Public Health Institute Journal (LJMU)
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A quantitative study on the attitudes, knowledge and behaviour of university students regarding food waste
No full textThe United Kingdom (UK) produces 6.6 million tonnes of household food waste annually; 70% of this was previously edible food (WRAP, 2021). This is nearly £14 billion of wasted food every year and equates to about £60 per month for an average household, or the equivalent of eight meals a week. A study by Zero Waste Scotland (Acheson, 2019) showed that most students at university waste approximately £5.25 worth of food a week, or £273 annually. The aim of this study was to assess university students’ attitudes, knowledge and behaviour towards food waste. An anonymous online questionnaire was distributed, using convenience sampling, to university students in the UK via Canvas and university student forums. Students were asked questions to show their knowledge around use-by and best-before dates, purchasing behaviours and preparation habits. Participants were also asked about attitudes towards food waste and why they can or cannot prevent food waste in the home. Questions were also asked about how these students disposed of food waste. There were 138 responses. The results of the questionnaire showed that students generally understood the difference between use-by and best-before dates, but a small percentage did not. This increases the likelihood of food poisoning if food is consumed past its use-by date and would contribute to food waste if disposed of past its best-before date, whilst still being safe to eat. The results of this study also showed that many students do not write a shopping list or check food stocks before going shopping, which can contribute to impulse purchases and over-buying food, which is ultimately wasted. Many students also struggled to buy economically for small households and ended up preparing too much food, which could either be wasted or contribute to other public health issues such as obesity. The results also showed that university students struggled to dispose of food in an environmentally friendly way as many university accommodations do not provide food waste bins. These results are displayed in graphs and are further discussed with comparisons and differences from the literature. The recommendations that have arisen from this study include enforcing legislation to ensure that food waste is disposed of in an environmentally friendly way and ensuring there are methods of food waste disposal in university accommodations that do not send the waste to landfill. Recommendations were also made for educational campaigns to increase awareness of food safety and the importance of proper food preparation to ensure food is not wasted unnecessarily. The researcher also felt a qualitative approach to this study would gather more in-depth opinions from participants
A quantitative analysis of the impact of Limited English Proficiency (LEP) on time to dispatch for individuals calling 999 to access emergency care from a regional NHS ambulance service in England.
No full textBackground: Telecommunication is the established method that the ambulance service is accessed by the public in emergency circumstances. By using verbal means alone, an Emergency Medical Dispatcher (EMD) must gain critical information from a caller to assess the severity of a patient’s injury or condition to ensure that resource to life-threatening incidents as a priority. Language barriers between the caller and the EMD during a 999 call have the potential to delay dispatching an emergency response vehicle due to miscommunication or the need to access a third-party translation service. This study explores the impact of Limited English Proficiency (LEP) on emergency response vehicle dispatch times for individuals calling 999 to access emergency care from a regional NHS ambulance service in England
Methods: Analysis of secondary data from a single, regional NHS ambulance service in England was undertaken to assess whether there was a statistically significant difference between time to dispatch for 999 callers with reported LEP and those who do not report LEP. Data were collected for 999 calls received between 01 January 2021 and 31 December 2021.
Results: For call categories 1 to 5, the mean to time to dispatch was statistically higher for 999 callers with LEP compared to time to dispatch for callers that did not report LEP (Call Categories 1 – 3, p = <.001; Category 4, p = .001; Category 5, p= .003).
