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Ahn RE, Senger-Carpenter T, Voepel-Lewis T. Factors Affecting Health Care Utilization Associations Among Young Adolescents With Persistent or Recurrent Pain. West J Nurs Res 2024; 46:766-772. [PMID: 39161279 DOI: 10.1177/01939459241273361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Abstract
BACKGROUND It is unclear how family factors affect health care utilization among youth with persistent or recurrent pain, despite potential relevance to interventions targeting treatment barriers. OBJECTIVE We aimed to examine health care utilization among young adolescents with persistent or recurrent pain and family factor influences toward higher health care utilization. METHODS We analyzed longitudinal data from the Adolescent Brain Cognitive Development Study and coded pain as none, infrequent (present 1-2 years), or persistent/recurrent pain (present 3-4 years). Higher health care utilization was coded as nonroutine or emergency department visit at ≥2 years. Parent-reported education, pain status, family income, and insurance status were recorded. Logistic regression examined the contributions of the child's pain and family factors toward higher health care utilization. RESULTS Among 5960 youth, 1908 (32%) had persistent/recurrent pain and 2199 (37%) had infrequent pain. Youth with persistent/recurrent pain were more likely to have higher health care utilization compared to those without pain (adjusted odds ratio [OR]: 2.39) or those with infrequent pain (OR: 1.79). Higher health care utilization was associated with parents' pain (adjusted OR: 1.22) and higher education (adjusted OR: 1.44), and family income below the poverty line (adjusted OR: 1.26), controlling for child characteristics and pain status. CONCLUSION Findings show how youths' persistent/recurrent pain, parental, and family socioeconomic factors affect health care utilization among young adolescents, emphasizing a need for family-centered care and economic policies.
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Affiliation(s)
- Rachel Elise Ahn
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Santa Monica UCLA Medical Center and Orthopaedic Hospital, University of California, Los Angeles, CA, USA
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Beales D, Boyle E, Fary R, Mikhailov A, Saunders B, Coates S, Evans K, Simic M, Sterling M, Bennell K, Rebbeck T. Patient acceptance of care of a novel care pathway for those at risk of poor outcomes from musculoskeletal pain: A mixed methods study. Musculoskelet Sci Pract 2024; 74:103178. [PMID: 39270531 DOI: 10.1016/j.msksp.2024.103178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 08/11/2024] [Accepted: 09/05/2024] [Indexed: 09/15/2024]
Abstract
OBJECTIVE Investigate people's acceptance of specialist musculoskeletal care within a new care pathway for common musculoskeletal conditions (low back pain, neck pain/whiplash, knee osteoarthritis). DESIGN Convergent parallel mixed methods design referencing the Theoretical Framework of Acceptability. The study included a subset of participants (n = 29) at-risk of poor outcomes from the intervention arm of the PAthway of CarE for common musculoskeletal conditions (PACE-MSK) trial. In the PACE-MSK arm, participants received specialist physiotherapist care as an adjunct to the care provided by their primary healthcare professional(s). One-to-one semi-structured interviews were conducted around 3-months after commencing in the trial. Quantitative data were collected at baseline and 3-month follow-up (health-related quality of life, pain self-efficacy, global perceived change, satisfaction). RESULTS Five themes were identified (Expectations and beliefs shaped patient experience; Clinical expertise and competence influence acceptance; Person-centred care; Mechanisms facilitating beneficial responses to care; Gaps in care pathway implementation). There were positive individual changes in physical quality of life for 17/29 (59%) participants, mental health quality of life for 12/29 (41%), pain self-efficacy for 8/29 (28%) and global perceived change for 19/29 (66%). Management met expectations with the majority reporting high levels of satisfaction. Integrating the qualitative and quantitative data with the Theoretical Framework of Acceptability, there were complementary meta-inferences in the constructs of 'ethicality', 'intervention coherence', 'self-efficacy' and 'affective attitude'. Divergence was identified in 'perceived effectiveness'. DISCUSSION In general, there was positive acceptance of the care pathway by participants. Specialist physiotherapists' care was perceived as a positive addition to usual care.
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Affiliation(s)
- Darren Beales
- Curtin EnAble Institute and Curtin School of Allied Health, Curtin University, GPO Box U1987, Perth, Western Australia, Australia, 6845. https://twitter.com/DBealesPhysio
| | - Eileen Boyle
- Curtin EnAble Institute and Curtin School of Allied Health, Curtin University, GPO Box U1987, Perth, Western Australia, Australia, 6845.
| | - Robyn Fary
- Curtin EnAble Institute and Curtin School of Allied Health, Curtin University, GPO Box U1987, Perth, Western Australia, Australia, 6845.
| | - Anton Mikhailov
- Curtin EnAble Institute and Curtin School of Allied Health, Curtin University, GPO Box U1987, Perth, Western Australia, Australia, 6845.
| | - Benjamin Saunders
- School of Medicine, Keele University, Keele, Staffordshire, ST5 5BG, United Kingdom.
| | - Sonia Coates
- Faculty of Medicine and Health, The University of Sydney, Susan Wakil Health Building, Western Ave, Sydney, New South Wales, 2006, Australia; School of Allied Health, Australian Catholic University, 33 Berry Street, North Sydney, New South Wales, 2060, Australia.
| | - Kerrie Evans
- Faculty of Medicine and Health, The University of Sydney, Susan Wakil Health Building, Western Ave, Sydney, New South Wales, 2006, Australia; Healthia Limited, Brisbane, Queensland, 4006, Australia.
| | - Milena Simic
- Faculty of Medicine and Health, The University of Sydney, Susan Wakil Health Building, Western Ave, Sydney, New South Wales, 2006, Australia.
| | - Michele Sterling
- RECOVER Injury Research Centre, NHMR CRE: Better Health Outcomes for Compensable Injuries University of Queensland, Level 7 STARS Building, Herston Road, Herston, 4006, Australia.
| | - Kim Bennell
- Centre for Health, Exercise & Sports Medicine, The University of Melbourne, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria, 3053, Australia.
| | - Trudy Rebbeck
- Faculty of Medicine and Health, The University of Sydney, Susan Wakil Health Building, Western Ave, Sydney, New South Wales, 2006, Australia.
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Kim CY, Choi BY, Ryoo SW, Son SY, Min JY, Min KB. Health Literacy and Health-Related Quality of Life in Older Adults with Mild Cognitive Impairment. J Am Med Dir Assoc 2024; 25:105253. [PMID: 39265633 DOI: 10.1016/j.jamda.2024.105253] [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: 03/01/2024] [Revised: 08/01/2024] [Accepted: 08/05/2024] [Indexed: 09/14/2024]
Abstract
OBJECTIVES Health literacy is considered crucial in health status outcomes, but little is known about the association among cognitively impaired persons. This study investigated the association between health literacy and health-related quality of life (HRQoL) in older adults with mild cognitive impairment (MCI). We further examined whether the association between health literacy and HRQoL depends on age, sex, and educational attainment. DESIGN A cross-sectional study was conducted between January and December 2022. SETTING AND PARTICIPANTS The study population was 233 older adults with MCI who visited the Veterans Health Service Medical Center in Seoul, Republic of Korea. METHODS The diagnosis of MCI was confirmed by a physician based on clinical and neuropsychological assessments. The European Health Literacy Survey Questionnaire and EuroQol Five Dimensions Questionnaire were used to measure the health literacy and HRQoL of the participants. RESULTS HRQoL was significantly correlated with health literacy (R = 0.25, P ≤ .001) and its 3 subdomains (R = 0.27, P ≤ .001 for healthcare; R = 0.19, P = .004 for disease prevention; and R = 0.18, P = .005 for health promotion). After adjustment for potential covariates, older adults with higher levels of health literacy were significantly associated with better HRQoL: β = 0.02 (P = .0021) for health literacy, β = 0.07 (P = .0001) for healthcare, and β = 0.04 (P = .0443) for disease prevention. The interactions between HRQoL and health literacy with the specific variables of age, sex, and education demonstrated a statistical significance (β = 0.02 with age, β = 0.03 with sex, and β = 0.06 with education). CONCLUSIONS AND IMPLICATIONS There was a significant association between health literacy and HRQoL among older adults with MCI. This finding suggests that improving health literacy of older adults with MCI may enhance HRQoL. An education intervention is recommended to reduce the existing health disparities due to low health literacy.
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Affiliation(s)
- Chae Yoon Kim
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Baek-Yong Choi
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Seung-Woo Ryoo
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Seok-Yoon Son
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Republic of Korea.
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea; Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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Drost LE, de Jong RDM, Stegeman M, Franx A, Vos MC. The influence of decisional conflict on treatment decision in pelvic organ prolapse-data from the SHADE-POP trial. Arch Gynecol Obstet 2024:10.1007/s00404-024-07723-8. [PMID: 39240322 DOI: 10.1007/s00404-024-07723-8] [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: 07/28/2024] [Accepted: 08/25/2024] [Indexed: 09/07/2024]
Abstract
PURPOSE Women with symptomatic pelvic organ prolapse are facing the choice between several treatment options and a potentially difficult decision. The aim of this study was to examine the effect of decisional conflict, patient characteristics and other decision-related factors on treatment decision in women with pelvic organ prolapse. METHODS Data from the SHADE-POP trial were used. Women with symptomatic pelvic organ prolapse who visited their gynaecologist for (new) treatment options were included. In all participants, demographical characteristics and validated questionnaires concerning decisional conflict (DCS), shared decision making (SDM-Q-9), information provision (SCIP-B), anxiety and depression (HADS) and satisfaction with care (PSQ-18) were collected 2 weeks after the visit. Analyses were performed using univariate and multivariate linear and logistic regression analyses. RESULTS Ninety six women with pelvic organ prolapse facing a treatment decision were included. An increase in decisional conflict as experienced by patients was related to the choice of more conservative treatment, such as pelvic floor muscle training or pessary, instead of surgery (p = 0.02). Shared decision making, better information provision and satisfaction with care were related to lower levels of decisional conflict (p = 0.001). CONCLUSION Decisional conflict in women with pelvic organ prolapse favours conservative treatment instead of surgery. Gaining knowledge on the effect of decisional conflict, patient characteristics and other decision-related factors on treatment decision in pelvic organ prolapse will be a step towards a better-guided treatment decision and better patient-reported outcomes for this group of patients. NL 55737.028.15, 30-10-2016.
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Affiliation(s)
- Larissa E Drost
- Department of Obstetrics and Gynaecology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands.
| | - Rachel D M de Jong
- Department of Obstetrics and Gynaecology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - Marjan Stegeman
- Department of Obstetrics and Gynaecology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - Arie Franx
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M Caroline Vos
- Department of Obstetrics and Gynaecology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
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Azambuja P, Bastos LS, Batista-da-Silva AA, Ramos GV, Kurtz P, Dias CM, da Silva EP, Arouca LE, Soares J, Sejvar JJ, Sigfrid L, Ranzani OT, Hamacher S, Bozza FA. Prevalence, risk factors, and impact of long COVID in a socially vulnerable community in Brazil: a prospective cohort study. LANCET REGIONAL HEALTH. AMERICAS 2024; 37:100839. [PMID: 39100241 PMCID: PMC11295704 DOI: 10.1016/j.lana.2024.100839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 05/24/2024] [Accepted: 07/02/2024] [Indexed: 08/06/2024]
Abstract
Background Long COVID is an emerging global public health issue. Socially vulnerable communities in low- and-middle-income countries were severely impacted by the pandemic and are underrepresented in research. This prospective study aimed to determine the prevalence of long COVID, its impact on health, and associated risk factors in one such community in Rio de Janeiro, Brazil. Methods A total of 710 individuals aged 18 and older, with confirmed SARS-CoV-2 infection at least three months prior, were enrolled between November 25, 2021, and May 5, 2022. Participants were assessed via telephone or in person using a standardized questionnaire to evaluate their perception of recovery, symptoms, quality of life, and functional status. Findings Twenty percent of participants did not feel fully recovered, 22% experienced new or persistent symptoms, 26% had worsened functional status, 18% had increased dyspnoea, and 32% reported a worse quality of life. Persistent symptoms included headache, cough, fatigue, muscle pain, and shortness of breath. Dyspnoea during the acute phase was the strongest independent predictor of worsening outcomes. Females and individuals with comorbidities were more likely to report worse recovery, functioning, dyspnoea, and quality of life. Interpretation Our findings reveal a high burden of severe and persistent physical and mental health sequelae in a socially vulnerable community following COVID-19. Funding UK Foreign, Commonwealth and Development Office and Wellcome Trust Grant (222048/Z/20/Z), Fundação Oswaldo Cruz (FIOCRUZ), Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), and the Centers for Disease Control and Prevention (CDC).
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Affiliation(s)
- Pedro Azambuja
- National Institute of Infectious Diseases Evandro Chagas, Oswaldo Cruz Foundation (INI-FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Leonardo S.L. Bastos
- Department of Industrial Engineering (DEI), Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil
- Tecgraf Institute, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil
| | - Amanda A. Batista-da-Silva
- Department of Industrial Engineering (DEI), Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil
- Tecgraf Institute, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil
| | | | - Pedro Kurtz
- D’Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil
- Hospital Copa Star, Rio de Janeiro, RJ, Brazil
- Paulo Niemeyer State Brain Institute (IECPN), Rio de Janeiro, RJ, Brazil
| | | | | | - Luna E. Arouca
- Associação de Desenvolvimento Redes da Maré, Rio de Janeiro, RJ, Brazil
| | - Jesus Soares
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James J. Sejvar
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Louise Sigfrid
- ISARIC Global Support Centre, Policy and Practice Research Group, Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Otavio T. Ranzani
- Barcelona Institute for Global Health, ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Silvio Hamacher
- Department of Industrial Engineering (DEI), Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil
- Tecgraf Institute, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil
| | - Fernando A. Bozza
- National Institute of Infectious Diseases Evandro Chagas, Oswaldo Cruz Foundation (INI-FIOCRUZ), Rio de Janeiro, RJ, Brazil
- D’Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
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Hung CT, Wang LM, Suk CW. National trends and disparities in herpes zoster vaccination among US older adults with chronic obstructive pulmonary disease, 2008 to 2022. Am J Infect Control 2024:S0196-6553(24)00657-6. [PMID: 39153516 DOI: 10.1016/j.ajic.2024.08.010] [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: 07/15/2024] [Revised: 08/10/2024] [Accepted: 08/12/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a risk factor for herpes zoster. Vaccination can prevent or attenuate herpes zoster and its related complications. However, evidence regarding vaccine uptake among patients with COPD is limited. Therefore, this study aimed to evaluate trends in herpes zoster vaccination and characteristics associated with vaccination among US older adults with COPD. METHODS Data from the 2008 to 2022 National Health Interview Survey were used. Participants aged ≥50 years were included. Joinpoint regression analysis was performed to analyze trends in herpes zoster vaccination. A multivariable logistic regression model was used to identify factors associated with vaccination. RESULTS From 2008 to 2022, an increasing trend in herpes zoster vaccination was observed (average annual percent change = 15.10, P < .01). This increasing trend was also observed when stratified by age groups. Disparities in vaccination were found across several factors, including age, sex, race or ethnicity, region, educational level, health insurance, income, smoking status, perceived health status, and flu and pneumococcal vaccination. CONCLUSIONS There has been an upward trend in herpes zoster vaccination over the past 15 years among older adults with COPD. Disparities across several characteristics existed, underscoring the necessity for targeted policies and interventions to promote equity in vaccination.
