Psychometric properties of the medical outcomes study: social support survey among methadone maintenance patients in Ho Chi Minh City, Vietnam: a validation study

The Impact of COVID-19 on Substance Use and Related Consequences among Patients in Office-Based Opioid Use Disorder Treatment

OBJECTIVES

The COVID-19 pandemic led to increased substance-related morbidity and mortality and transformed care for opioid use disorder (OUD). We assessed the perceived impacts of the pandemic on substance use and related consequences among patients in office-based addiction treatment (OBAT).

METHODS

We recruited patients with OUD on buprenorphine from July 2021 to July 2022, with data collection at baseline and 6 months. Exposures of interest were the following 6 domains potentially impacted by COVID-19: personal or family infection, difficulty accessing healthcare/medication, economic stressors, worsening physical or mental health, social isolation, and conflicts/disruptions in the home. Outcomes were past 30-day alcohol and other substance use, increased use, and substance-related consequences at baseline and 6 months. Generalized estimating equations Poisson regression models quantified associations between increasing impact domain scores and relative risks of each outcome.

RESULTS

All participants (N = 150) reported at least one domain negatively impacted by COVID-19 at both time points. Higher "worsening physical or mental health" domain scores were associated with increased relative risk of recent alcohol or drug use (adjusted risk ratio [aRR] 1.04, 95% confidence interval [CI]: 1.01-1.07). Relative risks of experiencing substance-related consequences increased with higher scores in the domains of economic stressors (aRR 1.07, 95% CI: 1.02-1.13), difficulty accessing healthcare/medication (aRR 1.11, 95% CI: 1.04-1.19), and worsening physical or mental health (aRR 1.08, 95% CI: 1.04-1.12).

CONCLUSIONS

Among patients with OUD, stressors from COVID-19 were common. Three life domains impacted by COVID-19 appeared to be associated with consequential substance use, highlighting opportunities to address barriers to healthcare access and economic stressors.

Revealing the Most Vulnerable Groups: Courtesy Stigma in Caregivers of Autistic Persons in Quebec

Introduction

Caregivers of autistic persons often face "courtesy stigma," a phenomenon by which caregivers experience stigma because of their association with a person whose disability may be stigmatized. Understanding the repercussions of this stigma is crucial not only for caregivers' mental health but also for the quality of care provided to their dependent. This study aimed to explore courtesy stigma among caregivers of autistic persons in Quebec, examining its prevalence and impact in order to identify groups that are particularly susceptible to negative outcomes.

Methods

This study used a cross-sectional online survey methodology employing quota sampling to collect responses from 194 participants. Data were collected using a computer-assisted web interview (CAWI) platform. The impact of courtesy stigma was measured in terms of care burden, mental health, and overall well-being of caregivers.

Results

The findings revealed that caregivers frequently experience rejection, isolation, and work-related challenges. Notably, caregivers' health was below average with the lowest reported health outcomes in Quebec. The caregivers who are the most vulnerable to negative outcomes included female caregivers, those aged 45 or older, financially strained households, caregivers of children requiring elevated levels of support, caregivers who isolated due to their autistic dependents, and those who experienced stigmatization directed at themselves or their children in the form of rejection.Interestingly, 60% of respondents reported that the caregiving burden was "not at all" to "somewhat" difficult, raising questions about factors that may mitigate caregiving challenges over time.

Conclusion

Negative outcomes from courtesy stigma vary depending on certain risk factors and individual characteristic. This study underscores the need for targeted public policies and interventions, particularly for those at a higher risk of experiencing the negative effects of courtesy stigma on the burden of care, overall health, and mental health. By tailoring resources and support for these priority groups, we can better address the challenges faced by families of autistic persons.

Treatment non-adherence among methadone maintenance patients and associated factors: a multicenter, cross-sectional study in Vietnam

OBJECTIVE

This multicenter, cross-sectional study was conducted to investigate the prevalence of treatment non-adherence and its associated factors among methadone maintenance patients in Vietnam.

METHODS

This secondary data analysis was conducted using the data from a previous study. Six hundred patients were interviewed face-to-face to collect data on their demographic characteristics and social support. Information about the treatment characteristics and patients' non-adherence was gathered from medical records and books monitoring their treatment process. Treatment non-adherence was defined as missing at least one methadone dose in the last three months.

RESULTS

The overall prevalence of non-adherence was 45.7%. The average social support score of patients who completely adhered to treatment was significantly higher than that of those who did not (p < 0.001). In the multivariate logistic regression model, for each one-unit increase in social support (one score), treatment time (a year), and patient's monthly income (one million Vietnam dongs), the odds of non-adherence decreased by 28% (aOR = 0.72, 95%CI 0.59-0.88, p = 0.002), 15% (aOR = 0.85, 95%CI 0.80-0.91, p < 0.001) and 9% (aOR = 0.91, 95%CI 0.85-0.97, p = 0.004), respectively. Patients living in Son La (a mountainous province) were 1.72 times (95%CI 1.09-2.71) more likely to be non-adherent as compared to those in other areas (p = 0.020). As per univariate analyses, other associated factors could be age, education level, family monthly income, occupation, and opioid relapse (p < 0.001).

