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Herath T, Perera M, Kasturiratne A. Under-utilisation of noncommunicable disease screening and healthy lifestyle promotion centres: A cross-sectional study from Sri Lanka. PLoS One 2024; 19:e0301510. [PMID: 38574085 PMCID: PMC10994285 DOI: 10.1371/journal.pone.0301510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/15/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Healthy Lifestyle Centres (HLCs) are state-owned, free-of-charge facilities that screen for major noncommunicable disease risks and promote healthy lifestyles among adults older than 35 years in Sri Lanka. The key challenge to their effectiveness is their underutilisation. This study aimed to describe the underutilisation and determine the factors associated, as a precedent of a bigger project that designed and implemented an intervention for its improvement. METHODS Data derived from a community-based cross-sectional study conducted among 1727 adults (aged 35 to 65 years) recruited using a multi-stage cluster sampling method from two districts (Gampaha and Kalutara) in Sri Lanka. A prior qualitative study was used to identify potential factors to develop the questionnaire which is published separately. Data were obtained using an interviewer-administered questionnaire and analysed using inferential statistics. RESULTS Forty-two percent (n = 726, 95% CI: 39.7-44.4) had a satisfactory level of awareness on HLCs even though utilisation was only 11.3% (n = 195, 95% CI: 9.80-12.8). Utilisation was significantly associated with 14 factors. The five factors with the highest Odds Ratios (OR) were perceiving screening as useful (OR = 10.2, 95% CI: 4.04-23.4), perceiving as susceptible to NCDs (OR = 6.78, 95% CI: 2.79-16.42) and the presence of peer support for screening and a healthy lifestyle (OR = 3.12, 95% CI: 1.54-6.34), belonging to the second (OR = 3.69, 95% CI: 1.53-8.89) and third lowest (OR = 2.84, 95% CI: 1.02-7.94) household income categories and a higher level of knowledge on HLCs (OR = 1.31, 95% CI: 1.24-1.38). When considering non-utilisation, being a male (OR = 0.18, 95% CI: 0.05-0.52), belonging to an extended family (OR = 0.43, 95% CI: 0.21-0.88), residing within 1-2 km (OR = 0.29, 95% CI: 0.14-0.63) or more than 3 km of the HLC (OR = 0.14, 95% CI: 0.04-0.53), having a higher self-assessed health score (OR = 0.97, 95% CI: 0.95-0.99) and low perceived accessibility to HLCs (OR = 0.12, 95% CI: 0.04-0.36) were significantly associated. CONCLUSION In conclusion, underutilisation of HLCs is a result of multiple factors operating at different levels. Therefore, interventions aiming to improve HLC utilisation should be complex and multifaceted designs based on these factors rather than merely improving knowledge.
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Affiliation(s)
- Thilini Herath
- Faculty of Health-Care Sciences, Department of Primary Health Care, Eastern University, Batticaloa, Sri Lanka
| | - Manuja Perera
- Faculty of Medicine, Department of Public Health, University of Kelaniya, Ragama, Sri Lanka
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Wei B, Zhao J, Li J, Feng J, Sun M, Wang Z, Shi C, Yang K, Qin Y, Zhang J, Ma J, Dong H. Pathogenic germline variants in BRCA1 and TP53 increase lung cancer risk in Chinese. Cancer Med 2023; 12:21219-21228. [PMID: 37930190 PMCID: PMC10726856 DOI: 10.1002/cam4.6692] [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: 06/07/2023] [Revised: 10/07/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUD Multiple studies have identified pathogenic germline variants in cancer susceptibility genes (CSGs) in Chinese lung cancer patients; however, accurate assessment of these variants' contributions to cancer predisposition is always hampered by the absence of data on the prevalence of these variants in the general population. It is necessary to conduct a large-scale case-control study to identify CSGs that significantly increase the risk of lung cancer. MATERIALS AND METHODS We performed targeted sequencing of a CSGs panel in 1117 lung cancer patients and 16,327 controls from the general Chinese population. RESULTS In comparison to controls, lung cancer patients had a considerably higher prevalence of pathogenic and likely pathogenic (P/LP) variations. Among lung cancer patients, 72% of P/LP variants carriers did not have a family cancer history, who would be ignored if germline testing was only provided for patients meeting family history-based criteria. Furthermore, compared to individuals with late-onset lung cancer, patients with early-onset lung cancer had a considerably higher prevalence of P/LP variations. With odds ratios (ORs) ranging from 4-fold (BRCA1: OR, 4.193; 95%CI, 1.382-10.768) to 29-fold (TP53: OR, 29.281; 95%CI, 1.523-1705.506), P/LP variants in the BRCA1 and TP53 genes were discovered to be strongly related to increased lung cancer risk. Additionally, with ORs ranging from 7.322-fold to infinity, we discovered 23 variations previously categorized as non-P/LP variants were highly enriched in lung cancer patients. CONCLUSION Our findings indicated that P/LP variants in BRCA1 and TP53 conferred increased risk of lung cancer in Chinese.
