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Faro JM, Nagawa CS, Orvek EA, Smith BM, Blok AC, Houston TK, Kamberi A, Allison JJ, Person SD, Sadasivam RS. Comparing recruitment strategies for a digital smoking cessation intervention: Technology-assisted peer recruitment, social media, ResearchMatch, and smokefree.gov. Contemp Clin Trials 2021; 103:106314. [PMID: 33571687 DOI: 10.1016/j.cct.2021.106314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Choosing the right recruitment strategy has implications for the successful conduct of a trial. Our objective was to compare a novel peer recruitment strategy to four other recruitment strategies for a large randomized trial testing a digital tobacco intervention. METHODS We compared enrollment rates, demographic and baseline smoking characteristics, and odds of completing the 6-month study by recruitment strategy. Cost of recruitment strategies per retained participant was calculated using staff personnel time and advertisement costs. FINDINGS We enrolled 1487 participants between August 2017 and March 2019 from: Peer recruitment n = 273 (18.4%), Facebook Ads n = 505 (34%), Google Ads = 200 (13.4%), ResearchMatch n = 356 (23.9%) and Smokefree.govn = 153 (10.3%). Mean enrollment rate per active recruitment month: 1) Peer recruitment, n = 13.9, 2) Facebook ads, n = 25.3, 3) Google ads, n = 10.51, 4) Research Match, n = 59.3, and 5) Smokefree.gov, n = 13.9. Peer recruitment recruited the greatest number of males (n = 110, 40.3%), young adults (n = 41, 14.7%), participants with a high school degree or less (n = 24, 12.5%) and smokers within one's social network. Compared to peer recruitment (retention rate = 57%), participants from Facebook were less likely (OR 0.46, p < 0.01, retention rate = 40%), and those from ResearchMatch were more likely to complete the study (OR 1.90, p < 0.01, retention rate = 70%). Peer recruitment was moderate in cost per retained participant ($47.18) and substantially less costly than Facebook ($173.60). CONCLUSIONS Though peer recruitment had lower enrollment than other strategies, it may provide greater access to harder to reach populations and possibly others who smoke within one's social network while being moderately cost-effective. ClinicalTrials.gov: NCT03224520.
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Affiliation(s)
- Jamie M Faro
- Division of Health Informatics and Implementation Science, Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States.
| | - Catherine S Nagawa
- Division of Health Informatics and Implementation Science, Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Elizabeth A Orvek
- Division of Health Informatics and Implementation Science, Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Bridget M Smith
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Spinal Cord Injury Quality Enhancement Research Initiative (QUERI), Hines VAMC, Chicago, IL, United States; Department of Pediatrics and Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Amanda C Blok
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Thomas K Houston
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, United States
| | - Ariana Kamberi
- Division of Health Informatics and Implementation Science, Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Jeroan J Allison
- Division of Health Informatics and Implementation Science, Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sharina D Person
- Division of Biostatistics and Health Services Research, Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Rajani S Sadasivam
- Division of Health Informatics and Implementation Science, Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
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202
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Pinheiro FL, Pacheco JM, Santos FC. Stable leaders pave the way for cooperation under time-dependent exploration rates. ROYAL SOCIETY OPEN SCIENCE 2021; 8:200910. [PMID: 33972841 PMCID: PMC8074787 DOI: 10.1098/rsos.200910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
The exploration of different behaviours is part of the adaptation repertoire of individuals to new environments. Here, we explore how the evolution of cooperative behaviour is affected by the interplay between exploration dynamics and social learning, in particular when individuals engage on prisoner's dilemma along the edges of a social network. We show that when the population undergoes a transition from strong to weak exploration rates a decline in the overall levels of cooperation is observed. However, if the rate of decay is lower in highly connected individuals (Leaders) than for the less connected individuals (Followers) then the population is able to achieve higher levels of cooperation. Finally, we show that minor differences in selection intensities (the degree of determinism in social learning) and individual exploration rates, can translate into major differences in the observed collective dynamics.
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Affiliation(s)
- Flávio L. Pinheiro
- NOVA Information Management School (NOVA IMS), Universidade Nova de Lisboa, Campus de Campolide, 1070-312 Lisboa, Portugal
- ATP-group, 2744-016 Porto Salvo, Portugal
| | - Jorge M. Pacheco
- Centro de Biologia Molecular e Ambiental, Universidade do Minho, 4710-057 Braga, Portugal
- Departamento de Matemática e Aplicações, Universidade do Minho, 4710-057 Braga, Portugal
- ATP-group, 2744-016 Porto Salvo, Portugal
| | - Francisco C. Santos
- INESC-ID and Instituto Superior Técnico, Universidade de Lisboa, 2744-016 Porto Salvo, Portugal
- ATP-group, 2744-016 Porto Salvo, Portugal
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203
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Pérez-Aldana CA, Lewinski AA, Johnson CM, Vorderstrasse AA, Myneni S. Exchanges in a Virtual Environment for Diabetes Self-Management Education and Support: Social Network Analysis. JMIR Diabetes 2021; 6:e21611. [PMID: 33492236 PMCID: PMC7870352 DOI: 10.2196/21611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/04/2020] [Accepted: 11/18/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Diabetes remains a major health problem in the United States, affecting an estimated 10.5% of the population. Diabetes self-management interventions improve diabetes knowledge, self-management behaviors, and clinical outcomes. Widespread internet connectivity facilitates the use of eHealth interventions, which positively impacts knowledge, social support, and clinical and behavioral outcomes. In particular, diabetes interventions based on virtual environments have the potential to improve diabetes self-efficacy and support, while being highly feasible and usable. However, little is known about the patterns of social interactions and support taking place within type 2 diabetes-specific virtual communities. OBJECTIVE The objective of this study was to examine social support exchanges from a type 2 diabetes self-management education and support intervention that was delivered via a virtual environment. METHODS Data comprised virtual environment-mediated synchronous interactions among participants and between participants and providers from an intervention for type 2 diabetes self-management education and support. Network data derived from such social interactions were used to create networks to analyze patterns of social support exchange with the lens of social network analysis. Additionally, network correlations were used to explore associations between social support networks. RESULTS The findings revealed structural differences between support networks, as well as key network characteristics of supportive interactions facilitated by the intervention. Emotional and appraisal support networks are the larger, most centralized, and most active networks, suggesting that virtual communities can be good sources for these types of support. In addition, appraisal and instrumental support networks are more connected, suggesting that members of virtual communities are more likely to engage in larger group interactions where these types of support can be exchanged. Lastly, network correlations suggest that participants who exchange emotional support are likely to exchange appraisal or instrumental support, and participants who exchange appraisal support are likely to exchange instrumental support. CONCLUSIONS Social interaction patterns from disease-specific virtual environments can be studied using a social network analysis approach to better understand the exchange of social support. Network data can provide valuable insights into the design of novel and effective eHealth interventions given the unique opportunity virtual environments have facilitating realistic environments that are effective and sustainable, where social interactions can be leveraged to achieve diverse health goals.
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Affiliation(s)
- Carlos A Pérez-Aldana
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Allison A Lewinski
- Durham Veterans Affairs Medical Center, Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, United States
- Duke University School of Nursing, Durham, NC, United States
| | - Constance M Johnson
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | | | - Sahiti Myneni
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
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204
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Ly M, Stephens S, Iruthayanathan R, Motl R, Finlayson M, Yeh EA. Physical Activity in Youth with Multiple Sclerosis receiving the ATOMIC intervention: Social connectedness above all else. Mult Scler Relat Disord 2021; 49:102795. [PMID: 33545667 DOI: 10.1016/j.msard.2021.102795] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Within the pediatric MS population, physical activity (PA) has been associated with positive health outcomes such as lower lesion and relapse rates (Grover et. al., 2015). Recently, associations between variables from a social-cognitive theory (SCT) and levels of PA in youth with multiple sclerosis have been reported (Sikes & Motl, 2020), suggesting a SCT-based intervention may be efficacious in changing PA. We developed and delivered a 12-week SCT-based intervention and sought to gain an understanding of youth's perspectives on PA over time. METHODS We performed a qualitative analysis on 34 coaching call transcripts from 13 participants as part of a theory-based intervention promoting PA in youth with MS (NCT03137602). Coaching calls were semi-structured and each participant was scheduled to have three coaching calls spaced monthly for three months. We used an inductive content analysis approach to analyze the data (Elo and Kyngas, 2008). RESULTS General themes from the calls aligned with the SCT constructs. Youth consistently discussed facilitators for changing PA over time, including a positive attitude, goal setting and social connectedness. There was increasing conversation around PA barriers over time including the environment and a lack of time. CONCLUSION Youth perceptions on PA can be either positive or negative and can change over time. There is an underlying emergence and importance of social connectedness within PA behaviours. Increases in coaching call content related to goal setting suggest a positive effect of coaching and SCT in these areas. Future studies will focus on interactions between SCT constructs, particularly social connectedness and increased physical activity.
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Affiliation(s)
- Mina Ly
- Division of Neurology, Department of Pediatrics, Neurosciences and Mental Health (RI), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Samantha Stephens
- Division of Neurology, Department of Pediatrics, Neurosciences and Mental Health (RI), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Renisha Iruthayanathan
- Division of Neurology, Department of Pediatrics, Neurosciences and Mental Health (RI), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Robert Motl
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - E Ann Yeh
- Division of Neurology, Department of Pediatrics, Neurosciences and Mental Health (RI), The Hospital for Sick Children, Toronto, Ontario, Canada; Faculty of Medicine, The University of Toronto, Toronto, Ontario, Canada.
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205
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Skinner A, Occhipinti JA, Osgood ND. A dynamic modelling analysis of the impact of tobacco control programs on population-level nicotine dependence. Sci Rep 2021; 11:1866. [PMID: 33479364 PMCID: PMC7820504 DOI: 10.1038/s41598-021-81460-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/28/2020] [Indexed: 11/23/2022] Open
Abstract
According to the 'hardening hypothesis', average nicotine dependence will increase as less dependent smokers quit relatively easily in response to effective public health interventions, so that sustained progress in reducing smoking prevalence will depend on shifting the emphasis of tobacco control programs towards intensive treatment of heavily dependent smokers (who comprise an increasing fraction of continuing smokers). We used a system dynamics model of smoking behaviour to explore the potential for hardening in a population of smokers exposed to effective tobacco control measures over an extended period. Policy-induced increases in the per capita cessation rate are shown to lead inevitably to a decline in the proportion of smokers who are heavily dependent, contrary to the hardening hypothesis. Changes in smoking behaviour in Australia over the period 2001‒2016 resulted in substantial decreases in current smoking prevalence (from 23.1% in 2001 to 14.6% in 2016) and the proportion of heavily dependent smokers in the smoking population (from 52.1% to 36.9%). Public health interventions that have proved particularly effective in reducing smoking prevalence (tobacco tax increases, smoke-free environment legislation, antismoking mass media campaigns) are expected to also contribute to a decline in population-level nicotine dependence.
