1
|
Lu Y, Zhao Y, Shangguan X, Lv B, Huang R. Patient attitude and determinants toward chronic diseases control: A cross-sectional survey in rural China. Front Public Health 2022; 10:970032. [PMID: 36311642 PMCID: PMC9606740 DOI: 10.3389/fpubh.2022.970032] [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: 06/15/2022] [Accepted: 09/21/2022] [Indexed: 01/25/2023] Open
Abstract
Objectives The patients' attitude is critical in disease control. This study aims to explore the determinants of patients' attitude and satisfaction. Methods A total of 844 patients in the rural areas of Shandong, Henan, and Sichuan provinces with hypertension or diabetes were randomly selected for investigation. The outcome variables were the patients' attitude and satisfaction toward chronic disease control, which were measured through patient self-reported. Binary logistic regression models were used to explore the determinants of patients' attitude and satisfaction. Results Teachers were more likely to regard that chronic disease management was helpful in their chronic disease control than that in farmers (OR = 3.994, 95% confidence interval (CI) = 1.309-12.188). Moreover, the probability of health institutions recording chronic diseases changes and guiding rehabilitation for patients regularly is considered helpful 2.688 times more than those that are not. In addition, receiving chronic disease management services can make patients repute that chronic disease management services are helpful in controlling chronic diseases more capably (OR = 1.582, 95% CI = 2.198-10.771). In terms of satisfaction, patients who do not know regular follow-up tend to be dissatisfied with chronic diseases control result (OR = 0.376, 95% CI = 0.192-0.737; OR = 0.592, 95%CI = 0.417-0.841). Conclusion The government increases the promotion of chronic disease management in rural areas to improve patients' awareness. Health institutions also can provide diversified services to meet the needs of more people. At last, paying more attention to the timeliness of health services need to be considered to develop a health plan.
Collapse
Affiliation(s)
- Yuanyuan Lu
- Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuhang Zhao
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaofang Shangguan
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Benyan Lv
- Management Institute, Xinxiang Medical University, Xinxiang, China,*Correspondence: Benyan Lv
| | - Rui Huang
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Rui Huang
| |
Collapse
|
2
|
Abbott L, Graven L, Schluck G, Lemacks J. A Structural Equation Modeling Analysis to Explore Diabetes Self-Care Factors in a Rural Sample. Healthcare (Basel) 2022; 10:1536. [PMID: 36011193 PMCID: PMC9407851 DOI: 10.3390/healthcare10081536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
Diabetes is a public health problem that requires management to avoid health sequelae. Little is known about the determinants that influence diabetes self-care activities among rural populations. The purpose of this analysis was to explore the relationships among diabetes self-care activities, diabetes knowledge, perceived diabetes self-management, diabetes fatalism, and social support among an underserved rural group in the southern United States. A diabetes health promotion program was tested during a cluster randomized trial that tested a disease risk reduction program among adults living with prediabetes and diabetes. A structural equation model was fit to test psychosocial factors that influence diabetes self-care activities using the Information-Motivation-Behavioral Skills Model of Diabetes Self-Care (IMB-DSC) to guide the study. Perceived diabetes self-management significantly predicted self-care behaviors, and there was also a correlation between perceived diabetes self-management and diabetes fatalism. Perceived diabetes self-management influenced diabetes self-care activities in this rural sample and had an association with diabetes fatalism. The findings of this study can facilitate clinical care and community programs targeting diabetes and advance health equity among underserved rural groups.
Collapse
Affiliation(s)
- Laurie Abbott
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA
| | - Lucinda Graven
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA
| | - Glenna Schluck
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA
| | - Jennifer Lemacks
- College of Nursing and Health Professions, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| |
Collapse
|
3
|
Bhatia S, Landier W, Paskett ED, Peters KB, Merrill JK, Phillips J, Osarogiagbon RU. Rural-Urban Disparities in Cancer Outcomes: Opportunities for Future Research. J Natl Cancer Inst 2022; 114:940-952. [PMID: 35148389 PMCID: PMC9275775 DOI: 10.1093/jnci/djac030] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/27/2021] [Accepted: 02/01/2022] [Indexed: 01/12/2023] Open
Abstract
Cancer care disparities among rural populations are increasingly documented and may be worsening, likely because of the impact of rurality on access to state-of-the-art cancer prevention, diagnosis, and treatment services, as well as higher rates of risk factors such as smoking and obesity. In 2018, the American Society of Clinical Oncology undertook an initiative to understand and address factors contributing to rural cancer care disparities. A key pillar of this initiative was to identify knowledge gaps and promote the research needed to understand the magnitude of difference in outcomes in rural vs nonrural settings, the drivers of those differences, and interventions to address them. The purpose of this review is to describe continued knowledge gaps and areas of priority research to address them. We conducted a comprehensive literature review by searching the PubMed (Medline), Embase, Web of Science, and Cochrane Library databases for studies published in English between 1971 and 2021 and restricted to primary reports from populations in the United States and abstracted data to synthesize current evidence and identify continued gaps in knowledge. Our review identified continuing gaps in the literature regarding the underlying causes of rural-urban disparities in cancer outcomes. Rapid advances in cancer care will worsen existing disparities in outcomes for rural patients without directed effort to understand and address barriers to high-quality care in these areas. Research should be prioritized to address ongoing knowledge gaps about the drivers of rurality-based disparities and preventative and corrective interventions.
