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Long SE, Lama Y, D'Angelo H. Digital Communication Inequalities Among U.S. Adults Reporting Current Cigarette Use. Am J Prev Med 2024; 66:307-314. [PMID: 37793558 PMCID: PMC10842098 DOI: 10.1016/j.amepre.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023]
Abstract
INTRODUCTION To reduce tobacco-related health problems, it is critical to reach people who smoke with smoking cessation information and treatment. However, digital communication inequalities may limit access to online information sources. METHODS Digital device ownership, high-speed internet access, and online health information-seeking were examined among adults reporting current smoking in the Health Information National Trends Survey (n=847). Data were collected in 2019 and 2020 and analyzed in 2022. Multivariable logistic regression models examined associations between demographics, digital technology access, and online health information-seeking. RESULTS Only 47.6% (95% CI 39.0%, 56.3%) of adults aged 65+, 54.2% of Black/African American adults (95% CI 37.8%, 69.8%), and 59.6% with high school or less education (95% CI 51.5%, 67.1%) reported high-speed internet access (vs. 74.0% overall, 95% CI 68.9%, 78.6%). Inequalities in device ownership, high-speed internet access, and online health information-seeking were found by education and income. Adults with high school or less education (vs. college or more) had 78% lower odds of digital device ownership (aOR 0.22, 95% CI 0.08, 0.59) and 75% lower odds of high-speed internet access (aOR 0.25, 95% CI 0.09, 0.71). High-speed internet access (vs. no digital device or high-speed internet) was associated with 4.9 times greater odds of online health information-seeking (95% CI 1.81, 13.4). CONCLUSIONS Digital communication inequalities among adults who smoke exist. Understanding digital technology access among lower income populations could inform the development and delivery of interventions and health communication strategies to improve health outcomes among this population.
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Affiliation(s)
| | - Yuki Lama
- National Cancer Institute, Rockville, Maryland
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2
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Zhang X, Zhang X, Zhang S, Ge L, Xu Y, Yao D, Hu X, Huang Z, Zhu T, Wang Z, Chen C. The association between health literacy and e-cigarette use: evidence from Zhejiang, China. Front Public Health 2024; 11:1321457. [PMID: 38239787 PMCID: PMC10794489 DOI: 10.3389/fpubh.2023.1321457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/12/2023] [Indexed: 01/22/2024] Open
Abstract
Objectives The worldwide popularity of electronic cigarettes (ECIG) is becoming a public health concern. Compared to conventional cigarettes (CIG), the harm caused by ECIG is more insidious. Studies have shown that lower health literacy (HL) is associated with CIG use; however, the relationship between HL and ECIG use remains controversial. Because ECIG emerged more recently than CIG, there are fewer relevant studies, and the sample populations and evaluation methods of HL in existing studies differ. This study conducted a large-sample survey to examine the relationship between HL and ECIG use. Methods As part of the 2022 China Health Literacy Survey, a total of 60,998 valid questionnaires were collected from September to November in 2022 using a stratified multistage probability proportional to the population size sampling frame. Chi-square tests and multinomial logistic regression was used to analyze the relationship between HL and ECIG use. Some demographic variables were included as covariates in the analysis. Results The study showed that the average HL score and the HL level of Zhejiang residents in 2022 were 42.8 and 30.8%, respectively. The prevalence of CIG and ECIG was 19.7 and 1.0%, respectively; 19% of participants exclusively used CIG, while only 0.3% of participants used ECIG exclusively; dual users accounted for 0.6%. After adjusting for covariates, adequate HL was associated with lower odds of ECIG-exclusive use (odds ratio [OR] = 0.452, p < 0.001), CIG-exclusive use (OR = 0.833, p < 0.001), and dual use (OR = 0.632, p < 0.001). Young age, male sex, unmarried status, high-income status, and absence of chronic disease were also associated with ECIG use. Conclusion HL was a protective factor against both patterns of ECIG use, especially ECIG-exclusive use. Health policymakers and public health practitioners should consider HL as a potential measure for ECIG control.
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Affiliation(s)
- Xuehai Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xinxin Zhang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Songjia Zhang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Lizheng Ge
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Yue Xu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Dingning Yao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiujing Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Zishuo Huang
- School of Innovation and Entrepreneurship, Wenzhou Medical University, Wenzhou, China
| | - Tingting Zhu
- Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine, Hangzhou, China
| | - Zixia Wang
- School of Business, Macau University of Science and Technology, Macau, China
| | - Chun Chen
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
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3
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Sun S, Yu H, Ling J, Yao D, Chen H, Liu G. The influence of health literacy and knowledge about smoking hazards on the intention to quit smoking and its intensity: an empirical study based on the data of China's health literacy investigation. BMC Public Health 2023; 23:2355. [PMID: 38017398 PMCID: PMC10685583 DOI: 10.1186/s12889-023-17292-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/22/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE This study explored the relationship between smokers' health literacy, knowledge of smoking hazards, and their intention to quit. METHODS Based on data from the 2019 Health Literacy and Tobacco Use Surveillance among residents of a city in Zhejiang Province, 1120 male smokers were screened. Differential tests were used to analyze whether smokers with varying levels of health literacy and knowledge about smoking hazards differed in their intention to quit smoking and the intensity of their intention. A multi-factor logistic regression model was constructed to explore the extent of these differences. RESULTS Only 24.8% of smokers had higher health literacy. Among smokers, those with an intention to quit had a higher health literacy level compared to those without such intention (32.7% vs. 17.0%, p < 0.001). Health literacy levels did not differ significantly between groups with different intensity of intention to quit (34.2% vs. 31.9% vs. 30.1%, p = 0.435). About 48.7% of the smokers a higher level of knowledge about smoking hazards. It was more prevalent in the intent to quit group compared to the no intent to quit group (54.0% vs. 43.4%, p < 0.001), and the low intent to quit group had lower knowledge compared to the moderate and high intent to quit groups (49.1% vs. 56.6% vs. 63.4%, p = 0.011). After adjusting for other influences, smokers with lower health literacy were less likely to have intention to quit (OR = 0.659, p = 0.016). And the association between knowledge about smoking hazards and whether smokers have the intention to quit is no longer significant, but it significantly affects the intensity of the intention to quit among smokers who already have the intention (OR = 0.623, p = 0.005). CONCLUSION General health literacy may play a role in facilitating smokers' progression from the stage of no intent to quit to one of intent to quit, but a more specific understanding of the harms of smoking may be needed to increase the strength of intent to quit.
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Affiliation(s)
- Siwen Sun
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huifang Yu
- Jiaxing Center for Disease Control and Prevention, Jiaxing, Zhejiang, China
| | - Jie Ling
- Jiaxing Center for Disease Control and Prevention, Jiaxing, Zhejiang, China
| | - Dingming Yao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Haixiao Chen
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.
| | - Guilin Liu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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4
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Wang L, Li Y, Li L, Zhang G. Association of health literacy with smoking behavior among Chinese men. Health Promot Int 2023; 38:daad113. [PMID: 37748868 DOI: 10.1093/heapro/daad113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Abstract
Health literacy may constitute a modifiable determinant of smoking behavior and intention to quit. Little is known about the extent to which health literacy affects smoking or quitting smoking. We assessed the nationally representative cross-sectional datasets from the China Health Literacy Surveillance (CHLS) initiated in 2018. Using polytomous logistic regression models, the study investigated the association of health literacy with smoking behavior and the intention to quit smoking among men aged 15-69 in China. After confounding factors were controlled, compared with having below basic health literacy, having adequate health literacy appeared to be an independent protective factor from current smoking [current smoking vs never smoking: adjusted odds ratio [OR], 0.88; 95% confidence interval (CI), 0.81-0.96; p = 0.003; current smoking vs former smoking: adjusted OR, 0.77; 95% CI, 0.64-0.92; p = 0.003], while having intermediate health literacy was associated with current smoking vs never smoking (adjusted OR, 1.09; 95% CI, 1.02-1.17; p = 0.011) or former smoking vs never smoking (adjusted OR, 1.22; 95% CI, 1.06-1.40; p = 0.005). And having adequate health literacy was associated with intending to quit among current smokers (adjusted OR, 1.25; 95% CI, 1.10-1.42; p < 0.001). Findings provide evidence that health literacy may serve as a critical and independent protective factor for reducing poor smoking behavior or enhancing cessation intention among men. Efforts should focus on developing and evaluating intervention to control tobacco use among men with low health literacy level.
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Affiliation(s)
- Lanlan Wang
- Department of Surveillance and Evaluation, Chinese Center for Health Education, Beijing, China
| | - Yinghua Li
- Department of Surveillance and Evaluation, Chinese Center for Health Education, Beijing, China
| | - Li Li
- Department of Surveillance and Evaluation, Chinese Center for Health Education, Beijing, China
| | - Gang Zhang
- Department of Surveillance and Evaluation, Chinese Center for Health Education, Beijing, China
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Timmons AC, Duong JB, Fiallo NS, Lee T, Vo HPQ, Ahle MW, Comer JS, Brewer LC, Frazier SL, Chaspari T. A Call to Action on Assessing and Mitigating Bias in Artificial Intelligence Applications for Mental Health. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1062-1096. [PMID: 36490369 PMCID: PMC10250563 DOI: 10.1177/17456916221134490] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Advances in computer science and data-analytic methods are driving a new era in mental health research and application. Artificial intelligence (AI) technologies hold the potential to enhance the assessment, diagnosis, and treatment of people experiencing mental health problems and to increase the reach and impact of mental health care. However, AI applications will not mitigate mental health disparities if they are built from historical data that reflect underlying social biases and inequities. AI models biased against sensitive classes could reinforce and even perpetuate existing inequities if these models create legacies that differentially impact who is diagnosed and treated, and how effectively. The current article reviews the health-equity implications of applying AI to mental health problems, outlines state-of-the-art methods for assessing and mitigating algorithmic bias, and presents a call to action to guide the development of fair-aware AI in psychological science.
