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Marr K, Maguet C, Scarlett H, Dray-Spira R, Dubertret C, Gressier F, Sutter-Dallay AL, Melchior M, van der Waerden J. Social determinants in prenatal antidepressant use and continuation: Systematic review and meta-analysis. Acta Psychiatr Scand 2024; 150:253-273. [PMID: 38145902 DOI: 10.1111/acps.13647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/15/2023] [Accepted: 11/29/2023] [Indexed: 12/27/2023]
Abstract
INTRODUCTION Depression is one of the most common co-morbidities during pregnancy; with severe symptoms, antidepressants are sometimes recommended. Social determinants are often linked with antidepressant use in the general population, and it is not known if this is the case for pregnant populations. Our objective was to determine if social determinants are associated with prenatal antidepressant intake via a systematic review and meta-analysis. METHODS A systematic search of five databases was conducted to identify publications from inception to October 2022 that reported associations with prenatal antidepressant intake (use/continuation) and one or more social determinants: education, race, immigration status, relationship, income, or employment. Eligible studies were included in random effects meta-analyses. RESULTS A total of 23 articles describing 22 studies were included. Education was significantly and positively associated with prenatal antidepressant continuation and heterogeneity was moderate. (Odds ratio = 0.83; 95% CI, 0.78 to 0.89; p < 0.00001; I2 = 53%). Meta-analyses of antidepressant use and education, race, and relationship status, and antidepressant continuation and income were not significant with high levels of heterogeneity. DISCUSSION While most social determinants in this review were not linked with prenatal antidepressant intake, lower maternal education level does seem to be associated with lower rates of prenatal antidepressant continuation. CONCLUSIONS Education appears to be linked with prenatal antidepressant intake. The low number of included studies precludes conclusive evidence for other social determinants.
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Affiliation(s)
- Ketevan Marr
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Charlotte Maguet
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Honor Scarlett
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Rosemary Dray-Spira
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Caroline Dubertret
- AP-HP, Groupe Hospital-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
- Faculté de Médecine, Université de Paris, Paris, France
| | - Florence Gressier
- CESP, Inserm UMR1178, Department of Psychiatry, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, Le Kremlin Bicêtre, France
| | - Anne-Laure Sutter-Dallay
- Inserm, Bordeaux Population Health Research Center, U1219, Bordeaux University, Bordeaux, France
- University Department of Child and Adolescent Psychiatry, Charles Perrens Hospital, Bordeaux, France
| | - Maria Melchior
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Judith van der Waerden
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
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Coughlin GH, Antush MT, Vella CA. Associations of sedentary behavior and screen time with biomarkers of inflammation and insulin resistance. J Behav Med 2024; 47:828-838. [PMID: 38796664 DOI: 10.1007/s10865-024-00498-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/06/2024] [Indexed: 05/28/2024]
Abstract
Sedentary behavior (SB) has been linked to risk factors of cardiometabolic disease, with inconsistent findings reported in the literature. We aimed to assess the associations of SB with multiple biomarkers of inflammation and insulin resistance in adults. Domain-specific SB, sitting time and moderate-to-vigorous physical activity (MVPA) were measured in 78 adults (mean ± SD 52.0 ± 10.8 y). Body fat percentage (BF%) was assessed using multi-frequency bioelectrical impedance. A blood draw assessed glucose, insulin, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), leptin, and adiponectin. Adiponectin-leptin ratio (ALR), homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-β) were calculated. Multivariable linear regression analyses, controlling for age, sex, MVPA, and BF%, were used to assess associations. After adjustment for age, sex and MVPA, total SB (7.5 ± 2.5 h/day) was positively associated with leptin, insulin, HOMA-IR, HOMA-β (Standardized Beta (β) range 0.21-0.32) and negatively associated with ALR (β = -0.24, p < 0.05 for all). Similarly, total sitting time (7.2 ± 2.9 h/day) was associated with TNF-α (β = 0.22) and ALR (β = -0.26). These associations were attenuated to non-significance after adjustment for BF%. Leisure screen time was detrimentally associated with IL-6 (β = 0.24), leptin (β = 0.21), insulin (β = 0.37), HOMA-IR (β = 0.37), and HOMA-β (β = 0.34), independent of age, sex and MVPA (p < 0.05 for all). Only the associations with insulin (β = 0.26), HOMA-IR (β = 0.26), and HOMA-β (β = 0.23) remained significant after further controlling BF% (p < 0.05). Self-reported SB is associated with biomarkers of inflammation and insulin resistance, independent of MVPA, and in some cases BF%.
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Affiliation(s)
- Grace H Coughlin
- University of Washington School of Medicine, Seattle, WA, USA
- University of Idaho, Moscow, ID, 83844, USA
| | - Maximilian T Antush
- Department of Movement Sciences, College of Education, Health and Human Sciences, University of Idaho, Moscow, ID, USA
| | - Chantal A Vella
- Department of Movement Sciences, College of Education, Health and Human Sciences, University of Idaho, Moscow, ID, USA.
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Pico ML, Rangel-Osuna F, Estrada MS, Granich A, Grunnet LG, Silvia CIR, Avila-Jimenez L, Christensen DL, Nielsen KK. "I have not been doing it because of my fear of something happening." Exploring perspectives on healthy dietary behaviors and physical activity in Mexican pregnant women and health care professionals: A qualitative study. Nutrition 2024; 126:112493. [PMID: 39018986 DOI: 10.1016/j.nut.2024.112493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/11/2024] [Accepted: 05/01/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVES Mexico exhibits one of the highest prevalence rates of overweight and obesity globally, accompanied by a surge in non-communicable diseases, which in turn leads to elevated mortality rates. Existing efforts to address rising obesity rates have shown limited effectiveness. Maternal weight, diet, and physical activity (PA) during pregnancy affect the mother's and offspring's health. Despite the importance of establishing and engaging in healthy behaviors during pregnancy, little is known about which factors impact these behaviors among pregnant women in Mexico. This study explored perspectives on factors impacting healthy dietary behaviors and PA in pregnancy from pregnant women and health care professionals in Mexico. METHODS We conducted semistructured interviews with 11 pregnant women and 12 health care professionals working in prenatal care. Data were analyzed using qualitative content analysis in a stepwise inductive approach. RESULTS Classifying factors at the 1) individual level, 2) relational level, and 3) health care system level, three overall themes emerged. At the individual level, challenges with lack of time and competing priorities as well as knowledge of healthy dietary behaviors and PA were identified. At the relational level, influencing factors encompassed financial, social, and emotional support along with descriptive norms. At the health care system level, guidelines for PA during pregnancy and the quality of care were noted. CONCLUSIONS This study identified factors impacting healthy dietary behaviors and PA in pregnancy in Mexico. Important considerations for future interventions include addressing sociocultural norms around healthy dietary behaviors and PA in pregnancy and involving pregnant women's families, closest social networks, and health care professionals working at the prenatal care unit.
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Affiliation(s)
- Majken Lillholm Pico
- Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Denmark.
| | | | | | | | - Louise Groth Grunnet
- Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Denmark
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Derboghossian G, Foust JB, Hayman LL. Social and Religious Networks with Respect to the Health Behaviors of African American Women: A Systematic Review. JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-024-02147-9. [PMID: 39354273 DOI: 10.1007/s10943-024-02147-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/24/2024] [Indexed: 10/03/2024]
Abstract
The aim of this systematic mixed studies review was to examine how social networks influence physical activity and dietary patterns among African American women. We searched PUBMED, CINAHL, JSTOR, SocioIndex, Medline, Cochrane Library, sportDISCUS, and PsycINFO to review articles published between Jan 1, 2007, and July 1, 2021. Only 23 studies met the inclusion criteria. All studies were conducted in the US. Social support received from family members, friends, and churches was found to positively influence physical activity and/or dietary patterns among African American women. An inconsistent relationship was found between social network size, health behavior characteristics of social networks, and physical activity and/or dietary patterns among African American women. Future research should incorporate structural and functional social network strategies to promote physical activity and healthy eating behaviors effectively and sustainably among African American women.
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Affiliation(s)
- Grace Derboghossian
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.
- University of Massachusetts Boston, 100 Morrissey Blvd, Boston, MA, 02125, USA.
| | - Janice B Foust
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Laura L Hayman
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
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Luo X, Wang S, Pu H, Long C, Ren Z, Lai Y. Knowledge mapping and research trends of the social determinants of health (SDoH): a scientometric analysis. REVIEWS ON ENVIRONMENTAL HEALTH 2024; 39:407-421. [PMID: 36746438 DOI: 10.1515/reveh-2022-0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
Social determinants of health (SDoH) play an essential role in the risk of developing diseases or medical disorders. Conducting a comprehensive retrospective analysis is necessary to better understand the development status, research hotspots, and development trends of SDoH research. The bibliometric analysis method is applied based on CiteSpace and VOS viewer to quantitatively analyze and visually review the articles published in the field of SDoH from Web of Science core databases from 2000 to 2021. We quantitatively analyzed the author, institution, and other basic information to probe the development of SDoH and then visually investigated the high-frequency keywords, burst keywords, and keyword clusters to understand better the evolution of hotspots and development directions of SDoH during the study period. Health inequality is the main keyword of the SDoH field, and disease burden is expected to maintain a hotspot in recent years. Further, research methodologies could be improved to explain how upstream SDoH influences human lived experience. Additionally, the SDoH field needs to utilize the horizons of the multidisciplinary approach to consider and discuss sustainable development issues to offer implications for health improvement policy and interventions.
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Affiliation(s)
- Xiaoyi Luo
- Chongqing Technology and Business University, Chongqing, China
| | - Shaobin Wang
- Institute of Geographic Sciences and Natural Resources Research CAS, Beijing, China
| | - Haixia Pu
- Chongqing Technology and Business University, Chongqing, China
| | - Chunfeng Long
- Chongqing Technology and Business University, Chongqing, China
| | - Zhoupeng Ren
- Institute of Geographic Sciences and Natural Resources Research CAS, Beijing, China
| | - Yingsi Lai
- Sun Yat-Sen University, Guangzhou, China
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Knowles C, Thornton E, Petersen K, Lereya ST, Humphrey N. Latent classes of adolescent health behaviour, social covariates and mental wellbeing: a longitudinal birth cohort study. BMC Public Health 2024; 24:2538. [PMID: 39294698 PMCID: PMC11409474 DOI: 10.1186/s12889-024-20004-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 09/05/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND Adolescent mental wellbeing has been declining in the United Kingdom for over a decade. Expansion of services to support the mental wellbeing of young people is a public health priority and a core component of the National Health Service's Long-Term Plan. In this paper, we leverage secondary analysis of a very large longitudinal dataset (#BeeWell) to generate insights regarding different patterns of health behaviour, their covariates, and consequences for mental wellbeing one year later. METHODS A Latent Class Analysis was conducted using data on physical activity, sleep, and eating habits collected in 2021 from 18,478 Year 8 pupils from Greater Manchester (United Kingdom) to (1) identify distinct latent classes of adolescent health behaviour; (2) establish factors likely to be associated with latent class membership; and (3) determine whether latent class membership contributes to variance in self-reported mental wellbeing one year later. RESULTS A three-class solution was identified as an excellent fit to the data, discriminating between: the Wellness Weary (n = 2,717; 15%); the Balanced Bunch (n = 7,377; 40%); and the Green and Dream Team (n = 8,384; 45%). Several factors significantly influenced class membership. Most notably, socio-economic disadvantage and social media use were linked with less favourable health behaviour patterns, whilst cisgender heterosexual girls were likely to endorse healthier patterns. After adjusting for covariates, the Green and Dream Team reported significantly greater mental wellbeing than the Balanced Bunch one year later. However, there was no difference between the Balanced Bunch and the Wellness Weary, signalling that health behaviours may support mental wellbeing, but only among the healthiest young people. CONCLUSIONS Beyond advancements in fundamental understanding, our findings yield significant translation opportunities through their use and application in health, education, and allied professional settings designed to support young people.
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Affiliation(s)
- Christopher Knowles
- Manchester Institute of Education, University of Manchester, Manchester, M15 6JA, UK.
- Ellen Wilkinson Building, University of Manchester, Oxford Road, Manchester, M15 6JA, UK.
| | - Emma Thornton
- Manchester Institute of Education, University of Manchester, Manchester, M15 6JA, UK
| | | | - Suzet Tanya Lereya
- Evidence Based Practice Unit (EBPU), University College London and Anna Freud, London, N1 9JH, UK
| | - Neil Humphrey
- Manchester Institute of Education, University of Manchester, Manchester, M15 6JA, UK
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Njagi D, Nyikuri M, Ndembi N. Integrating social behavioural insights in risk communication and community engagement approaches for better health outcomes in Africa. BMJ Glob Health 2024; 9:e015548. [PMID: 39237297 PMCID: PMC11381717 DOI: 10.1136/bmjgh-2024-015548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 08/25/2024] [Indexed: 09/07/2024] Open
Affiliation(s)
- Dorothy Njagi
- Africa Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia
| | - Mary Nyikuri
- Africa Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia
| | - Nicaise Ndembi
- Africa Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia
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Hildt-Ciupińska K. Self-assessment of health and care for health among employed men in Poland. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2024; 30:774-781. [PMID: 39011554 DOI: 10.1080/10803548.2024.2369395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
Objectives. Self-assessment of health is one of the most important factors determining manifestations in care for health, expressed in health-promoting behaviours. The way a person takes care of their health affects not only their health but also their well-being, quality of life and work ability. This study aimed to present results regarding self-assessment of health and care for health and the relationship with work ability in a group of working men aged 20-65 years. Methods. The sample of 600 men were assessed using a survey. The work ability index was used to measure work ability. An original survey was developed, which included questions about self-assessment of health and taking care of health, motives for taking care of health, physical activity, healthy eating and smoking. Results. Most men rated their health well and declared that they took care of it. Low health scores were obtained among overweight men, men without physical activity, men with unhealthy nutrition and smokers. High self-rated health was associated with good work ability. Conclusions. There is a constant need to make men of all ages aware of the role of individual health care in maintaining good health and high work ability.
