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Teferra AA, Alalwan MA, Keller-Hamilton B, Roberts ME, Lu B, Paskett ED, Chrzan K, Curran H, Ferketich AK. Adherence to COVID-19 Protective Measures in a Longitudinal Sample of Male Youth. Int J Behav Med 2023; 30:268-278. [PMID: 35543861 PMCID: PMC9091545 DOI: 10.1007/s12529-022-10090-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Adherence to COVID-19 protective measures is lowest for young people and males. The current study investigated characteristics associated with adherence to COVID-19 protective measures among male youth during the early months of the pandemic. METHOD The study used data from a prospective cohort study among male youth with baseline assessment in 2015/2016 and follow-up measurements in 2019 and summer 2020. Attrition-weighted multivariable ordinal logistic and log-binomial regression models were used to assess factors associated with adherence to overall and specific adherence measures, respectively. RESULTS Among 571 male youth (mean age 18.5), overall adherence was higher for those who were older (OR: 1.15; 95% CI: 1.03-1.30), non-White (OR: 1.96; 95% CI: 1.20-3.32), and residing in an urban area (OR: 2.06; 95% CI: 1.46-3.01). Overall adherence was lower for those who had a history of being drunk (OR: 0.65; 95% CI: 0.42-0.99). For outdoor mask-wearing, adherence was higher for youth with attention-deficit disorder or attention-deficit/hyperactivity disorder (RR: 1.58; 95% CI: 1.16-1.97) and lower for youth who currently used tobacco products (RR: 0.42; 95% CI: 0.21-0.70). Before a statewide mask mandate was issued, non-White youth were more likely to report wearing masks in outdoor spaces than their non-Hispanic White peers (RR: 2.34; 95% CI: 1.75-3.23). CONCLUSION The study identified demographic, psychosocial, and behavioral factors associated with adherence to COVID-19 protective behaviors among male youth. The findings illustrate characteristics that could be leveraged for targeted preventive efforts during the ongoing pandemic and future outbreaks in a low-compliance group.
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Affiliation(s)
- Andreas A Teferra
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA.
| | - Mahmood A Alalwan
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA
| | - Brittney Keller-Hamilton
- Center for Tobacco Research, Comprehensive Cancer Center, The Ohio State University, Columbus, USA
| | - Megan E Roberts
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, USA
| | - Bo Lu
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, USA
| | - Electra D Paskett
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA
- Center for Tobacco Research, Comprehensive Cancer Center, The Ohio State University, Columbus, USA
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, USA
| | - Kirsten Chrzan
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA
| | - Hayley Curran
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, USA
| | - Amy K Ferketich
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA
- Center for Tobacco Research, Comprehensive Cancer Center, The Ohio State University, Columbus, USA
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, USA
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Teferra AA, Wing JJ, Lu B, Xu W, Roberts ME, Ferketich AK. Examining trends in health care access measures among low-income adult smokers in Ohio: 2012-2019. Prev Med Rep 2023; 31:102106. [PMID: 36820365 PMCID: PMC9938324 DOI: 10.1016/j.pmedr.2022.102106] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 01/03/2023] Open
Abstract
Smokers are more likely to be low-income with limited access to health services. Although Medicaid expansion under the Patient Protection and Affordable Care Act improved access to care for low-income adults, long-term trends in health care access among low-income smokers remain uncharacterized. The study evaluated changes in five access measures among low-income nonelderly (19-64) adults (N = 28976) across smoking status using pooled data from a statewide survey in Ohio covering pre- (i.e., 2012) and post-Medicaid expansion periods (2015, 2017, and 2019) guided by a comprehensive framework of health care access. We found improvements in some, but not all, health care access measures among low-income smokers in the post-Medicaid-expansion period compared to the pre-expansion period. Compared to 2012, the odds for unmet dental care needs declined in 2015 (aOR = 0.67, 95 % CI = 0.45-1.01), 2017 (aOR = 0.53, 95 % CI = 0.35-0.81), and 2019 (aOR = 0.65, 95 % CI = 0.40-1.05) (p trend < 0.001). Similarly, the odds for unmet other health care needs (i.e., medical exams and supplies) were lower in 2015 (aOR = 0.64, 95 % CI = 0.39-1.06), 2017 (aOR = 0.56, 95 % CI = 0.34-0.93), and 2019 (aOR = 0.47, 95 % CI = 0.27-0.83) (p trend < 0.001). Difficulty paying medical bills was also significantly lower in 2015 (aOR = 0.62, 95 % CI = 0.43-0.89), 2017 (aOR = 0.57, 95 % CI = 0.39-0.83) and 2019 (aOR = 0.57, 95 % CI = 0.37-0.87) (p trend < 0.001). While there was notable progress in measures of affordability (i.e., paying medical bills) as well as care availability and accommodation (i.e., unmet needs), there were no meaningful changes in the approachability of care (i.e., having a usual source of care).
