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Jiang S, Street RL. The effects of patient-centered communication, social capital, and internet use on patient empowerment: a cross-sectional study in China. Glob Health Promot 2018. [DOI: 10.1177/1757975917749197] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Patient empowerment is a relatively new concept in the context of the Chinese health care system. Based on Street’s ecological framework of communication in healthcare settings, this study examined the social, clinical and media factors that could empower patients. Results from a survey of 401 Chinese adults (response rate, 34%) showed that respondents felt more empowered as health care consumers when they reported having more social capital bonding and bridging, and used the Internet for health purposes more often. Importantly, having had more positive patient-centered communicative experiences with health care providers not only predicted patient empowerment, it also moderated the effects of bridging social capital and Internet use on empowerment. Specifically, the more positive the experience of interacting with health care providers, the weaker the effects of bridging social capital and Internet use on patient empowerment. The findings have important implications for patient empowerment in health care, particularly within the context of China.
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Affiliation(s)
- Shaohai Jiang
- Department of Communications and New Media, National University of Singapore, Singapore
| | - Richard L. Street
- Department of Communication, Texas A&M University, College Station, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Houston Center for Innovation in Quality, Effectiveness and Safety; Michael E. DeBakey VA Medical Center; Houston, TX, USA
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Gao M, Xiao C, Zhang X, Li S, Yan H. Social capital and PTSD among PLWHA in China: the mediating role of resilience and internalized stigma. PSYCHOL HEALTH MED 2018; 23:698-706. [PMID: 29334231 DOI: 10.1080/13548506.2018.1426869] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Post-traumatic Stress Disorder (PTSD) is frequent among people living with HIV/AIDS (PLWHA). Few studies have investigated social-psychological predictors of PTSD in China. This study aimed to examine relationships between social capital, stigma, resilience and PTSD among PLWHA in China, and to provide effective suggestions for PTSD intervention. A cross-sectional study of 520 PLWHA was conducted from November 2015 to January 2016. Survey data were collected using anonymous self-reported questionnaire. Multivariable analyses were used to examine related factors of PTSD, and causal mediation analyses were conducted to assess whether stigma and resilience were mediators. Results indicated that higher risk of PTSD was independent associated with stronger stigma, decreasing social capital and lower resilience. There was an indirect relationship of social capital on PTSD mediated through resilience and HIV-related stigma. Therefore, PTSD intervention programs should not only pay attention to the role of social capital on PTSD, but also attach importance to stigma and resilience on PTSD symptoms.
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Affiliation(s)
- Mengting Gao
- a Information Center , Renmin Hospital of Wuhan University , Wuhan , China.,b School of Health Science , Wuhan University , Wuhan , China
| | - Chenchang Xiao
- b School of Health Science , Wuhan University , Wuhan , China
| | - Xuan Zhang
- c Department of nosocomial infection management , The Second People's Hospital of Shanxi Province , Taiyuan , China
| | - Shiyue Li
- b School of Health Science , Wuhan University , Wuhan , China
| | - Hong Yan
- b School of Health Science , Wuhan University , Wuhan , China
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Gong J, Xu Y, Chen X, Yang N, Li F, Yan Y. Persistent effect at 30-month post intervention of a community-based randomized trial of KM2H 2 in reducing stroke and heart attack among senior hypertensive patients. Int J Behav Nutr Phys Act 2018; 15:1. [PMID: 29291739 PMCID: PMC5749024 DOI: 10.1186/s12966-017-0635-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 12/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The effect of the Keep Moving toward Healthy Heart and Healthy Brain (KM2H2) program at 6-month post intervention has been assessed. The purpose of this study is to evaluate the KM2H2 program at 30-month post intervention. METHODS A total of 450 senior hypertensive patients from 12 community health centers were randomized by center to either receive KM2H2 plus standard care (6 centers, n = 232) or standard care only (6 centers, n = 218). Data for outcome measures at 30-month post intervention were analyzed. New cases of stroke and heart attack were verified with medical records; levels of physical activity were assessed using self-reported questionnaire. In addition to comparative analysis, adjusted incidence rate and program effects were determined using mixed effects modeling method. RESULTS At the 30-month follow-up, the adjusted incidence rate [95% CI] of stroke was 11.81% [5.90, 17.72] for patients in the intervention group and 19.78% [14.07, 25.50] (p = 0.03) for the control group. The adjusted incidence rate of heart attack was 3.34% [1.91, 8.58] and 6.68% [1.64, 11.73] for the intervention and control groups (p = 0.16), respectively; the proportion and the duration of engaging in regular physical activity were significantly greater for the intervention group than the control group. The reductions in blood pressure between the intervention and the control was not statistically significant. CONCLUSIONS The KM2H2 program showed a persistent effect up to 30 months post intervention in enhancing physical activity and reducing the risk of cardio-cerebrovascular events, particularly stroke. These findings demonstrate the persistent effect of the KM2H2 and suggest the need for a full-scale evaluation of the intervention program for practical use. TRIAL REGISTRATION ISRCTN Register ISRCTN12608966 . Registered 03 March 2015. Retrospectively registered.
