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Boursaw B, FitzGerald CA, Taylor LM, Landrau-Cribbs E, Caswell L, Cruz TH. Improving Health and Reducing Chronic Disease Disparities with Latinx Communities: Evaluating the Role of Documented Community-Based Intervention Participation. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02078-x. [PMID: 38969922 DOI: 10.1007/s40615-024-02078-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: 04/29/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/07/2024]
Abstract
PURPOSE Limited evidence exists on the impact of participation in community-based chronic disease self-management and prevention programs on health disparities. The purpose of this research was to determine the effects of participation in the Healthy Here Wellness Referral System on existing disparities in glycated hemoglobin (HbA1c), systolic blood pressure (BP), and diastolic BP among Hispanic/Latinx adults compared with non-Hispanic White adults. METHODS We merged administrative clinical and referral data from 2018 through 2022 for adult patients in six focus ZIP codes in New Mexico resulting in a sample of 1331 patients and used regression models to examine predictors of intervention participation as well as propensity-adjusted impacts of participation on HbA1c and BP outcomes. RESULTS Non-Hispanic White patients who were referred to community-based programming but did not participate saw statistically significant increases in HbA1c. Hispanic/Latinx patients saw statistically significant decreases in HbA1c with referral alone, with no added benefit from program participation. The impact of participation differed statistically significantly (t(683) = 3.55, p < .001) between these two groups for HbA1c levels, as well as for systolic (t(958) = 2.11, p = .04) and diastolic BP outcomes (t(958) = 2.96, p = .003). CONCLUSIONS Results of this study support the promise of using centralized referral systems to co-produce health improvement in community settings. Mixed findings highlight the need for further uptake of theory-informed measurement in evaluations seeking to understand heterogeneous program impacts by race and ethnicity.
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Affiliation(s)
- Blake Boursaw
- Transdisciplinary Research, Equity and Engagement (TREE) Center, College of Population Health, University of New Mexico, Albuquerque, NM, USA
| | - Courtney A FitzGerald
- Prevention Research Center, Department of Pediatrics, School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Lisa M Taylor
- College of Nursing, University of New Mexico, Albuquerque, NM, USA
| | - Erica Landrau-Cribbs
- Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, NM, USA
| | - Leigh Caswell
- Community and Health Equity, Presbyterian Healthcare Services, Albuquerque, NM, USA
| | - Theresa H Cruz
- Prevention Research Center, Department of Pediatrics, School of Medicine, University of New Mexico, Albuquerque, NM, USA.
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Wei X, Xu M, Yang L, Gao Z, Kuang J, Zhou K. Determinants Influencing Health-Promoting Behaviors in Individuals at High Risk of Stroke: A Cross-Sectional Study. HEALTH EDUCATION & BEHAVIOR 2024; 51:457-466. [PMID: 36960724 DOI: 10.1177/10901981231160149] [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] [Indexed: 03/25/2023]
Abstract
BACKGROUND Health-promoting behaviors and positive lifestyle changes are crucial for effective stroke prevention. However, individuals at high risk of stroke exhibit poor health behavior due to a deficiency of individual motivation. Moreover, there are only a few studies on health-promoting behaviors that have applied behavior change theories in individuals at high risk of stroke. OBJECTIVE This study aimed to use the theory of the planned behavior (TPB) model to investigate determinants of health-promoting behaviors for stroke prevention and control. METHOD In this cross-sectional study, 263 participants were recruited from five community health centers in Qingdao. Confirmatory factor analysis was performed to assess the reliability and validity of the constructs, and structural equation modeling was used to analyze the proposed relationships between the TPB-related variables. RESULTS The attitudes, subjective norms, and perceptions of behavioral control positively influenced behavioral intention. The behavioral intention had a positive effect on health-promoting behaviors. Attitudes, subjective norms, and perceived behavioral control were influenced primarily by the mediating variable behavioral intention to affect health-promoting behaviors. Stroke knowledge was an influential facilitator of behavioral attitudes, subjective norms, and perceived behavior control. CONCLUSION The TPB-based model is suitable for explaining health-promoting behaviors in individuals at risk of stroke and for guiding the development of effective health management programs. A comprehensive person-centered motivation behavior strategy that is based on health education and complemented by social support and health resource optimization is critical in promoting health behavior motivation and health promotion behaviors in stroke high-risk groups.
