1.“They say it may cause cancer:” A qualitative exploration of Filipinos' contraceptive misconceptions and primary healthcare interventions
Pamela Mae Q. Aseremo ; Jayne Patricia C. Herco ; Charlene A. Paraleon ; Azel Ruth E. Pumaras ; Nikki M. Matibag ; Kevin Jace A. Miranda ; Rogie Royce Z. Carandang
Acta Medica Philippina 2025;59(11):8-17
BACKGROUND AND OBJECTIVE
Contraceptives are widely acknowledged for preventing unwanted pregnancies. However, there is a prevalent lack of awareness regarding contraceptives, leading to unaddressed misconceptions. This study aimed to identify common contraceptive misconceptions among men and women of reproductive age and explore how primary health workers address them.
METHODSA qualitative study was conducted in two phases within District 5, Manila City. Phase 1 comprised focused group discussions with men and women of reproductive age (n=60), while Phase 2 involved conducting in-depth interviews with primary healthcare providers (n=16). MAXQDA, a qualitative software, to organize and code the data, was utilized.
RESULTSWomen of reproductive age reported several misconceptions about contraceptives, including concerns about adverse health effects, emotional and behavioral changes, perceived ineffectiveness, and cosmetic or bodily changes. For instance, they believed that contraceptives could lead to serious health complications, such as cancer, genital injury, and even death. Primary healthcare providers addressed these misconceptions through open dialogue during service delivery, particularly during prenatal and postpartum check-ups and infant immunizations. They utilized patient education strategies, including the teach-back method, and conducted community outreach and workshops on contraceptives and family planning, especially during Women’s Month.
CONCLUSIONSeveral misconceptions were identified among women of reproductive age regarding the proper use and safety of contraceptive methods, as well as misguided beliefs. In contrast, men did not exhibit any misconceptions about contraceptives, which warrants further investigation. Primary healthcare providers have taken a proactive approach to address this issue by offering comprehensive explanations and ensuring clear understanding between healthcare providers and women. Promoting contraceptive health literacy could help bridge the knowledge gap between men and women of reproductive age.
Human ; Contraceptives ; Contraceptive Agents ; Health Literacy ; Philippines
2.Association between health literacy and sugar-sweetened beverage consumption among Filipinos
Michelle Ann D. Aguilar ; Ma. Carmen C. Tolabing
Acta Medica Philippina 2025;59(12):52-59
BACKGROUND
Sugar-sweetened beverages (SSBs) are a common part of Filipino meals. Increased SSB consumption is linked to weight gain and increased risk of noncommunicable diseases (NCDs). Previous studies have shown that health literacy (HL) is associated with positive health outcomes. However, there are limited studies examining its relationship with specific dietary behavior, including SSB consumption.
OBJECTIVEThe study aims to investigate the association between HL and SSB consumption among Filipinos aged 15 to 70 years.
METHODSAn analytic cross-sectional study using secondary data from the 2018-2019 National Health Literacy Survey (NHLS) was conducted. A total of 1,765 study participants (15 to 70 years old) were included. Socio-demographic information, daily SSB consumption (33 was considered "sufficient." Multivariate logistic regression was conducted to estimate adjusted odds ratios and confidence intervals for daily SSB consumption.
RESULTSOut of the 1,765 study participants, 64.14% reported consuming (≥1 SSB drink per day, of whom majority (57.52%) were adults (31 to 59 years old), females (72.21%), married or in common-law partnership (65.70%), living in the Luzon region (47.23%), urban residents (71.94%), high school graduates (30.52%), have an annual household income of PhP 100,000–249,999 (37.03%), and employed (92.61%). Among those consuming ≥1 SSB drink per day, 51.89% had limited HL. Age, sex, and subnational level (National Capital Region, Luzon, Visayas, and Mindanao) were found to be significantly associated with the consumption of ≥1 SSB drink(s) per day. A weak association was found between HL and SSB consumption (aOR: 0.9591; 95% CI: 0.7832, 1.1747), that is, the adjusted odds of having limited HL were found to be slightly lower among those consuming ≥1 SSB drink(s) per day than those who consume
There was a high prevalence of daily SSB consumption among Filipinos. Among the variables considered, only age, sex, and subnational level were found to be significant determinants of SSB consumption. The findings of the study may provide valuable insights for targeted health promotion and education interventions in reducing SSB consumption among Filipinos such as workplace wellness programs, nutrition education, and the provision of healthier beverage alternatives. Priority should be given to younger individuals, males, and residents of the National Capital Region. This research also fills a gap in the literature regarding the role of HL in SSB consumption within the Philippine context. Findings of this study support adopting the Health Literacy Universal Precautions to ensure accessible health information and services for all, regardless of HL level.
