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Holy O, Machaczka O, Schovankova T, Navratilova D, Zimmermannova J, Klasterecka R, Vevoda J. Trends of cervical tumours amongst women from perspectives of demographic, socioeconomic and geographic indicators: retrospective ecological study in Czechia. Front Public Health 2024; 12:1347800. [PMID: 38813429 PMCID: PMC11133622 DOI: 10.3389/fpubh.2024.1347800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/30/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction For many infectious diseases, women are at higher risk and have a more severe disease course than men for many reasons, including biological differences, social inequalities, and restrictive cultural norms. The study focuses on infections with human papillomaviruses (HPV) in the form of cervical cancer as a gender-specific disease. The main goal is to evaluate cervical tumour incidence trends in the Czech female population in the HPV vaccination period 2012-2020 in relation to selected demographic, socioeconomic, and geographic indicators. Methods This is a retrospective ecological study. Data from publicly available databases about the incidence and mortality of cervical tumours (C53 Malignant neoplasm of cervix uteri, D06 Carcinoma in situ of cervix uteri according to ICD 10) and HPV vaccination rate were analysed and compared with demographic, socioeconomic and territorial data. Associations were searched using correlation analysis. Results There was a decreasing trend in the incidence of cervical cancer in the observed period. Regarding cervical tumours (C53, D06) and malignant neoplasm of cervix uteri incidence (C53), the decrease was approximately 11 and 20%, respectively. Differences between regions were observed in incidences and vaccination rates. Based on correlation analysis, indicators connected with urban/rural aspects, such as a share of urban population and population density, were statistically significant. The indicators related to higher cervical cancer incidence are the high unemployment rate of women, the high number of divorces, the high number of abortions, the high share of the urban population, the high number of students, and the high number of women with only primary education. On the other hand, the indicators related to lower cervical cancer incidence are the high gross domestic product (GDP), the high average gross monthly wage per employee, the high employment rate of women, the higher average age of mothers at birth, and the high number of women with tertiary education. Conclusion Results underline the problem of economically disadvantaged regions and families. Increasing vaccination rates, promoting regular screening for cervical cancer, and supporting awareness in the population, especially in regions with higher incidence rates, should be priorities for public health efforts.
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Affiliation(s)
- Ondrej Holy
- Science and Research Centre, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czechia
| | - Ondrej Machaczka
- Science and Research Centre, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czechia
- Department of Healthcare Management and Public Health, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czechia
| | - Tereza Schovankova
- Science and Research Centre, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czechia
| | - Daniela Navratilova
- Science and Research Centre, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czechia
- Department of Healthcare Management and Public Health, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czechia
| | - Jarmila Zimmermannova
- Science and Research Centre, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czechia
| | - Romana Klasterecka
- Department of Preclinical Subjects, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czechia
| | - Jiri Vevoda
- Department of Humanities and Social Sciences, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czechia
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Paek SC, Zhang NJ. Factors associated with the use of annual health checkups in Thailand: evidence from a national cross-sectional health and welfare survey. Front Public Health 2024; 12:1390125. [PMID: 38799693 PMCID: PMC11116713 DOI: 10.3389/fpubh.2024.1390125] [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: 02/23/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Thailand has provided free annual health checkups (AHC) since universal health coverage began in 2002. However, evidence regarding the equitable use of AHC is scarce. Thus, this study explored factors associated with the use of AHC in Thailand. Methods A cross-sectional study was conducted using data from the national 2015 Health and Welfare Survey. Respondents aged 15 years or above (n = 57,343) were selected as the study sample. Descriptive statistical analysis and multivariable binary logistic regression were conducted to examine the association between the use of AHC and factors selected on the basis on Andersen's Behavioral Model of Access to Medical Care. Results Among the study sample, approximately 4.9% (n = 2,815) had used AHC during the past year. Regarding predisposing factors, the use of AHC was positively related to age (e.g., over 61 vs. 15-30: AOR = 2.90 [95% CI = 2.40-3.52], p < 0.001) and female sex (AOR = 1.23 [95% CI = 1.12-1.35] p < 0.001). For enabling factors, the AHC use was positively associated with income (e.g., Q4 vs. Q1: AOR = 1.98 [95% CI = 1.75-2.25], p < 0.001), education (e.g., high vs. low: AOR = 3.11 [95% CI = 2.75-3.51], p < 0.001), being married (e.g., vs. single: AOR = 1.27 [95% CI = 1.11-1.46], p < 0.001), and urban residency (AOR = 1.12 [95% CI = 1.04-1.22], p = 0.006). For need-for-care factors, the AHC use was positively related to chronic disease (AOR = 1.26 [95% CI = 1.15-1.38], p < 0.001), non-smoking (e.g., vs. daily: AOR = 1.18 [95% CI = 1.03-1.36], p = 0.015), non-drinking (e.g., vs. 3-4 times per week: AOR = 1.26 [95% CI = 1.04-1.53], p = 0.016), and vegetable consumption (e.g., over 5 ladles vs. below 1 ladle: AOR = 1.86 [95% CI = 1.50-2.31], p < 0.001). Conclusion The results indicate that health awareness could play a significant role in the use of AHC. Individuals with high socioeconomic status (e.g., high-income people) and those with low-risk health behaviors (e.g., non-smokers) generally have a high interest in health and well-being. This may have been the primary reason for the high use of AHC among these groups. Thus, the government should continue to promote the public's health awareness through various public campaigns and education programs to increase the use of AHC.
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Affiliation(s)
- Seung Chun Paek
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Salaya, Thailand
- Health Solution Research Unit, Faculty of Social Sciences and Humanities, Mahidol University, Salaya, Thailand
| | - Ning Jackie Zhang
- College of Health Professions, Grand Valley State University, Grand Rapids, MI, United States
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Oshio T, Sugiyama K, Ashida T. Effect of social activities on health checkups and recommended doctor visits: a fixed-effects analysis in Japan. INDUSTRIAL HEALTH 2023; 61:446-454. [PMID: 36725030 PMCID: PMC10731418 DOI: 10.2486/indhealth.2022-0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
Health checkups are considered to promote occupational and public health. This study aimed to investigate the extent to which participation in social activities encourages middle-aged people to participate in health checkups and adhere to doctor-visit recommendations. We analyzed 337,024 longitudinal observational studies involving 33,420 individuals aged 50-59 yr in the baseline year (2005) derived from a nationwide, population-based, 14-wave survey. We estimated fixed-effects logistic models to elucidate how people's participation in health checkups and recommended doctor visits are affected by participation in social activities. Attending health checkups was positively associated with participation in social activities, with an odds ratio (OR) of 1.19 (95% confidence interval [CI]: 1.15-1.22) and a marginal effect of 3.3% (95% CI: 2.7%-3.9%). Adherence to doctor-visit recommendations was also positively associated with participation in social activities, with an OR of 1.15 (95% CI: 1.08-1.23) and a marginal effect of 3.3% (95% CI: 1.8%-4.8%), although the association was observed only among regular employees. These results provide new insights into the effectiveness of health checkups.
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Affiliation(s)
- Takashi Oshio
- Institute of Economic Research, Hitotsubashi University, Japan
| | - Kemmyo Sugiyama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Japan
- Department of Community Health, Public Health Institute, Japan
| | - Toyo Ashida
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Japan
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Coombs NM, Sewell L, Jackson MR, Borgelt K, Lee J, Porter JE. Student-led pop-up health check clinics: innovative health prevention strategy for a low socioeconomic community. Aust J Prim Health 2023; 29:606-612. [PMID: 37537837 DOI: 10.1071/py23034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND To improve preventative health screening in regional Victoria, Australia, a collaborative student-led health prevention strategy was initiated. The aim of this study is to evaluate the impact of four health check clinics using a free 'pop-up' format within community settings. METHODS A mixed methods, explanatory sequential design was used to explore community health data and participant experiences in utilising the free health check clinics. The clinics were delivered over 6months and located in three different communities within the regional government area. Descriptive statistics were used to analyse participant health data and a thematic analysis was utilised to determine themes from participant feedback and health outcomes. RESULTS The clinics were attended by 188 community members, largely impacted by government lockdowns during the coronavirus disease 2019 (COVID-19) pandemic. Health check results indicate the population is overweight and at high risk of diabetes. Participants enjoyed the free and convenient nature of the health check program and the location of the venues. Feedback from participants indicate the health education provided was useful and advocated for changes in current behaviours. Many embraced the new information and community connections and made changes to improve their future health. Others claimed to enjoy the clinic experience but reported no action from the recommendations. CONCLUSIONS Evaluation of the health check clinics indicate they had a minor, yet positive impact on the local community in increasing engagement with preventative screening strategies. COVID-19 restrictions impacted participant numbers and thus more research is needed in a time where community movement is not limited.
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Affiliation(s)
- Nicole M Coombs
- Federation University Australia, Institute of Health and Wellbeing-Nursing, Gippsland Campus, PO Box 3191, Gippsland Mail Centre, Churchill, Vic. 3841, Australia; and Collaborative Evaluation & Research Group (CERG) Federation University Australia, Gippsland Campus, PO Box 3191, Gippsland Mail Centre, Churchill, Vic. 3841, Australia
| | - Lauren Sewell
- Gippsland Primary Health Network, 11 Seymour Street, Traralgon, Vic. 3844, Australia
| | - Megan R Jackson
- Collaborative Evaluation & Research Group (CERG) Federation University Australia, Gippsland Campus, PO Box 3191, Gippsland Mail Centre, Churchill, Vic. 3841, Australia
| | - Kaye Borgelt
- Gippsland Primary Health Network, 11 Seymour Street, Traralgon, Vic. 3844, Australia
| | - Jessica Lee
- Federation University Australia, Institute of Health and Wellbeing-Nursing, Gippsland Campus, PO Box 3191, Gippsland Mail Centre, Churchill, Vic. 3841, Australia
| | - Joanne E Porter
- Collaborative Evaluation & Research Group (CERG) Federation University Australia, Gippsland Campus, PO Box 3191, Gippsland Mail Centre, Churchill, Vic. 3841, Australia
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Ekadinata N, Hsu HC, Chen YM, Chuang KY. Effects of social capital on healthcare utilization among older adults in Indonesia. Health Promot Int 2023; 38:daad104. [PMID: 37715938 DOI: 10.1093/heapro/daad104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023] Open
Abstract
Social capital potentially affects older adults' access to healthcare services. However, the effects of social capital on the use of various types of healthcare services using longitudinal data have yet to be explored. This study aimed to examine the effects of structural and cognitive social capital on different types of healthcare utilization by older adults in Indonesia. Data were from the Indonesian Family Life Survey (waves 4 and 5) in 2007 and 2014. The sample consisted of participants aged 60 years and older who completed both waves (n = 1374). Healthcare utilization by older adults assessed health posts (posyandu), health checkups, outpatient care and hospital admissions. Social capital consisted of neighborhood trust and community participation. Generalized estimating equation models were used for the analysis. Older adults with high community participation had a higher likelihood of using preventive care in posyandu (OR = 5.848, 95% CI = 2.585-13.232) and health checkup visits (OR = 1.621, 95% CI = 1.116-2.356). Meanwhile, neighborhood trust was related to a higher probability of hospital admissions (OR = 1.255, 95% CI = 1.046-1.505). Social capital significantly affects older adults' preventive and treatment healthcare utilization. Maximizing the availability of social participation and removing barriers to access to preventive and medical care in an age-friendly environment are suggested.