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Affiliation(s)
- Jie Gong
- Wuhan Center for Disease Prevention and Control, 24 Jianghan North Road, Wuhan, 430022, China.
| | - Yunan Xu
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, Florida, 32610, USA.
| | - Xinguang Chen
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, Florida, 32610, USA
| | - Niannian Yang
- Wuhan Center for Disease Prevention and Control, 24 Jianghan North Road, Wuhan, 430022, China
| | - Fang Li
- Wuhan Center for Disease Prevention and Control, 24 Jianghan North Road, Wuhan, 430022, China
| | - Yaqiong Yan
- Wuhan Center for Disease Prevention and Control, 24 Jianghan North Road, Wuhan, 430022, China
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Forsythe A. I doubt very seriously whether anyone will hire me; factors predicting employability perceptions in higher education. COGENT PSYCHOLOGY 2017. [DOI: 10.1080/23311908.2017.1385131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Yu B, Chen X, Yan Y, Gong J, Li F, Robserson E. Migration Stress, Poor Mental Health, and Engagement in Sex with High-Risk Partners: A Mediation Modeling Analysis of Data from Rural-to-Urban Migrants in China. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2017; 14:467-477. [PMID: 29098041 PMCID: PMC5662130 DOI: 10.1007/s13178-016-0252-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND There is a growing need for better understanding of mechanisms underpinning the relationship between migration stress and HIV risk behaviors for the development of HIV prevention and control policy. METHODS Survey data from a random sample of 1,293 Chinese rural-to-urban migrants were analyzed. Stress was assessed using the Domestic Migration Stress Questionnaire (DMSQ), mental health status was assessed using the Brief Symptoms Inventory (BSI), and having sex with high risk partners was assessed as if ever have had sex with high risk partners (e.g., sex workers, intravenous injection drug users, blood donors, persons infected with HIV, persons with sexually transmitted infection, and same gender partners) in the past year. The proposed relationship was tested using mediation modeling method. RESULTS Among the sample, 5.5% reported having had sex with high-risk partners in the past year. Mediation analysis indicated that the relationship between DMSQ scores and having sex with high-risk partners was mediated by BSI (coefficient =0.41, 95% CI [0.21, 0.65]), including its components of somatization (0.32 [0.15, 0.53]), obsessive-compulsive disorder (0.31 [0.07, 0.55]), depression (0.45 [0.23, 0.72]), anxiety (0.41 [0.23, 0.63]), and hostility (0.35 [0.17, 0.56]). Furthermore, the effect was more pronounced in males than in females. CONCLUSION The study findings provide new data advancing our understanding of the mechanism of engagement in risky sex, underscoring the need for the HIV prevention policies in China to pay more attention to mental health of the rural-to-urban migrant population.