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Affiliation(s)
- Chun-Tse Hung
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
| | - Li-Min Wang
- Department of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chi-Won Suk
- Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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Spina A, Andalib S, Flores D, Vermani R, Halaseh FF, Nelson AM. Evaluation of Generative Language Models in Personalizing Medical Information: Instrument Validation Study. JMIR AI 2024; 3:e54371. [PMID: 39137416 DOI: 10.2196/54371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 04/28/2024] [Accepted: 06/29/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Although uncertainties exist regarding implementation, artificial intelligence-driven generative language models (GLMs) have enormous potential in medicine. Deployment of GLMs could improve patient comprehension of clinical texts and improve low health literacy. OBJECTIVE The goal of this study is to evaluate the potential of ChatGPT-3.5 and GPT-4 to tailor the complexity of medical information to patient-specific input education level, which is crucial if it is to serve as a tool in addressing low health literacy. METHODS Input templates related to 2 prevalent chronic diseases-type II diabetes and hypertension-were designed. Each clinical vignette was adjusted for hypothetical patient education levels to evaluate output personalization. To assess the success of a GLM (GPT-3.5 and GPT-4) in tailoring output writing, the readability of pre- and posttransformation outputs were quantified using the Flesch reading ease score (FKRE) and the Flesch-Kincaid grade level (FKGL). RESULTS Responses (n=80) were generated using GPT-3.5 and GPT-4 across 2 clinical vignettes. For GPT-3.5, FKRE means were 57.75 (SD 4.75), 51.28 (SD 5.14), 32.28 (SD 4.52), and 28.31 (SD 5.22) for 6th grade, 8th grade, high school, and bachelor's, respectively; FKGL mean scores were 9.08 (SD 0.90), 10.27 (SD 1.06), 13.4 (SD 0.80), and 13.74 (SD 1.18). GPT-3.5 only aligned with the prespecified education levels at the bachelor's degree. Conversely, GPT-4's FKRE mean scores were 74.54 (SD 2.6), 71.25 (SD 4.96), 47.61 (SD 6.13), and 13.71 (SD 5.77), with FKGL mean scores of 6.3 (SD 0.73), 6.7 (SD 1.11), 11.09 (SD 1.26), and 17.03 (SD 1.11) for the same respective education levels. GPT-4 met the target readability for all groups except the 6th-grade FKRE average. Both GLMs produced outputs with statistically significant differences (P<.001; 8th grade P<.001; high school P<.001; bachelors P=.003; FKGL: 6th grade P=.001; 8th grade P<.001; high school P<.001; bachelors P<.001) between mean FKRE and FKGL across input education levels. CONCLUSIONS GLMs can change the structure and readability of medical text outputs according to input-specified education. However, GLMs categorize input education designation into 3 broad tiers of output readability: easy (6th and 8th grade), medium (high school), and difficult (bachelor's degree). This is the first result to suggest that there are broader boundaries in the success of GLMs in output text simplification. Future research must establish how GLMs can reliably personalize medical texts to prespecified education levels to enable a broader impact on health care literacy.
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Affiliation(s)
- Aidin Spina
- School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Saman Andalib
- School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Daniel Flores
- School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Rishi Vermani
- School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Faris F Halaseh
- School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Ariana M Nelson
- School of Medicine, University of California, Irvine, Irvine, CA, United States
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, Irvine, CA, United States
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Andréka L, Csenteri-Bárdos O, Szőllősi GJ, Andréka P, Jancsó Z, Vajer P. Cardiovascular risk factors among Roma and non-Roma populations in underprivileged settlements. BMC PRIMARY CARE 2024; 25:289. [PMID: 39118056 PMCID: PMC11312200 DOI: 10.1186/s12875-024-02555-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 07/31/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND The 'Taking the screening tests close to the people' program offers cardiovascular screening to the inhabitants of underprivileged settlements. This study aimed to evaluate the cardiovascular risk factors of underprivileged populations, including individuals who described themselves as belonging to the Roma population. METHODS During the program, we collected information about demographic features, lifestyle and current illnesses. A general health assessment (body weight, height, blood pressure and fasting blood glucose) and cardiovascular examination were performed. We analysed data on both Roma and non-Roma groups and used Pearson's chi-squared test and multiple logistic regression models to analyse the factors that contribute to the onset of comorbidities, with a special focus on ethnicity. RESULTS Data from 6211 participants were processed. Based on self-reports, the non-Roma population consisted of 5352 respondents (1364 men (25.5%) and 3988 women (74.5%)), and the Roma population comprised 859 respondents (200 men (23.3%) and 659 women (76.7%)). A total of 91.2% (4849) of the non-Roma population and 92.5% (788) of the Roma population exercised less than 3 h per week (p < 0.001). Of the non-Roma population, 71.7% (3512) had a body mass index above 25 kg/m2, while the corresponding figure was 72.4% (609) in the Roma population (p = 0.709). The median body mass index was 28.0 (24.6-31.9) in the non-Roma population and 28.8 (24.5-33.0) in the Roma population (p < 0.001). The prevalence of active smokers was 28.7% (1531) in the non-Roma population and 60.3% (516) in the Roma population (p < 0.001). The prevalence of hypertension was 54.9% (2824) in the non-Roma population and 49.8% (412) in the Roma population (p < 0.001). The prevalence of diabetes was 11.5% (95) in the Roma population and 12.2% (619) in the non-Roma population (p < 0.001). CONCLUSION We found a high prevalence of overweight and obesity, a lack of physical activity and an remarkably high smoking rate in the studied underprivileged population. Both type 2 diabetes and hypertension were more common among people living in underprivileged settlements than in the general Hungarian population. People living in underprivileged settlements need more attention in primary care.
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Affiliation(s)
- Lilla Andréka
- Doctoral College of Semmelweis University, Budapest, 1085, Hungary
- Gottsegen György National Cardiovascular Center, Budapest, 1096, Hungary
| | | | - Gergő József Szőllősi
- Gottsegen György National Cardiovascular Center, Budapest, 1096, Hungary
- Coordination Center for Research in Social Sciences, Faculty of Economics and Business, University of Debrecen, Debrecen, Hungary
| | - Péter Andréka
- Gottsegen György National Cardiovascular Center, Budapest, 1096, Hungary
| | - Zoltán Jancsó
- Gottsegen György National Cardiovascular Center, Budapest, 1096, Hungary
| | - Péter Vajer
- Department of Family Medicine, Semmelweis University, Budapest, 1085, Hungary.
- Gottsegen György National Cardiovascular Center, Budapest, 1096, Hungary.
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Mortensen M, Nilsen RM, Kvalheim VL, Bjørnstad JL, Svendsen ØS, Haaverstad R, Moi AL. The influence of socio-demographic and clinical factors on sick leave and return to work after open-heart surgery: a nationwide registry-based cohort study. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2024; 10:431-445. [PMID: 37858302 PMCID: PMC11307200 DOI: 10.1093/ehjqcco/qcad064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/27/2023] [Accepted: 10/18/2023] [Indexed: 10/21/2023]
Abstract
AIMS To estimate sick leave (SL) duration after first-time elective open-heart surgery and identify factors contributing to increased SL. METHODS AND RESULTS A retrospective nationwide cohort study combined data from the Norwegian Register for Cardiac Surgery and SL data from the Norwegian Labour and Welfare Administrations. All able-bodied adults who underwent first-time elective open-heart surgery in Norway between 2012 and 2021 were followed until 1 year after surgery. The impact of socio-demographic and clinical factors on SL after surgery was analysed using logistic regression and odds ratios. Of 5456 patients, 1643 (30.1%), 1798 (33.0%), 971 (17.8%), 1035 (18.9%), and 9 (0.2%) had SL of <3, 3-6, 6-9, and 9-12 months, and 1 year, respectively. SL >6 months was associated with female gender, primary education only, and average annual income. Post-operative stroke, post-operative renal failure, New York Heart Association Functional Classification system (NYHA) score >3, earlier myocardial infarction, and diabetes mellitus increased the odds of SL >6 months. CONCLUSION This study demonstrates that socio-demographic and clinical factors impact SL after first-time elective open-heart surgery. Patients who experience a stroke or develop renal failure after surgery have the highest odds of SL >6 months. Females and patients with low education levels, earlier myocardial infarction, or NYHA scores III-IV have a two-fold chance of SL >6 months. The findings allow for future investigations of pre- and post-surgery interventions that can most effectively reduce SL and aid return to work.
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Affiliation(s)
- Michael Mortensen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, P.O box 7030, 5020 Bergen, Norway
| | - Roy M Nilsen
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Venny L Kvalheim
- Department of Cardiothoracic Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Johannes L Bjørnstad
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
- Norwegian Register for Cardiac Surgery, Oslo, Norway
| | - Øyvind S Svendsen
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Norway
| | - Rune Haaverstad
- Department of Cardiothoracic Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Asgjerd L Moi
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, P.O box 7030, 5020 Bergen, Norway
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway
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10
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Vesoulis ZA, Diggs S, Brackett C, Sullivan B. Racial and geographic disparities in neonatal brain care. Semin Perinatol 2024; 48:151925. [PMID: 38897830 DOI: 10.1016/j.semperi.2024.151925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
In this review, we explore race-based disparities in neonatology and their impact on brain injury and neurodevelopmental outcomes. We discuss the historical context of healthcare discrimination, focusing on the post-Civil War era and the segregation of healthcare facilities. We highlight the increasing disparity in infant mortality rates between Black and White infants, with premature birth being a major contributing factor, and emphasize the role of prenatal factors such as metabolic syndrome and toxic stress in affecting neonatal health. Furthermore, we examine the geographic and historical aspects of racial disparities, including the consequences of redlining and limited access to healthcare facilities or nutritious food options in Black communities. Finally, we delve into the higher incidence of brain injuries in Black neonates, as well as disparities in adverse neurodevelopmental outcome. This evidence underscores the need for comprehensive efforts to address systemic racism and provide equitable access to healthcare resources.
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Affiliation(s)
- Zachary A Vesoulis
- Department of Pediatrics, Division of Newborn Medicine, Washington University School of Medicine, St. Louis, MO, USA.
| | - Stephanie Diggs
- Department of Pediatrics, Division of Newborn Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Cherise Brackett
- Department of Pediatrics, Division of Neonatology, University of Virginia, USA
| | - Brynne Sullivan
- Department of Pediatrics, Division of Neonatology, University of Virginia, USA
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11
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Spencer M, Kemp N, Cruickshank V, Nash R. Examining the relationship between demographic variables and perceived health literacy challenges in Tasmania, Australia. Health Promot J Austr 2024. [PMID: 39073282 DOI: 10.1002/hpja.905] [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: 02/27/2023] [Revised: 05/11/2024] [Accepted: 07/10/2024] [Indexed: 07/30/2024] Open
Abstract
ISSUE ADDRESSED Whilst there is a relationship between health literacy and health outcomes, the importance of social and personal demographic characteristics remains understudied., Identifying the factors responsible for creating health literacy challenges would help ensure that responses are tailored to individual or community needs. METHODS This survey included questions from five domains from the Health Literacy Questionnaire. Descriptive analyses and hierarchical regression were used to explore the relationship between the demographic characteristics and health literacy. Qualitative questions were subjected to thematic analysis, to identify the current barriers and proposed solutions. RESULTS A total of 255 participants completed the survey. Demographic characteristics that significantly predicted lower Health Literacy Questionnaire scores were having one or more chronic health conditions and living in an area of more socioeconomic disadvantage. Participants found 'navigating the health care system' the most difficult of the five elements measured. A total of 276 individual barriers to health literacy were identified and 162 solutions proposed. CONCLUSIONS This study provides an overview of our sample's health literacy and how their social demographic characteristics may predict their health literacy challenges. Findings from this study can be used to develop targeted interventions to respond to specific health literacy challenges identified within this population. SO WHAT?: Distinct from other research, whereby solutions are proposed by researchers, the participants in this study were encouraged to share their health literacy challenges and outline potential solutions to address these in their local context.
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Affiliation(s)
- Madeline Spencer
- School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Nenagh Kemp
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Sandy Bay, Tasmania, Australia
| | - Vaughan Cruickshank
- College of Arts, Law and Education, University of Tasmania, Launceston, Tasmania, Australia
| | - Rosie Nash
- School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Seet V, Abdin E, Jeyagurunathan A, Chik TS, Kit LJ, Sing LE, Verma S, Ker-Chiah W, Ng P, Subramaniam M. Health and disability - a multi-group latent class analysis of the World Health Organization Disability Assessment Schedule 2.0 among those with mental and physical health conditions. Health Qual Life Outcomes 2024; 22:57. [PMID: 39061074 PMCID: PMC11282711 DOI: 10.1186/s12955-024-02273-8] [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: 02/09/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND This study aims to identify disability classes among people with schizophrenia spectrum disorder, depression, anxiety or diabetes via the WHODAS 2.0; investigate the invariance of disability patterns among the four diagnostic groups; and examine associations between disability classes and sociodemographic variables. METHODS Patients seeking treatment for schizophrenia spectrum disorder, depression, anxiety or diabetes (n=1076) were recruited. Latent class analysis was used to identify disability classes based on WHODAS 2.0 responses. Measurement invariance was tested using multi-group latent class analysis. Associations between classes and sociodemographic variables were tested via multinomial logistic regression. RESULTS A five-class solution was identified; examination of model invariance showed that the partially constrained five-class model was most appropriate, suggesting that class structure was consistent while class membership differed across diagnostic groups. Finally, significant associations were found between class membership and ethnicity, education level, and employment status. CONCLUSIONS The results show the feasibility of using the WHODAS 2.0 to identify and compare different disability classes among people with mental or physical conditions and their sociodemographic correlates. Establishing a typology of different disability profiles will help guide research and treatment plans that tackle not just clinical but also functional aspects of living with either a chronic psychiatric or physical condition.
