I am a PhD (Society & Culture) Candidate at James Cook University, Singapore Campus. I am currently investigating the resilience of same-sex couples against socio-political stressors in Singapore. As a social scientist, I draw from the disciplines of psychology and sociology. My research interests include qualitative methods, coping and resilience, romantic relationships, gender & sexuality, and critical approaches to health and illness. I have extensive research experience in utilising qualitative methods to understand the lived experiences of and improve the services for healthcare workers, patients, and the LGBTQIA+ community. Supervisors: Dr Joanna Barlas, Dr Patrick Lin, and Prof Nigel Marsh
Upper Respiratory Tract Infections (URTIs) account for a substantial proportion of attendances at... more Upper Respiratory Tract Infections (URTIs) account for a substantial proportion of attendances at emergency departments. Although the majority are due to viruses, about one-quarter of URTI patients were inappropriately prescribed antibiotics at emergency departments. It is therefore imperative to understand factors influencing prescribing decisions, in order to develop effective interventions to reduce inappropriate antibiotic use. In-depth interviews were conducted using a semi-structured interview guide on purposively sampled junior physicians working at the emergency department in a 1600-bed adult acute-care general hospital in Singapore. In addition to questions regarding the clinical management of URTI cases, physicians were asked about the antibiotic prescribing practices at the emergency department. Responses were transcribed in verbatim and analysed using thematic analysis. Data saturation was reached with nine physicians. Using the Social Ecological Model, the physician’s d...
American journal of infection control, Jan 6, 2017
Good hand hygiene (HH) prevents health care-associated infections. We compared psychosocial and o... more Good hand hygiene (HH) prevents health care-associated infections. We compared psychosocial and organizational factors associated with HH compliance and perceived need for improvement among physicians, nurses, and allied health professionals (AHPs). We conducted a mixed-methods study in a 1,600-bed adult tertiary-care hospital in Singapore. Seven focus group discussions were conducted and data were analyzed using thematic analysis. The subsequent cross-sectional survey involved 1,064 staff members. Principal components analysis was performed to derive the latent factor structure that was applied in multivariable analyses. All staff members acknowledged that HH was an integral part of their work, but were noncompliant due to competing priorities. Physicians were forgetful but appreciated reminders. Nurses were intrinsically motivated for HH. After adjusting for gender, staff category, seniority, and dermatitis history, having positive knowledge-attitudes-behaviors (odds ratio [OR], 1...
ObjectivesThis study draws on qualitative insights on the barriers and facilitators to HIV testin... more ObjectivesThis study draws on qualitative insights on the barriers and facilitators to HIV testing, as well as perceptions of HIV self-testing (HIVST), to propose a framework to understand not only the benefits but also potential knock-on implications of introducing HIVST in the context of other STI testing.MethodsWe conducted semistructured, in-depth interviews with 30 gay, bisexual and other men who have sex with men aged 18 and 39 years old in Singapore. Interview topics included barriers and facilitators to HIV and other STI testing, as well as perceptions of HIVST. Interviews were audio-recorded, transcribed, coded and analysed using thematic analysis.ResultsFor HIV testing, participants cited the perceived risk of acquiring, susceptibility to and symptoms of HIV as internal motivators, while social influence and accessibility of HIV testing services were external motivators. For STI testing, perceived symptoms and partner notification of STI were reported as internal and exter...
Background Singapore’s healthcare system presents an ideal context to learn from diverse public a... more Background Singapore’s healthcare system presents an ideal context to learn from diverse public and private operational models and funding systems. Aim To explore processes underpinning decision-making for antibiotic prescribing, by considering doctors’ experiences in different primary care settings. Methods Thirty semi-structured interviews were conducted with 17 doctors working in publicly funded primary care clinics (polyclinics) and 13 general practitioners (GP) working in private practices (solo, small and large). Data were analysed using applied thematic analysis following realist principles, synthesised into a theoretical model, informing solutions to appropriate antibiotic prescribing. Results Given Singapore’s lack of national guidelines for antibiotic prescribing in primary care, practices are currently non-standardised. Themes contributing to optimal prescribing related first and foremost to personal valuing of reduction in antimicrobial resistance (AMR) which was enabled...
