scholarly works
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Item The factor structure of the environmental attitude scale in a community-based study in Lagos, Nigeria(Adventist University of Africa, 2019) Dipeolu A. A.; Akpa O. M.; Fadamiro A. J.Environmental Attitude (EA) has been understood to be a complex multidimensional construct with minimal empirical evidence in developing countries. In the present study, psychometric properties of an EA scale was empirically assessed using data from a community based study conducted in Nigeria. Different measures of EA were aggregated into a single EA scale and administered to 1,858 individuals. Mean (Standard deviation) and proportions were used to describe the distribution of continuous and discrete data respectively. Reliability of the scale was assessed using Cronbach's alpha. Varying hypothetical models of the EA were assessed using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Data were analyzed using IBM SPSS version 20 and AMOS version 21 at 5% significant level. Overall mean score and alpha coefficient for the combined EA measure was 381.7 (49.0) and 0.928 respectively. A 3-factor structure accounting for 36% cumulative variance in the scale item was extracted in an EFA. A nonorthogonal 3-factor model was a significant improvement over the original none-correlated 5-factor model [÷2 (1344) =29216.33, P<0.001; CAIC=9816.870]. The conceptualization of the EA as a non-orthogonal 3-factor structure provides a better fit to the present data. The 3-factor structure is advised in Nigeria and similar settings.Item Mitigating environmental sustainability challenges and enhancing health in urban communities: The multi-functionality of green infrastructure(Alanya University, Faculty of Engineering and Natural Sciences, 2020) Dipeolu A. A.; Akpa O. M.; Fadamiro J. A.Green Infrastructure (GI) facilities have capacity to enhance health and mitigate Environmental Sustainability Challenges (ESC). However, the extent of the mitigation and health benefits is unclear in developing countries. This study examined the impact of GI on ESC and Perceived Health (PH) of urban residents in Lagos Metropolis, Nigeria. Multi-stage sampling technique was used to select 1858 residents of Lagos Metropolis who completed semi-structured questionnaires. Descriptive statistics and chi-square test were used to explore data distributions and assess association of the availability of GI with resident’s PH and ESC. Odds ratio with 95% confidence interval (OR;95%CI) were estimated for good health and ESC mitigation. Participants were mostly men (58.9%) and younger than 50 years old (86.3%). Good health (20.5%) and high mitigation of ESC (collection and disposal of waste-52.7% and official development assistance 63.9%) were reported where GI is mostly available. Participants were more likely to report good health (OR:1.40; 95%CI:1.02-1.92) and high mitigation of ESC [water quality (OR:1.42; 95%CI:1.12-1.81) passenger transport mode (OR:1.41; 95%CI:1.06-1.89)] where GI are mostly available. Availability of Green infrastructure is supporting health and mitigating environmental sustainability challenges in the study area. Green infrastructure should be provided in urban areas where environmental sustainability is under threatItem Substance use and psychosocial functioning of adolescents in Benue state, Nigeria: Assessing the role of age(African Journal Online, 2019) Akpa O. M.; Okekunle A. P.Aim: To assess whether Substance Use (SU) is associated with Psychosocial Function (PF) among adolescent. Methods: Using a self-administered validated instrument, we obtained information on demographic, SU (defined as self reported affirmative use of one or more of any form of alcoholic drinks, cigarettes, hemps etc) and PF [using the adolescent psychosocial functioning inventory comprising of three subscales; optimism and coping strategies (OCS), behaviour and relationship problems (BRP) and general psychosocial dysfunction designed (GPD)] among 2272 apparently healthy adolescents. PF was categorized as ‘elevated’ if the psychosocial functioning index (PFI) score were >75th percentile, otherwise, ‘not elevated’ and multivariable-adjusted logistic regression was used to compute odds ratio (OR) and 95% confidence interval (CI) of SU for elevated PF risk. In addition, we applied Johnson Neyman (JN) technique to identifying the JN significance regions at which age moderated the SU-PF relationship at a statistical significance of two-sided P<0.05. Results: Prevalence of SU and elevated PF was 50.7% and 79.8% respectively. Prevalence of elevated PF differed insignificantly by sex, but the proportion of adolescent with elevated PFI on SU (82.6%) was significantly higher (P<0.001) compared to those with elevated PFI but not on SU (76.9%). Multivariable-adjusted odds of decreased OCS risk given SU exposure was; OR (95%CI): 1.3791 (1.1458-1.6698), P=0.0007. Similarly, multivariable-adjusted odds of elevated PF risk in the light of SU exposure was; OR (95%CI): 1.4286 (1.1617-1.7567), P=0.0007. Furthermore, the JN significance regions for moderated regression analyses of odds of decreased OCS risk was between 10.4years [OR (95%CI): 0.5820 (0.1411-1.0228), P=0.0097] and 16.7years [OR (95%CI): 0.3025 (0.0001-0.6050), P=0.0500]. Conclusion: Adolescents on SU are about one and half times at risk of psychosocial dysfunction and age significantly attenuated the SU-decreased OCS risk link particularly in early adolescence.Item Using the zero inflated negative binomial model to assess factors associated with occurrence of childhood