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Affiliation(s)
- Bin Yu
- Department of Epidemiology, University of Florida, USA
| | - Xinguang Chen
- Department of Epidemiology, University of Florida, USA
- Department of Chronic Disease, Wuhan Centers for Disease Prevention and Control, China
| | - Yaqiong Yan
- Department of Chronic Disease, Wuhan Centers for Disease Prevention and Control, China
| | - Jie Gong
- Department of Chronic Disease, Wuhan Centers for Disease Prevention and Control, China
| | - Fang Li
- Department of Chronic Disease, Wuhan Centers for Disease Prevention and Control, China
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Environmental factors and teenagers' personalities: The role of personal and familial Socio-Cultural Level. Behav Brain Res 2017; 325:181-187. [PMID: 28238826 DOI: 10.1016/j.bbr.2017.02.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 02/20/2017] [Accepted: 02/22/2017] [Indexed: 01/08/2023]
Abstract
Environmental (e.g., socio-cultural context), individual (e.g., genetic makeup), and interpersonal (e.g., caregiver-children relationships) factors can play a crucial role in shaping the development of the teenagers' personality. In this study, we focused on the Socio-Cultural Level that designates the set of preferences, knowledge, and behaviors that characterize an individual's way of life and depend on his or her cultural, social, and economic resources. We studied the relationship between Socio-Cultural Level (personal, maternal, and paternal) and Big Five personality traits of 191 teenagers living in the same geographical area. Results showed that Socioeconomic Status (i.e., parental education level and occupational prestige), which is the only dimension generally measured in investigations on Socio-Cultural Level, was not related with personality. In contrast, Cultural Capital and Social Capital were associated with different personality traits. Personal Cultural Capital was related to Openness to experience of boys and girls and to Extraversion of girls; personal Social Capital was related to Extraversion of girls, Emotional stability of boys, and Agreeableness of both boys and girls; maternal Cultural Capital was associated with Openness to experience of daughters. Overall, the personality of teenagers was more related to their own Cultural and Social Capital than to the Cultural and Social Capital of their parents. Moreover, the relationship between Cultural Capital and Social Capital of boys/girls and of fathers/mothers was moderate in strength. It seems that parents influence the development of personality of their teenagers indirectly, their Socio-Cultural Level shaping the Socio-Cultural Level of their sons and daughters.
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Gupta R, Kaur M, Islam S, Mohan V, Mony P, Kumar R, Kutty VR, Iqbal R, Rahman O, Deepa M, Antony J, Vijaykumar K, Kazmi K, Yusuf R, Mohan I, Panwar RB, Rangarajan S, Yusuf S. Association of Household Wealth Index, Educational Status, and Social Capital with Hypertension Awareness, Treatment, and Control in South Asia. Am J Hypertens 2017; 30:373-381. [PMID: 28096145 DOI: 10.1093/ajh/hpw169] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 12/22/2016] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE Hypertension control rates are low in South Asia. To determine association of measures of socioeconomic status (wealth, education, and social capital) with hypertension awareness, treatment, and control among urban and rural subjects in these countries we performed the present study. METHODS We enrolled 33,423 subjects aged 35-70 years (women 56%, rural 53%, low-education status 51%, low household wealth 25%, low-social capital 33%) in 150 communities in India, Pakistan, and Bangladesh during 2003-2009. Prevalence of hypertension and its awareness, treatment, and control status and their association with wealth, education, and social capital were determined. RESULTS Age-, sex-, and location-adjusted prevalence of hypertension in men was 31.5% (23.9-40.2%) and women was 32.6% (24.9-41.5%) with variations in prevalence across study sites (urban 30-56%, rural 11-43%). Prevalence was significantly greater in urban locations, older subjects, and participants with more wealth, greater education, and lower social capital index. Hypertension awareness was in 40.4% (urban 45.9, rural 32.5), treatment in 31.9% (urban 37.6, rural 23.6), and control in 12.9% (urban 15.4, rural 9.3). Control was lower in men and younger subjects. Hypertension awareness, treatment, and control were significantly lower, respectively, in lowest vs. highest wealth index tertile (26.2 vs. 50.6%, 16.9 vs. 44.0%, and 6.9 vs. 17.3%, P < 0.001) and lowest vs. highest educational status tertile (31.2 vs. 48.4%, 21.8 vs. 42.1%, and 7.8 vs. 19.2%, P < 0.001) while insignificant differences were observed in lowest vs. highest social capital index (38.2 vs. 36.1%, 35.1 vs. 27.8%, and 12.5 vs. 9.1%). CONCLUSIONS This study shows low hypertension awareness, treatment, and control in South Asia. Lower wealth and educational status are important in low hypertension awareness, treatment, and control.
