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.

This 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.

Following 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.

The 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.

The 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.

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.

To determine the relationship between nursing students’ CLE and their academic grit, self-esteem, and caring behaviors in the Central Philippines.

A 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.

The 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.

Students’ 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.

Education ; Health Education ; Global Health

BACKGROUND

Interprofessional collaboration is required as a learning outcome for medical school graduates. Clinical exposure to collaborative practice is one of the recommended strategies in the implementation of interprofessional education. Professionals in mental health units customarily engage in collaborative practice and can provide learning opportunities for medical students. Local data on interprofessional collaboration among practitioners in a mental health care setting in the pandemic is limited and merits study.

The goal of this study was to determine and then describe factors that influence collaborative practice among health professionals in an inpatient mental health care unit in the pandemic. It aimed to generate recommendations from practitioners on strategies to optimize opportunities for medical students to learn interprofessional collaboration.

This is a qualitative study which made use of key informant interviews (KIIs) and focused group discussions (FGDs) with members of a multiprofessional mental health team in the mental health unit of a tertiary medical center. Data was analyzed using thematic analysis.

The onset of the COVID-19 pandemic had drastically disrupted health care services and opportunities for interprofessional collaboration. Participants described their roles and identified six factors essential to reenergizing collaborative practice: resources and opportunities for meaningful interaction, quality of relationship and communication among team members, management goals and strategies relevant to the mental health needs and the context of patients and their families, guidelines for collaboration, interprofessional education appropriate to participant levels, and monitoring for quality assurance and improvement. Practical guidelines for promoting the identified factors were outlined. Recommendations to optimize opportunities for interprofessional education were also given.

Six factors were identified and described in the study. These can provide practitioners and students with a frame of reference for participating in and learning from collaborative practice in a mental health care unit as they work with other professionals on a shared concern. Addressing practical issues in real life settings will enhance their capacity to meaningfully collaborate with other professionals in managing patients, institutions, projects, and similar situations.

Introduction: Dental caries is a preventable chronic disease whereby identification of risk factors will facilitate preventive measures. This study aims to determine the level of oral health literacy (OHL), self-care practices (SCP), salivary parameters and ascertain its assocation with caries status amongst the undergraduates in IMU University. Methods: Levels of OHL (Knowledge-OHL, dental services utilisation, and label reading habit) and SCP were assessed through a self-administered questionnaire. Chairside saliva kits were used to measure the salivary parameters whilst clinical examination was performed to assess caries status. Independent T-test and Analysis of Variance (ANOVA) was used to compare differences between sex and courses respectively for measures of interest (OHL, SCP, salivary parameters, and caries status) whereas bivariate correlation with Pearsons’s coefficient was performed to examine their association with caries status. Results: The participants (n=132) had a mean Knowledge-OHL score of 23.75±8.09 with no significant difference between sex (females, 24.01±8.51; males, 23.48±7.69; p=0.15). Dentistry students had significantly higher Knowledge-OHL score than students of all other courses (p=0.01). The mean SCP score was 20.19±3.16 whereas mean DMFT was 2.32 ±3.14. All participants had healthy saliva parameters. Caries status was significantly correlated with Knowledge-OHL score (p=0.02, r=-0.18), dental services utilisation (p=0.04, r=-0.15) but not with label reading habit (p=0.78, r=0.03), SCP (p=0.30, r=-0.05) and all salivary parameters. Conclusion Knowledge-OHL and oral health services utilisation are significantly associated with oral health status
Dental Caries ; Health Literacy ; Oral Health ; Saliva ; Self Care

BACKGROUND

Ahigh-quality measurement tool is essential to accurately assess the innovative teaching strategies in health professions education. The Blended Teaching Assessment Tool (BTAT) aims to evaluate quality blended teaching or instructional delivery in Philippine health science programs. However, there is a lack of studies examining students' cognitive processes to support the validity of questionnaires.

Cognitive interviewing (CI) was employed to determine whether students interpreted and responded to the items correctly. Content analysis was done using Tourangeau's Cognitive framework. Four CIs were conducted by an expert moderator and note-taker with a total of 8 health science students (2 groups with 3 members, and 2 one-on-one interview) for around 1 to 2 hours via Zoom following a retroactive approach with verbal and spontaneous probing, guided by a semi-structured interview questionnaire.

Various issues related to comprehension, retrieval, judgment, and response were identified, leading to significant revisions of the tool from 82 items across 8 dimensions to 53 items across 5 dimensions. The challenges included unfamiliar terminology, ambiguous phrasing, complex statements, inconsistencies and irrelevance to students' real-life experiences. These findings emphasize the importance of students' feedback in enhancing the validity and reliability of assessment tools.

The Cognitive Interview identified crucial issues in comprehension, retrieval, judgment, and response, making it essential for developing the Blended Teaching Assessment Tool and ensuring valid responses on the quality of blended teaching and learning delivery.

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.

A 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.

Women 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.

Several 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.

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.

The study aims to investigate the association between HL and SSB consumption among Filipinos aged 15 to 70 years.

An 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.

Out 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 Occupations ; Education ; Philippines

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. Objective: The study aims to investigate the association between HL and SSB consumption among Filipinos aged 15 to 70 years. Methods: An 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 (<1 SSB drink per day or ≥1 SSB drink per day), and HL level (limited or sufficient) were extracted. An HL index score of ≤33 was classified as "limited," while a score >33 was considered "sufficient." Multivariate logistic regression was conducted to estimate adjusted odds ratios and confidence intervals for daily SSB consumption. Results: Out 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 <1 SSB drink/day. However, this association was found to be not statistically significant. Conclusion 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 beverage ; sweetened drink