Health

1. Dr. ABM Alauddin Chowdhury
Ph.D. (Global Health & Epidemiology, Hokkaido University Graduate School of Medicine, JAPAN)
Associate Professor & Head
Department of Public Health
Lecture 5: How to write research Prposal

2. Learning Outcomes
Steps of research proposal
Learning from the ‘Sample’ Proposal
Interested some topics for conducting research
Assignment
Presentation

3. Some Topics for conducting research
 Prevalence and Predictors of Depression, Anxiety, and Stress among Youth at the
Time of COVID-19
 Prevalence and Predictors of Depression, Anxiety, and Stress among elderly people
at the Time of COVID-19
 Prevalence and Predictors of Depression, Anxiety, and Stress among healthcare
workers at the Time of COVID-19
 Prevalence and Predictors of Depression, Anxiety, and Stress among university
students at the Time of COVID-19
https://www.hindawi.com/journals/drt/2020/8887727/

4. Some Topics for conducting research
 Female genital cutting in Somalia: a mixed-methods study
 Childhood Illness Prevalence and Health Seeking Behavior Patterns in Rural/
urban Syria/ Ethiopia
 Mother’s Illness Prevalence and Health Seeking Behavior Patterns in Rural Syria
https://bmjopen.bmj.com/content/9/4/e025078
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4581421/

5. Some Topics for conducting research
 Dietary behavior among the elderly people
 Cancer symptom experience and help seeking behaviour during the COVID-19
pandemic in the UK: a crosssectional population survey
https://bmjopen.bmj.com/content/bmjopen/11/9/e053095.full.pdf

6. Psychosocial Stressors and Level of Depression
among Elderly Tobacco Users Living in Urban
Slum Areas of Bangladesh: A Mixed Method
Study
Name :
Student, Department of Public Health
Daffodil International University

7. Presentation Outline
 Rationale of the study
 Objective of the study
 Study area
 Methodology
 Strength of the research team
 Expected policy implication

8. Rationale of the study
Globally, tobacco use causes nearly 7 million deaths per year.
(WHO 2011) and Bangladesh is one of the top ten countries in
the world with high tobacco use. (GATS 2009). Elderly people
(55–64 years) are more likely to smoke than younger people
(aged 25–34 years). (Nusrat et al 2017).
Evidence shows, depression and psychosocial stressors include
acute negative life events or chronic strains have been
implicated as risk factors for tobacco use. (Slopen N et al 2012)
About one-third of the urban populations in Bangladesh are
slum dwellers. (CUS 2005) The elderly people living in the slums
are in risky health behaviors due to anxiety and depression for
poor living conditions, social inferiority, less family support,

9. Rationale of the study cont’d.
 In earlier studies conducted in different parts of the world
addressed psychosocial stressors and depression are
significant risk factor for tobacco use among older adults in
United States (Natalie Slopen et at 2012), and Australia .(Pasco, J et
al 2008).
 We also found some studies carried out in Bangladesh that
explored the prevalence of tobacco smoking among young
slum dwellers (Kabir MA et al 2013) and another study found
the prevalence and pattern of tobacco use among adults
(Nigar Nargis et al 2015).
 So far as reviewed, we found no study which could address
psychosocial stressors and depression in relation with
tobacco use among elderly people in slum areas of
Bangladesh.

10. Objective of the study
General Objective
To assess the psychosocial stressors and level of depression among
elderly tobacco users living in urban slum areas of Bangladesh.
Specific objectives
 To determine the pattern of tobacco use among the elderly
population living in urban slum areas of Bangladesh.
 To assess the psychosocial stressors associated with tobacco use
among elderly urban slum dwellers in Bangladesh.
 To scale up the level of depression among elderly tobacco users in
urban slum areas of Bangladesh.
 To recommend tailor intervention to reduce the psychosocial
stressors and depression among elderly tobacco users.

11. Study area
 The study will be conducted in urban slum areas of Dhaka
Metropolitan City.
 For geographical representation of whole Dhaka City the
sample slum areas will be selected from both Dhaka North
City Corporation (DNCC) and Dhaka South City
Corporation (DSCC).
 We have selected following slums as study areas: Kollyanpur
slum, Karail basti, Zakir Hossain road- town hall camp,
Abdullahpur railgate from DNCC and Nubur, Wireless gate,
Monsur bil (Namapara), Hindu Mohollah from DSCC by
using multi-stage sampling strategy.

12. Methodology

13. Study Design and Type:
 As this study will adopt a mixed method approach. We will
follow both quantitative and qualitative methods.
 We will use a cross sectional survey to gather quantitative
data and 8 Focus Group Discussions (FGD’s) to obtain
qualitative data. Finally, we will integrate both data to draw
the inferences .
Study population:
 Study population will be the elderly tobacco users (both
male and female) aged 50 years and above living in the
urban slums of Dhaka Metropolitan City.

14. Selection criteria:
Inclusion criteria
 Elderly people both male and female living in urban slum
areas age 50 years and above.
 Persons living in the selected slums for at least 6 months.
Exclusion Criteria
 The critically ill or bed-ridden and mentally challenged
individuals.