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Affiliation(s)
- Vanessa Seet
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Tan Sing Chik
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Lum Joon Kit
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore, Singapore
| | - Lee Eng Sing
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Wei Ker-Chiah
- West Region, Institute of Mental Health, Singapore, Singapore
| | - Pamela Ng
- East Region, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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13
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Wu J, Yu W, Xu Z, Chen Y, Li J, Sun Q. Dietary Knowledge, Attitude, Practice Survey and Nutritional Knowledge-Based Intervention: A Cross-Sectional and Randomized Controlled Trial Study among College Undergraduates in China. Nutrients 2024; 16:2365. [PMID: 39064808 PMCID: PMC11279395 DOI: 10.3390/nu16142365] [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: 06/28/2024] [Revised: 07/18/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Understanding undergraduates' dietary literacy, including dietary knowledge, attitude and practice (KAP), is important for future health promotion policies. Therefore, this study aimed to investigate the current status and influencing factors of dietary literacy in Chinese college undergraduates and explore whether a nutritional lecture could improve their dietary literacy. METHODS This study included two parts: a cross-sectional study (n = 1026) conducted by a dietary literacy questionnaire, and a randomized controlled trail (RCT) that enrolled 99 college undergraduates who were randomized to a control group or a nutritional lecture group. Data from the questionnaire and 72 h food records were obtained on day 0, day 3 and day 100 before and after intervention. RESULTS This cross-sectional study showed that the mean scores of dietary KAP were respectively 100.0 (33.3), 59.1 (13.6) and 71.7 (11.7), with an excellent rate of 36.6%, 1.9% and 3.4%. Female upper-grade undergraduates and those with medicine-related majors illustrated higher dietary knowledge scores (p < 0.001). Dietary attitude rather than dietary knowledge had a significant impact on dietary practice (p < 0.001). This finding was in line with the results in the RCT study. Compared with the control group, dietary knowledge was significantly improved in the nutritional lecture group on both day 3 (p = 0.002) and day 100 (p = 0.023) after intervention. However, dietary behavior was improved only on day 3 post nutritional lecture (p = 0.029) but decreased to the original level 100 days later (p < 0.001). CONCLUSIONS This study discovered the unsatisfying status and discrepancy between dietary literacy among college undergraduates of different sex, majors and college years. Dietary attitude instead of dietary knowledge was discovered as a determining role in dietary practice. One nutritional lecture could improve undergraduates' dietary literacy but the effect was not long-lasting. Further studies with more reinforced and durable interventions are warranted.
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Affiliation(s)
- Junjie Wu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Wei Yu
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China;
| | - Zhuo Xu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Yuxuan Chen
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Jiaomei Li
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Qinghua Sun
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
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14
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Sousa S, Albuquerque G, Severo M, Costa AR, Moreira P, Lunet N, Padrão P. Development and validation of a photograph-based instrument to assess nutrition literacy: The NUTLY project. Appetite 2024; 198:107377. [PMID: 38679064 DOI: 10.1016/j.appet.2024.107377] [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: 10/05/2023] [Revised: 04/07/2024] [Accepted: 04/24/2024] [Indexed: 05/01/2024]
Abstract
Most instruments measuring nutrition literacy evaluate theoretical knowledge, not necessarily reflecting skills relevant to food choices. We aimed to develop and validate a photograph-based instrument to assess nutrition literacy (NUTLY) among adults in Portugal. NUTLY assesses the ability to distinguish foods with different nutritional profiles; from each of several combinations of three photographs (two foods with similar contents and one with higher content) participants are asked to identify the food with the highest energy/sodium content. The NUTLY version with 79 combinations, obtained after experts/lay people evaluations, was applied to a sample representing different age, gender and education groups (n = 329). Dimensionality was evaluated through latent trait models. Combinations with negative or with positive small factor loadings were excluded after critical assessment. Internal consistency was measured using Cronbach's alpha and construct validity by comparing NUTLY scores with those obtained in the Medical Term Recognition Test and the Newest Vital Sign (NVS), and across education and training in nutrition/health groups. The cut-off to distinguish adequate/inadequate nutrition literacy was defined through ROC analysis using the Youden index criterion, after performing a Latent class analysis which identified a two-class model to have the best goodness of fit. Test-retest reliability was assessed after one month (n = 158). The final NUTLY scale was unidimensional and included 48 combinations (energy: 33; sodium: 15; α = 0.74). Mean scores (±standard deviation) were highest among nutritionists (39.9 ± 4.4), followed by health professionals (38.5 ± 4.1) and declined with decreasing education (p < 0.001). Those with adequate nutrition literacy according to NVS showed higher NUTLY scores (37.9 ± 4.3 vs. 33.9 ± 6.9, p < 0.001). Adequate nutrition literacy was defined as a NUTLY score≥35 (sensitivity: 89.3%; specificity: 93.7%). Test-retest reliability was high (ICC = 0.77). NUTLY is a valid and reliable nutrition literacy measurement tool.
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Affiliation(s)
- Sofia Sousa
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal
| | - Gabriela Albuquerque
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Portugal
| | - Ana Rute Costa
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina da Universidade do Porto, Portugal
| | - Pedro Moreira
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal; Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Portugal; Centro de Investigação em Atividade Física, Saúde e Lazer da Universidade do Porto, Portugal
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina da Universidade do Porto, Portugal
| | - Patrícia Padrão
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Portugal; Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Portugal.
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Rahmawati BA, Rochmawati E. Trying to understand the illness: A qualitative investigation of health literacy of patients undergoing maintenance hemodialysis. Nurs Health Sci 2024; 26:e13120. [PMID: 38605631 DOI: 10.1111/nhs.13120] [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: 08/17/2023] [Revised: 12/19/2023] [Accepted: 03/28/2024] [Indexed: 04/13/2024]
Abstract
Limited health literacy is high among patients with chronic kidney disease, which can pose challenges in health care. Evidence of health literacy in Indonesia, particularly regarding patients undergoing hemodialysis, is lacking. In this study, we aimed to explore health literacy in adult patients undergoing maintenance hemodialysis. An inductive qualitative study was conducted. Individual semi-structured interviews were conducted with 10 adult patients undergoing hemodialysis, four family caregivers, and four healthcare professionals. Interviews were transcribed verbatim and analyzed thematically. Three themes emerged from the data: "Trying to understand the illness," "searching and obtaining health information," and "applying health information." Understanding and accepting the illness included raising awareness of the changes in their lives and accepting these changes. Participants actively sought information from healthcare professionals and other sources and used it carefully. Behavioral changes included patients' adherence to therapy, although participants often felt bored during the illness trajectory. Understanding the illness and being willing to seek and critically evaluate health information before implementing it are important. These aspects may affect patient outcomes and require further intervention and research.
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Affiliation(s)
- Berlian Ayu Rahmawati
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
- Muhammadiyah Siti Aminah Bumiayu Hospital, Brebes, Indonesia
| | - Erna Rochmawati
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
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16
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Kotlier JL, Fathi A, Kumaran P, Mayfield CK, Orringer M, Liu JN, Petrigliano FA. Randomized controlled trials in the shoulder arthroplasty literature rarely include key demographic and socioeconomic patient data. J Shoulder Elbow Surg 2024; 33:e296-e301. [PMID: 38373484 DOI: 10.1016/j.jse.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/17/2023] [Accepted: 12/26/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND It is well known that socioeconomic and demographic variables can greatly affect health outcomes. Previous studies across medical and surgical subspecialties have demonstrated that these variables are frequently under-reported in randomized controlled trials (RCTs). No such study currently exists that examines rates of reporting of sociodemographic variables in shoulder arthroplasty RCTs. This study aims to present these rates and explore the impact of failing to report socioeconomic variables in shoulder arthroplasty RCTs. METHODS The PubMed database was queried for the term shoulder arthroplasty. Sixty-five RCTs from the past 10 years were identified for inclusion from 5 high-impact orthopedic surgery journals. Each RCT was analyzed for patient age and sex or gender as well as the following sociodemographic variables: race, ethnicity, insurance status, income, work status, and education. It was also noted whether each of the above variable was mentioned in the results section of the article. Data were presented in a descriptive fashion as well as analyzed using χ2 and Fisher exact tests where appropriate. RESULTS From 2014 to 2023, the 65 shoulder arthroplasty RCTs published reported age in 40 of 65 (61.5%) in their results sections and 61 of 65 (93.8%) in any section. Sex or gender was reported in 27 of 65 (41.5%) in their results sections and 61 of 65 (93.8%) in any section. No articles included any sociodemographic variables in the results section. Reporting rates for sociodemographic variables in any section were as follows: race, 6 of 65 (9.2%); ethnicity, 5 of 65 (7.7%); work status, 4 of 65 (6.2%); and insurance status, 1 of 65 (1.5%). No studies included income or education of the enrolled patients. There was no difference in reporting sociodemographic variables by journal (P = .45) or by year of publication (P = .57). However, no study prior to 2020 included any sociodemographic variable (0 of 27, 0%), whereas from 2020 onward 6 studies included at least 1 (6 of 38, 15.8%). Sociodemographic variables were reported significantly less frequently than age and sex or gender (P = .001). DISCUSSION Our study found sociodemographic variables are rarely reported in shoulder arthroplasty RCTs, whereas age and sex or gender are reported with great frequency. In order to understand the results of shoulder arthroplasty RCTs, apply their findings to the care of our patients, and address health disparities, we must ensure these studies include patient sociodemographic data.
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Affiliation(s)
| | - Amir Fathi
- USC Keck School of Medicine, Los Angeles, CA, USA
| | | | | | | | - Joseph N Liu
- USC Keck School of Medicine, Los Angeles, CA, USA
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17
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Visser TS, Brul S, Deng J, Bonsel J, van Es E, Eygendaal D, de Vos RJ. Low socioeconomic status is associated with worse treatment outcomes in patients with Achilles tendinopathy. Br J Sports Med 2024; 58:579-585. [PMID: 38569849 DOI: 10.1136/bjsports-2023-107633] [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] [Accepted: 03/26/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE To assess whether there is a difference in symptom severity at baseline and 24 weeks follow-up between conservatively managed patients with Achilles tendinopathy (AT) with low socioeconomic status (SES) compared with those with high SES. METHODS In this prospective cohort study, 200 patients with AT were included and treated according to current guidelines. We linked a neighbourhood SES indicator based on income, employment and education level and divided the patient population into quintiles, with Q1 being the highest SES and Q5 the lowest. Symptom severity at baseline and follow-up was assessed using the Victorian Institute of Sports Assessment-Achilles (VISA-A) score. Treatment adherence was not measured. We used a general linear model and the mean VISA-A scores at baseline and at 6, 12 and 24 weeks follow-up were compared between Q1 (n=45) and Q5 (n=39), while adjusting for age, sex, body mass index (BMI), Ankle Activity Score, symptom duration and baseline VISA-A score. RESULTS Patients had a median age of 51 years and median BMI of 25.4, 40% were female. 74%, 70% and 58% of the participants completed the VISA-A at 6, 12 and 24 weeks, respectively. VISA-A scores at baseline were similar for Q1 and Q5 (43.9 and 41.8, p=0.591). At 24 weeks, there was a mean (95% CI) difference of 11.2 (1.0 to 21.3, p=0.032) points in favour of Q1 on the VISA-A score. CONCLUSION AT patients with low SES may have worse outcomes when treated using the current guidelines. The difference in VISA-A score at 24 weeks is larger than the minimal clinically important difference and might be clinically relevant, but comes with uncertainty due to the large dispersion in the data. Clinicians need to consider the impact of social inequality when developing and implementing treatment plans.
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Affiliation(s)
- Tjerk Sleeswijk Visser
- Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Sports Medicine, Haaglanden Medisch Centrum, The Hague, The Netherlands
| | - Stefano Brul
- Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Jie Deng
- Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Joshua Bonsel
- Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Eline van Es
- Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Denise Eygendaal
- Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Robert-Jan de Vos
- Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands
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Zhao T, Cai X, Zhang S, Wang M, Chen L, Wang J, Yu Y, Tao L, Xu X, Luo J, Wang C, Du J, Liu Y, Lu Q, Cui F. Differences in Vaccination Consultation Preferred by Primary Health Care Workers and Residents in Community Settings. Vaccines (Basel) 2024; 12:534. [PMID: 38793785 PMCID: PMC11126119 DOI: 10.3390/vaccines12050534] [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: 04/01/2024] [Revised: 04/24/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024] Open
Abstract
OBJECTIVE To evaluate the preference of primary HCWs and residents on vaccination consultation in community health services to provide evidence for vaccine hesitancy intervention strategies. METHODS A discrete choice model (DCM) was constructed to evaluate the preference difference between primary HCWs and residents on vaccination consultation in community health services in China during May-July 2022. RESULTS A total of 282 residents and 204 HCWs were enrolled in this study. The residents preferred consulting with an HCW-led approach (β = 2.168), with specialized content (β = 0.954), and accompanied by telephone follow-up (β = 1.552). In contrast, the HCWs preferred face-to-face consultation (β = 0.540) with an HCW-led approach (β = 0.458) and specialized content (β = 0.409), accompanied by telephone follow-up (β = 0.831). College residents and residents with underlying self-reported disease may be near-critically inclined to choose traditional consultation (an offline, face-to-face consultation with standardized content and more prolonged duration) rather than a new-media consulting group (an online consultation with specialized content within 5 min). Urban HCWs preferred long-term consultation groups (the resident-led offline consultation with follow-up lasting more than 5 min). In contrast, rural HCWs preferred efficient consultation (the HCW-led, short-duration, standardized offline consultation mode). CONCLUSION The selection preference for vaccine consultation reveals a gap between providers and demanders, with different groups exhibiting distinct preferences. Identifying these targeted gaps can help design more acceptable and efficient interventions, increasing their likelihood of success and leading to better resource allocation for policymakers to develop targeted vaccination policies.
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Affiliation(s)
- Tianshuo Zhao
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Xianming Cai
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Sihui Zhang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Mingting Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Linyi Chen
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Juan Wang
- Jiuzhaigou Center for Disease Control and Prevention, Ngawa 623099, China;
| | - Yajie Yu
- Yilan Center for Disease Control and Prevention, Harbin 154899, China
| | - Liandi Tao
- Longxi Center for Disease Control and Prevention, Longxi 748199, China
| | - Xiaoxia Xu
- Chengguan Center for Disease Control and Prevention, Lanzhou 730030, China;
| | - Jing Luo
- Suzhou Center for Disease Control and Prevention, Suzhou 234099, China
| | - Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Juan Du
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Yaqiong Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Qingbin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
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Dean YE, Motawea KR, Shebl MA, Elawady SS, Nuhu K, Abuzuaiter B, Awayda K, Fouad AM, Tanas Y, Batista R, Elsayed A, Hassan NAIF, El‐Sakka AA, Hasan W, Husain R, Lois A, Arora A, Arora A, Ayad E, Elbahaie MA, Shah J, Shady A, Chaudhuri D, Aiash H. Adherence to antihypertensives in the United States: A comparative meta-analysis of 23 million patients. J Clin Hypertens (Greenwich) 2024; 26:303-313. [PMID: 38488773 PMCID: PMC11007819 DOI: 10.1111/jch.14788] [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: 09/22/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 04/12/2024]
Abstract
Adherence to antihypertensives is crucial for control of blood pressure. This study analyzed factors and interventions that could affect adherence to antihypertensives in the US. PubMed, Scopus, Web of Science, and Embase were searched on January 21, 2022 and December 25, 2023 for studies on the adherence to antihypertensives in the US. Nineteen studies and 23 545 747 patients were included in the analysis, which showed that adherence to antihypertensives was the highest among Whites (OR: 1.47, 95% CI 1.34-1.61 compared to African Americans). Employment status and sex were associated with insignificant differences in adherence rates. In contrast, marital status yielded a significant difference where unmarried patients demonstrated low adherence rates compared to married ones (OR: 0.8, 95% CI 0.67-0.95). On analysis of comorbidities, diabetic patients reported lower adherence to antihypertensives (OR: 0.95, 95% CI 0.92-0.97); furthermore, patients who did not have Alzheimer showed higher adherence rates. Different BMIs did not significantly affect the adherence rates. Patients without insurance reported significantly lower adherence rates than insured patients (OR: 3.93, 95% CI 3.43-4.51). Polypill users had higher adherence rates compared with the free-dose combination (OR: 1.21, 95% CI 1.2-1.21), while telepharmacy did not prove to be as effective. Lower adherence rates were seen among African Americans, uninsured, or younger patients. Accordingly, interventions such as fixed-dose combinations should be targeted at susceptible groups. Obesity and overweight did not affect the adherence to antihypertensives.
