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Wang H, Feng Z, Zheng Z, Yang J. Chinese undergraduates' mental health help-seeking behavior: the health belief model. Front Psychol 2024; 15:1377669. [PMID: 38817829 PMCID: PMC11137748 DOI: 10.3389/fpsyg.2024.1377669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/03/2024] [Indexed: 06/01/2024] Open
Abstract
The detection rate of mental health problems among undergraduates has recently risen significantly. However, undergraduates underutilize mental health services; approximately a third only of undergraduates in need of treatment use school counseling resources. Based on a social psychological theoretical framework, the health belief model, factors of undergraduates' willingness to seek help when dealing with psychological problems were investigated. A cross-sectional online questionnaire and a snowball sampling method with 446 undergraduates investigated perceived susceptibility, perceived severity, perceived behavioral benefits, perceived barriers, self-efficacy, and cues to action to understand how students' mental health-seeking behaviors are affected. We found that perceived susceptibility (p < 0.01), perceived severity (p < 0.01), perceived benefits (p < 0.01), perceived barriers (p < 0.01), self-efficacy (p < 0.01), and cues to action (p < 0.01) significantly correlated with behavioral intention. Encouragement or counseling from others would be more likely to motivate undergraduates to seek mental health help. In addition, we used a bias-corrected Bootstrap approach to test the significance of the mediating effect, the mediation effect of cues to action between undergraduates' perceived susceptibility and mental health help-seeking behavior was utterly significant [mediation effect value of 0.077, with an SE value of 0.027 and a 95% CI (0.028, 0.133)]. It demonstrated that those who perceived themselves to be at high risk of developing a mental illness and who had received encouragement or counseling to seek mental health help were more likely to be motivated to seek mental health help. Multiple regression analyses indicated that self-efficacy (Z = 5.425, p < 0.01) and cues to action (Z = 6.673, p < 0.01) independently influenced behavioral intentions. Encouragement or counseling from others would be more likely to motivate undergraduates to seek mental health help.
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Affiliation(s)
| | - Zhuowen Feng
- College of Literature and News Communication, Guangdong Ocean University, Zhanjiang, Guangdong, China
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Nan J, Li Z, Zou X, Sun M, Gao J, Jiang Y. Fall risk perception in older adults: A concept analysis. J Clin Nurs 2024. [PMID: 38558421 DOI: 10.1111/jocn.17090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/10/2023] [Accepted: 12/08/2023] [Indexed: 04/04/2024]
Abstract
BACKGROUND Fall prevention is crucial for older adults. Enhanced fall risk perception can encourage older adults to participate in fall prevention programs. However, there is still no unified definition of the concept of fall risk perception. OBJECTIVE To explore the concept of fall risk perception in older adults. DESIGN A concept analysis. DATA SOURCES The literature was searched using online databases including PubMed, Cochrane Library, Embase, CINAHL Complete, PsycINFO, Web of Science, China National Knowledge Infrastructure, WangFang and SinoMed. Searches were also conducted in Chinese and English dictionaries. The literature dates from the establishment of the database to April 2023. METHODS The methods of Walker and Avant were used to identify antecedents, attributes and consequences of the concept of "fall risk perception" in older adults. RESULTS Eighteen publications were included eventually. The attributes were identified as: (1) dynamic change, with features of continuum and stage; (2) whether falls are taken seriously; (3) a self-assessment of the fall probability, which is driven by individual independence; and (4) involves multiple complex emotional responses. The antecedents were identified as: (1) demographic and disease factors; (2) psychological factors and (3) environmental factors. The consequences were identified as: (1) risk-taking behaviour; (2) risk compensation behaviour; (3) risk transfer behaviour; and (4) emotions. CONCLUSION A theoretical definition of fall risk perception was identified. A conceptual model was developed to demonstrate the theoretical relationships between antecedents, attributes and consequences. This is helpful for the development of relevant theories and the formulation of fall prevention measures based on fall risk perception as the intervention target.
