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Okyere J, Ayebeng C, Dickson KS. Clicks and checks: investigating the association between internet usage frequency and women's uptake of clinical breast examination in Ghana. BMC Health Serv Res 2024; 24:1113. [PMID: 39334073 PMCID: PMC11429456 DOI: 10.1186/s12913-024-11576-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 09/11/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND In resource-constrained settings, availability and access to mammography is a challenge. As such, the World Health Organization (WHO) recommends clinical breast examination (CBE) for women in such settings. Yet, CBE uptake remains low. We, therefore, aimed to contribute to the discourse on factors that influence women's screening practice by investigating the association between the frequency of internet use and women's uptake of CBE in Ghana. METHODS This study was based on data from 15,013 women who participated in the 2022 Ghana demographic and health survey. We performed descriptive analysis, computed Pearson's chi-square test, and fitted multivariable logistic regression models. The findings from the regression model were presented in adjusted odds ratio (AOR) at a 95% confidence interval. RESULTS Only 18.39% of women 15-49 years had their breasts examined by a healthcare provider. About 38.22% of the total sample often used the internet. Compared to women who did not use the internet at all, those who often used it had twice the odds of getting screened (COR = 2.86; 95%CI: 2.62-3.13). The odds of CBE uptake remained significantly higher among those who often used the internet (AOR = 1.26; 95%CI: 1.12-1.43) even after adjusting for the covariates. CONCLUSION We conclude that CBE uptake is significantly high among women who frequently use the internet. This association persists even when considering other influential factors such as age, education level, marital status, and socioeconomic status. As such, it is imperative for the Ministry of Health in collaboration with the Ghana Health Service to recognize the potential of digital health interventions, including online health education campaigns and telehealth services, in reaching and engaging women to get their breast examined by a healthcare provider.
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Affiliation(s)
- Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
- School of Nursing and Midwifery, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Castro Ayebeng
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
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Stephanopoli JP, Bouazzi L, Guerbaz-Sommi M, Graesslin O, Hurtaud A, Ilardo S, Chrusciel J, Barbaret C, Bertrand C, Sanchez S. Factors associated with deferral or non-performance of an organized breast cancer screening program during the COVID-19 pandemic in France. Cancer Med 2024; 13:e7444. [PMID: 39192606 DOI: 10.1002/cam4.7444] [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: 02/11/2024] [Revised: 06/12/2024] [Accepted: 06/18/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Delays in detection and treatment of breast cancer can lead to increased mortality. To date, participation in organized breast cancer screenings (OBCS) has been suboptimal worldwide. The objective of this study was to investigate the factors associated with deferral or non-performance of mammography during the COVID-19 pandemic for women who had previously participated in OBCS. METHODS A retrospective observational study was conducted on a cohort of 6282 women from the Aube Department of France, who were invited to an OBCS in 2020. Participants were divided into women who promptly underwent screening after receiving an invitation (between 22 and 25 months elapsed since the last mammogram), women who underwent late screening (≥26 months since the last mammogram), and those who were never screened. Data were collected from a self-reported questionnaire. Comparative and multivariable analyses modeling the probability of each type of attendance were performed using these data. RESULTS In total, 2301 women (aged 50-74 years) returned a valid questionnaire. Compared to women who promptly underwent mammography, non- and late-screening participants were younger, had less frequent gynecological follow-up and a less frequent history of colorectal cancer screening. Women with higher education status and those residing in socially disadvantaged areas were more likely to attend late. CONCLUSION The absence of regular gynecological follow-up and the absence of colorectal cancer screening were significant factors associated with deferral of or non-attendance at OBCS.
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Affiliation(s)
- Jean Papadacci Stephanopoli
- Department of General Medicine, Université de Reims Champagne-Ardenne, Reims, Marne, France
- Médecine générale, Maison de Santé Pluriprofessionnelle de la Forêt d'Orient, Piney, Aube, France
| | - Leila Bouazzi
- Comité Universitaire de Ressources pour la Recherche en Santé,, Université de Reims Champagne-Ardenne, Reims, Marne, France
| | - Myriam Guerbaz-Sommi
- CRCDC, Centre Régional de Coordination des Dépistages des Cancers du Grand Est, Troyes, Aube, France
| | - Olivier Graesslin
- Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, Marne, France
| | - Aline Hurtaud
- Department of General Medicine, Université de Reims Champagne-Ardenne, Reims, Marne, France
| | - Salvatore Ilardo
- Médecine générale, Maison de Santé Pluriprofessionnelle de la Forêt d'Orient, Piney, Aube, France
| | - Jan Chrusciel
- Department of Public Health and Performance, Centre Hospitalier de Troyes, Troyes, France
| | - Cécile Barbaret
- Univ. Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble Institute of Engineering, TIMC-IMAG,, Univ. Grenoble Alpes,, Grenoble, isère, France
| | - Camille Bertrand
- CRCDC, Centre Régional de Coordination des Dépistages des Cancers du Grand Est, Troyes, Aube, France
| | - Stéphane Sanchez
- Comité Universitaire de Ressources pour la Recherche en Santé,, Université de Reims Champagne-Ardenne, Reims, Marne, France
- Department of Public Health and Performance, Centre Hospitalier de Troyes, Troyes, France
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Braga C, Saad KR, Koike MK. The influence of the internet on choices about older adults' health and well-being. Rev Bras Enferm 2024; 77:e20230321. [PMID: 38747746 PMCID: PMC11095947 DOI: 10.1590/0034-7167-2023-0321] [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: 09/01/2023] [Accepted: 12/07/2023] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVES to describe the profile of older adults who access the internet to search for health information and identify the factors that can influence older adults' decisions about their health based on information collected online. METHODS 391 older adults answered an online questionnaire regarding habits and satisfaction with information about health collected on the internet. Data processing involved Logistic Regression. RESULTS higher education reduces by 44% the likelihood of an older adult following the health recommendations on internet sites. However, social activities and self-perceived health increase the possibility of following the recommendations by 83% and 71%, respectively. The belief that the internet promotes healthy habits increases by 29.2 times the probability of an older adult following the advice. FINAL CONSIDERATIONS knowing the profile of older adults who use the Internet can help professionals formulate public policies and build good information platforms on health and well-being.
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Affiliation(s)
- Cristina Braga
- Instituto de Assistência Médica ao Servidor Público Estadual de São Paulo. São Paulo, São Paulo, Brazil
| | - Karen Ruggeri Saad
- Universidade Federal do Vale do São Francisco. Petrolina, Pernambuco, Brazil
| | - Marcia Kiyomi Koike
- Instituto de Assistência Médica ao Servidor Público Estadual de São Paulo. São Paulo, São Paulo, Brazil
- Universidade de São Paulo. São Paulo, São Paulo, Brazil
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Liu J, Peng J, Chen M, Zhang T. Mediating and Moderating Effects of Internet Use on Urban-Rural Disparities in Health Among Older Adults: Nationally Representative Cross-Sectional Survey in China. J Med Internet Res 2023; 25:e45343. [PMID: 37768721 PMCID: PMC10570902 DOI: 10.2196/45343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 06/26/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The urban-rural disparities in health outcomes in China are remarkable. The internet has shown the potential to reduce the likelihood of contracting a disease by increasing disease knowledge. However, little is known about the effects of internet use in alleviating health inequities between urban and rural areas. OBJECTIVE This study aimed to examine the mediation and moderation of health disparities between urban and rural older adults through internet use. METHODS A total of 8223 respondents were selected from the China Health and Retirement Longitudinal Study 2018 data set. Basic activities of daily living, a brief Community Screening Instrument for Dementia, and the Centre for Epidemiologic Studies Depression Scale were used to measure functional disability, cognitive function, and depressive symptoms, respectively. Logistic regressions testing "internet use×urban-rural status" interactions for moderation and Karlson-Holm-Breen decomposition for mediation were performed. RESULTS Internet use moderated the urban-rural disparities in cognitive function (odds ratio 7.327, 95% CI 3.011-17.832) and depressive symptoms (odds ratio 1.070, 95% CI 1.037-1.787), but the moderating effects were significant only for those using the internet daily. Karlson-Holm-Breen results showed the suppression effects of using the internet daily (β=.012, 95% CI .002-.021) on the association between urban-rural status and cognitive function. The urban-rural inequality in depressive symptoms was partially attributed to the disparity in internet use (β=-.027, 95% CI -.043 to -.009). CONCLUSIONS The urban-rural inequalities in mental health are partially attributable to disparities in the prevalence of internet use between the 2 groups. However, using the internet is more beneficial for the psychological health of rural users, thereby alleviating the urban-rural disparities in health. Providing convenient channels for rural older adults to use the internet, improving the ability of rural users to effectively use the internet, and promoting internet popularity in rural areas are effective approaches to reducing urban-rural health inequalities.
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Affiliation(s)
- Jing Liu
- Administrative Office, Yuebei People's Hospital, Medical College, Shantou University, Shaoguan, China
| | - Junwei Peng
- Department of Chinese Integrative Medicine, Hebei Medical University, Shijiazhuang, China
| | - Minyan Chen
- Medical Insurance Department, Hangzhou Ninth People's Hospital, Hangzhou, China
| | - Tao Zhang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
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Radó N, Girasek E, Békási S, Győrffy Z. Digital Technology Access and Health-Related Internet Use Among People Experiencing Homelessness in Hungary: Quantitative Survey. J Med Internet Res 2022; 24:e38729. [PMID: 36260379 PMCID: PMC9631172 DOI: 10.2196/38729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/16/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background In recent years, there has been an increase in the use of digital technology for personal health and well-being. Previous research has revealed that these technologies might provide vulnerable populations, including those who are homeless, better access to health services and thus a greater chance of more personalized care. Objective However, little is known about the relationship between technology and health among people experiencing homelessness in Central and Eastern Europe. This study is part of a series of studies by the Digital Health Research Group at Semmelweis University (Budapest, Hungary) in cooperation with the Hungarian Charity Service of the Order of Malta; it aims to assess the existing technological resources available for the homeless population and their health-related internet use characteristics to set the ground for potential health policy interventions, enabling better access to health services by strengthening the digital components of the existing health care system. Methods Between April 19, 2021, and August 11, 2021, a total of 662 people from 28 institutions providing social services for people experiencing homelessness in Budapest, Hungary, were surveyed about their access to digital tools and internet use patterns. For selected questions, the responses of a representative sample of the Hungarian population were used for comparison as the reference group. Chi-square tests and logistic regression analyses were performed to identify variables affecting internet use for health-related reasons. Results The results demonstrated a considerable level of internet use in the homeless population; 52.9% (350/662) of the respondents used the internet frequently compared with 81.3% (1220/1500) of the respondents in the reference group. Among the homeless group, 69.6% (461/662) of the respondents reported mobile phone ownership, and 39.9% (264/662) of the respondents added that it had a smartphone function. Moreover, 11.2% (70/662) of the respondents had already used a health mobile app, and 34.6% (229/662) of the respondents had used the internet for medical purposes. On the basis of these characteristics, we were able to identify a broadly defined, digitally engaged group among people experiencing homelessness (129/662, 19.5%). This subpopulation was inclined to benefit from digitalization related to their personal health. Multivariate analysis demonstrated that internet use for health reasons was more significant for younger respondents, women, those with higher levels of education, and those with no chronic conditions. Conclusions Although compared with the general population, health-related internet use statistics are lower, our results show that the idea of involving homeless populations in the digital health ecosystem is viable, especially if barriers to access are systematically reduced. The results show that digital health services have great promise as another tool in the hands of community shelters for keeping homeless populations well ingrained in the social infrastructure as well as for disease prevention purposes.