Conclusion: This research suggests that when individuals with LEP call 999 to access emergency care from the ambulance service, there is a statistically significant increase to time to dispatch compared to those that do not experience language barriers during a 999 call. This research contributes directly to public health action at the participating NHS organisation by providing a foundation to its equality, diversity, and inclusion agenda, as one of the key areas for improvement is the impact of English as a second language on access to the 999-emergency service and the NHS 111 urgent care service. This research could support the recommendation to introduce standardised LEP reporting to allow for consistent recording of LEP cases on 999 calls to support robust monitoring that would allow for further investigation of the impact of language barriers to dispatch times
An interview study of vaccine hesitancy and vaccine vacillation towards the COVID-19 vaccine among LJMU University students
No full textBackground: Young adults generally do not consider themselves susceptible to COVID-19 infections and complications due to their age and level of physical health. However, there have been incidences where young adults with COVID-19 infections have experienced serious complications, disability, and even death. Young adults who need to be hospitalised due to COVID-19 infections and complications further increase burden on healthcare systems. Furthermore, young adults who are not vaccinated against COVID-19 could contribute to further risks for vulnerable groups. Research focusing on knowledge, perception and beliefs of university students regarding the COVID-19 vaccine, as well as factors and decision making processes which influence vaccine hesitancy and vaccine vacillation are limited. This study explores vaccine hesitancy and vaccine vacillation towards the COVID-19 vaccine amongst Liverpool John Moores University (LJMU) University Students
Methods: Face to face semi-structured interviews were carried out with two participants. Interviews lasted for 30 minutes, were recorded, stored and then transcribed verbatim.
Results: Thematic analysis was conducted. Findings from the interviews produced several sub-themes and themes: the knowledge, perception and beliefs of participants regarding the COVID-19 vaccine; perceptions of individual health risk and severity of COVID-19 infections in the society influencing the participants’ factors behind vaccine hesitancy and vaccine vacillation; desire for normality and duty of care influencing the participants’ decision-making processes; the participants’ knowledge, perception and beliefs, and their factors behind vaccine hesitancy and vaccine vacillation influenced their desire and need for the booster dose of the COVID-19 vaccine.
Conclusion: Findings from the study showed that the knowledge, perception and beliefs of university students regarding the COVID-19 vaccine could influence vaccine hesitancy and vaccine vacillation. By understanding the views, perception, and opinions of student, and the factors influencing their decisions, and their decision-making processes, public health education could be adapted to inform better dispersion and communication of information, and could allow for more informed decision-making when considering vaccines
Connection: A qualitative study exploring the experiences of professionals who delivered remote alcohol support during the Covid-19 pandemic in Greater Manchester.
No full textBackground: The Covid-19 pandemic saw the emergence of a significant public health concern in relation to alcohol use, with an unprecedented increase in alcohol related harm and consumption in England. The governments restrictions forced specialist alcohol treatment services to change from a traditional in-person offer of support to a model of remote support. Previous research has highlighted that remote alcohol support and interventions may be a way of overcoming traditional barriers to access support from alcohol services. Equally, research has highlighted that remote support increases barriers for those without the technology or the ability to access it. This study aimed to explore the experiences of professionals who delivered remote support during this period to understand the impact of these changes.
Methods: A qualitative phenomenological design was used to conduct the research. Semi-structured online interviews were undertaken with a sample of six professionals who had delivered remote support or interventions whilst working for or alongside alcohol treatment services within Greater Manchester during the Covid-19 pandemic.
Results: The findings highlighted both positive and negative themes around the switch to the model of remote alcohol support. The study highlighted that the increased flexibility offered by remote support from alcohol treatment services significantly increased engagement. Participants highlighted engagement from groups who had previously experienced barriers to accessing support from alcohol services. The research equally highlighted a belief from participants of the vital role that in-person support plays for those accessing alcohol treatment services. Participants universally raised concerns around risk and safeguarding issues when working remotely. Equally, the move away from in-person support was considered as a negative in relation to the building of a therapeutic alliance and the opportunity to build connections with others through group work.
Conclusion: The fundamental change in the offer of support during the Covid-19 pandemic has highlighted the need for a blended and flexible offer from specialist alcohol services. Choice in how support is received should be offered to anyone wanting to access services, whilst also ensuring that risk and safeguarding issues are correctly managed with in-person appointments when considered most appropriate to do so.