The International journal on drug policy, Jan 26, 2018
Sexualised substance use, or 'chemsex' has been shown to be a major factor driving the sy... more Sexualised substance use, or 'chemsex' has been shown to be a major factor driving the syndemic of HIV/AIDS in communities of gay, bisexual, and other men who have sex with men (GBMSM) around the world. However, there is a paucity of research on chemsex among GBMSM in Singapore due to punitive drug laws and the criminalisation of sexual behaviour between men. This qualitative descriptive study is the first to explore perceptions towards, motivators to engaging in, and the barriers to addressing the harms associated with chemsex among GBMSM in Singapore. We conducted 30 semi-structured in-depth interviews with self-identifying GBMSM between the ages of 18-39 in Singapore following a purposive sampling strategy. Interview topics included participants' perceptions of drug use among GBMSM in Singapore, perceptions towards chemsex, reasons for drug use and chemsex, and recommendations to address the harms associated with chemsex in Singapore. Interviews were audio-recorded, t...
Adult influenza and pneumococcal vaccination rates in Singapore are low, and factors influencing ... more Adult influenza and pneumococcal vaccination rates in Singapore are low, and factors influencing knowledge and attitudes of seniors towards influenza, pneumonia and their respective vaccines are not well-known. Our study aims to understand the barriers and facilitators towards getting influenza and pneumococcal vaccinations among seniors in Singapore, and subsequently inform the conduct of a relevant community-based educational intervention, as well as evaluate the intervention outcomes. We performed a mixed methods study with two components: Firstly, formative research was conducted among community-dwelling seniors, using focus group discussions (FGDs), to understand their knowledge and attitudes towards influenza, pneumonia and their respective vaccines. Next, a quantitative study was conducted to evaluate knowledge of seniors and the effectiveness of an educational intervention. Four FGDs were organised with 32 participants, who were predominantly female, of lower educational bac...
Background: Singapore’s healthcare system allows both antibiotic prescribing and dispensing acros... more Background: Singapore’s healthcare system allows both antibiotic prescribing and dispensing across public and private primary care settings, presenting an ideal context to learn from systems where dispensing is closely tied to diverse operational models and funding mechanisms. Aim: To explore processes underpinning decision-making for antibiotic prescribing by primary care doctors in Singapore, by examining doctors’ experiences in different primary care settings. Methods: Thirty semi-structured interviews were conducted with 17 doctors working in publicly funded primary care clinics (polyclinics) and 13 doctors working in private general practitioner (GP) clinics (solo, small group and large group practices). Interviews were audio-recorded and transcribed verbatim. Data were analysed using applied thematic analysis. Results: Given the lack of National Guidelines for antibiotic prescribing in the Singapore context, this practice is currently non-standardised in both private and publi...
Inappropriate antibiotics use and antimicrobial resistance (AMR) are increasingly becoming global... more Inappropriate antibiotics use and antimicrobial resistance (AMR) are increasingly becoming global health issues of great concern. Despite the established antibiotic stewardship programs (ASP) in many countries, limited efforts have been made to engage nurses and clearly define their roles in ASPs. An exploratory qualitative study was conducted to understand the facilitators and barriers that impact nurses' involvement and empowerment in antibiotic stewardship. Focus group discussions (FGDs) were conducted with purposively sampled nurses from three major public hospitals in Singapore. FGDs were audio-recorded and transcribed verbatim. Data were analysed using Applied Thematic Analysis and interpreted using the Social Ecological Model. At the intrapersonal level, nurses felt empowered in carrying out their roles in antibiotic administration. They saw themselves as gatekeepers to ensure that the prescribed antibiotics were administered appropriately. However, nurses felt they lacke...
