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The impact of paid sick leave mandates on Women's health. Soc Sci Med 2023; 323:115839. [PMID: 36989657 DOI: 10.1016/j.socscimed.2023.115839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023]
Abstract
The United States does not have a national program to provide job-protected paid leave to workers when they or a family member are ill or need to seek medical care. Many workers receive paid sick leave through their employers, but women, particularly parents, those without a college degree, and Latinas, are less likely than their counterparts to receive employer-provided paid sick leave (PSL). To address the shortfall in PSL coverage, several states and localities have passed laws mandating employers to provide PSL. I examine the impacts of three recent state-level paid sick leave policies on women's self-reported health using data from the Behavior Risk Factor Surveillance System. Using static and event-study difference-in-differences models, I find that PSL mandates decreased the proportion of women reporting fair or poor health by an average of 2.4 percentage points and reduced the number of days women reported their physical and mental health was not good by 0.68 days and 0.43 days in the past 30 days respectively. Effects were concentrated among parents, women without college degrees, and women of color. This study demonstrates that despite being a low-intensity policy, PSL improves women's health and well-being and that mandating workplace benefits may play a role in achieving health equity.
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Bolbocean C, Rhidenour KB, McCormack M, Suter B, Holder JL. COVID-19 Induced Environments, Health-Related Quality of Life Outcomes and Problematic Behaviors: Evidence from Children with Syndromic Autism Spectrum Disorders. J Autism Dev Disord 2023; 53:1000-1016. [PMID: 35672615 PMCID: PMC9172988 DOI: 10.1007/s10803-022-05619-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 11/29/2022]
Abstract
Between July 2020 and January 2021, 230 principal caregivers completed a questionnaire to measure proxy-assessed health-related quality of life outcomes (HRQoL), behavioral outcomes in children with syndromic autism spectrum disorders and COVID-19 induced changes to lifestyle and environments. HRQoL and behavioral outcomes reported earlier during the pandemic were generally worse compared to those reported later. COVID-19 induced reduction to a caregiver's mental health appointments, and hours spent watching TV were associated with decreases in HRQoL and increased the likelihood of problematic behaviors. Increasing time outdoors and time away from digital devices were positively associated with HRQoL and behaviors and might protect children from COVID-19 induced restrictions.
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Affiliation(s)
- Corneliu Bolbocean
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | | | - Maria McCormack
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund St. Suite 925, Houston, TX, 77030, USA
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Bernhard Suter
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - J Lloyd Holder
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund St. Suite 925, Houston, TX, 77030, USA
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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Health-related quality of life of the adult COVID-19 patients following one-month illness experience since diagnosis: Findings of a cross-sectional study in Bangladesh. PLoS One 2023; 18:e0279032. [PMID: 36812259 PMCID: PMC9946204 DOI: 10.1371/journal.pone.0279032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/29/2022] [Indexed: 02/24/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) stances an incredible impact on the quality of life and denigrates the physical and mental health of the patients. This cross-sectional study aimed to assess the health-related quality of life (HRQOL) of COVID-19 patients. We conducted this study at the National Institute of Preventive and Social Medicine (NIPSOM) of Bangladesh for the period of June to November 2020. All the COVID-19 patients diagnosed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay in July 2020 formed the sampling frame. The study enrolled 1204 adult (aged >18 years) COVID-19 patients who completed a one-month duration of illness after being RT-PCR positive. The patients were interviewed with the CDC HRQOL-14 questionnaire to assess HRQOL. Data were collected by telephone interview on the 31st day of being diagnosed and by reviewing medical records using a semi-structured questionnaire and checklist. Around two-thirds (72.3%) of the COVID-19 patients were males and a half (50.2%) were urban residents. In 29.8% of patients, the general health condition was not good. The mean (±SD) duration of physical illness and mental illness was 9.83(±7.09) and 7.97(±8.12) days, respectively. Most of the patients (87.0%) required help with personal care, and 47.8% required assistance with routine needs. The mean duration of 'healthy days' and 'feeling very healthy' was significantly lower in patients with increasing age, symptoms, and comorbidity. The mean duration of 'usual activity limitation', 'health-related limited activity', 'feeling pain/worried', and 'not getting enough rest' were significantly higher among patients' having symptoms and comorbidity. 'Not so good' health condition was significantly higher in females (OR = 1.565, CI = 1.01-2.42) and those having a symptom (OR = 32.871, CI = 8.06-134.0) of COVID-19 and comorbidity (OR = 1.700, CI = 1.26-2.29). Mental distress was significantly higher among females (OR = 1.593, CI = 1.03-2.46) and those having a symptom (OR = 4.887, CI = 2.58-9.24). Special attention should be given to COVID-19 patients having symptoms and comorbidity to restore their general health, quality of life, and daily activities.
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Das Gupta D, Wong DWS. Age-Dependent Differences in Frequent Mental Distress (FMD) of US Older Adults Living in Multigenerational Families versus Living Alone. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3747. [PMID: 36834440 PMCID: PMC9964232 DOI: 10.3390/ijerph20043747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Frequent mental distress (FMD) is prevalent among older Americans, but less is known about disparities in FMD of older adults living in multigenerational families versus living alone. We pooled cross-sectional data (unweighted, n = 126,144) from the Behavioral Risk Factor Surveillance System (BRFSS) between 2016 and 2020 and compared FMD (≥14 poor mental health days in the past 30 days = 1; 0 otherwise) of older adults (≥65 years) living in multigenerational families versus living alone in 36 states. After controlling for covariates, findings indicate 23% lower odds of FMD among older adults living in multigenerational households compared to counterparts living alone (adjusted odds ratio (AOR): 0.77; 95% confidence interval (CI): 0.60, 0.99). Findings also show that the reduction in the odds of FMD with each 5 year increase in age was larger among older adults living in multigenerational families by 18% (AOR: 0.56; 95% CI: 0.46, 0.70) compared to older adults living alone (AOR: 0.74; 95% CI: 0.71, 0.77), and this difference was significant at the 5% significance level. Multigenerational living may have a protective association with FMD among older adults. Further research is needed to identify multigenerational family and non-kin factors that translate into mental health advantages for older adults.
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Affiliation(s)
- Debasree Das Gupta
- Department of Kinesiology and Health Science, Emma Eccles Jones College of Education and Human Services, Utah State University, Logan, UT 84322, USA
| | - David W. S. Wong
- Department of Geography and Geoinformation Science, George Mason University, Fairfax, VA 22030, USA
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Dobre C, Băjenaru L, Drăghici R, Prada GI, Balog A, Herghelegiu AM. Sustainable Health-Related Quality of Life in Older Adults as Supported by the vINCI Technology. SENSORS (BASEL, SWITZERLAND) 2023; 23:2287. [PMID: 36850888 PMCID: PMC9964874 DOI: 10.3390/s23042287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
The vINCI technology represents an innovative instrument developed specifically but not exclusively for older adults by technology researchers together with a medical team specialized in geriatrics and gerontology. It was designed to be independently and effortlessly used by older adults in the comfort and safety of their own environment. It is a modular and flexible platform that can integrate a large array of various sensors and can easily adapt to specific healthcare needs. The pilot study tested sensors and standardized instruments capable of evaluating several care-related parameters and of generating personalized feedback for the user dedicated to optimizing physical activity level, social interaction, and health-related quality of life. Moreover, the system was able to detect and signal events and health-related aspects that would require medical assistance. This paper presents how the innovative vINCI technology improves quality of life in older adults. This is evidenced by the results obtained following the clinical validation of the vINCI technology by older adults admitted to the Ana Aslan National Institute of Gerontology and Geriatrics (NIGG) in Bucharest.
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Affiliation(s)
- Ciprian Dobre
- Faculty of Automatic Control and Computers, University Politehnica of Bucharest, 060042 Bucharest, Romania
- National Institute for Research and Development in Informatics, 011455 Bucharest, Romania
| | - Lidia Băjenaru
- Faculty of Automatic Control and Computers, University Politehnica of Bucharest, 060042 Bucharest, Romania
- National Institute for Research and Development in Informatics, 011455 Bucharest, Romania
| | - Rozeta Drăghici
- “Ana Aslan” National Institute of Gerontology and Geriatrics, 011241 Bucharest, Romania
| | - Gabriel-Ioan Prada
- “Ana Aslan” National Institute of Gerontology and Geriatrics, 011241 Bucharest, Romania
- Department of Geriatrics and Gerontology, “Carol Davila” Universty of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Alexandru Balog
- Doctoral School of Economic Informatics, Bucharest University of Economics Studies, 010374 Bucharest, Romania
| | - Anna Marie Herghelegiu
- “Ana Aslan” National Institute of Gerontology and Geriatrics, 011241 Bucharest, Romania
- Department of Geriatrics and Gerontology, “Carol Davila” Universty of Medicine and Pharmacy, 050474 Bucharest, Romania
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Hosseini M, Nasrabadi M, Mollanoroozy E, Khani F, Mohammadi Z, Barzanoni F, Amini A, Gholami A. Relationship of sleep duration and sleep quality with health-related quality of life in patients on hemodialysis in Neyshabur. Sleep Med X 2023; 5:100064. [PMID: 36865567 PMCID: PMC9972367 DOI: 10.1016/j.sleepx.2023.100064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/12/2023] Open
Abstract
Background As a public health priority, health-related quality of life (HRQoL) is associated with some factors like sleep disorders. Taking this into consideration, this study aimed at investigating the relationship between sleep duration and sleep quality with HRQoL in patients on hemodialysis. Methods This cross-sectional study was carried out among 176 patients on hemodialysis who were admitted to the dialysis ward of 22 Bahman hospital and a private renal clinic in Neyshabur (a city in North-East of Iran) in 2021. Sleep duration and quality were measured using an Iranian version of Pittsburgh Sleep Quality Index (PSQI) and HRQoL was evaluated with the Iranian version of a 12-Item Short Form Survey (SF-12). To analyze the data and examine the independent association of sleep duration and quality with HRQoL, multiple linear regression model was performed. Results The mean age of the participants was 51.6 ± 16.4 and 63.6% were male. Moreover, 55.1% and 5.7% of subjects reported a sleep duration shorter than 7 h and equal to or more than 9 h, respectively, and the value prevalence of poor sleep quality was reported as 78.2%. Furthermore, the reported overall score of HRQoL was 57.6 ± 17.9. According to the adjusted models, poor sleep quality was negatively associated with the total HRQoL score (B = -14.5, P < 0.001). Shedding light on sleep duration and Physical Component Summary (PCS), the result indicated that insufficient sleep duration (<7 h) had a borderline negative association with PCS (B = -5.96, p = 0.049). Conclusions Sleep duration and quality have important effects on HRQoL in patients on hemodialysis. Therefore, in line with improving sleep quality and HRQoL among these patients, essential interventions should be planned and performed.
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Affiliation(s)
- Minasadat Hosseini
- Student Research Committee, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Maryam Nasrabadi
- Public Health Department, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Ensiyeh Mollanoroozy
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Fatemeh Khani
- Student Research Committee, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Zahra Mohammadi
- Student Research Committee, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Faeze Barzanoni
- Student Research Committee, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Asieh Amini
- Ph.D. Candidate in English Language Teaching, Razi University, Kermanshah, Iran
| | - Ali Gholami
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran,Epidemiology & Biostatistics Department, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran,Corresponding author. Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Janbazan Ave, Neyshabur, Iran. Tel.: +98 51 42632470; fax: +98 51 43348895.