15. Sample size:
Sample will be calculated by following formula -
n=z2pq/d2
Where,
n= desired sample size
z = 1.96 (95% confidence interval)
p = Prevalence of smoking cigarettes (53.3%). (Prevalence and
correlates of smoking among urban adult men in Bangladesh: slum versus
non-slum comparison, Md Mobarak Hossain Khan, Aklimunnessa Khan,
Alexander Kraemer, Mitsuru Mori, BMC Public Health. 2009; 9:
149. Published online 2009 May 22. doi: 10.1186/1471-2458-9-149.)
= 0.533
q = 1-p = 1-0.533= 0.467
d = 5 %
So,
n = (1.96)2 (0.533X0.467)/ (0.05)2
=384

16. Dhaka South
City Corporation
Dhaka North
City Corporation
Banani
Mirpur Mohammadpur Dakkshinkhan
Jatrabari Ramna Kadamtali
Kollyanpur
slum
Karail
basti
Zakir Hossain
road
town hall camp
Abdullahpur
railgate
Nubur Wireless
gate
Monsur bil
(Namapara
)
1
ST
Stage
of
Sampling
2
nd
Stage
of
Sampling
Figure -1: Multistage sampling strategy
Hazaribag
Hindu
Mohollah
Dhaka Metropolitan
City
Sampling strategy

17. Dependent
Variable
(Tobacco
Consumption)
Socio-demographic Variables:
Age, Sex, Family type, Family Size, Education
level, Occupation, Monthly household income,
Spouse, Duration of living in the slum
Pattern of Tobacco Use:
Type of tobacco product, Number of use, Duration
of use, Intention to quit tobacco using, Reason for
no intention to quit.
Psychosocial stressors:
Natural disaster, Overcrowding, Stigma and
discrimination,
Unemployment, Disease, Verbal/physical abuse,
Marital/spousal conflict, Poverty.
Depression:
Depressive symptoms will be measured by widely
used 20 items in CES-D scale.
Independent
Variables
Conceptual Framework

18. Study Instruments:
A semi-structured questionnaire will be used for collecting
quantitative data.
FGDs will be conducted using FGDs guideline for qualitative
data collection.
 PI and Mentor of the study will play pivotal role in
developing study instruments that will be severally checked
by other team members and finalized after pretesting.

19. Data collection
 The quantitative and qualitative information collecting
work will be conducted by developing a team comprised of
6 Interviewers (3 Males & 3 Females) and 1 field Supervisor.
Field supervisor will be responsible for day-to-day
information collection, quality control of the regular
fieldwork, and conduct FGDs as well with the direction of
Principal Investigator (PI) and Mentor of the study.
 Before starting the data collection, interviewers will brief
the respondents about the objectives of the study in short
to make them mentally ready about the specific question.
 Before interview, an informed written consent will be
signed from the respondents and this written consent will
ensure not to disclose respondents’ personal information.

20. Quality control:
All the Field Data Collector and Supervisor of the study will
be trained intensively on the data collections tools and
techniques.
Before going to actual study, the Bengali version of the
questionnaire will be pre-tested in non-sampled
participants in the slum to get feedback on the suitability,
appropriateness and sequencing of the questions.
 All the collected data from interview will be coded. Then
the raw data will be checked for errors before input in
SPSS.

21. Data processing and analysis:
Quantitative
 All the collected data from interview will be rechecked and
then coded for errors and entered into the database using
SPSS software.
 We will use statistical tests like χ2 test, and bivariate and
multivariate (adjusted) logistic regression for quantitative
data analysis.
Qualitative
 We will code qualitative information separately.
 After coding, we will translate those data into English and
will perform thematic content analysis using considerable
diversity to provide descriptive results.
 Although the FGDs will be analyzed separately, inferences
will be drawn collectively from the results.

22. Ethical consideration
The study team will first meet the community leader in
slums , and explain the study objectives and will take their
oral consent to collect information regarding the study
topic.
To comply with all possible ethical issues, we will confirm
the participants that their participation will be sheer
private, voluntary, and can be terminated at any time
without reason and without any penalty.
An informed written consent will be taken from the
participants. While entering each household, we will gather
consent of participation from the household head as well.
This study protocol will be submitted to the BMRC for
ethical approval.
22

23. Strength of the research team
SI No Name of the Post No. of the Post
1. Principal Investigator
(Researcher)
1
2. Co- Researcher 1
3. Supervisor/Mentor 1
4. Field Supervisor 1
5. Field Data Collector 6
6. Data entry operator & Data
Analyst
2

24. Expected policy implication
 Findings regarding stressors among the urban slum elderly
people may suggest the role of family members, and the
role of slum-wise voluntary organizations.
 Knowing the extent of depression and other risky
behaviors, this study can recommend rationale of
counseling services and tailored intervention for elderly
people in slum areas.
 This finding may also be helpful in developing New BCC
materials, or it can be shared among health care experts to
initiate new policies to improve the mental health status
among elderly people in low –socio economic people.

26. Thank You So Much for Your Attention