Human ; Health Literacy ; Sugar-sweetened Beverages ; Sweetened Drink
4.Psychometric properties of self-report questionnaires in evaluating blended learning in health science university students: A systematic review
Valentin C. Dones III ; Maria Teresita B. Dalusong ; Donald G. Manlapaz ; Juan Alfonso S. Rojas ; Ma. Bianca Beatriz P. Ballesteros ; Ron Kevin S. Flores ; Kaela Celine C. Hor ; Jose Angelo D. Monreal ; Audrey Marie A. Narselles ; Jose Joaquin R. Reyes ; Lianna Andrea B. Sangatanan
Acta Medica Philippina 2025;59(Early Access 2025):1-14
BACKGROUND
Due to the COVID-19 outbreak, schools had to switch online. The sudden transition to blended teaching and learning (BTL) poses challenges for students and teachers, especially for health science programs that require hands-on practical experience. The validity, reliability, and responsiveness of these self-report questionnaires (SRQs) should be established to ensure the accuracy of the results as intended by the SRQ.
OBJECTIVESThis study critically appraised, compared, and summarized the psychometric properties of SRQ evaluating BTL among health science university students. This review determined the SRQ’s reliability, internal consistency, various forms of validity (content, criterion, construct), and responsiveness.
METHODSFollowing a 10-step procedure based on COSMIN guidelines, we conducted a systematic review of SRQs used by health science university students to evaluate blended teaching and learning. Studies were eligible if they reported psychometric properties of SRQs related to blended learning among university health science students; exclusions included studies focusing on perceptions, attitudes, self-efficacy, and satisfaction, as well as articles such as biographies, editorials, and conference materials. Searches covered multiple electronic databases until April 26, 2023, including PubMed, EMBASE, Web of Science, MEDLINE (OVID), PsycInfo, CINAHL, EBSCOHOST, ERIC, Scopus, Science Direct, Google Scholar, JSTOR, Acta Medica Philippina, Philippine Journal of Health Research and Development, and HERDIN, managed through Zotero. Two independent reviewers performed database searches, title and abstract screening, and full-text evaluations, with a third reviewer resolving any disputes. The COSMIN Risk of Bias Checklist was employed to evaluate included studies on the development and various measurement properties of SRQs. The reviewers assessed SRQ standards, including validity, reliability, internal consistency, measurement error, responsiveness, interpretability, and feasibility. Data extraction and result tabulation were independently completed, with content comparison by two health education experts. This evaluation categorized the SRQs into three quality and validity levels.
RESULTSThe study examined five articles; four were rated as 'doubtful' and one as 'inadequate' in the overall development of SRQ. All four 'doubtful' studies demonstrated questionable content validity when university students were asked about the questionnaire's relevance, comprehensiveness, and comprehensibility. Only half of these studies achieved an 'adequate' rating for content validity based on expert opinions on relevance and comprehensiveness. All but one study scored from 'very good' to 'adequate' in structural validity. Three out of the four studies scored a very good rating for internal consistency, while one was deemed 'inadequate' in internal consistency, cross-cultural validity, and reliability. Three out of four studies scored 'very good' on construct validity, but all overlooked criterion validity and responsiveness. Conducted in various locations, including Australia, Romania, Turkey, and Taiwan, these studies highlighted both common characteristics and limitations in questionnaire development according to the COSMIN guidelines. Four studies were deemed reliable and valid for BTL constructs (Category A); Wu et al. requires further validation (Category B). Study limitations included heterogeneity in populations, settings, and questionnaire versions, potential subjective bias in SRQ content comparison, and the evolving nature of SRQs in blended learning contexts.
