Prevalence and Factors Associated with Alcohol Use among Dayak Adolescents in Sarawak, Malaysia.

Introduction: Alcohol is classified as a psychoactive substance, and its dependence is one of the three leading risk factors for death, disability, or disease. Early age alcohol use by the age of 15 is implied to be harmful due to interference in the brain development of adolescents, causing alcohol-related problems later in life. This study aims to determine the prevalence and factors associated with alcohol use among Dayak adolescents in Sarawak, Malaysia. Methods: This was a cross-sectional quantitative research approach. A total of 12 districts within the 12 divisions were selected by multistage stratified cluster sampling. Dayak housing area lists were obtained from district offices and the local councils. The respondents were selected systematically according to male and female respondent houses, and they were interviewed using an interviewer-administered questionnaire. Data were entered into Microsoft Excel and analysed through IBM SPSS Version 27.0. Results: Dayak adolescents’ mean age was 17.31 years. They were either low-risk (50.0 %), hazardous (31.0%), abstainers (11.0%), harmful (5.0%) or alcohol dependant (3.0%) drinkers. Age (p<.001), gender (p<.05), ethnicity (p<.001), religion (p<.05), employment (p<.001), level of education (p<.01), allowance (p<.001), family relationship (p<.05), and family size (p<.05) were the potential predictors of alcohol use disorder. Conclusion: Dayak adolescent alcohol drinking is prevalent and a public health problem, particularly among disadvantaged socio-economic families. The lower proportion of abstainers suggested that alcohol use among adolescents is on the rise. Hence, the results should be utilised to do targeted health promotion regarding harmful alcohol use among adolescents since early use of alcohol among adolescents may lead to more severe health and non-health outcomes in the futur

Intention to Consume Alcohol among Dayak Adolescents in Sarawak: An Application of Theory of Planned Behavior.

Objectives: To explore the application of a model that integrates various factors that influence Dayak adolescents’ intentions to consume alcohol in Sarawak, Malaysia. Methods: A cross-sectional quantitative study was conducted from September 2019 to February 2022. Through multistage stratified cluster sampling, 12 districts were selected from 12 divisions. Respondents were selected randomly and were interviewed using a questionnaire. Results: Structural equation modeling was used to test the Theory of Planned Behavior (TPB) and explore the relationship between various variables and respondents’ intention to consume alcohol. The findings suggest that attitude (β =.22, p<.001), subjective norm (β= 33, p<.001), and perceived behavior control (β=−.41, p< .001) influenced the intention to consume alcohol. In contrast, alcohol consumption was associated with intention (β=.15, p < .001), attitude (β= .20, p< .001), and perceived behavior control (β=−.32, p< .001). Conclusion: The findings demonstrated that the TPB model can be used to explore various variables that influence the intention to consume alcohol among Dayak adolescents, with attitude, subjective norm, and perceived behavior control as the variable influencing the intention. This highlights the need for paying attention to those variables when developing age-appropriate strategies that address various social levels to curb alcohol consumption. Given the concerning rates of risky drinking and dependency, school-based health initiatives and focused screening for Dayak adolescents are crucial

5A's and 3A's Adolescent Smoking Interventions as Nicotine Dependence Endgame Initiatives in Sarawak, Malaysia

Anti-smoking initiatives in Malaysia have the potential to reduce adolescent smoking, but their effectiveness and the need for research support remain important considerations. This study aimed to examine the efficacy of two smoking cessation interventions, the 5A's and 3A's, in reducing smoking among male adolescents in Samarahan, Sarawak. From September 2020 to June 2021, twelve communities were randomly assigned to the 5A's, 3A's, or control groups. A total of 519 participants aged 13-17 years provided data on demographics, smoking habits, nicotine dependency, motivation, carbon monoxide levels, and monthly cigarette consumption. The interventions' effectiveness was evaluated at 1, 3, 6 and 9 months. Analysis of covariance revealed no significant main effects of time or group on nicotine dependence, although age had a significant effect. Post hoc analyses showed significant group differences at multiple time points. For motivation, there was a significant main effect of time, with Group 5A consistently demonstrating higher means. Significant group differences were observed at specific time points. Analysis of carbon monoxide levels indicated significant main effects for group and time, with Group 5A consistently exhibiting the lowest mean levels. Significant group differences emerged by the 6th month. Regarding the number of cigarettes smoked, significant group differences were found, with both Group 5A and Group 3A reporting lower levels compared to the control group. Our findings add to the existing body of knowledge on the success of initiatives aimed at reducing smoking rates among young people. However, there is still a need for additional investigations in this field to further advance our understanding

PREVALENCE OF RHEUMATIC HEART DISEASE AMONG SCHOOL-GOING CHILDREN IN NORTHERN AND SOUTHERN REGIONS OF SARAWAK, MALAYSIA

Rheumatic Heart Disease (RHD) is a preventable chronic heart disease caused by rheumatic fever. RHD can result in complications and can even conclude in unexpected death at a young age. This study aimed to estimate the prevalence of RHD among the school-going age group in the Northern and Southern regions of Sarawak. This research was conducted as a cross-sectional study in Samarahan and Kuching of the Southern Region and Miri of the Northern Region of Sarawak. The study population comprised school-going children within the divisions. The data on sociodemographic characteristics were collected through a questionnaire. At the same time, echocardiographic parameters were collected through a portable echocardiographic device. Cardiologists confirmed the abnormal cardiac findings. The overall prevalence of RHD was 14 per 1000 persons or 1.4%. Borderline RHD prevalence was 9 per 1000 persons or 0.9%, while the Definite RHD prevalence was 5 per 1000 persons or 0.5 %. With the prevalence obtained, more attention should be given to preventing this silent disease