pneumonia(Journal of the Indian Society for Probability and Statistics, 2018) Yusuf O. B.; Akpa O. M.; Akinpelu K. P.; Gbolahan A. O.Item Prevalence of psychosocial dysfunctional behaviours among in-school adolescents in Ikere-Ekiti, Ekiti state, Nigeria(African Journal Online, 2018) Ogunboyo O. F.; Akpa O. M.Psychosocial disorders affect people across all ages in both high and low income countries. Unfortunately, information on psychosocial functioning among children and adolescents are practically scarce in Nigeria. However, local studies can provide remote strategies to identify the risk factors, increase awareness, remove stigma and improve access to mental health services. In this work, prevalence of psychosocial disorders across participants’ demographic and background characteristics were examined.A self-administered Rosenberg Self-esteem Scale (RSS) and Strengths and Difficulties Questionnaire (SDQ) were used to screen for psychosocial symptoms among in-school adolescents. Participants were selected from six (6) secondary schools within Ikere Ekiti. The reliability of the scales were using Cronbach’s alpha. Preliminary data analyses were performed using descriptive statistics while independent t-test and ANOVA were used to compare psychosocial scores across selected background and demographic characteristics of the participants. The participants comprised 480 students, aged 11 to 19. Cronbach’s alpha showed a moderate reliability estimate of 0.60 for the SDQ and 0.43 for the RSS. It was observed that higher mean scores on self-esteem and prosocial behavior correlate with lower mean scores on psychosocial disorder symptoms. Moreover, male participants significantly (t=2.810, P=0.01) exhibited conduct problems more than their female counterparts while those from polygamous families also have higher inattention problems compared to their counterparts from monogamous homes (t= -2.980, p=0.003). The study revealed that boys are more exposed to externalizing behavioural problems while girls possess more pro-social features. Also, it was found that self-esteem and family type have an important role to play in adolescent psychosocial dysfunction.Item Data resource profile: Cardiovascular H3Africa Innovation Resource (CHAIR)(Oxford University Press, 2018) Owolabi M. O.; Akpa O. M.; Made F.; Adebamowo S. N.; Ojo A.; Adu D.; Motala A. A.; Mayosi B. M.; Ovbiagele B.; Adebamowo C.; Tayo B.; Rotimi C.; Akinyemi R.; Gebregziabher M.; Sarfo F.; Wahab K. W.Item Birth preparedness and complication readiness among Pokot nomadic pastoralists’ pregnant women in East Pokot district, Midwest- Kenya(Science Publishing Group, 2018) Kasmai K. E.; Akpa O. M.; Olayemi O.Birth Preparedness and Complication Readiness (BPCR) is a strategy to promote the timely use of skilled maternal and neonatal care, especially during childbirth, based on the theory that preparing for childbirth and being ready for complications reduces delays in seeking health care and averts serious complications that women face during child birth. However, information on BPCR among Pokot nomadic pastoralists have not been well documented in literatures. The purpose of this research was to determine factors affecting BPCR among Pokot nomadic pastoralists’ pregnant women living in East Pokot District of Kenya. A cross-sectional facility based study was conducted among 275 Pokot pregnant women, above 18 years of age who were on their second and third trimesters and attending various Antenatal Clinics (ANCs) in East Pokot district. This was response rate of 90.1%. A multi-stage sampling technique was used and data was collected from those who met the inclusion criteria between August-October, 2017, using a pretested researcher administered questionnaire. The data collected was analyzed using (SPSS) version 21. Chi-square was used to test the hypothesis. A p-value of <0.05 was considered significant. The results showed that practice of BPCR was low (28%) among the respondents. Being educated (OR=18, CI=3.83-85.16) and having high household income (OR=2.53, CI=1.37-4.66) increased practice of BPC R. Ethnic affiliation to Pokot (OR=4.85, CI=1.38-17.07), practicing African Traditional Religion (OR=2.48, CI=1.44-4.26), practicing pastoralism (OR=2, CI=1.17-3.42) were found to significantly reduce the level of BPCR. In conclusion, birth preparedness and complication readiness was low among Pokot nomadic pastoralist’s pregnant women. There is a need for more BPCR awareness programmes targeting pastoralists’ women and other vulnerable groups in the region.Item Modelling the factor structure of the Child Depression Inventory in a population of apparently healthy adolescents in Nigeria(Public Library of Science (PLOS), 2018) Olorunju S. B.; Akpa O. M.; Afolabi R. F.Background: Childhood and adolescent depression is common and often persists into adulthood with negative implications for school performances, peer relationship and behavioural functioning. The Child Depression Inventory (CDI) has been used to assess depression among adolescents in many countries including Nigeria but it is uncertain if the theoretical structure of CDI appropriately fits the experiences of adolescents in Nigeria. This study assessed varying theoretical modelling structure of the CDI in a population of apparently healthy adolescents in Benue state, Nigeria Methods: Data was extracted on CDI scale and demographic information from a total of 1, 963 adolescents (aged 10–19 years), who participated in a state wide study assessing adolescent psychosocial functioning. In addition to descriptive statistics and reliability