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Affiliation(s)
- Bing Wei
- Department of Molecular Pathology, Henan Key Laboratory of Molecular PathologyThe Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalZhengzhouHenanChina
| | - Jiadong Zhao
- Nanjing Shenyou Institute of Genome ResearchNanjingJiangsuChina
| | - Jun Li
- Department of Molecular Pathology, Henan Key Laboratory of Molecular PathologyThe Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalZhengzhouHenanChina
| | - Junnan Feng
- Department of Molecular Pathology, Henan Key Laboratory of Molecular PathologyThe Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalZhengzhouHenanChina
| | - Manman Sun
- Nanjing Shenyou Institute of Genome ResearchNanjingJiangsuChina
| | - Zhizhong Wang
- Department of Molecular Pathology, Henan Key Laboratory of Molecular PathologyThe Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalZhengzhouHenanChina
| | - Chao Shi
- Department of Molecular Pathology, Henan Key Laboratory of Molecular PathologyThe Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalZhengzhouHenanChina
| | - Ke Yang
- Department of Molecular Pathology, Henan Key Laboratory of Molecular PathologyThe Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalZhengzhouHenanChina
| | - Yue Qin
- Nanjing Shenyou Institute of Genome ResearchNanjingJiangsuChina
| | - Jing Zhang
- Nanjing Shenyou Institute of Genome ResearchNanjingJiangsuChina
| | - Jie Ma
- Department of Molecular Pathology, Henan Key Laboratory of Molecular PathologyThe Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalZhengzhouHenanChina
| | - Hui Dong
- Department of Gastroenterology, Shanghai Key Laboratory of Pancreatic DiseasesShanghai General Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
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Ren W, Ma X, Tarimo CS, Xing Y, Lv X, Liang Z. A study on the current state and equity level of the health promotion service demands among older adults in China. Int J Equity Health 2023; 22:67. [PMID: 37055791 PMCID: PMC10103517 DOI: 10.1186/s12939-023-01882-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/04/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Meeting the demands of older adults for health promotion services (DOAHPS) is essential for maintaining their health and enhancing their quality of life. The purpose of this study was to construct a model for evaluating DOAHPS to quantitatively evaluate the current state and equity level of DOAHPS in China, as well as to explore the main factors affecting DOAHPS' current state and equity level. METHODS This study analyzed the DOAHPS data from the "Survey on Chinese Residents' Health Service Demands in the New Era", which included 1542 older adults aged 65 and older. Relationships between evaluation indicators of DOAHPS were explored using Structural Equation Modeling (SEM). The Weighted TOPSIS method and Logistic regression (LR) were used to analyze the current state and factors impacting DOAHPS. The equity level of DOAHPS' allocation among different older adult groups and its influencing factors were determined using the Rank Sum Ratio (RSR) method and T Theil index. RESULTS The evaluation score for DOAHPS was 42.57 ± 1.51. Health status, health literacy and behavior were positively correlated with DOAHPS (r = 0.40, 0.38; P < 0.05). The LR results revealed that the most significant determinants of DOAHPS were sex, residence, education level and pre-retirement occupation (all P < 0.05). The number of older adults with very poor, poor, general, high and very high level health promotion service demands accounted for 2.27%, 28.60%, 53.05%, 15.43% and 0.65%, respectively. The total T Theil index of DOAHPS was 2.7433*10-4, and the intra-group difference contribution rate exceeded 72%. CONCLUSIONS Compared to the maximum level, the total DOAHPS level was found to be moderate, although the demands of urban seniors with higher levels of education may be substantially greater. The observed inequities in the allocation of DOAHPS were primarily related to differences in education level and pre-retirement occupation within group. To better address health promotion services for older adults, policymakers could target older males with low education who reside in rural regions.