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Affiliation(s)
- Adela C. Timmons
- University of Texas at Austin Institute for Mental Health Research
- Colliga Apps Corporation
| | | | | | | | | | | | | | - LaPrincess C. Brewer
- Department of Cardiovascular Medicine, May Clinic College of Medicine, Rochester, Minnesota, United States
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, Minnesota, United States
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Ma Y, Zhou M, Yu W, Zou Z, Ge P, Ma ZF, Tong Y, Li W, Li Q, Li Y, Zhu S, Sun X, Wu Y. Using the Unified Theory of Acceptance and Use of Technology (UTAUT) and e-health literacy(e-HL) to investigate the tobacco control intentions and behaviors of non-smoking college students in China: a cross-sectional investigation. BMC Public Health 2023; 23:765. [PMID: 37098499 PMCID: PMC10127360 DOI: 10.1186/s12889-023-15644-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/10/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Non-smoking college students are starting to smoke in increasing numbers, which shows that their tobacco control situation seems not optimistic. The UTAUT and e-HL are commonly used models and theories to predict health behaviors, while there are few studies on tobacco control. This paper aims to study the influencing factors of tobacco control intention and behavior of non-smoking college students in China by combining the UTAUT and e-HL. METHODS Based on the stratified sampling method, 625 college students from 12 universities were selected. Data were collected using a self-made questionnaire designed based on the UTAUT and e-health literacy scales. Data were analyzed by SPSS 22 and AMOS 26, including descriptive statistics, one-way variance analysis and structural equation model analysis. RESULTS The results of one-way variance analysis showed that there were significant differences in the score of non-smoking college students' tobacco control intention or behavior by hometowns, monthly living expenses, and parents' smoking history. Performance expectancy, effort expectancy, social influence had direct positive effects on behavioral intention. Facilitating condition, behavioral intention had direct positive impacts on use behavior and e-HL had an indirect positive impact on use behavior. CONCLUSIONS The combination of the UTAUT and e-HL can be used as an appropriate framework to predict the influencing factors of non-smoking college students' intention and behavior of tobacco control. Improving performance expectancy, effort expectancy, and e-HL among non-smoking college students, creating positive social environments, and providing facilitating condition are key aspects of increasing their tobacco control intention and behavior. It is also beneficial to promote the implementation of smoke-free campus and smoke-free family projects.
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Affiliation(s)
- Yuanyuan Ma
- School of Public Health, Shandong University, Jinan, 250012, China
| | - Mengxia Zhou
- School of Media and Communication, Shanghai Jiaotong University, Shanghai, 201100, China
| | - Wenli Yu
- School of Foreign Languages, Weifang University of Science and Technology, Shouguang, 262700, China
| | - Ziyue Zou
- School of Public Health, Shandong University, Jinan, 250012, China
| | - Pu Ge
- School of Management, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Zheng Feei Ma
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, BS16 1QY, UK
| | - Yuting Tong
- School of Public Health, Shandong University, Jinan, 250012, China
| | - Wei Li
- Department of Second Clinical Medical School, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Qiyu Li
- School of Humanities and Health Management, Jinzhou Medical University, Jinzhou, 121000, China
| | - Yunshan Li
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Siya Zhu
- School of Foreign Languages, Anhui University of Technology, Anhui, 243000, China
| | - Xinying Sun
- School of Public Health, Peking University, Haidian District, 38 Xueyuan Road, Beijing, 100191, China.
| | - Yibo Wu
- School of Public Health, Peking University, Haidian District, 38 Xueyuan Road, Beijing, 100191, China.
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Alarifi M, Jabour AM, Wu M, Aldosary A, Almanaa M, Luo J. Proposed Questions to Assess the Extent of Knowledge in Understanding the Radiology Report Language. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11808. [PMID: 36142078 PMCID: PMC9517641 DOI: 10.3390/ijerph191811808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Radiotherapy and diagnostic imaging play a significant role in medical care. The amount of patient participation and communication can be increased by helping patients understand radiology reports. There is insufficient information on how to measure a patient's knowledge of a written radiology report. The goal of this study is to design a tool that will measure patient literacy of radiology reports. A radiological literacy tool was created and evaluated as part of the project. There were two groups of patients: control and intervention. A sample radiological report was provided to each group for reading. After reading the report, the groups were quizzed to see how well they understood the report. The participants answered the questions and the correlation between the understanding of the radiology report and the radiology report literacy questions was calculated. The correlations between radiology report literacy questions and radiology report understanding for the intervention and control groups were 0.522, p < 0.001, and 0.536, p < 0.001, respectively. Our radiology literacy tool demonstrated a good ability to measure the awareness of radiology report understanding (area under the receiver operator curve in control group (95% CI: 0.77 (0.71-0.81)) and intervention group (95% CI: 0.79 (0.74-0.84))). We successfully designed a tool that can measure the radiology literacy of patients. This tool is one of the first to measure the level of patient knowledge in the field of radiology understanding.
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Affiliation(s)
- Mohammad Alarifi
- Health Informatics & Administration Department, College of Health Sciences, University of Wisconsin, Milwaukee, WI 53211, USA
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Abdulrahman M. Jabour
- Health Informatics Department, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Min Wu
- Health Informatics & Administration Department, College of Health Sciences, University of Wisconsin, Milwaukee, WI 53211, USA
| | - Abdullah Aldosary
- Body Imaging Department, Medical Imaging Administration, King Fahad Medical City, Riyadh 12231, Saudi Arabia
| | - Mansour Almanaa
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Jake Luo
- Health Informatics & Administration Department, College of Health Sciences, University of Wisconsin, Milwaukee, WI 53211, USA
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Li M, Sonoda N, Koh C, Yasumoto R, Morimoto A. Meta-analysis of the association between health literacy and smoking. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/152572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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9
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King LM, Barnett TE, Allen AC, Maizel JL, Wilson RE. Tobacco-related health inequalities among Black Americans: A narrative review of structural and historical influences. J Ethn Subst Abuse 2022:1-31. [PMID: 35839212 DOI: 10.1080/15332640.2022.2093812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We conducted a narrative literature review to examine contributing factors of disparities in tobacco usage and outcomes affecting Black Americans. We propose potential solutions that can be used to effectively address these disparities. We identified historical factors; socioeconomic factors; targeted marketing/advertising; the influence of racism/discrimination; neighborhood socioeconomic disadvantage; and mass incarceration. We call for more thorough examinations of these factors as a key element of tobacco-focused research and interventions to eliminate the disproportionate burdens faced by Black Americans. We advocate for greater emphases on the impacts of personal and structural racism on tobacco usage and outcomes affecting Black Americans.
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Affiliation(s)
| | - Tracey E Barnett
- University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas
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Penfornis KM, Van Vliet MHM, Meijer E, Gebhardt WA. Mapping the evidence on identity processes and identity-related interventions in the smoking and physical activity domains: a scoping review protocol. BMJ Open 2022; 12:e058405. [PMID: 35831054 PMCID: PMC9280881 DOI: 10.1136/bmjopen-2021-058405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 06/22/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Smoking and insufficient physical activity (PA), independently but especially in conjunction, often lead to disease and (premature) death. For this reason, there is need for effective smoking cessation and PA-increasing interventions. Identity-related interventions which aim to influence how people view themselves offer promising prospects, but an overview of the existing evidence is needed first. This is the protocol for a scoping review aiming to aggregate the evidence on identity processes and identity-related interventions in the smoking and physical activity domains. METHODS The scoping review will be guided by an adaption by Levac et al of the 2005 Arksey and O'Malley methodological framework, the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses: Extension for Scoping Review (PRISMA-ScR) and the 2017 Joanna Briggs Institute guidelines. It will include scientific publications discussing identity (processes) and/or identity-related interventions in the context of smoking (cessation) and/or physical (in)activity, in individuals aged 12 and over. A systematic search will be carried out in multiple databases (eg, PubMed, Web of Science). Records will be independently screened against prepiloted inclusion/exclusion criteria by two reviewers, using the Active Learning for Systematic Reviews machine learning artificial intelligence and Rayyan QCRI, a screening assistant. A prepiloted charting table will be used to extract data from included full-text articles. Findings will be reported according to the PRISMA-ScR guidelines and include study quality assessment. ETHICS AND DISSEMINATION Ethical approval is not required for scoping reviews. Findings will aid the development of future identity-related interventions targeting smoking and physical inactivity.
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Affiliation(s)
- Kristell M Penfornis
- Institute of Psychology, Unit Health, Medical & Neuropsychology, Leiden University, Leiden, The Netherlands
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Milon H M Van Vliet
- Public Health & Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- National eHealth Living Lab, Leiden University Medical Center, Leiden, The Netherlands
| | - Eline Meijer
- Public Health & Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- National eHealth Living Lab, Leiden University Medical Center, Leiden, The Netherlands
| | - Winifred A Gebhardt
- Institute of Psychology, Unit Health, Medical & Neuropsychology, Leiden University, Leiden, The Netherlands
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The Influence of Alcohol Consumption on Tobacco Use among Urban Older Adults: Evidence from Western China in 2017. SUSTAINABILITY 2022. [DOI: 10.3390/su14137752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Tobacco use is a global public health concern due to its association with a myriad of health hazards and costs. Previous studies have found that the disinhibiting influence of alcohol consumption may lead to an increase in tobacco use. In this study, we investigated why alcohol consumption is associated with tobacco use among older adults in Western China, and we attempted to explain the mechanisms that underlie the link between alcohol consumption and tobacco use. Methods: In this cross-sectional study, we employed a representative sample of 812 urban individuals aged 60 and older in 2017 in Western China. Results: We found that alcohol consumption (OR = 2.816, 95%CI: 1.770–4.479) was positively associated with tobacco use. Additionally, other factors, including gender (OR = 0.023, 95%CI: 0.009–0.060), age (OR = 0.758, 95%CI: 0.634–0.906), health literacy (OR = 0.977, 95%CI: 0.959–0.995) and functional impairment (OR = 0.871, 95%CI: 0.767–0.988) were also strongly related to tobacco use. Conclusions: Consistent with the results of existing studies, our findings demonstrated the disinhibiting influence of alcohol consumption on tobacco use, which confirmed the theoretical mechanisms that underlie the alcohol–tobacco link and implied the co-occurrence and co-use of alcohol and tobacco, which are used as “social lubricants” in the Chinese context. The importance of other factors related to tobacco use were also discussed. As the tobacco epidemic is combatted, joint interventions tailored to concurrent control over alcohol and tobacco need to be performed, and corresponding male-specific and age-specific health education and the reinforcement of health literacy must be considered as important priorities.
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PANAHI RAHMAN, HOSSEINI NOOSHIN, RAMEZANKHANI ALI, ANBARI MOHAMAD, AMJADIAN MOHIADIN, DEHGHANKAR LEILA, NIKNAMI SHAMSADDIN. Measuring the Structures of the Health Belief Model Integrated with Health Literacy in Predicting University Students' Adoption of Smoking Preventive Behaviors. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E51-E58. [PMID: 35647364 PMCID: PMC9121676 DOI: 10.15167/2421-4248/jpmh2022.63.1.2236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/03/2022] [Indexed: 11/04/2022]
Abstract
Objectives One of the priorities of public health in reducing smoking is to prevent young people from becoming smokers. Health literacy (HL), smoking, and preventive behaviors are related. Moreover, HL has a potential impact on strengthening the Health Belief Model (HBM). Considering the high prevalence of smoking among university students, the current study was conducted to measure the structures of the HBM integrated with HL in predicting university students' adoption of smoking preventive behaviors. Methods This was a cross-sectional descriptive study. Three hundred and forty dormitory students of Shahid Beheshti University of Medical Sciences (Teheran, Iran) in 2016, were selected through single-stage cluster sampling for the study. The data gathering tool was a researcher-made questionnaire based on the HBM and the HL inventory for adults (HELIA). The data were analyzed using the SPSS software version.16. Results The multiple regression analysis showed that the application of health information from five dimensions of HL, perceived susceptibility, self-efficacy, and decision-making dimensions were the predictors of smoking prevention. Also, the structures of this integrated model were able to anticipate 36.5% of the behavioral changes. Conclusion The HBM integrated with HL can be used as an appropriate framework for designing educational programs to encourage university students to adopt smoking preventive behaviors.
