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Berg CJ, Haardörfer R, Torosyan A, Dekanosidze A, Grigoryan L, Sargsyan Z, Hayrumyan V, Sturua L, Topuridze M, Petrosyan V, Bazarchyan A, Kegler MC. Examining local smoke-free coalitions in Armenia and Georgia: context and outcomes of a matched-pairs community-randomised controlled trial. BMJ Glob Health 2024; 9:e013282. [PMID: 38325896 PMCID: PMC10859987 DOI: 10.1136/bmjgh-2023-013282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 01/10/2024] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Local coalitions can advance public health initiatives such as smoke-free air but have not been widely used or well-studied in low-income and middle-income countries. METHODS We conducted a matched-pairs community-randomised controlled trial in 28 communities in Armenia and Georgia (N=14/country) in which we helped establish local coalitions in 2019 and provided training and technical assistance for coalition activity promoting smoke-free policy development and enforcement (2019-2021). Surveys of ~1450 households (Fall 2018, May-June 2022) were conducted to evaluate coalition impact on smoke-free policy support, smoke-free home adoption, secondhand smoke exposure (SHSe), and coalition awareness and activity exposure, using multivariable mixed modelling. RESULTS Bivariate analyses indicated that, at follow-up versus baseline, both conditions reported greater smoke-free home rates (53.6% vs 38.5%) and fewer days of SHSe on average (~11 vs ~12 days), and that intervention versus control condition communities reported greater coalition awareness (24.3% vs 12.2%) and activity exposure (71.2% vs 64.5%). Multivariable modelling indicated that intervention (vs control) communities reported greater rates of complete smoke-free homes (adjusted Odds Ratio [aOR] 1.55, 95% confiedence interval [CI] 1.11 to 2.18, p=0.011) and coalition awareness (aOR 2.89, 95% CI 1.44 to 8.05, p=0.043) at follow-up. However, there were no intervention effects on policy support, SHSe or community-based activity exposure. CONCLUSIONS Findings must be considered alongside several sociopolitical factors during the study, including national smoke-free policies implementation (Georgia, 2018; Armenia, 2022), these countries' participation in an international tobacco legislation initiative, the COVID-19 pandemic and regional/local war). The intervention effect on smoke-free homes is critical, as smoke-free policy implementation provides opportunities to accelerate smoke-free home adoption via local coalitions. TRIAL REGISTRATION NUMBER NCT03447912.
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Affiliation(s)
- Carla J Berg
- Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, USA
| | - Regine Haardörfer
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Arevik Torosyan
- National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia
| | - Ana Dekanosidze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
- Tbilisi State Medical University, Tbilisi, Georgia
| | - Lilit Grigoryan
- National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia
| | - Zhanna Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Varduhi Hayrumyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Lela Sturua
- National Center for Disease Control and Public Health, Tbilisi, Georgia
- Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Marina Topuridze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
- Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Alexander Bazarchyan
- National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia
| | - Michelle C Kegler
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Harutyunyan T, Sargsyan Z, Sahakyan S, Chiloyan A, Melkom Melkomian D, Khachadourian V. Predicting COVID-19 vaccination uptake in Armenia using the Health Belief Model: Results from a nationwide survey. Hum Vaccin Immunother 2023; 19:2165383. [PMID: 36688424 PMCID: PMC9980550 DOI: 10.1080/21645515.2023.2165383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Indexed: 01/24/2023] Open
Abstract
Health behavior theories have been effectively used for studying populations' awareness, attitudes, and beliefs related to COVID-19 preventative behaviors. The aim of this study was to explore the factors associated with the intention to get vaccinated against COVID-19 in the Armenian population using the Health Belief Model (HBM) as a framework. We applied stratified two-stage random sampling to conduct a telephone survey of 3,483 adults in 2021. The multi-domain survey instrument included questions on socio-demographic characteristics, COVID-19-related knowledge, COVID-19 susceptibility, severity and self-efficacy beliefs, sources of information on COVID-19, COVID-19 vaccination practice, and its benefits and barriers. We performed bivariate and hierarchical multivariate regression analysis with the entry of variables in blocks. In total, about 12% of the sample (n = 393) was vaccinated against COVID-19. Of 2,838 unvaccinated participants, about 53% (n = 1516) had an intention to get vaccinated. The final hierarchical logistic regression model containing socio-demographic characteristics, knowledge about COVID-19, and HBM constructs explained 43% of the variance in the intention to get vaccinated against COVID-19. Participants' age, employment status, average monthly expenditures, perceived threat, benefits, perceived barriers, self-efficacy, and cues to action were significant and independent predictors of the intention to get COVID-19 vaccination. This study confirmed the utility of the HBM in highlighting drivers of an important health-protective behavior in the context of pandemics. Health policy makers, communication specialists, and healthcare providers should particularly stress the effectiveness and safety of the vaccines in their efforts to increase vaccination rates and focus on unemployed and low-income population groups.