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Affiliation(s)
- Rajeev Gupta
- Department of Medicine, Eternal Heart Care Centre and Research Institute, Mount Sinai New York Affiliate, Jaipur, India
| | - Manmeet Kaur
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shofiqul Islam
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Canada
| | | | - Prem Mony
- Department of Community Medicine, St John's Medical College and Research Institute, Bangalore, India
| | - Rajesh Kumar
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Omar Rahman
- School of Life Sciences, Independent University, Dhaka, Bangladesh; and
| | - Mohan Deepa
- Madras Diabetes Research Foundation, Chennai, India
| | - Justy Antony
- Department of Community Medicine, St John's Medical College and Research Institute, Bangalore, India
| | | | - Khawar Kazmi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Rita Yusuf
- School of Life Sciences, Independent University, Dhaka, Bangladesh; and
| | - Indu Mohan
- Department of Medicine, Eternal Heart Care Centre and Research Institute, Mount Sinai New York Affiliate, Jaipur, India
| | - Raja Babu Panwar
- Administrative Office, Rajasthan University of Health Sciences, Jaipur, India
| | - Sumathy Rangarajan
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Canada
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Canada
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Villalonga-Olives E, Adams I, Kawachi I. The development of a bridging social capital questionnaire for use in population health research. SSM Popul Health 2016; 2:613-622. [PMID: 29349175 PMCID: PMC5757980 DOI: 10.1016/j.ssmph.2016.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/17/2016] [Accepted: 08/18/2016] [Indexed: 10/31/2022] Open
Abstract
Bridging social capital is defined as the connections between individuals who are dissimilar with respect to socioeconomic and other characteristics. There is an important gap in the literature related to its measurement. We describe the development and validation of a questionnaire to measure bridging social capital. We focused the development of the questionnaire to be suitable for use in Latino immigrant populations in the U.S. The structure of the questionnaire comprised the following: Socialization in the job place (5 items); Membership in community activities (16 items); Participation in community activities (5 items); Contact with similar/different people (7 items); Assistance (17 items); Trust of institutions, corporations and other people(14 items); and Trust of intimate people (3 items). First, we used focus groups (N=17 participants) to establish content validity with an inductive thematic analysis to identify themes and subthemes. Changes were made to the questionnaire based on difficulty, redundancy, length and semantic equivalence. Second, we analyzed the questionnaire's psychometric properties (N=138). We tested internal consistency with Cronbach alpha and construct validity with a Confirmatory Factor Analysis (CFA) for each sub-scale to test theoretical unity; discriminant validity to observe differences between participants from high and low SES backgrounds and different language; and content validity with an independent expert panel. Cronbach alphas ranged from 0.80 (Assistance) to 0.92 (Trust). CFA results indicated that CFI and TLI were higher than 0.90 in almost all the scales, with high factor loadings. The Wilcoxon tests indicated that there were statistically significant mean differences between SES and language groups (p<0.00). The independent expert panel determined that the questionnaire had good content validity. This is the first demonstration of a psychometrically validated questionnaire to measure bridging social capital in an immigrant population in the United States. Our questionnaire may be suitable for further refinement and adaptation to other immigrant groups in different countries.
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Affiliation(s)
- E. Villalonga-Olives
- Institute of Medical Psychology and Medical Sociology, Georg-August-University Göttingen, Göttingen, Germany
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - I. Adams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - I. Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Foschi R, Lauriola M. Do Amoral Familism and Political Distrust Really Affect North–South Differences in Italy? JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2016. [DOI: 10.1177/0022022116644986] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Especially in southern Italy, Banfield’s amoral familism is considered an obstacle to the formation of associations and growth of political participation. This article discusses Banfield’s concept, showing that it has been vulgarized merely as familism and, in particular, demonstrates that Banfield intended amoral familism to be understood in terms of political distrust. We investigated whether amoral familism or political distrust, operationalized as an individual difference variable, mediated the relationships between personality traits, personal values, and conventional and unconventional political acts, controlling for differences in political attitude. We recruited 405 participants, distributed across north, central, and southern Italy, to complete a questionnaire on political participation that also assessed Big Five personality factors, values, sociability and political attitude (expertise, interest, self-efficacy), and a new scale assessing amoral familism as a form of political distrust. Regression analyses were used to identify the best predictors of political acts, then structural equation modeling was used to test a model of political participation. Like political attitudes, familism mediated the relationships between personality traits, especially “openness to experience” and “taking conventional and unconventional political acts.” However, our data do not confirm the stereotype that northern and southern Italians differ in their tendency to amoral familism as defined by Banfield.
