Health information provision, health knowledge and health behaviours: Evidence from breast cancer screening

"Salud Mamaria", an internet-based psychoeducational program during the breast cancer diagnosis process: Protocol for a randomized controlled trial

Background

Some of the key challenges during the breast cancer diagnosis process include a lack of information and negative psychological consequences, such as distress and anxiety about the process. Implementing a psychoeducational program during the diagnosis process may enhance the well-being of women. "Salud Mamaria" is an Internet-Based Psychoeducational Program (IBPP) that comprises three interventions: A ("Improving Your Health Habits and Self-Care"), B ("Waiting for the Result of Your Biopsy"), and C ("Supporting You After Your Breast Cancer Diagnosis").

Objective

1) To evaluate changes in the study variables following each of the three interventions (A, B, and C), and 2) To assess the differences in study variables between the IBPP and an active control group.

Methods

This is a superiority trial employing an experimental design with two independent groups: an experimental group and an active control group. All participants will be randomized to one of the two conditions. Anxiety symptoms, negative screening of consequences, sense of coherence, satisfaction with the intervention, and system usability will be measured. Patients will be assigned to an intervention based on their clinical situation: without cancer suspicion (A), with cancer suspicion (B), or diagnosed with cancer (C). Questionnaires will be administered via the online platform before and after each intervention.

Conclusions

A psychoeducational program implemented during the breast cancer screening and diagnosis process may promote the health and well-being of women. It may also encourage adherence to medical screening recommendations, mitigating the lack of information and reducing associated distress.

Trial registration

ClinicalTrials.gov NCT05830461.

Can social media encourage diabetes self-screenings? A randomized controlled trial with Indonesian Facebook users

Nudging individuals without obvious symptoms of non-communicable diseases (NCDs) to undergo a health screening remains a challenge, especially in middle-income countries, where NCD awareness is low but the incidence is high. We assess whether an awareness campaign implemented on Facebook can encourage individuals in Indonesia to undergo an online diabetes self-screening. We use Facebook's advertisement function to randomly distribute graphical ads related to the risk and consequences of diabetes. Depending on their risk score, participants receive a recommendation to undergo a professional screening. We were able to reach almost 300,000 individuals in only three weeks. More than 1400 individuals completed the screening, inducing costs of about US$0.75 per person. The two ads labeled "diabetes consequences" and "shock" outperform all other ads. A follow-up survey shows that many high-risk respondents have scheduled a professional screening. A cost-effectiveness analysis suggests that our campaign can diagnose an additional person with diabetes for about US$9.

Effects of organized screening programs on breast cancer screening, incidence, and mortality in Europe

We link data on regional Organized Screening Programs (OSPs) throughout Europe with survey data and population-based cancer registries to estimate effects of OSPs on breast cancer screening (mammography), incidence, and mortality. Identification is from regional variation in the existence and timing of OSPs, and in their age-eligibility criteria. We estimate that OSPs, on average, increase mammography by 25 percentage points, increase breast cancer incidence by 16% five years after the OSPs implementation, and reduce breast cancer mortality by about 10% ten years after.

Assessment of Knowledge, Perceptions, and Attitudes During the Global Mpox Outbreak in June 2022: A Cross-Sectional Study From the United Arab Emirates

Objectives: To examine knowledge, worry, anxiety, and vaccine acceptance for mpox among UAE adults. Methods: An online survey, advertised on academic and social media platform in June 2022 collected data from 959 participants (aged 18 and above) on mpox beliefs, risks, knowledge, worry, anxiety, COVID-19 infection, vaccination, and willingness to receive the mpox vaccine. Bivariate and logistic regression analysis identified associations and predictors between variables. Results: 56% had optimal knowledge of mpox transmission and symptoms. 54% were worried, and 27% experienced anxiety related to the outbreak. Knowledge scores were higher among women, healthcare workers, and those with reliable information sources. High perceived infection risk, changes in precautionary measures, and belief in difficult treatment predicted more worry and anxiety. Higher worry and two or more doses of the COVID-19 vaccine predicted higher likelihood of taking the mpox vaccine. Conclusion: The UAE population showed low knowledge and high worry and anxiety during the global mpox outbreak. Increasing public awareness through targeted educational campaigns is vital. Promoting better understanding of infectious diseases, addressing concerns, and encouraging vaccine uptake can prepare for future outbreaks.

Knowledge, attitude and practice on prevention and control of pulmonary tuberculosis index cases family in Shebedino District, Sidama Region, Ethiopia

Introduction

Tuberculosis is a leading cause of death, despite being a largely curable and preventable disease. The goals of TB control are to reduce infection transmission, morbidity, and mortality until TB cannot be a threat to public health any longer while preventing drug resistance. Assessing KAP on TB control and prevention among family members is more essential, and taking action based on the result can break the transmission of TB infection.

Methods

From August to September 2022, a community-based cross-sectional study method was used. A total of 422 participants were selected from a list of sample frames who were family members of PTB patients who had used anti-TB medication in the previous 12 months prior to the study period using a systematic random sampling method. SPSS version 25 software was used to analyze the data. Bivariate and multivariate analyses were used to determine variables related to KAP on TB prevention and control. A variable with p-values less than 0.25 was included in the multivariable logistic regression model to find independent determinant factors. In the multivariate logistic regression, variables with p-values ≤0.05 were identified as statistically significant.

Result

A total of 414 family members responded to the survey questionnaire. The average knowledge score on TB was 17.11 ± 6.34. The majority (51.9%) of respondents had a good knowledge of TB cases. One-third of those polled had an unfavorable attitude towards PTB prevention, with a mean score of 3.16 ± 1.78 and 55.1% had good practice in preventing tuberculosis. Marital status (AOR = 1.7, 95% CI: 1.5-2.5) was an independent predictor of knowledge. Practice level is independently affected by occupation (AOR = 3.9; 95% CI = (1.7-8.7)) and health education on PTB (AOR = 2.4; 95% CI = (1.6-3.9).

