1
|
Lin Z, Chen S, Su L, Chen H, Fang Y, Liang X, Chan KF, Chen J, Luo B, Wu C, Wang Z. Exploring mother-daughter communication and social media influence on HPV vaccine refusal for daughters aged 9-17 years in a cross-sectional survey of 11,728 mothers in China. Hum Vaccin Immunother 2024; 20:2333111. [PMID: 38530324 DOI: 10.1080/21645515.2024.2333111] [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: 12/12/2023] [Accepted: 03/15/2024] [Indexed: 03/27/2024] Open
Abstract
This study investigated the influences of mother-daughter communication and social media on mothers' HPV vaccine refusal for their daughters aged 9-17. A cross-sectional online survey among 11,728 mothers of girls aged 9-17 in Shenzhen, China was implemented between July and October 2023. Multi-level logistic regression models were fitted. Among 11,728 participants, 43.2% refused to have their daughters receive an HPV vaccination. In multivariate analysis, more openness in the mother-daughter communication (AOR: 0.99, 95%CI: 0.98, 0.99), perceived more positive outcomes of mother-daughter communication (AOR: 0.77, 95%CI: 0.75, 0.79), higher frequency of exposure to testimonials about daughters' HPV vaccination (AOR: 0.81, 95%CI: 0.78, 0.85) and information encouraging parents to vaccinate their daughters against HPV on social media (AOR: 0.76, 95%CI: 0.73, 0.79), and thoughtful consideration of the veracity of the information specific to HPV vaccines (AOR: 0.80, 95%CI: 0.77, 0.83) were associated with lower vaccine refusal. Mothers who were not the main decision-makers of daughters' HPV vaccination (AOR: 1.28 to 1.46), negative outcome expectancies of mother-daughter communication (AOR: 1.06, 95%CI: 1.04, 1.08), and mothers' HPV vaccine refusal (AOR: 2.81, 95%CI: 2.58, 3.06) were associated with higher vaccine refusal for their daughters. The level of mothers' HPV vaccine refusal for their daughters was high in China. Openness and outcome expectancies of mother-daughter communication and information exposure on social media were considered key determinants of HPV vaccine refusal for daughters. Future HPV vaccination programs should consider these interpersonal factors.
Collapse
Affiliation(s)
- Zian Lin
- Department of Vaccination Clinic, Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Siyu Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lixian Su
- Department of Children's Group Health, Shenzhen Futian District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, China
| | - Yuan Fang
- Department of Health and Physical Education, the Education University of Hong Kong, Hong Kong SAR, China
| | - Xue Liang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kwok Fung Chan
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jianan Chen
- Department of Vaccination Clinic, Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Biyun Luo
- Department of Vaccination Clinic, Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Chuanan Wu
- Department of Vaccination Clinic, Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
2
|
Dubé E, Renaud MP, Lyonnais MC, Pelletier C, Fletcher C. "The needle is already ready to go": communities' and health care professionals' perceptions of routine vaccination in Nunavik, Canada. Int J Circumpolar Health 2024; 83:2295042. [PMID: 38105644 PMCID: PMC10732179 DOI: 10.1080/22423982.2023.2295042] [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: 07/19/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023] Open
Abstract
Inuit living in the northern region of Nunavik continue to experience significant health inequalities, which are rooted in colonialism that still have repercussions on their health-related perceptions and practices, including vaccination. This study aimed to explore the perceptions and determinants of routine vaccination among the Inuit of Nunavik by describing factors influencing vaccination decisions from the perspective of community members and health professionals. Semi-structured interviews focusing on the perception of vaccination and experience with vaccination and health services were conducted with 18 Inuit and 11 non-Inuit health professionals. Using the socio-ecological model, factors acting at the community and public policy (e.g. rumours and misinformation about vaccination, language barrier), organisational (e.g. complexity of the vaccination process, staff turnover, lack of specialised vaccination workers and interpreters), and intrapersonal and interpersonal (e.g. past experiences with vaccination, vaccine attitudes, social norms) levels were identified as having an impact on vaccination decisions. Improving vaccination coverage in Nunavik requires a more global reflection on how to improve and culturally adapt the health care and services offered to the Inuit population.
Collapse
Affiliation(s)
- Eve Dubé
- Direction des risques biologiques, Institut national de santé publique du Québec, Québec, Canada
- Département d’anthropologie, Université Laval, Québec, Canada
| | - Marie-Pierre Renaud
- École d’études autochtones, Université du Québec en Abitibi-Témiscamingue, Québec, Canada
| | | | - Catherine Pelletier
- Axe Maladies infectieuses et immunitaires, Centrre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Christopher Fletcher
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| |
Collapse
|
3
|
Avraham R, Simon-Tuval T, Van Dijk D. Determinants of physical activity habit formation: a theory-based qualitative study among young adults. Int J Qual Stud Health Well-being 2024; 19:2341984. [PMID: 38605587 PMCID: PMC11018029 DOI: 10.1080/17482631.2024.2341984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024] Open
Abstract
PURPOSE Engagement in physical activity significantly contributes to reducing the onset and severity of chronic diseases. Nonetheless, establishing habits around this behaviour remains a persistent challenge. This research endeavours to discern the determinants influencing the formation of physical activity habit among young adults in Israel, drawing upon a socio-ecological model. METHODS A qualitative approach with phenomenological-hermeneutical method was used. In-depth interviews were carried to cover four levels of the socio-ecological model. RESULTS Interviewees were categorized into three subgroups according to their physical activity habit strength: Habitually physically active (n = 8), Variably physically active (n = 11), and physically inactive (n = 6). The content analysis yielded four overarching themes associated with physical activity habit formation. Intrapersonal determinants encompassed personal traits, perceptions and attitudes, perceived benefits, and emotional responses related to physical activity. Interpersonal determinants encompassed social support, modelling support, and peer pressure. Community determinants pertained to social norms, resource availability, and accessibility. Finally, public policy considerations encompassed educational policies as well as workplace policies and cultural influences. CONCLUSIONS This study highlights the unique determinants contributing to the formation of physical activity habit. As intrapersonal and interpersonal factors are significant determinants, interventions should focus on these elements in order to promote this behaviour among young adults.
Collapse
Affiliation(s)
- Rinat Avraham
- Department of Nursing, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Tzahit Simon-Tuval
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Dina Van Dijk
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| |
Collapse
|
4
|
Sibindi T, Chipps JA, Crowley T. Eco-nursing competencies for nurses: A scoping review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100221. [PMID: 39069968 PMCID: PMC11276924 DOI: 10.1016/j.ijnsa.2024.100221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 06/10/2024] [Accepted: 06/25/2024] [Indexed: 07/30/2024] Open
Abstract
Background Nurses are tasked with addressing the health impacts of climate change. Eco-nursing competencies, covering knowledge, attitudes, and skills related to climate change, equip nurses to actively mitigate and adapt to its effects on health and the environment. Objective To synthesize existing literature on eco-nursing roles and competencies for nurses. Methods A scoping review of published papers examined nurses' roles and eco-nursing competencies. Databases searched included Academic Search Complete, CINAHL Plus, MEDLINE (PubMed), and Google Scholar. Search terms encompassed climate change and nursing synonyms, limited to English articles up to April 15, 2023. Thematic analysis was used to synthesize findings, delineating roles, and eco-nursing competencies. Results were tabulated. Results Out of 445 papers identified, 31 underwent data analysis. These papers highlighted nurses' roles in climate change (42%), along with climate change knowledge and skills (64.5%), and attitudes (13%). Roles encompassed research, education, advocacy, leadership, and clinical practice, with corresponding competencies embedded within existing core competencies for general nurses, nurse specialists, and nurse managers. Conclusion The review demonstrates that nurses' roles in climate change necessitate relevant knowledge, attitudes, and skills. Future research should contextualize these roles and eco-nursing competencies based on geographical locations, considering the distinct disease burden in each area. Registration The study protocol was registered in the Open Science Framework on 5 March 2023 before conducting the full study https://doi.org/10.17605/OSF.IO/9GC4N. Tweetable abstract Amidst growing concerns about climate change, nurses are increasingly tasked with preparing to mitigate its health impacts through the delineation of eco-nursing competencies. These competencies will equip nurses to effectively tackle the health and environmental ramifications of climate change, building upon existing core competencies tailored to various geographic contexts.
Collapse
|
5
|
Nielsen MH, Jensen AL, Pedersen ML, Seibæk L. Living with chronic obstructive pulmonary disease or type 2 diabetes in Greenland - a qualitative interpretive description study. Int J Circumpolar Health 2024; 83:2296706. [PMID: 38127836 PMCID: PMC10763871 DOI: 10.1080/22423982.2023.2296706] [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: 10/10/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Non-communicable diseases such as chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2D) represent major challenges for health systems all over the world. In an interview study, we explored patient experiences and perspectives of being diagnosed and living with COPD or T2D in Greenland. Participants (n = 24) were selected by purposeful sampling and recruited by phone. We conducted individual semi-structured interviews at the National Hospital in Nuuk and the four regional hospitals. Interviews were audio-recorded, transcribed verbatim, and analysed using interpretive description. Three themes emerged: shock and shame on receiving the diagnosis, coping with a changed life, and varying needs for care and communication. We found that being diagnosed with COPD or T2D required a rapid change in the participants' everyday lives and lifestyle behaviours. Some self-managed their disease well and were able to transfer their knowledge and integrate it into their daily lives, while others struggled to make lifestyle changes. Additionally, living with COPD or T2D could be related to silence and shame. The findings contribute to a better understanding of living with COPD or T2D in the Arctic region and the development of future, culturally-adapted patient education initiatives.
Collapse
Affiliation(s)
- Maja Hykkelbjerg Nielsen
- Queen Ingrid’s Hospital, Steno Diabetes Center Greenland, Nuuk, Greenland
- Greenland Center for Health Research, Department of Health and Nature, Ilisimatusarfik/University of Greenland, Nuuk, Greenland
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Annesofie Lunde Jensen
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Lynge Pedersen
- Queen Ingrid’s Hospital, Steno Diabetes Center Greenland, Nuuk, Greenland
- Greenland Center for Health Research, Department of Health and Nature, Ilisimatusarfik/University of Greenland, Nuuk, Greenland
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lene Seibæk
- Greenland Center for Health Research, Department of Health and Nature, Ilisimatusarfik/University of Greenland, Nuuk, Greenland
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| |
Collapse
|
6
|
Gammons AF, Farewell CV, Walker-Mao C, Ubriaco E, Leiferman JA. Psychological needs fulfillment and perinatal well-being among low-SES individuals: a mixed methods investigation. J Psychosom Obstet Gynaecol 2024; 45:2395838. [PMID: 39185793 PMCID: PMC11386509 DOI: 10.1080/0167482x.2024.2395838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 08/10/2024] [Accepted: 08/17/2024] [Indexed: 08/27/2024] Open
Abstract
Poor perinatal mental health is associated with deleterious effects and individuals with low socioeconomic status (SES) are at elevated risk. Fortifying multi-level resources of low-SES pregnant individuals to boost their well-being is a crucial step toward achieving equity in perinatal health. The purpose of this project was to explore what patterns of resources supported well-being among low-SES pregnant individuals in Colorado. In a prospective mixed methods cohort study, 23 low-SES pregnant individuals completed surveys and interviews. Participants were separated into 3 subgroups based on their overall Warwick-Edinburgh Mental Well-being Scale (WEMWBS) score and interviewed to identify multi-level resources that supported their well-being. Our analysis was framed by Self-Determination Theory which contends that three universal basic psychological needs are required for individuals to function in a healthy manner: autonomy, competence, and relatedness. We extrapolated resources that promoted perinatal competence, autonomy, and relatedness from the high well-being group. Perinatal-related knowledge (construct related to competence); mindfulness and intended pregnancy (constructs related to autonomy); and emotional, informational, and friend support, social capital, and connection to nature (constructs related to relatedness) were identified as the resources more frequently endorsed in the high well-being group. Targeting interventions to fortify specific multi-level resources that support the autonomy, competence, and relatedness of pregnant individuals facing socioeconomic disadvantage is a crucial step toward achieving equity in perinatal health.
Collapse
Affiliation(s)
- Alison F Gammons
- Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, Aurora, CO, USA
| | - Charlotte V Farewell
- Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, Aurora, CO, USA
| | - Chelsea Walker-Mao
- Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, Aurora, CO, USA
| | - Emma Ubriaco
- Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, Aurora, CO, USA
| | - Jenn A Leiferman
- Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, Aurora, CO, USA
| |
Collapse
|
7
|
Ayano G, Rooney R, Pollard CM, Dantas JAR, Lobo R, Jeemi Z, Burns S, Cunningham R, Monterosso S, Millar L, Hassan S, Dovchin S, Oliver R, Coleman K, Alati R. Risk and protective factors of youth crime: An umbrella review of systematic reviews and meta-analyses. Clin Psychol Rev 2024; 113:102479. [PMID: 39178756 DOI: 10.1016/j.cpr.2024.102479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 07/03/2024] [Accepted: 08/12/2024] [Indexed: 08/26/2024]
Abstract
INTRODUCTION Several systematic reviews and meta-analyses have been conducted on the risk and protective factors of youth crime. This study aims to consolidate this evidence using an umbrella review methodology. METHODS A systematic electronic search was conducted using multiple electronic databases. Strength of associations was evaluated using quantitative umbrella review criteria, and AMSTAR was used to assess the quality of the studies. RESULTS Among the 58 factors identified, 11 factors were supported by highly suggestive or suggestive evidence. Evidence of association was highly suggestive (class II) for substance use (odds ratio [OR] = 2·29, 95%CI 1·58-3.01), previous history of crime (OR = 2·03, 95%CI 1·62-2·45), moral development (OR = 3·98, 95%CI 3·57-4·39), psychopathology (OR = 2·22, 95%CI 1.40-2.69), adverse childhood experiences (OR = 1·37, 95%CI = 1·36-1·38), poor parental supervision (OR = 1·85, 95%CI 1·83-1·87), maltreatment or neglect (OR = 1·34, 95%CI 1·08-1·65), attachment (OR = 1·94; 95%CI 1.93-1·95), and school bullying (OR = 2·50; 95%CI 2·03-3·08); and suggestive (class III) for peer pressure (OR = 2·11, 95%CI 2·06-2·16) and supportive school environments (OR = 0·56; 95%CI 0·55-0·57). CONCLUSION The evidence-based atlas of key risk and protective factors identified in this umbrella review could be used as a benchmark for advancing research, prevention, and early intervention strategies for youth crime.