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Manna A, Vidgen H, Gallegos D. Examining the effectiveness of food literacy interventions in improving food literacy behavior and healthy eating among adults belonging to different socioeconomic groups- a systematic scoping review. Syst Rev 2024; 13:221. [PMID: 39198926 PMCID: PMC11350956 DOI: 10.1186/s13643-024-02632-y] [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: 07/30/2023] [Accepted: 07/30/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND In high-income countries, significant diet-related health inequalities exist between people of different socioeconomic backgrounds. Individuals who face socioeconomic challenges are less likely to meet dietary guidelines, leading to increased incidence and prevalence of morbidity and mortality associated with dietary risk factors. To promote healthy eating, strategies may focus on individual-level factors (e.g., knowledge, skills, and behavior) along with broader societal factors (e.g., social determinants of health). The concept of food literacy is considered an individual-level factor and has been framed as a skill set that individuals must possess to effectively navigate the complexities of the modern food system. Food literacy interventions can be a complementary but effective tool for encouraging healthy eating behavior among diverse populations, including those facing socioeconomic disadvantage. However, there is limited evidence to guide the design of food literacy intervention for vulnerable population groups. In the process of developing an ideal portfolio of solutions and strategies to promote food literacy and healthy eating for people experiencing socioeconomic disadvantage, this systematic scoping review aims to comprehensively examine the effects of food literacy interventions on promoting food literacy behavior and healthy eating in adults (18 years and above) from various socioeconomic groups (SEGs) in high-income countries. METHODS The review includes both qualitative and quantitative papers obtained from academic databases, including MEDLINE (via EBSCOhost), Embase, Web of Science, and Google Scholar. In addition to the electronic search, manual forward and backward citation searching will be conducted to identify additional relevant papers. Food literacy interventions will be evaluated across four domains: planning and management, selection, preparation, and consumption. Papers included in the review will be analyzed for process, impact, and outcome evaluation. The main outcome of a food literacy intervention is the modification in eating behavior, while the mechanism for this action will be through impact measure of food literacy behaviors. Implementation factors will be extracted for process evaluation. This review will also include a range of dietary behavior measures, such as diet quality index and dietary intake indicator. The screening process for all citations, full-text articles, and abstract data will be carried out by two reviewers independently. In case of any potential conflicts, they will be resolved through discussion. The quality of quantitative studies will be reviewed using the JBI critical appraisal checklist for analytical cross-sectional studies. The "Consolidated Criteria for Reporting Qualitative Studies (COREQ)" will be used to report on the quality of qualitative papers. SYSTEMATIC REVIEW REGISTRATION https://doi.org/10.17605/OSF.IO/TPNKU.
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Affiliation(s)
- Arijita Manna
- Queensland University of Technology Brisbane, Brisbane, Queensland, Australia.
| | - Helen Vidgen
- Queensland University of Technology Brisbane, Brisbane, Queensland, Australia
| | - Danielle Gallegos
- Queensland University of Technology Brisbane, Brisbane, Queensland, Australia
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Vettore MV, Stea TH, Zahl-Olsen R, Faerstein E. Longitudinal evidence of the influence of early life circumstances, family characteristics, social ties and psychological distress on healthy behaviours of Brazilian adults: The Pro-Saude cohort study. PLoS One 2024; 19:e0306565. [PMID: 39141669 PMCID: PMC11324140 DOI: 10.1371/journal.pone.0306565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/19/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND This study examined the influence of early life circumstances, family characteristics, social ties and psychological distress in adulthood on adult's health-related behaviours. METHODS A cohort study (Pro-Saúde Study) involving technical and administrative civil servants at university campuses in Rio de Janeiro State, Brazil was conducted in Rio de Janeiro, Brazil. Data from 2155 adults were collected at baseline (1999) and after a 13-year period (2012-13). Family characteristics at 12 years of age were assessed retrospectively in 1999. Gender, marital status, living situation, social support, social networks of relatives and psychological distress were also measured in 1999. Data collection in 2012-13 included information about marital status, social networks of relatives, cigarette smoking, fruit and vegetable consumption and physical exercise. A conceptual model testing the relationships between variables was assessed through structural equation modelling. RESULTS Female gender (β = 0.043), better social networks of relatives in 1999 (β = 0.053) and 2012-13 (β = 0.069) and low psychological distress (β = -0.048) directly predicted less smoking. Better social networks of relatives in 2012-13 was directly linked to higher consumption of fruits (β = 0.045) and vegetables (β = 0.051) and being physically active (β = 0.070). Low psychological distress directly predicted higher fruit consumption (β = -0.040). Family characteristics at 12 years-old, marital status and living with other people were linked indirectly with health behaviours through social networks, social support and psychological distress. CONCLUSIONS Adults with better early life family and social circumstances, and those who were married reported positive health behaviours through indirect pathways. Stronger social ties and lower psychological distress represented the pathways by which early life circumstances and relationship status influenced positive health behaviours.
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Affiliation(s)
- Mario V. Vettore
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Tonje H. Stea
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Rune Zahl-Olsen
- Department of Child and Adolescent Mental Health, Soerlandet Hospital, Kristiansand, Norway
| | - Eduardo Faerstein
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Umstattd Meyer MR, Houghtaling B, Wende ME, Kheshaifaty KH, Delgado H, Eze SA, Mecate C, Summerall Woodward R, Morgan RL, Krey KJ. A scoping review of policies to encourage breastfeeding, healthy eating, and physical activity among rural people and places in the United States. BMC Public Health 2024; 24:2160. [PMID: 39123168 PMCID: PMC11313091 DOI: 10.1186/s12889-024-19173-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 06/17/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Rural U.S. residents experience a disproportionate burden of diet and physical activity (PA) related chronic disease compared to urban residents, due to resource and economic challenges. Diverse policy approaches for chronic disease prevention have been implemented to address barriers to breastfeeding, healthy eating, and PA. Therefore, the purpose of this paper is to describe policy supports for breastfeeding, healthy eating, and/or PA occurring in rural U.S. areas. METHODS A scoping review was conducted March-June 2020 to identify policy, systems, and environment change approaches occurring in the rural U.S. for breastfeeding, healthy eating, and PA. Search procedures were guided by the PRISMA-ScR, Arksey and O'Malley's work (2007), and a science librarian. Medline, PubMed, Web of Science, and Agricola were used to identify peer-reviewed research. ProQuest Dissertations and Theses A&I were used to identify dissertation research. Grey literature searches included Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Policy results are reported and inclusion criteria were: (1) breastfeeding, healthy eating, and/or PA focus; (2) about policy factors; (3) specific to U.S. rural populations/places; and (4) English language. Outcomes (study/source design, objective(s), methods/measurement, setting, population characteristics, behavioral focus, policy-specific results) were extracted into a standardized Excel document. RESULTS Results include 122 total sources: original research, with some sources referencing multiple behaviors, (n = 74 sources: 8 breastfeeding, 41 healthy eating, 42 PA), grey literature (n = 45 sources: 16 breastfeeding, 15 healthy eating, 27 PA), and graduate research (n = 3 sources: 1 breastfeeding, 2 healthy eating, 1 PA). Breastfeeding policy initiatives included policies or programs at hospitals, increasing access to resources, and improving culture or norms at workplaces. Healthy eating policy initiatives included increasing access to healthy foods, reducing financial burden, implementing programs, food assistance programs, and healthy food prescriptions at healthcare facilities. PA policy initiatives focused on Complete Streets, joint or shared use efforts, Safe Routes to Schools, master plans for greenways, trails, and/or transportation, school health plans, and childcare/school standards. CONCLUSIONS Results from this scoping review compile and offer commentary on existing policy solutions to improve breastfeeding, healthy eating, and/or PA in the rural U.S.
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Affiliation(s)
- M Renée Umstattd Meyer
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA.
| | | | - Marilyn E Wende
- Department of Health Education and Behavior, College of Health and Human Performance University of Florida, Gainesville, FL, USA
| | - Khawlah H Kheshaifaty
- School of Nutrition and Food Science, Louisiana State University Agricultural Center, Louisiana State University, Baton Rouge, LA, USA
| | - Haley Delgado
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Stephanie A Eze
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Cassady Mecate
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Rebekah Summerall Woodward
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | | | - Kathy J Krey
- School of Education, Baylor University, Waco, TX, USA
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Nishizawa Y, Yamada T, Sugimoto K, Ozawa C, Tabuchi T, Ishikawa H, Fukuda Y. Quantitative Definition of Low-Health-Interest Populations by Using Regression Trees: A Nationwide Internet Survey in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1049. [PMID: 39200658 PMCID: PMC11354196 DOI: 10.3390/ijerph21081049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 08/02/2024] [Accepted: 08/06/2024] [Indexed: 09/02/2024]
Abstract
BACKGROUND Reducing health disparities is a public health issue. Identification of low-health-interest populations is important, but a definition of people with low health interest has not yet been established. We aimed to quantitatively define low-health-interest populations. METHODS A nationwide cross-sectional internet survey was conducted in 2022. We compiled regression tree (RT) analyses with/without adjustment for age, sex, and socioeconomic status with the 12-item Interest in Health Scale (IHS, score range 12-48) as an explanatory variable and the 10 composite health behaviors as a dependent variable. We defined the first IHS branching condition from the root node as a lower-health-interest group and the terminal node with the lowest health behaviors as the lowest-health-interest group. RESULTS The mean IHS value of 22,263 analyzed participants was 32.1 ± 5.6; it was higher in females and in those who were aged over 45 years, had a high education, a high income, or a spouse. The first branching condition was IHS 31.5, and the terminal node branched at 24.5, before/after adjustment for covariates. CONCLUSIONS We determined the cutoff values of the IHS as <32 for a lower-health-interest group and <25 for the lowest-health-interest group. Using these cutoffs might enable us to reveal the characteristics of low-health-interest populations.
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Grants
- 22FA1001 Japanese Ministry of Health, Labour and Welfare Grants-in-Aid for Scientific Research
- 19FA1005, 19FA1012, 19FG2001, 20F1005, 20FA2001, and 20EA1017 Health Labor Sciences Research Grants
- 19K13704, 19H01073, 19H01074, 20H00040, 20K10467, and 21H04856 the Japan Society for the Promotion of Science
- JPMJPF2017 JST (Japan Science and Technology Agency) Grant
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Affiliation(s)
- Yoko Nishizawa
- Teikyo University Graduate School of Public Health, Itabashi-ku, Tokyo 173-8605, Japan; (T.Y.); (H.I.); (Y.F.)
- Department of Medicine, Tokyo Women’s Medical University Adachi Medical Center, Adachi-ku, Tokyo 123-8558, Japan
| | - Takuya Yamada
- Teikyo University Graduate School of Public Health, Itabashi-ku, Tokyo 173-8605, Japan; (T.Y.); (H.I.); (Y.F.)
| | - Kumi Sugimoto
- Center for Occupational and Environmental Health, Teikyo University, Itabashi-ku, Tokyo 173-8605, Japan;
| | - Chie Ozawa
- Division of Cancer Information Service, National Cancer Center Japan Institute for Cancer Control, Chuo-ku, Tokyo 104-0045, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Chuo-ku, Osaka 541-8567, Japan;
- Division of Epidemiology, School of Public Health, Tohoku University Graduate School of Medicine, Sendai-shi 980-8575, Japan
| | - Hirono Ishikawa
- Teikyo University Graduate School of Public Health, Itabashi-ku, Tokyo 173-8605, Japan; (T.Y.); (H.I.); (Y.F.)
| | - Yoshiharu Fukuda
- Teikyo University Graduate School of Public Health, Itabashi-ku, Tokyo 173-8605, Japan; (T.Y.); (H.I.); (Y.F.)
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Meraz R, Osteen K, McGee J, Noblitt P, Viejo H. Influence of Neighborhood Disadvantage and Individual Sociodemographic Conditions on Heart Failure Self-care. J Cardiovasc Nurs 2024:00005082-990000000-00212. [PMID: 39102349 DOI: 10.1097/jcn.0000000000001131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
BACKGROUND Residence in socioeconomically disadvantaged neighborhoods and individual sociodemographic conditions contribute to worse heart failure (HF) outcomes and may influence HF self-care. However, associations between neighborhood disadvantage, socioeconomic conditions, and HF self-care are unclear. OBJECTIVE The purpose of this secondary analysis was to investigate whether neighborhood disadvantage and individual socioeconomic conditions predicted worse HF self-care. METHODS This study was a secondary analysis of baseline data from a mixed-method study of 82 adults with HF. Participant zip codes were assigned a degree of neighborhood disadvantage using the Area Deprivation Index. Those in the top 20% most disadvantaged neighborhoods (Area Deprivation Index ≥ 80) were compared with those in the least disadvantaged neighborhoods. The Self-Care of Heart Failure Index was used to measure self-care maintenance and monitoring. Multiple linear regression was conducted. RESULTS Of all participants, 59.8% were male, 59.8% were persons of color, and the mean age was 64.87 years. Residing in a disadvantaged neighborhood and living alone predicted worse HF self-care maintenance and monitoring. Having no college education was also a predictor of worse HF self-care maintenance. Although persons of color were more likely to reside in disadvantaged neighborhoods, race was not associated with HF self-care. CONCLUSION Residing in a disadvantaged neighborhood and living alone may be important risk factors for worse HF self-care. Differences in self-care cannot be attributed solely to the individual sociodemographic determinants of race, gender, age, annual household income, or marital status. More research is needed to understand the connection between neighborhood disadvantage and HF self-care.
