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Brown R, Sillence E, Pepper G. Individual characteristics associated with perceptions of control over mortality risk and determinants of health effort. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024; 44:1339-1356. [PMID: 37871995 DOI: 10.1111/risa.14243] [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: 01/10/2023] [Revised: 09/18/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
People who believe they have greater control over health and longevity are typically more likely to invest in their long-term health. Investigating individual differences in perceived control over risk and exploring different determinants of health effort may help to tailor health promotion programs to more effectively encourage healthy behaviors. From a sample of 1500 adults, we measured perceived control over 20 causes of death, overall perceived uncontrollable mortality risk (PUMR), state-level optimism, self-reported health effort, and the accuracy of estimations of avoidable deaths. We found individual differences in perceptions of control over specific causes of death based on age, gender, and income. PUMR was predicted by socioeconomic variables expected to influence exposure to risk and resource availability. Higher levels of PUMR, not perceptions of control over specific causes of death, predicted self-reported health effort. The strength of relationship between PUMR and lower health effort was not moderated by state-level optimism. Age and education both positively predicted greater accuracy in assessing the prevalence of avoidable deaths. We suggest that PUMR may capture people's "general sense" of mortality risk, influenced by both exposure to hazards and the availability of resources to avoid threats. Conversely, perceived control over specific risks may involve more deliberate, considered appraisals of risk. This general sense of risk is thought to play a more notable role in determining health behaviors than specific assessments of control over risk. Further study is needed to investigate the degree to which PUMR accurately reflects objective measures of individual risk.
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Affiliation(s)
- Richard Brown
- Psychology Department, Northumbria University, Newcastle, UK
| | | | - Gillian Pepper
- Psychology Department, Northumbria University, Newcastle, UK
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2
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Ren Z, Wesselius A, Stehouwer CDA, Brouwers MCGJ. Relationship between educational attainment and non-alcoholic fatty liver disease: A two-sample Mendelian randomization study. Dig Liver Dis 2024; 56:565-570. [PMID: 38104027 DOI: 10.1016/j.dld.2023.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Observational studies have identified an inverse association between education and non-alcoholic fatty liver disease (NAFLD). However, it is not possible to establish causality for this relationship. AIMS To gain more insight into the causal nature of the relationship between education and NAFLD. METHODS We performed two-sample Mendelian randomization (MR) analyses using summary-level, large-scale datasets to study the association of genetically predicted educational attainment (n = 1271 genetic instruments, obtained from 1,131,881 participants) with risk of NAFLD (i.e., liver fat [n = 32,858 participants] and electronic health record (EHR)-based NAFLD [n = 778,614 participants]). In sensitivity analyses, educational attainment was replaced by three education-related traits (i.e., genetically predicted cognition, math ability and highest math). RESULTS Inverse-variance weighted method showed a statistically significant association between genetically predicted educational attainment and liver fat (beta: -0.251, 95%CI: -0.305; -0.198) and EHR-based NAFLD (OR: 0.609, 95%CI: 0.547; 0.677). MR-Egger regression did not show statistically significant intercepts. Similar findings were obtained when other MR tests were used or when educational attainment was replaced by education-related traits. CONCLUSIONS This study suggests a causal, protective effect of higher education on NAFLD risk. Societal interventions targeted at people with low education are needed to alleviate the burden of NAFLD.
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Affiliation(s)
- Zhewen Ren
- Department of Internal Medicine, Division of Endocrinology and Metabolic Diseases, Maastricht University Medical Center, Maastricht, the Netherlands; Laboratory for Metabolism and Vascular Medicine, Maastricht University, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Anke Wesselius
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands; Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Laboratory for Metabolism and Vascular Medicine, Maastricht University, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Division of General Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Martijn C G J Brouwers
- Department of Internal Medicine, Division of Endocrinology and Metabolic Diseases, Maastricht University Medical Center, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
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Tang CS, Mars M, James J, Appleton KM. Associations between attitudes towards and reported intakes of sugars, low/no-calorie sweeteners, and sweet-tasting foods in a UK sample. Appetite 2024; 194:107169. [PMID: 38113982 DOI: 10.1016/j.appet.2023.107169] [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: 09/26/2023] [Revised: 12/02/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
Public health initiatives are currently aiming to lower free sugar intakes for health benefits, but attitudes towards sugars, their alternatives such as low/no-calorie sweeteners (LNCS), and towards sweet-tasting foods may be hampering efforts. This work investigated associations between attitudes towards and the reported intakes of sugars, LNCS and sweet-tasting foods, and identified latent attitude profiles in subpopulations of adults in the United Kingdom. A total of 581 adults completed a questionnaire assessing their usual intake of sugars, LNCS and sweet-tasting foods, attitudes towards these foods and various demographic characteristics. Six principal components explained 39.1% of the variance in the attitude responses, named: 'Personal Impact', 'Personal Management', 'Apathy', 'Negativity', 'Perceived Understanding' and 'Perceived Nonautonomy'. Personal Impact was negatively associated with reported consumption of sugar-food and sweet-tasting food groups more frequently (smallest β = -0.24, p < .01). Personal Management was positively associated with reporting adding sugar and consuming sugar-food and sweet-tasting food groups more frequently (smallest β = 0.14, p < .01). Three latent classes of participants with distinct patterns of attitudes were identified, labelled: 'Feeling Ill-equipped' (n = 52), 'Actively Engaged' (n = 162) or 'Unopinionated' (n = 367). Individuals who were classed as Actively Engaged reported adding LNCS more frequently than those classed as Feeling Ill-equipped (t(212) = -2.14, p<.01), who reported consuming sweet-tasting food groups more frequently than those classed as Unopinionated (t(417) = 2.65, p < .01). These findings suggest the need for personalised approaches within public health initiatives, to reduce free sugar intakes.
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Affiliation(s)
- Claudia S Tang
- Department of Psychology, Faculty of Science and Technology, Bournemouth University, Poole House, Talbot Campus, Bournemouth, BH12 5BB, UK; Consumer Culinary Experience Team, Kraft Heinz Research & Development Center, Nijmegen, 6534 AD, the Netherlands.
| | - Monica Mars
- Sensory Science and Eating Behaviour Group, Division of Human Nutrition, Wageningen University and Research, Wageningen, 6708 WE, the Netherlands.
| | - Janet James
- Department of Nursing Science, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth Gateway Building, St. Pauls Lane, Bournemouth, BH8 8GP, UK.
| | - Katherine M Appleton
- Department of Psychology, Faculty of Science and Technology, Bournemouth University, Poole House, Talbot Campus, Bournemouth, BH12 5BB, UK.
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Zhang X, Zhang X, Zhang S, Ge L, Xu Y, Yao D, Hu X, Huang Z, Zhu T, Wang Z, Chen C. The association between health literacy and e-cigarette use: evidence from Zhejiang, China. Front Public Health 2024; 11:1321457. [PMID: 38239787 PMCID: PMC10794489 DOI: 10.3389/fpubh.2023.1321457] [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: 10/14/2023] [Accepted: 12/12/2023] [Indexed: 01/22/2024] Open
Abstract
Objectives The worldwide popularity of electronic cigarettes (ECIG) is becoming a public health concern. Compared to conventional cigarettes (CIG), the harm caused by ECIG is more insidious. Studies have shown that lower health literacy (HL) is associated with CIG use; however, the relationship between HL and ECIG use remains controversial. Because ECIG emerged more recently than CIG, there are fewer relevant studies, and the sample populations and evaluation methods of HL in existing studies differ. This study conducted a large-sample survey to examine the relationship between HL and ECIG use. Methods As part of the 2022 China Health Literacy Survey, a total of 60,998 valid questionnaires were collected from September to November in 2022 using a stratified multistage probability proportional to the population size sampling frame. Chi-square tests and multinomial logistic regression was used to analyze the relationship between HL and ECIG use. Some demographic variables were included as covariates in the analysis. Results The study showed that the average HL score and the HL level of Zhejiang residents in 2022 were 42.8 and 30.8%, respectively. The prevalence of CIG and ECIG was 19.7 and 1.0%, respectively; 19% of participants exclusively used CIG, while only 0.3% of participants used ECIG exclusively; dual users accounted for 0.6%. After adjusting for covariates, adequate HL was associated with lower odds of ECIG-exclusive use (odds ratio [OR] = 0.452, p < 0.001), CIG-exclusive use (OR = 0.833, p < 0.001), and dual use (OR = 0.632, p < 0.001). Young age, male sex, unmarried status, high-income status, and absence of chronic disease were also associated with ECIG use. Conclusion HL was a protective factor against both patterns of ECIG use, especially ECIG-exclusive use. Health policymakers and public health practitioners should consider HL as a potential measure for ECIG control.
