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Hogg RE, Sivaprasad S, Wickens R, O’Connor S, Gidman E, Ward E, Treanor C, Peto T, Burton BJL, Knox P, Lotery AJ, Donnelly M, Rogers CA, Reeves BC. Home-Monitoring Vision Tests to Detect Active Neovascular Age-Related Macular Degeneration. JAMA Ophthalmol 2024:2817623. [PMID: 38662399 PMCID: PMC11046404 DOI: 10.1001/jamaophthalmol.2024.0918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/20/2024] [Indexed: 04/26/2024]
Abstract
Importance Most neovascular age-related macular degeneration (nAMD) treatments involve long-term follow-up of disease activity. Home-monitoring would reduce the burden on patients and their caregivers and release clinic capacity. Objective To evaluate 3 vision home-monitoring tests for patients to use to detect active nAMD compared with diagnosing active nAMD at hospital follow-up during the after-treatment monitoring phase. Design, Setting, and Participants This was a diagnostic test accuracy study wherein the reference standard was detection of active nAMD by an ophthalmologist at hospital follow-up. The 3 home-monitoring tests evaluated included the following: (1) the KeepSight Journal (KSJ [International Macular and Retinal Foundation]), which contains paper-based near-vision tests presented as word puzzles, (2) the MyVisionTrack (mVT [Genentech]) vision-monitoring mobile app, viewed on an Apple mobile operating system-based device, and (3) the MultiBit (MBT [Visumetrics]) app, viewed on an Apple mobile operating system-based device. Participants were asked to test weekly; mVT and MBT scores were transmitted automatically, and KSJ scores were returned to the research office every 6 months. Raw scores between hospital follow-ups were summarized as averages. Patients were recruited from 6 UK hospital eye clinics and were 50 years and older with at least 1 eye first treated for active nAMD for at least 6 months or longer to a maximum of 42 months before approach. Participants were stratified by time since starting treatment. Study data were analyzed from May to September 2021. Exposures The KSJ, mVT, and MBT were compared with the reference standard (in-hospital ophthalmologist examination). Main Outcomes and Measures Estimated area under receiver operating characteristic curve (AUROC). The study had 90% power to detect a difference of 0.06, or 80% power to detect a difference of 0.05, if the AUROC for 2 tests was 0.75. Results A total of 297 patients (mean [SD] age, 74.9 [6.6] years; 174 female [58.6%]) were included in the study. At least 1 hospital follow-up was available for 312 study eyes in 259 participants (1549 complete visits). Median (IQR) home-monitoring testing frequency was 3 (1-4) times per month. Estimated AUROC was less than 0.6 for all home-monitoring tests, and only the KSJ summary score was associated with lesion activity (odds ratio, 3.48; 95% CI, 1.09-11.13; P = .04). Conclusions and Relevance Results suggest that no home-monitoring vision test evaluated provided satisfactory diagnostic accuracy to identify active nAMD diagnosed in hospital eye service follow-up clinics. Implementing any of these evaluated tests, with ophthalmologists only reviewing test positives, would mean most active lesions were missed, risking unnecessary sight loss.
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Affiliation(s)
- Ruth E. Hogg
- Center for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Center, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Robin Wickens
- Bristol Trials Center, University of Bristol, Bristol, United Kingdom
| | - Sean O’Connor
- Center for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Eleanor Gidman
- Bristol Trials Center, University of Bristol, Bristol, United Kingdom
| | - Elizabeth Ward
- Bristol Trials Center, University of Bristol, Bristol, United Kingdom
| | - Charlene Treanor
- Center for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Tunde Peto
- Center for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Ben J. L. Burton
- James Paget University Hospitals NHS Trust, Great Yarmouth, United Kingdom
| | - Paul Knox
- University of Liverpool, Liverpool, United Kingdom
| | - Andrew J. Lotery
- Department of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Michael Donnelly
- Center for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Chris A. Rogers
- Bristol Trials Center, University of Bristol, Bristol, United Kingdom
| | - Barnaby C. Reeves
- Bristol Trials Center, University of Bristol, Bristol, United Kingdom
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Bosqui T, Mayya A, Farah S, Shaito Z, Jordans MJD, Pedersen G, Betancourt TS, Carr A, Donnelly M, Brown FL. Parenting and family interventions in lower and middle-income countries for child and adolescent mental health: A systematic review. Compr Psychiatry 2024; 132:152483. [PMID: 38631272 DOI: 10.1016/j.comppsych.2024.152483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 08/31/2023] [Accepted: 04/02/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Given the protective effect of nurturing caregivers and families for child and adolescent mental health, there is a need to review and synthesize research evidence regarding the effectiveness of parenting and family interventions in low and middle-income countries, including humanitarian settings. To advance practice, further understanding of the active ingredients of such interventions and implementation factors that lead to effectiveness are essential. METHOD This systematic