 
Associations between Sexual Orientation and Gender Identity (SOGI), and barriers to healthcare among LGBTQ+ population in Bangkok, Thailand: International Public Health Dissertation Prize Winner
No full textBackground: Despite the seeming social acceptance of the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community in Thailand, they are not legally accepted and recognised. LGBTQ+ individuals have varied Sexual Orientation and Gender Identities (SOGI) and can experience accessibility and acceptability barriers to healthcare which violate their right to health. As a result, physical and mental health can be negatively affected. There is a dearth of research on barriers to healthcare using the right to health approach experienced by LGBTQ+ population in Thailand. This study aimed to determine associations between barriers to healthcare and SOGI, and to explore understanding of SOGI questions among LGBTQ+ residing in Bangkok.
Methods: A quantitative study using an online questionnaire was undertaken. Data were collected between March to June 2022 with support from gatekeepers in Bangkok. Ethical approval; Reference Number PHIPGT2033. Descriptive statistics, using Kruskal-Walls test (with post-hoc testing), and Pearson’s Chi-square test were performed to determine the associations.
Results: A total of 229 participants were included for the analysis; the majority were aged 25-34 years old (64%). Almost 45% identified as heterosexual/straight, 39% as gay, and 7.9% bisexual. More than half were transgender (63%); 25% identified as male or female, and 12% having other gender identities. Gay men experienced significantly higher accessibility and acceptability barriers compared to bisexual and lesbian, respectively (p-value <0.05). There were significant differences between trans people and individuals with other gender identities and gender binary (p-value<0.05). Within trans community, trans male experienced higher financial barrier than trans female (p-value<0.001). Participants with young age, lower education, student status and lower income experienced higher level of both barriers (p-value<0.05)
Conclusion: With SO- and GI-segregated, transgender and gay individuals experienced significant accessibility and acceptability barriers to healthcare. Individuals with younger age, lower level of highest education, lower income and being a student experienced substantial barrier. It is crucial for public health practitioners to identify distinct barriers which may impact people with different SOGI and characteristics. Standardised collection of SOGI would help identify unique barriers and so could positively impact health policies ensuring the right to health for LGBTQ+ people to access equal healthcare in Thailand.
 
Editorial
No full textWelcome
Welcome to the fifth issue of the PHI journal. Our guest editorial comes from Simone McKenna who completed the BSc Public Health Programme last year and is currently studying on our MSc Public Health Programme. Simone won the prize for best undergraduate public health dissertation.
When I first heard I needed to do a dissertation in my final year BSc Public Health, it seemed pretty daunting and challenging, being a lot bigger than your usual assignment. However, I was also very excited, knowing that I had a passion for writing, as well as getting the chance to do a research project on a topic of my own choice, and pursuing my very own path. I had so many topics in mind, it was hard to choose one. I had already started thinking about potential topics as early as first year. I realized this is what is so interesting about public health, it is such a broad area with so many fascinating topics to research, with great scope for such intriguing, solid and well-informed research. When it came to actually doing my dissertation, I decided on a topic I was really passionate about: the impact of Instagram on body image in adolescent girls and young women. This ended up being a rewarding experience for me-getting to do a research project on a topic I was genuinely invested in, as part of a university degree in a renowned research institute. This meant I was particularly motivated, with the impact of Instagram on health and wellbeing having particularly resonated with me as a young woman who used social media. Independent learning/working is another skill of mine, and so I was thrilled at getting the chance to apply and develop this skill. I have been lucky enough to have supervisors who have been really helpful and supportive throughout my dissertation, making the whole thing a lot easier and less daunting for me, with regular and much needed encouragement. Currently, I am doing my MSc Public Health, further preparing for a career in research. I am working on another dissertation, this time looking at the topic of Adverse Childhood Experiences, another special interest of mine. Helping create better support for children and young people with Adverse Childhood Experiences is really important to me. This is something I have solid insight on, as well as a genuine concern for children and young people with Adverse Childhood Experiences and the various barriers they face, wanting to help make a difference and reduce those barriers. Choosing a topic that you are well-informed on and genuinely care about is key to conducting a good dissertation. Conducting your own research project is truly an amazing feeling and experience, as you are creating your very own piece of work to contribute significantly towards society. You can expand on many issues that are only viewed from a snapshot lens, or even overlooked, providing deeper perspectives. I am therefore pleased to see the continuing contributions of research that students have to offer, as they will all be sure to enhance public health knowledge and practice.
