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Boulton KA, Hodge MA, Jewell A, Ong N, Silove N, Guastella AJ. Diagnostic delay in children with neurodevelopmental conditions attending a publicly funded developmental assessment service: findings from the Sydney Child Neurodevelopment Research Registry. BMJ Open 2023; 13:e069500. [PMID: 36725093 PMCID: PMC9896183 DOI: 10.1136/bmjopen-2022-069500] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/20/2023] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Early developmental assessment is crucial for effective support and intervention. This study examined factors that contribute to (a) older child age when caregivers first became concerned about their child's development and (b) older child age at the point of entry into developmental and diagnostic assessment. We also quantified how factors contributed to risk of children not receiving an assessment by 5 years and considered the acceptability of electronic data capture for families. DESIGN This cross-sectional study collected information about caregiver developmental concerns, family history and child characteristics. SETTING Children and families entered a large, publicly funded hospital-based paediatric developmental assessment service. PARTICIPANTS Consecutively enrolled children (N=916) aged 6 months to 17 years with neurodevelopmental concerns and their caregivers. MAIN OUTCOMES AND MEASURES A developmental history questionnaire completed by caregivers. RESULTS The average age that caregivers identified developmental concerns was 3.0 years of age but the average age of a receiving a developmental assessment was 6.6 years. Only 46.4% of children received a diagnostic assessment by 5 years of age, even though 88.0% of caregivers were concerned about their child's development by that age. Parental age, relationship status, education level, prior use of support services and being from a culturally and linguistically diverse background contributed to age at identification of concern, age at diagnostic assessment and the likelihood of receiving a diagnostic assessment by 5 years. Electronic data capture had high acceptability, with 88.2% of caregivers reporting a preference for electronic completion of questionnaires. CONCLUSIONS The study shows a substantial delay in diagnostic assessments that leaves most vulnerable children without an assessment by school age and highlights contributors to delays. These delays highlight the complexity of delivering early intervention and support policies that rely on swift and appropriate developmental assessment to vulnerable families.
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Affiliation(s)
- Kelsie A Boulton
- Clinic for Autism and Neurodevelopment (CAN) research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Marie-Antoinette Hodge
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- Child Development Unit, Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, New South Wales, Australia
| | - Ailsa Jewell
- Clinic for Autism and Neurodevelopment (CAN) research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Natalie Ong
- Child Development Unit, Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, New South Wales, Australia
| | - Natalie Silove
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- Child Development Unit, Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, New South Wales, Australia
| | - Adam J Guastella
- Clinic for Autism and Neurodevelopment (CAN) research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
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Yamamoto K, Takita M, Kami M, Tani Y, Yamamoto C, Zhao T, Ohira T, Maeda M, Yasumura S, Sakai A, Hosoya M, Okazaki K, Yabe H, Tsubokura M, Shimabukuro M, Ohto H, Kamiya K. Loss of participation among evacuees aged 20-37 years in the disaster cohort study after the Great East Japan Earthquake. Sci Rep 2022; 12:19600. [PMID: 36380078 PMCID: PMC9665037 DOI: 10.1038/s41598-022-23896-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to clarify the characteristics of young evacuees who had missed the Comprehensive Health Check of the Fukushima Health Management Survey (FHMS) after the Great East Japan Earthquake in 2011. The FHMS has been conducted as a prospective cohort study to evaluate the health status of evacuees annually after the great earthquake in 2011. This study focused on the annual participation rate in the Comprehensive Health Check of evacuees aged between 20 and 37 years in 2011 who evacuated due to the Fukushima Daiichi Nuclear Power Plant accident. The characteristics of subjects who did not participate after the second survey year were identified with a multivariate logistic regression model. The participation rate was estimated at 26.6% (9720 among 36,502 residents) and 15.6% (5691 residents) in 2011 and 2012, respectively. The logistic regression model revealed the following characteristics at baseline as independent predictors of non-participation after the second year of the survey: age ≤ 24 years (adjusted odds ratio 2.11, 95% CI 1.84-2.42), 25-29 years of age (1.28, 1.13-1.45), men (1.52, 1.38-1.69), evacuation outside the municipality but within Fukushima prefecture (1.54, 1.40-1.70), evacuation outside the Fukushima prefecture (1.40, 1.21-1.63), anemia (1.23, 1.06-1.43), smoking habit (1.34, 1.21-1.48), and drinking habit (1.20, 1.09-1.32). A medical history of heart disease showed opposite odds ratios, which indicate the association with continuous participation (0.43, 0.26-0.72, respectively). We observed deteriorated participation in the prospective study of the Comprehensive Health Check of the FHMS among evacuees of a younger age group, men, those evacuated outside their municipalities, and those with history of anemia, smoking and drinking habits. Hence, the cohort study may have missed certain population groups with worse health behaviors. Thus, it is necessary to consider various measures to increase the participation rate in the disaster cohort study to understand the long-term health effects of disasters on younger residents in evacuation zones.
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Affiliation(s)
- Kana Yamamoto
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan.