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Affiliation(s)
- Xuehai Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xinxin Zhang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Songjia Zhang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Lizheng Ge
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Yue Xu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Dingning Yao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiujing Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Zishuo Huang
- School of Innovation and Entrepreneurship, Wenzhou Medical University, Wenzhou, China
| | - Tingting Zhu
- Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine, Hangzhou, China
| | - Zixia Wang
- School of Business, Macau University of Science and Technology, Macau, China
| | - Chun Chen
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
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Miller JL, Chung M, Williams LB, Connell A, Saleh ZT, Alhurani A, Bailey A, Rayens MK, Moser DK. Health Literacy and Perceived Control: Intermediary Factors in the Relationship Between Race and Cardiovascular Disease Risk in Incarcerated Men in the United States. J Cardiovasc Nurs 2023:00005082-990000000-00136. [PMID: 37787727 PMCID: PMC10985046 DOI: 10.1097/jcn.0000000000001022] [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] [Indexed: 10/04/2023]
Abstract
BACKGROUND Black race, inadequate health literacy, and poor perceived control are predictors of increased cardiovascular disease (CVD) risk. The purpose of this study was to explore the relationships among race, health literacy, perceived control, and CVD risk while controlling for known risk factors in incarcerated men. METHODS We included data from 349 incarcerated men to examine race and CVD risk (Framingham Risk Score) using a serial mediation model with health literacy and perceived control using 95% confidence intervals (CIs) from 5000 bootstrap samples. RESULTS Of the participants (age, 36 ± 10; education, 12 ± 2; body mass index, 28.3 ± 5.0), 64.2% were White and 35.8% were Black. Black incarcerated men were younger (P = .047) with lower levels of health literacy (P < .001). All 3 indirect effects of race on CVD were significant, whereas the direct effect of race was not. Black incarcerated men had higher levels of CVD risk through health literacy (a1b1 = 0.3571; 95% CI, 0.0948-0.7162) and lower levels of CVD risk through perceived control (a2b2 = -0.1855; 95% CI, -0.4388 to -0.0077). Black incarcerated men had higher levels of CVD risk through health literacy influenced by perceived control (a1b2d21 = 0.0627; 95% CI, 0.0028-0.1409), indicating that despite the protective effect of higher levels of perceived control in Black incarcerated men, CVD risk remained higher compared with their White counterparts. CONCLUSION Future CVD risk reduction interventions in incarcerated men, specifically Black incarcerated men, should include goals of improving health literacy and perceived control as modifiable risk factors.
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Slavik CE, Yiannakoulias N, Wilton R, Scott F. An Exploratory Study on the Impacts of Individual Skills and Health Information Exposure on Perceptions of Cancer Control and Expert Competence. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1584-1591. [PMID: 37103679 DOI: 10.1007/s13187-023-02303-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/21/2023] [Indexed: 06/19/2023]
Abstract
People's perceptions of control over their risk of cancer, and their perceptions of health experts' abilities to manage cancer risks, shape their beliefs about the effectiveness of expert-recommended cancer-preventive behaviors and actions. The aims of this exploratory study were to investigate the impact of individual skills and sources of health information on (i) internal locus of cancer control (ILOC) and (ii) perceived expert competence. Using a cross-sectional survey (n = 172), we collected data on individual health expertise, numeracy, health literacy, amounts of health information received from various sources, ILOC for cancer prevention and perceived expert competence (i.e., believing that health experts have the knowledge to correctly estimate cancer risks). Significant associations between health expertise and ILOC, and between health literacy and ILOC, were not observed in this study (OR = 2.15, 95%CI = 0.96-5.98; OR = 1.78, 95%CI = 0.97-3.63, respectively). Participants who received more health information from the news were more likely to perceive experts as competent (OR = 1.86, 95%CI = 1.06-3.57). Logistic regression analyses suggested that higher levels of health literacy among individuals with lower numeracy may promote ILOC but discourage expert competence beliefs. Analyses by gender suggested females with low educational attainment and lower numeracy may especially benefit from educational interventions to improve health literacy and promote ILOC. Our findings build off existing literature that point to a possible interaction between numeracy and health literacy. This research, with follow up work, may have practical implications for health educators aiming to promote specific cancer beliefs that lead to the uptake of expert-recommended cancer-preventive behaviors.
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Affiliation(s)
- Catherine E Slavik
- School of Earth, Environment and Society, General Sciences Building, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
| | - Niko Yiannakoulias
- School of Earth, Environment and Society, McMaster University, Hamilton, Canada
| | - Robert Wilton
- School of Earth, Environment and Society, McMaster University, Hamilton, Canada
| | - Fran Scott
- Department of Health, Aging & Society, McMaster University, Hamilton, Canada
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Hoveling LA, Lepe A, Boissonneault M, de Beer JAA, Smidt N, de Kroon MLA, Liefbroer AC. Educational inequalities in metabolic syndrome prevalence, timing, and duration amongst adults over the life course: a microsimulation analysis based on the lifelines cohort study. Int J Behav Nutr Phys Act 2023; 20:104. [PMID: 37667275 PMCID: PMC10478481 DOI: 10.1186/s12966-023-01495-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/29/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Educational inequalities in metabolic syndrome (MetS) are a growing public health concern. Intervening on modifiable factors may help reduce these inequalities, but there is a need for evidence on the long-term impact of intervening on these factors. Thus, we simulate the development of educational inequalities in MetS across the life course and assess the impact of intervening on the modifiable factors that contribute to these inequalities. METHODS We used data from the prospective multigenerational Dutch Lifelines Cohort Study to estimate the required input for a continuous-time microsimulation. The microsimulation projects the development of educational inequalities in MetS between ages 18 and 65, and assesses the potential benefit of intervening on smoking, alcohol use, diet quality, and health literacy. FINDINGS The likelihood of ever experiencing MetS between ages 18 and 65 varies from 32.5% among high educated women to 71.5% among low educated men. On average, 27.6% more individuals with low education will ever experience MetS between ages 18 and 65 compared to those with high education. Additionally, individuals with low education generally will develop MetS 2.3 years earlier, and will spend an extra 2.6 years with MetS, compared to individuals with high education. Changes to smoking behaviours in individuals with low education produced the largest effect; it would reduce inequalities in prevalence, timing and duration by an average of 7.5%, 9.5%, and 6.9%, respectively. CONCLUSIONS Interventions targeting the modifiable factors included in this study, especially smoking, could help reduce the estimated educational inequalities in MetS over the life course.
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Affiliation(s)
- Liza A Hoveling
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands.
| | - Alexander Lepe
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
| | - Michael Boissonneault
- Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW, University of Groningen, PO Box 11650, The Hague, 2502 AR, The Netherlands
| | - Joop A A de Beer
- Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW, University of Groningen, PO Box 11650, The Hague, 2502 AR, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
| | - Marlou L A de Kroon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Aart C Liefbroer
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
- Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW, University of Groningen, PO Box 11650, The Hague, 2502 AR, The Netherlands
- Department of Sociology, Vrije Universiteit Amsterdam, De Boelelaan 1081, Amsterdam, 1081 HV, The Netherlands
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Mahmood A, Kedia S, Dillon PJ, Kim H, Arshad H, Ray M. Food security status and breast cancer screening among women in the United States: Evidence from the Health and Retirement Study and Health Care and Nutrition Study. Cancer Causes Control 2023; 34:321-335. [PMID: 36695824 DOI: 10.1007/s10552-023-01667-1] [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: 01/26/2021] [Accepted: 01/03/2023] [Indexed: 01/26/2023]
Abstract
PURPOSE To assess the impact of food insecurity on biennial breast cancer screenings (i.e., mammography or breast X-ray) among older women in the United States (US). METHODS Data from the 2014 and 2016 waves of the Health and Retirement Study and the 2013 Health Care and Nutrition Study were used. The analyses were limited to a nationally representative sample of 2,861 women between 50 and 74 years of age, residing in the US. We employed a propensity score weighting method to balance observed confounders between food-secure and food-insecure women and fit a binary logistic regression to investigate population-level estimates for the association between food security and breast cancer screening. RESULTS Food insecurity was significantly associated with failure to obtain a mammogram or breast X-ray within the past two years. Food-insecure women had 54% lower odds of reporting breast cancer screening in the past 2 years (adjusted OR = 0.46; 95% CI 0.30-0.70, p-value < 0.001) as compared to food-secure women. Additional factors associated with a higher likelihood of receiving breast cancer screenings included greater educational attainment, higher household income, regular access to health care/advice, not smoking, and not being physically disabled or experiencing depressive symptoms. CONCLUSION Results demonstrate a socioeconomic gradient existing in regard to the utilization of regular breast cancer screenings among women. Those who tend to have lower education, lower income, and lack of reliable healthcare access are more likely to be food insecure. Thus, more likely to face the financial, logistical, or environmental barriers in obtaining screening services that accompany food insecurity.
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Affiliation(s)
- Asos Mahmood
- Center for Health System Improvement, College of Medicine, University of Tennessee Health Science Center, 956 Court Avenue, Coleman A218A, Memphis, TN, 38163, USA. .,Department of Medicine-General Internal Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Satish Kedia
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH, USA
| | - Hyunmin Kim
- School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Hassan Arshad
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Meredith Ray
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, TN, USA
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Shi H, Tung TH, Zhang MX, Luo C, Chen H, Wang W. Correlation Between Ontological Insecurity and Daily Epidemic Prevention Behavior Among Inpatients During the COVID-19 Pandemic. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231152320. [PMID: 36799368 PMCID: PMC9939917 DOI: 10.1177/00469580231152320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
This study evaluates inpatients' ontological insecurity and daily epidemic prevention behavior during the pandemic and explores the factors influencing daily epidemic prevention behaviors. The outbreak of coronavirus disease (COVID-19) in December 2019 caused a global public health crisis that has affected the very structure of society and the order of daily life. Ontological security is the ability to predict the impact of changes in social environments on personal security, such as during the pandemic. A cross-sectional study was used to collect data from 1185 inpatients of a hospital in Zhejiang, China, from July 11 to August 9, 2021. Our questionnaire recorded information on demographics, ontological insecurity, and daily epidemic prevention behaviors. The Mann-Whitney U test, Kruskal-Wallis H test, Spearman's correlation analysis, and logistic regression analysis were used to determine the influencing factors of daily epidemic prevention behavior on ontological security. Results showed a negative correlation between inpatients' ontological insecurity and daily epidemic prevention behavior (r = -.253, P < .001). The logistic regression analysis showed that the independent factors affecting daily epidemic prevention behavior include ontological insecurity (OR: 0.952; 95% CI: 0.937-0.968) (P < .001), sex (OR: 1.292; 95% CI: 1.004-1.663), age (OR: 0.880; 95%: 0.790-0.980), education (OR: 1.307; 95% CI: 1.098-1.556), and occupation [famers vs civil servants, staff or professional (OR: 0.596; 95% CI: 0.374-0.949),other versus civil servants, staff, or professional (OR: 0.693; 95% CI: 0.503-0.953)] (P < .05). Inpatients were shown to have good ontological security during the COVID-19 epidemic, younger patients, female patients, patients with stronger ontological security, patients with a higher educational level, and those who work in a fixed unit or organization showed higher levels of daily epidemic prevention behavior. Hospital managers should strengthen the intervention management of epidemic prevention behavior based on patient characteristics.
