1
|
Gisch UA, Robert M, Berlin N, Nebout A, Etilé F, Teyssier S, Andreeva VA, Hercberg S, Touvier M, Péneau S. Mastery Is Associated With Weight Status, Food Intake, Snacking, and Eating Disorder Symptoms in the NutriNet-Santé Cohort Study. Front Nutr 2022; 9:871669. [PMID: 35694168 PMCID: PMC9174750 DOI: 10.3389/fnut.2022.871669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/15/2022] [Indexed: 11/20/2022] Open
Abstract
Mastery is a psychological resource that is defined as the extent to which individuals perceive having control over important circumstances of their lives. Although mastery has been associated with various physical and psychological health outcomes, studies assessing its relationship with weight status and dietary behavior are lacking. The aim of this cross-sectional study was to assess the relationship between mastery and weight status, food intake, snacking, and eating disorder (ED) symptoms in the NutriNet-Santé cohort study. Mastery was measured with the Pearlin Mastery Scale (PMS) in 32,588 adults (77.45% female), the mean age was 50.04 (14.53) years. Height and weight were self-reported. Overall diet quality and food group consumption were evaluated with ≥3 self-reported 24-h dietary records (range: 3-27). Snacking was assessed with an ad-hoc question. ED symptoms were assessed with the Sick-Control-One-Fat-Food Questionnaire (SCOFF). Linear and logistic regression analyses were conducted to assess the relationship between mastery and weight status, food intake, snacking, and ED symptoms, controlling for sociodemographic and lifestyle characteristics. Females with a higher level of mastery were less likely to be underweight (OR: 0.88; 95%CI: 0.84, 0.93), overweight [OR: 0.94 (0.91, 0.97)], or obese [class I: OR: 0.86 (0.82, 0.90); class II: OR: 0.76 (0.71, 0.82); class III: OR: 0.77 (0.69, 0.86)]. Males with a higher level of mastery were less likely to be obese [class III: OR: 0.75 (0.57, 0.99)]. Mastery was associated with better diet quality overall, a higher consumption of fruit and vegetables, seafood, wholegrain foods, legumes, non-salted oleaginous fruits, and alcoholic beverages and with a lower consumption of meat and poultry, dairy products, sugary and fatty products, milk-based desserts, and sweetened beverages. Mastery was also associated with lower snacking frequency [OR: 0.89 (0.86, 0.91)] and less ED symptoms [OR: 0.73 (0.71, 0.75)]. As mastery was associated with favorable dietary behavior and weight status, targeting mastery might be a promising approach in promoting healthy behaviors. Clinical Trial Registry Number NCT03335644 at Clinicaltrials.gov.
Collapse
Affiliation(s)
- Ulrike A. Gisch
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris (CRESS), Bobigny, France
- Counseling Psychology, Department of Psychology, University of Potsdam, Potsdam, Germany
| | - Margaux Robert
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris (CRESS), Bobigny, France
| | - Noémi Berlin
- CNRS, EconomiX – UMR 7235, University of Paris Nanterre, Ivry-sur-Seine, France
| | | | - Fabrice Etilé
- INRAE, UR 1303 ALISS, Ivry-sur-Seine, France
- Paris School of Economics and INRAE, UMR1393 PjSE, Paris, France
| | - Sabrina Teyssier
- Grenoble Alpes University, INRAE, CNRS, Grenoble INP, GAEL, Grenoble, France
| | - Valentina A. Andreeva
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris (CRESS), Bobigny, France
- Department of Public Health, AP-HP Avicenne Hospital, Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris (CRESS), Bobigny, France
| | - Sandrine Péneau
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris (CRESS), Bobigny, France
| |
Collapse
|
2
|
Cros F, Lamy S, Grosclaude P, Nebout A, Bories P, Dupret-bories A. 933P The impact of patients’ and physicians’ characteristics on surgery decision for head and neck cancer: Results of a national survey. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
3
|
Dupret-Bories A, Grosclaude P, Lamy S, Nebout A, Bories P, Cros F. The impact of patients’ and physicians’ characteristics on surgery decision for head and neck cancer: Results of a national survey. