BackgroundGender norms practiced by respective societies increase the risk of violence by men against women. To date, there is a dearth of research evidence on changing gender norms through health promotion approaches around the globe, including in Sri Lanka. This study provides an evaluation of effectiveness of a health promotion intervention in changing the acceptance of gender norms among women.MethodsA quasi-experimental study was conducted in two rural villages in Anuradhapura district in Sri Lanka including women who have a child under five years of age. One village was allocated to receive an intervention developed based on a health promotion approach and the other village was a control. A community based mechanism to question selected gender norms among women was developed as the intervention. The pre- and post-intervention assessments of the level of acceptance of gender norms were done using an interviewer administered questionnaire and by using focus group discussions.ResultsFollowing the intervention, acceptances of prominent gender norms were changed significantly among the women receiving the intervention method. The control group showed no changes towards the acceptance of gender norms during this period. Women in the intervention group had higher levels of self-reported positive behavior changes and greater understanding of gender concepts compared to the control group.ConclusionThe acceptance of gender norms among women in rural villages in Sri Lanka can be changed by a community based intervention targeting gender norms.

In Sri Lanka, the main occupation of the alcohol users was students according to the International Standard Classification of Occupation. Attractiveness of the image of alcohol is one of the key determinants and this image develops through peer norms. Aim of the study was to assess the effectiveness of a health promotion intervention in changing the attractive image of alcohol among students. A quasi experimental study was conducted among students from grade 8 to 11 from two schools in Anuradhapura and Polonnaruwa districts in Sri Lanka as the intervention and control group respectively. Intervention was delivered through a group of voluntary students from grade 11 with training to challenge peer norms. Data were collected using self-administered questionnaires and the chi square test was performed by SPSS. Acceptance on 7 out of 10 norms towards alcohol were significantly reduced in the intervention group with a p value < 0.05 (95 CI level) by comparing post evaluation results in the intervention group with the post evaluation results in the control group according to the chi square test. A health promotion intervention consists of a trained student group is effective in challenging peer norms for reducing the attractive image of alcohol among students.

ObjectiveHealthy 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.SettingTwo districts (Gampaha and Kalutara) from the highest populous province (Western) located adjacent to the capital district of Sri Lanka.ParticipantsNine 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.MethodA 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.ResultsThe 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.ConclusionThe 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.

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IntroductionAttention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychiatric condition in childhood, which if untreated may have a negative effect on education, peer relationships and family disharmony. Methylphenidate is an effective treatment for ADHD, although its use is limited by poor compliance and side effects. Studies on effects of side effects on efficacy, and adherence of methylphenidate in developing countries are scarce. MethodsWe assessed the adherence, efficacy, and side effects of methylphenidate in children and adolescents treated at a child and adolescent psychiatry clinic of North Colombo Teaching Hospital, Ragama. We gathered information from guardians of the children treated with methylphenidate for at least 2 months, using an interviewer administered questionnaire. ResultsAmong the 149 participants, a majority were males and the mean age of the population was 10.4 years. More than 52% participants reported 100% compliance with methylphenidate, but only 12% complied with non-pharmacological therapies. While 75% believed the medication to be effective, only 17% perceived psychosocial strategies to be useful. Poor appetite (44%) was the most common side effect of methylphenidate and 43% did not report any side effect. There was a negative correlation between compliance with methylphenidate and the occurrence of poor appetite, as well as with not increasing the initial dose. DiscussionThe results of this study suggest that methylphenidate is an effective and well-tolerated treatment for children in Sri Lanka with ADHD.