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Affiliation(s)
- Huanhuan Shi
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Tao-Hsin Tung
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Mei-xian Zhang
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Chengwen Luo
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Haixiao Chen
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Weizhen Wang
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China,Weizhen Wang, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, No.150 Ximen Road of Linhai City, Taizhou 317000, P.R China.
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Murakami K, Kuriyama S, Hashimoto H. Economic, cognitive, and social paths of education to health-related behaviors: evidence from a population-based study in Japan. Environ Health Prev Med 2023; 28:9. [PMID: 36709974 PMCID: PMC9884565 DOI: 10.1265/ehpm.22-00178] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND There is substantial evidence on the association between lower education and unhealthy behaviors. However, the mechanism underlying this association remains unclear. This study aimed to examine whether income, health literacy, and social support mediate the association between education and health-related behaviors. METHODS A questionnaire survey was conducted in metropolitan areas in Japan from 2010 to 2011 among residents aged 25-50 years. Data from 3663 participants were used in this study. Health literacy was measured using the Communicative and Critical Health Literacy scale. Health-related behaviors were current smoking, poor dietary habits, hazardous drinking, and lack of exercise. Poisson regression analyses with robust variance estimators were conducted to examine the associations between education and these health-related behaviors. Multiple mediation analyses were conducted to estimate the magnitudes of the mediating effects of income, health literacy, and social support on these associations. RESULTS Less educated participants had higher risks of all unhealthy behaviors. Income mediated the associations of education with smoking (6.4%) and exercise (20.0%). Health literacy mediated the associations of education with dietary habits (15.4%) and exercise (16.1%). Social support mediated the associations of education with dietary habits (6.4%) and exercise (7.6%). The education-drinking association was mediated by income in the opposite direction (-10.0%). The proportions of the total effects mediated by income, health literacy, and social support were 9.8% for smoking, 24.0% for dietary habits, -3.0% for drinking, and 43.7% for exercise. CONCLUSIONS These findings may provide clues for designing effective interventions to reduce educational inequalities in health-related behaviors.
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Affiliation(s)
- Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan,Department of Health and Social Behavior, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan,Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan,Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Hideki Hashimoto
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Bradley H, Ho HY. Comprehensive Comparisons of Family Health Between Families With One Immigrant Parent and Native Families in Taiwan: Nationwide Population-Based Cohort Study. JMIR Public Health Surveill 2022; 8:e33624. [PMID: 36534459 PMCID: PMC9808584 DOI: 10.2196/33624] [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: 09/16/2021] [Revised: 02/19/2022] [Accepted: 10/11/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mothers and children in families with one immigrant parent have been reported to be healthier than those in native families; however, the health of the fathers in these families has rarely been discussed in literature. OBJECTIVE We aimed to comprehensively compare the health of all the family members between families with one immigrant parent (native fathers, immigrant mothers, and their children) and native families (native fathers, native mothers, and their children). METHODS We conducted a cohort study by using the Taiwan Maternal and Child Health Database to recruit live-born children and their parents from 2004 to 2016. Overall, we identified 90,670 fathers, 91,270 mothers, and 132,457 children in families with one immigrant parent and 1,666,775 fathers, 1,734,104 mothers, and 2,637,191 children in native families and followed up with them from 2004 to 2017. The outcomes comprised common physical and mental disorders, catastrophic illnesses, mortality, and child adversities and accidents. The covariates comprised the child's year of birth, parental age, low-income status, and physical or mental disorder status. Logistic regression was performed to compare the risks of the outcomes between families with one immigrant parent and native families. RESULTS The parents in families with one immigrant parent were more likely to be of low-income status and were older than the parents in native families. After adjusting for the covariates, fathers in families with one immigrant parent were found to have higher risks of physical and mental disorders, catastrophic illness, and mortality than fathers in native families. Conversely, mothers in families with one immigrant parent had lower risks of physical and mental disorders, catastrophic illness, and mortality than mothers in native families. Finally, the children in families with one immigrant parent generally had better physical and mental health but higher risks for leukemia, liver diseases, autism spectrum disorder, and road traffic accidents than children in native families. CONCLUSIONS The health status of the members of families with one immigrant parent was nonhomogeneous, and the poorer general health of fathers in such families suggests health inequalities in families with one immigrant parent.
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Affiliation(s)
| | - Hsing-Ying Ho
- Department of Healthcare Administration, Asia University, Taichung, Taiwan.,Department of Psychology, Asia University, Taichung, Taiwan
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12
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Wu YY, Zhang W. Demographic disparities in COVID-19 vaccine hesitancy among U.S. adults: Analysis of household pulse survey data from Jul 21 to Oct 11 in 2021. Vaccine 2022; 40:7510-7514. [PMID: 36371370 PMCID: PMC9637512 DOI: 10.1016/j.vaccine.2022.10.094] [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: 05/25/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022]
Abstract
Monitoring COVID-19 vaccine hesitancy helps design and implement strategies to increase vaccine uptake. Utilizing the large scale cross-sectional Household Pulse Survey data collected between July 21 and October 11 in 2021, this study aims to construct measures of COVID-19 vaccine hesitancy and identify demographic disparities among U.S. adults (18y+). Factor analysis identified three factors of vaccine hesitancy: safety concerns (prevalence: 70.1 %). trust issues (53.5 %), and not seen as necessary (33.8 %). Among those who did not show willingness to receive COVID-19 vaccine, females were more likely to have safety concerns (73.7 %) compared to males (66.7 %), but less likely to have trust issues (female: 49.7 %; male: 57.1 %) or not seen as necessary (female: 23.8 %; male 43.4 %). Higher education was associated with higher prevalence of not seen as necessary. Younger adults and Whites had higher prevalence of having trust issues and not seen as necessary compared to their counter parts.
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Affiliation(s)
- Yan Yan Wu
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI 96822, United States.
| | - Wei Zhang
- Department of Sociology, University of Hawai'i at Mānoa, 2424 Maile Way, Saunders Room 247, Honolulu, HI 96822, United States.
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13
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Liu PL, Zhao X, Ye JF. The Effects of the Use of Patient-Accessible Electronic Health Record Portals on Cancer Survivors’ Health Outcomes: Cross-sectional Survey Study. J Med Internet Res 2022; 24:e39614. [DOI: 10.2196/39614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/04/2022] [Accepted: 09/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background
In the past decade, patient-accessible electronic health record (PAEHR) systems have emerged as an important tool for health management both at the hospital level and individual level. However, little is known about the effects of PAEHR portals on the survivorship of patients with chronic health conditions (eg, cancer).
Objective
This study aims to investigate the effects of the use of PAEHR portals on cancer survivors’ health outcomes and to examine the mediation pathways through patient-centered communication (PCC) and health self-efficacy.
Methods
Data for this study were derived from the Health Information National Trends Survey (HINTS 5, Cycle 4) collected from February 2020 to June 2020. This study only involved respondents who reported having been diagnosed with cancer (N=626). Descriptive analyses were performed, and the mediation models were tested using Model 6 from the SPSS macro PROCESS. Statistically significant relationships among PAEHR portal use, PCC, health self-efficacy, and physical and psychological health were examined using bootstrapping procedures. In this study, we referred to the regression coefficients generated by min-max normalization as percentage coefficients (bp). The 95% bootstrapped CIs were used with 10,000 resamplings.
Results
No positive direct associations between PAEHR portal use and cancer survivors’ health outcomes were found. The results supported the indirect relationship between PAEHR portal use and cancer survivors’ psychological health via (1) PCC (bp=0.029; β=.023, 95% CI .009-.054), and (2) PCC and health self-efficacy in sequence (bp=0.006; β=.005, 95% CI .002-.014). Besides, the indirect association between PAEHR portal use and cancer survivors’ physical health (bp=0.006; β=.004, 95% CI .002-.018) via sequential mediators of PCC and health self-efficacy was also statistically acknowledged.
Conclusions
This study offers empirical evidence about the significant role of PAEHR portals in delivering PCC, improving health self-efficacy, and ultimately contributing to cancer survivors’ physical and psychological health.