Collapse
Affiliation(s)
- Smita Bhatia
- University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Wendy Landier
- University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | | | | | | | | | | |
Collapse
|
4
|
Fatalism, Social Support and Self-Management Perceptions among Rural African Americans Living with Diabetes and Pre-Diabetes. NURSING REPORTS 2021; 11:242-252. [PMID: 34968202 PMCID: PMC8608061 DOI: 10.3390/nursrep11020024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/29/2021] [Accepted: 04/08/2021] [Indexed: 02/01/2023] Open
Abstract
Diabetes is a public health problem and a major risk factor for cardiovascular disease, the leading cause of death in the United States. Diabetes is prevalent among underserved rural populations. The purposes of this study were to perform secondary analyses of existing clinical trial data to determine whether a diabetes health promotion and disease risk reduction intervention had an effect on diabetes fatalism, social support, and perceived diabetes self-management and to provide precise estimates of the mean levels of these variables in an understudied population. Data were collected during a cluster randomized trial implemented among African American participants (n = 146) in a rural, southern area and analyzed using a linear mixed model. The results indicated that the intervention had no significant effect on perceived diabetes management (p = 0.8), diabetes fatalism (p = 0.3), or social support (p = 0.4). However, the estimates showed that, in the population, diabetes fatalism levels were moderate (95% CI = (27.6, 31.3)), and levels of social support (CI = (4.0, 4.4)) and perceived diabetes self-management (CI = (27.7, 29.3)) were high. These findings suggest that diabetes fatalism, social support, and self-management perceptions influence diabetes self-care and rural health outcomes and should be addressed in diabetes interventions.
Collapse
|
5
|
Odoi EW, Nagle N, Zaretzki R, Jordan M, DuClos C, Kintziger KW. Sociodemographic Determinants of Acute Myocardial Infarction Hospitalization Risks in Florida. J Am Heart Assoc 2020; 9:e012712. [PMID: 32427043 PMCID: PMC7428988 DOI: 10.1161/jaha.119.012712] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Identifying social determinants of myocardial infarction (MI) hospitalizations is crucial for reducing/eliminating health disparities. Therefore, our objectives were to identify sociodemographic determinants of MI hospitalization risks and to assess if the impacts of these determinants vary by geographic location in Florida. Methods and Results This is a retrospective ecologic study at the county level. We obtained data for principal and secondary MI hospitalizations for Florida residents for the 2005-2014 period and calculated age- and sex-adjusted MI hospitalization risks. We used a multivariable negative binomial model to identify sociodemographic determinants of MI hospitalization risks and a geographically weighted negative binomial model to assess if the strength of associations vary by location. There were 645 935 MI hospitalizations (median age, 72 years; 58.1%, men; 73.9%, white). Age- and sex-adjusted risks ranged from 18.49 to 69.48 cases/10 000 persons, and they were significantly higher in counties with low education levels (risk ratio [RR]=1.033, P<0.0001) and high divorce rate (RR, 0.995; P=0.018). However, they were significantly lower in counties with high proportions of rural (RR, 0.996; P<0.0001), black (RR, 1.026; P=0.032), and uninsured populations (RR, 0.983; P=0.040). Associations of MI hospitalization risks with education level and uninsured rate varied geographically (P for non-stationarity test=0.001 and 0.043, respectively), with strongest associations in southern Florida (RR for <high school education, 1.036-1.041; RR for uninsured rate, 0.971-0.976). Conclusions Black race, divorce, rural residence, low education level, and lack of health insurance were significant determinants of MI hospitalization risks, but associations with the latter 2 were stronger in southern Florida. Thus, interventions for addressing MI hospitalization risks need to prioritize these populations and allocate resources based on empirical evidence from global and local models for maximum efficiency and effectiveness.
