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  1. Fulltext The Impact of the Ecosystem on Health Literacy Among Rural Communities in Protected Areas: Protocol for a Mixed Methods Study
    Abd Kadir NA, Azzeri A, Jaafar H, Mohd Noor MI, Kefeli Z
    JMIR Res Protoc, 2024 Jan 29;13:e51851.
    PMID: 38285500 DOI: 10.2196/51851
    BACKGROUND: Protected areas are crucial for the maintenance of human health and well-being. They aim to preserve biodiversity and natural resources to secure various ecosystem services that are beneficial to human health. Their ecological characteristics can influence local health literacy. Typically, communities surrounding protected areas have limited economic opportunities due to restriction policies to protect the ecosystem, resulting in socioeconomic disparities. The local community faces obstacles in gaining access to health care facilities and health information due to these limitations. It is difficult for them to locate, comprehend, and apply information and services to make better health-related decisions for themselves and others.

    OBJECTIVE: This study protocol examines the impact of the ecosystem on health literacy among rural communities in protected areas.

    METHODS: This study comprises 5 phases. In phase 1, we conduct a systematic review to identify the issue of health literacy in protected areas. In phase 2, we will collect data from stakeholders in a protected area of Pahang National Park and analyze the results using Net-Map analysis. In phase 3, we will conduct a survey among the adult community in Pahang National Park related to health literacy, socioeconomic status, health expenditure, and quality of life. In phase 4, informed by the results of the survey, we will determine suitable intervention programs to improve health literacy through a focus group discussion. Finally, in phase 5, we will conduct a costing analysis to analyze which intervention program is the most cost-effective.

    RESULTS: This study was funded by Universiti Sains Islam Malaysia (USIM) and strategic research partnership grants, and enrollment is ongoing. The first results are expected to be submitted for publication in 2024.

    CONCLUSIONS: This is one of the first studies to explore health literacy among rural communities in protected areas and will provide the first insights into the overall level of health literacy in the protected community, potential determinants, and a suitable intervention program with expected cost analysis. The results can be used to promote health literacy in other protected areas and populations.

    TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number Registry ISRCTN40626062; http://tinyurl.com/4kjxuwk5.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51851.

  2. Fulltext Health literacy status among community in the protected area: A protocol for systematic review and meta-analysis
    Abd Kadir NA, Azzeri A, Mohd Noor MI, Kefeli Z, Abdullah MF, Ramlee MNA, et al.
    Medicine (Baltimore), 2023 Apr 25;102(17):e33590.
    PMID: 37115076 DOI: 10.1097/MD.0000000000033590
    BACKGROUND: Adequate health literacy is necessary for individuals as it enables them to readily acquire information, process it, and apply it to health-related decisions. Various factors including geographical area will determine the disparity in health literacy status. Communities living in protected areas have limited health literacy and health status owing to a lack of access to infrastructure and medical facilities. Existing studies have discussed health literacy among various populations disproportionately affected by certain diseases. However, research remains underdeveloped, and the causal factors are largely untested. This research aims to better understand how population living conditions especially those who are living in protected areas are affected and exposed to limited health literacy.

    METHOD: This study will comprehensively review full-text papers published between 2013 and 2023. We will search 3 databases, PubMed, SCOPUS, and Web of Science, using the keyword search strategy to find articles related to the issue. Preferred Reporting Items for Systematic Reviews and Meta-Analyses will be used to guide the selection of relevant studies. The results will then be assessed using the standard Cochrane Quality assessment method. The outcome is addressed in light of a narrative synthesis that utilizes a theme category and focuses on each component's main conclusions.

    RESULT: This protocol describes the planned scope and methodology for the systematic review and meta-analysis that will provide current evidence on; The status of health literacy among the community in protected areas and; The effect of Protected Areas on health literacy according to their types and characteristics.

    CONCLUSION: Meta-analysis of low-to-high health literacy status will benefit the development of policy recommendations for protected areas.

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