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Saha A, Govil D, Muhammad T, Thomas AR. Unveiling the dynamics of social engagement and subjective health in older adults: A gendered perspective. Exp Gerontol 2024; 193:112472. [PMID: 38821323 DOI: 10.1016/j.exger.2024.112472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES As populations age globally, understanding the dynamics that influence the well-being of older individuals become increasingly crucial. The research employs a comprehensive approach to unravel the multifaceted interplay between social engagements and subjective health perceptions of older Indians, with a special focus on gender differences. SUBJECTS AND METHODS This study used data from the Longitudinal Aging Study in India (LASI) wave 1, 2017-18 with a total sample of 30,533 older adults aged 60 years and above. Bivariate analysis, chi-square tests and unadjusted and adjusted average marginal effects from logistic regression models were used to assess the relationship between social engagements and subjective health among older adults, stratified by gender. RESULTS The prevalence of poor health status decreased with higher frequency of social networks among both men (pp. (percentage point) = 6.1; CI (Confidence Interval): 10.6, 1.6) and women (pp. = 9.2; CI: 14.9, 3.4). The adjusted average marginal effects demonstrate that with an increase in the overall score of social engagement, the likelihood of poor health is almost reduced by half. For men, the prevalence of poor health was 9.8 pp. (95 % CI: 13.7, 5.8), while for women, it was 9.3 pp. (95 % CI: 15.2, 3.1). CONCLUSION Gendered perspectives unveil unique patterns, highlighting how societal expectations and roles assigned to each gender may influence the subjective health perceptions of older individuals. This study adds to the expanding knowledge base to enhance the well-being and fulfillment of aging populations, considering the complex interplay of social dynamics and gendered perspectives.
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Affiliation(s)
- Amiya Saha
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, - 400088, India.
| | - Dipti Govil
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, - 400088, India
| | - T Muhammad
- Department of Human Development and Family Studies, The Pennsylvania State University, PA- 16802, USA
| | - Arya Rachel Thomas
- School of Humanities and Social Sciences, Indian Institute of Technology, Madras, India
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15
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Kapukotuwa S, Nerida T, Batra K, Sharma M. Utilization of the multi-theory model (MTM) of health behavior change to explain health behaviors: A systematic review. Health Promot Perspect 2024; 14:121-135. [PMID: 39291044 PMCID: PMC11403345 DOI: 10.34172/hpp.42887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/02/2024] [Indexed: 09/19/2024] Open
Abstract
Background The utilization of a theoretical framework is vital in health promotion research, particularly when endeavoring to modify health behaviors. This systematic review aimed at evaluating and synthesizing evidence through studies conducted using the fourth-generation multi-theory model (MTM) of health behavior change for its effectiveness. Methods A comprehensive article search was performed across MEDLINE, CINAHL, and Academic Search Premier. The search focused on studies utilizing MTM from 2016 to December 2023, following the PRISMA guidelines for systemic reviews. Results An initial pool of 7583 articles was narrowed down through screening of titles, abstracts, and full texts. A total of 69 articles met the inclusion criteria. These studies, encompassing a global range of diverse target groups and health behaviors, were categorized as qualitative, cross-sectional, or experimental. The six qualitative studies revealed MTM themes for diverse health behaviors. The fifty-six cross-sectional studies showed MTM constructs effectively predicting behavior change, albeit with varying statistical significance. The seven experiments demonstrated MTM's role in initiating and sustaining change. For the initiation model, operationalized by 49 studies, the mean adjusted R2 was 38.4% (SD=16.4%). For the sustenance model, operationalized by 45 studies, the mean adjusted R2 was 38.9% (SD=15.5%). Conclusion This systematic review corroborates the MTM as a potent framework for understanding, predicting, and facilitating health behavior changes. Its universal applicability and effectiveness underscore the model's potential as a foundational tool in designing future health promotion strategies and interventions aimed at positive and enduring behavior modifications.
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Affiliation(s)
- Sidath Kapukotuwa
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Tara Nerida
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Kavita Batra
- Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
| | - Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
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Vereeken S, Bedendo A, Gilbody S, Hewit CE. Drowning in the ripple effect: identifying a syndemic network of health experience (with modifiable health behaviours) using the UK Biobank. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02726-x. [PMID: 39060724 DOI: 10.1007/s00127-024-02726-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
A Syndemic model of health experience in severe mental illness (SMI) involving modifiable health behaviour contributors has been theorised but has not yet been investigated. Over the next 10 years mental ill-health and suicidal behaviours have been predicted to increase which will decrease health experience and increase hospitalisation and associated costs. This paper investigated a Syndemic model of health experience in people with SMI informed by physical activity levels, exposure to nature, personal resilience levels, drugs related (tobacco smoking and alcohol consumption), and sleep behaviours using UK Biobank data. Results implementing SEM indicate partial evidence for a Syndemic model, with personal resilience being at its centre. Contrary to previous findings, drugs related behaviours did not play an important role in the model. Implementing a Syndemic framework approach to current health care strategies could be beneficial in the development of self-management strategies for people with SMI. This is the first paper using SEM analyses to investigate SMI under the Syndemic theory paradigm.
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Affiliation(s)
- Silke Vereeken
- Mental Health and Addiction, Department of Health Sciences, University of York, York, UK.
| | - Andre Bedendo
- Department of Health Sciences, Faculty of Sciences, University of York, York, UK
| | - Simon Gilbody
- Mental Health and Addiction, Department of Health Sciences, University of York, York, UK
- Hull York Medical School, York, UK
| | - Catherine E Hewit
- York Trials Unit, Department of Health Sciences, University of York, York, UK
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17
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Chua XH, Edney SM, Müller AM, Petrunoff NA, Whitton C, Tay Z, Goh CMJL, Chen B, Park SH, Rebello SA, Low A, Chia J, Koek D, Cheong K, van Dam RM, Müller-Riemenschneider F. Rationale, Design, and Baseline Characteristics of Participants in the Health@NUS mHealth Augmented Cohort Study Examining Student-to-Work Life Transition: Protocol for a Prospective Cohort Study. JMIR Res Protoc 2024; 13:e56749. [PMID: 39018103 PMCID: PMC11292158 DOI: 10.2196/56749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 04/18/2024] [Accepted: 04/18/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Integration of mobile health data collection methods into cohort studies enables the collection of intensive longitudinal information, which gives deeper insights into individuals' health and lifestyle behavioral patterns over time, as compared to traditional cohort methods with less frequent data collection. These findings can then fill the gaps that remain in understanding how various lifestyle behaviors interact as students graduate from university and seek employment (student-to-work life transition), where the inability to adapt quickly to a changing environment greatly affects the mental well-being of young adults. OBJECTIVE This paper aims to provide an overview of the study methodology and baseline characteristics of participants in Health@NUS, a longitudinal study leveraging mobile health to examine the trajectories of health behaviors, physical health, and well-being, and their diverse determinants, for young adults during the student-to-work life transition. METHODS University students were recruited between August 2020 and June 2022 in Singapore. Participants would complete biometric assessments and questionnaires at 3 time points (baseline, 12-, and 24-month follow-up visits) and use a Fitbit smartwatch and smartphone app to continuously collect physical activity, sedentary behavior, sleep, and dietary data over the 2 years. Additionally, up to 12 two-week-long bursts of app-based ecological momentary surveys capturing lifestyle behaviors and well-being would be sent out among the 3 time points. RESULTS Interested participants (n=1556) were screened for eligibility, and 776 participants were enrolled in the study between August 2020 and June 2022. Participants were mostly female (441/776, 56.8%), of Chinese ethnicity (741/776, 92%), undergraduate students (759/776, 97.8%), and had a mean BMI of 21.9 (SD 3.3) kg/m2, and a mean age of 22.7 (SD 1.7) years. A substantial proportion were overweight (202/776, 26.1%) or obese (42/776, 5.4%), had indicated poor mental well-being (World Health Organization-5 Well-Being Index ≤50; 291/776, 37.7%), or were at higher risk for psychological distress (Kessler Psychological Distress Scale ≥13; 109/776, 14.1%). CONCLUSIONS The findings from this study will provide detailed insights into the determinants and trajectories of health behaviors, health, and well-being during the student-to-work life transition experienced by young adults. TRIAL REGISTRATION ClinicalTrials.gov NCT05154227; https://clinicaltrials.gov/study/NCT05154227. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56749.
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Affiliation(s)
- Xin Hui Chua
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Sarah Martine Edney
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Nicholas A Petrunoff
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Clare Whitton
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Zoey Tay
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Claire Marie Jie Lin Goh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Bozhi Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Su Hyun Park
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Salome A Rebello
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Alicia Low
- Health Promotion Board, Singapore Government, Singapore, Singapore
| | - Janelle Chia
- Health Promotion Board, Singapore Government, Singapore, Singapore
| | - Daphne Koek
- Health Promotion Board, Singapore Government, Singapore, Singapore
| | - Karen Cheong
- Health Promotion Board, Singapore Government, Singapore, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Departments of Exercise and Nutrition Sciences and Epidemiology, Milken Institute of Public Health, The George Washington University, Washington, DC, United States
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Digital Health Center, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
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18
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Gawłowska B, Chawłowska E. An Assessment of Health Behaviours in Primary Care Patients: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1405. [PMID: 39057548 PMCID: PMC11275404 DOI: 10.3390/healthcare12141405] [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: 05/15/2024] [Revised: 06/21/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
A healthy lifestyle is a key determinant of health, especially for people with chronic diseases such as diabetes or hypertension. The health behaviours which contribute to a healthy lifestyle include the following: regular physical activity, preventive examinations, maintaining a proper diet and avoiding the consumption of alcohol or cigarettes. They have a significant impact on the disease process, controlling symptoms and preventing complications. The aim of this study was to examine the health behaviours related to diet, physical activity and prevention among Polish primary health care patients and to identify predictors of health behaviours. For this reason, the standardized Health Behaviour Scale (HBS) questionnaire was used. The study was conducted among 269 patients (including 61.71% women) in primary health care facilities. The mean age of participants was 52.89 years (±17.76). The mean HBS score was 36.93 ± 9.66. A statistically significant association was found between HBS scores and such sociodemographic variables as education (p = 0.0061, r = 0.17), body mass index (p = 0.0018, r = -0.20, β = -0.36) and self-assessed economic status (p = 0.0094, r = 0.16). Women's health behaviours as measured by HBS were significantly better than men's (p < 0.001, β = -6.82). A special focus should be given to the groups manifesting poorer health behaviours (e.g., men, older people and persons with low socioeconomic status) by offering them tailored health-promoting interventions.
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Affiliation(s)
- Barbara Gawłowska
- Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznań, Poland
| | - Ewelina Chawłowska
- Laboratory of International Health, Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznań, Poland
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19
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Oladosu AO, Chanimbe T. A two-pronged approach to understanding reciprocity and mental health relationship in developing countries: evidence from young informal construction workers in Nigeria. BMC Public Health 2024; 24:1851. [PMID: 38992669 PMCID: PMC11238371 DOI: 10.1186/s12889-024-19315-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 07/01/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Mental health problems disproportionately affect young people in developing countries. However, there is limited research on help-seeking behaviours and the social support systems that improve mental wellbeing among vulnerable youth populations. OBJECTIVE This mixed-methods study aimed to examine the relationship between social support reciprocity and mental health among young informal construction workers in Nigeria, a population at high-risk for occupational and socioeconomic stressors. METHODS A cross-sectional survey was administered to 686 informal workers to measure reciprocity, mental health-related quality of life, and covariates. In-depth interviews with 32 participants provided qualitative context. RESULTS Quantitative analyses showed 25% of participants reported poor mental health. Reciprocity positively predicted mental health after controlling for covariates. Qualitative findings revealed reciprocity occurs directly between individuals as well as indirectly through trade unions and religious groups. Indirect exchanges through groups helped address limitations of direct support due to limited resources. CONCLUSIONS This study fills important gaps in understanding how social relationships impact mental health in developing country contexts. Findings emphasize the role of collective action and community-based support systems in promoting mental wellbeing among vulnerable populations. Insights can inform culturally relevant, systems-level mental health interventions.
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Affiliation(s)
| | - Timothy Chanimbe
- Government and International Studies, Hong Kong Baptist University, Baptist University Road, AAB 11/F, Kowloon Tong, Hong Kong
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20
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Gebreegziabher E, Bui D, Cummings KJ, Frederick M, Nguyen A, Collins C, Melton D, Yang A, Jain S, Vergara X. Demographic changes in COVID-19 mortality during the pandemic: analysis of trends in disparities among workers using California's mortality surveillance system. BMC Public Health 2024; 24:1822. [PMID: 38977988 PMCID: PMC11232202 DOI: 10.1186/s12889-024-19257-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 06/24/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND There is limited information on the extent and patterns of disparities in COVID-19 mortality throughout the pandemic. We aimed to examine trends in disparities by demographics over variants in the pre- and post-vaccine availability period among Californian workers using a social determinants of health lens. METHODS Using death certificates, we identified all COVID-19 deaths that occurred between January 2020 and May 2022 among workers aged 18-64 years in California (CA). We derived estimates for at-risk worker populations using the Current Population Survey. The waves of COVID-19 mortality in the pre-vaccine availability period were March 2020-June 2020 (wave 1), and July 2020-November 2020 (wave 2), and in the post-vaccine availability period: December 2020-May 2021 (wave 3), June 2021-January 2022 (wave 4), and February 2022-May 2022 (wave 5). Poisson regression models with robust standard errors were used to determine wave-specific mortality rate ratios (MRRs). We examined the change in MRR across waves by including an interaction term between each demographic characteristic and wave period in different models. The role of potential misclassification of Race/ethnicity on death certificates was examined using probabilistic quantitative bias analysis as sensitivity analysis. RESULTS Among the 24.1 million working age CA population included in the study, there were 26,068 COVID-19 deaths in the period between January 2020 and May 2022. Compared with their respective reference groups, workers who were 50-64 years old, male, Native Hawaiian, Latino, or African American, foreign-born; individuals who had lower education; and unmarried were disproportionately affected by COVID-19 mortality. While disparities by sex, race/ethnicity and foreign-born status narrowed in later waves (post-vaccine availability), disparities by age, education level and marital status did not change substantially across waves. CONCLUSION Demographic disparities in COVID-19 mortality narrowed in the post-vaccine availability waves. However, the existence of disparities across all waves of the pandemic, even in an era of widespread vaccine coverage, could indicate remaining gaps in prevention and differential vulnerability. Addressing the underlying social, structural, and occupational factors that contribute to these disparities is critical for achieving health equity.
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Affiliation(s)
- Elisabeth Gebreegziabher
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA, 94804, USA.