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Affiliation(s)
- Nóra Radó
- Institute of Behavioural Sciences, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Edmond Girasek
- Institute of Behavioural Sciences, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Sándor Békási
- Health Centre, Hungarian Charity Service of the Order of Malta, Budapest, Hungary.,Telemedicine Workgroup, FitPuli Kft., Győr, Hungary
| | - Zsuzsa Győrffy
- Institute of Behavioural Sciences, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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Quialheiro A, Bobinski F, Haefliger JDG, Del Antonio R, Lins EF, Martins DF, d'Orsi E, Xavier AJ, Peres MA. A comprehensive program of cognitive stimulation with digital inclusion, physical activity and social interaction can modify BDNF levels and improve cognition in adults over 50: a randomized controlled pilot study. Aging Ment Health 2022; 26:1979-1987. [PMID: 34405737 DOI: 10.1080/13607863.2021.1966742] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To analyze the effect of a comprehensive program of cognitive stimulation with digital inclusion, physical activity and social interaction, called "Oficina da Lembrança" (OL), on the cognitive status and concentration of biomarkers of neuroplasticity, neurodegeneration in adults aged 50 years and over attending a Memory Clinic. METHODS In this pilot randomized controlled study, 64 patients without dementia aged 45 to 79 years, seen at a University Memory Clinic in Southern Brazil, were randomly allocated to the intervention and control groups. The intervention consisted of participation in OL for 12 weeks. Serum biomarkers (brain-derived neurotrophic factor [BDNF], S100β, and neuron-specific enolase [NSE]) and cognitive status were analyzed as primary and secondary outcomes. The Wilcoxon test and Generalized Estimating Equations (GEE) were applied. RESULTS Of the 64 patients invited to participate in the study, 33 (intervention: 17, control: 16) completed the study with all data. Improvement of cognitive status was significant in the intervention group (22.6 to 24.5) but not in the control group (20.1 to 21.1). There was a significant reduction of BDNF in OL participants, but no significant change was observed in the neurodegenerative biomarkers S100β or NSE. The concentration of BDNF decreased significantly post-OL in the intervention group (-288.1, 95%CI -362.1 to -94.1), even after adjusting for sex, age, and educational level. Cognitive status was significantly improved in OL participants. CONCLUSION The OL program improved cognitive status, reduced serum BDNF levels, and empowered digitally excluded older adults. There was no effect of this intervention on S100β or NSE. CLINICAL TRIAL REGISTRATION This study has a Universal Trial Number (UTN) U1111-1195-2642 and was registered in the Brazilian Clinical Trials Registry (ReBEC), number RBR-38X665.
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Affiliation(s)
- Anna Quialheiro
- Postgraduate Program in Public Health, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil.,Physiotherapy Course, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil.,Life and Health Sciences Research Institute (ICVS), Medicine School, University of Minho, Portugal
| | - Franciane Bobinski
- Experimental Neuroscience Laboratory (LaNex), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil
| | | | - Renata Del Antonio
- Hospital of the Federal University of Santa Catarina (UFSC), Florianopolis, Brazil
| | - Elisa Flores Lins
- Experimental Neuroscience Laboratory (LaNex), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil
| | - Daniel Fernandes Martins
- Experimental Neuroscience Laboratory (LaNex), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil
| | - Eleonora d'Orsi
- Postgraduate Program in Public Health, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil
| | - André Junqueira Xavier
- Postgraduate Program in Public Health, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil.,Medicine Course, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil
| | - Marco Aurélio Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
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Bertocchi FM, De Oliveira AC, Lucchetti G, Lucchetti ALG. Smartphone Use, Digital Addiction and Physical and Mental Health in Community-dwelling Older Adults: a Population-based Survey. J Med Syst 2022; 46:53. [PMID: 35716194 DOI: 10.1007/s10916-022-01839-7] [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: 01/14/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022]
Abstract
This study aims to assess mobile technology use (cell phones and smartphones), level of digital addiction, and the association of these factors with physical, mental and social health and quality of life (QOL) in community-dwelling older adults. A population-based study of a city with a low-income population in Brazil was carried out. Sociodemographics, cognition(MMSE), mental health(DASS-21), QOL(WHOQOL-bref), sleep quality(Pittsburgh Index), instrumental activities of daily living(Lawton), loneliness(UCLA), digital addiction(Internet Addiction Test) and cell phone/smartphone use were investigated. A total of 668 older adults (93.6% of total) were included; 175(26.2%) owned cell phones, 172(25.7%) smartphones and 321(48.1%) no mobile device. Smartphones owners were predominantly younger, white, had higher income, MMSE scores and social support, and were less dependent. However, no group differences were observed for depression, anxiety or stress symptoms, QOL, sleep disturbances or loneliness. Among 172 smartphone users, Structural Equation Models revealed that the degree of digital addiction was correlated with better physical and environmental conditions, in detriment of a poorer sleep quality. Hours of use were not correlated with health outcomes, whereas greater importance of the smartphone in life correlated with less depressive symptoms and lower loneliness. Different from previous studies in adults or adolescents, older adults who were smartphones users had similar health outcomes than those without Internet access. These findings serve to further our understanding on technology use in this age group.
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Affiliation(s)
| | | | - Giancarlo Lucchetti
- Division of Geriatrics, School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
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Yadav K, Babu R, Hariprasad R, Gupta R, Kumari M, Mehrotra R, Kumar S, Naik N, Gupta S, Singh S. Perspectives of Healthcare Providers and the General Population on a Cancer Awareness Portal: a Qualitative Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:561-567. [PMID: 32740859 DOI: 10.1007/s13187-020-01846-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study was aimed at a qualitative assessment of a cancer informational website, "India Against Cancer," developed by the ICMR-National Institute of Cancer Prevention and Research with the dual purpose of promoting cancer awareness among the general population and providing comprehensive information to healthcare providers. We used the narrative qualitative approach (data collection using in-depth interviews (IDIs) and focused group discussions (FGDs)) and content analysis. Purposive sampling was undertaken for both IDIs and FGDs. Thematic analysis was done on four themes: general cancer awareness, ease of comprehension of the Web portal, the relevance of the website content, and general comments and suggestions. Readability assessment of content of the website was conducted using Flesch-Kincaid Readability methodology. The general cancer awareness was enhanced among the participants after visiting the website. Ease of comprehension of the Web portal content was reported to fare well. The sections on "risk factors," "warning signs," and "diet and cancer" were mentioned as most relevant by the general population, whereas "myths and facts" and "screening guidelines" were most relevant for the healthcare workers. Similarly, references and epidemiology sections were most useful for healthcare researchers/professionals. Readability scores of content in English were appropriate for high school pass audience. The content on "India Against Cancer" website was found to serve its intended purpose of promoting cancer awareness among the general population and providing authentic cancer-related information to the healthcare providers. The suggestions received would enable us to enhance the utility of our website by tailoring it to the needs of the target audience.
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Affiliation(s)
- Kavita Yadav
- ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Roshani Babu
- ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Roopa Hariprasad
- ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Ruchika Gupta
- ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Malasha Kumari
- ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Ravi Mehrotra
- Department of Health Research, Indian Cancer Research Consortium, New Delhi, India
| | - Sanjeev Kumar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Navami Naik
- Indo-American Cancer Association, Atlanta, GA, USA
| | - Sanjay Gupta
- ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India.
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida, 201301, India.
| | - Shalini Singh
- ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
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Amiri P, Moulaei K, Bahaadinbeigy K, Ghaemi MM, Sheikhtaheri A. The information‐seeking behavior of medical sciences students toward COVID‐19 in mass and social media: A cross‐sectional study. Health Sci Rep 2022; 5:e648. [PMID: 35620539 PMCID: PMC9125876 DOI: 10.1002/hsr2.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 12/05/2022] Open
Abstract
Background and Aims During the COVID‐19 pandemic, college students can access health‐related information on the Internet to improve preventative behaviors, but they often judge the merits of such information and create challenges in the community. The aim of this study was to investigate information‐seeking behaviors in regard to COVID‐19 among students at Kerman University of Medical Sciences (KUMS) with the help of mass and social media. Methods The present study is a cross‐sectional study, which was conducted using an online researcher‐made questionnaire. An invitation to participate in the study was sent to 500 students at KUMS, of which 203 were selected according to the inclusion criteria and completed the questionnaire. Descriptive statistics were used to analyze the data. Results COVID‐19 news was mostly obtained through social media platforms such as WhatsApp, Telegram, Instagram, radio, and television, as well as online publications and news agencies. Social media platforms such as WhatsApp, Telegram, Instagram, and satellite networks such as BBC contained the most rumors about COVID‐19. Some of the most common misconceptions regarding COVID‐19 were as follows: “COVID‐19 is the deadliest disease in the world,” “COVID‐19 is a biological attack,” and “COVID‐19 disappears as the air temperature rises.” In addition, most of the virtual training provided through mass media focused on “refraining from visiting holy places and crowded locations such as markets,” “observing personal hygiene and refraining from touching the eyes, nose, and mouth with infected hands,” and “the role of quarantine in reducing the incidence of COVID‐19.” Conclusion Our findings demonstrated that during the pandemic, students used social media platforms the most to obtain health‐related information and these media have a significant impact on their willingness to engage in preventative behaviors and take the COVID‐19 risk seriously.
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Affiliation(s)
- Parasto Amiri
- Student Research Committee, Department of Health Information Management Kerman University of Medical Sciences Kerman Iran
| | - Khadijeh Moulaei
- Student Research Committee, Department of Health Information Management Kerman University of Medical Sciences Kerman Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute for Futures Studies in Health Kerman University of Medical Sciences Kerman Iran
| | - Mohammad Mehdi Ghaemi
- Medical Informatics Research Center, Institute for Futures Studies in Health Kerman University of Medical Sciences Kerman Iran
| | - Abbas Sheikhtaheri
- Department of Health Information Management, School of Health Management and Information Sciences Iran University of Medical Sciences Tehran Iran
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Internet use and subsequent health and well-being in older adults: An outcome-wide analysis. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2021.107156] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Social Capital Mediates the Association between the ICT Usage and Well-Being of Older People in Japan: Implication for a New Design Paradigm. SUSTAINABILITY 2022. [DOI: 10.3390/su14074148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
As the population ages, the question of how to prevent isolation among older people and increase their well-being becomes a social issue. It has often been argued that Information and Communication Technology (ICT) usage can be a solution to these challenges, but empirical studies have not shown consistent results. Moreover, there are even fewer studies targeting older people in Japan, which is the most aging country in the world. Therefore, using the psychological comprehensive data of Japanese people aged 60 and over recorded in World Values Survey Wave 7, we conducted a study to clarify the relationship between the ICT usage, social capital, and well-being of older people to make a meaningful contribution to policymakers and the scientific community. As a result of the analysis, it was shown that ICT usage indirectly enhances well-being by increasing social capital. This indicates that for older people, ICT usage does not have a large effect on enhancing well-being, but becomes sufficiently large only through the improvement of social capital. The pros and cons of such modern communication means should be utilized as a reference when considering the development of future communication means and a human coach—a person who supports the use of communication means by older people. In other words, to think about the spread of communication means to community-dwelling older people in the future, it is always necessary to think about technology usage emphasizing the relationship between older people and society.