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Affiliation(s)
- Adam Skinner
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - Jo-An Occhipinti
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Nathaniel D Osgood
- Department of Computer Science, University of Saskatchewan, Saskatoon, Canada
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206
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Gillespie A, Fink EL, Gardiner HM, Gadegbeku CA, Reese PP, Obradovic Z. Does Whom Patients Sit Next to during Hemodialysis Affect Whether They Request a Living Donation? KIDNEY360 2021; 2:507-518. [PMID: 35369020 PMCID: PMC8785989 DOI: 10.34067/kid.0006682020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/13/2021] [Indexed: 02/04/2023]
Abstract
Background The seating arrangement of in-center hemodialysis is conducive to patients forming a relationship and a social network. We examined how seating in the in-center hemodialysis clinic affected patients forming relationships, whether patients formed relationships with others who have similar transplant behaviors (homophily), and whether these relationships influenced patients (social contagion) to request a living donation from family and friends outside of the clinic. Methods In this 30-month, prospective cohort study, we observed the relationships of 46 patients on hemodialysis in a hemodialysis clinic. Repeated participant surveys assessed in-center transplant discussions and living-donor requests. A separable temporal exponential random graph model estimated how seating, demographics, in-center transplant discussions, and living-donor requests affected relationship formation via sociality and homophily. We examined whether donation requests spread via social contagion using a susceptibility-infected model. Results For every seat apart, the odds of participants forming a relationship decreased (OR, 0.74; 95% CI, 0.61 to 0.90; P=0.002). Those who requested a living donation tended to form relationships more than those who did not (sociality, OR, 1.6; 95% CI, 1.02 to 2.6; P=0.04). Participants who discussed transplantation in the center were more likely to form a relationship with another participant who discussed transplantation than with someone who did not discuss transplantation (homophily, OR, 1.9; 95% CI, 1.03 to 3.5; P=0.04). Five of the 36 susceptible participants made a request after forming a relationship with another patient. Conclusions Participants formed relationships with those they sat next to and had similar transplant behaviors. The observed increase in in-center transplant discussions and living-donation requests by the members of the hemodialysis-clinic social network was not because of social contagion. Instead, participants who requested a living donation were more social, formed more relationships within the clinic, and discussed transplantation with each other as a function of health-behavior homophily.
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Affiliation(s)
- Avrum Gillespie
- Division of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Edward L. Fink
- Department of Communication and Social Influence, Klein College of Media and Communication, Temple University, Philadelphia, Pennsylvania
| | - Heather M. Gardiner
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Crystal A. Gadegbeku
- Division of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Peter P. Reese
- Renal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Zoran Obradovic
- Center for Data Analytics and Biomedical Informatics, Temple University, Philadelphia, Pennsylvania
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207
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Tsuji T, Kanamori S, Miyaguni Y, Kondo K. Community-Level Sports Group Participation and Health Behaviors Among Older Non-Participants in a Sports Group: A Multilevel Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020531. [PMID: 33435252 PMCID: PMC7827491 DOI: 10.3390/ijerph18020531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 01/23/2023]
Abstract
This study validates the relationship between community-level sports group participation and the frequency of leaving the house and transtheoretical model stages of behavior change for exercise among older individuals who did not participate in a sports group. We used cross-sectional data from the 2016 Japan Gerontological Evaluation Study. The proportion of sports group participants at the community level was calculated using the data from 157,233 older individuals living in 1000 communities. We conducted a multilevel regression analysis to examine the relationship between the proportion of sports group participants and the frequency of leaving the house (1 day/week or less) and the transtheoretical model stages of behavior change for exercise. A statistically significant relationship was observed between a high prevalence of sports group participation and lower risk of homeboundness (odds ratio: 0.94) and high transtheoretical model stages (partial regression coefficient: 0.06) as estimated by 10 percentage points of participation proportion. Older individuals, even those not participating in a sports group, living in a community with a high prevalence of sports group participation are less likely to be homebound; they are highly interested and have numerous opportunities to engage in exercise.
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Affiliation(s)
- Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, Bunkyo City, Tokyo 112-0012, Japan
- Correspondence:
| | - Satoru Kanamori
- Graduate School of Public Health, Teikyo University, Itabashi City, Tokyo 173-8605, Japan;
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Shinjuku City, Tokyo 160-8402, Japan
| | - Yasuhiro Miyaguni
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu City, Aichi 474-8511, Japan; (Y.M.); (K.K.)
| | - Katsunori Kondo
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu City, Aichi 474-8511, Japan; (Y.M.); (K.K.)
- Center for Preventive Medical Sciences, Chiba University, Chiba City, Chiba 263-8522, Japan
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208
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Jackson SE, Brown J, Grabovac I, Cheeseman H, Osborne C, Shahab L. Smoking and Quitting Behavior by Sexual Orientation: A Cross-Sectional Survey of Adults in England. Nicotine Tob Res 2021; 23:124-134. [PMID: 32115647 PMCID: PMC7789956 DOI: 10.1093/ntr/ntaa042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 02/27/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To assess associations between sexual orientation and smoking and quitting behavior among adults in England. METHODS Data were collected from 112 537 adults (≥16 years) participating in a nationally representative monthly cross-sectional survey between July 2013 and February 2019. Sexual orientation was self-reported as heterosexual, bisexual, lesbian/gay, or prefer-not-to-say. Main outcomes were smoking status, e-cigarette use, cigarettes per day, time to first cigarette, motivation to stop smoking, motives for quitting, use of cessation support, and past-year quit attempts. Associations were analyzed separately for men and women using multivariable regression models adjusted for relevant covariates. RESULTS Smoking prevalence is now similar between gay (21.6%), prefer-not-to-say (20.5%) and heterosexual men (20.0%), and lesbian (18.3%) and heterosexual women (16.9%), but remains higher among bisexual men (28.2%, adjusted odds ratio [ORadj] = 1.41, 95% confidence interval [CI] = 1.11 to 1.79) and bisexual women (29.8%, ORadj = 1.64, 95% CI = 1.33 to 2.03) and lower among prefer-not-to-say women (14.5%, ORadj = 0.85, 95% CI = 0.72 to 0.99). Among smokers, bisexuals were less addicted than heterosexuals, with bisexual men smoking fewer cigarettes per day (Badj = -2.41, 95% CI = -4.06 to -0.75) and bisexual women less likely to start smoking within 30 min of waking (ORadj = 0.66, 95% CI = 0.45 to 0.95) than heterosexuals. However, motivation to stop smoking and quit attempts did not differ significantly. CONCLUSIONS In England, differences in smoking prevalence among people with different sexual orientations have narrowed, primarily driven by a larger decline in smoking rates among sexual minority groups than heterosexuals. Bisexual men and women remain more likely to smoke but have lower levels of addiction while being no less likely to try to quit. IMPLICATIONS This population-based study provides an up-to-date picture of smoking and quitting behavior in relation to sexual orientation among adults in England. Findings suggest that widely documented disparities in smoking prevalence have narrowed over recent years, with gay men and lesbian women no longer significantly more likely to smoke than heterosexuals, although smoking remains more common among bisexual men and women. Insights into differences in level of addiction, use of cessation support, and motives for quitting may help inform the development of targeted interventions to further reduce smoking among sexual minority groups.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | | | | | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
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209
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East KA, Hitchman SC, McNeill A, Ferguson SG, Yong HH, Cummings KM, Fong GT, Borland R. Trends in Social Norms Towards Smoking Between 2002 and 2015 Among Daily Smokers: Findings From the International Tobacco Control Four Country Survey (ITC 4C). Nicotine Tob Res 2021; 23:203-211. [PMID: 31532483 PMCID: PMC7789950 DOI: 10.1093/ntr/ntz179] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/12/2019] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To assess trends in daily smokers' social norms and opinions of smoking between 2002 and 2015 in Canada, the United States, the United Kingdom, and Australia. METHOD Data were from wave 1 (2002) to wave 9 (2013-2015) of the longitudinal International Tobacco Control Four Country Survey (Canada, the United States, the United Kingdom, Australia), involving 23 831 adult daily smokers. Generalized estimating equation logistic regression models, adjusted for demographics and survey design effects, assessed associations of wave and country with outcomes: (A) over half of five closest friends smoke, (B) agreeing that people important to you believe you should not smoke, (C) agreeing that society disapproves of smoking, and (D) negative opinion of smoking. RESULTS Between 2002 and 2015, adjusting for covariates, (A) over half of five closest friends smoke did not change (56% vs. 55%; adjusted odds ratio [AOR] = 0.95 [95% Confidence Interval = 0.85-1.07]), (B) agreeing that people important to you believe you should not smoke generally decreased (89% vs. 82%; AOR = 0.54 [0.46-0.64]) despite an increase around 2006-2007, (C) agreeing that society disapproves of smoking increased between 2002 and 2006-2007 (83% vs. 87%; AOR = 1.38 [1.24-1.54]) then decreased until 2013-2015 (78%; AOR = 0.74 [0.63-0.88]), and (D) negative opinion of smoking decreased between 2002 and 2010-2011 (54% vs. 49%; AOR = 0.83 [0.75-0.91]) despite an increase around 2005-2006 and at the final wave (2013-2015). Except friend smoking, Canada had the greatest, and the United Kingdom the lowest, antismoking social norms and opinions. CONCLUSIONS Except friend smoking and opinion of smoking, daily smokers' social norms became less antismoking between 2002 and 2015 despite increases around 2006-2007. Several potential explanations are discussed yet remain undetermined. IMPLICATIONS Increasingly comprehensive tobacco control policies alongside decreasing smoking prevalence in Canada, the United States, the United Kingdom, and Australia have led to the assumption that smoking has become denormalized in these countries. Absent from the literature is any formal assessment of social norms towards smoking over time. Contrary to our hypotheses, this study found that the injunctive social norms of daily smokers became less antismoking between 2002 and 2015, despite increases around 2006-2007. There was no change over time in the proportion of daily smokers who report that over half of their five closest friends smoke.
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Affiliation(s)
- Katherine A East
- National Addiction Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
| | - Sara C Hitchman
- National Addiction Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
| | - Stuart G Ferguson
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Hua-Hie Yong
- Cancer Council Victoria, Melbourne, VIC, Australia
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - K Michael Cummings
- Department of Psychiatry and Behavioural Sciences, Medical University of South Carolina, Charleston, SC
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Ron Borland
- Cancer Council Victoria, Melbourne, VIC, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
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210
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Vulliard L, Menche J. Complex Networks in Health and Disease. SYSTEMS MEDICINE 2021. [PMCID: PMC7263184 DOI: 10.1016/b978-0-12-801238-3.11640-x] [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] [Indexed: 11/13/2022] Open
Abstract
From protein interactions to signal transduction, from metabolism to the nervous system: Virtually all processes in health and disease rely on the careful orchestration of a large number of diverse individual components ranging from molecules to cells and entire organs. Networks provide a powerful framework for describing and understanding these complex systems in a wholistic fashion. They offer a unique combination of a highly intuitive, qualitative description, and a plethora of analytical, quantitative tools. Here we provide a brief introduction to the emerging field of network medicine. After an overview of the core concepts for connecting network characteristics to biological functions, we review commonly used networks, ranging from the molecular interaction networks that form the basis of all biological processes in the cell to the global transportation networks that govern the spread of global epidemics. Lastly, we highlight current conceptual and practical challenges.
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211
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Schneider JA, Young L, Ramachandran A, Michaels S, Cohen H, Robinson I, Alon L, Hill B, Nakasone S, Balenciaga M, Motley D, Bouris A, Khanna A, Ferreira M, Valente T, Schumm P. A Pragmatic Randomized Controlled Trial to Increase PrEP Uptake for HIV Prevention: 55-Week Results From PrEPChicago. J Acquir Immune Defic Syndr 2021; 86:31-37. [PMID: 33306562 PMCID: PMC7722461 DOI: 10.1097/qai.0000000000002518] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/08/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We tested preliminary efficacy of a peer change agent type I network intervention to increase pre-exposure prophylaxis (PrEP) linkage to care among network members connected to young Black men who have sex with men. DESIGN Parent study is a pragmatic randomized controlled trial with 110 weeks of total follow-up. Interim midpoint analyses are performed here using participant data before crossover assignment at 55 weeks. METHODS We randomly assigned 423 participants in Chicago to receive the network intervention, an opinion leader workshop with telephonic booster sessions, versus a time-matched control from 2016 to 2018. The consolidated surrogate outcome was PrEP referral and linkage to clinical care among network members connected to study participants and was collected from independent administrative data. RESULTS Each study participant in the trial (n = 423) had on average 1822 network contacts who could be eligible for PrEP referral and linkage. During the 55-week observation period, PrEP referral was most likely to occur within 3 days of an intervention session compared to control [odds ratio (OR) 0.07 (0.02-0.013); P = 0.007] resulting in 1-2 referrals of network members per session. Network members with referral or linkage were more likely to be connected to study participants in the intervention arm than the control condition [aOR 1.50 (1.09-2.06); P = 0.012]. CONCLUSIONS A peer change agent type I network intervention is preliminarily effective at diffusing PrEP through a network of individuals highly susceptible to HIV over 55 weeks. This low-intensity intervention demonstrated network-level impact among populations that have experienced limited PrEP care engagement in the United States.