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Affiliation(s)
- Yomna E. Dean
- Faculty of MedicineAlexandria UniversityAlexandriaEgypt
| | | | | | | | | | | | | | | | - Yousef Tanas
- Faculty of MedicineAlexandria UniversityAlexandriaEgypt
| | | | - Ahmed Elsayed
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
| | | | | | - Walaa Hasan
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
| | | | - Amanda Lois
- Medical University of South CarolinaCharlestonUSA
| | | | | | | | | | | | - Amr Shady
- SUNY Upstate Medical UniversitySyracuseUSA
| | | | - Hani Aiash
- SUNY Upstate Medical UniversitySyracuseUSA
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Agarwal N, DiGiorgio A, Michalopoulos GD, Letchuman V, Chan AK, Shabani S, Lavadi RS, Lu DC, Wang MY, Haid RW, Knightly JJ, Sherrod BA, Gottfried ON, Shaffrey CI, Goldberg JL, Virk MS, Hussain I, Glassman SD, Shaffrey ME, Park P, Foley KT, Pennicooke B, Coric D, Upadhyaya C, Potts EA, Tumialán LM, Fu KMG, Asher AL, Bisson EF, Chou D, Bydon M, Mummaneni PV. Impact of Educational Background on Preoperative Disease Severity and Postoperative Outcomes Among Patients With Cervical Spondylotic Myelopathy. Clin Spine Surg 2024; 37:E137-E146. [PMID: 38102749 DOI: 10.1097/bsd.0000000000001557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 10/03/2023] [Indexed: 12/17/2023]
Abstract
STUDY DESIGN Retrospective review of a prospectively maintained database. OBJECTIVE Assess differences in preoperative status and postoperative outcomes among patients of different educational backgrounds undergoing surgical management of cervical spondylotic myelopathy (CSM). SUMMARY OF BACKGROUND DATA Patient education level (EL) has been suggested to correlate with health literacy, disease perception, socioeconomic status (SES), and access to health care. METHODS The CSM data set of the Quality Outcomes Database (QOD) was queried for patients undergoing surgical management of CSM. EL was grouped as high school or below, graduate-level, and postgraduate level. The association of EL with baseline disease severity (per patient-reported outcome measures), symptoms >3 or ≤3 months, and 24-month patient-reported outcome measures were evaluated. RESULTS Among 1141 patients with CSM, 509 (44.6%) had an EL of high school or below, 471 (41.3%) had a graduate degree, and 161 (14.1%) had obtained postgraduate education. Lower EL was statistically significantly associated with symptom duration of >3 months (odds ratio=1.68), higher arm pain numeric rating scale (NRS) (coefficient=0.5), and higher neck pain NRS (coefficient=0.79). Patients with postgraduate education had statistically significantly lower Neck Disability Index (NDI) scores (coefficient=-7.17), lower arm pain scores (coefficient=-1), and higher quality-adjusted life-years (QALY) scores (coefficient=0.06). Twenty-four months after surgery, patients of lower EL had higher NDI scores, higher pain NRS scores, and lower QALY scores ( P <0.05 in all analyses). CONCLUSIONS Among patients undergoing surgical management for CSM, those reporting a lower educational level tended to present with longer symptom duration, more disease-inflicted disability and pain, and lower QALY scores. As such, patients of a lower EL are a potentially vulnerable subpopulation, and their health literacy and access to care should be prioritized.
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Affiliation(s)
- Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh School of Medicine
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Anthony DiGiorgio
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA
| | | | - Vijay Letchuman
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA
| | - Andrew K Chan
- Department of Neurosurgery, Columbia University Irving Medical Center, New York City, NY
| | - Saman Shabani
- Department of Neurological Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Raj Swaroop Lavadi
- Department of Neurological Surgery, University of Pittsburgh School of Medicine
| | - Daniel C Lu
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA
| | - Michael Y Wang
- Department of Neurological Surgery, University of Miami, Miami, FL
| | | | | | | | | | | | - Jacob L Goldberg
- Department of Neurological Surgery, Weill Cornell Medical Center, New York, NY
| | - Michael S Virk
- Department of Neurological Surgery, Weill Cornell Medical Center, New York, NY
| | - Ibrahim Hussain
- Department of Neurological Surgery, Weill Cornell Medical Center, New York, NY
| | | | - Mark E Shaffrey
- Department of Neurosurgery, University of Virginia, Charlottesville, VA
| | - Paul Park
- Department of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute, University of Tennessee, Memphis, TN
| | - Kevin T Foley
- Department of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute, University of Tennessee, Memphis, TN
| | - Brenton Pennicooke
- Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Domagoj Coric
- Neuroscience Institute, Carolina Neurosurgery & Spine Associates, Carolinas Healthcare System, Charlotte
| | - Cheerag Upadhyaya
- Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Eric A Potts
- Department of Neurological Surgery, Goodman Campbell Brain and Spine, Indianapolis, IN
| | - Luis M Tumialán
- Department of Neurosurgery, Barrow Neurologic Institute, Phoenix, AZ
| | - Kai-Ming G Fu
- Department of Neurological Surgery, Weill Cornell Medical Center, New York, NY
| | - Anthony L Asher
- Neuroscience Institute, Carolina Neurosurgery & Spine Associates, Carolinas Healthcare System, Charlotte
| | - Erica F Bisson
- Department of Neurosurgery, University of Utah, Salt Lake City, UT
| | - Dean Chou
- Department of Neurosurgery, Columbia University Irving Medical Center, New York City, NY
| | - Mohamad Bydon
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN
| | - Praveen V Mummaneni
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA
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Magi CE, Bambi S, Rasero L, Longobucco Y, El Aoufy K, Amato C, Vellone E, Bonaccorsi G, Lorini C, Iovino P. Health Literacy and Self-Care in Patients with Chronic Illness: A Systematic Review and Meta-Analysis Protocol. Healthcare (Basel) 2024; 12:762. [PMID: 38610184 PMCID: PMC11011384 DOI: 10.3390/healthcare12070762] [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: 02/08/2024] [Revised: 03/22/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Self-care plays a critical role in symptom recognition, management, and risk factor modification for patients with chronic illnesses. Despite its significance, self-care levels in this population are generally poor. Health literacy (HL) is pivotal for promoting effective self-care, yet the association across specific chronic illnesses remains fragmented and conflicting. Therefore, a systematic review and meta-analysis will be conducted. Inclusion criteria encompass quantitative studies involving adult patients with at least one chronic illness reporting on the association between a measure of HL and one or more elements of self-care behaviors as outcomes. Databases to be searched include PubMed, CINAHL, APA PsycINFO, Embase, Web of Science, and Cochrane Central Register of Controlled Trials. The studies will undergo risk of bias and certainty of evidence assessment using ROBINS-E and GRADE. Extracted data will include authors, publication date, aim(s), study location, design, sample characteristics, chronic illness type, study length, HL, and self-care measures. Understanding the link between HL and self-care can aid healthcare providers in implementing strategies to enhance health-promoting behaviors, contributing valuable insights to the scientific community and fostering nuanced discussions. This protocol ensures methodological transparency, stimulates discourse, and paves the way for informed interventions to improve overall health outcomes.
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Affiliation(s)
- Camilla Elena Magi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Laura Rasero
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Khadija El Aoufy
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Carla Amato
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Ercole Vellone
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
- Department of Nursing and Obstetrics, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
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22
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Sapbamrer R, Sittitoon N, Thongtip S, Chaipin E, Sutalangka C, La-up A, Thirarattanasunthon P, Thammachai A, Suwannakul B, Sangkarit N, Kitro A, Panumasvivat J, Srisookkum T. Socio-demographic, agricultural, and personal protective factors in relation to health literacy among farmers from all regions of Thailand. Front Public Health 2024; 12:1364296. [PMID: 38590809 PMCID: PMC10999635 DOI: 10.3389/fpubh.2024.1364296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/07/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Farmers are vulnerable to adverse health effects from pesticide exposure due to their health literacy (HL). Therefore, this study aims to investigate HL among farmers in four main regions of Thailand, investigating socio-demographics, agricultural, and personal protective factors to their HL. Methods This cross-sectional design study was conducted on 4,035 farmers from January to July 2023. The European Health Literacy Survey Questionnaire-47 items were used to measure HL. Results Thai farmers had a mean HL score of 34.7 ± 8.7, and the farmers in the North region of Thailand had the highest frequency of limited HL (75.8%). Socio-demographic factors that were associated with HL included gender, region of living, marital status, education level, co-morbidity, and number of family members. Agricultural factors associated with HL included planting status, working hours on farm, spraying pesticides, harvesting crops, pesticide use of >1 type, access information from government officers, access information from posters/brochures, information from online multimedia, and access information from neighbors. Personal protective factors that were associated with HL included wearing a hat, goggles, a rubber apron, and a long-sleeved shirt. Discussion Our study recommends that strategies and interventions to enhance the HL of farmers should be focused on the target populations, which include men, widows, or divorced, those with low levels of education, those who have co-morbidities, and those who applied pesticides of more than 1 type and improper personal protective equipment (PPE) use. The primary emphasis needs to be on the North region of Thailand, making that the target area to improve health equity in Thailand. These efforts would enhance the HL of farmers and sustainably improve pesticide safety behavior. Additionally, there is an urgent need for supportive measures aimed at altering on-farm practices and promoting education on alternative pest management strategies, particularly non-chemical crop protection, to ensure sustainable agriculture.
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Affiliation(s)
- Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Environmental and Occupational Medicine Excellence Center (EnOMEC), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nalin Sittitoon
- School of Environmental Health, Institute of Public Health, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Sakesun Thongtip
- Department of Environmental Health, School of Public Health, University of Phayao, Phayao, Thailand
| | - Eakasit Chaipin
- Department of Public Health, Faculty of Science, Rajabhat Lampang University, Lampang, Thailand
| | - Chatchada Sutalangka
- Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Aroon La-up
- Nakhonsawan Campus, Mahidol University, Nakhonsawan, Thailand
| | | | - Ajchamon Thammachai
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Boonsita Suwannakul
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Noppharath Sangkarit
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Amornphat Kitro
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Environmental and Occupational Medicine Excellence Center (EnOMEC), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jinjuta Panumasvivat
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Environmental and Occupational Medicine Excellence Center (EnOMEC), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Taweewun Srisookkum
- Department of Community Health, School of Public Health, University of Phayao, Phayao, Thailand
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23
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Estrada JAG. Unraveling socioeconomic determinants of health-related behavior, reception of information, and perceptions on disease disclosure at the time of the COVID-19 pandemic: did health insurance curb the disparities in the Philippines? BMC Public Health 2024; 24:767. [PMID: 38475807 DOI: 10.1186/s12889-024-18264-9] [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: 08/01/2023] [Accepted: 03/03/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The study uncovers micro and macro socioeconomic disparities in terms of health behavior, disease perception, and reception of information. Furthermore, findings shed light on the possible role of health insurance on access to information, disease perception and the adoption of preventive behaviors in the context of a public health emergency such as the COVID-19 pandemic. METHODS This study employed a cross-sectional design using the Philippine Demographic and Health Survey (DHS). With a total of 29,809 respondents, it evaluated the individual or household and systemwide socioeconomic determinants of four different outcomes: receipt of information, disease perception, uptake of free preventive services, and treatment-seeking behavior. In addition to logistic regression models with the socioeconomic variables as the independent variables, models for the evaluation of the moderating effect of insurance ownership were fitted. Predicted probabilities were reported for the analysis of moderating effects. RESULTS Findings show that individual and householdsocioeconomic determinants affected health-behavior and access to or receipt of information pertinent to the COVID-19 pandemic. Both education and wealth affected the receipt of information such that individuals in more advantaged socioeconomic positions were at least 30% more likely to have received information on COVID-19. Wealth was also associated to treatment-seeking behavior. Regional differences were seen across all dependent variables. Moreover, the study provides evidence that ownership of insurance can close education-based gaps in the uptake of free vaccination and COVID-19 testing. CONCLUSION It is imperative that targeted efforts be maximized by utilizing existing strategies and mechanisms to reach the marginalized and disadvantaged segments of the population. Health insurance may give off added benefits that increase proficiency in navigating through the healthcare system. Further research may focus on examining pathways by which health insurance or social policies may be used to leverage responses to public health or environmental emergencies.
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24
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Gao Q, Muniz Terrera G, Mayston R, Prina M. Multistate survival modelling of multimorbidity and transitions across health needs states and death in an ageing population. J Epidemiol Community Health 2024; 78:212-219. [PMID: 38212107 PMCID: PMC10958265 DOI: 10.1136/jech-2023-220570] [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: 03/10/2023] [Accepted: 12/23/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Unmet health needs have the potential to capture health inequality. Nevertheless, the course of healthcare needs fulfilment, and the role of multimorbidity in this process remains unclear. This study assessed the bidirectional transitions between met and unmet health needs and the transition to death and examined the effect of multimorbidity on transitions. METHODS This study was based on the China Health and Retirement Longitudinal Study, a nationally representative survey in 2011-2015 among 18 075 participants aged 45 and above (average age 61.1; SD 9.9). We applied a multistate survival model to estimate the probabilities and the instantaneous risk of state transitions, and Gompertz hazard models were fitted to estimate the total, marginal and state-specific life expectancies (LEs). RESULTS Living with physical multimorbidity (HR=1.85, 95% CI 1.58 to 2.15) or physical-mental multimorbidity (HR=1.45, 95% CI 1.15 to 1.82) was associated with an increased risk of transitioning into unmet healthcare needs compared with no multimorbidity. Conversely, multimorbidity groups had a decreased risk of transitioning out of unmet needs. Multimorbidity was also associated with shortened total life expectancy (TLEs), and the proportion of marginal LE for having unmet needs was more than two times higher than no multimorbidity. CONCLUSION Multimorbidity aggravates the risk of transitioning into having unmet healthcare needs in the middle and later life, leading to a notable reduction in TLEs, with longer times spent with unmet needs. Policy inputs on developing integrated person-centred services and specifically scaling up to target the complex health needs of ageing populations need to be in place.
