ABSTRACT
BACKGROUND: Obesity and its related cardiovascular-metabolic diseases are growing public health concerns. Despite global attention to obesity, its prevalence is steeply increasing in developing countries, especially in children and adolescents. Eating behaviours and physical activity are modifiable risk factors for obesity that can variably be shaped by families. Eating behaviours and physical activity are especially important during adolescence, given its significance as a foundational period for developing healthy lifestyles. This qualitative study aimed to explore barriers and opportunities around creating healthy lifestyles among adolescents in Indonesia, focussing on family environments from diverse socio-demographic backgrounds. METHOD: In-depth interviews using a semi-structured guide were undertaken with consecutively recruited 10-18-year-old adolescents with overweight or obesity, and their parents, from three different sites: urban (Jakarta, the capital city of Indonesia), peri-urban (West Java Province) and rural (Banten Province). Thematic analysis was used to identify patterns of meaning. RESULTS: Nineteen dyads were interviewed. Thematic analysis revealed four themes: limited knowledge of healthy lifestyles; healthy lifestyles not a concern of daily life; limited parenting skills, including inequity around gender roles; and aspects of availability and accessibility. These interconnected barriers influenced lifestyle practices at home within the context of daily preferences and decisions around food and activities. Gender role inequity and healthy food accessibility were more prominent in rural families than in those from urban or peri-urban settings. CONCLUSIONS: Healthy lifestyles in adolescence may be supported by strategies to enhance parenting skills, build individual motivation, and support the development of more enabling environments.
ABSTRACT
INTRODUCTION: Newly graduated medical doctors in their internships are positioned to strengthen the front line in combating COVID-19. We developed a Massive Open Online Course (MOOC) to equip them with adequate knowledge for COVID-19 management. This paper aims to analyze the MOOC and evaluate participant satisfaction and increase in knowledge after completing the course. METHODS: An observational study was conducted. Quantitative data were obtained from questionnaires and pre- and post-tests. Responses to open-ended questions of the questionnaires were collected. Analysis using the Quality Reference Framework was also completed. RESULTS: The MOOC consisted of fundamental knowledge of COVID-19 (Part A) and further enrichment (Part B), and the content was written in the Indonesian language. A total of 3,424 and 2,462 participants completed the course in August and November 2020, respectively. Most participants agreed that the platform was easy to navigate, the design was interesting, and the content was aligned with their needs. Pre- and post-test scores in Part A's subjects increased significantly. Factors contributing to and inhibiting usability and areas for improvement were further highlighted. DISCUSSION: The use of a specific quality framework facilitated a comprehensive evaluation of the MOOC's strengths, weaknesses, and areas for future improvements. The participants' satisfaction and pre- and post-test results showed that the current MOOC holds great potential benefit for continuing education for medical interns joining the frontliners during the pandemic. Future implementation should consider increasing the quality of learning resources, scaling up the platform and its technical supports, and enhancing organizational supports.