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Affiliation(s)
- Weicun Ren
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Xiwang Ma
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Clifford Silver Tarimo
- College of Public Health, Zhengzhou University, Zhengzhou, China
- Department of Science and Laboratory Technology, Dares Salaam Institute of Technology, Dares Salaam, Tanzania
| | - Yiqing Xing
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Xinyuan Lv
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Zhang Liang
- School of Political Science and Public Administration, Wuhan University, Wuhan, China.
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AbdulRaheem Y. Unveiling the Significance and Challenges of Integrating Prevention Levels in Healthcare Practice. J Prim Care Community Health 2023; 14:21501319231186500. [PMID: 37449436 PMCID: PMC10350749 DOI: 10.1177/21501319231186500] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
In recent years, there has been a global increase in human life expectancy, but preventable morbidity and mortality remain significant concerns. To address these issues, preventive healthcare practice has gained importance in various healthcare disciplines. Its goal is to maintain and promote health, reduce risk factors, diagnose illnesses early, and prevent complications. This approach encompasses different stages of disease progression, including primordial prevention, primary prevention, secondary prevention, tertiary prevention, and quaternary prevention. Primordial prevention focuses on addressing root causes and social determinants of diseases to prevent the emergence and development of risk factors. Primary prevention aims to prevent diseases before they occur by implementing interventions such as vaccinations and health education. Secondary prevention focuses on early detection and prompt intervention to prevent the progression of diseases. Tertiary prevention manages the consequences of diseases by restoring health and providing rehabilitation. Lastly, quaternary prevention aims to protect patients from unnecessary medical interventions and harm caused by excessive medicalization. Despite the recognition of the cost-effectiveness of preventive measures, a significant portion of healthcare resources and attention is still allocated to disease management, and only a small percentage of individuals receive all recommended preventive services. Healthcare providers need to prioritize the implementation of preventive care services, even when clinical interventions are necessary, and overcome barriers to preventive care. By investing in preventive care and implementing these strategies, healthcare practitioners can play a crucial role in disease prevention and contribute to the well-being of individuals, families, communities, and countries.
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Severino R, Espinoza M, Cabieses B. Health-related quality of life by household income in Chile: a concentration index decomposition analysis. Int J Equity Health 2022; 21:176. [PMID: 36514033 PMCID: PMC9749309 DOI: 10.1186/s12939-022-01770-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/29/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Health inequities have a profound impact on all dimensions of people's lives, with invariably worse results among the most disadvantaged, transforming them into a more fragile and vulnerable population. These unfair inequalities also affect dimensions focused on subjectivity, such as health-related quality of life (HRQoL), which has been positioned, in recent decades, as an important outcome in health decision-making. The main objective of this study is to estimate socioeconomic inequality in HRQoL of Chilean by household income. METHODS: Secondary analysis of the National Health Survey (ENS 2016-2017, Chile). This survey includes a nationally representative, stratified, and multistage household sample of people aged 15 and above. Socioeconomic inequality in HRQoL (EQ5D) is estimated by the concentration index (CI) ranked by household income. Decomposition analysis is conducted to examine potential explanatory sociodemographic factors. RESULTS: The CI for household income inequality in HRQoL was -0.063. The lower the household income, the worse the HRQoL reported by in Chile. The decomposition analysis revealed that socioeconomic position contributes 75,7% to inequality in the quality of life, followed by educational level (21.8%), female gender (17.3%), and type of Health Insurance (15%), age (-19.7%) and residence (-10.8%). Less than 1% corresponds to the unexplained residual component. CONCLUSIONS Our findings suggest the existence of a disproportionate concentration of worse HRQoL in the most disadvantaged socioeconomic groups in Chile. This inequality is largely, yet not completely, associated with household income. Other significant factors associated with this inequality are education, gender, and healthcare insurance. These results suggest the need of strengthening efforts to reducing socioeconomic gaps in health outcomes in Chile, as a means to achieve social justice and equity in health and healthcare.