- Medical Governance Research Institute, 2-12-13 -201 Takanawa, Minato, Tokyo, 108-0074, Japan.
| | - Morihito Takita
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
- Medical Governance Research Institute, 2-12-13 -201 Takanawa, Minato, Tokyo, 108-0074, Japan
| | - Masahiro Kami
- Medical Governance Research Institute, 2-12-13 -201 Takanawa, Minato, Tokyo, 108-0074, Japan
| | - Yuta Tani
- Medical Governance Research Institute, 2-12-13 -201 Takanawa, Minato, Tokyo, 108-0074, Japan
| | - Chika Yamamoto
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
| | - Tianchen Zhao
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Fukushima, 960-1295, Japan
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
- Department of Disaster Psychology, Fukushima Medical University School of Medicine, Fukushima, Fukushima, 960-1295, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Fukushima, 960-1295, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Fukushima, 960-1295, Japan
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Fukushima, 960-1295, Japan
| | - Kanako Okazaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Fukushima, 960-1295, Japan
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima, Fukushima, 960-8516, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Fukushima, 960-1295, Japan
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
- Department of Diabetes, Endocrinology and Metabolism School of Medicine, Fukushima Medical University School of Medicine, Fukushima, Fukushima, 960-1295, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Fukushima, 960-1295, Japan
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, 734-8553, Japan
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Zeschick N, Warkentin L, Kühlein T, Steininger P, Überla K, Hueber S, Sebastião M. Active monitoring of adverse reactions following COVID-19 and other vaccinations: a feasibility study as part of the CoVaKo project. Pilot Feasibility Stud 2022; 8:134. [PMID: 35780172 PMCID: PMC9250275 DOI: 10.1186/s40814-022-01088-y] [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: 10/22/2021] [Accepted: 06/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background The Corona-Vakzin-Konsortium project (CoVaKo) analyses the efficacy and safety of COVID-19 vaccines in a real-world setting, as well as breakthrough infections in Bavaria, Germany. A subproject of CoVaKo aims to identify adverse reactions of the COVID-19 vaccine and compare these to adverse reactions of other vaccines in an online survey. In a preceding feasibility study, the study materials were tested for comprehensibility, visual design, and motivation to participate, as well as for their ability to be implemented and carried out in primary care practices and vaccination centres. Methods We used a mixed-methods research design. First, three focus groups consisting of general population participants were organised to evaluate the study materials and survey. Second, a test roll-out was conducted in vaccination centres and primary care practices that involved implementing and quantitatively evaluating the online survey. Third, interviews were conducted with participating general practitioners and heads of vaccination centres four weeks after the test roll-out. Results Parts of the information and registration form proved incomprehensible, specifically regarding the recruitment material and/or online survey. For example, headings were misleading given that, relative to other vaccinations, the COVID-19 vaccination was overemphasised in the title. Participants requested additional information regarding the procedure and completion time. Within 31 days, 2199 participants, who received either a COVID-19 vaccination (99%) or at least one of the control vaccinations (1%), registered for the study. Participants (strongly) agreed that the registration process was easy to understand, that the completion time was reasonable, and that the technical setup was straightforward. Physicians and heads of the vaccination centres perceived the study as easy to integrate into their workflow. The majority expressed willingness to participate in the main study. Conclusions Our study indicated that identifying and documenting adverse reactions following vaccinations using an online survey is feasible. Testing materials and surveys provided valuable insight, enabling subsequent improvements. Participation from health professionals proved essential in ensuring the practicality of procedures. Lastly, adapting the study’s organisation to external fluctuating structures and requirements confirmed necessary for a successful implementation, especially due to dynamic changes in the nation’s COVID-19 vaccination strategies. Trial registration The trial was retrospectively registered at the “Deutsches Register Klinischer Studien” (DRKS-ID: DRKS00025881) on Oct 14, 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01088-y.
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Affiliation(s)
- Nikoletta Zeschick
- Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany.
| | - Lisette Warkentin
- Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Thomas Kühlein
- Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Philipp Steininger
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Klaus Überla
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Susann Hueber
- Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Maria Sebastião
- Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
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Khaing NEE, Lim CS, Soon SP, Oh HC. Prevalence and correlates of psychological distress and coronavirus anxiety among hospital essential services workers in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022; 51:283-291. [PMID: 35658151 DOI: 10.47102/annals-acadmedsg.202219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has affected almost all populations, with frontline workers experiencing a higher risk of mental health effects compared to other groups. Although there are several research studies focusing on the mental health effects of the pandemic on healthcare workers, there is little research about its impact on workers in outsourced hospital essential services. This study aims to examine the prevalence and correlates of psychological distress and coronavirus anxiety among staff working in 3 outsourced hospital essential services-housekeeping, porter service and maintenance services. METHODS A cross-sectional study was conducted among outsourced hospital essential services workers in a tertiary hospital. Data on demographics, medical history, lifestyle factors, psychosocial factors and mental well-being were collected using self-administered questionnaires. Robust logistic regression was used to determine risk factors associated with psychological distress and dysfunctional anxiety related to COVID-19. RESULTS A total of 246 hospital essential services workers participated in the study. The prevalence of psychological distress was 24.7%, and dysfunctional anxiety related to COVID-19 was 13.4%. Social support and workplace support were found to be independently associated with a lower risk of psychological distress, and social connectivity was associated with a lower risk of dysfunctional anxiety related to COVID-19. CONCLUSION These findings highlight the crucial roles of communities and workplaces in combating the mental health consequences of the pandemic. Public health programmes that aim to tackle the emerging mental health crisis in hospital essential services workers should incorporate strategies to address psychosocial factors, in addition to traditional self-care approaches.
