Early childhood caries (ECC) is a serious public health problem in both developing and developed countries. Given that children mainly depend on their parents for their day-to-day activities, it is important to investigate the extent of parental influence on the oral health of their children. The objective of this study is to review the association of parental knowledge, attitude, and practice of oral health with ECC among preschool children. PubMed, Medline, and Google scholar were used to search for related articles published within the past 10 years. All of the studies that investigated parental oral health practice have shown association with the development of dental caries. However, there were discrepancies in the outcome of studies that examined the association of parental knowledge and attitude with ECC. More investigations on parental knowledge and attitude are needed to clarify their association with ECC.

Introduction: Health information-seeking behaviour is a process of gathering information for individuals to understand and cope with his/her health problems. Apart from the Internet or Web 1.0, Web 2.0 tools has been increasingly used as alternative to seek health information and one such tool is social media platform. This study aims to identify cognitive determinants of health information-seeking behaviour through social media platforms among Malaysian adults. Methods: A cross-sectional study by means of convenience sampling was conducted during a nationwide pandemic lockdown. Cognitive determinants were defined as respondent’s perceived usefulness, perceived ease of user, perceived benefit, perceived costs, perceived behavioural control, and perceived risk towards social media use. Questionnaires were distributed via Google Form link to multiple social media platforms and cross-platform messaging app. Differences between group of sociodemographic factors and other independent variables were tested with nonparametric tests while multiple linear regression was employed to determine the significant predictors of the health information seeking behavior. Results: A total of 705 individuals responded to the survey invitation, the majority of which were females (65%), Malay (93.6%), married (52.1%), and received tertiary education (88.5%). Multiple linear regression analysis showed that perceived benefit (β= 0.612, 95% CI: 0.517-0.708, p<0.001), perceived usefulness (β= 0.653, 95% CI: 0.453-0.853, p<0.001), and perceived risk (β= 0.131, 95% CI: 0.03-0.259, p=0.044) significantly predict health information seeking behavior through social media platform. Conclusion: Our findings provide fundamental grounds for stakeholders to better understand and influence online behavior. Staying abreast of the current online trend is crucial as more people have begun to rely on social media for health information.

Introduction: Domains of adherence and non-adherence to hypertensive medications have not been extensively documented in Malaysia due to the absence of theoretically driven and culturally appropriate measurement tools, leading to a poor understanding of the adherence and underlying factors. We aim to identify these domains in Malaysian hypertensive patients and subsequently apply the findings to develop and validate the Malaysian Anti-Hypertensive Agents Non-Adherence Scale (MAANS). Methods: This study has an exploratory mixed-methods design. In Phase 1, we will recruit hypertensive patients from two health clinics to participate in a semi-structured interview. Recruitment of participants will terminate once thematic saturation is achieved. Coding and thematic analyses will be performed to identify the domains of adherence and non-adherence to anti-hypertensive medications. In Phase 2, based on the domains generated from Phase 1, we will develop the Malaysian Anti-Hypertensive Agents Non-Adherence Scale (MAANS). Four hundred hypertensive patients will be randomly selected. Data from 200 participants (serving as the calibration sample) will be subjected to exploratory factor analysis while data from additional 200 participants (serving as the validation sample) will be subjected to confirmatory factor analysis. Factor structure, predictive validity, and reliability of the MAANS will be statistically tested. Discussion: With the presence of the MAANS, health care providers can gather crucial information regarding barriers and facilitators to hypertensive treatment adherence and design effective health promotion programmes to reduce complications of uncontrolled hypertension. Trial registration: Ethical approval is granted by the Medical Research Ethics Committee, Ministry of Health, Malaysia (NMRR-18-3251-44694).