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Affiliation(s)
- RAHMAN PANAHI
- Department of Health Education and Health Promotion, School of Medical Sciences, Tarbiat Modares University,Tehran, Iran
| | - NOOSHIN HOSSEINI
- School of Medical Sciences, Ahvaz University of Medical Sciences, Ahvaz, Iran
| | - ALI RAMEZANKHANI
- Department of Health Services, Shahid Beheshti University of Medical SciencesTehran, Iran
| | - MOHAMAD ANBARI
- Occupational Health Department, School of Public Health and Institute of Public Health Research, Tehran University of Medical Science, Tehran, Iran
| | - MOHIADIN AMJADIAN
- Departments of Clinical Psychology and English language, School of Medicine, Medical Sciences University of Kurdistan, Sanandaj, Iran
| | - LEILA DEHGHANKAR
- Department of Nursing, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - SHAMSADDIN NIKNAMI
- School of health Sciences, Health Educalth Department, Tarbiat modares University, Tehran, Iran
- Correspondence: Shamsaddin Niknami, School of health Sciences, Health Education Department, Tarbiat modares University, Tehran, Iran - E-mail:
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Sabado-Liwag M, Zamora M, El-Toukhy S. Current state of unhealthy living characteristics in Black/African American and Latino populations: Tobacco use. Prog Cardiovasc Dis 2022; 71:27-36. [PMID: 35490867 PMCID: PMC10699915 DOI: 10.1016/j.pcad.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 04/24/2022] [Indexed: 11/29/2022]
Abstract
Over the past six decades, the United States has significantly improved tobacco-related health outcomes through mass efforts in policies, research, and behavioral and clinical interventions. Disparities persist, however, among communities of color who continue to suffer disproportionate rates of cardiovascular disease and other tobacco-related morbidity and mortality. In this review, we synthesize and discuss the tobacco use lifecycle across the lifespan, with special attention paid to socioecological determinants of tobacco-use behavior among Blacks and Latinos. This review summarizes the permeability of tobacco use and tobacco-related determinants across multiple levels of influence, from the individual to the societal, and highlights gaps in the tobacco control and prevention landscape. Given its continued evolution and impact on socially disadvantaged communities, we conclude with recommendations for improving current tobacco research and treatment and prevention efforts.
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Affiliation(s)
- Melanie Sabado-Liwag
- Department of Public Health, California State University, Los Angeles, Los Angeles, CA, United States of America.
| | - Mayra Zamora
- Department of Public Health, California State University, Los Angeles, Los Angeles, CA, United States of America
| | - Sherine El-Toukhy
- Division of Intramural Research, National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States of America
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14
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Ihm SH, Kim KI, Lee KJ, Won JW, Na JO, Rha SW, Kim HL, Kim SH, Shin J. Interventions for Adherence Improvement in the Primary Prevention of Cardiovascular Diseases: Expert Consensus Statement. Korean Circ J 2022; 52:1-33. [PMID: 34989192 PMCID: PMC8738714 DOI: 10.4070/kcj.2021.0226] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/05/2021] [Accepted: 11/10/2021] [Indexed: 01/01/2023] Open
Abstract
Over the last 2 decades, the management of chronic disease in Korea has been improved, but it has gradually stagnated. In order to improve care and reduce cardiovascular morbidity and mortality, it is crucial to improve primary prevention of cardiovascular diseases. In recent international guidelines for hypertension, diabetes, hyperlipidemia, obesity, and other conditions, adherence issues have become more frequently addressed. However, in terms of implementation in practice, separate approaches by dozens of related academic specialties need to be integrated into a systematic approach including clinician’s perspectives such as the science behind adherence, clinical skills, and interaction within team approach. In primary prevention for cardiovascular diseases, there are significant barriers to adherence including freedom from symptoms, long latency for therapeutic benefits, life-long duration of treatment, and need for combined lifestyle changes. However, to implement more systematic approaches, the focus on adherence improvement needs to be shifted away from patient factors to the effects of the treatment team and healthcare system. In addition to conventional educational approaches, more patient-oriented approaches such as patient-centered clinical communication skills, counseling using motivational strategies, decision-making by patient empowerment, and a multi-disciplinary team approach should be developed and implemented. Patients should be involved in a program of self-monitoring, self-management, and active counseling. Because most effective interventions on adherence improvement demand greater resources, the health care system and educational or training system of physicians and healthcare staff need to be supported for systematic improvement.
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Affiliation(s)
- Sang Hyun Ihm
- Division of Cardiology, Department of Internal Medicine and Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kwang-Il Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | | | | | - Jin Oh Na
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seung-Woon Rha
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
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15
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Panahi R, Osmani F, Javanmardi K, Ramezankhani A, Dehghankar L, Amini R, Haeri Mehrizi AA, Amjadian M, Anbari M, Hosseini N. The Relationship between Different Levels of Health Literacy and Smoking Prevention Among Medical Sciences Student. Int J Prev Med 2021; 12:124. [PMID: 34760135 PMCID: PMC8551777 DOI: 10.4103/ijpvm.ijpvm_460_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/24/2020] [Indexed: 11/04/2022] Open
Abstract
Background Higher rates of Smoking among university students have been reported in various studies. On the other hand, health literacy (HL) can improve health behaviors. In fact, identifying factors affecting the adoption of smoking preventive behaviors such as HL can help prevent and reduce the prevalence of smoking among people. The aim of this study was to identify the relationship between different levels of HL and adoption of smoking preventive behaviors among university student in 2016. Methods This was a cross-sectional descriptive study. Three hundred and forty-seven dormitory students of Shahid Beheshti University of Medical Sciences in Iran were selected through single-stage cluster sampling for the study. Data were collected using a measure of HL (the HL inventory for adults-HELIA) and a designed questionnaire to assess the adoption of smoking preventive behaviors. The data were analyzed using SPSS software version. 16 and descriptive statistical and Logistic regression test. Results The mean (SD) of the score for adoption of smoking preventive behaviors and HL were 45.91 (12.99) and 70.52 (14.12) out of 100, respectively. The results showed that the adoption of smoking preventive behaviors had significant relationship with variables such as HL, gender, father's education and not smoking (P < 0.05). Conclusions Less adoption of smoking preventive behaviors was seen in students with lower levels of HL, female students, students with illiterate fathers and smokers. Therefore, it seems essential to take these factors into consideration in designing preventive programs for smoking in target groups.
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Affiliation(s)
- Rahman Panahi
- Ph.D. in Health Education and Promotion, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fereshteh Osmani
- Infectious Disease Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Keyhan Javanmardi
- Department of Clinical Psychology, Faculty of Psychology, Kordistan University, Sanandaj, Iran
| | - Ali Ramezankhani
- Department of Health Services, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Dehghankar
- Lecture of Nursing, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Roohola Amini
- Department of Occupational Health, School of Medical Sciences, Isfahan University of Medical Science, Isfahan, Iran
| | - Ali Asghar Haeri Mehrizi
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Mohiadin Amjadian
- Department of Clinical Psychology, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohamad Anbari
- Department of Occupational Health, School of Public Health and Institute of Public Health Research, Tehran University of Medical Science, Tehran, Iran
| | - Nooshin Hosseini
- Department of Health Education, School of Medical Sciences, Ahvaz University of Medical Science, Ahvaz, Iran
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16
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Akbas Gunes N, Gucuk S. The Effect of Health Literacy Levels on Successful of Smoking Cessation Therapy: A Survey Study. EURASIAN JOURNAL OF FAMILY MEDICINE 2021. [DOI: 10.33880/ejfm.2021100306] [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] Open
Abstract
Aim: In this study, it was aimed to evaluate the effect of the health literacy levels of patients given smoking cessation treatment on the success of smoking cessation treatment.
Methods: In this study, 152 participants between the ages of 18-70 applied to a tertiary hospital smoking cessation outpatient clinic. The Fagerström Test for Nicotine Dependence was used to determine the level of cigarette addiction of the participants, and the European Health Literacy Scale was used to evaluate the levels of health literacy.
Results: When the health literacy levels of the participants with cigarette addiction were evaluated, 38 (25%) were inadequate, 64 (42.1%) were problematic. When the participants' smoking cessation status and general health literacy levels were compared, it was found to be statistically significant. It was determined that as the health literacy level increased, the success rates of individuals increased in smoking cessation therapy.
Conclusions: We have shown that increasing the level of health literacy is effective in increasing the success of smoking cessation treatment. Increasing health literacy should be part of the fight against smoking. This effect should be demonstrated by future studies on large populations.
Keywords: smoking cessation, health literacy, addiction
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Affiliation(s)
| | - Sebahat Gucuk
- Department of Family Medicine, Bolu Abant Izzet Baysal University
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17
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Cropsey KL, Wolford-Clevenger C, Sisson ML, Chichester KR, Hugley M, Azuero A, Businelle MS, Hendricks PS, Shelton RC, Carpenter MJ. A Pilot Study of Nicotine Replacement Therapy Sampling and Selection to Increase Medication Adherence in Low-Income Smokers. Nicotine Tob Res 2021; 23:1575-1583. [PMID: 33608735 PMCID: PMC8372633 DOI: 10.1093/ntr/ntab029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/12/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Adherence to smoking cessation medications remains suboptimal, particularly among low-income smokers. Guided, experiential sampling of nicotine replacement therapies (NRTs) may increase NRT adherence and smoking cessation over gold standard counseling plus NRT. The present pilot study aimed to examine feasibility, acceptability, and preliminary efficacy of a novel experiential intervention. AIMS AND METHODS This pilot randomized controlled trial (N = 83) compared gold standard smoking cessation treatment (four weekly sessions of behavioral counseling followed by self-selected combination NRT in week 5) to a novel experiential approach (ie, In Vivo; four weekly sessions of sampling each short form of NRT-gum, lozenge, inhaler, nasal spray-in-session while wearing the nicotine patch followed by NRT selection in week 5). Both groups received 8 weeks of nicotine patch plus their selected additional short form NRT for smoking cessation followed by a 1-month assessment. RESULTS Screening and enrollment rates supported feasibility. In Vivo was comparable in acceptability with the gold standard of care intervention; however, there was greater attrition in the In Vivo group compared with the gold standard of care group. Results suggested higher medication adherence and improvements in smoking behavior in the In Vivo intervention; with generally small-to-medium effect sizes. CONCLUSIONS This experiential approach to sampling NRT is feasible and acceptable to low-income people who smoke. This intervention may increase adherence and reduce harmful smoking behavior but needs to be tested on a larger scale. IMPLICATIONS Medication adherence remains a significant impediment to the successful smoking cessation. The results of this study suggest that guided sampling of NRT products improves adherence among low-income smokers. Additionally, this approach yielded greater improvements in smoking behavior compared with gold standard smoking cessation treatment. This intervention shows promise as a feasible smoking cessation treatment for low-income smokers.