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Silva GMD, Assumpção DD, Barros MBDA, Barros Filho ADA, Corona LP. [Low intake of dietary fibers among the elderly: 2014/2015 ISACAMP population-based study]. CIENCIA & SAUDE COLETIVA 2021; 26:3865-3874. [PMID: 34468679 DOI: 10.1590/1413-81232021269.2.28252019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 12/04/2019] [Indexed: 12/12/2022] Open
Abstract
The scope of this article is to evaluate the prevalence of inadequate dietary fiber intake and associated factors among elderly adults. A cross-sectional population-based study evaluating participants from the Health Survey of the City of Campinas (ISACAMP) was conducted in 2014/2015, with 1,074 elderly individuals (≥60 years). Dietary fiber intake was obtained using a 24-hour recall, and the prevalence of inadequate fibers was estimated according to the cut-off point of the Institute of Medicine (30 g/day for men and 21 g/day for women). The factors evaluated were sociodemographic conditions (sex, age, schooling, income, marital status), health (number of reported diseases) and lifestyle (physical activity, smoking and alcohol consumption). The prevalence of inadequate dietary fiber intake was 86.6%, being higher in men (RP=1.10), single or divorced (RP=1.09) and physically inactive (PR=1.07). Elderly adults with higher incomes and who reported having 1 to 2 chronic non-communicable diseases had a higher intake of fibers. The high prevalence of inadequate dietary fiber intake in the elderly adults indicates that health and nutrition actions should be developed to ensure adequate dietary intake of these compounds.
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Affiliation(s)
- Graziele Maria da Silva
- Laboratório de Epidemiologia Nutricional, Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas (UNICAMP). R. Pedro Zaccaria 1300, Jd. Santa Luiza. 13484-350 Limeira SP Brasil.
| | - Daniela de Assumpção
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas, UNICAMP. Campinas SP Brasil
| | | | | | - Ligiana Pires Corona
- Laboratório de Epidemiologia Nutricional, Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas (UNICAMP). R. Pedro Zaccaria 1300, Jd. Santa Luiza. 13484-350 Limeira SP Brasil.
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Chiu YC, Li FY. Effects of the digital divide on the prevention of food risk in Taiwan. Health Promot Int 2021; 37:6352240. [PMID: 34389869 DOI: 10.1093/heapro/daab125] [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: 11/12/2022] Open
Abstract
Given the frequent occurrence of various food incidents, food safety is a significant public health concern worldwide. Health information plays an important role in risk prevention. As its reach continues to broaden, the Internet is emerging as a major source of health information for the public, although some social groups continue to have limited access. This study investigates the relation between the digital divide and practices for preventing food incidents in Taiwan. Using a nationally representative survey of 2098 adults, the results of our multinomial logistic regression and bootstrapped mediation analysis indicate the existence of second- and third-level digital divides. The association between socioeconomic status and Internet use time and digital skills results in disparities in food risk prevention behaviors and is partially mediated by online food safety information acquisition. Our findings reveal that the digital divide exacerbates health inequalities in food risk prevention. In addition to providing useful food safety information online, communication interventions should address the digital inequality by delivering food safety information through alternative networks for disadvantaged members of the public.
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Affiliation(s)
- Yu-Chan Chiu
- Department of Bio-Industry Communication and Development, National Taiwan University, 1, sec 4, Roosevelt Road, 10617, Taipei, Taiwan
| | - Fang-Ying Li
- Aurora Healthcare US Corp 8 Electronics Avenue Danvers, MA 01923 USA
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Alshareef N, Yunusa I, Al-Hanawi MK. The Influence of COVID-19 Information Sources on the Attitudes and Practices Toward COVID-19 Among the General Public of Saudi Arabia: Cross-sectional Online Survey Study. JMIR Public Health Surveill 2021; 7:e28888. [PMID: 34081610 PMCID: PMC8330635 DOI: 10.2196/28888] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/21/2021] [Accepted: 05/19/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has resulted in panic among the general public, leading many people to seek out information related to COVID-19 through various sources, including social media and traditional media. Identifying public preferences for obtaining such information may help health authorities to effectively plan successful health preventive and educational intervention strategies. OBJECTIVE The aim of this study was to examine the impact of the types of sources used for obtaining COVID-19 information on the attitudes and practices of the general public in Saudi Arabia during the pandemic, and to identify the socioeconomic and demographic factors associated with the use of different sources of information. METHODS This study used data from a cross-sectional online survey conducted on residents of Saudi Arabia from March 20 to 24, 2020. Data were analyzed using descriptive, bivariate, and multivariable logistic regression analyses. Bivariate analysis of categorical variables was performed to determine the associations between information sources and socioeconomic and demographic factors. Multivariable logistic regression analyses were employed to examine whether socioeconomic and demographic variables were associated with the source of information used to obtain information about COVID-19. Moreover, univariable and multivariable logistic regression analyses were conducted to examine how sources of information influence attitudes and practices of adhering to preventive measures. RESULTS In this analysis of cross-sectional survey data, 3358 participants were included. Most participants reported using social media, followed by the Ministry of Health (MOH) of the Kingdom of Saudi Arabia, as their primary source of information. Seeking information via social media was significantly associated with lower odds of having an optimistic attitude (adjusted odds ratio [aOR] 0.845, 95% CI 0.733-0.974; P=.02) and adhering to preventive measures (aOR 0.725, 95% CI 0.630-0.835; P<.001) compared to other sources of information. Participants who obtained their COVID-19 information via the MOH had greater odds of having an optimistic attitude (aOR 1.437, 95% CI 1.234-1.673; P<.001) and adhering to preventive measures (aOR 1.393, 95% CI 1.201-1.615; P<.001) than those who obtained information via other sources. CONCLUSIONS This study provides evidence that different sources of information influence attitudes and preventive actions differently within a pandemic crisis context. Health authorities in Saudi Arabia should pay attention to the use of appropriate social media channels and sources to allow for more effective dissemination of critical information to the public.
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Affiliation(s)
- Noor Alshareef
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
- Health Economics Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ismaeel Yunusa
- College of Pharmacy, University of South Carolina, Columbia, SC, United States
| | - Mohammed Khaled Al-Hanawi
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
- Health Economics Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
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15
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Kouvonen A, Kemppainen L, Ketonen EL, Kemppainen T, Olakivi A, Wrede S. Digital Information Technology Use, Self-Rated Health, and Depression: Population-Based Analysis of a Survey Study on Older Migrants. J Med Internet Res 2021; 23:e20988. [PMID: 34125069 PMCID: PMC8240805 DOI: 10.2196/20988] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/28/2020] [Accepted: 05/19/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Previous studies have found that in general, poor health is associated with a lower likelihood of internet use in older adults, but it is not well known how different indicators of health are associated with different types of digital information technology (DIT) use. Moreover, little is known about the relationship between health and the types of DIT use in older ethnic minority and migrant populations. OBJECTIVE The aim of this study is to examine the associations among depressive symptoms and self-rated health (SRH) with different dimensions of DIT use in older migrants. METHODS We analyzed data from the Care, Health and Ageing of Russian-speaking Minority (CHARM) study, which is based on a nationally representative sample of community-dwelling, Russian-speaking adults aged 50 years or older residing permanently in Finland (men: 616/1082, 56.93%; age: mean 63.2 years, SD 8.4 years; response rate: 1082/3000, 36.07%). Data were collected in 2019 using a postal survey. Health was measured using depressive symptoms (measured using the Center for Epidemiologic Studies Depression Scale) and SRH. Binary logistic regression analyses were used to investigate the associations between the two health indicators and the following six outcomes: daily internet use, smartphone ownership, the use of the internet for messages and calls, social media use, the use of the internet for personal health data, and obtaining health information from the internet. A number of sociodemographic and socioeconomic factors were controlled for in the logistic regression regression analysis. Analyses were performed with weights accounting for the survey design and nonresponse. RESULTS After adjusting for sociodemographic and socioeconomic factors, depressive symptoms (odds ratio [OR] 2.68, 95% CI 1.37-5.24; P=.004) and poor SRH (OR 7.90, 95% CI 1.88-33.11; P=.005) were associated with a higher likelihood of not using the internet daily. Depressive symptoms (OR 1.88, 95% CI 1.06-3.35; P=.03) and poor SRH (OR 5.05, 95% CI 1.58-16.19; P=.006) also increased the likelihood of smartphone nonuse. Depressive symptoms were additionally associated with a lower likelihood of social media use, and poor SRH was associated with a lower likelihood of using the internet for messaging and calling. CONCLUSIONS Poor SRH and depressive symptoms are associated with a lower likelihood of DIT use in older adults. Longitudinal studies are required to determine the directions of these relationships.
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Affiliation(s)
- Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Research Institute of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Laura Kemppainen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | | | - Teemu Kemppainen
- Department of Geosciences and Geography, University of Helsinki, Helsinki, Finland
| | - Antero Olakivi
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Sirpa Wrede
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
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Zhu Y, Zhou Y, Long C, Yi C. The Relationship between Internet Use and Health among Older Adults in China: The Mediating Role of Social Capital. Healthcare (Basel) 2021; 9:healthcare9050559. [PMID: 34068702 PMCID: PMC8151524 DOI: 10.3390/healthcare9050559] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/02/2021] [Accepted: 05/07/2021] [Indexed: 11/18/2022] Open
Abstract
A growing academic attention has been paid to the health effects of Internet use among older adults. However, the relationship between Internet use and health among older adults in China remains to be studied further. On the one hand, existing research is still controversial on this issue. On the other hand, the underlying mechanism of how Internet use affects the health of older adults has not been fully explored. This article examined the relationship between Internet use and health among older adults with the mediating role of social capital in China based on the 2018 wave of China Health and Retirement Longitudinal Study (CHARLS). This study reveals that Internet use has a positive association with the health of older adults, and the positive effects of internet use among older adults are heterogeneous in age and residential location. In addition, this study also demonstrates that social capital plays a partial mediating role between Internet use and physical health among older adults. It is important for the government to take effective measures to expand Internet use and enhance social capital among older adults.