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Affiliation(s)
- Tsovinar Harutyunyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Zhanna Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Serine Sahakyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Araz Chiloyan
- Public Health Department, Ministry of Health, Yerevan, Armenia
| | | | - Vahe Khachadourian
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
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Grigoryan Z, Sargsyan Z, Muradyan D, Mnatsakanyan K, Hayrumyan V, Petrosyan V. A mixed-methods evaluation of the indoor and outdoor smoking ban in dining venues in Armenia: Early successes and challenges. Tob Induc Dis 2023; 21:167. [PMID: 38098749 PMCID: PMC10720263 DOI: 10.18332/tid/174899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Since March 2022, Armenia introduced a comprehensive smoking ban on all types of tobacco products in indoor and outdoor areas of hospitality venues. We aimed to rapidly appraise the implementation of the ban in the dining areas of the capital Yerevan and explore any differences in compliance and enforcement patterns between indoor and outdoor areas of the venues. METHODS We used a mixed-methods approach through quantitative air quality monitoring, qualitative observations, and in-depth interviews (IDIs). We visited one venue in each remote district of the city and more venues from the central districts that have a much higher density of dining areas. Overall, we made 24 measurements of PM2.5 particles, 24 unobtrusive observations in the 19 visited venues, and 11 IDIs with six visitors and five workers. We used Stata13 for the analysis of numerical data and completed direct deductive content analysis of the textual data. RESULTS Active tobacco use was observed in 12 out of 24 venues (50.0%) with more cases of smoking in outdoor areas (10 out of 12; 83.3%). No warning by workers or no reports to the police were observed. We detected elevated levels of PM2.5 particles in indoor and outdoor areas. The IDIs revealed predominantly negative attitudes towards the outdoor ban and the lack of awareness of and readiness to engage in the enforcement measures. The lack of enforcement by the owners and the respective bodies was mentioned as a contributor to continued violations of the ban. The change in the dynamic and the characteristics of the visitors, cleaner air, and less unpleasant work were mentioned as important positive aftermaths of the ban. CONCLUSIONS The Government of Armenia should enhance the monitoring and enforcement activities and organize tailored awareness-raising campaigns to inform the general public and the hospitality industry of the health and social implications of the ban.
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Affiliation(s)
- Zaruhi Grigoryan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Zhanna Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Diana Muradyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Kristina Mnatsakanyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Varduhi Hayrumyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
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LoParco CR, Sargsyan Z, Topuridze M, Sturua L, Kegler MC, Petrosyan V, Torosyan A, Grigoryan L, Bazarchyan A, Berg CJ. Associations Between Pro/Anti-Tobacco Media and Messaging Exposure and Knowledge and Support of Smoke-Free Policy Among Adults in Armenia and Georgia. J Public Health Manag Pract 2023:00124784-990000000-00190. [PMID: 37713644 PMCID: PMC10940185 DOI: 10.1097/phh.0000000000001828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
CONTEXT Despite high smoking rates, Armenia and Georgia recently adopted smoke-free policies (2022 and 2018). OBJECTIVE We examined associations between exposure to pro-tobacco media (news opposing smoke-free policies; cigarette, e-cigarette, heated tobacco product [HTP] advertisements) and anti-tobacco media (media, community-based action) and (1) knowledge that the policies applied to alternative tobacco products (ATPs), and (2) support for the policies applying to ATPs and various settings. DESIGN We analyzed 2022 survey data. SETTING Data were from 28 communities in Armenia and Georgia. PARTICIPANTS The sample comprised 1468 adults (31.6% past-month smokers). METHODS We conducted multivariable regressions, controlling for country and sociodemographics. RESULTS Participants were knowledgeable that the policy applied to ATPs (79.2%) and supportive of them applying to ATPs and various settings (means = 3.43 and 3.00; 1-4 = strongly support). Greater exposure to anti-tobacco media/community-based action correlated with more likely knowing that the policies applied to ATPs and greater support of the policies applying to various settings; HTP advertisement exposure correlated with less support of the policies applying to various settings. Less exposure to news opposing smoke-free policies and greater exposure to media supporting such policies correlated with greater support of the policies applying to ATPs. CONCLUSIONS Media and community-based action may promote smoke-free policy knowledge and support. HTP advertisements may uniquely undermine smoke-free policies.
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Affiliation(s)
- Cassidy R. LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health; George Washington Cancer Center; George Washington University, Washington, DC
| | - Zhanna Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Marina Topuridze
- Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia
- Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Lela Sturua
- Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia
- Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Michelle C. Kegler
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Arevik Torosyan
- National Institute of Health named after academician S. Avdalbekyan, MOH, Yerevan, Armenia
| | - Lilit Grigoryan
- National Institute of Health named after academician S. Avdalbekyan, MOH, Yerevan, Armenia
| | - Alexander Bazarchyan
- National Institute of Health named after academician S. Avdalbekyan, MOH, Yerevan, Armenia
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health; George Washington Cancer Center; George Washington University, Washington, DC
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Kegler MC, Dekanosidze A, Torosyan A, Grigoryan L, Rana S, Hayrumyan V, Sargsyan Z, Berg CJ. Community coalitions for smoke-free environments in Armenia and Georgia: A mixed methods analysis of coalition formation, implementation and perceived effectiveness. PLoS One 2023; 18:e0289149. [PMID: 37535574 PMCID: PMC10399883 DOI: 10.1371/journal.pone.0289149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/12/2023] [Indexed: 08/05/2023] Open
Abstract
Effective models for aligning public health and civil society at the local level have the potential to impact various global health issues, including tobacco. Georgia and Armenia Teams for Healthy Environments and Research (GATHER) is a collaboration between Armenia, Georgia and U.S. researchers involving a community randomized trial testing the impact of community coalitions to promote smoke-free policy adoption and compliance in various settings. Community Coalition Action Theory (CCAT) was used to guide and describe coalition formation, implementation and effectiveness. Mixed methods were used to evaluate 14 municipality-based coalitions in Georgia and Armenia, including semi-structured interviews (n = 42) with coalition leaders and active members, coalition member surveys at two timepoints (n = 85 and n = 83), and review of action plans and progress reports. Results indicated successful creation of 14 multi-sectoral coalitions, most commonly representing education, public health, health care, and municipal administration. Half of the coalitions created at least one smoke-free policy in specific settings (e.g., factories, parks), and all 14 promoted compliance with existing policies through no-smoking signage and stickers. The majority also conducted awareness events in school, health care, and community settings, in addition to educating the public about COVID and the dangers of tobacco use. Consistent with CCAT, coalition processes (e.g., communication) were associated with member engagement and collaborative synergy which, in turn, correlated with perceived community impact, skills gained by coalition members, and interest in sustainability. Findings suggest that community coalitions can be formed in varied sociopolitical contexts and facilitate locally-driven, multi-sectoral collaborations to promote health. Despite major contextual challenges (e.g., national legislation, global pandemic, war), coalitions were resilient, nimble and remained active. Additionally, CCAT propositions appear to be generalizable, suggesting that coalition-building guidance may be relevant for local public health in at least some global contexts.