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Affiliation(s)
- Nopryan Ekadinata
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei, Taiwan
- School of Nursing, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Hui-Chuan Hsu
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei, Taiwan
- Research Center of Health Equity, College of Public Health, Taipei Medical University, New Taipei, Taiwan
| | - Ya-Mei Chen
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Kun-Yang Chuang
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei, Taiwan
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Dou Z, Li X. Outcome of management based on "1+X" model in a health examination center. Am J Transl Res 2023; 15:5891-5899. [PMID: 37854228 PMCID: PMC10579014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/01/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To investigate the effect of management measures based on the "1+X" model in physical examination centers. METHODS This retrospective study was conducted on 5362 individuals who underwent physical examinations in Heping Hospital Affiliated to Changzhi Medical College from January 1, 2020 to December 31, 2022. These subjects were divided into an observation group (n=2681) and a control group (n=2681) according to the different management measures. Subjects from the control group were given routine management measures, while those from the observation group were given management measures based on the "1+X" model. The scores of negative emotions, waiting time for physical examination, acquisition of health knowledge, satisfaction for the physical examinations, and efficiency and degree of credibility in medical management were evaluated and compared between the two groups. RESULTS After management, the scores of anxiety and depression in both groups were significantly reduced in contrast to before management, and the two scores were significantly lower in the observation group than those in the control group (P<0.05). The observation group experienced significantly shorter waiting time for routine urination, blood sampling, internal and surgical examinations, and electrocardiogram than the control group (all P<0.001). The acquisition of health knowledge in the observation group was significantly better than that in the control group (P<0.05). The satisfaction rates of the observation group in the terms of service attitude, examination environment, health education, and follow-up services were significantly better than those in the control group (all P<0.05). Moreover, the efficiency and degree of credibility in medical management in the observation group were better than those in the control group. CONCLUSION The application of management measures based on the "1+X" model has a good effect in our physical examination center. On the one hand, it can significantly reduce the waiting time for various physical examinations and alleviate the negative emotions of physical examinees. On the other hand, it can effectively enhance the overall acquisition of health knowledge, the satisfaction of physical examination, and the efficiency and degree of credibility in medical management. This management model is worthy of clinical promotion and application.
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Affiliation(s)
- Zhiyong Dou
- Physical Examination Center, Heping Hospital Affiliated to Changzhi Medical CollegeChangzhi, Shanxi, China
| | - Xuyan Li
- Health Management Center, Heping Hospital Affiliated to Changzhi Medical CollegeChangzhi, Shanxi, China
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Heterogeneity in the Utilization of Fecal Occult Blood Testing and Colonoscopy among Migrants and Non-Migrants in Austria: Results of the Austrian Health Interview Survey. GASTROINTESTINAL DISORDERS 2023. [DOI: 10.3390/gidisord5010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Many European studies report lower participation in colorectal cancer screening among migrants than non-migrants. A major limitation of these studies is that usually, the heterogeneity of migrants cannot be accounted for. The aim of this investigation was to examine differences in the utilization of fecal occult blood testing and colonoscopy between non-migrants and the five largest migrant groups residing in Austria using data from the Austrian Health Interview Survey 2019. The two outcomes were compared between non-migrants and migrants using multivariable logistic regression adjusted for socioeconomic and health variables. Migrants from a Yugoslav successor state (OR = 0.61; 95%-CI: 0.44–0.83), Turkish (OR = 0.35; 95%-CI: 0.22–0.55), Hungarian (OR = 0.37; 95%-CI: 0.16–0.82) and German migrants (OR = 0.70; 95%-CI: 0.51–0.98) were less likely to have used a fecal occult blood test compared to non-migrants. Participation in colonoscopy was lower among Turkish migrants (OR = 0.42; 95%-CI: 0.27–0.67) and migrants from a Yugoslav successor state (OR = 0.56; 95%-CI: 0.42–0.75) than among non-migrants. The findings are consistent with studies from other countries and highlight barriers migrants face in accessing the health care system. To address these barriers, the heterogeneity of the population must be taken into account when developing educational materials in order to promote informed decisions about whether or not to participate in colorectal cancer screening.
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Chen YJ, Lin CF, Feng J, Chiu HL. Influencing factors of participation in and satisfaction with elderly health checkups: a cross-sectional study. Front Public Health 2023; 11:1104438. [PMID: 37188280 PMCID: PMC10177394 DOI: 10.3389/fpubh.2023.1104438] [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: 11/21/2022] [Accepted: 03/27/2023] [Indexed: 05/17/2023] Open
Abstract
Background Attending health checkups as a primary prevention strategy benefits older adults in facilitating the identification of health issues and risk factors for disease. Little is known about factors influencing participation in and satisfaction with a free annual elderly health checkup program (EHCP) in Taiwan. This study aimed to extend current knowledge related to the uptake of this service and individuals' views of the service. Methods This was a cross-sectional study using a telephone interview survey method to compare influencing factors and satisfaction between participants and non-participants of an EHCP. The individuals involved were older adults in Taipei, Taiwan. The random sampling method included 1,100 people, 550 older adults who had participated in the EHCP within the last 3 years, and 550 older adults who had not. A questionnaire containing personal characteristics and satisfaction with the EHCP was used. Independent t-test and Pearson's Chi-squared test were used to evaluate differences between the two groups. Associations between individual characteristics and health checkup attendance were estimated using log-binomial models. Results Results showed that 51.64% of participants reported being satisfied with the checkups; however, only 41.09% of non-participants were satisfied. In the association analysis, age, educational level, chronic diseases, and subjective satisfaction were related to older persons' participation. Furthermore, having a stroke was associated with a higher attendance rate [prevalence ratio: 1.49; 95% confidence interval: (1.13, 1.96)]. Conclusions The EHCP had a high proportion of satisfaction among participants, but the proportion was low among non-participants. Several factors were associated with participation and might lead to unequal healthcare service uptake. Health checkups need to increase among people at a young age, those with low educational backgrounds, and those without chronic diseases.
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Affiliation(s)
- Ying-Jen Chen
- Division of Geriatrics and General Internal Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chiou-Fen Lin
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Jie Feng
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Huei-Ling Chiu
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
- International Ph.D. Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
- *Correspondence: Huei-Ling Chiu
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Seilo N, Paldanius S, Autio R, Kunttu K, Kaila M. Health check attendance association with health and study-related factors: a register-based cohort study of Finnish university entrants. Environ Health Prev Med 2022; 27:34. [PMID: 35989266 PMCID: PMC9425058 DOI: 10.1265/ehpm.22-00032] [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] [Indexed: 11/12/2022] Open
Abstract
Background General health checks are an established component of preventive health care in many countries. Declining participation rates have raised concerns in health care providers. Understanding the reasons for attendance and non-attendance is necessary to improve the preventive health care system. The aim of this study was to examine health- and study-related factors associated with university entrants’ health check attendance. Methods Since 2009, an electronic health questionnaire (eHQ) has been conducted yearly to all Finnish university entrants by the Finnish Student Health Service (FSHS) to screen students for a general health check. The questionnaire comprises 26 questions about health, health habits and studying. The study population consisted of the 3346 entrants from the 2011–2012 academic year who were referred to a health check based on their eHQ responses. The eHQ data were linked with health check attendance information. Multivariable logistic regression was used to study the associations between the questionnaire responses and non-attendance of the health check. Results Male sex (OR 1.6, 95% CI % 1.4–1.9) and low engagement with studies (OR 1.5, 95% CI 1.2–2.0) were the variables most strongly associated with non-attendance. Having low state of mind was negatively associated with health check non-attendance thus enhanced the health-check attendance (OR 0.6, 95% CI 0.5–0.8). Conclusions The results suggest that providing health checks in student health care may serve as a way of reaching students with health concerns. However, motivating males and smokers to attend general health checks continue to be a challenge also in a university student population. That low engagement with studies associates with health check non-attendance points to need to improve collaboration between universities and student health care. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.22-00032.
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Affiliation(s)
- Noora Seilo
- Faculty of Medicine and Health Technology, Tampere University
| | | | - Reija Autio
- Faculty of Social Sciences, Tampere University
| | | | - Minna Kaila
- Public Health Medicine University of Helsinki
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Participation in Colorectal Cancer Screening among Migrants and Non-Migrants in Germany: Results of a Population Survey. GASTROINTESTINAL DISORDERS 2022. [DOI: 10.3390/gidisord4030011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Colorectal cancer screening can contribute to reducing colorectal cancer incidence and mortality. Findings on disparities in the utilization of colorectal cancer screening between migrants and non-migrants have been inconsistent, with some studies reporting lower, and some higher utilization among migrants. The aim of the present study was to examine potential disparities in fecal occult blood testing and colonoscopy among migrants in Germany. Data from a population survey on 11,757 men and women aged ≥50 years is used. Using multivariable logistic regression, the utilization of fecal occult blood testing and colonoscopy was compared between non-migrants, migrants from EU countries and migrants from non-EU countries, adjusting for socio-economic factors and also taking into account intersectional differences by sex and age. The study shows that migrants from the EU (adjusted OR = 0.73; 95%-CI: 0.57, 0.94) and from non-EU countries (adjusted OR = 0.39; 95%-CI: 0.31, 0.50) were less likely to utilize fecal occult blood testing than non-migrants. No disparities for the use of colonoscopy were observed. The findings are in line with studies from other countries and can be indicative of different barriers migrants encounter in the health system. Adequate strategies taking into account the diversity of migrants are needed to support informed decision-making among this population group.