CONCLUSIONThe systematic review reports the development and evaluation of SRQs for BTL while identifying gaps in their applicability to health science programs. The Blended Learning Scale (BLS) of Lazar et al. and the Blended Learning Questionnaire (BLQ) of Ballouk et al. showed an ‘adequate' rating for content validity. BLS revealed very good structural validity, internal consistency, and adequate content validation. Although the BLQ lacked Confirmatory Factor Analysis, it yielded valuable constructs for evaluating health sciences students' experiences in BTL. Both tools require improvements on recall period, completion time, interpretability, and feasibility. The review underscores the necessity for cont inuous assessment and enhancement of such instruments in BTL, advocating a rigorous scale development process. Furthermore, it encourages the customization of teaching and learning evaluation tools to suit specific institutional contexts while promoting further validation of these questionnaires across different populations in future research.
Human ; Psychometrics ; Checklist ; Self Report ; Universities ; Health Education
5.Post-pandemic implications of the nursing students' clinical learning environment and its relationship to academic grit, self-esteem, and caring behaviors: A cross-sectional study
Charlie C. Falguera ; Janet Alexis A. De los santos ; Carmen N. Firmo ; Paulo Batidor
Acta Medica Philippina 2025;59(Early Access 2025):1-10
BACKGROUND
The clinical learning environment (CLE) significantly influenced the nursing students' learning experience. While clinical learning is the heart of nursing education, certain non-academic factors might be influenced by CLE. Consequently, CLE may be affected during a health crisis like the COVID-19 pandemic.
OBJECTIVETo determine the relationship between nursing students’ CLE and their academic grit, self-esteem, and caring behaviors in the Central Philippines.
METHODSA descriptive cross-sectional study was conducted involving 462 nursing students enrolled during the COVID-19 pandemic. A purposive sampling technique was used to select the participants. Four self-report questionnaires were adopted to gather the data: a 42-item Clinical Learning Environment Inventory (CLEI) scale, short-form Grit (Grit-S) scale, Rosenberg’s Self-Esteem (RSE) scale, and Caring Behavior Inventory (CBI-24) scale. Spearman rho and rank-biserial correlation tools were used to analyze the data.
RESULTSThe results indicated that the clinical learning environment was positively associated with academic grit, selfesteem, and caring behavior. Some profiles of the participants, such as age, sex, year level, type of school, leadership experiences, clinical setting experience, and willingness to be a nurse, were significantly associated with the clinical learning environment, academic grit, self-esteem, and/or caring behavior.
CONCLUSIONSStudents’ CLE influences their academic grit, self-esteem, and caring behavior. That is, students who reported a more positive perception of CLE, the higher their academic grit, self-esteem, and caring behaviors. Furthermore, some students’ profile characteristics influence CLE, academic grit, self-esteem, and caring behavior. Enhancing CLE while promoting grit, self-esteem, and caring behaviors of nursing students affiliated with hospitals or any clinical learning settings and promoting alternative means of meeting CLE competencies when face-to-face interactions are restricted during a health crisis are recommended.
Human ; Clinical Practicum ; Preceptorship ; Mental Health ; Education, Nursing
6.A quasi-experimental study on the effectiveness of health education on the knowledge, attitude and practices about scabies among barangay health workers in Dagupan City.
Stefanie Mae S. BELMES-MORALES ; Gladys Maxima M. RAYOS ; Maria Aurora Teresa H. ROSARIO ; May F. GONZALES
Journal of the Philippine Medical Association 2025;104(1):67-78
BACKGROUND
Scabies, recognized as one of the neglected tropical diseases (NTDs) by the WHO continues to persist in our locality today. Health education emerges as an indispensable tool, aimed at enhancing the knowledge, attitudes, and practices (KAP) of Barangay Health Workers (BHWs). As the primary frontliners in our community, they encounter a wide array of skin conditions, but often lack the resources to manage them effectively.
OBJECTIVESThe primary objective of this study is to assess the impact of health education on the KAP of BHWs concerning Scabies infestation.
