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Greenberg P, O'Callaghan L, Fournier AA, Gagnon-Sanschagrin P, Maitland J, Chitnis A. Impact of living with an adult with depressive symptoms among households in the United States. J Affect Disord 2024; 349:107-115. [PMID: 38154583 DOI: 10.1016/j.jad.2023.12.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND The effect of depressive symptoms on individuals has been widely studied but their impact on households remains less explored. This study assessed the humanistic and economic impact of living with an adult with depressive symptoms on adults without depressive symptoms among households in the United States (US). METHODS The Medical Expenditure Panel Survey (MEPS) Household Component database was used to identify adults without depressive symptoms living in households with ≥1 adult with depressive symptoms (depression household) and adults without depressive symptoms living in households without an adult with depressive symptoms (no-depression household). Weighted generalized linear models with clustered standard errors were used to compare total income (USD 2020), employment status, workdays missed, quality of life (QoL), and healthcare resource utilization (HRU) between cohorts. RESULTS Adults without depressive symptoms living in a depression household (n = 1699) earned $4720 less in total annual income (representing 11.3% lower than the average income of $41,634 in MEPS), were less likely to be employed, missed more workdays per year, and had lower QoL than adults without depressive symptoms living in a no-depression household (n = 15,286). Differences in total annual healthcare costs and for most types of HRU, except for increased outpatient mental health-related visits, were not significant. LIMITATIONS Data is subject to reporting bias, misclassification, and other inaccuracies. Causal inferences could not be established. CONCLUSION The economic and humanistic consequences of depressive symptoms may extend beyond the affected adults and impact other adult members of the household.
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Affiliation(s)
- Paul Greenberg
- Analysis Group, Inc., 111 Huntington Ave., Boston, MA 02199, USA
| | | | | | | | - Jessica Maitland
- Analysis Group, Inc., 1190 Ave. des Canadiens-de-Montréal, Montréal, QC H3B 0G7, Canada.
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Liu Z, Liao Y, Hwang CL, Rethorst CD, Zhang X. Associations of online health information seeking with health behaviors of cancer survivors. Digit Health 2024; 10:20552076241238074. [PMID: 38495862 PMCID: PMC10943714 DOI: 10.1177/20552076241238074] [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: 08/02/2023] [Accepted: 02/22/2024] [Indexed: 03/19/2024] Open
Abstract
Objective To examine the effects of online health information seeking (OHIS) behavior on five health behaviors (regular physical activity, less sedentary, calorie checking, no alcohol consumption, and no smoking) among adult cancer survivors in the United States. Methods A cross-sectional analysis was conducted with adult cancer survivors (≥18 years old) from Cycles 2, 3, and 4 of the Health Information National Trends Survey (HINTS). The respondents self-reported OHIS, and the data on the five health behaviors were pooled to perform descriptive and multivariable logistic regression analyses using Stata 17.0. Results Of the 1245 adult cancer survivors, approximately 74% reported OHIS behavior for themselves within the previous year of the survey. We found that OHIS was significantly and positively associated with the level of physical activity (odds ratio [OR] = 1.53, p = .002) and calorie checking (OR = 1.64, p = .001), but not with sedentary behavior, smoking, and alcohol consumption after adjusting for age, sex, race/ethnicity, education, income, body mass index (BMI), marital status, depression, and general health. Conclusions Findings from this study suggest that most cancer survivors used various forms of digital tools and platforms to seek health information. The study also demonstrated an independent impact of OHIS behavior on physical activity and calorie checking. Healthcare professionals may need to encourage and guide cancer survivors to seek credible eHealth information and further utilize digital health tools as a platform for care delivery, promoting health behaviors and preventing adverse health outcomes among cancer survivors.
