Effectiveness of community-based diabetes and hypertension prevention and management programmes in Indonesia and Viet Nam: a quasi-experimental study.

INTRODUCTION: Non-communicable diseases (NCDs) have surpassed infectious diseases as the leading global cause of death, with the Southeast Asian region experiencing a significant rise in NCD prevalence over the past decades. Despite the escalating burden, screening for NCDs remains at very low levels, resulting in undetected cases, premature mortality and high public healthcare costs. We investigate whether community-based NCD prevention and management programmes are an effective solution. METHODS: In Indonesia, we compare participants in the community-based NCD screening and management programme Pos Pembinaan Terpadu-Penyakit Tidak Menular with matched non-participants with respect to their uptake of screening activities, health-related behaviour and knowledge and metabolic risk factors. We use statistical matching to redress a possible selection bias (n=1669). In Viet Nam, we compare members of Intergenerational Self-Help Clubs, which were offered similar NCD health services, with members of other community groups, where such services were not offered. We can rely on two waves of data and use a double-difference approach to redress a possible selection bias and to measure the impacts of participation (n=1710). We discuss strengths and weaknesses of the two approaches in Indonesia and Viet Nam. RESULTS: In Indonesia, participants have significantly higher uptake of screening for hypertension and diabetes (+13% from a control mean of 88% (95% CI 9% to 17%); +93% from a control mean of 48% (95% CI 79% to 108%)). In both countries, participants show a higher knowledge about risk factors, symptoms and complications of NCDs (Indonesia: +0.29 SD (0.13-0.45), Viet Nam: +0.17 SD (0.03-0.30)). Yet, the improved knowledge is only partly reflected in improved health behaviour (Viet Nam: fruit consumption +0.33 SD (0.15-0.51), vegetable consumption +0.27 SD (0.04-0.50)), body mass index (BMI) (Viet Nam: BMI -0.07 SD (-0.13 to -0.00)) or metabolic risk factors (Indonesia: systolic blood pressure: -0.13 SD (-0.26 to -0.00)). CONCLUSION: Community-based NCD programmes are well suited to increase screening and to transmit health knowledge. Due to their extensive outreach within the community, they can serve as a valuable complement to the screening services provided at the primary healthcare level. Yet, limited coverage, insufficient resources and a high staff turnover remain a problem. TRIAL REGISTRATION NUMBER: NCT05239572.

Associations between gaming disorder, parent-child relationship, parental supervision, and discipline styles: Findings from a school-based survey during the COVID-19 pandemic in Vietnam.

BACKGROUND AND AIMS: Vietnam implemented numerous measures to reduce the transmission of COVID-19 among school students, including study-at-home/self-quarantine. During the study-at-home period, adolescents may engage in more video gaming than usual, potentially contributing to gaming disorder. However, the regionally-representative prevalence of gaming disorder and its association with parenting practice and discipline practice have not been described. We assessed the prevalence of gaming disorder among Vietnamese adolescents during the initial 6 months of the COVID-19 pandemic and the associations between gaming disorder and parenting practice and discipline practice. METHODS: We conducted a school-based, self-administered cross-sectional survey of 2,084 students in Hanoi, Vietnam (response rate = 97.1%). The survey included standardized instruments translated from English to Vietnamese. We performed multilevel logistic regressions to assess the associations between parenting practice, discipline practice, and gaming disorder. RESULTS: The prevalence of gaming disorder among the respondents was 11.6%. Healthy parent-child relationship was protective against gaming disorder (Adj OR = 0.36; 95% CI = 0.21, 0.62). Non-supervision, non-discipline, violent discipline were positively associated with gaming disorder. DISCUSSION AND CONCLUSIONS: We found associations between gaming disorder and parent-child relationship, parental supervision, and parental discipline. Future interventional studies should consider assessing the effect of fostering healthy parent-child relationships and appropriate discipline on the occurrence or prognosis of gaming disorders.