INTRODUCTION: More than one billion people worldwide are affected by mental health disorders, making up 16% of the world's population. However, psychological morbidity has been understudied and disparately estimated among Filipinos living in low-income
communities in the Philippines.

PURPOSE: The specific aims of this descriptive, cross-sectional study were to 1) describe depression, anxiety, distress, and quality of life in a large sample of Filipinos from low-income communities in the Philippines; and 2) determine the prevalence and correlates of
depression, anxiety, and distress in this sample.

METHODS: A convenient sample of Filipinos (?18 years old) were recruited to participate in the study and asked to complete a general health survey. Only one person per household was eligible to participate in the study to avoid biases based on the prevalence of mental health disorders.

RESULTS: One thousand two hundred three participants, mean age, 49.5 ± 17.6 years, primarily women (64.6%) and married (58.4%) reported the following cardiometabolic disorders: overweight/obesity (29%), hypertension (43%), hyperlipidemia (21%), type 2
diabetes (14%), and current smoker (19%). The mean physical and mental quality of life was 46.2 ± 8.1 and 48.6 ± 7.7, respectively. Depression (21%), anxiety (39%) and distress (82%) were prevalent in the sample. Depression was associated with older age, higher distress and anxiety, and lower quality of life. Anxiety and distress were associated with younger age, female gender, higher depression, and lower quality of life.

CONCLUSION: Mental health disorders are prevalent in Filipinos from low-income communities. Findings provide empirical support for the provision of mental health services consistent with the World Health Organization's action plan in this understudied population. The high association between psychological morbidity and perceived physical and mental quality of life signifies the need to screen for depression in older adults and anxiety and distress in younger adults and women.

Human ; Male ; Female ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Depression ; Anxiety ; Mental Health ; Philippines

BACKGROUND AND OBJECTIVE

Committed to enhancing healthy living, learning, and working conditions, a health-promoting school is a potent influencer of behaviors and habits, reaching families and communities effectively. In the Western Pacific region, the Urbani School Health Kit (USHK) is one of the tools developed to integrate health promotion in schools; however, it needs to be updated to adapt to the evolving health challenges of lifestyle-related diseases. Hence, this study aimed to conduct a pilot training and evaluation of the updated USHK among school teachers in Manila.

METHODS

The USHK was updated with new materials on (1) health-enhancing physical activity; (2) healthy nutrition; and (3) family and community engagement. A two-day training-workshop with 30 school teachers was then conducted to facilitate the integration of the updated USHK in their class activities. We used a multi method evaluation design to assess the implementation of the USHK. Particularly, quantitative data were obtained from the participants’ feedback on the toolkit and their knowledge of health-related practices. One month later, field visits were conducted to assess the participants’ abilities in utilizing the toolkit into their classes or school activities. Qualitative interviews and classroom observations were also collected post-implementation to determine potential facilitators and barriers to program delivery, and suggestions for improvement. Descriptive statistics were used to summarize participant feedback, while Wilcoxon signed rank test was utilized to determine changes in participant knowledge pre- and post-training. Qualitative data were synthesized through content analysis.

RESULTS

Participants provided high satisfaction ratings for the training they received, as well as high scores for the updated USHK, in terms of its appropriateness and acceptability. Significant improvements in participants’ overall health promotion knowledge were also noted (Z=-4.456, p<0.001), articularly involving the domains of nutrition (Z=-2.972, p=0.003), physical activity (Z=-3.564, p<0.001), and family/community engagement (Z=-2.531, p=0.011). Meanwhile, participants also suggested further improvements in the toolkit to enhance its utilization in the local context. Administrative support was a crucial facilitator for implementing the USHK, while resource limitations were identified as significant barriers.

CONCLUSION

The updated USHK, which provides a more comprehensive health promotion approach for schools, is potentially feasible for implementation in educational institutions in Manila. The toolkit can be utilized by teachers and school nurses to integrate health promotion activities into the school environment and classroom activities. To facilitate its wider uptake and implementation in other schools, government support and resource availability are crucial.

Health Promotion ; Philippines

BACKGROUND AND OBJECTIVE

Global health highlights the transnational determinants, issues, and possible solutions for improving health outcomes. Addressing global health issues requires population-based approaches coupled with individualized healthcare across settings, including strategies for achieving health equity. Designing and implementing global health solutions requires competent nurse leaders who can facilitate multi-disciplinary collaborations, engage in policy development, and lead advocacies that support the global health agenda. Thus, this paper examined the stakeholder perspectives that informed the development of a leadership program on global health for nurse leaders in the Western Pacific Region (WPR).

