Browsing by Author "Guruge, G.N.D."

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Bullying in schools among early adolescents in Galenbindunuweva educational zone: prevalence, types, common responses and effectiveness of a health promotion intervention
(Sri Lanka Medical Association, 2015) Jayasinghe, V.P.K.K.; Perera, K.M.N.; Guruge, G.N.D.
INTRODUCTION AND OBJECTIVES: Bullying is a prevalent behavior of violence and a leading health issue among school going adolescents. Aims were to describe prevalence, types, common responses and factors associated with bullying among early adolescents in Galenbindunuwewa Educational Zone and to evaluate a health promotion intervention to reduce bullying among early adolescents in a school in the same zone. METHOD: The study had two components. A cross sectional study and a participatory action research. The former was conducted in three schools randomly selected from the Galenbindunuwewa Educational Zone. A multi¬stage sampling method recruited 372 participants to obtain data using a self-administered questionnaire. In the second component, all students in grades seven to nine of a randomly selected school participated In an intervention modeled on a health promotion approach. Determinants identified and addressed were poor understanding of bullying, school culture, media promotion of violence and attitudes towards bullying and violence. Evaluation employed participatory methods, and a mixed-method approach was used in collecting data. Quantitative data were analyzed using SPSS. Qualitative data were analyzed manually using thematic analysis. RESULTS: The prevalence of bullying was 57.6% (verbal bullying), 31.1% (physical bullying) and 30.8% {social bullying). The most common responses reported when being bullied were tolerating (67.2%) and walking away (66.4%). Attitudes towards bullying showed significant positive changes after the intervention. Post intervention level of all types of bullying reduced significantly among participants with significant changes in the addressed determinants. Conclusion: Bullying is a prevalent issue in the Galenbindunuwewa Educational Zone. The piloted health promotion intervention proved effective in addressing this problem.
Developing and validating a tool to assess empowerment for tobacco control
(Sri lanka Medical Association, 2015) Perera, K.M.N.; Guruge, G.N.D.; Jayawardana, P.L.
INTRODUCTION AND OBJECTIVES: Empowerment is defined as the mechanism by which individuals, organizations and communities gain mastery over their lives. Many tobacco control interventions aim to empower individuals but measuring empowerment is a challenge. Study aim was to develop a tool to assess empowerment for tobacco controf at individual level in the Moneragala District. METHOD: indicators were operationalized based on Zimmerman's psychological empowerment definition. Initial interviewer-administered tool was subjected to modified Delphi technique to determine content and consensual validity and a scoring system. Cognitive interviews were conducted to assess applicability to local context. Pre testing (n=30) and validation (n=200) were conducted in the Badulla District. Exploratory factor analysis was performed to assess construct validity. Based on communalities, Scree test and Eigenvalues derived from latter, Delphi technique was used to determine the factor structure which improved interpretability. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and Cohen's kappa coefficient respectively. RESULTS: Components extracted using principle component analysis showed high communalities (0.914 to 0.996). Eigenvalue cut-off taken was 0.3 and six constructs based on the Scree plot converged in 14 iterations in Varimax rotation. Final tool comprised 27 items under seven factors named "Perceived awareness"; "Motivation to involve and perceived mastery"; "Awareness and mobilization of resources"; "Perceived efficacy"; "Perceived competence in society", “perceived competence within network” and “community involvement” for tobacco control. Cronbach’s alpha was 0.91 demonstrating good internal consistency. Cohen’s kappa coefficient was 0.63 indiicating substancial agreement .CONCLUSION: Developed tool can be used in similar contexts to measure empowerment for tobacco control.
Effectiveness of a community-based participatory health promotion intervention to address knowledge, attitudes and practices related to intimate partner violence: a quasi-experimental study
(BioMed Central, 2024) Reyal, H.P.; Perera, M.N.; Guruge, G.N.D.
BACKGROUND Intimate partner violence is the most common form of violence experienced by women. It has detrimental consequences. A range of determinants cause intimate partner violence and to reduce it, effective interventions are required to address the determinants. Health promotion interventions have been recommended as effective to enable people to control over the determinants and to improve health. Hence, a community based participatory health promotion intervention was developed and tested in a selected study setting. The objective was to evaluate the effectiveness of a health promotion intervention in terms of addressing knowledge, attitudes and practices related to intimate partner violence.METHODS A quasi-experimental study was conducted by recruiting ninety women aged 15 to 49 years separately from two health administrative areas identified as the intervention area and the control area from the Kandy district of Sri Lanka. A pretested interviewer-administered questionnaire was used in both pre- and post-assessments. Selected groups of women from the intervention area were facilitated with a health promotion intervention to improve knowledge, attitudes and practices related to intimate partner violence. To evaluate the effectiveness of the intervention descriptive summaries and bivariate analysis were used.RESULTS The response rate was 90.9% (N = 90) during the pre-assessment and 87.9% (n = 87) and 82.8% (n = 82) from the intervention and control areas, respectively, during the post-assessment. Statistically significant improvement was reported in the total mean score comprising knowledge, attitudes, practices and identification of determinants from 59.6 to 80.8 in the intervention area [Pre-assessment: Mean = 59.6 (standard deviation-SD) = 17.5; Post-assessment: Mean = 80.8, SD = 19.0; p < 0.001) compared to the improvement in the control area from 62.2 to 63.0 (Pre-assessment: Mean = 62.2, SD = 17.3; Post-assessment: Mean = 63.0, SD = 18.9; p = 0.654).CONCLUSIONS The intervention was effective to improve knowledge, attitudes and practices related to intimate partner violence. Hence, the present approach can be used in similar contexts to address the knowledge, attitudes and certain practices related to intimate partner violence.
