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D'Anna LH, Chang K. Healthcare discrimination, anticipated HIV stigma, and income as predictors of HIV testing among a community sample of YBMSM. AIDS Care 2024; 36:212-219. [PMID: 37607018 DOI: 10.1080/09540121.2023.2240068] [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: 02/18/2022] [Accepted: 07/18/2023] [Indexed: 08/24/2023]
Abstract
Young Black men who have sex with men (YBMSM) are at particular risk for HIV, and knowing one's HIV status is key to preventing new HIV infections. Data were derived from a community-based study involving 250 YBMSM to examine the relationships between race-based discrimination experienced in healthcare settings, anticipated HIV stigma, household income and lifetime HIV testing. Lifetime HIV testing was regressed on racial discrimination in healthcare settings, anticipated HIV stigma, and income, and a significant 3-way interaction was found. To help interpret the 3-way interaction, lifetime HIV testing was regressed on racial discrimination in healthcare settings and anticipated HIV stigma in two separate models; with low-income and higher-income YBMSM. Anticipated HIV stigma was found to predict HIV testing among low-income YBMSM. A significant interaction was detected such that low-income YBMSM with low levels of anticipated HIV stigma were more likely to get tested for HIV regardless of experiences with healthcare discrimination, while low-income YBMSM who reported greater anticipated HIV stigma and more experiences of healthcare discrimination were less likely to get tested for HIV. Understanding the complexity of potential barriers is crucial for developing interventions to increase HIV testing within this population.
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Affiliation(s)
- Laura Hoyt D'Anna
- Center for Health Equity Research, California State University, Long Beach
| | - Kyle Chang
- Center for Health Equity Research, California State University, Long Beach
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Longitudinal associations between lifestyle, socio-economic position and physical functioning in women at different life stages. Eur J Ageing 2018; 16:167-179. [PMID: 31139031 DOI: 10.1007/s10433-018-0484-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Women's physical functioning declines with age and the rate of decline increases with age, but substantial disparities exist in trajectories over time. To inform development of interventions to optimise physical functioning across the adult life span, the aim is to explore which lifestyle and socio-economic position (SEP) factors contribute to disparities in physical functioning across the adult life span in women. Younger (born 1973-1978, n = 14,247), middle-aged (born 1946-1951, n = 13,715) and older (born 1921-1926, n = 12,432) participants from the Australian Longitudinal Study on Women's Health completed six questionnaires between 1996 and 2012 at approximate 3-year intervals. Physical functioning was measured with a 10-item subscale of the Short-Form Health Survey (score 1-100). Relationships between age and physical functioning were modelled using spline regression, stratified by baseline categories of physical activity, alcohol intake, smoking status, level of education, managing on income and index of neighbourhood socio-economic disadvantage for area. Multivariable models excluding one of the six factors were compared with models including all six factors to examine the relative importance of each factor. Women with unhealthy lifestyles (inactive, smokers or risky alcohol intake) and lower SEP had lower levels of physical functioning and more rapid declines across the adult life span. The variables with the greatest relative contribution to the models for physical functioning differed by age cohort: i.e. education and physical activity in younger women, managing on income and physical activity in middle-aged women and physical activity in older women. For optimal physical functioning, socio-economic factors seemed particularly important in younger and middle-aged women, while physical activity seemed important at all ages.
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Schuler BR. Health Perceptions and Quality of Life among Low-Income Adults. HEALTH & SOCIAL WORK 2015; 40:225-232. [PMID: 26285362 DOI: 10.1093/hsw/hlv045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Marginalized populations may be predisposed to poor health outcomes due to health dis parities. Although much of the research on health and quality of life is from the perspective of the impact of clinical diagnosis, there is a need for more diverse inquiries and recognition of the individuals' perceptions and preferences. The present study examined the importance of an individual's perception of his or her current health in predicting quality of life over and beyond the presence of physical or mental health conditions. The sample included 150 low-income adults, of which 84.7 percent were African American and 15.4 percent were of another minority race or ethnicity. Participants had an average monthly income of $703. Having a better perception of health was significantly associated with increased quality of life scores. Subjective perceptions of current health were a better predictor of quality of life than the presence of a serious physical or mental health condition. The article ends with a discussion of appropriate interventions to improve health perceptions in similar populations predisposed to poor health outcomes.
