Social Cognitive Theory Constructs That Predict Betel Nut Chewing Among Secondary Students

After alcohol, tobacco, and caffeine, areca or betel nut is the 4th most common substance of abuse in the world, and its prevalence of use in the Solomon Islands is estimated at 68% in young people. Long-term use of betel nut can result in detrimental health outcomes such as oral cancers and metabolic syndrome. Guided by the social cognitive theory (SCT), the purpose of this quantitative cross-sectional study was to determine whether the constructs of SCT predict betel nut use in Year 12 secondary students in the Solomon Islands. Five SCT constructs of expectations (outcome expectations and outcome expectancies), self-efficacy, self-efficacy to overcome barriers, self-control, and environment were used to build a model for the study. Data were collected from a convenience quota sample of 138 Year 12 secondary students through a 37-item questionnaire. Results from multiple linear regression and multiple logistic regression analysis indicated that only self-efficacy to overcome barriers (p \u3c .01) was significantly related to intent to not chew betel nut. SCT was weakly predictive with low explained variance for not chewing betel nut in secondary students. Findings contribute to social change by being useful for school health program developers and researchers working on strategies to improve intervention actions to reduce betel nut use

Social Cognitive Theory Constructs That Predict Betel Nut Chewing Among Secondary Students in the Solomon Islands

Background: After alcohol, tobacco, and caffeine, areca or betel nut is the fourth most commonly abused substance in the world. The prevalence of betel nut use in the Solomon Islands is estimated at 68% in young people. Long-term use can result in detrimental health outcomes such as oral cancers and metabolic syndrome. Methods: The purpose of this quantitative cross-sectional study was to determine whether the constructs of social cognitive theory (SCT) can predict betel nut use in Year 12 secondary students in the Solomon Islands. Five SCT constructs of expectations (outcome expectations and outcome expectancies), self-efficacy, self-efficacy to overcome barriers, self-control, and environment were used to build a model for the study. Data were collected from a convenience quota sample of 138 Year 12 secondary students through a 37-item questionnaire. Results: Multiple linear regression and multiple logistic regression analysis indicated self-efficacy to overcome barriers (p \u3c .01) was the only construct significantly related to intent to not chew betel nut. Conclusion: Social cognitive theory (SCT) was weakly predictive with low explained variance for not chewing betel nut in secondary students. Research findings contribute to knowledge useful for developers of school health programs and researchers working on strategies to improve intervention actions to reduce betel nut use. The SCT could be bolstered by newer theories like the integrative model or multi-theory model (MTM) of health behavior change for designing educational interventions aimed at limiting betel nut use in young people, especially school students

Prevalence of HPV infection and other risk factors in a Fijian population.

BACKGROUND: Cancer is among the leading contributors to morbidity and mortality in the Pacific, but the magnitude of the problem and the potential for prevention have not been comprehensively studied. Over the past decade, cervical cancer has been the most common cancer among women in Fiji with an age standardised cervical cancer incidence rate of 51 per 100,000. This rate is among the highest in the South Pacific region and in the world. This high cervical cancer incidence rate is likely linked to the low cervical screening rate, but it points also to the possibility of a high burden of human papillomavirus (HPV) infection. METHODS: We conducted a population-based survey in Fiji to provide information on human papillomavirus (HPV) prevalence, and the distribution of individual HPV types in a Fijian health-sub-district. We included 1,261 women aged between 16 and 64 years. A general primer GP5+/6+ mediatedpolymerase chain reaction (PCR) assay was used for HPV testing of 44 HPV types. RESULTS: The crude HPV prevalence in 1,244 women with an adequate HPV sample was 24.0% (95% confidence interval (CI), 21.7-26.4%) and the corresponding age standardised prevalence was 25.5% (95% CI, 23.1-28.1%). The prevalence of high-risk HPV types was 13.6% (95% CI, 11.8-15.6%). Among 1,192 women with adequate cytological results, 13 (1.1%) showed cervical abnormalities, the majority of which were high-grade intraepithelial lesions or worse. HPV prevalence declined from 35.8% in women aged <25 years to 18.6% in those aged 55-64 years of age. After adjustment, the only variables significantly associated with HPV-positivity were age (ranging from odds ratio (OR) 0.57 (95% CI, 0.36-0.89) for 25-34 year-old-women to OR 0.43 (95% CI, 0.20-0.89) for 55-64 year-old-women) and 'husband's extramarital sexual relationships' (OR 1.69; 95% CI, 1.17-2.34). CONCLUSION: These findings on HPV provide key information for future policy decisions on the most appropriate methods of cervical cancer prevention in Fiji and in the Pacific region

Prospective Surveillance of Invasive Group A Streptococcal Disease, Fiji, 2005–2007

These infections are more common and case-fatality rate is higher in Fiji than in industrialized countries

Prospective surveillance of invasive group a streptococcal disease, Fiji, 2005-2007.