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Affiliation(s)
| | | | | | | | - Hildie Cohen
- NORC at the University of Chicago, Chicago, IL; and
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212
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Nevard I, Green C, Bell V, Gellatly J, Brooks H, Bee P. Conceptualising the social networks of vulnerable children and young people: a systematic review and narrative synthesis. Soc Psychiatry Psychiatr Epidemiol 2021; 56:169-182. [PMID: 33140120 PMCID: PMC7870613 DOI: 10.1007/s00127-020-01968-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 09/23/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The relationship between social networks and health and wellbeing is increasingly demonstrated in vulnerable adult populations. This relationship for vulnerable children and young people has not hitherto been systematically reviewed. This narrative synthesis aims to consolidate research to provide a foundational basis for future health-related social network research and interventions for children and young people. METHODS This mixed methods systematic review synthesises research investigating whole, egocentric social networks of 32 vulnerable child groups with a mean age below 18. There were no setting, language or date restrictions. The quality was assessed using the Mixed Methods Appraisal Tool. Of 6360 search results, 49 were included for narrative synthesis. RESULTS The majority of pertinent research originates from the USA; the most frequently investigated vulnerabilities were minority ethnic status, homelessness and the presence of special educational needs. Research aims and methodologies varied significantly between studies. Key findings included (i) vulnerable (excluding minority ethnic) children and young people have impoverished networks (ii) access to networks is a protective factor against negative outcomes (iii) social ties, primarily immediate family, provide access to personal resources and (iv) network ties are to a degree substitutable. CONCLUSIONS Networks are associated with wellbeing and vulnerable children and young people commonly have impoverished networks, excluding cases where vulnerability classification relates to minority ethnic status. Network embeddedness is associated with positive outcomes, particularly for homeless children. Family are typically primary providers of support, but ties are substitutable when networks are restricted. Egocentric social network research is currently limited for vulnerable child populations. Further research could inform interventions that harness networks to improve health, wellbeing and functional outcomes for these child groups.
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Affiliation(s)
- Imogen Nevard
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK.
| | - Chloe Green
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Vicky Bell
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Judith Gellatly
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Helen Brooks
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
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213
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Marbin J, Balk SJ, Gribben V, Groner J. Health Disparities in Tobacco Use and Exposure: A Structural Competency Approach. Pediatrics 2021; 147:peds.2020-040253. [PMID: 33386342 DOI: 10.1542/peds.2020-040253] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Fourteen percent of US adults use tobacco products. Because many of those who use tobacco are parents and/or caregivers, children are disproportionately exposed to tobacco smoke. People who use tobacco products often become addicted to nicotine, resulting in tobacco dependence, a chronic, relapsing disease. Tobacco use and exposure are more likely to occur in vulnerable and marginalized groups, including those living in poverty. Although some view tobacco use as a personal choice, evidence suggests that structural forces play an important role in tobacco uptake, subsequent nicotine addiction, and perpetuation of use. Viewing tobacco use and tobacco dependence through a structural competency lens promotes recognition of the larger systemic forces perpetuating tobacco use, including deliberate targeting of groups by the tobacco industry, lack of enforcement of age-for-sale laws, inferior access to health insurance and health care, poor access to cessation resources, and economic stress. Each of these forces perpetuates tobacco initiation and use; in turn, tobacco use perpetuates the user's adverse health and economic conditions. Pediatricians are urged to view family tobacco use as a social determinant of health. In addition to screening adolescents for tobacco use and providing resources and treatment of tobacco dependence, pediatricians are encouraged to systematically screen children for secondhand smoke exposure and support family members who smoke with tobacco cessation. Additionally, pediatricians can address the structural issues perpetuating tobacco use by becoming involved in policy and advocacy initiatives.
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Affiliation(s)
- Jyothi Marbin
- University of California, San Francisco, San Francisco, California;
| | - Sophie J Balk
- Albert Einstein College of Medicine and Children's Hospital at Montefiore, Bronx, New York; and
| | - Valerie Gribben
- University of California, San Francisco, San Francisco, California
| | - Judith Groner
- College of Medicine, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
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214
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Pomeroy C, Bond RM, Mucha PJ, Cranmer SJ. Dynamics of social network emergence explain network evolution. Sci Rep 2020; 10:21876. [PMID: 33318501 PMCID: PMC7736284 DOI: 10.1038/s41598-020-78224-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 09/28/2020] [Indexed: 11/27/2022] Open
Abstract
Networked systems emerge and subsequently evolve. Although several models describe the process of network evolution, researchers know far less about the initial process of network emergence. Here, we report temporal survey results of a real-world social network starting from its point of inception. We find that individuals' ties undergo an initial cycle of rapid expansion and contraction. This process helps to explain the eventual interactions and working structure in the network (in this case, scientific collaboration). We propose a stylized concept and model of "churn" to describe the process of network emergence and stabilization. Our empirical and simulation results suggest that these network emergence dynamics may be instrumental for explaining network details, as well as behavioral outcomes at later time periods.
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Affiliation(s)
- Caleb Pomeroy
- Department of Political Science, The Ohio State University, Columbus, OH, 43210, USA
| | - Robert M Bond
- School of Communication, The Ohio State University, Columbus, OH, 43210, USA
| | - Peter J Mucha
- Carolina Center for Interdisciplinary Applied Mathematics, Department of Mathematics, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Skyler J Cranmer
- Department of Political Science, The Ohio State University, Columbus, OH, 43210, USA.
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215
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Similarity in functional brain connectivity at rest predicts interpersonal closeness in the social network of an entire village. Proc Natl Acad Sci U S A 2020; 117:33149-33160. [PMID: 33318188 DOI: 10.1073/pnas.2013606117] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
People often have the intuition that they are similar to their friends, yet evidence for homophily (being friends with similar others) based on self-reported personality is inconsistent. Functional connectomes-patterns of spontaneous synchronization across the brain-are stable within individuals and predict how people tend to think and behave. Thus, they may capture interindividual variability in latent traits that are particularly similar among friends but that might elude self-report. Here, we examined interpersonal similarity in functional connectivity at rest-that is, in the absence of external stimuli-and tested if functional connectome similarity is associated with proximity in a real-world social network. The social network of a remote village was reconstructed; a subset of residents underwent functional magnetic resonance imaging. Similarity in functional connectomes was positively related to social network proximity, particularly in the default mode network. Controlling for similarities in demographic and personality data (the Big Five personality traits) yielded similar results. Thus, functional connectomes may capture latent interpersonal similarities between friends that are not fully captured by commonly used demographic or personality measures. The localization of these results suggests how friends may be particularly similar to one another. Additionally, geographic proximity moderated the relationship between neural similarity and social network proximity, suggesting that such associations are particularly strong among people who live particularly close to one another. These findings suggest that social connectivity is reflected in signatures of brain functional connectivity, consistent with the common intuition that friends share similarities that go beyond, for example, demographic similarities.
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216
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Sarvey D, Welsh JW. Adolescent substance use: Challenges and opportunities related to COVID-19. J Subst Abuse Treat 2020; 122:108212. [PMID: 33272731 DOI: 10.1016/j.jsat.2020.108212] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/22/2020] [Accepted: 11/16/2020] [Indexed: 11/19/2022]
Abstract
Adolescent substance use is a significant public health concern within the United States that remains largely undertreated. The COVID-19 pandemic has exacerbated many preexisting risk factors for adolescent substance use, such as early life stress, social isolation, school connection, and boredom. Other effects include the potential for arrest in adolescent development, which can occur when there is disruption in expected developmental milestones. New cohorts of adolescents who may not otherwise initiate substances may now be at risk. The pandemic is also straining family systems, with potential for increased conflict and relapse that can occur in a bidirectional fashion. In parallel, the way in which we treat substance use disorders in youth has also shifted, with a dominance in digitally based platforms for delivery of most outpatient treatment. Challenges to utilizing virtual technology include fewer means of monitoring substance use remotely; privacy concerns; and ease of nonadherence with treatment by signing off the computer. Practitioners can utilize considerable opportunities for virtual care to reach adolescents at risk of developing a substance use disorder and/or those who may already have relapsed. Primary care providers and other general practitioners who frequently interface with youth should increase their baseline screening of youth.
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Affiliation(s)
- Dana Sarvey
- Department of Child and Adolescent Psychiatry, McLean Hospital, Instructor, Harvard Medical School, 115 Mill Street, Belmont, MA 02478, United States of America.
| | - Justine W Welsh
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive NE, Suite 200, Atlanta, GA 30329, United States of America.
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217
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Walk or Run to Quit: a 3-year evaluation of a physical activity-based smoking cessation intervention. J Smok Cessat 2020. [DOI: 10.1017/jsc.2020.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
AbstractIntroductionWalk or Run to Quit was a national program targeting smoking cessation through group-based running clinics. Increasing physical activity may facilitate smoking cessation as well as lead to additional health benefits beyond cessation.AimTo evaluate the impact of Walk or Run to Quit over 3 years.MethodsAdult male and female participants (N = 745) looking to quit smoking took part in 156 running-based cessation clinics in 79 locations across Canada. Using a pre-post design, participants completed questionnaires assessing physical activity, running frequency and smoking at the beginning and end of the 10-week program and at 6-months follow-up. Carbon monoxide testing pre- and post- provided an objective indicator of smoking status and coach logs assessed implementation.Results55.0% of program completers achieved 7-day point prevalence (intent-to-treat = 22.1%) and carbon monoxide significantly decreased from weeks 1 to 10 (P < 0.001). There was an increase in physical activity and running from baseline to end-of-program (P's<0.001). At 6-month follow-up, 28.9% of participants contacted self-reported prolonged 6-month abstinence (intent-to-treat = 11.4%) and 35.6% were still running regularly.ConclusionsAlthough attrition was a concern, Walk or Run to Quit demonstrated potential as a scalable behaviour change intervention that targets both cessation and physical activity.
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218
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Shrestha V. Maternal education and infant health gradient: New answers to old questions. ECONOMICS AND HUMAN BIOLOGY 2020; 39:100894. [PMID: 32759047 DOI: 10.1016/j.ehb.2020.100894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 05/10/2020] [Accepted: 05/15/2020] [Indexed: 06/11/2023]
Abstract
By using data from the National Vital Statistics System, this study provides an in-depth investigation of the well-documented mother's education- infant health gradient. The study allows for differential relationship between mother's education and infant health outcomes across localities based on income status by using birthweight and low birthweight as health measures. The results show that mother's education- infant birthweight relationship is more concentrated at relatively poor geographic areas. This can partially be explained by increases in utilization of health services among educated mothers residing in poorer areas compared to mothers with lower levels of education. Although the magnitude of education-health gradient has decreased in recent years, the gradient is still more pronounced in poorer localities. Access to health care during pregnancy, measured by adequacy of care, has improved particularly among less educated mothers living in poorer areas. However, smoking participation during pregnancy has declined substantially among less educated mothers across all geographic localities in recent years. Additionally, mother's education-infant health gradient is similar across black and white race groups.
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Affiliation(s)
- Vinish Shrestha
- Towson University, 8000 York Road Stephens Hall, Towson 21252, USA.