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Lobo ADJS, Santos L, Gomes S. [Level of dependency and quality of life of elderly]. Rev Bras Enferm 2015; 67:913-9. [PMID: 25590881 DOI: 10.1590/0034-7167.2014670608] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Accepted: 09/24/2014] [Indexed: 11/22/2022] Open
Abstract
The quality of life (QoL) in older adults is largely determined by their functional status and health conditions. With the purpose of investigate the QoL and the factors affecting it, and identify the degree of dependency of the elderly was carried out an observational cross-sectional exploratory and descriptive, involving 93 elderly. In collecting data we used the Barthel Index and MOS SF-36. In the identification of levels of dependency results indicate us that 40.0% are independent and 18.0% are dependents, minimum being 12.0% total-dependent. The results show us that, 88.0% of the subjects reported a score below 50.0% on average reported a QoL of 39 ± 10.0%. Checking that are a positive correlation between the degree of dependence and the index of QoL, especially in the physical component. It is therefore important to promote healthy aging in an attempt to favor the preservation of autonomy and functional capacity of the elderly.
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Affiliation(s)
| | - Luísa Santos
- Cabreira, Unidade de Cuidados de Saúde Personalizados Viver Mais, Agrupamento de Centros de Saúde Cávado II - Gerês, Amares, Portugal
| | - Sónia Gomes
- Hospital de Braga, Ministério da Saúde, Braga, Portugal
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Ahmad MM, Al-Daken LI, Ahmad HM. Quality of Life for Patients in Medical–Surgical Wards. Clin Nurs Res 2014; 24:375-87. [DOI: 10.1177/1054773813519470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to examine the quality of life (QoL) for patients in medical–surgical wards in Jordanian hospitals. A cross-sectional design was performed. The data were collected between January and April 2011 through individual interviews ( n = 746) using the Medical Outcome Study 36-item Short-Form (MOS-SF-36) and Charlson’s Co-morbidity Index (CCI). The private and public hospitals in the three largest cities in Jordan were represented. The MANOVA test was used to examine the health status based on patients’ co-morbidity level. The results showed that QoL for patients with severe co-morbidity has been affected negatively in many aspects more than both patients with no co-morbidity and patients with mild co-morbidity. However, although it is difficult to change the demographic characteristics, it is possible to improve the health status of patients with multiple co-morbidities, which will result in having a better QoL.
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Morton CM. The Moderating Effect of Substance Abuse Service Accessibility on the Relationship between Child Maltreatment and Neighborhood Alcohol Availability. CHILDREN AND YOUTH SERVICES REVIEW 2013; 35:1933-1940. [PMID: 24436505 PMCID: PMC3889130 DOI: 10.1016/j.childyouth.2013.09.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
This study investigates how the relationship between dense concentrations of alcohol retailers and high rates of child maltreatment may be moderated by the presence of substance abuse service facilities. Using a cross-sectional design, the study utilized data from Bergen County, New Jersey on child maltreatment reports, alcohol-selling retailers, substance abuse service facilities, and the United States Census. Findings indicate child maltreatment rates were higher in neighborhoods with lower socioeconomic status and those with greater alcohol outlet density. Neighborhoods with easily accessed substance abuse service facilities had lower rates of child maltreatment. Additionally, the relationship between child maltreatment and alcohol outlet density was moderated by the presence of substance abuse service facilities. The study findings highlight the relevance of making primary prevention approaches readily available and using multi-sector collaboration to reduce child maltreatment.
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Christens BD, Collura JJ, Tahir F. Critical hopefulness: a person-centered analysis of the intersection of cognitive and emotional empowerment. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2013; 52:170-84. [PMID: 23793530 DOI: 10.1007/s10464-013-9586-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Leaders in struggles for social justice agree on the importance and the difficulty of maintaining hopefulness while developing critical awareness of social issues. Research has indicated that the analogous components of psychological empowerment (emotional and cognitive) often do not co-vary across populations. This study used a person-centered analytic approach, latent class analysis, to identify subpopulations of participants (n = 1,322) according to the cognitive and emotional components of psychological empowerment. Four distinct sub-groups emerged: those who were relatively (1) critical but alienated, (2) uncritical but hopeful, (3) uncritical and alienated, or (4) critical and hopeful. These clusters were then examined for demographic differences and relationships with a set of conceptually relevant variables including social capital, psychological sense of community, openness, organizational participation and mental wellbeing. Results shed light on the complexity of empowerment processes and yield implications for ongoing community research and action.
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Affiliation(s)
- Brian D Christens
- School of Human Ecology, University of Wisconsin-Madison, 1300 Linden Drive, Madison, WI 53706, USA.
