Psychometric Evaluation of the Brunei-Malay SF-36 version 2 Health Survey

Objectives: To culturally adapt the Short Form Health-36 version 2 (SF-36v2) into the Brunei-Malay context and determine its reliability and validity for measuring health-related quality of life (HRQOL) in healthy individuals and patients with chronic kidney disease in Brunei Darussalam. Methods: An iterative multistep strategy involving setting up a bilingual expert panel, pretesting, text revision and back translation was used to prepare the Brunei-Malay SF-36v2 as an adaptation from the Malaysian-Malay SF-36v2. The Brunei-Malay SF-36v2 was then self-administered to a sample of healthy individuals (n=95) and predialysis chronic kidney disease outpatients (n=95) resident in Brunei. The mean (SD) age of the participants was 46.6 (17.8) years. Results: Data completion rate was 100% with minimal floor effects (≤0.21) in all the 8 domains and >15% ceiling effects in 3 of the 8 domain scales. Cronbach's alpha was >0.70 for all the 8 domain scales. Scaling success was 100% for convergent validity, with 100% item discriminant validity for all domain scales except Social Functioning (94%), Mental Health (85%) and General Health (85%). Principal component analysis of the two-factor dimension explained 68% overall variance and accounted for 81% reliable variance, but the exact SF-36 two-factor summary constructs in the standard algorithm were not replicated in the Bruneian population. Conclusions: The Brunei-Malay SF-36v2 is a valid and reliable instrument for measuring HRQOL in healthy individuals and patients with chronic kidney disease in Brunei. The summary scales should, however, be interpreted with caution. Further studies should be carried out to assess additional psychometric properties of the Brunei-Malay SF-36v2.

Effectiveness of Mobile Apps for Smoking Cessation: A Review.

INTRODUCTION: Smartphone-based smoking cessation interventions are increasingly used around the world. However, the effects of smartphone applications on applicability and efficacy on cessation rate and prevention of relapses are not often evaluated. Therefore, this review aims to assess the evidence on effectiveness of smartphone applications as an intervention tool for smoking cessation support. METHODS: We conducted the search using Ovid Medline/PubMed, CENTRAL and Scopus databases dated (January 2007-June 2016). Inclusion criteria include randomized control trials or intervention studies with mobile applications that offer smoking cessation support. Two assessors independently extracted and evaluated the data from each included study. RESULTS: The review of eight selected studies illustrate the use of smartphone applications in increasing quit rates among smokers, however adherence to app features influences quit rates. Audiovisual features followed by a quit plan, tracking progress and sharing features are most accepted and utilised app features. However, inconsistency was observed in their association with abstinence or quit rate. App engagement features increase the statistical significance in the quit rate. Development of smartphone applications was supported by behavior change theories in all studies nevertheless; heterogeneous forms of intervention were adopted within studies. Similarly, reduction in relapse attributed to enhanced discussion among quitters using social media applications was observed. CONCLUSIONS: Quality evidence is warranted with large sample size to measure effect size of the intervention. Future research on effectiveness and efficacy of smartphone alone and comparisons with other mHealth interventions, such as text messaging would be useful.

Assessment of content, quality and compliance of the STaR mobile application for smoking cessation.

INTRODUCTION: Smoking cessation support with smartphone applications is widely practised, however, quality and novel content is yet to be established. This study examined content, quality and compliance of the STaR (Sihat Tanpa Rokok - Healthy Without Smoking) smartphone application to smoking cessation clinical practice guidelines. METHODS: Mobile Application Rating Scale (MARS) was applied to assess the quality of the mobile application. A total of 33 compliance assessment criteria were developed, based on the smoking cessation clinical practice guidelines adopted by the Brunei Ministry of Health and used to rate the compliance. RESULTS: The STaR app has an average quality and compliance score. The mean MARS score of 3.31 and a subjective quality score of 2.50 was measured on a 5-point scale (from 1=inadequate to 5=excellent). The application contents that adhere to smoking cessation clinical practice guidelines suggest adequate adherence to the 5A (Ask, Advice, Assess, Assist, Arrange) and 5R motivational interventions (Relevance, Risks, Rewards, Roadblocks, Repetition) approach for smoking cessation. CONCLUSIONS: The STaR mobile app with the integration of all components of smoking cessation clinical practice guidelines (such as 5A approach and pharmacotherapy intervention) may improve quality scores.

Salivary testosterone as a potential indicator for risky behaviour associated with smoking-related peer pressure in adolescents.

Early smoking is considered an indicator for risky behaviour in adolescents. Although social indicators predicting adolescent smoking are known, biological indicators have not been defined. This study aimed to establish whether salivary testosterone could be used as a "predictive biomarker" for smoking-associated peer pressure. Saliva samples were collected from Bruneian adolescents (aged 13-17 years) by the passive drool method. Salivary testosterone concentration was determined by enzyme-linked immunosorbent assay. Salivary testosterone concentration and smoking-associated peer pressure indicators were compared between adolescent males and females and statistical significance was determined by an independent samples t-test. A significant positive relationship between smoking-associated peer pressure and salivary testosterone levels in adolescents was found. However, this relationship was not significant when males and females were considered separately. Our data suggest that students who have tried cigarette smoking and have friends who are cigarette smokers have higher salivary testosterone levels.

Development and application of the Imperial College Obesity Strategy Assessment Framework for analysing local obesity strategies.

BACKGROUND: Obesity is a major public health issue because of its increasing prevalence and impact on health. The management of overweight and obesity has been a government priority for many years. However, overweight and obesity management at a local level has often been ineffective. Although there is a need to examine obesity strategies and policies for local populations, there is currently no readily available framework for evaluating local obesity strategies. We therefore developed a framework, the Imperial College Obesity Strategy Assessment Framework (IC-OSAF), for examining the content of local obesity strategies. METHODS: We adapted two previous policy analysis frameworks (Bardach's Eightfold Path Framework and Collins' Health Policy Analysis Framework) and used these with information from national guidelines to develop an obesity strategy analysis framework. We then piloted this framework using the obesity strategy for one London primary care trust (PCT). RESULTS: The framework was applied successfully and helped identify limitations and omissions in the PCT obesity management strategy. CONCLUSIONS: The IC-OSAF is a practical, easy-to-use tool for the analysis of local obesity management strategies. The framework can help identify gaps and limitations in strategies to help reduce variations in obesity management between PCTs.