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Affiliation(s)
- Qian Gao
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK
- Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Rosie Mayston
- Global Health & Social Medicine & King's Global Health Institute, Social Science & Public Policy, King's College London, London, UK
| | - Matthew Prina
- Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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25
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Costa A, Henriques J, Alarcão V, Madeira T, Virgolino A, Henriques A, Feteira-Santos R, Polley M, Arriaga M, Nogueira P. Social prescribing for older adults in mainland Portugal: Perceptions and future prospects. Prev Med Rep 2024; 39:102652. [PMID: 38384966 PMCID: PMC10879768 DOI: 10.1016/j.pmedr.2024.102652] [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] [Received: 08/10/2023] [Revised: 02/03/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
Background In order to address health inequalities, which have been exacerbated by the COVID-19 pandemic, and promote older adults' quality of life, it is necessary to explore non-medical approaches such as social prescribing. Social prescribing is a person-centered approach that allows health professionals to refer patients to services provided by the social and community sectors. This study aimed to explore older adults' perceptions of social prescribing in mainland Portugal and to identify factors associated with these perceptions, providing insights for future implementation strategies. Methods A cross-sectional study was conducted with 613 older adults aged 65 to 93. Participants' sociodemographic, economic, and health characteristics were assessed, along with their perceptions of social prescribing's benefits and activity interest. Results Over 75% of respondents agreed that social prescribing would benefit the health system and their community. Most participants (87.7% and 89.7%, respectively) thought that activities like personal protection and development activities and cultural enrichment would be particularly relevant to them. Factors such as marital status, education, health status, and pain/discomfort levels influenced the perceived relevance of these activities. Conclusion This study reveals that older adults in mainland Portugal are open to social prescribing and suggests that tailored interventions considering individual preferences and characteristics can lead to more effective implementation and equal access to social prescribing. Further research and policy efforts should focus on integrating social prescribing into the healthcare system to support healthy aging in Portugal.
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Affiliation(s)
- Andreia Costa
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisboa, Lisbon 1600-190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Católica Research Centre for Psychological-Family and Social Wellbeing (CRC-W), Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisbon 1649-023, Portugal
| | - Joana Henriques
- Escola Nacional de Saúde Pública, ENSP, Centro de Investigação em Saúde Pública, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Avenida Padre Cruz, Lisboa 1600-560, Portugal
| | - Violeta Alarcão
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Centro de Investigação e Estudos de Sociologia (CIES-Iscte), Instituto Universitário de Lisboa (Iscte), Lisboa 1649-026, Portugal
| | - Teresa Madeira
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Adriana Henriques
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisboa, Lisbon 1600-190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Rodrigo Feteira-Santos
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Marie Polley
- University of Westminster, School of Social Sciences (Psychology), 115 New Cavendish Street, London W1W 6UW, United Kingdom
- Consultancy Ltd., Hitchin SG4 0AP, United Kingdom
| | - Miguel Arriaga
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Católica Research Centre for Psychological-Family and Social Wellbeing (CRC-W), Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisbon 1649-023, Portugal
| | - Paulo Nogueira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisboa, Lisbon 1600-190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Escola Nacional de Saúde Pública, ENSP, Centro de Investigação em Saúde Pública, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Avenida Padre Cruz, Lisboa 1600-560, Portugal
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Nuvunga S, Langa DC, Sacarlal J, Rossetto E, Baltazar CS. HIV prevalence and associated factors among married women, Mozambique, 2015: analysis of the 2015 National AIDS Indicator Survey (IMASIDA). Pan Afr Med J 2024; 47:94. [PMID: 38799187 PMCID: PMC11126754 DOI: 10.11604/pamj.2024.47.94.42781] [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: 01/25/2024] [Accepted: 02/19/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction epidemiological estimates from the 2021 Joint United Nations Program on HIV/AIDS (UNAIDS) emphasize the existing gender disparities, where women face a higher risk of HIV/AIDS exposure. In Mozambique, as of 2021, the HIV prevalence rate among the adult population stood at 12.5%, with an even more concerning rate of 15.4% among women of reproductive age. Methods a cross-sectional study was carried out with secondary data from the Survey on National Indicators of Vaccination, Malaria, and HIV/AIDS (IMASIDA 2015), where we included married women, both civil marriage and common law marriage of reproductive age 15-49 years. Statistical analyses, including chi-squared tests and logistic regression models, accounting for survey design, were employed to assess associations. Results the study findings showed that HIV prevalence was higher among married women aged 35-49 years (aOR=2.5; 95% CI: 1.3-4.6; p=0.005), those without formal education (aOR=7.7; 95% CI: 1.1-52.9; p=0.038) and those with primary education (aOR=9.8; 95% CI: 1.6-60.1; p=0.014), those who experienced domestic violence (aOR=1.8; 95% CI: 1.0-3.2; p=0.04), had an uncircumcised partner (aOR=1.9; 95% CI: 1.2-3.1; p=0.008), and had three or more lifetime sex partners (aOR=3.6; 95% CI: 2.9-7.3; p<0.001). Women who were in one lifelong union had a lower risk of HIV positivity (aOR=0.5; 96%CI: 0.3-0.8, p=0.005). Conclusion the findings of this study highlight sociodemographic, behavioral, and violent factors associated with HIV prevalence among women. These findings underscore the importance of targeted interventions and education programs aimed at reducing HIV transmission among females and promoting safer sexual practices.
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Affiliation(s)
- Samuel Nuvunga
- Mozambique Field Epidemiology Training Program, National Institute of Health, Maputo, Mozambique
| | | | - Jahit Sacarlal
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Erika Rossetto
- MassGenics, assigned to Mozambique Centers for Disease Control Prevention, Maputo, Mozambique
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Ikram M, Shen C, Pameijer CR. Racial and Socioeconomic Differences and Surgical Outcomes in Pancreaticoduodenectomy Patients: A Systematic Review of High- Versus Low-Volume Hospitals in the United States. Am Surg 2024; 90:292-302. [PMID: 37941362 DOI: 10.1177/00031348231211040] [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: 11/10/2023]
Abstract
BACKGROUND Pancreaticoduodenectomy (PD) is associated with better outcomes in high-volume hospitals. However, it is unknown whether and to what extent the improved performance of high-volume hospitals may be associated with racial and socioeconomic factors, which have been shown to impact operative and postoperative outcomes in major surgeries. This review aims to identify the differences in racial and socioeconomic characteristics of patients who underwent PD surgery in high- and low-volume hospitals. METHODS PubMed, Cochrane, and Web of Science were systematically searched between May 1, 2023 and May 7, 2023 without any time restriction on publication date. Studies that were conducted in the United States and had a direct comparison between high- and low-volume hospitals were included. RESULTS A total of 30 observational studies were included. When racial proportions were compared by hospital volume, thirteen studies reported that compared to high-volume hospitals, a higher percentage of racial minorities underwent PD in low-volume hospitals. Disparities in traveling distance, education levels, and median income at baseline between high- and low-volume hospitals were reported by four, three, and two studies, respectively. CONCLUSION A racial difference at baseline between high- and low-volume hospitals was observed. Socioeconomic factors were less frequently included in existing literature. Future studies are needed to understand the socioeconomic differences between patients receiving PD surgery in high- and low-volume hospitals.
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Affiliation(s)
- Mohammad Ikram
- Department of Surgery, Division of Outcomes Research and Quality, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Chan Shen
- Department of Surgery, Division of Outcomes Research and Quality, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
- Department of Public Health Sciences, Division of Health Services and Behavioral Research, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Colette R Pameijer
- Department of Surgery, Division of Surgical Oncology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
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Bai L, Tang H, Wang M. Dietary behaviors of rural residents in northeastern China: implications for designing intervention information and targeting high-risk population. Front Public Health 2024; 12:1239449. [PMID: 38389950 PMCID: PMC10883159 DOI: 10.3389/fpubh.2024.1239449] [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: 06/13/2023] [Accepted: 01/02/2024] [Indexed: 02/24/2024] Open
Abstract
Background Dietary behavior is a pivotal modifiable determinant in reducing the occurrence of obesity/overweight and chronic non-communicable diseases. Improving the dietary behavior of rural residents in China is imminent due to the poor performance of their dietary behavior. Nutrition knowledge and health literacy are considered as elements that are linked intimately to healthy dietary behaviors but lack research in the Chinese setting. Purpose The study is designed to explore the relationship between nutritional knowledge, health literacy and dietary behaviors and to analyze the performance under different demographic characteristics. Methods A face-to-face survey of 400 rural residents on their nutrition knowledge, functional health literacy and dietary intake of five food categories consisting of 32 items was conducted based on a validated questionnaire. Descriptive analysis, difference test including ANOVA, t-test and non-parametric test, and multivariate linear regression were used for data analysis. Results The results indicate that declarative nutrition knowledge, individuals' information application capacity, and dietary behaviors, especially the intake of fruits, dairy and beans, and vegetable are not ideal and requires improvement. Male, elder, low-income, unmarried, and low-education populations performed significantly worse and were the high-risk group. Procedural nutrition knowledge, information access capacity, information understanding capacity, and information application capacity have remarkable effects on better dietary behavior. Conclusion This study provides evidence-based guidance for prioritizing information and populations for healthy dietary interventions.
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Affiliation(s)
- Li Bai
- School of Biological and Agricultural Engineering, Jilin University, Changchun, China
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Haiheng Tang
- School of Biological and Agricultural Engineering, Jilin University, Changchun, China
| | - Mingliang Wang
- School of Business and Management, Jilin University, Changchun, China
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Scott TA, Mercedes CR, Lin HM, Katz D. Motivations and demographic differences in pregnant individuals in the decision to participate in research. Can J Anaesth 2024; 71:87-94. [PMID: 37919628 DOI: 10.1007/s12630-023-02635-8] [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: 04/20/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 11/04/2023] Open
Abstract
PURPOSE Although many patients agree to participate in research studies, many decline. The decision of whether or not to participate is especially complex in pregnant individuals as they may be concerned about both themselves and the fetus. We sought to understand patient reasoning for and demographic associations with participation in a trial surrounding the utility of epidural preservative-free morphine after successful vaginal delivery. METHODS We conducted a survey-based study in which parturients were approached within 36 hr after delivery to complete a survey assessing reasons for why they participated or not in the original trial. The survey also included self-reported demographics. Survey responses were categorized as follows: active participation, passive participation, ambivalence, aversion, miscommunication, clinical difficulty, unwilling to receive placebo, and screening failures. RESULTS The survey response rate was 47%. Having a bachelor's degree or higher was associated with participating in the study (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.07 to 3.64; P = 0.03). Race and ethnicity were not predictive of participation. Participants who self-identified as Black were more likely to select reasons of aversion for why they did not participate in the trial (OR, 2.6; 95% CI, 1.00 to 6.75; P = 0.05). Seventy-three percent of participants who self-identified as Black and declined to participate selected aversion, compared with 31% of those who self-identified as non-Black. Additionally, 71% of participants who self-identified as Hispanic and declined to participate selected aversion, compared with 32% of those who self-identified as non-Hispanic. CONCLUSIONS These findings can help identify areas for improvement of participation of pregnant individuals in research studies. Demographic associations may influence participation and reasons for participation.
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Affiliation(s)
- Talia A Scott
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1010, New York, NY, 10029, USA.
| | - Cynthia R Mercedes
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hung-Mo Lin
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniel Katz
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Wang A, Wan J, Zhu L, Chang W, Wen L, Tao X, Jin Y. Frailty and medication adherence among older adult patients with hypertension: a moderated mediation model. Front Public Health 2023; 11:1283416. [PMID: 38115848 PMCID: PMC10728772 DOI: 10.3389/fpubh.2023.1283416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
Objective Medication adherence has a critical impact on the well-being of older adult patients with hypertension. As such, the current study aimed to investigate the mediating role of health literacy between frailty and medication adherence and the moderating role of educational level. Methods This cross-sectional study included patients admitted to the geriatric unit of a hospital. Participants were interviewed using the four-item Morisky Medication Adherence Scale, the Frailty Phenotype Scale, and the Health Literacy Management Scale. Spearman's correlation coefficients were used to assess the association between variables. Mediation and moderated mediation analyses were performed using Process version 4.1 via Model 4 and 14, respectively. Results Data from 388 participants were analyzed. The median (IQR [P25-P75]) score for medication adherence was 4.00 (2.00-4.00). Results revealed that after controlling for age, sex, hypertension complication(s) and body mass index, frailty significantly contributed to medication adherence (βtotal -0.236 [95% confidence interval (CI) -0.333 to -0.140]). Medication adherence was influenced by frailty (βdirect -0.192 [95% CI -0.284 to -0.099]) both directly and indirectly through health literacy (βindirect -0.044 [95% CI -0.077 to -0.014]). Educational level moderated the pathway mediated by health literacy; more specifically, the conditional indirect effect between frailty and medication adherence was significant among older adult hypertensive patients with low, intermediate, and high educational levels (effect -0.052 [95% CI -0.092 to -0.106]; effect -0.041 [95% CI -0.071 to -0.012]; effect -0.026 [95% CI -0.051 to -0.006]). The relationship between frailty and medication adherence in older adult patients with hypertension was found to have mediating and moderating effects. Conclusion A moderated mediation model was proposed to investigate the effect of frailty on medication adherence. It was effective in strengthening medication adherence by improving health literacy and reducing frailty. More attention needs to be devoted to older adult patients with hypertension and low educational levels.
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Affiliation(s)
- Anshi Wang
- School of Public Health, Wannan Medical College, Wuhu, China
- Institutes of Brain Science, Wannan Medical College, Wuhu, China
| | - Jingjing Wan
- Department of Nursing, Anhui College of Traditional Chinese Medicine, Wuhu, China
| | - Lijun Zhu
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Weiwei Chang
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Liying Wen
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Xiubin Tao
- Nursing Department, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Yuelong Jin
- School of Public Health, Wannan Medical College, Wuhu, China
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Franzoi MA, Bayle A, Vaz-Luis I. Changing cancer representations toward comprehensive portraits to empower patients in their care journey. Ann Oncol 2023; 34:1082-1087. [PMID: 37816461 DOI: 10.1016/j.annonc.2023.09.3117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Affiliation(s)
- M A Franzoi
- Cancer Survivorship Group, Inserm U981, Gustave Roussy, Villejuif.
| | - A Bayle
- Bureau Biostatistique et Epidémiologie, Gustave Roussy, Université Paris-Saclay, Villejuif; INSERM, Université Paris-Saclay, CESP U1018 Oncostat, labelisé Ligue contre le cancer, Villejuif, France
| | - I Vaz-Luis
- Cancer Survivorship Group, Inserm U981, Gustave Roussy, Villejuif
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McConnell ML, Marshall EG, Stock D, Trenaman SC, Andrew MK. Is Dementia Related to a Longer Wait Time to be Assigned a New Primary Care Provider? An Analysis of the Nova Scotia Need a Family Practice Registry Derived from the PUPPY-Study. Can Geriatr J 2023; 26:502-510. [PMID: 38045885 PMCID: PMC10684307 DOI: 10.5770/cgj.26.681] [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: 12/05/2023] Open
Abstract
Background Access to Primary Care Providers (PCPs) is limited for many Canadians. "Unattached patients" are persons who do not have a PCP. Older adults living with dementia may face greater challenges seeking attachment. This study investigated whether older adults living with dementia experience differential wait times for PCPs compared to those without a diagnosis of dementia. Methods This was an observational descriptive study of the centralized wait-list data from the Nova Scotia (NS) Need a Family Practice Registry (NaFPR). Time on provider wait-list by dementia diagnosis and age were compared. Number of days on the registry across these measures was estimated. Multivariable proportional hazards regression was used to compare hazards of remaining on the registry over time. Results Unattached older adults living with dementia were on the NaFPR for less time compared to those without dementia (381.4 vs. 428.8 days, respectively). After adjusting for age, self-reported gender, comorbidity, rurality, income quintiles, and overall deprivation, older adults with dementia had a 1.13-fold (95% CI: 1.04-1.24) increase in the likelihood of leaving the NaFPR. Potential contributors to this small difference could be placement in Long Term Care (LTC) and subsequent facility PCP attachment. Conclusions Analysis of the NaFPR exhibited similarly time to PCP attachment despite a diagnosis of dementia. This represented an effective equality model of health care utilized in NS. Future studies should investigate whether an equity model with priority attachment for vulnerable patients would reduce hospitalization and LTC institutionalization.