- Heluna Health, 13300 Crossroads Pkwy. N #450, City of Industry, CA, 91746, USA.
| | - David Bui
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA, 94804, USA
- Heluna Health, 13300 Crossroads Pkwy. N #450, City of Industry, CA, 91746, USA
| | - Kristin J Cummings
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA, 94804, USA
| | - Matthew Frederick
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA, 94804, USA
- Public Health Institute, Oakland, CA, 94607, USA
| | - Alyssa Nguyen
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, 94804, USA
| | - Caroline Collins
- Heluna Health, 13300 Crossroads Pkwy. N #450, City of Industry, CA, 91746, USA
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, 94804, USA
| | - David Melton
- Heluna Health, 13300 Crossroads Pkwy. N #450, City of Industry, CA, 91746, USA
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, 94804, USA
| | - Alice Yang
- Heluna Health, 13300 Crossroads Pkwy. N #450, City of Industry, CA, 91746, USA
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, 94804, USA
| | - Seema Jain
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, 94804, USA
| | - Ximena Vergara
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA, 94804, USA
- Heluna Health, 13300 Crossroads Pkwy. N #450, City of Industry, CA, 91746, USA
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Richwine C, Meklir S. Hospitals' collection and use of data to address social needs and social determinants of health. Health Serv Res 2024. [PMID: 38952231 DOI: 10.1111/1475-6773.14341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVE To assess differences in hospitals' collection and use of data on patients' health-related social needs (HRSN) by availability of programs or strategies in place to address patients' HRSN and social determinants of health (SDOH) of communities. DATA SOURCES The 2021 American Hospital Association Annual Survey and 2022 Information Technology (IT) Supplement. STUDY DESIGN This cross-sectional study described hospitals' engagement in screening and the availability of programs or strategies to address nine different HRSN. We assessed differences in screening rates and uses of data collected through screening among hospitals with and without programs or strategies in place to address HRSN or SDOH using Chi-squared tests of independence. DATA COLLECTION/EXTRACTION METHODS Analyses were restricted to IT Supplement respondents with complete data for social needs questions asked in the Annual Survey (N = 1997). PRINCIPAL FINDINGS In 2022, hospitals used social needs data collected through screening for various purposes including discharge planning and clinical decision-making at their hospital as well as to refer patients to needed resources and assess community-level needs. Hospitals with a program or strategy in place had higher rates of screening across all domains and higher rates of using of data collected through screening for uses involving exchange or coordination with external entities. CONCLUSIONS Collection of social needs data may help inform the development of programs or strategies to address HRSN and SDOH, which in turn can enable providers to screen for these needs and use the data in the near term for care delivery and in the long term to address community and population needs.
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Affiliation(s)
- Chelsea Richwine
- Office of the National Coordinator for Health Information Technology, U.S. Department of Health and Human Services, Washington, DC, USA
| | - Samantha Meklir
- Office of the National Coordinator for Health Information Technology, U.S. Department of Health and Human Services, Washington, DC, USA
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22
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Tucker JS, Rodriguez A, Green HD, Seelam R, Henshel B, Pollard MS. Health-related social control among U.S. adults ages 30-80: Associations with alcohol use over four years. Soc Sci Med 2024; 352:117004. [PMID: 38815285 PMCID: PMC11239279 DOI: 10.1016/j.socscimed.2024.117004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 05/10/2024] [Accepted: 05/20/2024] [Indexed: 06/01/2024]
Abstract
Health-related social control (HRSC) includes efforts to regulate or influence others' health behaviors and is an important way interpersonal relationships can affect individual-level health. This study used egocentric network data to describe the size and composition of HRSC networks, identify trajectories of HRSC receipt, and examine how HRSC is related to binge drinking and alcohol-related problems. Data come from a U.S. nationally representative sample of 1235 adults age 30 and older (baseline mean age = 52, 52% female, 64% White) who completed four annual surveys between 2019 and 2022. On average, 30% of adults' network members were HRSC agents who told or reminded them to do things to protect their health. At baseline, 50% of respondents identified a spouse/partner as a HRSC agent, 56% a relative, 46% a friend, and 12% someone else. Respondents' relationships with HRSC agents were generally strong, 93% of agents were described as people "whose opinion matters," and only 10% were described as hassling or making life difficult for the respondent. Growth mixture modeling identified five trajectories of HRSC receipt over the four-year period: Stable High (36% of sample), Stable Moderate (47%), Stable Low (14%), Decreasing (2%), and Increasing (2%). Binge drinking was relatively consistent for the three Stable HRSC classes (ranging from 11% to 15% of individuals), decreased steadily for the Increasing HRSC class (32%-16%), and fluctuated for the Decreasing HRSC class (decreasing from 10% to 2%, then increasing to 8%). For alcohol problems, the Increasing HRSC class showed the largest increase (2%-21%) before dropping to near-baseline levels (4%), whereas the Decreasing HRSC class fluctuated during the first three waves followed by no individuals reporting alcohol problems at the last wave. Results highlight the importance of examining heterogeneity in adults' HRSC experiences because of its implications for understanding social influences on health-related behaviors.
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Affiliation(s)
- Joan S Tucker
- RAND, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | | | - Harold D Green
- Department of Applied Health Science, Indiana University School of Public Health- Bloomington, 1025 E 7th Street, Suite 116, Bloomington, IN, 47405, USA
| | - Rachana Seelam
- RAND, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Beate Henshel
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health- Bloomington, 2719 E. 10th Street, Innovation Center 137, Bloomington, IN, 47408, USA
| | - Michael S Pollard
- RAND, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
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Hebdon M, Pool N, Yee R, Herrera-Theut K, Yee E, Allen LA, Hasan A, Lindenfeld J, Calhoun E, Sweitzer NK, Welling A, Breathett K. Bias in team decision-making for advanced heart failure therapies: model application. J Interprof Care 2024; 38:695-704. [PMID: 38734870 PMCID: PMC11233123 DOI: 10.1080/13561820.2024.2346934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 04/17/2024] [Indexed: 05/13/2024]
Abstract
Bias in advanced heart failure therapy allocation results in inequitable outcomes for minoritized populations. The purpose of this study was to examine how bias is introduced during group decision-making with an interprofessional team using Breathett's Model of Heart Failure Decision-Making. This was a secondary qualitative descriptive analysis from a study focused on bias in advanced heart failure therapy allocation. Team meetings were recorded and transcribed from four heart failure centers. Breathett's Model was applied both deductively and inductively to transcripts (n = 12). Bias was identified during discussions about patient characteristics, clinical fragility, and prior clinical decision-making. Some patients were labeled as "good citizens" or as adherent/non-adherent while others benefited from strong advocacy from interprofessional team members. Social determinants of health also impacted therapy allocation. Interprofessional collaboration with advanced heart failure therapy allocation may be enhanced with the inclusion of patient advocates and limit of clinical decision-making using subjective data.
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Affiliation(s)
| | - Natalie Pool
- School of Nursing, University of Northern Colorado
| | - Ryan Yee
- Sarver Heart Center Research, University of Arizona
| | | | - Erika Yee
- College of Medicine, Departments of Medicine and Pediatrics, University of Michigan
| | - Larry A. Allen
- Division of Cardiovascular Medicine, University of Colorado
| | - Ayesha Hasan
- Division of Cardiovascular Medicine, Ohio State University
| | | | | | - Nancy K. Sweitzer
- Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona
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24
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Iftikhar MF, Rana MOR, Naeem A, Waqas MS, Khan MHUH, Khiyam U, Akhtar W, Mehmoodi A, Malik J. Sex disparity of DAPT noncompliance in patients with left main stem PCI with DES. Medicine (Baltimore) 2024; 103:e38724. [PMID: 38941403 PMCID: PMC11466136 DOI: 10.1097/md.0000000000038724] [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: 12/04/2023] [Accepted: 06/06/2024] [Indexed: 06/30/2024] Open
Abstract
This retrospective study aims to explore the sex disparity in dual antiplatelet therapy (DAPT) noncompliance among left main stem percutaneous coronary intervention (PCI) patients with drug-eluting stent (DES) and identify predictors associated with non-adherence. Data were collected from the medical records of 1585 patients, including 1104 males and 481 females, who underwent left main stem PCI with DES. Baseline characteristics, angiographic features, and DAPT compliance rates at 1 month and 12 months were analyzed. Univariate logistic regression was used to identify predictors of DAPT noncompliance. The overall DAPT noncompliance rate at 1 month was 8.5%, increasing to 15.5% at 12 months. Females exhibited slightly higher noncompliance rates than males at both 1 month (15.6% vs 14.5%) and 12 months (28.1% vs 19.0%), although the difference was not statistically significant. Smoking status showed a modest impact on non-adherence, with current smokers exhibiting a lower noncompliance rate (14.9% at 1 month). Prior coronary artery disease history was associated with increased noncompliance at 12 months (18.9%). Angiographic characteristics, including lesion location and Syntax score, had no consistent association with DAPT noncompliance. This study highlights sex disparity in DAPT noncompliance among patients undergoing left main stem PCI with DES. Comorbidities, socioeconomic status, smoking status, and prior coronary artery disease history were identified as predictors of non-adherence.
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Affiliation(s)
- Malik Faisal Iftikhar
- Department of Cardiology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | | | - Ather Naeem
- Department of Cardiovascular Medicine, Cardiovascular Analytics Group, Islamabad, Pakistan
| | | | | | - Umer Khiyam
- Department of Medicine, Peshawar Medical College, Pakistan
| | - Waheed Akhtar
- Department of Cardiology, Abbas Institute of Medical Sciences, Muzzafrabad, Pakistan
| | - Amin Mehmoodi
- Department of Medicine, Ibn e Seena Hospital, Kabul, Afghanistan
| | - Jahanzeb Malik
- Department of Cardiovascular Medicine, Cardiovascular Analytics Group, Islamabad, Pakistan
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25
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Pereira LM, Mallela JL, Carroll AJ, Washburn JJ, Robiner WN. Psychologists and Integrated Behavioral Health Simulation Training: A Survey of Medical Educators and Perspectives of Directors of Clinical Training. J Clin Psychol Med Settings 2024; 31:304-315. [PMID: 38615281 DOI: 10.1007/s10880-024-10015-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/15/2024]
Abstract
It is well established that the integration of behavioral healthcare into the medical home model improves patient outcomes, reduces costs, and increases resident learning. As academic health centers increasingly integrate behavioral healthcare, targeted training for interprofessional collaboration around behavioral healthcare is needed. Simulation educational approaches potentially can provide this training. Health service psychologists are well-poised to support this because of their specialized training in integrated healthcare. The present exploratory study aimed to evaluate existing simulation programs and develop recommendations for integrated behavioral health training and evaluation. Directors of ACGME accredited residency programs that are high utilizers of the medical home model (Pediatrics, Internal Medicine, Medicine/Pediatrics, Family Medicine) as well as Psychiatry residencies and medical schools with membership in the Society for Simulation in Healthcare were recruited to complete a 26-item survey to assess program usage of psychologists as part of simulation training for integrated behavioral healthcare services. Of 79 participants who completed initial items describing their training program, only 32 programs completed the entire survey. While many academic health centers offered integrated team and behavioral health simulations, few utilized psychology faculty in design, implementation, and evaluation. Other behavioral health providers (psychiatrists, social workers) were often involved in medical school and pediatric residency simulations. Few institutions use standardized evaluation. Qualitative feedback and faculty-written questionnaires were often used to evaluate efficacy. Survey responses suggest that psychologists play limited roles in integrated behavioral healthcare simulation despite their expertise in interdisciplinary training, integrated behavioral healthcare, and program evaluation.
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Affiliation(s)
- Lila M Pereira
- Division of Hematology/Oncology/SCT, Department of Pediatrics, New York Medical College, 19 Skyline Dr, Rm1NH12, Valhalla, NY, 10595, USA.
| | - Jaya L Mallela
- Division of Hematology/Oncology/SCT, Department of Pediatrics, New York Medical College, 19 Skyline Dr, Rm1NH12, Valhalla, NY, 10595, USA
| | - Allison J Carroll
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jason J Washburn
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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26
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Wiedicke A, Rattei F, Reifegerste D. Assigning Responsibility for Depression and Diabetes: Frame Building Factors in Health Coverage. HEALTH COMMUNICATION 2024; 39:1418-1428. [PMID: 37219397 DOI: 10.1080/10410236.2023.2216485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Although frame building is a crucial part of framing in health communication, it is much less understood than media frames or their effects on audiences (i.e. frame setting). To address this research gap, we analyzed the individual, organizational, and external factors of influence contributing to the media's portrayal of responsibility for two major health issues: depression and diabetes. To identify relevant factors, we conducted 23 semi-structured interviews with German journalists who regularly report on these health issues. Our findings indicate that the way in which media coverage portrays responsibilities in depression and diabetes is affected by a variety of factors. These include individual (journalist role perception, journalistic routines, academic background and personal experiences with depression, diabetes-related knowledge, and personal values and beliefs), organizational (editorial lines, space limits, time limitations and payment, and newsroom structures), and external (health news sources, audience interest, newsworthiness, and social norms) factors. Notably, there are differences between depression and diabetes coverage - especially regarding individual factors - confirming that frame building, similar to framing in general, should be examined with regard to specific issues. Nevertheless, some factors that seem important across different topics could be identified.
