Public Health Institute Journal (LJMU)
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A quantitative study on the attitudes, knowledge and experiences of university students on the consumption of processed foods during the Covid-19 lockdown
No full textThe exponential growth of COVID-19 cases has forced governments to impose lockdowns with restrictions concerning all aspects of human life. COVID-19 may compromise maintaining a healthy and varied diet when university students are already known to participate in risky eating behaviours, such as the increased consumption of high energy and processed foods. The pandemic-related lockdown is identified as a stressful event for humanity. As a result, the pandemic has strongly impacted everyone\u27s daily life, creating anxiety, fear, and panic. These stressful situations alter eating habits and increase the risk of overweight and obesity. The research aims to explore and assess the consumption of processed foods during the COVID-19 lockdown in university students studying within the UK. The research seeks to answer the research objectives and the principle research question; “How has the COVID-19 lockdown (2020) impacted the way university students consume processed foods?” This empirical research study used a quantitative approach to investigate university students\u27 attitudes, knowledge, and experiences on consuming processed foods during COVID-19 lockdown. The data collection method used was an online survey which was distributed through UK university Facebook pages. The questions which comprised the online survey orientated around, 1) The consumption of processed foods, 2) Knowledge, attitudes and experiences of the consumption of processed foods during the COVID-19 lockdown. The survey was conducted from 19th November 2020 to 30th March 2021. A total of 56 respondents have been included in the study, including both women (n=45; 80.4%) and men (n=11; 19.6%). The researcher used self-selection sampling, as the study specifically focused on university students. The researcher\u27s sampling method proved successful as the target number of responses for the online survey was 50 participants. The results show that most university students agree that processed food is less healthy than fresh food. However, the most significant barrier university students faced to eating less processed foods is the cost of fresh food. The results show that during the COVID-19 national lockdown there was a decrease in processed food consumption and an increase in homemade meals, as university students were more aware of what they were eating during this time. The researcher recommends that the UK government and policymakers promote unprocessed or minimally processed foods to reduce the risk of chronic non-communicable diseases associated with processed food within both university students and the wider public. As COVID-19 is new and current, further research is needed to better understand how the current pandemic has impacted how university students consume processed foods during the lockdown
Tuberculosis infection control measures in healthcare facilities, and their implementation in sub-Saharan Africa: A scoping review
No full textBackground: Tuberculosis (TB) is one of the top 10 causes of mortality and the leading cause of death from a single infectious agent globally. In 2019, the World Health Organization (WHO) African Region accounted for 25% of global TB incidence and occupational transmission of TB in healthcare facilities is considered one of the most important transmission factors. It is, therefore, important to address TB infection control measures that limit transmission in healthcare facilities, especially in light of increasing prevalence and new drug resistant strains. The aim of this review is to discuss TB infection control measures in healthcare facilities, and explore their implementation status in one of high TB burden regions: sub-Saharan Africa.
Methods: A scoping review was conducted, allowing the inclusion of different study designs which was necessary for answering the broad research questions. Intervention studies, literature reviews and grey literature were included to identify descriptions of TB infection control measures and their contribution to TB prevention. Cross-sectional and observational studies were included to explore the implementation of these measures in sub-Saharan Africa. The WHO guidance on TB infection control measures (2009) was used as a framework for description of the measures.
Results: Twenty-seven studies were included in the scoping review. Twelve studies (grey literature and traditional reviews) provided information about TB infection control measures, six intervention studies provided information on impact of some TB control measures on TB transmission, and nine studies provided information about the implementation status of the measures in sub-Saharan Africa. Four categories of TB control measures were identified: managerial; administrative; environmental; and personal protective. The review found poor implementation and reporting of the these measures in healthcare facilities in sub-Saharan Africa including low levels screening of coughing patients for TB, and poor implementation of environmental measures such as UV light, and personal protective measures such N95 respirators.