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219
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Alla F, Berlin I, Nguyen-Thanh V, Guignard R, Pasquereau A, Quelet S, Schwarzinger M, Arwidson P. Tobacco and COVID-19: a crisis within a crisis? CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2020; 111:995-999. [PMID: 33052586 PMCID: PMC7556572 DOI: 10.17269/s41997-020-00427-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/28/2020] [Indexed: 02/06/2023]
Abstract
During the pandemic, the world's media have publicized preliminary findings suggesting that tobacco use is protective against COVID-19. An ad hoc multidisciplinary group was created to address the major public health implications of this messaging. Key messages of this commentary are as follows: 1) The COVID-19 crisis may increase tobacco consumption and decrease access to healthcare. As a result, smoking-related morbidity and mortality could increase in the coming months and years; 2) Smoking and tobacco-related diseases are prognostic factors for severe COVID-19; and 3) In theory, smokers may be at lower risk of COVID-19 infection because of having fewer social contacts. In conclusion, tobacco control is a greater challenge than ever in the context of the COVID-19 pandemic. Public decision-makers must be vigilant in ensuring that public health practices are consistent and compliant with the principles of the WHO Framework Convention on Tobacco Control. In addition, researchers and the media have a responsibility to be cautious in communicating preliminary results that may promote non-evidence-based research, self-destructive individual behaviours, and commercial agendas.
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Affiliation(s)
- François Alla
- Bordeaux Population Health Research Center, UMR 1219, Inserm, Université de Bordeaux, 33000, Bordeaux, France.
| | - Ivan Berlin
- Département de pharmacologie, AP-HP, 75012, Paris, France
- Centre universitaire de médecine générale et de santé publique, 1011, Lausanne, Switzerland
| | - Viet Nguyen-Thanh
- Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Romain Guignard
- Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Anne Pasquereau
- Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Sylvie Quelet
- Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Michaël Schwarzinger
- Bordeaux Population Health Research Center, UMR 1219, Inserm, Université de Bordeaux, 33000, Bordeaux, France
| | - Pierre Arwidson
- Santé Publique France, The National Public Health Agency, Saint-Maurice, France
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220
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Lowenstein C, Dow WH, White JS. Peer effects in smoking cessation: An instrumental variables analysis of a worksite intervention in Thailand. SSM Popul Health 2020; 12:100659. [PMID: 32964096 PMCID: PMC7490727 DOI: 10.1016/j.ssmph.2020.100659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/26/2020] [Accepted: 08/20/2020] [Indexed: 11/16/2022] Open
Abstract
While smoking is widely acknowledged to be a social activity, limited evidence exists on the extent to which friends influence each other during worksite-based tobacco cessation interventions. Drawing on data from adult smokers (N = 1823) in a large, cluster randomized controlled trial in worksites in Thailand, this study examines the presence of social spillovers in the decision to abstain from smoking. We leverage a unique aspect of social network structure in these data-the existence of non-overlapping friendship networks-to address the challenge of isolating the effects of peers on smoking behavior from the confounding effects of endogenous friend selection and bidirectional peer influence. We find that individuals with workplace friends who have abstained from smoking during the trial are significantly more likely to abstain themselves. Instrumental variables estimates suggest that abstinence after 3 and 12 months increases 26 and 32 percentage points, respectively, for each additional workplace friend who abstains. These findings highlight the potential for workplace interventions to use existing social networks to magnify the effect of individual-level behavior change, particularly in low- and middle-income countries where tobacco cessation support tends to be limited.
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Affiliation(s)
- Christopher Lowenstein
- Division of Health Policy and Management, University of California, Berkeley School of Public Health, Berkeley, California, USA
| | - William H. Dow
- Division of Health Policy and Management, University of California, Berkeley School of Public Health, Berkeley, California, USA
| | - Justin S. White
- Philip R. Lee Institute for Health Policy Studies and Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
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221
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Singh T, Roberts K, Cohen T, Cobb N, Wang J, Fujimoto K, Myneni S. Social Media as a Research Tool (SMaaRT) for Risky Behavior Analytics: Methodological Review. JMIR Public Health Surveill 2020; 6:e21660. [PMID: 33252345 PMCID: PMC7735906 DOI: 10.2196/21660] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 10/05/2020] [Accepted: 11/06/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Modifiable risky health behaviors, such as tobacco use, excessive alcohol use, being overweight, lack of physical activity, and unhealthy eating habits, are some of the major factors for developing chronic health conditions. Social media platforms have become indispensable means of communication in the digital era. They provide an opportunity for individuals to express themselves, as well as share their health-related concerns with peers and health care providers, with respect to risky behaviors. Such peer interactions can be utilized as valuable data sources to better understand inter-and intrapersonal psychosocial mediators and the mechanisms of social influence that drive behavior change. OBJECTIVE The objective of this review is to summarize computational and quantitative techniques facilitating the analysis of data generated through peer interactions pertaining to risky health behaviors on social media platforms. METHODS We performed a systematic review of the literature in September 2020 by searching three databases-PubMed, Web of Science, and Scopus-using relevant keywords, such as "social media," "online health communities," "machine learning," "data mining," etc. The reporting of the studies was directed by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Two reviewers independently assessed the eligibility of studies based on the inclusion and exclusion criteria. We extracted the required information from the selected studies. RESULTS The initial search returned a total of 1554 studies, and after careful analysis of titles, abstracts, and full texts, a total of 64 studies were included in this review. We extracted the following key characteristics from all of the studies: social media platform used for conducting the study, risky health behavior studied, the number of posts analyzed, study focus, key methodological functions and tools used for data analysis, evaluation metrics used, and summary of the key findings. The most commonly used social media platform was Twitter, followed by Facebook, QuitNet, and Reddit. The most commonly studied risky health behavior was nicotine use, followed by drug or substance abuse and alcohol use. Various supervised and unsupervised machine learning approaches were used for analyzing textual data generated from online peer interactions. Few studies utilized deep learning methods for analyzing textual data as well as image or video data. Social network analysis was also performed, as reported in some studies. CONCLUSIONS Our review consolidates the methodological underpinnings for analyzing risky health behaviors and has enhanced our understanding of how social media can be leveraged for nuanced behavioral modeling and representation. The knowledge gained from our review can serve as a foundational component for the development of persuasive health communication and effective behavior modification technologies aimed at the individual and population levels.
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Affiliation(s)
- Tavleen Singh
- School of Biomedical Informatics, The University of Texas Health Science Center, Houston, TX, United States
| | - Kirk Roberts
- School of Biomedical Informatics, The University of Texas Health Science Center, Houston, TX, United States
| | - Trevor Cohen
- Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, United States
| | - Nathan Cobb
- Georgetown University Medical Center, Washington, DC, United States
| | - Jing Wang
- School of Nursing, The University of Texas Health Science Center, San Antonio, TX, United States
| | - Kayo Fujimoto
- School of Public Health, The University of Texas Health Science Center, Houston, TX, United States
| | - Sahiti Myneni
- School of Biomedical Informatics, The University of Texas Health Science Center, Houston, TX, United States
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Moss JL, Pinto CN, Mama SK, Rincon M, Kent EE, Yu M, Cronin KA. Rural-urban differences in health-related quality of life: patterns for cancer survivors compared to other older adults. Qual Life Res 2020; 30:1131-1143. [PMID: 33136241 DOI: 10.1007/s11136-020-02683-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Health-related quality of life (HRQOL) among older cancer survivors can be impaired by factors such as treatment, comorbidities, and social challenges. These HRQOL impairments may be especially pronounced in rural areas, where older adults have higher cancer burden and more comorbidities and risk factors for poor health. This study aimed to assess rural-urban differences in HRQOL for older cancer survivors and controls. METHODS Data came from Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey (SEER-MHOS), which links cancer incidence from 18 U.S. population-based cancer registries to survey data for Medicare Advantage Organization enrollees (1998-2014). HRQOL measures were 8 standardized subscales and 2 global summary measures. We matched (2:1) controls to breast, colorectal, lung, and prostate cancer survivors, creating an analytic dataset of 271,640 participants (ages 65+). HRQOL measures were analyzed with linear regression models including multiplicative interaction terms (rurality by cancer status), controlling for sociodemographics, cohort, and multimorbidities. RESULTS HRQOL scores were higher in urban than rural areas (e.g., global physical component summary score for breast cancer survivors: urban mean = 38.7, standard error [SE] = 0.08; rural mean = 37.9, SE = 0.32; p < 0.05), and were generally lower among cancer survivors compared to controls. Rural cancer survivors had particularly poor vitality (colorectal: p = 0.05), social functioning (lung: p = 0.05), role limitation-physical (prostate: p < 0.01), role limitation-emotional (prostate: p < 0.01), and global mental component summary (prostate: p = 0.02). CONCLUSION Supportive interventions are needed to increase physical, social, and emotional HRQOL among older cancer survivors in rural areas. These interventions could target cancer-related stigma (particularly for lung and prostate cancers) and/or access to screening, treatment, and ancillary healthcare resources.
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Affiliation(s)
- Jennifer L Moss
- National Cancer Institute, Bethesda, MD, USA. .,Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA.
| | - Casey N Pinto
- Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | | | | | - Erin E Kent
- University of North Carolina, Chapel Hill, NC, USA
| | - Mandi Yu
- National Cancer Institute, Bethesda, MD, USA
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Marqués-Sánchez P, Quiroga Sánchez E, Liébana-Presa C, Fernández-Martínez E, García-Rodríguez I, Benítez-Andrades JA. The consumption of alcohol by adolescent schoolchildren: Differences in the triadic relationship pattern between rural and urban environments. PLoS One 2020; 15:e0241135. [PMID: 33137141 PMCID: PMC7605695 DOI: 10.1371/journal.pone.0241135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 10/08/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Excessive alcohol consumption in adolescents is one of the most significant public health problems currently facing society. Social and geographical contexts contribute to the development of alcohol-related behavior in adolescents. The aim of this research is to analyze the social pattern related to alcohol consumption in adolescents based on their geographical environment. METHODOLOGY We designed a descriptive cross-sectional study based on social network analysis. We recruited 196 high school students between 16 and 18 years of age to participate in the study. The methodology applied was social network analysis by means of transitivity and homophily social triads. The data were analyzed using STATA statistical software. RESULTS AND CONCLUSIONS A total of 58.48% of rural adolescents consumed alcohol compared to 49.52% of urban adolescents. These results demonstrate that adolescents who live in rural areas exhibit a greater risk of drinking alcohol than those who live in urban areas. The presence of transitive triads increases the probability of sharing sociodemographic attributes in such a way that it may be considered one of the causes of homophily, contributing to adolescents taking greater risks, such as consuming alcohol.
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Affiliation(s)
- Pilar Marqués-Sánchez
- SALBIS Research Group, Faculty of Health Sciences, University of León, Ponferrada, Spain
| | - Enedina Quiroga Sánchez
- SALBIS Research Group, Faculty of Health Sciences, University of León, Ponferrada, Spain
- * E-mail:
| | - Cristina Liébana-Presa
- SALBIS Research Group, Faculty of Health Sciences, University of León, Ponferrada, Spain
| | | | - Isaías García-Rodríguez
- SECOMUCI Research Group, Escuela de Ingenierías Industrial e Informática, Universidad de León, León, Spain
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Evans-Polce RJ, Patrick ME, McCabe SE, Miech RA. Prospective associations of e-cigarette use with cigarette, alcohol, marijuana, and nonmedical prescription drug use among US adolescents. Drug Alcohol Depend 2020; 216:108303. [PMID: 32987363 PMCID: PMC7606638 DOI: 10.1016/j.drugalcdep.2020.108303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/10/2020] [Accepted: 09/13/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND As e-cigarette use continues to increase in the U.S., research is needed to understand its prospective risk for cigarette smoking and other substance use in young adulthood, including alcohol, marijuana, and nonmedical prescription drugs (NMPDs). METHODS This study used data from the Monitoring the Future (MTF) study a nationally representative annual survey of 12th graders (modal age 18) in the US. The analytic sample included 2014-2016 MTF cohorts that were selected and completed follow up one year later (modal age 19; n = 717). Using logistic regression, we examined cross-sectional and prospective associations of past 30-day e-cigarette use with past 30-day cigarette, alcohol, marijuana, and NMPD use. We examined prospective associations among the full sample and associations with incidence of each of these substances among those who reported no history of use in 12th grade. RESULTS In cross-sectional analysis, those who reported past 30-day e-cigarette use at age 18 were more likely to report past 30-day cigarette use, alcohol use, marijuana use, and NMPD use at age 19. In multivariable longitudinal analysis, past 30-day e-cigarette users at age 18 were more likely to report past 30-day cigarette, marijuana, and NMPD use at age 19, including e-cigarette users who had no history of using these substances at age 18. CONCLUSIONS This study suggests that e-cigarette use may be an indicator of future substance use risk in young adulthood. Adolescent e-cigarette users may benefit from secondary prevention efforts to mitigate this risk.
