Chapter 3

RESEARCH METHODOLOGY

This chapter discourses about the methodology and procedure used

in this study. It discusses research design, research setting, respondents and

sampling procedure, research instrument, scoring procedure, data

gathering procedure, and statistical tools.

Research Design

According to Polit and Beck (2012), a descriptive design aims to

describe the nature of conditions as they exist at the time of study. It

describes the characteristics of individuals, groups, physical environments,

and conditions. It also has a high degree of representativeness and is used

when very little is known about a topic or to explore a research question. A

descriptive design will be utilized to conduct this study. The extent of

effectiveness of the health promotion activities implemented in Sitio Patpat,

Lumbia by student nurses of Xavier University College of Nursing had not

been studied before. Hence, through the use of descriptive research, this

will enable the investigators to delve more to areas concerning this topic.

In a descriptive research design, the research variables used in this

study will be examined as they exist without interventions from the

investigators. It will enable the researchers to test for significant differences

among independent and dependent variables of this study. Furthermore, it

 36

will also help the researchers to acquire their main objective, which is to

determine the extent of effectiveness of the health promotion activities

implemented in Sitio Patpat, Lumbia. In this study, the following variables

that will be examined are: age, economic status, educational attainment,

family structure, gender, social participation, and sources of information.

These variables will be explored and analyzed to determine their

relationship and influence to the extent of effectiveness of the health

promotional activities implemented in Sitio Patpat, Lumbia.

Research Setting

This study will be conducted in Sitio Patpat, Barangay Lumbia,

Cagayan de Oro City and will only encompass this area. Sitio Patpat in

Barangay Lumbia has been affiliated with Xavier University Ateneo de

Cagayan particularly the College of Nursing for five years. Community

health nursing is an area of nursing that utilizes public health practice to

promote and protect the health of the population. It enhances the

capacity of individuals, families and communities to cope with their health

needs. Under this is rural health nursing which has the main focus to promote

and establish a progressive and healthy people in the community and one

of the areas where health promotion activities are facilitated and

implemented by the College of Nursing is the Sitio Patpat, Barangay

Lumbia. The area is divided into two, the Upper Patpat and the Lower 36
 37

Patpat or Cebuano. The area has a 1,200 total number of population and

231 total number of households as of 2016. The houses are primarily

congested and the place is remotely located from the city with an

approximate distance of 30km from Xavier University Ateneo de

Cagayan. The area is a sitio that lacks access to health institutions due to

its location and problems with land transportation. Problems like access to

water, waste management, and drainage system are also common. The

place also serves as one of the chief producers of cashew nuts in the city,

henceforth, the primary livelihood in the area is the selling of cashew nuts

in sacks. The residents in the area are fond of using herbal plants for

treatment and some grow herbal plants in their own backyards. The area is

crammed with plants everywhere and not all residents have their own

power and water supply. Lastly, the road going to Sitio Patpat is not

developed and also tends to be impassable during the rainy season.

Respondents and Sampling Procedure

The respondents of the study will be 231 households of Sitio Patpat,

Barangay Lumbia, Cagayan de Oro City. The inclusion criteria for selecting

the respondents will include a representative from each household who is

a permanent resident of the sitio, aged 18 60 years old, and who have

attended or participated on at least one of any of the programs

implemented by Xavier University College of Nursing. These criteria are

 38

selected so as to attain the desire of fully assessing the programs or activities

implemented. In order to fulfill the designated number of respondents, data

gathering is proposed to be conducted on May 2017.

The sampling method that will be used in the study is purposive or

judgmental sampling. This is for the reason that there are certain criteria to

be considered for the respondents included in the study. Questionnaires will

be formulated and given to target samples until the designated number of

household will be reached.

Purposive sampling technique is suitable when certain considerations

or factors will be laid down such as selecting of a particular item or when

making decisions in cases of incomplete responses or observations (Altares,

et al., 2012). In addition, to select the desired respondents, the researchers

will employ their knowledge about the population and will determine who

are those typical of the population or who are those learned about the

specific topic under inquiry (Polit and Beck, 2012). These are true in the case

of the research setting, Sitio Patpat. There were different programs

implemented in the upper and lower areas of the sitio and not all of the

residents were participative or were able to participate in the programs.

