Browsing by Author "Herath, T."

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Adaptation and validation of a Sinhala version of the radbound oral motor inventory (ROMP) for Parkinson's disease
(Medknow, 2022) Gamage, P.D.M.H.; Mohideen, M.S.; Galhena, P.; Weerasinghe, N.; Kumbukage, M.P.; Herath, T.; Senanayake, S.; Sirisena, D.; Senanayake, S.J.; Gooneratne, I.K.
Background: The Radboud Oral Motor Inventory for Parkinson's disease (ROMP) is a patient-rated assessment measuring patients' perceptions of speech, swallowing, and saliva control among patients with idiopathic Parkinson's disease (IPD). Objective: The present study was carried out to adapt and validate the Sinhala version of the ROMP questionnaire in a Sinhala-speaking patient cohort diagnosed with IPD. Materials and methods: The study population consisted of patients diagnosed with IPD attending a tertiary care neurology clinic at the National Hospital of Sri Lanka. ROMP was translated from English to Sinhala, and an expert committee verified its content. Construct validity was assessed by correlating the Sinhala ROMP scores with the subscales in speech, salivation, and swallowing of the Unified Parkinson's Disease Rating Scale and with five-point Likert-type scale to assess dysarthria, dysphagia, and drooling by a speech and language therapist. Test-retest reproducibility was assessed by repeating the questionnaire in 2 weeks. Results: A cohort of 21 patients was evaluated (male to female ratio = 2.5:1, mean age was 58.8 [±8.3] years). The Spearman's correlations between ROMP and the Likert-type scale assessment, that is, speech r = 0.85 (P < 0.01), swallowing r = 0.86 (P < 0.01), and drooling r = 0.88 (P < 0.01), and subscales of the UPDRS were statistically significant, that is, speech r = 0.75 (P < 0.01), swallowing r = 0.96 (P < 0.01), and salivation r = 0.94 (P < 0.01). Reproducibility of the three domains and total intraclass correlation coefficients indicated a high level of agreement in test-retest reproducibility (range: 0.98-0.99). The three subdomains of the instrument also had excellent internal consistency (total Cronbach's α = 0.99). Conclusion: The Sinhala version of ROMP has proved to be a good assessment tool for dysphagia, dysarthria, and drooling in the early stage of IPD patients.
Comparative Study of Impact of Innovation on Business Performance of Dlog PLC and Mtel PLC
(Faculty of Commerce and Management Studies, University of Kelaniya, Sri Lanka, 2016) Herath, T.; Rajapaksha, U.G.
Telecommunication is one of the competitive and innovative industries in Sri Lanka. The current study is conducted with the objective of examining the relationship between innovation and business performance and to identify what gives Dlog PLC the superior business performance compared to Mtel PLC in term of product innovation and marketing innovation comparatively. Research strategy was considered as survey method. Product innovation and marketing innovation are considered as independent variables. Business performance is considered as dependent variable. The target population is customers of Dlog PLC and Mtel PLC. Sample profile of 70 is selected for the collection of quantitative data through semi-structured questionnaires using simple random sampling method. The data was analyzed using ordinal logistics regression analysis model with the aid of SPSS. The final outcome of the research shows product innovation has more impact on business performance of Dlog PLC than marketing innovation compared to Mtel PLC.
Empowering communities to use healthy lifestyle centres: an implementation research from Sri Lanka
(BMJ Publishing Group Ltd, 2024) Herath, T.; Perera, M.; Guruge, D.; Kasturiratne, A.