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Kashutina MI, Kontsevaya AV, Kudryavtsev AV, Malyutina SK, Ipatov PV, Drapkina OM. Factors associated with awareness and passage of medical screening in hypertensive persons: data from the Know Your Heart study. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To analyze the demographic, socio-economic and behavioral factors associated with awareness and passage of medical screening among the hypertension adults from Arkhangelsk and Novosibirsk.Material and methods. The database was formed as part of the Know Your Heart study (2015-2018, Arkhangelsk, Novosibirsk, n=4504). For the present study, 2216 people with hypertension were selected. Binary logistic regression was used to determine the factors associated with awareness of ongoing medical screening and active participation in them.Results. The analysis determined that 82,5% of the hypertensive residents of Arkhangelsk and Novosibirsk aged 35-69 years old are aware of the medical screening, and 51,4% have passed (are going to pass) it. General factors associated both with greater awareness of ongoing preventive measures and with greater participation in them are female sex and contacts with doctors during the year. From the point of view of awareness, such a factor as the average income level turned out to be significant, while the absence of a permanent employment and the pension status were associated with the passage of medical screening.Conclusion. The awareness of the hypertensive residents of Arkhangelsk and Novosibirsk about the medical screening was 82,5%. The coverage level is still low. The identified factors associated with greater awareness of the medical screening and more active participation showed that medical specialists should be more attentive to the men working in urban areas with a low income level. More active work is also needed to involve in preventive contacts those persons who are not in constant contact with the healthcare system. This requires the consolidated work of various institutions and departments, including the media.
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Affiliation(s)
- M. I. Kashutina
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. V. Kontsevaya
- National Medical Research Center for Therapy and Preventive Medicine
| | | | - S. K. Malyutina
- Research Institute of Internal and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics
| | - P. V. Ipatov
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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Choi WS, Kim JH, Lee CH, Lee CE, Seo S. Adherence Improvement in Glaucoma Patients: Effects of Educational Intervention Using an Eye Drop Chart. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.12.1617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To evaluate the effects of an educational intervention using an eye drop chart and supplementary education on glaucoma patients’ adherence.Methods: In this multicenter prospective study, medically treated glaucoma patients were educated on the administration of eye drops using an eye drop chart. At the time of recruitment, all of the patients completed a questionnaire on demographic characteristics and adherence. Three months after the initial educational intervention, the patients were randomly divided into two groups: an education group and a control group. The education group received supplementary education. Immediately thereafter and at 6 months, all of the patients completed the questionnaire on adherence again. Changes in instillation behavior, the relationship between the adherence score and demographic characteristics, and factors contributing to an improvement in adherence and intraocular pressure were then analyzed.Results: The adherence scores were significantly higher in patients with fewer medications, a higher annual income and higher educational level, and an urban residence (p = 0.038, p = 0.033, p = 0.041 and p = 0.047, respectively). Education on the administration of eye drops and use of the eye drop chart improved adherence scores from 23.05 ± 3.52 to 21.30 ± 3.95 (p = 0.021) and significantly reduced the average intraocular pressure from 14.3 ± 2.9 to 12.4 ± 3.1 mmHg (p < 0.001). Working indoors (odds ratio [OR] = 5.47, p = 0.032) and supplementary education at 3 months (OR = 4.53, p = 0.030) were also correlated with improved adherence.Conclusions: An eye drop chart is an effective tool for improving adherence and intraocular pressure control in glaucoma patients. Improvement in adherence was especially notable in patients whose work predominantly involved indoor activity. The effectiveness of the eye drop chart was improved by supplementary education.
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Rombouts M, Raaijmakers LGM, Kuunders TJM, Van Steijn-Martens R, de Vuijst T, van Donkersgoed H, van de Goor LAM. The Acceptance and Use of the e-Health Instrument 'The Personal Health Check' in Four Dutch Municipalities: Lessons Learned. J Prim Prev 2021; 43:25-48. [PMID: 34714455 PMCID: PMC8887919 DOI: 10.1007/s10935-021-00651-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2021] [Indexed: 11/22/2022]
Abstract
This pilot study assessed the acceptance and use of the e-Health instrument “the Personal Health Check” (PHC) among clients and professionals in primary care settings. By filling in the online PHC instrument, participants were provided insights into their health and lifestyle. When results revealed an increased health risk, participants were advised to undertake additional lab tests measuring blood pressure and haemaglobin levels. Based on the online questionnaire and optional lab tests, participants then received a report that included individually-tailored feedback from the e-Health application about personal health risks and suggestions for health interventions. The PHC was implemented in 2016 in four Dutch municipalities that determined which neighbourhood(s) the PHC targeted and how participants were invited. The Unified Theory of Acceptance and Use of Technology was used as a theoretical framework to address our research questions. Methods used to assess acceptance were: PHC instrument data, data from additional questionnaires completed by PHC participants, focus groups with PHC participants and professionals in primary care, and telephone interviews with non-responders to the invitation to participate in the online PHC. Of the 21,735 invited, 12% participated. Our results showed that participants and professionals in this pilot were predominantly positive about the PHC. Participants reported that they made an effort to apply the PHC lifestyle advice they received. Almost all had the knowledge and resources needed to use the PHC online instrument. Invitations from general practitioners almost doubled participation relative to invitations from the sponsoring municipalities. The overall low response rate, however, suggests that the PHC is unsuitable as a foundation on which to develop local public health policy.
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Affiliation(s)
- M Rombouts
- Municipal Health Service West-Brabant, Breda, The Netherlands
| | | | - T J M Kuunders
- Municipal Health Service Hart Voor Brabant, 'S-Hertogenbosch, The Netherlands.,Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | | | - T de Vuijst
- Municipal Health Service Hart Voor Brabant, 'S-Hertogenbosch, The Netherlands
| | - H van Donkersgoed
- Netherlands Institute for Prevention and E-Health Development (NIPED), Amsterdam, The Netherlands
| | - L A M van de Goor
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Al-Hanawi MK, Chirwa GC. Economic Analysis of Inequality in Preventive Health Check-Ups Uptake in Saudi Arabia. Front Public Health 2021; 9:745356. [PMID: 34604166 PMCID: PMC8484695 DOI: 10.3389/fpubh.2021.745356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Undertaking preventive health check-ups has proven to be an important strategy in the fight against several diseases. However, various socioeconomic circumstances may hinder participating in such an important health exercise for many people. With the growth in the burden of non-communicable diseases in Saudi Arabia, it is thus essential that people take an active role in undertaking preventive health check-ups. However, the extent to which this behavior is determined by inequalities in socioeconomic circumstances remains not well-documented. The aim of this study was to examine the socioeconomic inequalities in undertaking preventive health check-ups in Saudi Arabia, using a national survey with a sample of 11,528 respondents. Methods: Data from the Saudi Family Health Survey conducted in 2018 by the General Authority for Statistics were used for the analysis of this study. Univariate, bivariate, and multivariate logistic regression analyses were employed to examine the socioeconomic factors associated with undertaking preventive health check-ups. Concentration indices were calculated, and associated concentration curves were used to assess the socioeconomic inequalities in preventive health check-ups uptake. Moreover, decomposition analysis was performed to examine the extent to which the socioeconomic variables affect uptake of preventive health check-ups. Results: The results reveal that being older adults, more educated, insured, and married increase the probability of undertaking preventive health check-ups. Regarding socioeconomic inequalities, preventive health check-ups uptake was concentrated among the wealthier (concentration index: 0.0831; P < 0.001). However, some differences were observed in terms of socioeconomic inequality across the regions. Decomposition of the Erreygers index supported the analysis of the determinants and suggested that income, and education were the primary drivers of the associated inequality. Conclusions: These results suggest that the government of Saudi Arabia should develop intervention programs and strategies that promote the uptake of health check-ups among the vulnerable group to reduce inequalities. Of particular importance is the need for more health-related education among the poor and those with lower education in order to raise their awareness on the benefits and advantages of conducting health examinations.
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Affiliation(s)
- 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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Obi IR, Obi KM, Seer-Uke EN, Onuorah SI, Okafor NP. Preventive health care services utilization and its associated factors among older adults in rural communities in Anambra State, Nigeria. Pan Afr Med J 2021; 39:83. [PMID: 34466185 PMCID: PMC8379407 DOI: 10.11604/pamj.2021.39.83.26997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 05/15/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction quality of life and life expectancy of people are improved when preventive health care services are utilized because these identify treatable health problems and puts life-threatening diseases in check. Morbidity and mortality associated with age-related chronic disease among the older adults is on the increase, therefore, this study aims at determining preventive health care services utilization among older adults in rural communities in Anambra State. Methods a cross sectional design adopted for this study was carried out on older adults from the ages of 65 years and above in rural communities in Anambra State from October 2019 to January 2020. Data were collected through researcher-administered structured questionnaire. Data were analysed using univariable and multivariable regression analysis. Results a total of 1944 older adults participated with an overall cluster percentage of 40.6% older adults utilizing investigated preventive health care services. The results of the multivariable analysis indicates that the following factors were associated with utilization of preventive healthcare services: male gender (aOR: 0.443, 95%CI: 0.281 - 5.472, p=0.47), level of education; primary (aOR: 1.536, 95%CI: 1.201 - 5.261, p=0.00), secondary (aOR: 4.516, 95%CI: 3.192 - 6.242, p=0.00), and tertiary (aOR: 3.407, 95%CI: 3.199 - 5.666, p=0.00)], income of N50,000-N100,000 (aOR: 2.754, 95%CI: 1.066 - 10.766, p=0.01), and N100,000 and above (aOR: 4.233, 95%CI: 1.846 - 12.811, p=0.00)], and health insurance [aOR: 0.691, 95%CI: 0.422 - 1.945, p=0.03]. Conclusion preventive health care services were under-utilized. Creating awareness on the importance of utilizing preventive health care services is highly recommended since most age-related chronic diseases once established may last a lifetime and affect quality of life and wellbeing.