review, an update from a previous review, included studies on any parenting or family intervention for children and adolescents aged 0-24, living in a low- or middle-income country, that quantitatively measured child or adolescent mental health outcomes. We searched Global Health, PubMed, PsychINFO, PILOTS and the Cochrane Library databases on the 9th July 2020, and updated on the 12th August 2022. Risk of bias was assessed using an adapted version of the NIH Quality Assessment Tool. We extracted data on: effectiveness outcomes, practice elements included in effective interventions, and implementation challenges and successes. MAIN FINDINGS We found a total of 80 studies (n = 18,193 participants) representing 64 different family or parenting interventions, 43 of which had evidence of effect for a child or adolescent mental health outcome. Only 3 studies found no effect on child, adolescent or caregiver outcomes. The most common practice elements delivered in effective interventions included caregiver psychoeducation, communication skills, and differential reinforcement. Key implementation strategies and lessons learned included non-specialist delivery, the engagement of fathers, and integrated or multi-sector care to holistically address family needs. PRELIMINARY CONCLUSIONS Despite a high level of heterogeneity, preliminary findings from the review are promising and support the use of parenting and family interventions to address the wider social ecology of children in low resource and humanitarian contexts. There are remaining gaps in understanding mechanisms of change and the empirical testing of different implementation models. Our findings have implications for better informing task sharing from specialist to non-specialist delivery, and from individual-focused to wider systemic interventions.
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Affiliation(s)
- Tania Bosqui
- Department of Psychology, American University of Beirut, Beirut, Lebanon; Trinity Centre for Global Health, Trinity College Dublin, Republic of Ireland.
| | - Anas Mayya
- Department of Psychology, American University of Beirut, Beirut, Lebanon.
| | - Sally Farah
- Department of Psychology, American University of Beirut, Beirut, Lebanon.
| | - Zahraa Shaito
- Department of Psychology, American University of Beirut, Beirut, Lebanon.
| | - Mark J D Jordans
- War Child Alliance, Amsterdam, The Netherlands; Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands.
| | - Gloria Pedersen
- Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, the George Washington University School of Medicine and Health Sciences, Washington D.C., United States
| | | | - Alan Carr
- University College Dublin, Dublin, Republic of Ireland.
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
| | - Felicity L Brown
- War Child Alliance, Amsterdam, The Netherlands; Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands.
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Reeves BC, Wickens R, O'Connor SR, Gidman EA, Ward E, Treanor C, Peto T, Burton BJL, Knox PC, Lotery A, Sivaprasad S, Donnelly M, Rogers CA, Hogg RE. Descriptive study of the challenges when implementing an app for patients with neovascular age-related macular degeneration to monitor their vision at home. BMJ Open 2024; 14:e077196. [PMID: 38453199 PMCID: PMC10921518 DOI: 10.1136/bmjopen-2023-077196] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVES Remote monitoring of health has the potential to reduce the burden to patients of face-to-face appointments and make healthcare more efficient. Apps are available for patients to self-monitor vision at home, for example, to detect reactivation of age-related macular degeneration (AMD). Describing the challenges when implementing apps for self-monitoring of vision at home was an objective of the MONARCH study to evaluate two vision-monitoring apps on an iPod Touch (Multibit and MyVisionTrack). DESIGN Diagnostic Test Accuracy study. SETTING Six UK hospitals. METHODS The study provides an example of the real-world implementation of such apps across health sectors in an older population. Challenges described include the following: (1) frequency and reason for incoming calls made to a helpline and outgoing calls made to participants; (2) frequency and duration of events responsible for the tests being unavailable; and (3) other technical and logistical challenges. RESULTS Patients (n=297) in the study were familiar with technology; 252/296 (85%) had internet at home and 197/296 (67%) had used a smartphone. Nevertheless, 141 (46%) called the study helpline, more often than anticipated. Of 435 reasons for calling, all but 42 (10%) related to testing with the apps or hardware, which contributed to reduced adherence. The team made at least one call to 133 patients (44%) to investigate why data had not been transmitted. Multibit and MyVisionTrack apps were unavailable for 15 and 30 of 1318 testing days for reasons which were the responsibility of the app providers. Researchers also experienced technical challenges with a multiple device management system. Logistical challenges included regulations for transporting lithium-ion batteries and malfunctioning chargers. CONCLUSIONS Implementation of similar technologies should incorporate a well-resourced helpline and build in additional training time for participants and troubleshooting time for staff. There should also be robust evidence that chosen technologies are fit for the intended purpose. TRIAL REGISTRATION NUMBER ISRCTN79058224.