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Agentic personality as mediator of social capital on developmental outcomes in the transition to adulthood: Evidence from Shanghai, China. J Adolesc 2016; 46:1-13. [DOI: 10.1016/j.adolescence.2015.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 06/15/2015] [Accepted: 10/13/2015] [Indexed: 12/20/2022]
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Wang Y, Chen X, Gong J, Yan Y. Relationships Between Stress, Negative Emotions, Resilience, and Smoking: Testing a Moderated Mediation Model. Subst Use Misuse 2016; 51:427-38. [PMID: 26894428 PMCID: PMC4855524 DOI: 10.3109/10826084.2015.1110176] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE More effective tobacco prevention and cessation programs require in-depth understanding of the mechanism by which multiple factors interact with each other to affect smoking behaviors. Stress has long been recognized as a risk factor for smoking. However, the underlying mediation and moderation mechanisms are far from clear. The purpose of this study was to examine the role of negative emotions in mediating the link between stress and smoking and whether this indirect link was modified by resilience. METHODS Survey data were collected using audio computer-assisted self-interview (ACASI) from a large random sample of urban residents (n = 1249, mean age = 35.1, 45.3% male) in Wuhan, China. Perceived stress, negative emotions (anxiety, depression), resilience were measured with reliable instruments also validated in China. Self-reported smoking was validated with exhaled carbon monoxide. RESULTS Mediation analysis indicated that two negative emotions fully mediated the link between stress and intensity of smoking (assessed by number of cigarettes smoked per day, effect =.082 for anxiety and.083 for depression) and nicotine dependence (assessed by DSM-IV standard, effect =.134 for anxiety and.207 for depression). Moderated mediation analysis demonstrated that the mediation effects of negative emotions were negatively associated with resilience. CONCLUSIONS Results suggest resilience interacts with stress and negative emotions to affect the risk of tobacco use and nicotine dependence among Chinese adults. Further research with longitudinal data is needed to verify the findings of this study and to estimate the effect size of resilience in tobacco intervention and cessation programs.
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Affiliation(s)
- Yan Wang
- a Department of Epidemiology , University of Florida , Gainesville , Florida , USA
| | - Xinguang Chen
- a Department of Epidemiology , University of Florida , Gainesville , Florida , USA
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The measurement of bridging social capital in population health research. Health Place 2015; 36:47-56. [DOI: 10.1016/j.healthplace.2015.09.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 08/17/2015] [Accepted: 09/11/2015] [Indexed: 11/20/2022]
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Efficacy of a Community-Based Physical Activity Program KM2H2 for Stroke and Heart Attack Prevention among Senior Hypertensive Patients: A Cluster Randomized Controlled Phase-II Trial. PLoS One 2015; 10:e0139442. [PMID: 26426421 PMCID: PMC4591119 DOI: 10.1371/journal.pone.0139442] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 09/10/2015] [Indexed: 11/21/2022] Open
Abstract
Objective To evaluate the efficacy of the program Keep Moving toward Healthy Heart and Healthy Brain (KM2H2) in encouraging physical activities for the prevention of heart attack and stroke among hypertensive patients enrolled in the Community-Based Hypertension Control Program (CBHCP). Design Cluster randomized controlled trial with three waves of longitudinal assessments at baseline, 3 and 6 months post intervention. Setting Community-based and patient-centered self-care for behavioral intervention in urban settings of China. Participants A total of 450 participants diagnosed with hypertension from 12 community health centers in Wuhan, China were recruited, and were randomly assigned by center to receive either KM2H2 plus standard CBHCP care (6 centers and 232 patients) or the standard care only (6 centers and 218 patients). Intervention KM2H2 is a behavioral intervention guided by the Transtheoretical Model, the Model of Personalized Medicine and Social Capital Theory. It consists of six intervention sessions and two booster sessions engineered in a progressive manner. The purpose is to motivate and maintain physical activities for the prevention of heart attack and stroke. Outcome Measures Heart attack and stroke (clinically diagnosed, primary outcome), blood pressure (measured, secondary outcome), and physical activity (self-report, tertiary outcome) were assessed at the individual level during the baseline, 3- and 6-month post-intervention. Results Relative to the standard care, receiving KM2H2 was associated with significant reductions in the incidence of heart attack (3.60% vs. 7.03%, p < .05) and stroke (5.11% vs. 9.90%, p<0.05), and moderate reduction in blood pressure (-3.72mmHg in DBP and -2.92 mmHg in DBP) at 6-month post-intervention; and significant increases in physical activity at 3- (d = 0.53, 95% CI: 0.21, 0.85) and 6-month (d = 0.45, 95% CI: 0.04, 0.85) post-intervention, respectively. Conclusion The program KM2H2 is efficacious to reduce the risk of heart attack and stroke among senior patients who are on anti-hypertensive medication. Findings of this study provide solid data supporting a formal phase-III trial to establish the effectiveness of KM2H2 for use in community settings for prevention. Trial Registration ISRCTN Register ISRCTN12608966