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Affiliation(s)
- Michelle C. Kegler
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Ana Dekanosidze
- Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia, United States of America
| | - Arevik Torosyan
- National Institute of Health, Ministry of Health, Yerevan, Armenia
| | - Lilit Grigoryan
- National Institute of Health, Ministry of Health, Yerevan, Armenia
| | - Shaheen Rana
- Intervention Development, Dissemination and Implementation Shared Resource, Winship Cancer Institute, Emory University, Atlanta, Georgia, United States of America
| | - Varduhi Hayrumyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Zhanna Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington Cancer Center, George Washington University, Washington, DC, United States of America
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Sargsyan Z, Grigoryan Z, Sahakyan S, Kelenjian K, Hayrumyan V, Agopian A, Harutyunyan T. Socio-demographic determinants of infectious disease knowledge in Armenia. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.652] [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: 11/12/2022] Open
Abstract
Abstract
Background
There is substantial evidence that infectious disease knowledge (IDK) predicts people's behavioral intentions and preventive practices. Since level of IDK varies across socio-economic contexts and imposes a substantial burden on vulnerable groups, we aimed to assess the relationship between socio-demographic factors and IDK in the adult population of Armenia.
Methods
A cross-sectional nationwide phone survey was conducted in the capital Yerevan and all Armenian provinces in 2021, using a stratified two-stage cluster sampling to complete a sample of 3,483 respondents. The questions on socio-demographic characteristics and IDK were included in a multi-domain structured survey questionnaire. Four questions measured IDK; a summative IDK score (0-4) was used in bivariate and multivariate linear regression analysis.
Results
Females constituted 71.0% of the sample. The mean age was 49.5 years. About 68% of the study participants had some vocational (12-13 years) or university degree education and 54.4% were employed. About one fifth of the respondents reported family monthly expenditures of less than 100,000 Armenian drams (AMD) ≈ $200, while the majority reported spending 101,000AMD to 400,000 AMD per month. The mean IDK score was 2.48. In the adjusted analysis, being female, holding a higher education level, being employed, having younger age and higher family monthly expenditures were positively associated with IDK score.
Conclusions
Our findings suggest that there is a gap in IDK affecting specific population groups such as older people, those with incomplete or secondary education, unemployed and financially disadvantaged people. Educational interventions and campaigns should target these groups to minimize the gap and ensure even prerequisites for good health.
Key messages
• Gender, age, education level, employment status and income level all independently influence population’s infectious disease knowledge.
• Health communication campaigns on infectious disease knowledge should particularly target males, older people and socially disadvantaged groups.
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Affiliation(s)
- Z Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - Z Grigoryan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - S Sahakyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - K Kelenjian
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - V Hayrumyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - A Agopian
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - T Harutyunyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
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Musheghyan L, Sahakyan S, Sargsyan Z, Muradyan D, Aslanyan L, Gharibyan N, Harutyunyan A, Khachadourian V, Petrosyan V. Predictors of seropositivity against SARS-COV-2: a population-based seroepidemiological study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.049] [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: 11/14/2022] Open
Abstract
Abstract
Background
Data on parameters of actual exposure to SARS-CoV-2 is limited, and specific population groups might be at a higher risk of infection. In line with the growing need for large-scale investigations to determine the presence of antibodies against SARS-CoV-2 among different population groups, we conducted a nationwide assessment in Armenia.
Methods
We performed a cross-sectional seroepidemiological study among the adult population in Armenia, in May-September 2021. A multi-stage cluster random sampling was performed to recruit the participants across the capital city and regions. The study had two main components: blood sampling, which took place in primary care facilities and a phone survey on socio-demographic characteristics, comorbidities, and previous history of COVID-19.
Results
The number of participants included in both blood sampling and phone survey was 3483. The nationwide prevalence of SARS-CoV 2 antibodies weighted by age and gender was 66.4% with significantly higher prevalence in urban compared to rural areas (67.3% vs 59.3%, p < 0.001). Only 22.7% (n = 772) of the total sample reported a previous history of PCR confirmed COVID-19, among whom antibodies were detected in 94.2% (n = 727). In the final adjusted model, the seropositivity was associated with being female (OR = 1.60, 95% CI: 1.32; 1.92), employed (OR = 1.41, 95% CI: 1.17; 1.69), and having previous PCR confirmed COVID-19 (OR = 10.6, 95% CI: 7.39; 15.21).
