Health Promotion & Physical Activity

Stakeholder perspectives on selecting falls prevention programmes in Brunei Darussalam

Muhammad Hassan Syaibani Hardifadhillah — 2026-09-18

Background: Falls are a major contributor to morbidity, disability, and loss of independence among older adults. Although several evidence-based falls prevention programmes have demonstrated effectiveness, decisions about which programmes to implement in practice should take into account feasibility, accessibility, and local context. Understanding the perspectives of key stakeholders is necessary to inform programme selection and implementation.

Methods: This qualitative descriptive study explored the perspectives of two key stakeholders, community-dwelling older adults and allied health professionals, regarding falls prevention programmes in Brunei Darussalam. Focus group discussions were conducted with older adults (n = 15), and semi-structured individual interviews with allied health professionals (n = 6). Participants discussed three established falls prevention programmes: the Otago Exercise Programme, Stepping On, and Lifestyle-integrated Functional Exercise. Data were analysed using reflexive thematic analysis.

Results: Four interrelated themes were identified. Older adults expressed agreement regarding the importance of reducing falls risk and supported initiatives to introduce falls prevention programmes, focusing primarily on accessibility rather than differentiating between specific interventions. In contrast, allied health professionals engaged more critically regarding programme delivery and sustainability. They expressed a conceptual preference for Stepping On, while considering how delivery could be adapted to local settings. Across both groups, the need for contextual and cultural adaptation emerged as a shared priority.

Conclusions: Stakeholder perspectives highlighted that programme preference was shaped less by intervention content or evidence base and more by feasibility, accessibility, and system fit. Integrating older adults’ and allied health professionals’ perspectives may enhance uptake, acceptability, and sustainability of fall prevention initiatives

Behavioural determinants of zero-dose and under-immunisation in conflict-affected Northwest and Southwest Cameroon

Delphine Chifor Fri — 2026-09-18

Background: Conflict in the Northwest and Southwest regions of Cameroon has disrupted routine immunisation, leaving many children without vaccines. To design better interventions, it was important to understand what had shifted in caregivers’ perceptions of vaccines and what influences their decisions to immunise their children.

Purpose: This study was designed to explore behavioural, socio-cultural, and structural determinants of immunisation uptake among doers and non-doers in conflict-affected Northwest and Southwest Cameroon, and to generate evidence to inform the design of specific interventions and service delivery adaptations.

Material and methods: A qualitative Doer/Non-Doer analysis was conducted in four health districts (Konye, Kumba South, Bamenda, Nwa) from March to June 2025. The study included 140 semi-structured interviews with caregivers, healthcare workers, and community leaders, plus six focus group discussions. Thematic analysis was guided by the Social-Ecological Model, COM-B, and Health Belief Model frameworks.

Results: Nine behavioural determinants distinguished doers from non-doers. All doers were confident in immunising their children, versus 67% of non-doers. Doers (70%) perceived their children as vulnerable to vaccine-preventable diseases, compared to 33% of non-doers. Non-doers (71%) incorrectly believed immunisation ended at 9 months. Barriers included vaccine stockouts, poor cold chain, clinic hours conflicting with farm work, security constraints, and misinformation from non-state armed groups.

Conclusions: Increasing immunisation coverage in conflict-affected Cameroon requires addressing individual perceptions, family dynamics, community norms, and health system challenges through family engagement, trust-building, and service adaptations

Factors associated with physical activity among adults with diabetes and hypertension in the Andaman and Nicobar Islands

Gayathri Ponath Sukumaran — 2026-09-18

Purpose: Regular physical activity is central to the management of Non-Communicable Diseases (NCDs) including Diabetes and Hypertension, with significant implications for glycemic control, blood pressure regulation and overall quality of life. However, physical activity patterns and factors associated with it in island populations such as South Andaman remain poorly documented.

Material and methods: A facility-based cross-sectional analytical study was conducted among 400 adults aged 18 years and above diagnosed with type 2 diabetes and/or hypertension who are currently on treatment.

Results: Among the total participants, the majority were females (55.5%) and aged below 60 years (68%). Moderate to high physical activity was reported by 77% of the participants. Among individuals with Diabetes, 25.6% reported low, 43.8% moderate and 30.6% high physical activity. Among those with Hypertension, 25.0% reported low, 42.4% moderate and 32.6% high activity levels. Participants with both Diabetes and Hypertension reported low activity in 19 (17.8%), moderate in 54 (50.5%) and high in 34 (31.8%). Physical activity levels were found to be significantly associated with age (p < 0.001), gender (p = 0.040), socioeconomic class (p < 0.001), type of family (p < 0.001), educational status (p = 0.003), employment status (p < 0.001), body mass index (p < 0.001) and sleep duration (p = 0.041) while religion, caste, marital status and resident status played no significance.

Conclusions: Overall, the findings suggest that majority of participants exhibited moderate to high physical activity and it appears to be associated with demographic and lifestyle factors than by the NCD itself

Parental perceptions of barriers and facilitators to active transportation to school for adolescents in Brunei Darussalam

Peng Boon Kiat — 2026-09-22

Background: Active transportation to school (ATS) helps reduce the burden of non-communicable diseases through improvement in physical activities. This study aimed to examined parental perceptions of barriers and facilitators to ATS amongst adolescents in Brunei Darussalam, to help inform future multi-sectoral policy.

Materials and methods: A cross-sectional national online survey was conducted amongst parents of secondary school students aged 10 to 19 years, using a self-designed questionnaire adapted from established literature and was piloted. A total of 392 eligible responses were analyzed. Descriptive statistics summarized parental perceptions using Likert ratings, whilst multiple linear regression assessed associations between sociodemographic factors and parental preferences to walking, cycling and using public transport for their children.

Results: Overall, majority of parents showed low preference for their children to walk (77.1%) or to cycle (75.2%) to school, primarily due to safety issues. Strong enabling factors included improved environmental and safety infrastructures such as safety camera installations, well-enforced school zones, and separated cycling pathways. Multiple linear regression findings showed that greater home-school distance significantly reduced preference for walking (p < 0.001), and parents were less likely to encourage cycling for female children (p = 0.036).

Conclusions: Safety concerns remain the predominant barrier to ATS for adolescents, while infrastructure enhancements and strengthened safety measures pave promising pathways to increase parental support for ATS initiatives in Brunei