Thus, in order to eliminate the bias of feedbacks from residents who were

not able to participate or be aware of any of the programs and to limit the

study only to residents present to any of the activity, a representative from

 39

all the households will be inquired if they were able to take part in at least

one of the activities or programs conducted. Only those who affirmed

participation will be taken account of in this study.

Research Instrument

The instrument to be adopted in this research to address the research

questions will be a researcher-made questionnaire. The questions

formulated were based from the related literatures gathered by the

researchers, which contain similar studies. The questionnaire was designed

to collect information from the respondents. Furthermore, a more

comprehensive version of the instrument to the Cebuano language was

translated by _______ from the Research Institute for Mindanao Culture

(RIMCU). A cover letter will be attached to the questionnaire to explain the

purpose and relevance of this research, and to obtain their consent to

participate in this research. Contact information of the researchers will be

provided in case the respondents have questions. This questionnaire have

four parts.

The first part inquires about the profile of the respondents. The

demographic profile was composed of age, gender, monthly income,

educational attainment, family structure, and primary source of

information. The questions have corresponding choices and the

respondents are to check their desired choice.

 40

The second part of the questionnaire is composed of

declarative statements, which tackle about the health promotion

programs implemented in Sitio Patpat, Lumbia. It includes hygienic

practices, sanitation practices, management of acute and chronic

disease, herbal medicine and maternal and child care. It aims to evaluate

whether the respondents were able to learn from the nursing students and

were able to apply these learnings in their daily lives. In this part, questions

were based from the microteachings that were implemented by the all the

nursing students who entered the community during school years 2015-2016

and 2016-2017.

The questionnaires are proposed to be validated by a public health

nurse, a community health nursing instructor, the community health nursing

coordinator of Xavier University College of Nursing, and the statistician. A

pilot study will be done to 30 respondents, wherein these respondents will

not be included in the research study proper.

The researchers will conduct a pilot testing to 30 respondents in Sitio

Patpat, Lumbia to determine the reliability of the questionnaire. The results

will then be validated by the statistician and the research adviser for further

evaluation.
 41

Scoring Procedures

Mean scores will be used to give the scoring for the answer of the

respondents. The scoring per item depends on the statement.

Scoring is as follows:

3 points for a response of Highly Effective

2 points for a response of Moderately Effective

1 point for a response of Not Effective

Table 1: Description of each extent of the effectiveness of implemented

health promotion activities according to scores.

Qualifiers Extent of Range Description

effectiveness
Highly Excellent 3.68-5.00 Individuals who believe
Effective
that the implementation

of health programs

were highly effective in

improving his/her skill in

health practices and

knowledge.

Moderately Good 2.34-3.67 Individuals who believe

Effective
that the implementation

of health programs
 42

were moderately

effective in improving

his/her skill in health

practices and

knowledge.

Not Effective Poor 1.00-2.33 Individuals who believe

that the implementation

of health programs

were not effective in

improving his/her skill in

health practices and

knowledge.

The scores were then added together to obtain the mean of the

respondents answers on the questionnaire. Interpretation came next. The

interpretation was done per category (utilization and knowledge about

hygienic practices, sanitation practices, management of acute and

chronic diseases, herbal medicine and maternal and child care) that was

based on the assigned verbal interpretation for each class intervals. A score

of 3.68-5 will mean that the implemented health programs has an excellent

impact on the health practices of community members. A score of 1.00-

 43

2.33 on the other hand will imply that the implemented health programs

has no impact on the health behaviors of community members.

Data Gathering Procedure

The researchers will collate data from respondents aged 18 years old

above in Sitio Patpat, Lumbia, Cagayan de Oro City. Prior to the

administration of the instrument, a pilot testing will be done to guarantee its

reliability and validity.

Upon arrival of the researchers in Sitio Patpat, Lumbia, the

researchers will be divided in pairs. The researchers will be tasked to assess

and distribute the questionnaires formulated. Instructions given to the

respondents will be delivered in a fitting language. The researchers will

introduce themselves to the respondents and explain the purpose and

relevance of the study. The informed consent will be present and will be

explained to every respondent. The researchers will also answer all of the

queries of the respondents regarding the tool.