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Affiliation(s)
- Karen L Cropsey
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Caitlin Wolford-Clevenger
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michelle L Sisson
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Keith R Chichester
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mickeah Hugley
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andres Azuero
- Department of Nursing, Family, Community & Health Systems, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael S Businelle
- Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Peter S Hendricks
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Richard C Shelton
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Hollings Cancer Center, Charleston, SC, USA
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18
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The Association Between Health Literacy and Tobacco Use: Results from a Nationally Representative Survey. J Community Health 2021; 47:63-70. [PMID: 34357496 DOI: 10.1007/s10900-021-01019-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
Dual use of conventional cigarettes and electronic cigarettes presents an emerging public health issue. Previous research has demonstrated a negative relationship between health literacy and conventional cigarette (CIG) use. However, the relationship between health literacy and e-cigarette (ECIG) use remains unclear. This studies examines the possible association of health literacy and CIG, ECIG, or dual use. A multinomial regression was used to model the association between health literacy and current CIG use, current ECIG use, or dual tobacco use status using state-optional data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS; N = 40,404). One-third of the sample (N = 13,478; 33.3%) had initiated tobacco use. Approximately 36.6% of participants exclusively used cigarettes. A smaller proportion of participants were dual users of ECIG and CIGs (7.0%) and e-cigarette exclusive users (4.5%). After adjusting for covariates, higher levels of oral health literacy was associated with lower odds of current dual use. However, there was no significant association between written HL and either conventional cigarette use or electronic cigarette use or after adjusting for covariates. Oral messaging around the dangers of CIG use may be effective at lowering odds of CIG or dual use, especially for those with higher levels of HL. Further research is needed to examine how to best disseminate information regarding the health risks of ECIGs.
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19
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Anderson MD, Merkin SS, Everson-Rose SA, Widome R, Seeman T, Magnani JW, Rodriguez CJ, Lutsey PL. Health Literacy Within a Diverse Community-Based Cohort: The Multi-Ethnic Study of Atherosclerosis. J Immigr Minor Health 2021; 23:659-667. [PMID: 33206278 PMCID: PMC8128937 DOI: 10.1007/s10903-020-01123-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Health literacy has yet to be described in a non-clinical, racially diverse, community-based cohort. METHODS Four questions assessing health literacy were asked during annual phone encounters with Multi-Ethnic Study of Atherosclerosis (MESA) participants between 2016 and 2018 (n = 3629). We used prevalence ratios (PRs) with 95% confidence intervals (CIs) to characterize how demographic and acculturation factors related to limited health literacy. Models adjusted for age, sex, and race/ethnicity, and race/ethnicity-stratified models were also examined. RESULTS Limited health literacy was prevalent in 15.4% of the sample. Participants who were older, female, lower-income, or less acculturated were at greater risk for having limited health literacy. Chinese, Hispanic, and Black participants were more likely than White participants to have limited health literacy. Patterns were similar when stratified by race/ethnicity. DISCUSSION Within MESA limited health literacy was common, particularly among Chinese and Hispanic participants, with some of the variance explained by differences in acculturation.
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Affiliation(s)
- Madison D Anderson
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55455, USA.
| | - Sharon Stein Merkin
- Division of Geriatrics, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Rachel Widome
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55455, USA
| | - Teresa Seeman
- Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jared W Magnani
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carlos J Rodriguez
- Department of Cardiovascular Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55455, USA
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20
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Ma T, Meng H, Ye Z, Jia C, Sun M, Liu D. Health Literacy Mediates the Association Between Socioeconomic Status and Productive Aging Among Elderly Chinese Adults in a Newly Urbanized Community. Front Public Health 2021; 9:647230. [PMID: 33898380 PMCID: PMC8062760 DOI: 10.3389/fpubh.2021.647230] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/08/2021] [Indexed: 02/05/2023] Open
Abstract
Productive aging, or older adults engaging in paid or unpaid activities that produce socially valued goods or services, has been suggested to have the beneficial impact on older adults' health and well-being. We performed a cross-sectional study to examine the influence of health literacy on the relationship between socioeconomic status (SES) and productive aging among older Chinese adults in a newly urbanized community. Data was collected from 995 older adults from a newly urbanized community between June and August 2013 in Chengdu, China. We used structural equation modeling (SEM) to test the hypothesized relationship among SES, health literacy and productive aging. Results showed that education attainment and income had a direct positive effect on health literacy (β = 0.47and β = 0.15, respectively). Education had a partial indirect effect on productive aging through health literacy (β = 0.27). And health literacy was an important factor in improving the productive aging of the elderly. Interventions targeting health education and health promotion should be taken to improve health literacy of older adults under the background of urbanization, especially for those with lower SES.
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Affiliation(s)
- Tianpei Ma
- Laboratory for Aging and Cancer Research, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Hongdao Meng
- School of Aging Studies, College of Behavioral & Community Sciences, University of South Florida, Tampa, FL, United States
| | - Zhiqiu Ye
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Chaoyong Jia
- Zhong He Community Health Service Center in Chengdu Hi-Techzone, Chengdu, China
| | - Min Sun
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Danping Liu
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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21
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He T, Liu L, Huang J, Li G, Guo X. Health Knowledge about Smoking, Role of Doctors, and Self-Perceived Health: A Cross-Sectional Study on Smokers' Intentions to Quit. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073629. [PMID: 33807331 PMCID: PMC8037039 DOI: 10.3390/ijerph18073629] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 01/04/2023]
Abstract
Limited empirical work has been done to compare the effects that health knowledge and advice from doctors have on smokers’ intentions to quit. This paper examines the association of smokers’ intentions to quit with health knowledge, advice from doctors, and self-perceived health. A sample of 2509 smokers aged 15–69 years old in Ningbo was used from China’s National Health Literacy Surveillance survey, conducted in 2018 and 2019. Respondents were asked whether they agree smoking causes stroke, heart attack, lung cancer; and heart diseases in adults, lung illnesses in children, and lung cancer in adults, by secondhand smoke, respectively. Using the logistic model, we found that knowing that smoking causes stroke and lung cancer more than doubles the odds of one’s intention to quit (OR = 2.705, p < 0.01), the effect of which is much greater than knowing that smoking causes lung cancer only (OR = 1.795, p < 0.01). Doctors’ advice to quit is more important than health knowledge, in terms of predicting smokers’ past cessation behaviours. In addition, smokers’ self-perceived health is negatively associated with their decisions to quit. This paper highlights that more resources should be directed towards training health care providers to advise smokers to quit, which might be more effective than health education alone.
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Affiliation(s)
- Tianfeng He
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, 38 Xueyuan Road, Beijing 100191, China; (T.H.); (J.H.); (G.L.)
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China
| | - Lefan Liu
- Center for Health Economics, School of Economics, University of Nottingham Ningbo China, Ningbo 315100, China;
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, 38 Xueyuan Road, Beijing 100191, China; (T.H.); (J.H.); (G.L.)
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, 38 Xueyuan Road, Beijing 100191, China; (T.H.); (J.H.); (G.L.)
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, 38 Xueyuan Road, Beijing 100191, China; (T.H.); (J.H.); (G.L.)
- Correspondence: ; Tel.: +86-10-82801062
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22
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Celebi C, Calik-Kutukcu E, Saglam M, Bozdemir-Ozel C, Inal-Ince D, Vardar-Yagli N. Health-Promoting Behaviors, Health Literacy, and Levels of Knowledge about Smoking-Related Diseases among Smokers and Non-smokers: A Cross-Sectional Study. Tuberc Respir Dis (Seoul) 2021; 84:140-147. [PMID: 33497564 PMCID: PMC8010416 DOI: 10.4046/trd.2020.0158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/26/2021] [Indexed: 01/20/2023] Open
Abstract
Background For generations, cigarette smoking has presented an important public health concern. This study aimed to compare the health-promoting behavior, exercise capacity, physical activity level, health literacy, and knowledge level of smoking-related diseases between smokers and non-smokers. Methods The study included 71 smokers (mean age, 32.69±8.55 years) and 72 non-smokers (mean age, 31.88±9.94 years) between the ages of 20 and 60 years. Assessments included a 6-minute walking test (6MWT), Godin Leisure-Time Physical Activity Questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), Cardiovascular Risk Factors Knowledge Level Scale (CARRF-KL), Asthma/COPD Awareness Questionnaire, the World Health Organization Quality of Life-Bref questionnaire (WHOQoL-Bref [TR]), and Health Literacy Questionnaire (HLQ). Results The results from the study show that the number of coronary artery disease risk factors measured significantly higher among the smoker group members when compared to that of the non-smoker group members (p=0.001). Smokers had significantly lower %6MWT distance than non-smokers (84.83±4.72 and 93.45±7.16, respectively; p<0.05). However, there were no significant differences between the smokers and non-smokers in terms of physical activity, CARRF-KL, HLQ, WHOQoL-Bref, and HPLP-II subscales or total scores (p>0.05). Additionally, while only forty-one smokers (57.7%) were active, 48 of the non-smoker group was active (66.7%). Conclusion Smokers suffer greater negative effects to their exercise capacity in comparison to non-smokers. Although smokers and non-smokers have similar levels of health literacy and similar levels of knowledge about cardiovascular disease risk factors and obstructive lung diseases, health professionals could continue to further increase individuals’ awareness of smoking-related risk factors and continue to emphasize the importance of physical activity and exercise for protecting cardiopulmonary health.
