OBJECTIVES: This descriptive-correlational study aims to determine the extent of socio-cognitive characteristics, perceived barriers and the factors contributing to treatment adherence among PTB patients.
METHODS: A survey was administered to PTB patients registered under the Directly Observed Treatment Short Course (DOTS) program of Binan and Cabuyao, Laguna.  Records review and key informant interview were also utilized to determine adherence rates.
RESULTS: There were 184 PTB patients who participated in the study. Knowledge on PTB and its treatment and perceived threat of PTB was high, and perceived barriers to PTB treatment is low; but the respondents were uncertain on the perceived benefits of PTB treatment adherence.  Perceived social support towards PTB treatment adherence was high, opportunity and time costs were low, and accessibility to PTB treatment services was high.  Adherence to daily medication taking was reported by 98.4% of the respondents and 78.3% of these had the intention to complete the duration of PTB treatment.  The level of knowledge on PTB and its treatment, and social support from the community, and treatment partners were the most significant predictors of PTB patients' adherence to treatment.
CONCLUSION: The adherence rate of the PTB patients to their treatment was high, and the extent of knowledge on PTB and its treatment was the greatest influencing factor towards PTB patients' adherence to treatment.

OBJECTIVES: This study assessed the existing Public Health Promotion and Education 210 module (PHPE 210) as basis for the revision of the learning resource material. Specifically, this study determined the stakeholders' perceptions on the module in terms of: (1) its presentation, organization, topics covered, clarity/user-friendliness and its relevance to practice; (2) its strengths and weaknesses; and (3) the topics that need to be integrated in the resource material.

METHODS: A qualitative approach was used for this study. Through purposive sampling, 4 focus group discussions and 11 key informant interviews were done. Topic Guide was used as the main data collection instrument. Informed consent was obtained prior to data collection. Data was described verbatim, emerging themes and actual quotations from the participants and informants were extracted in the succeeding analysis.

RESULTS: The results of the focus group discussions and key informant interviews, in general, were similar and actually complemented each other. The module was perceived to be relevant, comprehensive and logically organized. The historical foundation needs to be presented in a more concise and updated manner, and examples and practical applications of the PRECEDE-PROCEED model must be used. To update the module and make it more relevant to the present issues, innovative health promotion strategies such as social media, healthy settings, health in all policies, and multi-sectoral approach must be included in the revised version. Practical applications of the theories and health promotion and education strategies also need to be considered in the revision of the module. The module has to be presented in a more reader-friendly manner, easy-to-use and visually appealing to its readers.

CONCLUSION: This study demonstrated the importance of incorporating the perceptions of educators, module developers, practitioners, experts, and the learners or students in assessing and redesigning a more relevant learning resource material. With the current trends and emerging issues in health promotion and education, an evidence-based development and improvement of learning resource modules to make them relevant to changes have to be continuously undertaken.

OBJECTIVE: This paper aims to provide concise background information regarding the state of noncommunicable diseases (NCDs) and their risk factors as well as the existing efforts to address them in the Philippines in the last 25 years.

METHODS: A desk review of documents and literature review as well as analyses of available statistical data and several consultations with involved government agencies have been made to come up with summary figures and tables.

RESULTS: NCDs as well as metabolic conditions that can potentially lead to NCDs are on the rise in the last score of years. The Philippines, through the Department of Health, has been visionary in leading various projects and activities to fight NCDs over the last two decades, and its efforts are slowly paying off: the prevalence of tobacco use and that of hypertension have decreased over the last 5 years. NCD mortality (including premature deaths) and prevalence of behavioral risk factors, however, generally remain high, and the Philippines needs to accelerate whole-of-society and whole-of-government actions to sustain the gains and attain its NCD targets in the next 10 years or so.

CONCLUSION: The need to strengthen health system interventions and promote accountability of various sectors in addressing NCDs and its risk factors in the country arises. The development of a multisectoral action plan on NCD prevention and control is needed to halt the rise of NCDs in the country.