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Affiliation(s)
- Ifunanya Rosemary Obi
- Department of Physical and Health Education, Federal College of Education (Technical), Umunze, Nigeria
| | | | | | | | - Nonye Peculiar Okafor
- Department of Human Kinetics and Sports Studies, Alvan Ikoku College of Education, Owerri, Nigeria
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Chu CL, Lawana N. Decomposition of income-related inequality in health check-ups services participation among elderly individuals across the 2008 financial crisis in Taiwan. PLoS One 2021; 16:e0252942. [PMID: 34111198 PMCID: PMC8192017 DOI: 10.1371/journal.pone.0252942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 05/26/2021] [Indexed: 11/19/2022] Open
Abstract
Encouraging citizens to use health checkup services is a health promotion strategy. In nations with aging populations, ensuring equitable use of health check-ups by senior citizens is a public health concern. The objective of this research was to quantify income-related inequality and its effect on the use of health checkup services in Taiwan during the 2007-2008 global financial crisis. We used the 2005 and 2009 datasets of the Taiwan National Health Interview Surveys to assess how income-related inequality influenced health check-up use among older adults in Taiwan during the 2007-2008 financial crisis. Corrected concentration indices (CCIs) were calculated and decomposed to determine the influences of explanatory variables. The dependent variable was whether participants had used free senior health check-ups in the past year, and the determinant factors were health behavior, health situation, socioeconomic and demographic factors, and area health care resources accessibility factors. The study assessed 2,460 older adults from the 2005 dataset and 2,514 such individuals from the 2009 dataset. The utilization of health check-ups increased from 21.6% in 2005 to 34.0% in 2009. Income-related inequality in the use of health check-up services was generally tilted toward the higher income individuals among both women and men in 2005 and 2009, and income-related inequality decreased among women group and increased among men group with non significantly from 2005 to 2009 (women: CCI decreased from.0738 in 2005 to.0658 in 2009; men: CCI increased from.1068 in 2005 to.1256 in 2009). We analyzed the effect of explanatory factors on men's and women's intention to use health check-ups by using a probit model. After controlling for other factors, we determined that income significantly influenced women's health check-up service use in 2005 and men's in 2005 and 2009. Positive health behavior significantly increased health check-up services use among men and women group after the financial crisis, and negative health behavior significantly reduced health check-ups use among men across financial crisis. The 2008 global financial crisis strengthened the effect on health check-ups use of income-related inequality of elderly men, especially in older adults with negative health behaviors. Elderly men with negative health behaviors tended to contribute more income-related inequality in use health check-up services after the financial crisis. Health promotion initiatives should focus their efforts on elderly men with negative health behaviors.
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Affiliation(s)
- Chiao-Lee Chu
- Department of Long Term Care, National Quemoy University, Kimmen County, Taiwan
| | - Nozuko Lawana
- Social Policy, Knowledge Mobilization and Impact Assessment (SoKIA), Human Science Research Council (HSRC), Pretoria, South Africa
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Murayama H, Takahashi Y, Shimada S. Effectiveness of an Out-of-Pocket Cost Removal Intervention on Health Check Attendance in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115612. [PMID: 34073994 PMCID: PMC8197396 DOI: 10.3390/ijerph18115612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/19/2021] [Accepted: 05/22/2021] [Indexed: 11/16/2022]
Abstract
Annual health checks are important for identifying individuals at high risk for cardiometabolic diseases. However, there are socioeconomic disparities in health check attendance rates, and an intervention to lower financial barriers could be useful for increasing health check utilization. In this study, we aimed to evaluate the effectiveness of an out-of-pocket cost removal intervention on health check attendance in Japan. Data were obtained on beneficiaries of the National Health Insurance system of Yokohama City, Kanagawa Prefecture, Japan. In 2018, Yokohama started an intervention to remove out-of-pocket costs for specific health checks for all National Health Insurance beneficiaries. We analyzed data from 2015-2018 (131,295 people aged 40-74 years; 377,660 observations). A generalized estimating equation showed that people were more likely to receive specific health checks in 2018 (after the out-of-pocket cost removal intervention started) than in 2017 (immediately before the intervention; odds ratio [95% confidence interval] = 1.167 [1.149-1.185]), after adjusting for age, gender, tax exemption, and residential area. Stratified analyses revealed that the effectiveness of the out-of-pocket cost removal intervention was greater among the older age group and those who did not receive a tax exemption (i.e., those with relatively higher income). The present study showed that the out-of-pocket cost removal intervention could promote specific health check utilization. This indicates that removing financial barriers could motivate people's behavior regarding health check attendance.
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Affiliation(s)
- Hiroshi Murayama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan
- Correspondence: ; Tel.: +81-3-3964-3241
| | - Yuta Takahashi
- Health and Welfare Bureau, City of Yokohama, Kanagawa 231-0005, Japan; (Y.T.); (S.S.)
| | - Setaro Shimada
- Health and Welfare Bureau, City of Yokohama, Kanagawa 231-0005, Japan; (Y.T.); (S.S.)
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Mitričević S, Janković J, Stamenković Ž, Bjegović-Mikanović V, Savić M, Stanisavljević D, Mandić-Rajčević S. Factors Influencing Utilization of Preventive Health Services in Primary Health Care in the Republic of Serbia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3042. [PMID: 33809546 PMCID: PMC7999125 DOI: 10.3390/ijerph18063042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 11/26/2022]
Abstract
The use of preventive health services is a long-term health investment due to its potential to help individuals to take care of their health. This study aimed to explore the availability and performance of health services in primary health care (PHC) in the domain of general practice (GP), pediatrics, and gynecology, as well as to analyze the influence of sociodemographic and health determinants on the utilization of preventive health services. This descriptive study used data from the National Health Insurance Fund and the Statistical Office of the Republic of Serbia for 2015 and included 149 independent PHC units. The relationship between the utilization of preventive services and sociodemographic and health characteristics of the population was analyzed by bivariate and multivariate linear regression models. The higher health expenditure per capita and noncommunicable diseases mortality rate were, the more preventive health services were provided by a chosen GP. Children with a higher completion rate of primary school (p = 0.024), higher health expenditure (p = 0.017), and higher life expectancy at birth (p = 0.041) had more preventive health services. The fertility rate was positively associated with the number of preventive health services per 1000 women (p = 0.033). Our findings should serve as a starting point for where efforts should be made to achieve better health outcomes.
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Affiliation(s)
- Slavka Mitričević
- Cabinet of Minister without Portfolio in Charge of Demography and Population Policy, 11000 Belgrade, Serbia;
| | - Janko Janković
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (J.J.); (Ž.S.); (V.B.-M.)
- Centre-School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Željka Stamenković
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (J.J.); (Ž.S.); (V.B.-M.)
- Centre-School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Vesna Bjegović-Mikanović
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (J.J.); (Ž.S.); (V.B.-M.)
- Centre-School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Marko Savić
- Department for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.S.); (D.S.)
| | - Dejana Stanisavljević
- Department for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.S.); (D.S.)
| | - Stefan Mandić-Rajčević
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (J.J.); (Ž.S.); (V.B.-M.)
- Centre-School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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Association of health checkups with health-related quality of life among public servants: a nationwide survey in Taiwan. Health Qual Life Outcomes 2021; 19:42. [PMID: 33541360 PMCID: PMC7863473 DOI: 10.1186/s12955-021-01684-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preventive health checkups have gained in importance over the last decade. The association of health checkups and the number of diseases with health-related quality of life (HRQoL), including physical and mental health, remains unclear. We sought to investigate the aforementioned association among Taiwanese public servants. METHODS A cross-sectional survey was conducted using randomized and multistage stratified cluster sampling based on proportional probabilistic sampling. The questionnaires addressed demographics, job characteristics, health behaviors, health status, 3 types of health checkups during the preceding 3 years (government-paid health checkup [GPHC], self-paid health checkup [SPHC], and no health checkup [NOHC]), and physical component summary (PCS) and mental component summary (MCS) scores of the Short-Form Health Survey. In total 11,454 middle-aged public servants were analyzed. A multivariate general linear model (GLM) was used to estimate PCS and MCS scores by using least square means. RESULTS Health checkup types were associated with a significant difference in PCS scores among the public servants. Scores of PCS and MCS were both significantly higher in the GPHC group than in the NOHC group for those with no chronic diseases (51.20 vs. 50.66 [P = 0.008] and 46.23 vs. 45.58 [P = 0.02], respectively). Compared with the NOHC group, both scores of GPHC and SPHC groups were significantly associated with higher PCS scores for public servants with ≥ 2 chronic diseases (46.93 vs. 45.13 [P = 0.002] and 46.52 vs. 45.13 [P = 0.009], respectively). CONCLUSION In Taiwan, public servants undergoing GPHCs are more likely to report higher PCS scores than are those undergoing SPHCs. It is crucial that encourage periodically using the health checkup to improve health status and HRQoL.
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Panayota S, Petros G, Olympia K, Olga S, Daphne K. Factors that influence the health status of immigrants living in Greece. AIMS Public Health 2020; 7:287-300. [PMID: 32617356 PMCID: PMC7327390 DOI: 10.3934/publichealth.2020024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/06/2020] [Indexed: 11/18/2022] Open
Abstract
Aim To examine the health status of immigrants living in Greece and investigate the factors that influence it. Methodology A cross-sectional study with 1152 immigrants (response rate = 60%) was conducted during April 2013 to March 2014. Regarding the sampling method, as there is no accurate census of immigrants in Greece the snowball sampling was used. Data collection included demographic characteristics, health status, medication and self-reported preventive health examinations of immigrants (blood count, blood pressure, cholesterol, and blood sugar measurement). Results The majority of immigrants originated from Albania (51.4%), while 52.6% were males with mean age 37.6 years. Of those 63.5% were working, 80.9% had legal documents for living and working in Greece and 58.2% had valid health and social security. Most of the immigrants (66.6%) considered their health as good/very good. Immigrants without health insurance, lower monthly family income and worst self-reported health did not adhere with their medication treatment due to cost. Immigrants with legal documents and health insurance performed more often blood count measurement, blood pressure measurement, cholesterol measurement and blood sugar measurement. Increased monthly family income was also associated with higher probability of blood count measurement. Very poor/poor/average self-reported health and increased age were associated with higher probability of taking medicines for chronic diseases. Conclusions Self-reported health of immigrants in Greece is good/very good while absence of health insurance and legal documents, lower income and worst self-reported health are associated with worst health outcomes.