We undertook a prospective active surveillance study of invasive group A streptococcal (GAS) disease in Fiji over a 23-month period, 2005-2007. We identified 64 cases of invasive GAS disease, which represents an average annualized all-ages incidence of 9.9 cases/100,000 population per year (95% confidence interval [CI] 7.6-12.6). Rates were highest in those >65 years of age and in those <5 years, particularly in infants, for whom the incidence was 44.9/100,000 (95% CI 18.1-92.5). The case-fatality rate was 32% and was associated with increasing age and underlying coexisting disease, including diabetes and renal disease. Fifty-five of the GAS isolates underwent emm sequence typing; the types were highly diverse, with 38 different emm subtypes and no particular dominant type. Our data support the view that invasive GAS disease is common in developing countries and deserves increased public health attention

High Burden of Impetigo and Scabies in a Tropical Country

Scabies and impetigo are often thought of as nuisance diseases, but have the potential to cause a great deal of morbidity and even mortality if infection becomes complicated. Accurate assessments of these diseases are lacking, particularly in tropical developing countries. We performed a series of studies in infants and primary school children in Fiji, a tropical developing country in the South Pacific. Impetigo was very common: more than a quarter of school-aged children and 12% of infants had active impetigo. Scabies was also very common affecting 18% of school children and 14% of infants. The group A streptococcus was the most common infective organism followed by Staphylococcus aureus. The size of the problem has been underestimated, particularly in the Pacific. It is time for more concerted public health efforts in controlling impetigo and scabies

Health research in the Pacific.

The Pacific Island countries are geographically scattered, with contrasting environmental, social, and political systems, and in varying stages of economic development, but all are going through a rapid epidemiological transition. Processes that took place over thousands of years in Western countries have been very much compacted in time in the Pacific. These processes have produced major changes in environment and lifestyle, which have produced epidemics of non-communicable disease. While it is important to consider non-communicable diseases as a group, it is also important to conduct research into their specific causes. There has been a great deal of research into cardiovascular disease and diabetes in the Pacific, but it is only recently that the importance of cancer as a major source of mortality and morbidity in the Pacific has been recognised, even though it appears to carry a similar burden of morbidity and mortality. It is therefore important that research into the causes and control of cancer in the Pacific is conducted. However, it is also crucially important that this research both learns from the successes and avoids the mistakes of the past. In particular, it is crucial that cancer research in the Pacific is not another opportunity for "research colonialism," but instead provides opportunities for Pacific-training of Pacific health researchers and the conduct of Pacific-led research

Acute rheumatic fever and rheumatic heart disease in Fiji: prospective surveillance, 2005-2007.

OBJECTIVES: To determine the incidence and clinical features of acute rheumatic fever (ARF) in Fiji, and the clinical features of patients presenting to hospital in Fiji with rheumatic heart disease (RHD). DESIGN AND SETTING: A prospective surveillance study at the Colonial War Memorial Hospital in Suva over a 23-month period from December 2005 to November 2007. MAIN OUTCOME MEASURES: Incidence of ARF; clinical features of ARF and RHD. RESULTS: The average annualised incidence of definite cases of ARF in children aged 5-15 years was 15.2 per 100,000 (95% CI, 9.0-22.6). The clinical features of ARF were similar to those in classic descriptions. Carditis was very common, occurring in 79% of cases. There were 103 admissions for RHD in which detailed information was collected, with the most common reason for admission being cardiac failure (51%). The median age at admission with RHD was 26.8 years, and there were 10 deaths of patients with RHD (case fatality rate, 9.7%). CONCLUSIONS: Although apparently declining in incidence since the middle of the 20th century, ARF remains a significant health problem in Fiji. RHD affects young people, leading to premature morbidity and mortality. There is an urgent need for effective control of ARF and RHD in Fiji