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Wang Y, Chen X. Stress and alcohol use in rural Chinese residents: A moderated mediation model examining the roles of resilience and negative emotions. Drug Alcohol Depend 2015; 155:76-82. [PMID: 26342628 PMCID: PMC4586155 DOI: 10.1016/j.drugalcdep.2015.08.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/05/2015] [Accepted: 08/17/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Little research has been done on alcohol use and dependence among rural residents in China, a sub-population that might be under increased stress due to the rapid modernization and urbanization processes. We aimed to assess rural residents' levels of stress, negative emotions, resilience, alcohol use/dependence and the complex relationships among them. METHODS Survey data from a large random sample (n=1145, mean age=35.9, SD=7.7, 50.7% male) of rural residents in Wuhan, China were collected using Audio Computer-Assisted Self-Interview. RESULTS The sample had high prevalence of frequently perceived stress (47%) and high prevalence of ever (54.4%), past 30-day (40.4%), and binge drinking (13.8%). Approximately 11% met the criterion for intermediate to severe alcohol dependence. Mediation analysis indicated that the association between perceived stress (predictor) and alcohol dependence (outcome) was fully mediated by anxiety (indirect effect=.203, p<.01) and depression (indict effect=.158, p<.05); moderation analysis indicated that association between stress and two negative emotions (mediators) was significantly modified by resilience (moderator); an integrative moderated mediation analysis indicated that the indirect effect from stress to alcohol dependence through negative emotions was also moderated by resilience. CONCLUSIONS Negative emotions play a key role in bridging stress and alcohol dependence, while resilience significantly buffers the impact of stress on depression, reducing the risk of alcohol dependence. Resilience training may be an effective component for alcohol intervention in rural China.
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Affiliation(s)
- Yan Wang
- University of Florida, Gainesville, USA.
| | - Xinguang Chen
- University of Florida, Gainesville, USA,Wuhan Center for Disease Prevention and Control, Wuhan, China
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Palamida E, Papagiannidis S, Xanthopoulou D, Stamati T. Capital, Motives, and Their Link to Investment Intentions: The Moderating Role of the Financial Crisis in Greece. JOURNAL OF SMALL BUSINESS MANAGEMENT 2015. [DOI: 10.1111/jsbm.12186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Development and Evaluation of the Brief Sexual Openness Scale-A Construal Level Theory Based Approach. PLoS One 2015; 10:e0136683. [PMID: 26308336 PMCID: PMC4550254 DOI: 10.1371/journal.pone.0136683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 08/06/2015] [Indexed: 11/29/2022] Open
Abstract
Obtaining reliable and valid data on sensitive questions represents a longstanding challenge for public health, particularly HIV research. To overcome the challenge, we assessed a construal level theory (CLT)-based novel method. The method was previously established and pilot-tested using the Brief Sexual Openness Scale (BSOS). This scale consists of five items assessing attitudes toward premarital sex, multiple sexual partners, homosexuality, extramarital sex, and commercial sex, all rated on a standard 5-point Likert scale. In addition to self-assessment, the participants were asked to assess rural residents, urban residents, and foreigners. The self-assessment plus the assessment of the three other groups were all used as subconstructs of one latent construct: sexual openness. The method was validated with data from 1,132 rural-to-urban migrants (mean age = 32.5, SD = 7.9; 49.6% female) recruited in China. Consistent with CLT, the Cronbach alpha of the BSOS as a conventional tool increased with social distance, from .81 for self-assessment to .97 for assessing foreigners. In addition to a satisfactory fit of the data to a one-factor model (CFI = .94, TLI = .93, RMSEA = .08), a common factor was separated from the four perspective factors (i.e., migrants’ self-perspective and their perspectives of rural residents, urban residents and foreigners) through a trifactor modeling analysis (CFI = .95, TLI = .94, RMSEA = .08). Relative to its conventional form, CTL-based BSOS was more reliable (alpha: .96 vs .81) and valid in predicting sexual desire, frequency of dating, age of first sex, multiple sexual partners and STD history. This novel technique can be used to assess sexual openness, and possibly other sensitive questions among Chinese domestic migrants.