Background Singapore’s healthcare system presents an ideal context to learn from diverse public a... more Background Singapore’s healthcare system presents an ideal context to learn from diverse public and private operational models and funding systems. Aim To explore processes underpinning decision-making for antibiotic prescribing, by considering doctors’ experiences in different primary care settings. Methods Thirty semi-structured interviews were conducted with 17 doctors working in publicly funded primary care clinics (polyclinics) and 13 general practitioners (GP) working in private practices (solo, small and large). Data were analysed using applied thematic analysis following realist principles, synthesised into a theoretical model, informing solutions to appropriate antibiotic prescribing. Results Given Singapore’s lack of national guidelines for antibiotic prescribing in primary care, practices are currently non-standardised. Themes contributing to optimal prescribing related first and foremost to personal valuing of reduction in antimicrobial resistance (AMR) which was enabled...
Objectives This study draws on qualitative insights on the barriers and facilitators to HIV testi... more Objectives This study draws on qualitative insights on the barriers and facilitators to HIV testing, as well as perceptions of HIV self-testing (HIVST), to propose a framework to understand not only the benefits but also potential knock-on implications of introducing HIVST in the context of other STI testing. Methods We conducted semistructured, in-depth interviews with 30 gay, bisexual and other men who have sex with men aged 18 and 39 years old in Singapore. Interview topics included barriers and facilitators to HIV and other STI testing, as well as perceptions of HIVST. Interviews were audio-recorded, transcribed, coded and analysed using thematic analysis. Results For HIV testing, participants cited the perceived risk of acquiring, susceptibility to and symptoms of HIV as internal motivators, while social influence and accessibility of HIV testing services were external motivators. For STI testing, perceived symptoms and partner notification of STI were reported as internal and ...
Despite evolving social and political attitudes, many countries, including Singapore, still do no... more Despite evolving social and political attitudes, many countries, including Singapore, still do not recognize couples in same-sex relationships. Much remains to be understood about the processes and strategies that help these couples maintain their relationships, especially in Asian societies. This study explored the ways in which gay men in intimate relationships safeguarded their relationships and remained resilient in Singapore. Semi-structured interviews were conducted with nine gay men in long-term relationships. The data were analyzed using interpretive phenomenological analysis. The analysis generated three superordinate themes, a) Making do with things we cannot change, b) Remaining resilient through social and financial capital, and c) Our love is stronger than the challenges we face. The emergent themes pointed to the ways in which participants coped with or shielded themselves against socio-political stressors that negatively impacted their relationships in the Singapore c...
Upper Respiratory Tract Infections (URTIs) account for a substantial proportion of attendances at... more Upper Respiratory Tract Infections (URTIs) account for a substantial proportion of attendances at emergency departments. Although the majority are due to viruses, about one-quarter of URTI patients were inappropriately prescribed antibiotics at emergency departments. It is therefore imperative to understand factors influencing prescribing decisions, in order to develop effective interventions to reduce inappropriate antibiotic use. In-depth interviews were conducted using a semi-structured interview guide on purposively sampled junior physicians working at the emergency department in a 1600-bed adult acute-care general hospital in Singapore. In addition to questions regarding the clinical management of URTI cases, physicians were asked about the antibiotic prescribing practices at the emergency department. Responses were transcribed in verbatim and analysed using thematic analysis. Data saturation was reached with nine physicians. Using the Social Ecological Model, the physician’s d...
American journal of infection control, Jan 6, 2017
Good hand hygiene (HH) prevents health care-associated infections. We compared psychosocial and o... more Good hand hygiene (HH) prevents health care-associated infections. We compared psychosocial and organizational factors associated with HH compliance and perceived need for improvement among physicians, nurses, and allied health professionals (AHPs). We conducted a mixed-methods study in a 1,600-bed adult tertiary-care hospital in Singapore. Seven focus group discussions were conducted and data were analyzed using thematic analysis. The subsequent cross-sectional survey involved 1,064 staff members. Principal components analysis was performed to derive the latent factor structure that was applied in multivariable analyses. All staff members acknowledged that HH was an integral part of their work, but were noncompliant due to competing priorities. Physicians were forgetful but appreciated reminders. Nurses were intrinsically motivated for HH. After adjusting for gender, staff category, seniority, and dermatitis history, having positive knowledge-attitudes-behaviors (odds ratio [OR], 1...
