1.Effectiveness of customized training programs on knowledge, attitudes, and practices (KAP) related to antimicrobial resistance (AMR) among food handlers in the greater Manila area, Philippines: A quasi-experimental study.
Geraldine B. Dayrit ; Kathyleen S. Nogrado ; Regine O. Mendiola ; John Robert Carabeo Medina ; Fresthel Monica M. Climacosa
Acta Medica Philippina 2026;60(5):80-91
BACKGROUND AND OBJECTIVES
Antimicrobial resistance (AMR) constitutes an escalating global public health menace, intensified by the excessive utilization of antibiotics in human healthcare and agriculture. In the Philippines, the extensive misuse of antimicrobials in food production, especially in chicken, swine, aquaculture, and agriculture exacerbate AMR, presenting considerable threats to public health. Since the transmission of AMR is closely linked to food safety, food handlers play a critical role in mitigating its spread. This study evaluates the knowledge, attitude, and practices (KAP) of food handlers in the Greater Manila Area concerning AMR and the utilization of antimicrobials.
METHODSThis quasi-experimental study involved developing and implementing a customized training program based on pre-training KAP questionnaires, featuring specialized training materials for fruits and vegetables sellers, meat handlers, seafood vendors, and street food vendors. The training, conducted in partnership with government entities and industry specialists, emphasized AMR awareness, food safety rules, and optimal procedures for reducing AMR hazards.
RESULTSThe results showed statistically significant differences in pre- and post-intervention mean percentage scores in the participants’ knowledge, attitudes, and practices about food handling and AMR. There was also substantial improvement observed across all four occupational groups as post-test scores increased in comparison to their baseline scores.
CONCLUSIONThis study underscores the pivotal role of food handlers in combating AMR and stresses the necessity for a training program that is focused on AMR education within food safety initiatives. The training program should be customized, for example, according to the length of experience of the food handler, to either provide basic food safety measures or to improve and upgrade the acquired baseline knowledge and skills related to food safety. This particular study showed the importance of providing food handlers with essential knowledge and skills on food safety and proper food handling to aid in the mitigation of AMR transmission.
Human ; Food Safety ; Knowledge ; Attitude
2.Relationship of Filipino MSUD children’s nutrient intake, nutritional status, and leucine level and caregiver's nutrition knowledge, attitudes, and practices.
Marife D. Sevilla ; Cecile Leah T. Bayaga ; Maria Sofia V. Amarra ; Ebner Bon G. Maceda ; Francisco N. De Los Reyes ; Leniza de Castro-Hamoy
Acta Medica Philippina 2026;60(5):92-108
BACKGROUND AND OBJECTIVES
Diet compliance is critical in managing Maple Syrup Urine Disease (MSUD) to prevent physiological and neurological damage. However, there is a lack of studies looking at factors critical to diet compliance. This study determined the caregivers’ nutrition knowledge, attitudes, and feeding practices (KAP); and its relationship to Filipino MSUD children’s leucine level, nutritional status, and nutrient intake.
METHODSA cross-sectional, sequential explanatory research approach using survey was utilized. Data tools were questionnaires and food records.
RESULTSThe participants were 20 caregivers and 21 MSUD children (aged 6 to 83 months). Caregivers had moderately high feeding practices and knowledge scores and had positive attitudes towards providing adequate nutritional care; still, they were struggling with diet compliance.
Their nutrition knowledge was related to their attitude (p-value: 0.021), feeding practices (p-value: 0.037), and their children’s weight-for-age (p-value: 0.036). Furthermore, knowledge and feeding practices were related to the children’s natural-protein status (p-value: 0.043 and 0.006, respectively). The caregivers’ sex was related to the children’s leucine (p-value=0.010), those with female caregivers had lower leucine by 470 μmol/L on average. Moreover, children with good leucine control belonged to higher-income households (p-value=0.049).