Collapse
Affiliation(s)
- Getinet Ayano
- School of Population Health, Curtin University, Perth, WA, Australia.
| | - Rosanna Rooney
- School of Population Health, Curtin University, Perth, WA, Australia
| | | | - Jaya A R Dantas
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Roanna Lobo
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Zakia Jeemi
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Sharyn Burns
- School of Population Health, Curtin University, Perth, WA, Australia
| | | | | | - Lynne Millar
- School of Population Health, Curtin University, Perth, WA, Australia; Telethon Kids Institute, Perth, WA, Australia
| | - Sharinaz Hassan
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Sender Dovchin
- School of Education, Curtin University, Perth, WA, Australia
| | - Rhonda Oliver
- School of Education, Curtin University, Perth, WA, Australia
| | - Kael Coleman
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Rosa Alati
- School of Population Health, Curtin University, Perth, WA, Australia; Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|
8
|
Beavis AL, Krishnamoorthi MS, Adler S, Fleszar LG, Moran MB, Rositch AF. Contemporary provider perspectives on how to address HPV vaccine hesitancy in the US: A qualitative study. Vaccine X 2024; 20:100533. [PMID: 39170855 PMCID: PMC11334775 DOI: 10.1016/j.jvacx.2024.100533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 07/20/2024] [Accepted: 07/22/2024] [Indexed: 08/23/2024] Open
Abstract
Introduction Despite over 15 years of real-world data that supports the safety and efficacy of the human papillomavirus (HPV) vaccine, in the United States vaccine hesitancy persists. Many studies have focused on vaccine-hesitant parents, but fewer have examined provider perspectives on how to address HPV vaccine hesitancy. Methods Between July 2021-April 2022, we recruited providers in Maryland and the broader Mid-Atlantic region who practiced pediatrics, primary care, family medicine, or adolescent medicine and who provided outpatient care for children ages 10-17. Semi-structured virtual interviews focused on provider-reported strategies to address HPV vaccine-hesitant parents, as well as perceived barriers to successful vaccination and provider perspectives on specific interventions to address parental hesitancy. Audio recordings were transcribed and analyzed via a combination of deductive and inductive coding. Higher-level themes within the domains of strategies, barriers, and perspectives on specific proposed interventions were identified. Results and discussion A total of sixteen providers completed an interview. Within the domain of provider-reported strategies, the following themes emerged: 1) leveraging continuity of care and established parental trust, 2) supporting parental autonomy, 3) tailoring the approach to specific concerns of vaccine-hesitant parents, 4) normalizing the HPV vaccine, and 5) focusing on health prevention and cancer prevention. Barriers providers identified were: 1) limited time, 2) lack of common ground with parents, 3) parent-child decision discordance, 4) availability of misinformation, and 5) parental concerns such as safety and necessity. In the domain for proposed interventions, providers favored interventions that saved time or were not resource-intense, that did not single out the HPV vaccine as different, were patient friendly, and leveraged efficiency through the electronic medical record. The insights from this study can help inform the development of provider-acceptable and feasible tools and interventions to address parental HPV vaccine hesitancy.
Collapse
Affiliation(s)
- Anna L. Beavis
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Sarah Adler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Laura G. Fleszar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Meghan B. Moran
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anne F. Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
9
|
Smeltz L, Sacks J, DeWaters A. From the "backburner" to the forefront: Qualitative analysis of medical and physician assistant students' reflections on Crip Camp. Disabil Health J 2024; 17:101652. [PMID: 38879413 DOI: 10.1016/j.dhjo.2024.101652] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND Disability-focused health professions education must evolve to portray the lives of disabled patients, lived experiences of ableism, and disability history more accurately and authentically. Methods of education that utilize first-person perspectives of disabled people to deliver authentic representations are limited in the current literature. OBJECTIVE To explore first-year medical and physician assistant students' reflections on healthcare access, healthcare providers' roles, and barriers to health equity for patients with disabilities after watching an exemplar, first-person perspective documentary titled Crip Camp: A Disability Revolution. METHODS A three-part, student-created disability curriculum "Introduction to Disability and Anti-Ableist Healthcare" was offered as an elective for first-year medical students during the 2021-2022 and 2022-2023 academic years. The disability curriculum was required for first-year physician assistant students during the 2023-2024 academic year. One curricular component was watching Crip Camp: A Disability Revolution and completing a 500-750-word reflective essay. Qualitative thematic analysis was used to organize essay responses. RESULTS Seven major themes emerged in the students' essays highlighting the importance of disability-focused education, the necessity of understanding the historical context and mistreatment of people with disabilities, limitations of health policies and health systems, the role of trainees and providers, and intersectionality. Themes were aligned with the socioecological model and disability consciousness to reflect healthcare delivery and education benefit, respectively. CONCLUSION Crip Camp: A Disability Revolution was an effective educational intervention to provide and apply knowledge in reflecting on healthcare experiences of people with disabilities. The themes have implications for health professions education and health care delivery.
Collapse
Affiliation(s)
- Lydia Smeltz
- Penn State College of Medicine, Hershey, PA, USA.
| | | | - Ami DeWaters
- Penn State College of Medicine, Hershey, PA, USA
| |
Collapse
|
10
|
Choo J, Noh S, Moon J, Park J, Jeoung Y, Song W. Intention to quit electronic cigarette smoking among university students who are e-cigarette users. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:2137-2146. [PMID: 35882069 DOI: 10.1080/07448481.2022.2103383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/25/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To identify factors that are significantly associated with the intention to quit electronic cigarette smoking (ECS) at multiple, ecological levels among university students. PARTICIPANTS 365 students who were e-cigarette users from Seoul metropolitan areas, South Korea. METHODS A cross-sectional study through an online survey. RESULTS Of participants, 62.7% had the intention to quit ECS-17.2% within one month, 14.0% within six months, and 31.5% when the time is right. Factors significantly associated with the intention to quit ECS were identified: "device type," "a shorter duration of ECS," and "having started ECS for quitting traditional cigarette smoking" at the intrapersonal-level; "negative attitudes of either peers or family members toward ECS" at the interpersonal-level; and "exposure to community smoking cessation educations" at the community-level. CONCLUSIONS Approximately one-thirds of university e-cigarette users had no intention to quit ECS. The factors identified should be integrated into university level, behavioral smoking cessation strategies.
Collapse
Affiliation(s)
- Jina Choo
- College of Nursing, Korea University, Seoul, South Korea
- Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, South Korea
| | - Songwhi Noh
- College of Nursing, Korea University, Seoul, South Korea
| | - Jihyun Moon
- College of Nursing, Korea University, Seoul, South Korea
| | - Jinah Park
- College of Nursing, Korea University, Seoul, South Korea
| | - Yoonjoo Jeoung
- College of Nursing, Korea University, Seoul, South Korea
| | - Wonji Song
- College of Nursing, Korea University, Seoul, South Korea
| |
Collapse
|
11
|
Mitchell E, Tavui A, Andersson S, Lake S, Koroivueti A, Koroivueta J, Kaurasi R, Bechu V, Kaldor J, Steer A, Romani L. Acceptability of a nationwide scabies mass drug administration (MDA) program in Fiji: a qualitative interview-based study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 51:101194. [PMID: 39295851 PMCID: PMC11408017 DOI: 10.1016/j.lanwpc.2024.101194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/23/2024] [Accepted: 08/22/2024] [Indexed: 09/21/2024]
Abstract
Background Fiji has among the highest global reported prevalence of scabies. Mass drug administration (MDA) has been identified as a potentially effective strategy to control scabies, but acceptability of MDA from the perspectives of people receiving and delivering scabies MDA programs remains underexplored in Fiji and globally. Methods A qualitative study was conducted after completion of the national MDA campaign. Participants included 44 community members and 12 key informants across the Central and Western Divisions of Fiji. Semi-structured face-to-face and virtual interviews were conducted in August and September 2023. An interpretive research approach was adopted, and data were analysed using deductive and inductive techniques. Findings We identified several barriers and facilitators to scabies MDA acceptability. Facilitators included prior experiences of scabies and knowledge of the potential health benefit of MDA, community attitudes to MDA and neighbours' adherence practices, endorsement of MDA by community leaders, community consultation and exposure to community sensitisation, and involvement of local key informants during planning and implementation. Barriers included a lack of trust in MDA campaigns, religious beliefs, limited reach of community sensitisation, and challenges to implementing MDA in urban locations. Interpretation This is the first qualitative study documenting acceptability of a nationwide scabies-MDA globally. It identified diverse socio-structural factors that influenced MDA implementation and acceptability. Future MDA programs could benefit from widespread community sensitisation, tailored approaches to urban and rural MDA design and delivery, and the inclusion of communities in the co-design and implementation of MDA programs. Funding The National Health and Medical Research Council (NHMRC) investigator grant-LR and the Macquarie Group Foundation 50th Celebration Awards-AS.
Collapse
Affiliation(s)
- Elke Mitchell
- Kirby Institute, UNSW Sydney, Sydney, Australia
- Melbourne School of Population and Global Heath, Melbourne University, Australia
| | - Aminiasi Tavui
- Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Susanna Lake
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Aminiasi Koroivueti
- Murdoch Children's Research Institute, Melbourne, Australia
- Ministry of Health and Medical Services, Fiji
| | | | | | | | - John Kaldor
- Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Andrew Steer
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Lucia Romani
- Kirby Institute, UNSW Sydney, Sydney, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| |
Collapse
|
12
|
Okkenhaug I, Jensen MR, Solhaug S. Barriers and Facilitators for Physical Activity Among Children and Youth With Autism-A Scoping Review. J Phys Act Health 2024; 21:965-979. [PMID: 39151899 DOI: 10.1123/jpah.2024-0075] [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: 01/30/2024] [Revised: 06/14/2024] [Accepted: 06/18/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND The purpose of this scoping review was to systematically synthesize barriers and facilitators for physical activity (PA) among children and youth with autism spectrum disorders (ASD) across the socioecological model. METHODS Five electronic databases were searched in March 2022 for studies examining barriers and facilitators for PA among children and youth with ASD. An updated search was performed in April 2024. The framework synthesis method was utilized, and the socioecological model was the chosen framework. RESULTS Fifty-four studies published from 2008 to 2024 were included. Among the included studies, 57% included the perspectives of children and youth with ASD alone or together with proxies (eg, parents, teachers, and coaches), while 43% included only the perspectives of proxies. Barriers and facilitators on the intrapersonal and interpersonal levels were most substantial. The analysis led to 2 main categories of barriers and facilitators, those unique to children and youth with ASD, and those similar to what had been identified through research on children and youth, both typically developing and with other disabilities. CONCLUSIONS This comprehensive scoping review shows the complexity of factors contributing to barriers and facilitators for PA among children and youth with ASD, and highlights both the factors unique to this population and more general factors affecting PA participation. The findings from this synthesis might be used to guide the development of inclusive PA in physical education, organized sports, and other community PA arenas.
Collapse
Affiliation(s)
- Ingrid Okkenhaug
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Magnus Rom Jensen
- Library Section for Research Support, Data and Analysis, Norwegian University of Science and Technology, Trondheim, Norway
| | - Solvor Solhaug
- Library Section for Research Support, Data and Analysis, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
13
|
Balvanz P, Olvera RG, McGladrey M, Booty M, Beard D, Ellison S, McClay C, Nouvong M, Oser CB, Yamoah O, Martinez LS. Leveraging local knowledge to contextualize the opioid epidemic within HEALing Communities Study communities: A Photovoice protocol. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 165:209460. [PMID: 39067764 DOI: 10.1016/j.josat.2024.209460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 06/10/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024]
Abstract
Since its inception 30 years ago, Photovoice has gained increasing popularity as a research method and more recently has been incorporated within randomized controlled trial (RCT) designs. Photovoice is a participatory action research method that pairs photography with focus group discussions to record community strengths and concerns, build critical consciousness, and reach policymakers. Adherence of Photovoice implementation to these original tenets of Photovoice varies. This article provides the Photovoice protocol developed by the authors to improve the methodological rigor of Photovoice integration into RCTs and help contextualize the landscape for the HEALing Communities Study (HCS: NCT04111939), a greater than $350 million investment by the National Institute on Drug Abuse along with the Substance Abuse and Mental Health Services Administration to reduce opioid overdose deaths in 67 of the hardest-hit communities in four states (Kentucky, Massachusetts, New York, and Ohio). The product of a cross-state collaboration, this HCS Photovoice protocol provides ethical and methodological tools for incorporating Photovoice into RCT designs to enhance community engagement, communication campaigns, and data-driven decision-making about evidence-based practice selection and implementation.
