Validation of the comprehensive feeding practice questionnaire among school aged children in Jordan: A factor analysis study

BACKGROUND: Obesity has become a significant worldwide contributor to morbidity with an alarming increase in the incidence of childhood obesity. Few studies have evaluated parental feeding practices and their impact on child obesity in the Middle East. The Comprehensive Feeding Practice questionnaire (CFPQ; Musher-Eizenman & Holub, 2007) has been validated in different age groups and in different countries, however no previous studies have validated the questionnaire in the Middle East. METHOD: In this study, 970 children aged 6–12 completed the Arabic translated version of the CFPQ. The height and weight of the children were also measured. Confirmatory factor and exploratory factor analysis were used to evaluate different factor models. An ordinal logistic regression was conducted to evaluate the association between maternal feeding practices and child weight status. RESULTS: Confirmatory analysis of the CFPQ determined that the original 12 factor structure of the questionnaire was not suitable for this sample. The analysis suggested that the most suitable structure was an 11 factors model (CMIN/DF = 2.18, GFI = 0.92, CFI = 0.93, TLI = 0.92 and RMSEA = 0.03) that included Modelling, Monitoring, Child control, Food as a reward, Emotional regulation, Involvement, Restriction for health, Restriction for weight control, Environment, Teach and encourage and Pressure. Of the children tested, 12.6% were obese and 25.1% were overweight. The ordinal regression showed Restriction to health and weight, Emotional regulation and maternal BMI were negatively associated with healthy weight status, while Modelling, Monitoring, Child Control, Environment, Involvement, and Teach and encourage were positively associated with healthy weight status. CONCLUSION: The Arabic translated version of the CFPQ was validated among the study sample, and the best fit for the model was found to utilize 11 factors. This study indicated that child weight status was associated with maternal feeding practices. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12966-017-0478-y) contains supplementary material, which is available to authorized users

Effects of Traffic Air Pollution on Respiratory Health and Allergies in Schoolchildren

The objective of the study is to investigate gender differences in the respiratory effects of air pollution in schoolchildren. We studied 1397 schoolchildren from two locations in Egypt; Cairo city with high level of air pollution and Shbeen Al Koom in the Delta with low level of air pollution. Lung function testing was done by the Vitalograph spirometer. The Arabic version of ISAAC questionnaire was used (the International Study of Asthma and Allergies in Childhood). Air pollution measurements were collected from the Government sites in both locations. Boys in Shbeen Al Koom had significantly (p< 0.05) higher lung function tests than boys in Cairo. There was no significant differences in lung function tests between girls in both locations. Children in Cairo had significantly (p< 0.01) higher prevalence rates of asthma, rhinitis and eczema than children in Shbeen Al Koom. The prevalence rates of ever rhinitis were 6% and 3% higher in boys and girls in Cairo compared with Shbeen Al Koom, respectively. Children who developed rash less than 2 years of age were 2% and 5% higher in boys and girls in Cairo compared with Shbeen Al Koom, respectively. The prevalence of other allergic symptoms were 2-3% and 3-5% higher in boys and girls in Cairo compared with Shbeen Al Koom, respectively. The present study shows the adverse respiratory effects of exposure to traffic air pollution on schoolchildren showing gender difference. The study will help to implement strategic health intervention programmes to improve the respiratory health of children

Validation of the Arabic version of medication adherence report scale questionnaire and beliefs about medication -specific questionnaire: A factor analysis study

Medication Adherence Report Scale questionnaire (MARS-5) and the Beliefs about Medication Questionnaire-specific (BMQ-specific) are well known tools to assess adherence to medication and beliefs of chronic patients. However, validated Arabic versions of such questionnaires are lacking. We aim to validate the Arabic versions of BMQ-specific and MARS-5. In this study, a cross-sectional study was performed between November 2019 and March 2020. Participants were reached from secondary and tertiary care clinics in Jordan. Exploratory factor analysis (EFA) and Confirmatory Factor analysis (CFA) were conducted to validate the employed questionnaires on the tested sample. The internal consistency of the questionnaires was assessed by calculating Cronbach's alpha, and Cronbach's alpha if item is deleted. A total of 485 patients who met the inclusion criteria were recruited. The mean age of the participants was 57.14 years (22-82 years); and 39% of the participants were older than 65 years. The most common chronic diseases reported by participants were hypertension and diabetes mellitus, 35.7 and 32.2% respectively. EFA suggested two-factor model for BMQ-specific and one-factor model for MARS-5 which was confirmed by CFA analyses. The resulted Cronbach's alphas of the questionnaires ranged from 0.89-0.93. Both analyses showed that the Arabic versions of both MARS-5 and BMQ-specific are valid and can be used for the suggested study population. Further validation-based research may enhance the transcultural adaptation of such questionnaires