Collapse
Affiliation(s)
- Evah Wangui Odoi
- Comparative and Experimental Medicine College of Veterinary Medicine The University of Tennessee Knoxville TN
| | - Nicholas Nagle
- Department of Geography The University of Tennessee Knoxville TN
| | - Russell Zaretzki
- Department of Business Analytics and Statistics The University of Tennessee Knoxville TN
| | - Melissa Jordan
- Public Health Research Division of Community Health Promotion Florida Department of Health Tallahassee FL
| | - Chris DuClos
- Environmental Public Health Tracking Division of Community Health Promotion Florida Department of Health Tallahassee FL
| | | |
Collapse
|
6
|
Abstract
BACKGROUND Osteoarthritis (OA) is a degenerative disease causing decreased mobility. Use of autologous platelet-rich plasma (PRP) provides a reparative alternative in the management of OA. METHODS/PURPOSE This study assessed effectiveness of nurse practitioner-injected PRP to manage knee OA in a rural setting. RESULTS Twenty patients were followed for 1 month after PRP treatment. Knee function and pain levels were assessed using a knee function score (Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form [KOOS-PS]). CONCLUSIONS Overall, the 20 patients who participated in this study experienced significant improvement in knee function scores, decreased pain, and decreased use of pain medications.
Collapse
|
7
|
Roncoroni J, Tucker CM, Wall W, Wippold G, Ratchford J. Associations of Health Self-efficacy With Engagement in Health-Promoting Behaviors and Treatment Adherence in Rural Patients. FAMILY & COMMUNITY HEALTH 2019; 42:109-116. [PMID: 30768475 DOI: 10.1097/fch.0000000000000219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Rural residents have lower levels of engagement in health-promoting behaviors and treatment adherence than their urban counterparts. This cross-sectional study sought to understand the role of health self-efficacy as a precursor to engagement in health-promoting behaviors and treatment adherence in 273 rural patients. Structural equation model was used to examine whether health self-efficacy predicted engagement in health-promoting behaviors and treatment adherence. Results show that health self-efficacy predicts engagement in health-promoting behaviors and treatment adherence. Boosting patients' health self-efficacy could be a way of increasing their engagement in health-promoting behaviors and treatment adherence and thus of improving their health outcomes.
Collapse
Affiliation(s)
- Julia Roncoroni
- Department of Counseling Psychology, Morgridge College of Education, University of Denver, Denver, Colorado (Dr Roncoroni and Ms Ratchford); Department of Psychology, University of Florida, Gainesville (Dr Tucker); Department of Psychology, Fayetteville State University, Fayetteville, North Carolina (Dr Wall); and Department of Psychology, University of South Carolina, Columbia (Dr Wippold)
| | | | | | | | | |
Collapse
|
8
|
Oh H, Noh H, Sims OT, Guo Y, Sawyer P. A comparison of urban and non-urban African American older adults on health-related characteristics. SOCIAL WORK IN HEALTH CARE 2018; 57:762-773. [PMID: 30118652 DOI: 10.1080/00981389.2018.1497748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although residential geographic health disparities have been noted in the previous literature, studies are specifically lacking on intra-group health comparisons of African American older adults by residential geography. The purpose of this study was to determine if health-related characteristics of African American older adults varied by residential geography. Socioeconomic demographics, medical conditions, primary care use, and self-ratings of general health, social activity, and physical activity were compared in a community-dwelling sample of 327 urban and non-urban African American older adults. Urban and non-urban African American older adults were compared on health-related factors. Compared to urban African American older adults, those in non-urban areas had lower incomes, lower self-ratings of general health, social activity, and physical activity, and a higher frequency of arthritis and gastroenterological and urological conditions. Despite poorer general health and medical conditions, non-urban African American older adults were less likely to visit the doctor when needed. Study findings suggest residential geography may be an underappreciated underlying contributing factor to inter-group health disparities between African American and white older adults and not race alone. Therefore, social workers in public health, health care, and clinical settings should be aware of the interaction between race and residential geography.