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Lee Y, Ye M, Tully J, Salah S, Kerob D, Abuabara K. The impact of dermatitis on health-related quality of life: Data from the National Health and Nutrition Examination Survey. J Eur Acad Dermatol Venereol 2023; 37:e175-e179. [PMID: 36151939 DOI: 10.1111/jdv.18600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/14/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Yong Lee
- Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California, USA
| | - Morgan Ye
- Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California, USA
| | - Janell Tully
- Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California, USA.,University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA
| | - Samir Salah
- La Roche-Posay Laboratoire dermatologique, Levallois Perret, France
| | - Delphine Kerob
- La Roche-Posay Laboratoire dermatologique, Levallois Perret, France
| | - Katrina Abuabara
- Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California, USA.,University of California Berkeley, School of Public Health, Berkeley, California, USA
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Tobia L, Muselli M, De Luca F, Cofini V, Mastrangeli G, Fabiani L, Necozione S. Community pharmacists' perceptions and experiences of stress during COVID-19. J Pharm Policy Pract 2023; 16:17. [PMID: 36707906 PMCID: PMC9880923 DOI: 10.1186/s40545-023-00523-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/15/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Pharmacists play a crucial role in the COVID-19 pandemic scenario, performing frontline roles for the community, and supporting the healthcare system. This study aimed at investigating stress and its correlates among this category of workers at a high risk of SARS-CoV-2 infection. METHODS The participants for this study were employees of the "Municipal Pharmaceutical Company" of L'Aquila (Italy). Data were collected using an anonymous, web-based, self-administered questionnaire. Two independent surveys were conducted, from June to July 2020, and in January 2021. RESULTS Two separate groups of respondents were involved: a total of 37 workers participated in the first survey (mean age 44.9 ± 10.7, 75.7% women) and 18 in the second survey (mean age 45.9 ± 9.2, 94.4% women). The average total scores of the perceived stress (GHQ-12 score) increased significantly from 15.5 to 18.2 (p = 0.0438), showing a moderate level of stress in the category investigated. CONCLUSIONS We observed a strong emotional exhaustion in the study sample of pharmacists, who reported high-risk perceptions and fear. A comprehensive assistance should be granted to support the well-being of healthcare workers who provide an essential service, despite the high risk of infection.
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Affiliation(s)
- Loreta Tobia
- grid.158820.60000 0004 1757 2611Department of Life, Health and Environmental Sciences, University of L’Aquila, (MeSVA-UNIVAQ), Piazzale Salvatore Tommasi 1, 67100 Coppito, AQ Italy
| | - Mario Muselli
- grid.158820.60000 0004 1757 2611Department of Life, Health and Environmental Sciences, University of L’Aquila, (MeSVA-UNIVAQ), Piazzale Salvatore Tommasi 1, 67100 Coppito, AQ Italy
| | - Fabio De Luca
- grid.158820.60000 0004 1757 2611Department of Life, Health and Environmental Sciences, University of L’Aquila, (MeSVA-UNIVAQ), Piazzale Salvatore Tommasi 1, 67100 Coppito, AQ Italy
| | - Vincenza Cofini
- grid.158820.60000 0004 1757 2611Department of Life, Health and Environmental Sciences, University of L’Aquila, (MeSVA-UNIVAQ), Piazzale Salvatore Tommasi 1, 67100 Coppito, AQ Italy
| | - Giada Mastrangeli
- grid.158820.60000 0004 1757 2611Department of Life, Health and Environmental Sciences, University of L’Aquila, (MeSVA-UNIVAQ), Piazzale Salvatore Tommasi 1, 67100 Coppito, AQ Italy
| | - Leila Fabiani
- grid.158820.60000 0004 1757 2611Department of Life, Health and Environmental Sciences, University of L’Aquila, (MeSVA-UNIVAQ), Piazzale Salvatore Tommasi 1, 67100 Coppito, AQ Italy
| | - Stefano Necozione
- grid.158820.60000 0004 1757 2611Department of Life, Health and Environmental Sciences, University of L’Aquila, (MeSVA-UNIVAQ), Piazzale Salvatore Tommasi 1, 67100 Coppito, AQ Italy
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Agner J, Meyer M, Kaukau TM, Liu M, Nakamura L, Botero A, Sentell T. Health Literacy, Social Networks, and Health Outcomes among Mental Health Clubhouse Members in Hawai'i. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:837. [PMID: 36613158 PMCID: PMC9820034 DOI: 10.3390/ijerph20010837] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Health literacy is the ability to obtain and utilize health information to make health-related decisions and to navigate health systems. Although health literacy has traditionally been understood as an individual-level construct, current research is revealing the impact that social networks can have on health literacy. To date, no studies have examined associations between health literacy and social networks among people with serious mental illness (PWSMI), who are at high risk of physical illness and premature mortality. To begin to fill this gap, this study explores associations between health literacy, relationships with health discussion partners, and self-reported health outcomes in a racially diverse sample of Clubhouse members in Hawai'i. Clubhouses are community mental health centers that promote recovery from mental illness through destigmatization, meaningful activity, and strong social relationships. Health literacy was assessed using two single-item screeners (SILS). In a sample of 163 members, 56.2% reported adequate ability to understand health-related instructions or pamphlets, and 43.3% reported adequate confidence filling out medical forms independently. This is consistent with other health literacy studies with PWSMI in the United States, and indicates lower health literacy within this group than is reported in national averages. Multivariate logistic regression revealed a larger Clubhouse staff social network and completing high school were significantly associated with requiring less help to read materials. Higher age, male gender, and being Native Hawaiian and/or Pacific Islander were associated with less confidence filling out medical forms, while higher self-efficacy was associated with higher confidence filling out medical forms. This study provides preliminary evidence that relationships fostered within Clubhouses are associated with health literacy among PWSMI, and highlights the need for more research to examine how social networks and health literacy interventions can be leveraged in community mental health settings to improve health outcomes within this vulnerable population.
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Affiliation(s)
- Joy Agner
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA
| | - Monet Meyer
- Department of Psychology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | | | - Maileen Liu
- Department of Psychology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Lisa Nakamura
- Department of Psychology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Adriana Botero
- Hawai‘i School of Professional Psychology, Chaminade University of Honolulu, Honolulu, HI 96816, USA
| | - Tetine Sentell
- Office of Public Health Studies, Thompson School of Social Work, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
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Singh I, Asnani MR, Harrison A. Health-Related Quality of Life in Adolescents With Chronic Illness in Jamaica: Adolescent and Parent Reports. J Adolesc Health 2023; 72:12-20. [PMID: 36202679 DOI: 10.1016/j.jadohealth.2022.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE The aim of this study is to assess the level of agreement between adolescents' self-assessment and parent-proxy reports on health-related quality of life (HRQOL) in Jamaican adolescents with chronic illness. METHODS A cross-sectional study was conducted, recruiting adolescents living with a chronic illness (ALCIs)-asthma, human immunodeficiency virus, insulin-dependent diabetes mellitus, or sickle cell disease and age/sex-matched healthy adolescents. Data were collected on HRQOL from adolescents and parents using the Pediatric Quality of Life Scale. Parent-adolescent agreement was determined at group level (Wilcoxon signed-rank test) and individual level (intraclass correlation coefficient). RESULTS Two hundred twenty-six (226) parent/adolescent pairs participated: 130 ALCIs and 96 healthy peers; mean age 14.9 ± 2.8 years; 58% females. Adolescents with and without chronic illness reported similar HRQOL; parent-proxies reported better HRQOL for healthy adolescents compared to ALCIs. Intraclass correlation demonstrated higher levels of parent-adolescent correlation for ALCIs than healthy adolescents (ALCIs: 0.11-0.34; healthy adolescents: 0.01-0.10). At group level, analyses demonstrated better parent-proxy rating of QOL in all of the scores with the exception of the general health score. Parent-proxies overestimated QOL for asthma and insulin-dependent diabetes mellitus but not for sickle cell disease and human immunodeficiency virus. Linear regression modeling revealed that female sex and living with chronic illness were significant predictors of agreement. DISCUSSION Parent-proxies overestimated adolescents' QOL compared to adolescents' report regardless of whether the adolescent was living with a chronic illness or not. As such, health care providers should elicit feedback from the adolescent wherever possible and proxy reports should be used as complementary information rather than primary source.
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Affiliation(s)
- Indira Singh
- Department of Child and Adolescent Health, The University of the West Indies, Mona, Kingston, Jamaica
| | - Monika Rani Asnani
- Caribbean Institute for Health Research-Sickle Cell Unit, The University of the West Indies, Mona, Kingston, Jamaica
| | - Abigail Harrison
- Department of Child and Adolescent Health, The University of the West Indies, Mona, Kingston, Jamaica.
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Bolbocean C, van der Pal S, van Buuren S, Anderson PJ, Bartmann P, Baumann N, Cheong JLY, Darlow BA, Doyle LW, Evensen KAI, Horwood J, Indredavik MS, Johnson S, Marlow N, Mendonça M, Ni Y, Wolke D, Woodward L, Verrips E, Petrou S. Health-Related Quality-of-Life Outcomes of Very Preterm or Very Low Birth Weight Adults: Evidence From an Individual Participant Data Meta-Analysis. PHARMACOECONOMICS 2023; 41:93-105. [PMID: 36287335 PMCID: PMC9813180 DOI: 10.1007/s40273-022-01201-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Assessment of health-related quality of life for individuals born very preterm and/or low birthweight (VP/VLBW) offers valuable complementary information alongside biomedical assessments. However, the impact of VP/VLBW status on health-related quality of life in adulthood is inconclusive. The objective of this study was to examine associations between VP/VLBW status and preference-based health-related quality-of-life outcomes in early adulthood. METHODS Individual participant data were obtained from five prospective cohorts of individuals born VP/VLBW and controls contributing to the 'Research on European Children and Adults Born Preterm' Consortium. The combined dataset included over 2100 adult VP/VLBW survivors with an age range of 18-29 years. The main exposure was defined as birth before 32 weeks' gestation (VP) and/or birth weight below 1500 g (VLBW). Outcome measures included multi-attribute utility scores generated by the Health Utilities Index Mark 3 and the Short Form 6D. Data were analysed using generalised linear mixed models in a one-step approach using fixed-effects and random-effects models. RESULTS VP/VLBW status was associated with a significant difference in the Health Utilities Index Mark 3 multi-attribute utility score of - 0.06 (95% confidence interval - 0.08, - 0.04) in comparison to birth at term or at normal birthweight; this was not replicated for the Short Form 6D. Impacted functional domains included vision, ambulation, dexterity and cognition. VP/VLBW status was not associated with poorer emotional or social functioning, or increased pain. CONCLUSIONS VP/VLBW status is associated with lower overall health-related quality of life in early adulthood, particularly in terms of physical and cognitive functioning. Further studies that estimate the effects of VP/VLBW status on health-related quality-of-life outcomes in mid and late adulthood are needed.
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Affiliation(s)
- Corneliu Bolbocean
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
| | - Sylvia van der Pal
- Netherlands Organisation for Applied Scientific Research, The Hague, the Netherlands
| | - Stef van Buuren
- Netherlands Organisation for Applied Scientific Research, The Hague, the Netherlands
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Peter Bartmann
- Department of Neonatology and Paediatric Intensive Care, University Hospital Bonn, Children's Hospital, Bonn, Germany
| | - Nicole Baumann
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
- Department of Health Sciences, University of Leicester, Leicester, UK
- Department of Psychology, University of Warwick, Warwick, UK
| | - Jeanie L Y Cheong
- Department of Obstetrics and Gynaecology, Clinical Sciences, Murdoch Children's Research Institute, Newborn Services, Royal Women's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Brian A Darlow
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Lex W Doyle
- Department of Obstetrics and Gynaecology, Clinical Sciences, Murdoch Children's Research Institute, Newborn Services, Royal Women's Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - John Horwood
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Marit S Indredavik
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Marina Mendonça
- Department of Obstetrics and Gynaecology, Clinical Sciences, Murdoch Children's Research Institute, Newborn Services, Royal Women's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Yanyan Ni
- Department of Obstetrics and Gynaecology, Clinical Sciences, Murdoch Children's Research Institute, Newborn Services, Royal Women's Hospital, University of Melbourne, Melbourne, VIC, Australia
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Dieter Wolke
- Department of Psychology, Warwick Medical School, University of Warwick and Division of Health Sciences, Warwick, UK
| | - Lianne Woodward
- Faculty of Health, University of Canterbury, Christchurch, New Zealand
| | - Erik Verrips
- Netherlands Organisation for Applied Scientific Research, The Hague, the Netherlands
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
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Barr ML, McNamara J. Community-Based Participatory Research: Partnering with College Students to Develop a Tailored, Wellness-Focused Intervention for University Campuses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16331. [PMID: 36498404 PMCID: PMC9735608 DOI: 10.3390/ijerph192316331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
College students face unique challenges with leading healthful lifestyles. Using a community-based participatory research approach, college student research partners at two land-grant universities collected data and developed a tailored intervention to improve the well-being of college students. To inform the design of the program, college students were trained to conduct a needs assessment that included a campus-wide survey on the health behaviors of college students, environmental audits of health policies and food pantries on campus, and stakeholder interviews with campus health professionals. Outcomes of the needs assessment data highlighted university students ranked their health as "good" but nutrition health as "fair/poor." Low or very low food security was self-reported by 36.9% of participants and had an overall diet quality score of 47.6 ± 10.1 out of 100. Health professional interview data indicated campuses provide healthful resources to students, but students are not aware those resources exist. Utilizing the needs assessment data previously mentioned, the nominal group technique was then used for student research partners to collaboratively determine the best intervention approaches and develop a wellness program. Student partners identified (1) education, (2) sharing of campus resources, and (3) incentives as important areas of intervention. Using the data collected, the student research partners developed a program titled, The College Cooking Connection, to address health-related quality of life in college students. Using a community-based participatory research approach to program planning, educators and researchers have a greater likelihood of addressing the current needs of the population they are targeting and developing a successful intervention to meet those health concerns. This study aims to partner with young adult university students to understand the college environment and allow the target community to be involved with the development of intervention programs for their campus.