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Kumar AD, Durham DD, Lane L, Perera P, Rivera MP, Henderson LM. Randomized control trial of unconditional versus conditional incentives to increase study enrollment rates in participants at increased risk of lung cancer. J Clin Epidemiol 2022; 141:11-17. [PMID: 34469801 PMCID: PMC8903037 DOI: 10.1016/j.jclinepi.2021.08.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/05/2021] [Accepted: 08/21/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Understanding how incentives and their timing influence study enrollment rates is important to efficient study design and increasing the generalizability of findings. This 2-arm, parallel randomized trial evaluated how conditional vs. unconditional mailed incentives of a $20 gift card affected study enrollment in a sample of participants screened for lung cancer screening. METHODS Eligible participants included Black and White adults who underwent lung cancer screening with low-dose CT and had negative screening results at two North Carolina imaging facilities in 2018. We used a stratified randomization scheme, by sex and race, to assign incentive type (conditional vs. unconditional). We used the Tailored Design Method with six points of mailed contact to engage participants. We compared study enrollment rates using chi-square tests and logistic regression analyses. RESULTS After adjusting for sex, race, age, smoking status, participant residence, and screening site, participants who received unconditional incentives were 74% more likely to enroll than those who received conditional incentives (adjusted OR = 1.74 (95% CI: 1.01, 3.00). CONCLUSIONS Type of incentive can play a role in increasing study enrollment, especially mailed surveys that target individuals who currently or previously smoked. Unconditional incentives may be worth the initial cost to engage study participants.
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Affiliation(s)
- Anjali D. Kumar
- Department of Epidemiology, University of North Carolina, Chapel Hill,Corresponding author.
| | | | - Lindsay Lane
- Department of Radiology, University of North Carolina, Chapel Hill
| | - Pasangi Perera
- Department of Radiology, University of North Carolina, Chapel Hill
| | - M. Patricia Rivera
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of North Carolina, Chapel Hill,Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill
| | - Louise M. Henderson
- Department of Epidemiology, University of North Carolina, Chapel Hill,Department of Radiology, University of North Carolina, Chapel Hill,Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill
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Does the use of telephone reminders to increase survey response rates affect outcome estimates? An ancillary analysis of a prospective cohort study of patients with low back pain. BMC Musculoskelet Disord 2021; 22:893. [PMID: 34670521 PMCID: PMC8529745 DOI: 10.1186/s12891-021-04787-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/12/2021] [Indexed: 11/15/2022] Open
Abstract
Background Research is often undertaken using patient-reported outcomes from questionnaires. Achieving a high response rate demands expensive and time-consuming methods like telephone reminders. However, it is unknown whether telephone reminders change outcome estimates or only affect the response rate in research of populations with low back pain (LBP). The aim is to compare baseline characteristics and the change in outcome between patients responding before and after receiving a telephone reminder. Methods This is an ancillary analysis of data from a prospective cohort study employing questionnaires from 812 adults with LBP lasting more than 3 months. Patients not responding to the 52-week questionnaire were sent reminder emails after two and 3 weeks and delivered postal reminders after 4 weeks. Patients still not responding were contacted by telephone, with a maximum of two attempts. Patients were categorised into three groups: 1) patients responding before a telephone reminder was performed; 2) patients responding after the telephone reminder and 3) patients not responding at all. A positive outcome was defined as a 30% improvement on the Roland Morris Disability Questionnaire after 52 weeks. Results A total of 695 patients (85.2%) responded. Of these, 643 patients were classified in Group 1 and 52 patients were classified in Group 2. One hundred seventeen were classified in Group 3. No differences in outcome or baseline characteristics was found. In Group 1, 41.3% had a positive outcome, and in Group 2 48.9% had a positive outcome (P = 0.297). In group 3, non-respondents were younger, more often unemployed, more often smokers, more often reported co-morbidity, and reported higher depression scores than respondents. Conclusions Using a telephone reminder had no consequence on outcome estimates nor were there any differences in baseline characteristics between patients who responded before or after the telephone reminder. Trial registration The initial trial was registered in Clinicaltrials.gov (NCT03058315).
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Eccleston CE, Courtney-Pratt H, McInerney F, Johnstone A, Doherty K. Predictors of dementia knowledge in a rural general public sample. Aust J Rural Health 2021; 29:530-537. [PMID: 34351673 DOI: 10.1111/ajr.12777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 04/28/2021] [Accepted: 06/18/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To investigate dementia knowledge within a rural Australian general public cohort and understand demographic predictors of knowledge in this population. DESIGN A cross-sectional study comprising quantitative surveys. SETTING 321 participants were recruited from the Tasmanian general public (February-September 2017). PARTICIPANTS 28% of participants were from remote or outer regional postcodes; the remainder were from inner regional areas. The median age was 46 years; 35% were male. 30% had participated in prior dementia education, 29% had worked with people living with dementia, and 23% had no identified personal experience of people living with dementia. INTERVENTIONS No interventions were conducted as part of this study. MAIN OUTCOME MEASURES Dementia knowledge was assessed using the Dementia Knowledge Assessment Scale. Demographic variables were also collected. RESULTS Mean dementia knowledge was moderate and participants scored highest on the care considerations subscale. Those with personal experience with a person living with dementia scored significantly higher on all subscales, and overall, than those without. Dementia education, general education, and previous work, care or close relationship with people living with dementia were all significant predictors in a regression model explaining nearly a third of the variance in overall dementia knowledge. CONCLUSION While personal experience of dementia improves knowledge of the condition, dementia education is the most important predictor. Deficits identified in knowledge of risk factors, and incomplete knowledge about aspects important to quality care, suggest a need for further education for the general public, particularly in the light of the rising prevalence of dementia in ageing rural populations.