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e14151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14151 Background: The choice between surgical or medical treatments in head and neck cancer is a function of many patient-related and disease-related factors. We investigated how physicians' behavioral characteristics and patients’ socioeconomic status could affect medical decision-making. Methods: A nationwide cross-sectional online survey of surgeons and (radiation) oncologists specialized in head and neck oncology collected data on medical decision-making for 7 clinical vignettes involving head and neck squamous cell carcinoma patients that were representative of routine practice. Questionnaires elicited physicians' demographic and occupational characteristics along with their individual behavioral characteristics according to the decision theory framework. Patients’ gender and socioeconomic position were distributed across vignettes using a Latin square design. Results: We obtained 206 assessable answers. A multivariate analysis shows that surgeons suggested surgery more often than other professionals, which is mostly related to vignettes corresponding to clinical cases for which there is no consensus, so oncologists are 68% less likely than surgeons to choose surgery. For clinical vignette with an absence of consensus, physicians with lower risk aversion recommend more often surgery compared to those with higher risk aversion (OR = 1.88, p = 0.052). When the vignette corresponds to a clinical case for which there is a surgical consensus decision the isolated male blue-collar worker has a 75% lower chance of being offered surgery compared to the married male small business owner (OR = 0.25, p = 0.024). We did not observe any differences based on the patient's gender. Conclusions: Patients’ socioeconomic status did affect our clinical management decisions in head and neck oncology. The significant association between medical decision and individual behavioral characteristics of the physician documented still understudied mechanisms that involved nonbiological factor to explain clinical practices variations.
Collapse
Affiliation(s)
| | - Pascale Grosclaude
- UMR 1027, Inserm University of Toulouse 3 Paul Sabatier, Team Equity, Toulouse, France
| | - Sebastien Lamy
- University of Toulouse III Paul Sabatier, Toulouse, France
| | - Antoine Nebout
- Université Paris-Saclay, INRA, Research Unit 1303 ALISS, Paris, France
| | - Pierre Bories
- ONCOMIP Cancer Healthcare Network, Toulouse Cedex 9, France
| | | |
Collapse
|
4
|
Bories P, Lamy S, Simand C, Bertoli S, Delpierre C, Malak S, Fornecker L, Moreau S, Récher C, Nebout A. Physician uncertainty aversion impacts medical decision making for older patients with acute myeloid leukemia: results of a national survey. Haematologica 2018; 103:2040-2048. [PMID: 30006448 PMCID: PMC6269286 DOI: 10.3324/haematol.2018.192468] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/12/2018] [Indexed: 12/11/2022] Open
Abstract
Elderly patients with acute myeloid leukemia can be treated with intensive chemotherapy, low-intensity therapy such as low-dose aracytine or hypomethylating agents, or best supportive care. The choice between these treatments is a function of many patient-related and disease-related factors. We investigated how physicians’ behavioral characteristics affect medical decision-making between intensive and non-intensive therapy in this setting. A nationwide cross-sectional online survey of hematologists collected data on medical decision-making for 6 clinical vignettes involving older acute myeloid leukemia patients that were representative of routine practice. Questionnaires elicited physicians’ demographic and occupational characteristics along with their individual behavioral characteristics according to a decision theory framework. From the pattern of responses to the vignettes, a K-means clustering algorithm was used to distinguish those who were likely to prescribe more intensive therapy and those who were likely to prescribe less intensive or no therapy. Multivariate analyses were used to identify physician’s characteristics predictive of medical decision-making. We obtained 230 assessable answers, which represented an adjusted response rate of 45.4%. A multivariate model (n=210) revealed that physicians averse to uncertainty recommend significantly more intensive chemotherapy: Odds Ratio (OR) [95% Confidence Interval (CI)]: 1.15 [1.01;1.30]; P=0.039. Male physicians who do not conform to the expected utility model (assumed as economically irrational) recommend more intensive chemotherapy [OR (95% CI) = 3.45 (1.34; 8.85); P=0.01]. Patient volume per physician also correlated with therapy intensity [OR (95% CI)=0.98 (0.96; 0.99); P=0.032]. The physicians’ medical decision-making was not affected by their age, years of experience, or hospital facility. The significant association between medical decision and individual behavioral characteristics of the physician identifies a novel non-biological factor that may affect acute myeloid leukemia patients’ outcomes and explain variations in clinical practice. It should also encourage the use of validated predictive models and the description of novel bio-markers to best select patients for intensive chemotherapy or low-intensity therapy.