CONCLUSIONS

A high non-adherence rate was found among Vietnamese methadone maintenance patients. Interventions involving social support, occupation, income, and education are needed to improve their treatment adherence.

Cross-cultural adaptation and validation of the medical outcome study social support survey among mothers of children aged 6-23 months in Indonesia

BACKGROUND

Social support significantly influences a mother's adherence to complementary feeding guidelines, with family support fostering a positive attitude towards this practice. The Medical Outcome Study Social Support Survey (MOS-SSS) is a multidimensional scale designed to evaluate functional aspects of social support, but no instrument has been validated for Indonesia.

PURPOSE

The study aims to validate the MOS-SSS instrument for measuring mothers' social support in providing complementary food to infants and young children aged 6-23 months in Indonesia.

METHODS

A cross-sectional survey was conducted on 196 mothers with children aged 6-23 months in West Sumatera, Indonesia. The MOS-SSS's internal consistency was assessed using Cronbach alpha, composite reliability, and split-half analysis, while its construct validity was evaluated using convergent and discriminant validity.

RESULTS

The Indonesian version of the MOS-SSS among mothers with children aged 6-23 months has been found to be satisfactory in content validity through translation and expert review. The questionnaire exhibits strong convergent and discriminant validity, reliable construct reliability, and internal consistency.

CONCLUSIONS AND IMPLICATIONS

The MOS-SSS questionnaire was found to be reliable and valid in measuring the social support mothers perceive in providing complementary feeding to their infants and young children. Future research should explore the psychometric properties of the Indonesian version of the MOS-SSS in various populations, including pregnant women, lactating mothers, and women with special conditions.

"I am not the same as before": a mixed-methods study on depression in people with spinal injury in Qatar

Incidence of spinal injury is high in the Middle East and North African region (MENA) due to the high incidence of road traffic crashes. A spinal injury may trigger mental health issues. Compared to the general population, people with spinal injury are at higher risk for developing major depression, anxiety, post-traumatic stress disorders, substance abuse, and suicide.

Objectives

The objectives of the study were to determine depression prevalence; identify relationships between depression and cause and site of spinal injury, sociodemographic factors, and social support; and explore the lived experiences of depression in people with spinal injury in Qatar.

Methods

A sequential cross-sectional mixed methods study was conducted. In the quantitative component, the universal sample consisted of 106 consenting individuals presenting with spinal injury at Hamad General Hospital, Doha, Qatar between January and December 2020. The Patient Health Questionnaire-9 was used to assess levels of depression and the Medical Outcomes Study Social Support Survey was used to assess perceived social support. The cause and site of injury were obtained from patient records. In the qualitative component, semi-structured in-depth interviews were conducted with 12 purposively selected participants from the quantitative component.

Results

Spinal injury had a negative impact on participants physical, mental, social, and spiritual wellbeing. In total, 69% of participants had some level of depression: 28% mild, 25.5% minimal, and 15% moderate to severe. Depression was not associated with socio-demographic factors, or the cause or site of spinal injury. Higher levels of emotional/informational support and positive social interaction were associated with milder depression. Social support and religious faith were critical in assisting participants to cope with their new situation.

Conclusions

Depression is prevalent among people with spinal injury attending health services. Early detection, referral, and treatment of depression are recommended. Strategies to enhance emotional/informational support and positive social interaction should be developed and tested with people with spinal injury.

Reliability, construct validity, and factorial structure of a Swedish version of the medical outcomes study social support survey (MOS-SSS) in patients with chronic pain

OBJECTIVES

This study aimed to examine the psychometric properties of a Swedish version of the Medical Outcomes Study Social Support Survey (MOS-SSS).

METHODS

Standard forward-backward translation was used. A cross-sectional survey was conducted among treatment seeking individuals with chronic pain included in a clinical cohort. Internal consistency was measured with Cronbach's α, test-retest reliability was examined with intraclass correlation, confirmatory factor analyses was used for examining factor structure, and correlations between the MOS-SSS and selected health validity measures were used for testing concurrent validity hypotheses.

RESULTS

182 participants were included in the study. Internal consistency measured with Cronbach's alpha was acceptable for all subscales and for the total support index of the MOS-SSS. Test-retest reliability was moderate - good for the different subscales, and was good for the overall support index. The original four factor model of the MOS-SSS was confirmed, and the concurrent validity hypotheses were also confirmed; however, the associations were weaker than expected.

CONCLUSIONS

The Swedish version of the MOS-SSS was found psychometrically sound and offers a systematic assessment of social support in specialized pain care.