Conclusions
Over 66% of the population were seropositive for antibodies against SARS-CoV 2; and over ⅕ of the sample reported a previous PCR diagnosis. Factors associated with increased odds of seropositivity included gender, employment status, and place of residence. Targeted interventions are recommended to minimize the risk of infection among those groups, including vaccination and infection prevention and control measures.
Key messages
• The prevalence of SARS-CoV 2 antibodies is about three times higher than the rate of infection based on PCR confirmed prevalence of COVID-19.
• Women, people living in urban areas, and those employed are at a higher risk for exposure to SARS-CoV 2.
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Affiliation(s)
- L Musheghyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - S Sahakyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - Z Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - D Muradyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - L Aslanyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - N Gharibyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - A Harutyunyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - V Khachadourian
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - V Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
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Sahakyan S, Musheghyan L, Muradyan D, Sargsyan Z, Petrosyan V, Khachadourian V, Harutyunyan A. The impact of smoking on immunological response to SARS-COV 2: a nationwide seroepidemiological study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.143] [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: 11/13/2022] Open
Abstract
Abstract
Background
Smoking influences cellular and humoral immune responses and affects the immune system by increasing inflammation and decreasing activity against infections. The current study investigates the association between smoking and immunological response to SARS-CoV-2 in the Armenian population.
Methods
We performed a nationwide cross-sectional seroepidemiological study among the adult population (≥18 years old) in Armenia. We used a multi-stage cluster random sampling to recruit participants from the capital city and all regions of Armenia. We invited selected participants to primary healthcare facilities to provide blood samples for antibody testing followed by a phone survey on demographic characteristics, smoking status, and other variables. Logistic regression analysis was used to test the relationship between smoking and having SARS-CoV-2 antibodies adjusted for other covariates.
Results
3483 people participated in the study (71% women). The total sample included 16.8% current smokers (n = 571), 8.6% past smokers (n = 294) and 76.4% never smokers (n = 2538). The prevalence of SARS CoV-2 antibodies among current smokers was statistically significantly lower as compared with never smokers (46.9% vs 73.4%, p-value<0.001). In the multivariable logistic regression model, the odds of having SARS CoV-2 antibodies among the current smokers was 70% lower (OR 0.30, 95%CI: 0.22; 0.40) compared to never smokers, when adjusted for demographic factors and the time of PCR diagnosis of COVID-19. No statistically significant difference was found between past smokers and having SARS CoV-2 antibodies.
Conclusions
In addition to being a risk factor for various chronic diseases, smoking weakens immune response to infectious diseases, including COVID-19, worsening the outcomes. The significantly lower level of antibody prevalence among smokers with previous PCR confirmed COVID 19 implies a poorer immune response to the infection and not a lower risk of getting the infection.
Key messages
• Smoking weakens immune response and contributes to a higher burden of infectious diseases, such as COVID-19.
• Lower level of antibody prevalence among smokers indicates a poorer immune response to the infection rather than a lower risk of getting the infection.
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Affiliation(s)
- S Sahakyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - L Musheghyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - D Muradyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - Z Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - V Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - V Khachadourian
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
| | - A Harutyunyan
- Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia
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Hayrumyan V, Sargsyan Z, Grigoryan Z, Harutyunyan A, Harutyunyan T. COVID-19 protective health behaviors among
smokers and non-smokers in Armenia. Tob Prev Cessat 2022. [DOI: 10.18332/tpc/150950] [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: 11/24/2022]
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Sargsyan Z, Hayrumyan V, Grigroyan Z, Harutyunyan A, Harutyunyan T. Perceived susceptibility and severity of COVID-19 by smoking status. Tob Prev Cessat 2022. [DOI: 10.18332/tpc/150962] [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: 11/24/2022]
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Hayrumyan V, Harutyunyan A, Torosyan A, Grigoryan L, Sargsyan Z, Bazarchyan A, Petrosyan V, Dekanosidze A, Sturua L, Kegler MC, Berg CJ. Tobacco-related risk perceptions, social influences and public smoke-free policies in relation to smoke-free home restrictions: findings from a baseline cross-sectional survey of Armenian and Georgian adults in a community randomised trial. BMJ Open 2022; 12:e055396. [PMID: 35131832 PMCID: PMC8823221 DOI: 10.1136/bmjopen-2021-055396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 01/19/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Given high prevalence of smoking and secondhand smoke exposure in Armenia and Georgia and quicker implementation of tobacco legislation in Georgia versus Armenia, we examined correlates of having no/partial versus complete smoke-free home (SFH) restrictions across countries, particularly smoking characteristics, risk perceptions, social influences and public smoking restrictions. DESIGN Cross-sectional survey study design. SETTING 28 communities in Armenia and Georgia surveyed in 2018. PARTICIPANTS 1456 adults ages 18-64 in Armenia (n=705) and Georgia (n=751). MEASUREMENTS We used binary logistic regression to examine aforementioned correlates of no/partial versus complete SFH among non-smokers and smokers in Armenia and Georgia, respectively. RESULTS Participants were an average age of 43.35, 60.5% women and 27.3% smokers. In Armenia, among non-smokers, having no/partial SFHs correlated with being men (OR=2.63, p=0.001) and having more friend smokers (OR=1.23, p=0.002); among smokers, having no/partial SFHs correlated with being unmarried (OR=10.00, p=0.001), lower quitting importance (OR=0.82, p=0.010) and less favourable smoking attitudes among friends/family/public (OR=0.48, p=0.034). In Georgia, among non-smokers, having no/partial SFHs correlated with older age (OR=1.04, p=0.002), being men (OR=5.56, p<0.001), lower SHS risk perception (OR=0.43, p<0.001), more friend smokers (OR=1.49, p=0.002) and fewer workplace (indoor) restrictions (OR=0.51, p=0.026); among smokers, having no/partial SFHs correlated with being men (OR=50.00, p<0.001), without children (OR=5.88, p<0.001), daily smoking (OR=4.30, p=0.050), lower quitting confidence (OR=0.81, p=0.004), more friend smokers (OR=1.62, p=0.038) and fewer community restrictions (OR=0.68, p=0.026). CONCLUSIONS Private settings continue to lack smoking restrictions in Armenia and Georgia. Findings highlight the importance of social influences and comprehensive tobacco legislation, particularly smoke-free policies, in changing household smoking restrictions and behaviours. TRIAL REGISTRATION NUMBER NCT03447912.