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Affiliation(s)
- Jiang Nan
- Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Zhuoran Li
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xueqiong Zou
- Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Manyao Sun
- Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jing Gao
- Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Yuyu Jiang
- Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, Jiangnan University, Wuxi, China
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Ashida S, Hellem A, Bucklin R, Carson M, Casteel C. Developing Community-Level Implementation Networks to Connect Older Adults to Evidence-Based Falls Prevention Programs. Health Promot Pract 2024:15248399241237953. [PMID: 38509756 DOI: 10.1177/15248399241237953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Background: Evidence-based falls prevention programs are available in many communities, but participation in such programs remains low. This study aimed to develop community-based referral networks of organizations to facilitate the uptake of evidence-based falls prevention programs through engaging older adults at risk for falls with the RememberingWhen™ program and connecting them to evidence-based programs in Midwestern communities. Methods: Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), referral networks were developed in two Midwestern communities (urban and micropolitan) through a seven-step community engagement plan: establishing and operationalizing the State-level Advisory Board (SAB), identifying falls prevention resources, conducting community assessments, developing Local Advisory Groups (LAG), operationalizing the LAG, developing referral network and protocols, and implementing the network. Semistructured interviews guided by the RE-AIM framework were conducted with members of the SAB, LAG, administrators and staff from organizations that participated in networks, and older adult participants. Results: After participating in the development of referral networks, participants felt they learned important skills that they can use to develop additional collaborations and networks in the future, emphasized the benefits of building community capacity among organizations with common missions. Interview data yielded strategies on enhancing the referral network's reach, impact, adoption, implementation efficiency, and maintenance. Conclusion: Future sustainability studies of such networks should explore identified challenges and strategies to sustain efforts. Results highlight the importance of ongoing funds to support the efforts of organizational networks in communities.
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Affiliation(s)
| | | | | | | | - Carri Casteel
- University of Iowa, Iowa City, IA, USA
- University of Iowa Injury Prevention Research Center, Iowa City, IA, USA
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Kehrer-Dunlap AL, Bollinger RM, Holden B, Ances BM, Stark S. Examining the impact of a health report card on follow through with fall risk recommendations: an observational study. BMC Geriatr 2024; 24:166. [PMID: 38365585 PMCID: PMC10873987 DOI: 10.1186/s12877-024-04686-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 01/09/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Increasing older adults' awareness of their personal fall risk factors may increase their engagement in fall prevention. The purpose of this study was to explore the impact of and participant satisfaction with a comprehensive occupational therapy fall risk screening and recommendations for evidence-based fall prevention strategies based on personalized fall risk results for community-dwelling older adults. METHODS Cognitively normal participants (Clinical Dementia Rating = 0) were recruited from an ongoing longitudinal study of memory and aging. Participants completed 2 annual in-home visits, fall risk questionnaires, and 12 months of fall monitoring between visits. Participants received a health report card with their fall risks and tailored recommendations in 6 domains. Participants completed follow-up questions at their next annual in-home visit about the fall risk recommendations and their satisfaction with receiving their fall risk results. RESULTS Two hundred five participants completed 2 annual visits and 12 months of fall monitoring. Of the 6 domains of recommendations provided, participants were most likely to follow through with getting an annual eye exam and reviewing their medications with their doctor or pharmacist. Older adults who fell were significantly more likely to receive recommendations for finding fall prevention classes (p = 0.01) and having a doctor or pharmacist review their medications (p = 0.004). The majority of participants were satisfied receiving their fall risk results (92%) and believed it to be beneficial (90%), though few participants shared their results with their doctor (20%). CONCLUSIONS An occupational therapy fall risk screening and tailored recommendations were not sufficient to encourage follow through with fall risk recommendations. Older adults may benefit from additional support and encouragement to reduce their fall risk. Additional research is needed to examine awareness of fall risks and follow through with fall risk recommendations among community-dwelling older adults.