METHODS

The study used a descriptive qualitative approach to generate key recommendations for a context-appropriate, multi-country capacity-building program for nurse leaders on global health. The Analysis Design, Development, Implementation, and Evaluation (ADDIE) model and reflexive approach were employed to guide the development of the training design. Twenty-five nurse leaders from World Health Organization Collaborating Centers (WHO-CC) in the Western Pacific participated. Qualitative data were collected from participant feedback and post-activity sessions throughout program implementation.

RESULTS

Thematic analysis of stakeholder data revealed that the program (1) capitalized on equipping nurse leaders with the concepts related to global health and developing competencies in leadership, policy engagement, and advocacy; (2) ensured learning strategies by having participants from varied contexts and experiences; and (3) reflected on the strengths and limitations of the use of the online platform.

CONCLUSION

This paper contributed to the growing literature on global health and programs that support addressing global health issues. The findings underscored the urgent need to capacitate nurses in leadership positions who contribute to addressing emerging issues in global health. The paper recommended improvements in the design and implementation of the Global Health Nursing Leadership Program to engage more nurse leaders across the region and enhance content and delivery.

Global Health

BACKGROUND AND OBJECTIVES

Nurses have a pivotal role in nurturing the capabilities of individuals, families, and population groups for better health. However, underserved communities in the Philippines, such as those with socioeconomic inadequacies, geographic isolation, and service access problems, have significant limitations in attaining the highest possible level of health. Hence, a community extension service (Project “Lusog-Linang”), employing community-engaged research, was launched with the residents of an underserved locality in Central Luzon. The current paper aimed to describe the engagement of the community residents in describing their current health situation and related priority problems, as well as explore appropriate initiatives to manage the identified problems.

METHODS

Community-engaged research was utilized to enable the residents of Barangay San Vicente, Bamban, Tarlac to participate in health capacity building. Particularly, records review and focus group discussions were conducted to assess the community’s health needs and to identify the residents’ perceived problems. The findings were presented in a community assembly, where residents further discussed their priority health concerns and potential interventions to address them. Quantitative data were summarized through descriptive statistics, while qualitative information was synthesized via content analysis.

RESULTS

The priority community health problems included healthcare inaccessibility (trained staff, health equipment, and facility access), food insecurity, water supply limitations, and environmental sanitation. Moreover, there was inadequate knowledge and skills among the residents in health promotion, disease prevention, and illness management. While Barangay San Vicente had limited socioeconomic resources to optimize their health capacities, the sense of community among the residents is a vital resource towards empowering them to improve their health.

CONCLUSION

The results could be utilized as a launching pad for developing appropriate health programs for the residents of Barangay San Vicente. Hence, the next steps in Project “Lusog-Linang” should include the identification and training of core group members toward community mobilization, and further exploring collaborative and sustainable partnerships across organizations to ensure that the community will have long-term solutions to their problems. Consequently, this project could guide public health workers in ensuring the active involvement and participation of the community members in managing their own health.

Capacity Building

BACKGROUND: Worldwide trends in health risks, lifestyle behaviors, health perceptions, and health-seeking patterns suggest alarming disparities among individuals from low- and middle-income countries. Such international comparisons are particularly troubling for older individuals (≥60 years). OBJECTIVES: This study aims to compare health risks, lifestyle behaviors, health perceptions, and health-seeking patterns between younger (<60) and older (≥60) Filipinos from rural communities in the Philippines. METHODS: A comparative cross-sectional study was employed with 863 younger and 427 older Filipinos. Data were analyzed using frequencies, chi-squares, and T-tests. RESULTS: Older participants were more likely to be single/widowed, ≤ high school education and had higher rates of hypertension, high cholesterol, diabetes, and depression. They reported poorer health status and went to the village health center when sick. Furthermore, they were less likely to drink alcohol and see a physician. CONCLUSION There were significant differences in modifiable health risks and lifestyle behaviors and differences in health perceptions between younger and older cohorts of Filipinos living in rural areas in the Philippines. Our findings suggest the need to design separate health promotion interventions that target older and younger Filipinos' unique needs from rural communities.
Low-Middle-Income Countries ; Aging ; Cross-sectional ; Population Health ; Philippines