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Affiliation(s)
- Xiao Wei
- Qingdao University, Qingdao, China
| | | | - Li Yang
- Qingdao University, Qingdao, China
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Salandi J, Hayden MC, Heinrichs K, Limbach M, Schultz K, Schwarzl G, Neumeister W, Loerbroks A. Can an educational intervention in the context of inpatient pulmonary rehabilitation improve asthma self-management at work? A study protocol of a randomized controlled trial. BMC Pulm Med 2024; 24:40. [PMID: 38233800 PMCID: PMC10795332 DOI: 10.1186/s12890-024-02847-8] [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: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Asthma self-management (e.g., trigger avoidance or correct medication use) is a cornerstone of therapy. Its successful implementation in everyday working life is determined by psychosocial working conditions, in particular by support from superiors and colleagues and the job decision latitude (i.e., when and how to carry out which tasks). To empower individuals with asthma to modify their working conditions, employees need to use certain communication skills and acquire specific knowledge. Both could be taught as part of patient education during pulmonary rehabilitation. Therefore, the aim of the planned study is the development and multicentre implementation of an education module for individuals with asthma during their rehabilitation and to generate evidence on its effectiveness. METHODS Participants (n ≥ 180) will be recruited, randomized into an intervention and a control group, trained and surveyed in two rehabilitation clinics. The intervention group will receive the supplementary patient education module "Asthma and Work" while the control group will participate in a program on " Eating behaviour" (both 2 × 50 min). The effectiveness of the intervention will be examined based on pre-post measurements (T1 and T2) and a 3-month follow-up (T3). We will consider behavioural intention (T2) and asthma self-management at work (T3) as primary outcomes. Secondary outcomes will include self-management-related knowledge, self-efficacy, number of sick days, number of exacerbations, asthma control (Asthma Control Test), asthma-related quality of life (Marks Asthma Quality of Life Questionnaire), and subjective employment prognosis (Brief Scale Measuring the Subjective Prognosis of Gainful Employment). The pre-post comparisons are to be evaluated using univariate analyses of covariance. DISCUSSION Improving asthma self-management at work could increase the work ability and social participation of employees with asthma. This could reduce costs, e.g. in terms of asthma-related sick leave. TRIAL REGISTRATION German Clinical Trials Register (ID: DRKS00031843).
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Affiliation(s)
- Julia Salandi
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany.
| | - Markus C Hayden
- Clinic Bad Reichenhall, Centre for Rehabilitation, Pneumology and Orthopaedics, Bad Reichenhall, Germany
| | - Katherina Heinrichs
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Limbach
- Clinic Bad Reichenhall, Centre for Rehabilitation, Pneumology and Orthopaedics, Bad Reichenhall, Germany
| | - Konrad Schultz
- Clinic Bad Reichenhall, Centre for Rehabilitation, Pneumology and Orthopaedics, Bad Reichenhall, Germany
| | - Gabriele Schwarzl
- Clinic Bad Reichenhall, Centre for Rehabilitation, Pneumology and Orthopaedics, Bad Reichenhall, Germany
| | | | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
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Gerdes SMB, Ekelund CK, Rode L, Miltoft CB, Midtgaard J, Jørgensen FS, Pihl K, Tabor A, Riishede I. Motivation towards first trimester screening for preeclampsia among pregnant women in Denmark: A cross-sectional questionnaire study. Acta Obstet Gynecol Scand 2023; 102:1531-1540. [PMID: 37533170 PMCID: PMC10577627 DOI: 10.1111/aogs.14632] [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: 02/16/2023] [Revised: 05/16/2023] [Accepted: 06/20/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION The aim of this cross-sectional questionnaire study was to investigate motivation to participate in a possible new screening for preeclampsia in the first trimester of pregnancy among Danish pregnant women through a questionnaire based on Theory of Planned Behavior developed for this specific purpose. The new screening combines maternal characteristics with mean arterial pressure, uterine artery pulsatility index and biochemical markers to predict the risk of preeclampsia, whereas the current Danish screening uses maternal characteristics alone. MATERIAL AND METHODS Participation was offered to a proportion of women attending a first or a second trimester screening scan at two University Hospitals in Copenhagen. The questionnaire was set up in REDCap® and answers were entered directly into the database, which was accessed via a QR-code. RESULTS We invited 772 pregnant women to participate in the questionnaire survey between November 2021 and April 2022 at Copenhagen University Hospital Rigshospitalet (study site one) (n = 238) and Copenhagen University Hospital Hvidovre (study site two) (n = 534). The response rate was 71.8% (171/238) at study site one and 33.9% (181/534) at study site two. A total of 352 women were included in the study (total participation rate 45.6%). Most women had a positive attitude towards preeclampsia screening in pregnancy, and 99.4% said they would participate in a risk assessment for preeclampsia if given the opportunity. A total of 97.4% answered "yes" to whether a first trimester preeclampsia screening should be offered to all pregnant women in Denmark. Positive motivation to participate in preeclampsia screening was correlated with having a network with a positive attitude towards preeclampsia screening. CONCLUSIONS The results of this study indicate that Danish pregnant women have a positive attitude towards participation in a first trimester screening for preeclampsia. This observation might be useful in relation to possible future implementation in Denmark.