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14
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Subyani AA, Fadel HA, Bokhary A, Ghunaim AM, Alharbi HH, Alghamdi KA, Alshali K. Knowledge, Attitudes, and Practices of COVID-19 Safety Measures Among Type 1 Diabetes Mellitus Patients at King Abdulaziz University Hospital: A Cross-Sectional Study. Cureus 2022; 14:e27713. [PMID: 36081971 PMCID: PMC9440986 DOI: 10.7759/cureus.27713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19), an infectious disease caused by an enveloped RNA beta coronavirus, has become a pandemic, with a mortality rate ranging from 0.7% to 10.8%. Although older adults with comorbidity are more likely to suffer severe disease and eventual mortality, diabetes mellitus (DM) is one of the most frequently reported noncommunicable diseases shown to predict poor prognosis in COVID-19 patients. Aim: To determine the knowledge, attitudes, and practices (KAP) of COVID-19 safety measures and factors associated with poor knowledge and practice among type 1 diabetes mellitus (T1DM) patients at King Abdulaziz University Hospital (KAUH), Jeddah. Methodology: This cross-sectional study included 267 patients with T1DM aged 18-65, admitted to the hospital from January to June 2020. Data were collected via phone interviews during September 2020. The questionnaire consisted of 15 questions for knowledge, five for attitude, and eight concerning practices, and some questions were based on diabetes and COVID-19 specifically. Results: Overall, 64 participants with a median age of 53 years were studied. The median COVID-19 knowledge score showed poor (11.50%), average (43.75%), and good knowledge (6.25%). Most of the participants practiced precautionary measures outside their homes. Conclusion: In conclusion, half of the population had poor COVID-19 knowledge, 60.9% of the participants felt anxious, and most of them performed precautionary measures, including wearing a facemask, maintaining a 1-m distance, and washing their hands regularly.
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15
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Zhang W, Wu YY, Wu B. Racial/Ethnic Disparities in Getting COVID-19 Vaccine: Do Age, Gender, and Education Matter? Health Equity 2022; 6:500-507. [PMID: 36186620 PMCID: PMC9518807 DOI: 10.1089/heq.2022.0025] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Wei Zhang
- Department of Sociology, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Yan Yan Wu
- Thompson School of Social Work & Public Health, University of Hawaiʻi at Mānoa, Honolulu, Hawaii USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York, USA
- NYU Aging Incubator, New York University, New York, New York, USA
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16
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Espinosa M, Artieta-Pinedo I, Paz-Pascual C, Bully-Garay P, García-Álvarez A. Attitudes toward medicalization in childbirth and their relationship with locus of control and coping in a Spanish population. BMC Pregnancy Childbirth 2022; 22:529. [PMID: 35764947 PMCID: PMC9241227 DOI: 10.1186/s12884-022-04748-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/06/2022] [Indexed: 12/02/2022] Open
Abstract
The dominant model of childbirth in most Western countries is medicalized childbirth. Women's beliefs about whether childbirth should be a medicalized process to a greater or lesser degree may be related, in addition to contextual factors, to internal factors. The objective of the study is to find out if women’s locus of control (LC) and stress coping strategies (CS) are related to having a more favourable or less favourable attitude towards medicalization (ATMC). A cross-sectional study was carried out with the participation of 248 women recruited in primary care centres by their midwives. All the women filled in answers on a mobile phone app with various different measurement instruments: the questionnaire created by Benyamini to evaluate their ATMC; the Spanish version of the Wallston MLC to evaluate their LC; and the Spanish adaptation of the “Revised Prenatal Coping Inventory (NuPCI)” scale for the assessment of their CS. The women presented a favourable attitude towards medicalization, with a mean ATMC score of 3.42. Both the LC and the CS of women during pregnancy are related to this attitude. Specifically, having an internal LC and using preparative CS both lower the probability of presenting a favourable attitude towards medicalization, while the lack of a paid job raises the probability. For each point in internal locus and preparatory coping, the ATMC score decreased by 0.02 and 0.23 points, respectively, while it increased by 0.18 for not having a paid job. The influence of these psychological factors must be taken into account in the development of content and interventions that promote a more natural birth.
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Affiliation(s)
- Maite Espinosa
- Osakidetza-Basque Health Service, Biocruces-Bizkaia Health Research Institute, C/ Edificio Biocruces 3, Plaza De Cruces, 48903, Barakaldo, Spain.
| | - Isabel Artieta-Pinedo
- Osakidetza-Basque Health Service, Biocruces-Bizkaia Health Research Institute, C/ Edificio Biocruces 3, Plaza De Cruces, 48903, Barakaldo, Spain.,Primary Care Midwife Zuazo Health Centre, OSI BARAKALDO-SESTAO-OSAKIDETZA, C/ Lurkizaga Kalea, s/n, 48902, Barakaldo, Spain.,Associate Professor of the School of Nursing, University of the Basque Country, C/ Barrio Sarriena S/N, 48940, Leioa, Spain
| | - Carmen Paz-Pascual
- Osakidetza-Basque Health Service, Biocruces-Bizkaia Health Research Institute, C/ Edificio Biocruces 3, Plaza De Cruces, 48903, Barakaldo, Spain.,Primary Care Midwife Markonzaga Health Centre, OSI BARAKALDO-SESTAO-OSAKIDETZA, C/ Antonio Trueba Kalea 17, 48910, Sestao, Spain.,Lecturer in the Midwifery Training Unit of the Basque Country, Hospital de Basurto-OSAKIDETZA, C/ Montevideo Etorbidea 18, 48013, Bilbao, Spain
| | - Paola Bully-Garay
- Paola Bully Methodological and Statistical Consultant, C/ Barrio La Sota, 48190, Sopuerta, Spain
| | - Arturo García-Álvarez
- Osakidetza-Basque Health Service, Biocruces-Bizkaia Health Research Institute, C/ Edificio Biocruces 3, Plaza De Cruces, 48903, Barakaldo, Spain
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17
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Islam MS, Ullah MA, Islam US, Hossain S, Araf Y, Das A, Khan AN, Islam NN, Sarkar B, Shohael AM. Influence on attitudes and lifestyle due to lockdown amidst COVID-19 pandemic: a perception-based analysis among Bangladeshi residents. BMC Public Health 2021; 21:1974. [PMID: 34724917 PMCID: PMC8559693 DOI: 10.1186/s12889-021-12012-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 09/28/2021] [Indexed: 12/18/2022] Open
Abstract
Background Countrywide lockdown or stay-at-home order has been implemented to slow down the transmission of emergent coronavirus. However, the influence on attitudes and lifestyle due to lockdown amidst the coronavirus disease 2019 (COVID-19) pandemic has been poorly understood. The present study aimed to investigate the influence on attitudes and lifestyle due to lockdown amidst the COVID-19 pandemic among Bangladeshi residents. Methods A cross-sectional survey carried out involving 1635 community dwellers across eight divisions in Bangladesh conducted from April 15, 2020 to May 10, 2020. A structured questionnaire incorporating socio-demographic, attitudes towards lockdown and adverse lifestyle amidst lockdown measures was employed to collect data using the Google Forms. Multiple regression analyses were executed to determine the associated factors of positive attitudes towards lockdown and adverse lifestyle. Results The mean scores of attitudes towards lockdown were 67.9 (SD = 8.4) out of 85 with an overall correct rate (positive attitudes) of 79.9%; whereas the mean scores of adverse lifestyle amidst lockdown were 16.1 (SD = 4.8) out of 34 with an overall rate of 47.4%. The factors associated with more positive attitudes towards lockdown included being female, divorced, higher educated, and students. Conversely, being male, having no formal education, and rural residence were associated factors of adverse lifestyle amidst the COVID-19 pandemic. Conclusions The findings reflect how the COVID-19 lockdown has preciously impacted the attitudes, and lifestyle of Bangladeshi citizens, which will contribute to promoting appropriate measures during a subsequent zonal or complete lockdown.
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Affiliation(s)
- Md Saiful Islam
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh.,Centre for Advanced Research Excellence in Public Health, Savar, Dhaka, Bangladesh
| | - Md Asad Ullah
- Department of Biotechnology and Genetic Engineering, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Ummay Soumayia Islam
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Sahadat Hossain
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Yusha Araf
- Department of Genetic Engineering and Biotechnology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Anindya Das
- Department of Genetic Engineering and Biotechnology, University of Dhaka, Dhaka, Bangladesh
| | - Asir Newaz Khan
- Department of Economics and Social Science, BRAC University, Dhaka, Bangladesh
| | - Nafisa Nawal Islam
- Department of Biotechnology and Genetic Engineering, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Bishajit Sarkar
- Department of Biotechnology and Genetic Engineering, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Abdullah Mohammad Shohael
- Department of Biotechnology and Genetic Engineering, Jahangirnagar University, Savar, Dhaka, Bangladesh.