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Affiliation(s)
- Varduhi Hayrumyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Arusyak Harutyunyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Arevik Torosyan
- MOH National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia
| | - Lilit Grigoryan
- MOH National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia
| | - Zhanna Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Alexander Bazarchyan
- MOH National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Ana Dekanosidze
- Non-Communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Lela Sturua
- Non-Communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Michelle C Kegler
- Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| | - Carla J Berg
- Department of Prevention and Community Health, George Washington University, Washington, District of Columbia, USA
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Hayrumyan V, Sargsyan Z, Harutyunyan A, Torosyan A, Grigoryan L, Petrosyan V, Bazarchyan A, Kegler M, Berg C. Public attitude towards tobacco taxation policy in Armenia. Tob Prev Cessat 2021. [DOI: 10.18332/tpc/143636] [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: 11/24/2022]
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13
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Sargsyan Z, Hayrumyan V, Harutyunyan A, Torosyan A, Grigoryan L, Petrosyan V, Bazarchyan A, Kegler M, Berg C. Youth access to tobacco products in Armenia. Tob Prev Cessat 2021. [DOI: 10.18332/tpc/143635] [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: 11/24/2022]
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14
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Harutyunyan A, Hayrumyan V, Sargsyan Z, Torosyan A, Dekanosidze A, Kegler M, Sturua L, Berg CJ. Smokers' and non-smokers' secondhand smoke experiences and interactions to reduce exposure in Armenia and Georgia. Tob Prev Cessat 2021; 7:6. [PMID: 33537511 PMCID: PMC7845734 DOI: 10.18332/tpc/131059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/28/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Armenia and Georgia have high rates of smoking and secondhand smoke exposure (SHSe). Greater progress in recent smoke-free legislation in Georgia and Armenia provides a pivotal time for examining the impact on smokers' and non-smokers' experiences and interactions regarding SHSe. METHODS Surveys were conducted in 28 communities in Armenia (n=705) and Georgia (n=751) in 2018 and assessed past 30-day SHSe and smoking in different contexts, as well as attitudes toward and interactions regarding SHSe. RESULTS In this sample (mean age 43.4 years, SD=13.5; 60.5% female; 27.3% smokers), SHSe among non-smokers was usually in homes (42.7%), cars (42.4%), and outdoor public places (38.2%); smokers also reported smoking usually in these places (70.0%, 62.1%, and 60.0%, respectively). Smokers indicated greater likelihood of putting out cigarettes and non-smokers indicated greater likelihood of asking smokers to put them out in places where smoking was prohibited versus allowed (76.5% vs 57.3%, and 46.6% vs 30.7%, respectively). Moreover, 89.9% of smokers indicated being very likely to put out cigarettes around small children if asked and 75.8% indicated trying to minimize SHSe. While 39.7% of participants reported seeing requests to smokers to put out cigarettes in the past 6 months, only 23.3% of smokers reported being asked to do so. Non-smokers in Georgia versus Armenia reported greater likelihood of engaging in behaviors to lower SHSe (p<0.001). CONCLUSIONS Smoke-free legislation may catalyze more behaviors to lower SHSe, particularly among non-smokers; however, private settings (e.g. homes) remain prominent SHSe sources. Public health efforts must consider implications of such policies on SHSe in private settings.