Background: In the Philippines, 34 Filipinos are killed daily due to road injuries. Of the reported road traffic fatalities, 25% in the world, 34% in South East Asia, and 53% in the Philippines are riders of motorized two- or three-wheeled vehicles. Objectives: Considering that motorcycle drivers are most affected by road-related injuries in Metro Manila, this study aimed to determine the prevalence of helmet use, identify the factors affecting the intent to use helmets, and determine the factors associated with consistent helmet use among motorcycle drivers in District IV, Quezon City. Methods: Eight barangays were included in the sample and respondents were chosen through systematic random sampling. Results: A self-administered questionnaire was used. There were 421 respondents with a prevalence for consistent helmet-use of 67.46% (CI 95%: 62.81-71.78). It was found that the aggregate belief score was associated with the intention to use helmets. Meanwhile, every unit increase in knowledge score increased the odds of consistent helmet use by 1.21 (95% CI: 1.06-1.37). In addition, those with intention were 7.48 times more likely to consistently wear helmets than those who do not (95% CI: 2.80- 19.97). Conclusion Various sub-factors such as experience, formal driving education, perceived behavioral control, benefits, and ergonomic barriers may have contributed to the result; however, further studies are needed to establish these relationships.
Intention ; Health Belief Model ; Theory of Planned Behavior

COVID-19

Background: The College of Public Health, University of the Philippines Manila (CPH-UPM) was engaged by the Center for Health Development Calabarzon (CHD 4A) to design, implement and manage the retooling of their personnel following implementation of Executive Order No. 336 on the rationalization of the Philippine government’s executive branch. Objective: To describe the training design and present outputs of the training modules designed for the CHD 4A staff. Methods: We reviewed the project documentation, which included the inception report, minutes of meetings, training modules, and post-training reports. Abstracted information was validated through internal discussion by a core group, which had representatives from the two organizations involved from project inception to close-out. Results: The design, development and implementation of the training were the product of collaborative efforts between CHD 4A and the technical team from the College of Public Health, University of the Philippines Manila. Technical staff of CHD 4A were trained in the competency areas in which gaps between the expected and perceived level of performance across all salary grades were highest: results orientation, planning and organizing, technical expertise, quality service focus, coordination and networking, and managing change. Nine training courses were implemented from May to July 2016, which was attended by 230 participants. All training modules were highly rated by participants (range: 3.60 to 3.85) based on a four-point scale, with 4 as the highest rating and 1 as the lowest. Comparison of pre- and post-tests for the modules on coordination and networking, and managing change showed a statistically significant increase in scores at the conclusion of their respective sessions. Conclusion The design of a training program for an organization’s personnel must be tailor-fit to and answer the needs of its employees. Trainers must be willing to make dynamic changes and adapt to immediate feedback from participants. The implementing party and organization itself must both ensure thorough evaluation of the effects of the training to achieve the organization’s long-term goals.
Staff Development ; Teaching ; Education ; Workforce

Objective: To assess the competency levels of the technical staff of the Center for Health Development Calabarzon (CHD 4A) to inform the development of a human resource management plan. Methods: A cross-sectional assessment design to determine the CHD 4A technical staff's competency level was utilized. The team from the College of Public Health, University of the Philippines Manila invited all the CHD 4A technical staff to complete a self-assessment using the Learning and Development Needs Assessment Tool (LDNA) (version 3-45), rating their perceived competency and the level of importance to their functions on core and functional competencies stipulated in the Department of Health Compendium of Competency Standards. Gaps were identified by comparing perceived competency levels with a predetermined standard for each agency's salary grade or position. Results: All 67 technical staff took part in the assessment. Entry- and senior-level professionals had minimal deviations from predetermined standards, with gaps in quality service focus and teamwork for the former and planning and political savvy for the latter. In contrast, mid-career professionals had larger gaps in magnitude and number than entry and senior-level staff – the largest being on results orientation – reflective of newly-promoted staff's adjustment period. Of note, these gaps were based on the prevailing competency standards in force at the time of assessment in 2015. Findings may need to be revisited when the agency updates the core and functional competency standards. Conclusion The participants perceived core and functional competencies as important, with the level of perceived importance increasing as the salary bracket increases. Core competency gaps were widest in integrity and quality service focus. Simultaneously, results orientation, and planning and organizing were the functional competencies that registered the widest gap and prioritized. Training needs assessments should be conducted in times of change to ensure an organization's training programs' relevance and to develop peak-level employee performance.
Staff Development ; Needs Assessment