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18
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Syan SK, Gohari MR, Levitt EE, Belisario K, Gillard J, DeJesus J, MacKillop J. COVID-19 Vaccine Perceptions and Differences by Sex, Age, and Education in 1,367 Community Adults in Ontario. Front Public Health 2021; 9:719665. [PMID: 34631647 PMCID: PMC8494003 DOI: 10.3389/fpubh.2021.719665] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/02/2021] [Indexed: 12/04/2022] Open
Abstract
Background: COVID-19 is a global pandemic and vaccination efforts may be impeded by vaccine hesitancy. The present study examined willingness to receive a COVID-19 vaccine, the associated reasons for willingness/unwillingness, and vaccine safety perceptions in a cross-sectional assessment of community adults in Ontario. Methods: One thousand three hundred sixty seven individuals (60.6% female, mean age = 37.5%) participated in this study between January 15, 2021 and February 15, 2021. Perceptions of vaccine safety and reasons for willingness/unwillingness to receive the COVID-19 vaccine were investigated using an online assessment. Perceptions were investigated in general and by age, sex and education using analysis of variance. Results: Overall, 82.8% of the sample reported they were willing to receive a COVID-19 vaccine and 17.2% reported they were unwilling. The three most common reasons for unwillingness were long-term side effects (65.5%), immediate side effects (60.5%), and lack of trust in the vaccine (55.2%). Vaccine willingness significantly differed by sex and education level, with female participants and those with less than a bachelor's degree being more likely to report unwillingness. Perception of COVID-19 vaccine safety was significantly lower (-10.3%) than vaccines in general and differed by age, sex and education, with females, older adults, and individuals with less than a bachelor's degree reporting lower perceived COVID-19 vaccine safety. Conclusion: In this sample of community adults, the COVID-19 vaccine hesitancy rate was less than one in five individuals, but with higher rates in population subgroups. Targeting public health messaging to females and individuals with less than bachelor's degree, and addressing concerns about long-term and immediate side effects may increase vaccine uptake.
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Affiliation(s)
- Sabrina K Syan
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Mahmood R Gohari
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Emily E Levitt
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Kyla Belisario
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Jessica Gillard
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Jane DeJesus
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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19
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Laborde C, Crouzet M, Carrère A, Cambois E. Contextual factors underpinning geographical inequalities in disability-free life expectancy in 100 French départements. Eur J Ageing 2021; 18:381-392. [PMID: 34483802 DOI: 10.1007/s10433-020-00589-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 01/16/2023] Open
Abstract
The objectives were to estimate disability-free life expectancy (DFLE) and life expectancy with disability (DLE) by gender for the 100 French départements (administrative geographical subdivisions) and to investigate associations with socioeconomic factors, supply of healthcare and services for older persons. DFLE and DLE at age 60 are estimated using the Sullivan method and based on the GALI indicator provided by the French cross-sectional survey Vie Quotidienne et Santé 2014. In 2014, DFLE for men and women aged 60 was 14.3 years and 15.6 years, respectively. Variations across départements were considerable (5.4 years for men, 6.7 years for women). Multivariate random effects meta-regression models indicated a negative association for men between DFLE and some of the socioeconomic contextual indicators (ratio of manual workers to higher-level occupations and unemployment rate); the level of in-home nursing services (HNS) was negatively associated with DFLE and density of nurses positively associated with DLE. Among women, ratio of manual workers to higher-level occupations, unemployment rate, proportion of the population living in large urban areas, density of nurses, and level of HNS were negatively associated with DFLE; density of physiotherapy supply was associated positively with DFLE and negatively with DLE. Our results suggest that geographical inequalities in health expectancies are significantly correlated with socioeconomic status and with healthcare supply, support for older persons, and urban environments, particularly among women. These results underline the importance of monitoring these indicators and disparities at infra-national-level, and of investigating their relations with local context, particularly the supply of healthcare and services.
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Affiliation(s)
- Caroline Laborde
- Inserm, CESP, Echappement aux anti-infectieux et pharmaco-épidémiologie, Université Paris-Saclay, UVSQ, 78180 Montigny-le-Bretonneux, France
- Observatoire régional de santé Île-de-France, Département de l'Institut Paris Région, Paris, France
| | - Maude Crouzet
- UMR7363 SAGE, Université de Strasbourg, Strasbourg, France
| | - Amélie Carrère
- Institut national d'études démographiques (Ined), Paris, France
- Université PSL Paris-Dauphine (LEDa-LEGOS), Paris, France
- Université Paris-Créteil (Erudite), Paris, France
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20
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Kutyba J, Jedrzejczak WW, Gos E, Bieńkowska K, Raj-Koziak D, Skarżyński PH. Self-help interventions chosen by subjects with chronic tinnitus - a retrospective study of clinical patients. Int J Audiol 2021; 61:686-691. [PMID: 34410211 DOI: 10.1080/14992027.2021.1964040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Self-help (without specialist support) can play an important role in tinnitus therapy. The purpose of this study was to investigate what fraction of subjects with tinnitus use self-help, what techniques are most commonly used to reduce tinnitus severity, and what distinguishes patients that use self-help from others. DESIGN retrospective, observational study. STUDY SAMPLE Adult patients admitted to our hospital clinic (460 participants) aged 19-83 years and reporting chronic tinnitus. The survey concerned therapy attempts prior to the clinic visit as well as self-help techniques chosen freely by the patient to reduce tinnitus severity. RESULTS Data showed that 40.9% of the respondents chose some action themselves to reduce their tinnitus severity. Among the reported self-help techniques, acoustic stimulation was the most popular. In addition, patients chose distraction attention, relaxation, meditation, yoga, and physical activity. The likelihood of undertaking self-help increases with better education and higher tinnitus severity. CONCLUSIONS Knowledge about patients' preferences of forms of self-help may help the health practitioner suggest a more suitable form of therapy. Due to the great interest in using sound therapy in tinnitus, it would be worthwhile looking at new forms of this therapy, for example increasingly popular mobile applications.
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Affiliation(s)
- Justyna Kutyba
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | | | - Elżbieta Gos
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Katarzyna Bieńkowska
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Danuta Raj-Koziak
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Piotr Henryk Skarżyński
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Heart Failure and Cardiac Rehabilitation Department, 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.,Institute of Sensory Organs, Warsaw, Poland
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21
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The Association Between Health Literacy and Tobacco Use: Results from a Nationally Representative Survey. J Community Health 2021; 47:63-70. [PMID: 34357496 DOI: 10.1007/s10900-021-01019-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
Dual use of conventional cigarettes and electronic cigarettes presents an emerging public health issue. Previous research has demonstrated a negative relationship between health literacy and conventional cigarette (CIG) use. However, the relationship between health literacy and e-cigarette (ECIG) use remains unclear. This studies examines the possible association of health literacy and CIG, ECIG, or dual use. A multinomial regression was used to model the association between health literacy and current CIG use, current ECIG use, or dual tobacco use status using state-optional data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS; N = 40,404). One-third of the sample (N = 13,478; 33.3%) had initiated tobacco use. Approximately 36.6% of participants exclusively used cigarettes. A smaller proportion of participants were dual users of ECIG and CIGs (7.0%) and e-cigarette exclusive users (4.5%). After adjusting for covariates, higher levels of oral health literacy was associated with lower odds of current dual use. However, there was no significant association between written HL and either conventional cigarette use or electronic cigarette use or after adjusting for covariates. Oral messaging around the dangers of CIG use may be effective at lowering odds of CIG or dual use, especially for those with higher levels of HL. Further research is needed to examine how to best disseminate information regarding the health risks of ECIGs.
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22
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Ye Y, Wu R, Ge Y, Wang T, Yao X, Yang Y, Long C, Chen F, Tang S, Huang R. Preventive behaviours and family inequalities during the COVID-19 pandemic: a cross-sectional study in China. Infect Dis Poverty 2021; 10:100. [PMID: 34284821 PMCID: PMC8290209 DOI: 10.1186/s40249-021-00884-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 07/07/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is an international public health threat, and people's participation in disease-related preventive behaviours is the key to controlling infectious diseases. This study aimed to assess the differences in adopting preventive behaviours among populations to explore potential individual and household factors and inequalities within families. METHODS This online survey was conducted in April 2020. The directional stratified convenient sampling method was used to select 4704 participants from eight provinces in eastern, central, and western China. The questionnaire included demographic information, household variables, and five target prevention behaviours. The chi-squared test, binary multilevel model, and Mantel-Haenszel hierarchical analysis were used for data analysis in the study. RESULTS Approximately 71.2% of the participants had appropriate outdoor prevention, and 32.9% of the participants had indoor protection in place. Sharing behaviours (P < 0.001) and education level (P < 0.001) were positively associated with adopting preventive measures. The inhibiting effect of household crowding and stimulating effect of high household income on preventive behaviours were determined in this study. Household size was negatively associated with living area (β = -0.057, P < 0.05) and living style (β = -0.077, P < 0.05). Household income was positively associated with age (β = 0.023, P < 0.05), and relationship with friends (β = 0.053, P < 0.05). Vulnerable groups, such as older adults or women, are more likely to have inadequate preventive behaviours. Older adults (OR = 1.53, 95% CI 1.09-2.15), women (OR = 1.37, 95% CI 1.15-1.64), and those with more than 2 suspected symptoms (OR = 1.85, 95% CI 1.07-3.19) were more likely to be affected by the inhibiting effect of household crowding, while the stimulating effect of high household income was limited in these groups. CONCLUSIONS Inequalities in COVID-19 prevention behaviours exist between families and inadequate adoption of prevention by vulnerable groups are noteworthy. This study expands the research perspective by emphasizing the role of household factors in preventive behaviours and by focusing on family inequalities. The government should use traditional media as a platform to enhance residents' public health knowledge. Targeted additional wage subsidies, investments in affordable housing, financial support for multigenerational households, and temporary relocation policies may deserve more attention. Communities could play a critical role in COVID-19 prevention.