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Affiliation(s)
- Yumei Zhu
- School of Finance and Public Administration, Shanghai Lixin University of Accounting and Finance, Shanghai 201620, China;
| | - Yifan Zhou
- School of Political Science and Public Administration, East China University of Political Science and Law, Shanghai 201620, China;
| | - Cuihong Long
- School of Economics, East China Normal University, Shanghai 200062, China;
| | - Chengzhi Yi
- School of International and Public Affairs, China Institute for Urban Governance, Shanghai Jiaotong University, Shanghai 200030, China
- Correspondence:
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17
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Duplaga M. The association between Internet use and health-related outcomes in older adults and the elderly: a cross-sectional study. BMC Med Inform Decis Mak 2021; 21:150. [PMID: 33957909 PMCID: PMC8100743 DOI: 10.1186/s12911-021-01500-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/20/2021] [Indexed: 11/15/2022] Open
Abstract
Background Older adults and elderly persons can experience a significant digital divide. However, there are many studies reporting that the use of the Internet has benefits related to a person’s health status and social inclusion. It is not fully clear if Internet use and health-related outcomes share common antecedents or if using the Internet may have a favourable effect on the determinants responsible for good health. The main aim of this study was to assess the relationship between the use of the Internet and health-related outcomes in older adults and elderly people in Poland. Methods The effect of the use of the Internet was analysed with regression models after adjusting for sociodemographic factors. The data used for the analysis were obtained through a telephone-based survey on a representative sample of Polish adults at least 50 years of age. Results By categorising the frequency of Internet use by the respondents, it was found that some categories were significantly related to less favourable health behaviours. Rare Internet users were less likely to undertake physical activity than nonusers (odds ratio, OR, 95% confidence interval, 95%CI 0.48, 0.28–0.83). Those using the Internet every day less frequently consumed fruit and vegetables (OR, 95%CI 0.64, 0.42–0.99). Internet use was also associated with more frequent consumption of alcohol (OR, 95%CI 1.65, 1.09–2.50 comparing nonusers with those accessing the Internet several times a week). Persons rarely using the Internet, but not those who accessed it at least a few times a week, possessed a lower health literacy than nonusers (OR, 95%CI 0.71, 0.52–0.97). Internet users were also more likely to assess their health status as unsatisfactory (OR, 95%CI 0.59, 0.42–0.82 comparing nonusers with those using the Internet daily). Finally, the use of the Internet was consistently associated with a lower prevalence of chronic conditions and disability, as well as less frequent visits to health care facilities. Conclusions In conclusion, in contrast to earlier findings, Internet use is not associated with favourable patterns of lifestyle or higher self-rated health in older Polish adults. However, persons with chronic conditions or disabilities less frequently declare the use of the Internet. It was also revealed that older adults and the elderly who make use of the Internet are less likely to utilise health services.
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Affiliation(s)
- Mariusz Duplaga
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Skawińska Str. 8, 31-066, Kraków, Poland.
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18
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Liu PL. COVID-19 information on social media and preventive behaviors: Managing the pandemic through personal responsibility. Soc Sci Med 2021; 277:113928. [PMID: 33865093 PMCID: PMC8040317 DOI: 10.1016/j.socscimed.2021.113928] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 02/07/2023]
Abstract
In the face of a pandemic, social media have found to be vital information channels that might exert a positive influence on people's preventive behaviors. However, little is known about the underlying processes that may mediate or moderate the relationship. The present study examined the relation between novel coronavirus disease (COVID-19) information consumption on social media and preventive behaviors, as well as the mediation role of personal responsibility and moderation role of health orientation. A sample of 511 online participants (mean age = 32.47 years) responded to anonymous questionnaires regarding COVID-19 information consumption on social media, health orientation, personal responsibility, and preventive behaviors. Bias-corrected bootstrap method was used to test the moderated mediation model. Results indicated that after controlling for participants' age, gender, education, income, and insurance, personal responsibility mediated the relationship between COVID-19 information consumption on social media and preventive behaviors. Meanwhile, the direct relation between COVID-19 information consumption on social media and preventive behaviors, and the mediation effect of personal responsibility were moderated by health orientation. The present study can extend our knowledge about how risk information consumption on social media is related to one's behavioral outcomes. Implications and limitations about the present study are also discussed.
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Affiliation(s)
- Piper Liping Liu
- Department of Communication, University of Macau, Avenida da Universidade, Taipa, Macao.
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19
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Liu PL. COVID-19 Information Seeking on Digital Media and Preventive Behaviors: The Mediation Role of Worry. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 23:677-682. [DOI: 10.1089/cyber.2020.0250] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Piper Liping Liu
- Department of Communications and New Media, National University of Singapore, Singapore, Singapore
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20
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Williams BD, Pendleton N, Chandola T. Cognitively stimulating activities and risk of probable dementia or cognitive impairment in the English Longitudinal Study of Ageing. SSM Popul Health 2020; 12:100656. [PMID: 32984495 PMCID: PMC7495111 DOI: 10.1016/j.ssmph.2020.100656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 08/12/2020] [Accepted: 08/14/2020] [Indexed: 11/09/2022] Open
Abstract
Objectives To examine the association between cognitive stimulating activities (CSA) in later life (internet/email use, employment, volunteering, evening classes, social club membership and newspaper reading) and risk of cognitive impairment or dementia using marginal structural models to account for time-varying confounding affected by prior exposure. Methods Data were used from the English Longitudinal Study of Ageing waves 1 (2002) to 7 (2014), a nationally representative sample of adults in England aged ≥50. Self-reported participation in CSAs were measured as binary exposures from waves 2 (2004) to 6 (2012), with final sample sizes between n = 3937 and n = 2530 for different CSAs. Baseline exposure and covariates were used to create inverse probability of treatment and censoring weights (IPTCW). IPTCW repeated measures Poisson and linear regression were used to estimate each CSAs effect on risk of probable cognitive impairment or dementia at wave 7 (defined as a score of ≤11/27 on a modified telephone interview for cognitive status (TICS-27)). Results were compared to standard regression adjustment. Results Internet use at any wave (Risk ratios between 0.62 and 0.69) and volunteering in waves 3 to 6 (RRs between 0.516 and 0.633) were associated with reduced risk of cognitive impairment in IPTCW models. Standard estimates were similar for both internet use and volunteering. Newspaper reading (RR 95% Confidence interval 0.74–0.99) and social club membership (RR 95% CI 0.54–0.86) at wave 6 were significantly associated with risk of cognitive impairment in standard models, but not in the IPTCW models (RR 95% CI 0.82–1.11 and 0.60–1.08 respectively). Employment and evening classes were not associated with cognitive impairment in either model. Conclusions We found that volunteering and internet use were associated with reduced risk of cognitive impairment. Associations between newspaper reading or social club membership and cognitive impairment may be due to time-varying confounding affected by prior exposure. Confounding affected by past exposure is a problem in studies of cognitive function. We addressed this using inverse probability weighted marginal structural models. Volunteering and internet use were protective against cognitive impairment. Other cognitively stimulating activities were protective with standard regression. But these associations were non-significant in the marginal structural models.
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Affiliation(s)
- Benjamin David Williams
- Cathie Marsh Institute for Social Research, Humanities Bridgeford Street Building, University of Manchester, Manchester, M13 9PL, UK
| | - Neil Pendleton
- Institute of Brain, Behaviour and Mental Health, Stopford Building, University of Manchester, Manchester, M13 9PT, UK
| | - Tarani Chandola
- Cathie Marsh Institute for Social Research, Humanities Bridgeford Street Building, University of Manchester, Manchester, M13 9PL, UK
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21
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The Impact of Internet Use on Health Outcomes of Rural Adults: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186502. [PMID: 32906700 PMCID: PMC7559417 DOI: 10.3390/ijerph17186502] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/03/2020] [Accepted: 09/05/2020] [Indexed: 11/16/2022]
Abstract
Health, as basic human capital, is quite important for rural adults. However, in China, the average level of public health facilities and services is far lower in rural areas than in cities. In recent years, the internet has developed rapidly in China, and is increasingly affecting rural adults in a positive way. The purpose of this paper is to reveal whether internet use can be an effective way to improve the health of rural adults. This study used three rounds of data from the China Family Panel Studies (CFPS) collected in 2014, 2016, and 2018. After eliminating samples due to attrition, the study included 7528 villagers who were at least 16 years old. A panel logit model was employed to conduct an empirical analysis. The results indicate that internet use has a significantly positive impact on health outcomes of rural adults. By using the internet, rural adults can find a large amount of health information, increase their social interaction, and maintain physical exercise to improve their health. Thus, it is important to promote internet use for health purposes in rural areas. In addition, internet use had heterogeneous effects on the health of rural adults of different genders, age groups, and education levels. Attention should be focused on highly educated older men to improve the effects of internet use.
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22
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Neil-Sztramko SE, Belita E, Levinson AJ, Boyko J, Dobbins M. Evaluation of an online knowledge translation intervention to promote cancer risk reduction behaviours: findings from a randomized controlled trial. BMC Cancer 2019; 19:1138. [PMID: 31752751 PMCID: PMC6873728 DOI: 10.1186/s12885-019-6361-2] [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: 08/20/2019] [Accepted: 11/14/2019] [Indexed: 11/13/2022] Open
Abstract
Background Many cancers are preventable through lifestyle modification; however, few adults engage in behaviors that are in line with cancer prevention guidelines. This may be partly due to the mixed messages on effective cancer prevention strategies in popular media. The goal of the McMaster Optimal Aging Portal (the Portal) is to increase access to trustworthy health information. The purpose of this study was to explore if and how knowledge translation strategies to disseminate cancer prevention evidence using the Portal influence participants’ knowledge, intentions and health behaviors related to cancer risk. Methods Adults ≥40 years old, with no cancer history were randomized to a 12-week intervention (weekly emails and social media posts) or control group. Quantitative data on knowledge, intentions and behaviors (physical activity, diet, alcohol consumption and use of tobacco products) were collected at baseline, end of study and 3 months later. Participant engagement was assessed using Google Analytics, and participant satisfaction through open-ended survey questions and semi-structured interviews. Results Participants (n = 557, mean age 64.9) were predominantly retired (72%) females (81%). Knowledge of cancer prevention guidelines was higher in the intervention group at end of study only (+ 0.3, p = 0.01). Intentions to follow cancer prevention guidelines increased in both groups, with no between-group differences. Intervention participants reported greater light-intensity physical activity at end of study (+ 0.7 vs. 0.1, p = 0.03), and reduced alcohol intake at follow u (− 0.2 vs. + 0.3, p < 0.05), but no other between-group differences were found. Overall satisfaction with the Portal and intervention materials was high. Conclusions Dissemination of evidence-based cancer prevention information through the Portal results in small increases in knowledge of risk-reduction strategies and with little to no impact on self-reported health behaviours, except in particular groups. Further tailoring of knowledge translation strategies may be needed to see more meaningful change in knowledge and health behaviours. Trial registration ClinicalTrials.gov NCT03186703, June 14, 2017.