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Affiliation(s)
- Andreas A. Teferra
- Center for Child Health Equity and Outcomes Research, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA,Corresponding author at: Center for Child Health Equity and Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, 431 S. 18th St., Columbus, OH, USA.
| | - Jeffrey J. Wing
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Bo Lu
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Wendy Xu
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Megan E. Roberts
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Amy K. Ferketich
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
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Roberts ME, Keller-Hamilton B, Teferra AA. Tobacco 21's Impact Amid the E-Cigarette Surge. Public Health Rep 2023; 138:62-67. [PMID: 35060798 PMCID: PMC9730164 DOI: 10.1177/00333549211061772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Nationwide implementation of Tobacco 21 (raising the legal sales age for all tobacco products to 21) is occurring against the backdrop of an electronic cigarette (e-cigarette) epidemic among young people, which makes Tobacco 21 evaluation difficult. To address this issue, we examined young adult use of e-cigarettes separately from use of other tobacco products. Our objective was to determine whether use changed after Tobacco 21 implementation and whether those changes differed by product. METHODS In Columbus, Ohio, which began enforcing Tobacco 21 in 2017, we surveyed incoming first-year undergraduates at a large, public university in 2016 (Cohort 1; n = 529) and re-contacted them in 2018. We surveyed a new sample of incoming first-year students in 2018 (Cohort 2; n = 611). Survey items assessed tobacco use, sources for obtaining tobacco, and attitudes surrounding Tobacco 21. RESULTS Both cross-sectional (Cohort 1 vs Cohort 2) and prospective (pre-post Tobacco 21 in Cohort 1) analyses indicated a slight decline in most tobacco use from 2016 to 2018, but e-cigarette use more than doubled during the same period. Students enrolled throughout the transition to Tobacco 21 (Cohort 1) perceived little effect of Tobacco 21 on peer use. The largest proportions (35.3%-43.5%) of combustible tobacco were obtained outside Columbus; 61.8% of e-cigarette users reported obtaining e-cigarettes through borrowing. CONCLUSIONS Tobacco 21 was associated with reductions in combustible and smokeless tobacco use, but its impact was not sufficient to curb the surge in e-cigarette use. Tobacco 21 should be contextualized as part of a broader network of tobacco control efforts, including additional youth-access regulations, that may be needed to address e-cigarette use among young people.