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Affiliation(s)
- Abigail L Kehrer-Dunlap
- Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Ave, 63110, St Louis, MO, Box 8505, USA
| | - Rebecca M Bollinger
- Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Ave, 63110, St Louis, MO, Box 8505, USA
| | - Brianna Holden
- Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Ave, 63110, St Louis, MO, Box 8505, USA
| | - Beau M Ances
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Susan Stark
- Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Ave, 63110, St Louis, MO, Box 8505, USA.
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D’Avanzo P, Shourya S, Brin M, Kaw S, Kay E, Batey DS, Radix A, Belkind U, Tanner M, Galindo C, Ferrara S, Ott C, Ramirez SO, Schnall R. Identifying Key Factors to PrEP Initiation and Persistence Among YMSM Through Focus Groups and Surveys in Two High-Priority Settings. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2024; 36:33-47. [PMID: 38349352 PMCID: PMC11034730 DOI: 10.1521/aeap.2024.36.1.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Cisgender men are diagnosed with HIV at a rate four times greater than cisgender women, with 71% of infections attributed to male-male sexual contact. Despite expanding accessibility, pre-exposure prophylaxis (PrEP) for HIV prevention is initiated by only 30% of people with PrEP indications. Five focus groups with 42 young men who have sex with men from New York and Alabama were conducted to identify key factors to PrEP initiation and persistence. Thirty focus group participants completed a survey on demographics, PrEP choices and health care attitudes. Findings suggest provider competency significantly influences PrEP use due to stigmatization in medical settings. Participants noted benefits of PrEP including HIV protection and sexual empowerment, yet barriers like cost and side effects were prevalent. Our findings outline barriers and facilitators to PrEP use among young men who have sex with men in two high priority settings that will inform PrEP care updates in participating clinics.
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Affiliation(s)
- Paul D’Avanzo
- Columbia University and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032
| | - Shivesh Shourya
- Columbia University School of Nursing, 516 W. 168 Street, New York, NY, 10032
| | - Maeve Brin
- Columbia University School of Nursing, 516 W. 168 Street, New York, NY, 10032
| | - Shivani Kaw
- Columbia University School of Nursing, 516 W. 168 Street, New York, NY, 10032
| | - Emma Kay
- Magic City Wellness Center, 3220 5 Avenue South, Suite 100, Birmingham, AL, 35222
| | - D. Scott Batey
- Tulane University School of Social Work, 127 Elk Place, New Orleans, LA, 70112
| | - Asa Radix
- Callen-Lorde, 356 W. 18 Street, New York, NY, 10011
| | - Uri Belkind
- Callen-Lorde, 356 W. 18 Street, New York, NY, 10011
| | - Mary Tanner
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, Georgia, 30329
| | - Carla Galindo
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, Georgia, 30329
| | - Stephen Ferrara
- Columbia University School of Nursing, 516 W. 168 Street, New York, NY, 10032
| | - Corilyn Ott
- University of Birmingham at Alabama, School of Nursing and School of Medicine, 1701 University Boulevard, Birmingham, Alabama 35294
| | | | - Rebecca Schnall
- Columbia University School of Nursing, 516 W. 168 Street, New York, NY, 10032
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Koh VJW, Matchar DB, Chan AWM, Lee JML, Lai WX, Rosario D, George A, Ho V, Ismail NHB, Lien CTC, Merchant RA, Tan SM, Wong CH, Xu T. Reducing Falls Among Community-Dwelling Older Adults From Clinicians' Perspectives: A Systems Modeling Approach. Innov Aging 2023; 7:igad077. [PMID: 37694132 PMCID: PMC10484166 DOI: 10.1093/geroni/igad077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Indexed: 09/12/2023] Open
Abstract
Background and Objectives Falls among older adults are a significant health problem globally. Studies of multicomponent fall prevention programs in randomized controlled trials demonstrate effectiveness in reducing falls; however, the translation of research into the community remains challenging. Although there is an increasing interest to understand the factors contributing to implementation barriers, the dynamic relationships between factors are less well examined. Furthermore, evidence on implementation barriers from Asia is lacking as most of these studies originate from the West. As such, this study aims to engage stakeholders in uncovering the factors that facilitate or inhibit implementing community-based fall prevention programs in Singapore, with a focus on the interrelationship between those factors. Research Design and Methods Health care professionals familiar with fall prevention programs were invited to discuss the enablers and challenges to the implementation. This effort was facilitated using a systems modeling methodology of Group Model Building (GMB) to share ideas and create a common conceptual model of the challenges. The GMB employs various engagement techniques to draw on the experiences and perceptions of all stakeholders involved. Results This process led to the development of a Causal Loop Diagram (CLD), a qualitative conceptual model of the dynamic relationships between the barriers and facilitators of implementing fall prevention programs. Results from the CLD show that implementation is influenced by two main drivers: health care provider factors that influenced referrals, and patient factors that influenced referral acceptance and long-term adherence. Key leverage points for potential interventions were identified as well. Discussion and Implications The overall recommendation emphasized closer coordination and collaboration across providers to ensure sustainable and effective community-based fall prevention programs. This has to be supported by a national effort, involving a multidisciplinary stakeholder advisory group. These findings generated would be promising to guide future approaches to fall prevention.