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Affiliation(s)
- Sarah E Neil-Sztramko
- McMaster University, 175 Longwood Rd South, Suite 210a, Hamilton, ON, L8P 3Y2, Canada. .,The National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada.
| | - Emily Belita
- McMaster University, 175 Longwood Rd South, Suite 210a, Hamilton, ON, L8P 3Y2, Canada
| | - Anthony J Levinson
- McMaster University, 175 Longwood Rd South, Suite 210a, Hamilton, ON, L8P 3Y2, Canada
| | - Jennifer Boyko
- McMaster University, 175 Longwood Rd South, Suite 210a, Hamilton, ON, L8P 3Y2, Canada
| | - Maureen Dobbins
- McMaster University, 175 Longwood Rd South, Suite 210a, Hamilton, ON, L8P 3Y2, Canada.,The National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada
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Tomioka K, Kurumatani N, Saeki K. Cross-Sectional Association Between Types of Leisure Activities and Self-rated Health According to Gender and Work Status Among Older Japanese Adults. J Epidemiol 2019; 29:424-431. [PMID: 30318494 PMCID: PMC6776474 DOI: 10.2188/jea.je20180108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Participation in leisure activities (LA) is essential for successful aging. Our aim was to investigate the cross-sectional association of types of LA with self-rated health (SRH) by gender and work status. Methods The target population was all residents aged ≥65 years in a municipality (n = 16,010; response rate, 62.5%). We analyzed 4,044 men and 4,617 women without disabilities. LA were categorized into 14 types. SRH was assessed through the SF-8. Excellent or very good SRH was defined as positive SRH. Covariates included age, marital status, education, subjective economic status, body mass index, chronic diseases, alcohol, smoking, walking time, depression, and cognitive functioning. Multiple logistic regressions were used to calculate the odds ratio (OR) and 95% confidence interval (CI) for positive SRH, with non-participation as the reference. Results After adjustment for covariates and mutual adjustment for other LA, participation in the following types of LA was positively associated with positive SRH: sports activities among working men (OR 1.46; 95% CI, 1.07–2.00), non-working men (OR 1.33; 95% CI, 1.04–1.69), and non-working women (OR 1.74; 95% CI, 1.41–2.15); cooking among non-working men (OR 1.65; 95% CI, 1.18–2.33) and non-working women (OR 1.28; 95% CI, 1.03–1.60); musical activities among working men (OR 1.44; 95% CI, 1.01–2.05) and non-working women (OR 1.59; 95% CI, 1.29–1.95); and technology usage only among working men (OR 1.41; 95% CI, 1.01–1.96). In contrast, TV watching was negatively associated with positive SRH among non-working women (OR 0.69; 95% CI, 0.56–0.85). Conclusions Our results suggest that encouraging older adults to participate in types of LA appropriate to their gender and work status might be a key to positive SRH.
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Affiliation(s)
- Kimiko Tomioka
- Nara Prefectural Health Research Center, Nara Medical University
| | - Norio Kurumatani
- Nara Prefectural Health Research Center, Nara Medical University
| | - Keigo Saeki
- Nara Prefectural Health Research Center, Nara Medical University
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Jin Y, Jing M, Ma X. Effects of Digital Device Ownership on Cognitive Decline in a Middle-Aged and Elderly Population: Longitudinal Observational Study. J Med Internet Res 2019; 21:e14210. [PMID: 31359864 PMCID: PMC6690159 DOI: 10.2196/14210] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/02/2019] [Accepted: 06/18/2019] [Indexed: 01/17/2023] Open
Abstract
Background Cognitive decline is a major risk factor for disability and death and may serve as a precursor of dementia. Digital devices can provide a platform of cognitively stimulating activities which might help to slow cognitive decline during the process of normal aging. Objective This longitudinal study aimed to examine the independent protective factors of desktop and cellphone ownership against cognitive decline in mid-life and older adulthood and to examine the combined effect of desktop and cellphone ownership on the same outcome. Methods Data was obtained from a China Health and Retirement Longitudinal Studies (CHARLS) cohort made up of 13,457 community-dwelling adults aged 45 years or above in 2011-2012. They were followed for 4 years, with baseline measurements taken as well as 2 two-year follow-up visits. Cognitive function was tested during the baseline test and follow-up visits. A global cognition z-score was calculated based on two domains: word recall and mental intactness. The key independent variables were defined as: whether one had desktops with internet connection at home and whether one had a cellphone. An additional categorical variable of three values was constructed as: 0 (no desktop or cellphone), 1 (desktop or cellphone alone), and 2 (desktop and cellphone both). Mixed-effects regression was adjusted for demographic and health behavior as well as health condition risk factors. Results Adjusted for demographic and health behavior as well as health condition risk factors, desktop and cellphone ownership were independently associated with subsequent decreased cognitive decline over the four-year period. Participants without a desktop at home had an adjusted cognitive decline of –0.16 standard deviations (95% CI –0.18 to –0.15), while participants with a desktop at home had an adjusted cognitive decline of –0.10 standard deviations (95% CI –0.14 to –0.07; difference of –0.06 standard deviations; P=.003). A similar pattern of significantly protective association of 0.06 standard deviations (95% CI 0.03-0.10; P<.001) between cellphone ownership and cognitive function was observed over the four-year period. Additionally, a larger longitudinal protective association on cognitive decline was observed among those with both of the digital devices, although the 95% CIs for the coefficients overlapped with those with a single digital device alone. Conclusions Findings from this study underscored the importance of digital devices as platforms for cognitively stimulating activities to delay cognitive decline. Future studies focusing on use of digital devices are warranted to investigate their longitudinal protective factors against cognitive decline at mid- and later life.
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Affiliation(s)
- Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Mingxia Jing
- Department of Public Health, Shihezi University School of Medicine, Xinjiang, China
| | - Xiaochen Ma
- China Center for Health Development Studies, Peking University, Beijing, China
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Song Y, Chen YY. Information and communication technology among early and late middle-aged adults in urban China: Daily use and anticipated support in old age. Australas J Ageing 2019; 38:e85-e92. [PMID: 31077541 DOI: 10.1111/ajag.12668] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 04/02/2019] [Accepted: 04/07/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Guided by the unified theory of acceptance and use of technology (UTAUT), the study explored information and communications technology (ICT) use and anticipation among middle-aged adults in urban China. METHODS Path analysis was performed on data from 401 participants aged 45-65 to examine the associations between anticipated ICT support and the acceptance and adoption process of ICT. RESULTS For the late middle-aged adults, those who had greater belief in ICT usefulness and received more social support for ICT use were more likely to anticipate greater ICT support in old age. These associations were not found in the early middle-aged group. DISCUSSION The frequency of ICT use may be the key explanation for different ICT predictors and patterns. The constructs of UTAUT are sequential steps. Middle-aged adults may believe in ICT usefulness even though they have not witnessed it in person.
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Affiliation(s)
- Yajun Song
- Department of Social Work, East China University of Science and Technology, Shanghai, China
| | - Yan-Yan Chen
- Department of Social Work, Fudan University, Shanghai, China
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Souza BBD, Cembranel F, Hallal ALC, d'Orsi E. Consumption of fruits and vegetables and association with life habits and nutritional status: a prospective study in a cohort of the elderly. CIENCIA & SAUDE COLETIVA 2019; 24:1463-1472. [PMID: 31066848 DOI: 10.1590/1413-81232018244.03782017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/01/2017] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to estimate the association between life habits and adequate consumption of fruits and vegetables (F&V) after four years of follow-up among elderly of a cohort in Florianópolis, Santa Catarina. This is a longitudinal population-based study, the sample being composed of individuals 60 years of age or older living in the urban area of the city of Florianópolis-SC. The baseline study took place in 2009-2010 and the second wave in 2013-2014. Adequate consumption was assessed by considering the frequency of ingestion of F&V at least five times a day at least five times a week. Life habits (smoking, alcohol consumption, physical activity and Internet use) and a biological variable (nutritional status) were associated. Multilevel logistic regression was used for the statistical analysis. There was a 5.23% increase in F&V consumption between evaluations. In the adjusted final models, internet use was associated with a greater chance of regular consumption of F&V (OR = 1.48, 95% CI: 1.09 - 2.01), while overweight was associated with a lower chance of outcome (OR = 0.76, 95% CI: 0.61 - 0.95). In conclusion, using the internet has proven to contribute significantly to a more adequate diet in F&V, as well as being overweight has shown to be a risk factor.
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Affiliation(s)
- Bianca Bittencourt de Souza
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina (UFSC). Campus Universitário, Trindade. 88040-900 Florianópolis SC Brasil.
| | | | | | - Eleonora d'Orsi
- Departamento de Saúde Pública, UFSC. Florianópolis SC Brasil
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Nam S, Han SH, Gilligan M. Internet Use and Preventive Health Behaviors Among Couples in Later Life: Evidence from the Health and Retirement Study. THE GERONTOLOGIST 2019; 59:69-77. [PMID: 29790951 DOI: 10.1093/geront/gny044] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/16/2018] [Indexed: 12/18/2022] Open
Abstract
Background and Objectives The aim of this study was to examine the link between internet use and preventive health behaviors. We focused on couples to examine whether there were cross-partner associations between internet use and preventive health behaviors. Research Design and Methods The data for this study came from the 2010 and 2012 waves of the Health and Retirement Study and the sample consisted of 5,143 pairs of coupled-individuals. Preventive health behaviors included cancer screenings (mammogram and prostate tests), cholesterol tests, and flu shots. Logistic multilevel actor-partner interdependence models were employed to test the study hypotheses. Results Internet use was associated with a higher likelihood of receiving prostate exams and cholesterol tests for husbands, net of demographic and health characteristics, and insurance status. We found that wives' internet use was associated with a higher likelihood of receiving flu shots and prostate exams for husbands, but husbands' internet use was not associated with wives' preventive health behaviors. Discussion and Implications Research linking internet use and preventive health behaviors is important because such behaviors are associated not only with health of the older population but also with substantial reductions in health care expenditures. Our findings suggested that internet use of older adults is associated with their own preventive health behaviors, as well as their spouses' preventive health behaviors. Interventions and programs to facilitate older adults' preventive health behaviors should consider couple-based approaches.
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Affiliation(s)
- Sangbo Nam
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa
| | - Sae Hwang Han
- Department of Gerontology, University of Massachusetts Boston, Boston, Massachusetts
| | - Megan Gilligan
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa
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Krug RDR, d'Orsi E, Xavier AJ. Association between use of internet and the cognitive function in older adults, populational longitudinal study EpiFloripa Idoso. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22:e190012. [PMID: 30892475 DOI: 10.1590/1980-549720190012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 04/05/2018] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To estimate the association between the internet and the gain or loss cognite along of four years in older adults. METHODS Longitudinal study, a population-based, with older adults residents in a capital of southern Brazil (≥ 60 years) surveyed in 2009-10 (baseline) and in 2013-14 (follow-up). The outcome was assessed by clinically significant gain or loss of four or more points in the score of the Mini Mental State Examination between the two interviews. The use of internet was measured longitudinally (maintained or not internet usage, stop use of internet, started using the internet, retained the use of internet). Odds Ratios (OR) were estimated adjusted for sex, age, household income, education level and cognitive screening at baseline. RESULTS Respondents were 1.705 older adults in 2009-10 and 1.197 in 2013-14. There was a significant association between keep using internet and cognitive performance, with greater chance of cognitive gain (OR= 3.3; 95%CI 1.1 - 9.8) and lower cognitive impairment (OR = 0.39; 95%CI 0.17 - 0.88) for older adults who kept using the internet. CONCLUSION Older adults who continue using the internet were more likely to gain significant cognitive and lower cognitive loss. Topromote the internet use in older adults can help a strategy for cognitive stimulation in older adults.