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Affiliation(s)
- Megan E. Roberts
- College of Public Health, The Ohio State University, Columbus, OH, USA
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Tetreault E, Teferra AA, Keller-Hamilton B, Shaw S, Kahassai S, Curran H, Paskett ED, Ferketich AK. Perceived Changes in Mood and Anxiety Among Male Youth During the COVID-19 Pandemic: Findings From a Mixed-Methods Study. J Adolesc Health 2021; 69:227-233. [PMID: 34112599 PMCID: PMC8316306 DOI: 10.1016/j.jadohealth.2021.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/29/2021] [Accepted: 05/10/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic has changed almost every aspect of our lives. Young adults are vulnerable to pandemic-related adverse mental health outcomes, but little is known about the impact on adolescents. We examined factors associated with perceived changes in mood and anxiety among male youth in urban and Appalachian Ohio. METHODS In June 2020, participants in an ongoing male youth cohort study were invited to participate in an online survey that included questions about changes in mood, anxiety, closeness to friends and family, and the major impacts of the pandemic. Weighted log-binomial regression models were used to assess the risk of worsened mood and increased anxiety. Chi-square tests were used to examine the association between perceived changes in mood and anxiety and perceived changes in closeness to friends and family and open-ended responses to a question about COVID-19's impact on participants. RESULTS Perceived worsened mood and increased anxiety during the pandemic were associated with higher household socioeconomic status, older age, feeling less close to friends and family, and reporting that COVID-19 negatively affected mental health. A perceived increase in anxiety was also associated with a history of symptoms of depression or anxiety. CONCLUSIONS Specific subgroups of male youth may be at heightened risk of worsening mental health during the COVID-19 pandemic. Interventions should target vulnerable adolescents and seek to increase closeness to social contacts. Such efforts could involve novel programs that allow youth to stay connected to friends, which might mitigate the negative impact on mental health.
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Affiliation(s)
| | - Andreas A Teferra
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio
| | - Brittney Keller-Hamilton
- Center For Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | - Shreya Shaw
- Biomedical Science Program, The Ohio State University College of Medicine, Columbus, Ohio
| | - Soliana Kahassai
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio
| | - Hayley Curran
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio
| | - Electra D Paskett
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio; Division of Cancer Prevention and Control, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio
| | - Amy K Ferketich
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio; Division of Cancer Prevention and Control, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio.
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Hutchcraft ML, Teferra AA, Montemorano L, Patterson JG. Differences in Health-Related Quality of Life and Health Behaviors Among Lesbian, Bisexual, and Heterosexual Women Surviving Cancer from the 2013 to 2018 National Health Interview Survey. LGBT Health 2021; 8:68-78. [PMID: 33325783 PMCID: PMC7826421 DOI: 10.1089/lgbt.2020.0185] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose: Health-related quality of life (HRQoL) and health behaviors contribute to cancer morbidity and mortality, which are elevated in lesbian and bisexual women (LBW). The purpose of this study was to assess differences in HRQoL and health behaviors between heterosexual and lesbian women and heterosexual and bisexual women cancer survivors. Methods: We pooled 2013-2018 National Health Interview Survey data. HRQoL comprised physical, mental, financial, and social health domains. Health behaviors included tobacco and alcohol use, physical activity, and preventive health care. Weighted, multivariable logistic regression models estimated odds ratios (ORs) with 95% confidence intervals (CIs). Results: The sample included 10,830 heterosexual, 141 lesbian, and 95 bisexual cancer survivors. Lesbian women reported higher odds of fair/poor self-rated health (OR: 1.68, 95% CI 1.02-2.78), chronic obstructive pulmonary disease (OR: 1.98, 95% CI 1.09-3.56), and heart conditions (OR: 1.90, 95% CI 1.16-3.12) than heterosexual women. Bisexual women reported higher odds of severe psychological distress (OR: 3.03, 95% CI 1.36-6.76), heart conditions (OR: 1.98, 95% CI 1.12-3.53), and food insecurity (OR: 2.89, 95% CI 1.29-6.50) than heterosexual women. For health behaviors, lesbian women reported greater odds of current (OR: 2.34, 95% CI 1.26-4.34) and former tobacco use (OR: 1.89, 95% CI 1.21-2.96), and bisexual women had lower odds of a recent mammogram (OR: 0.42, 95% CI 0.23-0.78) than heterosexual women. Conclusions: LBW cancer survivors reported disparities in HRQoL and health behaviors. In cancer care settings, identification of LBW patients requiring physical and mental health promotion, financial services, and supported tobacco cessation may improve health and survival.