Is Social Support Associated with Colorectal Cancer Care Utilization? A Multilevel Mixed-Effects Model of a Cross-Sectional Cohort Study in Vietnam

OBJECTIVE

To investigate the relationship between the social support (SS) and colorectal cancer (CRC) care utilization of patients in the central region of Vietnam.

METHODS

This was a cross-sectional cohort study in which the cohort was defined as all residential patients diagnosed with CRC in a tertiary hospital, Hue Central Hospital (HCH), in central Vietnam from 2013 to 2019. Social support was considered the main independent variable and was evaluated using the Medical Outcomes Study Social Support Survey (MOS-SSS), a self-administered 19-item SS survey. MOS-SSS is a widely used scale for assessing social support in CRC patients because it is brief, easy to use, reliable, and valid. In this study, we considered a data framework with a multilevel structure that included the patient level and duration of diagnosis as the second level. We estimated the magnitude of SS and CRC-specific treatment modalities using multilevel mixed-effects (MM) models under a hierarchical approach.

RESULTS

The findings indicated that CRC care utilization rates were 89.9%, 48.5%, and 30.6% for surgical resection, chemotherapy, and radiation therapy, respectively. The overall trend of SS decreased significantly and affected the CRC care utilization. We found a positive effects of overall SS, as well as emotional and tangible support, on the number of hospitalization admissions and chemotherapy utilization.

CONCLUSION

This study suggests that the use of the MOS-SSS should be continued in the long term for CRC patients to enhance medical accessibility and care utilization.

Opioid relapse and its predictors among methadone maintenance patients: a multicenter, cross-sectional study in Vietnam

BACKGROUND

Opioid relapse, one of the common and severe problems during methadone maintenance treatment, can give rise to poor treatment outcomes. This study measured the opioid relapse rate and its associated factors among methadone maintenance patients in Vietnam.

METHODS

Information about the demographic characteristics and social support of 655 patients was collected through direct interviews. Medical records were used to gather data on treatment characteristics. Relapse was determined via urine opioid test results.

RESULTS

The overall relapse rate of patients during treatment was 13.1%. According to the multivariate logistic regression model, living in mountainous areas (adjusted odds ratio (aOR) = 3.63, 95% CI 1.90-7.46) and long duration of drug use in the past (aOR = 1.06, 95% CI 1.03-1.09) were associated with an increase in the odds of opioid relapse. By contrast, living with many family members (aOR = 0.69, 95% CI 0.55-0.85), having longer treatment time (aOR = 0.80, 95% CI 0.73-0.87), and completely adhering to treatment (aOR = 0.38, 95% CI 0.23-0.64) were protective for opioid relapse. As per the univariate analyses, the odds of opioid relapse declined by 25% for each increase of one close friend or relative (OR = 0.75, 95% CI 0.66-0.86). Regarding social support (range score: 0-100), each additional increase of one score was associated with a 1% decrease in the odds of opioid relapse (OR = 0.99, 95% CI 0.98-0.99). Patient sex, education level, occupation type, patient's monthly income, family's monthly income, the number of previous treatments, daily methadone dose, comorbidity, and received antiretroviral therapy were not associated with opioid relapse among patients (p > 0.05).

CONCLUSIONS

Residence, the role of family and social support, and treatment adherence should be paid more attention to guarantee and enhance the success of methadone maintenance treatment.

Exploring the relationships between health literacy, social support, self-efficacy and self-management in adults with multiple chronic diseases

BACKGROUND

Self-management in chronic diseases is essential to slowing disease progression and preventing complications. However, empirical research on the associations of critical factors, such as health literacy, social support, and self-efficacy with self-management in the context of multiple chronic diseases is scarce. This study aimed to investigate these associations and provides insights for healthcare providers to develop effective educational strategies for people with multiple chronic diseases.

METHODS

Using a cross-sectional survey design, adults (n = 600) diagnosed with at least two chronic diseases were conveniently recruited. To measure health literacy, social support, self-efficacy, and chronic disease self-management behaviours, the Health Literacy Questionnaire (HLQ), Medical Outcome Study - Social Support Survey, Self-efficacy in Managing Chronic Disease, and Self-management in Chronic Diseases instruments were utilized respectively. Comorbidity status was assessed using Age-adjusted Charlson Comorbidity Index (ACCI). A generalised linear regression model was used with a backward technique to identify variables associated with self-management.