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Affiliation(s)
- Yisheng Ye
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
| | - Ruijun Wu
- China National Center for Biotechnology Development, Beijing, China
| | - Yao Ge
- China National Center for Biotechnology Development, Beijing, China
| | - Tao Wang
- China Science and Technology Exchange Center, Beijing, China
| | - Xin Yao
- High Technology Research and Development Center, Beijing, China
| | - Yao Yang
- National Center for Science and Technology Evaluation, Beijing, China
| | - Chengxu Long
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
| | - Fangfei Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
| | - Rui Huang
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
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Craveiro D, Marques S, Zvěřinová I, Máca V, Ščasný M, Chiabai A, Suarez C, Martinez-Juarez P, García de Jalón S, Quiroga S, Taylor T. Explaining inequalities in fruit and vegetable intake in Europe: The role of capabilities, opportunities and motivations. Appetite 2021; 165:105283. [PMID: 33991644 DOI: 10.1016/j.appet.2021.105283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Abstract
People who do not eat enough fruit and vegetables (F&V) have incremental health risks. Most Europeans do not comply with health recommendations relating to F&V consumption and this is especially true for those with lower-level education, which reinforces structural inequalities in health and wellbeing among Europeans. This study investigated the role of key behavioural triggers - capabilities, opportunities and motivation (in the COM-B model) - as pathways for educational differentials in F&V intake in Europe. A cross-sectional survey-based study was conducted in five European countries differing widely in their consumption habits, wealth, and climatic conditions. A structural equation model was designed to study how capabilities (diet perceived knowledge, health purchase criteria), opportunities (financial availability, social norms), and motivations (health value, habits strength) affect educational inequalities in the intake of F&V (5 portions a day) as mediators. Multi-group comparisons assessed country differences. People with higher levels of education were more likely to eat the recommended diet, i.e., at least 5 portions of F&V a day. Countries in the sample vary significantly in the percentage of people complying with the recommendation, but not significantly in terms of relative education differentials. The educational gap in the intake of F&V is mainly explained by education differentials in financial availability, diet knowledge, and habits in inserting F&V in main meals. Policies targeting dietary inequalities should address behavioural triggers affecting dietary intake, for example by subsidising F&V, developing targeted dietary awareness campaigns, or by intervening in mass catering contexts to facilitate the implementation of healthy habits.
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Affiliation(s)
- Daniela Craveiro
- Instituto Universitário de Lisboa (ISCTE-IUL), CIS-IUL, Lisbon, Portugal; Lisbon School of Economics and Management, CSG/SOCIUS-ISEG, Universidade de Lisboa, Lisbon, Portugal.
| | - Sibila Marques
- Instituto Universitário de Lisboa (ISCTE-IUL), CIS-IUL, Lisbon, Portugal
| | - Iva Zvěřinová
- Environment Centre, Charles University, Prague, Czech Republic
| | - Vojtěch Máca
- Environment Centre, Charles University, Prague, Czech Republic
| | - Milan Ščasný
- Environment Centre, Charles University, Prague, Czech Republic
| | | | - Cristina Suarez
- Department of Economics, Universidad de Alcalá, Alcalá, Spain
| | - Pablo Martinez-Juarez
- Department of Economics, Universidad de Alcalá, Alcalá, Spain; Department of Communication and Media Studies, University Carlos III of Madrid, Madrid, Spain
| | - Silvestre García de Jalón
- Basque Centre for Climate Change, BC3, Leioa, Spain; Department of Agricultural Economics, Statistics and Business Management, Universidad Politécnica de Madrid, Madrid, Spain
| | - Sonia Quiroga
- Department of Economics, Universidad de Alcalá, Alcalá, Spain
| | - Timothy Taylor
- European Centre for Environment and Human Health, University of Exeter Medical School, Exeter, United Kingdom
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24
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Alsaedi MG, AlQahtani BS, Zahrani AK, Alshareef SE, Alzubaidy KA, Alzubaidy BA, Alharbi SY, Almutairi OM, Alharby MB, Basheikh AA. Assessment of Knowledge, Attitude, and Practice Regarding COVID-19 Ocular Manifestations in the Western Region of Saudi Arabia. Open Ophthalmol J 2021. [DOI: 10.2174/1874364102115010025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introduction:
Ocular manifestations, such as conjunctivitis, redness, and tearing, were reported in patients with Coronavirus Disease 2019 (COVID-19).
Objective:
To investigate the level of knowledge, attitude, and practice about the ocular manifestations of COVID-19 and protective eye measures among the general population in the western region of Saudi Arabia.
Methods:
A cross-sectional study was conducted over two months with 800 participants from the general population and a 39-item online structured validated questionnaire using Google Forms. The collected data were analyzed using the SPSS program version 20 and a P-value <0.05 was considered statistically significant.
Results and Discussion:
Among the participants (n = 800), 71.9% were females, 50% were highly educated, and 61.8% had moderate incomes. The overall mean total knowledge score was 25.185 ± 3.774, with significant differences regarding age group, gender, and income. Most of the Saudi residents with high monthly incomes, especially females, were knowledgeable regarding the ocular manifestations of COVID-19 (25.0957 ± 3.4311). The average total knowledge, attitude, and practice score was 42.1419 ± 4.833, which was average (medium level), with significant differences regarding age group, gender, and income; a high mean was obtained from the age group >50–60, females, and high-income class.
Conclusion:
Detailed information about the epidemiology of COVID-19 and an understanding of emerging related health issues, such as ocular manifestations, should be empowered to the public while considering the least knowledgeable groups.
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25
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Poggiogalle E, Kiesswetter E, Romano M, Saba A, Sinesio F, Polito A, Moneta E, Ciarapica D, Migliaccio S, Suwalska A, Wieczorowska-Tobis K, Pałys W, Łojko D, Sulmont-Rossé C, Feart C, Brug J, Volkert D, Donini LM. Psychosocial and cultural determinants of dietary intake in community-dwelling older adults: A Determinants of Diet and Physical Activity systematic literature review. Nutrition 2020; 85:111131. [PMID: 33545539 DOI: 10.1016/j.nut.2020.111131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/30/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Knowledge of factors determining dietary intake is important to develop targeted strategies to prevent malnutrition and age-related diseases. The aim of the present systematic review was to analyze the state of the art regarding the role of social status, cultural aspects, and psychological distress on dietary intake in community-dwelling older adults. METHODS A systematic search was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedure. Titles, abstracts, and full texts were screened for predefined inclusion and exclusion criteria. RESULTS Thirty-nine studies were included. Seven different groups of psychosocial and cultural determinants were associated with dietary intake. Family structure and living situation (e.g., loneliness, marital status), educational level, and income were the most important determinants associated with dietary choices and eating behavior. Less frequently, social assets, demographic parameters, psychosocial status, and awareness of current dietary recommendations were associated with the quality of the eating pattern. CONCLUSIONS The results of our review indicate heterogeneity of the studies in the field of social and psychological determinants of dietary patterns in older adults, but some important conclusions can be drawn. Further research harmonizing and integrating approaches and methodologies are required to better understand the determinants of dietary intake and the complexity of their interactions.
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Affiliation(s)
| | - Eva Kiesswetter
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | | | - Anna Saba
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Fiorella Sinesio
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Angela Polito
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Elisabetta Moneta
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Donatella Ciarapica
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, Foro Italico University of Rome, Rome, Italy
| | - Aleksandra Suwalska
- Department of Mental Health, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Wiktor Pałys
- Department of Mental Health, Poznan University of Medical Sciences, Poznan, Poland
| | - Dorota Łojko
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Claire Sulmont-Rossé
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, Dijon, France
| | - Catherine Feart
- University of Bordeaux, INSERM, BPH, U1219, Bordeaux, France
| | - Johannes Brug
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
| | - Lorenzo M Donini
- Department of Experimental Medicine, Sapienza University, Rome, Italy.
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Abate H, Mekonnen CK. Knowledge, Attitude, and Precautionary Measures Towards COVID-19 Among Medical Visitors at the University of Gondar Comprehensive Specialized Hospital Northwest Ethiopia. Infect Drug Resist 2020; 13:4355-4366. [PMID: 33299333 PMCID: PMC7720997 DOI: 10.2147/idr.s282792] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/11/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Novel coronavirus disease 2019 (COVID-19) is an emerging respiratory disease caused by severe acute respiratory syndrome coronavirus. It was designated a public health emergency of international concern on January 30, 2020. COVID-19 has no effective treatment; nonetheless, early recognition of the disease and applying prevention strategies will help to mitigate the virus propagation. OBJECTIVE This study aimed to assess the knowledge, attitude, and precautionary measures of medical center visitors at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. METHODS An institutional-based cross-sectional study was conducted from July 15 to August 15, 2020. A consecutive sampling technique was used to select the study participants. Data were collected by using a pre-tested structured, self-administered questionnaire. Data were analyzed using SPSS version 20. To explain the study variables, frequency tables, figures, and percentages were used. Bivariable and multivariable logistic regressions were used to see the association between independent and dependent variables. RESULTS The prevalence of poor knowledge, attitude, and precautionary measures was 42.2%, 39%, and 41.6%, respectively. Being female (AOR=2.79, 95% CI=1.752-4.44), divorced (AOR=0.29, 95% CI=0.09-0.88), and residing in a rural location (AOR=1.93, 95% CI=1.07-3.26) were significantly associated with poor knowledge. Being female (AOR=95%, CI=1.21-2.98), a farmer (AOR=4.13, 95% CI=1.60-10.63), residing in a rural location (AOR=2.53, 95% CI=1.31-4.88), poor knowledge (AOR=2.38, 95% CI=1.52-3.72), and negative attitude (AOR=3.25, 95% CI=2.07-5.09) were significantly associated with poor precautionary measures. Increasing income in one unit of Ethiopian birr (ETB) (AOR=0.26, 95% CI=0.031-0.051) was significantly associated with negative attitude. CONCLUSION The finding of this study showed that more than one-third of the participants had poor knowledge, attitude, and precautionary measures towards COVID-19 disease. A comprehensive health education program concerning knowledge, attitude, and precautionary measures toward COVID-19 ought to be strengthened.