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Affiliation(s)
- Cihat Celebi
- Traditional and Complementary Medicine Department, General Directorate of Health Services, Turkish Republic Ministry of Health, Ankara, Turkey
| | - Ebru Calik-Kutukcu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Melda Saglam
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Cemile Bozdemir-Ozel
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Naciye Vardar-Yagli
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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23
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Naja S, Elyamani R, Al Ibrahim A, Al Kubaisi N, Itani R, AbdulRouf P. 'The newest vital sign among pregnant women attending women wellness and research Centre in Qatar: a cross-sectional study'. BMC Pregnancy Childbirth 2021; 21:73. [PMID: 33478419 PMCID: PMC7819321 DOI: 10.1186/s12884-021-03542-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 01/05/2021] [Indexed: 11/24/2022] Open
Abstract
Background Health literacy is a vital strategy to consider when designing health-promoting programs, and health literacy is a priority in Qatar’s national health agenda. In the context of pregnancy, inadequate health literacy has been linked to several adverse outcomes among pregnant women such as unplanned conception, smoking, and lack of multi-vitamin intake. Given the paucity of data, this study aimed to assess the level of health literacy and its determinants among pregnant women in the State of Qatar. Methods An analytical cross-sectional design was utilized. First, we piloted the measurement tools on 10% of the calculated sample size. Accordingly, the items of the measurement tools were revised. Next, we utilized a structured questionnaire to interview the participants about their socio-demographic characteristics, pregnancy-related factors, and the Newest Vital Sign Tool. A chi-square test was employed to investigate the association level among variables, with significance set to P < 0.05. A logistic regression model was used to identify the factors associated with a low literacy level. Results We found that almost four in 10 pregnant women (n = 138,45.4%) had inadequate health literacy. Furthermore, the insufficient level of health literacy was significantly associated with low educational background, decreased household income, and primigravida. However, uncontrolled glycaemia was the only significant predictor of inadequate health literacy through logistic regression. The scale was found to be reliable, with a calculated Cronbach’s alpha of 0.8. Conclusions Low health literacy is common among pregnant women in the State of Qatar. Thus, public health officials should focus on delivering tailored health literacy interventions to pregnant women in the country. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03542-w.
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Affiliation(s)
- Sarah Naja
- Department of Community Medicine, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar.
| | - Rowaida Elyamani
- Department of Community Medicine, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Abdullah Al Ibrahim
- Department of Obstetrics and Gynecology, Hamad Medical Corporation, Doha, Qatar
| | | | - Rayan Itani
- Department of Obstetrics and Gynecology, Hamad Medical Corporation, Doha, Qatar
| | - Palli AbdulRouf
- Department of Obstetrics and Gynecology, Hamad Medical Corporation, Doha, Qatar
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24
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Klein EG, Macisco J, Lazard A, Busho A, Oslock A, Worly B. Framing pregnancy-related smoking cessation messages for women of reproductive age. Addict Behav Rep 2020; 12:100290. [PMID: 32637566 PMCID: PMC7330874 DOI: 10.1016/j.abrep.2020.100290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/06/2020] [Accepted: 06/07/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Communicating harms of smoking and benefits of quitting to tobacco users to motivate cessation is critical to reduce the burden of tobacco-related disease. Most messaging strategies focus on health risks of smoking using loss-framing; yet, gain-framed messages to increase confidence in quitting have shown promise for smokers with lower self-efficacy. This study examined the impact of message framing on perceived effectiveness of targeted, pregnancy-related smoking cessation messages among pregnant and not-pregnant smoking women of reproductive age. METHODS An obstetrics-gynecological clinic-based sample of female, current smokers of reproductive age (18-44 years old) was recruited during January to May 2019 (n = 135). Participants self-reported ratings for 10 pregnancy-related cessation messages (half gain-framed) on a validated perceived effectiveness scale. Multivariable regression analyses were conducted using generalized estimating equations to account for clustering by message themes. RESULTS Gain-framed messages were rated significantly higher (0.20; p < 0.01) compared to loss-framed messages for perceived effectiveness, after accounting for quit intentions, self-efficacy to quit, health literacy, cessation risk perceptions, nicotine dependence, and pregnancy status. CONCLUSIONS Gain-framed health messages about cessation were deemed to be more effective than loss-framed messages among adult female smokers. Targeted, positively framed messages to highlight the benefits of quitting to women of reproductive age show promise as a strategy to promote smoking cessation.
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Affiliation(s)
- Elizabeth G. Klein
- College of Public Health, Ohio State University, Columbus, OH, United States
| | - Joseph Macisco
- College of Public Health, Ohio State University, Columbus, OH, United States
| | - Allison Lazard
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, United States
| | - Audrey Busho
- College of Medicine, Ohio State University, Columbus, OH, United States
| | - Austin Oslock
- College of Public Health, Ohio State University, Columbus, OH, United States
- College of Medicine, Ohio State University, Columbus, OH, United States
| | - Brett Worly
- College of Medicine, Ohio State University, Columbus, OH, United States
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Vianello FA, Zaccagnini F, Pinato C, Maculan P, Buja A. Health status of female Moldovan migrants to Italy by health literacy level and age group: a descriptive study. BMC Public Health 2020; 20:1502. [PMID: 33008354 PMCID: PMC7532569 DOI: 10.1186/s12889-020-09582-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 09/21/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Migration flows from Eastern Europe to Italy have been large and continue to grow. The purpose of this study was to examine the health status of a population of Moldovan migrant women, and their access to health care services in northern Italy, by age group and health literacy level. METHODS We administered an ad-hoc questionnaire to adult Moldovan women. A bivariate analysis was conducted to test the association between health literacy and age groups with other variables (lifestyles, symptoms and diseases, access to health services). A stepwise logistic regression analysis was run to test the association between access to primary care and health literacy. Moreover, the study compare Moldovan women data with a sample of Italian women of the same age range living in North-Eastern region. RESULTS Our sample included 170 Moldovan women (aged 46.5 ± 12.3) in five occupational categories: home care workers (28.2%); cleaners (27.1%); health care workers (5.9%); other occupations (28.8%); and unemployed (10%). Active smokers were twice as prevalent among the women with a low health literacy. Health literacy level also determined access to primary healthcare services. For all age groups, the Moldovan sample reported a higher prevalence of allergies, lumbar disorders and depression than the Italian controls. CONCLUSIONS The reported prevalence of some diseases was higher among Moldovan migrant women than among Italian resident women. Health literacy was associated with the migrant women's lifestyle and the use of primary health care services, as previously seen for the autochthonous population.
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Affiliation(s)
- Francesca Alice Vianello
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Piazza Capitaniato 3, 35129, Padova, Italy
| | - Federica Zaccagnini
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Piazza Capitaniato 3, 35129, Padova, Italy
| | - Carlo Pinato
- Melanoma and Sarcoma Unit, Veneto Institute of Oncology, IOV-IRCCS, via Gattamelata 64, 35128, Padova, Italy
| | - Pietro Maculan
- Department of Cardiological, Thoracic and Vascular Sciences, and Public Health, University of Padua, Via Loredan 18, 35128, Padova, Italy
| | - Alessandra Buja
- Department of Cardiological, Thoracic and Vascular Sciences, and Public Health, University of Padua, Via Loredan 18, 35128, Padova, Italy.
- Laboratory for Assessing Health Care Services and Health Promotion, Hygiene and Public Health Unit, Dept. of Cardiological, Thoracic and Vascular Sciences, and Public Health, University of Padova, Via Loredan, 18, 35131, Padova, Italy.
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Giuliani M, Brual J, Eng L, Liu G, Papadakos T, Giannopoulos E, Papadakos J. Investigating the Smoking Cessation Informational Needs of Cancer Patients and Informal Caregivers. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:954-964. [PMID: 31119706 DOI: 10.1007/s13187-019-01547-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Continued smoking at the time of a cancer diagnosis can severely impact the efficacy of cancer patient treatment and survival. The time of diagnosis can serve as a "teachable moment" for smoking cessation education, since patients may be receptive to discussions about quitting. Caregivers may have a pivotal role in supporting patients with their cessation efforts. The purpose of this study was to identify the smoking cessation informational needs of cancer patients and their caregivers. A needs assessment survey was administered to both patients and caregivers that assessed information needs across five domains: (1) General Information and Support; (2) Smoking, Health and Disease; (3) Relationships; (4) Testimonials; (5) Interventions. Mean importance scores were determined based on the proportion of respondents who ranked how important individual items were within the broader domains. Forty patients and twenty-two caregivers completed the survey. Among patients, the mean age was 61 years, with 35% diagnosed with a head and neck malignancy and 62% reporting as current smokers. Among caregivers, the mean age was 58 years, with 81% reporting to be the patient's immediate family member and 50% as current smokers. The General Information and Support domain was rated as the most important domain for both cancer patients and caregivers. The top preferred modality for receiving smoking cessation education across all domains was pamphlets for both groups. This study identifies the key informational elements that should be considered in the development of smoking cessation resources to meet the informational needs of cancer patients and caregivers.
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Affiliation(s)
- Meredith Giuliani
- Cancer Education Program, Princess Margaret Cancer Centre, 585 University Ave, Munk Building B-PMB 130, Toronto, Ontario, M5G 2M9, Canada.
- Radiation Medicine Program, Princess Margaret Cancer Centre, Room 5-978A, 610 University Avenue, Toronto, Ontario, M5G 2M9, Canada.
- Department of Radiation Oncology, University of Toronto, Toronto, ON, M5T 1P5, Canada.
| | - Janette Brual
- Cancer Education Program, Princess Margaret Cancer Centre, 585 University Ave, Munk Building B-PMB 130, Toronto, Ontario, M5G 2M9, Canada
| | - Lawson Eng
- Division of Medical Oncology and Hematology, Princess Margaret Hospital, University of Toronto, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
| | - Geoffrey Liu
- Division of Medical Oncology and Hematology, Princess Margaret Hospital, University of Toronto, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
| | - Tina Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, 585 University Ave, Munk Building B-PMB 130, Toronto, Ontario, M5G 2M9, Canada
- Patient Education, Cancer Care Ontario, Toronto, Ontario, M5S 1A1, Canada
| | - Eleni Giannopoulos
- Cancer Education Program, Princess Margaret Cancer Centre, 585 University Ave, Munk Building B-PMB 130, Toronto, Ontario, M5G 2M9, Canada
| | - Janet Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, 585 University Ave, Munk Building B-PMB 130, Toronto, Ontario, M5G 2M9, Canada
- Patient Education, Cancer Care Ontario, Toronto, Ontario, M5S 1A1, Canada
- Institute of Health Policy, Management & Evaluation, University of Toronto, 4th Floor, 155 College St, Toronto, ON, M5T 3M6, Canada
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Katyal T, Durazo A, Hartman-Filson M, Vijayaraghavan M. Responses to Graphic Warning Labels among Low-income Smokers. Am J Health Behav 2020; 44:603-616. [PMID: 33121579 PMCID: PMC7994008 DOI: 10.5993/ajhb.44.5.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: Graphic warning labels (GWLs) are effective in communicating tobacco-related harms. Methods: In this mixed-methods study, we used purposive sampling to recruit 100 low-income smokers in the San Francisco Bay Area between October 2017 and February 2018 to participate in an intervention promoting smoke-free homes. We presented the 2009 Food and Drug Administration-proposed GWLs and explored perceptions of affect, efficacy, and appeal using questionnaires at baseline, 3- and 6-months follow-up. Because of participants' interest in this topic, we subsequently conducted a qualitative sub-study among 20 participants exploring perceived efficacy of GWLs on smoking cessation. Results: In all, 87.3% and 59.2% agreed that GWLs were useful and would motivate cessation behaviors, respectively, at baseline. We found that the most common responses were shock (61.8%) and disgust (55.3%), whereas anger (29.0%) and annoyance (19.7%) were less common. Participants also reported that GWLs unequivocally illustrating smoking's harmful effects were more appealing than non-specific images, as were images that depicted positive cessation-related effects. Conclusions: GWLs appear to be an important health communication among low-income smokers. Future studies on GWLs should examine the association of negative affect and cessation among this population.