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Affiliation(s)
- Barnaby C Reeves
- Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - Robin Wickens
- Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sean R O'Connor
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Eleanor Alma Gidman
- Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - E Ward
- Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - Charlene Treanor
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Tunde Peto
- Queen's University Belfast Faculty of Medicine Health and Life Sciences, Belfast, UK
| | - Ben J L Burton
- James Paget University Hospitals NHS Trust, Liverpool, UK
| | | | | | | | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Chris A Rogers
- Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ruth E Hogg
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Hogg RE, Wickens R, O'Connor S, Gidman E, Ward E, Peto T, Burton BJL, Knox P, Lotery AJ, Sivaprasad S, Donnelly M, Rogers CA, Reeves BC. Inequalities in Uptake and Use of Digital Applications for Home-Monitoring of Neovascular Age-Related Macular Degeneration in an Elderly Visually Impaired Population: The MONARCH Study. Transl Vis Sci Technol 2024; 13:2. [PMID: 38427348 PMCID: PMC10913936 DOI: 10.1167/tvst.13.3.2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/08/2024] [Indexed: 03/02/2024] Open
Abstract
Purpose To describe inequalities in the Monitoring for Neovascular Age-related Macular Degeneration Reactivation at Home (MONARCH) diagnostic test accuracy study for: recruitment; participants' ability to self-test; and adherence to testing using digital applications during follow-up. Methods Home-monitoring vision tests included two tests implemented as software applications (apps: MyVisionTrack and MultiBit) on an iPod Touch device. Patients were provided with all hardware required to participate (iPod and MIFI device) and trained to use the apps. Regression models estimated associations of age, sex, Index of Multiple Deprivation, strata of time since first diagnosis, and baseline visual acuity at study entry on outcomes of willingness to participate, ability to perform tests, and adherence to weekly testing. Results A minority of patients who were approached were willing-in-principle to participate. Increasing age was associated with being unwilling-in-principle to participate. Patients from the most deprived areas had a 47% decrease in odds of being willing compared to those from the middle quintile deprived areas (odds ratio, 0.53; 95% confidence interval = 0.32, 0.88). Increasing age and worse deprivation were not consistently associated either with ability to self-monitor with the index tests, or adherence to weekly testing. Conclusions Associations of increasing age and worse deprivation index were associated with unwillingness-in-principle to participate despite the provision of hardware' highlighting the potential for inequality with interventions of the kind evaluated. Translational Relevance The clear evidence of inequalities in participation should prompt future research on ways to encourage adoption of mobile health technologies by underserved populations.
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Affiliation(s)
- Ruth E. Hogg
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Robin Wickens
- Bristol Trials Centre, University of Bristol, Bristol, UK
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Sean O'Connor
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Institute of Nursing and Health Research, Ulster University, Londonderry, UK
| | - Eleanor Gidman
- Bristol Trials Centre, University of Bristol, Bristol, UK
| | - Elizabeth Ward
- Bristol Trials Centre, University of Bristol, Bristol, UK
| | - Tunde Peto
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Paul Knox
- University of Liverpool, Liverpool, UK
| | - Andrew J. Lotery
- Department of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Htay MNN, Su TT, Donnelly M. Risk-Stratified Breast Cancer Screening in Malaysia: Challenges and Opportunities. Asian Pac J Cancer Prev 2024; 25:785-791. [PMID: 38546061 DOI: 10.31557/apjcp.2024.25.3.785] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION Breast cancer is the commonest cancer among Malaysian women. Current clinical practice guidelines (CPG) by the Ministry of Health, Malaysia comprise recommendations based on a risk stratification approach. AIM This paper reviewed and reflected on the challenges and uncertainties that needed to be considered regarding the implementation and delivery of risk-stratified breast cancer screening in Malaysia. METHODS Our iterative writing, discussions and reflections revolved around the results of key relevant literature search from the Ministry of Health Malaysia website, PubMed, and Google Scholar, and on feedback from local clinical experts in the field of breast cancer screening practice. The articles related to risk-stratified breast cancer screening, genetic testing, screening guidelines for the Malaysia population, and articles published in English were included in this narrative review. RESULT Further infrastructure and workforce capacity building is needed in order to achieve successful wider implementation e.g.; genetic counselling and testing services are limited in Malaysia. Furthermore, there is a need to elicit Malaysian women's views and evaluate their acceptance of risk-stratified breast cancer screening. The primary healthcare setting is an obvious potential avenue to introduce and deliver initial risk assessment and stratification. However, the workload and willingness of Malaysian primary healthcare doctors to practice risk-stratified screening is yet to be explored to have a better understanding on their perspective. CONCLUSION AND RECOMMENDATION Identifying a valid and appropriate risk model tailored to the population profile and needs of Malaysian women and conducting a pilot project of risk-stratified screening, guided by implementation science would provide lessons and insights for policymakers, health service managers, and public and primary health care professionals. The results of these activities would increase the likelihood that decisions and plans would lead to the successful implementation in Malaysia of a sustainable and effective breast cancer screening strategy that incorporates a patient-sensitive, risk-stratified approach.