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Neri L, McEwan P, Sennfält K, Baboolal K. Characterizing the relationship between health utility and renal function after kidney transplantation in UK and US: a cross-sectional study. Health Qual Life Outcomes 2012; 10:139. [PMID: 23173709 PMCID: PMC3539915 DOI: 10.1186/1477-7525-10-139] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 09/26/2012] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Chronic allograft nephropathy (CAN) occurs in a large share of transplant recipients and it is the leading cause of graft loss despite the introduction of new and effective immunosuppressants. The reduction in renal function secondary to immunologic and non-immunologic CAN leads to several complications, including anemia and calcium-phosphorus metabolism imbalance and may be associated to worsening Health-Related Quality of Life. We sought to evaluate the relationship between kidney function and Euro-Qol 5 Dimension Index (EQ-5Dindex) scores after kidney transplantation and evaluate whether cross-cultural differences exist between UK and US. METHODS This study is a secondary analysis of existing data gathered from two cross-sectional studies. We enrolled 233 and 209 subjects aged 18-74 years who received a kidney transplant in US and UK respectively. For the present analysis we excluded recipients with multiple or multi-organ transplantation, creatinine kinase ≥200 U/L, acute renal failure, and without creatinine assessments in 3 months pre-enrollment leaving 281 subjects overall. The questionnaires were administered independently in the two centers. Both packets included the EQ-5Dindex and socio-demographic items. We augmented the analytical dataset with information abstracted from clinical charts and administrative records including selected comorbidities and biochemistry test results. We used ordinary least squares and quantile regression adjusted for socio-demographic and clinical characteristics to assess the association between EQ-5Dindex and severity of chronic kidney disease (CKD). RESULTS CKD severity was negatively associated with EQ-5Dindex in both samples (UK: ρ= -0.20, p=0.02; US: ρ= -0.21, p=0.02). The mean adjusted disutility associated to CKD stage 5 compared to CKD stage 1-2 was Δ= -0.38 in the UK sample, Δ= -0.11 in the US sample and Δ= -0.22 in the whole sample. The adjusted median disutility associated to CKD stage 5 compared to CKD stage 1-2 for the whole sample was 0.18 (p<0.01, quantile regression). Center effect was not statistically significant. CONCLUSIONS Impaired renal function is associated with reduced health-related quality of life independent of possible confounders, center-effect and analytic framework.
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Affiliation(s)
- Luca Neri
- Dipartimento di Scienze Mediche e di Comunità, Università degli Studi di Milano, Milano, Italy
- Center for Outcomes Research, Department of Health Management and Policy, Saint Louis University, Saint Louis, MO, USA
- Dipartimento di Medicina del Lavoro, “L. Devoto”, quarto piano, Via San Barnaba, 8, Milano, Italy
| | - Phil McEwan
- Cardiff Research Consortium, Cardiff, United Kingdom
| | - Karin Sennfält
- HEOR Europe, Bristol-Myers Squibb, Rueil-Malmaison, Paris, France
| | - Kesh Baboolal
- University Hospital of Wales Heath Park, Cardiff, United Kingdom
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Lobo A, Carvalho J, Santos P. Effects of Training and Detraining on Physical Fitness, Physical Activity Patterns, Cardiovascular Variables, and HRQoL after 3 Health-Promotion Interventions in Institutionalized Elders. INTERNATIONAL JOURNAL OF FAMILY MEDICINE 2011; 2010:486097. [PMID: 22332008 PMCID: PMC3275997 DOI: 10.1155/2010/486097] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 12/20/2010] [Accepted: 12/21/2010] [Indexed: 05/14/2023]
Abstract
The purpose of this study is to assess the effects of different strategies of health on the levels of physical activity (PA), physical fitness (PF), cardiovascular disease (CVD) risk factors and quality of life (QoL) of the institutionalized elderly. Concurrently studies were made of the effect of detraining on these same variables. In this investigation we carried out a prospective longitudinal study with an experimental design, with 1 year plus 3 months of a detraining period. Methodology. (a) A questionnaire with socio-demographic characteristics and a QoL scale (MOS SF-36); (b) Functional Fitness Test to assess PF; (c) An MTI Actigraph to evaluate the PA; (d) Biochemical analysis of blood, blood pressure and bio-impedance. The Main Results Indicated That: (i) ST significantly improved strength and body flexibility and AT the aerobic endurance, agility/dynamic balance and lower strength and flexibility; (ii) Implications of detraining were more evident on the PA groups in the lower body flexibility, which is associated with agility/dynamic balance and lower strength in the AT group; (iii) Cardiovascular variables improved significantly especially blood pressure, cholesterol and glucose in the ST and HDL in the AT group; not having undergone significant changes with the detraining. The results of this thesis contribute positively to highlight the importance of PA in the promotion of health, prevention and reduction of CVD risk factors and the improvement of the PF and QoL.
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Affiliation(s)
- Alexandrina Lobo
- Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, 4200-450 Porto, Portugal
| | - Joana Carvalho
- Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, 4200-450 Porto, Portugal
| | - Paula Santos
- Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, 4200-450 Porto, Portugal
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