A majority of hypertensive patients will end up suffering uncontrolled hypertension, which is partly due to poor medication adherence. This paper aimed to review a range of interventions that could improve anti-hypertensive medication adherence. Literature search was conducted using PubMed, Scopus, Medline, and Science Direct databases, with publication dates confined to between October 2009 and October 2019. Eventually, only 11 studies were used for this study. It was found that interventions that are based on or include patient education, patient interviews, patient reminders, self-management and behavioural modifications have the potential to improve patients’ adherence to anti-hypertensive therapy. Most successful interventions involve patient reminder, self-management and behavioural intervention.

Introduction: Unintentional injuries among children are considered a major public health concern since they are one of the leading causes of child death and disability. Inadequate study has been done on whether and how parental influences are linked to childhood injury at home especially among the community with low-socioeconomic status. The study aims to determine the factors affecting unintentional home injury prevention practice among low socioeconomic status (B40) parents of under-five children in Selangor, Malaysia. Methods: This is a cross-sectional and quantitative study. A sample size of 453 parents will be sampled among B40 parents with under-five children in Selangor using a stratified random sampling method. For analysis, only complete questionnaires will be used. Data entry and statistical analysis will be carried out using IBM SPSS version 28.0. Chi-square/Fisher Exact test and simple logistic regression will be used for data analysis. Multiple logistic regression will be used to examine the predictors of poor home injury prevention practice. Discussion: Findings from the study will provide insight on challenges experienced by B40 parents of children under five in implementing preventive injury measures at home.

Introduction: Urinary incontinence (UI) is a condition which is common and is closely linked to vaginal delivery. Pelvic floor muscle exercise (PFME) are considered the first line management of UI and regular practice of PFME is a key factor in its effectiveness. This study was designed to investigate the effectiveness of theory-based intervention using social media to reduce UI among postpartum women. Methods: This is a randomized controlled trial with the final number of recruited participants of 104. The participants were assigned randomly either to control or intervention groups and were followed up at three and six months. The primary outcome of this study was severity of UI. Adherence to exercises was the secondary outcome. Results: After the intervention, at three months and six months follow-up, there were significant differences between the two groups regarding the practice of PFMEs (p≤ 0.05). Friedman’s analysis of variance showed that there was a significant difference in respect of the exercise adherence rating scale among the intervention group at baseline, at three months and post six months (p≤ 0.05). In the intervention group at baseline the mean (standard deviation, sd) of the International Consultation on Incontinence Questionnaire Short Form was 3.00 (1.94) whereas at three months it decreased to 1.96 (1.69), which decreased further to 1.04 (0.51) at six months. Conclusion: theory-based education delivered through social media is a feasible and effective way of increasing the practice of PFMEs, and can lead to decrease of severity UI.

Introduction: Previous medication adherence studies primarily focused on the domains of non-adherence in hypertension treatment and less attention has been given on domains that encourage adherence to anti-hypertensive medications. The current study is aimed to identify the domains of adherence and non-adherence to anti-hypertensive medications among hypertensive patients in Kuala Lumpur, Malaysia. Methods: Hypertensive patients from two public health clinics in Kuala Lumpur were invited for in-depth interviews until thematic saturation. Audio recordings from these interviews were transcribed verbatim. Transcripts were then analysed deductively with the guidance of the World Health Organization Medication Adherence Framework to extract the domains of adherence and non-adherence to anti-hypertensive medications. Results: Ten patients who were predominantly Malays and aged 34-73 years old participated the study. Patient-related (encompassing knowledge, attitude, belief and culture, lifestyle, personal barriers, self-efficacy, and cue to action), socioeconomic (encompassing social support), condition-related (encompassing nature of illness and presence of multiple co-morbidities), therapy-related (encompassing experience of receiving treatment, barrier in treatment, and side effects of treatment), and healthcare system (encompassing access to healthcare and healthcare center experience) domains were identified as central to the medication-taking behaviour of hypertensive patients. Conclusion: Sixteen codes of adherence and 22 codes of non-adherence to anti-hypertensive medications were identified, which were distributed across five domains (patient-related, socioeconomic, condition-related, therapy related, and healthcare system domains). These findings can help to inform future development of medication adherence questionnaires, individualised interventions for patients with adherence problems, and targeted health promotion programmes to reduce uncontrolled hypertension.