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Affiliation(s)
- Rebecca J. Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI, 48109, USA
| | - Megan E. Patrick
- Institute for Translational Research in Children’s Mental Health and Institute of Child Development, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI, 48109, USA,Rogel Cancer Center, University of Michigan, Ann Arbor, MI, 48109, USA,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Richard A. Miech
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, 48104
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225
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Carmona-Pírez J, Poblador-Plou B, Díez-Manglano J, Morillo-Jiménez MJ, Marín Trigo JM, Ioakeim-Skoufa I, Gimeno-Miguel A, Prados-Torres A. Multimorbidity networks of chronic obstructive pulmonary disease and heart failure in men and women: Evidence from the EpiChron Cohort. Mech Ageing Dev 2020; 193:111392. [PMID: 33129797 DOI: 10.1016/j.mad.2020.111392] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/31/2020] [Accepted: 10/26/2020] [Indexed: 12/23/2022]
Abstract
Patients with heart failure (HF) and/or chronic obstructive pulmonary disease (COPD) constitute a complex population with different phenotypes based on pathophysiology, comorbidity, sex and age. We aimed to compare the multimorbidity patterns of HF and COPD in men and women using network analysis. Individuals aged 40 years or older on 2015 of the EpiChron Cohort (Aragon, Spain) were stratified by sex and as having COPD (n = 28,608), HF (n = 13,414), or COPD and HF (n = 3952). We constructed one network per group by obtaining age-adjusted phi correlations between comorbidities. For each sex, networks differed between the three study groups; between sexes, similarities were found for the two HF groups. We detected some specific diseases highly connected in all networks (e.g., cardio-metabolic, respiratory diseases, and chronic kidney failure), and some others that were group-specific that would require further study. We identified common clusters (i.e., cardio-metabolic, cardiovascular, cancer, and neuro-psychiatric) and others specific and clinically relevant in COPD patients (e.g., behavioral risk disorders were systematically associated with psychiatric diseases in women and cancer in men). Network analysis represents a powerful tool to analyze, visualize, and compare the multimorbidity patterns of COPD and HF, also facilitated by developing an ad hoc website.
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Affiliation(s)
- Jonás Carmona-Pírez
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC. Miguel Servet University Hospital, 50009, Zaragoza, Spain; Aragon Health Service (SALUD). Department III of Zaragoza, Zaragoza, Spain.
| | - Beatriz Poblador-Plou
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC. Miguel Servet University Hospital, 50009, Zaragoza, Spain.
| | - Jesús Díez-Manglano
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC. Miguel Servet University Hospital, 50009, Zaragoza, Spain; Internal Medicine Department, Royo Villanova Hospital, Zaragoza, Spain.
| | - Manuel Jesús Morillo-Jiménez
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC. Miguel Servet University Hospital, 50009, Zaragoza, Spain.
| | | | | | - Antonio Gimeno-Miguel
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC. Miguel Servet University Hospital, 50009, Zaragoza, Spain.
| | - Alexandra Prados-Torres
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC. Miguel Servet University Hospital, 50009, Zaragoza, Spain.
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226
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Hameed I, Irfan BZ. Social Media
Self‐Control
Failure leading to antisocial aggressive behavior. HUMAN BEHAVIOR AND EMERGING TECHNOLOGIES 2020. [DOI: 10.1002/hbe2.226] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Irfan Hameed
- Faculty of Business Administration Iqra University Karachi Pakistan
| | - Bibi Zainab Irfan
- College of Business Management Institute of Business Management Karachi Pakistan
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227
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Smoking Prevalence, Attitudes and Behavior among Dental Students in Poland and Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207451. [PMID: 33066192 PMCID: PMC7602041 DOI: 10.3390/ijerph17207451] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 12/26/2022]
Abstract
The aim of the study was to perform preliminary research to compare the smoking prevalence, attitudes and behavior between dentistry students in two universities in Europe using the standardized Global Health Professions Student Survey (GHPSS) questionnaire. This was cross-sectional carried out among dentistry students from the Medical University in Bialystok, Poland and Sapienza University of Rome, Italy. There were 582 participants; 282 were Italians, 202 were smokers and 42% were Italians. The response rate was 79.9% of Italian students and 79.6% of Polish students. The prevalence of smoking was significantly higher among Italian students (42% vs. 28.0%). Attitudes and behaviour of smokers and non-smokers differed statistically. Polish and Italian dental students presented statistically different behavior regarding the time to smoke the first cigarette, the willingness to stop smoking and trying to stop smoking in the last year. The multiple logistic regression analysis revealed that two independent variables, exposure to second-hand smoke (SHS) both at home and in public places (OR = 3.26 and OR = 5.9, respectively), showed a significantly higher occurrence of smoking. There is a high use of tobacco among dental students, which is particularly high in Italian dental students. Students realizes the positive perception of their own tobacco counsellor role in a dental setting. Dental students should be role models to their peers and patients.
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228
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Tjora T, Skogen JC, Sivertsen B. Increasing similarities between young adults' smoking and snus use in Norway: a study of the trends and stages of smoking and snus epidemic from 2010 to 2018. BMC Public Health 2020; 20:1511. [PMID: 33023560 PMCID: PMC7539463 DOI: 10.1186/s12889-020-09604-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/23/2020] [Indexed: 12/22/2022] Open
Abstract
Background The prevalence of smoking has been decreasing in Norway for decades. In contrast, the prevalence of snus use has recently increased substantially, especially among females. While there is a clear social gradient in smoking, with a higher smoking prevalence among individuals with low socioeconomic status (SES), a possible social gradient in snus use has been less studied. The aim of the current study was to investigate the trends of smoking and snus use and to examine whether ongoing changes in snus use are similar to prior smoking epidemic development. Methods The study was based on the 2010 (n = 5836), 2014 (n = 13,319) and 2018 (n = 24,515) waves from a nation-wide, cross-sectional, health survey of higher education in Norway (the SHoT study). Variables on smoking, snus use, gender, age and SES were used. Chi-square tests and logistic regression analyses were used to test significance, and Mantel–Haenszel weights were used to test the trends in stratified cross-tabulations. Results Daily smoking decreased from 5.9 to 1.5% between 2010 and 2018, while daily snus use increased from 13.4 to 19.9%. Female snus use almost doubled, from 10.9 to 19.2%. Low SES was associated with both daily smoking and snus use across all three waves. Occasional smoking was also associated with low SES at all waves, but occasional snus use was only associated with low SES in 2010. There were no significant changes over time in either the association between occasional or daily smoking and SES or the association between occasional or daily snus use and SES. Conclusions The overall smoking decrease indicated that the Norwegian smoking epidemic is in its latest stage. Steady male snus use, doubled female snus use and a clear social gradient in snus use all indicate that the snus epidemic in Norway has progressed. If this trend continues, a main implication is that snus prevalence will soon peak, first in males and then in females.
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Affiliation(s)
- Tore Tjora
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Alcohol & Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research & Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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229
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Shiffman D, Louie JZ, Devlin JJ, Rowland CM, Mora S. Concordance of Cardiovascular Risk Factors and Behaviors in a Multiethnic US Nationwide Cohort of Married Couples and Domestic Partners. JAMA Netw Open 2020; 3:e2022119. [PMID: 33104207 PMCID: PMC7588939 DOI: 10.1001/jamanetworkopen.2020.22119] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
IMPORTANCE Married couples and domestic partners have been reported to share similar environmental exposures, adopt similar behavior patterns, and have similar transferable characteristics. However, the degree to which couples share similar levels of cardiovascular risk factors and behaviors is uncertain. OBJECTIVE To assess within-couple concordance of the American Heart Association-defined Life's Simple 7 (LS7). DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study with a longitudinal substudy of employees and spouses (or domestic partners) who participated in an employer-sponsored health assessment program throughout the United States between October 2014 and December 2018. Data were analyzed from November 1, 2019, to August 4, 2020. EXPOSURES Having a spouse or domestic partner. MAIN OUTCOMES AND MEASURES The LS7 risk factors and behaviors (smoking status, body mass index, exercise, diet, total cholesterol, blood pressure, and fasting glucose) were assessed by questionnaires, examinations, and laboratory tests. LS7 categories were scored as 2 for ideal, 1 for intermediate, or 0 for poor and summed to generate a CV health score. RESULTS The study included 10 728 participants (5364 couples): 7% were African American, 11% Hispanic, 21% Asian, and 54% White (median [interquartile range] age, 50 [41-57] years for men and 47 [39-55] for women). For most couples, both members were in the ideal category or both were in a nonideal category. Concordance ranged from 53% (95% CI, 52%-54%) for cholesterol to 95% (95% CI, 94%-95%) for diet. For the CV health score, in 79% (95% CI, 78%-80%) of couples both members were in a nonideal category, which was associated mainly with unhealthy diet (94% [95% CI, 93%-94%] of couples) and inadequate exercise (53% [95% CI, 52%-55%] of couples). However, in most couples, both members were in the ideal category for smoking status (60% [95% CI, 59%-61%] of couples) and glucose (56% [95% CI, 55%-58%]). Except for total cholesterol, when 1 member of a couple was in the ideal category, the other member was likely also to be in the ideal category: the adjusted odds ratios for also being in the ideal category ranged from 1.3 (95% CI, 1.1-1.5; P ≤ .001) for blood pressure to 10.6 (95% CI, 7.4-15.3; P ≤ .001) for diet. Concordance differed by ethnicity, socioeconomic status, and geographic location. A 5-year longitudinal analysis of 2186 couples found modest changes in concordance of blood pressure (from 55% [95% CI, 53%-57%] to 59% [95% CI, 57%-61%]; P < .001 for trend) and fasting glucose (from 64% [95% CI, 62%-66%] to 59% [95% CI, 57%-61%]; P < .001 for trend) with no change in other factors. CONCLUSIONS AND RELEVANCE In this study, high concordance of nonideal behaviors was found within couples; behavioral modification programs may benefit both the targeted and the nontargeted member of a couple.
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Affiliation(s)
- Dov Shiffman
- Quest Diagnostics Nichols Institute, San Juan Capistrano, California
| | - Judy Z Louie
- Quest Diagnostics Nichols Institute, San Juan Capistrano, California
| | - James J Devlin
- Quest Diagnostics Nichols Institute, San Juan Capistrano, California
| | - Charles M Rowland
- Quest Diagnostics Nichols Institute, San Juan Capistrano, California
| | - Samia Mora
- Center for Lipid Metabolomics, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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230
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Ogburn EL, Shpitser I, Lee Y. Causal inference, social networks and chain graphs. JOURNAL OF THE ROYAL STATISTICAL SOCIETY. SERIES A, (STATISTICS IN SOCIETY) 2020; 183:1659-1676. [PMID: 34316102 PMCID: PMC8313030 DOI: 10.1111/rssa.12594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Traditionally, statistical inference and causal inference on human subjects rely on the assumption that individuals are independently affected by treatments or exposures. However, recently there has been increasing interest in settings, such as social networks, where individuals may interact with one another such that treatments may spill over from the treated individual to their social contacts and outcomes may be contagious. Existing models proposed for causal inference using observational data from networks of interacting individuals have two major shortcomings. First, they often require a level of granularity in the data that is infeasible in practice to collect in most settings and, second, the models are high dimensional and often too big to fit to the available data. We illustrate and justify a parsimonious parameterization for network data with interference and contagion. Our parameterization corresponds to a particular family of graphical models known as chain graphs. We argue that, in some settings, chain graph models approximate the marginal distribution of a snapshot of a longitudinal data-generating process on interacting units. We illustrate the use of chain graphs for causal inference about collective decision making in social networks by using data from US Supreme Court decisions between 1994 and 2004 and in simulations.