Background and Objectives: Tuberculosis (TB) continues to be a public health concern in the Philippines. Vulnerable populations in congregate settings such as drug abuse treatment and rehabilitation centers (DATRCs) have higher risks of TB transmission and infection. With the Duterte administration’s intensified campaign against illegal drugs, government-retained DATRCs are filled to capacity. There is an identified need to profile drug users and dependents living in DATRCs. Furthermore, national guidelines for TB management specific to this population is absent. A study was conducted to determine the profile of admitted clients diagnosed with TB, TB prevalence, treatment outcomes and choice of TB diagnostic modalities in six (6) Luzon-based DATRCs from 2013-2015. Methods: All medical records of drug users admitted in this period were reviewed. Information on the total patient census was sought from DATRC heads and used to compute for prevalence. Results: A total of 347 records were obtained. Overall TB prevalence in the study sites was 7,216 per 100,000 population. The typical individual diagnosed with TB in a DATRC was male, with a mean age of 35 years, with at least high school education, and unemployed. Weight loss and fatigue were the most common symptoms reported. The majority (79.83%) completed TB treatment in the DATRCs. Sputum microscopy and chest x-ray were both used for TB diagnosis in 92.80% (322) of the cases. Conclusion The high burden of TB in Luzon-based, government-retained DATRCs is alarming and underscore the critical need for standards and guidelines in the National Tuberculosis Control Program addressing the unique context of these facilities.
Substance Abuse Treatment Centers ; Prevalence ; Philippines ; Tuberculosis ; Psychiatric Rehabilitation ; Behavior Therapy

Background and Objectives: Tuberculosis (TB) remains a public health problem in the Philippines despite trends indicating a decline in the burden of disease. Persons who use drugs who are confined in government-retained drug abuse treatment and rehabilitation centers (DATRCs) face an increased risk for TB because of the congestion in the facility coupled with the absence of guidelines on TB management specific to DATRCs. Thus, this study was conducted to document the current case finding and case holding practices as well as TB treatment pathway in six (6) Luzon-based, government-retained DATRCs.

Methods: Key informant interviews were conducted with DATRC personnel involved in TB diagnosis and management in six selected DATRCs in Luzon, Philippines. Interviews were transcribed and coded for thematic analysis. We compared the DATRC practices with the provisions of the 2014 National TB Control Program (NTP) Manual of Procedures. Results were validated through a workshop with (a) a group of physicians and rehabilitation practitioners assigned in other DATRCs; and (b) a group of experts who have experience in managing or overseeing DATRCs in the country.

Results: Two physicians and four nurses participated in the interviews. Variations in case finding and case holding practices in six DATRCs have been found. National guidelines exist for congregate settings but are more specific to jails/prisons, which are administratively and operationally different from DATRCs.

Conclusion: Development of special guidelines for TB case finding and case holding in DATRCs as well as staff training on the latest NTP Manual of Procedures are recommended. However, gaps and inequities posed by the current set-up underscore the need to address health system-wide factors affecting the practice and performance of these facilities.

Key Words: tuberculosis, case finding, case holding, drug abuse treatment and rehabilitation centers, Philippines

Background and Objectives: The Philippine Department of Health (DOH) is mandated by law to, among others, develop capacities and accredit physicians and rehabilitation practitioners across the country on the assessment and management of drug dependence. This paper describes the design and presents the outputs of an advanced course on screening and assessment of drug dependence developed by DOH in partnership with the College of Public Health of the University of the Philippines Manila, Philippine College of Addiction Medicine, and the Group for Addiction Psychiatry of the Philippines.

Methodology: Review, abstraction and synthesis of data from training-related documents and records for the training activities implemented in 2014.

Results: The Level 2a course is a five-day program that focuses on enhancing the skills of physicians and rehabilitation practitioners on the screening and assessment of drug dependence using team-based and practical learning approaches, and builds on learnings from the basic accreditation course. A total of 36 participants from ten Drug Abuse Treatment and Rehabilitation Centers (DATRCs) in nine regions completed the pilot implementation of the course in 2014. In general, the overall participant feedback on the training was mainly favorable based on data from 47% of participants who agreed or strongly agreed to statements on the relevance and attainment of the course aims (mean rating of 1.10±0.31, 1 = Strongly agree, 5 = Strongly disagree), and the appropriateness of its content (1.24±0.43) and design (1.18±0.39). A paired-samples t-test comparing scores for 44% of participants showed that there was a highly statistically significant difference in the pre-test (54%±13%) and post-test scores (69%±10%); t(16)=6.4240, p <0.0001.

Conclusion: Development and design of capability-building initiatives in the field of drug rehabilitation will necessitate alignment with practice standards, grounding in the real-world setting in which professionals work, and orientation towards practical learning.