CONCLUSIONWith caregiver's nutrition knowledge having been possibly associated with the children’s weight-forage, and their knowledge and feeding practices with the children's natural protein status, as well as knowledge positively affecting both attitude and feeding practice, interventions for improving all caregivers’ nutrition knowledge and feeding practices are recommended. Additionally, with caregivers’ sex and income having been found to be related to metabolic control, it is suggested that strategies to better manage these barriers be carried out. These may include improving support for male caregivers, with children under their care having higher leucine than those cared for by their female counterparts. Added provisions may likewise be planned for further reducing the impact of income-related barriers.
Human ; Caregivers ; Attitude ; Maple Syrup Urine Disease ; Child ; Children
3.Local understandings and first aid responses to burn injuries: A phenomenological study in an urban Indonesian community.
Hardin LA RAMBA ; Yarwin YARI ; Ulfa Nur ROHMAH ; Fitri Diana ASTUTI ; Fransiska Anita Ekawati Rahayu SA’PANG ; Indra Gilang PAMUNGKAS ; Kristoforus MARSELINUS
Acta Medica Philippina 2026;60(8):107-114
BACKGROUND
Burn injuries remain a significant global public health problem, causing substantial morbidity, mortality, and economic burden, particularly in low- and middle-income countries where nearly 90% of cases occur. Despite the importance of timely and appropriate first aid in reducing complications, community responses to burn injuries in many settings continue to rely on traditional or non-evidence-based practices.
OBJECTIVESThis qualitative phenomenological study explored community-based knowledge and responses related to the causes and first aid of burn injuries.
METHODSThe study involved ten (10) purposively selected informants residing in South Mangga Dua Urban Village, Central Jakarta, Indonesia. Data collection methods included semi-structured interviews, direct observations, and focus group discussions (FGDs). Thematic analysis was used.
RESULTSThree (3) core domains were identified: (1) community perceptions of burn causes and classifications, (2) indigenous first aid practices used in domestic settings, and (3) sources of knowledge and information pathways related to burn first aid. Participants commonly attributed burns to incidents involving fire, hot liquids, and electrical faults. Their understanding of burn severity was limited to superficial assessments, with little awareness of clinical classifications. First aid responses were largely based on traditional practices such as the application of toothpaste, honey, or aloe vera, while evidencebased practices like using running water were rarely mentioned. Notably, most participants relied on familial teachings and informal community experiences as their primary sources of knowledge, with limited exposure to health professionals or verified media content.
CONCLUSIONCommunity knowledge is culturally rooted but misaligned with medical standards, potentially leading to unsafe practices. Culturally sensitive health education integrating traditional beliefs and accurate information is essential to improve outcomes in burn injury management.
Wounds And Injuries ; Residence Characteristics ; Public Health ; Mortality ; Insemination, Artificial, Heterologous ; Income ; Financial Stress ; Burns ; Health Education ; Attitude ; First Aid ; Medicine ; Health Communication ; Urban Population
4.Bridging stroke care through technology: Knowledge, attitudes, and practices of barangay health workers in Quezon City on a telestroke network.
Gerard Vincent A. Aguas ; Dan Neftali A. Juangco ; Deborah A. Bernardo
Philippine Journal of Neurology 2026;29(1):36-43
BACKGROUND
Stroke is a leading cause of morbidity and mortality in the Philippines. Telestroke systems have been introduced to improve timely recognition and referral; however, their effectiveness depends on utilization at the community level.
OBJECTIVETo assess stroke and telestroke knowledge, attitudes, practices, and barriers among barangay health workers (BHWs), and to determine factors associated with telestroke utilization.
METHODSA cross-sectional study was conducted among 202 BHWs. Data were collected using a structured questionnaire assessing knowledge, attitudes, practices, and perceived barriers. Descriptive statistics were used to summarize responses. Associations between variables were analyzed using appropriate statistical tests, with significance set at p < 0.05.