OBJECTIVE Healthy lifestyle centres (HLCs), a state service that screens for major non-communicable disease (NCD) risk factors and promotes lifestyle modifications in Sri Lanka, report underutilisation. The study aimed to assess the effectiveness of a participatory intervention to empower communities in improving HLC utilisation.DESIGN A quasi-experimental study based on the principles of community-based participatory research SETTING: Six rural communities each as the intervention (IG) (Gampaha district) and comparison (CG) groups (Kalutara district) from the capital province of Sri Lanka.PARTICIPANTS Study population was healthy individuals aged 35-65 years, the target group of HLCs in Sri Lanka. A random sample of 498 individuals was selected from each group for evaluation.INTERVENTIONS Community support groups (CSGs) were established and empowered using health promotion approach from August 2019 to February 2020. Group discussions and participatory mapping were conducted to identify determinants of underutilisation of HLCs, design activities to address prioritised determinants and develop indicators to monitor the progress of CSGs.PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was improvement of HLC utilisation and the secondary outcome was initiation of lifestyle modifications.RESULTS Significant improvements were seen in the IG, compared with the CG in the seven determinants that contribute to HLC utilisation. The largest differences were seen in reducing negative perceptions of susceptibility for NCDs (pre=64.7%; post=33.3%; p<0.001) and usefulness of screening (pre=66.6%; post=17.3%; p<0.001). The HLC utilisation in IG increased by 29.5% (pre=5.85%; 95% CI 3.74 to 7.95, post=35.3%; 95% CI 30.9 to 39.8, p<0.001), while the utilisation of the CG showed no difference. Furthermore, there was an improvement in the proportion of users who initiated lifestyle modification (pre=64.3%; post=89.9%; p=0.039) in IG, which was not observed in CG.CONCLUSION HLC utilisation and initiation of lifestyle modification can be improved by a community-based health promotion intervention through empowering CSGs.TRIAL REGISTRATION NUMBER SLCTR/2019/028.
Factors influencing the decision to use state-funded healthy lifestyle centres in a low-income setting: a qualitative study from Sri Lanka
(BMJ Publishing Group, 2023) Herath, T.; Perera, M.; Kasturiratne, A.
OBJECTIVE: Healthy lifestyle centres (HLCs) in Sri Lanka provide screening and lifestyle modification services targeting major non-communicable diseases (NCDs). Even though the service is highly accessible and affordable, HLCs are underused by its target population (adults >35 years). We aimed to explore the factors that influence the decision-making process of utilisation of HLCs in Sri Lanka. SETTING: Two districts (Gampaha and Kalutara) from the highest populous province (Western) located adjacent to the capital district of Sri Lanka. PARTICIPANTS: Nine service providers, 37 HLC clients and 52 community participants were selected using judgemental, convenient and purposive sampling methods. Theoretical sampling method was used to decide the sample size for each category. METHOD: A qualitative study design based on constructivist grounded theory was used. Data collected using in-depth interviews and focus group discussions during January to July 2019 and were analysed using the constant comparison method. RESULTS: The decision-making process of utilisation of HLCs was found to be a chain of outcomes with three main steps, such as: intention, readiness and utilisation. Awareness of HLCs, positive attitudes on health, intrinsic or extrinsic motivators, positive attitudes on NCDs and screening were internal factors with a positive influence on intention. Readiness was positively influenced by positive characteristics of the HLCs. It was negatively influenced by negative attitudes on staff and services of HLCs and negative past experiences related to services in state healthcare institutions and HLCs, service provider-related barriers and employment-related barriers. Family-related factors, social support and norms influenced both intention and readiness, either positively or negatively. CONCLUSION: The decision-making process of utilisation of HLCs links with factors originating from internal, family, service provider and societal levels. Thus, a multifactorial approach that addresses all these levels is needed to improve the utilisation of HLCs in Sri Lanka.
Nutritional information and healthiness of ready-to-eat/cooked packaged food products available for children in Sri Lanka and attitudes of parents living in Western province toward purchasing
(Faculty of Science, University of Kelaniya Sri Lanka, 2022) Grero, K. M. U.; Pathiraje, P. M. H. D.; Herath, T.