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Affiliation(s)
- Vanessa Jean Wen Koh
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
| | - David B Matchar
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
- Department of Medicine (General Internal Medicine), Duke University Medical Center, Durham, North Carolina, USA
| | - Angelique Wei-Ming Chan
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
| | - June May-Ling Lee
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
| | - Wei Xuan Lai
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
| | - Dulcie Rosario
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
| | - Anne George
- Rehabilitation Services, Changi General Hospital, Singapore, Singapore
| | - Vanda Ho
- Department of Geriatric Medicine, National University Hospital, Singapore, Singapore
| | | | | | - Reshma A Merchant
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | | | - Chek Hooi Wong
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
| | - Tianma Xu
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
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Pettersson B, Lundell S, Lundin-Olsson L, Sandlund M. 'Maintaining balance in life'-exploring older adults' long-term engagement in self-managed digital fall prevention exercise. Eur Rev Aging Phys Act 2023; 20:12. [PMID: 37464299 DOI: 10.1186/s11556-023-00322-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Accidental falls are one of the greatest threats to older adults' health and well-being. The risk of falling can be significantly reduced with strength and balance interventions. However, there needs to be further knowledge into how older adults can be supported to achieve a maintained exercise behaviour. Therefore, the aim of this study was to explore factors that enabled older adults to maintain their exercise during a 1-year self-managed digital fall prevention exercise intervention. METHODS This study used a grounded theory methodology. Semi-structured individual interviews were conducted by phone or conference call. Eighteen community-dwelling older adults aged 70 years or more participated. The participants had a self-reported exercise dose of 60 min or more per week during the last three months of participation in a 12-months intervention of self-managed digital fall prevention exercise, the Safe Step randomized controlled trial. Open, axial, and selective coding, along with constant comparative analysis, was used to analyze the data. RESULTS The analysis resulted in a theoretical model. We found that the fall prevention exercise habits of adults were developed through three stages: Acting against threats to one's own identity, Coordinating strategies to establish a routine, and Forming habits through cues and evaluation. The main category of Maintaining balance in life encases the participants transition through the three stages and reflects balance in both physical aspects and in between activities in daily life. The process of maintaining balance in life and desire to do so were mediated both by intrinsic person-dependent factors and the Safe Step application acting as an external mediator. CONCLUSION This study identified three stages of how older adults developed self-managed fall prevention exercise habits, supported by a digital application. The generated theoretical model can inform future interventions aiming to support long-term engagement in digitally supported and self-managed fall prevention interventions.