Collapse
Affiliation(s)
- Peter Balvanz
- General Internal Medicine, Boston Medical Center, Boston, MA, United States of America.
| | - Ramona G Olvera
- CATALYST, The Ohio State University, College of Medicine, Columbus, OH, United States of America.
| | - Margaret McGladrey
- Department of Health Management and Policy, College of Public Health, UK.
| | - Marisa Booty
- Department of Sociology, University of Kentucky, Lexington, KY, United States of America.
| | - Dacia Beard
- Boston University School of Public Health, Boston, MA, United States of America.
| | - Sylvia Ellison
- HEALing Communities Study, The Ohio State University, College of Medicine, Columbus, OH, United States of America.
| | - Craig McClay
- General Internal Medicine, Boston Medical Center, Boston, MA, United States of America.
| | - Monica Nouvong
- General Internal Medicine, Boston Medical Center, Boston, MA, United States of America.
| | - Carrie B Oser
- Department of Sociology, University of Kentucky, Lexington, KY, United States of America.
| | - Owusua Yamoah
- Swetland Center for Environmental Health, Case Western Reserve University, Cleveland, OH, United States of America.
| | - Linda Sprague Martinez
- Health Disparities Institute, University of Connecticut School of Medicine, UConn Health, Hartford Connecticut, United States of America.
| |
Collapse
|
14
|
Colon Hidalgo D, Calhoun K, Neumeier A. Cultivating Diversity, Equity, and Inclusion in Pulmonary and Critical Care Training: A Path Toward Health Care Excellence. Crit Care Clin 2024; 40:789-803. [PMID: 39218486 DOI: 10.1016/j.ccc.2024.05.009] [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] [Indexed: 09/04/2024]
Abstract
Pulmonary and Critical Care Medicine (PCCM) fellowship training faces increasing competition but lacks diversity, hindering health care excellence. Despite a growing interest in the field, programs lack diverse representation. Addressing this issue is crucial to combat health disparities and bias, benefiting trainees, practitioners, and patients. Sustainable solutions are vital for achieving diversity, equity, and inclusion in PCCM. Strategies for achieving equity among training programs include adopting inclusive recruitment practices, recognizing differential attainment, addressing bias, fostering an equitable academic climate, and implementing multifaceted strategic processes to enhance diversity in mentorship including recognition and compensation for diversity and equity work.
Collapse
Affiliation(s)
- Daniel Colon Hidalgo
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, 12700 East 19th Avenue, 9C03, Aurora, CO 80045, USA
| | - Kara Calhoun
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, 12700 East 19th Avenue, 9C03, Aurora, CO 80045, USA
| | - Anna Neumeier
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, 12700 East 19th Avenue, 9C03, Aurora, CO 80045, USA; Denver Health Pulmonary, Critical Care and Sleep Medicine Division, 777 Bannock Street, Denver, CO 80204, USA.
| |
Collapse
|
15
|
Pico ML, Rangel-Osuna F, Estrada MS, Granich A, Grunnet LG, Silvia CIR, Avila-Jimenez L, Christensen DL, Nielsen KK. "I have not been doing it because of my fear of something happening." Exploring perspectives on healthy dietary behaviors and physical activity in Mexican pregnant women and health care professionals: A qualitative study. Nutrition 2024; 126:112493. [PMID: 39018986 DOI: 10.1016/j.nut.2024.112493] [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: 01/10/2024] [Revised: 04/11/2024] [Accepted: 05/01/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVES Mexico exhibits one of the highest prevalence rates of overweight and obesity globally, accompanied by a surge in non-communicable diseases, which in turn leads to elevated mortality rates. Existing efforts to address rising obesity rates have shown limited effectiveness. Maternal weight, diet, and physical activity (PA) during pregnancy affect the mother's and offspring's health. Despite the importance of establishing and engaging in healthy behaviors during pregnancy, little is known about which factors impact these behaviors among pregnant women in Mexico. This study explored perspectives on factors impacting healthy dietary behaviors and PA in pregnancy from pregnant women and health care professionals in Mexico. METHODS We conducted semistructured interviews with 11 pregnant women and 12 health care professionals working in prenatal care. Data were analyzed using qualitative content analysis in a stepwise inductive approach. RESULTS Classifying factors at the 1) individual level, 2) relational level, and 3) health care system level, three overall themes emerged. At the individual level, challenges with lack of time and competing priorities as well as knowledge of healthy dietary behaviors and PA were identified. At the relational level, influencing factors encompassed financial, social, and emotional support along with descriptive norms. At the health care system level, guidelines for PA during pregnancy and the quality of care were noted. CONCLUSIONS This study identified factors impacting healthy dietary behaviors and PA in pregnancy in Mexico. Important considerations for future interventions include addressing sociocultural norms around healthy dietary behaviors and PA in pregnancy and involving pregnant women's families, closest social networks, and health care professionals working at the prenatal care unit.
Collapse
Affiliation(s)
- Majken Lillholm Pico
- Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Denmark.
| | | | | | | | - Louise Groth Grunnet
- Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Denmark
| | | | | | | | | |
Collapse
|
16
|
Pardo C, Watson B, Pinkhasov O, Afable A. Social determinants of perinatal mental health. Semin Perinatol 2024; 48:151946. [PMID: 39174405 DOI: 10.1016/j.semperi.2024.151946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
Social inequities and mental health are public health and medical conditions that are inextricably linked. Perinatal mental health is influenced by social, physical, and biological factors, with additional stressors related to pregnancy. The social determinants of health (SDOH) encompasses all conditions in which people live and grow, inclusive of cultural norms that reflect the diverse populations we serve. To best understand the mechanisms by which the SDOH affects perinatal mental health, we introduce the Urban Stress Model and describe the link between urban realities to stress response and potential mechanisms that link urban living to increased risk of adverse perinatal mental health. Given the increased diversity of patient populations, cultural considerations are paramount in understanding the utility and best practices in screening and interventions among ethnically diverse communities. Building on our Urban Stress Model and a structural determinants of health framework, we present examples of interventions to address the social inequities of perinatal mental health from the policy to community levels.
Collapse
Affiliation(s)
- Christina Pardo
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.
| | - Breanna Watson
- School of Public Health, Downstate Health Sciences University, Brooklyn NY, USA
| | - Olga Pinkhasov
- College of Medicine, Downstate Health Sciences University, Brooklyn NY, USA
| | - Aimee Afable
- School of Public Health, Downstate Health Sciences University, Brooklyn NY, USA
| |
Collapse
|
17
|
Johnston K, Qaloewai S, Rasavuka T, Preston R, Strivens E, Larkins S. 'Letting it be': a grounded theory about dementia care in Fiji. Aging Ment Health 2024; 28:1390-1400. [PMID: 38629413 DOI: 10.1080/13607863.2024.2340737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 04/02/2024] [Indexed: 09/12/2024]
Abstract
OBJECTIVES This research study aimed to discover how dementia affecting older people was perceived, experienced, and managed by stakeholders in the Pacific Island country of Fiji. METHOD A transformational grounded theory approach was used. Semi-structured interviews and focus groups with key stakeholders in the major towns of Suva, Lautoka, and Nadi were carried out. Transcripts were analysed in line with transformational grounded theory methods. RESULTS A total of 50 participants (40 service providers, eight family caregivers, one person with dementia, and one village elder) shared their views and experiences about dementia. A grounded theory about dementia care management was constructed. 'Letting it be' is the grounding socio-cultural construct that interweaves and binds together the processes of dementia care management. It expresses a compassionate approach to caring for older people with dementia that involves searching for knowledge and support, and application of traditional care practices within the strength of family and community networks. CONCLUSION In Fiji, support for dementia centres on the integration of community understandings, and promotion of cultural values of wellbeing and care, with service provision. It also focuses on support for families and communities through social welfare, community networks, and education.
Collapse
Affiliation(s)
- Karen Johnston
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Sefanaia Qaloewai
- College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Taniela Rasavuka
- Saint Giles Hospital, Fiji Ministry of Health and Medical Services, Suva, Fiji
| | - Robyn Preston
- School of Health, Medical and Applied Sciences, CQUniversity, Townsville, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Australia
| | - Sarah Larkins
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| |
Collapse
|
18
|
Singichetti B, Wang YC, Golightly YM, Marshall SW, Naumann RB. Trends and disparities in alcohol-DWI license suspensions by suspension duration, North Carolina, 2007-2016. PLoS One 2024; 19:e0310270. [PMID: 39302993 DOI: 10.1371/journal.pone.0310270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 08/22/2024] [Indexed: 09/22/2024] Open
Abstract
PURPOSE To examine trends and potential disparities in North Carolina (NC) driving while impaired by alcohol (alcohol-DWI) license suspensions from 2007-2016. Specific objectives included: 1) examining personal (e.g., race/ethnicity) and contextual (e.g., residential segregation) characteristics of alcohol-DWI license suspensions by suspension duration; and 2) examining trends in annual suspension rates by race/ethnicity, sex, and duration. METHODS We linked NC administrative licensing and county-level survey data from several sources from 2007-2016. Suspensions were categorized by duration: 1 to <4 years and 4 years or longer (proxies for initial and repeat suspensions, respectively). We calculated counts, percentages, and suspensions rates (per 1,000 person-years) with 95% confidence intervals, examined trends in annual suspension rates by race/ethnicity, sex, and suspension duration. RESULTS We identified 220,471 initial and 41,526 repeat license suspensions. Rates among males were three times that of females. 21-24-year-old (rates: 6.9 per 1,000 person-years for initial; 1.5 for repeat) and Black (4.1 for initial; 1.0 for repeat) individuals had the highest suspension rates. We observed decreases in annual initial and repeat suspension rates among males, but only in repeat suspensions for females during the study period. A substantial decrease in annual initial suspension rates was observed among Hispanic individuals relative to other racial/ethnic groups, while annual repeat suspension rates exhibited large decreases for most racial/ethnic groups. The highest overall suspension rates occurred in counties with higher proportions of the population without health insurance and with the highest levels of Black/White residential segregation. CONCLUSIONS Potential disparities by race/ethnicity and sex existed by alcohol-DWI license suspension duration (i.e., initial vs. repeat suspensions) in NC. Contextual characteristics associated with suspensions, including a high degree of residential segregation, may provide indications of underlying structures and mechanisms driving potential disparities in alcohol-DWI outcomes.
Collapse
Affiliation(s)
- Bhavna Singichetti
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Yudan Chen Wang
- Department of Counseling, North Carolina A&T State University, Greensboro, North Carolina, United States of America
- Department of Maternal and Child Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Yvonne M Golightly
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Stephen W Marshall
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Rebecca B Naumann
- Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| |
Collapse
|
19
|
Fu L, Burns RD, Zhe S, Bai Y. What explains adolescents' physical activity and sports participation during the COVID-19 pandemic? - an interpretable machine learning approach. J Sports Sci 2024:1-13. [PMID: 39300762 DOI: 10.1080/02640414.2024.2404783] [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: 02/24/2024] [Accepted: 09/09/2024] [Indexed: 09/22/2024]
Abstract
Adolescents' physical activity (PA) and sports participation declined due to the COVID-19 pandemic. This study aimed to determine the critical socio-ecological factors for PA and sports participation using a machine learning approach. We did a cross-sectional secondary data analysis utilising the 2021 National Survey of Children's Health (NSCH) dataset (N=16,166; 49.0% female). We applied an interpretable machine learning approach (e.g. decision tree-based models) that examined the critical factors associated with PA and sports participation. The factors related to the intrapersonal, interpersonal, organisational, and community levels of the socio-ecological model. Out of the 25 factors examined, our findings unveiled the 11 critical factors associated with PA and the 10 critical factors associated with sports participation. Factors at the intrapersonal levels (e.g. age, screen time, and race) held greater importance to PA than those at the other three levels. While interpersonal factors (e.g. parent participation in children's events/activities, family's highest educational level, and family income level) were most important for sports participation. This study identified that the common critical factors of physical activity and sports participation during the COVID-19 pandemic mainly relied on intrapersonal and interpersonal levels. Unique factors were discussed.
Collapse
Affiliation(s)
- Lingyi Fu
- Department of Health & Kinesiology, University of Utah, Salt Lake City, USA
| | - Ryan D Burns
- Department of Health & Kinesiology, University of Utah, Salt Lake City, USA
| | - Shandian Zhe
- Kahlert School of Computing, University of Utah, Salt Lake City, USA
| | - Yang Bai
- Department of Health & Kinesiology, University of Utah, Salt Lake City, USA
| |
Collapse
|
20
|
Pittalis C, Sackey C, Okeny P, Nandi B, Gajewski J. Surgical informed consent practices and influencing factors in sub-Saharan Africa: a scoping review of the literature. BMJ Qual Saf 2024; 33:653-662. [PMID: 38160058 DOI: 10.1136/bmjqs-2023-016823] [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: 10/12/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Current international standards in consent to surgery practices are usually derived from health systems in Western countries, while little attention has been given to other contexts such as sub-Saharan Africa (SSA), despite this region facing the highest burdens of disease amenable to surgery globally. The aim of this study was to examine how the concept of informed consent for surgery is interpreted and applied in the context of SSA, and factors affecting current practices. METHODS A systematic search of Medline, Embase and African Journal OnLine databases as well as grey sources was executed in May 2023 to retrieve relevant literature published since 2010 in English language against a set of given criteria. The socioecological framework for health was used for organising and summarising the identified evidence. RESULTS A total of 27 papers were included in the review. Findings revealed that consent to surgery practices is generally substandard across SSA and the process is not adequate. Patients' understanding of informed consent is limited, likewise awareness of their rights to decision-making. A range of factors at the individual, interpersonal, institutional and system/societal levels affect the informed consent process. CONCLUSION There is a need to find more culturally acceptable and ethical ways to include the participation of patients in the decision-making process for surgical treatment in the SSA and define standards more closely aligned with the local context.