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Affiliation(s)
- Megan L. Hutchcraft
- Department of Obstetrics and Gynecology, Carle Illinois College of Medicine, Champaign, Illinois, USA
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Markey Cancer Center, Lexington, Kentucky, USA
| | - Andreas A. Teferra
- Department of Public Health, Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Lauren Montemorano
- Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Patterson JG, Russomanno J, Teferra AA, Jabson Tree JM. Disparities in food insecurity at the intersection of race and sexual orientation: A population-based study of adult women in the United States. SSM Popul Health 2020; 12:100655. [PMID: 32864410 PMCID: PMC7442904 DOI: 10.1016/j.ssmph.2020.100655] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 08/16/2020] [Accepted: 08/18/2020] [Indexed: 02/07/2023] Open
Abstract
Food insecurity affects 1 in 8 American adults annually, and is more prevalent in Black and sexual minority women. We applied an intersectional approach to investigate food insecurity prevalence in women with intersecting minority race and sexual orientation. We used two United States surveillance systems-National Health Interview Survey (NHIS) 2013-2018 and National Health and Nutrition Examination Survey (NHANES) 2005-2014, to estimate how race and sexual orientation jointly influence food insecurity prevalence in women aged 18-59 years (NHIS: N = 47596; NHANES: N = 5106). All analyses were stratified for Supplemental Nutrition Assistance Program (SNAP) use. Relative measures estimated weighted prevalence ratios (PR) comparing Black and White sexual minority women (SMW) to heterosexual White women. Absolute prevalence measures estimated the excess prevalence of food insecurity due to multiple marginalization. Patterns of food insecurity prevalence were similar across NHIS and NHANES, and differed only for non-SNAP users. Relative prevalence of food insecurity was greater in Black SMW than heterosexual White women in NHIS (PR: 2.16; 95% confidence interval [CI], 1.41-3.30) and NHANES (PR: 2.79; 95% CI, 1.73-4.51). The strength of the association between multiple marginalization and food insecurity was stronger for Black SMW than White SMW. Absolute measures were significant only for NHIS and did not support our a priori hypothesis: For non-SNAP users, being Black and sexual minority reduced the joint disparity in food insecurity by approximately 50% (Synergy Index: 0.52; 95% CI, 0.11-0.93). Overall, our study illuminated population-level differences in food insecurity among women of diverse minority races and sexual orientations. Black SMW experienced high rates of food insecurity, which may contribute to chronic disease disparities. Yet, intersecting minority social positions (race and sexual orientation) reduced food insecurity; these findings are unexpected and must be further investigated. Increasing SNAP use among multiply marginalized women may attenuate food insecurity disparities.
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Affiliation(s)
- Joanne G. Patterson
- The Ohio State University Comprehensive Cancer Center, 1841 Neil Avenue, 400A Cunz Hall, Columbus, OH, 43210, United States
| | - Jennifer Russomanno
- University of Tennessee Graduate School of Medicine, Office of Continuing Education & Professional Development, 1924 Alcoa Highway, Box U94, Knoxville, TN, 37920, United States
| | - Andreas A. Teferra
- The Ohio State University College of Public Health, 1841 Neil Avenue, Cunz Hall, Columbus, OH, 43210, United States
| | - Jennifer M. Jabson Tree
- University of Tennessee Department of Public Health, 1814 Andy Holt Avenue, 360 HPER, Knoxville, TN, 37996, United States
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Habtewold TD, Mohammed SH, Endalamaw A, Mulugeta H, Dessie G, Berhe DF, Birhanu MM, Islam MA, Teferra AA, Asefa NG, Alemu SM. Higher educational and economic status are key factors for the timely initiation of breastfeeding in Ethiopia: A review and meta-analysis. Acta Paediatr 2020; 109:2208-2218. [PMID: 32239528 DOI: 10.1111/apa.15278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/18/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
Abstract
AIM To investigate the association between initiation of breastfeeding within 1 hour after birth (TIBF) and maternal educational status, paternal educational status, household income, marital status, media exposure and parity in Ethiopia. METHODS We searched PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases. All studies were conducted in Ethiopia and published from 2000 to 2019 were included. To obtain the pooled odds ratio (OR), data were fitted in random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ2 and I2 statistics. This meta-analytic review was reported in compliance with the PRISMA statement. RESULTS Out of 553 studies retrieved, 25 fulfilled our inclusion criteria. High maternal educational status (P < .001), paternal educational status (P = .001) and household income (P = .002), being married (P = .001) and multiparity (P = .01) were significantly associated with TIBF. There was no significant publication bias. CONCLUSIONS Our meta-analysis showed that TIBF was associated with high educational and economic status, being married and multiparity. This suggests that the meta-analysis detected small associations that many previous studies in Ethiopia have not been able to show. Our findings can be useful for comparisons with other countries.