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Affiliation(s)
- Beatrice Pettersson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, 90187, Umeå, Sweden.
| | - Sara Lundell
- Department of Sociology, Umeå University, Umeå, Sweden
| | - Lillemor Lundin-Olsson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, 90187, Umeå, Sweden
| | - Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, 90187, Umeå, Sweden
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van Scherpenseel M, van Veenendaal L, Donné L, te Velde S, Ronteltap A. Engaging community-dwelling older adults in fall prevention programs: a qualitative study on strategies promoting participation in fall prevention programs among community-dwelling older adults. Front Public Health 2023; 11:1150659. [PMID: 37483936 PMCID: PMC10359893 DOI: 10.3389/fpubh.2023.1150659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/08/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Fall rates and fall-related injuries among community-dwelling older adults (≥65 years) are expected to increase rapidly, due to the aging population worldwide. Fall prevention programs (FPPs), consisting of strength and balance exercises, have been proven effective in reducing fall rates among older adults. However, these FPPs have not reached their full potential as most programs are under-enrolled. Therefore, this study aims to identify promising strategies that promote participation in FPPs among community-dwelling older adults. Methods This is an exploratory qualitative study. Previously, barriers and facilitators for participation in FPPs by older adults had been identified. Next, six strategies had been designed using the Intervention Mapping approach: (1) reframing; (2) informing about benefits; (3) raising awareness of risks; (4) involving social environment; (5) offering tailored intervention; (6) arranging practicalities. Strategies were validated during semi-structured interviews with community-dwelling older adults (n = 12) at risk of falling. Interviews were audio-recorded, transcribed, and analyzed following a qualitative thematic methodology, with a hybrid approach. Results All strategies were considered important by at least some of the respondents. However, two strategies stood out: (1) reframing 'aging' and 'fall prevention': respondents preferred to be approached differently, taking a 'life course' perspective about falls, and avoiding confronting words; and (2) 'informing about benefits' (e.g., 'living independently for longer'); which was mentioned to improve the understanding of the relevance of participating in FPPs. Other strategies were considered important to take into account too, but opinions varied more strongly. Discussion This study provides insight into potential strategies to stimulate older adults to participate in FPPs. Results suggest that reframing 'aging' and 'fall prevention' may facilitate the dialogue about fall prevention, by communicating differently about the topic, for example 'staying fit and healthy', while focusing on the benefits of participating in FPPs. Gaining insight into the strategies' effectiveness and working mechanisms is an area for future research. This could lead to practical recommendations and help professionals to enhance older adults' participation in FPPs. Currently, the strategies are further developed to be applied and evaluated for effectiveness in multiple field labs in a central Dutch region (Utrecht).
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Affiliation(s)
- Meike van Scherpenseel
- Research Group Innovation of Human Movement Care, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, Netherlands
| | - Lidia van Veenendaal
- Research Group Proactive Care for Older Adult People Living at Home, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, Netherlands
- Bachelor Nursing Studies, Institute for Nursing Studies, HU University of Applied Sciences Utrecht, Utrecht, Netherlands
| | - Lennie Donné
- Research Group Innovation in Healthcare Processes in Pharmacology, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, Netherlands
- Program Group Persuasive Communication, Department of Communication Science, University of Amsterdam, Amsterdam, Netherlands
| | - Saskia te Velde
- Research Group Innovation of Human Movement Care, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, Netherlands
| | - Amber Ronteltap
- Research Group Innovation of Human Movement Care, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, Netherlands
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Chippendale T, Chen SW. The Stroll Safe outdoor falls prevention program: Participant experiences in eight community sites. Arch Gerontol Geriatr 2023; 108:104926. [PMID: 36641881 DOI: 10.1016/j.archger.2023.104926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/16/2022] [Accepted: 01/08/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVES Outdoor falls can negatively impact the quality of life of community-dwelling older adults. Although there are differences in risk factors for indoor and outdoor falls, none of the existing evidence-based fall prevention programs specifically targets outdoors falls. To fill this gap, the Stroll Safe program was developed. The purpose of this study was to explore participant's experiences in the Stroll Safe program RESEARCH DESIGN AND METHODS: In this qualitative study, we conducted focus groups at eight community program sites with Stroll Safe program participants. Thematic analysis, with both deductive and inductive coding were used. Researcher triangulation was employed to increase trustworthiness of the findings RESULTS: Four major themes emerged from the data, including (1) Precipitants of behavioral change, (2) Behavioral change, (3) Program design, and 4) Enjoyment of program experience. Several sub-themes were also uncovered DISCUSSION AND IMPLICATIONS: Although the qualitative findings are consistent with the quantitative findings from the efficacy trial, the results also reveal benefits that were not captured by the quantitative analysis. In addition, the findings related to the influence of the group leader and program design can be used to guide future implementation science studies.