RESULTS

Participants' mean age was 61 years (SD = 15.3), 46% were female, and most had up to 12 years of education (82.3%). Mean scores for HLQ domains 1-5 varied from 2.61 to 3.24 (possible score 1-4); domains 6-9 from 3.29 to 3.65 (possible score 1-5). The mean scores were 52.7 (SD = 10.4, possible score 0-95), 5.46 (SD = 1.9, possible score 0-10) and 82.1 (SD = 12.4, possible score 30-120) for social support, self-efficacy, and self-management, respectively. Mean ACCI was 6.7 (SD = 2.1). Eight factors (age > 65 years, being female, 4 health literacy domains, greater social support, and higher self-efficacy levels) were significantly associated with greater self-management behaviours while comorbidity status was not. The factors that showed the strongest associations with self-management were critical health literacy domains: appraisal of health information, social support for health, and healthcare provider support.

CONCLUSIONS

Developing critical health literacy abilities is a more effective way to enhance self-management behaviours than relying solely on self-confidence or social support, especially for people with multiple chronic diseases. By facilitating communication and patient education, healthcare providers can help patients improve their critical health literacy, which in turn can enhance their self-management behaviours.

Psychometric Properties of the Peruvian Version of the MOS Scale for Social Support in Cancer Patients and Convergent Network with Quality of Life

Introduction

One of the key psychosocial factors that impact mental and emotional health is social support. While much research has been conducted on the role of social support in the lives of cancer patients, there is a lack of studies that consider populations who need specific tools to assess this concept.

Purpose

The aim of this study was to evaluate the psychometric properties of the MOS Social Support Scale (1991) in 499 Peruvian cancer patients between the ages of 18 and 87 (M= 46.30, SD = 15.747).

Methods

In this study, three models of the MOS were analyzed based on 19-item versions (four factor, second order and bifactor model).

Results

The results showed a better psychometric fit in the 19-item bifactor model with optimal fit indices through the structural equation method (SB-χ2/df = 1.94, CFI = 0.966, TLI= 0.955, SRMR = 0.038 and RMSEA = 0.058). Additionally, there was evidence of configural, metric and scalar invariance with this instrument according to the gender of the surveyed cancer patients. Convergent validity using a network analysis approach revealed positive associations between social support dimensions and quality of life.

Conclusion

Emotional support and positive interactions dimensions were found to be important interconnections in the overall network, as indicated by their greater centralities. Therefore, this instrument could be suggested as a reliable way to evaluate cancer patients and their perceived support.

Psychological status on informal carers for stroke survivors at various phases: a cohort study in China

Background

In China, the risk of stroke is higher than that in developed countries such as Europe and North America. Informal caregivers play a major role in providing support to stroke survivors. Currently, only limited studies on changes in psychological state of the caregivers at different stages of stroke have been published.

Purpose

To investigate the stress and psychological state of informal caregivers of stroke patients in different periods and to explore the factors that affect their states.

Methods

202 informal caregivers of stroke patients were selected in a 3a-grade hospital in Chengdu, Sichuan. Follow-up was conducted by face-to-face interviews, telephone calls, or home visits on days 3, 2 months, and 1 year after onset. We investigated the basic information about the caregivers, including their anxiety, depression and social support conditions. We analyzed the pressure and psychological conditions of informal caregivers at different stages of stroke and analyzed its influencing factors. The data were displayed by the number and percentage of the cases; the continuous variables were described by means and standard deviation. In addition, the data were compared by Pearson correlation analysis and logistic regression analysis.

Results

(1) Within 3 days after the onset of stroke, the informal caregivers had the highest stress, the most severe anxiety and depression, the heaviest burden, and the lowest score of medical-social support. Over time, the pressure and burden of the caregivers are gradually decreasing, anxiety and depression are increasing, and social support is also increasing. (2) The stress and psychological status of informal stroke caregivers are affected by multiple factors, including the caregiver's age, relationship with the patient, patient's age, and patient's physical conditions.

Conclusion

The stress and psychological status of informal caregivers varied in the different stages of stroke, and they were affected by several factors. Medical staff should pay attention to informal caregivers while providing care for patients. Relevant interventions may be developed based on the results to improve the health of informal caregivers and thus to promote the health of patients.

Assessment of the level of social support and associated factors among cancer patients in the comprehensive cancer center at Ethiopia: Ordinal logistic regression analysis level of social support and associated factors among cancer patients

Introduction

Cancer is a serious and common disease, which had a substantial problem in the social status of patients. There was no empirical evidence on the effect of cancer on social support.

Objective

This study aimed to determine the level of social support among cancer patients in a comprehensive cancer center in Ethiopia.

Methods

An institution-based cross-sectional study was done. About 386 study participants who were selected through systematic random sampling involved in the study. Training and close supervision and monitoring were done. The collected data were analyzed using SPSS-25. Descriptive statistics and Chi-square test were done. Ordinal bivariate and multivariate logistic regression were done to show the net effect of independent variables on the dependent variable. Model fitting information, the goodness of test, and the test of parallel line assumption test of the ordinal logistic regression model were carried out.