RESULTSRespondents had high stroke knowledge (75.5%, SD = 17.45) and telestroke knowledge (85.5%, SD = 18.82), as well as favorable attitudes (mean = 4.37). However, only 31.1% reported telestroke utilization. The most commonly reported barriers were lack of training (61.4%) and poor internet connectivity (15.8%). Telestroke familiarity was significantly associated with higher knowledge (p = 0.005) and more favorable attitudes (p = 0.001). Stroke-related training (p = 0.001) and years of experience (p = 0.001) were significantly associated with higher utilization.
CONCLUSIONDespite high knowledge and favorable attitudes, telestroke utilization among BHWs remains low. Training, familiarity, and infrastructure appear to play key roles in bridging the gap between knowledge and practice. Strengthening these factors may improve the effectiveness of community-based telestroke systems.
Human ; Occupational Groups ; Knowledge ; Attitude ; Stroke ; Technology
5.Knowledge, attitude, and practices on leptospirosis among the residents of a selected urban community in Quezon City, Philippines: A cross-sectional study.
Maria Junelle Kristine V. Cruz ; Alyssa Beatriz M. Coquia ; Elyzha Joyce P. Crave ; Janine Czareniñ ; a P. Crescini ; Geryl R. Cruz ; Keanu Myles V. Cruz ; Veronica B. Cuasay ; Louella R. Cueva ; Juan Martin G. Cunan ; Jhossven Dave Ymanuel V. Cunanan ; Franchesca Aliana C. Custodio ; Anya Patrisha C. Dael
Health Sciences Journal 2026;15(1):52-61
Introduction:
Leptospirosis is a zoonotic disease transmitted through exposure to water or soil contaminated with the urine of infected animals, particularly rats. Despite ongoing prevention efforts, leptospirosis remains a public health concern in the Philippines, especially in flood-prone urban communities. This study assessed the knowledge, attitudes, and practices (KAP) regarding leptospirosis among residents of Barangay Doña Imelda, Quezon City, and examined the association of selected sociodemographic factors
with KAP.
Methods:
A cross-sectional design was used with 345 residents of Barangay Doña Imelda. Data were collected using an adapted KAP questionnaire. Open-ended questions were used to probe the responses further. Statistical analyses included descriptive statistics and Spearman’s Rho correlation, Independent T-test, One-way and Welch ANOVA, and appropriate post hoc tests. Relationships among KAP domains were evaluated using Spearman’s rank correlation coefficient. Statistical significance was set at p < 0.05.
Results:
Respondents demonstrated high levels of knowledge (86.80%) and positive attitudes (90.91%) toward leptospirosis, but comparatively lower practice scores (69.25%). Knowledge scores differed significantly according to household size and civil status, while attitude and practice scores varied significantly across sex, educational attainment, and household income. Weak but significant positive correlations were observed between knowledge and attitude (rs = 0.126, p = 0.020), knowledge and practice (rs = 0.169, p = 0.002), and attitude and practice (rs = 0.170, p = 0.001).
Conclusion
Residents of Barangay Doña Imelda demonstrated adequate knowledge and positive attitudes toward leptospirosis; however, preventive practices remained suboptimal. Significant associations between KAP and selected sociodemographic factors were identified. Targeted health education, improved symptom recognition, and increased access to preventive resources may help strengthen leptospirosis prevention in high-risk urban communities.
Leptospirosis
;
Knowledge
;
Attitude
;
Parks, Recreational
;
Philippines
6.Variations in management strategies for stable coronary artery disease in the Asia-Pacific region: Insights from a multinational survey.