Conclusions: Despite the presence of well-designed WHO guidelines for TB infection control measures in healthcare facilities, there is poor implementation of them in sub-Saharan Africa. Therefore, a rapid global response to infection control in healthcare facilities is required for controlling TB
Knowledge, Attitudes, Perceptions, and Practices towards Cardiovascular Disease Risk Prevention and Management in Patients Living with HIV in Sub-Saharan Africa: A Qualitative Systematic Review
No full textBackground: Cardiovascular diseases (CVD) are projected to bypass HIV as the most common cause of death in sub-Saharan Africa (SSA) by the year 2030. People living with HIV (PLHIV) are more likely to develop and suffer from complications of CVD compared to their HIV negative counterparts. CVD prevention is therefore critical in this group to maintain positive health outcomes and improve health indices in the entire region. To achieve this, it is important to assess patients’ understanding of CVD risks and explore their perceptions and practices, to design targeted interventions. This review was therefore performed to synthesise the best available qualitative evidence of the knowledge, attitudes, perceptions, and practices of CVD risk prevention and management from the perspective of PLHIV.
Methods: Three electronic databases (MEDLINE, CINAHL, PUBMED) were searched for references up to August 2021. Six records from Malawi, Kenya, and South Africa were retrieved and synthesised through a thematic analysis approach. PLHIV in most of the studies had poor knowledge and perceptions about CVD risks.
Results: Analysed data were categorised under two broad themes, namely, knowledge and perceptions, and attitudes and practices. Psychological factors such as stress and denial of HIV status and behavioural factors such as poor diet, physical inactivity, and taking antiretrovirals (ARVs) were often cited as the cause of CVDs. Patients were aware of the dangers of CVDs such as sudden death, vision loss, and heart attacks but had varied attitudes and practices towards its prevention. Financial hardship, unavailability of medication, and hearsay were the main factors that prevented adoption and adherence to both lifestyle measures and medical treatment. Conversely, social, community, family, and peer support, as well as the fear of developing life-threatening complications, motivated some PLHIV to adopt health-seeking behaviours and medical management.
Conclusions: These findings highlight the need for improved patient education and multi-morbid health promotion. It also stresses the need for health policy reforms, and an integrated approach to HIV and CVD treatment and care in SSA
A quantitative study to explore the experience of employees using Personal Protective Equipment (PPE) during the COVID-19 pandemic (March-December 2020)
No full textThis research study focused on exploring employees’ experience with the use of personal protective equipment (PPE) during the COVID-19 pandemic, from March to December 2020. Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus called SARS-CoV-2, the first incidence of this new virus being recorded on 31 December 2019, following a report of a cluster of cases of ‘viral pneumonia’ in Wuhan, People’s Republic of China (WHO, 2020). Although positive impacts such as significantly reducing the infection rates of coronavirus cases have been linked to the use of PPE, a review of the literature around workers’ experience, attitude and awareness highlighted negative effects such as anxiety or depression have been associated with the use of PPE. Additional factors have also been found to have had an influence on these outcomes. To explore this further, an online survey was completed by 78 UK workers who had been using PPE since the start of the pandemic. The participants were recruited through social media (Twitter) and organisation’s gatekeepers. Data was analysed using Excel for descriptive statistics and chi-squared tests were performed. The results showed that the vast majority of participants (90%) had been using additional PPE since the pandemic started and those participants who were using PPE prior to the COVID-19 pandemic were more likely to agree that PPE was important. Generally, participants had a positive attitude towards the use of PPE but expressed that there were challenges when wearing such equipment, for example the level of comfort. Finally, as found in previous research and highlighted in this study as well, it is recommended that companies should do more in regards to spreading awareness about the use of PPE in the workplace, whilst further research can be developed and enhancements could also be made in relation to the equipment itself. The findings presented in this study and the literature reviewed can be a starting point in looking at better ways to improve users’ experience of using PPE. 