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Affiliation(s)
| | | | - Youjin Lee
- University of Pennsylvania, Philadelphia, USA
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231
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Wang W, Lu M, Cai Y, Feng N. Awareness and use of e-cigarettes among university students in Shanghai, China. Tob Induc Dis 2020; 18:76. [PMID: 32994762 PMCID: PMC7516251 DOI: 10.18332/tid/125748] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/26/2020] [Accepted: 07/26/2020] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The use of electronic cigarettes (e-cigarettes) in adults is increasing globally, and similar trends may be observed in the young population. Our objective was to estimate the awareness and use of e-cigarettes among the students from two comprehensive universities in Shanghai, China, and to identify the factors that may influence their decision to use e-cigarettes and their possible adverse effects. METHODS An online cross-sectional survey was conducted among the students of Shanghai Jiao Tong University and Fudan University. A total of 869 students (412 males and 457 females), mean age 21.09 years (SD=2.44), were recruited in 2018. Multivariate binary logistic regression analyses were performed to explore the associations between ever e-cigarette use and influencing factors. RESULTS Of the responding students, 88.4% were aware of e-cigarettes, 4.6% had used e-cigarettes at least once in their lifetime, and 1.7% were current e-cigarettes users. Males and smokers were more likely to use e-cigarettes (ever used e-cigarettes even once) than females (OR=3.51; 95% CI: 1.69–7.27; p=0.001) and non-smokers (OR=28.58; 95% CI: 14.03–58.20; p<0.001). University students were easily motivated to use e-cigarettes when their peers also used them, and the risk ratio was 4.15 (95% CI: 2.11–8.19) compared with if their peers never used e-cigarettes. The major factors found to motivate university students to use e-cigarettes were the belief that e-cigarettes were less harmful or not harmful (55.0%) and the perception that e-cigarettes were helpful to quit smoking (37.5%). The survey also indicated that 72.4% of the respondents heard about e-cigarettes from television advertisements, 42.7% from websites online, and 41.2% from their parents and friends. CONCLUSIONS University students who were males, cigarette smokers and whose peers used e-cigarettes were more likely to use e-cigarettes. The use of traditional cigarettes should be controlled strictly in order to reduce the likelihood of e-cigarette use among university students.
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Affiliation(s)
- Wenyuanyue Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Maojie Lu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuyang Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
| | - Nannan Feng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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232
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Murakami K, Ishikuro M, Ueno F, Noda A, Onuma T, Obara T, Kuriyama S. Social predictors of continued and indoor smoking among partners of non-smoking pregnant women: the TMM BirThree Cohort Study. J Epidemiol 2020; 31:635-641. [PMID: 32963213 PMCID: PMC8593571 DOI: 10.2188/jea.je20200313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Secondhand smoke (SHS) from partners is a major source of exposure for non-smoking women. However, epidemiological studies have rarely examined social factors associated with continued and indoor smoking among pregnant women's partners. METHODS We analyzed data on 6091 partners of non-smoking pregnant women in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Partners' age, education, income, workplace SHS exposure (almost never or sometimes, almost every day), and pregnant women's smoking history (never, quit before pregnancy awareness, quit after pregnancy awareness) were used as social factors. Multivariate logistic regression analyses were conducted to examine the associations of social factors with partners' continued smoking and indoor smoking. RESULTS Among 2432 smoking partners, 2237 continued to smoke after pregnancy awareness. Workplace SHS exposure was associated with increased risk of partners' continued smoking: the odds ratio of workplace SHS exposure almost every day compared with almost never or sometimes was 2.08 (95% confidence interval, 1.52-2.83). Women's quitting smoking after-but not before-pregnancy awareness was associated with decreased risk of partners' continued smoking: the odds ratio of women's quitting after pregnancy awareness compared with never smoking was 0.57 (95% confidence interval, 0.40-0.80). About one-third of partners who continued to smoke did so indoors. Older age, lower education, workplace SHS exposure, and women's quitting smoking after pregnancy awareness were associated with increased risk of partners' indoor smoking. CONCLUSIONS Workplace SHS exposure and pregnant women's smoking history were associated with continued smoking and indoor smoking among partners of non-smoking pregnant women.
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Affiliation(s)
- Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Fumihiko Ueno
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Aoi Noda
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Department of Pharmaceutical Sciences, Tohoku University Hospital
| | - Tomomi Onuma
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Department of Pharmaceutical Sciences, Tohoku University Hospital
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University
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233
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Within-Family Transmission of Alcohol Use Disorder in Parent-Offspring, Sibling, and Cousin Pairs: A Contagion Model. J Nerv Ment Dis 2020; 208:637-645. [PMID: 32502073 PMCID: PMC7927980 DOI: 10.1097/nmd.0000000000001190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To determine whether alcohol use disorder (AUD) is transmitted within families as predicted by contagion, we examined parent-offspring, siblings, and cousin pairs ascertained from Swedish registries with a primary case with AUD. Our outcome variable was AUD registration in at-risk secondary cases. In offspring, risks for AUD registration in the 3 years after a parental index registration residing in the same household, neighborhood, or municipality increased by 1.6%, -0.5%, and 0.3%, respectively. For siblings of sibling index cases, parallel results were 3.2%, 1.2%, and 0.3%. For cousins of cousin index cases, no excess risk was seen for those residing in the same neighborhood or municipality. In siblings, AUD transmission was stronger in same versus opposite sex pairs and from older to younger versus younger to older siblings. These results support the hypothesis that AUD is transmitted among close family relationships and over limited geographical distances by a temporally dynamic contagion model.
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234
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Bernstein J, Randall P. Against the Public Goods Conception of Public Health. Public Health Ethics 2020. [DOI: 10.1093/phe/phaa021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Public health ethicists face two difficult questions. First, what makes something a matter of public health? While protecting citizens from outbreaks of communicable diseases is clearly a matter of public health, is the same true of policies that aim to reduce obesity, gun violence or political corruption? Second, what should the scope of the government’s authority be in promoting public health? May government enact public health policies some citizens reasonably object to or policies that are paternalistic? Recently, some theorists have attempted to address these questions by arguing that something is a matter of public health if and only if it involves a health-related public good, such as clean water or herd immunity. Relatedly, they have argued that appeals to the promotion of public health should only be used to justify the provision of health-related public goods. This public goods conception of public health (PGC) is meant to enjoy advantages over its rivals in three respects: it provides a better definition of public health than rival views, it respects moral disagreement, and it avoids licensing objectionably paternalistic public health policies. We argue, however, that the PGC does just as poorly, or worse, than its rivals in all three respects.
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Affiliation(s)
| | - Pierce Randall
- Stockdale Center for Ethical Leadership, United States Naval Academy
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235
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Yang T, Zhu Z, Barnett R, Zhang W, Jiang S. Tobacco Advertising, Anti-Tobacco Information Exposure, Environmental Smoking Restrictions, and Unassisted Smoking Cessation Among Chinese Male Smokers: A Population-Based Study. Am J Mens Health 2020; 13:1557988319856152. [PMID: 31185783 PMCID: PMC6563409 DOI: 10.1177/1557988319856152] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The study examined the prevalence of unassisted smoking cessation among Chinese urban male smokers and factors important in the decision to quit. A cross-sectional survey employing multistage sampling involving 5,782 participants in six cities in China was conducted. Survey respondents reported their smoking cessation status and related individual and environmental variables. Among current smokers 1,112 or 35.0% (95% CI [31.0%, 40.8%]) had attempted to quit and of those who had made such an attempt 87.6% reported that they had done so without assistance. Of all former smokers (3,389), most (97.6%; 95% CI [96.7%, 98.5%]) quit without assistance. Logistic regression analysis showed those who engaged in physical exercise and who had more belief in their ability to quit were more than twice as likely to make a quit attempt and be successful than those in comparable reference groups. Exposure to tobacco advertising was negatively associated with both unassisted quit attempts and success. By contrast, exposure to anti-tobacco information was positively associated with unassisted quit attempts while household and workplace smoking restrictions were negatively associated with unassisted attempts to quit. Most attempts to quit smoking among Chinese males are unassisted. Unassisted attempts to quit smoking and success rates are highly influenced by the presence of environmental smoking restrictions, tobacco advertising, and exposure to anti-tobacco information. Smoking cessation programs and policies in China need to pay greater attention to the social and cultural norms, which perpetuate high levels of smoking.
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Affiliation(s)
- Tingzhong Yang
- 1 Children's Hospital/Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, China
| | - Zan Zhu
- 2 Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, China
| | - Ross Barnett
- 3 Department of Geography, University of Canterbury, Christchurch, New Zealand
| | - Weifang Zhang
- 4 Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuhan Jiang
- 5 School of Humanities and Management, Zhejiang Chinese Medical University. Hangzhou, China
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236
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Schröders J, Dewi FST, Nilsson M, Nichter M, Sebastian MS. Effects of social network diversity in the disablement process: a comparison of causal inference methods and an outcome-wide approach to the Indonesian Family Life Surveys, 2007-2015. Int J Equity Health 2020; 19:128. [PMID: 32736632 PMCID: PMC7393827 DOI: 10.1186/s12939-020-01238-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 07/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social networks (SN) have been proven to be instrumental for healthy aging and function as important safety nets, particular for older adults in low and middle-income countries (LMICs). Despite the importance of interpreting health outcomes in terms of SN, in many LMICs - including Indonesia - epidemiological studies and policy responses on the health effects of SN for aging populations are still uncommon. Using outcome-wide multi-method approaches to longitudinal panel data, this study aims to outline more clearly the role of SN diversity in the aging process in Indonesia. We explore whether and to what degree there is an association of SN diversity with adult health outcomes and investigate potential gender differences, heterogeneous treatment effects, and effect gradients along disablement processes. METHODS Data came from the fourth and fifth waves of the Indonesian Family Life Survey fielded in 2007-08 and 2014-15. The analytic sample consisted of 3060 adults aged 50+ years. The primary exposure variable was the diversity of respondents' SN at baseline. This was measured through a social network index (SNI), conjoining information about household size together with a range of social ties with whom respondents had active contact across six different types of role relationships. Guided by the disablement process model, a battery of 19 outcomes (8 pathologies, 5 impairments, 4 functional limitations, 2 disabilities) were included into analyses. Evidence for causal effects of SN diversity on health was evaluated using outcome-wide multivariable regression adjustment (RA), propensity score matching (PSM), and instrumental variable (IV) analyses. RESULTS At baseline, 60% of respondents had a low SNI. Results from the RA and PSM models showed greatest concordance and that among women a diverse SN was positively associated with pulmonary outcomes and upper and lower body functions. Both men and women with a high SNI reported less limitations in performing activities of daily living (ADL) and instrumental ADL (IADL) tasks. A high SNI was negatively associated with C-reactive protein levels in women. The IV analyses yielded positive associations with cognitive functions for both men and women. CONCLUSIONS Diverse SN confer a wide range of strong and heterogeneous long-term health effects, particularly for older women. In settings with limited formal welfare protection, intervening in the SN of older adults and safeguarding their access to diverse networks can be an investment in population health, with manifold implications for health and public policy.