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Affiliation(s)
- Tracy Chippendale
- Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, 82 Washington Square East, 6th floor, New York, NY 10003, United States.
| | - Szu-Wei Chen
- Program in Occupational Therapy, Washington University School of Medicine, United States
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Lohman MC, Fallahi A, Mishio Bawa E, Wei J, Merchant AT. Social Mediators of the Association Between Depression and Falls Among Older Adults. J Aging Health 2023:8982643231152276. [PMID: 36633960 DOI: 10.1177/08982643231152276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To investigate the role of social factors in the association between depression and falls among older adults. METHODS The sample included data from 3443 older adults from three waves of the Health and Retirement Study (2010-2014). A Lifestyle Questionnaire was used to measure social engagement, social network contact, and neighborhood social context. Mediating effects of social factors were estimated through causal mediation analysis. Results: Poorer social engagement and network contact were associated with greater likelihood of falls, while poorer neighborhood context was associated with greater likelihood of fall injuries. Social engagement mediated a significant portion of the effect of depression on falls (OR: 1.03, 95% CI: 1.00, 1.06), and neighborhood context mediated a portion of the effect of depression on fall injuries (OR: 1.03, 95% CI: 1.00, 1.07). Discussion: The direct and indirect impacts of social factors suggest that considering them may help improve existing fall prevention approaches.
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Affiliation(s)
- Matthew C Lohman
- Department of Epidemiology and Biostatistics, 2629University of South Carolina, Arnold School of Public Health, Columbia, SC, USA
| | - Afsaneh Fallahi
- Department of Epidemiology and Biostatistics, 2629University of South Carolina, Arnold School of Public Health, Columbia, SC, USA
| | - Eric Mishio Bawa
- Department of Epidemiology and Biostatistics, 2629University of South Carolina, Arnold School of Public Health, Columbia, SC, USA
| | - Jingkai Wei
- Department of Epidemiology and Biostatistics, 2629University of South Carolina, Arnold School of Public Health, Columbia, SC, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, 2629University of South Carolina, Arnold School of Public Health, Columbia, SC, USA
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Bateman LB, Hall AG, Anderson WA, Cherrington AL, Helova A, Judd S, Kimberly R, Oates GR, Osborne T, Ott C, Ryan M, Strong C, Fouad MN. Letter to the Editor Response: Exploring COVID-19 Vaccine Hesitancy Among Stakeholders in African American and Latinx Communities in the Deep South Through the Lens of the Health Belief Model. Am J Health Promot 2023:8901171221146436. [PMID: 36630288 PMCID: PMC9843136 DOI: 10.1177/08901171221146436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The purpose of this submission to respond to a Letter to the Editor recently submitted regarding our manuscript, "Exploring COVID-19 Vaccine Hesitancy among Stakeholders in African American and Latinx Communities in the Deep South through the Lens of the Health Belief Model" published in the American Journal of Health Promotion in February, 2022. The manuscript reported on a study that had as its purpose to qualitatively explore perceptions related to COVID-19 vaccination intention among African American and Latinx participants and suggest potential intervention strategies.
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Affiliation(s)
- Lori B. Bateman
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA,Lori Brand Bateman, PhD, School of Medicine, The University of Alabama at Birmingham, MT 623, 1720 2nd Ave South, Birmingham, AL 35294, USA.