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Affiliation(s)
- Claire E Eccleston
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Helen Courtney-Pratt
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Fran McInerney
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Amber Johnstone
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Kathleen Doherty
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
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Łaszewska A, Helter T, Simon J. Perceptions of Covid-19 lockdowns and related public health measures in Austria: a longitudinal online survey. BMC Public Health 2021; 21:1502. [PMID: 34344343 PMCID: PMC8331215 DOI: 10.1186/s12889-021-11476-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/01/2021] [Indexed: 01/12/2023] Open
Abstract
Background Introducing national lockdown has been effective in containing Covid-19. However, several studies indicated negative impacts of lockdowns on the well-being and mental health of many people. In Austria, the first Covid-19-related lockdown was introduced on 16 March 2020 with most restrictions being lifted 1 month later. Seven months after that, in November 2020, the second full lockdown was implemented. The aim of this study was to compare the perceptions and experiences of the general population related to the first and second Covid-19 lockdowns in Austria. Methods Two waves of an online survey were conducted in May and December 2020 asking respondents about their concerns related to the Covid-19 illness, personal experiences of the lockdowns, perceptions of and compliance with imposed public health measures, and the impact of the Covid-19 pandemic on different aspects of life during the two lockdowns. Descriptive statistics including frequency analysis were used to compare respondents’ answers collected in the two waves of the survey. T-test and chi-square tests were used to test differences between the two lockdowns. Results Five hundred sixty participants were included in the first wave and a sub-sample of 134 participants in the second wave of data collection. During the second lockdown, study respondents were more concerned about their family members contracting Covid-19 when compared with the first lockdown. Compliance with public health measures was overall lower during the second lockdown, although it varied according to the type of the measure. Closure of schools was seen as the least essential restriction during the second lockdown, while wearing masks gained additional approval between the first and the second lockdown. Larger negative impacts of the Covid-19 pandemic on friendships, leisure activities, education and community were reported during the second lockdown. Conclusions The study found that the extended duration of the pandemic and recurring lockdowns restricting freedom of movement and social contacts appear to have caused significant disruptions to many areas of life. Furthermore, declining adherence to most public health measures over time raises a question about the effectiveness of future lockdown measures. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11476-3.
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Affiliation(s)
- Agata Łaszewska
- Medical University of Vienna, Center for Public Health, Department of Health Economics, Kinderspitalgasse 15, 1090, Vienna, Austria.
| | - Timea Helter
- Medical University of Vienna, Center for Public Health, Department of Health Economics, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - Judit Simon
- Medical University of Vienna, Center for Public Health, Department of Health Economics, Kinderspitalgasse 15, 1090, Vienna, Austria
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Recruitment strategies for a pragmatic cluster randomized oral health trial in pediatric primary care settings. Contemp Clin Trials Commun 2021; 21:100748. [PMID: 33665473 PMCID: PMC7905074 DOI: 10.1016/j.conctc.2021.100748] [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: 07/14/2020] [Revised: 01/25/2021] [Accepted: 02/09/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives To describe multilevel recruitment strategies for an ongoing clinical trial in pediatric primary care settings, and assess adoption and reach of these strategies via the RE-AIM framework. Methods This study is part of a larger pragmatic cluster randomized clinical trial focused on the effectiveness of interventions on the practice, provider, and caregiver levels on dental utilization for Medicaid-enrolled 3-6 year old children. Pediatric practices were recruited according to the proportion of Medicaid-eligible children, geographic region, and County. In accordance with the RE-AIM framework, providers reached were those approached directly and consented, and those who participated in the intervention training adopted to deliver the intervention. Caregivers reached were those approached and consented at their child's well-child visit to participate in the trial. Results Recruitment goals were met over a 21 month period, with an overall enrollment of 18 practices, 62 providers, and 1024 caregivers-child dyads. The majority of practices enrolled were small, suburban, and located in an urban county. The participation rates among approached providers and caregivers was 93% and 84% respectively. Enablers for recruitment was the one-on-one interaction with the provider and caregivers. Barriers to recruitment for caregivers included no-shows and cancellations at well-child visits. Adoption of intervention among providers was high, and caregiver reached were representative of the eligible target population. Conclusions Active approaches to recruitment, such as utilizing opinion leaders, in-person recruitment, and building relationships with practice staff, can result in successful enrollment and imp lementation of a multi-level intervention in pediatric primary care settings.