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Affiliation(s)
- Hailemichael Abate
- Department of Medical Nursing, College of Health Science, Gondar, Ethiopia
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27
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Wu M, Han H, Lin T, Chen M, Wu J, Du X, Su G, Wu D, Chen F, Zhang Q, Zhou H, Huang D, Wu B, Wu J, Lai T. Prevalence and risk factors of mental distress in China during the outbreak of COVID-19: A national cross-sectional survey. Brain Behav 2020; 10:e01818. [PMID: 32869541 PMCID: PMC7667324 DOI: 10.1002/brb3.1818] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/01/2020] [Accepted: 08/09/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE As a result of the pandemic of COVID-19, the public have been experiencing psychological distress. However, the prevalence of psychological distress during the COVID-19 pandemic remains unknown. Our objective was to evaluate the prevalence of psychological distress during COVID-19 outbreak and their risk factors, especially their internal paths and causality. METHODS A nationwide cross-sectional survey of the prevalence of mental disorders was conducted. We used Hospital Anxiety and Depression Scale (HADS) to estimate the prevalence of anxiety and depression. The internal paths and the causality of the psychological health were analyzed using a structural equation modeling (SEM) approach. RESULTS A total of 24,789 respondents completed the survey. We found that the overall prevalence of anxiety, depression, combination of anxiety, and depression were 51.6% (95% CI: 51.0-52.2), 47.5% (95% CI: 46.9-48.1), and 24.5% (95% CI: 24.0-25.0), respectively. The risk of psychological disorders in men was higher than that in women. The status of psychological health was different across different age groups, education levels, occupations, and income levels. The SEM analysis revealed that inadequate material supplies, low income, low education, lack of knowledge or confidence of the epidemic, and lack of exercise are major risk factors for psychological distress. CONCLUSIONS The evidence from this survey poses serious challenges related to the high prevalence of psychological distress, but also offers strategies to deal with the mental health problems caused by the COVID-19 pandemic.
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Affiliation(s)
- Mindan Wu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.,Department of Respiration, Shantou Central Hospital, Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, China
| | - Huanqin Han
- Department of Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Tingkui Lin
- Department of Hospital Office, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Min Chen
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jun Wu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xufei Du
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Guomei Su
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Dong Wu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Fagui Chen
- Department of Respiration, Shantou Central Hospital, Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, China
| | - Qichuan Zhang
- Department of Respiration, Shantou Central Hospital, Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, China
| | - Hailin Zhou
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Dan Huang
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Bin Wu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jiayuan Wu
- Department of Clinical Research, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Tianwen Lai
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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28
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Mansouri M, Sharifi F, Yaghubi H, Varmaghani M, Tabrizi YM, Nasiri M, Sadeghi O. Sugar-sweetened beverages consumption in relation to hypertension among Iranian university students: the MEPHASOUS study. Eat Weight Disord 2020; 25:973-982. [PMID: 31115792 DOI: 10.1007/s40519-019-00713-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/10/2019] [Indexed: 01/01/2023] Open
Abstract
PURPOSE This study aimed to assess the link between sugar-sweetened beverages (SSBs) consumption and hypertension among a large population in the Middle East. METHODS In this cross-sectional study (a part of Mental and Physical Health Assessment of University Student: MEPHASOUS study), 66,634 university students from all provinces of Iran, aged ≥ 18 years, were included. A self-administered dietary habits questionnaire was used to assess SSBs consumption as well as other dietary intakes. Participants were categorized based on three levels of SSB consumption: < 1 time/wk, 1-3 times/wk, and ≤ 3 times/wk. Hypertension was defined as systolic blood pressure (SBP) of ≥ 140 and diastolic blood pressure of ≥ 90. RESULTS Compared with those in the bottom category, students in the top category of SSBs consumption were more likely to have hypertension (OR 1.71, 95% CI 1.54-1.90). This association remained significant even after adjusting for confounding variables; such that participants in the highest category of SSBs consumption had 2.17 times greater odds of hypertension compared with those in the lowest category (OR 2.17, 95% CI 1.91-2.47). Stratified analysis based on gender and BMI status revealed such significant association in men (OR 2.12, 95% CI 1.79-2.50) and women (OR 2.03, 95% CI 1.67-2.48), and in all categories of BMI including students with underweight (OR 2.53, 95% CI 1.81-3.52), normal-weight (OR 2.13, 95% CI 1.81-2.51), overweight (OR 2.14, 95% CI 1.58-2.89) and obesity (OR 1.59, 95% CI 1.00-2.53). CONCLUSION Our results support previous findings indicating a significant positive association between SSBs consumption and hypertension. LEVEL OF EVIDENCE Level III, cross-sectional analytic studies.
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Affiliation(s)
- Masoume Mansouri
- Student Health Services, Students' Health and Consultation Center, Tarbiat Modares University, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Research Institute, University of Tehran, Tehran, Iran
| | - Hamid Yaghubi
- Department of Psychology, Shahed University, Tehran, Iran
| | - Mehdi Varmaghani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Yousef Moghadas Tabrizi
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Science, University of Tehran, Tehran, Iran
| | - Morteza Nasiri
- Department of Operating Room Technology, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Sadeghi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, P.O. Box 14155-6117, Iran. .,Gerash University of Medical Sciences, Gerash, Iran. .,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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29
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Wolf MS, Serper M, Opsasnick L, O'Conor RM, Curtis L, Benavente JY, Wismer G, Batio S, Eifler M, Zheng P, Russell A, Arvanitis M, Ladner D, Kwasny M, Persell SD, Rowe T, Linder JA, Bailey SC. Awareness, Attitudes, and Actions Related to COVID-19 Among Adults With Chronic Conditions at the Onset of the U.S. Outbreak: A Cross-sectional Survey. Ann Intern Med 2020; 173:100-109. [PMID: 32271861 PMCID: PMC7151355 DOI: 10.7326/m20-1239] [Citation(s) in RCA: 347] [Impact Index Per Article: 86.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The evolving outbreak of coronavirus disease 2019 (COVID-19) is requiring social distancing and other measures to protect public health. However, messaging has been inconsistent and unclear. OBJECTIVE To determine COVID-19 awareness, knowledge, attitudes, and related behaviors among U.S. adults who are more vulnerable to complications of infection because of age and comorbid conditions. DESIGN Cross-sectional survey linked to 3 active clinical trials and 1 cohort study. SETTING 5 academic internal medicine practices and 2 federally qualified health centers. PATIENTS 630 adults aged 23 to 88 years living with 1 or more chronic conditions. MEASUREMENTS Self-reported knowledge, attitudes, and behaviors related to COVID-19. RESULTS A fourth (24.6%) of participants were "very worried" about getting the coronavirus. Nearly a third could not correctly identify symptoms (28.3%) or ways to prevent infection (30.2%). One in 4 adults (24.6%) believed that they were "not at all likely" to get the virus, and 21.9% reported that COVID-19 had little or no effect on their daily routine. One in 10 respondents was very confident that the federal government could prevent a nationwide outbreak. In multivariable analyses, participants who were black, were living below the poverty level, and had low health literacy were more likely to be less worried about COVID-19, to not believe that they would become infected, and to feel less prepared for an outbreak. Those with low health literacy had greater confidence in the federal government response. LIMITATION Cross-sectional study of adults with underlying health conditions in 1 city during the initial week of the COVID-19 U.S. outbreak. CONCLUSION Many adults with comorbid conditions lacked critical knowledge about COVID-19 and, despite concern, were not changing routines or plans. Noted disparities suggest that greater public health efforts may be needed to mobilize the most vulnerable communities. PRIMARY FUNDING SOURCE National Institutes of Health.