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Affiliation(s)
- Sandra Maria Behnke Gerdes
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Charlotte Kvist Ekelund
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Center of Fetal Medicine, Department of ObstetricsCopenhagen University Hospital RigshospitaletCopenhagenDenmark
| | - Line Rode
- Center of Fetal Medicine, Department of ObstetricsCopenhagen University Hospital RigshospitaletCopenhagenDenmark
- Department of Clinical BiochemistryCopenhagen University Hospital RigshospitaletGlostrupDenmark
| | - Caroline Borregaard Miltoft
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Center of Fetal Medicine, Department of ObstetricsCopenhagen University Hospital RigshospitaletCopenhagenDenmark
| | - Julie Midtgaard
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Center for Applied Research in Mental Health Care (CARMEN)Mental Health Center GlostrupGlostrupDenmark
| | - Finn Stener Jørgensen
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Fetal Medicine Unit, Department of Obstetrics and GynecologyCopenhagen University Hospital HvidovreHvidovreDenmark
| | - Kasper Pihl
- Fetal Medicine Unit, Department of Obstetrics and GynecologyCopenhagen University Hospital HvidovreHvidovreDenmark
| | - Ann Tabor
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Center of Fetal Medicine, Department of ObstetricsCopenhagen University Hospital RigshospitaletCopenhagenDenmark
| | - Iben Riishede
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Center of Fetal Medicine, Department of ObstetricsCopenhagen University Hospital RigshospitaletCopenhagenDenmark
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Kgasi M, Chimbo B, Motsi L. mHealth Self-Monitoring Model for Medicine Adherence of Patients With Diabetes in Resource-Limited Countries: Structural Equation Modeling Approach. JMIR Form Res 2023; 7:e49407. [PMID: 37870902 PMCID: PMC10628689 DOI: 10.2196/49407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to serious challenges and emphasized the importance of using technology for health care operational transformation. Consequently, the need for technological innovations has increased, thus empowering patients with chronic conditions to tighten their adherence to medical prescriptions. OBJECTIVE This study aimed to develop a model for a mobile health (mHealth) self-monitoring system for patients with diabetes in rural communities within resource-limited countries. The developed model could be based on the implementation of a system for the self-monitoring of patients with diabetes to increase medical adherence. METHODS This study followed a quantitative approach, in which data were collected from health care providers using a questionnaire with close-ended questions. Data were collected from district hospitals in 3 South African provinces that were selected based on the prevalence rates of diabetes and the number of patients with diabetes treated. The collected data were analyzed using smart partial least squares to validate the model and test the suggested hypotheses. RESULTS Using variance-based structural equation modeling that leverages smart partial least squares, the analysis indicated that environmental factors significantly influence all the independent constructs that inform patients' change of behavior toward the use of mHealth for self-monitoring of medication adherence. Technology characteristics such as effort expectancy, self-efficacy, and performance expectancy were equally significant; hence, their hypotheses were accepted. In contrast, the contributions of culture and social aspects were found to be insignificant, and their hypotheses were rejected. In addition, an analysis was conducted to determine the interaction effects of the moderating variables on the independent constructs. The results indicated that with the exception of cultural and social influences, there were significant interacting effects on other independent constructs influencing mHealth use for self-monitoring. CONCLUSIONS On the basis of the findings of this study, we conclude that behavioral changes are essential for the self-monitoring of chronic diseases. Therefore, it is important to enhance those effects that stimulate the behavior to change toward the use of mHealth for self-monitoring. Motivational aspects were also found to be highly significant as they triggered changes in behavior. The developed model can be used to extend the research on the self-monitoring of patients with chronic conditions. Moreover, the model will be used as a basic architecture for the implementation of fully fledged systems for self-monitoring of patients with diabetes.