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Affiliation(s)
- Toshali Katyal
- School of Public Health, University of California, Berkeley, CA
| | - Arturo Durazo
- Postdoctoral Fellow, Center for Tobacco Control Research and Education, University of California, San Francisco, CA
| | - Marlena Hartman-Filson
- Assistant Professor, Division of General Internal Medicine, University of California, San Francisco, CA
| | - Maya Vijayaraghavan
- Assistant Professor, Division of General Internal Medicine, University of California, San Francisco, CA;,
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Gwinnutt JM, Verstappen SM, Humphreys JH. The impact of lifestyle behaviours, physical activity and smoking on morbidity and mortality in patients with rheumatoid arthritis. Best Pract Res Clin Rheumatol 2020; 34:101562. [PMID: 32646673 DOI: 10.1016/j.berh.2020.101562] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Rheumatoid arthritis (RA) is associated with pain, disability and increased risk of developing comorbidities and premature mortality. While these poor outcomes have improved in line with advances in the treatment of RA, they still persist to some degree today. Physical activity and smoking are two areas of patients' lives where changes may have a substantial impact on the poor outcomes associated with RA. Physical activity in RA has been well studied, with many randomised trials indicating the benefits of physical activity on pain and disability. A number of observational studies have assessed the impact of smoking on RA, also indicating the benefits of quitting smoking on RA-related outcomes, but with less consistent findings, potentially due to epidemiological challenges (e.g. collider bias, recall bias). There are also a number of barriers preventing patients making these positive lifestyle changes, such as lack of time and motivation, lack of knowledge and advice, as well as disease-specific barriers, such as pain and fatigue.
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Affiliation(s)
- James M Gwinnutt
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
| | - Suzanne Mm Verstappen
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK
| | - Jenny H Humphreys
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Influence of Puerperal Health Literacy on Tobacco Use during Pregnancy among Spanish Women: A Transversal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082910. [PMID: 32340128 PMCID: PMC7216153 DOI: 10.3390/ijerph17082910] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 11/18/2022]
Abstract
Background: Despite the fact that tobacco use during pregnancy produces adverse perinatal effects, some women continue to smoke. Health literacy (HL) is essential for health outcomes in adults. However, little is known about HL in pregnant women or postpartum women. The study aimed to analyse the relationship between the degree of HL of women during the early puerperium and tobacco use during pregnancy. Methods: A multicentre, descriptive, cross-sectional study was carried out with women in the early puerperium in a region of eastern Spain, between November 2017 and May 2018. Their HL level was obtained using the Newest Vital Sign (NVS) tool. Multivariate logistic models were adjusted to estimate the magnitude of association with tobacco use in pregnancy. Odds ratios (OR) were estimated with a 95% confidence interval. Results: 193 were included in the total. 29.5% (57) of pregnant women smoked tobacco during pregnancy, with a smoking cessation rate of 70.1% (40) while pregnant. 42.0% (81) of pregnant women had inadequate or limited HL. A low level of HL was strongly associated with tobacco use, adjusted by catchment area and age of first pregnancy (LRT p < 0.001; ROC curve = 0.71, 95% CI: 0.64–0.79). Conclusion: A low HL is associated with tobacco consumption during pregnancy. Whether low HL reflects the wide constellation of already-known socioeconomic, political and commercial determinants of tobacco use, or whether incorporating HL support interventions strengthens tobacco cessation activities in pregnancy, warrants further research. Still, it should be considered as essential to understanding the health disparities related to its consumption.
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Shen SA, Jafari A, Qualliotine JR, DeConde AS. Follow-Up Adherence Is Associated with Outcomes After Endoscopic Sinus Surgery. Ann Otol Rhinol Laryngol 2020; 129:707-714. [PMID: 32079413 DOI: 10.1177/0003489420908291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Clinical follow-up after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) allows for assessment of the sinonasal cavity, debridement, and tailoring of medical therapies. Frequency and timing of postoperative clinical visits is debated, but the impact of adherence on disease-specific outcomes is not well understood. In this longitudinal study, we assessed the association between follow-up adherence and quality of life (QOL) outcomes in the 12 months after ESS. METHODS A retrospective review of patients undergoing ambulatory ESS for CRS between 11/2016 and 1/2018 was performed. We assessed sociodemographic characteristics, radiographic severity, and QOL utilizing the 22-item sinonasal outcome test (SNOT-22). Patients were categorized as "non-adherent," "moderately-adherent," and "fully-adherent" to a 1-, 3- and 5-week postoperative visit schedule. RESULTS A total of 166 patients met the inclusion criteria. Of these, 55 (33.1%) were fully-adherent, 105 (63.2%) were moderately-adherent, and 6 (3.6%) were non-adherent within the 6 weeks following ESS. In the immediate postoperative period, fully-adherent patients demonstrated worse QOL (SNOT-22: 31.2 ± 23.1 vs 27.5 ± 17.6, P = .047). This cohort also had greater psychological dysfunction at baseline and 12-months (P < .05) after ESS. Extra-nasal symptom scores increased at a lower rate in the fully-adherent cohort (0.12 vs 1.29 points per 6 months, P = .038), as did ear/facial symptoms (1.17 vs 3.05 points per 6 months, P = .044). CONCLUSION Despite worse symptom severity in the immediate postoperative period, patients who are more adherent to the follow-up schedule demonstrated slower return of symptoms in the extra-rhinological and ear-facial domains. These findings suggest that clinical adherence and management may impact the long-term evolution of ESS outcomes.
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Affiliation(s)
- Sarek A Shen
- School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Aria Jafari
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, CA, USA
| | - Jesse R Qualliotine
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, CA, USA
| | - Adam S DeConde
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, CA, USA
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Yaya S, Bishwajit G. Exposure to second-hand smoking as a predictor of fetal loss: Egypt Demographic and Health Survey 2014. Int Health 2020; 11:561-567. [PMID: 31184367 DOI: 10.1093/inthealth/ihz021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 02/13/2019] [Accepted: 03/18/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Exposure to tobacco smoking during pregnancy has been shown to be associated with elevated risk of adverse pregnancy outcomes such as miscarriage and stillbirth. However, little is known regarding the association between passive smoking and birth outcomes. This study aims to measure the prevalence of passive smoking and assess its relationship with adverse birth outcomes. METHODS Self-reported birth outcomes (stillbirth/miscarriage/abortion) was the dependent variable that was regressed against self-reported exposure to household smoking along with various individual and community-level factors. We used propensity score matching to identify the sample and used regression analysis to quantify the association between passive smoking and birth outcomes. Sensitivity analysis was conducted to check for the robustness of the associations. RESULTS Of the 5540 women studied, about half (50.3%, 95% CI=49.3-51.3) reported being exposed to smoking by household members. The prevalence of stillbirth was 14.6% (95% CI=13.9-15.3). In the logistic regression analysis, the confounder-adjusted OR of stillbirth in relation to exposure to smoking was 1.321 (95% CI=1.150-1.517). In the subgroup analysis, we found that the association was significant among certain age groups only. CONCLUSION The findings of the present study imply a mildly positive association between the occurrence of stillbirth and exposure to smoking in the household.
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Affiliation(s)
- Sanni Yaya
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, Canada
| | - Ghose Bishwajit
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, Canada.,School of Medicine and Health Medicine, Tongji Medical College, Wuhan, Hubei, China
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Chido-Amajuoyi OG, Mantey D, Cunningham S, Yu R, Kelder S, Hawk E, Cinciripini P, Shete S. Characteristics of us adults attempting tobacco use cessation using e-cigarettes. Addict Behav 2020; 100:106123. [PMID: 31605837 PMCID: PMC6905082 DOI: 10.1016/j.addbeh.2019.106123] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 09/04/2019] [Accepted: 09/04/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Use of e-cigarettes for tobacco cessation efforts is a growing trend in the United States. However, little is known about the factors that determine the use of e-cigarettes for this specific purpose. METHODS This study examined current and former cigarette smokers that reported ever using e-cigarettes. Data were obtained from a 2018 Texas population health assessment survey (n = 569) and weighted to be representative to Texas. A multivariable logistic regression was used to assess the socio-demographic and behavioral correlates of using e-cigarettes for tobacco cessation. RESULTS Overall, 41.3% of e-cigarette users reported using them for tobacco cessation. Among ever e-cigarette users, Non-Hispanic blacks (aOR: 0.21; 95% CI, 0.07-0.64), males (aOR: 0.40; 95% CI, 0.20-0.80), and individuals not confident in obtaining health information (aOR: 0.38; 95% CI, 0.15-0.96) were less likely to use e-cigarettes for tobacco use cessation. Conversely, among ever e-cigarette users, odds of using e-cigarettes for tobacco cessation were higher among those who were 35-44 years old (aOR: 3.68, 95% CI: 1.26-10.71), those who received advice to quit smoking from a healthcare professional (aOR: 2.77, 95% CI, 1.36-5.64), and those with more than 5 years since their last routine checkup (aOR: 3.91; 95% CI, 1.23-12.45). CONCLUSION Findings from this study suggest that both health behaviors and sociodemographic factors predict use of e-cigarettes for the purpose of tobacco cessation. Furthermore, the relationship between use of e-cigarettes as a cessation device and being advised to quit tobacco use by a healthcare professional calls for additional investigation.
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Affiliation(s)
- Onyema Greg Chido-Amajuoyi
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, USA
| | - Dale Mantey
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Sonia Cunningham
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Robert Yu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Steven Kelder
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ernest Hawk
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, USA
| | - Paul Cinciripini
- Department of Behavioral Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, USA; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Hoover DS, Wetter DW, Vidrine DJ, Nguyen N, Frank SG, Li Y, Waters AJ, Meade CD, Vidrine JI. Enhancing Smoking Risk Communications: The Influence of Health Literacy and Message Content. Ann Behav Med 2019. [PMID: 29538662 DOI: 10.1093/abm/kax042] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Efforts are needed to ensure that smokers with lower health literacy are provided with understandable and impactful information about the health consequences of smoking and benefits of quitting. Purpose To test the influence of health literacy on smokers' responses to health risk messages manipulated on framing (gain vs. loss) and emotionality (factual vs. emotional). Methods Participants (N = 402) were randomized to evaluate one of four sets of smoking risk messages (factual gain-framed, factual loss-framed, emotional gain-framed, or emotional loss-framed). Multiple linear regressions examined main effects of health literacy, message emotionality, and message framing on: (a) risk perceptions, (b) behavioral expectations (i.e. cut down, limit, quit), and (c) risk knowledge. Two-way interactions of health literacy with emotionality and framing were examined for these outcomes. Analyses were based on theory-driven, a priori hypotheses. Results As hypothesized, main effects emerged such that smokers with higher health literacy reported stronger risk perceptions and knowledge retention regardless of message type. Additionally, emotional (vs. factual) and gain- (vs. loss-) framed messages were associated with certain lower risk perceptions regardless of health literacy level. Consistent with hypotheses, two-way crossover interactions emerged between health literacy and emotionality. Among smokers with higher health literacy, factual messages produced higher perceived risk and stronger expectations for quitting. Among smokers with lower health literacy, emotional messages produced higher perceived risk and stronger expectations for quitting. Conclusions Health literacy plays an important role in influencing how smokers respond to different risk messages. One's health literacy should be considered when determining whether risk communications emphasize factual or emotional content.