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Affiliation(s)
- Julia Schröders
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Fatwa Sari Tetra Dewi
- Department of Health Behaviour, Environment and Social Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Mark Nichter
- School of Anthropology, University of Arizona, Tucson, AZ, USA
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237
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Nagawa CS, Emidio OM, Lapane KL, Houston TK, Barton BA, Faro JM, Blok AC, Orvek EA, Cutrona SL, Smith BM, Allison JJ, Sadasivam RS. Teamwork for smoking cessation: which smoker was willing to engage their partner? Results from a cross-sectional study. BMC Res Notes 2020; 13:344. [PMID: 32690076 PMCID: PMC7372767 DOI: 10.1186/s13104-020-05183-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/14/2020] [Indexed: 12/05/2022] Open
Abstract
Objective Smokers are greatly influenced by those living with them, but strategies that increase partner support for smoking cessation are lacking. Using a cross-sectional study design, we explored factors associated with willingness to engage a partner in smoking cessation in smokers registered on a web-assisted tobacco intervention trial. Results Study participants (n = 983) were recruited between July 2018 and March 2019. About 28% of smokers were willing to engage their partner in cessation efforts. The odds of willingness to engage a partner were more than two-fold for smokers reporting presence of other smokers in the immediate family (adjusted odds ratio (aOR): 2.18; 95% confidence interval (CI) 1.51–3.15 for 1–3 smokers; aOR, 3.12; 95% CI 1.95–4.98 for ≥ 4 smokers) compared to those with no smokers in the immediate family. Women had lower odds of willingness to engage (aOR; 0.82; 95% CI 0.58–1.16) than men, but this was not statistically significant. Use of e-cigarettes and visitation to a smoking cessation website prior to the intervention were both positively associated with willingness to engage partners in cessation. Future research should assess whether interventions tailored to smokers willing to engage partners or spouses could increase effectiveness of partner support during cessation.
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Affiliation(s)
- Catherine S Nagawa
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.
| | - Oluwabunmi M Emidio
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Kate L Lapane
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Thomas K Houston
- Learning Health Systems, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Bruce A Barton
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Jamie M Faro
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Amanda C Blok
- Veterans Affairs Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, United States Department of Veterans Affairs, Ann Arbor, MI, USA.,Systems, Populations and Leadership Department, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Elizabeth A Orvek
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Sarah L Cutrona
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.,Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center, Bedford, MA, USA
| | - Bridget M Smith
- Center of Innovation for Complex Chronic Healthcare, Spinal Cord Injury Quality Enhancement Research Initiative, Hines VA Medical Center, Chicago, IL, USA.,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - Jeroan J Allison
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Rajani S Sadasivam
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
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238
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Lee Y, Ogburn EL. Network Dependence Can Lead to Spurious Associations and Invalid Inference. J Am Stat Assoc 2020. [DOI: 10.1080/01621459.2020.1782219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Youjin Lee
- Center for Causal Inference, University of Pennsylvania , Philadelphia , PA
| | - Elizabeth L. Ogburn
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
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239
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Takagi D, Yokouchi N, Hashimoto H. Smoking behavior prevalence in one's personal social network and peer's popularity: A population-based study of middle-aged adults in Japan. Soc Sci Med 2020; 260:113207. [PMID: 32712558 DOI: 10.1016/j.socscimed.2020.113207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/11/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
Abstract
Although previous social network studies have consistently shown the social influence of peers' smoking on one's (ego's) smoking, few studies have examined how the influence differs according to peers' structural positions in the network. Investigations are also lacking on whether vulnerability to the influence varies by ego's socioeconomic position. Thus, the present study aimed to examine how the association between peers' smoking and ego's smoking differs by peers' popularity in ego's personal network and ego's educational attainment. We used data from the third-wave Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) conducted in 2017, which targeted middle-aged (32-58-year-old) residents in four municipalities within Japanese metropolitan areas. Information on four close peers' characteristics and behaviors and their mutual relationships was collected by the name generator and name interpreter methods. Data on 1989 respondents and 7956 peers were evaluated. Peers' eigenvector centrality was used as their popularity index in ego's personal network. We set ego's smoking as an outcome, regressed on each peer's smoking, each peer's popularity, and ego's educational attainment adjusting for ego's age, sex, working status, marital status, spouse's/partner's smoking status, as well as similarity in socioeconomic backgrounds between peer and ego, using a logistic regression model with robust standard errors. We then added a three-way interaction term for these three explanatory variables to the model. Results showed that peer's smoking status was related to ego's smoking even more strongly when the peer was popular but only in the case of ego with lower educational attainment. The results suggested that the disparity in smoking behavior across socioeconomic positions may be partly explained by susceptibility to social influence from one's personal network among the socioeconomically vulnerable. This study proposes a plausible method for pinpointing the peer influencer in one's personal social network to close the socioeconomic gap in smoking.
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Affiliation(s)
- Daisuke Takagi
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | | | - Hideki Hashimoto
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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240
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Pan YJ, Chen YC, Lu SR, Juang KD, Chen SP, Wang YF, Fuh JL, Wang SJ. The influence of friendship on migraine in young adolescents: A social network analysis. Cephalalgia 2020; 40:1321-1330. [PMID: 32635765 DOI: 10.1177/0333102420940700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The current study explored whether the chances of having migraine are influenced by a youth's friendship with a migraineur. METHODS The study was centered on a community-based non-referral cohort of eighth graders from two middle schools in Taiwan. Among the 642 recruited adolescent students, 610 (95%) (mean age 14.1 years, male ratio 51.2%) nominated three good friends and completed a validated headache questionnaire for migraine diagnosis at the follow-up survey 1 year later. To explore social influences on incident migraine, we used longitudinal statistical models to examine whether the development of migraine in one adolescent during the 1-year observational period was associated with that in his/her friends. RESULTS Overall, 1700 social ties were established in the social network based on the reported lists of good friends. Randomization test for the homophily effect demonstrated that the students with migraine tended to cluster together in the social network even when those with incident migraine were also considered (p = 0.003). Besides, when friendship choices were mutual, the relative risk of an adolescent becoming a migraineur was 3.26 (95% CI: 1.25-8.47, p = 0.015) if his/her friend became a migraineur (induction) during the 1-year observational period. CONCLUSION To the best of our knowledge, this is the first study to demonstrate that migraine may spread through social networks in young adolescents. Both homophily and induction effects are possibly contributory.
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Affiliation(s)
- Yi-Ju Pan
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Institute of Public Health, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Yu-Chun Chen
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shiang-Ru Lu
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kai-Dih Juang
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Psychiatry, Centro Hospitalar Conde de Sao Januario, Macau
| | - Shih-Pin Chen
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yen-Feng Wang
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Jong-Ling Fuh
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
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241
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Picard M, Sandi C. The social nature of mitochondria: Implications for human health. Neurosci Biobehav Rev 2020; 120:595-610. [PMID: 32651001 DOI: 10.1016/j.neubiorev.2020.04.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 04/13/2020] [Accepted: 04/15/2020] [Indexed: 12/15/2022]
Abstract
Sociality has profound evolutionary roots and is observed from unicellular organisms to multicellular animals. In line with the view that social principles apply across levels of biological complexity, a growing body of data highlights the remarkable social nature of mitochondria - life-sustaining endosymbiotic organelles with their own genome that populate the cell cytoplasm. Here, we draw from organizing principles of behavior in social organisms to reveal that similar to individuals among social networks, mitochondria communicate with each other and with the cell nucleus, exhibit group formation and interdependence, synchronize their behaviors, and functionally specialize to accomplish specific functions within the organism. Mitochondria are social organelles. The extension of social principles across levels of biological complexity is a theoretical shift that emphasizes the role of communication and interdependence in cell biology, physiology, and neuroscience. With the help of emerging computational methods capable of capturing complex dynamic behavioral patterns, the implementation of social concepts in mitochondrial biology may facilitate cross-talk across disciplines towards increasingly holistic and accurate models of human health.
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Affiliation(s)
- Martin Picard
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, USA; Department of Neurology, H. Houston Merritt Center, Columbia Translational Neuroscience Initiative, Columbia University Irving Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA.
| | - Carmen Sandi
- Laboratory of Behavioral Genetics, Brain Mind Institute, Swiss Federal Institute of Technology Lausanne (EPFL), Switzerland
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242
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Caponnetto P, Maglia M, Floresta D, Ledda C, Vitale E, Polosa R, Rapisarda V. A randomized controlled trial to compare group motivational interviewing to very brief advice for the effectiveness of a workplace smoking cessation counseling intervention. J Addict Dis 2020; 38:465-474. [PMID: 32634052 DOI: 10.1080/10550887.2020.1782564] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Studies show that smokers have a lower work performance due to time spent smoking, increased fatigue perception and are more absent from work due to smoking-related diseases. The workplace could represent an important location to promote smoking cessation. METHODS This study is a multi-center, controlled trial for smoking cessation counseling at the participants' workplace, where 656 randomized participants received four sessions of group motivational interviewing or four sessions of very brief advice and were followed up for 52 weeks. RESULTS The Continuous Quit Rate (CQR) was higher for the smoking cessation counseling group than for the very brief advice group during weeks 9 to 12 (17.5% vs. 3.6%) weeks 9 to 24 (13.4% vs. 3.4%) and weeks 9 to 52 (10.3% vs. 3.1%). CONCLUSIONS This study demonstrated that motivational interviewing is an efficacious smoking cessation approach for smokers at their workplace. The short-term and long-term cessation rate of the intervention of the smoking cessation counseling group exceeded that of very brief advice.
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Affiliation(s)
- Pasquale Caponnetto
- "Centro per la Prevenzione e Cura del Tabagismo - CPCT", Center of Excellence for the acceleration of Harm Reduction - CoEHAR, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.,Health Science and Sport, University of Stirling, Stirling, UK
| | - Marilena Maglia
- "Centro per la Prevenzione e Cura del Tabagismo - CPCT", Center of Excellence for the acceleration of Harm Reduction - CoEHAR, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Daniele Floresta
- Health and Safety Manager of Eurospin Sicily and Calabria, Italy
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Ermanno Vitale
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Riccardo Polosa
- "Centro per la Prevenzione e Cura del Tabagismo - CPCT", Center of Excellence for the acceleration of Harm Reduction - CoEHAR, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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243
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Kim-Knauss Y, Lang FR. Late-Life Preparedness and Its Correlates: A Behavioral Perspective on Preparation. J Gerontol B Psychol Sci Soc Sci 2020; 76:1555-1564. [PMID: 32622349 DOI: 10.1093/geronb/gbaa088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The present study examined the extent of late-life preparedness and its correlates. In accordance with behavior theories, we postulated that those who have prior experience with caregiving and who perceive such activities as more useful and less risky are more likely to engage in late-life preparatory activities. Because the perceived distance until aging-related life challenges become prevalent may play a role in late-life preparedness, we hypothesized that the effects of the correlates would vary depending on one's subjective remaining life expectation (SRLE). METHODS Building upon cross-sectional data including 581 German adults from 18 to 93 years, we fitted a hurdle model that separately analyzes the presence and variety of self-reported action engagement to better handle the zero-inflated count measure of preparatory activities. RESULTS The results revealed that the effects of perceived utility, caregiving experience, and SRLE were significant for both the presence and variety of activities. SRLE was found to moderate the observed effects in the models: The effect of perceived utility on the presence of at least one late-life preparatory activity was larger for those with lower SRLE. In contrast, among those with higher SRLE, having provided care increased the variety of preparatory activities. DISCUSSION Findings suggest that some of the examined psychosocial factors are similarly associated with both the presence of at least one and the variety of late-life preparatory activities, although the extent of their effects varies depending on one's subjective life stage.