tests, Exploratory Factor Analysis (EFA) and Confirmatory Factor analysis (CFA) were used to model the underlying factor structure and its adequacy. The suggested new model was compared with existing CDI models as well as the CDI’s original theoretical model. A model is considered better, if it has minimum Root Mean Square Error of Approximation (RMSEA <0.05), Minimum value of Discrepancy (CMNI/DF<3.0) and Alkalike information criteria. All analyses were performed at 95% confidence level , using the version 21 of AMOS and the R software. Results :Participants were 14.7±2.1 years and mostly male (54.3%), from Monogamous homes (67.9%) and lived in urban areas (52.2%). The measure of the overall internal consistency of the 2-factor CDI was α = 0.84. The 2-factor model had the minimum RMSEA (0.044), CMIN/DF (2.87) and least AIC (1037.996) compared to the other five CDI models. Conclusion: The child depression inventory has a 2-factor structure in a non-clinical general population of adolescents in Nigeria. Future use of the CDI in related setting may consider the 2-factor model.Item The factor structure of the adapted who quality of life bref questionnaire in a sample of adolescents in Nigeria(Faculty of Basic and Applied Medical Sciences, 2018) Akpa O. M.; Fowobaje K. R.The World Health Organization’s Quality of Life Instrument (WHOQOL-BREF) is widely validated and popularly used in assessing perceived quality of life (QOL) of adolescents and the general population. Though the WHOQOL-BREF has been used in some studies in Nigeria, its theoretical structure has not been comprehensively investigated. This study examined the factor structure of the Adopted WHOQOL-BREF questionnaire and it theoretical structure in a large sample of adolescents in Nigeria. Data on demographic characteristics and QOL were extracted from 1,963 adolescents who participated in a state-wide study on psychosocial functioning and quality of life of adolescents in Benue State, Nigeria. Descriptive statistics were used to present the distribution of the data while Cronbach’s alpha and Polychoric ordinal alpha were used to describe the internal consistency (reliability) of the adapted WHOQOL-BREF and alpha value of 0.700 was considered reliable. Structural analysis was performed to extract the underlying factors while confirmatory factor analyses were used to assess some hypothesized structure of the adapted WHO-QOL BREF. Relative Chi-square test value ≤3.0 was regarded a good fit while multiple fit indexes with values ≥0.90 (for acceptable fit) were used for assessing diverse aspects of the models. All analyses were performed at 5% significance level using IBM SPSS statistics version 20, R package and AMOS version 21. Participants were mostly male (54.8%) and 14.7±1.4 years old with 51.0% residing in rural areas. The overall internal consistency of the 4-factor model was 0.862 (for Cronbach’s Alpha) and 0.989 (for Polychoric Alpha) while the 2-factor model had 0.870 (for Cronbach’s Alpha) and 0.990 (for Polychoric Alpha). The Cattelle’s Scree plot, Horn’s parallel analysis and the confirmatory factor analysis revealed a 2-factor model as the best model for the WHO-QOL BREF. The 23-item 2-factor structure had a relative Chi-square test value with all fit indices within the acceptable range. The adapted WHO QOL BREF can be safely used to assess quality of life among Adolescents in Nigeria and related settings. Using the two factors extracted in the present study may yield better results in settings similar to the present study location.Item Treatment satisfaction and medication adherence among hypertensive patients seeking care in selected hospitals in Ibadan, Nigeria(Faculty of Basic and Applied Medical Sciences, 2018) Ajayi D. T.; Adedokun B. O.; Owoeye D. O.; Akpa O. M.Poor adherence to hypertension treatment is a major health-related problem, and a significant risk factor for complications, disability and hypertension associated mortality. There is a paucity of evidence on the impact of treatment satisfaction on medication adherence among hypertensive patients in Nigeria. This study aimed to determine the association between treatment satisfaction and medication adherence among hypertensive patients in Ibadan, Nigeria. A descriptive cross-sectional study was conducted, wherein hypertensive patients were consecutively recruited from 5 hospitals in Ibadan, Nigeria. A pre-tested, interviewer-administered questionnaire was used to collect data. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8), and treatment satisfaction using the 9-item Treatment Satisfaction Questionnaire for Medication (TSQM). Descriptive statistics were computed for all variables. Bivariate analysis was carried out using chi-square test, and multivariate analysis using binary logistic regression. Sensitivity analysis was conducted to adjust for unmeasured binary confounders. Statistical significance was set at p < 0.05 for a 2-tailed. A total of 342 respondents with the mean age of 59.6 ± 12.6 years participated in the study. The overall prevalence of medication adherence was 35.1% (MMAS-8 scores = 8). Treatment satisfaction (AOR=2.03, 95% CI: 1.21-3.43) was independently associated with medication adherence. Sensitivity analysis revealed that the observed association between treatment satisfaction and medication adherence was unlikely to be due to unmeasured confounding variables. Medication adherence was low, and treatment satisfaction independently increases medication adherence. Treatment satisfaction strategies should be part of any treatment intervention packages in this population.