Socioenvironmental Factors of Rheumatic Heart Disease among School-Going Children in Sarawak, Malaysia: A Mixed-Method Study

Socioenvironmental elements could explain the primordial and primary prevention of Rheumatic Heart Disease (RHD) in the local context. A well-planned, encompassing way to deal with RHD in the local setting is essential. Therefore, this study sought to investigate the socioenvironmental determinants of RHD among school-going children and to investigate the aetiology of RHD in the local setting. This study was conducted as a sequential explanatory mixed-methods design. A cross-sectional study was conducted in the first phase, followed by a qualitative study based on the grounded theory approach. The study was conducted in Kuching, Samarahan and Miri divisions in Sarawak among primary and secondary school-going children. The cross-sectional data collection was conducted via face-to-face interviews, while the qualitative phase was conducted via in-depth interviews. There was a preponderance of low socioeconomic status and large family size with RHD. Based on the grounded theory approach, the causes of rheumatic heart disease were classified into internal and external factors. After integrating the findings, the qualitative findings confirmed the quantitative results by confirmation and expansion without discordance. The findings would be vital for the management of RHD in terms of implementations in practice, theory, and subsequent research, as the factors were explained in the local context

Intention to Consume Alcohol among Dayak Adolescents in Sarawak: An Application of Theory of Planned Behavior

Objectives: To explore the application of a model that integrates various factors that influence Dayak adolescents' intentions to consume alcohol in Sarawak, Malaysia.Methods: A cross-sectional quantitative study was conducted from September 2019 to February 2022. Through multistage stratified cluster sampling, 12 districts were selected from 12 divisions. Respondents were selected randomly and were interviewed using a questionnaire.Results: Structural equation modeling was used to test the Theory of Planned Behavior (TPB) and explore the relationship between various variables and respondents' intention to consume alcohol. The findings suggest that attitude (β=.22, p<.001), subjective norm (β = .33, p < .001), and perceived behavior control (β =−.41, p<.001) influenced the intention to consume alcohol. In contrast, alcohol consumption was associated with intention (β=.15, p < .001), attitude (β=.20, p<.001), and perceived behavior control (β=−.32, p<.001).Conclusion: The findings demonstrated that the TPB model can be used to explore various variables that influence the intention to consume alcohol among Dayak adolescents, with attitude, subjective norm, and perceived behavior control as the variable influencing the intention. This highlights the need for paying attention to those variables when developing age-appropriate strategies that address various social levels to curb alcohol consumption. Given the concerning rates of risky drinking and dependency, school-based health initiatives and focused screening for Dayak adolescents are crucial

Community-based quit smoking intervention in Sarawak, Malaysia

Rising worldwide adolescent smoking necessitates national and global research to establish intervention methods. This research evaluated the efficacies of ask, advise, assess, assist, arrange (5A’s) and ask, advise, act (3A’s) interventions. Self-reported quit-smoking attempts were the outcome measure. Six villages were randomly selected and equally divided into three groups: 5A’s, 3A’s, and control (no intervention). There were 519 current participant-smokers aged 13-17 followed-up by phone (first and third months) and face-to-face interviews (sixth and ninth months). Most 3A’s participants (n=12, 7.1%) quitted smoking in the first month, followed by the 5A’s (n=9, 5.3%) and the control (n=3, 1.9%). In the third month, 5A’s participants topped the rank (n=16, 10.7%), followed by the 3A’s (n=14, 9.2%), and control (n=5, 3.4%). As per sixth-month follow-up, the 5A’s group maintained its position on top of the list (n =27, 21.4%), followed by the 3A’s (n=22, 17.1%) and the control (n=5, 4.0%). The majority of 5A’s participants quitted smoking after nine months (n=36, 33.0%), followed by the 3A’s (n=27, 25.5%), while control maintained its position (n=5, 5.0%). Division health officers and school health-teams nationwide should implement them

Community-based quit smoking intervention in Sarawak, Malaysia

Rising worldwide adolescent smoking necessitates national and global research to establish intervention methods. This research evaluated the efficacies of ask, advise, assess, assist, arrange (5A’s) and ask, advise, act (3A’s) interventions. Self-reported quit-smoking attempts were the outcome measure. Six villages were randomly selected and equally divided into three groups: 5A’s, 3A’s, and control (no intervention). There were 519 current participant-smokers aged 13-17 followed-up by phone (first and third months) and face-to-face interviews (sixth and ninth months). Most 3A’s participants (n=12, 7.1%) quitted smoking in the first month, followed by the 5A’s (n=9, 5.3%) and the control (n=3, 1.9%). In the third month, 5A’s participants topped the rank (n=16, 10.7%), followed by the 3A’s (n=14, 9.2%), and control (n=5, 3.4%). As per sixth-month follow-up, the 5A’s group maintained its position on top of the list (n =27, 21.4%), followed by the 3A’s (n=22, 17.1%) and the control (n=5, 4.0%). The majority of 5A’s participants quitted smoking after nine months (n=36, 33.0%), followed by the 3A’s (n=27, 25.5%), while control maintained its position (n=5, 5.0%). Division health officers and school health-teams nationwide should implement them