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Affiliation(s)
- Diana Stewart Hoover
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, USA
| | - David W Wetter
- Center for Health Outcomes and Population Equity, University of Utah, Salt Lake City, USA
| | - Damon J Vidrine
- Stephenson Cancer Center and the Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Nga Nguyen
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Summer G Frank
- Stephenson Cancer Center and the Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Yisheng Li
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Andrew J Waters
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Services, Bethesda, USA
| | - Cathy D Meade
- Division of Population Science, Health Outcomes, and Behavior, Moffitt Cancer Center, Tampa, USA.,Department of Oncologic Sciences, University of South Florida College of Medicine, Tampa, USA
| | - Jennifer I Vidrine
- Stephenson Cancer Center and the Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
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Green AC, Driezen P, Noar SM, Hammond D, Fong GT. Impact of adding and removing warning label messages from cigarette packages on adult smokers' awareness about the health harms of smoking: findings from the ITC Canada Survey. Tob Control 2019; 28:e56-e63. [PMID: 31253717 PMCID: PMC7495415 DOI: 10.1136/tobaccocontrol-2018-054885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Adding messages to cigarette health warning labels (HWLs) about the harms of smoking increases awareness of these health facts, but little is known about the impact of removing messages. This is the first study to directly investigate the impact of adding and removing messages from cigarette HWLs on smokers' awareness of harms. METHODS Data were drawn from nine waves of the International Tobacco Control (ITC) Canada Survey, a national representative cohort of adult smokers (n=5863) conducted nearly annually between 2002 and 2013-2014. Two analytical approaches were conducted: generalised estimating equation (GEE) regression models estimated adjusted percentages of correct smoking-related health statements at each wave and segmented regression analyses modelled temporal trends in awareness before and after the revisions by measuring the difference in slopes. RESULTS Adding messages to HWLs significantly increased awareness that smoking causes blindness (OR=3.36 (95% CI 2.71 to 4.18); p<0.001; estimated increase of 1.01 million smokers in Canada) and bladder cancer (OR=2.14 (95% CI 1.71 to 2.66), p<0.001; estimated increase of 1.09 million smokers). Adding the warning that nicotine causes addiction did not significantly impact smokers' awareness. Removing messages was shown to decrease awareness that cigarette smoke contains carbon monoxide (OR=0.53 (95% CI 0.41 to 0.70), p<0.001; estimated decrease of 342 000 smokers) and smoking causes impotence (p=0.007 for the difference in slopes; estimated decrease of 354 000 smokers). CONCLUSIONS Adding messages to HWLs increases smokers' awareness of health facts, but removing messages decreases awareness. These findings demonstrate the importance of carefully considering the implications of adding and especially removing messages from HWLs and the importance of regularly revising warnings.
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Affiliation(s)
- Annika C Green
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Seth M Noar
- School of Journalism and Mass Communication, University of North Carolina, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Differential associations of health literacy with Austrian adolescents' tobacco and alcohol use. Public Health 2019; 174:74-82. [PMID: 31323600 DOI: 10.1016/j.puhe.2019.05.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/20/2019] [Accepted: 05/28/2019] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Tobacco use and alcohol use have their origin in adolescence, and risky use of these substances is amongst the leading preventable causes of morbidity and mortality. Health literacy (HL) encompasses the skills that are decisive to make appropriate health decisions in this context. Given the paucity of evidence on the link between HL and adolescents' health behaviors, the present study examined overall HL and different components of HL and their associations with smoking and alcohol use among 13 to 17-year-old Austrian students. STUDY DESIGN Data were obtained from a national survey carried out in Austria (N = 4219; 56% females) as part of the Health Behaviour in School-aged Children: World Health Organization (WHO) collaborative cross-national study. METHODS We tested two structural equation models, one including the overall HL scale as the predictor and one with the three subscales of HL 'finding,' 'understanding and appraising,' and 'applying' health-related information as predictors of smoking and alcohol use. RESULTS Although overall HL was related to all indicators of adolescents' smoking and drinking, the three HL components had differential effects on these behaviors. The easier it was for the participants to 'understand and appraise' and 'apply' health-related information, the less frequently they had smoked and drunk alcohol and the less was the amount of alcohol they had consumed. Contrarily, the easier it was for the participants to 'find' information, the more they had smoked and drunk alcohol. CONCLUSIONS Our results indicate that availability of health-related information may be insufficient on its own to prevent or reduce risky substance use. This is of particular importance for the development and improvement of primary prevention programs targeting adolescent populations.
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Glover LM, Ma JZ, Kesh A, Tompkins LK, Hart JL, Mattingly DT, Walker K, Robertson RM, Payne T, Sims M. The social patterning of electronic nicotine delivery system use among US adults. Prev Med 2018; 116:27-31. [PMID: 30171967 PMCID: PMC9186153 DOI: 10.1016/j.ypmed.2018.08.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/23/2018] [Accepted: 08/28/2018] [Indexed: 10/28/2022]
Abstract
There is little research examining the social patterning of electronic nicotine delivery system (ENDS) use. This study investigated the association between socioeconomic status (SES) (education, income, and employment status) and current and former ENDS use. Data were collected from 2561 participants from the American Heart Association Tobacco Regulatory and Addiction Center (A-TRAC) online survey. Participants were 18-64 years old and reported demographic, SES, and ENDS use. Poisson regression was used to estimate prevalence ratios (PR 95% confidence interval-CI) of participants' current and former (vs. never) ENDS use. Models were adjusted for age, sex, sexual orientation, race/ethnicity, marital status, and reasons for ENDS use. In the unadjusted analysis, ENDS use was primarily patterned by education and employment status. College educated persons (vs. those with less than a high school diploma) had a 37% greater prevalence of current ENDS use (PR 1.37, 95% CI 1.20-1.55), and a 16% greater prevalence of former ENDS use (PR 1.16, 95% CI 1.06-1.28) in the fully-adjusted model. Persons with household incomes above $90 K (vs. less than $20,000) had a greater prevalence of current (PR 1.30, 95% CI 1.19-1.41) and former (PR 1.17, 95% CI 1.05-1.30) ENDS use. Those who were employed (vs. not employed) had a 13% greater prevalence of current ENDS use (PR 1.13, 95% CI 1.07-1.19) after full adjustment. Higher SES (vs. lower SES) persons were more likely to use ENDS.
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Affiliation(s)
- LáShauntá M Glover
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Jennie Z Ma
- School of Medicine, University of Virginia, Charlottesville, VA 22904, USA
| | - Anshula Kesh
- American Heart Association, American Stroke Association, Dallas, TX 75231, USA
| | - Lindsay K Tompkins
- Department of Epidemiology and Population Health, University of Louisville, KY- 40292, USA
| | - Joy L Hart
- Department of Communication, University of Louisville, KY 40292, USA
| | | | - Kandi Walker
- Department of Communication, University of Louisville, KY 40292, USA
| | | | - Tom Payne
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA.
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Quisenberry AJ, Scott AE, Shoben AB, Ferketich AK, Cooper SE, Berman M, Peters E, Ellen Wewers M, Klein EG. Health Literacy and Attention to Cigarette Health Warning Labels among Rural Smokers. TOB REGUL SCI 2018; 4:38-46. [PMID: 31363489 PMCID: PMC6667177 DOI: 10.18001/trs.4.6.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We evaluated the association of health literacy and attention to the pictorial imagery of 9 health warning labels (HWLs) in a tobacco advertisement among rural US smokers. We hypothesized that lower health literacy would be associated with greater visual attention to pictorial portions of HWLs and evaluated the association between health literacy and recall of advertisement elements. METHODS Adult smokers from Appalachian Ohio (N = 180) viewed a pictorial HWL encompassing 20% or 33% of a cigarette advertisement while eye tracking software recorded eye movements toward the advertisement. Health literacy was measured with The Short Test of Functional Health Literacy in Adults. RESULTS Generalized linear regression revealed that every one-unit decrease in health literacy increased viewing time of the pictorial portion of the health warning label by 1.3 percentage points. Logistic regression revealed that the odds of recalling elements of the pictorial portion of the health warning label increased 20% for every one-unit increase in health literacy. CONCLUSIONS Rural smokers with lower health literacy view pictorial portions of health warning labels longer than those with greater health literacy supporting that health literacy is an important consideration in health communications, including future cigarette warning labels.
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Affiliation(s)
| | - Ayanna E Scott
- Ohio State University Center for the Advancement of Team Science, Analytics, and Systems Thinking, Columbus, OH
| | - Abigail B Shoben
- Ohio State University College of Public Health, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
| | - Amy K Ferketich
- Ohio State University College of Public Health, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
| | - Sarah E Cooper
- Ohio State University College of Public Health, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
| | - Micah Berman
- Ohio State University College of Public Health, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
| | - Ellen Peters
- Ohio State University Psychology Department, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
| | - Mary Ellen Wewers
- Ohio State University College of Public Health, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
| | - Elizabeth G Klein
- Ohio State University College of Public Health, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
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Improving Health Literacy. The New American Thoracic Society Guidelines for Patient Education Materials. Ann Am Thorac Soc 2018; 13:1208-11. [PMID: 27509148 DOI: 10.1513/annalsats.201605-337ot] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Panahi R, Ramezankhani A, Tavousi M, Osmani F, Karami A, Niknami S. Effect of Educational Intervention on Health Literacy and Adoption of Smoking Preventive Behaviors among University Students. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2018. [DOI: 10.21859/jech.5.2.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Magnani JW, Mujahid MS, Aronow HD, Cené CW, Dickson VV, Havranek E, Morgenstern LB, Paasche-Orlow MK, Pollak A, Willey JZ. Health Literacy and Cardiovascular Disease: Fundamental Relevance to Primary and Secondary Prevention: A Scientific Statement From the American Heart Association. Circulation 2018; 138:e48-e74. [PMID: 29866648 PMCID: PMC6380187 DOI: 10.1161/cir.0000000000000579] [Citation(s) in RCA: 226] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Health literacy is the degree to which individuals are able to access and process basic health information and services and thereby participate in health-related decisions. Limited health literacy is highly prevalent in the United States and is strongly associated with patient morbidity, mortality, healthcare use, and costs. The objectives of this American Heart Association scientific statement are (1) to summarize the relevance of health literacy to cardiovascular health; (2) to present the adverse associations of health literacy with cardiovascular risk factors, conditions, and treatments; (3) to suggest strategies that address barriers imposed by limited health literacy on the management and prevention of cardiovascular disease; (4) to demonstrate the contributions of health literacy to health disparities, given its association with social determinants of health; and (5) to propose future directions for how health literacy can be integrated into the American Heart Association's mandate to advance cardiovascular treatment and research, thereby improving patient care and public health. Inadequate health literacy is a barrier to the American Heart Association meeting its 2020 Impact Goals, and this statement articulates the rationale to anticipate and address the adverse cardiovascular effects associated with health literacy.