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Affiliation(s)
- Tesfa Dejenie Habtewold
- Department of Nursing College of Health Science Debre Berhan University Debre Berhan Ethiopia
- Department of Epidemiology University Medical Centre Groningen University of Groningen Groningen The Netherlands
- Department of Quantitative Economics School of Business and Economics Maastricht University Maastricht Netherlands
| | - Shimels Hussien Mohammed
- Department of Community Nutrition School of Nutritional Sciences and Dietetics Tehran University Tehran Iran
| | - Aklilu Endalamaw
- Department of Pediatrics and Child Health Nursing College of Medicine and Health Sciences Bahir Dar University Bahir Dar Ethiopia
| | - Henok Mulugeta
- Department of Nursing College of Health Science Debre Markos University Debre Markos Ethiopia
| | - Getenet Dessie
- Department of Nursing School of Health Science College of Medicine and Health Science Bahir Dar University Bahir Dar Ethiopia
| | - Derbew Fikadu Berhe
- School of Pharmacy College of Health Science Mekelle University Mekelle Ethiopia
| | - Mulugeta Molla Birhanu
- School of Clinical Sciences Department of Medicine, Epidemiology and Prevention Division Monash University Melbourne Vic. Australia
| | - Md. Atiqul Islam
- Department of Statistics Shahjalal University of Science and Technology Sylhet Bangladesh
| | - Andreas A. Teferra
- Division of Epidemiology College of Public Health The Ohio State University Columbus OH USA
| | - Nigus Gebremedhin Asefa
- Department of Epidemiology University Medical Centre Groningen University of Groningen Groningen The Netherlands
| | - Sisay Mulugeta Alemu
- Global Health Unit University Medical Centre Groningen University of Groningen Groningen The Netherlands
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Roberts ME, Teferra AA, Keller-Hamilton B, Patterson JG, Ferketich AK. Shared and unique risk factors for tobacco use among rural versus urban adolescents. Prev Med 2020; 140:106239. [PMID: 32853669 PMCID: PMC7680386 DOI: 10.1016/j.ypmed.2020.106239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 11/16/2022]
Abstract
Researchers have proposed numerous factors that may contribute to rural adolescents' heightened risk for tobacco use. Some of these include well-known risk factors for tobacco use, whereas others concern factors unique to rural populations, reflecting norms and values ("rural culture") that accept and encourage tobacco use. This study aimed to test a broad range of tobacco-use risk factors to determine which were a) universal risk factors for both urban and rural adolescents vs. b) unique risk factors for rural adolescents. Data came from a prospective cohort study of 1220 adolescent males in Ohio who were aged 11-16 (average = 14 years) when surveyed at baseline (2015-2016). Follow-up surveys occurred every 6 months. The present study examined tobacco-use outcomes-prevalent use and incident use-by the two-year follow-up (2017-2018). Findings indicated a higher prevalence of ever-use of cigarette and smokeless tobacco among rural, vs. urban, adolescents at baseline. By the two-year follow-up, the urban/rural difference was attenuated but remained. Stratified multivariable logistic regression indicated that some baseline risk factors were associated with subsequent tobacco use for both rural and urban adolescents. Having an adult tobacco user in the home (for prevalent use) and susceptibility to a male family member offer of tobacco products (for both prevalent and incident use) were associated with tobacco use only for rural adolescents. These findings align with qualitative work demonstrating that masculinity and an intergenerational tobacco culture are important to male adolescents. This unique rural profile should be considered when developing prevention efforts.