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Affiliation(s)
- Sourtzi Panayota
- Sector of Public Health, Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Galanis Petros
- Center for Health Services Management and Evaluation, Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantakopoulou Olympia
- Center for Health Services Management and Evaluation, Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Siskou Olga
- Center for Health Services Management and Evaluation, Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Kaitelidou Daphne
- Center for Health Services Management and Evaluation, Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece
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Flitcroft L, Chen WS, Meyer D. The Demographic Representativeness and Health Outcomes of Digital Health Station Users: Longitudinal Study. J Med Internet Res 2020; 22:e14977. [PMID: 32589150 PMCID: PMC7381012 DOI: 10.2196/14977] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 11/20/2019] [Accepted: 12/15/2019] [Indexed: 11/30/2022] Open
Abstract
Background Digital health stations offer an affordable and accessible platform for people to monitor their health; however, there is limited information regarding the demographic profile of users and the health benefits of this technology. Objective This study aimed to assess the demographic representativeness of health station users, identify the factors associated with repeat utilization of stations, and determine if the health status of repeat users changed between baseline and final health check. Methods Data from 180,442 health station users in Australia, including 8441 repeat users, were compared with 2014-2015 Australian National Health Survey (NHS) participants on key demographic and health characteristics. Binary logistic regression analyses were used to compare demographic and health characteristics of repeat and one-time users. Baseline and final health checks of repeat users were compared using McNemar tests and Wilcoxon signed rank tests. The relationship between the number of checks and final health scores was investigated using generalized linear models. Results The demographic profile of SiSU health station users differs from that of the general population. A larger proportion of SiSU users were female (100,814/180,442, 55.87% vs 7807/15,393, 50.72%), younger (86,387/180,442, 47.88% vs 5309/15,393, 34.49% aged less than 35 years), and socioeconomically advantaged (64,388/180,442, 35.68% vs 3117/15,393, 20.25%). Compared with NHS participants, a smaller proportion of SiSU health station users were overweight or obese, were smokers, had high blood pressure (BP), or had diabetes. When data were weighted for demographic differences, only rates of high BP were found to be lower for SiSU users compared with the NHS participants (odds ratio [OR] 1.26; P<.001). Repeat users were more likely to be female (OR 1.37; P<.001), younger (OR 0.99; P<.001), and from high socioeconomic status areas—those residing in socioeconomic index for areas quintiles 4 and 5 were significantly more likely to be repeat users compared with those residing in quintile 1 (OR 1.243; P<.001 and OR 1.151; P<.001, respectively). Repeat users were more likely to have a higher BMI (OR 1.02; P<.001), high BP (OR 1.15; P<.001), and less likely to be smokers (OR 0.77; P<.001). Significant improvements in health status were observed for repeat users. Mean BMI decreased by 0.97 kg/m2 from baseline to final check (z=−14.24; P<.001), whereas the proportion of people with high BP decreased from 15.77% (1080/6848) to 12.90% (885/6860; χ21=38.2; P<.001). The proportion of smokers decreased from 11.91% (1005/8438) to 10.13% (853/8421; χ21=48.4; P<.001). Number of repeat health checks was significantly associated with smoking status (OR 0.96; P<.048) but not with higher BP (P=.14) or BMI (P=.23). Conclusions These findings provide valuable insight into the benefits of health stations for self-monitoring and partially support previous research regarding the effect of demographics and health status on self-management of health.
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Affiliation(s)
- Leah Flitcroft
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Australia
| | - Won Sun Chen
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Australia
| | - Denny Meyer
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Australia
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Professionals' Perceptions: "Why is Lead Poisoning Prevalent in Lancaster County?". INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132281. [PMID: 31252687 PMCID: PMC6651429 DOI: 10.3390/ijerph16132281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/23/2019] [Accepted: 06/26/2019] [Indexed: 11/16/2022]
Abstract
Background: The prevalence of lead poisoning in children under the age of six years living in Lancaster County, Pennsylvania continues to be greater than the state-wide prevalence for this age group. This study aims to determine the factors that contribute to the high lead poisoning rates. Methods: For this qualitative study, the researchers recruited a convenience sample of professionals providing healthcare and social welfare services in the county. Researchers conducted in-depth interviews with participants. The research team audio recorded, transcribed verbatim, and analyzed each interview using NVivo 12 software. Results: The 16 interviewed participants identified factors that contribute to high lead poisoning rates including knowledge levels, housing status, and competing interests. Specifically, low knowledge levels, renting as opposed to home ownership, and having competing interests seemed to minimize the attention directed towards preventing lead poisoning. The experts offered recommendations to address the high lead poisoning rates including increasing lead knowledge levels of both community members and landlords, through creating and distributing health promotion material, enacting policies to empower renters, and systematically collaborating to streamline lead poisoning related information and services. Conclusions: Findings provide insights to factors that Lancaster can address to achieve a decrease in lead poisoning rates. This study provides information that can be utilized by public health professionals to develop appropriate interventions.
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Sommer I, Titscher V, Teufer B, Klerings I, Nußbaumer-Streit B, Szelag M, Affengruber L, Wagner G, Glechner A, Kien C, Ebenberger A, Schiller-Frühwirth I, Dorner TE, Siebenhofer A, Haditsch B, Bachler H, Siebert U, Gartlehner G. [Evidence-based recommendations for the revision of the Austrian periodic health examination]. Wien Med Wochenschr 2019; 169:339-349. [PMID: 31187373 DOI: 10.1007/s10354-019-0699-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/15/2019] [Indexed: 12/27/2022]
Abstract
The Austrian periodic health examination (PHE) was introduced in 1974 as a health insurance benefit and was redesigned for the last time in 2005. Therefore, the aim of this work was to revise the scientific basis of the PHE using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We updated the scientific evidence of examinations and consultations that are currently part of the PHE and searched and integrated new examinations. We assessed the expectations of the population towards the PHE in three focus groups. A panel of experts developed evidence-based recommendations for the revised PHE. They formulated 26 recommendations on 20 target diseases or risk factors. In comparison to the previous PHE, the panel added screening for abdominal aortic aneurysm, osteoporotic fracture risk, and chronic kidney disease to the recommendations, while screening for asymptomatic bacteriuria, screening for iron deficiency/pernicious anaemia, and risk identification of glaucoma should no longer be included.
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Affiliation(s)
- Isolde Sommer
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich.
| | - Viktoria Titscher
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Birgit Teufer
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Irma Klerings
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Barbara Nußbaumer-Streit
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Monika Szelag
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Lisa Affengruber
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Gernot Wagner
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Anna Glechner
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Christina Kien
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Agnes Ebenberger
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | | | - Thomas E Dorner
- Zentrum für Public Health, Abteilung für Sozial- und Präventivmedizin, Medizinische Universität Wien, Wien, Österreich
| | - Andrea Siebenhofer
- Institut für Allgemeinmedizin und evidenzbasierte Versorgungsforschung, Medizinische Universität Graz, Graz, Österreich.,Institut für Allgemeinmedizin, Goethe-Universität, Frankfurt am Main, Deutschland
| | | | | | - Uwe Siebert
- Institut für Public Health, Medical Decision Making und Health Technology Assessment, UMIT - Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik, Hall i.T., Österreich.,Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gerald Gartlehner
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich.,Research Triangle Institute International, Raleigh, NC, USA
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Implementation of patient-centered physical training for older people accessing routine health care. Wien Klin Wochenschr 2019; 131:241-243. [PMID: 31115650 DOI: 10.1007/s00508-019-1513-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 05/02/2019] [Indexed: 11/27/2022]
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Dorner TE, Wilfinger J, Hoffman K, Lackinger C. Association between physical activity and the utilization of general practitioners in different age groups. Wien Klin Wochenschr 2019; 131:278-287. [PMID: 31076889 PMCID: PMC6570780 DOI: 10.1007/s00508-019-1503-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/24/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Physical activity (PA) is an important tool in health promotion, prevention, curation, and rehabilitation and should be part of general practitioners (GP) consultations. For tailoring GP's service it is important to know the PA habits of the clients. METHODS Data from the Austrian Health Interview Survey 2014 with 15,770 subjects were analyzed. The association between PA, measured with the Physical Activity Questionnaire of the European Health Intervies Survey (EHIS-PAQ) and having visited a GP within the last 4 weeks was examined in different age groups (15-29, 30-64, and 65+ years). In multivariate analyses we adjusted for sociodemographic and health-related variables (body mass index, 17 chronic diseases, and the use of medication). RESULTS In subjects aged 15-29 years and 30-64 years fulfilling aerobic PA recommendations was significantly associated with a lower chance of having consulted the GP with unadjusted OR (95% CI) 0.82 (0.70-0.96) and 0.90 (0.82-0.99), respectively, whereas work-related PA was associated with a higher chance, with OR 1.21 (1.03-1.42) and 1.10 (1.00-1.20), respectively. Adjusting for sociodemographic and health-related factors led to loss of significance. In subjects aged 30-64 years, muscle strengthening PA was associated with a higher chance for GP consultation with OR 1.12 (1.00-1.24) in the fully adjusted model. In subjects aged 65+ years, PA was associated with a lower chance of having visited the GP with OR 0.74 (0.64-0.86) and 0.83 (0.71-0.97) for work related PA and total PA, respectively, in the fully adjusted model. CONCLUSION The association of PA and GP consultation is dependent on age and type of PA, and partly mediated by sociodemographic and health-related factors.
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Affiliation(s)
- Thomas E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria.
| | - Julia Wilfinger
- Department for Health Promotion and Prevention, SPORTUNION Austria, Falkestraße 1, 1010, Vienna, Austria
| | - Kathryn Hoffman
- Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/I, 1090, Vienna, Austria
| | - Christian Lackinger
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria.,Department for Health Promotion and Prevention, SPORTUNION Austria, Falkestraße 1, 1010, Vienna, Austria
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Mayer S, Spickschen J, Stein KV, Crevenna R, Dorner TE, Simon J. The societal costs of chronic pain and its determinants: The case of Austria. PLoS One 2019; 14:e0213889. [PMID: 30893370 PMCID: PMC6426226 DOI: 10.1371/journal.pone.0213889] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 03/04/2019] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Chronic pain is among the most burdensome conditions. Its prevalence ranges between 12% and 30% in Europe, with an estimated 21% among Austrian adults. The economic impact of chronic pain from a societal perspective, however, has not been sufficiently researched. This study aims to provide an estimate of the societal costs for working-age adults with chronic pain in Austria. It explores the impact of sex, number of pain sites, self-reported pain severity, health literacy and private health insurance on costs associated with chronic pain. METHODS A bottom-up cost-of-illness study was conducted based on data collected from 54 adult patients with chronic pain at three Viennese hospital outpatient departments. Information on healthcare costs including out-of-pocket expenses and productivity losses due to absenteeism and informal care were collected over 12 months. Resource use estimates were combined with unit costs and mean costs per patient were calculated in € for year 2016. RESULTS Mean annual societal costs were estimated at EUR 10191. Direct medical costs were EUR 5725 including EUR 1799 out-of-pocket expenses (mainly pain relieving activities and private therapy). Productivity losses including informal care amounted to EUR 4466. Total costs for women and patients with three or more pain sites were significantly higher. No association with health literacy was found but there was a tendency towards higher out-of-pocket expenses for patients with complementary private health insurance. CONCLUSION This study is the first to provide a comprehensive assessment of the individual and societal burden of chronic pain in Austria. It highlights that chronic pain is associated with substantial direct medical costs and productivity losses. Patient costs may show systematic differences by health insurance status, implying a need for future research in this area.