METHODSA quasi-experimental, one-group pre-test-post-test design assessed the effectiveness of a 30-minute face-to-face lecture on BHWs’ KAP regarding Scabies infestation in the community. The study was conducted on April 25, 2023 at the Dagupan City Health office utilizing random population sampling.
RESULTSThe study included 45 BHW participants, 71.11% of whom had prior Scabies knowledge mainly from seminars/training (42.22%). Initially, most had poor baseline knowledge. Less than half (46.67%) identified skin manifestations and treatment accurately. Most displayed positive attitudes toward environmental management (91.11%) and fomite infection control (77.78%). After the lecture, the participants' total scores increased.
CONCLUSIONBHWs bridge the gap between healthcare and underserved populations. Equipping them with knowledge of diseases such as Scabies is imperative. This underscores the effectiveness of health education in enhancing their KAP towards Scabies. By empowering them, we can reduce the impact of NTDs in vulnerable communities. These findings have potential implications for future training programs, awareness campaigns, and further studies involving healthcare workers.
Human ; Scabies ; Health Education
7.Post-pandemic implications of the nursing students' clinical learning environment and its relationship to academic grit, self-esteem, and caring behaviors: A cross-sectional study.
Charlie C. FALGUERA ; Janet Alexis A. DE LOS SANTOS ; Carmen N. FIRMO ; Paulo BATIDOR
Acta Medica Philippina 2025;59(18):71-80
BACKGROUND
The clinical learning environment (CLE) significantly influenced the nursing students' learning experience. While clinical learning is the heart of nursing education, certain non-academic factors might be influenced by CLE. Consequently, CLE may be affected during a health crisis like the COVID-19 pandemic.
OBJECTIVETo determine the relationship between nursing students’ CLE and their academic grit, self-esteem, and caring behaviors in the Central Philippines.
METHODSA descriptive cross-sectional study was conducted involving 462 nursing students enrolled during the COVID-19 pandemic. A purposive sampling technique was used to select the participants. Four self-report questionnaires were adopted to gather the data: a 42-item Clinical Learning Environment Inventory (CLEI) scale, short-form Grit (Grit-S) scale, Rosenberg’s Self-Esteem (RSE) scale, and Caring Behavior Inventory (CBI-24) scale. Spearman rho and rank-biserial correlation tools were used to analyze the data.
RESULTSThe results indicated that the clinical learning environment was positively associated with academic grit, selfesteem, and caring behavior. Some profiles of the participants, such as age, sex, year level, type of school, leadership experiences, clinical setting experience, and willingness to be a nurse, were significantly associated with the clinical learning environment, academic grit, self-esteem, and/or caring behavior.
CONCLUSIONSStudents’ CLE influences their academic grit, self-esteem, and caring behavior. That is, students who reported a more positive perception of CLE, the higher their academic grit, self-esteem, and caring behaviors. Furthermore, some students’ profile characteristics influence CLE, academic grit, self-esteem, and caring behavior. Enhancing CLE while promoting grit, self-esteem, and caring behaviors of nursing students affiliated with hospitals or any clinical learning settings and promoting alternative means of meeting CLE competencies when face-to-face interactions are restricted during a health crisis are recommended.
Human ; Clinical Practicum ; Preceptorship ; Mental Health ; Education, Nursing
8.Psychometric properties of self-report questionnaires in evaluating blended learning in health science university students: A systematic review.
Valentin C. DONES III ; Maria Teresita B. DALUSONG ; Donald G. MANLAPAZ ; Juan Alfonso S. ROJAS ; Ma. Bianca Beatriz P. BALLESTEROS ; Ron Kevin S. FLORES ; Kaela Celine C. HO ; Jose Angelo D. MONREAL ; Audrey Marie A. NARCELLES ; Jose Joaquin R. REYES ; Lianna Andrea B. SANGATANAN
Acta Medica Philippina 2025;59(16):79-92
BACKGROUND
Due to the COVID-19 outbreak, schools had to switch online. The sudden transition to blended teaching and learning (BTL) poses challenges for students and teachers, especially for health science programs that require hands-on practical experience. The validity, reliability, and responsiveness of these self-report questionnaires (SRQs) should be established to ensure the accuracy of the results as intended by the SRQ.
