Conference Papers

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Risk factors for low resilience among grade 10 adolescents in the Gampaha District
(Sri Lanka Medical Association, 2023) Manori, D.M.S.; Jayawardana, P.L.; Godamunne, P.
INTRODUCTION: Resilience denotes the ability to withstand adversity and bounce back from difficult life events. OBJECTIVE: To determine risk factors for low resilience among Grade 10 adolescents in the District of Gampaha. METHODS: A case-control study with a computed sample size of 128 in each among cases (low resilience) and controls (high resilience) was conducted. Cases and controls were selected by applying simple random sampling to a descriptive study where the magnitude of resilience was determined. For data analysis bivariate (using chi-square test) followed by multiple logistic regression were applied. Results were expressed as adjusted odds ratios with 95% confidence intervals. RESULTS: Risk factors for low resilience were: one or both parents dead (AOR=3.4; 95% CI [1.1, 10.1]; p=0.031), mother’s educational level ≤GCE A/L (AOR=2.3; 95% CI [1.4, 3.6]; p=0.001), losing temper frequently (AOR=2.5; 95% CI [1.9, 3.4]; p<0.001), having <6 friends (AOR=1.4; 95% CI [1.03;1.9]; p<0.048), having <6 close friends (AOR=1.6; 95% CI [1.06, 2.5]; p=0.024), having conflicts with friends (AOR=2.0; 95% CI [1.03, 3.74]; p=0.040), lack of support from home (AOR=1.5; 95% CI [1.04, 2.20]; p=0.031), not seeking help when facing difficult situations (AOR=1.7; 95% CI [1.2, 2.3]; p=0.001), sleeping for <8 hours/day (AOR=1.4; 95% CI [1.2, 1.8]; p=0.007), lack of religious affiliations (AOR=2.6; 95% CI [1.2, 5.7]; p < 0.015) and non-attending Sunday school (AOR=2.1; 95% CI [1.5, 3.2]; p<0.001). CONCLUSION: Eleven risk factors were identified. Recommend conducting cognitive behavioural therapy-based interventions regularly at the school level targeting to minimize the impact of the above risk factors.
Public health midwives’ perception on breast cancer early detection services provided through well woman clinics in the Gampaha District, Sri Lanka
(College of the Community Physicians of Sri Lanka, 2013) Vithana, P.V.S.C.; Hemachandra, D.K.N.N.; Ariyarathne, M.A.Y.; Jayawardana, P.L.
INTRODUCTION: Being most common cancer diagnosed in Sri Lanka, breast cancer accounts for 27% of female cancer-mortality. Early-detection of breast cancer is conducted using clinical breast examination (CBE) and increasing awareness on breast self-examination through well woman clinics (WWCs). OBJECTIVE: To identify Public health midwives' (PHMs') perception on the importance and deficiencies of the breast cancer early-detection services provided through WWCs, and their suggestions on improving the breast cancer early-detection services. METHODS: A qualitative study using four focus group discussions (FGDs) consisting of 8-10 participants per each FGD were conducted among 38 PHMs in the Gampaha District during July to September 2008. FGD guide included discussion points on availability of guidelines and protocols, training received, time for clinic-sessions, adequacy of resources, support from other sectors, and reasons for low-participation and their recommendations for improving utilization of services. Two experts conducted FGDs as moderator and data recorder. FGDs were audio-recorded, transcribed and analyzed using constant comparison and identifying themes and categories. Results were presented in narrative form. RESULTS: All the PHMs had a firm realization on the need of breast cancer early-detection. FGDs revealed non-availability of guidelines, lack of training, lack of skills and material to provide health education, inability to provide privacy during CBE, shortage of stationery and lack of community awareness and motivation. The suggestions for the improvements identified in FGDs were capacity building of PHMs, making availability of guidelines, rescheduling clinics, improving the supervision, strengthening the monitoring, improving coordination between clinical and preventive sectors, and improving community awareness. CONCLUSIONS AND RECOMMENDATIONS: The components to be improved in breast cancer early-detection services were identified. Study recommends training programmes at basic and post basic levels on a regular basis and supervision for the sustenance of the program.
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.

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