Although tobacco use is declining in several countries including India (dropping from 35% in 2009... more Although tobacco use is declining in several countries including India (dropping from 35% in 2009–10 to 29% 2016–17 among adults)—it still poses a huge burden on India, as the world’s second largest consumer of tobacco products. In Bihar state, with a prevalence of 25%, the Bihar School Teachers Study (BSTS) successfully enlisted teachers as role models for encouraging quitting and changing social norms pertaining to tobacco. The study used a mixed-methods approach to identify factors associated with teachers’ quitting. Qualitative data were collected through focus groups with teachers and school principals. Quantitative data were collected through a written survey administered to school personnel post-intervention. Key findings from focus groups were that teachers and principals quit using tobacco and promoted cessation because they wanted to model positive behaviors; specific information about tobacco’s harms aided cessation; and the BSTS intervention facilitated a school environm...
In India, tobacco kills 900 000 people every year though the burden of tobacco is faced dispropor... more In India, tobacco kills 900 000 people every year though the burden of tobacco is faced disproportionately in poorer states such as Bihar. Teachers may be a particularly influential group in setting norms around tobacco use in the Indian context. However, tobacco use among teachers remains high and perceptions of tobacco-related health risks are unexplored. To qualitatively explore perceptions about tobacco use among teachers in Bihar and to examine how risk information may be communicated through a variety of message formats, 12 messages on tobacco health risks varying in formats were tested in focus groups with teachers from Bihar. Participants stated that teachers were already aware of tobacco-related health risks. To further increase awareness of these risks, the inclusion of evidence-based facts in messages was recommended. Communicating risk information using negative emotions had a great appeal to teachers and was deemed most effective for increasing risk perception. Messages using narratives of teachers' personal accounts of quitting tobacco were deemed effective for increasing knowledge about the benefits of quitting. To conclude, messages using evidence-based information, possibly with negative emotions, testimonials with role models and those messages emphasizing self-efficacy in the format of narratives appear to appeal to teachers in Bihar.
One of the fundamental causes of the spread of HIV/AIDS in sub-Saharan Africa is gender inequalit... more One of the fundamental causes of the spread of HIV/AIDS in sub-Saharan Africa is gender inequality within a context of income disparity and poverty. Not only are females biologically more susceptible than males to infection with HIV they are more at risk because of sociocultural conditioning. In many parts of Africa the manifestations of this inequality can be seen at an early age. Girls have fewer opportunities than boys. They are seen primarily as future child bearers and nurturers. At an early age girls are socialized to perform subservient roles. When older they often lack crucial psychosocial skills such as the ability to communicate assertively to think critically to make decisions and negotiate to solve problems in social relationships to resist pressure and to cope with emotions and conflict. African girls enter into relationships with the opposite sex as unequal partners. Many interventions and much research have focused on adolescents yet the gender-based socialization of ...
The governments of South Asia designed the 1990's as the Decade of the Girl Child, in order t... more The governments of South Asia designed the 1990's as the Decade of the Girl Child, in order to confront the extreme discrimination faced by girls in the region. A range of research studies undertaken by UNICEF and other agencies leading up to the Decade had documented the aspects and degrees of discrimination against girls in the region - with the most severe conditions in India, Bangladesh, Nepal and Pakistan.
Perceptions of tobacco are a relatively unexplored issue in disadvantaged populations in India an... more Perceptions of tobacco are a relatively unexplored issue in disadvantaged populations in India and France. The objectives of this study included the following: obtain qualitative information on representations of tobacco use and cessation within two vulnerable populations; identify cultural factors that influence tobacco use and cessation; and acquire information for the development of effective tobacco cessation strategies. A total of 21 focus groups were conducted in India and France. All study participants were disadvantaged adults 18 years old or older. Sixty women resided in South Delhi in India and 163 adults with disabilities resided in the south of France. They were all current tobacco users. Data were collected by focus group and analysed with thematic coding. In both samples, the most relevant reasons of tobacco use were daily life circumstances, which were also a major barrier to quitting. None of the participants reported that quitting difficulties could be due to depend...
... from the NGOs, such as BRAC and the Grameen Bank; philanthropic trusts in India such as Birla... more ... from the NGOs, such as BRAC and the Grameen Bank; philanthropic trusts in India such as Birla, Tata, Mahendra, and Ambani; and in the private sector, Nokia and Archies Stores, to explore the long-envisaged establishment of an independent foundation for Meena. ...