ObjectivesThis study draws on qualitative insights on the barriers and facilitators to HIV testin... more ObjectivesThis study draws on qualitative insights on the barriers and facilitators to HIV testing, as well as perceptions of HIV self-testing (HIVST), to propose a framework to understand not only the benefits but also potential knock-on implications of introducing HIVST in the context of other STI testing.MethodsWe conducted semistructured, in-depth interviews with 30 gay, bisexual and other men who have sex with men aged 18 and 39 years old in Singapore. Interview topics included barriers and facilitators to HIV and other STI testing, as well as perceptions of HIVST. Interviews were audio-recorded, transcribed, coded and analysed using thematic analysis.ResultsFor HIV testing, participants cited the perceived risk of acquiring, susceptibility to and symptoms of HIV as internal motivators, while social influence and accessibility of HIV testing services were external motivators. For STI testing, perceived symptoms and partner notification of STI were reported as internal and exter...
Background Singapore’s healthcare system presents an ideal context to learn from diverse public a... more Background Singapore’s healthcare system presents an ideal context to learn from diverse public and private operational models and funding systems. Aim To explore processes underpinning decision-making for antibiotic prescribing, by considering doctors’ experiences in different primary care settings. Methods Thirty semi-structured interviews were conducted with 17 doctors working in publicly funded primary care clinics (polyclinics) and 13 general practitioners (GP) working in private practices (solo, small and large). Data were analysed using applied thematic analysis following realist principles, synthesised into a theoretical model, informing solutions to appropriate antibiotic prescribing. Results Given Singapore’s lack of national guidelines for antibiotic prescribing in primary care, practices are currently non-standardised. Themes contributing to optimal prescribing related first and foremost to personal valuing of reduction in antimicrobial resistance (AMR) which was enabled...
The International journal on drug policy, Jan 26, 2018
Sexualised substance use, or 'chemsex' has been shown to be a major factor driving the sy... more Sexualised substance use, or 'chemsex' has been shown to be a major factor driving the syndemic of HIV/AIDS in communities of gay, bisexual, and other men who have sex with men (GBMSM) around the world. However, there is a paucity of research on chemsex among GBMSM in Singapore due to punitive drug laws and the criminalisation of sexual behaviour between men. This qualitative descriptive study is the first to explore perceptions towards, motivators to engaging in, and the barriers to addressing the harms associated with chemsex among GBMSM in Singapore. We conducted 30 semi-structured in-depth interviews with self-identifying GBMSM between the ages of 18-39 in Singapore following a purposive sampling strategy. Interview topics included participants' perceptions of drug use among GBMSM in Singapore, perceptions towards chemsex, reasons for drug use and chemsex, and recommendations to address the harms associated with chemsex in Singapore. Interviews were audio-recorded, t...
Adult influenza and pneumococcal vaccination rates in Singapore are low, and factors influencing ... more Adult influenza and pneumococcal vaccination rates in Singapore are low, and factors influencing knowledge and attitudes of seniors towards influenza, pneumonia and their respective vaccines are not well-known. Our study aims to understand the barriers and facilitators towards getting influenza and pneumococcal vaccinations among seniors in Singapore, and subsequently inform the conduct of a relevant community-based educational intervention, as well as evaluate the intervention outcomes. We performed a mixed methods study with two components: Firstly, formative research was conducted among community-dwelling seniors, using focus group discussions (FGDs), to understand their knowledge and attitudes towards influenza, pneumonia and their respective vaccines. Next, a quantitative study was conducted to evaluate knowledge of seniors and the effectiveness of an educational intervention. Four FGDs were organised with 32 participants, who were predominantly female, of lower educational bac...