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Affiliation(s)
- Makenzie L. Barr
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY 40506, USA
| | - Jade McNamara
- Department of Food Science and Nutrition, University of Maine, Orono, ME 04473, USA
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Zullo L, Grzenda A, Vargas SM, Miranda J. Age-Associated Differences in Mental Distress Among Sexual and Gender Minority Adults. Psychiatr Serv 2022; 73:1352-1358. [PMID: 35734867 DOI: 10.1176/appi.ps.202100059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to use a large population-based sample to investigate age-associated differences in mental distress among sexual and gender minority (SGM) adults compared with their heterosexual, cisgender counterparts. METHODS Data were pooled from five cycles (2014-2018) of the Behavioral Risk Factor Surveillance System (BRFSS) survey (N=762,541) and included states that administered the optional SGM module during that interval. Mean days of self-reported mental distress and the rate of frequent mental distress (≥14 days of mental distress per month) were calculated for each age and SGM identity stratum by using linear and logistic regression, respectively. Models controlled for socioeconomic factors and medical comorbid conditions. All analyses accounted for the complex survey design of the BRFSS. RESULTS Among those ages 18-24 years, mean days of mental distress and the rate of frequent mental distress were significantly higher for SGM subgroups compared with cisgender, heterosexual adults. Among those ages 45-54, 55-64, or ≥65, no differences were noted between SGM groups and their cisgender, heterosexual peers. CONCLUSIONS Younger SGM respondents reported the highest levels of mental distress. Differences in general mental distress were less detectable with increasing age. The findings suggest that SGM young adults have an increased need for mental health services.
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Affiliation(s)
- Lucas Zullo
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles (all authors); Olive View-UCLA Medical Center, Sylmar, California (Grzenda); Departments of Psychology and Preventive Medicine, University of Southern California, Los Angeles (Vargas)
| | - Adrienne Grzenda
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles (all authors); Olive View-UCLA Medical Center, Sylmar, California (Grzenda); Departments of Psychology and Preventive Medicine, University of Southern California, Los Angeles (Vargas)
| | - Sylvanna M Vargas
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles (all authors); Olive View-UCLA Medical Center, Sylmar, California (Grzenda); Departments of Psychology and Preventive Medicine, University of Southern California, Los Angeles (Vargas)
| | - Jeanne Miranda
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles (all authors); Olive View-UCLA Medical Center, Sylmar, California (Grzenda); Departments of Psychology and Preventive Medicine, University of Southern California, Los Angeles (Vargas)
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Ringsten M, Iwarsson S, Lexell EM. PROTOCOL: Interventions to improve outdoor mobility among adults with disability. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1280. [PMID: 36908835 PMCID: PMC9538711 DOI: 10.1002/cl2.1280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows: to assess the efficacy of interventions aiming to improve outdoor mobility for people with disability and to explore if the efficacy varies between different populations and different intervention components.
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Affiliation(s)
- Martin Ringsten
- Cochrane Sweden, Research and Development Skåne University Hospital Lund Sweden
- Department of Health Sciences Lund University Lund Sweden
| | | | - Eva Månsson Lexell
- Department of Health Sciences Lund University Lund Sweden
- Department of Neurology, Rehabilitation Medicine, Cognitive Medicine and Geriatrics Skåne University Hospital Lund-Malmö Sweden
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Comparative performance of the EuroQol EQ-5D-5L and the CDC healthy days measures in assessing population health. J Patient Rep Outcomes 2022; 6:64. [PMID: 35696002 PMCID: PMC9192869 DOI: 10.1186/s41687-022-00474-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 06/02/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives To examine the comparative performance of EuroQol EQ-5D-5L and Center for Disease Control Healthy Days measures in assessing population health.
Methods Using data from 2014 Alberta Community Health Survey, a cross-sectional population-based survey (N = 7559), conducted in Alberta, Canada, we examined construct validity of the measures as indicators of population health. Differences in EQ-5D-5L index score, visual analogue scale (EQ-VAS), and CDC unhealthy days index across socio-demographic subgroups were tested by Mann–Whitney and Kruskal–Wallis tests using known-groups approach. Results EQ-5D-5L and CDC Healthy Days provided comparable assessments of population health in this sample. Both measures discriminated between subgroups defined by self-perceived health status, level of education, and material deprivation. The discriminative ability of CDC Healthy Days was limited in capturing variability in health among age groups compared to the EQ-5D-5L. Among participants who reported 0 unhealthy days, the proportion of those with level 3 problems in pain/discomfort varied from 1.1% for participants aged 18–24 to 19.2% for those over 75 years. Conclusions EQ-5D-5L demonstrated better construct validity than CDC Healthy Days in assessing health in a population-based sample of adults.
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Jones HJ, Butsch Kovacic M, Lambert J, Almallah WR, Becker R, de las Fuentes L, Bakas T. A randomized feasibility trial of the Midlife Black Women's Stress and Wellness intervention (B-SWELL); a community participatory intervention to increase adoption of Life's Simple 7 healthy lifestyle behaviors. Transl Behav Med 2022; 12:1084-1095. [PMID: 36208220 PMCID: PMC9677463 DOI: 10.1093/tbm/ibac075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Black women have a disproportionately higher incidence of cardiovascular disease-related mortality than other groups, yet they are less likely to receive culturally proficient education and competent preventive care. PURPOSE The purpose of this study was to determine feasibility of the Midlife Black Women's Stress and Wellness intervention (B-SWELL); a culturally adapted, 8-week group intervention leveraging stress reduction and goal setting to increase awareness and adoption of Life's Simple 7 (LS7) healthy lifestyle behaviors. METHODS A randomized feasibility trial was conducted. Participants (N = 48, mean age = 55 years) were randomized to the B-SWELL or a group wellness (WE) intervention that lacked stress reduction and goal setting instruction. We hypothesized that B-SWELL participants would achieve a lower perceived stress, greater self-efficacy, improved LS7 scores, fewer symptoms (depression and unhealthy days), and greater perceived general health compared to WE participants. Survey data were collected at three timepoints: baseline, 8 weeks, and 12 weeks. RESULTS Both B-SWELL and WE groups had low attrition and navigated the online platform well. Further, both groups experienced lower perceived stress, improved LS7 scores, reduced depressive symptoms, and greater perceived general health from baseline to 8 weeks. Based on data trends, participants in the B-SWELL had more improvement in perceived stress, self-efficacy, and mental and physical unhealthy days compared to WE participants. CONCLUSION The B-SWELL is a feasible intervention for midlife Black women. Positive data trends were found for both B-SWELL and WE groups. Based on observations from the feasibility study, a larger outcomes-based study is planned.
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Affiliation(s)
- Holly J Jones
- Ohio State University College of Nursing Martha S. Pitzer Center for Women, Children, and Youth, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Melinda Butsch Kovacic
- University of Cincinnati College of Allied Health Sciences 3225 Eden Ave, Cincinnati, OH 45267, USA
- Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA
- University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA
| | - Joshua Lambert
- University of Cincinnati College of Nursing, 3110 Vine Street, Cincinnati, OH 45221, USA
| | - Wala’a R Almallah
- University of Cincinnati College of Nursing, 3110 Vine Street, Cincinnati, OH 45221, USA
| | - Richard Becker
- University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA
| | - Lisa de las Fuentes
- Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63110, USA
| | - Tamilyn Bakas
- University of Cincinnati College of Nursing, 3110 Vine Street, Cincinnati, OH 45221, USA
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Porter KJ, You W, Estabrooks PA, Zoellner JM. Relationships among changes in physical activity, quality of life, and obesity-Status following a behavioral intervention for rural Appalachian adults. Prev Med Rep 2022; 29:101949. [PMID: 36161126 PMCID: PMC9502328 DOI: 10.1016/j.pmedr.2022.101949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/05/2022] [Accepted: 08/10/2022] [Indexed: 11/17/2022] Open
Abstract
Increasing weekly strength training was associated with reduced unhealthy days. No other physical activity and health-related quality of life (HRQoL) changes were linked. Baseline obesity did not moderate physical activity and HRQoL change relationships.
Improved health-related quality of life (HRQoL) is one benefit of physical activity. Yet, there is limited intervention research exploring (1) whether changes in physical activity influence changes in HRQoL among community-based populations and (2) if baseline obesity status influences the relationships. This exploratory analysis used secondary data from rural Appalachian adults who completed the MoveMore arm of a larger randomized control trial (n = 105, Mage = 41.8, 82 % female, 96 % White, Mincome= $25,911). Specifically, this study examined associations among changes in physical activity and HRQOL and whether baseline obesity status moderated changes. Three HRQoL variables (self-rated health status, total unhealthy days, days poor health impacted activities) and two physical activity variables [weekly moderate-vigorous physical activity (MVPA) minutes, weekly strength training minutes] were collected at baseline and 6-months. Regression models, adjusted for age, gender, race, income, education, assessed associations between physical activity and HRQoL change variables. Moderation analyses explored the influence of baseline obesity status on these relationships. Participants reported significant improvements in self-rated health status (P = 0.001), weekly MVPA minutes (P = 0.008), and weekly strength training minutes (P < 0.001). Increasing weekly strength training minutes was associated with fewer days poor health impacted activities (B = -0.040, P = 0.013). Weekly minutes of MVPA was not associated with HRQoL variables. Baseline obesity status did not moderate relationships. Findings suggest increasing weekly strength training may reduce days poor health impacted activities and that relationships among changes in physical activity and HRQoL were not impacted by baseline obesity. Findings have implications for promoting strength activities in community-based physical activity interventions for rural populations.
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Affiliation(s)
- Kathleen J. Porter
- University of Virginia, School of Medicine, Department of Public Health Sciences, 16 East Main Street Suite 101 Christiansburg, VA 24073, United States
- Corresponding author.
| | - Wen You
- University of Virginia, School of Medicine, Department of Public Health Sciences, Charlottesville, VA 22903, United States
| | - Paul A. Estabrooks
- University of Utah, College of Health, Department of Health & Kinesiology, Salt Lake City, UT 84112, United States
| | - Jamie M. Zoellner
- University of Virginia, School of Medicine, Department of Public Health Sciences, 16 East Main Street Suite 101 Christiansburg, VA 24073, United States
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Cowden RG, Wȩziak-Białowolska D, McNeely E, VanderWeele TJ. Are depression and suffering distinct? An empirical analysis. Front Psychol 2022; 13:970466. [PMID: 36186371 PMCID: PMC9518749 DOI: 10.3389/fpsyg.2022.970466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Depression and the subjective experience of suffering are distinct forms of distress, but they are sometimes commingled with one another. Using a cross-sectional sample of flight attendants (n = 4,652), we tested for further empirical evidence distinguishing depression and suffering. Correlations with 15 indices covering several dimensions of well-being (i.e., physical health, emotional well-being, psychological well-being, character strengths, social well-being, financial/material well-being) indicated that associations with worse well-being were mostly stronger for depression than suffering. There was a large positive correlation between depression and suffering, but we also found evidence of notable non-concurrent depression and suffering in the sample. After dividing participants into four groups that varied based on severity of depression and suffering, regression analyses showed higher levels of well-being among those with both none-mild depression and none-mild suffering compared to those with moderate-severe depression, moderate-severe suffering, or both. All indices of well-being were lowest among the group of participants with moderate-severe depression and moderate-severe suffering. In addition to providing further evidence supporting a distinction between depression and suffering, our findings suggest that concurrent depression and suffering may be more disruptive to well-being than when either is present alone.