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Affiliation(s)
- Yaeji Kim-Knauss
- Institute of Psychogerontology, Friedrich-Alexander University of Erlangen-Nuremberg, Germany
| | - Frieder R Lang
- Institute of Psychogerontology, Friedrich-Alexander University of Erlangen-Nuremberg, Germany
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244
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Hamamatsu Y, Ide H, Kakinuma M, Furui Y. Maintaining Physical Activity Level Through Team-Based Walking With a Mobile Health Intervention: Cross-Sectional Observational Study. JMIR Mhealth Uhealth 2020; 8:e16159. [PMID: 32618576 PMCID: PMC7367537 DOI: 10.2196/16159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 04/07/2020] [Accepted: 04/21/2020] [Indexed: 12/11/2022] Open
Abstract
Background The health conditions of Japanese salespersons may be adversely affected by their lifestyle. Face-to-face or on-site health interventions are not convenient for salespersons because of their tendency for out-of-office sales. Previous studies showed that mobile health (mHealth) interventions (compared to usual practice) have great potential to promote physical activity. For Japanese salespersons, mHealth can offer additional convenience to change their physical activity habits because they can access the mHealth contents anytime and anywhere. However, the specific elements that are most important to maintain physical activity levels using an mHealth approach remain unclear. Objective We aimed to identify elements that account for both a high average physical activity level and can help to prevent a decrease in physical activity during a 9-week intervention period. Methods Salespersons were recruited from 11 Japanese companies. A team-based walking intervention was held from October to December 2018 (for a total of 9 weeks), during which the walking step data were recorded by smartphone apps. Average walking steps of each participant during the intervention and the difference in walking steps between the initial and the final week were respectively used as dependent variables. The effects of team characteristics (ie, frequency of communication with team members and team size) and behavioral characteristics (ie, number of days with recorded steps on the apps) on the average walking steps, and the difference in walking steps between the initial and the final week were estimated using multiple and multilevel regression analyses. Results Of the 416 participants, walking step data of 203 participants who completed postintervention assessments were included in the analyses. Multiple regression analysis of the average walking steps showed that the number of days with recorded steps was positively correlated with the log-transformed average walking steps (β=.01, P<.001). Multilevel analysis of the average walking steps considering the company level estimated that the intraclass correlation coefficient was 37%. This means that belonging to the same company largely affected an individual’s average walking steps. Multiple regression analysis of the difference in walking steps showed that communication with team members once or twice a week correlated with preventing a decrease in walking steps from the initial to the final week (β=1539.4, P=.03), and being on a larger team correlated with a decrease in walking steps from the initial to the final week (β=–328.4, P=.01). Conclusions This study showed that the elements accounting for high average walking steps and those preventing the decrease in walking steps from the initial to the final week differed. Behavioral characteristics correlated positively with average walking steps. Team characteristics (ie, regular communication and a smaller team size) significantly correlated with preventing a decrease in walking steps.
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Affiliation(s)
- Yuri Hamamatsu
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan.,Healthcare and Wellness Division, Mitsubishi Research Institute Inc, Tokyo, Japan
| | - Hiroo Ide
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Michiru Kakinuma
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan.,Healthcare and Wellness Division, Mitsubishi Research Institute Inc, Tokyo, Japan
| | - Yuji Furui
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
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245
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Menawi W, Najem T, Khalil A, Suleiman J, Dabas A, Abdullah RA, Shareef N, Khraiwesh T. Self-rated health and psychological health among hypertensive patients in Palestine. Health Psychol Open 2020; 7:2055102920973258. [PMID: 33282328 PMCID: PMC7686639 DOI: 10.1177/2055102920973258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The study has investigated the self-rated psychological health of hypertensive patients in Palestine. To that end, a stratified random sample of 502 hypertensive patients (aged ⩾ 18 years) was asked to complete a validated Arabic version of the General Health Questionnaire (GHQ-28). After collection, the data were analyzed using descriptive statistics, Mann-Whitney U test and logistic regression. In this study, it was found the mean scores for GHQ were statistically higher for females than males (p < 0.05). The females were found to be 1.701 (95% CI = 1.025-2.823) times more at risk of psychological disorders compared to males. In conclusion, improvement of social determinants of hypertensive patients can make a difference in their psychological/mental health.
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Affiliation(s)
- Wafaa Menawi
- Faculty of Medicine and Health Sciences,
An-Najah National University, Palestine
| | - Taghreed Najem
- Faculty of Medicine and Health Sciences,
An-Najah National University, Palestine
| | - Aziza Khalil
- Faculty of Medicine and Health Sciences,
An-Najah National University, Palestine
| | - Jiyana Suleiman
- Faculty of Medicine and Health Sciences,
An-Najah National University, Palestine
| | - Areej Dabas
- Faculty of Medicine and Health Sciences,
An-Najah National University, Palestine
| | | | - Noor Shareef
- Faculty of Medicine and Health Sciences,
An-Najah National University, Palestine
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246
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Myneni S, Lewis B, Singh T, Paiva K, Kim SM, Cebula AV, Villanueva G, Wang J. Diabetes Self-Management in the Age of Social Media: Large-Scale Analysis of Peer Interactions Using Semiautomated Methods. JMIR Med Inform 2020; 8:e18441. [PMID: 32602843 PMCID: PMC7367515 DOI: 10.2196/18441] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/14/2020] [Accepted: 06/04/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Online communities have been gaining popularity as support venues for chronic disease management. User engagement, information exposure, and social influence mechanisms can play a significant role in the utility of these platforms. OBJECTIVE In this paper, we characterize peer interactions in an online community for chronic disease management. Our objective is to identify key communications and study their prevalence in online social interactions. METHODS The American Diabetes Association Online community is an online social network for diabetes self-management. We analyzed 80,481 randomly selected deidentified peer-to-peer messages from 1212 members, posted between June 1, 2012, and May 30, 2019. Our mixed methods approach comprised qualitative coding and automated text analysis to identify, visualize, and analyze content-specific communication patterns underlying diabetes self-management. RESULTS Qualitative analysis revealed that "social support" was the most prevalent theme (84.9%), followed by "readiness to change" (18.8%), "teachable moments" (14.7%), "pharmacotherapy" (13.7%), and "progress" (13.3%). The support vector machine classifier resulted in reasonable accuracy with a recall of 0.76 and precision 0.78 and allowed us to extend our thematic codes to the entire data set. CONCLUSIONS Modeling health-related communication through high throughput methods can enable the identification of specific content related to sustainable chronic disease management, which facilitates targeted health promotion.
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Affiliation(s)
- Sahiti Myneni
- University of Texas School of Biomedical Informatics at Houston, Houston, TX, United States
| | - Brittney Lewis
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Tavleen Singh
- University of Texas School of Biomedical Informatics at Houston, Houston, TX, United States
| | - Kristi Paiva
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Seon Min Kim
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Adrian V Cebula
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Gloria Villanueva
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Jing Wang
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
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247
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Jackson SE, Proudfoot H, Brown J, East K, Hitchman SC, Shahab L. Perceived non-smoking norms and motivation to stop smoking, quit attempts, and cessation: a cross-sectional study in England. Sci Rep 2020; 10:10487. [PMID: 32591555 PMCID: PMC7320183 DOI: 10.1038/s41598-020-67003-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/29/2020] [Indexed: 02/02/2023] Open
Abstract
This study examined the prevalence of non-smoking norms in England and their associations with motivation to stop smoking, quit attempts, and cessation. Data were from a representative cross-sectional survey of 1,521 adults (301 combustible tobacco smokers). Descriptive non-smoking norms were endorsed, with just 16% of adults (12% of smokers) believing smoking was uncommon. Injunctive non-smoking norms were more prevalent, with 60-77% of adults (17-48% of smokers) viewing smoking as something of which others disapproved. Personal non-smoking norms were also prevalent among all adults (73% indicated they would prefer to live with a non-smoker) but not smokers (69% had no preference). Smokers who endorsed stronger descriptive non-smoking norms had increased odds of reporting high motivation to stop smoking (ORadj = 1.63, 95%CI 1.06-2.52). Female (but not male) past-year smokers who endorsed stronger injunctive (ORadj = 2.19, 95%CI 1.41-3.42) and personal (ORadj = 1.90, 95%CI 1.29-2.82) non-smoking norms had increased odds of having made a past-year quit attempt. In conclusion, perceived descriptive non-smoking norms are not held by the majority of adults in England. Injunctive and personal non-smoking norms are prevalent among all adults but lower among smokers. There is some evidence that smokers - in particular, women - who endorse stronger non-smoking norms are more likely to be motivated to stop smoking and to make a quit attempt.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK.
- Shaping Public Health Policies To Reduce Inequalities and Harm (SPECTRUM) Consortium, Edinburgh, UK.
| | - Hannah Proudfoot
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- Shaping Public Health Policies To Reduce Inequalities and Harm (SPECTRUM) Consortium, Edinburgh, UK
| | - Katherine East
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Shaping Public Health Policies To Reduce Inequalities and Harm (SPECTRUM) Consortium, Edinburgh, UK
| | - Sara C Hitchman
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Shaping Public Health Policies To Reduce Inequalities and Harm (SPECTRUM) Consortium, Edinburgh, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- Shaping Public Health Policies To Reduce Inequalities and Harm (SPECTRUM) Consortium, Edinburgh, UK
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248
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Agent-based Modeling in Tobacco Regulatory Science: Exploring 'What if' in Waterpipe Smoking. TOB REGUL SCI 2020; 6:171-178. [PMID: 32582820 DOI: 10.18001/trs.6.3.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives Waterpipe tobacco smoking (WTS) is an emerging public health crisis, particularly among youth and young adults. Different from the use of other tobacco products and e-cigarettes, WTS tends to be a social activity occurring among friends or persons associated with social networks. In this paper, we review a potential strategy for WTS-related research. Methods As a bottom-up computational model, agent-based modeling (ABM) can simulate the actions and interactions of agents, as well as the dynamic interactions between agents and their environments, to gain an understanding of the functioning of a system. ABM is particularly useful for incorporating the influence of social networks in WTS, and capturing people's space-time activity and the spatial distribution of WTS venues. Results Comprehensive knowledge of WTS-related behaviors at the individual level is needed to take advantage of ABM and use it to examine policies such as the interaction between WTS and cigarette smoking and the effect of flavors used in waterpipe tobacco. Longitudinal and WTS-specific surveys and laboratory experiments are particularly helpful to understand WTS basic mechanisms and elicit individual preferences, respectively. Conclusions We argue that the uniqueness of WTS makes ABM a promising tool to be used in WTS-related research, as well as understanding use of other tobacco products.
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249
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Xu R. Statistical methods for the estimation of contagion effects in human disease and health networks. Comput Struct Biotechnol J 2020; 18:1754-1760. [PMID: 32695268 PMCID: PMC7355717 DOI: 10.1016/j.csbj.2020.06.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 11/17/2022] Open
Abstract
Contagion effects, sometimes referred to as spillover or influence effects, have long been central to the study of human disease and health networks. Accurate estimation and identification of contagion effects are important in terms of understanding the spread of human disease and health behavior, and they also have various implications for designing effective public health interventions. However, many challenges remain in estimating contagion effects and it is often unclear when it is difficult to correctly estimate contagion effects, or why a particular method would need to be applied. In this review I explain the challenges in estimating contagion effects, and how they can be framed as an omitted variable bias problem. I then discuss how such challenges have been addressed in randomized experiments and traditional statistical analyses, as well as several state-of-the-art statistical methods. Finally, I conclude by summarizing recent advancements and noting remaining challenges, as well as appropriate next steps.
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Affiliation(s)
- Ran Xu
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
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250
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Sekentei as a Socio-Cultural Determinant of Cognitive Function among Older Japanese People: Findings from the NEIGE Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124480. [PMID: 32580416 PMCID: PMC7345683 DOI: 10.3390/ijerph17124480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/08/2020] [Accepted: 06/16/2020] [Indexed: 11/16/2022]
Abstract
Sekentei (social appearance) is a Japanese concept that describes a person’s sense of implicit societal pressure to conform to social norms. However, evidence of a relationship between sekentei and health outcomes is sparse. This study examined the association between sekentei and cognitive function among community-dwelling older Japanese people. Baseline data were obtained from the Neuron to Environmental Impact across Generations (NEIGE) study conducted in 2017; 526 randomly sampled community-dwelling individuals aged 65–84 years living in Tokamachi, Niigata Prefecture, Japan were analyzed. The 12-item Sekentei Scale was used to assess sekentei. Cognitive function levels were evaluated with the Japanese version of Mini-Mental State Examination (MMSE-J; ranging from 0–30). Approximately 10% and 25% had cognitive decline and mild cognitive impairment, respectively (MMSE-J scores of ≤23 and 24–26, respectively). Multinomial logistic regression analysis showed that both high and low levels of sekentei were associated with lower cognitive function, particularly mild cognitive impairment, after adjusting for sociodemographic factors, health behaviors, health conditions, and genetic factors. The current findings suggest that a moderate level of sekentei consciousness is beneficial for cognitive health, and that sekentei could be an important socio-cultural factor affecting cognitive function.
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