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Affiliation(s)
- Michael S Wolf
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (M.S.W., L.O., R.M.O., L.C., J.Y.B., G.W., S.B., M.E., P.Z., A.R., M.A., S.C.B.)
| | - Marina Serper
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (M.S.)
| | - Lauren Opsasnick
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (M.S.W., L.O., R.M.O., L.C., J.Y.B., G.W., S.B., M.E., P.Z., A.R., M.A., S.C.B.)
| | - Rachel M O'Conor
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (M.S.W., L.O., R.M.O., L.C., J.Y.B., G.W., S.B., M.E., P.Z., A.R., M.A., S.C.B.)
| | - Laura Curtis
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (M.S.W., L.O., R.M.O., L.C., J.Y.B., G.W., S.B., M.E., P.Z., A.R., M.A., S.C.B.)
| | - Julia Yoshino Benavente
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (M.S.W., L.O., R.M.O., L.C., J.Y.B., G.W., S.B., M.E., P.Z., A.R., M.A., S.C.B.)
| | - Guisselle Wismer
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (M.S.W., L.O., R.M.O., L.C., J.Y.B., G.W., S.B., M.E., P.Z., A.R., M.A., S.C.B.)
| | - Stephanie Batio
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (M.S.W., L.O., R.M.O., L.C., J.Y.B., G.W., S.B., M.E., P.Z., A.R., M.A., S.C.B.)
| | - Morgan Eifler
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (M.S.W., L.O., R.M.O., L.C., J.Y.B., G.W., S.B., M.E., P.Z., A.R., M.A., S.C.B.)
| | - Pauline Zheng
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (M.S.W., L.O., R.M.O., L.C., J.Y.B., G.W., S.B., M.E., P.Z., A.R., M.A., S.C.B.)
| | - Andrea Russell
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (M.S.W., L.O., R.M.O., L.C., J.Y.B., G.W., S.B., M.E., P.Z., A.R., M.A., S.C.B.)
| | - Marina Arvanitis
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (M.S.W., L.O., R.M.O., L.C., J.Y.B., G.W., S.B., M.E., P.Z., A.R., M.A., S.C.B.)
| | - Daniela Ladner
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois (D.L., M.K., S.D.P., T.R., J.A.L.)
| | - Mary Kwasny
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois (D.L., M.K., S.D.P., T.R., J.A.L.)
| | - Stephen D Persell
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois (D.L., M.K., S.D.P., T.R., J.A.L.)
| | - Theresa Rowe
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois (D.L., M.K., S.D.P., T.R., J.A.L.)
| | - Jeffrey A Linder
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois (D.L., M.K., S.D.P., T.R., J.A.L.)
| | - Stacy C Bailey
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (M.S.W., L.O., R.M.O., L.C., J.Y.B., G.W., S.B., M.E., P.Z., A.R., M.A., S.C.B.)
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30
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Akalu Y, Ayelign B, Molla MD. Knowledge, Attitude and Practice Towards COVID-19 Among Chronic Disease Patients at Addis Zemen Hospital, Northwest Ethiopia. Infect Drug Resist 2020; 13:1949-1960. [PMID: 32612371 PMCID: PMC7322118 DOI: 10.2147/idr.s258736] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/11/2020] [Indexed: 12/23/2022] Open
Abstract
Purpose The recent outbreak of coronavirus disease 2019 (COVID-19) is the worst global crisis after the Second World War. Since no successful treatment and vaccine have been reported, efforts to enhance the knowledge, attitudes, and practice of the public, especially the high-risk groups, are critical to manage COVID-19 pandemic. Thus, this study aimed to assess knowledge, attitude, and practice towards COVID-19 among patients with chronic disease. Patients and Methods A cross-sectional study was conducted among 404 chronic disease patients from March 02 to April 10, 2020, at Addis Zemen Hospital, Northwest Ethiopia. Both bivariable and multivariable logistic regression analyses with a 95% confidence interval were fitted to identify factors associated with poor knowledge and practice towards COVID-19. The adjusted odds ratio (AOR) was used to determine the magnitude of the association between the outcome and independent variables. P-value <0.05 was considered statistically significant. Results The mean age of the participants was 56.5±13.5. The prevalence of poor knowledge and poor practice was 33.9% and 47.3%, respectively. Forty-one percent of the participants perceived that avoiding of attending a crowded population is very difficult. Age (AOR=1.05, (95% CI (1.01–1.08)), educational status of “can’t read and write” (AOR=7.1, 95% CI (1.58–31.93)), rural residence (AOR=19.0, 95% CI (6.87–52.66)) and monthly income (AOR=0.8, 95% CI (0.79–0.89)) were significantly associated with poor knowledge. Being unmarried (AOR=3.9, 95% CI (1.47–10.58)), cannot read and write (AOR=2.7, 95% CI (1.03–7.29)), can read and write (AOR=3.5, 95% CI (1.48–8.38)), rural residence (AOR=2.7, 95% CI (1.09–6.70)), income of <7252 Ethiopian birr (AOR=2.3, 95% CI (1.20–4.15)) and poor knowledge (AOR=8.6, 95% CI (3.81–19.45)) were significantly associated with poor practice. Conclusion The prevalence of poor knowledge and poor practice was high. Leaflets prepared in local languages should be administered and health professionals should provide detailed information about COVID-19 to their patients.
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Affiliation(s)
- Yonas Akalu
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhanu Ayelign
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Meseret Derbew Molla
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Warner E, Nannarone M, Smail-Crevier R, Manuel D, Lashewicz B, Patten S, Schmitz N, MacQueen G, Wang JL. The relationship between depression risk perception and self-help behaviours in high risk Canadians: a cross-sectional study. BMC Public Health 2020; 20:876. [PMID: 32505198 PMCID: PMC7276077 DOI: 10.1186/s12889-020-08983-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 05/24/2020] [Indexed: 12/21/2022] Open
Abstract
Background Self-help may reduce the risk of depression, and risk perception of depression may influence initiating self-help. It is unknown how risk perception is associated with self-help behaviours. The objectives of this study are to (1) describe the self-help strategies used by high-risk Canadians in relation to the accuracy of perceived depression risk, by sex, and (2) identify demographic and clinical factors associated with self-help behaviours. Methods Baseline data from a randomized controlled trial including 358 men and 356 women at high-risk of developing depression were used. Following methods used in cancer research, risk perception accuracy was determined by comparing the participant’s self-perceived and objective risk of developing depression and classifying as accurate, over-estimation and under-estimation based on a ± 10% threshold. The participant’s objective depression risk was assessed using sex-specific multivariable risk predictive algorithms. Frequency of using 14 self-help strategies was assessed. One-way ANOVA testing was used to detect if differences in risk perception accuracy groups existed, stratified by sex. Linear regression was used to investigate the clinical and demographic factors associated with self-help behaviours, also stratified. Results Compared to accurate-estimators, male over-estimators were less likely to “leave the house daily,” and “participate in activities they enjoy.” Male under-estimators were also less likely to “participate in activities they enjoy.” Both male ‘inaccurate’ perception groups were more likely to ‘create lists of strategies which have worked for feelings of depression in the past and use them’. There were no significant differences between self-help behaviours and risk perception accuracy in women. Regression modeling showed negative relationships between self-rated health and self-help scores, irrespective of sex. In women, self-help score was positively associated with age and educational attainment, and negatively associated with perceived risk. In men, a positive relationship with unemployment was also seen. Conclusions Sex differences exist in the factors associated with self-help. Risk perception accuracy, work status, and self-rated health is associated with self-help behaviours in high-risk men. In women, factors related to self-help included age, education, self-rated health status, and perceived risk. More research is needed to replicate findings. Trial registration Prospectively registered at ClinicalTrials.gov (NCT02943876) as of 10/21/16.
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Affiliation(s)
- Emily Warner
- The Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Molly Nannarone
- The Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | | | - Douglas Manuel
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Scott Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Norbert Schmitz
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada
| | - Glenda MacQueen
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Jian Li Wang
- The Institute of Mental Health Research, University of Ottawa, Ottawa, Canada. .,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
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Odoi EW, Nagle N, Zaretzki R, Jordan M, DuClos C, Kintziger KW. Sociodemographic Determinants of Acute Myocardial Infarction Hospitalization Risks in Florida. J Am Heart Assoc 2020; 9:e012712. [PMID: 32427043 PMCID: PMC7428988 DOI: 10.1161/jaha.119.012712] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Identifying social determinants of myocardial infarction (MI) hospitalizations is crucial for reducing/eliminating health disparities. Therefore, our objectives were to identify sociodemographic determinants of MI hospitalization risks and to assess if the impacts of these determinants vary by geographic location in Florida. Methods and Results This is a retrospective ecologic study at the county level. We obtained data for principal and secondary MI hospitalizations for Florida residents for the 2005-2014 period and calculated age- and sex-adjusted MI hospitalization risks. We used a multivariable negative binomial model to identify sociodemographic determinants of MI hospitalization risks and a geographically weighted negative binomial model to assess if the strength of associations vary by location. There were 645 935 MI hospitalizations (median age, 72 years; 58.1%, men; 73.9%, white). Age- and sex-adjusted risks ranged from 18.49 to 69.48 cases/10 000 persons, and they were significantly higher in counties with low education levels (risk ratio [RR]=1.033, P<0.0001) and high divorce rate (RR, 0.995; P=0.018). However, they were significantly lower in counties with high proportions of rural (RR, 0.996; P<0.0001), black (RR, 1.026; P=0.032), and uninsured populations (RR, 0.983; P=0.040). Associations of MI hospitalization risks with education level and uninsured rate varied geographically (P for non-stationarity test=0.001 and 0.043, respectively), with strongest associations in southern Florida (RR for <high school education, 1.036-1.041; RR for uninsured rate, 0.971-0.976). Conclusions Black race, divorce, rural residence, low education level, and lack of health insurance were significant determinants of MI hospitalization risks, but associations with the latter 2 were stronger in southern Florida. Thus, interventions for addressing MI hospitalization risks need to prioritize these populations and allocate resources based on empirical evidence from global and local models for maximum efficiency and effectiveness.
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Affiliation(s)
- Evah Wangui Odoi
- Comparative and Experimental Medicine College of Veterinary Medicine The University of Tennessee Knoxville TN
| | - Nicholas Nagle
- Department of Geography The University of Tennessee Knoxville TN
| | - Russell Zaretzki
- Department of Business Analytics and Statistics The University of Tennessee Knoxville TN
| | - Melissa Jordan
- Public Health Research Division of Community Health Promotion Florida Department of Health Tallahassee FL
| | - Chris DuClos
- Environmental Public Health Tracking Division of Community Health Promotion Florida Department of Health Tallahassee FL
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