Collapse
Affiliation(s)
- Hyejung Oh
- a Department of Social Work , California State University Bakersfield , Bakersfield , CA , USA
| | - Hyunjin Noh
- b School of Social Work , The University of Alabama , Tuscaloosa , AL , USA
| | - Omar T Sims
- c Department of Social Work , The University of Alabama at Birmingham , Birmingham , AL , USA
- d Department of Health Behavior , The University of Alabama at Birmingham , Birmingham , AL , USA
- e Comprehensive Center for Healthy Aging , The University of Alabama at Birmingham , Birmingham , AL , USA
- f Center for AIDS Research , The University of Alabama at Birmingham , Birmingham , AL , USA
| | - Yuqi Guo
- b School of Social Work , The University of Alabama , Tuscaloosa , AL , USA
| | - Patricia Sawyer
- g Division of Gerontology, Geriatrics, and Palliative Care , The University of Alabama at Birmingham , Birmingham , AL , USA
| |
Collapse
|
9
|
Abstract
BACKGROUND Cardiovascular disease is a major cause of death for people living in the United States. African Americans bear a disproportionate burden of cardiovascular disease. Interventions designed to target multiple risk factors may facilitate elimination of cardiovascular disease health disparities. OBJECTIVE The purpose of this study was to evaluate a culturally relevant cardiovascular health promotion intervention that could potentially reduce cardiovascular disease risk among a group of rural African American adults by improving intentions, attitudes, norms, and self-efficacy to increase produce consumption, reduce dietary saturated fat intake, and increase exercise. METHODS A cluster randomized controlled trial design was used to evaluate the effect of the "With Every Heartbeat Is Life" cardiovascular health promotion program among rural African Americans. The African American congregants of 12 rural churches located in northern Florida were randomly assigned to either an intervention group that received a culturally relevant cardiovascular health promotion intervention or a control group. Data analysis using linear mixed model was performed to compare group differences from pretest to posttest. RESULTS The cardiovascular health promotion intervention had a positive influence on the intentions, attitudes, norms, and self-efficacy of rural African Americans to increase produce consumption and reduce dietary saturated fat. The intervention also enhanced participants' attitudes and self-efficacy regarding exercise. CONCLUSION The culturally relevant cardiovascular health promotion program presented to cluster groups of rural African American participants had positive influences on psychosocial variables associated with engaging in cardiovascular health recommendations. Nurse-led interventions in community settings can potentially reduce cardiovascular disease risk.
Collapse
|
10
|
Burkes RM, Gassett AJ, Ceppe AS, Anderson W, O'Neal WK, Woodruff PG, Krishnan JA, Barr RG, Han MK, Martinez FJ, Comellas AP, Lambert AA, Kaufman JD, Dransfield MT, Wells JM, Kanner RE, Paine R, Bleecker ER, Paulin LM, Hansel NN, Drummond MB. Rural Residence and Chronic Obstructive Pulmonary Disease Exacerbations. Analysis of the SPIROMICS Cohort. Ann Am Thorac Soc 2018; 15:808-816. [PMID: 29584453 PMCID: PMC6207115 DOI: 10.1513/annalsats.201710-837oc] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 03/06/2018] [Indexed: 12/13/2022] Open
Abstract
Rationale: Rural residence is associated with poor outcomes in several chronic diseases. The association between rural residence and chronic obstructive pulmonary disease (COPD) exacerbations remains unclear.Objectives: In this work, we sought to determine the independent association between rural residence and COPD-related outcomes, including COPD exacerbations, airflow obstruction, and symptom burden.Methods: A total of 1,684 SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) participants with forced expiratory volume in 1 second/forced vital capacity < 0.70 had geocoding-defined rural-urban residence status determined (N = 204 rural and N = 1,480 urban). Univariate and multivariate logistic and negative binomial regressions were performed to assess the independent association between rurality and COPD outcomes, including exacerbations, lung function, and symptom burden. The primary exposure of interest was rural residence, determined by geocoding of the home address to the block level at the time of study enrollment. Additional covariates of interest included demographic and clinical characteristics, occupation, and occupational exposures. The primary outcome measures were exacerbations determined over a 1-year course after enrollment by quarterly telephone calls and at an annual research clinic visit. The odds ratio (OR) and incidence rate ratio (IRR) of exacerbations that required treatment with medications, including steroids or antibiotics (total exacerbations), and exacerbations leading to hospitalization (severe exacerbations) were determined after adjusting for relevant covariates.Results: Rural residence was independently associated with a 70% increase in the odds of total exacerbations (OR, 1.70 [95% confidence interval (CI), 1.13-2.56]; P = 0.012) and a 46% higher incidence rate of total exacerbations (IRR 1.46 [95% CI, 1.02-2.10]; P = 0.039). There was no association between rural residence and severe exacerbations. Agricultural occupation was independently associated with increased odds and incidence of total and severe exacerbations. Inclusion of agricultural occupation in the analysis attenuated the association between rural residence and the odds and incidence rate of total exacerbations (OR, 1.52 [95% CI, 1.00-2.32]; P = 0.05 and IRR 1.39 [95% CI, 0.97-1.99]; P = 0.07). There was no difference in symptoms or airflow obstruction between rural and urban participants.Conclusions: Rural residence is independently associated with increased odds and incidence of total, but not severe, COPD exacerbations. These associations are not fully explained by agriculture-related exposures, highlighting the need for future research into potential mechanisms of the increased risk of COPD exacerbations in the rural population.
