1.Weathering the storm: Stress management of Filipino first responders using the "Mi Salud" stress check app.
Hilton Y. LAM ; Anna Cristina A. TUAZON ; Carlos Primero D. GUNDRAN ; Cattleya Amber V. SORIANO ; Rodita C. SILVA ; Ferdinand V. ANDRADE ; Jhonel R. FLORES ; Darynne Ariana M. SOLIDUM ; Sheila Marie C. MARTINEZ ; Jean Mariz VILLANUEVA ; Jhomer A. SORNOZA ; Airene May M. PASION ; Joana Ophelia M. REAL
Acta Medica Philippina 2025;59(14):7-22
BACKGROUND AND OBJECTIVE
First responders must be physically and mentally healthy to ensure effective emergency response. However, literature showed that Filipino first responders continue to have elevated levels of stress and increased risk for post-traumatic stress and other mental health problems months after their deployment. The “Mi Salud” app was created to help Filipino first responders, their team leaders, and their agencies monitor and manage the responders’ real-time stress levels before, during, and after their deployment more effectively.
METHODSThe “Mi Salud” app was pretested with Filipino first responders (n=30) to establish convergent validity using existing validated scales measuring the same construct. Participants also completed a Likert scale and questionnaire to assess user experience and app recommendations. During the rollout, first responders (n=32) tested the app and completed a survey on user experience and app recommendations. A focus group discussion (n=11; FGD) was conducted to further explore their experiences with the app. Survey data were analyzed using descriptive statistical methods, while FGD data were examined through thematic analysis.
RESULTSResults from the online survey showed that the app was generally found to be helpful and that the recommendations within the app were useful. The emerging themes from the FGD corroborated many of the themes from the survey, particularly the benefits of using the app and the app’s ease of use. Positive effects were observed both on the responders and on the responders’ team leader and teammates, which further established the value of the “Mi Salud” app.
CONCLUSIONThe findings show that the “Mi Salud” stress check-app may serve as a useful tool for monitoring and managing the stress levels, a critical aspect for Filipino first responders to maintain optimal functioning during deployments and daily activities.
Human ; Emergency Responders ; Mental Health ; Mobile Applications ; Philippines
2.Measuring hepatitis B-related stigma: A systematic review of questionnaire-based studies.
Jaconiah Shelumiel T. MANALAYSAY ; Diego Nathaniel D. MINA ; Brian Arth M. URBANO ; Cathlyn B. GERALDO ; Josephine D. AGAPITO ; Janus P. ONG ; Joana Ophelia M. REAL ; Hilton Y. LAM
Acta Medica Philippina 2025;59(14):89-104
BACKGROUND AND OBJECTIVE
Stigma remains a profound barrier to public health, particularly in managing diseases such as Hepatitis B, which is highly prevalent in hyperendemic regions like the Philippines. The social stigma associated with such health conditions can severely limit access to care and hinder adherence to treatment, exacerbating the overall disease burden. Despite the critical impact of stigma on health outcomes, there is a notable gap in the systematic evaluation of the tools used to measure stigma related to health conditions like Hepatitis B. This study aims to fill this gap by reviewing existing instruments for their methodologies, reliability, and validity to inform the development of a refined tool tailored to the Philippine context.
METHODSA systematic search was conducted across six databases, including PubMed, Cochrane Database of Systematic Reviews, Open Grey, DissOnline, Philippine Health Research Registry (PHRR), and Health Research and Development Information Network (HERDIN), following PRISMA guidelines. The search strategy focused on identifying quantitative and mixed-methods studies using questionnaires to measure HBV-related stigma and discrimination. Studies published between January 1, 1992, and December 31, 2023, were considered. The selection process involved screening for duplicates, reviewing titles and abstracts, and performing a full-text review based on predetermined eligibility criteria.