Objective: To develop and test a quantitative, interviewer-administered food frequency questionna... more Objective: To develop and test a quantitative, interviewer-administered food frequency questionnaire (FFQ) to ascertain nutrient intakes of individuals in northern India. Design: A 92-item FFQ was developed based on food use and market surveys of the study area. A validation study was conducted consisting of 24-h diet recalls (24HR) administered on 6 randomly selected days over 1 year. Two FFQs were administered, one each at the beginning and end of the 1-year period. FFQ and 24HR-derived nutrient scores were compared using correlation and regression analyses and by computing differences between nutrient intakes estimated by the two methods. Setting: Rural villages in Bhavnagar District, Gujarat, North India. Subjects: 60 individuals who agreed to provide all necessary data. Results: Pearson (parametric) correlation coefficients averaged 0.69 in comparing nutrient scores derived from the 24HR with those from the first FFQ and 0.72 in comparing the second FFQ (P < 0.0001). Spearman correlation coefficients were virtually identical to the Pearson correlations, averaging 0.68 and 0.72, respectively. In regression analyses, most coefficients were close to 1.0 (perfect linear association). Nutrient scores were significantly and consistently higher on both FFQs relative to the 24HR. Conclusions: This FFQ produces results broadly comparable, and superior in some respects, to those commonly used in the West. Higher than average measures of association indicate its suitability for comparing exposures within this study population in reference to health-related endpoints.
In India, tobacco kills 900 000 people every year though the burden of tobacco is faced dispropor... more In India, tobacco kills 900 000 people every year though the burden of tobacco is faced disproportionately in poorer states such as Bihar. Teachers may be a particularly influential group in setting norms around tobacco use in the Indian context. However, tobacco use among teachers remains high and perceptions of tobacco-related health risks are unexplored. To qualitatively explore perceptions about tobacco use among teachers in Bihar and to examine how risk information may be communicated through a variety of message formats, 12 messages on tobacco health risks varying in formats were tested in focus groups with teachers from Bihar. Participants stated that teachers were already aware of tobacco-related health risks. To further increase awareness of these risks, the inclusion of evidence-based facts in messages was recommended. Communicating risk information using negative emotions had a great appeal to teachers and was deemed most effective for increasing risk perception. Messages using narratives of teachers' personal accounts of quitting tobacco were deemed effective for increasing knowledge about the benefits of quitting. To conclude, messages using evidence-based information, possibly with negative emotions, testimonials with role models and those messages emphasizing self-efficacy in the format of narratives appear to appeal to teachers in Bihar.
Although tobacco use is declining in several countries including India (dropping from 35% in 2009... more Although tobacco use is declining in several countries including India (dropping from 35% in 2009–10 to 29% 2016–17 among adults)—it still poses a huge burden on India, as the world’s second largest consumer of tobacco products. In Bihar state, with a prevalence of 25%, the Bihar School Teachers Study (BSTS) successfully enlisted teachers as role models for encouraging quitting and changing social norms pertaining to tobacco. The study used a mixed-methods approach to identify factors associated with teachers’ quitting. Qualitative data were collected through focus groups with teachers and school principals. Quantitative data were collected through a written survey administered to school personnel post-intervention. Key findings from focus groups were that teachers and principals quit using tobacco and promoted cessation because they wanted to model positive behaviors; specific information about tobacco’s harms aided cessation; and the BSTS intervention facilitated a school environm...
In India, tobacco kills 900 000 people every year though the burden of tobacco is faced dispropor... more In India, tobacco kills 900 000 people every year though the burden of tobacco is faced disproportionately in poorer states such as Bihar. Teachers may be a particularly influential group in setting norms around tobacco use in the Indian context. However, tobacco use among teachers remains high and perceptions of tobacco-related health risks are unexplored. To qualitatively explore perceptions about tobacco use among teachers in Bihar and to examine how risk information may be communicated through a variety of message formats, 12 messages on tobacco health risks varying in formats were tested in focus groups with teachers from Bihar. Participants stated that teachers were already aware of tobacco-related health risks. To further increase awareness of these risks, the inclusion of evidence-based facts in messages was recommended. Communicating risk information using negative emotions had a great appeal to teachers and was deemed most effective for increasing risk perception. Messages using narratives of teachers' personal accounts of quitting tobacco were deemed effective for increasing knowledge about the benefits of quitting. To conclude, messages using evidence-based information, possibly with negative emotions, testimonials with role models and those messages emphasizing self-efficacy in the format of narratives appear to appeal to teachers in Bihar.