Collapse
Affiliation(s)
| | - Amanda J Gassett
- Department of Environmental and Occupational Health Sciences, School of Public Health, and
| | - Agathe S Ceppe
- Marsico Lung Institute/Cystic Fibrosis Research Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Wayne Anderson
- Marsico Lung Institute/Cystic Fibrosis Research Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Wanda K O'Neal
- Marsico Lung Institute/Cystic Fibrosis Research Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Prescott G Woodruff
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco, School of Medicine, San Francisco, California
| | - Jerry A Krishnan
- Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois, Chicago, Illinois
| | - R Graham Barr
- Department of Medicine, Columbia University Medical Center, New York, New York
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, Michigan
| | - Fernando J Martinez
- Department of Medicine, Weill Cornell Medical College, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | | | - Allison A Lambert
- Division of Pulmonary and Critical Care, University of Washington, Seattle, Washington
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, and
| | - Mark T Dransfield
- Division of Pulmonary and Critical Care, University of Alabama at Birmingham, Birmingham, Alabama
| | - J Michael Wells
- Division of Pulmonary and Critical Care, University of Alabama at Birmingham, Birmingham, Alabama
| | - Richard E Kanner
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Robert Paine
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Eugene R Bleecker
- Division of Pulmonary, Critical Care, Allergy and Immunologic Diseases, Wake Forest University, Winston-Salem, North Carolina; and
| | - Laura M Paulin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | |
Collapse
|
11
|
Abstract
BACKGROUND Oral and pharyngeal cancer is highly treatable if diagnosed early, yet late diagnosis is commonplace apparently because of delays in undergoing an oral cancer examination. PURPOSE We explored predictors of scheduling and attending an oral cancer examination among a sample of Black and White men who were at high risk for oral cancer because they smoked. METHODS During an in-person interview, participants (N = 315) from rural Florida learned about oral and pharyngeal cancer, completed survey measures, and were offered a free examination in the next week. Later, participants received a follow-up phone call to explore why they did or did not attend their examination. RESULTS Consistent with the notion that scheduling and attending an oral cancer exam represent distinct decisions, we found that the two outcomes had different predictors. Defensive avoidance and exam efficacy predicted scheduling an examination; exam efficacy and having coping resources, time, and transportation predicted attending the examination. Open-ended responses revealed that the dominant reasons participants offered for missing a scheduled examination were conflicting obligations, forgetting, and confusion or misunderstanding about the examination. CONCLUSIONS The results suggest interventions to increase scheduling and attending an oral cancer examination.
Collapse
|
12
|
Brismée JM, Yang S, Lambert ME, Chyu MC, Tsai P, Zhang Y, Han J, Hudson C, Chung E, Shen CL. Differences in musculoskeletal health due to gender in a rural multiethnic cohort: a Project FRONTIER study. BMC Musculoskelet Disord 2016; 17:181. [PMID: 27113571 PMCID: PMC4845308 DOI: 10.1186/s12891-016-1042-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/20/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Very few studies have investigated differences in musculoskeletal health due to gender in a large rural population. The aim of this study is to investigate factors affecting musculoskeletal health in terms of hand grip strength, musculoskeletal discomfort, and gait disturbance in a rural-dwelling, multi-ethnic cohort. METHODS Data for 1117 participants (40 years and older, 70% female) of an ongoing rural healthcare study, Project FRONTIER, were analyzed. Subjects with a history of neurological disease, stroke and movement disorder were excluded. Dominant hand grip strength was assessed by dynamometry. Gait disturbance including stiff, spastic, narrow-based, wide-based, unstable or shuffling gait was rated. Musculoskeletal discomfort was assessed by self-reported survey. Data were analyzed by linear, logistic regression and negative binomial regressions as appropriate. Demographic and socioeconomic factors were adjusted in the multiple variable analyses. RESULTS In both genders, advanced age was a risk factor for weaker hand grip strength; arthritis was positively associated with musculoskeletal discomfort, and fair or poor health was significantly associated with increased risk of gait disturbance. Greater waist circumference was associated with greater musculoskeletal discomfort in males only. In females, advanced age is the risk factor for musculoskeletal discomfort as well as gait disturbance. Females with fair or poor health had weaker hand grip strength. Higher C-reactive protein and HbA1c levels were also positively associated with gait disturbance in females, but not in males. CONCLUSION This cross-sectional study demonstrates how gender affects hand grip strength, musculoskeletal discomfort, and gait in a rural-dwelling multi-ethnic cohort. Our results suggest that musculoskeletal health may need to be assessed differently between males and females.