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Affiliation(s)
- Richard G. Cowden
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States
- *Correspondence: Richard G. Cowden,
| | - Dorota Wȩziak-Białowolska
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States
- Sustainability and Health Initiative (SHINE), Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, United States
- Centre for Evaluation and Analysis of Public Policies, Faculty of Philosophy, Jagiellonian University, Cracow, Poland
| | - Eileen McNeely
- Sustainability and Health Initiative (SHINE), Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Tyler J. VanderWeele
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States
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Han X, Shi SK, Zhao J, Nogueira LM, Bandi P, Fedewa SA, Jemal A, Yabroff KR. The first year of the COVID-19 pandemic and health among cancer survivors in the United States. Cancer 2022; 128:3727-3733. [PMID: 35989581 PMCID: PMC9537961 DOI: 10.1002/cncr.34386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/24/2022] [Accepted: 06/08/2022] [Indexed: 11/19/2022]
Abstract
Background Cancer survivors represent a population with high health care needs. If and how cancer survivors were affected by the first year of the coronavirus disease 2019 (COVID‐19) pandemic are largely unknown. Methods Using data from the nationwide, population‐based Behavioral Risk Factor Surveillance System (2017–2020), the authors investigated changes in health‐related measures during the COVID‐19 pandemic among cancer survivors and compared them with changes among adults without a cancer history in the United States. Sociodemographic and health‐related measures such as insurance coverage, employment status, health behaviors, and health status were self‐reported. Adjusted prevalence ratios of health‐related measures in 2020 versus 2017–2019 were calculated with multivariable logistic regressions and stratified by age group (18–64 vs. ≥65 years). Results Among adults aged 18–64 years, the uninsured rate did not change significantly in 2020 despite increases in unemployment. The prevalence of unhealthy behaviors, such as insufficient sleep and smoking, decreased in 2020, and self‐rated health improved, regardless of cancer history. Notably, declines in smoking were larger among cancer survivors than nonelderly adults without a cancer history. Few changes were observed for adults aged ≥65 years. Conclusions Further research is needed to confirm the observed positive health behavior and health changes and to investigate the role of potential mechanisms, such as the national and regional policy responses to the pandemic regarding insurance coverage, unemployment benefits, and financial assistance. As polices related to the public health emergency expire, ongoing monitoring of longer term effects of the pandemic on cancer survivorship is warranted. Among cancer survivors aged 18–64 years, the uninsured rate did not change significantly in 2020 despite increases in unemployment. The prevalence of unhealthy behaviors, such as insufficient sleep and smoking, decreased in 2020, and self‐rated health improved, regardless of cancer history.
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Affiliation(s)
- Xuesong Han
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Sylvia Kewei Shi
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Jingxuan Zhao
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Leticia M Nogueira
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Priti Bandi
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Stacey A Fedewa
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA.,Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia, USA
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - K Robin Yabroff
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
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Alamir YA, Zullig KJ, Kristjansson AL, Wen S, Misra R, Montgomery-Downs H. A theoretical model of college students' sleep quality and health-related quality of life. J Behav Med 2022; 45:925-934. [PMID: 35962152 DOI: 10.1007/s10865-022-00348-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 07/06/2022] [Indexed: 10/15/2022]
Abstract
Poor sleep confers significant morbidities and is highly prevalent among college students in the United States. This research assessed sleep quality and its association with health-related quality of life (HRQOL). Further, because sleep quality research often lacks a theoretical foundation, we applied a theoretical model using selected constructs from the Theory of Planned Behavior (TPB) and Health Belief Model (HBM). A random, stratified sample of undergraduate students participated in an online survey (N = 494). Structural equation modeling assessed the association between theoretical constructs, sleep quality, and HRQOL. The final model fit was acceptable, with ~ 20% of the variance in sleep quality explained by the theoretical constructs and control variables. HBM constructs were indirectly and negatively related to sleep quality, mediated through behavioral intention, and also positively and directly associated with behavioral intention. Behavioral intention was strongly and negatively associated with sleep quality. Approximately 31% of the variance in HRQOL was explained by poor sleep quality, behavioral intention, and gender. Poor sleep was most strongly associated with reduced HRQOL. HBM constructs and behavioral intention from TPB were significantly associated with poor sleep quality, and poor sleep was significantly related to poor HRQOL.
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Affiliation(s)
- Yahya Ahmed Alamir
- Department of Health Education and Promotion, Faculty of Public Health & Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Keith J Zullig
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, PO Box 9190, Morgantown, WV, 26506-9190, USA.
| | - Alfgeir L Kristjansson
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, PO Box 9190, Morgantown, WV, 26506-9190, USA
| | - Sijin Wen
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, PO Box 9190, Morgantown, WV, 26506, USA
| | - Ranjita Misra
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, PO Box 9190, Morgantown, WV, 26506-9190, USA
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Can integrating the Memory Support Intervention into cognitive therapy improve depression outcome? A randomized controlled trial. Behav Res Ther 2022; 157:104167. [DOI: 10.1016/j.brat.2022.104167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/12/2022] [Accepted: 07/22/2022] [Indexed: 11/18/2022]
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Houghtaling L, Osypuk TL. Health disparities among millennial veterans by sexual orientation. MILITARY PSYCHOLOGY 2022; 35:204-214. [PMID: 37133547 PMCID: PMC10157000 DOI: 10.1080/08995605.2022.2099708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The objective of this study was to examine sexual orientation-based disparities in six self-reported health outcomes among millennial aged military veterans. We collected data using The Millennial Veteran Health Study, a cross-sectional internet-based survey with extensive quality control measures. The survey was fielded April through December 2020 and targeted millennial aged veterans across the United States. A total of 680 eligible respondents completed the survey. We assessed six binary health outcomes: alcohol use, marijuana use, frequent chronic pain, opioid misuse, high psychological distress, and fair or poor health status. Using logistic regression adjusted for a range of demographic, socioeconomic, and military-based covariates, we find that bisexual veterans consistently report worse health than straight veterans for all six health outcomes tested. Results for gay or lesbian, compared to straight veterans, were less consistent. Sensitivity models with continuous outcomes, and stratified by gender, found similar results. These results have implications for improving the health of bisexual individuals, including addressing discrimination, belonging, and social identity, particularly in institutional settings that have traditionally heteronormative and masculine cultures such as the military.
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Affiliation(s)
- Laura Houghtaling
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
- Minnesota Population Center, University of Minnesota, Minneapolis, Minnesota
| | - Theresa L. Osypuk
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
- Minnesota Population Center, University of Minnesota, Minneapolis, Minnesota
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Wolfe RM, Beck-Felts K, Speakar B, Spaulding WD. Domains of Vulnerability, Resilience, Health Habits, and Mental and Physical Health for Health Disparities Research. Behav Sci (Basel) 2022; 12:240. [PMID: 35877310 PMCID: PMC9312124 DOI: 10.3390/bs12070240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 02/01/2023] Open
Abstract
Health disparities associated with severe mental illness (SMI) have become a major public health concern. The disparities are not directly due to the SMI. They involve the same leading causes of premature death as in the general population. The causes of the disparities are therefore suspected to reflect differences in health-related behavior and resilience. As with other problems associated with SMI, studying non-clinical populations at risk for future onset provides important clues about pathways, from vulnerability to unhealthy behavior and compromised resilience, to poor health and reduced quality of life. The purpose of this study was to identify possible pathways in a sample of public university students. Four domains of biosystemic functioning with a priori relevance to SMI-related vulnerability and health disparities were identified. Measures reflecting various well-studied constructs within each domain were factor-analyzed to identify common sources of variance within the domains. Relationships between factors in adjacent domains were identified with linear multiple regression. The results reveal strong relationships between common factors across domains that are consistent with pathways from vulnerability to health disparities, to reduced quality of life. Although the results do not provide dispositive evidence of causal pathways, they serve as a guide for further, larger-scale, longitudinal studies to identify causal processes and the pathways they follow to health consequences.
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Affiliation(s)
- Rebecca M. Wolfe
- Department of Psychology, College of Arts and Sciences, University of Nebraska-Lincoln, Lincoln, NE 68588, USA; (B.S.); (W.D.S.)
| | - Katie Beck-Felts
- The Psychology Department, College of Science & Mathematics, Rowan University, Glassboro, NJ 08028, USA;
| | - Brianna Speakar
- Department of Psychology, College of Arts and Sciences, University of Nebraska-Lincoln, Lincoln, NE 68588, USA; (B.S.); (W.D.S.)
| | - William D. Spaulding
- Department of Psychology, College of Arts and Sciences, University of Nebraska-Lincoln, Lincoln, NE 68588, USA; (B.S.); (W.D.S.)
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Sarfan LD, Gasperetti CE, Gumport NB, Harvey AG. Outcomes From the Transdiagnostic Sleep and Circadian Intervention (TranS-C) for Midlife and Older Adults With Serious Mental Illness and Sleep and Circadian Dysfunction. Behav Ther 2022; 53:585-599. [PMID: 35697424 PMCID: PMC10927276 DOI: 10.1016/j.beth.2022.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 12/21/2021] [Accepted: 02/10/2022] [Indexed: 12/19/2022]
Abstract
The present study tested outcomes of the Transdiagnostic Sleep and Circadian Intervention (TranS-C) among midlife and older adults with serious mental illness (SMI). Further, we tested predictors-credibility, expectancy, usefulness, and utilization-that may affect TranS-C outcomes. Midlife and older participants from a community setting (>49 years, 62.3% female, 37.7% African American or Black) with sleep and circadian problems and SMI were randomized to receive TranS-C plus usual care (TranS-C+UC, n = 27) or usual care followed by delayed treatment with TranS-C (UC-DT, n = 26). Immediate and delayed TranS-C data were combined to increase power (combined n = 52). Outcomes were assessed at pretreatment, posttreatment, and 6-month follow-up. Credibility and expectancy were assessed during the second session. Usefulness and utilization of TranS-C skills were assessed at posttreatment and 6-month follow-up. TranS-C+UC, relative to UC-DT, was associated with improvements in depression symptoms, sleep disturbance, overall sleep health, and select sleep/wake outcomes, though not all improvements were sustained at 6-month follow-up. Lower usefulness of TranS-C skills predicted more severe sleep disturbance at posttreatment and daytime sleep-related impairment at posttreatment and 6-month follow-up. Lower utilization predicted more severe psychiatric symptoms at posttreatment, sleep disturbance at posttreatment and 6-month follow-up, and overall impairment and daytime sleep-related impairment at 6-month follow-up. Higher credibility and expectancy predicted greater usefulness of TranS-C skills at posttreatment and 6-month follow-up and greater utilization at 6-month follow-up. Together, findings highlight benefits of TranS-C for midlife and older adults with SMI. However, boosting credibility, expectancy, utilization, and usefulness may meaningfully improve TranS-C outcomes.
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Antwi GO, Lohrmann DK, Jayawardene W, Chow A, Obeng CS, Sayegh AM. Associations between Cigarette Smoking and Health-Related Quality of Life in Adult Survivors of Adolescent and Young Adult Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:508-516. [PMID: 32728997 DOI: 10.1007/s13187-020-01837-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This cross-sectional, secondary data analysis examines the association between cigarette smoking and self-reported health-related quality of life (HRQoL) in adult survivors of Adolescent and Young Adult Cancer. Pooled data for survivors of Adolescent and Young Adult Cancer (N = 1495) were drawn from the 2016 and 2017 Behavioral Risk Factor Surveillance Survey. Binary logistic regression models were utilized to examine independent associations between each of the four HRQoL domains (i.e., self-related general health, activity limitation days, poor physical, and mental health days) and cigarette smoking. Of the 1495 Adolescent and Young Adult Onset Cancer Survivors (AYAO-CS) in this study, approximately 30% reported currently smoking cigarettes. Relative to never smokers, the odds of reporting fair/poor general health were significantly higher for current and former smokers: (OR = 3.95, 95% CI: 2.08-7.50) and (OR = 2.51, 95% CI: 1.46-4.32), respectively. Likewise, current smokers were significantly more likely to report frequent days of poor physical health (OR = 2.79, 95% CI: 1.38-5.65). The study findings suggest a significant cross-sectional association between cigarette smoking and poor health-related quality of life in adult survivors of adolescent and young adult cancer. These findings, although cross-sectional, underscore the need for prospective studies to examine the longitudinal association between HRQoL and cigarette smoking among cancer survivors. Findings also help establish both the need for smoking cessation programs and the importance of effective strategies for addressing HRQoL issues among cancer survivors.