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Affiliation(s)
- Megan E Roberts
- College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, United States of America.
| | - Andreas A Teferra
- College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, United States of America
| | - Brittney Keller-Hamilton
- Center for Tobacco Research, Comprehensive Cancer Center, The Ohio State University, 3650 Olentangy River Rd, Columbus, OH 43214, United States of America
| | - Joanne G Patterson
- The Ohio State University Comprehensive Cancer Center, 400A Cunz, 1841 Neil Ave, Columbus, OH 43210, United States of America
| | - Amy K Ferketich
- College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, United States of America
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Hutchcraft MLG, Patterson JG, Teferra AA, Montemorano L, Backes FJ. Differences in self-reported health-related quality of life in heterosexual and sexual minority women surviving cancer: 2013 to 2018 national health interview survey. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e19038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19038 Background: Health related quality of life (HRQoL) is associated with excess morbidity and mortality after cancer diagnosis. While a growing body of research indicates that sexual minority women (lesbian and bisexual women; SMW) experience greater risk for cancer diagnoses and cancer-related mortality, there is a paucity of evidence describing HRQoL in this population. This is a critical omission as assessment of sexual orientation differences in HRQoL may inform clinical interventions to improve health and survival of SMW after cancer diagnosis. This study examined associations between sexual orientation and HRQoL domains among female cancer survivors. Methods: Data from the 2013-2018 National Health Interview Survey (NHIS) was pooled. HRQoL was defined using individual indices across physical health, mental health, social, and financial domains. The association between sexual orientation and individual indices of HRQoL was assessed using weighted multivariable logistic regression analyses. Results: The sample included 97909 heterosexual, 1424 lesbian, and 1235 bisexual women who reported a cancer diagnosis. Sexual minority women were more likely to be college graduates (p < 0.001) and employed (p < 0.001); however, they had higher rates of being uninsured (p = 0.01) than their heterosexual counterparts. Reproductive cancers—including breast, ovarian, cervical, and uterine—accounted for 51% of cancer diagnoses in heterosexual women and 57.2% in SMW (p = 0.06). Sexual minority and heterosexual women had more similarities than differences in individual indices of HRQoL; however, several pertinent differences were noted. Specifically, SMW had higher odds of moderate (OR 1.46 [1.01-2.13]) and severe psychological distress (OR 2.10 [1.17-3.77]); chronic health conditions, including COPD (OR 1.72 [1.06-2.80]) and heart disease (OR 1.93 [1.32-2.83]); financial concerns about retirement (OR 1.36 [1.01-1.83]); food insecurity (OR 2.13 [1.23-3.68]), and severe food insecurity (OR 2.44 [1.28-4.67]). Conclusions: Sexual minority women with cancer diagnoses report worse indices of HRQoL. Poorer HRQoL may influence excess morbidity and mortality evidenced in these populations; however, future longitudinal studies are needed to assess prospective risk. Given our results, implementing interventions in the cancer setting to identify sexual minority patients in need of physical and mental health and financial services may reduce disparities.