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Affiliation(s)
- Rodrigo Severino
- grid.7870.80000 0001 2157 0406Unidad de Evaluación de Tecnologías en Salud, Centro de Investigación Clínica, Pontificia Universidad Católica de Chile, Facultad de Medicina, Santiago, Chile
| | - Manuel Espinoza
- grid.7870.80000 0001 2157 0406Unidad de Evaluación de Tecnologías en Salud, Centro de Investigación Clínica, Pontificia Universidad Católica de Chile, Facultad de Medicina, Santiago, Chile ,grid.7870.80000 0001 2157 0406Department of Public Health, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Piso 2, Santiago, Chile
| | - Báltica Cabieses
- grid.412187.90000 0000 9631 4901Instituto de Ciencias E Innovación en Medicina (ICIM), Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
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Reynoso-Noverón N, Chang S, Herrera-Montalvo LA, Meneses-García A. Cancer Prevention Behaviors in Workers of a Referral Cancer Center in Mexico City: A Pilot Study on Early Detection Awareness for Cancer. Cancer Control 2022; 29:10732748221133625. [PMID: 36219671 PMCID: PMC9557829 DOI: 10.1177/10732748221133625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Prevention strategies for cancer are necessary. Health workers who often
serve as role models bear responsibility for prevention counseling and
programs. However, whether their habits and behaviors reflect prevention
goals are unknown. We describe the prevalence of cancer risk factors and
prevention behaviors in health workers of a referral cancer center in Mexico
City. Methods Cross-sectional study in which workers of the National Cancer Institute were
invited to participate in a prevention program, risk factor survey, and
nutrition, psychological, and genetic counseling were included. The
likelihood of cancer was calculated based on the presence of risk factors.
Factors associated with prevention behaviors were identified by logistic
regression. Results We recruited 301 workers; 77% were women. The median self-reported BMI was
26.4 kg/m2, 9.97% smoked, 78% drank alcohol, and 89% did not
get at least 150 min/week of physical activity. In women, age (OR = 1.3
95%CI 1.01-1.06) and physical activity of 150 min/week (OR = 2.52 95% CI
1.28-4.96) were associated with cancer prevention behaviors. No risk factors
were associated with healthy behaviors among men. Conclusion Health workers may have unhealthy lifestyles and behaviors, is essential to
create supportive environments to promote cancer prevention counseling and
programs effectively.
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Affiliation(s)
- Nancy Reynoso-Noverón
- Researcher in Medical Science,
Prevention Research Center and Research Direction,
Instituto
Nacional de Cancerología, Ciudad de
Mexico, Mexico,Nancy Reynoso-Noverón, Researcher in
Medical Science, Prevention Research Center and Research Direction, Instituto
Nacional de Cancerología, Belisario Domínguez¸ Tlalpan, Ciudad de Mexico 14080,
Mexico.
| | - Shine Chang
- Department of Epidemiology,
Division of Cancer Prevention and Population Sciences,
The University
of Texas MD Anderson Cancer Center,
Houston, USA
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Pathak R, Kang D, Lu Y, Mansuri F, Kasen S, Deng Y, Chen H. Should we abandon annual physical examination? - A meta-analysis of annual physical examination and all-cause mortality in adults based on observational studies. Prev Med 2022; 161:107130. [PMID: 35787845 DOI: 10.1016/j.ypmed.2022.107130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/16/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022]
Abstract
Several meta-analyses based on randomized clinical trials data have failed to find an association between the annual physical examination (APE) and reduced mortality; however, no comparable meta-analysis based on observational data exists. We conducted a meta-analysis of observational studies comparing APE versus non-APE in adults for all-cause mortality. English-language searches of four databases (PubMed, CINAHL, EMBASE, and Google Scholar) between the years 2000 to 2019 yielded seven observational studies that investigated APE versus non-APE in healthy adults in relation to all-cause mortality. Random effects models were used to calculate pooled hazard ratios and 95% confidence intervals (CI), and to incorporate variation between studies. During follow-up periods that ranged from two to 25 years, there were 35,055 deaths among 633,957 participants. APE was significantly associated with a 45% lower hazard of all-cause mortality, with pooled hazard ratio of 0.55 (95% CI 0.48 to 0.64, P < 0.01) for all participants. This meta-analysis of seven observational studies in the past 20 years provides evidence of an association between APE and a lower hazard of all-cause mortality, a finding that contrasts with findings based on meta-analyses of randomized clinical trials data. Nonetheless, at present the evidence available about the effectiveness or ineffectiveness of APE on all-cause mortality still needs further study.