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Affiliation(s)
- Mmamolefe Kgasi
- Faculty of ICT, Tshwane University of Technology, Pretoria, South Africa
- School of Computing, University of South Africa, Johannesburg, South Africa
| | - Bester Chimbo
- School of Computing, University of South Africa, Johannesburg, South Africa
| | - Lovemore Motsi
- School of Computing, University of South Africa, Johannesburg, South Africa
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Oni TO, Adebowale SA, Afolabi AA, Akinyemi AI, Banjo OO. Perceived health facility-related barriers and post-abortion care-seeking intention among women of reproductive age in Osun state, Nigeria. BMC Womens Health 2023; 23:311. [PMID: 37328732 PMCID: PMC10273618 DOI: 10.1186/s12905-023-02464-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/07/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Post-abortion care (PAC) prevents death and complications caused by unsafe abortion which is widespread in Nigeria. Yet, there is sparse community-based evidence on women's intention to seek PAC should they have an abortion. This study examined the influence of perceived health facility-related barriers (HFRB) on post-abortion care-seeking intention (PACSI) among women of reproductive ages in Osun state, Nigeria. METHODS The study focused on women in a sexual relationship and who were residents of Osun state. A community-based survey was implemented using a multi-stage sampling technique. The calculated sample size (with attrition) was 1200 and data were collected from women aged 15-49 years, using open data kit (ODK). However, 1,065 complete responses were received on the ODK server, indicating an 88.8% response rate. Models were estimated using ordered logistic regression (Ologit) (α0.05) and data analysis was performed using Stata 14.0. RESULTS Mean age of the women was 29.3±7.6 years and 34.01% had the intention to seek PAC in health facilities. Lack of service confidentiality and unavailability of equipment specific to abortion were the two most reported barriers that would prevent women from seeking PAC. The adjusted Ologit model showed that respondents with perceived low HFRB had higher odds (aOR=1.60; CI=1.12-2.11) of seeking PAC in the health facility. Also, women who were employed and skilled were more likely (aOR=1.51; CI=1.13-2.01) while women who had PAC support from spouses/partners had higher odds of healthy PACSI (aOR=2.03; CI=1.48-2.78). Other identified predictors of PAC seeking intention included level of education, employment status, and spousal/partner support. CONCLUSION Perceived lack of trust in service provision and necessary equipment specific to abortion care had a negative influence on women's PACSI in Osun state. Reassuring health interventions that focus on improving the public perception of healthcare services and confidence to use the facility will likely improve the patronage of health facility for post-abortion care in Osun sate.