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Chen X, Yu B, Zhou D, Zhou W, Gong J, Li S, Stanton B. A Comparison of the Number of Men Who Have Sex with Men among Rural-To-Urban Migrants with Non-Migrant Rural and Urban Residents in Wuhan, China: A GIS/GPS-Assisted Random Sample Survey Study. PLoS One 2015; 10:e0134712. [PMID: 26241900 PMCID: PMC4524597 DOI: 10.1371/journal.pone.0134712] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/13/2015] [Indexed: 11/23/2022] Open
Abstract
Background Mobile populations and men who have sex with men (MSM) play an increasing role in the current HIV epidemic in China and across the globe. While considerable research has addressed both of these at-risk populations, more effective HIV control requires accurate data on the number of MSM at the population level, particularly MSM among migrant populations. Methods Survey data from a random sample of male rural-to-urban migrants (aged 18-45, n=572) in Wuhan, China were analyzed and compared with those of randomly selected non-migrant urban (n=566) and rural counterparts (580). The GIS/GPS technologies were used for sampling and the survey estimation method was used for data analysis. Results HIV-related risk behaviors among rural-to-urban migrants were similar to those among the two comparison groups. The estimated proportion of MSM among migrants [95% CI] was 5.8% [4.7, 6.8], higher than 2.8% [1.2, 4.5] for rural residents and 1.0% [0.0, 2.4] for urban residents, respectively. Among these migrants, the MSM were more likely than non-MSM to be older in age, married, and migrated to more cities. They were also more likely to co-habit with others in rental properties located in new town and neighborhoods with fewer old acquaintances and more entertainment establishments. In addition, they were more likely to engage in commercial sex and less likely to consistently use condoms. Conclusion Findings of this study indicate that compared to rural and urban populations, the migrant population in Wuhan consists of a higher proportion of MSM who also exhibit higher levels of HIV-related risk behaviors. More effective interventions should target this population with a focus on neighborhood factors, social capital and collective efficacy for risk reduction.
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Affiliation(s)
- Xinguang Chen
- Department of Epidemiology, University of Florida, Gainesville, Florida, United States of America
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
- School of Public Health, Wuhan University, Wuhan, China
- Pediatric Prevention Research Center, Wayne State University, Detroit, Michigan, United States of America
- * E-mail:
| | - Bin Yu
- Department of Epidemiology, University of Florida, Gainesville, Florida, United States of America
| | - Dunjin Zhou
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Wang Zhou
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Jie Gong
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Shiyue Li
- School of Public Health, Wuhan University, Wuhan, China
| | - Bonita Stanton
- Pediatric Prevention Research Center, Wayne State University, Detroit, Michigan, United States of America
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Chen X, Wang P, Wegner R, Gong J, Fang X, Kaljee L. Measuring Social Capital Investment: Scale Development and Examination of Links to Social Capital and Perceived Stress. SOCIAL INDICATORS RESEARCH 2015; 120:669-687. [PMID: 25648725 PMCID: PMC4310564 DOI: 10.1007/s11205-014-0611-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Individuals with greater social capital have better health outcomes. Investment in social capital likely increases one's own social capital, bearing great implications for disease prevention and health promotion. In this study, the authors developed and validated the Social Capital Investment Inventory (SCII). Direct effects of social capital investment on perceived stress, and indirect effects through social capital were examined. 397 Participants from Beijing and Wuhan, China completed surveys. Analyses demonstrated that the SCII has a single factor structure and strong internal consistency. Structural equation modeling showed that individuals who invested more in social capital had greater bonding social capital, and subsequently less perceived stress. Results suggest that disease prevention and health promotion programs should consider approaches to encourage social capital investment; individuals may be able to reduce stress by increasing their investment in social capital. Future research is needed to provide additional empirical support for the SCII and observed structural relationships.