| | - Allyson G. Hall
- School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - William A. Anderson
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Anna Helova
- School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Suzanne Judd
- School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert Kimberly
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gabriela R. Oates
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tiffany Osborne
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Corilyn Ott
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA,School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Melissa Ryan
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christian Strong
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mona N. Fouad
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
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Exploration of COVID-19 Pandemic Prevention Behaviors among Healthcare Workers. Healthcare (Basel) 2023; 11:healthcare11020153. [PMID: 36673522 PMCID: PMC9859533 DOI: 10.3390/healthcare11020153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/21/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023] Open
Abstract
Since the outbreak of COVID-19, the pandemic has become an important topic of global public health. To reduce the rapid spread of the pandemic, compliance with preventive behaviors has become one of the important guidelines from the World Health Organization (WHO). Healthcare workers stand on the frontline for pandemic prevention, and preventive behaviors are essential measures to protect their health and safety. The purpose of this study was to propose an integrative model that explained and predicted COVID-19 preventive behaviors among healthcare workers. The study integrated workplace safety climate and the health belief model (HBM) to verify the impact of workplace safety climate and health belief factors on the safety attitude, safety compliance, and safety satisfaction of healthcare workers performing COVID-19 pandemic prevention behaviors. A cross-sectional study was conducted from March to August 2021 with a self-administered online questionnaire. The sample of the study was drawn from healthcare workers of a famous medical institution in Taipei City as research subjects. After collecting 273 valid questionnaires and verifying them through the analysis of structural equation modeling (SEM), the findings revealed that workplace safety climate had an impact on health belief factors, and then health belief factors had impacts on safety attitudes. In addition, safety attitude affected safety compliance, while safety compliance further affected safety satisfaction. The study showed that workplace safety climate can strengthen healthcare workers' health beliefs and further affect their safety attitudes, safety compliance, and safety satisfaction. The study attempted to propose a model of healthcare workers' pandemic prevention behaviors as a reference for medical facility administrators in real practice.
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Wang K, Chen M, Zhang X, Zhang L, Chang C, Tian Y, Wang X, Li Z, Ji Y. The Incidence of Falls and Related Factors among Chinese Elderly Community Residents in Six Provinces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14843. [PMID: 36429561 PMCID: PMC9690932 DOI: 10.3390/ijerph192214843] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/03/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
This cross-sectional study classified the factors related to falls among residents ≥ 60 years old in China in order to provide evidence for the prevention of falls in the elderly. A total of 2994 participants were enrolled, and the correlations between social demography, physical health, self-health management awareness, family support, and fall risk were analyzed. Factors influencing falls were classified by location, cause, and the activity during falls. Suffering from osteoarthropathy (OR = 1.761, 95% CI: 1.234-2.513, p < 0.05), depression or anxiety (OR = 1.896, 95% CI: 1.331-2.700, p < 0.001), household size > 2 (OR = 1.806, 95% CI: 1.042-3.130, p < 0.05), and poor self-assessed health (OR = 1.478, 95% CI: 1.107-1.972, p < 0.01) were risk factors. Higher participation in community health programs (OR = 0.522, 95% CI: 0.298-0.912, p < 0.05) and spousal support (OR = 0.909, 95% CI: 0.841-0.981, p < 0.05) were protective factors. Falls were divided into the following categories: stairs/hallway (vision, attention problems), bath/toilet (vision, attention problems, slipping), indoor housework (dizziness, leg weakness), and outdoor activities (attention, surface problems). While acknowledging that the personal physical and mental health of the elderly may lead to falls, community support, accelerated transformation of housing, and the construction of barrier-free environments play an important role in reducing the risk of falls.