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Affiliation(s)
- Tosin Olajide Oni
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Stephen Ayo Adebowale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
- Population and Health Research Entity, North-West University, Mafikeng, South Africa
| | - Anuoluwapo Adeyimika Afolabi
- Department of Community Medicine, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Akanni Ibukun Akinyemi
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
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Du M, Kong H, Ran L, Ran Y, Bai L, Du Y, Guan H, Dong Y, Zhao Y. Associations among health-promoting lifestyle, self-care agency and health-related quality of life in Bai older adults with hypertension in Yunnan China. BMC Geriatr 2022; 22:942. [PMID: 36476421 PMCID: PMC9730677 DOI: 10.1186/s12877-022-03608-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous Chinese studies focused on the prevalence and influential factors of hypertension; however, little is known about their self-care literacy and quality of life among the Bai older adults with hypertension. The purpose of this research was to explore the associations among health-promoting lifestyle, self-care agency, and health-related quality of life in Bai ethnic older patients with hypertension, as well as the related factors of hypertension self-care abilities. METHODS A total of 472 Bai ethnic hypertension older adults aged 60 and above were enrolled in this study voluntarily from 5 rural communities of the Bai ethnic group. The Exercise of Self-Care Agency Scale (ESCAS) was employed to assess the Self-care ability of hypertension for the subjects, the Health-promoting lifestyle profile II(HPLP-II) was utilized to evaluate the health behavior, and MOS 36-Item Short Form Health Survey (SF-36) was chosen to assess the HRQOL for the studying population. All descriptive analyses, including demographic characteristics, socio-economic status, and clinical characteristics were stratified by Bai hypertensive elderly. Pearson correlation analysis model was used to examine the associations among health-promoting lifestyle, self-care agency, and health-related quality of life in Bai ethnic elderly with hypertension. RESULTS The HPLP-II, ESCA, and of HRQOL levels of the subjects were low, and the mean HPLP and ESCA scores had no significant statistical variance among different age groups. Significant statistical differences were found in Bai elderly subjects in the domain of PF and PH as well as the overall score in SF-36(all P< 0.01), 60-64 year group had the highest score of the above three domains in SF-36 than other age groups. The SF-36 scores were positively associated with HPLP and ESCA levels. CONCLUSION The HPLP-II, ESCA, and of HRQOL levels of the Bai subjects were poor in the Bai ethnic hypertensive elderly. The HRQOL scores of subjects were positively connected with HPLP-II and ESCA abilities. More attention should be paid to lifestyle, healthy behaviors, and self-care abilities improvements to enhance the better HRQOL of Bai minority older adults with hypertension.
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Affiliation(s)
- Mengqi Du
- grid.21729.3f0000000419368729Teacher’s College of Columbia University, New York, NY USA
| | - Hongqian Kong
- Disease Control and Prevention Center, Yunnan Qujing, China
| | - Lingyun Ran
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Yuanyuan Ran
- grid.506978.5Hunan University of Finance and Economics, Changsha, China
| | - Leixao Bai
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Yongxue Du
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Hongxue Guan
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Yong Dong
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Ying Zhao
- Disease Control and Prevention Center, Yunnan Lijiang, China
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Doshmangir L, Jabbari H, Arab-Zozani M, Naghavi-Behzad M, Abedi Z, Mostafavi H. Factors affecting hospital services overutilization and reductive strategies in Iran: a qualitative study to explore experts' views. Hosp Pract (1995) 2022; 50:416-424. [PMID: 36222088 DOI: 10.1080/21548331.2022.2134679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES This study aimed to investigate the viewpoints of the main stakeholders of the Iranian healthcare system about the overutilization of hospital services and strategies to eliminate or reduce it in Iran. METHODS This is a qualitative study and thematic data analysis using face-to-face semi-structured interviews and Focus Group Discussions (FGDs). We conducted eight interviewers and two FGDs with hospital stakeholders including faculty members, insurance organizations' authorities, experienced hospital administrative staff, hospital managers, and health-care providers. RESULTS The factors leading to the overutilization of hospital services were categorized into four main themes including site of service, quality, supplier push, and demand pull. Strategies for eliminating or reducing the overutilization of hospital services are also identified based on the influential factors. CONCLUSION Addressing overutilization of hospital services in the health system and adherence to policies for reducing or eliminating overutilization is a way to make preventive strategies to overcome overutilization. Developing a national plan to integrate utilization management into health system programs is a strategy to combat overutilization in various levels of the health system including hospital setting.
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Affiliation(s)
- Leila Doshmangir
- Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
- Social Determinants of Health Research Centre, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Jabbari
- Department of Community Medicine, School of Medicine, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Zeinab Abedi
- Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hakimeh Mostafavi
- Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Abdullah N, Kueh YC, Kuan G, Yahaya FH, Lee YY, Lee YY. A Theory Planned Behaviour of Study on Improving Abdominal Bloating among the Malays Population: A Qualitative Study. Malays J Med Sci 2022; 29:77-88. [PMID: 36818903 PMCID: PMC9910364 DOI: 10.21315/mjms2022.29.6.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/18/2022] [Indexed: 12/25/2022] Open
Abstract
Background Abdominal bloating (AB) is a common medical complaint known to diminish patients' quality of life. However, lifestyle and behavioural changes could mitigate its expression and severity. This study sought to explore the health beliefs, intentions and health-promoting behaviours among people with AB in Kelantan, Malaysia. Methods The theory of planned behaviour (TPB) was employed to explore the factors that influence the management of adults with AB, namely health beliefs and intentions. An interview guide was developed by adapting the TPB and the findings of prior studies concerning the factors associated with AB management. All eligible participants took part in in-depth interviews. Results The mean age of the participants was 32.5 years old (standard deviation [SD] = 14.19 years old) and the majority of participants were female (58.3%). The themes and sub-themes that emerged following the application of the TPB framework represented the qualitative results of this study, which indicated that the health beliefs, intentions and health-promoting behaviours observed among people with AB were closely related. Conclusion The findings of this study suggest that the adoption of a healthy lifestyle could be an effective means of improving AB. Thus, it is vital to implement a health education programme that promotes health-related beliefs and intentions in order to trigger health-promoting behaviour among people with AB.