Collapse
Affiliation(s)
- J M Brismée
- Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA
| | - S Yang
- Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA
| | - M E Lambert
- F. Marie Hall Institute for Rural and Community Health Research, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA
| | - M C Chyu
- Graduate Healthcare Engineering, Whitacre College of Engineering, Texas Tech University, Lubbock, TX, 79409, USA
| | - P Tsai
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA
| | - Y Zhang
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA
| | - J Han
- Department of Nutrition and Food Hygiene, Xinjiang Medical University, Xinjiang, China
| | - C Hudson
- F. Marie Hall Institute for Rural and Community Health Research, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA
| | - Eunhee Chung
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, USA
| | - C L Shen
- Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA.
| |
Collapse
|
13
|
Grant JS, Steadman LA. Barriers to Diabetes Self-Management Among Rural Individuals in the Workplace. Workplace Health Saf 2016; 64:243-8. [PMID: 27016376 DOI: 10.1177/2165079916628877] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Higher rates of type 2 diabetes mellitus (T2DM) are found in rural populations and barriers lessen the ability of these individuals to effectively manage diabetes. By lessening potential barriers to self-care management, health professionals, especially occupational health nurses, can assist individuals confidently manage T2DM. In this article, the authors provide an overview of diabetes self-management barriers for rural populations and implications for health professionals who assist individuals with T2DM in the workplace.
Collapse
|
14
|
Okwechime IO, Roberson S, Odoi A. Prevalence and Predictors of Pre-Diabetes and Diabetes among Adults 18 Years or Older in Florida: A Multinomial Logistic Modeling Approach. PLoS One 2015; 10:e0145781. [PMID: 26714019 PMCID: PMC4699892 DOI: 10.1371/journal.pone.0145781] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 12/08/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Individuals with pre-diabetes and diabetes have increased risks of developing macro-vascular complications including heart disease and stroke; which are the leading causes of death globally. The objective of this study was to estimate the prevalence of pre-diabetes and diabetes, and to investigate their predictors among adults ≥18 years in Florida. METHODS Data covering the time period January-December 2013, were obtained from Florida's Behavioral Risk Factor Surveillance System (BRFSS). Survey design of the study was declared using SVYSET statement of STATA 13.1. Descriptive analyses were performed to estimate the prevalence of pre-diabetes and diabetes. Predictors of pre-diabetes and diabetes were investigated using multinomial logistic regression model. Model goodness-of-fit was evaluated using both the multinomial goodness-of-fit test proposed by Fagerland, Hosmer, and Bofin, as well as, the Hosmer-Lemeshow's goodness of fit test. RESULTS There were approximately 2,983 (7.3%) and 5,189 (12.1%) adults in Florida diagnosed with pre-diabetes and diabetes, respectively. Over half of the study respondents were white, married and over the age of 45 years while 36.4% reported being physically inactive, overweight (36.4%) or obese (26.4%), hypertensive (34.6%), hypercholesteremic (40.3%), and 26% were arthritic. Based on the final multivariable multinomial model, only being overweight (Relative Risk Ratio [RRR] = 1.85, 95% Confidence Interval [95% CI] = 1.41, 2.42), obese (RRR = 3.41, 95% CI = 2.61, 4.45), hypertensive (RRR = 1.69, 95% CI = 1.33, 2.15), hypercholesterolemic (RRR = 1.94, 95% CI = 1.55, 2.43), and arthritic (RRR = 1.24, 95% CI = 1.00, 1.55) had significant associations with pre-diabetes. However, more predictors had significant associations with diabetes and the strengths of associations tended to be higher than for the association with pre-diabetes. For instance, the relative risk ratios for the association between diabetes and being overweight (RRR = 2.00, 95% CI = 1.55, 2.57), or obese (RRR = 4.04, 95% CI = 3.22, 5.07), hypertensive (RRR = 2.66, 95% CI = 2.08, 3.41), hypercholesterolemic (RRR = 1.98, 95% CI = 1.61, 2.45) and arthritic (RRR = 1.28, 95% CI = 1.04, 1.58) were all further away from the null than their associations with pre-diabetes. Moreover, a number of variables such as age, income level, sex, and level of physical activity had significant association with diabetes but not pre-diabetes. The risk of diabetes increased with increasing age, lower income, in males, and with physical inactivity. Insufficient physical activity had no significant association with the risk of diabetes or pre-diabetes. CONCLUSIONS There is evidence of differences in the strength of association of the predictors across levels of diabetes status (pre-diabetes and diabetes) among adults ≥18 years in Florida. It is important to monitor populations at high risk for pre-diabetes and diabetes, so as to help guide health programming decisions and resource allocations to control the condition.