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Affiliation(s)
| | - Franziska Rattei
- Department of Media and Communication Research, University of Erfurt
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27
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Jackisch J, Noor N, Raitakari OT, Lehtimäki T, Kähönen M, Cullati S, Delpierre C, Kivimäki M, Carmeli C. Does the effect of adolescent health behaviours on adult cardiometabolic health differ by socioeconomic background? Protocol for a population-based cohort study. BMJ Open 2024; 14:e078428. [PMID: 38806419 PMCID: PMC11138306 DOI: 10.1136/bmjopen-2023-078428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 05/08/2024] [Indexed: 05/30/2024] Open
Abstract
INTRODUCTION Adolescence is a sensitive period for cardiometabolic health. Yet, it remains unknown if adolescent health behaviours, such as alcohol use, smoking, diet and physical activity, have differential effects across socioeconomic strata. Adopting a life-course perspective and a causal inference framework, we aim to assess whether the effects of adolescent health behaviours on adult cardiometabolic health differ by levels of neighbourhood deprivation, parental education and occupational class. Gaining a better understanding of these social disparities in susceptibility to health behaviours can inform policy initiatives that aim to improve population health and reduce socioeconomic inequalities in cardiometabolic health. METHODS AND ANALYSIS We will conduct a secondary analysis of the Young Finns Study, which is a longitudinal population-based cohort study. We will use measures of health behaviours-smoking, alcohol use, fruit and vegetable consumption, and physical activity-as exposure and parental education, occupational class and neighbourhood deprivation as effect modifiers during adolescence (ages 12-18 years). Eight biomarkers of cardiometabolic health (outcomes)-waist circumference, body mass index, blood pressure, low-density lipoprotein cholesterol, apolipoprotein B, plasma glucose and insulin resistance-will be measured when participants were aged 33-40. A descriptive analysis will investigate the clustering of health behaviours. Informed by this, we will conduct a causal analysis to estimate effects of single or clustered adolescent health behaviours on cardiometabolic health conditional on socioeconomic background. This analysis will be based on a causal model implemented via a directed acyclic graph and inverse probability-weighted marginal structural models to estimate effect modification. ETHICS AND DISSEMINATION The Young Finns study was conducted according to the guidelines of the Declaration of Helsinki, and the protocol was approved by ethics committees of University of Helsinki, Kuopio, Oulu, Tampere and Turku. We will disseminate findings at international conferences and a manuscript in an open-access peer-reviewed journal.
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Affiliation(s)
- Josephine Jackisch
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Nazihah Noor
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
| | - Olli T Raitakari
- Centre for Population Health Research & Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, TYKS Turku University Hospital, Turku, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Tampere University, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
- Finnish Cardiovascular Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
- Quality of Care Service, University of Geneva, Geneve, Switzerland
| | - Cyrille Delpierre
- CERPOP, UMR1295, Inserm, Toulouse III University-Paul Sabatier, Toulouse, France
| | - Mika Kivimäki
- UCL Brain Sciences, University College London, London, UK
- Clinicum, University of Helsinki Faculty of Medicine, Helsinki, Finland
| | - Cristian Carmeli
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
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Crowther ME, Ferguson SA, Gupta CC, Reynolds AC. The Development and Validation of the Health Belief Model for Shift Workers (HBM-SW) Scale. Behav Sleep Med 2024; 22:353-377. [PMID: 37807653 DOI: 10.1080/15402002.2023.2265520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
OBJECTIVE Shift work is associated with circadian misalignment, sleep loss, and suboptimal health behaviors, which may contribute to longer term negative health outcomes. To inform future interventions for shift workers, the present study aimed to develop and evaluate the Health Belief Model for Shift Workers (HBM-SW) scale. METHODS The HBM-SW development involved a seven-step process, including a literature review, expert panel analysis, cognitive interviews with shift workers, and a trial with a pilot sample of shift workers (n = 153). Utilizing exploratory factor analysis for factor identification and item reduction, the developed scale loaded on seven factors in line with the theoretical framework of the Health Belief Model: Perceived Threat, Perceived Severity, Perceived Benefits, Perceived Barriers, Cues to Action, Self-efficacy, and Health Motivation. Validation of the scale was conducted utilizing Pittsburgh Sleep Quality Index, International Physical Activity Questionnaire, and Food Frequency Questionnaire. RESULTS The pilot sample had an average age of 34.0 (18.0) years, was majority female (54.2%), with an average of 8.0 (11.0) years shift work experience. The HBM-SW showed good - excellent (α = 0.74-0.93) internal consistency and moderate - good (ICC = 0.64-0.89) test re-test reliability. Using health behavior outcome measures, the HBM-SW scale showed meaningful correlations with sleep quality, sleep duration, diet quality and leisure time physical activity, and acceptable validity and reliability. Further testing should be conducted in a larger sample to facilitate confirmatory factor analysis. CONCLUSIONS The developed Health Belief Model for Shift Workers scale is likely beneficial for use in future studies of interventions for shift workers.
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Affiliation(s)
- Meagan E Crowther
- Appleton Institute, CQUniversity Australia, Adelaide, South Australia, Australia
| | - Sally A Ferguson
- Appleton Institute, CQUniversity Australia, Adelaide, South Australia, Australia
| | - Charlotte C Gupta
- Appleton Institute, CQUniversity Australia, Adelaide, South Australia, Australia
| | - Amy C Reynolds
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Adelaide, South Australia, Australia
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29
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Rhodes RE, Beauchamp MR. Development of the social dimensions of health behaviour framework. Health Psychol Rev 2024:1-17. [PMID: 38679879 DOI: 10.1080/17437199.2024.2339329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/01/2024] [Indexed: 05/01/2024]
Abstract
ABSTRACTDespite rapid theoretical expansion in conceptualising individual and environmental processes, the examination of social processes associated with health behaviours has a less cohesive theoretical landscape. The purpose of this mapping review and content analysis was to develop a taxonomy of social dimensions applicable to health behaviours. Michie et al. (2014) 'ABC of Theories of Behaviour Change' text, which includes 83 behaviour change theories, was used as the data-set, whereby an iterative concurrent content analysis was undertaken with respect to all relational/interpersonal psychological dimensions. The analysis resulted in a social dimensions of health behaviour (SDHB) framework of 10 dimensions, including seven sub-types of social appraisal dimensions and three-sub-types of social identification dimensions. The SDHB revealed that specific dimensions, such as descriptive norm, are prevalent in behavioural theories, while other dimensions have seen less attention. Further, while most social constructs in behavioural theories are represented by only one social dimension in the SDHB, other constructs have complex representation. This version 1.0 of the SDHB framework should assist in specifying the core social dimensions in health behaviour, provide a common lexicon to discuss relational constructs in psychological theories, amalgamate the disparate social constructs literature and identify opportunities for further research to advance theory development and interventions.
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Affiliation(s)
- Ryan E Rhodes
- Behavioural Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Mark R Beauchamp
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
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30
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Hald SR, Tatari CR, Kirkegaard P, Tranberg M, Andersen B, Nielsen CP. "Well, that Was Pretty Clever!"-Ethnic Minority Women's Views on HPV Self-Sampling Devices for Cervical Cancer Screening: Attitudes to Brushes, First-Void Urine, and Menstrual Blood Devices. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01963-9. [PMID: 38472631 DOI: 10.1007/s40615-024-01963-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Ethnic minority women are less likely to participate in cervical cancer uteri (CCU) screening compared to native women. Human Papillomavirus (HPV) self-sampling kits for CCU screening may be a potential strategy to increase participation. This study aimed to explore views and attitudes on four different types of self-sampling kits (two brushes, a first-void urine device, and a menstrual blood device) among non-Western ethnic minority women living in Denmark. METHODS The study was a social science single case study based on focus group interviews with 30 women aged 32-54 with non-Western background from a deprived area. A phenomenological approach was applied to describe the phenomenon "self-sampling" as seen from the women's lifeworlds. The interviews were transcribed verbatim and analysed using systematic text condensation. RESULTS The women expressed significant interest in the possibility of using HPV self-sampling kits as an alternative to being screened by their general practitioner. They were particularly motivated to use the non-invasive self-sampling kits for CCU screening as they were deemed suitable for addressing cultural beliefs related to their bodies and virginity. The women expressed interest in the use of the invasive self-sampling kits but were cautious, primarily due to lack of confidence in correctly performing self-sampling with a brush and due to cultural beliefs. CONCLUSION The use of non-invasive self-sampling kits, such as a first-void urine collection device and menstrual blood pad, represents a promising solution to overcome cultural barriers and promote greater equality in CCU screening participation among non-Western ethnic minority women.
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Affiliation(s)
- Signe Ruby Hald
- Department of Public Health Programmes, Randers Regional Hospital, University Research Clinic for Cancer Screening, Randers, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Camilla Rahr Tatari
- Department of Public Health Programmes, Randers Regional Hospital, University Research Clinic for Cancer Screening, Randers, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Pia Kirkegaard
- Department of Public Health Programmes, Randers Regional Hospital, University Research Clinic for Cancer Screening, Randers, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Mette Tranberg
- Department of Public Health Programmes, Randers Regional Hospital, University Research Clinic for Cancer Screening, Randers, Denmark
- Department of Pathology, Randers Regional Hospital, Randers, Denmark
| | - Berit Andersen
- Department of Public Health Programmes, Randers Regional Hospital, University Research Clinic for Cancer Screening, Randers, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Camilla Palmhøj Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Public Health Research, Central Denmark Region, Aarhus, Denmark
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De Souza L, Schmader T. When People Do Allyship: A Typology of Allyship Action. PERSONALITY AND SOCIAL PSYCHOLOGY REVIEW 2024:10888683241232732. [PMID: 38459800 DOI: 10.1177/10888683241232732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
ACADEMIC ABSTRACT Despite increased popular and academic interest, there is conceptual ambiguity about what allyship is and the forms it takes. Viewing allyship as a practice, we introduce the typology of allyship action which organizes the diversity of ways that advantaged individuals seek to support those who are disadvantaged. We characterize allyship actions as reactive (addressing bias when it occurs) and proactive (fostering positive outcomes such as feelings of inclusion, respect, and capacity), both of which can vary in level of analysis (i.e., targeting oneself, one or a few other individuals, or institutions). We use this framework to profile six productive yet largely independent bodies of social psychological literature on social action and directly compare relative benefits and constraints of different actions. We suggest several future directions for empirical research, using the typology of allyship to understand when, where, and how different forms of allyship might succeed. PUBLIC ABSTRACT Despite increased popular and academic interest in the word, people differ in what they believe allyship is and the forms it takes. Viewing allyship as a practice, we introduce a new way (the typology of allyship action) to describe how advantaged individuals seek to support those who are disadvantaged. We characterize allyship actions as reactive (addressing bias when it occurs) and proactive (increasing positive outcomes such as feelings of inclusion, respect, and capacity), both of which can vary in level (i.e., targeting oneself, one or a few other individuals, or institutions). We use this framework to profile six large yet mostly separate areas of social psychological research on social action and directly compare the relative benefits and limitations of different actions. We suggest several future directions for how the typology of allyship action can help us understand when, where, and how different forms of allyship might succeed.
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Affiliation(s)
- Lucy De Souza
- The University of British Columbia, Vancouver, Canada
| | - Toni Schmader
- The University of British Columbia, Vancouver, Canada
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32
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Ng IK. Physicians, know thy patient. J R Coll Physicians Edinb 2024; 54:84-88. [PMID: 38523064 DOI: 10.1177/14782715241240510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Person-centered care is presently the standard healthcare model, which emphases shared clinical decision-making, patient autonomy and empowerment. However, many aspects of the modern-day clinical practice such as the increased reliance on medical technologies, artificial intelligence, and teleconsultation have significantly altered the quality of patient-physician communications. Moreover, many countries are facing an aging population with longer life expectancies but increasingly complex medical comorbidities, which, coupled with medical subspecialization and competing health systems, often lead to fragmentation of clinical care. In this article, I discuss what it truly means for a clinician to know a patient, which is, in fact, a highly intricate skill that is necessary to meet the high bar of person-centered care. I suggest that this can be achieved through the implementation of a holistic biopsychosocial model of clinical consultation at the physician level and fostering coordinated and continuity of care at the health systems level.
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Affiliation(s)
- Isaac Ks Ng
- Department of Medicine, National University Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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33
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Ullah F, Ragazzoni L, Hubloue I, Barone-Adesi F, Valente M. The Use of the Health Belief Model in the Context of Heatwaves Research: A Rapid Review. Disaster Med Public Health Prep 2024; 18:e34. [PMID: 38384190 DOI: 10.1017/dmp.2024.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
As heatwaves increase and intensify worldwide, so has the research aimed at outlining strategies to protect individuals from their impact. Interventions that promote adaptive measures to heatwaves are encouraged, but evidence on how to develop such interventions is still scarce. Although the Health Belief Model is one of the leading frameworks guiding behavioral change interventions, the evidence of its use in heatwave research is limited. This rapid review aims to identify and describe the main themes and key findings in the literature regarding the use of the Health Belief Model in heatwaves research. It also highlights important research gaps and future research priorities. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 10 articles were included, with a geographic distribution as follows: United States (n = 1), Australia (n = 1), Pakistan (n = 1), and China (n = 1), as well as Malaysia (n = 2), Germany (n = 1), and Austria (n = 1). Results showed a lack of research using the Health Belief Model to study heatwaves induced by climate change. Half of the studies assessed heatwave risk perception, with the 2 most frequently used constructs being Perceived Susceptibility and Perceived Severity. The Self-efficacy construct was instead used less often. Most of the research was conducted in urban communities. This review underscores the need for further research using the Health Belief Model.
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Affiliation(s)
- Farman Ullah
- Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health (CRIMEDIM), Università del Piemonte Orientale (UPO), Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale (UPO), Novara, Italy
| | - Luca Ragazzoni
- Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health (CRIMEDIM), Università del Piemonte Orientale (UPO), Novara, Italy
- Department of Sustainable Development and Ecological Transition, Università del Piemonte Orientale (UPO), Italy
| | - Ives Hubloue
- Research Group on Emergency and Disaster Medicine (REGEDIM), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Francesco Barone-Adesi
- Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health (CRIMEDIM), Università del Piemonte Orientale (UPO), Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale (UPO), Novara, Italy
| | - Martina Valente
- Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health (CRIMEDIM), Università del Piemonte Orientale (UPO), Novara, Italy
- Department of Sustainable Development and Ecological Transition, Università del Piemonte Orientale (UPO), Italy
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Novaes EMDFD, Aquino EML, Gabrielli L, Matos SMAD, Griep RH, Fonseca MDJMD, Almeida MDCCD, Patrão AL. [Body image perception, socioeconomic characteristics, and lifestyle in women participating in ELSA-Brasil in Bahia, Brazil]. CAD SAUDE PUBLICA 2024; 40:e00107823. [PMID: 38381869 PMCID: PMC10877697 DOI: 10.1590/0102-311xpt107823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/30/2023] [Accepted: 10/09/2023] [Indexed: 02/23/2024] Open
Abstract
Body image distortion is an alteration in the perception of the body that can have repercussions on health. This study aims to estimate the prevalence of body image accuracy and distortion among women participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) living in Bahia State, Brazil, and to investigate associations with socioeconomic characteristics, lifestyle, and gynecological care seeking. A total of 609 women aged 50 to 69 years participated in the study, who answered face-to-face questionnaires from 2012 to 2014. The Stunkard silhouette scale was used to investigate accurate or distorted perception for more or less weight. The relative risk ratio (RR) was calculated by multinomial logistic regression using Stata 13. Most participants have an accurate perception of their own bodies (53.7%). Among those with distorted perception, there is a tendency to distort towards less weight (38.1%). In the multinomial regression analysis, the variables race/skin color and education remained associated with the distortion towards underweight. The race/skin color variable was positively associated with the distortion towards underweight among Mixed-race women (RR = 1.89; 95%CI: 1.13-3.16) and black (RR = 2.10; 95%CI: 1.25-3.55), while the education variable among those with up to high school education (RR = 1.65; 95%CI: 1.18-2.33). There were no associations with the other variables or with distortion for more weight. The results contribute to explaining the relationships between body image perception and socioeconomic factors, revealing that women of different races/skin colors and varying educational levels are influenced in different ways by social discourses, impacting the perception of their body image.