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Affiliation(s)
- Rodrigo de Rosso Krug
- Programa de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - Florianópolis (SC), Brasil.,Programa de Pós-Graduação em Atenção Integral à Saúde, Centro de Ciências da Saúde e Agropecuária, Universidade de Cruz Alta - Cruz Alta (RS), Brasil
| | - Eleonora d'Orsi
- Programa de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - Florianópolis (SC), Brasil.,Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - Florianópolis (SC), Brasil
| | - André Junqueira Xavier
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina - Florianópolis (SC), Brasil.,Universidade do Sul de Santa Catarina - Palhoça (SC), Brasil
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d’ Orsi E, Xavier AJ, Rafnsson SB, Steptoe A, Hogervorst E, Orrell M. Is use of the internet in midlife associated with lower dementia incidence? Results from the English Longitudinal Study of Ageing. Aging Ment Health 2018; 22:1525-1533. [PMID: 28795579 PMCID: PMC6127001 DOI: 10.1080/13607863.2017.1360840] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 07/24/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Dementia is expected to affect one million individuals in the United Kingdom by 2025; its prodromal phase may start decades before its clinical onset. The aim of this study is to investigate whether use of internet from 50 years of age is associated with a lower incidence of dementia over a ten-year follow-up. METHODS We analysed data based on 8,238 dementia free (at baseline in 2002-2004) core participants from the English Longitudinal Study of Ageing. Information on baseline use of internet was obtained through questionnaires; dementia casesness was based on participant (or informant) reported physician diagnosed dementia or overall score on the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Cox proportional hazards regression analysis was used for examining the relationship between internet use and incident dementia. RESULTS There were 301 (5.01%) incident dementia cases during the follow-up. After full multivariable adjustment for potential confounding factors, baseline internet use was associated with a 40% reduction in dementia risk assessed between 2006-2012 (HR = 0.60 CI: 0.42-0.85; p < 0.05). CONCLUSION This study suggests that use of internet by individuals aged 50 years or older is associated with a reduced risk of dementia. Additional studies are needed to better understand the potential causal mechanisms underlying this association.
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Affiliation(s)
- Eleonora d’ Orsi
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Campus Universitário Trindade, Florianópolis, Brazil ZIP CODE: 88040-900; Tel: +55 48 37219388;
| | - Andre Junqueira Xavier
- Universidade do Sul de Santa Catarina, Av Pedra Branca, 25 - Cidade Universitária, ZIP CODE: 88137-270, Palhoça, Brazil; Tel: +55(48)91647539;
| | - Snorri Bjorn Rafnsson
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK. Tel: +44 (0)20 7679 2000;
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK WC1E 6BT, UK. Tel: +44 (0)20 7679 2000;
| | - Eef Hogervorst
- Applied Cognitive Research NCSEM, Loughborough University, LE11 3TU UK, Tel:+44 (0)1509 223020;
| | - Martin Orrell
- Institute of Mental Health, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, NG7 2UH, UK; Tel: +441159515151;
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Abstract
Internet use has spread rapidly worldwide in recent years, but the proportion of older people who use it remains low in Taiwan. Meanwhile, due to population aging in the country, chronic diseases have become more prevalent among older people. This study explores the link between exposure to the Internet and adoption of a healthy lifestyle among the middle-aged and elderly people. Data are drawn from the Topic on Health of the 2011 Taiwan Social Change Survey. We use the logistic regression as the baseline model and apply the propensity-score weighting method to identify the effect of Internet use on exercising, vegetable and fruit eating, betel nut chewing, smoking, and heavy drinking. Our results show that people aged 40 years and older who use the Internet regularly are more likely to adopt an overall healthy lifestyle. The findings suggest that the Internet is a good channel to enhance people's health investment.
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Affiliation(s)
- Yu-I Peng
- National Taipei University, New Taipei City, Taiwan
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Krug RDR, Xavier AJ, d'Orsi E. Factors associated with maintenance of the use of internet, EpiFloripa Idoso longitudinal study. Rev Saude Publica 2018; 52:37. [PMID: 29641661 PMCID: PMC5893268 DOI: 10.11606/s1518-8787.2018052000216] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 09/22/2017] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To describe the use of the internet and to identify the sociodemographic and health factors associated with changes in the use of the internet over four years in older adults participating in the Brazilian EpiFloripa Idoso study. METHODS This is a longitudinal home-based, population-based study with 1,197 older adults who live in the urban area of Florianópolis, State of Santa Catarina, Brazil. We applied a face-to-face interview. We describe the use of internet according to frequency, place, devices, and motives of the use of the internet. To identify factors associated with changes in the use of the internet, we categorized the outcome as: non-use of the internet, stopped using the internet, started using the internet, and kept using the internet. The independent variables were sex, age, family income, education level, family arrangement, marital status, presence of caregiver, paid work, and cognitive impairment screening. We used multinomial logistic regression with risk ratio (RR) estimates and their respective confidence intervals (95%CI). RESULTS The prevalence of the use of internet increased from 22.9% in 2009-2010 to 26.6% in 2013-2014. Of the total number of older adults who participated in the study, 7.5% started using the internet, 3.2% stopped using it, 19.1% kept their use, and 70.2% kept their non-use in the analyzed period. Of the older adults who used the internet, most used it every day or almost every day of the week, in their own home, on desktop or portable computers, mainly to send and receive messages, to search for information to learn or investigate something, to find information about goods and services, and to use news, social networking, and health information websites. The factors associated with the use of internet over four years were: being male (RR = 2.19, 95%CI 1.48-3.26), higher monthly family income (RR = 3.53, 95%CI 1.35-9.23), higher education level (RR = 2.64, 95%CI 1.57-4.43), and no presence of caregiver (RR = 0.08, 95%CI 0.02-0.31). CONCLUSIONS Although the use of the internet is increasing among older adults, most of the population is still digitally excluded, especially women with lower income and education level. Strategies that promote the digital inclusion of older adults should be stimulated, aiming to universalize the use of the internet, and they should take into account socioeconomic and gender inequalities.
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Affiliation(s)
- Rodrigo de Rosso Krug
- Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Ciências Médicas. Florianópolis, SC, Brasil.,Universidade de Cruz Alta. Programa de Pós-Graduação em Atenção Integral em Saúde. Cruz Alta, RS, Brasil
| | - André Junqueira Xavier
- Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Saúde Coletiva. Florianópolis, SC, Brasil
| | - Eleonora d'Orsi
- Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Ciências Médicas. Florianópolis, SC, Brasil.,Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Saúde Coletiva. Florianópolis, SC, Brasil
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Kim EJ, Yuan Y, Liebschutz J, Cabral H, Kazis L. Understanding the Digital Gap Among US Adults With Disability: Cross-Sectional Analysis of the Health Information National Trends Survey 2013. JMIR Rehabil Assist Technol 2018; 5:e3. [PMID: 29549074 PMCID: PMC5878361 DOI: 10.2196/rehab.8783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 01/02/2018] [Accepted: 01/06/2018] [Indexed: 01/08/2023] Open
Abstract
Background Disabilities affect more than 1 in 5 US adults, and those with disabilities face multiple barriers in accessing health care. A digital gap, defined as the disparity caused by differences in the ability to use advanced technologies, is assumed to be prevalent among individuals with disabilities. Objective This study examined the associations between disability and use of information technology (IT) in obtaining health information and between trust factors and IT use. We hypothesized that compared to US adults without disabilities, those with disabilities are less likely to refer to the internet for health information, more likely to refer to a health care provider to obtain health information, and less likely to use IT to exchange medical information with a provider. Additionally, we hypothesized that trust factors, such as trust toward health information source and willingness to exchange health information, are associated with IT use. Methods The primary database was the 2013 Health Information National Trends Survey 4 Cycle 3 (N=3185). Disability status, the primary study covariate, was based on 6 questions that encompassed a wide spectrum of conditions, including impairments in mobility, cognition, independent living, vision, hearing, and self-care. Study covariates included sociodemographic factors, respondents’ trust toward the internet and provider as information sources, and willingness to exchange medical information via IT with providers. Study outcomes were the use of the internet as the primary health information source, use of health care providers as the primary health information source, and use of IT to exchange medical information with providers. We conducted multivariate logistic regressions to examine the association between disability and study outcomes controlling for study covariates. Multiple imputations with fully conditional specification were used to impute missing values. Results We found presence of any disability was associated with decreased odds (adjusted odds ratio [AOR] 0.65, 95% CI 0.43-0.98) of obtaining health information from the internet, in particular for those with vision disability (AOR 0.27, 95% CI 0.11-0.65) and those with mobility disability (AOR 0.51, 95% CI 0.30-0.88). Compared to those without disabilities, those with disabilities were significantly more likely to consult a health care provider for health information in both actual (OR 2.21, 95% CI 1.54-3.18) and hypothetical situations (OR 1.80, 95% CI 1.24-2.60). Trust toward health information from the internet (AOR 3.62, 95% CI 2.07-6.33), and willingness to exchange via IT medical information with a provider (AOR 1.88, 95% CI 1.57-2.24) were significant predictors for seeking and exchanging such information, respectively. Conclusions A potential digital gap may exist among US adults with disabilities in terms of their recent use of the internet for health information. Trust toward health information sources and willingness play an important role in people’s engagement in use of the internet for health information. Future studies should focus on addressing trust factors associated with IT use and developing tools to improve access to care for those with disabilities.
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Affiliation(s)
- Eun Ji Kim
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, United States
| | - Yiyang Yuan
- University of Massachusetts Medical School, Worcester, MA, United States
| | | | - Howard Cabral
- Boston University School of Public Health, Boston, MA, United States
| | - Lewis Kazis
- Boston University School of Public Health, Boston, MA, United States
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Scheerder A, van Deursen A, van Dijk J. Determinants of Internet skills, uses and outcomes. A systematic review of the second- and third-level digital divide. TELEMATICS AND INFORMATICS 2017. [DOI: 10.1016/j.tele.2017.07.007] [Citation(s) in RCA: 386] [Impact Index Per Article: 55.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lee HY, Kim J, Sharratt M. Technology use and its association with health and depressive symptoms in older cancer survivors. Qual Life Res 2017; 27:467-477. [PMID: 29128998 DOI: 10.1007/s11136-017-1734-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE Acknowledging the expanding influence of technology in the promotion of health and wellness, this study assessed the role of information and communication technology (ICT) use in the lives of older cancer survivors. METHODS A community sample of cancer survivors aged 65 and older (N = 1411) was extracted from a 2011 U.S. National Health and Aging Trends Study dataset. Weighted multiple regression and multinomial logistic regression analyses were performed to explore the relationships between survey respondents' ICT use and their self-rated health status and depressive symptoms. RESULTS The majority of respondents reported rarely or never engaging in ICT use. Greater use of communication technology such as emailing or texting was associated with decreased risk for severe depressive symptoms and higher self-rated health status. Information technology use was not associated with depressive symptoms and self-rated health status. CONCLUSIONS Investigation into reasons behind older cancer survivors' apparent low rates of engagement with ICT is warranted, particularly the examination of access as a potential barrier. Findings indicated that frequent use of communication technology was positively linked with mental and physical wellness. The nature of the relationships between communication technology use and physical and mental health merits further research, helping to determine whether community-based educational efforts to improve technology access and skills may benefit the growing population of older cancer survivors.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, University of Minnesota, Twin Cities, 105 Peters Hall, 1404 Gortner Avenue, St. Paul, MN, 55108, USA.