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Affiliation(s)
- Susanne Mayer
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Jonah Spickschen
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - K. Viktoria Stein
- International Foundation for Integrated Care, Wolfson College, Oxford, United Kingdom
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas E. Dorner
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute Applied Diagnostics, Vienna, Austria
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Larsen LB, Sondergaard J, Thomsen JL, Halling A, Sønderlund AL, Christensen JR, Thilsing T. Digital Recruitment and Acceptance of a Stepwise Model to Prevent Chronic Disease in the Danish Primary Care Sector: Cross-Sectional Study. J Med Internet Res 2019; 21:e11658. [PMID: 30664466 PMCID: PMC6360391 DOI: 10.2196/11658] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 09/27/2018] [Accepted: 09/29/2018] [Indexed: 12/12/2022] Open
Abstract
Background During recent years, stepwise approaches to health checks have been advanced as an alternative to general health checks. In 2013, we set up the Early Detection and Prevention project (Tidlig Opsporing og Forebyggelse, TOF) to develop a stepwise approach aimed at patients at high or moderate risk of a chronic disease. A novel feature was the use of a personal digital mailbox for recruiting participants. A personal digital mailbox is a secure digital mailbox provided by the Danish public authorities. Apart from being both safe and secure, it is a low-cost, quick, and easy way to reach Danish residents. Objective In this study we analyze the association between the rates of acceptance of 2 digital invitations sent to a personal digital mailbox and the sociodemographic determinants, medical treatment, and health care usage in a stepwise primary care model for the prevention of chronic diseases. Methods We conducted a cross-sectional analysis of the rates of acceptance of 2 digital invitations sent to randomly selected residents born between 1957 and 1986 and residing in 2 Danish municipalities. The outcome was acceptance of the 2 digital invitations. Statistical associations were determined by Poisson regression. Data-driven chi-square automatic interaction detection method was used to generate a decision tree analysis, predicting acceptance of the digital invitations. Results A total of 8814 patients received an invitation in their digital mailbox from 47 general practitioners. A total of 40.22% (3545/8814) accepted the first digital invitation, and 30.19 % (2661/8814) accepted both digital invitations. The rates of acceptance of both digital invitations were higher among women, older patients, patients of higher socioeconomic status, and patients not diagnosed with or being treated for diabetes mellitus, chronic obstructive pulmonary disease, or cardiovascular disease. Conclusions To our knowledge, this is the first study to report on the rates of acceptance of digital invitations to participate in a stepwise model for prevention of chronic diseases. More studies of digital invitations are needed to determine if the acceptance rates seen in this study should be expected from future studies as well. Similarly, more research is needed to determine whether a multimodal recruitment approach, including digital invitations to personal digital mailboxes will reach hard-to-reach subpopulations more effectively than digital invitations only.
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Affiliation(s)
- Lars Bruun Larsen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jens Sondergaard
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Janus Laust Thomsen
- Research Unit for General Practice, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Anders Halling
- Department of Clinical Sciences in Malmö, Centre for Primary Health Care Research, Lund University, Lund, Sweden
| | - Anders Larrabee Sønderlund
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Trine Thilsing
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
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Shim KY, Seo S, Lee SJ, Lee CE. Eye Drop Chart for Improvement of Topical Eye Drops Administration and Adherence. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.2.160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kyu Young Shim
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
| | - Sam Seo
- Cheil Eye Hospital, Daegu, Korea
| | - Soo Jin Lee
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
| | - Chong Eun Lee
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
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Sommer I, Titscher V, Gartlehner G. Participants' expectations and experiences with periodic health examinations in Austria - a qualitative study. BMC Health Serv Res 2018; 18:823. [PMID: 30376830 PMCID: PMC6208031 DOI: 10.1186/s12913-018-3640-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/22/2018] [Indexed: 12/02/2022] Open
Abstract
Background The engagement of citizens in the development of evidence-based screening programs is internationally supported. The aim of our research was to explore the motivations and reasons of adult citizens in Austria for attending periodic health examinations (PHE) as well as their satisfaction with the way PHE are organized. Methods We conducted three focus groups with a random sample of previous attenders of PHE. Participants were stratified by age, gender, and education. The discussions were recorded, transcribed, and analyzed using a thematic analysis approach. Results Main motivations of attenders (n = 30) were to detect diseases early, to prevent suffering, and to live a long, healthy life. They believed that PHE work as an incentive of health behavior change. As possible reasons not to attend PHE, participants mentioned lack of awareness, time constraints, unpleasant prior experiences, and fear of harm or negative consequences. They wanted the range of examinations to be selected based on individual risks and to be more comprehensive. Some participants expressed frustration with the lack of time doctors dedicated to the examination or discussion of the results. Throughout the discussion, participants realized there is a great diversity among doctors in the quality of health examinations and how content is delivered. Conclusion The study showed that attenders of PHE have high expectations concerning the beneficial outcomes of PHE. They requested a comprehensive and individualized program that does not reflect the scientific evidence from effectiveness studies of PHE. These findings indicate serious shortcomings in the communication of benefits and harms of screening interventions and highlight the need for a more proactive communication about aims and content of the program.
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Affiliation(s)
- Isolde Sommer
- Department for Evidence-based Medicine and Clinical Epidemiology, University of Continuing Education (Danube University Krems), Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria.
| | - Viktoria Titscher
- Department for Evidence-based Medicine and Clinical Epidemiology, University of Continuing Education (Danube University Krems), Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Gerald Gartlehner
- Department for Evidence-based Medicine and Clinical Epidemiology, University of Continuing Education (Danube University Krems), Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria.,RTI-UNC Evidence-based Practice Center, Research Triangle Institute International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, Raleigh, North Carolina, 27709-2194, USA
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Stafford M, von Wagner C, Perman S, Taylor J, Kuh D, Sheringham J. Social connectedness and engagement in preventive health services: an analysis of data from a prospective cohort study. LANCET PUBLIC HEALTH 2018; 3:e438-e446. [PMID: 30143472 PMCID: PMC6123501 DOI: 10.1016/s2468-2667(18)30141-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/09/2018] [Accepted: 07/12/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Evidence of the possible health benefits of social connectedness is increasing. We aimed to examine poor social connectedness as a possible barrier to participation in preventive health services among older people (aged 53-69 years). METHODS We analysed data from a prospective cohort study of 5362 socially stratified births from the Medical Research Council National Survey of Health and Development enrolled in England, Scotland, and Wales in March 1946. At ages 68-69 years, participants reported participation in blood pressure and cholesterol measurement, eyesight and dental check-ups, influenza immunisation, and bowel and breast cancer screening. Our primary outcome measure summed participation across all these tests and services at ages 68-69 years. We tested associations between structural and functional social connectedness from ages 53 years to 69 years and total count of participation in these preventive services in Poisson models controlling for sex, education, occupational class, employment, chronic illnesses, and general practitioner consultations for health problems. FINDINGS 940 (44%) of 2132 participants attended all preventive services within the recommended timeframes. At ages 68-69 years, being unmarried or not cohabiting (incident rate ratio [IRR] 1·33, 95% CI 1·20-1·47) and small personal social networks (IRR 1·51, 1·32-1·71) were independently associated with non-participation in more services, with associations consistent across most services. High social relationship quality at ages 68-69 years (IRR 0·91, 95% CI 0·87-0·95) and increasing social relationship quality from ages 53 years to 69 years (IRR 0·93, 0·89-0·97) were associated with low risk of non-participation. INTERPRETATION Individuals with poor social connectedness appear to be at greater risk of not engaging in the full range of preventive services than individuals with good social connectedness. Improvement of access to social contacts and networks in older ages is already recommended for the maintenance of good mental health. This study suggests that social connectedness could also improve participation in a wide range of preventive health services, and hence could improve use of the health-care system and population health. FUNDING UK Medical Research Council.
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Affiliation(s)
- Mai Stafford
- The Health Foundation, London, UK; MRC Unit for Lifelong Health and Ageing, University College London, London, UK.
| | - Christian von Wagner
- Department of Behavioural Science and Health, University College London, London, UK
| | - Sarah Perman
- Screening Quality Assurance Service, Public Health England, London, UK
| | - Jayne Taylor
- London Borough of Hackney & City of London Corporation, Hackney Service Centre, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Jessica Sheringham
- National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care North Thames, Department of Applied Health Research, University College London, London, UK
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Rotarou ES, Sakellariou D. Determinants of utilisation rates of preventive health services: evidence from Chile. BMC Public Health 2018; 18:839. [PMID: 29976166 PMCID: PMC6034328 DOI: 10.1186/s12889-018-5763-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 06/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preventive health services play a vital role in population health. However, access to such services is not always equitably distributed. In this article, we examine the barriers affecting utilisation rates of preventive health services, using Chile as a case study. METHODS We conducted a cross-sectional study analysing secondary data from 206,132 Chilean adults, taken from the 2015 National Socioeconomic Characterisation Survey of the Government of Chile. We carried out logistic regressions to explore the relationship between the dependent variable use of preventive services and various demographic and socioeconomic variables. RESULTS Categories more likely to use preventive services were women (OR=1.16; 95%CI: 1.11-1.21) and inactive people (OR=1.41; 95%CI: 1.33-1.48). By contrast, single individuals (OR= 0.85 ; 95%CI: 0.80-0.91) and those affiliated with the private healthcare provider (OR= 0.89; 95%CI: 0.81-0.96) had fewer odds of undertaking preventive exams. CONCLUSIONS The findings underline the necessity of better information campaigns on the availability and necessity of preventive health services, addressing health inequality in accessing health services, and tackling lifestyle-related health risks. This is particularly important in countries - such as Chile - characterised by high income inequality and low utilisation rates of preventive health services.
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Affiliation(s)
- Elena S. Rotarou
- Department of Economics, University of Chile, Diagonal Paraguay 257, Office 1506, 8330015 Santiago, Chile
| | - Dikaios Sakellariou
- Cardiff University, School of Healthcare Sciences, Eastgate House, Newport Road 35-43, Cardiff, CF24 0AB UK
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Yamaguchi M, Yoshida T, Yamada Y, Watanabe Y, Nanri H, Yokoyama K, Date H, Miyake M, Itoi A, Yamagata E, Masumoto T, Okayama Y, Yoshinaka Y, Kimura M. Sociodemographic and physical predictors of non-participation in community based physical checkup among older neighbors: a case-control study from the Kyoto-Kameoka longitudinal study, Japan. BMC Public Health 2018; 18:568. [PMID: 29716551 PMCID: PMC5930753 DOI: 10.1186/s12889-018-5426-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 04/10/2018] [Indexed: 11/10/2022] Open
Abstract
Background It is difficult to obtain detailed information on non-participants in physical and health examination checkups in community-based epidemiological studies. We investigated the characteristics of non-participants in a physical and health examination checkup for older adults in a nested study from the Japanese Kyoto-Kameoka Longitudinal Study. Methods We approached a total of 4831 people aged ≥65 years in 10 randomly selected intervention regions. Participants responded to a mail-based population survey on needs in the sphere of daily life to encourage participation in a free face-to-face physical checkup examination; 1463 participants (706 men, 757 women) participated in the physical checkup. A multiple logistic regression model was performed to investigate the adjusted odds ratios (aOR) of non-participation based on sociodemographic status apart from psychological and physiological frailty as assessed by the validated Kihon Checklist. Results There was a significant, inverse relationship between non-participation and frequently spending time alone among individuals who lived with someone or other family structure (aOR = 0.53, standard error [SE] 0.08 in men, aOR = 0.66, SE 0.09 in women). Very elderly (over 80 years old) women, poorer health consciousness and current smoking in both sexes and poor self-rated health in men, were significantly related to higher non-participation rates. In both sexes, individuals who did not participate in community activities were significantly more likely to be non-participants than individuals who did (aOR = 1.94, SE 0.23 in men, aOR = 3.29, SE 0.39 in women). Having low IADL and physical functioning scores were also associated with higher rates of non-participation. Conclusion Health consciousness and lack of community activity participation were predictors of non-participation in a physical checkup examination among older adults. In addition, lower IADL and physical functioning/strength were also predictors of non-participation. On the contrary, older inhabitants living with someone tended to participate in the physical checkup examination for social interchange when they were frequently alone in the household. This study suggests the importance of considering aging especially for women and poor sociodemographic background and physical frailty for both sexes so that older people can access health programs without difficulty. Trial registration UMIN000008105. Registered 26 April 2012. Retrospectively registered. Electronic supplementary material The online version of this article (10.1186/s12889-018-5426-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Miwa Yamaguchi
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, 162-8636, Japan.