The respondents will be given 10 minutes to answer the questionnaire.

The researchers will stay at the side of the respondents in case they have

questions or have difficulty in understanding the questions presented. To the

respondents who have trouble in reading and understanding, the questions

will be read and recapitulated. The respondents will be guaranteed that

the information obtained from them will be kept confidential and explain
 44

that the results of the survey are vital to the purpose of the study. The

collated questionnaires will be retrieved.

Statistical Tools

Statistical parameters of descriptive and inferential in nature will be

used in the study in order to characterize the contents of the data gathered

and to make inferences on the general population from the null hypothesis

tested. Under descriptive statistics, tools utilized will be frequency

distribution table, measures of central tendency, specifically the mean, and

measures of variability, specifically variance and standard deviation.

Meanwhile, t-test and f-test will be used under inferential statistics.

Frequency distribution table is a method of summarizing collected

data through tabulating or grouping them into appropriate categories

which then reflect the corresponding frequencies of observations from

each category. It contains the class limits, class size, class boundaries, class

marks, cumulative frequency, and percentage (Altares, et al., 2012). In this

study, the frequency distribution table will be used in order to organize the

data gathered into their respective categories. The researchers will utilize

the table in finding differences according to the respondents

demographics such as age, economic status, educational attainment,

family structure, gender, sources of information, and in determining the

most and the least frequent findings from each category. Meanwhile,
 45

percentage was added to the table to determine the relativity of each

data to another. It will be utilized in presenting the differences in proportion

of among independent variables such as age, economic status,

educational attainment, family structure, gender, social participation, and

sources of information. Percentage will be calculated by dividing the total

response in a category to the total number of responses collected from the

sample. The quotient is then multiplied to 100.

On the other hand, measures of central tendency will be used in the

study, specifically the arithmetic mean. The arithmetic mean is the total of

all values of a category divided by the number of respondents included in

the study. The mean is a reliable method of measurement when making

inferences or generalization about a population. According to Altares, et

al. (2012), it is the point which balances all the values on either side. The

mean will be used in this study to determine the average age of the

respondents of the study and the scoring system for the respondents

perception on extent of effectiveness of the programs implemented.

Another tools used in the study will be variance and standard

deviation, which fall under measures of variability. The standard deviation

is calculated through extracting the square root of the sum of the squared

deviations of the mean. Then, it is divided by the number of scores, while

variance is simply the average of the squared deviations. When lesser

 46

values are taken from these measures, greater consistency of the set of

data is implied (Altares, et al. 2012). These tool will be used in the study to

establish to homogeneity of the data gathered or how similar or varied they

are particularly on the second problem where the extent of effectiveness

of the programs implemented are investigated. This will identify on how

similar or varied the results of the extent of effectiveness are with regards to

age, economic status, educational attainment, family structure, gender,

and sources of information.

For inferential statistics, t-test and f-test were utilized. The t-test is used

to determine if there statistical differences between two independent

sample groups. Since the study will consist of samples, the t-test will be used

to find out if there are any significant between the means of both gender

in evaluating the extent of effectiveness of health programs implemented

in their community. This will be used in variables with two possible choices,

specifically the gender groups.

Lastly, the analysis of variance uses an f-test in order to compare the

means when there are three or more groups present in a study. Unlike z-test

or t-test, there is a comparison not only limited to two groups, thus, an

extension of comparison to more groups (Chernick and Friis, 2003). In this

study, the tool will be used in testing the hypothesis based from the findings

where there are three or more choices involved to be compared. These

 47

are age, economic status, educational attainment, family structure, and

sources of information. This will be the tool that will guide the study to

whether reject or accept the null hypothesis. A 0.05 level of significance will

be used to test the hypothesis.

 48

APPENDIX A

Letter Addressed to the Barangay Captain

February 20, 2017

Hon. WILHELM E. VALENCIA

Barangay Captain
Lumbia, Cagayan de Oro City

Dear Sir,

Peace be with you!