Results

A total of 386 study subjected were included in the final analysis. The poor, moderate, and strong levels of social support among cancer patients were found to be 45.3%, 34.2%, and 20.5% respectively. The mean score of social support among cancer patients was 10.4 ± 2.6SD. Age, Marital status, residence, educational status, stage III were found to be significant factors for the level of social support.

Conclusion

and recommendation: The level of poor, moderate, and strong social support was found to be 45.3%, 34.2 and 20.5 respectively. Emphasis should be given to those cancer patients who had poor social support, and frequent social status assessment should be done.

Validation of Multidimensional Scale of Perceived Social Support (MSPSS) in Vietnamese Among People Living with HIV/AIDS

Social support plays a vital role in the health of HIV/AIDS patients, but there needs to be a validated instrument to measure social support in Vietnam. This cross-sectional study was to validate a Vietnamese translation of the Multidimensional Perceived Social Support Scale (MSPSS). The study had three stages: [1] translation to Vietnamese, [2] pilot testing, and [3] validation of the translation. Stage 1, including forward and backward translation by four independent translators, resulted in a good content validity translation. Pilot testing was done on 30 HIV/AIDS patients: the translation was understandable, and no change was required. Five hundred HIV/AIDS patients were recruited in stage 3. The translation had excellent internal consistency (Cronbach's alpha: 0.90), good test-retest reliability (intra-class correlation coefficient: 0.95), and good concurrent validity. Construct validity was well established by confirmatory factor analysis. The Vietnamese translation of the MSPSS is reliable and valuable for measuring perceived social support.

Dietary, Psychological and Lifestyle Factors Associated with Premenstrual Symptoms

Purpose

To measure the associations of diet, psycological distress, and lifestyle factors with premenstrual symptoms (PMSx) in women in Riyadh, Saudi Arabia.

Patients and Methods

An interview-based, cross-sectional study was conducted on 1831 women aged 18-50 years seen in primary healthcare centers and teaching institutes in Riyadh from December 2015 to June 2016. Question topics included sociodemographics, physical activity, smoking, and dietary habits information. PMSx were assessed using a symptom checklist with 6 domains: anxiety/mood changes; abdominal/back/joint pain; increased appetite/weight gain, breast pain/tenderness, severe headache, and ≥3 PMS symptoms (any). Multivariable logistic regression analyses were conducted to provide adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for factors associated with each PMSx domain.

Results

Except for breast pain, drinking >5 cups of Arabic coffee was associated with increased odds of anxiety/mood [aOR 2.44 (95% CI 1.44, 4.12)], pain [1.83 (1.13, 2.98)], appetite/weight gain [1.66 (1.10, 2.50)], headache [1.57 (1.00, 2.56)] and ≥3 symptoms [1.50 (1.07, 2.11)]. A significant association was noted between sugar intake and anxiety/mood symptoms [1.53 (1.07, 2.19)] and abdominal/back pain symptoms [1.84 (1.17, 2.88)]. Increased severity of psychological distress was associated with all symptom domains: anxiety/mood [2.75 (1.92, 3.94)]; pain [1.45 (0.92, 2.28)]; appetite/weight gain [2.01 (1.53, 2.65)]; breast pain [2.19 (1.68, 2.88)]; headache [1.86 (1.37, 2.54)] and ≥3 symptoms [3.52 (2.49, 4.95)]. Low physical activity was significantly associated with odds of breast pain symptoms [1.29 (1.04, 1.59)]. Smokers were 3.41 (1.19, 9.77) times as likely to report any ≥3 symptoms compared to nonsmokers.

Conclusion

Several potentially modifiable factors, such as diet and stress, were positively associated with PMSx. Thus, we suggest that increasing women's awareness of healthy lifestyles, particularly diet and stress reduction, may help to reduce the occurrence of premenstrual symptoms.

An adaptive design to screen, treat, and retain people with opioid use disorders who use methamphetamine in methadone clinics (STAR-OM): study protocol of a clinical trial

BACKGROUND

Methamphetamine use could jeopardize the current efforts to address opioid use disorder and HIV infection. Evidence-based behavioral interventions (EBI) are effective in reducing methamphetamine use. However, evidence on optimal combinations of EBI is limited. This protocol presents a type-1 effectiveness-implementation hybrid design to evaluate the effectiveness, cost-effectiveness of adaptive methamphetamine use interventions, and their implementation barriers in Vietnam.

METHOD

Design: Participants will be first randomized into two frontline interventions for 12 weeks. They will then be placed or randomized to three adaptive strategies for another 12 weeks. An economic evaluation and an ethnographic evaluation will be conducted alongside the interventions.

PARTICIPANTS

We will recruit 600 participants in 20 methadone clinics.

ELIGIBILITY CRITERIA

(1) age 16+; (2) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) scores ≥ 10 for methamphetamine use or confirmed methamphetamine use with urine drug screening; (3) willing to provide three pieces of contact information; and (4) having a cell phone.