An online survey exploring the impact of the UK Menthol Ban on Liverpool John Moores University Student’s cigarette consumption
No full textSmoking is the leading cause of premature and preventative death with 14% of the UK population currently participating in smoking, of which 900,000 are menthol smokers. Menthol cigarettes are flavoured with a menthol compound and are popular amongst young people due to the fresh taste. The Menthol Ban was implemented on the 20th May 2020 to discourage the younger population from participating in smoking and encourage those who smoke menthol cigarettes to quit. A quantitative study using an online survey with health students in Liverpool John Moores University who were 18+ years and previously smoked menthol cigarettes, was undertaken. The research assessed the impact of the menthol ban on student smoking behaviour. The main findings from the online survey were that cigarette consumption did increase with the majority of participants (35%) smoking a few more cigarettes than before the menthol ban. In addition to this, the study found that only 15.4% of participants quit smoking and the rest continued to participate in smoking with the addition of the alternatives. Almost half of participants (45%) stated feelings of anger and upset towards the menthol ban as they believed that their freedom of choice was being withdrawn from them and they were being governed by a nanny state. In addition, 63.8% of respondents felt that it was badly advertised as some were not aware of the menthol ban until it actually happened. However, a small minority (15%) believed this was appropriate stewardship and were happy with the menthol ban because it encouraged them to quit smoking. Further qualitative research is needed to gather in-depth understanding of the thoughts and feelings people displayed as a result of the menthol ban being put in to place. 
Gender based violence and bystander intervention programmes - an investigation into community members’ knowledge, attitudes and confidence to intervene
No full textBackground: Gender based violence (GBV) and more specifically violence against women and girls (VAWG) is global issue which occurs at alarming rates, with an estimated one in three women having experienced some form of GBV inflicted by an intimate partner or non-partner at some point in their life. VAWG and GBV was a pandemic in itself long before the outbreak of COVID-19, however since its outbreak, VAWG has been exacerbated, notably in, but not limited to, the domestic sphere. Bystander intervention (BI) programmes have shown potential as a main preventive strategy for GBV and VAWG and is considered one method to change societal attitudes in an attempt to reduce the prevalence of related violence. Such programmes have typically been implemented in education settings, with few programmes implemented in the wider community. The aim of this project was to evaluate what level of awareness and knowledge members within communities have regarding GBV and BI, their attitudes towards GBV, their confidence of being an active bystander and the need/want for BI programmes as an approach to reduce VAWG.
Methods: A quantitative approach was used (with the inclusion of some open-ended questions) through an online survey. The survey drew on Banyard’s Confidence Scale, the Bystander Attitude Scale revised, the Bystander Behaviour Scale Revised and the Intent to Help Scale. The survey covered questions on participant’s basic demographics, their knowledge of GBV and BI, their attitudes to GBV, their confidence and readiness to intervene and the perceived participant need for BI in community settings. Participants (n=130) were recruited using a convenience sampling method via social media. Quantitative data was analysed using descriptive and correlational statistics in SPSS. Open-ended qualitative survey answers were transcribed and coded. This study was approved by the Research Ethics Committee at Liverpool John Moores University.
Results: Data analysis revealed that the majority of participants had some understanding and awareness of GBV and BI, with most (60.7%, n=79) participants acknowledging that GBV is an issue in their community. The results of this study found that over half of the respondents had heard of the term GBV (52.7%) with a significant relationship between individuals who were educated and their knowledge of GBV (P= .016). A significant effect was observed between participants’ attitudes towards GBV and whether they had heard of the term GBV (P = .001). There was no significant relationship discovered between individuals’ attitudes towards GBV and their age, employment status or whether they had heard of BI. Over half (58.1%, n= 75) of participants reported having previously heard of the term BI. There was no significant correlation reported between having heard of BI and level of education age or employment status. There was a significant relationship between Individuals’ confidence to intervene in cases of GBV and having heard of GBV (P= .033) suggesting that those previous knowledge and understanding of GBV have higher confidence to intervene.