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Affiliation(s)
- Godfred O Antwi
- Department of Public Health and Health Education, The College at Brockport, State University of New York, Brockport, NY, 14420, USA.
| | - David K Lohrmann
- Department of Applied Heath Science, Indiana University School of Public Health Bloomington, Bloomington, IN, 47405, USA
| | - Wasantha Jayawardene
- Department of Applied Heath Science, Indiana University School of Public Health Bloomington, Bloomington, IN, 47405, USA
- Institute for Research on Addictive Behavior, Indiana University School of Public Health Bloomington, Bloomington, IN, USA
| | - Angela Chow
- Department of Applied Heath Science, Indiana University School of Public Health Bloomington, Bloomington, IN, 47405, USA
| | - Cecilia S Obeng
- Department of Applied Heath Science, Indiana University School of Public Health Bloomington, Bloomington, IN, 47405, USA
| | - Aaron M Sayegh
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, 47405, USA
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76
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Businelle MS, Garey L, Gallagher MW, Hébert ET, Vujanovic A, Alexander A, Kezbers K, Matoska C, Robison J, Montgomery A, Zvolensky MJ. An Integrated mHealth App for Smoking Cessation in Black Smokers With Anxiety: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e38905. [PMID: 35635746 PMCID: PMC9153912 DOI: 10.2196/38905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 04/24/2022] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Black smokers have greater difficulty in quitting and higher rates of smoking-related diseases and disabilities than the general population. The smoking disparities experienced by this group are, in part, a consequence of multiple chronic life stressors (eg, racial discrimination) that engender increased exposure to interoceptive stress symptoms (eg, anxiety), which can ultimately lead to smoking as a means of immediate emotion regulation. OBJECTIVE This study aimed to culturally adapt and initially test a novel mobile intervention (ie, Mobile Anxiety Sensitivity Program for Smoking [MASP]) that targets anxiety sensitivity (AS; a proxy for difficulty and responsivity to interoceptive stress) among Black smokers. The MASP intervention is culturally informed to address interoceptive stress management difficulties among Black smokers and is thus hypothesized to facilitate smoking cessation. METHODS In phase 1, a total of 25 Black smokers with elevated AS will be administered MASP for 6 weeks. Following the completion of phase 1, we will further refine the MASP based on qualitative and quantitative data from participants to produce the final MASP iteration. In phase 2, a total of 200 Black smokers with elevated AS will be enrolled and randomly assigned to receive nicotine replacement therapy and either the smartphone-based National Cancer Institute QuitGuide app for standard mobile smoking cessation treatment or the MASP intervention. All participants in phases 1 and 2 will be enrolled remotely and will complete a web-based study screener; smartphone-based baseline assessment; daily smartphone-based ecological momentary assessments for 6 weeks; phone-based end-of-treatment qualitative interviews; and smartphone-based follow-up assessments at postbaseline weeks 1, 2 (quit date), 3, 4, 5, 6, 28, and 54 (weeks 28 and 54 follow-ups will be completed by phase 2 participants only). The MASP intervention is intended to offset barriers to treatment and encourage treatment engagement via smartphones. RESULTS This project was funded in September 2020. Phase 1 data collection began in January 2022. Phase 2 data collection is scheduled to begin in July 2022. CONCLUSIONS If successful, data from this study will support culturally informed treatment approaches for Black smokers and, pending findings of efficacy, provide an evidence-based mobile intervention for smoking cessation that is ready for dissemination and implementation. TRIAL REGISTRATION ClinicalTrials.gov NCT04838236; https://clinicaltrials.gov/ct2/show/NCT04838236. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/38905.
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Affiliation(s)
- Michael S Businelle
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- HEALTH Institute, University of Houston, Houston, TX, United States
| | - Lorra Garey
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Matthew W Gallagher
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
- Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, United States
| | - Emily T Hébert
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Austin, TX, United States
| | - Anka Vujanovic
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Adam Alexander
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Krista Kezbers
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Cameron Matoska
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Jillian Robison
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Audrey Montgomery
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Michael J Zvolensky
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
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COVID-19 Biomedical Plastics Wastes—Challenges and Strategies for Curbing the Environmental Disaster. SUSTAINABILITY 2022. [DOI: 10.3390/su14116466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The rise of the COVID-19 outbreak has made handling plastic waste much more difficult. Our superior, hyper-hygienic way of life has changed our behavioural patterns, such as the use of PPE (Personal Protective Equipment), the increased desire for plastic-packaged food and commodities, and the use of disposable utensils, as a result of the fear of transmission. The constraints and inefficiencies of our current waste management system, in dealing with our growing reliance on plastic, could worsen its mismanagement and leakage into the environment, causing a new environmental crisis. A sustainable, systemic, and hierarchical plastic management plan, which clearly outlines the respective responsibilities as well as the socioeconomic and environmental implications of these actions, is required to tackle the problem of plastic pollution. It will necessitate action strategies tailored to individual types of plastic waste and country demand, as well as increased support from policymakers and the general public. The situation of biomedical plastic wastes during the COVID-19 epidemic is alarming. In addition, treatment of plastic waste, sterilisation, incineration, and alternative technologies for transforming bio-plastic waste into value-added products were discussed, elaborately. Our review would help to promote sustainable technologies to manage plastic waste, which can only be achieved with a change in behaviour among individuals and society, which might help to safeguard against going from one disaster to another in the coming days.
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Mason TM, Szalacha LA, Tofthagen CS, Buck HG. Quality of Life of Older Adults With Complicated Grief: A Mixed Methods Exploration. J Gerontol Nurs 2022; 48:19-26. [PMID: 35511060 DOI: 10.3928/00989134-20220404-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current mixed methods study investigated what changes in quality of life (QOL) mean to older adults with complicated grief treated with Accelerated Resolution Therapy (ART) post-hospice services. An informational matrix, which included select patient characteristics (e.g., number of comorbidities, single versus multiple deaths, relationship role), four identified qualitative themes, end of study QOL scores measured by the Centers for Disease Control and Prevention Health-Related QOL Healthy Days Module, and changes in scores from baseline to end of study, was created to analyze the data. Results showed that although a history of multiple deaths may contribute to greater improvements in QOL with therapy, having at least one comorbidity resulted in a richer description and endorsement of QOL in response to treatment. This is the first longitudinal, randomized controlled trial using a mixed methods approach to examine QOL of hospice family caregivers with complicated grief who are receiving ART. This study identifies potential links of QOL and caregiver characteristics, providing nurses with foundational knowledge for assessment, care, and further research on the experiences of complicated grief. [Journal of Gerontological Nursing, 48(5), 19-26.].
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Derynda B, Siegel J, Maurice L, Cook N. Virtual Lifelong Learning Among Older Adults: Usage and Impact During the COVID-19 Pandemic. Cureus 2022; 14:e24525. [PMID: 35651387 PMCID: PMC9138274 DOI: 10.7759/cureus.24525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022] Open
Abstract
Social isolation and loneliness are major health concerns for older adults, with the current prevalence of social isolation among older adults estimated to be as high as 43%. In older adults, loneliness and social isolation have both been linked with poor health outcomes including falls, re-hospitalizations, dementia, and all-cause mortality. During the coronavirus disease 2019 (COVID-19) pandemic, older adults constituted one of the most at-risk groups and were faced with some of the strictest and earliest social distancing recommendations, which were associated with increased feelings of loneliness and increased rates of depression and anxiety, upwards of 12%. The objective of this study was to identify the impact of online social connection on feelings of isolation and companionship among older adults during the COVID-19 pandemic. Following the Centers for Disease Control and Prevention (CDC) guidelines in March 2020, two South Florida social and educational programs for older adults adopted online programming utilizing the Zoom platform. A research team worked collaboratively with senior stakeholders to develop and administer a survey to understand the impact of online social connections on feelings of social isolation. One year later in 2021, the survey was reviewed, modified, and re-administered. Respondents of the survey included 211 older adults (mean age 75.5 years old). Notable findings included a strong association between frequency of online class attendance and increased feelings of connectedness (p<0.001), improved spirits (p<0.001), and decreased feelings of social isolation (p<0.001). These results underscore the importance and contribution of online programming among older adults during times of social isolation. Overall, clinical practitioners should consider the importance of initiating discussions with older adults regarding returning to activities that they enjoyed prior to the COVID-19 pandemic.
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80
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Guo M, Lou Y, Zhang N. Consideration of future consequences and self-control mediate the impact of time perspectives on self-rated health and engagement in healthy lifestyles among young adults. CURRENT PSYCHOLOGY 2022; 42:1-11. [PMID: 35496365 PMCID: PMC9037054 DOI: 10.1007/s12144-022-03135-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 12/03/2022]
Abstract
The study investigated how different time perspectives predict people's self-rated health and engagement in healthy lifestyles, and explored the mediating effects of consideration of future consequences (CFC) and self-control as the underlying mechanisms. Young adults (n = 299, M age = 23.65, ranges from 18 to 30 years old) completed measures of time perspectives, CFC, self-control and engagement in daily health behaviors. Generalized linear regression models showed that Past-Negative time perspective negatively predicted sleep quality; Future time perspective negatively predicted unhealthy eating patterns; Future time perspective was the only protective factor of risky drinking, while both Past-Positive and Future time perspective were protective factors of smoking. Mediation analyses showed that CFC-Immediate and self-control mediated the relationship between Future time perspective and eating patterns. Results suggested that consideration of future consequences and self-control partially explained how time perspectives affect engagement in healthy lifestyles among young Chinese adults. Implications of the current research for promoting healthy living and directions for future research are discussed. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-03135-6.
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Affiliation(s)
- Mengxi Guo
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310058 China
| | - Yiling Lou
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310058 China
| | - Ning Zhang
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310058 China
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81
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Khabibullina A, Aleksandrova E, Gerry CJ, Vlassov V. First population norms for the EQ-5D-3L in the Russian Federation. PLoS One 2022; 17:e0263816. [PMID: 35349577 PMCID: PMC8963536 DOI: 10.1371/journal.pone.0263816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 01/27/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose
The EQ–5D survey instrument is routinely applied to general and patient specific populations in many countries, as a means of measuring Health Related Quality of Life (HRQOL) and/or informing Health Technology Assessment. The instrument is the subject of growing interest in the Russian Federation, as too is Health Technology Assessment. This research is the first to systematically present the EQ–5D–3L nationally representative population norms and to examine the socioeconomic and socio-demographic characteristics of the instrument among a representative sample of the Russian population.
Methods
Based on a nationally representative health and well-being survey of the Russian population, conducted in November 2017, we establish the descriptive results, including the EQ-VAS and the EQ-5D Index, by age and gender, examine the correspondence between the EQ–5D health classifications and the separate EQ-VAS scores, and draw on a set of augmented logistic regressions to evaluate the association between the presence of problems in each dimension and various socio-economic and health-related characteristics.
Results
We find strong evidence that the EQ-5D instrument is sensitive to underlying observed and latent health experiences, that it mirrors many of the characteristics familiar from other settings but that there are Russian specificities which merit further research, particularly with respect to the anxiety/depression dimension of the instrument.
Conclusion
This research represents an important landmark for HRQOL studies in Russia as well as for the prospects of continuing to develop the scholarly and practical infrastructure necessary for Russian Health Technology Assessment to advance.
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Affiliation(s)
- Alina Khabibullina
- International Centre for Health Economics, Management and Policy, National Research University Higher School of Economics, St. Petersburg, Russian Federation
| | - Ekaterina Aleksandrova
- International Centre for Health Economics, Management and Policy, National Research University Higher School of Economics, St. Petersburg, Russian Federation
| | - Christopher J. Gerry
- International Centre for Health Economics, Management and Policy, National Research University Higher School of Economics, St. Petersburg, Russian Federation
- Oxford School of Global and Area Studies, University of Oxford, Oxford, England
- * E-mail:
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russian Federation
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82
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Mohd Yusuf SY, Md-Yasin M, Mohd Miswan MF. Does Less Pain Predict Better Quality of Life among Malaysian Patients with Mild–Moderate Knee Osteoarthritis? Clin Pract 2022; 12:219-230. [PMID: 35447854 PMCID: PMC9031927 DOI: 10.3390/clinpract12020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022] Open
Abstract
This study aims to identify the relationship between knee functional status and Health-Related QoL (HRQoL) in mild to moderate knee osteoarthritis (OA) patients and to ascertain which subdomain of knee functional status best predicts good HRQoL. A cross-sectional study was conducted in an orthopaedic clinic of a tertiary hospital in Malaysia. Patients aged 40–75 years old with mild–moderate primary knee OA were recruited. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and SF-36 questionnaires were used to measure knee functional status and HRQoL, respectively. Subdomains of KOOS include “function in daily living”, “function in recreational activities”, “pain”, “symptom”, and “knee-specific quality of life”. Subdomains for SF-36 are Physical Component Summary (PCS) and Mental Component Summary (MCS). Overall, 290 patients fulfilled the inclusion criteria of the study, with a mean age of 66.8 years old (±7.06). Majority were female (57.6%) and Malay (79.7%). The relationships between all KOOS and HRQoL subdomains were significant. “Pain” contributed most towards better physical HRQoL ((PCS) Adj. B (95% CI); 0.063 (0.044, 0.169)), while “function in daily living” contributed most towards better mental HRQoL ((MCS) Adj. B (95% CI); 0.624 (0.478, 0.769)). Thus, better HRQoL was related to better pain control and improved “function in daily living” in these patients.
