/library/oar/handle/123456789/31978 2025-12-22T05:54:49Z /library/oar/handle/123456789/125278 Title: A cross-sectional study to assess childhood vaccine hesitancy in the Maltese Islands Abstract: Background: Literature on vaccine hesitancy in the Maltese Islands is limited to perspectives from local healthcare professionals or students amidst the COVID-19 pandemic, or as part of international studies which compare various countries. Aim: The main aim of this dissertation was therefore to gain more insight into local vaccine hesitancy by focusing mainly on parents’/guardians’ views and perceptions on childhood vaccines at a point in time (during late 2023). Specific objectives were to assess whether they prioritised certain vaccines over others and whether they believed that there are other important vaccines besides those on the National Immunisation Schedule. Methodology: For this quantitative cross-sectional study, Google Forms was used to create an English and Maltese version of the questionnaire and the URL links were then distributed online through reputable Facebook groups. Its sections were demographics, the validated PACV (Parental Attitudes about Childhood Vaccinations) tool and a section on local vaccination settings. Other methods of data collection were the involvement of proxies (nurses) working at the National Immunisation Service (NIS) who shared QR codes to both language versions, with parents/guardians who attended the site with their children. An email invitation containing the URL links, was sent to all parents/guardians who use the free childcare scheme. Results and Discussion: A total of 1112 individuals responded to the questionnaire, out of which 912 (82.0%) suited the inclusion criteria and completed it. The necessary weighting was carried out. Many participants always chose to vaccinate their children (79.2%) and without delay (76.7%) and many also trusted their children’s doctors (81.3%) and confided with them on issues regarding childhood vaccines (89.2%). Such findings were similar to those from other vaccine hesitancy studies which also used the PACV tool. However, there were also several hesitant findings mainly in the questions on safety and efficacy of childhood vaccines from the PACV tool. Although some of these issues were also expressed in certain studies, others contrasted quite significantly. The most alarming of these was that only 9.4% of participants believed that children do not need to receive fewer vaccines over a short period of time. Key themes that emerged from the results were the tendency to opt for natural childhood immunity rather than vaccines (in 40.5% of participants), the MMR vaccine not being among the top 3 prioritised vaccines, and the influenza nasal spray not influencing perceptions on the importance of the childhood influenza vaccine (no influence in 61.0% of those in favour and in 71.1% of those against). Hesitancy was also observed in the final section on local vaccination settings, particularly towards the adult influenza and COVID-19 vaccines. Vaccine hesitancy was especially prevalent in the 18-24 age group, those whose education was up till secondary level, and the Gozo district. Educational level and District were each found to have an independent effect upon vaccine hesitancy. Overall PACV scores were statistically associated with different age categories (p-value: 0.029), different levels of education (p-value: <0.001) and different districts (p-value: <0.001). Mitigating the above hesitancies among the population will therefore help to enhance local vaccine confidence. Various recommendations for doing so have been outlined at the end of this dissertation. Description: M.Sc.(Melit.) 2024-01-01T00:00:00Z /library/oar/handle/123456789/125277 Title: Geospatial networking dating apps : an exploratory study on the knowledge, attitudes and practices of a sample of the resident population of the Maltese Islands Abstract: Introduction: The development and surge of use of internet dating sites and dating apps have led to numerous ramifications pertaining to the dynamics of negotiation of sex, contraceptive use, and sexual practices, further led by socio-cultural changes in the pursuit of romantic relationships. This has in turn brought about a research interest in the area and investigation of local use and its myriad implications. Aims and Objectives: The aim of the research is to be an exploratory study targeting at gaining insight into the usage of dating apps in Malta and associated knowledge, attitudes and practices. Materials and Methods: An online survey was disseminated via the social media platform Facebook using paid advertisements and distribution amongst popular pages in Malta. Self-completed information about usage patterns, motivations, user characteristics, sexual behaviours and perceived risks and benefits of dating app use were collected. Conclusions gathered from dating app user respondents collected is applicable to the study context with restricted external validity and generalisability. Results and Discussion: A total of 95 responses were collected. Most dating app users were female, young, (25-34-years), had attained at least a tertiary level of education. They were of a heterosexual orientation and were born in Malta. The responders were either in an exclusive relationship, dating casually or single and not dating. Most of them had undergone formal sexualities and relationships education. The most popular dating apps overall were Tinder, Bumble, Badoo and Facebook Dating. The leading dating apps specifically targeting GBMSM were Grindr, followed by Scruff. Motivations for dating app use were diverse, ranging from passing time to sexual, relational and social motives. Survey respondents were most aware of HIV/AIDS, gonorrhoea, syphilis and chlamydia. The Malta-based sexual health services which were known by most respondents were the genitourinary clinic, breast screening, Richmond Foundation and Caritas. Two-thirds of respondents had partaken in sexual activities in the previous 12 months and one-third had not, with most of the former having had one sexual partner, followed by 2 to 5. Casual dating has been significantly associated with having casual sex. Being in an exclusive relationship and being single and not actively dating was in turn associated with lack of multiple partners. Survey respondents aged between 25-34 have been found to have significant associations with having sexual relations while drunk. Pregnancy considerations post-intercourse were very important in individuals who were in an exclusive relationship and those who were single and not actively dating. Moreover, the female survey respondents were also linked to placing high importance on perceptions that considerations of cancer, local soreness or pain, emotional considerations, and urinary tract infections. When considering the sample population, being born in Malta was linked to perceptions that considerations of physical issues related to body image and self-esteem being deemed as not being important or of a neutral nature. Conclusion The implications of dating app use on the local sexual health scene are considerable. Characterization of users, and associated knowledge, attitudes and behaviours, leading to the development targeted health promotion campaigns can improve the health of these populations considerably. Description: M.Sc.