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Affiliation(s)
- Miranda L. McConnell
- Primary Care Research Unit, Dalhousie Departments of Family Medicine, Dalhousie University, Halifax
| | - Emily Gard Marshall
- Primary Care Research Unit, Dalhousie Departments of Family Medicine, Dalhousie University, Halifax
| | - David Stock
- Primary Care Research Unit, Dalhousie Departments of Family Medicine, Dalhousie University, Halifax
| | - Shanna C. Trenaman
- Department of Medicine (College of Pharmacy), Dalhousie University, Halifax
| | - Melissa K. Andrew
- Department of Medicine (Geriatrics), Dalhousie University, Halifax, NS
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Hughes J, Flood T. Patients' experiences of engaging with electronic Patient Reported Outcome Measures (PROMs) after the completion of radiation therapy for breast cancer: a pilot service evaluation. J Med Radiat Sci 2023; 70:424-435. [PMID: 37550951 PMCID: PMC10715367 DOI: 10.1002/jmrs.711] [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: 12/24/2022] [Accepted: 07/21/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION Over 60 % of people who develop breast cancer will receive radiation therapy (RT) as part of their treatment. Side effects of RT may include inflammation, erythema, desquamation and fatigue. Electronic Patient Reported Outcomes Measures (ePROMs) enable patients to report side effects prior to their scheduled post-RT appointment. This pilot service evaluation aims to explore patients' perceptions regarding the value of the ePROM system, ease of its use and barriers to using the system, after breast irradiation. METHODS From July-November 2021, evaluation surveys were posted to 100 people who had received RT to their breast to explore their experience of using the ePROM. Ethical approval was obtained through Ulster University and the Western Health and Social Care Trust (WHSCT), Northern Ireland. RESULTS Fifty-two people responded to the survey, of which 27 respondents indicated that they had accessed the ePROM. Despite few participants experiencing significant side effects, the majority of participants recommended the ePROM indicating that it was an important source of support. Those who experienced significant side effects found the system to be prompt and effective. Barriers to accessing the ePROM included technical issues with the link, concerns about confidentiality and forgetting to access the link. Access to the ePROM increased with higher education levels. CONCLUSIONS This pilot service evaluation demonstrated that ePROMs are valued by patients and can provide rapid real-time access to support, offering individual care and reassurance. For patients with longer RT schedules (>10 fractions), the introduction of ePROMs during RT was viewed favourably by participants. All patients may benefit from the option of receiving ePROMs post-RT.
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Affiliation(s)
- Jane Hughes
- North West Cancer Centre, Altnagelvin HospitalWestern Health and Social Care TrustDerryUK
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Hart RK, Christiansen SG, Reneflot A, Hauge LJ. Adolescents' primary care consultations before and after parental suicide: evidence from population-wide data. Eur Child Adolesc Psychiatry 2023; 32:2453-2462. [PMID: 36175569 PMCID: PMC10682049 DOI: 10.1007/s00787-022-02095-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 09/23/2022] [Indexed: 11/03/2022]
Abstract
Parental bereavement is associated with distress and poorer long-term outcomes among adolescents. Adolescents who lose a parent to suicide fare worse than their peers even before bereavement. Based on the current literature, we cannot distinguish such initial differences from the medium and long-term effect of parental suicide. We study the impact of parental suicide on adolescents' General Practitioner visits for mental health or psychosocial reasons. Within-individual models account for time-invariant differences between the bereaved and non-bereaved. We investigate if effects differ from the impact of parental death from other causes, and vary with sex and socioeconomic background. Full population data on Norwegian residents aged 10-19 in the period 2006-2015 are drawn from registers (N = 1 405 suicide bereaved, 12 982 bereaved by other causes, and 1 182 819 non-bereaved controls). Records include data on use of health services, parental mortality, and sociodemographic characteristics of parent and child. Mental health consultations increase gradually in the quarters leading up to the parental suicide, significantly more for girls than for boys. Two years prior to bereavement, 2.4% of the subsequently suicide bereaved have a mental health consultation in any given quarter. In the year of bereavement, this increases with 6% points. Health care workers should be aware that boys are less likely to turn to their GP for support before parental bereavement from suicide.
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Affiliation(s)
- Rannveig K Hart
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway.
| | | | - Anne Reneflot
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway
| | - Lars Johan Hauge
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway
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Ahmead M, Daghlas F. The effect of the COVID-19 pandemic on the provision of outpatient clinic services in East Jerusalem hospitals: patients' perspectives. Front Public Health 2023; 11:1252449. [PMID: 38074699 PMCID: PMC10704241 DOI: 10.3389/fpubh.2023.1252449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
Background Due to the decreased availability, accessibility, and quality of services, the COVID-19 pandemic has an impact on the healthcare system. In the wake of the COVID-19 pandemic, patients' perceptions of healthcare have changed, and out-patient visits to clinics have decreased. As part of the COVID-19 outbreak in East Jerusalem, this study aims to assess how patients perceive the way that outpatient clinic services were delivered before and during COVID-19 outbreak. Methodology Convenience sampling and self-reported questionnaires were used in a cross-sectional study. Three hundred people from three significant outpatient clinic hospitals in East Jerusalem-Al-Makassed Hospital, Augusta Victoria Hospital, and Sant-Joseph Hospital- made up the sample. Multivariate tests, frequencies, and percentages were used in the statistical analysis. Results The results showed that the most of the participants (98.6%) had negative opinion when the current situation is compared with before the COVID-19 period in terms of accessibility, availability of resources, quality of care, attitudes and patient's preference. Finally, multivariate analysis indicated a significant relationship between participant opinion and education level and participants with educational levels of 12 study years or less had more positive opinions of the delivery of the healthcare system during the COVID-19 outbreak period than the group with more than 12 study years. Also, the multivariate analysis revealed a significant `relationship between participant opinion and the duration of the illness as those with years of illness and less had more negative opinion toward the delivery of the healthcare system than those with more than 3 years of illness. Conclusion This study found that when the current situation during the COVID-19 outbreak is compared to before the COVID-19 period in terms of accessibility, availability of resources, quality of care, attitudes, and patient preferences, the majority of the participants with chronic diseases or cancer had a negative opinion. Policymakers and health managers should enhance patient preferences and attitudes during the COVID-19 pandemic and other pandemics by increasing accessibility, availability of health resources, and the quality of healthcare.
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James PB, Yendewa GA, Bah AJ, Osborne A, Kpagoi SS, Margao EK, Kangbai J, Wardle J. Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey. BMC Pregnancy Childbirth 2023; 23:810. [PMID: 37993807 PMCID: PMC10664373 DOI: 10.1186/s12884-023-06126-y] [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: 09/02/2022] [Accepted: 11/14/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND A nationwide assessment of the link between women's empowerment and homebirth has not been fully examined in Sierra Leone. Our study examined the association between women's empowerment and homebirth among childbearing women in Sierra Leone using the 2019 Sierra Leone Demographic Health Survey (2019 SLDHS) data. METHOD We used the individual file (IR) of the 2019 SLDHS dataset for our analysis. A total of 7377 women aged 15-49 years who gave birth in the five years preceding the survey were included. Outcome variable was "home birth of their last child among women in the five years preceding the 2019 SLDHS. Women's empowerment parameters include women's knowledge level, economic participation, decision-making ability and power to refuse the idea of intimate partner violence. We used the complex sample command on SPSS version 28 to conduct descriptive and multivariate logistic regression analyses. RESULTS Three in every 20 women had home childbirth (n = 1177; 15.3%). Women with low [aOR 2.04; 95% CI 1.43-2.92] and medium [aOR 1.44; 95%CI 1.05-1.97] levels of knowledge had higher odds of giving birth at home compared to those with high levels of knowledge. Women who did not have power to refuse the idea of intimate partner violence against women were more likely to had given birth at home [aOR 1.38; 95% CI1.09-1.74]. In addition, women with no [aOR 2.71; 95% CI1.34-5.46) and less than four antenatal care visits [aOR 2.08; 95% CI:1.51-2.88] and for whom distance to a health facility was a major problem [aOR 1.95; 95% CI1.49-2.56] were more likely to have had a homebirth. However, no statistically significant association was observed between a women's decision-making power and home birth [aOR 1.11; 95% CI 0.86-1.41]. CONCLUSION Despite improvements in maternal health indicators, homebirth by unskilled birth attendants is still a public health concern in Sierra Leone. Women with low knowledge levels, who did not have power to refuse the idea of intimate partner violence against women, had less than four ANC visits and considered distance to a health facility as a major problem had higher odds of giving birth at home. Our findings reflect the need to empower women by improving their knowledge level through girl child and adult education, increasing media exposure, changing societal norms and unequal power relations that promote gender-based violence against women, and improving roads and transport infrastructure.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, Australia.
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - George A Yendewa
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - Augustus Osborne
- Department of Biological Sciences, School of Environmental Sciences, Njala University, Njala Campus, Njala, Sierra Leone
| | - Satta Sylvia Kpagoi
- Bo Government Hospital, Ministry of Health and Sanitation, Bo, Sierra Leone
- School of Community Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone
| | - Emmanuel Kamanda Margao
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Jia Kangbai
- School of Community Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone
- Faculty of Health Sciences and Disaster Management, Eastern Technical University of Sierra Leone, Kenema, Sierra Leone
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, Australia
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Pivac I, Markić J, Poklepović Peričić T, Aranza D, Marušić A. Evaluating health claim assessment skills of parents with preschool children: A cross-sectional study using Informed Health Choices Claim Evaluation Tool. J Glob Health 2023; 13:04156. [PMID: 37917876 PMCID: PMC10622117 DOI: 10.7189/jogh.13.04156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Abstract
Background Health literacy is a global problem and is particularly relevant when making health care decisions about small children. We analysed how parents of preschool children assess health claims and explored the predictors of their assessment skill. Methods We conducted a survey with questions from the Claim Evaluation Tools (CET) database, part of the Informed Health Choices (IHC) project, in ten paediatric primary care practices of the Split-Dalmatia County Health Center, Split, Croatia, from 1 February to 31 March 2023. Eligible participants were parents accompanying preschool-aged children for check-ups. We also collected data on parents' and children's demographic and health characteristics (including the presence of any chronic illness in the child), visits to paediatric emergency service, hospitalisations, vaccination status, the presence of chronic illness of parents or relatives, and whether parents had to made treatment decisions for themselves and/or their family member. Results Overall, 402 parents of preschool children (median age 35 years (interquartile range (IQR) = 31.0-38.3)) had a median IHC CET test score of 10.0 (IQR = 8.0-11.0) out of 12 questions. The multiple regression analysis showed that female gender, higher level of education, being employed, and having a history of a visit to paediatric emergency service were significant predictors of the test score, explaining 21.9% of the variance. Conclusions Parents of preschool children have a very good ability for critical assessment of health-related statements in a complex health care system and an environment of generally unsatisfactory health literacy. Further studies should explore how parents understand health claims in different geographical, socio-economic and cultural setting, and explore educational interventions to increase critical thinking abilities and informed decision-making, especially among fathers, unemployed parents and those with lower levels of education.
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Affiliation(s)
- Ivan Pivac
- University of Split School of Medicine, Split, Croatia
| | - Joško Markić
- University of Split School of Medicine, Split, Croatia
- Department of Pediatrics, University Hospital of Split, Split, Croatia
| | | | - Diana Aranza
- University Department of Health Studies, University of Split, Split, Croatia
| | - Ana Marušić
- University of Split School of Medicine, Split, Croatia
- Center for Evidence-based Medicine, University of Split School of Medicine, Split, Croatia
- Department for Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
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Büttner M, Krogh D, Siggelkow H, Singer S. Impairments in quality of life and predictors of symptom burden in patients with hypoparathyroidism: results from a population-based survey. Endocrine 2023; 82:419-426. [PMID: 37450218 PMCID: PMC10543843 DOI: 10.1007/s12020-023-03443-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE To investigate the quality of life (QoL) in patients with hypoparathyroidism (hypoPT) compared to the general population and to identify sociodemographic and clinical factors that are associated with symptom burden. METHODS Patients with a diagnosis of hypoPT participated in an online survey. Information regarding the survey was distributed by treating physicians or a self-help organization. Quality of life was assessed using the EORTC QLQ-C30 and symptom burden using the Hypoparathyroid Patient Questionnaire (HPQ28). Multivariate linear regression analysis was used to compare QoL of hypoPT patients with the general population (adjusted for age, sex, education)and to identify factors associated with symptom burden. RESULTS Altogether, 264 hypoPT patients provided information on QoL and symptom burden. HypoPT was associated with worse cognitive (β = -15.9; p < 0.01) and emotional functioning (β = -12.3; p = 0.04) compared to the general population. The highest symptom burden in hypoPT patients was observed for the domains loss of vitality (mean: 61.4; SD: 21.9), pain and cramps (mean: 43.7; SD: 26.5), and numbness and tingling sensations (mean: 38.9; SD: 30.0). Female gender was associated with a higher symptom burden across all nine domains of the HPQ28, while longer disease duration was associated with a lower symptom burden in neurovegetative symptoms, loss of vitality, depression and anxiety, and depressive symptoms. CONCLUSION HypoPT patients have impaired QoL compared to the general population. Being female is strongly associated with high symptom burden.
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Affiliation(s)
- Matthias Büttner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany.
- University Cancer Centre, Mainz, Germany.
| | - Dieter Krogh
- Netzwerk Hypopara im Bundesverband Schilddrüsenkrebs-Ohne Schilddrüse leben e.V, Berlin, Germany
| | - Heide Siggelkow
- Clinic of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University of Göttingen, Göttingen, Germany
- MVZ Endokrinologikum Göttingen, Göttingen, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
- University Cancer Centre, Mainz, Germany
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Cofini V, Muselli M, Limoncin E, Lolli C, Pelaccia E, Guido M, Fabiani L, Necozione S. The Perception of the Quality of Professional Healthcare Assistance for the Management of Endometriosis: Findings from a National Survey in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6978. [PMID: 37947536 PMCID: PMC10649906 DOI: 10.3390/ijerph20216978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 11/12/2023]
Abstract
(1) Background: endometriosis is included in the list of chronic and disabling pathologies. This study aimed to examine patients' points of view about the quality of care for endometriosis during the COVID-19 pandemic; (2) Methods: we conducted a survey on knowledge about endometriosis, management of endometriosis, perceived mental and physical well-being, and perceived changes in the quality of care during the pandemic; (3) Results: out of 1065 participants, 875 were included in the analysis, with an average age of 34. Overall, patients had positive perceptions of care accessibility and cleanliness (95%), but less satisfaction with visit hours (86%). Those with better physical and psychological health were more satisfied with service hours, while those treated at specialised centres were more content with cleanliness. Satisfaction with clarity was linked to specialist treatment, and perceived availability to listen correlated with age, complications, and overall health status; (4) Conclusions: patients' perspectives are crucial for patient education and advocate for specialised interdisciplinary networks to support endometriosis management and patients' well-being. These findings highlight the importance of considering patient viewpoints, particularly in the context of the COVID-19 pandemic's impact on healthcare systems and suggest a need for further research from the patient's perspective.