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Affiliation(s)
- Kun Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Meijun Chen
- School of Public Health, The University of Hong Kong, Hong Kong 999077, China
| | - Xiaoyue Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Lanchao Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Yu Tian
- Xinjiekou Community Health Service Center of Xicheng District, Beijing 100035, China
| | - Xiaofeng Wang
- Ronghua Community Health Service Center of Beijing Economic-Technological Development Area, Beijing 100176, China
| | - Zhijing Li
- School of Health Humanities, Peking University Health Science Center, Beijing 100191, China
| | - Ying Ji
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China
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Maswadi K, Ghani NA, Hamid S. Factors influencing the elderly’s behavioural intention to use smart home technologies in Saudi Arabia. PLoS One 2022; 17:e0272525. [PMID: 36040877 PMCID: PMC9426941 DOI: 10.1371/journal.pone.0272525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/21/2022] [Indexed: 12/05/2022] Open
Abstract
In recent years, smart home technologies have offered opportunities for elderly people to manage their daily health-related activities. Despite the advancement in smart home technology (SHT), the level of end-user acceptance among elderly people is still low. This study proposes an SHT framework by examining the determinants of elderly behavioural intention (BI) to use smart home technologies by extending the Unified Theory of Acceptance and Use of Technology (UTAUT) model. This study uses the quantitative approach to survey about 486 elderly people in Saudi Arabia, and it applies the Partial Least Square Structural Equation Model (PLS-SEM) technique to perform the data analysis. Findings reveal that culture influence and technology awareness are significant factors in determining the BI to use SHT among elderly people. The study also finds that attitude mediates the relationships between performance expectancy, effort expectancy, and behavioural intention. We find that region and education moderate the relationships between culture influence, technology awareness, and behavioural intention. This study theoretically extends the UTAUT theory by including external constructs: culture influence, technology awareness, attitude, education, and region.
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Affiliation(s)
- Kholoud Maswadi
- Faculty of Computer Science and Information Technology, University Malaya, Kuala Lumpur, Malaysia
- Department of Management Information Systems, Jazan University, Jazan, Saudi Arabia
| | - Norjihan Abdul Ghani
- Faculty of Computer Science and Information Technology, University Malaya, Kuala Lumpur, Malaysia
- * E-mail: (NAG); (SH)
| | - Suraya Hamid
- Faculty of Computer Science and Information Technology, University Malaya, Kuala Lumpur, Malaysia
- * E-mail: (NAG); (SH)
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Chaieb S, Ben Mrad A, Hnich B. From Personal Observations to Recommendation of Tailored Interventions based on Causal Reasoning: a case study of Falls Prevention in Elderly Patients. Int J Med Inform 2022; 163:104765. [PMID: 35461148 DOI: 10.1016/j.ijmedinf.2022.104765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/31/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE While the challenge of estimating the efficacy of therapies using observational data has received a lot of attention, little work has been done on estimating the treatment effect from interventions. In this paper, we tackle this problem by proposing an early guidance system based on a causal Bayesian network (CBN) for recommending personalized interventions. We are interested in the elderly fall prevention context. The objective is to develop a practical tool to help doctors estimate the effects of each intervention (or compound interventions) on a given patient and then choose the one that best fits each patient's health situation to reduce the risk of falling. METHODS On a real-world elderly information base, we undertake an empirical investigation for the proposed approach, which is based on a 44-node CBN. Then, we describe what is possible to achieve using state-of-the-art machine learning methods, namely Support Virtual Machine (SVM), Decision Tree (DT), and Bayesian Network (BN), and how well these methods can be used in recommending personalized interventions compared to the proposed approach. RESULTS 1174 elderly patients from Lille University Hospital, between January 2005 and December 2018 are included. The results reveal that none of the classifiers is significantly superior to the others, even if BN delivers somewhat better results (41.6%) and DT most often slightly lower performance (31.2%). Results also show that none of these three classifiers performs comparable to the proposed system (89.7%). The interventions recommended by the system are in agreement with the expert's judgment to a satisfactory level. The reaction of the physicians to the proposed system in its first trial version was very favorable. CONCLUSION The study showed the efficacy and utility of the causality-based strategy in recommending tailored interventions to prevent elderly falls compared to automated learning methods that had failed to infer a solid interventional paradigm for precision medicine.
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Affiliation(s)
- Salma Chaieb
- University of Sousse, ISITCom, 4011 Sousse, Tunisia; University of Sfax, CES Lab, 3038 Sfax, Tunisia.
| | - Ali Ben Mrad
- University of Sfax, ISAAS, 1013 Sfax, Tunisia; University of Sfax, CES Lab, 3038 Sfax, Tunisia
| | - Brahim Hnich
- University of Monastir, FSM, 5000 Monastir, Tunisia; University of Sfax, CES Lab, 3038 Sfax, Tunisia.
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