| | - Jeehoon Kim
- Department of Sociology, Social Work, and Criminology, Idaho State University, Pocatello, ID, USA
| | - Monica Sharratt
- School of Social Work, University of Minnesota, Twin Cities, 105 Peters Hall, 1404 Gortner Avenue, St. Paul, MN, 55108, USA
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Richards A, Inslicht SS, Metzler TJ, Mohlenhoff BS, Rao MN, O'Donovan A, Neylan TC. Sleep and Cognitive Performance From Teens To Old Age: More Is Not Better. Sleep 2017; 40:2972132. [PMID: 28364476 DOI: 10.1093/sleep/zsw029] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2017] [Indexed: 11/14/2022] Open
Abstract
Objectives To determine the interaction of age and habitual sleep duration in predicting cognitive performance in a large sample of participants aged 15 to 89 years. Methods This study is a cross-sectional analysis of performance data gathered between January 2012 and September 2013. First-time players (N = 512823) of three internet cognitive training games measuring processing speed, working memory, visuospatial memory, and arithmetic participated in the study. Results Performance was based on a measure of speed and accuracy for each game. The relationship between performance and self-reported habitual sleep duration was examined in the sample as a whole and across 10-year age groups starting at age 15 and ending at 75 and older. Performance peaked at 7 h of sleep duration for all three games in the sample as a whole, and the decrements in performance for sleep durations greater than 7 h were either comparable or greater in the youngest as compared to the oldest age groups. Conclusions These findings challenge the hypothesis that deteriorating cognitive performance with long sleep duration is driven by medical comorbidities associated with aging. Further, these data are consistent with an optimal dose model of sleep and suggest that the model for the homeostatic recovery of cognitive function as a function of sleep duration should incorporate a curvilinear decline with longer duration sleep, indicating that there may be a cost to increased sleep. Replication and further research is essential for clarifying the sleep duration-cognition relationship in youth and adults of all ages.
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Affiliation(s)
- Anne Richards
- University of California, San Francisco, CA.,San Francisco VA Medical Center, San Francisco, CA
| | - Sabra S Inslicht
- University of California, San Francisco, CA.,San Francisco VA Medical Center, San Francisco, CA
| | | | - Brian S Mohlenhoff
- University of California, San Francisco, CA.,San Francisco VA Medical Center, San Francisco, CA
| | | | - Aoife O'Donovan
- University of California, San Francisco, CA.,San Francisco VA Medical Center, San Francisco, CA
| | - Thomas C Neylan
- University of California, San Francisco, CA.,San Francisco VA Medical Center, San Francisco, CA
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Jiang S, Street RL. Pathway Linking Internet Health Information Seeking to Better Health: A Moderated Mediation Study. HEALTH COMMUNICATION 2017; 32:1024-1031. [PMID: 27464036 DOI: 10.1080/10410236.2016.1196514] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The Internet increasingly has been recognized as an important medium with respect to population health. However, little is known about the mechanisms that underlie the potential impact of health-related Internet use on health outcomes. Based on the three-stage model of health promotion using interactive media, this study empirically tested a moderated mediation pathway model. Results showed that the effect of Internet health information seeking on three health outcomes (general, emotional, and physical) was completely mediated by respondents' access to social support resources. In addition, users' online health information seeking experience positively moderated this mediation path. The findings have significant theoretical and practical implications for the design of Internet-based health promotion resources to improve health outcomes.
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Affiliation(s)
- Shaohai Jiang
- a Department of Communication , Texas A&M University
| | - Richard L Street
- a Department of Communication , Texas A&M University
- b Department of Medicine , Baylor College of Medicine
- c Houston Center for Innovation in Quality , Effectiveness, and Safety, Michael E. DeBakey VA Medical Center
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Krug RDR, Silva AQAD, Schneider IJC, Ramos LR, d'Orsi E, Xavier AJ. Cognitive cooperation groups mediated by computers and internet present significant improvement of cognitive status in older adults with memory complaints: a controlled prospective study. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 75:228-233. [PMID: 28489142 DOI: 10.1590/0004-282x20170021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 12/27/2016] [Indexed: 03/31/2023]
Abstract
Objective To estimate the effect of participating in cognitive cooperation groups, mediated by computers and the internet, on the Mini-Mental State Examination (MMSE) percent variation of outpatients with memory complaints attending two memory clinics. Methods A prospective controlled intervention study carried out from 2006 to 2013 with 293 elders. The intervention group (n = 160) attended a cognitive cooperation group (20 sessions of 1.5 hours each). The control group (n = 133) received routine medical care. Outcome was the percent variation in the MMSE. Control variables included gender, age, marital status, schooling, hypertension, diabetes, dyslipidaemia, hypothyroidism, depression, vascular diseases, polymedication, use of benzodiazepines, exposure to tobacco, sedentary lifestyle, obesity and functional capacity. The final model was obtained by multivariate linear regression. Results The intervention group obtained an independent positive variation of 24.39% (CI 95% = 14.86/33.91) in the MMSE compared to the control group. Conclusion The results suggested that cognitive cooperation groups, mediated by computers and the internet, are associated with cognitive status improvement of older adults in memory clinics.
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Affiliation(s)
- Rodrigo de Rosso Krug
- Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Ciência Médicas, Florianópolis SC, Brasil
| | - Anna Quialheiro Abreu da Silva
- Universidade do Sul de Santa Catarina, Palhoça SC, Brasil.,Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Florianópolis SC, Brasil
| | - Ione Jayce Ceola Schneider
- Universidade Federal de Santa Catarina, Curso de Fisioterapia, Programa de Pós-Graduação em Ciências da Reabilitação, Araranguá SC, Brasil
| | - Luiz Roberto Ramos
- Universidade de Federal de São Paulo, Programa de Pós-Graduação em Saúde Coletiva, São Paulo SP, Brasil
| | - Eleonora d'Orsi
- Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Ciência Médicas, Florianópolis SC, Brasil.,Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Florianópolis SC, Brasil
| | - André Junqueira Xavier
- Universidade do Sul de Santa Catarina, Palhoça SC, Brasil.,Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Florianópolis SC, Brasil
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Estacio EV, Whittle R, Protheroe J. The digital divide: Examining socio-demographic factors associated with health literacy, access and use of internet to seek health information. J Health Psychol 2017; 24:1668-1675. [DOI: 10.1177/1359105317695429] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This article aims to examine the socio-demographic characteristics associated with access and use of Internet for health-related purposes and its relationship with health literacy. Data were drawn from a health literacy survey ( N = 1046) and analysed using logistic regression. Results show a strong association between health literacy, internet access and use. Socio-demographic characteristics particularly age, education, income, perceived health and social isolation also predict internet access. Thus, in addition to widening access, the movement towards digitisation of health information and services should also consider digital skills development to enable people to utilise digital technology more effectively, especially among traditionally hard-to-reach communities.
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The role of social media use in improving cancer survivors’ emotional well-being: a moderated mediation study. J Cancer Surviv 2017; 11:386-392. [DOI: 10.1007/s11764-017-0595-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 01/03/2017] [Indexed: 10/20/2022]
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Marques LP, Schneider IJC, d'Orsi E. Quality of life and its association with work, the Internet, participation in groups and physical activity among the elderly from the EpiFloripa survey, Florianópolis, Santa Catarina State, Brazil. CAD SAUDE PUBLICA 2016; 32:e00143615. [PMID: 28001209 DOI: 10.1590/0102-311x00143615] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 03/22/2016] [Indexed: 11/22/2022] Open
Abstract
The study aimed to investigate the association between changes in social relations and physical activity on the quality of life of the elderly in the city of Florianópolis, Santa Catarina state, Brazil. Data on 1,197 elderly from two waves of the population and household survey, EpiFloripa Idoso, were analyzed. Multiple linear regression was performed to estimate association of social change variables and lifestyle on quality of life score (QoL; measured by CASP-16 Brazil, score can range from 0, which represents no QoL to 48, total satisfaction in all domains of CASP). The average QoL score in the sample was 37.6 (95%CI: 37.2; 38.1). The social relations that were associated with positive QoL score were to start to work, to continue to use the Internet, to start participating in religious or lifestyle groups, to remain and to become physically active, and for those who were physically active, but became inactive in the second wave. To remain living with family had a negative effect on QoL score for the elderly. Some changes in social relations had a positive effect on QoL, and results reaffirmed the importance of physical activity to healthy aging, since to pursue it in some of the waves was better than to remain inactive.
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Affiliation(s)
- Larissa Pruner Marques
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis, Brasil
| | | | - Eleonora d'Orsi
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis, Brasil
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Smith SG, McGregor LM, Raine R, Wardle J, von Wagner C, Robb KA. Inequalities in cancer screening participation: examining differences in perceived benefits and barriers. Psychooncology 2016; 25:1168-1174. [PMID: 27309861 PMCID: PMC5082500 DOI: 10.1002/pon.4195] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 06/09/2016] [Accepted: 06/10/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Inequalities exist in colorectal cancer (CRC) screening uptake, with people from lower socioeconomic status backgrounds less likely to participate. Identifying the facilitators and barriers to screening uptake is important to addressing screening disparities. We pooled data from 2 trials to examine educational differences in psychological constructs related to guaiac fecal occult blood testing. METHODS Patients (n = 8576) registered at 7 general practices in England, within 15 years of the eligible age range for screening (45-59.5 years), were invited to complete a questionnaire. Measures included perceived barriers (emotional and practical) and benefits of screening, screening intentions, and participant characteristics including education. RESULTS After data pooling, 2181 responses were included. People with high school education or no formal education reported higher emotional and practical barriers and were less likely to definitely intend to participate in screening, compared with university graduates in analyses controlling for study arm and participant characteristics. The belief that one would worry more about CRC after screening and concerns about tempting fate were strongly negatively associated with education. In a model including education and participant characteristics, respondents with low emotional barriers, low practical barriers, and high perceived benefits were more likely to definitely intend to take part in screening. CONCLUSIONS In this analysis of adults approaching the CRC screening age, there was a consistent effect of education on perceived barriers toward guaiac fecal occult blood testing, which could affect screening decision making. Interventions should target specific barriers to reduce educational disparities in screening uptake and avoid exacerbating inequalities in CRC mortality.
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Affiliation(s)
- S G Smith
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
- Department of Epidemiology and Public Health, University College London, London, UK.
| | - L M McGregor
- Department of Epidemiology and Public Health, University College London, London, UK
| | - R Raine
- Department of Applied Health Research, University College London, London, UK
| | - J Wardle
- Department of Epidemiology and Public Health, University College London, London, UK
| | - C von Wagner
- Department of Epidemiology and Public Health, University College London, London, UK
| | - K A Robb
- Department of Epidemiology and Public Health, University College London, London, UK
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Morton TA, Wilson N, Haslam C, Birney M, Kingston R, McCloskey LG. Activating and Guiding the Engagement of Seniors With Online Social Networking: Experimental Findings From the AGES 2.0 Project. J Aging Health 2016; 30:27-51. [PMID: 27530332 DOI: 10.1177/0898264316664440] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Guided by theoretical and empirical work attesting to the health benefits of social connections, we tested whether Internet connectivity, and training in its use for social purposes, can support the well-being of older adults receiving care. METHOD Participants ( N = 76) were randomly assigned to receive 3 months training versus care-as-usual. Cognitive and mental health were assessed before and after the intervention. RESULTS Results show significant cognitive improvements across time in the training, but not control, group. This effect was mediated through a combination of increased social activity, improved self-competence, and maintained personal identity strength. Indirect effects on mental health outcomes via these processes were also observed. DISCUSSION These findings suggest that Internet access and training can support the self and social connectedness of vulnerable older adults and contribute positively to well-being.