Collapse
Affiliation(s)
- Pierre Bories
- Regional Cancer Network Onco-Occitanie, Toulouse University Institute of Cancer-Oncopole .,Department of Hematology, Toulouse University Institute of Cancer-Oncopole
| | - Sébastien Lamy
- INSERM Unit 1027, Faculty of Medicine, Toulouse.,Department of Clinical Pharmacology, Toulouse University Hospital
| | | | - Sarah Bertoli
- Department of Hematology, Toulouse University Institute of Cancer-Oncopole
| | | | - Sandra Malak
- Department of Hematology, Rene Huguenin Hospital, Curie Institute, Saint-Cloud
| | - Luc Fornecker
- Department of Hematology, Strasbourg University Hospital
| | | | - Christian Récher
- Department of Hematology, Toulouse University Institute of Cancer-Oncopole
| | | |
Collapse
|
5
|
Massin S, Nebout A, Ventelou B. Predicting medical practices using various risk attitude measures. Eur J Health Econ 2018; 19:843-860. [PMID: 28861629 DOI: 10.1007/s10198-017-0925-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 08/08/2017] [Indexed: 05/17/2023]
Abstract
This paper investigates the predictive power of several risk attitude measures on a series of medical practices. We elicit risk preferences on a sample of 1500 French general practitioners (GPs) using two different classes of tools: scales, which measure GPs' own perception of their willingness to take risks between 0 and 10; and lotteries, which require GPs to choose between a safe and a risky option in a series of hypothetical situations. In addition to a daily life risk scale that measures a general risk attitude, risk taking is measured in different domains for each tool: financial matters, GPs' own health, and patients' health. We take advantage of the rare opportunity to combine these multiple risk attitude measures with a series of self-reported or administratively recorded medical practices. We successively test the predictive power of our seven risk attitude measures on eleven medical practices affecting the GPs' own health or their patients' health. We find that domain-specific measures are far better predictors than the general risk attitude measure. Neither of the two classes of tools (scales or lotteries) seems to perform indisputably better than the other, except when we concentrate on the only non-declarative practice (prescription of biological tests), for which the classic money-lottery test works well. From a public health perspective, appropriate measures of willingness to take risks may be used to make a quick, but efficient, profiling of GPs and target them with personalized communications, or interventions, aimed at improving practices.
Collapse
Affiliation(s)
- Sophie Massin
- Artois University, UMR 9221, Lille Economie Management (LEM), UFR EGASS, 9 Rue du Temple, BP 10665, 62030, Arras Cedex, France.