OUTCOMES

Outcomes are measured at 13, 26, and 49 weeks and throughout the interventions. Primary outcomes include the (1) increase in HIV viral suppression, (2) reduction in HIV risk behaviors, and (3) reduction in methamphetamine use. COVID-19 response: We developed a response plan for interruptions caused by COVID-19 lockdowns to ensure data quality and intervention fidelity.

DISCUSSION

This study will provide important evidence for scale-up of EBIs for methamphetamine use among methadone patients in limited-resource settings. As the EBIs will be delivered by methadone providers, they can be readily implemented if the trial demonstrates effectiveness and cost-effectiveness.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04706624. Registered on 13 January 2021. https://clinicaltrials.gov/ct2/show/NCT04706624.

HIV-related stigma, symptoms of depression and their association with suicidal ideation among people living with HIV in Ho Chi Minh City, Vietnam

To date, little are known about HIV-related stigma, symptoms of depression (SOD) and suicidal ideation among people living with HIV (PLHIV) in Vietnam. This study aimed to estimate the level of stigma, SOD and suicidal ideation and to explore the direction and magnitude of the relationship between stigma, SOD and suicidal ideation among Vietnamese PLHIV. A cross-sectional study was conducted in four outpatient clinics providing healthcare services including antiretroviral therapy (ART) for PLHIV in Ho Chi Minh City. At each clinic, patients were chosen using the systematic sampling technique. Participants underwent face-to-face interviews through a pre-defined structural questionnaire that included validated scales. Among 777 PLHIV in the analysis, most were male (81.1%) and the average age was 34.3 (SD = 8.8) years. Two-thirds of PLHIV had a moderate-to-high level of HIV stigma. Symptoms of depression were identified in 41.4% of PLHIV. Suicidal ideation was reported by 26.3% of PLHIV. Based on univariate and multivariate logistic regression, higher levels of SOD and HIV stigma were positively associated with suicidal ideation. For PLHIV with extreme stigma and SOD, the probability of having suicidal ideation was up to 80%. The prevalence and association found in this study indicates that interventions for SOD and stigma not only help reduce these two problems but also help address and minimize suicidal ideation in this vulnerable population. In Vietnam, to optimize such interventions, the involvement of families and communities is crucial.

Correlates of days of medication for opioid use disorder exposure among people living with HIV in Northern Vietnam

BACKGROUND

In Vietnam, access to medications for opioid use disorder (MOUD) for people living with HIV has rapidly expanded, but MOUD use over time remains low. We sought to assess factors associated with days of MOUD treatment exposure.

METHODS

From 2015 to 2019, patients with OUD in six Northern Vietnamese HIV clinics were randomized to receive HIV clinic-based buprenorphine (BUP/NX) or referral for methadone maintenance therapy (MMT) and followed for 12 months. All MOUD doses were directly observed and abstracted from dosing logs. The primary outcome was days of MOUD treatment exposure (buprenorphine or methadone) received over 12 months. Negative binomial regression modelled associations with days of MOUD exposure.

RESULTS

Of 281 participants, 264 (94%) were eligible for analysis. Participants were primarily male (97%), unmarried (61%), employed (54%), and previously arrested (83%). Participants had a mean 187 (SD 150) days of MOUD exposure with 134 (51%) having at least 180 days, and 35 (13.2%) having at least 360 days of MOUD exposure. Age (IRR 1.26, 95% CI 1.02-1.55), income (IRR 0.96, 95% CI 0.93-1.001), and methadone (IRR 1.88, 95% CI 1.51-2.42) were associated with MOUD exposure in multivariate models. Multivariate models predicted 127 (95% CL 109-147) days of MOUD exposure for HIV clinic based-buprenorphine vs 243 (95% CL 205-288) for MMT.

CONCLUSION

MOUD treatment exposure was suboptimal among patients with HIV and OUD in Northern Vietnam and was influenced by several factors. Interventions to support populations at risk of lower MOUD exposure as well programs administering MOUD should be considered in countries seeking to expand access to MOUD.

Translation, Adaption, and Psychometric Testing of the Myanmar Version of the Medical Outcomes Study Social Support Survey for People Living With HIV/AIDS

Introduction: Valid and reliable instruments are crucial for measuring perceived social support among people living with HIV (PLHIV). We aimed to investigate the psychometric properties of the English version of the 19-item Medical Outcomes Study Social Support Survey (MOS-SSS) adapted for PLHIV in Myanmar. Methods: Based on a standard cross-cultural procedure, we adapted the MOS-SSS and formed a Myanmar version of the scale (MOS-SSS-M), and then tested its validity and reliability. A sample of 250 eligible PLHIV was collected from a closed Facebook group that included more than 10,000 Myanmars, most of whom were PLHIV. Results: The MOS-SSS-M achieved a Cronbach's α of 0.82-0.95. Confirmatory factor analysis revealed an acceptable fit index for the four-factor structure. Construct validity was demonstrated by significant association with self-reported HIV stigma and stress levels, and further confirmed by the findings of Rasch analysis. Conclusion: The MOS-SSS-M with a four-factor structure can be used to measure the level and categories of perceived social support among PLHIV in Myanmar.