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Affiliation(s)
- Arusyak Harutyunyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Varduhi Hayrumyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Zhanna Sargsyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Arevik Torosyan
- National Institute of Health named after academician S. Avdalbekyan, Ministry of Health, Yerevan, Armenia
| | - Ana Dekanosidze
- Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Michelle Kegler
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, United States.,Winship Cancer Institute, Emory University, Atlanta, United States
| | - Lela Sturua
- Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia.,Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States.,George Washington Cancer Center, George Washington University, Washington, United States
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Hayrumyan V, Harutyunyan A, Sargsyan Z, Torosyan A, Dekanosidze A, Kegler M, Sturua L, Berg C. Smoking cessation practices in Armenia and Georgia. Tob Prev Cessat 2020. [DOI: 10.18332/tpc/128404] [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: 11/24/2022]
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16
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Topuridze M, Berg C, Dekanosidze A, Torosyan A, Sargsyan Z, Hayrumyan V, Maglakelidze N, Sturua L, Kegler M. Smokers’ and non-smokers’ receptivity to smoke-free air policies and related messaging in support and opposition in Armenia and Georgia. Tob Prev Cessat 2020. [DOI: 10.18332/tpc/128303] [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: 11/24/2022]
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17
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Grigoryan Z, Harutyunyan A, Sargsyan Z, Hayrumyan V. Motivations and barriers to smoking cessation among TB patients. Tob Prev Cessat 2020. [DOI: 10.18332/tpc/128407] [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: 11/24/2022]
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18
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Harutyunyan A, Sargsyan Z, Grigoryan Z, Hayrumyan V, Petrosyan V. Effectiveness of tobacco dependence treatment training: Experiences of Armenian TB patients. Tob Prev Cessat 2020. [DOI: 10.18332/tpc/128400] [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: 11/24/2022]
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19
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Grigoryan Z, Hayrumyan V, Sargsyan Z, Petrosyan V. Do primary healthcare providers have the competency of providing adolescent-friendly health services? Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.917] [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: 11/15/2022] Open
Abstract
Abstract
Background
Investment in adolescents' health is one of the most rewarding efforts for meeting the Sustainable Development Goals. The national standard on state assured free-of-charge services defines the minimum requirements of adolescent-friendly healthcare services (AFHS) in primary healthcare facilities (PHCFs); however, services for adolescents are highly inconsistent in terms of quality and coordination. We aimed to assess the PHC providers' (PHPs) capacity to provide AFHS in PHC facilities in Armenia.
Methods
A qualitative cross-sectional study through in-depth interviews and focus-group discussions was conducted in two biggest cities of Armenia. Overall, six focus group discussions and 16 in-depth interviews were conducted with adolescents (18 and 19 years old), PHPs, managers of PHCFs, and experts in adolescent health. Eight PHC facilities were chosen for conducting observations. The WHO Global standards for quality health-care services for adolescents guided the deductive content analysis.
Results
PHPs' capacity to provide AFHS in assessed PHCFs was not satisfactory. PHPs did not know the specific age range of adolescence and the content of AFHS in the national standard. PHPs perceived friendliness of services as welcoming and good attitude. Facility managers and most PHPs did not participate in professional education activities to advance their expertise in adolescent health. Experts concluded that services provided to adolescents were not “friendly” and PHPs did not have appropriate competencies. However, PHPs' had the opposite opinion - they were confident in their knowledge and skills to work with adolescents. Adolescents complained that PHPs did not provide explanations for provided services and lacked appropriate communication skills.
Conclusions
The PHCFs have formal grounds to provide AFHS, however lack of appropriate competencies among PHPs and managers of PHCs hinder advancement of AFHS.
Key messages
Qualitative findings suggest that visited PHCFs fail to appropriately implement AFHS as guided by the national standard. Provision of AFHS can be promoted in PHCFs through strengthening PHPs' competencies via continuous professional development activities.
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Affiliation(s)
- Z Grigoryan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - V Hayrumyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Z Sargsyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - V Petrosyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
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Sargsyan Z, Harutyunyan T, Sahakyan S. Factors associated with car safety seats’ use. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.863] [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: 11/12/2022] Open
Abstract
Abstract
Background
Road traffic injuries are the number one cause of death in children aged 5-14 years. The evidence shows that, if correctly installed and used, child restraints can reduce infants' death by approximately 70%, and deaths among children by up to 80%. In the absence of compulsory car safety seat (CSS) legislation in Armenia, parents play the decisive role in child passenger safety. This study aimed to investigate the practice of CSS-s among Armenian parents and to find the determinants of CSS use.
Methods
In 2018, the study team conducted a self-administered survey among parents of children 0-6 years old living in Yerevan, the capital of Armenia. Using two stage cluster sampling, 33 kindergartens were chosen as clusters by simple random sampling and from each cluster 10 parents received a questionnaire. The study team applied a multivariable logistic regression model using the backward elimination approach to finalize the independent predictors of CSS-s use.
Results
Overall, 263 parents returned completed questionnaires, of which 26.2% (69) were CSS users. The CSS non-users included those who did not have a CSS (163) or had a CSS but used it sometimes, seldom or never (31). The study results showed that the factors associated with the CSS-s use among Armenian parents in the adjusted analyses were age in children (OR = 0.61, p = 0.003), attitude score (OR = 1.53, p = 0.003), knowledge score (OR = 1.45, p = 0.011) regarding CSS-s, consistent driver's side seatbelt compliance (OR = 3.4, p = 0.005), and monthly expenditures (OR = 3.35, p = 0.024).
Conclusions
This study was the first exploration of Armenian parents' practice of CSS-s. Our findings might serve as a starting point for further research on proper use of CSS among Armenian parents not only in Yerevan, but across all regions of the country. The revealed predictors of parental CSS-s use might be used for the development of fruitful interventions to enhance the practice of CSS-s in Armenia.
Key messages
This was the first-time exploration of CSS-s practice and predictors of CSS-s use in Armenia, where there is no CSS law and parents play the sole role in child passenger safety. Educational interventions for children and their parents on the importance of age and size appropriate CSS-s usage will help increase CSS-s use among Armenian parents.