Conclusions: BI have the ability to constructively engage men and women in the fight against violence towards women. Positive changes in behavioural, cognitive, and attitudinal indicators have been documented after bystander interventions. The use of the socio-ecological model has pinpointed numerous protective factors across the societal, community, interpersonal and individual levels which can help develop future BI programmes as a primary preventive method against GBV and VAWG. Further research into the effectiveness of BI in low income and high alcohol dependence areas are needed to fully understand the effectiveness of BI in communities where GBV incidence remains high
Evaluating the Effectiveness of Current Interventions on the Prevention of Adolescent Pregnancy in Low and Middle-Income Countries: A Scoping Review to Evaluate Interventions and Strategies
No full textBackground: Adolescent pregnancy is a global public health concern though with higher prevalence in low and middle-income countries (LMICs). Approximately 21 million girls become pregnant every year with an estimated 12 million of those going on to give birth. Preventing adolescent pregnancy requires having knowledge of causation or determinants so that relevant and effective strategies can be implemented to reduce the prevalence of adolescent pregnancy in LMICs. The aim of this review is to evaluate the effectiveness of current interventions on the prevention of adolescent pregnancy in LMICs.
Method: The scoping review was conducted based on Arksey and O’Malley’s framework, the methodology and guidance of conducting scoping review developed by the Joanna Briggs Institute (JBI) and using the PRISMA guidelines for reporting scoping review. The search included three electronic databases (Medline, PsycINFO and CINAHL) and grey literature from google scholar. The search was confined to studies published from 2010-2021 with participants aged 13-19 years. Studies were included if they had intervention programs on adolescent pregnancy in LMICs.
Results: The scoping review included 10 studies that were relevant to the topic of review and met the criteria after abstract and full text screening. Interventions such as access to targeted family planning, cash transfer, educational empowerment programs and text-messaging programs were identified to have a significant impact on reducing adolescent pregnancy. However, these intervention programs had their limitations which included access to health services, cost effectiveness and reluctant behaviour of individuals. There is a need for further research and longer duration programs and evaluation studies to effect changes.
Conclusions: Adolescents in LMICs are exposed to risky sexual behaviours and geographical factors that increases pregnancy outcome such as poverty, early marriage, and abuse. The result of this study provides an insight as to why further research needs to be done to improve adolescent’s sexual reproductive health
What factors affect childhood obesity in deprived areas, in children aged 5-16 years old? A qualitative systematic review
No full textBackground: Obesity in childhood is a significant issue for public health and costs the NHS an estimated £6.1 billion per year to treat the conditions associated with obesity (DOHSC, 2020). This review highlights the impact of deprivation on obesity levels. It discusses how deprivation can affect exercise and diet in families and children. It also discusses the various stakeholders required to increase success of obesity interventions, and how its impact can contribute to tackling the causes.
Methods: This research is a systematic review of qualitative studies using a narrative approach. The PEO framework was used to develop a suitable question for the review. Searches were then conducted using grey literature and the following databases: PubMed, Web of Science, CINAHL, Medline and PsychInfo. All studies were imported to Endnote for duplicate removal, title and abstract screening, and full text screening. This eliminated studies that did not fit the inclusion criteria. Those studies that passed the criteria checks (N=4) were hand coded, line by line, to identify descriptive and analytical themes and sub-themes.
Results: Five key themes were identified from the analysis. These were common understanding of health behaviour, values, services, and congruence, lead responsibility, influencing factors and reluctance in behaviour change.