Introduction: Premarital sexual is a sexual and reproductive health concern among adolescents in Malaysia. Guided by the constructs of the Social Cognitive Theory (SCT), this study aimed to determine the moderating role of gender on premarital sexual practices among the late adolescents in Kuantan, Pahang. Methods: Probability sampling was utilized to sample the late adolescents from tertiary educational centres. Confirmatory factor analysis (CFA) was conducted to verify the factor structure of the observed variables, with the interrelationship between variables were studied using structural equation modelling (SEM). Moderation analysis was completed via multigroup analysis (MGA). Results: A response rate of 72.2% was obtained, with 390 adolescents aged 18 to 19 years old participated in the study. The total mean for premarital sexual practices was 1.14 ± 0.47, with highest mean observed for masturbation (1.33 ± 0.83). Attitude (β = -0.111, p = 0.021), religiosity (β = -0.014, p = 0.032) and high-risk activities (β = 0.999, p < 0.001) illustrated significant relationships with premarital sexual practices. A moderated regression analysis showed significant interactive effects between gender and premarital sexual practices, with negative association between attitude and religiosity with premarital sexual practices were found among male respondents. Conclusion: This empirical study demonstrated significant moderation effect of gender between attitude and religiosity with premarital sexual practices among targeted late adolescents’ population in Pahang, Malaysia. Any efforts to tackle issue related to premarital sexual practices among similar population should be directed towards male adolescents with lower religiosity score.

Introduction: The use of the lean approach in healthcare has rapidly gained popularity globally, although this approach was more routinely used in the manufacturing sector as opposed to health. Besides, recent studies confirm the suitability of the lean approach applications for improving the quality of medical care. This study aimed to determine the Lean approach’s capacity to improve the waiting time in outpatient clinics in hospitals. Methods: The systematic review approach was employed to help in the research procedures. Search databases used included Ovid, Google scholar, PubMed, MEDLINE, and archive. Besides, search terminologies such as the Lean approach, Hospital-implementation, waiting time, and patient flow were used to help identify sources that best suited the investigation process. Results: The review revealed that the lean approach is suitable for the reduction of waiting times as well as for improving efficiency in the clinic. The outcomes provide a basis for reducing the average waiting time within the hospital. Conclusion: This study recommended that healthcare facilities and departments should take a keen interest in implementing the Lean approaches, as they are crucial for reducing waiting time.

Introduction: During the COVID-19 pandemic, healthcare providers have been in great fear due to the high risk of contracting COVID-19 infection at any time. This study aimed to determine the mediating role of resilience on the relationship between fear of COVID-19 and burnout in primary care healthcare providers in Malaysia. Methods: This was an online cross-sectional study involving 1280 healthcare providers aged 18 years and older from 30 government primary care clinics in Malaysia. We used the COVID-19 Fear Scale, the Copenhagen Burnout Inventory Scale, and the Short Brief Resilience Scale to collect data from the respondents. Smart-PLS was used to perform mediation analysis. Results: The mean age of the respondents was 36 years old and mean duration of working experience was 11 years. The majority of the respondents were female (82.4%) and Malays (82.3%). The study population consisted of nurses (47.4%), doctors (26%), medical assistants (11.9), healthcare assistant (7.1%), medical laboratory technicians (6.4%) and drivers(1.3).The results show that fear of COVID-19 positively predicts burnout. According to the results, resilience mediates the relationship between fear of COVID-19 and all the three burnout domains, namely personal burnout (β=0.175,p<0.001), work-related burnout (β=0.175,p<0.001) and client-related burnout (β=0.172,p<0.001). Additionally, resilience reduces the impact of COVID-19 fear on the three domains of burnout. Conclusion: Our study has reported a mediating effect of resilience on the relationship between fear of COVID-19 and burnout.