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Affiliation(s)
- Nurzulaikha Abdullah
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Yee Cheng Kueh
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Garry Kuan
- Exercise and Sports Science, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,Department of Life Sciences, Brunel University, London, United Kingdom
| | | | - Yeong Yeh Lee
- Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,GI and Motility Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
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Jormand H, Mohammadi N, Khani Jeihooni A, Afzali Harsini P. Self-care behaviors in older adults suffering from knee osteoarthritis: Application of theory of planned behavior. Front Public Health 2022; 10:958614. [PMID: 36408046 PMCID: PMC9672679 DOI: 10.3389/fpubh.2022.958614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background Osteoarthritis is one of the main reasons causing disablement. Educational intervention for self-care behaviors of patients suffering from knee osteoarthritis is important because its effect on quality of patient life decreases the economic burden of disorder on society and family. This study aimed to investigate the effect of educational intervention based on the theory of planned behavior (TPB) on promoting self-care behaviors in elderly patients suffering from knee osteoarthritis. Methods This quasi-experimental study was performed on 200 elderlies suffering from knee osteoarthritis in the rheumatology clinics of Shiraz, Iran, in 2019. The subjects were divided into two groups (100 experimental and 100 control). Before and after 4 months, both experimental and control groups filled a questionnaire. After administering a pre-test to both groups, only the experimental group was trained based on the TPB constructs on self-care behaviors in elderly people suffering from knee osteoarthritis in eight sessions by presenting educational films and images, power points, and group discussions for solving problems. Results The mean age of the experimental group was 67.25 ± 3.64, and the mean age of the control group was 66.12 ± 3.50. The average scores of attitudes, subjective norms, perceived behavioral control, intention, and behavior before the educational intervention did not have significant differences in experimental and control groups, however, 4 months after the educational intervention, the paired t-test indicated significant enhancement in every construct in the experimental group, but no significant changes in the control group. Conclusion According to the results, the educational intervention increased the self-care behaviors of patients suffering from knee osteoarthritis based on the theory of planned behavior. Therefore, the results of this study can be used in theory-based intervention strategies for self-care behaviors of patients suffering from knee osteoarthritis.
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Affiliation(s)
- Hanieh Jormand
- Autism Spectrum Disorders Research Center and Clinical Research Development Unit of Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nasim Mohammadi
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran,*Correspondence: Ali Khani Jeihooni
| | - Pooyan Afzali Harsini
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Hsieh HL, Lai JM, Chuang BK, Tsai CH. Determinants of Telehealth Continuance Intention: A Multi-Perspective Framework. Healthcare (Basel) 2022; 10:healthcare10102038. [PMID: 36292485 PMCID: PMC9601836 DOI: 10.3390/healthcare10102038] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 11/04/2022] Open
Abstract
Owing to the COVID-19 pandemic, many countries’ physicians in the world have used telehealth to visit patients via telehealth. The study aimed to integrate the theory of planned behavior (TPB), the technology acceptance model (TAM), and self-determination theory (SDT) to explore the adoption behavior of a telehealth system. A convenient sample of residents was drawn from the population of Nantou County in Taiwan and analyzed via structural equation modeling. The findings revealed that attitude, perceived behavioral control, perceived usefulness, and perceived autonomy support jointly have significantly positive effects on continuance intention. Results also confirmed that perceived autonomy support, perceived ease of use, and perceived usefulness jointly have significantly positive effects on attitude. Furthermore, this study also showed that a crucial mediators’ role is played by perceived ease of use, perceived usefulness, and attitude. The conclusions and practical implications of the research will hopefully provide health organizations and institutions with some innovative insights and foresights, which in turn will promote better practices and services of telehealth technology.