| | - Antoine Nebout
- ALISS UR1303, INRA, Université Paris-Saclay, F-94205, Ivry-Sur-Seine, France
| | - Bruno Ventelou
- Aix-Marseille Univ, CNRS, EHESS, Centrale Marseille, Aix-Marseille School of Economics, Marseille, France
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
- The Regional Health Observatory of Provence-Alpes-Cote d'Azur (ORS-PACA), Marseille, France
| |
Collapse
|
6
|
Nebout A, Cavillon M, Ventelou B. Comparing GPs' risk attitudes for their own health and for their patients' : a troubling discrepancy? BMC Health Serv Res 2018; 18:283. [PMID: 29650004 PMCID: PMC5898012 DOI: 10.1186/s12913-018-3044-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 03/20/2018] [Indexed: 12/29/2022] Open
Abstract
Background In this paper, we report the results of risk attitudes elicitation of a French general practitioners national representative sample (N=1568). Methods Willingness to take risks in four different domains (daily life, financial matters, own health and patient health) was collected through a large-scale telephone interview of GPs using self-reported 11-point Likert scale questions. Results We uncover some specificities of the GPs population regarding their attitudes towards risk. In particular, we detect an important positive gap between their willingness to take risks in the domain of their own health and in the domain of the heath of their patients. This “patient-regarding” risk aversion is discussed with respect to its important consequences regarding medical behavior bias. Conclusions We confirm the self-other discrepancy found in the medical literature on physicians’ behaviors and emphasize the utility of the study and measures of personality traits such as “risk attitudes” for the medical professions and for the population they address.
Collapse
Affiliation(s)
| | | | - Bruno Ventelou
- Aix Marseille University, CNRS, EHESS, Centrale Marseille, Aix Marseille School of Economics, Marseille, 13000, France
| |
Collapse
|
7
|
Massin S, Ventelou B, Nebout A, Verger P, Pulcini C. Cross-sectional survey: risk-averse French general practitioners are more favorable toward influenza vaccination. Vaccine 2014; 33:610-4. [PMID: 25545596 DOI: 10.1016/j.vaccine.2014.12.038] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 12/08/2014] [Accepted: 12/15/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We tested the following hypotheses: (i) risk-averse general practitioners (GPs) are more likely to be vaccinated against influenza; (ii) and risk-averse GPs recommend influenza vaccination more often to their patients. In risk-averse GPs, the perceived benefits of the vaccine and/or the perceived risks of the infectious disease might indeed outweigh the perceived risks of the vaccine. PATIENTS/METHODS In 2010-2012, we conducted a cross-sectional survey of a nationwide French representative sample of 1136 GPs. Multivariate analyses adjusted for four stratification variables (age, gender, urban/suburban/rural practice location and annual patient consultations) and for GPs' characteristics (group/solo practice, and occasional practice of alternative medicine, e.g., homeopathy) looked for associations between their risk attitudes and self-reported vaccination behavior. Individual risk attitudes were expressed as a continuous variable, from 0 (risk-tolerant) to 10 (risk-averse). RESULTS Overall, 69% of GPs reported that they were very favorable toward vaccination in general. Self-reported vaccination coverage was 78% for 2009/2010 seasonal influenza and 62% for A/H1N1 pandemic influenza. Most GPs (72%) reported recommending the pandemic influenza vaccination to at-risk young adults in 2009, but few than half (42%) to young adults not at risk. In multivariate analyses, risk-averse GPs were more often vaccinated against seasonal (marginal effect=1.3%, P=0.02) and pandemic influenza (marginal effect=1.5%, P=0.02). Risk-averse GPs recommended the pandemic influenza vaccination more often than their more risk-tolerant colleagues to patients without risk factors (marginal effect=1.7%, P=0.01), but not to their at-risk patients and were more favorable toward vaccination in general (marginal effect=1.5%, P=0.04). CONCLUSION Individual risk attitudes may influence GPs' practices regarding influenza vaccination, both for themselves and their patients. Our results suggest that risk-averse GPs may perceive the risks of influenza to outweigh the potential risks related to the vaccine.