Collapse
Affiliation(s)
- Chiara Pittalis
- Institute of Global Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Cherie Sackey
- Institute of Global Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Paul Okeny
- Institute of Global Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Surgery, Makerere University College of Health Sciences, Kampala, Uganda
| | - Bip Nandi
- Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi
- Michael E Debakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Jakub Gajewski
- Institute of Global Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| |
Collapse
|
21
|
Men Q, Li W, Khan A, Gillies RM. Challenges and strategies for navigating Australian healthcare access: experience from Chinese international students. Int J Equity Health 2024; 23:189. [PMID: 39300503 DOI: 10.1186/s12939-024-02273-6] [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: 07/01/2024] [Accepted: 09/12/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Australia hosts over 680,000 international students, contributing $47.8 billion to the Australian economy in 2023, and Chinese students rank first among all nationalities. However, despite their considerable numbers, research focusing on their access to healthcare services is scant. This study aimed to explore barriers and supports regarding the utilisation of healthcare services among Chinese international students studying in Australia. METHODS Semi-structured interviews were conducted in Chinese between October and December 2023 with 25 Chinese international students (age range, 19-30; female/male, n = 18/7; undergraduate/postgraduate/doctoral, n = 1/18/6) enrolled in three Australian universities to understand the healthcare challenges they encountered and the coping strategies they recommended. These interviews were recorded, and thematic analysis was applied to the interview data. An adapted social-ecological model was used to identify barriers and pragmatic strategies to deal with the challenges at different levels. RESULTS Chinese international students in Australia faced healthcare barriers at different levels. Individual barriers included language and cultural disparities, lack of knowledge about the healthcare system, and reluctance to seek help. Institutional barriers involved high costs, difficulties regarding appointments, and procedures related to the referral system. Policy barriers included insurance coverage and reimbursement issues. The students interviewed for this study proposed individual-level strategies, such as trying various methods to reduce language barriers, seeking information online, and using online resources and consultations. A central appointment platform and multilingual medical service were recommended from students to medical institutions, while medical service guidance and psychological support were suggested to education institutions. Higher-level strategies were also reported, which were mainly pertaining to insurance terms and coverage for overseas students and improving the accessibility of medical information. CONCLUSIONS Our study identifies barriers to healthcare access for Chinese international students in Australia, including culture-specific challenges. To mitigate these issues, we recommend self-directed health promotion, targeted support by education institutions, enhanced cross-cultural communication and expanded telemedicine by hospitals, and attention to insurance coverage. Future research should explore optimising these approaches to improve support systems and policy frameworks.
Collapse
Affiliation(s)
- Qinglin Men
- Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, China
| | - Wen Li
- School of Education, Faculty of Humanities, Arts and Social Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.
| | - Robyn M Gillies
- School of Education, Faculty of Humanities, Arts and Social Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| |
Collapse
|
22
|
Ballard AM, Corozo Angulo B, Laramee N, Pace Gallagher J, Haardörfer R, Freeman MC, Trostle J, Eisenberg JNS, Lee GO, Levy K, Caruso BA. Multilevel factors drive child exposure to enteric pathogens in animal feces: A qualitative study in northwestern coastal Ecuador. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003604. [PMID: 39292655 PMCID: PMC11410186 DOI: 10.1371/journal.pgph.0003604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 08/26/2024] [Indexed: 09/20/2024]
Abstract
Exposure to animal feces and associated enteric pathogens poses significant risks to child health. However, public health strategies to mitigate enteric infections among children largely aim to reduce exposure to human feces, overlooking transmission pathways related to animal feces. In this study we examine if and how children are exposed to enteric pathogens in animal feces in northwestern coastal Ecuador. We conducted qualitative interviews with mothers of children aged 10-18 months that owned (n = 32) and did not own (n = 26) animals in urban and rural communities. Using thematic analysis, we identified community, household, and child behavioral factors that influence exposure. We also compared child exposure by household animal ownership. Our findings revealed myriad opportunities for young children to be exposed to enteric pathogens in many locations and from multiple animal sources, regardless of household animal ownership. Animal feces management practices (AFM) used by mothers, such as rinsing feces into ditches and throwing feces into surrounding areas, may increase environmental contamination outside their homes and in their communities. Unsafe AFM practices were similar to unsafe child feces management practices reported in other studies, including practices related to defecation location, feces removal and disposal, environmental contamination cleaning, and handwashing. Findings suggest that animal feces may contaminate the environment along similar pathways as human feces. Identification and incorporation of safe AFM practices, similar to those developed for child feces management, would 1) mitigate child exposure to enteric pathogens by reducing animal feces contamination in domestic and public spaces; and 2) enable an integrated approach to address enteric pathogen exposure pathways related to animal and child feces.
Collapse
Affiliation(s)
- April M Ballard
- Department of Population Health Sciences, Georgia State University School of Public Health, Atlanta, Georgia, United States of America
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America
| | | | - Nicholas Laramee
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America
| | - Jayden Pace Gallagher
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America
| | - Matthew C Freeman
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America
| | - James Trostle
- Department of Anthropology, Trinity College, Hartford, Connecticut, United States of America
| | - Joseph N S Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Gwenyth O Lee
- Rutgers Global Health Institute and Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, United States of America
| | - Karen Levy
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, United States of America
| | - Bethany A Caruso
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America
| |
Collapse
|
23
|
Xie Y, Gao S, Wang Q, Cai M, Feng S, Huang Z, Huang Y, Hong Y, Tan X, Li J, Yuan L, Liu F, Jiang H. Multilevel factors associated with HIV-related stigma among women living with HIV in Guangdong Province, China: a social-ecological model-informed study. Arch Public Health 2024; 82:160. [PMID: 39294812 PMCID: PMC11409580 DOI: 10.1186/s13690-024-01382-6] [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: 01/24/2024] [Accepted: 08/27/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND HIV-related stigma continues to hinder optimal HIV care, and its determinants should be understood at multiple levels. Based on the social-ecological model, this study aimed to explore factors associated with HIV-related stigma among women living with HIV in Guangdong Province, China. METHODS A cross-sectional study was conducted from July to August 2022 to recruit newly reported women living with HIV with a history of pregnancy or current pregnancy in 2021 in 21 cities in Guangdong Province. HIV-related stigma was assessed using an abbreviated Chinese version of Berger's HIV Stigma Scale. Univariate and multivariable hierarchical regression analyses based on the social-ecological model were conducted to explore factors associated with HIV-related stigma and its four dimensions (personalized stigma, disclosure concerns, negative self-image and concerns about public attitudes) at the community/hospital, interpersonal, and individual levels. RESULTS A moderate level of HIV-related stigma was found among the 360 participants included, with a mean score of 45.26. Multivariable hierarchical regression analysis showed that at the community/hospital-level, individuals were more likely to experience high levels of HIV-related stigma if they had experienced the discriminatory behaviors from health care workers (aOR = 2.34, 95%CI: 1.48-3.70) and if they rated serostatus disclosure services as less helpful (aOR = 0.69, 95%CI: 0.48-0.98). At the interpersonal-level, individuals with an HIV-positive partner (aOR = 1.71, 95%CI: 1.01-2.90) were more likely to experience high levels of HIV-related stigma than those with an HIV-negative or unknown partner. Individuals with high resilience (aOR = 0.22, 95%CI: 0.13-0.35) had lower levels of HIV-related stigma at the individual-level. In addition, ever experiencing discriminatory behaviors from health care workers, thinking serostatus disclosure services helpful, having ever seen publicity about personal interest protection services and complaint channels for people living with HIV(PLHIV), knowing about care and support services for PLHIV from social organizations at the community/hospital-level, partner notification and support at the interpersonal-level, and violations of personal interests, resilience at the individual-level were also associated with different dimensions of HIV-related stigma. CONCLUSIONS HIV-related stigma was moderate among women living with HIV. The social-ecological model can facilitate a better understanding of factors associated with HIV-related stigma. Multilevel intervention strategies need to be tailored to reduce HIV-related stigma.
Collapse
Affiliation(s)
- Yufan Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Shuang Gao
- Guangdong Women and Children Hospital, Guangzhou, 511400, China
| | - Qian Wang
- Department of Women Healthcare, Center for Women and Children Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Min Cai
- Guangdong Women and Children Hospital, Guangzhou, 511400, China
| | - Shuaixin Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Zhaoqian Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Ying Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Yeting Hong
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Xiaoxia Tan
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Jinbin Li
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China
| | - Li Yuan
- Guangdong Women and Children Hospital, Guangzhou, 511400, China
| | - Fenghua Liu
- Guangdong Women and Children Hospital, Guangzhou, 511400, China.
| | - Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Haizhu District, No. 283 Jianghai Road, Guangzhou, 510310, China.
| |
Collapse
|
24
|
Hamilton K, Dunn K, Keech JJ, Peden AE. A qualitative analysis of parents' beliefs about portable pool safety behaviours. J Health Psychol 2024:13591053241275588. [PMID: 39292001 DOI: 10.1177/13591053241275588] [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: 09/19/2024] Open
Abstract
The aim of this study was to develop an in-depth understanding of the beliefs parents hold regarding portable pool safety behaviours using the theory of planned behaviour (TPB). Semi-structured interviews were conducted with parents (N = 15) of children aged 5 years and younger who owned a portable pool. Interviews examined three key safety behaviours: supervising within arms' reach, fencing portable pools deeper than 30 cm, and emptying and storing portable pools safely after use. Parents identified a range of advantages, disadvantages, normative influences, and facilitators and barriers towards the three behaviours. The identification of these salient behavioural, normative, and control beliefs enrich limited understandings of portable pool safety behaviours of parents with young children. Current findings fill a knowledge gap in portable pool safety and provide potential targets for messages to improve parents' behaviours for their young children around portable pools in the hope of preventing loss of life.
Collapse
Affiliation(s)
- Kyra Hamilton
- Griffith University, Australia
- University of Jyväskylä, Finland
- University of California, Merced, USA
| | | | | | - Amy E Peden
- University of New South Wales, Australia
- James Cook University, Australia
| |
Collapse
|
25
|
Li SA, Stevens C, Zhang Ke Jiang C. Impact of the COVID-19 pandemic on Canadian performing and creative artists: An interpretive descriptive study using the social-ecological model. PLoS One 2024; 19:e0310369. [PMID: 39288119 PMCID: PMC11407613 DOI: 10.1371/journal.pone.0310369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/29/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Public health restrictions during the Coronavirus-2019 (COVID-19) pandemic in Canada have substantially reduced the work and income of performing and creative artists. We aimed to understand how factors at the public policy, community, organizational, interpersonal and individual levels affected Canadian performing and creative artists' health and livelihood during the pandemic. METHODS We interviewed 14 creative and performing artists from an academic hospital-based healthcare center in Toronto, Canada. In addition, we conducted secondary data analysis on an existing set of 17 transcribed interviews from a quality improvement study that included relevant information to answer the present study's research question. We applied an interpretive descriptive approach to our qualitative inquiry and used the social-ecological model (SEM) as our analytic framework. RESULTS We identified factors at all levels of the SEM that tended to synergistically affect the health and livelihood of artists during the COVID-19 pandemic. Public health restrictions and government financial assistance programs have downstream effects on other levels. During the pandemic, many artists sensed an overwhelming loss of community, financial instability, and limited access to healthcare; which in turn affected their health. For those who accessed financial assistance programs, the stability of income afforded time for rest without the stress of food insecurity or housing instability. CONCLUSIONS Use of the SEM as an analytic framework reflects the multidirectional intricacy and dynamic interplay among factors operating within and across all five levels, bringing to light potential areas of improvement at various levels to strengthen resilience and reduce risk factors associated with artists' health and healthcare access. Findings also accentuated the fragility of precarious work that inundates the performing arts industry, which emphasizes the need for interventions and policies to address this issue. Such interventions might include financial support programs for artists, access to affordable healthcare services, and efforts to strengthen social support networks within the arts community.
Collapse
Affiliation(s)
- Shelly-Anne Li
- Department of Family & Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- The Al & Malka Green Artists' Health Centre, University Health Network, Toronto, Ontario, Canada
| | - Clive Stevens
- The Al & Malka Green Artists' Health Centre, University Health Network, Toronto, Ontario, Canada
| | - Coco Zhang Ke Jiang
- The Al & Malka Green Artists' Health Centre, University Health Network, Toronto, Ontario, Canada
| |
Collapse
|
26
|
Yang Y, Li Z, Wen J. Long term impact of Wenchuan earthquake on population mental and behavioral disorders in heavily-stricken areas: An ecological study based on big data. J Affect Disord 2024; 361:589-595. [PMID: 38908558 DOI: 10.1016/j.jad.2024.06.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/20/2024] [Accepted: 06/19/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND This study aimed to explore and evaluate the development trends and differential changes in the prevalence of mental and behavioral disorders among the earthquake survivors in exposure groups (highly hard-hit areas) and control groups (general disaster areas) from 2015 to 2019, as well as to investigate the potential influencing factors. METHODS Data was obtained from the Sichuan Health Information System and the Sichuan Health Yearbook, the prevalence of the exposure group and the control group were calculated, the difference between the two groups was evaluated using the prevalence rate ratio, and a fixed effect model was developed to investigate the potential influencing factors of the prevalence. RESULTS The prevalence by gender and age in the exposure group was always greater than those in the control group (RR>1), although the disparity between the two proceeded to diminish with time. The urbanization rate (β = 0.0448, P < 0.05) and disaster area levels (β = 0.0104, P < 0.05) were risk factors for the prevalence of mental and behavioral disorders. LIMITATIONS The study only collected data at the group level following the Wenchuan earthquake. Consequently, the findings are only applicable at the group level. Furthermore, diagnostic criteria for various types of mental and behavioral disorders diseases were not provided. CONCLUSIONS The earthquake has a significant long-term impact on mental health. It is necessary to continuously monitor the mental health of Wenchuan earthquake survivors and take appropriate post-disaster intervention measures.