Evaluating the efectiveness of a community based health promotion intervention on knowledge improvement regarding low birth weight and its determinants among antenatal couples in Sri Lanka
(Springer Nature, 2024) Guruge, G.N.D.; Young, S.M.; Perera, K.M.N.; Dharmaratne, S.D.; Gunathunga, M.W.
BACKGROUND Improvement of the knowledge of pregnant mothers and their partners related to low birth weight (LBW) is a vital factor in preventing LBW and reducing its prevalence. OBJECTIVES Implement and evaluate the effectiveness of a community based health promotion intervention on preg nant mothers and their partners to increase knowledge on birth weight and its determinants. The second objective is to determine the difference of the birth weight after implementing the intervention. METHODS A quasi experimental study design was used, and the setting was 806 pregnant mothers, 403 each in two dis tricts. In 26 ANCs, twenty six initial training sessions were conducted as a group, with an average of three hours for each session. Three follow up sessions were conducted in each ANC over 04 months (in total 104 sessions). All sessions were conducted in groups of 10 to 20 antenatal couples. The pregnant mothers and their partners completed interviewer administered questionnaires. Pre and post data were analysed based on four major knowledge categories using statistical methods. The McNemar’s Chi Square test; Chi Square test, Fisher’s Exact test, Paired t test, Student’s independent sample t test, Wilcoxon Signed Ranks test and Mann Whitney U test methods were applied as appropriate. RESULTS Both mothers and their partners in the intervention group (IG) reached significantly higher gains in knowledge than in the comparison group (CG). The participants who got the lowest scores for knowledge, at the pre assessment, in IG, also improved more than the CG {mothers (p = 0.002) and partners (p = 0.007)}. The mean birth weight shows that the IG has significantly improved for both mothers (p < 0.001) and partners (p = 0.013) with low knowledge scores (< 50% of total). CONCLUSIONS Knowledge about birth weight and its determinants among pregnant mothers and their partners improved significantly.
Household expenditure on tobacco consumption in Monaragala district
(Sri Lanka Medical Association, 2016) Perera, K.M.N.; Guruge, G.N.D.; Jayawardana, P.L.
INTRODUCTION AND OBJECTIVES: The link between tobacco and poverty is well established. Monaragala is the poorest rural district in the southern parts of Sri Lanka and second poorest in the country. The Central Bank statistics state that 2.7% of household expenditure is spent on “liquor, drugs and tobacco”. This figure is much lower than the global estimates and findings in other countries. This study aimed to describe the expenditure on tobacco and its impact on food and education related expenditures at household level in Monaragala District. METHOD: A cross-sectional study design was used. A representative sample of 1160 households was recruited using a four-stage cluster sampling method. A simple random sampling method was used to select an individual aged between 15 to 59 years from the selected household. Data were obtained by a pre-tested, validated questionnaire was administered by trained interviewers. Recall method was used to obtain expenditure related data. RESULTS: Median monthly household income was LKR 20,000 (IQR=LKR 12,000-30,000). The median monthly expenditure on tobacco was LKR 1000 (IQR: 400-2000) with the highest spending tertile reporting a median of LKR 2700 (IQR 2000-3600). The proportionate expenditure from the monthly income ranged from 0.0% to 50% with a median of 5.0% (IQR=2.0-10.0). The poorest reported the highest mean proportionate expenditure (9.8%, SD=10) from the household income. Medium and high spenders spent significantly less on children’s education compared to others. CONCLUSION: The household expenditure on tobacco products in rural poor communities in Sri Lanka is probably greater than the current estimates.
Identifying influential determinants for non-communicable diseases among school children using Health Promotion approach
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Thilokshika, R.M.S.; Guruge, G.N.D.
Introduction: World Health Organisation (WHO) estimates for deaths attributed to non- communicable Diseases (NCD) in Sri Lanka have increased up to 75% of total deaths. NCD cause more than three quarters of all deaths and nearly 1 in 5 people die prematurely from NCD. According to the views of school children and staff and observations, NCD risk was high in Wallisinghe Harishchandra Maha Vidyalaya in Anuradapura District. Objective: To empower school children to identify influential determinants for non- communicable disease through the health promotion approach. Methods: A community-based study was conducted with a group of school children (n =15) who are in the age range 12-15 years. Interactive discussions were facilitated with school children about current NCD risk among children and identified most influential structural determinants to address to reduce NCD risk. Observation of behavioural patterns, measuring BMI of school children also helped to identify influential determinants. Results: Eighteen determinants were identified through discussion including peer influence, lack of experience, media influence, poor awareness of parents and children, food preparation methods of children. Five determinants were identified through observation including availability of packed foods in shops, junk food consumption among children, fixable price of junk foods. Six determinants were prioritized by them according to the criteria like importance, changeability, magnitude, majority view and easiness to address. Those included poor awareness of parents and children, peer influence and media influence. Conclusions: School children were successfully able to identify influential determinants for non- communicable diseases. Health promotion approach is effective in enabling school children to identify the determinants of non-communicable diseases.