Collapse
Affiliation(s)
- Ifechukwude Obiamaka Okwechime
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, United States of America
| | - Shamarial Roberson
- Florida Department of Health, Bureau of Chronic Disease Prevention, Tallahassee, Florida, United States of America
| | - Agricola Odoi
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, United States of America
| |
Collapse
|
15
|
Logan HL, Guo Y, Emanuel AS, Shepperd JA, Dodd VJ, Marks JG, Muller KE, Riley JL. Determinants of First-Time Cancer Examinations in a Rural Community: A Mechanism for Behavior Change. Am J Public Health 2015; 105:1424-31. [PMID: 25973820 DOI: 10.2105/ajph.2014.302516] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES After conducting a media campaign focusing on the importance of oral and pharyngeal cancer (OPC) examinations, we assessed mechanisms of behavior change among individuals receiving an OPC examination for the first time. METHODS We used data from 2 waves of telephone surveys of individuals residing in 36 rural census tracts in northern Florida (n = 806). The second survey occurred after our media intervention. We developed media messages and modes of message delivery with community members via focus groups and intercept interviews. We performed a mediation analysis to examine behavior change mechanisms. RESULTS Greater exposure to media messages corresponded with heightened concern about OPC. Heightened concern, in turn, predicted receipt of a first-time OPC examination, but only among men. CONCLUSIONS We extended earlier studies by measuring an outcome behavior (receipt of an OPC examination) and demonstrating that the putative mechanism of action (concern about the disease) explained the link between a media intervention and engaging in the target behavior. Improving the quality of media campaigns by engaging community stakeholders in selecting messages and delivery methods is an effective strategy in building public health interventions aimed at changing behaviors.
Collapse
Affiliation(s)
- Henrietta L Logan
- At the time of the study, Henrietta L. Logan, Amber S. Emanuel, Virginia J. Dodd, John G. Marks, and Joseph L. Riley III were with the Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville. Yi Guo and Keith E. Muller were with the Department of Health Outcomes and Policy, College of Medicine, University of Florida. James A. Shepperd was with the Department of Psychology, College of Liberal Arts and Science, University of Florida
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Maiti S, Sinha NK, Khan MM, Das PK, Chattopadhyay JC. Diabetes in rural individuals of different nutritional status and the alarming situation demands focus more on its under-nutrition association. Arch Physiol Biochem 2015; 121:26-31. [PMID: 25244251 DOI: 10.3109/13813455.2014.959973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To study the relationship of nutritional-status with diabetes. DESIGN The socioeconomics/anthropometrics, blood-glucose/systemic-hypertension are evaluated in consecutively-selected diabetic-patients. SETTING Semi-urban/rural India. SUBJECTS Hyperglycaemic patients (total 90/male 37). RESULTS Blood-glucose (PP-mean ± SE) in individuals is overweight - 38.89% (226.94 ± 9.59), normal-weight - 50% (217.58 ± 1.34), underweight - 11.11% (305.50 ± 21.35) indicating most hyperglycaemia in undernourished-group (F = 6.357, p < 0.003). This group occupies higher glucose-groups in ≤140, 141-270, and ≥270 mg/dL. The blood-glucose negatively correlates with waist(r = -0.282; p < 0.01) and hip (r = -0.254; p < 0.05) circumference indicating the under-nutrition association with glucose-homeostasis (F = 7.6-8.2, p < 0.001). The higher glucose is noticed in more number of individuals in lower (<40 years) age-group (χ(2 )= 12.86; p < 0.002/ρ = -0.355; p < 0.001). The prevalence of hypertension is 28% (underweight = 20%, overweight = 27%, normal = 30%). The group of 141-270 mg/dL glucose has 45% and rest groups together have 23% hypertensive individuals relating directly, hypertension and diabetic-onset. CONCLUSIONS Diabetes, explored in <40 years group and even more in female should be extensively studied accounting WHO categorization (1985/TRS/727) of malnutrition related diabetes (MRDM). Further, different interactive risk-factors should be properly addressed and the global-malnutrition/gender-based inequities be eradicated.