| | - Tsukasa Yoshida
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, 162-8636, Japan.,Senior Citizen's Welfare Section, Kameoka City Government, Kyoto, 621-8501, Japan
| | - Yosuke Yamada
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, 162-8636, Japan.,Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan.,Faculty of Economics and Business Administration, Kyoto Gakuen University, Kyoto, 621-8555, Japan
| | - Yuya Watanabe
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan.,Faculty of Health and Sports Science, Doshisha Unviersity, Kyoto, 610-0394, Japan.,Department of Health and Sports Sciences, Kyoto Gakuen University, Kyoto, 621-8555, Japan
| | - Hinako Nanri
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, 162-8636, Japan.,Department of Health and Sports Sciences, Kyoto Gakuen University, Kyoto, 621-8555, Japan
| | - Keiichi Yokoyama
- Faculty of Economics and Business Administration, Kyoto Gakuen University, Kyoto, 621-8555, Japan
| | - Heiwa Date
- Faculty of Data Science, Shiga University, Shiga, 522-8522, Japan
| | - Motoko Miyake
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kyoto, 621-8555, Japan
| | - Aya Itoi
- Department of Health, Sports and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Hyogo, 650-0046, Japan
| | - Emi Yamagata
- Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyoto, 610-0395, Japan
| | - Taeko Masumoto
- Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyoto, 610-0395, Japan
| | - Yasuko Okayama
- Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyoto, 610-0395, Japan
| | - Yasuko Yoshinaka
- Faculty of Economics and Business Administration, Kyoto Gakuen University, Kyoto, 621-8555, Japan
| | - Misaka Kimura
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan. .,Department of Health and Sports Sciences, Kyoto Gakuen University, Kyoto, 621-8555, Japan.
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Shin HY, Kang HT, Lee JW, Lim HJ. The Association between Socioeconomic Status and Adherence to Health Check-up in Korean Adults, Based on the 2010-2012 Korean National Health and Nutrition Examination Survey. Korean J Fam Med 2018; 39:114-121. [PMID: 29629044 PMCID: PMC5876046 DOI: 10.4082/kjfm.2018.39.2.114] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 04/27/2017] [Accepted: 05/07/2017] [Indexed: 01/09/2023] Open
Abstract
Background We investigated the association between socioeconomic status and adherence to health check-ups in a Korean population aged 40 years or older. Methods This cross-sectional study included 12,311 participants who participated in the 2010–2012 Korean National Health and Nutrition Examination Survey. Self-reported questionnaires were used to assess each participant's socioeconomic status (household income, occupation, and education) and adherence to health check-ups. Results Men with a higher income (highest vs. lowest: odds ratio [OR], 1.799; 95% confidence interval [CI], 1.296–2.497) and men with a higher education level (≥12 vs. <6 years: OR, 1.488; 95% CI, 1.078–2.054) and office workers compared with manual workers (men: OR, 1.431; 95% CI, 1.077–1.902; women: OR, 1.783; 95% CI, 1.256–2.532) appeared to undergo more health check-ups. In particular, men and women with a higher income and education appeared more likely to undergo opportunistic health check-ups (men: highest vs. lowest income: OR, 2.380; 95% CI, 1.218–4.653; ≥12 vs. <6 years education: OR, 2.121; 95% CI, 1.142–3.936; women: highest vs. lowest income: OR, 4.042; 95% CI, 2.239–7.297; ≥12 vs. <6 years education: OR, 2.475; 95% CI, 1.283–4.775). Conclusion A higher socioeconomic status was associated with a higher rate of participation in health check-ups. More efforts are needed to identify the factors associated with disparity in adherence to health check-ups.
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Affiliation(s)
- Hyun-Young Shin
- Department of Family Medicine, Myongji Hospital, Goyang, Korea.,Department of Epidemiology and Health Promotion and Institute for Health Promotion, Yonsei University Graduate School of Public Health, Seoul, Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jae Woo Lee
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Hyoung-Ji Lim
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
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Sakellariou D, Rotarou ES. Utilisation of cancer screening services by disabled women in Chile. PLoS One 2017; 12:e0176270. [PMID: 28459874 PMCID: PMC5411071 DOI: 10.1371/journal.pone.0176270] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 04/07/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Research has shown that women with disabilities face additional challenges in accessing and using healthcare services compared to non-disabled women. However, relatively little is known about the utilisation of cancer screening services for women with disabilities. This study addresses this gap by examining the utilisation of the Papanicolaou test and mammography for disabled women in Chile. METHODS We used cross-sectional data, taken from a 2015 nationally-representative survey. Initially, we employed logistic regressions to test for differences in utilisation rates for the Papanicolaou test (66,281 observations) and the mammogram (35,294 observations) between disabled and non-disabled women. Next, logistic regressions were used to investigate the demographic, socioeconomic, and health-related factors affecting utilisation rates for cancer screening services for disabled women (sample sizes: 5,823 observations for the Papanicolaou test and 5,731 observations for the mammogram). RESULTS Disabled women were less likely to undergo screening tests than non-disabled women. For the Papanicolaou test and mammography, the multivariable regression models showed that living in rural areas, having higher education, being affiliated with a private health insurance company, giving a good health self-assessment score, and being under medical treatment for other illnesses were associated with higher utilisation rates. On the other hand, being single, inactive with regard to employment, and having a better income were linked with lower utilisation. While utilisation rates for both disabled and non-disabled women have increased since 2006, the utilisation disparity has slightly increased. CONCLUSIONS This study shows the influence of various factors in the utilisation rates of preventive cancer screening services for disabled women. To develop effective initiatives targeting inequalities in the utilisation of cancer screening tests, it is important to move beyond an exclusively single-disease approach and acknowledge the complexity of the patient population.
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Affiliation(s)
| | - Elena S Rotarou
- Department of Economics, University of Chile, Santiago, Chile
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Haruyama Y, Yamazaki T, Endo M, Kato R, Nagao M, Umesawa M, Sairenchi T, Kobashi G. Personal status of general health checkups and medical expenditure: A large-scale community-based retrospective cohort study. J Epidemiol 2017; 27:209-214. [PMID: 28142031 PMCID: PMC5394218 DOI: 10.1016/j.je.2016.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 06/09/2016] [Indexed: 12/03/2022] Open
Abstract
Background We sought to clarify the association between the personal utilization of general health checkups (GHCs) and medical expenditures (MEs) in a middle-aged Japanese population. Methods A retrospective cohort study was conducted. Subjects were 33,417 residents (15,819 males and 17,598 females) aged 48 years or older in 2010 who were invited to undergo GHCs every year. Official records on GHCs from 2002 to 2007 and MEs from 2008 to 2010 were provided by Soka City, Saitama Prefecture, Japan. The utilization of GHCs was divided into zero times (non-utilizers), 1–3 times (low-frequency utilizers), and 4–6 times (high-frequency utilizers). Tweedie distributions in the generalized linear model were used to analyze the association between MEs and the subgroups of GHC utilization after adjustment for age and sex. Results Of the 33,417 subjects, 20,578 (61.6%) were non-utilizers, 5,777 (17.3%) were low-frequency utilizers, and 7,062 (21.1%) were high-frequency utilizers, based on the attendance to GHCs from 2002 to 2007. Compared with the non-utilizers, the high-frequency utilizers showed significantly higher outpatient MEs (JPY394,700 vs. JPY373,100). The low- and high-frequency utilizers showed significantly lower inpatient MEs (JPY224,000 and JPY181,500 vs. JPY309,300) and total MEs (JPY610,600 and JPY580,700 vs. JPY689,600) than the non-utilizers based on the pooled data from 2008 to 2010. Conclusions This study suggests that the outpatient MEs rise when annual GHCs are increasingly attended (not including the GHC cost), but inpatient and total MEs are lower. To reduce MEs, increasing the rates of attendance at GHCs by the general public may be important. To clarify the association between General Health Checkups and Medical Expenditures. A retrospective cohort study was conducted in a middle-aged Japanese population. Non-, low-, and high-frequency utilizers were divided based on the 6-year GHCs. 3-year MEs were analyzed using Tweedie distribution for a generalized linear model. Outpatient MEs rise when GHCs are frequent, but inpatient and total MEs are lower.
