11. The pooled rate of MDR-TB prevalence, determinants and treatment outcome was estimated with a random-effects model. Heterogeneity was assessed by the I2 and publication bias through funnel plot. RESULTS: The 34 studies that were retained for final analysis enrolled a total of 7461 TB or MDR-TB patients. We found that 2.18% (95% CI 1.44-2.92%) of newly diagnosed and 21.07% (95% CI 11.47-30.67%) of previously treated patients have MDR-TB with overall prevalence of 7.24% (95% CI 6.11-8.37). History of previous treatment is the major determinant (pooled OR = 4.78 (95% CI 3.16-6.39)), while contact history and adherence also contributed. In this review the pooled death computed among 5 articles showed that 12.25% (95% CI 9.39-15.11%) of MDR-TB patients were died in the course of treatment. Complication, drug side effects and HIV infection were the main determinants for the death. CONCLUSION AND RECOMMENDATION: The prevalence is by far higher than the previous reports. It is mainly associated with history of previous treatment along with contact history. However, the treatment outcomes are comparable with previous studies, yet it is a concern. Comorbidities, drug side effects and HIV sero-positivity were the determinants. Thus, proper treatment of drug susceptible TB and early detection and treatment of MDR-TB before complication develops along with prevention of drug side effect and contacts with MDR-TB cases are very important.

Testicular self examination among Bahir Dar University students: application of integrated behavioral model.

BACKGROUND: Though the incidence of Testicular cancer among young is rising, little attention is given to promoting testicular self-examination which is recommended for its early prevention in developing countries. This study aimed to assess testicular self-examination and associated factors among Bahir Dar University students using integrated behavioral model. METHODS: Cross sectional study was conducted among Bahir Dar University students in September, 2016. Systematic sampling technique was used to select 884 participants. Data was collected using self-administer questionnaire, entered into EPI Data 3.1 and exported to SPSS 21 for analysis. Path analysis was done using STATA 14.2 to check causal effect of integrated behavioral model constructs on testicular self-examination. Internal reliability of the items was checked using Cronbach's alpha. Multivariable linear and Logistic regression were used to predict the role of independent variable on Intention and TSE respectively. Findings with p-value <0.05 at 95% confidence interval were considered as statistically significant in the final model. RESULTS: Only 11.8% of the students practiced testicular self-examination in the previous year. Experiential and Instrumental attitude, Perceived control and Self-efficacy were significantly predicted behavioral intention with ß coefficient 0.33, 0.12, -0.08 and 0.36. Students' academic unit [OR = 0.31, 95% CI: 0.15-0.63], educational status of student's father AOR = 2.25; CI: 1.15-4.44] and [AOR = 3.00; CI: 1.36-6.64], Intention [OR = 1.2, 95% CI: 1.1-1.31], Know-how of TSE [OR = 3.35, 95% CI:1.94-5.80] and knowledge [AOR = 3.93; CI: 2.30-6.72] were the significant predictors of testicular self-examination. The finding of path analysis also demonstrated as Experiential and Instrumental attitude, Perceived control and Self-efficacy have significant effect on intention with path coefficient of 0.33, 0.12, -0.07 and 0.36. Intention, Knowledge and Know-how have effect on testicular self-examination with path coefficient of 0.2, 0.36 and 0.22 respectively. CONCLUSIONS: Magnitude of testicular self-examination is low among university students and it is a product of the type of the college, family educational status, intention, Know-how and knowledge. So, behavior change communication strategy that focus on these behavioral factors should be designed and implemented to improve students' regular practice of testicular self-examination.