We, the 3rd year nursing students of Xavier University Ateneo de Cagayan,
will be conducting a research study entitled, Extent of Effectiveness of the Health
Promotion Activities Implemented in Sitio Patpat, Barangay Lumbia. This research
would involve an impact study that aims to evaluate the health promotion
programs implemented by the College of Nursing in Sitio Patpat. In line with this,
we would like to ask permission from your good office if we could conduct the
study in your barangay. We would also like to ask for demographic data of the
residents of Sitio Patpat, especially the total population of both Upper and Lower
Patpat.
If you have questions or inquiries, please contact this number
(09972494902). Hoping for your positive response.

Sincerely yours,

Stephanie Joy Escala

Group Leader

Noted by:

Mrs. Glenda P. De Vera RN, MAN

Clinical Instructor and Research Adviser
 49

APPENDIX B

Cover Letter

Xavier University Ateneo de Cagayan

College of Nursing

CONSENT TO PARTICIPATE IN RESEARCH

Title of Project: Extent of Effectiveness on Health Promotion Activities Implemented
in Sitio Patpat, Barangay Lumbia, Cagayan de Oro City: Implications
to Health

Principal Investigator: Daniel Nero Casio, Michael Cordenillo, Nabila Dipatuan,

Augie Marie Don, Stephanie Joy Escala, Rigel Kent Flores, Mary
Kristine Gerali, Philip Gabriel Gimotea, Sean Allison Go

Adviser: Mrs. Glenda P. De Vera RN, MAN

You are invited to participate in a research study conducted by Daniel

Casio, Michael Cordenillo, Nabila Dipatuan, Augie Marie Don, Stephanie Joy
Escala, Rigel Kent Flores, Mary Kristen Gerali, Philip Gabriel Gimotea, and Sean
Allison Go of Xavier University-Ateneo de Cagayan. You must be at least 18 year
of age to take part of this research study. Your participation is voluntary. You
should read the information below and ask the questions about anything you do
not understand, before deciding whether or not to participate. Please take much
time if you need to read the consent form. You may also decide to discuss it with
your family or friends. If you decide to participate, you will be asked to sign this
form. You will be given a copy of this form. The purpose of the study is to evaluate
the effectiveness of the health teachings given to you. If you volunteer to
participate in this study, you will be asked to answer a questionnaire about the
health teachings we implemented in Sitio Patpat, Lumbia. The questionnaire will
take about 10 minutes of your time and the questionnaire will be given
immediately after you agree to participate in this study. There are no reasonably
foreseeable risks or discomfort; however if there are any discomfort you feel upon
answering the questionnaire, you may tell the researchers. Your participation in
this research is confidential. Only members if the research team will access to the
associated with this study. The data will be stored and secured at the investigators
school in a locked cabinet and password protected computer. If you have any
questions about your right as a study subject or you would like to speak with
someone on the research team to have questions answered about the research,
or in the event the researcher cannot be reached, please contact Stephanie Joy
Escala at stephaniejoy.escala@yahoo.com with questions or concerns about the
study. Your decision to be in this research is voluntary. You can stop at any time.
You do not have to answer any questions you do not want to answer. Refusal to
take part in or withdrawing from this study will involve no penalty. You are not
 50

waiving any legal claims, rights, or remedies because of your participation in this
study. The researcher may withdraw you from this research if circumstances arise
which warranting doing so.

If you agree to take part in this research study and the information outlined
above, please sign your name and indicate the date below.

A copy of this form will be given to you for your records.

SIGNATURE OF RESEARCH PARTICIPANT:

I have read (or someone has read to me) the information provided
above. I have been given a chance to ask questions. My questions have been
answered to my satisfaction, and I agree to participate in this study. I have been
given a copy of this form.

THUMB
MARK

______________________________
Name of Participant

______________________________ ___________________
Signature of Participant Date

SIGNATURE OF INVESTIGATOR

I have explained the research to the subject and answered all of his/her
questions. I believe that he/she understands the information described in this
document and freely consents to participate.

______________________________
Name of Investigator
______________________________ ______________
Signature of Investigator Date
 51

APPENDIX C

Questionnaires (English Version)

Xavier University Ateneo de Cagayan

College of Nursing

Part I Profile of the Respondents

Instructions: Please ( ) the following that applies.