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Affiliation(s)
| | - Estela M L Aquino
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | - Ligia Gabrielli
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | | | | | | | | | - Ana Luísa Patrão
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
- Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal
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Maxwell-Smith C, Breare H, Dominguez Garcia A, Sim TF, Blackford K, Chih HJ, Jancey J, Mullan BA. Pharmacists' perceptions and delivery of health behaviour change recommendations: Mapping the COM-B model. Res Social Adm Pharm 2024; 20:115-123. [PMID: 37926620 DOI: 10.1016/j.sapharm.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Pharmacists are trusted and accessible healthcare professionals who are well-positioned to deliver brief health behaviour change technique-based interventions for chronic health conditions. However, little is known about the factors influencing pharmacists' use of behaviour change techniques and their capacity to deliver these interventions within community pharmacy. OBJECTIVES This study employed the COM-B model to explore the factors that explain pharmacists' delivery of behaviour change techniques in practice. A secondary objective was to ascertain whether capability, opportunity, and motivation are associated with and explain significant variance in the use of behaviour change techniques during patient interactions. METHODS Two-hundred and eleven Australian pharmacists (mean age = 36.1, SD = 10.7) completed a survey on their capability, opportunity, and motivation to deliver behaviour change techniques, and their delivery and frequency of use in practice. RESULTS Most pharmacists (91.3%) use behaviour change techniques during patient interactions. Results from a simple linear regression showed that a composite COM score was associated with pharmacists' behaviour change technique use F(1,195) = 47.12, β = 0.44, 95 % CI [0.09, 0.16], p < .001, and their frequency of use (F(1,198) = 44.19, β = 0.43, 95 % CI [0.02, 0.06], p < .001). While capability, opportunity, and motivation were individually associated with the range and frequency of behaviour change technique used, motivation was the only significant variable in the composite model for range (β = 0.35, 95 % CI [0.11, 0.41], p < .001) and frequency of behaviour change technique use (β = 0.22, 95 % CI [0.01, 0.09], p < .05). CONCLUSIONS Pharmacist motivation was the most important construct explaining behaviour change technique use. Interventions should seek to foster pharmacist motivation and may benefit from adopting COM-B as a behaviour change framework, to understand the factors influencing the delivery of behaviour change interventions.
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Affiliation(s)
- Chloe Maxwell-Smith
- Behavioural Science and Health Research Group, Curtin University, Bentley, Western Australia, Australia; School of Population Health, Curtin University, Bentley, Western Australia, Australia; EnAble Institute, Curtin University, Bentley, Western Australia, Australia.
| | - Hayley Breare
- Behavioural Science and Health Research Group, Curtin University, Bentley, Western Australia, Australia; School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Alejandro Dominguez Garcia
- Behavioural Science and Health Research Group, Curtin University, Bentley, Western Australia, Australia; School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Tin Fei Sim
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia; Pharmaceutical Society of Australia, Australia
| | - Krysten Blackford
- School of Population Health, Curtin University, Bentley, Western Australia, Australia; Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Hui Jun Chih
- School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Jonine Jancey
- School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Barbara A Mullan
- Behavioural Science and Health Research Group, Curtin University, Bentley, Western Australia, Australia; School of Population Health, Curtin University, Bentley, Western Australia, Australia; EnAble Institute, Curtin University, Bentley, Western Australia, Australia
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Majiwa H, Bukachi SA, Omia D, Fèvre EM. Knowledge, perceptions, and practices around zoonotic diseases among actors in the livestock trade in the Lake Victoria crescent ecosystem in East Africa. Front Public Health 2024; 11:1199664. [PMID: 38264255 PMCID: PMC10805025 DOI: 10.3389/fpubh.2023.1199664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/19/2023] [Indexed: 01/25/2024] Open
Abstract
Background Zoonotic diseases such as anthrax, rabies, brucellosis, and Rift Valley fever pose a direct threat to health and undercut livelihoods in the communities in which they occur. A combination of anthropogenic and animal activities like migration and interaction with wildlife and their respective parasites and vectors drives the emergence and re-emergence of zoonotic diseases. Consequently, One Health interdisciplinary approaches that incorporate social scientists can provide key insights into complex local perceptions. The approach calls for collaboration between the human and animal health sectors, including the sharing of disease surveillance data necessary to alleviate disease impacts. Livestock traders interact closely with livestock, which puts them at elevated risk of infection and creates conditions by which they may spread zoonotic disease. It is thus essential to examine practices among actors involved in the livestock trade to understand the most appropriate ways to mitigate these risks. Methods A qualitative study was conducted among the actors in the livestock trade in Busia County on their knowledge and perceptions of zoonotic diseases and practices that may contribute to the spread, control, and prevention of zoonotic disease transmission. A thematic analysis framework was used to categorize and synthesize data from in-depth interviews (IDIs), key informant interviews (KIIs), and structured observations. Results Whereas participants could list livestock diseases, they could not identify which ones were zoonoses, demonstrating insufficient knowledge of zoonosis. They identify sick animals by checking for dropped ears, excess mucus production, diarrhea, bloody urinal discharge, and general animal activity levels. To prevent the spread of these diseases, they wash their animals, isolate sick animals from the rest of the stock, and vaccinate their animals. They seek help from animal health professionals for sick animals as part of curative practices. This shows that they perceive the diseases as serious and that they need to be attended to by professionals. The results also show that they perceive animals from outside the region to be more vulnerable to diseases compared to those from within. The actors in the livestock trade engage in practices like skinning dead animals before burying them; to them, this is a normal practice. Some also consume dead carcasses. These increase the risk of zoonotic disease transmission. Conclusion The actors involved in the livestock trade are critical in the prevention and elimination of zoonotic diseases; hence, they need to be involved when developing intervention programs and policies for animal health extension services. Training them as a continuum of animal health workers blends lay and professional knowledge, which, alongside their intense contact with large numbers of animals, becomes a critical disease surveillance tool. Increasing awareness of zoonoses by using multi-disciplinary teams with social scientists is urgently needed so that practices like skinning dead animals before disposing of them and consumption of dead carcasses can be minimized.
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Affiliation(s)
- Hamilton Majiwa
- Institute of Anthropology Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Salome A. Bukachi
- Institute of Anthropology Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Dalmas Omia
- Institute of Anthropology Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Eric M. Fèvre
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
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Wearn A, Shepherd L. Determinants of routine cervical screening participation in underserved women: a qualitative systematic review. Psychol Health 2024; 39:145-170. [PMID: 35296200 DOI: 10.1080/08870446.2022.2050230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Routine, population-wide cervical screening programmes reduce cervical cancer incidence and mortality. However, socioeconomically deprived communities and ethnic minority groups typically have lower uptake in comparison to the general population and thus are described as 'underserved.' A systematic qualitative literature review was conducted to identify relevant determinants of participation for these groups. METHODS Online databases were searched for relevant literature from countries with well-established, call-recall screening programmes. Overall, 24 articles were eligible for inclusion. Data was synthesized via Framework synthesis. Dahlgren & Whitehead's social model of health was used as a broad a priori coding framework. RESULTS Participation was influenced by determinants at multiple levels. Overall, patient-provider relationships and peer support facilitated engagement. Cultural disparities, past healthcare experience and practical barriers hindered service access and exacerbated negative thoughts, feelings and attitudes towards participation. Complex interrelationships between determinants suggest barriers have a cumulative effect on screening participation. CONCLUSIONS These findings present a framework of psychosocial determinants of cervical screening uptake in underserved women and emphasise the role of policy makers and practitioners in reducing structural barriers to screening services. Additional work, exploring the experience of those living within socioeconomically disadvantaged areas, is needed to strengthen understanding in this area.
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Affiliation(s)
- Angela Wearn
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Lee Shepherd
- Department of Psychology, Northumbria University, Northumberland Building, Newcastle Upon Tyne, UK
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Baek SU, Won JU, Yoon JH. Association between long working hours and the onset of problematic alcohol use in young workers: A population-based longitudinal analysis in South Korea. J Affect Disord 2024; 344:141-148. [PMID: 37820956 DOI: 10.1016/j.jad.2023.10.020] [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: 07/18/2023] [Revised: 09/05/2023] [Accepted: 10/08/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Long working hours can negatively impact mental health. We examined the association between long working hours and problematic alcohol use among young Korean workers. METHODS We included a nationally representative sample of workers below the age of 40 from the Youth Panel between 2016 and 2020 (N = 7846; observations: 27,646). The exposure variable was working hours per week. Problematic alcohol use was assessed using the CAGE questionnaire, and generalized estimating equations were used to account for repeated measurements. RESULTS Observations of the participants revealed that 5 % worked < 35 h/week, 51 % worked 35-40 h/week, 24 % worked 41-48 h/week, 11 % worked 49-54 h/week, and 9 % worked ≥55 h/week. The prevalence of problematic alcohol use among the workers was 2 % for <35 h/week, 2 % for 35-40 h/week, 3 % for 41-48 h/week, 4 % for 49-54 h/week, and 4 % for ≥55 h/week. The adjusted odds ratios (95 % confidence intervals) for the association between working hours per week and the onset of problematic alcohol use in the following year were 0.86 (0.45-1.66) for <35 h, 1.56 (1.22-1.99) for 41-48 h, 2.03 (1.49-2.75) for 49-54 h, and 1.68 (1.17-2.42) for ≥55 h, compared to 35-40 h. LIMITATIONS The observational design of the study prevented the establishment of a causal relationship between working hours and the onset of problematic alcohol use. CONCLUSION Long working hours were associated with the development of problematic alcohol use. Policy interventions should promote healthier drinking habits among workers with long work hours.
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Affiliation(s)
- Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Aya Pastrana N, Agudelo-Londoño S, Franco-Suarez O, Otero Machuca J, Guzman-Tordecilla DN, López Sánchez MC, Rodriguez-Patarroyo M, Rivera-Sánchez CA, Castro-Barbudo D, Trujillo AJ, Maniar V, Vecino-Ortiz AI. Improving COVID-19 vaccine uptake: a message co-design process for a national mHealth intervention in Colombia. Glob Health Action 2023; 16:2242670. [PMID: 37643136 PMCID: PMC10467523 DOI: 10.1080/16549716.2023.2242670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/23/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND COVID-19 vaccination is a global priority. Latin American countries have some of the highest COVID-19 death rates worldwide with vaccination hampered by a variety of reasons, including mis- and disinformation, vaccine hesitancy, and vaccine supply constraints. Addressing vaccine hesitancy through effective messages has been found to help increase vaccine uptake. Participatory processes could be used to co-design health messages for this purpose. OBJECTIVE This article describes the methodology used to co-design evidence-based audio messages to be deployed in a cohort of individuals through an interactive voice response (IVR) mobile phone survey intervention, aimed towards increasing vaccination uptake in an adult population in Colombia. METHODS Participants of the COVID-19 vaccination message co-design process included a sample of the general population of the country, representatives of the funder organisation, and research team members. The co-design process consisted of four phases: (1) formative quantitative and qualitative research, (2) message drafting based on the results of the formative research, (3) message content evaluation, and (4) evaluation of the voices to deliver the audio messages; and was informed by reflexive meetings. RESULTS Three categories of evidence-based audio messages were co-designed, each corresponding to an arm of the mHealth intervention: (1) factual messages, (2) narrative messages, and (3) mixed messages. An additional fourth arm with no message was proposed for control. The iterative co-design process ended with a total of 14 audio messages recorded to be deployed via the intervention. CONCLUSIONS Co-developing health messages in response to health emergencies is possible. Adopting more context-relevant, participatory, people-centred, and reflexive multidisciplinary approaches could help develop solutions that are more responsive to the needs of populations and public health priorities. Investing resources in message co-design is deemed to have a greater potential for influencing behaviours and improving health outcomes.