Psychometric properties and factor structure of the Medical Outcomes Study Social Support Survey Instrument in a sample of Spanish older adults

The aim of this study was to explore the factor structure of the MOS-SSS in a sample of community-dwelling Spanish older adults. The sample comprised 406 community-dwelling older adults aged between 65 to 99 years old (M _age = 74.88, SD = 6.75). Confirmatory factor analysis (CFA) was performed, and four possible models were compared: the one-factor, the three-factor, the four-factor and the five-factor model, using an additional analysis with a second-order factor. The internal consistency reliability and convergent validity of the scale were also assessed. For the 19-item MOS-SSS scale, the five-factor model had the best fit to the data. All five subscales of the MOS-SSS showed adequate internal consistency, good convergent and discriminant validity. These findings contribute to the literature on the factor structure of the MOS-SSS in Spanish older adults. The MOS-SSS is a reliable and valid scale that can be used to assess Spanish older adults' social support perception for social services, health and in research contexts.

The relationship between social support, stressful events, and menopause symptoms

Many women going through the menopausal transition experience vasomotor symptoms (VMS), and research has shown that there is a large amount of variation in their frequency and severity. Many lifestyle factors have been found to co-vary with VMS, including the level of social support received by the woman, and how stressed she is. Stress is well documented to worsen menopause symptoms, and there is some evidence that support eases them; however, there is little research into whether support is an effective buffer against the negative effects of stress on VMS. Using nine years of data from the Study of Women’s Health Across the Nation (n = 2718), we use multilevel Poisson regression with random effects to test: 1) if more social support is associated with decreased VMS frequency, 2) if increased life stress worsens VMS, and 3) if support acts as a buffer against stress. After adjusting for age, marital status, smoking, self-perceived overall health, ethnicity, and menopausal status, we find that stress increases the frequency of VMS. Contrary to our hypothesis, we did not find strong evidence that emotional support led to lower VMS frequency, or that support buffers against the effects of stress. Experience of a stressful event, but not amount of social support, was included in the best fitting model; with the degree to which the woman was upset by the life stressor having the largest effect on menopause symptoms. Here, women who said they were currently upset by a stressful event experienced 21% more VMS than women who had experienced no life stressor. This research highlights that social factors may impact the menopausal transition.

Validation and psychometric properties of the community assessment inventory in Iranian persons who use drug

Objective

Social support is a key factor in the treatment and rehabilitation process of persons who use drug (PWUD). This highlights the need for a valid and reliable tool for assessing social support. The cultural and psychometric properties of community assessment inventory (CAI) in PWUDs under methadone therapy were examined in Iran in 2019.

Methods

The study was carried out as a validation and methodological study. At first, the original tool was translated into Farsi using forward-backward method. After ensuring face validity and content validity, construct reliability of the tool was supported using explorative and confirmatory factor analysis (EFA & CFA) using a sample group of 392 participants. The participants were selected through convenient-quota sampling from 24 drug clinics. Reliability of the questionnaire was supported using Pearson correlation coefficient and internal consistency based on Cronbach’s alpha.

Results

To determine content validity of the tool, CVI and CVR of it were obtained, which were on average equal to 0.79 and 0.59 respectively. The EFA supported correlation of the 37itmes of the tool (KMO = 0.975, Chi-square = 15,051.6, P_value=0.0001). The main indices of the model, based on CFA were higher than 0.9, which support goodness of fit of the model (χ2/DF = 2.98, CFI = 0.91, NFI, TLI = 0.905 GF = 0.92, REMSEA = 0.07, R2 = 0.99). Reliability of the tool based on internal consistency (Cronbach’s alpha) for the subscales were in 0.8–0.95 interval and equal to 0.85 for the whole tool.

Conclusion

As the results showed, CAI had acceptable indices for Iranian PWUDs under methadone therapy. The tool can be used for assessing social support level in the study population. It is a reliable and valid tool for studies in pertinent fields.