OBJECTIVESThis study critically appraised, compared, and summarized the psychometric properties of SRQ evaluating BTL among health science university students. This review determined the SRQ’s reliability, internal consistency, various forms of validity (content, criterion, construct), and responsiveness.
METHODSFollowing a 10-step procedure based on COSMIN guidelines, we conducted a systematic review of SRQs used by health science university students to evaluate blended teaching and learning. Studies were eligible if they reported psychometric properties of SRQs related to blended learning among university health science students; exclusions included studies focusing on perceptions, attitudes, self-efficacy, and satisfaction, as well as articles such as biographies, editorials, and conference materials. Searches covered multiple electronic databases until April 26, 2023, including PubMed, EMBASE, Web of Science, MEDLINE (OVID), PsycInfo, CINAHL, EBSCOHOST, ERIC, Scopus, Science Direct, Google Scholar, JSTOR, Acta Medica Philippina, Philippine Journal of Health Research and Development, and HERDIN, managed through Zotero. Two independent reviewers performed database searches, title and abstract screening, and full-text evaluations, with a third reviewer resolving any disputes. The COSMIN Risk of Bias Checklist was employed to evaluate included studies on the development and various measurement properties of SRQs. The reviewers assessed SRQ standards, including validity, reliability, internal consistency, measurement error, responsiveness, interpretability, and feasibility. Data extraction and result tabulation were independently completed, with content comparison by two health education experts. This evaluation categorized the SRQs into three quality and validity levels.
RESULTSThe study examined five articles; four were rated as 'doubtful' and one as 'inadequate' in the overall development of SRQ. All four 'doubtful' studies demonstrated questionable content validity when university students were asked about the questionnaire's relevance, comprehensiveness, and comprehensibility. Only half of these studies achieved an 'adequate' rating for content validity based on expert opinions on relevance and comprehensiveness. All but one study scored from 'very good' to 'adequate' in structural validity. Three out of the four studies scored a very good rating for internal consistency, while one was deemed 'inadequate' in internal consistency, cross-cultural validity, and reliability. Three out of four studies scored 'very good' on construct validity, but all overlooked criterion validity and responsiveness. Conducted in various locations, including Australia, Romania, Turkey, and Taiwan, these studies highlighted both common characteristics and limitations in questionnaire development according to the COSMIN guidelines. Four studies were deemed reliable and valid for BTL constructs (Category A); Wu et al. requires further validation (Category B). Study limitations included heterogeneity in populations, settings, and questionnaire versions, potential subjective bias in SRQ content comparison, and the evolving nature of SRQs in blended learning contexts.
CONCLUSIONThe systematic review reports the development and evaluation of SRQs for BTL while identifying gaps in their applicability to health science programs. The Blended Learning Scale (BLS) of Lazar et al. and the Blended Learning Questionnaire (BLQ) of Ballouk et al. showed an ‘adequate' rating for content validity. BLS revealed very good structural validity, internal consistency, and adequate content validation. Although the BLQ lacked Confirmatory Factor Analysis, it yielded valuable constructs for evaluating health sciences students' experiences in BTL. Both tools require improvements on recall period, completion time, interpretability, and feasibility. The review underscores the necessity for cont inuous assessment and enhancement of such instruments in BTL, advocating a rigorous scale development process. Furthermore, it encourages the customization of teaching and learning evaluation tools to suit specific institutional contexts while promoting further validation of these questionnaires across different populations in future research.
Human ; Psychometrics ; Checklist ; Self Report ; Universities ; Health Education
9.Pandemic-related health literacy: a systematic review of literature in COVID-19, SARS and MERS pandemics.
Jun Jie Benjamin SENG ; Cheng Teng YEAM ; Caleb Weihao HUANG ; Ngiap Chuan TAN ; Lian Leng LOW
Singapore medical journal 2025;66(5):244-255
INTRODUCTION:
Health literacy plays an essential role in one's ability to acquire and understand critical medical information in the coronavirus disease 2019 (COVID-19) infodemic and in other pandemics. We aimed to summarise the assessment, levels and determinants of pandemic-related health literacy and its associated clinical outcomes.