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Affiliation(s)
- Nathaly Aya Pastrana
- IMEK Centro de Investigación en Mercadeo & Desarrollo, Santiago de Cali, Colombia
- Instituto de Salud Pública, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Oscar Franco-Suarez
- Instituto de Salud Pública, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Jessica Otero Machuca
- Instituto de Salud Pública, Pontificia Universidad Javeriana, Bogotá, Colombia
- Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | | | | | - Antonio J. Trujillo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Vidhi Maniar
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andres I. Vecino-Ortiz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Yun B, Oh J, Choi J, Rozek LS, Park H, Sim J, Kim Y, Lee J, Yoon JH. Socioeconomic Disparities in the Association Between All-Cause Mortality and Health Check-Up Participation Among Healthy Middle-Aged Workers: A Nationwide Study. J Korean Med Sci 2023; 38:e384. [PMID: 38147834 PMCID: PMC10752744 DOI: 10.3346/jkms.2023.38.e384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/27/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND This study assessed the relationship between non-participation in health check-ups and all-cause mortality and morbidity, considering socioeconomic status. METHODS Healthy, middle-aged (35-54 years) working individuals who maintained either self-employed or employee status from 2006-2010 were recruited in this retrospective cohort study from the National Health Insurance Service in Korea. Health check-up participation was calculated as the sum of the number of health check-ups in 2007-2008 and 2009-2010. Adjusted hazard ratio (HR) and 95% confidence interval (CI) of all-cause mortality were estimated for each gender using multivariable Cox proportional hazard models, adjusting for age, income, residential area, and employment status. Interaction of non-participation in health check-ups and employment status on the risk of all-cause mortality was further analyzed. RESULTS Among 4,267,243 individuals with a median 12-year follow-up (median age, 44; men, 74.43%), 89,030 (2.09%) died. The proportion (number) of deaths of individuals with no, one-time, and two-time participation in health check-ups was 3.53% (n = 47,496), 1.66% (n = 13,835), and 1.33% (n = 27,699), respectively. The association between health check-up participation and all-cause mortality showed a reverse J-shaped curve with the highest adjusted HR (95% CI) of 1.575 (1.541-1.611) and 1.718 (1.628-1.813) for men and women who did not attend any health check-ups, respectively. According to the interaction analysis, both genders showed significant additive and multiplicative interaction, with more pronounced additive interaction among women who did not attend health check-ups (relative excess risk due to interaction, 1.014 [0.871-1.158]). CONCLUSION Our study highlights the significant reverse J-shaped association between health check-up participation and all-cause mortality. A pronounced association was found among self-employed individuals, regardless of gender.
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Affiliation(s)
- Byungyoon Yun
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Juyeon Oh
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Jaesung Choi
- Department of Global Economics, Sungkyunkwan University, Seoul, Korea
| | - Laura S Rozek
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Heejoo Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Juho Sim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Yangwook Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Jongmin Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Jin-Ha Yoon
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea.
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Ródenas-Munar M, Monserrat-Mesquida M, Gómez SF, Wärnberg J, Medrano M, González-Gross M, Gusi N, Aznar S, Marín-Cascales E, González-Valeiro MA, Serra-Majem L, Pulgar S, Segu M, Fitó M, Torres S, Benavente-Marín JC, Labayen I, Zapico AG, Sánchez-Gómez J, Jiménez-Zazo F, Alcaraz PE, Sevilla-Sánchez M, Herrera-Ramos E, Schröder H, Bouzas C, Tur JA. Perceived Quality of Life Is Related to a Healthy Lifestyle and Related Outcomes in Spanish Children and Adolescents: The Physical Activity, Sedentarism, and Obesity in Spanish Study. Nutrients 2023; 15:5125. [PMID: 38140384 PMCID: PMC10745413 DOI: 10.3390/nu15245125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Maintaining a healthy lifestyle is crucial for safeguarding the well-being and quality of life perception, appropriate growth, and development of children and adolescents, while also mitigating the risk of future adult-onset diseases. OBJECTIVE To assess associations between perceived quality of life and healthy lifestyle and related outcomes in Spanish children and adolescents. METHODS Cross-sectional analysis of 8-16-year-old children and adolescents (n = 3534) were included in the nationwide study of Physical Activity, Sedentarism, and Obesity in Spanish Youth (PASOS). Data were collected through (1) questionnaires on health-related quality of life (HRQoL), healthy lifestyle outcomes (dietary intake, physical fitness, sleep, and screen time), and (2) anthropometric measurements for weight status assessment. Data were analysed by logistic regression, using the health-related quality of life (HRQoL) as the grouping variable. RESULTS Participants with a lower HRQoL were those with a lower adherence to the MedDiet and lower achievement of the recommended daily intake of fruit and vegetables. They were also less likely to follow the recommendations for screen time and sleep (with the exception of the weekend) compared to participants with a higher HRQoL. Participants with a lower HRQoL showed a lower healthy weight status and poorer physical fitness than those with a higher HRQoL. CONCLUSIONS Healthy eating habits, healthy weight status (normal weight), appropriate sleep time, physical fitness, and limited screen time play a crucial role in the perceived quality of life in children and adolescents.
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Affiliation(s)
- Marina Ródenas-Munar
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.R.-M.); (M.M.-M.)
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain (M.G.-G.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Margalida Monserrat-Mesquida
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.R.-M.); (M.M.-M.)
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain (M.G.-G.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Santiago F. Gómez
- Gasol Foundation Europe, 08830 Sant Boi de Llobregat, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28049 Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Institute for Medical Research, 08003 Barcelona, Spain
- GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, 25003 Lleida, Spain
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain (M.G.-G.)
- EpiPHAAN Research Group, Universidad de Málaga—Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain;
| | - María Medrano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain (M.G.-G.)
- ELIKOS Group, Institute for Sustainability and Food Chain Innovation (IS-FOOD), Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Spain
| | - Marcela González-Gross
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain (M.G.-G.)
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, 28223 Madrid, Spain;
| | - Narcís Gusi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (N.G.)
| | - Susana Aznar
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha-Toledo Campus, 45004 Toledo, Spain (F.J.-Z.)
| | - Elena Marín-Cascales
- UCAM Research Center for High Performance Sport, Universidad Católica de Murcia, 30107 Murcia, Spain; (E.M.-C.)
- Faculty of Sport Sciences, Universidad Católica de Murcia, 30107 Murcia, Spain
| | - Miguel A. González-Valeiro
- Faculty of Sports Sciences and Physical Education, Universidade da Coruña, 15001 A Coruña, Spain (M.S.-S.)
| | - Lluís Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain (M.G.-G.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas, Spain;
- Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, 35001 Las Palmas, Spain
| | - Susana Pulgar
- Regional Unit of Sports Medicine of Principado de Asturias, Municipal Sports Foundation of Avilés, 33402 Avilés, Spain
| | - Marta Segu
- FC Barcelona Foundation, 08028 Barcelona, Spain;
| | - Montse Fitó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain (M.G.-G.)
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Institute for Medical Research, 08003 Barcelona, Spain
| | - Silvia Torres
- Gasol Foundation Europe, 08830 Sant Boi de Llobregat, Spain
- Faculty of Health Science and Wellbeing, University of Vic-University Central of Catalonia, 08500 Barcelona, Spain
| | - Juan Carlos Benavente-Marín
- EpiPHAAN Research Group, Universidad de Málaga—Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain;
| | - Idoia Labayen
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain (M.G.-G.)
- ELIKOS Group, Institute for Sustainability and Food Chain Innovation (IS-FOOD), Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Spain
| | - Augusto G. Zapico
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, 28223 Madrid, Spain;
- Department of Didactics of Language, Arts and Physical Education, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Jesús Sánchez-Gómez
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (N.G.)
| | - Fabio Jiménez-Zazo
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha-Toledo Campus, 45004 Toledo, Spain (F.J.-Z.)
| | - Pedro E. Alcaraz
- UCAM Research Center for High Performance Sport, Universidad Católica de Murcia, 30107 Murcia, Spain; (E.M.-C.)
- Faculty of Sport Sciences, Universidad Católica de Murcia, 30107 Murcia, Spain
| | - Marta Sevilla-Sánchez
- Faculty of Sports Sciences and Physical Education, Universidade da Coruña, 15001 A Coruña, Spain (M.S.-S.)
| | - Estefanía Herrera-Ramos
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas, Spain;
| | - Helmut Schröder
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28049 Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Institute for Medical Research, 08003 Barcelona, Spain
| | - Cristina Bouzas
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.R.-M.); (M.M.-M.)
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain (M.G.-G.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain; (M.R.-M.); (M.M.-M.)
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain (M.G.-G.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain
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Mercado J, Espinosa-Curiel IE, Martínez-Miranda J. Embodied Conversational Agents Providing Motivational Interviewing to Improve Health-Related Behaviors: Scoping Review. J Med Internet Res 2023; 25:e52097. [PMID: 38064707 PMCID: PMC10746972 DOI: 10.2196/52097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/20/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Embodied conversational agents (ECAs) are advanced human-like interfaces that engage users in natural face-to-face conversations and interactions. These traits position ECAs as innovative tools for delivering interventions for promoting health-related behavior adoption. This includes motivational interviewing (MI), a therapeutic approach that combines brief interventions with motivational techniques to encourage the adoption of healthier behaviors. OBJECTIVE This study aims to identify the health issues addressed by ECAs delivering MI interventions, explore the key characteristics of these ECAs (eg, appearance, dialogue mechanism, emotional model), analyze the implementation of MI principles and techniques within ECAs, and examine the evaluation methods and primary outcomes of studies that use ECAs providing MI interventions. METHODS We conducted a scoping review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) methodology. Our systematic search covered the PubMed, Scopus, IEEE Xplore, ACM Digital, and PsycINFO databases for papers published between January 2008 and December 2022. We included papers describing ECAs developed for delivering MI interventions targeting health-related behaviors and excluded articles that did not describe ECAs with human appearances and without the necessary evaluation or MI explanation. In a multistage process, 3 independent reviewers performed screening and data extraction, and the collected data were synthesized using a narrative approach. RESULTS The initial search identified 404 articles, of which 3.5% (n=14) were included in the review. ECAs primarily focused on reducing alcohol use (n=5, 36%), took on female representations (n=9, 64%), and gave limited consideration to user ethnicity (n=9, 64%). Most of them used rules-driven dialogue mechanisms (n=13, 93%), include emotional behavior to convey empathy (n=8, 57%) but without an automatic recognition of user emotions (n=12, 86%). Regarding MI implementation, of 14 studies, 3 (21%) covered all MI principles, 4 (29%) included all processes, and none covered all techniques. Most studies (8/14, 57%) conducted acceptability, usability, and user experience assessments, whereas a smaller proportion (4/14, 29%) used randomized controlled trials to evaluate behavior changes. Overall, the studies reported positive results regarding acceptability, usability, and user experience and showed promising outcomes in changes in attitudes, beliefs, motivation, and behavior. CONCLUSIONS This study revealed significant advancements in the use of ECAs for delivering MI interventions aimed at promoting healthier behaviors over the past 15 years. However, this review emphasizes the need for a more in-depth exploration of ECA characteristics. In addition, there is a need for the enhanced integration of MI principles, processes, and techniques into ECAs. Although acceptability and usability have received considerable attention, there is a compelling argument for placing a stronger emphasis on assessing changes in attitudes, beliefs, motivation, and behavior. Consequently, inclusion of more randomized controlled trials is essential for comprehensive intervention evaluations.
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Affiliation(s)
- José Mercado
- Unidad de Transferencia Tecnológica Tepic, Centro de Investigación Científica y de Educación Superior de Ensenada, Tepic, Nayarit, Mexico
| | - Ismael Edrein Espinosa-Curiel
- Unidad de Transferencia Tecnológica Tepic, Centro de Investigación Científica y de Educación Superior de Ensenada, Tepic, Nayarit, Mexico
| | - Juan Martínez-Miranda
- Unidad de Transferencia Tecnológica Tepic, Centro de Investigación Científica y de Educación Superior de Ensenada, Tepic, Nayarit, Mexico
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Yuan GF, Tam CC, Yang X, Qiao S, Li X, Shen Z, Zhou Y. Associations Between Internalized and Anticipated HIV Stigma and Depression Symptoms Among People Living with HIV in China: A four-wave Longitudinal Model. AIDS Behav 2023; 27:4052-4061. [PMID: 37392272 DOI: 10.1007/s10461-023-04119-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 07/03/2023]
Abstract
Previous research has documented that HIV-related stigma (e.g., internalized and anticipated stigma) is detrimental to the mental health of people living with HIV (PLWH). However, longitudinal data on the bidirectional relationship between HIV-related stigma and depression symptoms are limited. The purpose of this study was to examine the bidirectional association among internalized and anticipated HIV stigma and depression symptoms among Chinese PLWH. A four-wave longitudinal design (6 months intervals) was employed among 1,111 Chinese PLWH (Mage = 38.58, SD = 9.16, age range: 18-60 years; 64.1% men). The bidirectional model was examined using a random-intercept cross-lagged panel model (RI-CLPM), which evaluated the within- and between-person effects of study variables. At the within-person level, results indicated that depression symptoms at T2 mediated the linkage between internalized HIV stigma at T1 and anticipated HIV stigma at T3, and that anticipated HIV stigma at both T2 and T3 mediated the relationship between depression symptoms at the previous time point and internalized HIV stigma at the subsequent time point. Furthermore, a bidirectional association was found between anticipated HIV stigma and depression symptoms across four waves. At the between-person level, internalized and anticipated HIV stigma were significantly associated with depression symptoms. This study highlights the complex interplay between different forms of HIV-related stigma and mental health problems among PLWH and underscores the importance of considering the bidirectional relationship between the development of psychopathology and stigmatization process in clinical practice.
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Affiliation(s)
- Guangzhe Frank Yuan
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Cheuk Chi Tam
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Xueying Yang
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Shan Qiao
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Zhiyong Shen
- Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Yuejiao Zhou
- Guangxi Center for Disease Control and Prevention, Nanning, China
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Ramos SD, Kannout L, Khan H, Klasko-Foster L, Chronister BN, Du Bois S. A Neighborhood-level analysis of mental health distress and income inequality as quasi-longitudinal risk of reported COVID-19 infection and mortality outcomes in Chicago. DIALOGUES IN HEALTH 2023; 2:100091. [PMID: 36530218 PMCID: PMC9731648 DOI: 10.1016/j.dialog.2022.100091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022]
Abstract
Extant literature investigates the impact of COVID-19 on mental health outcomes, however there is a paucity of work examining mental health distress as a risk factor for COVID-19 outcomes. While systemic variables like income inequality relate to both mental health and COVID-19, more work is needed to test theoretically informed models including such variables. Using a social-ecological framework, we aimed to address these gaps in the literature by conducting a neighborhood-level analysis of potential mental health distress and systemic- (income inequality) level predictors of reported COVID-19 infection and mortality over time in Chicago. Neighborhood-level comparisons revealed differences in mental health distress, income inequality, and reported COVID-19 mortality, but not reported COVID-19 infection. Specifically, Westside and Southside neighborhoods generally reported higher levels of mental health distress and greater concentration of poverty. The Central neighborhood showed a decline in reported mortality rates over time. Multi-level negative binomial models established that Zip-codes with greater mental health distress were at increased reported COVID-19 infection risk, yet lower mortality risk; Zip-codes with more poverty were at increased reported COVID-19 infection risk, yet lower mortality risk; and Zip-codes with the highest percentage of People of Color were at decreased risk of reported COVID-19 mortality. Taken together, these findings substantiate Chicago neighborhood-level disparities in mental health distress, income inequality, and reported COVID-19 mortality; identify unique differential associations of mental health distress and income inequality to reported COVID-19 infection and reported mortality risk; and, offer an alternative lens towards understanding COVID-19 outcomes in terms of race/ethnicity.