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Confortin SC, Giehl MWC, Antes DL, Schneider IJC, d'Orsi E. Positive self-rated health in the elderly: a population-based study in the South of Brazil. CAD SAUDE PUBLICA 2015; 31:1049-60. [PMID: 26083179 DOI: 10.1590/0102-311x00132014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 12/08/2014] [Indexed: 11/21/2022] Open
Abstract
The objective was to identify factors associated with positive self-rated health in the elderly in Florianópolis, Santa Catarina State, in the South of Brazil. This population-based cross-sectional study evaluated 1,705 elderly. Self-rated health was classified as positive (very good or good) or negative (fair, poor, and very poor). Crude and adjusted Poisson regression was used to identify associated factors. Prevalence of positive self-rated health was 51.2%, associated with male gender (PR = 1.13), more than 5 years of schooling, moderate (PR = 1.33) or high alcohol intake (PR = 1.37), leisure-time activity (PR = 1.20), Internet use (PR = 1.21), fewer diseases, mild/moderate dependence (PR = 2.20) or no dependence (PR = 2.67), no falls (PR = 1.19), and non-use of polypharmacy (PR = 1.27). Several modifiable factors were identified that can affect positive self-rated health in the elderly and contribute to the development of strategies to improve their quality of life.
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Affiliation(s)
| | | | | | | | - Eleonora d'Orsi
- Universidade Federal de Santa Catarina, Florianópolis, Brasil
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Azadmanjir Z, Safdari R, Ghazisaeidi M. From self-care for healthy people to self-management for cancer patients with cancer portals. Asian Pac J Cancer Prev 2015; 16:1321-5. [PMID: 25743792 DOI: 10.7314/apjcp.2015.16.4.1321] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Self-care to prevent cancer and self-management to cope with the disease are two discrete effective mechanisms for improving of control and management of neoplasia. Both them have certain strategies and practices. Often the two are used interchangeably despite their different approaches. Strategies of self-care usually refer to prevention at different levels include primary, secondary and tertiary. In contrast, strategies of self-management are related to management and alleviation of unpleasant cancer-related symptoms and treatment-related side effects for improving the quality of life of cancer survivors. Successful promoting of self-care and self-management strategies need people and survivor empowerment. Within this context, innovative approaches open a new window. In this paper after a brief review of related strategies and practices, we provide an explanation of how cancer portals may play an important role in the empowerment process and what are key potentials for implementing of self- care and self-management strategies for cancer.
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Affiliation(s)
- Zahra Azadmanjir
- Health Information Management Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran E-mail :
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Smith SG, Curtis LM, O'Conor R, Federman AD, Wolf MS. ABCs or 123s? The independent contributions of literacy and numeracy skills on health task performance among older adults. PATIENT EDUCATION AND COUNSELING 2015; 98:991-7. [PMID: 25936579 PMCID: PMC4468001 DOI: 10.1016/j.pec.2015.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 02/13/2015] [Accepted: 04/12/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the relationship between literacy and numeracy and their association with health task performance. METHODS Older adults (n=304) completed commonly used measures of literacy and numeracy. Single factor literacy and numeracy scores were calculated and used to predict performance on an established set of health self-management tasks, including: (i) responding to spoken information; (ii) comprehension of print and (iii) multimedia information; and (iv) organizing and dosing medication. Total and sub-scale scores were calculated. RESULTS Literacy and numeracy measures were highly correlated (rs=0.68; ps<0.001). In multivariable models adjusted for age, gender, race, education, and comorbidity, lower literacy (β=0.44, p<0.001) and numeracy (β=0.44, p<0.001) were independently associated with worse overall task performance and all sub-scales (literacy range, β=0.23-0.45, ps<0.001; numeracy range, β=0.31-0.41, ps<0.001). Multivariable analyses with both constructs entered explained more variance in overall health task performance compared with separate literacy and numeracy models (8.2% and 10% respectively, ps<0.001). CONCLUSION Literacy and numeracy were highly correlated, but independent predictors of health task performance. These skill sets are complementary and both are important for health self-management. PRACTICE IMPLICATIONS Self-management interventions may be more effective if they consider both literacy and numeracy skills rather than focusing on one specific ability.
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Affiliation(s)
- Samuel G Smith
- Health Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, USA; Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
| | - Laura M Curtis
- Health Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, USA
| | - Rachel O'Conor
- Health Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, USA
| | - Alex D Federman
- Division of General Internal Medicine, Mount Sinai School of Medicine, New York, USA
| | - Michael S Wolf
- Health Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, USA; Department of Learning Sciences, Northwestern University, Chicago, USA
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Shahab L, Brown J, Gardner B, Smith SG. Seeking health information and support online: does it differ as a function of engagement in risky health behaviors? Evidence from the health information national trends survey. J Med Internet Res 2014; 16:e253. [PMID: 25380308 PMCID: PMC4259986 DOI: 10.2196/jmir.3368] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 08/13/2014] [Accepted: 08/30/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Internet is an important tool to deliver health behavior interventions, yet little is known about Internet access and use of health-related information, or support, by the intended intervention recipients. OBJECTIVE Our aim was to evaluate whether health-related Internet use differed as a function of common health-risk behaviors (excessive alcohol consumption, smoking, low fruit/vegetable intake, inactive/sedentary lifestyle, unprotected sun exposure, or obesity). METHODS Sociodemographic, health behavior characteristics, and information on Internet access and use were assessed in the nationally representative US Health Information National Trends Survey (HINTS) 4. Data from 3911 participants collated in 2011/12 were included. RESULTS Of the 78.2% (95% CI 76.1-80.1) of participants who had ever accessed the Internet, approximately three-quarters (78.2%, 95% CI 75.4-80.7) had obtained health-related information online last year. About half had used the Internet as the first source of health-related information (47.8%, 95% CI 44.8-50.7) or to access behavioral support (56.9%, 95% CI 53.7-60.0) in the last year. Adjusting for sociodemographic determinants of going online (being younger, white, female, with at least college education) revealed few differences in Internet access and use between health-risk behaviors. Participants with inadequate sun protection were less likely to access the Internet (OR 0.59, 95% CI 0.04-0.88) and those with low fruit/vegetable intake were less likely to have gone online to obtain health-related information last year (OR 0.60, 95% CI 0.45-0.80). Smokers in particular were likely to use the Internet to obtain behavioral support (OR 1.90, 95% CI 1.35-2.68). CONCLUSIONS Internet access and use to obtain health-related information and support is widespread and mostly independent of engagement in various health-risk behaviors. However, those with low fruit/vegetable intake or inadequate sun-protective behaviors may be more difficult to reach with Internet-based interventions. In addition, when developing online health promotions, relevant sociodemographic determinants of Internet use need to be targeted to maximize their impact.
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Affiliation(s)
- Lion Shahab
- Department of Epidemiology and Public Health, University College London, London, United Kingdom.
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Xavier AJ, d'Orsi E, de Oliveira CM, Orrell M, Demakakos P, Biddulph JP, Marmot MG. English Longitudinal Study of Aging: can Internet/E-mail use reduce cognitive decline? J Gerontol A Biol Sci Med Sci 2014; 69:1117-21. [PMID: 25116923 DOI: 10.1093/gerona/glu105] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cognitive decline is a major risk factor for disability, dementia, and death. The use of Internet/E-mail, also known as digital literacy, might decrease dementia incidence among the older population. The aim was to investigate whether digital literacy might be associated with decreased cognitive decline in older adulthood. METHODS Data from the English Longitudinal Study of Aging cohort with 6,442 participants aged 50-89 years, followed for 8 years, with baseline cognitive testing and four additional time points. The main outcome variable was the relative percentage change in delayed recall from a 10-word-list learning task across five separate measurement points. In addition to digital literacy, socioeconomic variables, including wealth and education, comorbidities, and baseline cognitive function were included in predictive models. The analysis used Generalized Estimating Equations. RESULTS Higher education, no functional impairment, fewer depressive symptoms, no diabetes, and Internet/E-mail use predicted better performance in delayed recall. CONCLUSIONS Digital literacy may help reduce cognitive decline among persons aged between 50 and 89 years.
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Affiliation(s)
- André J Xavier
- Health Academic Unit, Universidade do Sul de Santa Catarina, Florianópolis, Brazil.
| | - Eleonora d'Orsi
- Department of Public Health, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | | | - Martin Orrell
- Mental Health Sciences Unit, Faculty of Brain Sciences, University College London, UK
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d'Orsi E, Xavier AJ, Steptoe A, de Oliveira C, Ramos LR, Orrell M, Demakakos P, Marmot MG. Socioeconomic and lifestyle factors related to instrumental activity of daily living dynamics: results from the English Longitudinal Study of Ageing. J Am Geriatr Soc 2014; 62:1630-9. [PMID: 25243677 DOI: 10.1111/jgs.12990] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To investigate socioeconomic, demographic, and lifestyle factors that predict incident instrumental activity of daily living (IADL) impairment and recovery. DESIGN Data from English Longitudinal Study of Ageing (ELSA), a biennial prospective observational study. SETTING Individuals aged 50 and older living in England. PARTICIPANTS A sample of 8,154 individuals without any difficulty in activities of daily living (ADLs) or IADLs was selected from the initial 11,391 participants. MEASUREMENTS The first outcome was impairment in at least one IADL, and the second was IADL recovery. Main predictor: baseline socioeconomic position measured according to wealth. Outcomes and predictors were measured at each of the five follow-up interviews. Unadjusted and adjusted incidence rate ratios (IRR) and 95% confidence intervals were calculated through 2-year lagged Poisson regression in generalized estimating equation models, adjusted for sociodemographic, lifestyle, quality-of-life, and health variables. RESULTS Between any two consecutive waves, 1,656 (20.3%) participants developed some IADL impairment. Those with higher socioeconomic position, better quality of life, vigorous physical activity, paid work, digital literacy (use of Internet or e-mail), and cultural leisure activities had significantly lower risk of IADL impairment. There was a significant association between smoking, cardiovascular disease, arthritis, poor memory, diabetes mellitus, and depressive symptoms and IADL impairment. Better quality of life, good self-rated memory and vigorous physical activity were independent predictors of IADL recovery. CONCLUSION Better quality of life, vigorous physical activity, not smoking, paid work, cultural leisure activities, and digital literacy are modifiable factors that can decrease the incidence of IADL impairment. Good quality of life and vigorous physical activity have a significant role in recovery. Low socioeconomic position was a predictor of incident impairment of IADLs but not recovery.
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Affiliation(s)
- Eleonora d'Orsi
- Department of Public Health, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
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