RESULTSThe initial search yielded 1,198 articles, with 24 duplicates removed. After title and abstract screening, 28 articles were considered for full-text review, resulting in 17 relevant articles in the final analysis with 15 unique instrumentations. The majority of studies employed cross-sectional designs (n=8), with a significant concentration in Asian countries (n=11), indicating a regional focus in HBV stigma research. The review identified a range of questionnaire methodologies, but most studies lacked specificity regarding the type of stigma measured. The Likert Scale was the most commonly used measurement tool, yet few studies provided cut-off values for stigma levels. Validity and reliability testing was reported in 12 articles, including pilot studies, Cronbach’s alpha, and factor analysis.
CONCLUSIONThe lack of a universal methodology and specificity in existing instruments underscores the importance of developing a refined tool that can accurately capture the nuances of stigma and discrimination associated with HBV. The urgent need for standardized, reliable, and culturally sensitive questionnaires is evident, underscoring their importance in developing effective public health strategies and improving treatment outcomes for individuals living with HBV, especially in the Philippines.
Human ; Social Stigma ; Hepatitis B, Chronic ; State-of-the-art Review ; Review Literature As Topic
3.Cost-effectiveness analysis of various Coronavirus Disease (COVID-19) vaccines against emerging variants of concern in the Philippines.
Haidee A. VALVERDE ; Clarence C. YACAPIN ; Paul Matthew D. PASCO ; Joana Ophelia M. REAL ; Jaifred Christian F. LOPEZ ; Hannah Eleanor CLAPHAM ; Yi Zhen CHEW ; Chris Erwin G. MERCADO ; Siobhan BOTWRIGHT ; Madison SILZLE ; Hilton Y. LAM
Acta Medica Philippina 2025;59(14):37-48
OBJECTIVES
During the early COVID-19 pandemic (2020 to mid-2021), the Philippine government relied on nonpharmaceutical interventions such as lockdowns and Enhanced Community Quarantine (ECQ). With the emergency use authorization of vaccines, assessing their potential impact became essential. This study develops a Philippine model to evaluate the epidemiologic and economic effects of COVID-19 vaccination, estimating its impact on mortality, hospitalization, and mild/asymptomatic cases under various prioritization strategies, including booster doses and the presence of variants of concern.
METHODSA dynamic transmission model (DTM) with an SEIR (Susceptible-Exposed-Infected-Recovered) structure was calibrated using local data, including case numbers, deaths, seroprevalence, vaccination coverage, and intervention costs. The model’s outputs informed a cost-effectiveness analysis (CEA) from health system and societal perspectives over a two-year horizon. Incremental Cost-Effectiveness Ratios (ICERs) were calculated, with costs adjusted to 2020 prices and discount rates of 3%-10% applied. Sensitivity analyses, including one-way and probabilistic approaches, assessed robustness, while a budget impact analysis (BIA) estimated government expenditures in 2020 and 2021.
RESULTSWithout vaccination, daily cases could have peaked at 400,000 between February and May 2021. A vaccination campaign was projected to reduce cases to around 20,000, significantly lowering mortality.
From the health system perspective, the estimated cost without vaccination was PhP 14.46 trillion, with 93.83 million QALYs. With vaccination, costs dropped to PhP 2.36 trillion, while QALYs increased to 101.79 million. From the societal perspective, costs were PhP 14.68 trillion without vaccination and PhP 2.38 trillion with vaccination, with the same QALY outcomes.
CEA results confirmed that vaccination was cost-saving, with ICERs of -PhP 1,520,727.28 per QALY (health system) and -PhP 1,546,171.63 per QALY (societal). Sensitivity analyses supported these findings, with oneway sensitivity analysis showing minimal impact from parameter changes and probabilistic sensitivity analysis confirming cost-saving outcomes. The BIA estimated government expenditures of PhP 983.45 billion in 2020 and PhP 1.47 trillion in 2021 for the vaccine scenario, lower than the no-vaccine scenario.
CONCLUSIONIndeed, our modeling has shown that COVID-19 vaccines could mitigate the spread of COVID-19 and provide good value for money.
Human ; Covid-19 ; Cost-effectiveness Analysis ; Vaccines ; Philippines