Beyond biomedical and comorbidity approaches: Exploring associations between affinity group membership, health and health seeking behaviour among MSM/MSW in Nairobi, Kenya

We explored general health and psychosocial characteristics among male sex workers and other men who have sex with men in Nairobi, Kenya. A total of 595 MSM/MSW were recruited into the study. We assessed group differences among those who self-reported HIV positive (SR-HIVP) and those who self-reported HIV negative (SR-HIVN) and by affinity group membership. Quality of life among SR-HIVP participants was significantly worse compared to SR-HIVN participants. Independent of HIV status and affinity group membership, participants reported high levels of hazardous alcohol use, harmful substance use, recent trauma and childhood abuse. The overall sample exhibited higher prevalence of moderate to severe depressive symptoms compared to the general population. Quality of life among participants who did not report affinity group membership (AGN) was significantly worse compared to participants who reported affinity group membership (AGP). AGN participants also reported significantly lower levels of social support. Membership in affinity groups was found to influence health seeking behaviour. Our findings suggest that we need to expand the mainstay biomedical and comorbidity focused research currently associated with MSM/MSW. Moreover, there are benefits to being part of MSM/MSW organisations and these organisations can potentially play a vital role in the health and well-being of MSM/MSW.

Stress Experiences and Mental Health of Pregnant Women: The Mediating Role of Social Support

Stress in pregnancy is an exceedingly common issue that impacts the mother's mental health and the health of her baby. Yet, women with a supportive network of friends and family may experience lower stress and improved mental health. Therefore, the aims of this secondary analysis were to (a) examine relationships between stress experiences (i.e. perceived stress, pregnancy-specific stress) and indicators of mental health (i.e. absence of depressive symptoms and resourcefulness), (b) determine the effects of social support on stress experiences and indicators of mental health, and (c) determine if social support mediates the relationship between stress experiences and indicators of mental health. A convenience sample of 82 women in their second and third trimester of pregnancy participated in the parent study. Findings indicate that stress experiences were moderately correlated with indicators of mental health and social support predicted stress experiences and indicators of mental health. All social support mediation models were not significant with the exception of social support mediating the relationship between pregnancy-specific stress and resourcefulness. This was the first study to investigate the mediating role of social support on the relationship between pregnancy-specific stress and resourcefulness. Pregnant women may benefit from social support interventions to meaningfully reduce their stress and promote mental health. Such interventions may be physical activity, group prenatal care, or even peripartum home visits.

Depression and Anxiety as Key Factors Associated With Quality of Life Among Lung Cancer Patients in Hai Phong, Vietnam

Background: Cancer is a leading cause of death. People living with cancer experience a variety of symptoms that might profoundly affect their quality of life (QoL). Objective: The study aims to identify factors associated with the QoL of patients with lung cancer at the oncology department of Viet Tiep Hospital, Hai Phong city, Vietnam in 2018. Methods: A cross-sectional study was conducted to collect data from lung cancer inpatients in Hai Phong city, Vietnam. The EQ-5D-5L and the EuroQol (EQ)-visual analogue scale (EQ VAS) were used to assess health-related quality of life (QoL). A multivariable regression analysis was performed on the EQ-5D utility score and the EQ VAS score as dependent variables, and socioeconomic, social support, and psychological factors as potential predictors. Results: A total of 125 lung cancer patients were enrolled in this study. The highest proportion of respondents reporting any problems was in anxiety/depression (92.8%), pain/discomfort (81.2%), usual activities (75.2%), and mobility (60%) dimensions, while the lowest percentage was in self-care dimension (40.8%). The multivariate analyses showed that a low QoL score was significantly associated with depression, incapacity to pay, low response to treatment, and presence of side effects. Conclusion: QoL of lung cancer patients is associated with anxiety/depression and other factors that can be modified by specific interventions. It is therefore possible to take care of psychological aspects to improve the QoL of Vietnamese people suffering from this condition.

Validation of the Farsi version of the medical outcomes study-social support survey for mammography

BACKGROUND

Social support can provide psychosocial benefits to promote positive health behaviors such as mammography screening. The purpose of this study was to assess the psychometric properties of the Mammography Social Support (MSS) scale among Iranian woman.

METHODS

Participants were selected from women referring to healthcare centers in Sanandaj, Iran. A total of 434 questionnaires were completed (response rate 91%). The study sample for study 1 included 204 participants for the Exploratory Factor Analysis (EFA). Construct validity was determined by confirmatory factor analysis (CFA) using a study sample of 230 women in study 2. The reliability coefficient for each scale was calculated using Cronbach's alpha, corrected item-total correlations and test-retest respectively.

RESULTS

CFA affirmed the three-factor structure of the MSS in measuring the functional dimensions of social support for mammography behavior consisting of 19 items. Initial results of the CFA did not fully support the proposed three-factor model. After the model was modified, the fit indices indicated, x² was 2.3, Comparative Fit Index (CFI) = 0.96, Tucker- Lewis Index (TLI) = 0.95 providing a strong fit to the data. Cronbach's alphas for the subscales ranged from 0.82 and 0.90, whereas the alpha for the overall scale was 0.91. The 2-week test-retest reliability of MSS was 0.95.

CONCLUSION

This study provides evidence for the psychometric properties to support the Farsi version of the MSS when applied to Iranian women. Exploring the three-factor model in relation to related concepts is suggested for future studies.