METHODS:
A systematic review was performed in Medline ® , Embase ® , PsycINFO ® , CINAHL ® and four major preprint servers. Observational and interventional studies that evaluated health literacy related to the novel COVID-19, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) were included. Items used in health literacy instruments were grouped under the themes of knowledge, attitudes and practices. Determinants of health literacy were grouped into five domains: sociodemographic, medical, psychological/psychiatric, health systems-related and others.
RESULTS:
Of the 2,065 articles screened, 70 articles were included. Of these, 21, 17 and 32 studies evaluated health literacy related to COVID-19, SARS and MERS, respectively. The rates of low pandemic health literacy ranged from 4.3% to 57.9% among medical-related populations and from 4.0% to 82.5% among nonmedical populations. Knowledge about the symptoms and transmission of infection, worry about infection, and practices related to mask usage and hand hygiene were most frequently evaluated. Sociodemographic determinants of health literacy were most frequently studied, among which higher education level, older age and female gender were found to be associated with better health literacy. No studies evaluated the outcomes associated with health literacy.
CONCLUSION
The level of pandemic-related health literacy is suboptimal. Healthcare administrators need to be aware of health literacy determinants when formulating policies in pandemics.
Humans
;
Health Literacy
;
COVID-19/epidemiology*
;
Severe Acute Respiratory Syndrome/epidemiology*
;
Health Knowledge, Attitudes, Practice
;
Pandemics
;
SARS-CoV-2
;
Coronavirus Infections/epidemiology*
;
Middle East Respiratory Syndrome Coronavirus
;
Female
;
Male
10.Health literacy and self-care among patients with chronic kidney disease in a primary care setting.
Han-Kwee HO ; Eileen Yi-Ling KOH ; Adina ABDULLAH ; Ngiap-Chuan TAN
Singapore medical journal 2025;66(6):307-313
INTRODUCTION:
The study objective was to determine the levels of self-care and health literacy (HL) and their associations among patients with chronic kidney disease (CKD).
METHODS:
This was a cross-sectional, questionnaire-based study conducted in a public primary care setting in Singapore. A total of 289 participants aged 21-80 years with hypertension were recruited. Self-care profiles were measured using the Hypertension Self-Care Profile (HTN-SCP; range 0-240, domain range 0-80). Health literacy was measured using the Short-Form Health Literacy Scale (HLS-SF12; range 0-50, limited literacy ≤33).
RESULTS:
The mean self-care score was 182.7 (standard deviation [SD] 23.2). The median HL score was 34.7 (interquartile range [IQR] 31.9-40.3), and 31.1% of participants had limited HL. Self-care was not associated with age, CKD status, household income and education, but was associated with gender and HL score. In the final regression model, lower HL scores (adjusted β = 1.03, 95% confidence interval [CI] 0.7 to 1.36, P < 0.001) and male gender (adjusted β = -5.29, 95% CI -10.56 to -0.03, P = 0.049) were associated with lower self-care scores. The HL scores were associated with self-care domains of self-efficacy (HL: β = 0.30, 95% CI 0.17 to 0.42, P < 0.001), motivation (HL: β = 0.40, 95% CI 0.26 to 0.53, P < 0.001) and behaviour (HL: β = 0.38, 95% CI 0.26 to 0.50, P < 0.001).
CONCLUSION
Thirty-one percent of the participants had limited HL. Self-care was not associated with age, race, CKD status, household income or education. Male gender and limited HL were associated with lower self-care. Self-care was associated with self-efficacy, motivation and behaviour. Future research could focus on more targeted approaches to improve self-care and HL among patients with CKD.
Humans
;
Male
;
Female
;
Health Literacy
;
Middle Aged
;
Self Care
;
Cross-Sectional Studies
;
Aged
;
Adult
;
Primary Health Care
;
Renal Insufficiency, Chronic/therapy*
;
Singapore
;
Surveys and Questionnaires
;
Aged, 80 and over
;
Young Adult
;
Hypertension/therapy*


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