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Affiliation(s)
- Stephen D. Ramos
- University of California San Diego, Division of Infectious Diseases and Global Public Health, Department of Medicine, San Diego, CA 92093, USA
- San Diego State University, SDSU Research Foundation, San Diego, CA 92120, USA
| | - Lynn Kannout
- Illinois Institute of Technology, Department of Psychology, Chicago, IL 60616, USA
| | - Humza Khan
- Illinois Institute of Technology, Department of Psychology, Chicago, IL 60616, USA
| | - Lynne Klasko-Foster
- Brown University, Department of Psychiatry and Human Behavior, Providence, RH 02912, USA
| | - Briana N.C. Chronister
- Herbert Wertheim School of Public Health, University of California San Diego, San Diego, CA 92093, USA
- School of Public Health, San Diego State University, San Diego, CA 92182, USA
| | - Steff Du Bois
- Illinois Institute of Technology, Department of Psychology, Chicago, IL 60616, USA
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Souto-Miranda S, Saraiva I, Spruit MA, Marques A. Core outcome set for pulmonary rehabilitation of patients with COPD: results of a modified Delphi survey. Thorax 2023; 78:1240-1247. [PMID: 37758457 DOI: 10.1136/thorax-2023-220522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/04/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION There is high heterogeneity of outcomes and measures reported in pulmonary rehabilitation (PR) trials of people with chronic obstructive pulmonary disease (COPD). This hinders study comparability and benchmarking of PR. We have developed a core outcome set (COS) to overcome these challenges. METHODS This study was informed by a systematic review and two qualitative studies and had patient involvement since its inception. A two-round Delphi survey was available in seven languages. Outcomes (n=63) scored 7-9 (crucial) by ≥70% of the participants and 1-3 (not that important) by ≤15% of participants from both groups in the Likert scale were automatically included in the COS, while outcomes that were considered crucial by only one of the groups were further discussed by the authors in a meeting. RESULTS A total of 299 people (n=229 healthcare professionals/researchers/policy-makers; n=70 people with COPD and informal caregivers) participated in the survey (83% retention), which covered 29 countries/five continents. After the second round, six outcomes were included and three were added in the meeting. The final COS contains dyspnoea, fatigue, functional exercise capacity, health-related quality of life, health behaviours/lifestyle, knowledge about the disease, lower limb muscle function, personal goals and problematic activities of daily living. CONCLUSION A COS for PR of people with COPD is now available and can be used by different stakeholders to improve consistency and comparability of studies, benchmark PR and improve the quality of care provided. Future research should establish the core measures and investigate the uptake of this COS.
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Affiliation(s)
- Sara Souto-Miranda
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
- Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
- Department of Medical Sciences (DCM), University of Aveiro, Aveiro, Portugal
| | | | - Martijn A Spruit
- Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Research and Development, Ciro, Horn, The Netherlands
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal
- Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
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Ruiz MJ, Chisholm B, de Martelly V, Chor J. Sexual and Gender Minority Patients' First Pelvic Examination Experiences: What Clinicians Need to Know. J Pediatr Adolesc Gynecol 2023:S1083-3188(23)00447-3. [PMID: 38012980 DOI: 10.1016/j.jpag.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/05/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023]
Abstract
STUDY OBJECTIVE The aim of this study was to identify factors that influence the first pelvic exam experiences of sexual and gender minority (SGM) adolescents and young adults who were assigned female at birth (AFAB). METHODS Using purposive sampling, we recruited SGM AFAB individuals, ages 18-24, who had had at least 1 pelvic examination. Semi-structured interviews and an iterative approach allowed for the emergence of factors influencing the first pelvic exam experience. Items included in the final code directory had a Krippendorff's alpha intercoder reliability score greater than 0.7. Interviews were analyzed using ATLAS.ti. RESULTS Thirty participants completed interviews. Fourteen participants identified as bisexual, 2 as gay, 1 as lesbian, 3 as pansexual, 8 as queer, and 2 as straight/heterosexual. Sixteen participants identified as cisgender, 9 as genderqueer/gender nonconforming, and 5 as transgender. Factors influencing the first pelvic exam experience were organized as patient- or clinician-level factors. The patient-level factors of gender identity, sexual orientation, history of sexual trauma, and participant's relationship to their body were central factors influencing the exam experience. Speculum insertion during the exam induced anxiety and pain for some. The clinician-level factors of gender, age, and race or ethnicity influenced the exam experience. Most participants preferred detailed communication. Participants offered recommendations to ensure gender-affirming, patient-centered care during the first pelvic exam. CONCLUSION SGM AFAB individuals identified patient- and clinician-level factors influencing their first pelvic exam experiences. This study underscores the need for changes in medical education and health systems to ensure that SGM AFAB individuals have their needs met and feel comfortable in reproductive health settings.
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Affiliation(s)
- Maria J Ruiz
- The University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Briyana Chisholm
- The University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Victoria de Martelly
- The University of Chicago, Department of Obstetrics and Gynecology, Chicago, Illinois
| | - Julie Chor
- The University of Chicago, Department of Obstetrics and Gynecology, Chicago, Illinois.
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Marsh L, McNoe B, Venter N, Quigg R, Notoa F, Reeder AI. Awareness of cancer among adolescents: A study of nine focus groups in Aotearoa New Zealand. Health Promot J Austr 2023. [PMID: 37961934 DOI: 10.1002/hpja.826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 09/22/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023] Open
Abstract
ISSUE ADDRESSED One third of cancers are potentially preventable by modifying key risk factors that arise during adolescence. To help inform prevention efforts, we investigated adolescents' understanding of cancer risk factors, symptoms and signs and barriers to help-seeking. METHODS Nine focus groups were conducted with purposefully sampled, binary-gendered friendship groups of 12 to 17-year-olds. Interviews were analysed using a qualitative descriptive method based on the topic schedule, transcripts and field notes. RESULTS Behavioural, genetic and environmental factors were commonly explored as risk factors. Most cancer symptoms identified focused on physical indicators, such as lumps and skin appearance. Facilitators and barriers to good health choices involved both external and internal factors: education, affordability, attitudes and the social environment. Most participants indicated they would talk to trusted friends and family members about health issues, but only when the condition became 'serious'. The most common source of health information was the internet. CONCLUSIONS Adolescents have a good understanding of behavioural risk factors, but poor knowledge of some key cancer symptoms. A support system was recognised to be a substantive factor in dealing with health issues, as were youth-focused health services. Understanding of the preventability of many cancers was not widespread with participants. SO WHAT?: The results emphasise a requirement for appropriate, affordable and accessible youth-focused health services. There is a need for age- and culturally appropriate interventions that improve knowledge of cancer symptoms. Immunisation against the viruses implicated in cervical cancer is one example of a clinical cancer prevention intervention in adolescence.
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Affiliation(s)
- Louise Marsh
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Bronwen McNoe
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Noeleen Venter
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Robin Quigg
- Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Faith Notoa
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Anthony I Reeder
- Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Sumo J, Wilbur J, Julion WA, Schoeny ME, Cummings P. Grandmothers residing with grandchildren: Social determinants of health, health behaviors, and health outcomes. J Women Aging 2023; 35:513-525. [PMID: 36976632 DOI: 10.1080/08952841.2023.2188863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/30/2023] [Accepted: 03/03/2023] [Indexed: 03/29/2023]
Abstract
The purpose of this study was to explore the associations between social determinants of health, health behaviors, and physical and mental health among African American and Hispanic caregiving grandmothers. We use cross-sectional secondary data from the Chicago Community Adult Health Study, originally designed to understand the health of individual households based on residential context. In a multivariate regression model, discrimination, parental stress, and physical health problems were significantly associated with depressive symptoms in caregiving grandmothers. Considering the multiple sources of stress experienced by this grandmother sample, researchers should develop and strengthen contextually relevant interventions for improving the health of caregiving grandmothers. Healthcare providers must be equipped with skills to address caregiving grandmothers' unique needs related to stress. Finally, policy makers should promote the development of legislation that can positively influence caregiving grandmothers and their families. Expanding the lens through which caregiving grandmothers living in minoritized communities are viewed can catalyze meaningful change.
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Affiliation(s)
- Jen'nea Sumo
- College of Nursing, Rush University, Chicago, Illinois, USA
| | - JoEllen Wilbur
- College of Nursing, Rush University, Chicago, Illinois, USA
| | | | | | - Peter Cummings
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Ahadinezhad B, Khosravizadeh O, Rafiei S, Habibi N, Karimkhani Z, Maleki A. What is the uptake rate of breast self-examination in Iranian women? Estimation based on systematic review and meta-analysis. BMC Womens Health 2023; 23:538. [PMID: 37848904 PMCID: PMC10580562 DOI: 10.1186/s12905-023-02688-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 10/05/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Breast self-examination is a simple, painless, confidential and inexpensive screening method for early diagnosis that does not require specialized tools and equipment. In this study, we have estimated the pooled percentage of breast self-examination (BSE) in Iranian women. METHODS All the published literatures between 2012 and 2022 have been reviewed. Searches were performed in PubMed, Web of Science, ProQuest, Science Direct, Google Scholar, Scientific Information and Magiran databases. The effect size was the pooled percentage of breast self-examination (BSE). In order to check the heterogeneity, the estimation of the I2 index and extraction of the Galbraith plot were used, and the drivers of heterogeneity have been identified through meta-regression and estimates were made based on subgroups. All the analysis was done in STATA 15. RESULTS From the initial 294 records, 38 were included in the final analysis in which 9960 women have been studied. The heterogeneity of the studies was high based on the variation in OR (I2 = 98.4%, heterogeneity X2 = 2278.21 (d.f. = 37), p < 0.01). The pooled rate of BSE based on fixed and random methods was obtained as 15.46 (95% CI: 14.83 to 16.09) and 24.74 (95% CI: 19.62 to 29.86) percent, respectively. The highest pooled percentage BSE (39.41%, 95% CI: 30.98 to 47.83) was obtained from studies that investigated the action phase in the Trans theoretical model. The pooled percentage obtained from the studies conducted in the central regions of Iran was higher than other cities (27.47%, 95% CI: 17.38 to 37.55). CONCLUSION The result from our analysis determined that performing breast self-examination in Iranian women is low. Health policy makers can increase the rate of breast self-examination in Iran by implementing basic educational programs in schools and encouraging and justifying women in social health centers.
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Affiliation(s)
- Bahman Ahadinezhad
- Department of Health Services Management, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Omid Khosravizadeh
- Department of Health Services Management, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sima Rafiei
- Department of Health Services Management, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | | | - Aisa Maleki
- Department of Health Services Management, Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran.
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Bytyçi-Katanolli A, Obas KA, Ramadani Q, Fota N, Jerliu N, Merten S, Gerold J, Zahorka M, Kwiatkowski M, Probst-Hensch N. Effectiveness of behavioural change interventions on physical activity, diet and body mass index of public primary healthcare users in Kosovo: the KOSCO cohort. BMJ Open 2023; 13:e071100. [PMID: 37813529 PMCID: PMC10565199 DOI: 10.1136/bmjopen-2022-071100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 09/13/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Prevalent physical inactivity and poor nutrition contribute to high non-communicable disease (NCD) morbidity and mortality in Kosovo. To improve health services for patients with NCD the Accessible Quality Healthcare project developed behaviour change interventions following the principles of the WHO Package of Essential NCD (PEN) protocol. They were implemented into the public primary healthcare (PHC) system of five early-stage implementation municipalities (ESIM, 2018) and seven late-stage implementation municipalities (2020). OBJECTIVE To assess the effect of the behaviour change interventions; motivational stages of behaviour change for physical activity and nutrition; and body mass index (BMI). DESIGN Prospective cohort study. DATA COLLECTION AND ANALYSIS We included 891 public PHC users aged 40 years and above, who were enrolled in the KOSCO (Kosovo Non-Communicable Disease Cohort) cohort in 2019 and followed-up biannually until February 2021. The PHC users who consulted for themselves any health service were approached and recruited for cohort participation. Each participant contributed up to four self-reports of nutrition and physical activity, and up to three reports of motivation to change for a better lifestyle. These outcomes were modelled prospectively with robust mixed-effects Poisson regressions. The association between behaviour change interventions and BMI was quantified using linear regression. RESULTS There was a high rate of smokers 20.5% and obesity 53.1%, and high rates of self-reported diagnoses of diabetes: 57.1%; hypertension 62.6%. We found no effect of residing in an ESIM, but adherence to both guidelines was higher in ESIM at the latest follow-up time point. ESIM residence was also associated with a twofold increase in the probability of reporting a high motivation for a better lifestyle and with a statistically non-significant decrease in BMI of -0.14 kg/m2 (95% CI: -0.46 to 0.19) at the latest follow-up. CONCLUSION The longitudinal results extend evidence on the effect of WHO PEN protocol in promoting physical activity and nutritional behaviour in the Kosovo context.
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Affiliation(s)
- Ariana Bytyçi-Katanolli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Katrina Ann Obas
- Qualitätsmanagement & Patientensicherheit, Universitätsspital Zürich, Zurich, Switzerland
| | | | - Nicu Fota
- Accessible Quality Healthcare Project, Prishtina, Kosovo
| | - Naim Jerliu
- National Institute of Public Health Kosovo, Prishtina, Kosovo
- Medical Faculty, University of Prishtina, Prishtina, Kosovo
| | - Sonja Merten
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Jana Gerold
- University of Basel, Basel, Switzerland
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | | | - Marek Kwiatkowski
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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