Conclusion

Knowledge, attitudes, and preventive practices about tuberculosis were not satisfactory when compared to several national and international studies. It is necessary to strengthen the program for health education and awareness-building on PTB.

COVID-19 health information sources and their associations with preventive behaviors: A typological study with older residents in Seoul, South Korea

Considering that individuals' health information can enable their adoption of health behaviors, we examined the use of health information sources related to COVID-19 and its association with preventive behaviors in a sample of older residents in Seoul, South Korea (N = 400, M age = 76.1 years). Latent profile analysis of 12 sources of health information representing conventional media, online sources, interpersonal networks, and health professionals or authorities yielded a 4-group typology: limited, moderate/traditional, moderate/digital, and diverse. In a multivariate model with the diverse group as a reference, the limited group (B = -4.48, SE = 1.14, p < .001) and the moderate/digital group (B = -2.73, SE = 0.76, p < .001) were associated with lower adherence to COVID-19 preventive behaviors. Our findings support the heterogeneity in the use of health information sources and the hypothesis that groups with restricted sources of health information would report less desirable behaviors. The findings also underscored the importance of proper use of digital health information. Efforts should be made not only to help older adults with low education access diverse sources of health information, including digital sources, but also to empower them to build digital and health literacy.

Impact of a Personal Health Record Intervention Upon Surveillance Among Colorectal Cancer Survivors: Feasibility Study

BACKGROUND

There are currently an estimated 1.5 million individuals living in the United States with colorectal cancer (CRC), and although the 5-year survival rate has increased, survivors are at risk for recurrence, particularly within the first 2-3 years after treatment. National guidelines recommend continued surveillance after resection to identify recurrence early on. Adherence among survivors ranges from 23% to 94%. Novel interventions are needed to increase CRC survivors' knowledge and confidence in managing their cancer and thus to increase adherence to follow-up surveillance.

OBJECTIVE

The objective of this study is to develop and test the feasibility and efficacy of a stand-alone, web-based personal health record (PHR) to increase surveillance adherence among CRC survivors, with patient beliefs about surveillance as secondary outcomes.

METHODS

A pre- and postintervention feasibility trial was conducted testing the efficacy of the colorectal cancer survivor (CRCS)-PHR, which had been previously developed using an iterative, user-centered design approach.

RESULTS

The average age of the sample was 58 (SD 9.9) years, with 57% (16/28) male and the majority married (20/28, 71%) and employed full-time (15/28, 54%). We observed a significant increase in adherence to colonoscopy (before: 11/21, 52% vs after: 18/21, 86%; P=.005) and CEA (14/21, 67% vs 20/21, 95%; P=.01), as well as a slight increase in CT scans (14/21, 67% vs 18/21, 86%; P=.10). The only significant impact on secondary outcome (patient beliefs) was benefits of CEA test (P=.04), as most of the beliefs were high at baseline.

CONCLUSIONS

This feasibility study lays the groundwork for continued development of the CRCS-PHR to increase CRC surveillance. Patient-centered technologies, such as the CRCS-PHR, represent an important potential approach to improving the receipt of guideline-concordant care and follow-up surveillance, and not just for CRC survivors. Researchers should continue to develop patient-centered health technologies with clinician implementation in mind to increase patient self-efficacy and surveillance adherence.

What Drives Elderly People in China Away from COVID-19 Information?

Background: A worrying phenomenon has emerged in recent years: a growing number of people have stopped seeking coronavirus disease 2019 (COVID-19) information and have started deliberately avoiding it. Even though the virulence of COVID-19 has now weakened, the proportion of severe illnesses and deaths in elderly people is still much higher than in other age groups. However, no study has focused on this topic. This is the first study to explore the level of COVID-19 information avoidance among elderly people, and to identify the barriers and potential factors associated therewith. Methods: Convenience sampling was used to recruit 907 elderly people in Wuhan, China. Data collection measures included a sociodemographic questionnaire, health information avoidance scale, information overload scale, general self-efficacy scale, and health anxiety inventory. Results: A total of 72.3% of elderly participants reported COVID-19 information avoidance. Regarding COVID-19-related information reading habits, 44.5% of the elderly only read the title, 16.0% merely skimmed through the content, and 22.9% skipped all relevant information. The most common reasons for this result were information overload (67.5%), underestimation of the infection risk (58.1%), and uselessness of information (56.4%). The main factors associated with COVID-19 information avoidance were recorded as information overload, age, health anxiety, and children (p < 0.05). Conclusions: China should strengthen its health communication regarding COVID-19 in accordance with the characteristics of elderly people, adopt more attractive publicity methods on traditional media, improve censorship about health information, and pay more attention to the childless elderly and the elderly aged 80 and above.

Does retirement affect secondary preventive care use? Evidence from breast cancer screening

This paper examines the causal impact of retirement on preventive care use by focusing on breast cancer screening. It contributes to a better understanding of the puzzling results in the literature reporting mixed effects on health care consumption at retirement. We use five waves of data from the Eurobarometer surveys conducted between 1996 and 2006, covering 25 different European countries. We address the endogeneity of retirement by using age thresholds for pension eligibility as instrumental variables in a bivariate probit model. We find that retirement reduces mammography use and other secondary preventive care use. Our results suggest that health status, income, and knowledge on cancer prevention and treatment contribute little to our understanding of the effects of retirement. Instead, our evidence suggests important effect heterogeneity based on the generosity of the social health insurance system and organized screening programs.