Collapse
Affiliation(s)
- Sophie Massin
- Aix Marseille Université (Aix Marseille School of Economics-SESSTIM UMR 912, Inserm IRD), Marseille, France; Université d'Artois, LEM, UMR 8179, Arras, France
| | - Bruno Ventelou
- Aix Marseille Université (Aix Marseille School of Economics-SESSTIM UMR 912, Inserm IRD), Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France; CNRS, U6579 (greqam) , Marseille, France
| | - Antoine Nebout
- Aix Marseille Université (Aix Marseille School of Economics-SESSTIM UMR 912, Inserm IRD), Marseille, France; INRA, UR 1303 ALISS, Ivry-sur-Seine, France
| | - Pierre Verger
- Aix Marseille Université (Aix Marseille School of Economics-SESSTIM UMR 912, Inserm IRD), Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Céline Pulcini
- Aix Marseille Université (Aix Marseille School of Economics-SESSTIM UMR 912, Inserm IRD), Marseille, France; CHU de Nancy, Service de Maladies Infectieuses, Nancy, France; Université de Lorraine, Université Paris Descartes, EA 4360 Apemac, Nancy, France.
| |
Collapse
|
8
|
Michel-Lepage A, Ventelou B, Nebout A, Verger P, Pulcini C. Cross-sectional survey: risk-averse French GPs use more rapid-antigen diagnostic tests in tonsillitis in children. BMJ Open 2013; 3:e003540. [PMID: 24163205 PMCID: PMC3808757 DOI: 10.1136/bmjopen-2013-003540] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES We tested the following hypotheses: (1) risk-averse general practitioners (GPs) might use more Rapid Antigen Diagnostic Tests (RADTs) in tonsillitis in children, probably to decrease their diagnostic uncertainty regarding the aetiology of the disease (viral vs due to group A Streptococcus); and (2) GPs not using RADT might prescribe more antibiotics when they are risk averse. DESIGN, SETTING AND PARTICIPANTS We conducted a cross-sectional survey of a nationwide French representative sample of 1093 GPs in 2012. OUTCOME MEASURES Multivariate analyses adjusted on the four stratification variables (age, gender, location and volume of activity, ie, the number of annual consultations) were performed to identify the risk domains associated with indicators of good or poor practice. RESULTS 69.4% of GPs were aware of national guidelines regarding tonsillitis and declared that they had taken these guidelines into account for their last paediatric tonsillitis case. 59.1% declared they used RADT in their last patient aged between 3 and 16 years presenting with tonsillitis; 29.7% of these tests were positive. Among the GPs who used RADT, 30.7% prescribed an antibiotic; 98.3% did either prescribe an antibiotic because of a positive RADT result, or did not prescribe an antibiotic in view of a negative result. Among the GPs who did not use RADT, 50.7% prescribed an antibiotic. In multivariate analyses, risk-averse GPs declared being more aware of and compliant with guidelines (OR=1.56, p<0.01), and used RADTs more often for their last patient (OR=1.30, p<0.05). Among GPs not using RADT in their last patient, risk-averse GPs prescribed more antibiotics compared with risk-tolerant doctors (OR=1.18, p<0.05). CONCLUSIONS Individual risk attitudes influenced GPs' practices in tonsillitis, particularly the use of RADTs and antibiotic prescriptions.
Collapse
Affiliation(s)
- Audrey Michel-Lepage
- Aix Marseille Université (Aix Marseille School of Economics—SESSTIM UMR 912, Inserm IRD), Marseille, France
- IHU, Fondation Méditerranée Infection, Marseille, France
| | - Bruno Ventelou
- Aix Marseille Université (Aix Marseille School of Economics—SESSTIM UMR 912, Inserm IRD), Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
- CNRS, U6579 (greqam), Marseille, France
| | - Antoine Nebout
- Aix Marseille Université (Aix Marseille School of Economics—SESSTIM UMR 912, Inserm IRD), Marseille, France
- INRA, UR 1303 ALISS, F-94200 Ivry-sur-Seine, France
| | - Pierre Verger
- Aix Marseille Université (Aix Marseille School of Economics—SESSTIM UMR 912, Inserm IRD), Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Céline Pulcini
- Aix Marseille Université (Aix Marseille School of Economics—SESSTIM UMR 912, Inserm IRD), Marseille, France
- Service d'Infectiologie, CHU de Nice, Nice, France
- Faculté de Médecine, Université Nice-Sophia Antipolis, Nice, France
| |
Collapse
|