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Affiliation(s)
- Salma Yasmin Mohd Yusuf
- Department of Primary Care Medicine, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh 47000, Malaysia;
| | - Mazapuspavina Md-Yasin
- Department of Primary Care Medicine, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh 47000, Malaysia;
- Correspondence: ; Tel.: +60-19-356-4020
| | - Mohd Fairudz Mohd Miswan
- Department of Orthopaedic, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh 47000, Malaysia;
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Vidrine JI, Shih YCT, Businelle MS, Sutton SK, Hoover DS, Cottrell-Daniels C, Fennell BS, Bowles KE, Vidrine DJ. Comparison of an automated smartphone-based smoking cessation intervention versus standard quitline-delivered treatment among underserved smokers: protocol for a randomized controlled trial. BMC Public Health 2022; 22:563. [PMID: 35317789 PMCID: PMC8939152 DOI: 10.1186/s12889-022-12840-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking is the leading cause of preventable morbidity and mortality in the United States. Individuals with low socioeconomic status have disproportionately high smoking rates and greater difficulty quitting smoking. Efficiently connecting underserved smokers to effective tobacco cessation programs is crucial for disease prevention and the elimination of health disparities. Smartphone-based interventions have the potential to enhance the reach and efficacy of smoking cessation treatments targeting underserved smokers, but there is little efficacy data for these interventions. In this study, we will partner with a large, local hunger-relief organization to evaluate the efficacy and economic impact of a theoretically-based, fully-automated, and interactive smartphone-based smoking cessation intervention. METHODS This study will consist of a 2-group randomized controlled trial. Participants (N = 500) will be recruited from a network of food distribution centers in West Central Florida and randomized to receive either Standard Treatment (ST, n = 250) or Automated Treatment (AT, n = 250). ST participants will be connected to the Florida Quitline for telephone-based treatment and will receive a 10-week supply of nicotine replacement therapy (NRT; transdermal patches and lozenges). AT participants will receive 10 weeks of NRT and a fully-automated smartphone-based intervention consisting of interactive messaging, images, and audiovisual clips. The AT intervention period will span 26 weeks, with 12 weeks of proactive content and 26 weeks of on-demand access. ST and AT participants will complete weekly 4-item assessments for 26 weeks and 3-, 6-, and 12-month follow-up assessments. Our primary aim is to evaluate the efficacy of AT in facilitating smoking abstinence. As secondary aims, we will explore potential mediators and conduct economic evaluations to assess the cost and/or cost-effectiveness of ST vs. AT. DISCUSSION The overall goal of this project is to determine if AT is better at facilitating long-term smoking abstinence than ST, the more resource-intensive approach. If efficacy is established, the AT approach will be relatively easy to disseminate and for community-based organizations to scale and implement, thus helping to reduce tobacco-related health disparities. TRIAL REGISTRATION Clinical Trials Registry NCT05004662 . Registered August 13, 2021.
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Affiliation(s)
- Jennifer I Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 4115 E. Fowler Avenue, Tampa, FL, 33617, USA. .,Department of Oncologic Sciences, University of South Florida, Morsani College of Medicine, Tampa, FL, USA. .,Department of Psychology, University of South Florida, Tampa, FL, USA.
| | - Ya-Chen Tina Shih
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael S Businelle
- Stephenson Cancer Center, TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Cherell Cottrell-Daniels
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 4115 E. Fowler Avenue, Tampa, FL, 33617, USA
| | - Bethany Shorey Fennell
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 4115 E. Fowler Avenue, Tampa, FL, 33617, USA
| | - Kristina E Bowles
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 4115 E. Fowler Avenue, Tampa, FL, 33617, USA
| | - Damon J Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 4115 E. Fowler Avenue, Tampa, FL, 33617, USA.,Department of Oncologic Sciences, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
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Gender differences in the association between unmet support service needs and mental health among American cancer caregivers. Support Care Cancer 2022; 30:5469-5480. [PMID: 35304632 DOI: 10.1007/s00520-022-06966-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Cancer caregiving can be distressing, and many caregivers have support service needs. Given the role gender has played in shaping norms around caring, gender may influence caregiving experiences. Using Behavioral Risk Factor Surveillance System data, 2015-2018, we aimed to examine gender as an effect modifier of the unmet support service needs and mental health association among cancer caregivers. METHODS Our n = 5814 sample represented approximately 4.8 million caregivers. Mental health was operationalized as number of mentally unhealthy days over the past 30 (MUDs) and Frequent Mental Distress (FMD, MUDs ± 14 days). Unmet supportive care needs included endorsement of needing but not receiving caregiving classes, help accessing services, support groups, counseling, and respite care. We conducted zero-inflated negative binomial (ZINB) and logistic regression analyses to examine the associations between unmet needs with MUDs and FMD and then tested gender as an effect modifier. RESULTS Cancer caregivers reported an average of 6 MUDs. Approximately 20% of caregivers reported FMD, and 17% reported having any unmet needs. Gender moderated the unmet needs and FMD association. Among female caregivers, those with unmet needs were more likely to report FMD (aOR: 2.167; 95%CI: 1.447, 3.243); among male caregivers, no association was found (aOR: 0.970; 95%CI: 0.471, 2.001). In the ZINB model of MUDs, no significant moderation effect of gender was found. CONCLUSION Though distress does not appear to vary by gender, having unmet support needs may negatively affect mental health in female cancer caregivers. Studies on gendered experiences can inform strategies to meet caregiver needs.
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Gliske K, Welsh JW, Braughton JE, Waller LA, Ngo QM. Telehealth Services for Substance Use Disorders During the COVID-19 Pandemic: Longitudinal Assessment of Intensive Outpatient Programming and Data Collection Practices. JMIR Ment Health 2022; 9:e36263. [PMID: 35285807 PMCID: PMC8923149 DOI: 10.2196/36263] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/04/2022] [Accepted: 02/04/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The onset of the COVID-19 pandemic necessitated the rapid transition of many types of substance use disorder (SUD) treatments to telehealth formats, despite limited information about what makes treatment effective in this novel format. OBJECTIVE This study aims to examine the feasibility and effectiveness of virtual intensive outpatient programming (IOP) treatment for SUD in the context of a global pandemic, while considering the unique challenges posed to data collection during an unprecedented public health crisis. METHODS The study is based on a longitudinal study with a baseline sample of 3642 patients who enrolled in intensive outpatient addiction treatment (in-person, hybrid, or virtual care) from January 2020 to March 2021 at a large substance use treatment center in the United States. The analytical sample consisted of patients who completed the 3-month postdischarge outcome survey as part of routine outcome monitoring (n=1060, 29.1% response rate). RESULTS No significant differences were detected by delivery format in continuous abstinence (χ22=0.4, P=.81), overall quality of life (F2,826=2.06, P=.13), financial well-being (F2,767=2.30, P=.10), psychological well-being (F2,918=0.72, P=.49), and confidence in one's ability to stay sober (F2,941=0.21, P=.81). Individuals in hybrid programming were more likely to report a higher level of general health than those in virtual IOP (F2,917=4.19, P=.01). CONCLUSIONS Virtual outpatient care for the treatment of SUD is a feasible alternative to in-person-only programming, leading to similar self-reported outcomes at 3 months postdischarge. Given the many obstacles presented throughout data collection during a pandemic, further research is needed to better understand under what conditions telehealth is an acceptable alternative to in-person care.
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Affiliation(s)
- Kate Gliske
- Butler Center for Research, Hazelden Betty Ford Foundation, Center City, MN, United States
| | - Justine W Welsh
- Department of Psychiatry and Behavioral Services, Emory University School of Medicine, Emory University, Atlanta, GA, United States
| | - Jacqueline E Braughton
- Butler Center for Research, Hazelden Betty Ford Foundation, Center City, MN, United States
| | - Lance A Waller
- Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Quyen M Ngo
- Butler Center for Research, Hazelden Betty Ford Foundation, Center City, MN, United States
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86
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Bijl RC, Bangert SE, Shree R, Brewer AN, Abrenica-Keffer N, Tsigas EZ, Koster MPH, Seely EW. Patient journey during and after a pre-eclampsia-complicated pregnancy: a cross-sectional patient registry study. BMJ Open 2022; 12:e057795. [PMID: 35241475 PMCID: PMC8896051 DOI: 10.1136/bmjopen-2021-057795] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To gain insight into the patient journey through a pre-eclampsia-complicated pregnancy. DESIGN Cross-sectional patient registry study. SETTING Online patient registry initiated by the Preeclampsia Foundation. PARTICIPANTS Women with a history of pre-eclampsia enrolled in The Preeclampsia Registry (TPR). PRIMARY AND SECONDARY OUTCOME MEASURES Retrospective patient-reported experience measures concerning awareness of pre-eclampsia, timing and type of information on pre-eclampsia received, involvement in decision making regarding medical care, mental/emotional impact of the pre-eclampsia-complicated pregnancy and impact on future pregnancy planning. RESULTS Of 3618 TPR-participants invited to complete the Patient Journey questionnaire, data from 833 (23%) responders were available for analysis. Most responders were white (n=795, 95.4%) and lived in the USA (n=728, 87.4%). Before their pre-eclampsia diagnosis, 599 (73.9%) responders were aware of the term 'pre-eclampsia', but only 348 (43.7%) were aware of its associated symptoms. Women with a lower level of education were less likely to have heard of pre-eclampsia (OR 0.36, 95% CI 0.21 to 0.62). Around the time of diagnosis, 29.2% of responders did not feel involved in the decision making, which was associated with reporting a serious mental/emotional impact of the pre-eclampsia experience (OR 2.46, 95% CI 1.58 to 3.84). Over time, there was an increase in the proportion of women who were aware of the symptoms of pre-eclampsia (32.2% before 2011 to 52.5% after 2016; p<0.001) and in the proportion of responders stating they received counselling about the later-life health risks associated with pre-eclampsia (14.2% before 2011 to 25.6% after 2016; p=0.005). CONCLUSIONS This study demonstrates that improved patient education regarding pre-eclampsia is needed, that shared decision making is of great importance to patients to enhance their healthcare experience, and that healthcare providers should make efforts to routinely incorporate counselling about the later-life health risks associated with pre-eclampsia. TRIAL REGISTRATION NUMBER NCT02020174.