Collapse
Affiliation(s)
- Yanlin Yang
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu 610041, PR China
| | - Zhuyue Li
- Medical Equipment Innovation Research Center, West China School of Medicine, Med+X Center for Manufacturing, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Jin Wen
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu 610041, PR China.
| |
Collapse
|
27
|
Owokuhaisa J, Turyakira E, Ssedyabane F, Tusubira D, Kajabwangu R, Musinguzi P, Galiwango M, Randall TC, Kakongi N, Castro CM, Atukunda EC, Maling S. Barriers and facilitators of retention in care after cervical cancer screening: patients' and healthcare providers' perspectives. BMC Womens Health 2024; 24:516. [PMID: 39272088 PMCID: PMC11401415 DOI: 10.1186/s12905-024-03343-1] [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: 11/08/2023] [Accepted: 08/28/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Cervical cancer continues to threaten women's health, especially in low-resource settings. Regular follow-up after screening and treatment is an effective strategy for monitoring treatment outcomes. Consequently, understanding the factors contributing to patient non-attendance of scheduled follow-up visits is vital to providing high-quality care, reducing morbidity and mortality, and unnecessary healthcare costs in low-resource settings. METHODS A descriptive qualitative study was done among healthcare providers and patients who attended the cervical cancer screening clinic at Mbarara Regional Referral Hospital in southwestern Uganda. In-depth interviews were conducted using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and thematically analysed in line with the social-ecological model to identify barriers and facilitators. RESULTS We conducted 23 in-depth interviews with 5 healthcare providers and 18 patients. Health system barriers included long waiting time at the facility, long turnaround time for laboratory results, congestion and lack of privacy affecting counselling, and healthcare provider training gaps. The most important interpersonal barrier among married women was lacking support from male partners. Individual-level barriers were lack of money for transport, fear of painful procedures, emotional distress, and illiteracy. Inadequate and inaccurate information was a cross-cutting barrier across the individual, interpersonal, and community levels of the socio-ecological model. The facilitators were social support, positive self-perception, and patient counselling. CONCLUSIONS Our study revealed barriers to retention in care after cervical cancer screening, including lack of partner support, financial and educational constraints, and inadequate information. It also found facilitators that included social support, positive self-perception, and effective counselling.
Collapse
Affiliation(s)
- Judith Owokuhaisa
- Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Eleanor Turyakira
- Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Frank Ssedyabane
- Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Deusdedit Tusubira
- Department of Biochemistry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Rogers Kajabwangu
- Department of Obstetrics & Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Pius Musinguzi
- Department of Nursing, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Martin Galiwango
- Department of Electrical and Electronics Engineering, Faculty of Applied Sciences and Technology, Mbarara University of Science of Science and Technology, Mbarara, Uganda
| | - Thomas C Randall
- Department of Global Health and Social Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nathan Kakongi
- Department of Biochemistry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Cesar M Castro
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Esther C Atukunda
- Faculty of Medicine, Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Samuel Maling
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| |
Collapse
|
28
|
Williams TL, Nilsson Wikmar L, Phillips J, Joseph C. Healthcare providers perspective of chronic pain management in persons with traumatic spinal cord injury accessing the public system in a region of South Africa. Disabil Rehabil 2024:1-9. [PMID: 39263816 DOI: 10.1080/09638288.2024.2399228] [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: 03/28/2024] [Revised: 08/27/2024] [Accepted: 08/28/2024] [Indexed: 09/13/2024]
Abstract
PURPOSE Persons with traumatic spinal cord injury (PWTSCI) have expressed a lack of education from healthcare providers and poor shared-decision making between providers and clients. The aim was to explore the healthcare providers' perspective on factors influencing the optimal management of chronic pain. METHODS Healthcare providers were recruited from two institutions at tertiary healthcare level. Interviews explored current chronic pain management practices, influencing factors and recommendations for improvement. Data saturation occurred after interviewing 11 participants. Thematic analysis was used through a socio-ecological model. RESULTS The challenges to optimal pain management include appropriate assessment and management of psychological health (intrapersonal level), substance abuse amongst patients (intrapersonal level), access to medication for providers and lack of knowledge by providers (interpersonal and organizational level). To improve chronic pain management, an interdisciplinary team approach should be operationalized at policy and organizational level, monitoring and adjustment of interventions should take place (interpersonal), and family members/caregivers should be involved in the planning and monitoring (interpersonal). CONCLUSION Factors, at the interpersonal, intrapersonal, organizational and policy levels, influence optimal chronic pain management in the traumatic spinal cord injury (TSCI) population. To mitigate challenges, guidelines for chronic pain management should be developed, particularly for low-resourced developing countries.
Collapse
Affiliation(s)
- Tammy-Lee Williams
- Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Lena Nilsson Wikmar
- Department of Neurobiology, Faculty of Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Joliana Phillips
- Department of Research Development and Postgraduate Support, Faculty of Research and Innovation, University of The Western Cape, Cape Town, South Africa
| | - Conran Joseph
- Division of Physiotherapy, Faculty of Health and Rehabilitation services, Stellenbosch University, Stellenbosch, South Africa
| |
Collapse
|
29
|
Warren SE, Lopez LC, Anthony T, Coco L. Communication Public Health: An Integration of Audiology, Speech-Language Pathology, and Public Health. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:3022-3039. [PMID: 39083459 DOI: 10.1044/2024_jslhr-23-00491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
PURPOSE Health care is advancing toward a collaborative and integrative approach that promotes general health and wellness while addressing health inequities through the consideration of broader social and economic factors that influence the well-being of the entire population. Recently, there has been growing evidence of public health concept applications in fields related to speech, language, and hearing. However, there is an outstanding need to explicitly define the intersection of public health, including prevention and health promotion, and the discipline of communication sciences and disorders (CSD) across the areas of education, clinical practice, research, and policy. The authors propose a definition for this intersection using the new term communication public health. METHOD This tutorial provides guidance on how to conceptualize communication public health and invites refinement and expansion of the intersection between public health and CSD. Because readers are experts in CSD, this tutorial aims to supplement existing knowledge with information on public health to achieve three main objectives: (a) increase knowledge of the application of public health concepts among speech, language, hearing, and related professionals (SLHP+); (b) introduce the concept of communication public health; and (c) discuss the relevance of communication public health across domains within CSD. The authors utilize the socioecological model to provide examples of applications. RESULTS The concept of communication public health is proposed as the collaborative area of CSD and public health, which encompasses prevention and promotion of equity in communication health through individual-, community-, and population-level efforts. The goals of communication public health are achieved through applications of public health principles in CSD education, clinical practice, research, and policy. CONCLUSION Communication public health defines an area of collaboration between public health and CSD in which SLHP+ can apply public health concepts to both advance communication health and address health disparities.
Collapse
Affiliation(s)
- Sarah E Warren
- School of Communication Sciences and Disorders, The University of Memphis, TN
| | - Leslie C Lopez
- Department of Communication Disorders, School of Allied Health Professions, Louisiana State University Health Sciences Center, New Orleans
| | - Teresa Anthony
- College of Public Health, University of South Florida, Tampa
| | - Laura Coco
- School of Speech, Language, and Hearing Sciences, College of Health and Human Services, San Diego State University, CA
| |
Collapse
|
30
|
Haverfield MC, Ma J, Walling A, Bekelman DB, Brown-Johnson C, Lo N, Lorenz KA, Giannitrapani KF. Communication processes in an advance care planning initiative: A socio-ecological perspective for service evaluation. Palliat Med 2024:2692163241277394. [PMID: 39254148 DOI: 10.1177/02692163241277394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
BACKGROUND Advance care planning initiatives are becoming more widespread, increasing expectations for providers to engage in goals of care conversations. However, less is known about how providers communicate advance care planning within and throughout a health care system. AIM To explore perspectives of communication processes in the rollout of an advance care planning initiative. DESIGN Theoretically informed secondary analysis of 31 semi-structured interviews. SETTING/PARTICIPANTS Key partners in a Veterans Health Administration goals of care initiative. RESULTS Using the constant comparative approach followed by qualitative mapping of themes to the layers of the Socio-Ecological Model, four themes and corresponding Socio-Ecological layers were identified: Goals of Care Communication Training (Policy, Community, and Institutional) requires more resources across sites and better messaging to reduce provider misconceptions and promote an institutional culture invested in advance care planning; Interprofessional Communication (Interpersonal) suggests care team coordination is needed to facilitate continuity in goals of care messaging; Communication in Documentation (Institutional, Interpersonal, and Intrapersonal) highlights the need for capturing the context for goals of care preferences; and Patient/Family Communication (Interpersonal and Intrapersonal) encourages offering materials and informational resources early to facilitate rapport building and readiness to determine goals of care. CONCLUSIONS Findings support the need for initiatives to incorporate an evaluation of how goals of care are discussed beyond the interpersonal exchange between patient and provider and signal opportunities for applying the Socio-Ecological Model to better understand goals of care communication processes, including opportunities to improve initiation and documentation of goals of care.
Collapse
Affiliation(s)
- Marie C Haverfield
- VA Palo Alto, Center for Innovation to Implementation (Ci2i), Menlo Park, CA, USA
- Department of Communication Studies, San José State University, San Jose, CA, USA
| | - Jessica Ma
- Geriatrics Research, Education, and Clinical Center, Durham VA Health System, Durham, NC, USA
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC, USA
| | - Anne Walling
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- VA Center for the Study of Healthcare Innovation, Implementation, & Policy (CSHIIP), Los Angeles, CA, USA
| | - David B Bekelman
- Department of Medicine, Department of Veterans Affairs, Eastern Colorado Health Care System, Aurora, CO, USA
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Cati Brown-Johnson
- VA Palo Alto, Center for Innovation to Implementation (Ci2i), Menlo Park, CA, USA
- School of Medicine, Stanford University, Stanford, CA, USA
| | - Natalie Lo
- VA Palo Alto, Center for Innovation to Implementation (Ci2i), Menlo Park, CA, USA
| | - Karl A Lorenz
- VA Palo Alto, Center for Innovation to Implementation (Ci2i), Menlo Park, CA, USA
- School of Medicine, Stanford University, Stanford, CA, USA
| | - Karleen F Giannitrapani
- VA Palo Alto, Center for Innovation to Implementation (Ci2i), Menlo Park, CA, USA
- School of Medicine, Stanford University, Stanford, CA, USA
| |
Collapse
|
31
|
Pang J, Xu Y, Liu Q, Huang J, Li P, Ma L, Zeng C, Ma X, Xie H. Trajectories of cognitive function development and predictive factors in disabled middle-aged and older adults. Front Public Health 2024; 12:1436722. [PMID: 39314790 PMCID: PMC11416970 DOI: 10.3389/fpubh.2024.1436722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/30/2024] [Indexed: 09/25/2024] Open
Abstract
Objective To explore the trajectories of cognitive function development and predictive factors in disabled middle-aged and older adults. Methods Utilizing data from 983 disabled middle-aged and older adults in the China Health and Retirement Longitudinal Study (CHARLS) from 2013 to 2020, latent growth mixture models were constructed to analyze the categories of cognitive function development trajectories and their predictive factors. Results The cognitive function trajectories of the disabled middle-aged and older adults were classified into three categories: rapid decline (32.6%), Slow decline (36.1%), and Stable (31.2%). Multinomial logistic regression analysis identified age, gender, residence, education, marital status, household income, sleep duration, depression, hearing ability, and social participation as predictors of these trajectories. Conclusion There is heterogeneity in the cognitive function development trajectories among disabled middle-aged and older adults. Healthcare professionals can implement targeted health management based on the characteristics of different groups to prevent the deterioration of cognitive function in this population.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Hui Xie
- College of Nursing, Bengbu Medical University, Bengbu, Anhui, China
| |
Collapse
|
32
|
Arita K, Ishibashi Y, Tajima T, Ikechi Y, Ishibashi H. Validity and reliability of the Checklist for Habitual Physical Activity for people 75 years and older in Japan. Psychogeriatrics 2024. [PMID: 39252381 DOI: 10.1111/psyg.13189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 08/05/2024] [Accepted: 08/18/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND Despite health benefits, many older adults struggle to meet physical activity guidelines, leading to stagnant activity levels. While integrating physical activity into daily routines has been proposed as a promising strategy for older adults, fit-for-purpose measurement tools to assess such routines are lacking. The Checklist for Habitual Physical Activity (CHaPA) was developed based on the positive deviance approach and socio-ecological model to assess daily behaviours encouraging physical activity among adults aged 75 and older. It has been confirmed for its content and face validity. However, to ensure its broader applicability and usefulness, assessing its construct validity and reliability is necessary. Therefore, this study aims to assess the construct validity and reliability of the CHaPA and accordingly update the tool. METHODS To validate the construct validity of the CHaPA 22-item version, we conducted item analysis and exploratory and confirmatory factor analyses. We removed inappropriate items based on predefined criteria. Then, we assessed the reliability, internal consistency, test-retest reliability, and measurement errors of the CHaPA final version. RESULTS Item analyses and factor analyses resulted in the deletion of 11 items. The results of confirmatory factor analysis validated the CHaPA 11-item version with the three-factor structure based on model fit index with χ2/degree of freedom = 1.25, comparative fit index = 0.965, Tucker-Lewis index = 0.952, and root-mean-square error of approximation = 0.038. Omega coefficient (0.90) showed excellent internal consistency. Intraclass correlation coefficient (ICC) demonstrated good test-retest reliability (ICC (1, 2) = 0.77, 95% CI = 0.34-0.89, standard error of measurement = 1.75). CONCLUSIONS We finalised the CHaPA 11-item version as a valid and reliable instrument for assessing daily behaviours conducive to physical activity among individuals aged 75 years and older. We need to examine the methods and effectiveness of disseminating this checklist to ensure its utilisation as a resource for promoting healthy ageing and aiding older adults in maintaining active lifestyles.
