Physical Activity Among Adolescents in India: A Qualitative Study of Barriers and Enablers
HEALTH EDUCATION & BEHAVIOR
2018; 45 (6): 926–34
Global treatment costs of breast cancer by stage: A systematic review
2018; 13 (11): e0207993
Inadequate physical activity (PA) levels are reported in Indian youth, with lowest levels among adolescents, particularly girls. We aimed to identify barriers to and enablers of PA among school children in New Delhi and examine potential differences by gender and school type (government vs. private). A total of 174 students (private school students = 88, 47% girls; government school students = 86, 48% girls) aged 12 to 16 years from two Delhi schools participated in 16 focus group discussions (FGDs) conducted by bilingual moderators. We conducted FGDs separately for girls and boys, for students in Grades VIII and IX, and for private and government schools. We conducted FGDs among government school students in Hindi and translated the transcriptions to English for analysis. We coded transcriptions using a combination of inductive and deductive approaches, guided by the "youth physical activity promotion model." We identified various personal, social, and environmental barriers and enablers. Personal barriers: Private school girls cited body image-related negative consequences of PA participation. Social barriers: Girls from both schools faced more social censure for participating in PA. Environmental barriers: Reduced opportunity for PA in schools was commonly reported across all participants. Personal enablers: All participants reported perceived health benefits of PA. Social enablers: Several participants mentioned active parents and sports role models as motivators for increasing PA. Few environmental enablers were identified. This study highlights the need for further investment in physical activity within schools and for gender-sensitive policies for encouraging PA participation among adolescents in India.
View details for DOI 10.1177/1090198118778332
View details for Web of Science ID 000452478900009
View details for PubMedID 29969921
'No time for health:' exploring couples' health promotion in Indian slums.
Health promotion international
Published evidence on treatment costs of breast cancer varies widely in methodology and a global systematic review is lacking.This study aimed to conduct a systematic review to compare treatment costs of breast cancer by stage at diagnosis across countries at different levels of socio-economic development, and to identify key methodological differences in costing approaches.MEDLINE, EMBASE, and NHS Economic Evaluation Database (NHS EED) before April 2018.Studies were eligible if they reported treatment costs of breast cancer by stage at diagnosis using patient level data, in any language.Study characteristics and treatment costs by stage were summarised. Study quality was assessed using the Drummond Checklist, and detailed methodological differences were further compared.Twenty studies were included, 15 from high-income countries and five from low- and middle-income countries. Eleven studies used the FIGO staging system, and the mean treatment costs of breast cancer at Stage II, III and IV were 32%, 95%, and 109% higher than Stage I. Five studies categorised stage as in situ, local, regional and distant. The mean treatment costs of regional and distant breast cancer were 41% and 165% higher than local breast cancer. Overall, the quality of studies ranged from 50% (lowest quality) to 84% (highest). Most studies used regression frameworks but the choice of regression model was rarely justified. Few studies described key methodological issues including skewness, zero values, censored data, missing data, and the inclusion of control groups to estimate disease-attributable costs.Treatment costs of breast cancer generally increased with the advancement of the disease stage at diagnosis. Methodological issues should be better handled and properly described in future costing studies.
View details for DOI 10.1371/journal.pone.0207993
View details for Web of Science ID 000451325700098
View details for PubMedID 30475890
View details for PubMedCentralID PMC6258130
Is India's policy framework geared for effective action on avoidable blindness from diabetes?
Indian journal of endocrinology and metabolism
2016; 20 (Suppl 1): S42–50
Joint involvement of couples is an effective strategy to increase contraceptive use and improve reproductive health of women. However, engaging couples to understand how their gender attitudes affect their personal and family health is an idea in search of practice. This mixed-methods study explores opportunities and barriers to couples' participation in health promotion in three slums of Delhi. For each couple, surveys and semi-structured interviews were conducted with husbands and wives individually to contrast self and spousal work, time, interest in health, sources of information related to health and depth of knowledge (n = 62). Urban poverty forces men to work long hours and women to enter part-time work in the informal sector. Paid work induces lack of availability at home, lack of interest in health information and in performing household chores and a self-perception of being healthy among men. These factors inhibit men's' participation in community-based health promotion activities. Women's unpaid work in the household remains unnoticed. Women were expected to be interested in and to make time to attend community-based health-related activities. Men recalled significantly less sources of health information than their spouse. Men and their wives showed similar depth of health-related knowledge, likely due to their spousal communication, with women acting as gatekeepers. Health promotion planners must recognize time constraints, reliance on informal interpersonal communication as a source of health information and the need to portray positive masculinities that address asymmetric gender relations. Innovative, continuous and collaborative approaches may support couples to proactively care about health in low-resource settings.
View details for DOI 10.1093/heapro/day101
View details for PubMedID 30590523
Enhancing mental health literacy in India to reduce stigma: the fountainhead to improve help-seeking behaviour
JOURNAL OF PUBLIC MENTAL HEALTH
2014; 13 (3): 146-+
The growing burden of avoidable blindness caused by diabetic retinopathy (DR) needs an effective and holistic policy that reflects mechanisms for early detection and treatment of DR to reduce the risk of blindness.We performed a comprehensive health policy review to highlight the existing systemic issues that enable policy translation and to assess whether India's policy architecture is geared to address the mounting challenge of DR. We used a keyword-based Internet search for documents available in the last 15 years. Two reviewers independently assessed retrieved policies and extracted contextual and program-oriented information and components delineated in national policy documents. Using a "descriptive analytical" method, the results were collated and summarized as per themes to present status quo, gaps, and recommendations for the future.Lack of focus on building sustainable synergies that require well laid out mechanisms for collaboration within and outside the health sector and poor convergence between national health programs appears to be the weakest links across policy documents.To reasonably address the issues of consistency, comprehensiveness, clarity, context, connectedness, and sustainability, policies will have to rely more strongly on evidence from operational research to support decisions. There is a need to involve multiple stakeholders from multiple sectors, recognize contributions from not-for-profit sector and private health service providers, and finally bring about a nuanced holistic perspective that has a voice with implementable multiple sector actions.
View details for DOI 10.4103/2230-8210.179773
View details for PubMedID 27144136
View details for PubMedCentralID PMC4847449