Conclusions: This review aimed to collect data on obesity levels in deprived areas. The data found the need for early intervention in schools for both parents and children to assist with development of healthy social norms. It was found that supermarkets need to provide sufficient levels of nutritional food at a reasonable price and food deserts are something to be addressed. The high density of fast-food restaurants needs to be considered by Local Authorities, especially those in lower income communities. Implementations need to be targeted at ethnic minority groups as well as areas of deprivation, with a more tailored approach to interventions
Exploring young (aged 20-25) UK black ethnic minority adults’ experiences of physical activity during the 1st COVID-19 lockdown
No full textBackground: The research aimed to explore the young UK black ethnic minority adult’s aged 20 to 25 experiences of how they had maintained their physical activity for the duration of the 1st COVID-19 lockdown. The research focused on Black African, African-Caribbean, and Black British Citizen population groups. The research endeavoured to identify physical activity levels before the lockdown and during the lockdown, ascertain facilitators and barriers to physical activity during the lockdown, and understand the perceived impact of physical activity levels during the lockdown on health and wellbeing.
Methods: The research utilised a qualitative methodology using online semi-structured interviews through Zoom, the teleconference program. Thematic analysis was employed to recognise, analyse, and convey the patterns and themes in the data. The participants in this research were ten young black ethnic minority adults\u27 aged 20 to 23 residing in the UK.
Results: All of the participants displayed an understanding of physical activity and its role in their lives. Findings also demonstrate that some participants were physically active with aerobic exercises before the lockdown; however, their physical activity levels decreased at the beginning of the lockdown due to behavioural change and other personal commitments such as university. During the lockdown, facilitators to physical activity were identified as: self-concept, body image, inspiration/ role model, social influence, and employment. Barriers to physical activity participation were demotivation, a lack of physical activity infrastructure, and mental health problems. The impacts of physical activity during the lockdown on health and wellbeing identified that most participants who engaged in little physical activity had experienced more positive health and wellbeing than those who did not participate in any physical activity.
Conclusions: The key recommendations of this research pinpoint the need to investigate the gap in young UK black ethnic minority adults\u27 physical activity during the 1st COVID-19 lockdown. This might aid with understanding the physical activity levels of young black UK ethnic minority adults\u27 and provide additional support for them if needed. Another recommendation is that government policies may be used to target young black UK ethnic minority groups with educational resources on participating in physical activity before and during a future national lockdown. Lastly, establishing age-appropriate health promotion interventions in physical activity may encourage young black UK adults aged 20 to 25 to participate in physical activity
Socioeconomic factors affecting maternal mortality in Sub- Saharan Africa: A scoping review
No full textBackground: One of the most serious global health issues is maternal health. Maternal mortality is considered an important topic in global health and development debates. Although some nations have achieved significant improvements, Sub-Saharan Africa (SSA) continues to account for half of all maternal fatalities worldwide. There is a consensus concerning the importance of a strong health system, skilled delivery attendants, and women\u27s rights for maternal health. There is no single easy, uncomplicated measure that can dramatically reduce maternal mortality; however, there is widespread agreement on the need for a robust health system, trained delivery attendants, and women\u27s rights for maternal health. This study aims to identify socioeconomic factors associated with maternal mortality in Sub-Saharan Africa.
Methods: Peer-reviewed journal articles were collected from two databases (Medline and CINAHL) exploring quantitative and qualitative studies conducted in SSA (English language; between 2010 and 2021). The five-stage methodological framework of Arskey and O’Malley for scoping reviews was followed. Extracted data was charted and summarized narratively. After removal of duplicates and screening against the inclusion criteria. Sixteen articles met the inclusion criteria.
Results: The major determinants of maternal health service usage and maternal mortality were socioeconomic class, education, caste/ethnicity, religion, and culture. The key intermediary factors were women\u27s residence, maternal age during childbirth, number of children, and media exposure. In SSA, the health system has evolved as a critical and independent intermediary component in maternal health.
Conclusions: Tailored programmes addressing cultural beliefs and attitudes, as well as low educational attainment, are required. Women\u27s rights should be at the forefront of these activities. The creation of empirically validated metrics to assess and examine the link between women\u27s empowerment and maternal health should be the focus of future research
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