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Affiliation(s)
- Z Sargsyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - T Harutyunyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - S Sahakyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
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Hayrumyan V, Grigoryan Z, Sargsyan Z, Harutyunyan A, Petrosyan V. Barriers to reproductive health services utilization among adolescents. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.959] [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: 11/13/2022] Open
Abstract
Abstract
Background
Adolescents' access to quality reproductive health services is crucial for their psychosocial and physical wellbeing. Yet, adolescents encounter various barriers while utilizing reproductive health services, globally. Adolescent-friendly health services (AFHS) is an evidence-based intervention to meet the reproductive health needs inclusively of all adolescents. The study aimed to explore adolescents' experiences while seeking reproductive health services in primary healthcare facilities (PHCF) in Armenia.
Methods
We conducted a qualitative cross-sectional study using in-depth interviews, focus group discussions and observations of PHCFs. The study participants included adolescents (aged 18-19 years) (n = 17), PHC providers (PHP) (n = 29), managers of PHCFs (n = 7) and experts in the field of adolescent health (n = 5) from the two largest cities in Armenia. The Global standards for quality healthcare services for adolescents guided the instrument development process and deductive content analysis.
Results
Barriers to the utilization of reproductive health services by adolescents at PHCFs were related to various personal, cultural, and social factors. PHPs and experts blamed adolescents' insufficient knowledge of reproductive health and related services for being a major barrier. However, adolescents' reported a different set of important barriers to reproductive health services: PHPs' judgmental attitude, lack of efforts to protect privacy and confidentiality (due to lack of PHP competencies to provide AFHS and inadequate PHCF infrastructure), negative public opinion and lack of community support.
Conclusions
The study findings shed light on different perspectives related to various challenges adolescents come across in PHCFs. Addressing identified barriers have the potential of positively influencing adolescents' experiences while utilizing reproductive health services in PHCFs.
Key messages
Adolescents’ insufficient knowledge, PHPs’ judgmental attitude, lack of privacy and confidentiality, and negative public opinion are among the main barriers to the reproductive health services. Further enforcement of adolescent-friendly health services in primary healthcare facilities is needed to ensure accessibility of quality reproductive health services for all adolescents.
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Affiliation(s)
- V Hayrumyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Z Grigoryan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Z Sargsyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - A Harutyunyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - V Petrosyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
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22
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Topuridze M, Berg CJ, Dekanosidze A, Torosyan A, Grigoryan L, Bazarchyan A, Sargsyan Z, Hayrumyan V, Maglakelidze N, Sturua L, Haardörfer R, Kegler MC. Smokers' and Nonsmokers' Receptivity to Smoke-Free Policies and Pro- and Anti-Policy Messaging in Armenia and Georgia. Int J Environ Res Public Health 2020; 17:ijerph17155527. [PMID: 32751714 PMCID: PMC7432748 DOI: 10.3390/ijerph17155527] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 12/02/2022]
Abstract
Garnering support for smoke-free policies is critical for their successful adoption, particularly in countries with high smoking prevalence, such as Armenia and Georgia. In 2018, we surveyed 1456 residents (ages 18–64) of 28 cities in Armenia (n = 705) and Georgia (n = 751). We examined support for cigarette and electronic nicotine delivery systems (ENDS)/heated tobacco product (HTP) smoke-free policies in various locations and persuasiveness of pro- and anti-policy messaging. Participants were an average age of 43.35, 60.5% female, and 27.3% current smokers. Nonsmokers versus smokers indicated greater policy support for cigarette and ENDS/HTP and greater persuasiveness of pro-policy messaging. Armenians versus Georgians generally perceived pro- and anti-policy messaging more persuasive. In multilevel linear regression, sociodemographics (e.g., female) and tobacco use characteristics (e.g., smoking less frequently, higher quitting importance) correlated with more policy support. Greatest policy support was for healthcare, religious, government, and workplace settings; public transport; schools; and vehicles carrying children. Least policy support was for bar/restaurant outdoor areas. The most compelling pro-policy message focused on the right to clean air; the most compelling anti-policy message focused on using nonsmoking sections. Specific settings may present challenges for advancing smoke-free policies. Messaging focusing on individual rights to clean air and health may garner support.
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Affiliation(s)
- Marina Topuridze
- Non-Communicable Diseases Department, National Center for Disease Control and Public Health, Tbilisi 0198, Georgia; (M.T.); (A.D.); (N.M.); (L.S.)
- School of Natural Sciences and Medicine, Ilia State University, Tbilisi 0162, Georgia
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington Cancer Center, George Washington University, Washington, DC 20052, USA
- Correspondence:
| | - Ana Dekanosidze
- Non-Communicable Diseases Department, National Center for Disease Control and Public Health, Tbilisi 0198, Georgia; (M.T.); (A.D.); (N.M.); (L.S.)
| | - Arevik Torosyan
- National Institute of Health Named after Academician S. Avdalbekyan, MoH, Yerevan 0051, Armenia; (A.T.); (L.G.); (A.B.)
| | - Lilit Grigoryan
- National Institute of Health Named after Academician S. Avdalbekyan, MoH, Yerevan 0051, Armenia; (A.T.); (L.G.); (A.B.)
| | - Alexander Bazarchyan
- National Institute of Health Named after Academician S. Avdalbekyan, MoH, Yerevan 0051, Armenia; (A.T.); (L.G.); (A.B.)
| | - Zhanna Sargsyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan 0019, Armenia; (Z.S.); (V.H.)
| | - Varduhi Hayrumyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan 0019, Armenia; (Z.S.); (V.H.)
| | - Nino Maglakelidze
- Non-Communicable Diseases Department, National Center for Disease Control and Public Health, Tbilisi 0198, Georgia; (M.T.); (A.D.); (N.M.); (L.S.)
| | - Lela Sturua
- Non-Communicable Diseases Department, National Center for Disease Control and Public Health, Tbilisi 0198, Georgia; (M.T.); (A.D.); (N.M.); (L.S.)