Lucky CUENZA ; Satoshi HONDA ; Khi Yung FONG ; Mitsuaki SAWANO ; F Aaysha CADER ; Purich SURUNCHUPAKORN ; Wishnu Aditya WIDODO ; Mayank DALAKOTI ; Jeehoon KANG ; Misato CHIMURA ; Mohammed AL-OMARY ; Zhen-Vin LEE ; Novi Yanti SARI ; Thanawat SUESAT ; Tanveer AHMAD ; Jose Donato MAGNO ; Chen Ting TAN ; Badai Bhatara TIKSNADI ; Uditha HEWARATHNA ; Faisal HABIB ; Derek Pok Him LEE ; Jonathan YAP
Annals of the Academy of Medicine, Singapore 2025;54(5):283-295
INTRODUCTION:
Randomised controlled trials (RCTs) have informed guideline recommendations for the management of stable coronary artery disease (CAD). However, the real-world impact of contemporary guidelines and trials on practising physicians in the Asia-Pacific region remains uncertain. We aimed to evaluate the knowledge, attitudes and practices among cardiovascular physicians in the region regarding stable CAD management.
METHOD:
An anonymised cross-sectional electronic survey was administered to cardiovascular practitioners from the Asia Pacific, assessing 3 domains: 1) baseline knowledge on recent trials and society guideline, 2) attitudes towards stable CAD, and 3) case scenarios reflecting management preferences. Correlations among knowledge, attitudes and practice scores were assessed between physicians from developed and developing countries using Pearson correlation.
RESULTS:
Overall, 713 respondents from 21 countries completed the survey. The mean knowledge score was 2.90±1.18 (out of 4), with 37.3% of respondents answering all questions correctly, while 74.6% noted that guidelines have significant impact on their practice. Despite guidelines recommending optimal medical therapy, majority chose revascularisation (range 53.4- 90.6%) as the preferred strategy for the case scenarios. Practitioners from developed regions had higher knowledge scores and lower attitude scores compared to developing regions, while practice scores were similar in both groups. Weakly positive correlations were noted between knowledge, attitude and practice scores.
CONCLUSION
Variations exist in knowledge and attitudes towards guideline recommendations and correspondingly actual clinical practice in the Asia Pacific, with most practitioners choosing an upfront invasive strategy for the treatment of stable CAD. These differences reflect real-world disparities in guideline interpretation and clinical adoption.
Humans
;
Coronary Artery Disease/therapy*
;
Cross-Sectional Studies
;
Practice Patterns, Physicians'/statistics & numerical data*
;
Asia
;
Health Knowledge, Attitudes, Practice
;
Surveys and Questionnaires
;
Male
;
Practice Guidelines as Topic
;
Female
;
Attitude of Health Personnel
;
Middle Aged
;
Developing Countries
7.Utilising a COM-B framework to modify antibiotic prescription behaviours following third molar surgeries.
Chee Weng YONG ; Ruth CHOE ; Sarah Kho Xian CHUA ; Jing Li LUM ; Wendy Chia-Wei WANG
Annals of the Academy of Medicine, Singapore 2025;54(6):340-349
INTRODUCTION:
Antimicrobial resistance (AMR) poses a critical global health threat, with millions of deaths attributed to it annually. Antibiotic stewardship to combat AMR is the responsibility of all healthcare professionals. Despite evidence suggesting that it is unnecessary, dentists routinely prescribe prophylactic antibiotics following third molar (3M) surgeries.
METHOD:
This mixed-methods study examined the behavioural barriers influencing antibiotic prescribing practices within the Division of Oral and Maxillofacial Surgery at the National University Centre for Oral Health Singapore. This study used the capability, opportunity and motivation for behavioural change or COM-B framework to implement interventions targeting the behavioural barriers.
RESULTS:
Pre- and post-intervention data over 6 months showed a significant reduction in antibiotic prescriptions from 84.45% to 20.89%, following the implementation of COM-B strategies (P<0.001). Qualitative feedback from focus group discussions highlighted a positive shift in clinicians' attitudes towards antibiotic reduction, acknowledging the minimal infection risk associated with non-prescribing practices. Notably, complication rates remained stable throughout the study period, indicating no adverse effects from reduced antibiotic usage.