Collapse
Affiliation(s)
- Kuniko Arita
- Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Hachioji, Japan
| | - Yu Ishibashi
- Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Hachioji, Japan
| | - Takayuki Tajima
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | | | - Hitomi Ishibashi
- Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Hachioji, Japan
| |
Collapse
|
33
|
Shin HD, Kemp J, Groves S, Bennett-Poynter L, Pape C, Lascelles K, Strudwick G. Help-Seeking Needs Related to Suicide Prevention for Individuals in Contact With Mental Health Services: A Rapid Scoping Review. J Psychiatr Ment Health Nurs 2024. [PMID: 39244728 DOI: 10.1111/jpm.13102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/17/2024] [Accepted: 08/22/2024] [Indexed: 09/10/2024]
Abstract
INTRODUCTION Prior mental healthcare utilisation presents an important window of opportunity for providing suicide prevention interventions. To date, no reviews have consolidated the help-seeking needs of individuals in contact with mental health services. This warrants further attention given this group may have different needs for interventions compared with the general population who have not sought help previously. AIM The purpose of this rapid scoping review was to summarise the available literature on help-seeking needs related to suicide prevention among individuals in contact with mental health services from healthcare settings. METHOD Cochrane rapid review and Joanna Briggs Institute scoping review methodologies were adapted, and databases, including MEDLINE, Scopus, CINAHL, PsycInfo and EMBASE, were searched. RESULTS A total of 42 primary studies were included in analysis. Reported barriers and facilitators to help-seeking behaviours identified within studies were mapped onto the socio-ecological model. Barriers and facilitators identified included knowledge and attitudes towards healthcare utilisation, family and peer support, interactions with healthcare professionals, provision of holistic care, and the creation of a supportive atmosphere and safe space to promote open discussions of suicide-related concerns. DISCUSSION The findings of this review offer valuable insights into areas for improvement in addressing help-seeking needs for individuals who are in contact with health services related to suicide prevention. IMPLICATION FOR RESEARCH The findings serve as a foundation for shaping mental health initiatives informing approaches and care delivery tailored towards individuals who are in contact with health services. The reported barriers and facilitators offer insights to inform the development of mental health support tools to enhance care and considerations for evaluations.
Collapse
Affiliation(s)
- Hwayeon Danielle Shin
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Jessica Kemp
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Charlotte Pape
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Gillian Strudwick
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
34
|
Rosin M, Ni Mhurchu C, Mackay S. Implementing healthy food policies in health sector settings: New Zealand stakeholder perspectives. BMC Nutr 2024; 10:119. [PMID: 39244614 PMCID: PMC11380432 DOI: 10.1186/s40795-024-00924-z] [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: 04/21/2024] [Accepted: 08/23/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND In 2016, a voluntary National Healthy Food and Drink Policy was released to improve the healthiness of food and drinks for sale in New Zealand health sector organisations. The Policy aims to role model healthy eating and demonstrate commitment to health and well-being of hospital staff and visitors and the general public. This study aimed to understand the experiences of hospital food providers and public health dietitians/staff in implementing the Policy, and identify tools and resources needed to assist with the implementation. METHODS A maximum variation purposive sampling strategy (based on a health district's population size and food outlet type) was used to recruit participants by email. Video conference or email semi-structured interviews included 15 open-ended questions that focused on awareness, understanding of, and attitudes towards the Policy; level of support received; perceived customer response; tools and resources needed to support implementation; and unintended or unforeseen consequences. Data was analysed using a reflexive thematic analysis approach. RESULTS Twelve participants (eight food providers and four public health dietitians/staff) were interviewed; three from small (< 100,000 people), four from medium (100,000-300,000 people) and five from large (> 300,000 people) health districts. There was agreement that hospitals should role model healthy eating for the wider community. Three themes were identified relating to the implementation of the Policy: (1) Complexities of operating food outlets under a healthy food and drink policy in public health sector settings; (2) Adoption, implementation, and monitoring of the Policy as a series of incoherent ad-hoc actions; and (3) Policy is (currently) not achieving the desired impact. Concerns about increased food waste, loss of profits and an uneven playing field between food providers were related to the voluntary nature of the unsupported Policy. Three tools could enable implementation: a digital monitoring tool, a web-based database of compliant products, and customer communication materials. CONCLUSIONS Adopting a single, mandatory Policy, provision of funding for implementation actions and supportive tools, and good communication with customers could facilitate implementation. Despite the relatively small sample size and views from only two stakeholder groups, strategies identified are relevant to policy makers, healthcare providers and public health professionals.
Collapse
Affiliation(s)
- Magda Rosin
- Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand.
- Centre for Translational Health Research: Informing Policy and Practice (TRANSFORM), Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Cliona Ni Mhurchu
- Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand
- Centre for Translational Health Research: Informing Policy and Practice (TRANSFORM), Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sally Mackay
- Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand
| |
Collapse
|
35
|
Chirinos DA, Vargas EA, Kershaw KN, Wong M, Everson-Rose SA. Psychosocial profiles and blood pressure control: results from the multi-ethnic study of atherosclerosis (MESA). J Behav Med 2024:10.1007/s10865-024-00513-2. [PMID: 39242445 DOI: 10.1007/s10865-024-00513-2] [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: 01/11/2024] [Accepted: 07/30/2024] [Indexed: 09/09/2024]
Abstract
Growing research shows psychosocial factors are associated with blood pressure (BP) control among individuals with hypertension. To date, little research has examined multiple psychosocial factors simultaneously to identify distinguishing profiles among individuals with hypertension. The association of psychosocial profiles and BP control remains unknown. To characterize the psychosocial profiles of individuals with hypertension and assess whether they are associated with BP control over 14 years. We included 2,665 MESA participants with prevalent hypertension in 2002-2004. Nine psychosocial variables representing individual, interpersonal, and neighborhood factors were included. BP control was achieved if systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) < 9090 mmHg. Latent profile analysis (LPA) revealed an optimal model of three psychosocial profile groups (AIC 121,229; entropy = .88) "Healthy", "Psychosocially Distressed" and "Discriminated Against". Overall, there were no significant differences in systolic and diastolic BP control combined, across the profiles. Participants in the "Discriminated Against" profile group were significantly less likely [OR= 0.60; 95% CI: 0.43, 0.84] to have their DBP < 9090 mmHg as compared to the "Healthy" profile, but this was attenuated with full covariate adjustment. Discrete psychosocial profiles exist among individuals with hypertension but were not associated with BP control after full covariate adjustment.
Collapse
Affiliation(s)
- Diana A Chirinos
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lakeshore Drive, Suite 1400, Chicago, IL, 60611, USA.
| | - Emily A Vargas
- The National Academies of Sciences, Engineering and Medicine, Washington, DC, USA
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lakeshore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Mandy Wong
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lakeshore Drive, Suite 1400, Chicago, IL, 60611, USA
| | | |
Collapse
|
36
|
Boucham M, Salhi A, El Hajji N, Gbenonsi GY, Belyamani L, Khalis M. Factors associated with frailty in older people: an umbrella review. BMC Geriatr 2024; 24:737. [PMID: 39237866 PMCID: PMC11376099 DOI: 10.1186/s12877-024-05288-4] [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: 01/10/2024] [Accepted: 08/07/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND The number of frail older people is increasing worldwide, and all countries will be confronted with their growing needs for healthcare and social support. The aim of this umbrella review was to summarize the evidence on the factors associated with frailty in older people, using a socioecological approach. METHODS PubMed (MEDLINE), Scopus, Web of Science, ScienceDirect, Hinari (research4life), and the Trip database were systematically searched up to April 2023. Systematic reviews of observational studies that explored factors associated with frailty in older adults aged 60 years and over were considered for inclusion. No language, geographical or setting restrictions were applied. However, we excluded systematic reviews that investigated frailty factors in the context of specific diseases. The Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses and the ROBIS tool were used to assess the quality and risk of bias in the included studies. RESULTS Forty-four systematic reviews were included, covering 1,150 primary studies with approximately 2,687,911 participants overall. Several risk factors, protective factors and biomarkers were found to be associated with frailty, especially in community-dwelling older people, including 67 significant associations from meta-analyses. The certainty of the evidence was rated as moderate or reached moderate levels for seven factors relevant to older people. These factors include depression (OR 4.66, 95% CI 4.07 to 5.34), loneliness (OR 3.51, 95% CI 2.70 to 4.56), limitations in activities of daily living (OR 2.59, 95% CI 1.71 to 3.48), risk of malnutrition (OR 3.52, 95% CI 2.96 to 4.17), Dietary Inflammatory Index score (OR 1.24, 95% CI 1.16 to 1.33), maximal walking speed (Standardized Mean Difference (SMD) -0.97, 95% CI -1.25 to -0.68), and self-reported masticatory dysfunction (OR 1.83, 95% CI 1.55 to 2.18). Additionally, only greater adherence to a Mediterranean diet showed a high level of evidence (OR 0.44, 95% CI 0.31 to 0.64). CONCLUSIONS This umbrella review will provide guidance for prevention strategies and clinical practice by promoting healthy lifestyles and addressing all modifiable risk factors associated with frailty. Future systematic reviews should consider heterogeneity and publication bias, as these were the main reasons for downgrading the level of evidence in our review. REGISTRATION PROSPERO 2022, CRD42022328902.
Collapse
Affiliation(s)
- Mouna Boucham
- Department of Public Health, Mohammed VI Center for Research and Innovation, Rabat, Morocco.
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco.
| | - Amal Salhi
- National School of Public Health, Rabat, Morocco
| | - Naoual El Hajji
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
| | - Gloria Yawavi Gbenonsi
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
| | - Lahcen Belyamani
- Mohammed VI Center for Research and Innovation, Mohammed VI University of Sciences and Health, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Mohamed Khalis
- Department of Public Health, Mohammed VI Center for Research and Innovation, Rabat, Morocco
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
- Higher Institute of Nursing Professions and Technical Health, Rabat, Morocco
- Laboratory of Biostatistics, Clinical, and Epidemiological Research, & Laboratory of Community Health (Public Health, Preventive Medicine and Hygiene), Department of Public Health, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| |
Collapse
|
37
|
Nagle A, Lerma K, Sierra G, White K. Barriers to Preferred Contraception Use in Mississippi. J Womens Health (Larchmt) 2024. [PMID: 39229716 DOI: 10.1089/jwh.2024.0127] [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: 09/05/2024] Open
Abstract
Introduction: Many Americans are not using the contraceptive method they prefer, but there has been limited study of how this may be related to health system barriers. We evaluated how such barriers to contraceptive care are related to unmet contraceptive preference in Mississippi and which contraceptive methods are preferred by those who report an unmet preference. Materials and Methods: Between September 2020 and February 2021, we used social media advertisements to recruit Mississippi residents 18-45 years of age, who were assigned female at birth, for an online survey. We asked respondents if they wanted to use a different contraceptive method or start using one, and if so, which method they preferred. We assessed barriers in the reproductive healthcare services environment (e.g., long wait for appointments, unaffordability or lack of insurance acceptance). We used multivariable-adjusted Poisson regression models to test the relationship between experiencing one or more barriers to reproductive healthcare and having an unmet contraceptive preference. Results: Among 462 eligible respondents, 37% had an unmet contraceptive preference. Most respondents (83%) reported one or more barriers to accessing office-based reproductive healthcare. Respondents who experienced a barrier had almost twice the prevalence of unmet preference as people who experienced no barrier (prevalence ratio 1.81, 95% confidence interval: 1.14-2.86). Among respondents with unmet preference, short-acting hormonal, long-acting reversible, and permanent methods were most desired. Conclusion: We find that nearly two-fifths of reproductive-aged Mississippians with capacity for pregnancy are not using their preferred contraceptive method. Structural barriers to care are very common and are significantly associated with experiencing unmet contraceptive preference, undermining reproductive autonomy.
Collapse
Affiliation(s)
- Amanda Nagle
- Population Research Center, The University of Texas at Austin, Austin, Texas, USA
- Department of Sociology, The University of Texas at Austin, Austin, Texas, USA
| | - Klaira Lerma
- Population Research Center, The University of Texas at Austin, Austin, Texas, USA
- Department of Obstetrics and Gynecology, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Gracia Sierra
- Population Research Center, The University of Texas at Austin, Austin, Texas, USA
| | - Kari White
- Department of Sociology, The University of Texas at Austin, Austin, Texas, USA
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, USA
- Resound Research for Reproductive Health, Austin, Texas, USA
| |
Collapse
|
38
|
Zwolski C, Rethorn T, Thomas S, Goodway J, Paterno M, Quatman-Yates C, Schmitt L. A Qualitative Study of Factors Perceived to Influence Physical Activity among Young Athletes after ACL Reconstruction. Int J Sports Phys Ther 2024; 19:1052-1067. [PMID: 39267628 PMCID: PMC11392025 DOI: 10.26603/001c.122324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 07/19/2024] [Indexed: 09/15/2024] Open
Abstract
Background Despite evidence of alarming declines in physical activity levels after anterior cruciate ligament reconstruction (ACLR), very little is known about how young athletes perceive their experiences with engagement in sports and physical activity in the years following ACLR. Hypothesis/Purpose The purpose of this study was to answer the research question, "what are the lived experiences and perceptions of factors that facilitate or hinder physical activity among young athletes following ACLR?". Study Design Qualitative Study. Methods Ten participants were included in this qualitative study at a median of 5.9 (4.3-10.2) years after adolescent ACLR. Using an interpretive phenomenological methodology, semi-structured interviews were conducted with each participant. Data collection focused on participants' lived experiences related to physical activity participation in the years after ACLR. Iterative coding with two independent coders and a peer debriefing process were used to identify themes from the data. Results Factors perceived to influence physical activity after ACLR spanned all levels of the socioecological framework. Three overarching themes were generated during thematic analysis: 1) navigation of barriers (common obstacles, injury-related limitations, unique adaptations), 2) movement motives (ingrained desire to move, external motivators, internal motivation), and 3) movement mindset (envisions for future physical activity, perceived impact of injury, belief in the power of sports). Conclusion The themes identified in this study indicate that the adolescent ACLR experience has the potential to significantly influence one's physical activity into young adulthood, both positively and negatively. These findings serve as an important foundation for future studies to explore the psychological and environmental factors identified as important to one's physical activity participation in the years following adolescent ACLR. Level of Evidence Level 3.