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Affiliation(s)
- Rianne C Bijl
- Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Sophie E Bangert
- Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Raj Shree
- Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA
| | - Alina N Brewer
- Preeclampsia Foundation, Melbourne, Florida, USA
- Juneau Biosciences LLC, Salt Lake City, Utah, USA
| | | | | | - Maria P H Koster
- Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Ellen W Seely
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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87
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Thornewill J, Antimisiaris D, Ezekekwu E, Esterhay R. Transformational strategies for optimizing use of medications and related therapies through us pharmacists and pharmacies: Findings from a national study. J Am Pharm Assoc (2003) 2022; 62:450-460. [PMID: 34758925 PMCID: PMC8572696 DOI: 10.1016/j.japh.2021.10.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 10/26/2022]
Abstract
SETTING Nonoptimized medication therapies (NOMTs) are associated with likely avoidable illnesses and mortality affecting millions of people and costing an estimated $528 billion per year in excess health spending in the United States. The coronavirus disease 2019 (COVID-19) pandemic brought into focus barriers limiting the ability of U.S. pharmacists and pharmacies to provide services that can reduce NOMTs and improve U.S. population health. OBJECTIVES This National Science Foundation Center for Health Organization Transformation study explored potential strategies that U.S. pharmacists, pharmacies, and their partners could implement to reduce NOMTs while also delivering other forms of value to U.S. populations from 2021 to 2025 (during and after the COVID-19 pandemic). DESIGN A panel of senior leaders representing the U.S. pharmacist and pharmacy sector participated in a 4-round Delphi process to identify unmet needs, barriers, change drivers, and priority strategies for meeting those needs. Data were gathered and analyzed by public health researchers, most of whom are outside the pharmacist and pharmacy sector. RESULTS A comprehensive set of evidence-based strategies with potential to reduce NOMTs, protect and improve population health and well-being, and strengthen the sector were identified. Four transformational strategies were recommended: comprehensive payment and practice transformation, strengthening pharmacy data interoperability infrastructure, development of unifying measurement and management mechanisms, and development of a more robust national research infrastructure. Strengthening health equity was a cross-cutting strategy affecting all areas. CONCLUSION The results may be of interest to policy makers, pharmacists, pharmacies, physicians, nurses and other clinicians, pharmaceutical firms, plan sponsors, plans, health systems, clinics, aging care, digital technology companies, and others interested in optimizing outcomes from medications and related therapies for U.S. POPULATIONS
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88
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Association of Poor Mental-Health Days With COVID-19 Infection Rates in the U.S. Am J Prev Med 2022; 62:326-332. [PMID: 35067362 PMCID: PMC8557977 DOI: 10.1016/j.amepre.2021.08.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Limited evidence exists about the association between prior prevalence of poor mental health at the area level and subsequent rates of COVID-19 infections. This association was tested using area-level nationwide population data in the U.S. METHODS A nationwide study including 2,839 U.S. counties was conducted. Poor mental health was the age-adjusted average number of days within the past 30 days that adults reported poor mental health, including depression, stress, and problems with emotions, from the Behavioral Risk Factor Surveillance System. COVID-19 infection rates were cumulative confirmed cases between January 22 and October 7, 2020 per 100,000 people in the general population. Bayesian spatial mixed-effects regression estimated the relationship between COVID-19 infection and poor mental-health days at the county level in 2019 and change in poor mental health between 2010 and 2019, adjusted for several covariates. RESULTS Poor mental-health days in 2019 were positively associated with higher COVID-19 infection rates (RRR=1.059, 95% credible interval=1.003, 1.117). Change in mental health was not significantly associated with COVID-19. CONCLUSIONS Prior rates of poor mental health in a county were associated with a higher burden of COVID-19 infection. Interventions that improve well-being and strengthen mental-health systems at the community and other geographic levels are needed to address post-COVID-19 mental health problems.
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89
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Antol DD, Hagan A, Nguyen H, Li Y, Haugh GS, Radmacher M, Greenlund KJ, Thomas CW, Renda A, Hacker K, Shrank WH. Change in self-reported health: A signal for early intervention in a medicare population. HEALTHCARE (AMSTERDAM, NETHERLANDS) 2022; 10:100610. [PMID: 34933272 PMCID: PMC11304208 DOI: 10.1016/j.hjdsi.2021.100610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/14/2021] [Accepted: 12/06/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Health plans and risk-bearing provider organizations seek information sources to inform proactive interventions for patients at risk of adverse health events. Interventions should take into account the strong relationship between social context and health. This retrospective cohort study of a Medicare Advantage population examined whether a change in self-reported health-related quality of life (HRQOL) signals a subsequent change in healthcare needs. METHODS A retrospective longitudinal analysis of administrative claims data was conducted for participants in a Medicare Advantage plan with prescription drug coverage (MAPD) who responded to 2 administrations of the Centers for Disease Control and Prevention 4-item Healthy Days survey within 6-18 months during 2015-2018. Changes in HRQOL, as measured by the Healthy Days instrument, were compared with changes in utilization and costs, which were considered to be a reflection of change in healthcare needs. RESULTS A total of 48,841 individuals met inclusion criteria. Declining HRQOL was followed by increases in utilization and costs. An adjusted analysis showed that every additional unhealthy day reported one year after baseline was accompanied by an $8 increase in monthly healthcare costs in the subsequent six months for the average patient. CONCLUSIONS Declining HRQOL signaled subsequent increases in healthcare needs and utilization. IMPLICATIONS Findings suggest that HRQOL assessments in general, and the Healthy Days instrument in particular, could serve as a leading indicator of the need for interventions designed to mitigate poor health outcomes and rising healthcare costs. LEVEL OF EVIDENCE III.
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Affiliation(s)
| | - Angela Hagan
- Office of Health Affairs and Advocacy, Humana Inc., Louisville, KY, USA
| | - Hannah Nguyen
- Digital Health & Analytics, Humana Inc., Louisville, KY, USA
| | - Yong Li
- Humana Healthcare Research, Louisville, KY, USA
| | - Gilbert S Haugh
- Digital Health & Analytics, Humana Inc., Louisville, KY, USA
| | | | - Kurt J Greenlund
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Craig W Thomas
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Andrew Renda
- Office of Health Affairs and Advocacy, Humana Inc., Louisville, KY, USA
| | - Karen Hacker
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - William H Shrank
- Office of Health Affairs and Advocacy, Humana Inc., Louisville, KY, USA
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90
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Coakley KE, Cargas S, Walsh-Dilley M, Mechler H. Basic Needs Insecurities Are Associated with Anxiety, Depression, and Poor Health Among University Students in the State of New Mexico. J Community Health 2022; 47:454-463. [PMID: 35124789 PMCID: PMC8818275 DOI: 10.1007/s10900-022-01073-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 12/29/2022]
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91
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Boehmer U, Jesdale BM, Streed CG, Agénor M. Intersectionality and cancer survivorship: Sexual orientation and racial/ethnic differences in physical and mental health outcomes among female and male cancer survivors. Cancer 2022; 128:284-291. [PMID: 34499367 PMCID: PMC8738152 DOI: 10.1002/cncr.33915] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Because of concerns about sexual minorities' poor cancer survivorship, this study compared cancer survivors' health outcomes in relation to multiple intersecting social positions, namely gender, sexual orientation, and race/ethnicity. METHODS This secondary data analysis used 2014-2019 Behavior Risk Factor Surveillance Survey data. The survey respondents consisted of 40,482 heterosexual and sexual minority men and 69,302 heterosexual and sexual minority women who identified as White, Black, or Hispanic. Logistic regression models compared White, Black, and Hispanic male and female cancer survivors' health status, depression, and health-related quality of life by sexual orientation. Models were adjusted for sociodemographic characteristics and access to care. RESULTS Mental health findings showed consistency, with sexual minority male and female cancer survivors having 2 to 3 times greater odds of depression and/or poor mental health among White, Black, and Hispanic survivors. Among White women, sexual minorities reported greater odds of fair or poor health, poor physical health, and poor activity days, whereas White sexual minority men showed similar odds in comparison with their heterosexual counterparts. Among Black and Hispanic sexual minority men and women, differences in the odds of fair or poor health, poor physical health, and poor activity days in comparison with their heterosexual counterparts were mostly explained by sociodemographic and access-to-care factors. CONCLUSIONS Physical and mental health outcomes vary in relation to sexual orientation and race/ethnicity among both female and male cancer survivors. Clinicians, researchers, and health care administrators must better understand and address the unique needs of cancer survivors in relation to multiple axes of social inequality to advance cancer equity.
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Affiliation(s)
- Ulrike Boehmer
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Bill M. Jesdale
- Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Carl G. Streed
- Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts;,Center for Transgender Medicine and Surgery, Boston Medical Center, Boston, Massachusetts
| | - Madina Agénor
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island;,Fenway Institute, Fenway Health, Boston, Massachusetts
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92
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Moon I, Han J. Moderating Effects of Physical Activity on the Relationship between Adverse Childhood Experiences and Health-Related Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:668. [PMID: 35055490 PMCID: PMC8775782 DOI: 10.3390/ijerph19020668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/01/2022] [Accepted: 01/05/2022] [Indexed: 11/16/2022]
Abstract
The effects of adverse childhood experiences (ACEs) on health-related quality of life (HRQOL) and their associations with physical activities (PA) are well-documented. However, the specific effects of different types of ACEs (e.g., child abuse and household dysfunction) on HRQOL and the role of PA are inconclusive. The purpose of this study is to find the buffering role of PA as a moderator that may reduce the negative impact of ACEs in general and the specific effects of different types of ACEs on HRQOL, perceived physical health, and mental health over time. The 2019 Behavioral Risk Fact Surveillance System (BRFSS), a state-based surveillance system supported by the CDC in the U.S., was used for this study. A total of 127,370 respondents from 17 states were selected for this study. First, descriptive statistics were generated and correlation analyses were conducted to find the association among variables and examine the possible predictors of HRQOL. Moderation models were then tested using Structural Equation Modeling (SEM). HRQOL in adults is negatively associated with ACEs, but is positively associated with PA. We found buffering effects of physical activity in the following relationships: (1) child abuse and HRQOL, (2) child abuse and perceived physical health, (3) ACEs and perceived mental health, (4) child abuse and perceived mental health, and (5) household dysfunction and perceived mental health. Our findings suggest that improvement of PA level is a significant predictor of improved HRQOL of adults with ACEs.
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Affiliation(s)
- Ingyu Moon
- School of Social Work, Nyack College, New York, NY 10004, USA
| | - Junghee Han
- Department of Social Work, University of Southern Indiana, Evansville, IN 47712, USA;
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93
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Kemp B, Grumbach JM, Montez JK. U.S. State Policy Contexts and Physical Health among Midlife Adults. SOCIUS : SOCIOLOGICAL RESEARCH FOR A DYNAMIC WORLD 2022; 8:10.1177/23780231221091324. [PMID: 36268202 PMCID: PMC9581408 DOI: 10.1177/23780231221091324] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This study examines how state policy contexts may have contributed to unfavorable adult health in recent decades. It merges individual-level data from the 1993-2016 Behavioral Risk Factor Surveillance System (n=2,166,835) with 15 state-level policy domains measured annually on a conservative to liberal continuum. We examined associations between policy domains and health among adults ages 45-64 years and assess how much of the associations is accounted by adults' socioeconomic, behavioral/lifestyle, and family factors. A more liberal version of the civil rights domain was associated with better health. It was disproportionately important for less-educated adults and women, and its association with adult health was partly accounted by educational attainment, employment, and income. Environment, gun safety, and marijuana policy domains were, to a lesser degree, predictors of health in some model specifications. In sum, health improvements require a greater focus on macro-level factors that shape the conditions in which people live.
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94
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Mason TM, Szalacha LA, Tofthagen CS, Buck HG. A Longitudinal Examination of Quality of Life of Older Adults with Complicated Grief Receiving Accelerated Resolution Therapy. J Palliat Med 2022; 25:119-123. [PMID: 34551271 PMCID: PMC8721495 DOI: 10.1089/jpm.2021.0267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Objective: To examine the effect of Accelerated Resolution Therapy (ART) on the quality of life (QOL) of older adults with complicated grief (CG) over time. Design: Subanalysis of a randomized controlled trial. Setting/Subject: Older adult, former caregivers were recruited from a large hospice in the southeastern United States to be treated with ART for CG. Measurement: The CDC Health-Related Quality of Life (HRQOL) Healthy Days Module was administered pre-, post-, and eight weeks after therapy. Results: The subsample consisted of 27 older adults. A multilevel model indicated a statistically significant, negative difference of 8.21 (improvement) in QOL scores for each period of data collection (β = -8.21, t = 4.02, p < 0.001). Both the intervention (11%, p = 0.013) and time (7.8%, growth curve p = 0.014) contributed significantly. Conclusion: There was a significant large effect of ART on CG. This study supports concurrent improved patient-related outcome-QOL.