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Affiliation(s)
- Yasuo Haruyama
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan.
| | | | - Motoki Endo
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Rika Kato
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Masanori Nagao
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Mitsumasa Umesawa
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Toshimi Sairenchi
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
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Tsujiguchi H, Hori D, Kambayashi Y, Hamagishi T, Asakura H, Mitoma J, Kitaoka M, Olando AE, Thao NTT, Yamada Y, Hayashi K, Konoshita T, Sagara T, Shibata A, Nakamura H. Sex- and Age-Specific Associations of Social Status and Health-Related Behaviors with Health Check Attendance: Findings from the Cross-Sectional Kanazawa Study. Health (London) 2017. [DOI: 10.4236/health.2017.99093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Groenenberg I, Crone MR, van Dijk S, Ben Meftah J, Middelkoop BJC, Assendelft WJJ, Stiggelbout AM. Determinants of participation in a cardiometabolic health check among underserved groups. Prev Med Rep 2016; 4:33-43. [PMID: 27413659 PMCID: PMC4929048 DOI: 10.1016/j.pmedr.2016.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 04/24/2016] [Accepted: 04/29/2016] [Indexed: 11/24/2022] Open
Abstract
Cardiometabolic diseases affect underserved groups disparately. Participation in health checks is also lower, widening health inequalities in society. Two-stage screening (non-invasive health risk assessment (HRA) and GP consultations for high-risk individuals) seems cost-effective, provided that drop-out rates are low in both steps. We aimed to explore the process of decision-making regarding HRA participation among underserved groups (45–70 y): native Dutch with a lower socioeconomic status (SES), Turkish, Moroccan, and Surinamese participants. We conducted a cross-sectional questionnaire study. The questionnaire comprised the following determinants: a self-formulated first reaction, a structured set of predefined determinants, and the most important barrier(s) and facilitator(s) for HRA completion. We used univariable and (stepwise) multivariate logistic regression analyses to assess which determinants were associated with HRA completion. Of the 892 participants in the questionnaire, 78% (n = 696) also completed the HRA. Moroccans and patients from GP practices with a predominantly non-Western population less often completed the HRA. A lower SES score, wanting to know one's risk, not remembering receiving the invitation (thus requiring a phone call), fear of the test result and/or adjusting lifestyle, perceived control of staying healthy, wanting to participate, and perceiving no barriers were associated with completing the HRA. We conclude that our ‘hard-to-reach’ population may not be unwilling to participate in the HRA. A more comprehensive approach, involving key figures within a community informing people about and providing help completing the HRA, would possibly be more suitable. Efforts should be particularly targeted at the less acculturated immigrants with an external locus of control. Participation is lowest in GP practices with a predominant non-Western population. Patients are positive about a health check, whether they participate or not. Still, about one quarter of patients does not participate in the health check. These patients do not want to know their risk and lack control over staying healthy. Telephone follow-up is crucial as patients forget receiving the written invitation.
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Affiliation(s)
- I Groenenberg
- Leiden University Medical Center, Department of Public Health and Primary Care, Hippocratespad 21, PO Box 9600, V0-P, 2300 RC Leiden, The Netherlands
| | - M R Crone
- Leiden University Medical Center, Department of Public Health and Primary Care, Hippocratespad 21, PO Box 9600, V0-P, 2300 RC Leiden, The Netherlands
| | - S van Dijk
- Leiden University, Department of Social Sciences, Institute for Psychology, Health, Medical, and Neuropsychology, Pieter de la Court Building, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - J Ben Meftah
- Leiden University Medical Center, Department of Public Health and Primary Care, Hippocratespad 21, PO Box 9600, V0-P, 2300 RC Leiden, The Netherlands
| | - B J C Middelkoop
- Leiden University Medical Center, Department of Public Health and Primary Care, Hippocratespad 21, PO Box 9600, V0-P, 2300 RC Leiden, The Netherlands
| | - W J J Assendelft
- Radboud University Medical Center, Department of Primary and Community Care, Nijmegen, The Netherlands
| | - A M Stiggelbout
- Leiden University Medical Center, Department of Medical Decision Making, 2300 RC Leiden, The Netherlands
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Dorner TE. [Epidemiology of obesity in Austria]. Wien Med Wochenschr 2015; 166:79-87. [PMID: 26650060 DOI: 10.1007/s10354-015-0409-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 11/19/2015] [Indexed: 01/12/2023]
Abstract
The purpose of this article was to compile all existing data regarding the prevalence of obesity in Austria in all age groups, and to perform additional analyses. Prevalence of obesity in the adult Austrian population varies between 8.3 and 19.9% in men, and 9.0 and 19.8% in women with increasing trends over time. Prevalence of obesity in children and adolescents in Austria varies between 3.1 and 9.0% in boys and between 2.2 and 7.3% in girls. Factors associated with obesity include higher age, lower educational level, profession, migration background, living in eastern parts of Austria, lack of social support, and psycho-social pressure. In women, socio-economic parameters are stronger associated with obesity compared to men. Obesity is associated with hypertension, diabetes mellitus, osteoarthritis, and low back pain, and deteriorated quality of live, in both sexes, and in men additionally with a history of heart attack, and in women additionally with anxiety/depression.
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Affiliation(s)
- Thomas E Dorner
- Institute of Social Medicine, Center for Public Health, Medical University Vienna, Kinderspitalgasse 15/I, 1090, Wien, Österreich.
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Groenenberg I, Crone MR, van Dijk S, Ben Meftah J, Middelkoop BJC, Assendelft WJJ, Stiggelbout AM. Response and participation of underserved populations after a three-step invitation strategy for a cardiometabolic health check. BMC Public Health 2015; 15:854. [PMID: 26335782 PMCID: PMC4558779 DOI: 10.1186/s12889-015-2139-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 08/11/2015] [Indexed: 11/30/2022] Open
Abstract
Background Ethnic minority and native Dutch groups with a low socioeconomic status (SES) are underrepresented in cardiometabolic health checks, despite being at higher risk. We investigated response and participation rates using three consecutive inexpensive-to-costly culturally adapted invitation steps for a health risk assessment (HRA) and further testing of high-risk individuals during prevention consultations (PC). Methods A total of 1690 non-Western immigrants and native Dutch with a low SES (35–70 years) from six GP practices were eligible for participation. We used a ‘funnelled’ invitation design comprising three increasingly cost-intensive steps: (1) all patients received a postal invitation; (2) postal non-responders were approached by telephone; (3) final non-responders were approached face-to-face by their GP. The effect of ethnicity, ethnic mix of GP practice, and patient characteristics (gender, age, SES) on response and participation were assessed by means of logistic regression analyses. Results Overall response was 70 % (n = 1152), of whom 62 % (n = 712) participated in the HRA. This was primarily accomplished through the postal and telephone invitations. Participants from GP practices in the most deprived neighbourhoods had the lowest response and HRA participation rates. Of the HRA participants, 29 % (n = 207) were considered high-risk, of whom 59 % (n = 123) participated in the PC. PC participation was lowest among native Dutch with a low SES. Conclusions Underserved populations can be reached by a low-cost culturally adapted postal approach with a reminder and follow-up telephone calls. The added value of the more expensive face-to-face invitation was negligible. PC participation rates were acceptable. Efforts should be particularly targeted at practices in the most deprived areas. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2139-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Iris Groenenberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, V0-P, 2300, RC, Leiden, The Netherlands.
| | - Mathilde R Crone
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, V0-P, 2300, RC, Leiden, The Netherlands.
| | - Sandra van Dijk
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, V0-P, 2300, RC, Leiden, The Netherlands.
| | - Jamila Ben Meftah
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, V0-P, 2300, RC, Leiden, The Netherlands.
| | - Barend J C Middelkoop
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, V0-P, 2300, RC, Leiden, The Netherlands.
| | - Willem J J Assendelft
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, V0-P, 2300, RC, Leiden, The Netherlands. .,Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Anne M Stiggelbout
- Department of Medical Decision Making, Leiden University Medical Center, 2300, RC, Leiden, The Netherlands.
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Eichinger M, Titze S, Haditsch B, Dorner TE, Stronegger WJ. How are physical activity behaviors and cardiovascular risk factors associated with characteristics of the built and social residential environment? PLoS One 2015; 10:e0126010. [PMID: 26035294 PMCID: PMC4452766 DOI: 10.1371/journal.pone.0126010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 03/27/2015] [Indexed: 12/02/2022] Open
Abstract
Background The aim of our study was to identify perceptions of built and social residential characteristics and their association with behaviors such as physical activity (PA), nutrition and smoking and with cardiovascular risk factors (elevated BMI and fasting blood glucose). Methods Among participants of a preventive medical checkup at an Austrian District Health Insurance Fund (n=904, response rate = 82.2%, 42% women, 18-91 years) self-reported and measured data were collected. Results Total PA was positively associated with the presence of trees along the streets and high levels of pro-physical activity social modeling (SM) and it was negatively related to perceived safety from crime. More leisure-time PA was associated with higher levels of cycling/walking infrastructure and high levels of SM. PA for transportation was positively related to high levels of connectivity and high levels of SM. Better behavioral cardiovascular risk factor profiles (smoking and nutrition) were associated with high levels of SM and high levels of total PA. Lower BMI values were associated with high levels of infrastructure and high levels of SM. Conclusions Both built and social residential characteristics are important correlates of PA as well as of major cardiovascular risk factors besides PA.
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Affiliation(s)
- Michael Eichinger
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstrasse 6, 8010, Graz, Austria
- * E-mail:
| | - Sylvia Titze
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
| | - Bernd Haditsch
- Styrian District Health Insurance Fund, Friedrichgasse 18, 8010, Graz, Austria
| | - Thomas E. Dorner
- Institute of Social Medicine, Medical University of Vienna, Rooseveltplatz 3, 1090, Vienna, Austria
| | - Willibald J. Stronegger
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstrasse 6, 8010, Graz, Austria
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Groenenberg I, Crone MR, van Dijk S, Gebhardt WA, Ben Meftah J, Middelkoop BJC, Stiggelbout AM, Assendelft WJJ. 'Check it out!' Decision-making of vulnerable groups about participation in a two-stage cardiometabolic health check: a qualitative study. PATIENT EDUCATION AND COUNSELING 2015; 98:234-244. [PMID: 25457176 DOI: 10.1016/j.pec.2014.10.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/16/2014] [Accepted: 10/11/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Exploring determinants influencing vulnerable groups regarding (non-) participation in the Dutch two-stage cardiometabolic health check, comprising a health risk assessment (HRA) and prevention consultations (PCs) for high-risk individuals. METHODS Qualitative study comprising 21 focus groups with non-Western (Surinamese, Turkish, Moroccan) immigrants aged 45-70, adult children from one of these descents, native Dutch with a lower socioeconomic status, and healthcare professionals working with these groups. RESULTS Reasons for not completing the HRA included (flawed) risk perceptions, health negligence, (health) illiteracy, and language barriers. A face-to-face invitation from a reliable source and community outreach to raise awareness were perceived as facilitating participation. Reasons for not attending the PCs overlapped with completing the HRA but additionally included risk denial, fear about the outcome, its potential consequences (lifestyle changes and medication prescription), and disease-related stigma. CONCLUSION Reasons for not completing the HRA were mainly cognitive, whereas reasons for not attending the PCs were also affective. PRACTICE IMPLICATIONS When designing a two-stage health check, choice of invitation method seems important, as does training healthcare professionals in techniques to effectively handle patients' (flawed) risk perceptions and attitudinal ambivalence. Focus should be on promoting informed choices by providing accurate information.
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Affiliation(s)
- Iris Groenenberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Mathilde R Crone
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Sandra van Dijk
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Winnifred A Gebhardt
- Department of Health, Medical, and Neuropsychology, Leiden University, Leiden, The Netherlands.
| | - Jamila Ben Meftah
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Barend J C Middelkoop
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Anne M Stiggelbout
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Willem J J Assendelft
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
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