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Ylitalo KR, Meyer MRU, Lanning BA, During C, Laschober R, Griggs JO. Simple screening tools to identify limited health literacy in a low-income patient population. Medicine (Baltimore) 2018. [PMID: 29517689 PMCID: PMC5882442 DOI: 10.1097/md.0000000000010110] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Adults with limited health literacy have difficulty managing chronic conditions, higher hospitalization rates, and more healthcare expenditures. Simple screening tools have been developed, but limited work has evaluated instruments among low-income populations. This study assessed health literacy among primary care patients of a federally qualified health center, and compared a single screening question about perceived difficulty completing medical forms.A cross-sectional survey was administered to English-speaking patients ≥40 years. Both the Newest Vital Sign (NVS), a 6-item questionnaire, and a single-item screening question about perceived difficulty with completing medical forms, assessed health literacy. Logistic regression was used to identify predictors of inadequate health literacy and receiver operator curves compared the NVS and single-item question.Participants (n = 406) were, on average, aged 58.5 years (±11.3), 72.2% female, and identified as Hispanic/Latino (19.2%), non-Hispanic white (31.0%), non-Hispanic black (40.9%), or other (8.9%). Of the 406 participants, 335 (82.5%) completed the NVS. Patients who declined NVS were more likely to be older (P < .001) and male (P = .01). Only 13.7% had adequate health literacy. Older adults, Hispanic and non-Hispanic black patients, patients with missed office visits, and those reporting less confidence completing medical forms were significantly more likely to have inadequate health literacy. Perceived confidence completing medical forms demonstrated low sensitivity but high specificity at multiple thresholds.This is the first investigation to compare the NVS and confidence completing medical forms question. Many patients declined health literacy assessments, but health literacy screening may identify patients who need additional health education and resources.
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Affiliation(s)
- Kelly R Ylitalo
- Baylor University, Public Health Program Family Health Center, Waco, TX, USA
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Adding Health Literacy to the Health Belief Model: Effectiveness of an Educational Intervention on Smoking Preventive Behaviors Among University Students. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018. [DOI: 10.5812/ircmj.13773] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Boland VC, Stockings EA, Mattick RP, McRobbie H, Brown J, Courtney RJ. The Methodological Quality and Effectiveness of Technology-Based Smoking Cessation Interventions for Disadvantaged Groups: A Systematic Review and Meta-analysis. Nicotine Tob Res 2018; 20:276-285. [PMID: 28034998 DOI: 10.1093/ntr/ntw391] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 12/21/2016] [Indexed: 01/08/2023]
Abstract
Aims To assess the methodological quality and effectiveness of technology-based smoking cessation interventions in disadvantaged groups. Method Four databases (EMBASE, Cochrane, Medline, and PsycInfo) were searched for studies conducted from 1980 to May 2016. Randomized controlled trials that compared a behavioral smoking cessation intervention delivered primarily through a technology-based platform (eg, mobile phone) with a no-intervention comparison group among disadvantaged smokers were included. Three reviewers assessed all relevant studies for inclusion, and one reviewer extracted study, participant and intervention-level data, with a subset crosschecked by a second reviewer. Results Thirteen studies targeting disadvantaged smokers (n =4820) were included. Only one study scored highly in terms of methodological rigor on EPOC criteria for judging risk of bias. Of the 13 studies using a technology-based platform, most utilized websites (n = 5) or computer programs (n = 5), and seven additionally offered nicotine replacement therapy. Technology-based interventions increased the odds of smoking cessation for disadvantaged groups at 1 month (odds ratio [OR] 1.70, 95% confidence interval [CI] 1.10, 2.63), 3 months (OR 1.30, 95% CI 1.07, 1.59), 6 months (OR 1.29, 95% CI 1.03, 1.62), and 18 months post-intervention (OR 1.83, 95% CI 1.11, 3.01). Conclusion Few methodologically rigorous studies were identified. Mobile phone text-messaging, computer- and website-delivered quit support showed promise at increasing quit rates among Indigenous, psychiatric and inpatient substance use disorder patients. Further research is needed to address the role technology-based interventions have on overcoming health inequalities to meet the needs of disadvantaged groups. Implications This review provides the first quantitative evidence of the effectiveness of a range of technology-based smoking cessation interventions among disadvantaged smokers, with separate estimates on the basis of intervention type, and cessation outcome measure. Providing cost-effective, easily accessible and real-time smoking cessation treatment is needed, and innovative technology-based platforms will help reach this endpoint. These interventions need to be tested in larger scale randomized controlled trial designs and target broader disadvantaged groups. Data collection beyond 6 months is also needed in order to establish the efficacy of these intervention approaches on long-term cessation rates among disadvantaged population groups.
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Affiliation(s)
- Veronica C Boland
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Randwick, Australia
| | - Emily A Stockings
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Randwick, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Randwick, Australia
| | - Hayden McRobbie
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Jamie Brown
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Ryan J Courtney
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Randwick, Australia
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Braun RT, Hanoch Y, Barnes AJ. Tobacco use and health insurance literacy among vulnerable populations: implications for health reform. BMC Health Serv Res 2017; 17:729. [PMID: 29141639 PMCID: PMC5688641 DOI: 10.1186/s12913-017-2680-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 11/03/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Under the Affordable Care Act (ACA), millions of Americans have been enrolling in the health insurance marketplaces. Nearly 20% of them are tobacco users. As part of the ACA, tobacco users may face up to 50% higher premiums that are not eligible for tax credits. Tobacco users, along with the uninsured and racial/ethnic minorities targeted by ACA coverage expansions, are among those most likely to suffer from low health literacy - a key ingredient in the ability to understand, compare, choose, and use coverage, referred to as health insurance literacy. Whether tobacco users choose enough coverage in the marketplaces given their expected health care needs and are able to access health care services effectively is fundamentally related to understanding health insurance. However, no studies to date have examined this important relationship. METHODS Data were collected from 631 lower-income, minority, rural residents of Virginia. Health insurance literacy was assessed by asking four factual questions about the coverage options presented to them. Adjusted associations between tobacco use and health insurance literacy were tested using multivariate linear regression, controlling for numeracy, risk-taking, discount rates, health status, experiences with the health care system, and demographics. RESULTS Nearly one third (31%) of participants were current tobacco users, 80% were African American and 27% were uninsured. Average health insurance literacy across all participants was 2.0 (SD 1.1) out of a total possible score of 4. Current tobacco users had significantly lower HIL compared to non-users (-0.22, p < 0.05) after adjustment. Participants who were less educated, African American, and less numerate reported more difficulty understanding health insurance (p < 0.05 each.) CONCLUSIONS: Tobacco users face higher premiums for health coverage than non-users in the individual insurance marketplace. Our results suggest they may be less equipped to shop for plans that provide them with adequate out-of-pocket risk protection, thus placing greater financial burdens on them and potentially limiting access to tobacco cessation and treatment programs and other needed health services.
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Affiliation(s)
- Robert T. Braun
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 E. Main St., 9th Floor, Richmond, Virginia, 23219 USA
| | - Yaniv Hanoch
- Department of Psychology, Plymouth University, Plymouth, UK
| | - Andrew J. Barnes
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 E. Main St., 9th Floor, Richmond, Virginia, 23219 USA
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Abstract
Objectives Health literacy—the ability to obtain, process, and understand basic health information—is a major determinant of an individual’s overall health and health care utilization. In this project, the authors examined predictors of health literacy levels, including numeracy and graphic literacy, among an adult population in the Upper Midwest. Methods The research was conducted at the Minnesota State Fair. Three previously validated scales were used to assess health literacy: Newest Vital Sign, the General Health Numeracy Test, and questions from Galesic and Garcia-Retamero’s Graph Literacy Scale. Demographic information—such as age, educational attainment, zip code, and other potential predictors and modifiers—was collected. Multivariate linear regression was conducted to examine the independent effects of educational attainment, race, ethnicity, gender, and rural or urban location on overall health literacy and scores on each of the individual instruments. Results A total of 353 Upper Midwest residents completed the survey, with the majority being white, college-educated, and from an urban area. Having a graduate or professional degree or being under the age of 21 were associated with increased health literacy scores, while having a high school diploma or some high school education, being Asian American, or being American Indian/Alaska Native were associated with lower health literacy scores. Conclusion Advanced health literacy skills, including the ability to calculate and compare information, were problematic even in well-educated populations. Understanding numerical and graphical information was found to be particularly difficult, and more research is needed to understand these deficits and how best to address them.
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Stewart DW, Reitzel LR, Correa-Fernández V, Cano MÁ, Adams CE, Cao Y, Li Y, Waters AJ, Wetter DW, Vidrine JI. Social support mediates the association of health literacy and depression among racially/ethnically diverse smokers with low socioeconomic status. J Behav Med 2014; 37:1169-79. [PMID: 25391450 DOI: 10.1007/s10865-014-9566-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 03/31/2014] [Indexed: 01/10/2023]
Abstract
Nearly half of U.S. adults have health literacy (HL) difficulties, and lack the ability to effectively obtain, process, and understand health information. Poor HL is associated with depression, yet mechanisms of this relation are unclear. This study examined whether social support mediated the relation between HL and depressive symptoms in 200 low-socioeconomic status (SES), racially/ethnically diverse smokers enrolled in cessation treatment. Mediation analyses were conducted using bootstrapping and controlling for SES and nicotine dependence. In simple mediation models, social support [Interpersonal Support Evaluation List (ISEL) total, subscales (Appraisal, Belonging, Tangible)] mediated the effect of HL on depression, such that lower HL was associated with lower perceived support, which predicted higher depressive symptoms (ps < .05). A multiple mediation model, with ISEL subscales entered simultaneously as mediators, was significant (p < .05) but only the Belonging subscale demonstrating independent significance (p < .05). Thus, social support may be a critical factor underlying the HL-depression relationship in low-SES, racially/ethnically diverse smokers.
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Affiliation(s)
- Diana W Stewart
- Department of Health Disparities Research, Unit 1440, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX, 77230-1402, USA,
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