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Affiliation(s)
- Rashmi Pathak
- Study Design and Data Analysis Center, College of Public Health, University of South Florida, USA; University of Oklahoma Health Science Center, USA
| | - Di Kang
- Study Design and Data Analysis Center, College of Public Health, University of South Florida, USA; Department of Bioinformatics and Biostatistics, The Moffitt Cancer Center & Research Institute, USA
| | - Yuanyuan Lu
- Study Design and Data Analysis Center, College of Public Health, University of South Florida, USA
| | - Fahad Mansuri
- Study Design and Data Analysis Center, College of Public Health, University of South Florida, USA
| | - Stephanie Kasen
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA
| | - Yunlong Deng
- The 3(rd) Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Henian Chen
- Study Design and Data Analysis Center, College of Public Health, University of South Florida, USA.
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Agrawal S, Makuch S, Lachowicz G, Dróżdż M, Dudek K, Mazur G. How Sociodemographic Factors Impact the Utilization of Recommended Clinical Preventive Screening Services in Poland: A Nationwide Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413225. [PMID: 34948831 PMCID: PMC8701877 DOI: 10.3390/ijerph182413225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/30/2021] [Accepted: 12/13/2021] [Indexed: 12/03/2022]
Abstract
Cardiovascular disease (CVD) and cancer are the most frequent causes of mortality in Poland. To date, no study in Poland has attempted to analyze the impact of sociodemographic factors on the utilization of all recommended preventive services for these diseases. To address this challenge, a nationwide cross-sectional study was conducted. One thousand adults aged 18 years or older were interviewed using computer-assisted telephone surveys conducted via random selection. A representative population was obtained in accordance with existing demographics per voivodeship in Poland. We assessed whether factors such as age, gender, body mass index (BMI), net income, household size, place of residence, and education impacted the odds ratio of utilizing recommended preventive services for CVD and cancer. We determined that elderly patients receive influenza vaccination, measure blood pressure, PSA concentration, glucose and lipid profiles, and undergo colonoscopy and mammography more often than younger counterparts. Men were more often influenza vaccinated (OR = 1.56, 95% CI: 1.07–2.27) than women, while women measured blood glucose more often than men (OR = 0.62, 95% CI: 0.42–0.93). Furthermore, net income < 2000 PLN, BMI < 24 kg/m2 and at least secondary education level were found to be crucial predictors of undergoing mammography (OR = 2.16; 95% CI: 1.26–3.72), cervical smear tests (OR = 1.99, 95% CI: 1.24–3.17), and lipid measurements (OR = 1.76, 95% CI: 1.07–2.91), respectively. Educating people and financial support seem to play a crucial role in implementing novel campaigns and preventive programs in Poland. Addressing each significant factor may be of paramount importance in improving the receipt of preventive services and warranting greater preventive care coverage in the Polish population.
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Affiliation(s)
- Siddarth Agrawal
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska St. 213, 50-556 Wrocław, Poland; (G.L.); (G.M.)
- Correspondence: ; Tel.: +48-71-736-40-00; Fax: +48-71-736-40-09
| | - Sebastian Makuch
- Department of Clinical and Experimental Pathology, Wroclaw Medical University, St. K. Marcinkowskiego 1, 50-368 Wrocław, Poland;
| | - Gabriella Lachowicz
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska St. 213, 50-556 Wrocław, Poland; (G.L.); (G.M.)
| | - Mateusz Dróżdż
- Faculty of Medicine, Wroclaw Medical University, J. Mikulicza-Radeckiego 5, 50-345 Wrocław, Poland;
| | - Krzysztof Dudek
- Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, St. I. Łukasiewicza 5, 50-371 Wrocław, Poland;
| | - Grzegorz Mazur
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska St. 213, 50-556 Wrocław, Poland; (G.L.); (G.M.)