- Public Health Department Petre Shotadze Tbilisi Medical Academy, Tbilisi 0144, Georgia
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (R.H.); (M.C.K.)
| | - Michelle C. Kegler
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (R.H.); (M.C.K.)
- Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA
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Berg CJ, Dekanosidze A, Torosyan A, Grigoryan L, Sargsyan Z, Hayrumyan V, Topuridze M, Sturua L, Harutyunyan A, Kvachantiradze L, Maglakelidze N, Gamkrelidze A, Abovyan R, Bazarchyan A, Kegler MC. Examining smoke-free coalitions in Armenia and Georgia: baseline community capacity. Health Educ Res 2019; 34:495-504. [PMID: 31504495 PMCID: PMC6758643 DOI: 10.1093/her/cyz024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/02/2019] [Indexed: 06/10/2023]
Abstract
Local coalitions can advance public health initiative but have not been widely used or well-studied in low- and middle-income countries. This paper provides (i) an overview of an ongoing matched-pairs community-randomized controlled trial in 28 communities in Armenia and Georgia (N = 14/country) testing local coalitions to promote smoke-free policies/enforcement and (ii) characteristics of the communities involved. In July-August 2018, key informants (e.g. local public health center directors) were surveyed to compare their non-communicable disease (NCD) and tobacco-related activities across countries and across condition (intervention/control). More than half of the informants (50.0-57.1%) reported their communities had programs addressing hypertension, diabetes, cancer and human papilloma virus, with 85.7% involving community education and 32.1% patient education programs. Eleven communities (39.3%) addressed tobacco control, all of which were in Georgia. Of those, all included public/community education and the majority (72.7-81.8%) provided cessation counseling/classes, school/youth prevention programs, healthcare provider training or activities addressing smoke-free environments. Informants in Georgia versus Armenia perceived greater support for tobacco control from various sectors (e.g. government, community). No differences were found by condition assignment. This paper provides a foundation for presenting subsequent analyses of this ongoing trial. These analyses indicate wide variability regarding NCD-related activities and support across communities and countries.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, USA
- Winship Cancer Institute, Emory University, 1365 Clifton Road NE, Atlanta, GA, USA
| | - Ana Dekanosidze
- National Center for Disease Control and Public Health, 4 Kakheti Hwy, Tbilisi, Georgia
| | - Arevik Torosyan
- National Institute of Health named after academician S. Avdalbekyan, MoH, Komitasi Ave. 49/4, Yerevan, Armenia
| | - Lilit Grigoryan
- National Institute of Health named after academician S. Avdalbekyan, MoH, Komitasi Ave. 49/4, Yerevan, Armenia
| | - Zhanna Sargsyan
- Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan, Armenia
| | - Varduhi Hayrumyan
- Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan, Armenia
| | - Marina Topuridze
- National Center for Disease Control and Public Health, 4 Kakheti Hwy, Tbilisi, Georgia
| | - Lela Sturua
- National Center for Disease Control and Public Health, 4 Kakheti Hwy, Tbilisi, Georgia
| | - Arusyak Harutyunyan
- Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan, Armenia
| | - Lela Kvachantiradze
- National Center for Disease Control and Public Health, 4 Kakheti Hwy, Tbilisi, Georgia
| | - Nino Maglakelidze
- National Center for Disease Control and Public Health, 4 Kakheti Hwy, Tbilisi, Georgia
| | - Amiran Gamkrelidze
- National Center for Disease Control and Public Health, 4 Kakheti Hwy, Tbilisi, Georgia
| | - Romela Abovyan
- Department of Epidemiology of Noncommunicable and Nosocomial Infectious Disease, National Center for Disease Control and Prevention, MOH RA, Mkhitar Heratsu St. 12, Yerevan, Armenia
| | - Alexander Bazarchyan
- National Institute of Health named after academician S. Avdalbekyan, MoH, Komitasi Ave. 49/4, Yerevan, Armenia
| | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, USA
- Winship Cancer Institute, Emory University, 1365 Clifton Road NE, Atlanta, GA, USA
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Sargsyan Z, Harutyunyan A, Hayrumyan V, Grigoryan Z, Petrosyan V. Smoking cessation counseling: a survey among tuberculosis patients in Armenia. Tob Prev Cessat 2019. [DOI: 10.18332/tpc/105227] [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: 11/24/2022]
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Hayrumyan V, Harutyunyan A, Grigoryan Z, Sargsyan Z, Petrosyan V. Tobacco dependence treatment provision by tuberculosis physicians in Armenia. Tob Prev Cessat 2019. [DOI: 10.18332/tpc/105273] [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: 11/24/2022]
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