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Affiliation(s)
| | - Joanne G Patterson
- The Ohio State University Comprehensive Cancer Center, c/o College of Public Health, Columbus, OH
| | - Andreas A Teferra
- The Ohio State University, College of Public Health, Division of Epidemiology, Columbus, OH
| | - Lauren Montemorano
- The Ohio State University Wexner Medical Center, Department of Obstetrics & Gynecology, Columbus, OH
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Teferra AA, Vonk JM, Boezen HM. Longitudinal changes in airway hyperresponsiveness and COPD mortality. Eur Respir J 2020; 55:13993003.01378-2019. [PMID: 31699839 DOI: 10.1183/13993003.01378-2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/15/2019] [Indexed: 01/03/2023]
Affiliation(s)
- Andreas A Teferra
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Judith M Vonk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - H Marike Boezen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands .,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Brinkman MC, Teferra AA, Kassem NO, Kassem NO. Effect of electric heating and ice added to the bowl on mainstream waterpipe semivolatile furan and other toxicant yields. Tob Control 2020; 29:s110-s116. [PMID: 31542776 PMCID: PMC7050391 DOI: 10.1136/tobaccocontrol-2019-054961] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 06/10/2019] [Accepted: 06/13/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVES We examined mainstream total particulate matter, nicotine, cotinine, menthol, pyrene, carbon monoxide (CO) and semivolatile furan yields from a commercial waterpipe with two methods for heating the tobacco, quick-light charcoal (charcoal) and electric head (electric) and two water bowl preparations: with (ice) and without ice (water). METHODS Emissions from a single brand of popular waterpipe tobacco (10 g) were generated using machine smoking according to a two-stage puffing regimen developed from human puffing topography. Tobacco and charcoal consumption were calculated for each machine smoking session as mass lost, expressed as a fraction of presmoking mass. RESULTS The heating method had the greatest effect on toxicant yields. Electric heating resulted in increases in the fraction of tobacco consumed (2.4 times more, p<0.0001), mainstream nicotine (1.4 times higher, p=0.002) and semivolatile furan yields (1.4 times higher, p<0.03), and a decrease in mainstream CO and pyrene yields (8.2 and 2.1 times lower, respectively, p<0.001) as compared with charcoal. Adding ice to the bowl resulted in higher furan yields for electric heating. Menthol yields were not different across the four conditions and averaged 0.16±0.03 mg/session. 2-Furaldehyde and 5-(hydroxymethyl)-2-furaldehyde yields were up to 230 and 3900 times higher, respectively, than those reported for cigarettes. CONCLUSION Waterpipe components used to heat the tobacco and water bowl preparation can significantly affect mainstream toxicant yields. Mainstream waterpipe tobacco smoke is a significant source of inhalation exposure to semivolatile furans with human carcinogenic and mutagenic potential. These data highlight the need for acute and chronic inhalation toxicity data for semivolatile furans and provide support for the establishment of limits governing sugar additives in waterpipe tobacco and educational campaigns linking waterpipe tobacco smoking behaviours with their associated harm.
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Affiliation(s)
| | - Andreas A Teferra
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Noura O Kassem
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Nada Of Kassem
- School of Public Health, San Diego State University, San Diego, California, USA
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Teferra AA, Keller-Hamilton B, Roberts ME, Reiter PL. HPV Vaccine Coverage among Adolescent Males in Ohio: Results of a Longitudinal Study. Ohio J Public Health 2019; 2:15-23. [PMID: 36147558 PMCID: PMC9491334 DOI: 10.18061/ojph.v2i2.9030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Human papillomavirus (HPV) vaccine has been recommended for males in the United States since 2011, yet little is known about vaccine coverage among adolescent males in Ohio. Our longitudinal study examined HPV vaccine coverage among adolescent males in Ohio and identified predictors of vaccination. METHODS The Buckeye Teen Health Study recruited adolescent males ages 11-16 and their parents from one urban county and nine rural counties in Ohio. We report longitudinal vaccination data on 1126 adolescent males, with baseline data from 2015-2016 and follow-up data from 2017-2018. We used multivariable Poisson regression to identify predictors of HPV vaccine initiation that occurred between baseline and follow-up. RESULTS At baseline, 42.4% of parents reported their sons had initiated the HPV vaccine series. Among parents whose sons were unvaccinated at baseline, 36.3% indicated initiation at follow-up. Initiation at follow-up was more common among sons who had received influenza vaccine (RR = 1.54, 95% CI = 1.08-2.18) or whose parents indicated lack of a recent visit to a doctor as the main reason for not yet vaccinating at baseline (RR = 1.41, 95% CI = 1.02-1.95). Initiation was less common among sons whose parents had an associate's degree or some college education (RR = 0.28, 95% CI = 0.46-0.99). Main reasons for not vaccinating changed from baseline to follow-up among parents of unvaccinated sons. CONCLUSIONS Although HPV vaccine initiation increased over time, many adolescent males in Ohio remain unvaccinated. Findings can help guide future strategies for increasing HPV vaccine coverage among this population.