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Obi IR, Obi KM, Seer-Uke EN, Onuorah SI, Okafor NP. Preventive health care services utilization and its associated factors among older adults in rural communities in Anambra State, Nigeria. Pan Afr Med J 2021; 39:83. [PMID: 34466185 PMCID: PMC8379407 DOI: 10.11604/pamj.2021.39.83.26997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 05/15/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction quality of life and life expectancy of people are improved when preventive health care services are utilized because these identify treatable health problems and puts life-threatening diseases in check. Morbidity and mortality associated with age-related chronic disease among the older adults is on the increase, therefore, this study aims at determining preventive health care services utilization among older adults in rural communities in Anambra State. Methods a cross sectional design adopted for this study was carried out on older adults from the ages of 65 years and above in rural communities in Anambra State from October 2019 to January 2020. Data were collected through researcher-administered structured questionnaire. Data were analysed using univariable and multivariable regression analysis. Results a total of 1944 older adults participated with an overall cluster percentage of 40.6% older adults utilizing investigated preventive health care services. The results of the multivariable analysis indicates that the following factors were associated with utilization of preventive healthcare services: male gender (aOR: 0.443, 95%CI: 0.281 - 5.472, p=0.47), level of education; primary (aOR: 1.536, 95%CI: 1.201 - 5.261, p=0.00), secondary (aOR: 4.516, 95%CI: 3.192 - 6.242, p=0.00), and tertiary (aOR: 3.407, 95%CI: 3.199 - 5.666, p=0.00)], income of N50,000-N100,000 (aOR: 2.754, 95%CI: 1.066 - 10.766, p=0.01), and N100,000 and above (aOR: 4.233, 95%CI: 1.846 - 12.811, p=0.00)], and health insurance [aOR: 0.691, 95%CI: 0.422 - 1.945, p=0.03]. Conclusion preventive health care services were under-utilized. Creating awareness on the importance of utilizing preventive health care services is highly recommended since most age-related chronic diseases once established may last a lifetime and affect quality of life and wellbeing.
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Affiliation(s)
- Ifunanya Rosemary Obi
- Department of Physical and Health Education, Federal College of Education (Technical), Umunze, Nigeria
| | | | | | | | - Nonye Peculiar Okafor
- Department of Human Kinetics and Sports Studies, Alvan Ikoku College of Education, Owerri, Nigeria
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Chu CL, Lawana N. Decomposition of income-related inequality in health check-ups services participation among elderly individuals across the 2008 financial crisis in Taiwan. PLoS One 2021; 16:e0252942. [PMID: 34111198 PMCID: PMC8192017 DOI: 10.1371/journal.pone.0252942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 05/26/2021] [Indexed: 11/19/2022] Open
Abstract
Encouraging citizens to use health checkup services is a health promotion strategy. In nations with aging populations, ensuring equitable use of health check-ups by senior citizens is a public health concern. The objective of this research was to quantify income-related inequality and its effect on the use of health checkup services in Taiwan during the 2007-2008 global financial crisis. We used the 2005 and 2009 datasets of the Taiwan National Health Interview Surveys to assess how income-related inequality influenced health check-up use among older adults in Taiwan during the 2007-2008 financial crisis. Corrected concentration indices (CCIs) were calculated and decomposed to determine the influences of explanatory variables. The dependent variable was whether participants had used free senior health check-ups in the past year, and the determinant factors were health behavior, health situation, socioeconomic and demographic factors, and area health care resources accessibility factors. The study assessed 2,460 older adults from the 2005 dataset and 2,514 such individuals from the 2009 dataset. The utilization of health check-ups increased from 21.6% in 2005 to 34.0% in 2009. Income-related inequality in the use of health check-up services was generally tilted toward the higher income individuals among both women and men in 2005 and 2009, and income-related inequality decreased among women group and increased among men group with non significantly from 2005 to 2009 (women: CCI decreased from.0738 in 2005 to.0658 in 2009; men: CCI increased from.1068 in 2005 to.1256 in 2009). We analyzed the effect of explanatory factors on men's and women's intention to use health check-ups by using a probit model. After controlling for other factors, we determined that income significantly influenced women's health check-up service use in 2005 and men's in 2005 and 2009. Positive health behavior significantly increased health check-up services use among men and women group after the financial crisis, and negative health behavior significantly reduced health check-ups use among men across financial crisis. The 2008 global financial crisis strengthened the effect on health check-ups use of income-related inequality of elderly men, especially in older adults with negative health behaviors. Elderly men with negative health behaviors tended to contribute more income-related inequality in use health check-up services after the financial crisis. Health promotion initiatives should focus their efforts on elderly men with negative health behaviors.