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Patel S, Boulton KA, Redoblado-Hodge MA, Papanicolaou A, Barnett D, Bennett B, Drevensek S, Cramsie J, Ganesalingam K, Ong N, Rozsa M, Sutherland R, Williamsz M, Pokorski I, Song YJC, Silove N, Guastella AJ. The Acceptability and Efficacy of Electronic Data Collection in a Hospital Neurodevelopmental Clinic: Pilot Questionnaire Study. JMIR Form Res 2021; 5:e18214. [PMID: 33464217 PMCID: PMC7854031 DOI: 10.2196/18214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 10/13/2020] [Accepted: 11/04/2020] [Indexed: 01/30/2023] Open
Abstract
Background There is a growing need for cost-efficient and patient-centered approaches to support families in hospital- and community-based neurodevelopmental services. For such purposes, electronic data collection (EDC) may hold advantages over paper-based data collection. Such EDC approaches enable automated data collection for scoring and interpretation, saving time for clinicians and services and promoting more efficient service delivery. Objective This pilot study evaluated the efficacy of EDC for the Child Development Unit, a hospital-based diagnostic assessment clinic in the Sydney Children’s Hospital Network. Caregiver response rates and preference for EDC or paper-based methods were evaluated as well as the moderating role of demographic characteristics such as age, level of education, and ethnic background. Methods Families were sent either a paper-based questionnaire via post or an electronic mail link for completion before attending their first on-site clinic appointment for assessment. A total of 62 families were provided a paper version of the questionnaire, while 184 families were provided the online version of the same questionnaire. Results Completion rates of the questionnaire before the first appointment were significantly higher for EDC (164/184, 89.1%) in comparison to paper-based methods (24/62, 39%; P<.001). Within the EDC group, a vast majority of respondents indicated a preference for completing the questionnaire online (151/173, 87.3%), compared to paper completion (22/173, 12.7%; P<.001). Of the caregiver demographic characteristics, only the respondent’s level of education was associated with modality preference, such that those with a higher level of education reported a greater preference for EDC (P=.04). Conclusions These results show that EDC is feasible in hospital-based clinics and has the potential to offer substantial benefits in terms of centralized data collation, time and cost savings, efficiency of service, and resource allocation. The results of this study therefore support the continued use of electronic methods to improve family-centered care in clinical practices.
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Affiliation(s)
- Shrujna Patel
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Kelsie Ann Boulton
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Marie Antoinette Redoblado-Hodge
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Child Development Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, Australia
| | - Angela Papanicolaou
- Child Development Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, Australia
| | - Diana Barnett
- Child Development Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, Australia
| | - Beverley Bennett
- Child Development Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, Australia
| | - Suzi Drevensek
- Child Development Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, Australia
| | - Jane Cramsie
- Child Development Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, Australia
| | - Kalaichelvi Ganesalingam
- Child Development Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, Australia
| | - Natalie Ong
- Child Development Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, Australia
| | - Magdalen Rozsa
- Child Development Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, Australia
| | - Rebecca Sutherland
- Child Development Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, Australia
| | - Marcia Williamsz
- Child Development Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, Australia
| | - Izabella Pokorski
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Yun Ju Christine Song
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Natalie Silove
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Child Development Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, Australia
| | - Adam John Guastella
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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11
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Tassiopoulos K, Roberts-Toler C, Fichtenbaum CJ, Koletar SL. Web-Based Data Collection for Older Adults Living With HIV in a Clinical Research Setting: Pilot Observational Study. J Med Internet Res 2020; 22:e18588. [PMID: 33174854 PMCID: PMC7688395 DOI: 10.2196/18588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/26/2020] [Accepted: 08/26/2020] [Indexed: 01/25/2023] Open
Abstract
Background Longitudinal follow-up of older persons living with HIV is essential for the ascertainment of aging-related clinical and behavioral outcomes, and self-administered questionnaires are necessary for collecting behavioral information in research involving persons living with HIV. Web-based self-reported data collection results in higher data quality than paper-and-pencil questionnaires in a wide range of populations. The option of remote web-based surveys may also increase retention in long-term research studies. However, the acceptability and feasibility of web-based data collection in clinical research involving older persons living with HIV have never been studied. Objective This study aims to assess the acceptability and feasibility of a web-based survey to collect information on sexual, substance use, and physical activity behaviors; compare the data quality of the web-based survey with that of a paper-and-pencil questionnaire; and summarize web-based survey metrics. Methods This pilot study took place within the AIDS Clinical Trials Group A5322 study, a longitudinal cohort of men and women living with HIV (aged ≥40 years), followed at 32 clinical sites in the United States and Puerto Rico. A total of 4 sites participated in this study. A web-based survey was created using self-administered questionnaires typically completed in A5322 via paper and pencil. Pilot study participants completed these questionnaires via web-based survey at one research visit in lieu of paper-and-pencil administration. Two questions were added to assess feasibility, defined as participants’ perception of the ease of web-based survey completion (very hard, hard, easy, very easy), and their preferred format (computer or tablet, paper and pencil, no preference) for completing the questions in the future (acceptability). Feasibility and acceptability were summarized overall and by demographic and clinical characteristics; the proportion of evaluable data by web-based survey versus previously administered paper-and-pencil questionnaires (data quality) was compared for each question. Results Acceptability and feasibility were high overall: 50.0% (79/158) preferred computer or tablet, 38.0% (60/158) reported no preference, and 12.0% (19/158) preferred paper and pencil; 93.0% (147/158) reported survey completion easy or very easy. Older age was associated with lower odds of preferring computer or tablet to paper and pencil (odds ratio per 1-year increase in age: 0.91, 95% CI 0.85-0.98). Individuals who found the survey hard or very hard had a lower median neurocognitive test score than those who found it easy or very easy. Data quality with web-based survey administration was similar to or higher than that with paper-and-pencil administration for most questions. Conclusions Web-based survey administration was acceptable and feasible in this cohort of older adults living with HIV, and data quality was high. Web-based surveys can be a useful tool for valid data collection and can potentially improve retention in long-term follow-up studies.