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Affiliation(s)
- Vincenza Cofini
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (V.C.); (C.L.); (E.P.); (M.G.); (L.F.); (S.N.)
| | - Mario Muselli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (V.C.); (C.L.); (E.P.); (M.G.); (L.F.); (S.N.)
| | - Erika Limoncin
- Department of Dynamic, Clinical Psychology and Health Sciences, Sapienza University of Rome, 00185 Rome, Italy;
| | - Chiara Lolli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (V.C.); (C.L.); (E.P.); (M.G.); (L.F.); (S.N.)
| | - Erika Pelaccia
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (V.C.); (C.L.); (E.P.); (M.G.); (L.F.); (S.N.)
| | - Maurizio Guido
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (V.C.); (C.L.); (E.P.); (M.G.); (L.F.); (S.N.)
| | - Leila Fabiani
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (V.C.); (C.L.); (E.P.); (M.G.); (L.F.); (S.N.)
| | - Stefano Necozione
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (V.C.); (C.L.); (E.P.); (M.G.); (L.F.); (S.N.)
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Crafoord MT, Sundberg K, Nilsson MI, Fjell M, Langius-Eklöf A. Patients' Individualized Care Perceptions and Health Literacy Using an Interactive App During Breast and Prostate Cancer Treatment: Two Parallel Randomized Controlled Trials. Comput Inform Nurs 2023; 41:706-716. [PMID: 36749849 DOI: 10.1097/cin.0000000000001007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The use of symptom management mobile apps can reduce patients' symptom burden during cancer treatment, but the evidence is lacking about their effect on care. Moreover, if patients' health literacy can be improved, it needs to be more rigorously tested. This study aimed to evaluate patients' perceptions of individualized care and health literacy using an interactive app in two randomized trials. Patients undergoing neoadjuvant chemotherapy for breast cancer (N = 149) and radiotherapy for prostate cancer (N = 150) were consecutively included and randomized into one intervention or control group. Outcome measures were Individualized Care Scale, Swedish Functional Health Literacy Scale, and Swedish Communicative and Critical Health Literacy Scale. In the breast cancer trial, no group differences were observed regarding individualized care or health literacy. Most patients had sufficient health literacy levels. In the prostate cancer trial, intervention group patients rated higher perceived individualized care regarding decision control at follow-up than the control group. Less than half had sufficient health literacy levels and intervention group patients significantly improved their ability to seek, understand, and communicate health information. Education level explained significant variance in health literacy in both trials. Using an interactive app can positively affect individualization in care and health literacy skills among patients treated for prostate cancer, although further research is warranted.
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Affiliation(s)
- Marie-Therése Crafoord
- Author Affiliations : Department of Neurobiology, Care Sciences and Society, Karolinska Institutet (Ms Crafoord, and Drs Sundberg, Fjell, and Langius-Eklöf); Function Area Social Work in Health Care, Karolinska University Hospital, and Karolinska Institutet, Department of Neurobiology, Care Sciences and Society (Dr Nilsson); and Academic Primary Care Center, Stockholm County Council (Dr Nilsson), Stockholm, Sweden
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Estrela M, Semedo G, Roque F, Ferreira PL, Herdeiro MT. Sociodemographic determinants of digital health literacy: A systematic review and meta-analysis. Int J Med Inform 2023; 177:105124. [PMID: 37329766 DOI: 10.1016/j.ijmedinf.2023.105124] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/18/2023] [Accepted: 06/05/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Differences in digital health literacy levels are associated with a lack of access to digital tools, usage patterns, and the ability to effectively use digital technologies. Although some studies have investigated the impact of sociodemographic factors on digital health literacy, a comprehensive evaluation of these factors has not been conducted. Therefore, this study sought to examine the sociodemographic determinants of digital health literacy by conducting a systematic review of the existing literature. METHODS A search of four databases was conducted. Data extraction included information on study characteristics, sociodemographic factors, and the digital health literacy scales used. Meta-analyses for age and sex were conducted using RStudio software with the metaphor package. RESULTS A total of 3922 articles were retrieved, of which 36 were included in this systematic review. Age had a negative effect on digital health literacy (B = -0.05, 95%CI [-0.06; -0.04]), particularly among older adults, whereas sex appeared to have no statistically significant influence among the included studies (B = - 0.17, 95%CI [-0.64; 0.30]). Educational level, higher income, and social support also appeared to have a positive influence on digital health literacy. DISCUSSION This review highlighted the importance of addressing the digital health literacy needs of underprivileged populations, including immigrants and individuals with low socioeconomic status. It also emphasizes the need for more research to better understand the influence of sociodemographic, economic, and cultural differences on digital health literacy. CONCLUSIONS Overall, this review suggests digital health literacy is dependent on sociodemographic, economic, and cultural factors, which may require tailored interventions that consider these nuances.
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Affiliation(s)
- Marta Estrela
- iBiMED-Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal; Department of Social, Political and Territorial Sciences, University of Aveiro, Portugal; Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal; Health Sciences Research Center, University of Beira Interior (CICS-UBI), Covilhã, Portugal.
| | - Guilherme Semedo
- Medical Devices Department, Critical Catalyst, Matosinhos, Portugal
| | - Fátima Roque
- Health Sciences Research Center, University of Beira Interior (CICS-UBI), Covilhã, Portugal; Research Unit for Inland Development, Guarda Polytechnic Institute (UDI-IPG), Guarda, Portugal
| | - Pedro Lopes Ferreira
- Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal; Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Maria Teresa Herdeiro
- iBiMED-Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
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Ahn YJ, Kang EM, Kiatkawsin K, Zielinski S. Relationships between Community Festival Participation, Social Capital, and Subjective Well-Being in a Cross-Cultural Context. Healthcare (Basel) 2023; 11:2361. [PMID: 37628557 PMCID: PMC10454757 DOI: 10.3390/healthcare11162361] [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: 07/19/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
This study explores the relationships among social capital, community festival participation, and subjective well-being (SWB). It examines the mediating role of festival participation between social capital and SWB. The dataset Social Well-being Survey in Asia from the Philippines and Thailand was collected using nationwide surveys in 2016. The total number of respondents was 1057 in the Philippines and 982 in Thailand. The results affirm several determinants related to SWB, which is composed of happiness and overall life satisfaction. The models show significant relationships among festival participation, social capital, and SWB. The results indicate strong associations among social capital with family and relatives, festival participation, and SWB. The interaction effects between the two countries are included. Structural and cognitive social capital with kinship groups were important determinants in facilitating festival participation, and positively associated with SWB. Moreover, the results identify the mediating effect of festival participation between social capital with family and relatives and SWB. The results can provide similarities and differences in the relationships among social capital and kinship groups, community festival participation, and SWB between the Philippines and Thailand. This study offers important empirical evidence of a cross-cultural study in the context of the Philippines and Thailand.
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Affiliation(s)
- Young-joo Ahn
- Department of Hospitality and Tourism Management, Sejong University, Seoul 05006, Republic of Korea; (Y.-j.A.); (E.M.K.)
| | - Eunice Minjoo Kang
- Department of Hospitality and Tourism Management, Sejong University, Seoul 05006, Republic of Korea; (Y.-j.A.); (E.M.K.)
| | - Kiattipoom Kiatkawsin
- Business Communication and Design, Singapore Institute of Technology, 10 Dover Drive, Singapore 138683, Singapore;
| | - Seweryn Zielinski
- Department of Hospitality and Tourism Management, Sejong University, Seoul 05006, Republic of Korea; (Y.-j.A.); (E.M.K.)
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Alfaifi JA, Alqarni SAM, Alqarni A, Alqahtani MM, Alshomrani RA. Parents' Knowledge, Attitude, and Practice Regarding Traditional Medicine on Their Children: A Community-Based Cross-Sectional Study in Bisha City, Saudi Arabia. Cureus 2023; 15:e43136. [PMID: 37577274 PMCID: PMC10412750 DOI: 10.7759/cureus.43136] [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] [Accepted: 08/08/2023] [Indexed: 08/15/2023] Open
Abstract
Background The use of traditional medicine (TM) in children is widespread, particularly in developing countries. Parents often rely on TM to treat their children's illnesses or maintain their health. However, the safety and efficacy of TM are often unclear, and there is a need to assess parents' knowledge, attitudes, and practices toward its use. Methods This is a community-based cross-sectional study conducted in Bisha, Saudi Arabia, with a sample size of 555. The study used a modified questionnaire to collect data. The data were collected from March to June 2023. This study involved both descriptive and inferential statistics. Results The study included 555 participants, most of whom were female, Saudi nationals, and married and had a bachelor's degree. More than half of the participants reported using TM, and most believed that it had fewer side effects and could be taken with allopathic medicines. However, many participants did not believe that TM could prevent or cure all diseases or that it was always safe. The median knowledge score was 4.0, with higher scores associated with older age and higher educational level. Most participants had a positive attitude toward TM, with higher attitude scores associated with younger age, male gender, lower educational level, and healthcare-related occupation. The median practice score was 31.0, with higher scores associated with younger age, male gender, illiteracy, and healthcare-related occupation. Overall, the study highlights the importance of understanding the patterns of use, knowledge, attitudes, and practices of TM in the population, particularly among different demographic groups. Conclusions This study highlights the need for better regulation and supervision of TM outlets to ensure the safety and efficacy of the products. It also emphasizes the importance of consulting healthcare professionals before using TM on children. The findings suggest that healthcare providers should be knowledgeable about TM and provide guidance to parents on its appropriate use.
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Affiliation(s)
- Jaber A Alfaifi
- Pediatrics, College of Medicine, University of Bisha, Bisha, SAU
| | | | - Anas Alqarni
- College of Medicine, University of Bisha, Bisha, SAU
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He AH, Manouchehrinia A, Glaser A, Ciccarelli O, Butzkueven H, Hillert J, McKay KA. Association between clinic-level quality of care and patient-level outcomes in multiple sclerosis. Mult Scler 2023; 29:1126-1135. [PMID: 37392018 PMCID: PMC10413789 DOI: 10.1177/13524585231181578] [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: 02/19/2023] [Revised: 04/27/2023] [Accepted: 05/21/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) quality of care guidelines are consensus-based. The effectiveness of the recommendations is unknown. OBJECTIVE To determine whether clinic-level quality of care affects clinical and patient-reported outcomes. METHODS This nationwide observational cohort study included patients with adult-onset MS in the Swedish MS registry with disease onset 2005-2015. Clinic-level quality of care was measured by four indicators: visit density, magnetic resonance imaging (MRI) density, mean time to commencement of disease-modifying therapy, and data completeness. Outcomes were Expanded Disability Status Scale (EDSS) and patient-reported symptoms measured by the Multiple Sclerosis Impact Scale (MSIS-29). Analyses were adjusted for individual patient characteristics and disease-modifying therapy exposure. RESULTS In relapsing MS, all quality indicators benefitted EDSS and physical symptoms. Faster treatment, frequent visits, and higher data completeness benefitted psychological symptoms. After controlling for all indicators and individual treatment exposures, faster treatment remained independently associated with lower EDSS (-0.06, 95% confidence interval (CI): -0.01, -0.10) and more frequent visits were associated with milder physical symptoms (MSIS-29 physical score: -16.2%, 95% CI: -1.8%, -29.5%). Clinic-level quality of care did not affect any outcomes in progressive-onset disease. CONCLUSION Certain quality of care indicators correlated to disability and patient-reported outcomes in relapse-onset but not progressive-onset disease. Future guidelines should consider recommendations specific to disease course.
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Affiliation(s)
- Anna H He
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden/Centre for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ali Manouchehrinia
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden/Centre for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Glaser
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Olga Ciccarelli
- Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Helmut Butzkueven
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Jan Hillert
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Kyla Anne McKay
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden/Centre for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
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Levinsen AKG, Kjaer TK, Maltesen T, Jakobsen E, Gögenur I, Borre M, Christiansen P, Zachariae R, Laurberg S, Christensen P, Kroman N, Larsen SB, Degett TH, Hölmich LR, Brown PDN, Johansen C, Kjær SK, Thygesen LC, Dalton SO. Educational differences in healthcare use among survivors after breast, prostate, lung, and colon cancer - a SEQUEL cohort study. BMC Health Serv Res 2023; 23:674. [PMID: 37349718 PMCID: PMC10286377 DOI: 10.1186/s12913-023-09683-2] [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] [Received: 03/31/2023] [Accepted: 06/10/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Many cancer survivors experience late effects after cancer. Comorbidity, health literacy, late effects, and help-seeking behavior may affect healthcare use and may differ among socioeconomic groups. We examined healthcare use among cancer survivors, compared with cancer-free individuals, and investigated educational differences in healthcare use among cancer survivors. METHODS A Danish cohort of 127,472 breast, prostate, lung, and colon cancer survivors from the national cancer databases, and 637,258 age- and sex-matched cancer-free individuals was established. Date of entry was 12 months after diagnosis/index date (for cancer-free individuals). Follow-up ended at death, emigration, new primary cancer, December 31st, 2018, or up to 10 years. Information about education and healthcare use, defined as the number of consultations with general practitioner (GP), private practicing specialists (PPS), hospital, and acute healthcare contacts 1-9 years after diagnosis/index date, was extracted from national registers. We used Poisson regression models to compare healthcare use between cancer survivors and cancer-free individuals, and to investigate the association between education and healthcare use among cancer survivors. RESULTS Cancer survivors had more GP, hospital, and acute healthcare contacts than cancer-free individuals, while the use of PPS were alike. One-to-four-year survivors with short compared to long education had more GP consultations (breast, rate ratios (RR) = 1.28, 95% CI = 1.25-1.30; prostate, RR = 1.14, 95% CI = 1.10-1.18; lung, RR = 1.18, 95% CI = 1.13-1.23; and colon cancer, RR = 1.17, 95% CI = 1.13-1.22) and acute contacts (breast, RR = 1.35, 95% CI = 1.26-1.45; prostate, RR = 1.26, 95% CI = 1.15-1.38; lung, RR = 1.24, 95% CI = 1.16-1.33; and colon cancer, RR = 1.35, 95% CI = 1.14-1.60), even after adjusting for comorbidity. One-to-four-year survivors with short compared to long education had less consultations with PPS, while no association was observed for hospital contacts. CONCLUSION Cancer survivors used more healthcare than cancer-free individuals. Cancer survivors with short education had more GP and acute healthcare contacts than survivors with long education. To optimize healthcare use after cancer, we need to better understand survivors' healthcare-seeking behaviors and their specific needs, especially among survivors with short education.