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Affiliation(s)
- Chiao-Lee Chu
- Department of Long Term Care, National Quemoy University, Kimmen County, Taiwan
| | - Nozuko Lawana
- Social Policy, Knowledge Mobilization and Impact Assessment (SoKIA), Human Science Research Council (HSRC), Pretoria, South Africa
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Gender Differences on Psychosocial Factors Affecting COVID-19 Preventive Behaviors. SUSTAINABILITY 2021. [DOI: 10.3390/su13116148] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Previous studies have reported differences between men and women in the adoption of preventive behaviors against infectious diseases. This study aims to examine gender differences on a set of psychosocial factors shown to influence preventive behaviors against infectious diseases such as COVID-19. We conducted a web survey (N = 1.004) a few weeks after the end of the peak of the first wave of infections in Chile. The survey assessed participants’ perception of risk and worry about the COVID-19 pandemic, confidence in the government’s competence and integrity in dealing with the crisis, attribution of responsibility to various stakeholders, and adoption of preventive behaviors such as hygiene, distancing, and information-seeking. Our results confirm significant gender-based differences for both the psychosocial factors and the adoption of preventive behaviors. We conclude that women show a higher level of worry and fear of the pandemic and are keener to adopt preventive hygiene and social distancing behaviors. Similarly, participants report a low level of trust in government authorities, with women reporting the lowest trust level. The implications of these findings for the design of future risk communication strategies are discussed.
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Mehndiratta A, Mishra SC, Bhandarkar P, Chhatbar K, Cluzeau F, PrimaryCareDoctors T. Increasing identification of foot at risk of complications in patients with diabetes: a quality improvement project in an urban primary health centre in India. BMJ Open Qual 2020; 9:bmjoq-2019-000893. [PMID: 32764027 PMCID: PMC7412605 DOI: 10.1136/bmjoq-2019-000893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 06/12/2020] [Accepted: 06/22/2020] [Indexed: 11/04/2022] Open
Abstract
The majority of foot amputations are preventable in people with diabetes. Guidelines recommend that people with diabetes should receive a foot examination for risk assessment, at least annually. In an audit at a primary health centre (PHC) in Mumbai, India, no patient with diabetes was offered preventive foot assessment in preceding 12 months. Problem analysis identified a lack of clinic policy, training and equipment for foot assessment. There was no standardised referral pathway for patients identified with foot at risk of diabetes complications. Furthermore, limited data review, high patient volumes and little time available with healthcare providers were important constraints. A quality improvement project was carried out at the PHC from January to September 2017. The project aimed at increasing compliance to standardised foot assessment in patients with diabetes presenting to the PHC from a baseline of 0% to 100% over 6 months. This would help identify patients having a foot at risk of complications due to diabetes. The Quality Standard on foot assessment was adopted from the Ministry of Health and Family Welfare Diabetic Foot Guideline. The electronic medical record (EMR) was standardised, health providers were trained, PHC processes and referral pathways were redesigned. Plan-Do-Study-Act was used to address barriers with weekly data review. 88.2% (848) of patients with diabetes visiting the PHC during the study period received a foot examination. Out of these, 11% (95) were identified to have a foot at risk and referred to a specialist foot centre. 57% of referred patients followed with specialised foot protection services. Training of healthcare providers, standardisation of processes and regular data feedback can improve diabetic foot care. Integrating quality indicators in the EMR helps monitor compliance. The inability to use doctor's time efficiently was the biggest challenge and sustaining the change will require organisational changes with suitable task shifting.
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Affiliation(s)
- Abha Mehndiratta
- Global Health and Development Group, Imperial College London, London, UK
| | - Satish Chandra Mishra
- Department of Surgery, WHO Collaboration Centre for Research in Surgical Care Delivery in LMIC, Bhabha Atomic Research Centre Hospital, Mumbai, India
| | - Prashant Bhandarkar
- Department of Surgery, WHO Collaboration Centre for Research in Surgical Care Delivery in LMIC, BARC Hospital, Bhabha Atomic Research Centre Hospital, Mumbai, India
| | - Kunal Chhatbar
- Department of Surgery, WHO Collaboration Centre for Research in Surgical Care Delivery in LMIC, BARC Hospital, Bhabha Atomic Research Centre Hospital, Mumbai, India
| | - Francoise Cluzeau
- Global Health and Development Group, Imperial College London, London, UK
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