One of the fundamental causes of the spread of HIV/AIDS in sub-Saharan Africa is gender inequalit... more One of the fundamental causes of the spread of HIV/AIDS in sub-Saharan Africa is gender inequality within a context of income disparity and poverty. Not only are females biologically more susceptible than males to infection with HIV they are more at risk because of sociocultural conditioning. In many parts of Africa the manifestations of this inequality can be seen at an early age. Girls have fewer opportunities than boys. They are seen primarily as future child bearers and nurturers. At an early age girls are socialized to perform subservient roles. When older they often lack crucial psychosocial skills such as the ability to communicate assertively to think critically to make decisions and negotiate to solve problems in social relationships to resist pressure and to cope with emotions and conflict. African girls enter into relationships with the opposite sex as unequal partners. Many interventions and much research have focused on adolescents yet the gender-based socialization of ...
The governments of South Asia designed the 1990's as the Decade of the Girl Child, in order t... more The governments of South Asia designed the 1990's as the Decade of the Girl Child, in order to confront the extreme discrimination faced by girls in the region. A range of research studies undertaken by UNICEF and other agencies leading up to the Decade had documented the aspects and degrees of discrimination against girls in the region - with the most severe conditions in India, Bangladesh, Nepal and Pakistan.
Perceptions of tobacco are a relatively unexplored issue in disadvantaged populations in India an... more Perceptions of tobacco are a relatively unexplored issue in disadvantaged populations in India and France. The objectives of this study included the following: obtain qualitative information on representations of tobacco use and cessation within two vulnerable populations; identify cultural factors that influence tobacco use and cessation; and acquire information for the development of effective tobacco cessation strategies. A total of 21 focus groups were conducted in India and France. All study participants were disadvantaged adults 18 years old or older. Sixty women resided in South Delhi in India and 163 adults with disabilities resided in the south of France. They were all current tobacco users. Data were collected by focus group and analysed with thematic coding. In both samples, the most relevant reasons of tobacco use were daily life circumstances, which were also a major barrier to quitting. None of the participants reported that quitting difficulties could be due to depend...
... from the NGOs, such as BRAC and the Grameen Bank; philanthropic trusts in India such as Birla... more ... from the NGOs, such as BRAC and the Grameen Bank; philanthropic trusts in India such as Birla, Tata, Mahendra, and Ambani; and in the private sector, Nokia and Archies Stores, to explore the long-envisaged establishment of an independent foundation for Meena. ...
Objective: To develop and test a quantitative, interviewer-administered food frequency questionna... more Objective: To develop and test a quantitative, interviewer-administered food frequency questionnaire (FFQ) to ascertain nutrient intakes of individuals in northern India. Design: A 92-item FFQ was developed based on food use and market surveys of the study area. A validation study was conducted consisting of 24-h diet recalls (24HR) administered on 6 randomly selected days over 1 year. Two FFQs were administered, one each at the beginning and end of the 1-year period. FFQ and 24HR-derived nutrient scores were compared using correlation and regression analyses and by computing differences between nutrient intakes estimated by the two methods. Setting: Rural villages in Bhavnagar District, Gujarat, North India. Subjects: 60 individuals who agreed to provide all necessary data. Results: Pearson (parametric) correlation coefficients averaged 0.69 in comparing nutrient scores derived from the 24HR with those from the first FFQ and 0.72 in comparing the second FFQ (P < 0.0001). Spearman correlation coefficients were virtually identical to the Pearson correlations, averaging 0.68 and 0.72, respectively. In regression analyses, most coefficients were close to 1.0 (perfect linear association). Nutrient scores were significantly and consistently higher on both FFQs relative to the 24HR. Conclusions: This FFQ produces results broadly comparable, and superior in some respects, to those commonly used in the West. Higher than average measures of association indicate its suitability for comparing exposures within this study population in reference to health-related endpoints.
In India, tobacco kills 900 000 people every year though the burden of tobacco is faced dispropor... more In India, tobacco kills 900 000 people every year though the burden of tobacco is faced disproportionately in poorer states such as Bihar. Teachers may be a particularly influential group in setting norms around tobacco use in the Indian context. However, tobacco use among teachers remains high and perceptions of tobacco-related health risks are unexplored. To qualitatively explore perceptions about tobacco use among teachers in Bihar and to examine how risk information may be communicated through a variety of message formats, 12 messages on tobacco health risks varying in formats were tested in focus groups with teachers from Bihar. Participants stated that teachers were already aware of tobacco-related health risks. To further increase awareness of these risks, the inclusion of evidence-based facts in messages was recommended. Communicating risk information using negative emotions had a great appeal to teachers and was deemed most effective for increasing risk perception. Messages using narratives of teachers' personal accounts of quitting tobacco were deemed effective for increasing knowledge about the benefits of quitting. To conclude, messages using evidence-based information, possibly with negative emotions, testimonials with role models and those messages emphasizing self-efficacy in the format of narratives appear to appeal to teachers in Bihar.
Uploads
Papers by M. Aghi