The influence of the cost-of-living crisis, self-efficacy, and religiosity on quality-of-life for patients with sickle cell disease

Aims:This study examined the role of the individual impact of the cost-of-living crisis, self-efficacy, religiosity, demographic factors, and their influence on the health-related quality of life (HRQoL) of individuals with sickle cell disease (SCD). Methods:A global online survey with 443 participants living with SCD (51.5% males and 48.8% females) was conducted. HRQoL was measured using the 12-Item Short Form Survey (SF-12). Independent variables consisted of the individual impact of the cost-of-living crisis (ICoLC), sickle cell self-efficacy, religiosity, and demographic factors (age, gender, education, and country of residence). Quantile regression analysis was conducted.Results:Self-efficacy was positively associated with HRQoL, demonstrating the importance of self-efficacy in managing SCD. ICoLC was negatively associated with HRQoL, emphasising the challenges faced by individuals with SCD during the cost-of-living crisis. UK participants reported significantly higher HRQoL than US participants, suggesting national disparities. Unlike prior findings, religiosity was negatively associated with HRQoL.Conclusion:This study highlights the roles of self-efficacy, the cost-of-living crisis, religiosity, and demographic factors in affecting the HRQoL of individuals with SCD. Our findings suggest a need for interventions increasing self-efficacy, mitigating financial challenges resulting from the crisis, and providing tailored support for individuals with differing levels of religiosity. They also emphasise the need for region-specific healthcare delivery and support systems. Future research should explore these relationships qualitatively, to develop interventions to ameliorate HRQoL for people with SCD, regardless of where they live, improving outcomes and overall well-being during the cost-of-living crisis and beyond

The influence of the cost-of-living crisis, self-efficacy, and religiosity on quality-of-life for patients with sickle cell disease

Aims:This study examined the role of the individual impact of the cost-of-living crisis, self-efficacy, religiosity, demographic factors, and their influence on the health-related quality of life (HRQoL) of individuals with sickle cell disease (SCD). Methods:A global online survey with 443 participants living with SCD (51.5% males and 48.8% females) was conducted. HRQoL was measured using the 12-Item Short Form Survey (SF-12). Independent variables consisted of the individual impact of the cost-of-living crisis (ICoLC), sickle cell self-efficacy, religiosity, and demographic factors (age, gender, education, and country of residence). Quantile regression analysis was conducted.Results:Self-efficacy was positively associated with HRQoL, demonstrating the importance of self-efficacy in managing SCD. ICoLC was negatively associated with HRQoL, emphasising the challenges faced by individuals with SCD during the cost-of-living crisis. UK participants reported significantly higher HRQoL than US participants, suggesting national disparities. Unlike prior findings, religiosity was negatively associated with HRQoL.Conclusion:This study highlights the roles of self-efficacy, the cost-of-living crisis, religiosity, and demographic factors in affecting the HRQoL of individuals with SCD. Our findings suggest a need for interventions increasing self-efficacy, mitigating financial challenges resulting from the crisis, and providing tailored support for individuals with differing levels of religiosity. They also emphasise the need for region-specific healthcare delivery and support systems. Future research should explore these relationships qualitatively, to develop interventions to ameliorate HRQoL for people with SCD, regardless of where they live, improving outcomes and overall well-being during the cost-of-living crisis and beyond

Validation of the Arabic version of the Multiple Sclerosis Impact Scale (MSIS-29):A Rasch analysis study

Background: Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord. This cross-sectional study aimed to validate the Arabic version of the Multiple Sclerosis Impact Scale-29 (MSIS-29) using Rasch analysis to assess quality of life in Jordanian MS patients. Method: Rasch analysis was conducted to evaluate the suitability of the model for the present study. Model fit was assessed by computing item/person separation reliability, Infit and Outfit mean square (MSQ) values, Cronbach's alpha, and the Akaike Information Criterion (AIC). Results: A total of 301 MS patients were enrolled in the study. Significant Likelihood ratios for all three scales (MSIS-29-PHYSICAL, MSIS-29-PSYCHOLOGICAL, and MSIS-29-TOTAL) supported the use of a partial credit Rasch model. An issue with disordered thresholds was resolved by collapsing adjacent response categories. Item reliability scores for MSIS-29-PHYS and MSIS-29-PSYCH were 0.95 and 0.89, respectively, while person reliability scores were 0.92 and 0.84, respectively. Infit and outfit MSQ were within the acceptable range for all items on the MSIS-29-PSYCH scale. However, for the MSIS-29-PHYS scale, item MSIS-29_17 exceeded the acceptable range in both infit (1.93) and outfit (1.82) MSQs, and item MSIS-29_20 exceeded the acceptable range in infit (1.81). The Wright map also indicated that most items were considered relatively easy by the respondents, exhibiting various difficulty levels on the latent scale. Conclusion: The Arabic version of the MSIS-29 is a valid and reliable tool for evaluating quality of life in Jordanian MS patients