Background: Singapore’s healthcare system allows both antibiotic prescribing and dispensing acros... more Background: Singapore’s healthcare system allows both antibiotic prescribing and dispensing across public and private primary care settings, presenting an ideal context to learn from systems where dispensing is closely tied to diverse operational models and funding mechanisms. Aim: To explore processes underpinning decision-making for antibiotic prescribing by primary care doctors in Singapore, by examining doctors’ experiences in different primary care settings. Methods: Thirty semi-structured interviews were conducted with 17 doctors working in publicly funded primary care clinics (polyclinics) and 13 doctors working in private general practitioner (GP) clinics (solo, small group and large group practices). Interviews were audio-recorded and transcribed verbatim. Data were analysed using applied thematic analysis. Results: Given the lack of National Guidelines for antibiotic prescribing in the Singapore context, this practice is currently non-standardised in both private and publi...
Inappropriate antibiotics use and antimicrobial resistance (AMR) are increasingly becoming global... more Inappropriate antibiotics use and antimicrobial resistance (AMR) are increasingly becoming global health issues of great concern. Despite the established antibiotic stewardship programs (ASP) in many countries, limited efforts have been made to engage nurses and clearly define their roles in ASPs. An exploratory qualitative study was conducted to understand the facilitators and barriers that impact nurses' involvement and empowerment in antibiotic stewardship. Focus group discussions (FGDs) were conducted with purposively sampled nurses from three major public hospitals in Singapore. FGDs were audio-recorded and transcribed verbatim. Data were analysed using Applied Thematic Analysis and interpreted using the Social Ecological Model. At the intrapersonal level, nurses felt empowered in carrying out their roles in antibiotic administration. They saw themselves as gatekeepers to ensure that the prescribed antibiotics were administered appropriately. However, nurses felt they lacke...
Background Singapore’s healthcare system presents an ideal context to learn from diverse public a... more Background Singapore’s healthcare system presents an ideal context to learn from diverse public and private operational models and funding systems. Aim To explore processes underpinning decision-making for antibiotic prescribing, by considering doctors’ experiences in different primary care settings. Methods Thirty semi-structured interviews were conducted with 17 doctors working in publicly funded primary care clinics (polyclinics) and 13 general practitioners (GP) working in private practices (solo, small and large). Data were analysed using applied thematic analysis following realist principles, synthesised into a theoretical model, informing solutions to appropriate antibiotic prescribing. Results Given Singapore’s lack of national guidelines for antibiotic prescribing in primary care, practices are currently non-standardised. Themes contributing to optimal prescribing related first and foremost to personal valuing of reduction in antimicrobial resistance (AMR) which was enabled...
Objectives This study draws on qualitative insights on the barriers and facilitators to HIV testi... more Objectives This study draws on qualitative insights on the barriers and facilitators to HIV testing, as well as perceptions of HIV self-testing (HIVST), to propose a framework to understand not only the benefits but also potential knock-on implications of introducing HIVST in the context of other STI testing. Methods We conducted semistructured, in-depth interviews with 30 gay, bisexual and other men who have sex with men aged 18 and 39 years old in Singapore. Interview topics included barriers and facilitators to HIV and other STI testing, as well as perceptions of HIVST. Interviews were audio-recorded, transcribed, coded and analysed using thematic analysis. Results For HIV testing, participants cited the perceived risk of acquiring, susceptibility to and symptoms of HIV as internal motivators, while social influence and accessibility of HIV testing services were external motivators. For STI testing, perceived symptoms and partner notification of STI were reported as internal and ...
Despite evolving social and political attitudes, many countries, including Singapore, still do no... more Despite evolving social and political attitudes, many countries, including Singapore, still do not recognize couples in same-sex relationships. Much remains to be understood about the processes and strategies that help these couples maintain their relationships, especially in Asian societies. This study explored the ways in which gay men in intimate relationships safeguarded their relationships and remained resilient in Singapore. Semi-structured interviews were conducted with nine gay men in long-term relationships. The data were analyzed using interpretive phenomenological analysis. The analysis generated three superordinate themes, a) Making do with things we cannot change, b) Remaining resilient through social and financial capital, and c) Our love is stronger than the challenges we face. The emergent themes pointed to the ways in which participants coped with or shielded themselves against socio-political stressors that negatively impacted their relationships in the Singapore c...
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Papers by Muhamad Alif Bin Ibrahim