1. Name (Optional):_______________________________________
2. Age: (Please Check)
18 years old 35 years old
36 years old 55 years old
56 years old 75 years old
3. Gender: (Please Check)
Male
Female
4. How much does your family earn per month? (Please Check)
Below 5180
5181-9180
9181-13180
Above 13181
5. Highest Educational Attainment (Please Check)
None
Elementary
High School Level
High School Graduate
College Level
College Graduate
Others: Please specify:
 52

6. Are you married? (Please Check)

Yes
No
If yes, who are you living with? (Please Check)
Wife/Husband and children
Cousin, grandmother/grandfather, Uncle, Auntie
If no, who are you living with? (Please Check)
Children
Cousin, grandmother/grandfather, Uncle, Auntie
7. Where do you get health information? (Please Check One)
Broadcast Media
Television
Radio
Internet and/or Social Media (Such as Facebook, Twitter,
Instagram, etc.)
Print Media
Newspaper
Brochure/Magazines
Books
Resource Persons
Parents, Relatives, Friends, Neighbors
Barangay Health Center (BHWs and Nurses)
Hospital (Doctors and Nurses)
Others (Specify): ________________________
 53

Part II: HEALTH TEACHINGS

Instructions: Please ( ) the following the best option that reflects your
response.

3 Highly Effective Health Promotion Programs are highly

effective.
2 Moderately Effective Health Promotion Programs are
moderately effective.
1 Not Effective Health Promotion Programs are not
effective.

3 2 1

HYGIENIC PRACTICES
1. I am aware that hygiene practices such as bathing, tooth
brushing and handwashing are important to effectively
prevent disease.
2. I am aware of the different diseases I can get from doing
unhygienic practices such as diarrhea, dengue,
tuberculosis and food poisoning.
3. I am aware on how to properly perform body hygiene
such as bathing at least once a day, brushing my teeth at
least three times a day and washing my hands after using
the toilet.
4. I am aware on how to properly use the different materials
needed in implementing good body hygiene such as
soap, water, toothbrush, etc.
5. I am practicing proper hygienic practices such as bathing,
tooth brushing and handwashing.
SANITATION PRACTICES
1. I am aware that proper food and water storage is
important to ensure that the food we eat and the water
we drink and use are clean.
2. I am aware that perishable foods like meat, poultry, fish,
milk, eggs, raw fruits and vegetables should be stored in
the refrigerator or freezer temperatures to keep them from
getting spoiled.
 54

3. I am aware that water containers should be covered to

avoid formation of mosquito breeding sites and water
contamination.
4. I am aware that canned foods are safe indefinitely as long
as they are not exposed to freezing temperatures or
temperatures above 32 C.
5. I am aware that bacteria breed fastest in food that is
warm and wet, especially if it contains sugar or animal
protein like milk.
6. I am aware that drainage system is used to remove
wastewater in the land surface.
7. I am aware that I need to dispose my garbage properly
because they may clog the drainage areas.
8. I am aware that clogged drainage areas may serve as
breeding sites and areas where pests can reside.
9. I am aware that a polluted drainage system may damage
aquatic life.
10. I am aware that proper drainage system is important to
avoid flood brought about by rainwater in the area.
11. I am aware of the importance and advantages of waste
segregation such as prevention of diseases and reducing
environment pollution.
12. I am aware of the difference between non-
biodegradable wastes, which refers to wastes that cannot
be easily, decompose and biodegradable wastes which
refers to wastes that can be easily decompose.
13. I am aware of the different diseases I can acquire if I do
not practice waste segregation properly.
14. I am now encouraged to practice proper waste
segregation
15. I have been practicing proper waste segregation.
MANAGEMENT OF ACUTE AND CHRONIC DISEASE
ACUTE DISEASES:
DENGUE
1. I am aware that Aedes aegypti is the mosquito that
causes dengue.
 55