CONCLUSION
These findings demonstrated that the COM-B model can be successfully applied to modify deeply ingrained prescription habits, and underscored the effectiveness of a structured behavioural change intervention in enhancing compliance with antibiotic stewardship guidelines. The study advocates continuation of initiatives to sustain this positive trend and mitigate AMR in clinical practice.
Humans
;
Molar, Third/surgery*
;
Anti-Bacterial Agents/therapeutic use*
;
Singapore
;
Antimicrobial Stewardship/methods*
;
Practice Patterns, Dentists'/statistics & numerical data*
;
Antibiotic Prophylaxis
;
Female
;
Attitude of Health Personnel
;
Male
;
Tooth Extraction
;
Adult
;
Focus Groups
;
Practice Patterns, Physicians'
8.In my time: A qualitative exploration of the junior doctor experience in Singapore over the years.
Caitlin Alsandria O'HARA ; Nur Haidah Ahmad KAMAL ; En Ci Isaac ONG ; De Wei Isaac CHUNG ; Siew Ngan Faith LIM ; Malcolm Ravindran MAHADEVAN
Annals of the Academy of Medicine, Singapore 2025;54(9):542-560
INTRODUCTION:
Despite efforts to improve junior doctors' working conditions, burnout, distress and disillusionment persist, with implications for patient outcomes. This qualitative study analysed factors shaping the lived experiences of junior doctors in Singapore and their changes over time, thereby seeking to inform improvements to working conditions.
METHOD:
Thirty purposively sampled respondents who were junior doctors in Singapore between 1975 and 2022 were interviewed. Respondents were grouped into 3 cohorts: (1) junior, (2) middle and (3) senior. Employing the framework method of qualitative analysis, open coding was performed with reference to the individual, interpersonal, institutional, community and policy levels of the socioecological model (SEM). Four themes emerged: (1) inherent challenges of junior doctorship, (2) exacerbating factors, (3) alleviating factors and (4) responses of junior doctors to their experiences. Codes were reconstructed into a modified SEM, demonstrating trickle-down effects of interpersonal or structural forces on the individual doctor and pertinent factors evolving with time.
RESULTS:
Across cohorts, respondents echoed mental and physical challenges. While senior cohort doctors recounted higher patient-to-doctor ratios and longer working hours, junior cohort doctors cited new difficulties. These include a hostile medicolegal landscape, patients' increasingly complex needs and expectations, and higher administrative loads. Amid these difficulties, alleviating factors included good workplace relationships alongside institutional interventions. Doctors responded differently to their challenges. Some externalised difficulties through expression and advocacy; others internalised them, whether into fulfilment or distress.
CONCLUSION
While some facets of junior doctorship have improved with time, new challenges that warrant consideration are emerging. Junior doctors should be centred, listened to and empowered in shaping improvements to working conditions.
Singapore
;
Humans
;
Qualitative Research
;
Medical Staff, Hospital/psychology*
;
Male
;
Female
;
Adult
;
Burnout, Professional/psychology*
;
Workload/psychology*
;
Attitude of Health Personnel
;
Interviews as Topic
;
Job Satisfaction
9.Knowledge, attitude, and practices on sunscreen use among acne vulgaris patients: A cross-sectional study in the National Capital Region and Region 4A
Florence Ruiz-Buenaventura ; Cheryl Anne Cera-Dizon ; Catherine Denise Consunji Gloria
Journal of the Philippine Medical Association 2025;103(2):1-15
BACKGROUND
Acne patients often use medications, either over the counter or prescribed by dermatologists, to manage their condition. Dermatologists frequently include sunscreens as part of these treatment plans alongside acne medications. This research aims to determine the level of knowledge, attitudes, and practices regarding sunscreen use among respondents who are confirmed acne patients and have been prescribed sunscre-en as part of their treatment regimen.
OBJECTIVEThis research examines the current knowledge, attitudes, and practices of acne patients regarding sunscreen use as part of their acne t reatment regimen, considering demographic factors. The knowledge, attitudes, and practices of the respondents will be compared across different age groups, genders, and employment statuses.