Collapse
Affiliation(s)
- Christin Zwolski
- Department of Pediatrics Cincinnati Children's Hospital Medical Center
- Division of Sports Medicine Cincinnati Children's Hospital Medical Center
- Division of Occupational Therapy and Physical Therapy Cincinnati Children's Hospital Medical Center
| | - Timothy Rethorn
- Jameson Crane Sports Medicine Institute The Ohio State University Wexner Medical Center
| | - Staci Thomas
- Division of Sports Medicine Cincinnati Children's Hospital Medical Center
| | | | - Mark Paterno
- Department of Pediatrics Cincinnati Children's Hospital Medical Center
- Division of Sports Medicine Cincinnati Children's Hospital Medical Center
- Division of Occupational Therapy and Physical Therapy Cincinnati Children's Hospital Medical Center
| | | | - Laura Schmitt
- Jameson Crane Sports Medicine Institute The Ohio State University Wexner Medical Center
| |
Collapse
|
39
|
Carson V, Zhang Z, Boyd M, Potter M, Li J, Kuzik N, Hunter S. Moderators of movement behaviour changes among Canadian toddlers and preschoolers throughout the first 2 years of the COVID-19 pandemic. Appl Physiol Nutr Metab 2024; 49:1228-1240. [PMID: 38815592 DOI: 10.1139/apnm-2023-0453] [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] [Indexed: 06/01/2024]
Abstract
Primary objectives were to examine: (1) changes in movement behaviours (i.e., outdoor play (OP), organized physical activity (PA), screen time (ST), sleep) across the first 2 years of coronavirus disease-2019 (COVID-19) among Canadian toddlers and preschoolers, and (2) intrapersonal, interpersonal, community, and policy moderators of change in movement behaviors. Participants were 341 Canadian parents of children (start of study: 1-4 years; 48% female). Participants completed online questionnaires regarding their children's movement behaviours and intrapersonal, interpersonal, and community factors at five time-points before and throughout the pandemic (T1-T5). Data from government websites were also used for some community and policy factors. Linear mixed models were conducted. Compared to pre-COVID-19 (T1): OP was on average 30 min/day higher at T2 and T3; organized PA was on average 62, 44, and 37 min/day lower at T2, T3, and T4, respectively; ST was on average 67, 17, 38, and 52 min/day higher at T2, T3, T4, and T5, respectively; and sleep was on average 30, 36, and 82 min/day lower at T3, T4, and T5, respectively. Significant moderating variables were observed for OP (parental education, parental work inside home, COVID-19 restriction severity), organized PA (children's sex, started kindergarten, nonparental care, parental education, household income, parental employment status, house type, indoor home space and support for PA), ST (nonparental care, parental marital status) and sleep (children's T1 age group, started kindergarten, parental place of birth, parental employment status). All movement behaviors changed across the first 2 years of COVID-19 but patterns and moderators were behaviour-specific. Children from lower socioeconomic status families had the least optimal patterns.
Collapse
Affiliation(s)
- Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Zhiguang Zhang
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Madison Boyd
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Morgan Potter
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Joshua Li
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Nicholas Kuzik
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
- Children's Hospital of Eastern Ontario - Research Institute, Ottawa, ON, Canada
| | - Stephen Hunter
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
40
|
Roybal KL, Husa RA, Connolly M, Dinh C, Bensley KMK, Wendt SJ. Perceptions of multi-cancer early detection tests among communities facing barriers to health care. HEALTH AFFAIRS SCHOLAR 2024; 2:qxae102. [PMID: 39220580 PMCID: PMC11363867 DOI: 10.1093/haschl/qxae102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 08/03/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024]
Abstract
Marginalized racial and ethnic groups and rural and lower income communities experience significant cancer inequities. Blood-based multi-cancer early detection tests (MCEDs) provide a simple and less invasive method to screen for multiple cancers at a single access point and may be an important strategy to reduce cancer inequities. In this qualitative study, we explored barriers and facilitators to MCED adoption among communities facing health care access barriers in Alaska, California, and Oregon. We used reflexive thematic analysis to analyze general barriers to cancer screening, MCED-specific barriers, facilitators of MCED adoption, and MCED communication strategies. We found barriers and facilitators to MCED adoption across 4 levels of the social-ecological model: (1) individual, (2) interpersonal, (3) health care system, and (4) societal. These included adverse psychological impacts, positive perceptions of MCEDs, information and knowledge about cancer screening, the quality of the patient-provider relationship, a lack of health care system trustworthiness, logistical accessibility, patient supports, and financial accessibility. Optimal MCED communication strategies included information spread through the medical environment and the community. These findings underscore the importance of understanding and addressing the multilevel factors that may influence MCED adoption among communities facing health care access barriers to advance health equity.
Collapse
Affiliation(s)
- Kristi L Roybal
- Health Research Accelerator, Providence Research Network, Portland, OR 97213, United States
| | - Robyn A Husa
- Health Research Accelerator, Providence Research Network, Portland, OR 97213, United States
| | - Maria Connolly
- Health Research Accelerator, Providence Research Network, Portland, OR 97213, United States
| | - Catherine Dinh
- Health Research Accelerator, Providence Research Network, Portland, OR 97213, United States
| | - Kara M K Bensley
- Health Research Accelerator, Providence Research Network, Portland, OR 97213, United States
| | - Staci J Wendt
- Health Research Accelerator, Providence Research Network, Portland, OR 97213, United States
| |
Collapse
|
41
|
Reaves RP, De Oliveira G, Martinez AJS. Exploring Psychosocial Distress in Caregivers of Children and Youth With Special Health Care Needs. J Psychosoc Nurs Ment Health Serv 2024; 62:37-46. [PMID: 38537107 DOI: 10.3928/02793695-20240321-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
PURPOSE Caring for a child or youth with special health care needs (CYSHCN) can be overwhelming. Parents and caregivers may experience psychosocial distress, such as depression, frustration, and hopelessness. The purpose of the current study was to gain further insight into families' perspectives on the psychosocial impacts of caring for CYSHCN to identify gaps in health care systems and strengthen systems of support. METHOD A qualitative descriptive design was used in 16 parents and caregivers. Colaizzi's method of analysis and semi-structured interviews were used. RESULTS Six themes emerged from this study: (1) Stigma and Isolation, (2) Religion as a Coping Mechanism, (3) Financial Challenges, (4) Bearing the Burden, (5) Familial Denial, and (6) System-Related Concerns. CONCLUSION Psychiatric-mental health nurses (PMHNs) are in a pivotal position to use their knowledge, skills, and experiences to guide families. PMHNs can also engage communities and enhance mental health promotion to break the stigma associated with having a CYSHCN. [Journal of Psychosocial Nursing and Mental Health Services, 62(9), 37-46.].
Collapse
|
42
|
Mastwyk S, Taylor NF, Lowe A, Dalton C, Peiris CL. "You don't know what you don't know": Knowledge, attitudes, and current practice of physiotherapists in recognising and managing metabolic syndrome, a mixed methods study. Physiotherapy 2024; 124:75-84. [PMID: 38875840 DOI: 10.1016/j.physio.2024.01.008] [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: 04/12/2023] [Revised: 12/11/2023] [Accepted: 01/24/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES To determine the knowledge, attitudes, and current practice of primary care physiotherapists in recognising and managing clients with metabolic syndrome. DESIGN Mixed-methods research design comprising an online survey and focus groups. PARTICIPANTS Australian and English physiotherapists (n = 183) working in a primary care setting responded to the survey. Twelve physiotherapists participated in focus groups. RESULTS Metabolic syndrome was not on physiotherapists radar. They did not screen for metabolic syndrome nor provide management for it in primary care. Although most physiotherapists had some awareness of metabolic syndrome, they were not knowledgeable. Physiotherapists reported a need to focus on their clients' presenting condition, and there was uncertainty on whether metabolic syndrome management was within their scope of practice. Despite this, physiotherapists felt they had an important role to play in exercise and physical activity prescription for chronic disease management and were keen to further their knowledge and skills related to metabolic syndrome. Survey responses and focus group data were convergent. CONCLUSION Physiotherapists working in primary care settings are well-placed to identify metabolic risk factors in their clients and provide physical activity interventions to enhance management but currently lack knowledge to embed this in clinical practice. Training and resources are required to enable physiotherapists to identify and manage metabolic syndrome within their practice. CONTRIBUTION OF PAPER.
Collapse
Affiliation(s)
- Sally Mastwyk
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia; Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK.
| | - Nicholas F Taylor
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia; Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia.
| | - Anna Lowe
- National Centre for Sports & Exercise Medicine, Sheffield Hallam University, Sheffield, UK.
| | - Caroline Dalton
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK.
| | - Casey L Peiris
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia; Allied Health, The Royal Melbourne Hospital, Parkville, Australia.
| |
Collapse
|
43
|
Sileo KM, Muhumuza C, Wanyenze RK, Kershaw TS, Ellerbe B, Muñoz S, Sekamatte S, Lule H, Kiene SM. Effects of a community-based, multi-level family planning intervention on theoretically grounded intermediate outcomes for couples in rural Uganda: Results from a mixed methods pilot evaluation. Br J Health Psychol 2024; 29:551-575. [PMID: 38242837 PMCID: PMC11258211 DOI: 10.1111/bjhp.12713] [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: 04/10/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024]
Abstract
OBJECTIVES This study tested the theoretically grounded conceptual model of a multi-level intervention, Family Health = Family Wealth (FH = FW), by examining FH = FW's effect on intermediate outcomes among couples in rural Uganda. FH = FW is grounded in the social-ecological model and the social psychological theory of transformative communication. DESIGN A pilot quasi-experimental controlled trial. METHODS Two matched clusters (communities) were randomly allocated to receive the FH = FW intervention or an attention/time-matched water, sanitation and hygiene intervention (N = 140, 35 couples per arm). Quantitative outcomes were collected through interviewer-administered questionnaires at baseline, 7-months and 10-months follow-up. Focus group discussions (n = 39) and semi-structured interviews (n = 27) were conducted with subsets of FH = FW participants after data collection. Generalized estimated equations tested intervention effects on quantitative outcomes, and qualitative data were analysed through thematic analysis-these data were mixed and are presented by level of the social-ecological model. RESULTS The findings demonstrated an intervention effect on family planning determinants across social-ecological levels. Improved individual-level family planning knowledge, attitudes and intentions, and reduced inequitable gender attitudes, were observed in intervention versus comparator, corroborated by the qualitative findings. Interpersonal-level changes included improved communication, shared decision-making and equitable relationship dynamics. At the community level, FH = FW increased perceived acceptance of family planning among others (norms), and the qualitative findings highlighted how FH = FW's transformative communication approach reshaped definitions of a successful family to better align with family planning. CONCLUSIONS This mixed methods pilot evaluation supports FH = FW's theoretically grounded conceptual model and ability to affect multi-level drivers of a high unmet need for family planning.
Collapse
Affiliation(s)
- Katelyn M Sileo
- Department of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Christine Muhumuza
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Rhoda K Wanyenze
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - Trace S Kershaw
- Department of Social and Behavior Science, Yale School of Public Health, New Haven, Connecticut, USA
| | - Brooke Ellerbe
- Department of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Suyapa Muñoz
- Department of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA
| | | | - Haruna Lule
- Global Centre of Excellence in Health (GLoCEH), Kampala, Uganda
| | - Susan M Kiene
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
- Division of Epidemiology and Biostatistics, San Diego State University (SDSU) School of Public Health, San Diego, California, USA
| |
Collapse
|
44
|
Garcia KA, Wippold GM, Goodrum NM, Williams MM, Kloos B. Bridging health self-efficacy and patient engagement with patient-centered culturally sensitive health care for Black American adults. JOURNAL OF COMMUNITY PSYCHOLOGY 2024. [PMID: 39213672 DOI: 10.1002/jcop.23147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/03/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
This study investigates whether systems-level interventions, specifically patient-centered culturally sensitive health care (PC-CSHC) from healthcare providers, office staff, and the clinic environment, moderate the relationship between health self-efficacy and patient engagement among Black American adults. An online survey was completed by 198 Black American adults. PC-CSHC from healthcare providers, office staff, and the clinic environment did not mitigate the adverse effects of low health self-efficacy on patient engagement. However, PC-CSHC from healthcare providers (b = 0.38) was as significant as health self-efficacy (b = 0.37) in predicting patient engagement, R2 = 0.47, F(9, 177) = 19.61, p < 0.001. Provider-delivered PC-CSHC can enhance patient engagement among Black American adults. This systems-level approach has the potential to reach more patients than intrapersonal interventions alone and alleviates the undue burden placed on Black Americans to leverage intrapersonal strengths in the face of health disparities rooted in structural racism.