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Affiliation(s)
- Zhaoli Liu
- College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas, USA
| | - Yue Liao
- College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas, USA
| | - Chueh-Lung Hwang
- College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas, USA
| | - Chad D. Rethorst
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Research, Dallas, Texas, USA
| | - Xiaoli Zhang
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
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Chen L, Xu X. Relationships between the Physical Activity Intensity and the Medical Expenditure of Middle-Aged and Elderly People: Parsing from the CHARLS Database. Behav Sci (Basel) 2023; 13:566. [PMID: 37504013 PMCID: PMC10376150 DOI: 10.3390/bs13070566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/24/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023] Open
Abstract
There are many studies on the impact of physical activity on health but few studies on the relationship between physical activity and medical expenditure among the elderly. Based on the China Health and Retirement Longitudinal Survey (CHARLS) database and selected 4456 valid samples, this paper used a two-part model to analyze the effects of high, moderate, and low physical activity intensity on medical expenditure. It is found that the intensity of physical activity was negatively correlated with medical expenditure, and the medical expenditure of the high physical activity intensity group was significantly lower than that of the low physical activity intensity group. For example, compared to people with no physical activity, the total medical expenditure decreased by 22.4%, 40.4%, and 62.5% per week in those with low, moderate, and high physical activity intensity. Thus, the government should provide more places for the elderly to exercise, planning special exercise areas for the elderly in community playgrounds, such as a dancing square, which will also help the elderly to increase their amount of exercise per week and develop a daily exercise habit.
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Affiliation(s)
- Linhong Chen
- School of Marxism, Chongqing Technology and Business University, Chongqing 400067, China
| | - Xiaocang Xu
- School of Economics and Management, Huzhou University, Huzhou 313000, China
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Litzelman K, Choi H, Maher M, Harnish A. How do spouses of cancer survivors engage with mental healthcare? An exploratory analysis of visit characteristics. Psychooncology 2021; 30:1973-1981. [PMID: 34291844 DOI: 10.1002/pon.5773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/06/2021] [Accepted: 07/12/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To better understand how cancer caregivers engage with mental healthcare, this exploratory study sought to assess the distribution and correlates of visit characteristics for mental health-related medical care among spouses of cancer survivors. METHODS Using nationally representative data from the Medical Expenditures Panel Survey, we assessed the proportion of caregivers who received a mental health-related prescription or psychotherapy visit across care settings (office based, outpatient hospital, emergency room, or inpatient visit), provider type (psychiatric, primary care, other specialty, or other), and visit purpose (regular checkup, diagnosis and treatment, follow-up, psychotherapy, other), and the health condition(s) associated with the visit. Logistic and multinomial regressions assessed the predisposing, enabling, need, and survivor characteristics associated with the visit characteristics. RESULTS A plurality of spouses of cancer survivors accessed mental healthcare through an office-based visit (90%) with a primary care provider (47%). One third accessed treatment as part of a regular check-up (32%). Several factors were associated with visit characteristics, notably the cancer survivor's health status and healthcare utilization. CONCLUSIONS The findings provide an important reminder of the often-invisible mental health burden experienced by cancer caregivers and confirm the importance of routine primary care as a doorway to mental healthcare. Assessing how the care recipient's care needs and caregiving itself may act as barriers to specialty care will be a critical future research trajectory.
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Affiliation(s)
- Kristin Litzelman
- Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, Wisconsin, USA.,University of Wisconsin-Carbone Cancer Center, Madison, Wisconsin, USA
| | - Hyojin Choi
- Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Molly Maher
- Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Autumn Harnish
- Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Schulz SVW, Schumann U, Otto S, Kirsten J, Treff G, Janni W, Huober J, Leinert E, Steinacker JM, Bizjak DA. Two-year follow-up after a six-week high-intensity training intervention study with breast cancer patients: physiological, psychological and immunological differences. Disabil Rehabil 2021; 44:4813-4820. [PMID: 33974472 DOI: 10.1080/09638288.2021.1921861] [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: 10/21/2022]
Abstract