Collapse
Affiliation(s)
- Smarajit Maiti
- Department of Biochemistry and Biotechnology, Cell and Molecular Therapeutics Laboratory, Oriental Institute of Science and Technology , Midnapore, West Bengal , India
| | | | | | | | | |
Collapse
|
17
|
Kurti AN, Logan H, Manini T, Dallery J. Physical activity behavior, barriers to activity, and opinions about a smartphone-based physical activity intervention among rural residents. Telemed J E Health 2014; 21:16-23. [PMID: 25379976 DOI: 10.1089/tmj.2014.0034] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Rural Americans engage in less physical activity (PA) and experience higher rates of consequent health problems (i.e., obesity, cardiovascular disease) than urban Americans. Although geographic barriers have historically made this population hard to reach, rural individuals are increasingly gaining access to smartphones. Thus, the purpose of this study was to evaluate PA behavior and barriers to PA among rural residents and to gauge their receptiveness to a smartphone-based PA intervention that is currently in the development stage. MATERIALS AND METHODS Rural Floridian adults (n=113), 18 years of age and older, completed surveys to assess PA behavior, PA barriers, and opinions about an intervention to increase PA. Specifically, they were asked to imagine a program that would require them to do PA with their mobile phones and whether they viewed intended aspects of the program as helpful. The present work is therefore formative research that sought to determine the feasibility and acceptability of a smartphone-based intervention among rural residents. RESULTS of the survey will inform the development of a tailored, smartphone-based PA intervention. RESULTS The 37.2% of participants with low PA levels (<600 metabolic equivalent [MET]-min per week) were more likely to report personal and environmental barriers to PA than the 47.8% of participants with moderate PA levels (≥600 MET-min per week). More barriers were reported among participants who self-reported as white and among participants of older age, lower education level, and lower socioeconomic status. Additionally, 75.9% of participants reported features of the intervention as at least somewhat helpful. CONCLUSIONS The growing ubiquity of smartphones among rural residents, combined with participants' positive response to the program description, supports the acceptability of a smartphone-based PA intervention for rural communities. Given the participants' receptiveness, future research should evaluate the efficacy of smartphone-delivered health behavior interventions among this population.
Collapse
Affiliation(s)
- Allison N Kurti
- 1 Department of Psychology, University of Florida , Gainesville, Florida
| | | | | | | |
Collapse
|
18
|
Newell SM, Logan HL, Guo Y, Marks JG, Shepperd JA. Evaluating tablet computers as a survey tool in rural communities. J Rural Health 2014; 31:108-17. [PMID: 25243953 DOI: 10.1111/jrh.12095] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Although tablet computers offer advantages in data collection over traditional paper-and-pencil methods, little research has examined whether the 2 formats yield similar responses, especially with underserved populations. We compared the 2 survey formats and tested whether participants' responses to common health questionnaires or perceptions of usability differed by survey format. We also tested whether we could replicate established paper-and-pencil findings via tablet computer. METHODS We recruited a sample of low-income community members living in the rural southern United States. Participants were 170 residents (black = 49%; white = 36%; other races and missing data = 15%) drawn from 2 counties meeting Florida's state statutory definition of rural with 100 persons or fewer per square mile. We randomly assigned participants to complete scales (Center for Epidemiologic Studies Depression Inventory and Regulatory Focus Questionnaire) along with survey format usability ratings via paper-and-pencil or tablet computer. All participants rated a series of previously validated posters using a tablet computer. Finally, participants completed comparisons of the survey formats and reported survey format preferences. FINDINGS Participants preferred using the tablet computer and showed no significant differences between formats in mean responses, scale reliabilities, or in participants' usability ratings. CONCLUSIONS Overall, participants reported similar scales responses and usability ratings between formats. However, participants reported both preferring and enjoying responding via tablet computer more. Collectively, these findings are among the first data to show that tablet computers represent a suitable substitute among an underrepresented rural sample for paper-and-pencil methodology in survey research.
Collapse
Affiliation(s)
- Steve M Newell
- University of Florida, Department of Psychology, Gainesville, Florida
| | | | | | | | | |
Collapse
|
19
|
Guo Y, Logan HL, Dodd VJ, Muller KE, Marks JG, Riley JL. Health literacy: a pathway to better oral health. Am J Public Health 2014; 104:e85-91. [PMID: 24832423 DOI: 10.2105/ajph.2014.301930] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES We examined whether health literacy was associated with self-rated oral health status and whether the relationship was mediated by patient-dentist communication and dental care patterns. METHODS We tested a path model with data collected from 2 waves of telephone surveys (baseline, 2009-2010; follow-up, 2011) of individuals residing in 36 rural census tracts in northern Florida (final sample size n = 1799). RESULTS Higher levels of health literacy were associated with better self-rated oral health status (B = 0.091; P < .001). In addition, higher levels of health literacy were associated with better patient-dentist communication, which in turn corresponded with patterns of regular dental care and better self-rated oral health (B = 0.003; P = .01). CONCLUSIONS Our study showed that, beyond the often-reported effects of gender, race, education, financial status, and access to dental care, it is also important to consider the influence of health literacy and quality of patient-dentist communication on oral health status. Improved patient-dentist communication is needed as an initial step in improving the population's oral health.
Collapse
Affiliation(s)
- Yi Guo
- Yi Guo and Keith E. Muller are with the Department of Health Outcomes and Policy, College of Medicine, and Henrietta L. Logan, Virginia J. Dodd, John G. Marks, and Joseph L. Riley III are with the Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville
| | | | | | | | | | | |
Collapse
|