Collapse
Affiliation(s)
- Kaylyn A Garcia
- Psychology Department, University of South Carolina, Columbia, South Carolina, USA
| | - Guillermo M Wippold
- Psychology Department, University of South Carolina, Columbia, South Carolina, USA
| | - Nada M Goodrum
- Psychology Department, University of South Carolina, Columbia, South Carolina, USA
| | | | - Bret Kloos
- Psychology Department, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
45
|
Amuge PM, Ndekezi D, Mugerwa M, Bbuye D, Rutebarika DA, Kizza L, Namugwanya C, Baita A, Elyanu PJ, Ntege PN, Kiragga D, Birungi C, Kekitiinwa AR, Kiragga A, Sekadde MP, Salazar NA, Mandalakas AM, Musoke P. Facilitators and barriers to initiating and completing tuberculosis preventive treatment among children and adolescents living with HIV in Uganda: a qualitative study of adolescents, caretakers and health workers. AIDS Res Ther 2024; 21:59. [PMID: 39210349 PMCID: PMC11363537 DOI: 10.1186/s12981-024-00643-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
INTRODUCTION People living with HIV (PLHIV) have a 20-fold risk of tuberculosis (TB) disease compared to HIV-negative people. In 2021, the uptake of TB preventive treatment among the children and adolescents living with HIV at the Baylor-Uganda HIV clinic was 45%, which was below the national target of 90%. Minimal evidence documents the enablers and barriers to TB preventive treatment (TPT) initiation and completion among children and adolescents living with HIV(CALHIV). We explored the facilitators and barriers to TPT initiation and completion among CALHIV among adolescents aged 10-19years and caretakers of children below 18years. METHODS We conducted a qualitative study from February 2022 to March 2023, at three paediatric and adolescent HIV treatment centers in Uganda. In-depth interviews were conducted at TPT initiation and after completion for purposively selected health workers, adolescents aged 10-19 years living with HIV, and caretakers of children aged below 18years. RESULTS The desire to avoid TB disease, previous TB treatment, encouragement from family members, and ministry of health policies emerged as key facilitators for the children and adolescents to initiate TPT. Barriers to TPT initiation included; TB and HIV-related stigma, busy carer and adolescent work schedules, reduced social support from parents and family, history of drug side effects, high pill burden and fatigue, and perception of not being ill. TPT completion was enabled by combined TPT and ART refill visits, delivery of ART and TPT within the community, and continuous education and counseling from health workers. Reported barriers to TPT completion included TB and HIV-related stigma, long waiting time. Non-disclosure of HIV status by caretakers to CALHIV and fear of side effects was cited by health workers as a barrier to starting TPT. Facilitators of TPT initiation and completion reported by healthcare workers included patient and caretaker health education, counselling about benefits of TPT and risk of TB disease, having same appointment for TPT and ART refill to reduce patient waiting time, adolescent-friendly services, and appointment reminder phone calls. CONCLUSION The facilitators and barriers of TPT initiation and completion among CALHIV span from individual, to health system and structural factors. Health education about benefits of TPT and risk of TB, social support, adolescent-friendly services, and joint appointments for TPT and ART refill are major facilitators of TPT initiation and completion among CALHIV in Uganda.
Collapse
Affiliation(s)
- Pauline Mary Amuge
- Mulago Hospital, Baylor College of Medicine Children's Foundation-Uganda, Block 5, P.O. Box 72052, Kampala, Uganda.
| | - Denis Ndekezi
- Department of Social Aspect of Health, Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Kampala, Uganda
| | - Moses Mugerwa
- Mulago Hospital, Baylor College of Medicine Children's Foundation-Uganda, Block 5, P.O. Box 72052, Kampala, Uganda
| | - Dickson Bbuye
- Mulago Hospital, Baylor College of Medicine Children's Foundation-Uganda, Block 5, P.O. Box 72052, Kampala, Uganda
| | - Diana Antonia Rutebarika
- Department of Research and Clinical Care, Joint Clinical Research Center, Lubowa, Wakiso, Uganda
| | - Lubega Kizza
- Medical Department, Makerere Joint AIDS Program-Mulago ISS Clinic, Kampala, Uganda
| | - Christine Namugwanya
- Mulago Hospital, Baylor College of Medicine Children's Foundation-Uganda, Block 5, P.O. Box 72052, Kampala, Uganda
| | - Angella Baita
- Mulago Hospital, Baylor College of Medicine Children's Foundation-Uganda, Block 5, P.O. Box 72052, Kampala, Uganda
| | - Peter James Elyanu
- Mulago Hospital, Baylor College of Medicine Children's Foundation-Uganda, Block 5, P.O. Box 72052, Kampala, Uganda
| | - Patricia Nahirya Ntege
- Mulago Hospital, Baylor College of Medicine Children's Foundation-Uganda, Block 5, P.O. Box 72052, Kampala, Uganda
| | - Dithan Kiragga
- Mulago Hospital, Baylor College of Medicine Children's Foundation-Uganda, Block 5, P.O. Box 72052, Kampala, Uganda
| | - Carol Birungi
- Medical Department, Makerere Joint AIDS Program-Mulago ISS Clinic, Kampala, Uganda
| | | | - Agnes Kiragga
- African Population and Health Research Center, Nairobi, Kenya
| | | | | | | | - Philippa Musoke
- Department of Paediatrics and Child Health, Makerere University Johns Hopkins University (MUJHU) Care Limited, Kampala, Uganda
| |
Collapse
|
46
|
Haroen H, Maulana S, Harlasgunawan AR, Rahmawati S, Riansyah A, Musthofa F, Pardosi JF. Barriers and Facilitators of Early Palliative Care in the Trajectory of People Living with Chronic Condition: A Mini Review Using Socio-ecological Framework to Inform Public Health Strategy. J Multidiscip Healthc 2024; 17:4189-4197. [PMID: 39224483 PMCID: PMC11368106 DOI: 10.2147/jmdh.s473457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024] Open
Abstract
The increasing incidence of chronic conditions on a global scale requires a comprehensive approach to palliative care, which is recognized as an essential element of the continuum of care for people with life-threatening conditions. It has been argued that the integration of early palliative care for people with chronic conditions is beneficial. Nevertheless, barriers to integrating early palliative care have been extensively not reviewed. This review aimed to explore the barriers and facilitators of integrating early palliative care for people living with chronic conditions, employing a socio-ecological framework to provide a critical understanding of the influencing factors at multiple levels. The method was a mini review. This review emphasizes the complex and diverse factors that either hinder or facilitate progress in four areas: individual (such as gaps in knowledge and emotional reactions), interpersonal (such as support from family caregiver), healthcare professionals and policy (such as barriers in education, guidelines, and collaboration among professionals), and community (such as societal knowledge and attitudes). Each level presents unique challenges and opportunities for enhancing early palliative care integration, from addressing misconceptions and fears at the individual level, to fostering supportive policies and community awareness. In conclusion, the effective management of early palliative care requires a comprehensive strategy that spans various dimensions, including educational initiatives, policy adjustments, and active involvements of the community. Healthcare systems are supposed to enhance the integration of early palliative care into the trajectory of chronic conditions and enhance the quality of life of affected persons and their families by recognizing and addressing the socio-ecological elements involved.
Collapse
Affiliation(s)
- Hartiah Haroen
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Sidik Maulana
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Alia Rahmi Harlasgunawan
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
- Nursing Department, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Sri Rahmawati
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Alvi Riansyah
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Faizal Musthofa
- Nursing Department, Universitas Padjadjaran Hospital, Sumedang, Indonesia
| | - Jerico Franciscus Pardosi
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
47
|
Khanna A, Govil M, Ayele N, Saadi A. Disparities in Delirium across the Continuum of Care and Associations with Social Determinants of Health. Semin Neurol 2024. [PMID: 39209285 DOI: 10.1055/s-0044-1788976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Disparities exist in the identification, treatment, and management of delirium. These disparities can be most holistically and comprehensively understood by using a social-ecological model-which acknowledges multilevel impacts including individual, interpersonal, organizational, community, and policy-level factors-as well as a social determinant of health framework, that considers nonmedical factors that influence health outcomes. This narrative review leverages both frameworks to identify and discuss existing literature pertaining to the intersection of these social risk factors and delirium, focusing specifically on disparities due to racial and/or ethnic identity, language ability, and socioeconomic differences. We also look at disparities and the potential role of these social risk factors throughout the continuum of care, including prehospitalization, hospitalization, and posthospitalization factors. Understanding and analyzing the role of these inequities is critical to ensuring better health outcomes for patients at risk of and/or with delirium.
Collapse
Affiliation(s)
- Anu Khanna
- Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts
| | - Malvika Govil
- Department of Neurology, New York Langone Health, New York University Grossman School of Medicine, New York City, New York
| | - Nohamin Ayele
- Department of Neurology, Northwestern Medicine, Feinberg School of Medicine, Chicago, Illinois
| | - Altaf Saadi
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| |
Collapse
|
48
|
Uhm JY. Knowledge of and attitude toward diabetes care as predictors of school nurses' partnership with parents: A cross-sectional study. NURSE EDUCATION TODAY 2024; 143:106378. [PMID: 39241489 DOI: 10.1016/j.nedt.2024.106378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 08/20/2024] [Accepted: 08/27/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Collaboration between parents and school nurses is important for effective healthcare in schools. This study focuses on the competency of school nurses, which encompasses their knowledge and self-efficacy in diabetes care, and investigates how these factors, along with workload, influence healthcare partnerships in schools. However, it is unknown whether school nurses' knowledge and self-efficacy about diabetes care, as well as their workload, affect school healthcare partnerships concerning children with type 1 diabetes. AIM This study aimed to investigate the impact of school nurses' self-efficacy, knowledge, attitude, and role overload on healthcare partnerships with parents of children with type 1 diabetes in schools. DESIGN A cross-sectional, descriptive design. SETTING AND PARTICIPANTS Between December 2023 and January 2024 in South Korea, 142 elementary- and middle-school nurses participated in this study. METHODS School healthcare partnership, self-efficacy in diabetes education, knowledge of and attitude toward school healthcare for type 1 diabetes, and the role-overload scale were utilized in the analysis. Data were analyzed using multiple regression. RESULTS Knowledge of school healthcare (β = 0.34, p < .001) and attitude toward it (β = 0.29 p = .001) for type 1 diabetes, as well as the grade level of the current employing school (β = -0.15, p = .039) were predictors of school healthcare partnerships. These three variables explained 30.3 % of the total variance in school healthcare partnerships (F = 21.44, p < .001). CONCLUSIONS Knowledge of school healthcare and attitudes toward it for type 1 diabetes were identified as factors in school nurses' school healthcare partnerships. Therefore, interventions to strengthen school nurses' competencies should be developed to improve school healthcare partnerships.
Collapse
Affiliation(s)
- Ju-Yeon Uhm
- Department of Nursing, Pukyong National University, Busan 48513, South Korea.
| |
Collapse
|
49
|
Martin JN, Pace TWW. Colonialism as a Social Determinant of Health in Puerto Rico: Using the Socioecological Model to Examine How the Jones Act Impacted Health After Hurricane María. J Transcult Nurs 2024:10436596241274123. [PMID: 39206586 DOI: 10.1177/10436596241274123] [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: 09/04/2024] Open
Abstract
INTRODUCTION Puerto Rico is a territory of the United States, making Puerto Ricans vulnerable to damaging colonial policy. The purpose of this article is to utilize the socioecological model (SEM) to evaluate how the Jones Act impacted Puerto Rico after Hurricane María, examining colonialist policy as a social determinant of health (SDOH) in Puerto Rico. METHODS Levels of the SEM used in this examination included: individual, institutional, community, policy, and context. RESULTS Evaluation of the Jones Act using the model demonstrated relationships between all socioecological levels. The Jones Act caused delays and increased prices for goods needed to rebuild community utility infrastructure, which led to extended closures of institutions like workplaces, schools, and hospitals, and ultimately contributed to increased acute and chronic physical and mental illness among Puerto Ricans. DISCUSSION This evaluation establishes that colonialist policy negatively impacts the health of Puerto Ricans, positioning colonialism as an SDOH.
Collapse
Affiliation(s)
| | - Thaddeus W W Pace
- University of Arizona, Tucson, USA
- University of Arizona Cancer Center, Tucson, USA
| |
Collapse
|
50
|
Malope SD, Norris SA, Joffe M. Culture, community, and cancer: Understandings of breast cancer from a non-lived experience among women living in Soweto. RESEARCH SQUARE 2024:rs.3.rs-4797158. [PMID: 39257971 PMCID: PMC11384026 DOI: 10.21203/rs.3.rs-4797158/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
Background Individual perceptions compounded with socio-cultural beliefs and health system factors are key determinants of people's health seeking behavior and are widely cited as the causes of delayed breast cancer diagnosis among women from structurally vulnerable settings. Asking: "how do women with a non-lived experience of cancer understand the disease and, what informs their health seeking behaviors?", we explored individual, sociocultural and health system elements from a conceptual model derived from the Socioecological, Health Belief and Cancer Stigma Frameworks, to understand perspectives of breast cancer in a South African urban community setting. Methods Using a deductive approach, we conducted a qualitative study consisting of 6 focus group discussions among 34 women from Soweto, Johannesburg (aged 35-74 years) and followed-up with 20 semi-structured in-depth interviews. Results Findings revealed some awareness of breast and other cancers, but confusion and gaps in understanding of the disease, resulting in socio-culturally influenced misperceptions of risks, causes, and outcomes following treatment of breast cancer. This fueled perceptions of profound fear and stigma against people with breast and other cancers. These findings together with participant perceptions of primary healthcare providers being unwelcoming, under-resourced, and insufficiently trained to deal with breast cancer, resulted in women reporting being reluctant to participating in screening/early detection care seeking behavior. They only accessed primary care when experiencing extreme pain or ill-health. Participants suggested as solutions for future interventions, the need for sustained community engagement, harnessing existing clinic and community stakeholders and resources to provide clear and understandable breast cancer information and encouragement for screening uptake. Conclusions Health literacy gaps surrounding breast cancer fuels socio-culturally influenced misperceptions, fear, stigma, and fatalism among community women from Soweto, South Africa. Women perceive primary care providers of having insufficient knowledge, skills, and resources to provide effective breast cancer screening services. Participants suggested the need for greater community engagement involving primary clinics and existing community stakeholders working hand in hand. Clear, understandable, and consistent information about breast cancer must be regularly disseminated and communities must be regularly encouraged to utilise breast cancer screening services.
Collapse
|