Significant differences in the length and weight measurements of Jordanian infants as compared to the WHO 2006 growth standards

BACKGROUND: In 2006, the World Health Organization (WHO) introduced new growth standards based on data derived globally from optimally nourished breastfed infants. The aim of this study was to assess the effects of implementing WHO growth standards on the growth patterns of Jordanian infants. In addition, it was to ascertain the necessity of establishing country-specific growth standards and charts tailored to Jordanian infants.MATERIALS AND METHODS: The data of 102,846 infants (50.1% boys, 49.9% girls) aged 0–24 months, from 115 primary healthcare centers across the country were retrieved from a National E-health Program. Weight and length measurements were analyzed, and age- and sex-specific z-scores were calculated relative to the WHO growth standards. Data was analyzed using SPSS version 26. Mann–Whitney U test was performed to determine significant differences between the measurements for boys and girls in terms of age, length, and weight.RESULTS: Jordanian infants exhibited significantly shorter length-for-age measurements than WHO standards with mean z-scores of −0.56 and −0.38, for boys and girls, respectively. Weight-for-age measurements showed a good fit and were comparable to the WHO growth standards for boys (mean z score = −0.05) and girls (mean z score = 0.04). Notably, Jordanian infants displayed higher weight-for-length measurements, with mean z-scores of 0.51 for boys and 0.47 for girls.CONCLUSION: The availability of Jordanian-specific growth standards will improve the accuracy of assessing infant growth and enhance the monitoring and evaluation of their health and development

Evaluating Influenza Vaccination Practices among COPD Patients

Chronic Obstructive Pulmonary Disease (COPD) stands as a global health concern linked to considerable morbidity and mortality. In Jordan, the prevalence of COPD is substantial, but research in this area is limited. Exacerbations of COPD can lead to severe outcomes, including hospitalization and increased cardiovascular risk. Influenza is a significant trigger of exacerbations in COPD patients, and vaccination is recommended. However, studies have shown negative attitudes towards the influenza vaccine. This cross-sectional study aimed to investigate the knowledge, attitudes, practices, and intentions of COPD patients in Jordan regarding influenza vaccination. Data were collected through a custom-designed questionnaire from 300 COPD patients. The study revealed low influenza vaccination rates, with forgetfulness and lack of knowledge about vaccine effectiveness being the main barriers. Higher knowledge and positive attitudes were associated with greater intention to vaccinate. To tackle these challenges, it is recommended to implement customized health education campaigns, foster collaborations with healthcare providers, and engage in community-focused initiatives to enhance acceptance of the influenza vaccine among COPD patients in Jordan. These findings underscore the importance of addressing knowledge gaps and negative attitudes to enhance vaccine uptake and improve health outcomes for COPD patients

Evaluating the validity of international standards of Height, weight, and body mass index on Jordanian children and adolescents

Background: the variations in a child's overall body shape and figure among different countries are attributable to differences in genetics, environmental factors, and the interaction between these elements. This study aims to evaluate the validity, reliability, and appropriateness of ap-plying the international growth standards to Jordanian children and adolescents aged 2-19 years old. Methods: 65828 Jordanian children and adolescents (43% males; 57% females) aged 2-19 years old were selected from the Hakeem Program database and various private schools across Jordan. Height-for-age, weight-for-age, and body mass index (BMI)-for-age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The z-score for each record was computed based on international equations. Results: Mean z-scores for height-for-age, weight-for-age, and BMI-for-age for both genders showed significant deviation from the international standards across most age intervals. It was found that in most age groups, Jordanian children and adolescents were shorter and lighter than the CDC and WHO standards, except for females at ages ≥ 16 years which were heavier with higher BMI-for-age values than CDC standards based on weight-for-age and BMI-for-age equations. Moreover, Jordanian males at ages ≥ 12 years had lower BMI-for-age values than the CDC standards. Conclusions: Jordanian children and adolescents showed significant deviations in their measurements from international standards and growth reference values. The development of a population-specific growth chart is highly recommended to enhance the accuracy of evaluating children’s and adolescents' wellness