Simone McKenn
A survey study investigating the knowledge, attitudes and practices of students attending universities in the United Kingdom with regards to food labelling on prepacked food
No full textMany individuals fail to read, understand or comply with the information presented on food labels, such as ‘best before’ and ‘use-by’ dates, allergen information and nutritional information. Various studies have found links between failing to check and understand the items on food labels, and unhealthy dieting, allergenic reactions, foodborne illness, and excess food waste. These impacts have negative implications for public and environmental health, and often lead to economic loss. Although many previous studies have investigated the knowledge, attitudes and practises of students regarding food labelling, there was a gap in literature for up-to-date research involving United Kingdom (UK) university students and food labelling. Therefore, the aim of this research was to investigate the knowledge, attitudes and practises of university students studying in the UK, regarding food labelling on prepacked food. This study hoped to gain an insight and answer questions on students’ levels of knowledge and beliefs, as well as purchasing and consumption practises when it comes to prepacked food labels. This quantitative study collected data through an online questionnaire which was posted on various social media platforms such as Instagram, Snapchat and Facebook. A convenience sampling method was used, collecting responses from 66 students, with findings including demographic information, and the knowledge, attitudes and practises that they had surrounding food labelling. Microsoft Excel was used to present the findings in graphs and tables. Results showed that 98.5% of students agreed to the importance of checking best before and use-by dates, and displayed a satisfactory level of knowledge on the meanings behind them. However, many students did not comply with the corresponding disposal practises, as 34.8% of students reported only disposing of a product with a ‘use-by’ date if the quality seemed poor. Almost half of students did not read the nutritional information on food labels. Older age groups of students, and those who lived at home with family, displayed the most food labelling knowledge. Students who were not responsible for purchasing food that they ate displayed less knowledge than students who had at least some food purchasing responsibility. Unfortunately, the questionnaires lacked responses from certain groups of individuals, for example, some levels of university study (Masters and PhD), older age groups and purchasing responsibility levels. Therefore, the researcher recommends that further research targeting these groups of students should be carried out to gain a better insight and to represent all UK university students. Further recommendations by the researcher to improve public and environmental health involve new clubs/campaigns introduced by the university, which encourage and explain the importance of correct food labelling practises; universities producing digital guides with food safety tips; the NHS producing posters to be displayed in university buildings, detailing the negative consequences of a poor nutritional diet; and the incorporation of education surrounding expiry dates into the school curriculum
A survey study investigating the attitudes and perceptions of tattoo studios towards infection control and hygiene practices
No full textThe number of operating tattoo studios is increasing faster than ever within the United Kingdom (UK), formulating a growing public health concern amongst professionals. Tattoo studios that aren’t operating safely and hygienically can potentially spread blood-borne diseases as a result. Very few studies in the UK have investigated the attitudes and perceptions of tattoo studios towards their infection control and hygiene practices. This study looked to help fill this gap. Additionally, the legislative controls relating to safe tattooing differs across the UK and can therefore result in inconsistent hygiene practices across different boroughs. This research study used the convenience sampling method, a non-probability sampling method, to recruit tattoo artists in the Greater Manchester area as participants. The study involved the completion of an anonymous questionnaire to understand the demographic of tattoo artists, their knowledge, attitudes and understanding of good hygiene practice and infection control. The main findings of the research study were that tattoo studios within the Greater Manchester area have a good understanding of good hygiene and infection control practices and implement them in their procedures. The overall average of participants who provided an answer that related to good hygiene and infection control practice was calculated at 95.56%, leaving an average of 4.44% of participants who provided an answer against the desired hygiene and infection control practices. Contrary to this, although they showed good levels of practice, 12.9% of respondents didn’t believe that blood-borne disease could be transmitted through tattooing, showing a lack of education and understanding of the reasons for hygiene practices. This study highlights possible reasons for these results, such as lack of mandatory training across the UK and the incidence of ‘underground’ unlicensed tattoo studios operating with low hygiene standards