PURPOSE Previously we demonstrated the feasibility of a six-week-long combination of high-intensity interval endurance and strength training (HIT/HIRT) for women with nonmetastatic breast cancer leading to improvements in psychological well-being and performance. Now we report results of a 24-month follow-up. METHODS Previous intervention (IG, n = 10; 58.7 ± 8.4yrs) and control group (CG, n = 9; 58.8 ± 6.6yrs) were asked for follow-up examinations 12 (T12) and 24 months (T24) after cessation of the supervised training (POST). Medical history, mental well-being, performance and immunological variables were analyzed with respect to intervention start (PRE). RESULTS IG maximum oxygen consumption (⩒O2peak) 12%-improved POST (p = 0.05) and declined to baseline values T24, while CG ⩒O2peak increased 12% T24 (p = 0.01). IG strength (1RM) increased 31% POST (p < 0.001) and remained above baseline level T24 (p = 0.003), whereas CG 1RM slightly improved T24 (+19%, p = 0.034). IG Anxiety and Depression decreased POST and did not change until T24. IG C-reactive protein decreased POST and increased to pre-exercise levels T24. CG immunological/inflammatory/life quality markers did not change. CONCLUSIONS Six weeks of HIT/HIRT by breast cancer patients can induce similar beneficial effects like two years of convalescence, but outcomes were unstable and showed a fast backslide in aerobic capacity, activity level and in pro-inflammatory state within 12 months.IMPLICATIONS FOR REHABILITATIONHigh-intensity interval endurance and strength training (HIT/HIRT) for female breast cancer patients was shown to improve psychological well-being and performance, but long-term effects/adherence are unknown.Significant backslides in aerobic capacity, activity level as well as in the pro-inflammatory response after one and two years are observed and should be monitored.Continuous supervision and/or support of breast cancer patients before, during, and after medical care due to poor training adherence when voluntarily executed is recommended.
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Affiliation(s)
- Sebastian V W Schulz
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Uwe Schumann
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Stephanie Otto
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Johannes Kirsten
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Gunnar Treff
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Jens Huober
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Elena Leinert
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Jürgen M Steinacker
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Daniel A Bizjak
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
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Song L, Guan T, Guo P, Song F, Van Houtven C, Tan X, Keyserling TC. Cardiovascular disease, risk factors, and health behaviors among cancer survivors and spouses: A MEPS Study. Cancer Med 2020; 9:6864-6874. [PMID: 32750221 PMCID: PMC7520310 DOI: 10.1002/cam4.3336] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/30/2020] [Accepted: 07/08/2020] [Indexed: 01/26/2023] Open
Abstract
Purpose The purpose of this study was to examine the prevalences of CVD, CVD risk factors. and health behaviors among cancer survivor‐spouse dyads, assess how these prevalences differ by role (survivor vs spouse) and gender, and report congruences in health behaviors between survivors and their spouses. Methods We identified 1026 survivor‐spouse dyads from the 2010‐2015 Medical Expenditure Panel Survey. We used weighted multivariable logistic and linear regressions to analyze the data related to CVD, CVD risk factors, and health behaviors. Results Survivors and spouses reported high prevalences of CVD and CVD risk factors but low engagement in healthy behaviors, including non‐smoking, physical activity, and maintaining a healthy weight (proxy for healthy diet). Gender and role differences were significantly related to the prevalence of CVD, CVD risk factors, and health behaviors among survivors and spouses. From 39% to 88% of survivors and spouses were congruent in their current smoking status, physical activity engagement/disengagement, and BMI. Conclusion Cancer survivors and spouses have high rates of CVD and CVD risk factors and poor engagement in healthful lifestyle behaviors. A high proportion of survivors and spouses were congruent in their current smoking status, physical activity engagement/disengagement, and BMI. Effective lifestyle interventions are needed for this high‐risk population. Couple‐focused interventions may be well‐suited for these dyads and warrant further study. Implications for Cancer Survivors Both cancer survivors and their spouses need to be non‐moking, more physically active, and maintain normal BMI in order to reduce their high risk of CVD and CVD risk factors.
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Affiliation(s)
- Lixin Song
- School of Nursing, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, UNC-CH, Chapel Hill, NC, USA
| | - Ting Guan
- School of Social Work, UNC-CH, Chapel Hill, NC, USA
| | - Peiran Guo
- School of Nursing, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
| | - Fengyu Song
- General Education, West Coast University, Anaheim, CA, USA
| | - Courtney Van Houtven
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.,Margolis Center for Health Policy, Duke University, Durham, NC, USA
| | - Xianming Tan
- Lineberger Comprehensive Cancer Center, UNC-CH, Chapel Hill, NC, USA.,Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA
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