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Affiliation(s)
- Tina M. Mason
- Moffitt Cancer Center, Tampa, Florida, USA.,Address correspondence to: Tina M. Mason, PhD, APRN, AOCN, AOCNS, FCNS, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33606, USA
| | - Laura A. Szalacha
- College of Nursing, University of South Florida, Tampa, Florida, USA.,Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | | | - Harleah G. Buck
- Csomay Center for Gerontological Excellence, University of Iowa College of Nursing, Iowa City, Iowa, USA
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95
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Amoah PA, Nyamekye KA, Owusu-Addo E. A multidimensional study of public satisfaction with the healthcare system: a mixed-method inquiry in Ghana. BMC Health Serv Res 2021; 21:1320. [PMID: 34886857 PMCID: PMC8656047 DOI: 10.1186/s12913-021-07288-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 11/12/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Many governments in sub-Saharan Africa have recently sought to improve their health systems by increasing investment in healthcare facilities and introducing social insurance programmes. However, little is known about the impact of these intended improvements on public perceptions about the healthcare systems. This article examines whether and why people of different socioeconomic and ideological backgrounds are satisfied (or not) with the current healthcare system in Ghana from a social ecological perspective. METHOD Data were elicited from a cross-sectional mixed-method study conducted in four regions in Ghana in 2018. We used ordinal logistic regression and thematic analysis techniques to analyse the data. RESULTS Satisfaction with the healthcare system was generally low. From our quantitative study, intrapersonal factors (e.g., being older and having good health and well-being status); interpersonal factors (e.g., linking social capital); community factors (e.g., living in rural areas); and organisational and public policy factors (e.g., trust in the health system, favouring welfare policies, and being interested in politics) were positively associated with satisfaction with the healthcare system. These were corroborated by the qualitative study, which showed that poor attitudes of health personnel, financial constraints, perceived poor health facilities, and perceived inefficacy of services contribute to dissatisfaction with the healthcare system. CONCLUSION Strategies to improve satisfaction with the healthcare system in Ghana should incorporate ecological perspectives by considering factors such as demographic profile, health needs, political orientation, issues of trust in the healthcare system, and the dynamics and impact of social relationships of populations concerned.
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Affiliation(s)
- Padmore Adusei Amoah
- School of Graduate Studies, Institute of Policy Studies, Department of Applied Psychology, Lingnan University, 8 Castle Peak Rd., Tuen Mun, Hong Kong (SAR), China.
| | - Kingsley Atta Nyamekye
- Department of Planning and Sustainability- School of Geo-Sciences, University of Energy and Natural Resources, Sunyani, Ghana
| | - Ebenezer Owusu-Addo
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science & Technology (KNUST), Private Mail Bag, University Post Office, Kumasi, Ghana
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96
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Anderson JG, Flatt JD, Jabson Tree JM, Gross AL, Rose KM. Characteristics of Sexual and Gender Minority Caregivers of People With Dementia. J Aging Health 2021; 33:838-851. [PMID: 33998313 PMCID: PMC8844879 DOI: 10.1177/08982643211014767] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Given what little is known about the experiences of sexual and gender minority (SGM) caregivers of people with Alzheimer's disease and related dementias (ADRD), the aim of the current study was to describe psychosocial measures among these caregivers. Methods: We used an online survey and social media recruitment strategies. Results: Of 286 caregivers, the majority were gay men. Most respondents were white, with a third identifying as Latino American. The plurality of caregivers identified as a spouse/partner and were providing care for someone who identified as a sexual minority; one-fifth cared for someone transgender. Sexual orientation, perceived stress, caregiver stigma, and microaggressions were psychosocial factors associated with family quality of life and depressive symptoms in the caregivers. Discussion: This study is the first to provide a focused description of the characteristics and psychosocial needs of SGM caregivers of someone with ADRD, supporting development of targeted interventions for this population.
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Affiliation(s)
- Joel G Anderson
- College of Nursing, 4292University of Tennessee-Knoxville, Knoxville TN, USA
| | - Jason D Flatt
- School of Public Health, 14722University of Nevada-Las Vegas, Las Vegas, NV, USA
| | | | - Alden L Gross
- 1466Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Karen M Rose
- Center for Healthy Aging, Self-Management and Complex Care, College of Nursing, 2647The Ohio State University, Columbus, OH, USA
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97
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Smidt MN, Jimmieson NL, Bradley LM. Predicting Employee Participation in, and Satisfaction With, Wellness Programs: The Role of Employee, Supervisor, and Organizational Support. J Occup Environ Med 2021; 63:1005-1018. [PMID: 34334781 DOI: 10.1097/jom.0000000000002341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the role of employee, supervisor, and organizational support in the prediction of employee participation in wellness programs. METHODS Data were collected at two-time points (T1 and T2) from 194 Australian employees. RESULTS Hierarchical binary logistic regressions revealed that higher levels of employee and supervisor support for wellness at T1 each predicted T2 participation, and high supervisor support was more effective when organizational support was high and did not compensate for when organizational support was low. Employees with higher perceptions of T1 poor general health had a lower likelihood of T2 participation, and higher levels of T1 supervisor support was a further deterrent to participation. CONCLUSIONS Different sources of support for wellness predict employee attendance at wellness programs and it is important to ensure that supervisor and organizational support are aligned.
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Affiliation(s)
- Michelle N Smidt
- School of Management, Queensland University of Technology, Queensland, Australia
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98
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Roy Paladhi U, Dalve KN, Gurrey SO, Hawes SE, Mills B. Firearm ownership and access to healthcare in the U.S.: A cross-sectional analysis of six states. Prev Med 2021; 153:106830. [PMID: 34624385 DOI: 10.1016/j.ypmed.2021.106830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 11/20/2022]
Abstract
Provider-led firearm storage counseling is a form of firearm suicide prevention intervention. Little research examines whether barriers to healthcare access for at-risk individuals limit this intervention's impact. This study explores the relationship between household firearm presence/storage practices and healthcare access/utilization using a cross-sectional analysis of the 2017 Behavioral Risk Factor Surveillance System (BRFSS), which included state-representative data from six states that completed the Firearm Safety and Healthcare Access Modules: California, Idaho, Kansas, Oregon, Texas, and Utah. Exposures were household firearm presence and firearm storage practices. Outcomes were lacking health insurance, not having a healthcare provider, inability to afford care, and no recent routine checkup. Logistic regression models adjusted for age, sex, education, employment, children in the household, and state of residency. Our analysis included 31,888 individuals; 31.1% reported a household firearm. Compared to those in firearm-owning households, those in non-firearm-owning households had higher odds of being uninsured (aOR 1.99, 95%CI 1.60-2.48), not having a provider (aOR 1.40, 95%CI 1.18-1.67), and reporting cost as a barrier to care (aOR 1.37, 95%CI 1.13-1.67). Among firearm-owning households, those with firearms stored loaded and unlocked had higher odds of lacking a personal healthcare provider (aOR 1.52, 95%CI 1.07-2.15) compared to individuals in homes where firearms were stored unloaded. Results indicate that while individuals in firearm-owning households are more likely than non-firearm owning households to have healthcare access, those in homes with the riskiest firearm storage practices had less access. Provider-led counseling may have limited reach for individuals in homes with risky firearm storage practices.
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Affiliation(s)
- Unmesha Roy Paladhi
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Department of Global Health, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Kimberly N Dalve
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Firearm Injury & Policy Research Program, Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, USA
| | - Sixtine O Gurrey
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Firearm Injury & Policy Research Program, Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, USA
| | - Stephen E Hawes
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Brianna Mills
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Firearm Injury & Policy Research Program, Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, USA
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Shih E, Aylward BS, Kunkle S, Graziani G. Health-Related Quality of Life among Members using an On-Demand Behavioral Health Platform: A Pilot Observational Study (Preprint). JMIR Form Res 2021; 6:e35352. [PMID: 35802408 PMCID: PMC9308074 DOI: 10.2196/35352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/21/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Despite the well-known adverse health conditions and negative economic outcomes associated with mental health problems, accessing treatment is difficult due to reasons such as availability and cost. As a solution, digital mental health services have flooded the industry, and new studies are quickly emerging that support their potential as an accessible and cost-effective way to improve mental health outcomes. However, many mental health platforms typically use clinical tools such as the Patient Health Questionnaire-9 (PHQ-9) or General Anxiety Disorder-7 (GAD-7). Yet, many individuals that seek out care do not have clinical symptomatology and thus, traditional clinical measures may not adequately capture symptom improvement in general well-being. As an alternative, this study used the health-related quality of life (HRQoL) tool from the Centers for Disease Control and Prevention “Healthy Days” measure. This subjective measure of well-being is an effective way to capture HRQoL and might be better suited as an outcome measure for treatments that include both clinical and subclinical individuals. Objective The purpose of this study was to describe changes in HRQoL in clinical and subclinical members assessing virtual care and to examine the association between text-based behavioral coaching and virtual clinical sessions with changes in HRQoL. Methods A total of 288 members completed the 4-item HRQoL measure at baseline and at 1 month following use of the Ginger on demand behavioral health platform. Baseline anxiety and depression levels were collected using the GAD-7 and PHQ-9, respectively. Results Members completed on average 1.92 (SD 2.16) coaching sessions and 0.91 (SD 1.37) clinical sessions during the assessment month. Paired samples t tests revealed significant reductions in the average number of unhealthy mental health days between baseline (mean 16, SD 8.77 days) and follow-up (mean 13.2, SD 9.02 days; t287=5.73; P<.001), and in the average number of days adversely impacted (meanbaseline 10.9, meanfollow-up 8.19; t287=6.26; P<.001). Both subclinical members (t103=3.04; P=.003) and clinical members (t183=5.5; P<.001) demonstrated significant improvements through reductions in adversely impacted days over a month. Clinical members also demonstrated significant improvements through reductions in unhealthy mental health days (t183=5.82; P<.001). Finally, member engagement with virtual clinical sessions significantly predicted changes in unhealthy mental health days (B=–0.96; P=.04). Conclusions To our knowledge, this study is one of the first to use the HRQoL measure as an outcome in an evaluation of a digital behavioral health platform. Using real-world longitudinal data, our preliminary yet promising results show that short-term engagement with virtual care can be an effective means to improve HRQoL for members with subclinical and clinical symptoms. Further follow-up of reported HRQoL over several months is needed.
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Affiliation(s)
- Emily Shih
- Ginger, San Francisco, CA, United States
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100
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Vidrine DJ, Bui TC, Businelle MS, Shih YCT, Sutton SK, Shahani L, Hoover DS, Bowles K, Vidrine JI. Evaluating the Efficacy of Automated Smoking Treatment for People With HIV: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e33183. [PMID: 34787590 PMCID: PMC8663670 DOI: 10.2196/33183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/03/2021] [Indexed: 11/29/2022] Open
Abstract
Background Smoking prevalence rates among people with HIV are nearly 3 times higher than those in the general population. Nevertheless, few smoking cessation trials targeting smokers with HIV have been reported in the literature. Efforts to develop and evaluate sustainable, low-cost, and evidence-based cessation interventions for people with HIV are needed. Given the widespread proliferation of mobile phones, the potential of using mobile health apps to improve the reach and efficacy of cessation interventions is promising, but evidence of efficacy is lacking, particularly among people with HIV. Objective This study will consist of a 2-group randomized controlled trial to evaluate a fully automated smartphone intervention for people with HIV seeking cessation treatment. Methods Participants (N=500) will be randomized to receive either standard treatment (ST; 250/500, 50%) or automated treatment (AT; 250/500, 50%). ST participants will be connected to the Florida Quitline and will receive nicotine replacement therapy in the form of transdermal patches and lozenges. This approach, referred to as Ask Advise Connect, was developed by our team and has been implemented in numerous health systems. ST will be compared with AT, a fully automated behavioral treatment approach. AT participants will receive nicotine replacement therapy and an interactive smartphone-based intervention that comprises individually tailored audiovisual and text content. The major goal is to determine whether AT performs better in terms of facilitating long-term smoking abstinence than the more resource-intensive ST approach. Our primary aim is to evaluate the efficacy of AT in facilitating smoking cessation among people with HIV. As a secondary aim, we will explore potential mediators and moderators and conduct economic evaluations to assess the cost and cost-effectiveness of AT compared with ST. Results The intervention content has been developed and finalized. Recruitment and enrollment will begin in the fall of 2021. Conclusions There is a critical need for efficacious, cost-effective, and sustainable cessation treatments for people with HIV who smoke. The AT intervention was designed to help fill this need. If efficacy is established, the AT approach will be readily adoptable by HIV clinics and community-based organizations, and it will offer an efficient way to allocate limited public health resources to tobacco control interventions. Trial Registration ClinicalTrials.gov NCT05014282; https://clinicaltrials.gov/ct2/show/NCT05014282 International Registered Report Identifier (IRRID) PRR1-10.2196/33183
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Affiliation(s)
- Damon J Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Thanh C Bui
- Stephenson Cancer Center, TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Michael S Businelle
- Stephenson Cancer Center, TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Ya-Chen Tina Shih
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, United States
| | - Lokesh Shahani
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | - Kristina Bowles
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Jennifer I Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
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