As a result of drastic changes in dietary habits and lifestyles, overweight and obesity among schoolchildren in Sri Lanka have more than doubled in the last decade. Research show that a substantial percentage of urban schoolchildren tend to consume excessive amounts of processed foods on daily basis. Children’s food purchases and choices are primarily depend on parents/guardians. Thus, the present study is carried out to assess the nutritional content and healthfulness of ready-to-eat (RTE) and ready-to-cook (RTC) packaged foods available in Sri Lankan supermarkets, and parental attitudes toward purchasing them. The Nutrient Profile Model (NPM) for Sri Lanka was used to evaluate RTE/RTC foods and nonalcoholic beverages as they are more likely to be part of a healthy or less healthy diet based on the nutritional information on the package. In total, 192 products were collected and categorized into highly consuming five broad food categories; (i) ready-to-eat cereal, fine bakery wares, and confectionery products (ii) ready to eat savouries (iii) sugary beverages (iv) milk and dairy products and (v) prepared/ready-to-cook foods, to collect nutritional information. Among collected food products, 29 (15%) products were unable to evaluate due to incomplete nutritional labelling while all the tested food products were unable to be recognized as healthier for marketing. Moreover, among 26 (13.54%) products that carried health and nutrition-related claims, 19 (73.7%) were recognized as less healthy, while others were unable to evaluate due to the absence of nutritional information. A descriptive research design was used to identify the factors influencing parents’ purchasing behaviour towards RTE/RTC food products. Using an online questionnaire, a sample size of 151 parents/guardians living in Western province who had one or more children, between the ages of 3-13 were selected using a stratified random sampling method. Results of the multiple regression model analysis revealed that the monthly household income, children’s influence/preference, and commercial aspects are positively influenced (p<0.05) by the parent’s purchasing behaviour. Even though, parents’ opinion was negatively influenced (p<0.05) the parent’s purchasing behaviour toward RTE/RTC food products. The findings suggest that effective policies should be implemented to increase the relative availability of healthier ready-to-eat packaged foods, as well as to improve the provision of nutritional labelling.
Under-utilisation of noncommunicable disease screening and healthy lifestyle promotion centres: A cross-sectional study from Sri Lanka
(Public Library of Science, 2024) Herath, T.; Perera, M.; Kasturiratne, A.
BACKGROUND Healthy Lifestyle Centres (HLCs) are state-owned, free-of-charge facilities that screen for major noncommunicable disease risks and promote healthy lifestyles among adults older than 35 years in Sri Lanka. The key challenge to their effectiveness is their underutilisation. This study aimed to describe the underutilisation and determine the factors associated, as a precedent of a bigger project that designed and implemented an intervention for its improvement. METHODS Data derived from a community-based cross-sectional study conducted among 1727 adults (aged 35 to 65 years) recruited using a multi-stage cluster sampling method from two districts (Gampaha and Kalutara) in Sri Lanka. A prior qualitative study was used to identify potential factors to develop the questionnaire which is published separately. Data were obtained using an interviewer-administered questionnaire and analysed using inferential statistics. RESULTS Forty-two percent (n = 726, 95% CI: 39.7–44.4) had a satisfactory level of awareness on HLCs even though utilisation was only 11.3% (n = 195, 95% CI: 9.80–12.8). Utilisation was significantly associated with 14 factors. The five factors with the highest Odds Ratios (OR) were perceiving screening as useful (OR = 10.2, 95% CI: 4.04–23.4), perceiving as susceptible to NCDs (OR = 6.78, 95% CI: 2.79–16.42) and the presence of peer support for screening and a healthy lifestyle (OR = 3.12, 95% CI: 1.54–6.34), belonging to the second (OR = 3.69, 95% CI: 1.53–8.89) and third lowest (OR = 2.84, 95% CI: 1.02–7.94) household income categories and a higher level of knowledge on HLCs (OR = 1.31, 95% CI: 1.24– 1.38). When considering non-utilisation, being a male (OR = 0.18, 95% CI: 0.05–0.52), belonging to an extended family (OR = 0.43, 95% CI: 0.21–0.88), residing within 1–2 km (OR = 0.29, 95% CI: 0.14–0.63) or more than 3 km of the HLC (OR = 0.14, 95% CI: 0.04– 0.53), having a higher self-assessed health score (OR = 0.97, 95% CI: 0.95–0.99) and low perceived accessibility to HLCs (OR = 0.12, 95% CI: 0.04–0.36) were significantly associated. CONCLUSION In conclusion, underutilisation of HLCs is a result of multiple factors operating at different levels. Therefore, interventions aiming to improve HLC utilisation should be complex and multifaceted designs based on these factors rather than merely improving knowledge.