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Affiliation(s)
- Katherine Tassiopoulos
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Carla Roberts-Toler
- Center for Biostatistics in AIDS Research, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Carl J Fichtenbaum
- Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Susan L Koletar
- Division of Infectious Diseases, Department of Medicine, Ohio State University, Columbus, OH, United States
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12
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Zingone F, Siniscalchi M, Savarino EV, Barberio B, Cingolani L, D'Incà R, De Filippo FR, Camera S, Ciacci C. Perception of the COVID-19 Pandemic Among Patients With Inflammatory Bowel Disease in the Time of Telemedicine: Cross-Sectional Questionnaire Study. J Med Internet Res 2020; 22:e19574. [PMID: 33006945 PMCID: PMC7654503 DOI: 10.2196/19574] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/07/2020] [Accepted: 09/14/2020] [Indexed: 01/08/2023] Open
Abstract
Background After the COVID-19 outbreak, the Italian Government stopped most regular health care activity. As a result, patients with inflammatory bowel disease (IBD) had limited access to outpatient clinics and hospitals. Objective This study aimed to analyze the perception of the COVID-19 emergency among patients with IBD during the early weeks of the lockdown. Methods We invited adult patients with IBD from the University of Salerno (Campania, South Italy) and the University of Padua (Veneto, North Italy) by email to answer an ad hoc anonymous survey about COVID-19. We also collected data on demographic and disease characteristics. Results In total, 167 patients with IBD from Padua and 83 patients from Salerno answered the survey (age: mean 39.7 years, SD 13.9 years; female: n=116, 46.4%). We found that patients with IBD were particularly worried about the COVID-19 pandemic (enough: 77/250, 30.8%; much/very much: 140/250, 56.0%), as they felt more vulnerable to COVID-19 due to their condition (enough: 70/250, 28.0%; much/very much: 109/250, 43.6%). Patients with IBD from the red zone of Veneto were more worried than patients from Campania (P=.001), and men felt more susceptible to the virus than women (P=.05). Additionally, remote medicine was appreciated more by younger patients than older patients (P=.04). Conclusions The results of our survey demonstrate that the lockdown had a significant impact on the psychological aspects of patients with IBD and suggest the need for increasing communication with patients with IBD (eg, through telemedicine) to ensure patients receive adequate health care, correct information, and proper psychological support.
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Affiliation(s)
- Fabiana Zingone
- Inflammatory Bowel Disease Center, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy
| | - Monica Siniscalchi
- Inflammatory Bowel Disease Center, Department of Medicine, Surgery, Dentistry, Scuola Medica Salernitana, University of Salerno, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Edoardo Vincenzo Savarino
- Inflammatory Bowel Disease Center, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy
| | - Brigida Barberio
- Inflammatory Bowel Disease Center, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy
| | - Linda Cingolani
- Inflammatory Bowel Disease Center, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy
| | - Renata D'Incà
- Inflammatory Bowel Disease Center, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy
| | - Francesca Romana De Filippo
- Inflammatory Bowel Disease Center, Department of Medicine, Surgery, Dentistry, Scuola Medica Salernitana, University of Salerno, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Silvia Camera
- Inflammatory Bowel Disease Center, Department of Medicine, Surgery, Dentistry, Scuola Medica Salernitana, University of Salerno, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Carolina Ciacci
- Inflammatory Bowel Disease Center, Department of Medicine, Surgery, Dentistry, Scuola Medica Salernitana, University of Salerno, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
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13
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van Gelder MMHJ, Merkus PJFM, van Drongelen J, Swarts JW, van de Belt TH, Roeleveld N. The PRIDE Study: Evaluation of online methods of data collection. Paediatr Perinat Epidemiol 2020; 34:484-494. [PMID: 31868970 PMCID: PMC7496449 DOI: 10.1111/ppe.12618] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 10/04/2019] [Accepted: 10/09/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Large birth cohort studies are extremely valuable in assessing associations between early life exposures and long-term outcomes. Establishing new birth cohorts is challenging due to declining participation rates. Online methods of data collection may increase feasibility, but have not been evaluated thoroughly. OBJECTIVE The primary objective of the ongoing PRegnancy and Infant DEvelopment (PRIDE) Study is to identify exposures during pregnancy and in early life that may affect short-term or long-term health of mother and/or child. In this manuscript, we aimed to evaluate methods of recruitment and online data collection applied. POPULATION Dutch women aged ≥18 years in early pregnancy. DESIGN Prospective cohort study. METHODS Initially, only prenatal care providers recruited participants, but alternative recruitment methods were added as a result of disappointing participation rates, including collaboration with "Moeders voor Moeders" (organisation that visits women in early pregnancy) and Facebook advertisements. Data on demographic characteristics, obstetric history, maternal health, life style factors, occupational exposures, nutrition, pregnancy complications, and infant outcomes are primarily collected through Web-based questionnaires at multiple time points during and after pregnancy. Additional data collection components include paternal questionnaires, blood and saliva sampling, and linkage to medical records. PRELIMINARY RESULTS By September 2019, 9573 women were included in the PRIDE Study, of which 1.3% completed paper-based questionnaires. Mean age of the women analysed was 30.6 years, 71.1% had a high level of education, 57.2% were primiparae, and mean gestational age at enrolment was 9.9 (range 3, 37) weeks, with slight differences between recruitment methods. Pregnancy outcome was known for 89.8%. Retention rate at 6 months after the estimated date of delivery was estimated at 70%. Multiple validation studies conducted within the PRIDE Study indicated high data quality. CONCLUSION(S) Although challenging and time-consuming, online methods for recruitment and data collection may enable the establishment of new birth cohort studies.