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Affiliation(s)
- Andreas A. Teferra
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio
| | | | - Megan E. Roberts
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Paul L. Reiter
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio
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Teferra AA, Vonk JM, Boezen HM. Sex, smoking and body mass index: do they aid in uncovering the complex mechanisms behind airway hyperresponsiveness? Expert Rev Respir Med 2018; 12:989-991. [PMID: 30362836 DOI: 10.1080/17476348.2018.1541741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Andreas A Teferra
- a Department of Epidemiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.,b GRIAC Research Institute , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Judith M Vonk
- a Department of Epidemiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.,b GRIAC Research Institute , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - H Marike Boezen
- a Department of Epidemiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.,b GRIAC Research Institute , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
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Tegegne BS, Mengesha MM, Teferra AA, Awoke MA, Habtewold TD. Association between diabetes mellitus and multi-drug-resistant tuberculosis: evidence from a systematic review and meta-analysis. Syst Rev 2018; 7:161. [PMID: 30322409 PMCID: PMC6190557 DOI: 10.1186/s13643-018-0828-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 10/01/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) poses a significant risk for the development of active tuberculosis (TB) and complicates its treatment. However, there is inconclusive evidence on whether the TB-DM co-morbidity is associated with a higher risk of developing multi-drug-resistant tuberculosis (MDR-TB). The aim of this meta-analysis was to summarize available evidence on the association of DM and MDR-TB and to estimate a pooled effect measure. METHODS PubMed, Excerpta Medica Database (EMBASE), Web of Science, World Health Organization (WHO), and Global Health Library database were searched for all studies published in English until July 2018 and that reported the association of DM and MDR-TB among TB patients. To assess study quality, we used the Newcastle-Ottawa Scale for cohort and case-control studies and the Agency for Healthcare Research and Quality tool for cross-sectional studies. We checked the between-study heterogeneity using the Cochrane Q chi-squared statistic and I2 and examined a potential publication bias by visual inspection of the funnel plot and Egger's regression test statistic. The random-effect model was fitted to estimate the summary effects, odds ratios (ORs), and 95% confidence interval (CIs) across studies. RESULTS This meta-analysis of 24 observational studies from 15 different countries revealed that DM has a significant association with MDR-TB (OR = 1.97, 95% CI = 1.58-2.45, I2 = 38.2%, P value for heterogeneity = 0.031). The significant positive association remained irrespective of country income level, type of DM, how TB or DM was diagnosed, and design of primary studies. A stronger association was noted in a pooled estimate of studies which adjusted for at least one confounding factor, OR = 2.43, 95% CI 1.90 to 3.12. There was no significant publication bias detected. CONCLUSIONS The results suggest that DM can significantly increase the odds of developing MDR-TB. Consequently, a more robust TB treatment and follow-up might be necessary for patients with DM. Efforts to control DM can have a substantial beneficial effect on TB outcomes, particularly in the case of MDR-TB. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016045692 .
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Affiliation(s)
- Balewgizie Sileshi Tegegne
- Department of Epidemiology and Biostatistics, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Melkamu Merid Mengesha
- Department of Epidemiology and Biostatistics, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Andreas A Teferra
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Mamaru Ayenew Awoke
- Amref Health Africa in Ethiopia, Monitoring, Evaluation and Research Unit, Addis Ababa, Ethiopia
| | - Tesfa Dejenie Habtewold
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Teferra AA, Mengistu D. Knowledge and attitude towards nursing clinical preceptorship among Ethiopian nurse educators: An institution-based cross-sectional study. International Journal of Africa Nursing Sciences 2017. [DOI: 10.1016/j.ijans.2017.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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