Knowledge and attitude towards intimate partner violence among ever-married women: A Cross-sectional study from Sri Lanka
(AIJR Publisher, 2020) Reyal, H.P.; Perera, K.M.N.; Guruge, G.N.D.
ABSTRACT: Effective approaches are needed to address high prevalence of intimate partner violence (IPV) against women in developing countries. Among them, addressing the attitudes of women justifying IPV is crucial. Yet, Sri Lankan studies so far have not adequately examined the community members’ knowledge and attitude toward IPV. Hence, this study aimed at i) describing knowledge and attitude towards IPV among women, ii) explore the association of socio-demographic variables with knowledge and attitude towards IPV, and iii) examine the association of knowledge and attitude with the abuse experiences. A cross-sectional survey was conducted with women (n = 600) aged 15-49 years from a selected health administrative area in Sri Lanka. Multistage cluster sampling was used to select participants and data collection was performed using an interviewer-administered questionnaire. Descriptive summaries, cross-tabulations and logistic regression analysis were performed to describe and explore the associations. Most respondents had poor knowledge (64.3%, n=386) on IPV with approximately half of them having attitudes generally justifying IPV (48.7%, n=292). Women with low levels of education and low household income were more likely to justify IPV. Further, employed women had good knowledge on IPV. Poor knowledge on IPV increased the risk of being abuse by 1.5 times and women who had justifying attitudes toward IPV had two times risk of being abuse. The necessity of interventions to be targeted on knowledge and attitudes and the contributory socio-demographic factors such as education, employment and income are emphasized. KEYWORDS: Abuse, women, socio-demographic factors, knowledge, attitude
Knowledge on low birth weight among pregnant women and their partners in Anuradhapura District
(Sri Lanka Medical Association, 2016) Guruge, G.N.D.; Perera, K.M.N.; Dharmaratne, S.D.; Gunatunga, W.
INTRODUCTION: Birth weight has potential to cause life cycle effects of under-nutrition. Knowledge on low birth weight (LBW) among pregnant mothers and their partners is an important determinant. OBJECTIVES: The aim was to describe the knowledge on LBW among pregnant mothers and their partners in the District of Anuradhapura. METHOD: A cross-sectional study design was used among 806 participants, selected by a systematic sampling method to represent the pregnant mothers (n=403) and their partners (n=403) in Anuradhapura District. Data were collected by a pretested interviewer administered questionnaire. Percentages and 95% Confidence Intervals were used to describe knowledge. Chi Square test was used to compare the groups. RESULTS: Majority knew that fetus grow (women: n=315, 79.3%; partners: n=216, 54.4%) even though only a minority knew ways to monitor it. The majority identified negative consequences of impaired fetal growth. The majority of women (n=257, 64.7%) knew the expected birth weight. However, only a minority knew their BMI (n=88, 22.2%) or the expected weight gain (n=55, 13.9%). Majority managed to correctly identify most determinants of LBW. The majority (women; n=287, 72.3%; partners: n=205, 51.6%) identified all the nutrient groups needed in a well-balanced meal. However, the knowledge on locally available food items rich in selected nutrient groups was poor. The percentage of women with good knowledge was significantly higher compared to the partners in majority of assessed components. CONCLUSIONS: Participants reflected satisfactory knowledge on most components. However, the knowledge may be below the application level. Partners’ knowledge was poor compared to the pregnant women.
A Six-step process to reduce bullying in schools; The content of a health promotion intervention to reduce bullying among early adolescents in a rural school in Sri Lanka
(2021) Jayasinghe, V.P.K.K; Guruge, G.N.D.; Perera, K.M.N.
ABSTRACT: Bullying is a form of aggression which has negative impacts on health. Bullying acts are reported to be common among early adolescents in rural schools in Sri Lanka. It is timely to design and implement interventions aiming to reduce bullying in schools in Sri Lanka. In this article, we aim to describe the process and the content of a health promotion intervention carried out aiming to reduce bullying among early adolescents in a rural school in Sri Lanka. The intervention is comprised of a six-step process. A logical framework developed based on Samarasinghe et al (2011) was used to guide the intervention. The content of the intervention was designed following health promotion principles. Health promotion aims for empowering people-to take collective community actions aiming to achieve desired health outcomes. The intervention for bullying was designed aiming for empowering early adolescents -to generate collective actions to reduce bullying in their school. In the intervention, adolescents not merely participated but also engaged and involved in modifying the planned intervention. Different activities, brainstorming sessions, facilitated discussions, role plays, etc. were carried out in the process. In this intervention, the health promotion approach we employed enabled engagement and involvement of adolescents beyond mere participation in the intervention. KEYWORDS: adolescents, bullying, health promotion, school