2. I am aware that I can effectively prevent mosquito bites

by wearing long pants and long sleeves.
3. I am aware that I need to empty stagnant water from old
tires, trash cans, and flower pots in order to prevent the
reproduction of the mosquito that cause dengue.
4. I am aware that avoiding stagnant water and staying
indoors for two hours after sunrise and before sunset will
decrease my possibility of getting mosquito bites.
5. I am aware that I need to consult a doctor when anyone
in my family have fever as high as 41C, headache,
muscle and joint pain, nosebleed, eye pain, and skin rash
that appear two to five days after the onset of fever.
MEASLES
1. I am aware that a virus causes measles.
2. I am aware that children are at high risk for contracting
measles.
3. I am aware that measles can be spread through air when
the infected person talks, breathes, coughs or sneezes
4. I am informed and able to elaborate the importance of
complying with the vaccination of measles which requires
two doses; the first dose at 12 through 15 months of age,
and the second dose before entering school at 4 through
6 years of age.
5. I am aware that I need to consult a doctor when anyone
in my family have include cough, fever, red eyes and
white spots on mouth.
SCABIES
1. I am aware that scabies is caused by a mite that is spread
through close skin-to-skin contacts.
2. I am aware that avoiding personal contact with the
infected person is important as a prevention.
3. I am aware that I need to frequently clean the rugs and
furniture in our house since this is where the scabies mite is
commonly found.
 56

4. I am aware that I need to consult a doctor when anyone

in my family manifest mite burrows, rash, scratching and
itching as these are the common signs and symptoms.
5. I am aware that if one my family gets infected, medication
compliance is important in getting rid of scabies.
CHRONIC DISEASES:
1. I am aware that tuberculosis is caused by bacteria that
are spread through the air from person to person and that
medication compliance is important when anyone in my
family contracted tuberculosis.
2. I need to consult a doctor if anyone in my family
experiences chest pain, cough for more than 3 weeks,
fever, weight loss and coughing up blood as these are
common the signs and symptoms.
3. I am aware that it is important to cover the mouth and
nose when coughing or sneezing as prevention for
tuberculosis.
4. I am aware that blood pressure beyond 130/80 mmHg is
considered hypertension and that smoking should be
stopped and alcohol should be minimize to prevent
complications brought about by hypertension.
5. I am aware that hypertension cannot be cured instead it
can only be controlled by religiously taking my prescribed
medication, maintaining a low salt diet, and performing
daily exercises for 30 minutes in order to maintain a normal
blood pressure level.
HERBAL MEDICINE
1. I am aware that there are only 10 herbal plants approved
by the Department of Health.
2. I am aware that each herbal plant have specific usage
and way to prepare.
3. I have used herbal medication at least once for any of the
common diseases (e.g. colds, diarrhea, cough, wounds,
etc.)
4. I believe that herbal medications have been effective in
alleviating/treating common diseases.
 57

5. I have practiced the appropriate preparation and usage

of herbal medications at least once.
MATERNAL AND CHILD CARE
1. I am aware of the free prenatal check-up in the health
center and utilize it to monitor the health of my child and
my health also.
2. I am aware of the micronutrient program of the
Department of Health wherein the health center provide
vitamin A, iron and iodine supplement to promote the
health of children.
3. I am aware that healthy lifestyle and diet during my
prenatal and postnatal phase helps me in becoming
healthy and prepare myself for the possible outcomes of
my pregnancy.
4. I am aware of the importance of family planning which is
to allow people to attain their desired number of children
and determine the spacing of pregnancies.
5. I am aware that there are different types of contraceptive
such as natural family planning, barrier methods,
hormonal methods and surgical methods.
6. I am aware the side effects of oral contraceptives are
nausea, weight gain, headache, breast tenderness,
breakthrough bleeding, mild hypertension and
depression.
7. I am aware that ORESOL is an oral rehydrating solution and
can be made at home by preparing 1 liter of water,
teaspoon salt and 6 teaspoons of sugar
8. I am aware that I will make homemade ORESOL by the
time anyone in my family experience dehydration such as
from vomiting and diarrhea.
9. I am aware that I need to breastfeed my child during the
first six months of his life.
10. I am aware of the advantages of breastfeeding for my
child such as increased resistance to infections, fewer
incidence of hospitalization and provide sufficient
nutrition.
 58

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