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Affiliation(s)
- Marleen M. H. J. van Gelder
- Department for Health EvidenceRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands,Radboud REshape Innovation CenterRadboud University Medical CenterNijmegenThe Netherlands
| | - Peter J. F. M. Merkus
- Department of Paediatric PulmonologyRadboudumc Amalia Children's HospitalRadboud University Medical CenterNijmegenThe Netherlands
| | - Joris van Drongelen
- Department of Obstetrics and GynaecologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Jessie W. Swarts
- Department for Health EvidenceRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Tom H. van de Belt
- Radboud REshape Innovation CenterRadboud University Medical CenterNijmegenThe Netherlands,Radboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Nel Roeleveld
- Department for Health EvidenceRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
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14
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Bond DM, Hammond J, Shand AW, Nassar N. Comparing a Mobile Phone Automated System With a Paper and Email Data Collection System: Substudy Within a Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e15284. [PMID: 32763873 PMCID: PMC7479579 DOI: 10.2196/15284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/06/2019] [Accepted: 06/13/2020] [Indexed: 12/16/2022] Open
Abstract
Background Traditional data collection methods using paper and email are increasingly being replaced by data collection using mobile phones, although there is limited evidence evaluating the impact of mobile phone technology as part of an automated research management system on data collection and health outcomes. Objective The aim of this study is to compare a web-based mobile phone automated system (MPAS) with a more traditional delivery and data collection system combining paper and email data collection (PEDC) in a cohort of breastfeeding women. Methods We conducted a substudy of a randomized controlled trial in Sydney, Australia, which included women with uncomplicated term births who intended to breastfeed. Women were recruited within 72 hours of giving birth. A quasi-randomized number of women were recruited using the PEDC system, and the remainder were recruited using the MPAS. The outcomes assessed included the effectiveness of data collection, impact on study outcomes, response rate, acceptability, and cost analysis between the MPAS and PEDC methods. Results Women were recruited between April 2015 and December 2016. The analysis included 555 women: 471 using the MPAS and 84 using the PEDC. There were no differences in clinical outcomes between the 2 groups. At the end of the 8-week treatment phase, the MPAS group showed an increased response rate compared with the PEDC group (56% vs 37%; P<.001), which was also seen at the 2-, 6-, and 12-month follow-ups. At the 2-month follow-up, the MPAS participants also showed an increased rate of self-reported treatment compliance (70% vs 56%; P<.001) and a higher recommendation rate for future use (95% vs 64%; P<.001) as compared with the PEDC group. The cost analysis between the 2 groups was comparable. Conclusions MPAS is an effective and acceptable method for improving the overall management, treatment compliance, and methodological quality of clinical research to ensure the validity and reliability of findings.
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Affiliation(s)
- Diana M Bond
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jeremy Hammond
- Strategic Ventures, University of Sydney, Sydney, Australia
| | - Antonia W Shand
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department for Maternal Fetal Medicine, Royal Hospital for Women, Sydney, Australia
| | - Natasha Nassar
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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15
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Sexuality After Treatment of Diffuse Large B-cell Lymphoma: Patients' Experiences and Psychometric Testing of the Sexual Adjustment Questionnaire-Swedish Version II. Cancer Nurs 2020; 44:499-508. [PMID: 32804757 PMCID: PMC8560151 DOI: 10.1097/ncc.0000000000000866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Sexuality is an important part of health-related quality of life. To ensure adequate supportive interventions, valid and reliable instruments specific to sexual changes and adjustments after cancer treatment are needed. Objectives The aims of this study were to test the psychometric properties of the Sexual Adjustment Questionnaire-Swedish version II (SAQ-SII) in patients treated for diffuse large B-cell lymphoma and to describe and explore patients' experiences of sexuality after treatment. Methods A cross-sectional study was conducted in 2019, using SAQ-SII and data from the National Quality Registry for Leukemia–subregistry for Lymphoma, which included 257 patients (25% response rate). An exploratory factor analysis was performed for psychometric evaluation. Internal consistency was assessed by Cronbach's α. Independent t tests, analysis of variance, and multiple regression were used to describe patients' experiences of sexuality. Results The exploratory factor analysis resulted in a 4-factor structure, explaining 65.7% of the total scale variance (SAQ-SII). The Cronbach's α for the SAQ-SII was 0.88 and varied between 0.70 and 0.89 across subscales. Sexuality was affected in various ways and extent. Sexual Interest was most affected, whereas Sexual Function was least affected. Being male, of younger age, without comorbidities, and in a relationship were associated to a higher Sexual Interest. Conclusions The SAQ-SII is a valid and reliable instrument to measure changes and adjustments in sexuality in patients treated for lymphoma. Implications for Practice Assessments of sexuality in a broad sense should be an integrated part of cancer care to ensure timely interventions for those who need and want support.