METHODSThis study purposefully collected data from patients with active acne on the use of sunscreens alongside acne medications. The sample included males and females aged 18-27, 28-40, and 40+ residing in either the National Capital Region or the CALABARZON Region, with 105 respondents in each group. Data was gathered using a validated Knowledge, Attitudes, and Practices (KAP) questionnaire, consisting of 30 questions that had undergone reliability testing via Cronbach's alpha. Responses were recorded on a 3-point Likert scale to model the interaction of KAP variables. The research material was distributed through Google Forms in June 2024. Data analysis was conducted using R, specifically the psych package, and the Kruskal-Wallis test was applied to compare groups, determining if significant differences existed among them. This test was incorporated within RStudio.
RESULTSFindings indicated that respondents generally demonstrated a high level of understanding regarding the importance of sunscreen when used alongside acne treatments, particularly acknowledging its role in preventing acne scarring and reducing skin sensitivity caused by treatment products. Additionally, attitudes toward sunscreen use were largely positive, with respondents rejecting common misconceptions about sunscreen. However, actual sunscreen application practices were moderate, with adherence levels varying across the sample. Significant differences in sunscreen use were observed based on employment status, gender, and age.
CONCLUSIONAcne patients in this study had a high level of knowledge and a positive attitude on the use of sunscreen together with their acne medications. consistency in sunscreen application was moderate. unemployed respondents were more receptive to external influences regarding sunscreen use. Female respondents were more informed and proactive than male respondents. Younger respondents were more influenced by social networks. This research highlights the need for continued education on the benefits of sunscreen use to be able to achieve an effective acne vulgaris management.
Human ; Knowledge ; Attitude ; Acne Vulgaris ; Sunscreen ; Sunscreening Agents
10.Knowledge and attitude of Filipino caregivers of patients with dementia admitted for other health issues in a tertiary hospital in Metro Manila: A descriptive cross-sectional study
Raymond U. Tan ; Grace O. Orteza
Acta Medica Philippina 2025;59(8):65-76
BACKGROUND AND OBJECTIVES
The demographic background, level of knowledge, and attitude of caregivers are pillars of care in dementia. Family and non-family members take on this role. Studies have been done on their knowledge and attitude, but none have focused on them during hospitalization, wherein greater stress is imposed on both the caregiver and the patient. This study aims to determine the profiles, and its association with knowledge, and attitudes of caregivers of hospitalized patients with dementia in a tertiary hospital in Metro Manila.
METHODSA single-center descriptive cross-sectional design using Demographic profile Questionnaire, Alzheimer’s Disease Knowledge Scale (ADKS), and Dementia Attitude Scale (DAS) were used on Filipino caregivers of inpatients with dementia in Metro Manila. Simple and multivariable linear regression were used to assess demographic factors in relation to the attitude and knowledge of the caregivers.
RESULTSEighteen females with a mean age of 49 (SD=8) years old participated. Ten participants completed college. Six (33.3%) of the respondents were family members, five (27.8%) were occupational caregivers, four (22.2%) were house-helps, and two (11.1%) were nurses. Majority (66%) had 3-10-year duration of caregiving. Mean score of knowledge scale is 21.17 out of 30. Age, education, caregiver role, and attitude were positively associated with knowledge. The mean score for attitude level is 119.83 out of 140. Age, education, duration, caregiving role, patient’s age, and knowledge were positively associated with attitude; with education being statistically significant (p=0.046).
CONCLUSIONCaregivers exhibited reasonable knowledge for such caregivers to carry out their duties on inpatients with dementia at an adequate level, with several factors correlating positively, indicating areas for improvement. Their attitude scores revealed positive disposition; with education emerging as statistically significant. Continuing education and targeted interventions can further enhance quality of caregiving.
Dementia ; Caregiver Burden ; Attitude ; Knowledge ; Philippines


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