(Melit.) 2024-01-01T00:00:00Z /library/oar/handle/123456789/125276 Title: Knowledge, skills, and behaviours of young adults in Malta on sexual health Abstract: Recent emerging statistics regarding sexually transmitted infections (STIs) diagnosis and unintended pregnancy raise questions as to potential associated factors. Alarmingly high rates of STIs such as chlamydia, gonorrhoea, and human immunodeficiency virus (HIV) are reported for Malta (ECDC, 2024a; ECDC, 2024b). The age of a woman at the birth of their first child has been progressively increasing, alas almost half of all pregnancies worldwide are estimated to be unintended (UNFPA, 2022). Contraceptive methods such as the condom and the oral contraceptive pill (OCP) are designed to help mitigate such aforementioned issues, therefore certain failings in making use of such may be present. The last EHIS done locally reported that 41% of individuals had not made use of a contraceptive method within the past year (Borg et al., 2023). This study set out to find whether young adults’ (YA) in Malta knowledge, attitudes, and behaviours on contraception affects their use of such, and also affects their comprehension and attitudes on STIs and unintended pregnancies. An online questionnaire encompassing these three topics targeting YA in Malta was sent out through four co-operating institutions: the University of Malta, the Malta College of Arts, Science and Technology, the Institute of Tourism Studies, and the Ministry for Health. A sample size of 384 individuals was needed, out of which 317 responses were recorded. The results obtained showed that YA in Malta have a good level and understanding on contraceptives, STIs and pregnancy, respectively. Respondents’ skills and behaviours are attributable to such. Whilst the majority of respondents stated that they had sex without using a condom at some point, they affirm that sex without using a condom is not worth the risk. The biggest concern for YA is that of unintended pregnancy, which may be attributable to the consequences and heavy stigma associated with such. On the other hand, the majority of respondents have never been tested for STIs and are unlikely to do so in the near future as they perceive themselves as not being at risk of acquiring a STI. The vast majority of respondents stated they make use of some form of contraceptive method, thus showcasing responsibility and awareness on the risks associated with non-use. Consequential to the results obtained, a set of recommendations were put forth in order to bridge the gap from the shortcomings identified through this study. An integrated policy incorporating the various needs and challenges individuals face nowadays is required, which further implies the need of better sexual education programmes and awareness campaigns. Refining the current services offered whilst introducing new initiatives ought to prove fruitful with regards to finding alternative solutions, particularly on STI testing and contraception use. Further studies on the topic need to be carried out, both locally and internationally, so as to better understand the current atmosphere and its challenges on all individuals. Description: M.Sc.(Melit.) 2024-01-01T00:00:00Z /library/oar/handle/123456789/125275 Title: Challenges and barriers to healthy eating habits and food choices : a discrete choice study Abstract: Aim of the study: This study aimed to distinguish specific food product characteristics that lead to healthy food product choices in two cohorts of different educational levels. Preferred food product characteristics and influencing factors were linked, namely, price, healthiness, and taste, impacting food choices according to participants’ sociodemographic characteristics. Methods: A total of 406 participants from different educational levels were recruited, through a mixture of sampling techniques, and took part in an online discrete choice experiment (DCE) that elicited participant stated preferences (SP) for food choice questions (n = 10). Participants were presented with equal amounts of two (2) food items of the same food source (for example: one kilogram (1kg) of chicken breast and one kilogram (1kg) of chicken nuggets). Each choice task contained four (4) pairs of different prices, and for each price-pair, participants were asked to choose one price from each pair. This descriptively captured respondents’ willingness to pay for one product over another, whilst is elicited the participants’ trade off point (if any) for the selected food products, based on the price. Participant sociodemographic data was also captured at the beginning of the DCE questionnaire. Data was exported from Qualtricsxm as an IBM SPSS statistical software package compatible file, and data analysis was carried out on SPSS. Chisquared test of association was used to evaluate associations amongst and between variables and all p values generated were statistically significant if they resulted less than 0.05. ANOVA and T-tests were used to derive unadjusted means and standard errors. P-values were also generated to assess the statistical significance between each food product characteristic (e.g., as tastiness and healthiness) and demographic variables. Mental health data was analysed using the Mental Health Inventory-5 (MHI-5) score. Multivariate analysis was performed to minimise confounding effects and link the true significance of these variables. A forward stepwise linear regression was performed for the most significant demographic variables on the food product characteristics and mental health. This study received ethical approval from University of Malta’s Faculty Research Ethics Committee (FREC) prior to its initiation. Results: Most of the data was collected from Maltese citizens of a healthy weight, or who were in the overweight BMI category. Results for the DCE choice tasks showed that educational level had minimal effect on healthy food product choices, and that healthy weight individuals were more likely to give more value to food product healthiness over price. A link was also established between female respondents and price-driven choices. Discussion and conclusions: The analysis revealed further complexities with certain food products, which was most prominent during the analysis and results presentation of the second choice task in the DCE tool (whole/ skimmed milk), where anomalous results were a consequence an interplay of attributes that went beyond healthiness and price. This could have also indicated that other underlying social and contextual factors might have been affecting food choices, clearly impacting the respondents’ decision-making processes. One of the most significant links that were established in this study revealed how female participants were more price-conscious when making food choices over male participants. From the multivariate analysis of food attributes’ importance to respondents, most sociodemographic characteristics transpired to have significant importance, however educational level was never significant. Description: M.Sc.(Melit.) 2024-01-01T00:00:00Z