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Affiliation(s)
| | - Jhih-Ming Lai
- Department of Information Technology and Management, Tzu Chi University of Science and Technology, Hualien 973302, Taiwan
| | | | - Chung-Hung Tsai
- Department of Information Technology and Management, Tzu Chi University of Science and Technology, Hualien 973302, Taiwan
- Correspondence:
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Aleshchenko E, Swart E, Spix C, Voigt M, Trocchi P, Langer T, Calaminus G, Baust K, Glogner J, Ihle P, Küpper-Nybelen J, Lüpkes C, Kloppe T, Horenkamp-Sonntag D, Meier I, Marschall U, Dröge P, Klein M, Weiss A, Apfelbacher C. Long-term care, care needs and wellbeing of individuals after cancer in childhood or adolescence (VersKiK): study protocol of a large scale multi-methods non-interventional study. BMC Health Serv Res 2022; 22:1176. [PMID: 36127717 PMCID: PMC9487026 DOI: 10.1186/s12913-022-08549-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It has been shown previously that a relevant proportion of childhood cancer survivors suffers from late effects, which are often directly related to the cancer itself or its therapy, resulting in particular follow-up needs, additionally burdening healthcare systems. Being diagnosed with cancer at a vulnerable stage of development, this group of cancer survivors is at comparatively higher risk of relapse or subsequent cancer. Although national and international follow-up guidelines based on treatment modalities have been developed, their implementation seems to leave room for improvement. Additionally, they lack a sufficient consideration of the survivors' psychosocial needs, affecting their adherence to them. The aim of the VersKiK study is to provide representative information on late effects in childhood and adolescence cancer survivors in Germany. The main research objectives are: (1) to describe the state of follow-up care among survivors after a cancer diagnosis in childhood or adolescence; (2) to quantify the occurrence of late effects among this group of survivors; (3) to examine the adherence to selected audiological and cardiological follow-up guidelines and to identify factors affecting it; (4) to explore actual follow-up needs of paediatric cancer survivors; (5) to review selected follow-up guidelines with the aim to improve and expand them. METHODS VersKiK is designed as a mixed-methods non-interventional study. We will use claims data from statutory health insurance companies in combination with individually linked population-based registry data from the German Childhood Cancer Registry (GCCR). This data base will permit us to quantify diagnoses and procedures in comparison to the general population as well as the adherence to existing follow-up guidelines. Additional information will be obtained through interviews with childhood and adolescence cancer survivors and their informal caregivers, as well as in focus groups with healthcare professionals. DISCUSSION The present study aims to research the actual needs of individuals after cancer diagnosis and treatment in childhood or adolescence - physical, psychological and organisational - in order to improve existing follow-up guidelines. These improvements might further positively affect not only actual care provided to paediatric cancer survivors, but also benefit healthcare systems in general while decreasing consequent medical visits in this group of patients. TRIAL REGISTRATION Registered at German Clinical Trial Register (ID: DRKS00025960 and DRKS00026092).
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Affiliation(s)
- E Aleshchenko
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto Von Guericke Univiersity, Magdeburg, Germany.
| | - E Swart
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto Von Guericke Univiersity, Magdeburg, Germany
| | - C Spix
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - M Voigt
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - P Trocchi
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto Von Guericke Univiersity, Magdeburg, Germany
| | - T Langer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - G Calaminus
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - K Baust
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - J Glogner
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - P Ihle
- PMV Research Group at the Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Cologne, Köln, Germany
| | - J Küpper-Nybelen
- PMV Research Group at the Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Cologne, Köln, Germany
| | - C Lüpkes
- OFFIS-Institute for Information Technology, Oldenburg, Germany
| | - T Kloppe
- OFFIS-Institute for Information Technology, Oldenburg, Germany
| | | | - I Meier
- Techniker Krankenkasse (TK), Hamburg, Germany
| | | | - P Dröge
- AOK Research Institute (WIdO), Berlin, Germany
| | - M Klein
- DAK-Gesundheit, Hamburg, Germany
| | - A Weiss
- Medical Sociology, Institute for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.,Bavarian Care and Nursing Authority, Amberg, Germany
| | - C Apfelbacher
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto Von Guericke Univiersity, Magdeburg, Germany
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