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Affiliation(s)
- Xinguang Chen
- Wuhan University Global Health Center, Wuhan, China
- School of Medicine, Wayne State University, Detroit, MI, USA
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Peigang Wang
- Wuhan University Global Health Center, Wuhan, China
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Rhiana Wegner
- School of Medicine, Wayne State University, Detroit, MI, USA
- Psychology Department, Wayne State University, Detroit, MI, USA
| | - Jie Gong
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Xiaoyi Fang
- Beijing Normal University Developmental Institute, Beijing, China
| | - Linda Kaljee
- School of Medicine, Wayne State University, Detroit, MI, USA
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Wutich A, Ruth A, Brewis A, Boone C. Stigmatized Neighborhoods, Social Bonding, and Health. Med Anthropol Q 2014; 28:556-77. [DOI: 10.1111/maq.12124] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Amber Wutich
- School of Human Evolution and Social Change; Arizona State University
| | - Alissa Ruth
- School of Human Evolution and Social Change; Arizona State University
| | - Alexandra Brewis
- School of Human Evolution and Social Change; Arizona State University
| | - Christopher Boone
- School of Sustainability and School of Human Evolution and Social Change; Arizona State University
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Hussen SA, Tsegaye M, Argaw MG, Andes K, Gilliard D, del Rio C. Spirituality, social capital and service: factors promoting resilience among Expert Patients living with HIV in Ethiopia. Glob Public Health 2014; 9:286-98. [PMID: 24520996 DOI: 10.1080/17441692.2014.880501] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
People living with HIV (PLHIV) in Ethiopia and other developing nations face numerous challenges to their health and well-being, including poverty, limited healthcare infrastructure and high levels of societal stigma. Despite these challenges, resilient trajectories have been observed even within such resource-limited settings. In Ethiopia, such resilience is exemplified by the 'Expert Patients (EPTs)', HIV-positive lay health workers who function as adherence counsellors, health educators, outreach workers and community advocates. We conducted a multi-method qualitative study with 20 EPTs in Addis Ababa, Ethiopia in order to understand pathways to resilience in this selected population. Participants described three key mechanisms of resilient coping: (1) the use of spirituality and faith-based practices to manage psychological difficulties associated with living with HIV; (2) utilisation of social capital from family and community networks as a buffer against the psychological and economic consequences of societal stigma; and (3) serving others as a mechanism for finding optimism and purpose in life. Interventions designed to facilitate and/or augment these social processes in the wider community may be promising strategies for improving health among PLHIV in Ethiopia and other resource-limited settings.
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Affiliation(s)
- Sophia Ahmed Hussen
- a Hubert Department of Global Health , Rollins School of Public Health of Emory University , Atlanta , GA , USA
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Kelly M, Zimmer-Gembeck MJ, Boislard-P MA. Identity, intimacy, status and sex dating goals as correlates of goal-consistent behavior and satisfaction in Australian youth. J Adolesc 2012; 35:1441-54. [DOI: 10.1016/j.adolescence.2012.03.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 02/26/2012] [Accepted: 03/05/2012] [Indexed: 11/26/2022]
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Kaljee LM, Chen X. Social capital and risk and protective behaviors: a global health perspective. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2011; 2011:113-122. [PMID: 23243387 PMCID: PMC3521560 DOI: 10.2147/ahmt.s26560] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Social capital and health research has emerged as a focus of contemporary behavioral epidemiology, while intervention research is seeking more effective measures to increase health protective behaviors and decrease health-risk behaviors. In this review we explored current literature on social capital and health outcomes at the micro-, mesa-, and macro-levels with a particular emphasis on research that incorporates a social capital framework, and adolescent and young adult engagement in risk behaviors. These data indicate that across a broad range of socio-cultural and economic contexts, social capital can affect individuals’ risk for negative health outcomes and their engagement in risk behaviors. Further research is needed which should focus on differentiating and measuring positive and negative social capital within both mainstream and alternative social networks, assessing how social constructions of gender, ethnicity, and race – within specific cultural contexts – mediate the relationship between social capital and risk and/or protective behaviors. This new research should integrate the existing research within historical socioeconomic and political conditions. In addition, social capital scales need to be developed to be both culturally and developmentally appropriate for use with adolescents living in a diversity of settings. Despite the proliferation of social capital research, the concept remains underutilized in both assessment and intervention development for adolescents’ and young adults’ engagement in risk behaviors and their associated short- and long-term poor health outcomes.
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Affiliation(s)
- Linda M Kaljee
- Pediatric Prevention Research Center, The Carmen and Ann Department of Pediatrics, Wayne State University, Detroit, MI, USA
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Intimacy, identity and status: Measuring dating goals in late adolescence and emerging adulthood. MOTIVATION AND EMOTION 2011. [DOI: 10.1007/s11031-011-9253-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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