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van Eenbergen MC, Vromans RD, Tick LW, Vreugdenhil G, Krahmer EJ, Mols F, van de Poll-Franse LV. Comparing cancer survivors in population-based samples with those in online cancer communities: Identifying differences in internet use and information needs (Preprint). JMIR Cancer 2020; 8:e19379. [PMID: 35258460 PMCID: PMC8941444 DOI: 10.2196/19379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/07/2020] [Accepted: 01/25/2022] [Indexed: 01/23/2023] Open
Abstract
Background Most Western countries have websites that provide information on cancer and the opportunity to participate in online cancer communities (OCCs). The number of patients with cancer that participate in these OCCs is growing. These patients are relatively easy to approach for research purposes. Objective The objective of this study is to determine the differences and similarities between survivors of cancer in population-based samples and survivors participating in OCCs who use the internet in relation to their illness. Methods In 2017, we drew a sample of 539 population-based patients and 531 OCC patients. The population-based patients were sent a paper-based questionnaire, and the OCC patients were sent the same questionnaire on the web. In the questionnaire, we asked patients about their sociodemographics, internet use, sources of information, media use, and wishes regarding future internet use for health care–related purposes, and the effect of internet use on their health care consumption. Results The response rate of population-based internet users was 47% (233/496), and that of the OCC group was 40.3% (214/531). The OCC group had a significantly higher education level (P<.001), was younger (P<.001), had more survivors that were employed (P<.001), and attached greater importance to the internet (171/214, 79.9% vs 126/233, 54.1%; P<.001) and fellow survivors (107/214, 50% vs 60/233, 25.8%; P<.001). Compared with the population-based group, the OCC group reported more intensive internet use immediately after diagnosis, during treatment, and during follow-up (P<.001 in each case). There were similarities in terms of the relative importance that survivors attach to the various sources of information, the topics on which they seek information, and their wishes for future eHealth possibilities. The OCC group reported a greater need to participate in a web-based class or chat with others (92/214, 43% vs 44/233, 18.9%). Conclusions We conclude that survivors who are members of an OCC are not representative of survivors of cancer in general. There are significant differences in sociodemographic characteristics, internet use during their treatment journey, internet search frequency during their cancer journey, and participation wishes. Using web-based information and communication can support shared decision-making and may facilitate the active participation of patients during their treatment. For research purposes, it is important to take the bias in OCC groups into account.
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Affiliation(s)
- Mies C van Eenbergen
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Ruben D Vromans
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Lidwine W Tick
- Department of Medical Oncology, Maxima Medical Center, Veldhoven, Netherlands
| | - Gerard Vreugdenhil
- Department of Medical Oncology, Maxima Medical Center, Veldhoven, Netherlands
| | - Emiel J Krahmer
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Floortje Mols
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
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17
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Cattaneo G, Bartrés-Faz D, Morris TP, Solana Sánchez J, Macià D, Tormos JM, Pascual-Leone A. The Barcelona Brain Health Initiative: Cohort description and first follow-up. PLoS One 2020; 15:e0228754. [PMID: 32045448 PMCID: PMC7012435 DOI: 10.1371/journal.pone.0228754] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 01/22/2020] [Indexed: 11/19/2022] Open
Abstract
The Barcelona Brain Health Initiative is a longitudinal cohort study that began in 2017 and aims to understand and characterize the determinants of brain health maintenance in middle aged adults. A cohort of 4686 individuals between the ages of 40 and 65 years free from any neurological or psychiatric diseases was established, and we collected extensive demographic, socio-economic information along with measures of self-perceived health and lifestyles (general health, physical activity, cognitive activity, socialization, sleep, nutrition and vital plan). Here we report on the baseline characteristics of the participants, and the results of the one-year follow-up evaluation. Participants were mainly women, highly educated, and with better lifestyles compared with the general population. After one year 60% of participants completed the one-year follow-up, and these were older, with higher educational level and with better lifestyles in some domains. In the absence of any specific interventions to-date, these participants showed small improvements in physical activity and sleep, but decreased adherence to a Mediterranean diet. These changes were negatively associated with baseline scores, and poorer habits at baseline were predictive of an improvement in lifestyle domains. Of the 2353 participants who completed the one-year follow-up, 73 had been diagnosed with new neurological and neuropsychiatric diseases. Changes in vital plan at follow-up, as well as gender, sleep quality and sense of coherence at baseline were shown to be significant risk factors for the onset of these diagnoses. Notably, gender risk factor decreased in importance as we adjusted by sleep habits, suggesting its potential mediator effects. These findings stress the importance of healthy lifestyles in sustaining brain health, and illustrate the individual benefit that can be derived from participation in longitudinal observational studies. Modifiable lifestyles, specifically quality of sleep, may partially mediate the effect of other risk factors in the development of some neuropsychiatric conditions.
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Affiliation(s)
- Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - David Bartrés-Faz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Timothy P. Morris
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Javier Solana Sánchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Dídac Macià
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Josep M. Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States of America
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