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Affiliation(s)
| | - Trille Kristina Kjaer
- Survivorship and Inequality in Cancer, Danish Cancer Institute, 49 Strandboulevarden, Copenhagen, 2100, Denmark
| | - Thomas Maltesen
- Statistics and Data Analysis, Danish Cancer Institute, Copenhagen, Denmark
| | - Erik Jakobsen
- Department of Thoracic surgery, Odense University hospital, Odense, Denmark
| | - Ismail Gögenur
- Department of Surgery, Center for Surgical Science, Zealand University Hospital, Køge, Denmark
- Institute for Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - Michael Borre
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Peer Christiansen
- Danish Breast Cancer Group Center and Clinic for Late Effects, Aarhus, Denmark
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Robert Zachariae
- Danish Breast Cancer Group Center and Clinic for Late Effects, Aarhus, Denmark
| | - Søren Laurberg
- Department of Surgery, Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Christensen
- Department of Surgery, Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aarhus University Hospital, Aarhus, Denmark
| | - Niels Kroman
- Department of Breast Surgery, Copenhagen University Hospital Herlev, Copenhagen, Denmark
- Danish Cancer Society, Copenhagen, Denmark
| | - Signe Benzon Larsen
- Survivorship and Inequality in Cancer, Danish Cancer Institute, 49 Strandboulevarden, Copenhagen, 2100, Denmark
- Urological Research Unit, Department of Urology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thea Helene Degett
- Survivorship and Inequality in Cancer, Danish Cancer Institute, 49 Strandboulevarden, Copenhagen, 2100, Denmark
| | | | - Peter de Nully Brown
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christoffer Johansen
- Cancer late effects, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Psychological Aspects of Cancer, Danish Cancer Institute, Copenhagen, Denmark
| | - Susanne K Kjær
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Institute, 49 Strandboulevarden, Copenhagen, 2100, Denmark
- Danish Research Center for Equality in Cancer, Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Næstved, Denmark
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Touzani R, Dembele E, Schultz E, Rouquette A, Seguin L, Dufour JC, Bannier M, Mancini J. The French General Population's Perception of New Information and Communication Technologies for Medical Consultations: National Survey. J Med Internet Res 2023; 25:e45822. [PMID: 37327032 PMCID: PMC10337435 DOI: 10.2196/45822] [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: 01/18/2023] [Revised: 04/06/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND The development of telehealth and telemedicine, in the form of increased teleconsultation and medical telemonitoring, accelerated during the COVID-19 health crisis in France to ensure continued access to care for the population. Since these new information and communication technologies (ICTs) are diverse and likely to transform how the health care system is organized, there is a need better to understand public attitudes toward them and their relationship with peoples' current experience of health care. OBJECTIVE This study aimed to determine the French general population's perception of the usefulness of video recording/broadcasting (VRB) and mobile Health (mHealth) apps for medical consultations in France during the COVID-19 health crisis and the factors associated with this perception. METHODS Data were collected for 2003 people in 2 waves of an online survey alongside the Health Literacy Survey 2019 (1003 in May 2020 and 1000 in January 2021) based on quota sampling. The survey collected sociodemographic characteristics, health literacy levels, trust in political representatives, and perceived health status. The perceived usefulness of VRB in medical consultations was measured by combining 2 responses concerning this technology for consultations. The perceived usefulness of mHealth apps was measured by combining 2 responses concerning their usefulness for booking doctor appointments and for communicating patient-reported outcomes to doctors. RESULTS The majority (1239/2003, 62%) of respondents considered the use of mHealth apps useful, while only 27.6% (551/2003) declared VRB useful. The factors associated with the perceived usefulness of both technologies were younger age (≤ 55 years), trust in political representatives (VRB: adjusted odds ratio [aOR] 1.68, 95% CI 1.31-2.17; mHealth apps: aOR 1.88, 95% CI 1.42-2.48), and higher (sufficient and excellent) health literacy. The period of the beginning of the COVID-19 epidemic, living in an urban area, and being limited in daily activities were also associated with perceiving VRB positively. The perceived usefulness of mHealth apps increased with the level of education. It was also higher in people who had 3 or more consultations with a medical specialist. CONCLUSIONS There are important differences in attitudes toward new ICTs. Perceived usefulness was lower for VRB than for mHealth apps. Moreover, it decreased after the initial months of the COVID-19 pandemic. There is also the possibility of new inequalities. Hence, despite the potential benefits of VRB and mHealth apps, people with low health literacy considered them to be of little use for their health care, possibly increasing their difficulties in accessing health care in the future. As such, health care providers and policy makers need to consider those perceptions to guarantee that new ICTs are accessible and beneficial to all.
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Affiliation(s)
- Rajae Touzani
- Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
- Institut Paoli-Calmettes, SESSTIM U1252, Marseille, France
| | - Elodie Dembele
- Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
| | - Emilien Schultz
- Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
- Médialab, Sciences Po, 75007 Paris, France, Paris, France
| | - Alexandra Rouquette
- Public Health and Epidemiology Department, AP-HP, Bicêtre Hôpitaux Universitaires Paris Sud, Le Kremlin-Bicêtre, France
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM U1018, Villejuif, France
| | - Lorène Seguin
- Institut Paoli-Calmettes, Département d'Oncologie Médicale, Marseille, France
| | - Jean-Charles Dufour
- APHM, Hop Timone, BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, Marseille, France
| | - Marie Bannier
- Institut Paoli-Calmettes, Département de Chirurgie Oncologique, Marseille, France
| | - Julien Mancini
- Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
- APHM, Hop Timone, BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, Marseille, France
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Mohsin F, Wyatt L, Belli H, Ali S, Onakomaiya D, Misra S, Yusuf Y, Mammen S, Zanowiak J, Hussain S, Zafar H, Lim S, Islam N, Ahmed N. The Prevalence and Correlates of Diabetes Distress among South Asians Living in New York City (NYC): Baseline Results from a Randomized Trial. RESEARCH SQUARE 2023:rs.3.rs-2806895. [PMID: 37333263 PMCID: PMC10275056 DOI: 10.21203/rs.3.rs-2806895/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Background Type 2 diabetes (T2D) disproportionately affects South Asians in the United States (US). Living with T2D can be challenging due to the distress it can create for an individual. Distress associated with diabetes, commonly known as diabetes distress (DD), may lead to complications and challenges with the management of diabetes. This study aims to describe the prevalence of DD among a sample of South Asians in New York City (NYC) seeking care in community-based primary care settings and its association with sociodemographic characteristics and clinical measures. Methods This study utilized baseline data from the Diabetes Research, Education, and Action for Minorities (DREAM) Initiative, an intervention designed to reduce hemoglobin A1C (HbA1c) among South Asians with uncontrolled T2D in NYC. DD was measured using the Diabetes Distress Scale (DDS). First, descriptive statistics were used to analyze sociodemographic variables. Chi-square tests assessed categorical variables and Wilcoxon Rank Sum tests assessed continuous variables using a Type I error rate of 0.05. Logistic regression was performed to determine if HbA1c and mental health, along with other covariates, were associated with dichotomized DDS subscales. Results Overall, 415 participants completed the DDS at baseline. Median age was 56 years (IQR: 48-62). A total of 25.9% had high emotional burden distress, 6.6% had high physician-related distress, and 22.2% had high regimen-related distress based on subscales. In adjusted analyses, individuals with any days of poor mental health had significantly higher odds of overall distress (OR:3.7, p=0.014), emotional burden distress (OR:4.9, p<0.001), and physician-related distress (OR:5.0, p=0.002) compared to individuals with no days of poor mental health. Individuals with higher HbA1c had significantly higher odds of regimen-related distress (OR:1.31, p=0.007). Conclusions Findings suggest that DD is prevalent among this sample of South Asians with diagnosed T2D in NYC. Screening for DD in patients with prediabetes/diabetes should be considered by providers to help provide mental and physical health services during primary care visits. Future research can also benefit from a longitudinal analysis of the impact of DD on diabetes self-management, medication adherence, and mental and physical health. Trial registration This study uses baseline data from "Diabetes Management Intervention For South Asians" (NCT03333044), which was registered with clinicaltrials.gov on 6/11/2017.
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Turnbull J, MacLellan J, Churruca K, Ellis LA, Prichard J, Browne D, Braithwaite J, Petter E, Chisambi M, Pope C. A multimethod study of NHS 111 online. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2023; 11:1-104. [PMID: 37464813 DOI: 10.3310/ytrr9821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Background NHS 111 online offers 24-hour access to health assessment and triage. Objectives This study examined pathways to care, differential access and use, and workforce impacts of NHS 111 online. This study compared NHS 111 with Healthdirect (Haymarket, Australia) virtual triage. Design Interviews with 80 staff and stakeholders in English primary, urgent and emergency care, and 41 staff and stakeholders associated with Healthdirect. A survey of 2754 respondents, of whom 1137 (41.3%) had used NHS 111 online and 1617 (58.7%) had not. Results NHS 111 online is one of several digital health-care technologies and was not differentiated from the NHS 111 telephone service or well understood. There is a similar lack of awareness of Healthdirect virtual triage. NHS 111 and Healthdirect virtual triage are perceived as creating additional work for health-care staff and inappropriate demand for some health services, especially emergency care. One-third of survey respondents reported that they had not used any NHS 111 service (telephone or online). Older people and those with less educational qualifications are less likely to use NHS 111 online. Respondents who had used NHS 111 online reported more use of other urgent care services and make more cumulative use of services than those who had not used NHS 111 online. Users of NHS 111 online had higher levels of self-reported eHealth literacy. There were differences in reported preferences for using NHS 111 online for different symptom presentations. Conclusions Greater clarity about what the NHS 111 online service offers would allow better signposting and reduce confusion. Generic NHS 111 services are perceived as creating additional work in the primary, urgent and emergency care system. There are differences in eHealth literacy between users and those who have not used NHS 111 online, and this suggests that 'digital first' policies may increase health inequalities. Limitations This research bridged the pandemic from 2020 to 2021; therefore, findings may change as services adjust going forward. Surveys used a digital platform so there is probably bias towards some level of e-Literacy, but this also means that our data may underestimate the digital divide. Future work Further investigation of access to digital services could address concerns about digital exclusion. Research comparing the affordances and cost-benefits of different triage and assessment systems for users and health-care providers is needed. Research about trust in virtual assessments may show how duplication can be reduced. Mixed-methods studies looking at outcomes, impacts on work and costs, and ways to measure eHealth literacy, can inform the development NHS 111 online and opportunities for further international shared learning could be pursued. Study registration This study is registered at the research registry (UIN 5392). Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research Programme and will be published in full in Health and Social Care Delivery Research; Vol. 11, No. 5. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Joanne Turnbull
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Jennifer MacLellan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kate Churruca
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Louise A Ellis
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Jane Prichard
- School of Health Sciences, University of Southampton, Southampton, UK
| | | | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Emily Petter
- NHS Hampshire, Southampton and Isle of Wight Clinical Commissioning Group, Winchester, UK
| | - Matthew Chisambi
- Imperial College Health Partners, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Catherine Pope
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Storr Krogh C, Skovgard L, Lynning M, Steenberg JL. Reasons for Engaging in Complementary and Alternative Medicine Among Highly Educated Women With Multiple Sclerosis. Int J MS Care 2023; 25:104-110. [PMID: 37250196 PMCID: PMC10211353 DOI: 10.7224/1537-2073.2021-133] [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: 11/02/2023]
Abstract
BACKGROUND Previous research has shown that users of complementary and alternative medicine (CAM) among persons with multiple sclerosis are more likely to be women and to have a higher level of education compared with nonusers. This qualitative study was performed to explore the motivations linked to CAM use among highly educated women with multiple sclerosis. METHODS The study was based on a phenomenological approach, and 8 semistructured, in-depth qualitative interviews were performed. Data were transcribed verbatim and analyzed through meaning condensation and identification of recurring themes. RESULTS Regarding the informants' motivations for CAM use, 3 main themes emerged: (1) Self-reliance is essential in disease management, (2) conventional health care lacks a holistic approach, and (3) personal experience is the primary guide. CONCLUSIONS The interviewees wanted approaches to health care that supported their desire to actively participate in the management of their disease. They were critical of the conventional health care system, and they emphasized the importance of letting their own personal experiences, as well as those of others, guide their decisions.
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Affiliation(s)
| | - Lasse Skovgard
- From the Danish MS Society, Valby, Denmark (CSK, LS, ML, JLS)
| | - Marie Lynning
- From the Danish MS Society, Valby, Denmark (CSK, LS, ML, JLS)
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Seboka BT, Negashe M, Yehualashet DE, Kassawe C, Namaro M, Yigeremu M. Health literacy and health information sources in relation to foodborne and waterborne diseases among adults in Gedeo zone, southern Ethiopia, 2022: A community-based cross-sectional study. Heliyon 2023; 9:e15856. [PMID: 37215875 PMCID: PMC10196801 DOI: 10.1016/j.heliyon.2023.e15856] [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] [Received: 10/27/2022] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Foodborne and waterborne illnesses affect billions of people each year and impose a significant burden on public health globally. To reduce the prevalence of foodborne and waterborne illness in resource-constrained settings like Ethiopia, it is essential to recognize and address the factors that influence health literacy and the sources of health information. We explored health literacy and health information sources regarding foodborne and waterborne illnesses among adults in the Gedeo zone. Methods A community-based quantitative study was undertaken between March and April 2022 in the Gedeo zone in southern Ethiopia. A semi-structured, pretested, and interviewer-administered questionnaire was used to collect data from 1,175 study participants selected through a systematic sampling technique. Data were entered in Epidata version 4.6 and analyzed in STATA version 14.2. Data were analyzed using descriptive statistics and the Chi-square test, and multivariate logistic regression analysis was used to assess the associations between variables at a significance level of 0.05. Further, a structural equation model or path analysis was also used in the data analysis. Result 1,107 (about 51% men) study participants were included in the analysis. About 25.5% of the participants had a foodborne or waterborne illness in the last six months before the survey. Family members and/or close friends were the most-used channel of health information (43.3%), and the internet or online sources were the least-used (14.5%). The result of path analysis shows that seeking health information, having adequate health literacy, and foodborne and waterborne literacy were significantly associated with lower incidences of foodborne or waterborne illness. Conclusion Our findings showed that individuals with a higher level of health literacy and foodborne and waterborne illness literacy had a lower incidence of foodborne and waterborne illness. Similarly, obtaining health information is positively associated with lowering the incidence of foodborne and waterborne illnesses. Importantly, our findings show mass media has the potential to reach a large audience when educating adults about foodborne and waterborne illnesses.
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Affiliation(s)
| | - Misrak Negashe
- Department of Psychiatry, Dilla University, Dilla, Ethiopia
| | | | | | | | - Mahlet Yigeremu
- Department Obstetrics and Gynecology, College of Health Sciences, Addis Ababa University, Ethiopia
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