A quantitative study exploring the knowledge, attitudes and behaviour of undergraduate students in the United Kingdom towards food safety: Environmental Health Dissertation Prize Winner
No full textFood-borne illness is a major public health concern that results in over 2.2 million deaths per year in the United Kingdom (UK) due to consumption of contaminated food. Studies conducted worldwide have noted shortcomings in food safety knowledge, attitudes and behaviour among university students. Although students themselves are not considered to be at high risk, there are broader implications, as they will eventually become caregivers for their households and a majority will be responsible for vulnerable groups in their immediate environment. The study aimed to explore the overall food safety knowledge, attitudes and behaviours of UK undergraduate students and to compare the relationship between their knowledge, attitudes and behaviour and demographic characteristics. To gather data for this study, a quantitative research design was employed using an online questionnaire as the data collection method. The questionnaire was distributed through the researcher’s social media page, Canvas and with the help of a gatekeeper to recruit Public Health Institute students. Data analysis was conducted using SPSS (version 27) and Spearman’s correlation was used to measure association between variables. The sample for this study consisted of 54 undergraduate students in the UK, with half of the respondents being between 18-25 years, with more than half being female. The mean knowledge score was 3.31 out of seven questions. There was a weak positive correlation found between food safety knowledge and behaviour scores [r=0.168], as well as a weak positive correlation between food safety attitudes and behaviours (r=0.295). The study found that female respondents had better food safety knowledge, attitudes and more hygienic food behaviours. Most respondents did not correctly answer questions related to keeping foods at safe temperatures and cross-contamination. Additionally, participants rarely practiced using a thermometer to determine correct temperatures of foods and they discarded leftover food prematurely. The results can help students to increase their knowledge and awareness of food poisoning. The study highlights the need for educational initiatives, particularly in the context of food insecurity for this population
Cannabis comparative study: public impact and government intervention across the United Kingdom and Canada
No full textThis research paper aimed to compare, contrast, and analyse the extent to which cannabis had harmful impacts and whether current policies in Canada and the United Kingdom (UK) are successful in controlling and monitoring these impacts. Cannabis is one of the most accessible and used narcotics globally. Known for its medical and recreational properties, it is a drug of cultural and economic importance for various countries globally (WHO,2020). Throughout this study the policies examined included the UK’s Misuse of Drugs Act 1971, with declassification reviews in 2004 and 2009; as well as the Canadian Cannabis Act 2018. Comparisons were made across both populations with insight into how they differ and whether one should adopt the other’s approach. Focus was held on the actions of each policy regarding their regulation measures and success with protection regarding public health. All policies were examined according to a set criterion ensuring that they were evidence-based, with peer-reviewed data. Evidence-based policies need to be examined as it demonstrates not only practical implementation of policies, but also provides scientific data and knowledge needed to ensure the credibility of each policy. Examination also considered governmental policy reviews and secondary academic reviews to allow for a transparent analysis across both populations. Examples of those reviewed included, as previously mentioned, the Canadian Cannabis Study 2017 and the UK Advisory Council on Drugs Misuse 2001. With public approval rates of cannabis legislation increasing over previous years in the UK (Office of National Statistics, UK, 2022), it raises the question: are healthcare policies within the UK outdated and is there a need for re-examination of The Misuse of Drugs 1971, specifically regarding cannabis at local and regional levels? Impacts of cannabis were identified and analysed with inclusions of harms and risk across various industrial categories, including cannabis-related drug offenses, health impacts both physical and mental, and economic impact
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