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Affiliation(s)
- Mila Nu Nu Htay
- Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia
| | - Tin Tin Su
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Monash University (Malaysia), Jalan Lagoon, Selatan, Bandar Sunway, Selangor State, Malaysia
| | - Michael Donnelly
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, Northern, Ireland
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Al-walah MA, Donnelly M, Heron N. Barriers, enablers and motivators of the "I'm an active Hero" physical activity intervention for preschool children: a qualitative study. Front Pediatr 2024; 12:1333173. [PMID: 38357506 PMCID: PMC10864600 DOI: 10.3389/fped.2024.1333173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/18/2024] [Indexed: 02/16/2024] Open
Abstract
Background Insufficient physical activity (PA) in early childhood is linked to adverse health outcomes and a heightened risk of obesity. Successful PA programmes often require input from key stakeholders, such as parents and educators. However, research on stakeholders' perspectives regarding PA programmes for preschool children is limited, impeding effective programme design and implementation. Objectives This study aims to explore the perspectives of key stakeholders to gain insights into the challenges, facilitators, and motivators that influence the planning, execution, and sustainability of the "I'm an Active Hero (IAAH) intervention component," a preschool-based initiative designed to promote PA among young children. Methods Semi-structured interviews were conducted in Saudi Arabia with individual preschool principals (n = 2), and focus group discussions were held, respectively, with preschool staff members (n = 4, all female) and parents (4 mothers, 5 fathers). Results A thematic analysis identified four main themes: (1) Barriers to parental involvement in preschool PA interventions, such as time constraints, lack of flexibility, limited space, and a shortage of trained staff; (2) Risks and benefits of children's programme participation; (3) Motivators including rewards, non-financial incentives, and concerns about childhood obesity and a sedentary lifestyle; (4) Facilitating factors for overcoming barriers, including staff training, time reallocation, staff coordination, space optimization, non-financial incentives, and sustaining partnerships. Conclusion This study's findings are crucial for childcare professionals, preschools, education authorities, and policymakers, offering valuable insights for future research. However, further collaboration with key stakeholders is essential to enhance individual attitudes and preschool policies for effective intervention implementation.
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Affiliation(s)
- Mosfer A. Al-walah
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Neil Heron
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- School of Medicine, Keele University, Newcastle-Under-Lyme, Staffordshire, England
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Ngan TT, Tien TH, Donnelly M, O’Neill C. Financial toxicity among cancer patients, survivors and their families in the United Kingdom: a scoping review. J Public Health (Oxf) 2023; 45:e702-e713. [PMID: 37541834 PMCID: PMC10687873 DOI: 10.1093/pubmed/fdad143] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 07/04/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND The aim of this scoping review was to identify key research gaps and priorities in order to advance policy and practice for people living with cancer in the UK. METHODS The review adhered to PRISMA guidelines for scoping review. We searched MEDLINE, EMBASE, Scopus, Web of Science and Google Scholar on 16 July 2022. There were no restrictions in terms of study design and publication time; gray literature was included. The key words, 'financial' or 'economic', were combined with each of the following words 'hardship/stress/burden/distress/strain/toxicity/catastrophe/consequence/impact.' RESULTS 29/629 studies/reports published during 1982-2022 were eligible to be included in the review. No study conducted a comprehensive inquiry and reported all aspects of financial toxicity (FT) or used a validated measure of FT. The most three commonly reported outcomes related to financial hardship were financial well-being (24/29), benefit/welfare (17/29) and mental health status (16/29). CONCLUSIONS It is evident that FT is experienced by UK cancer patients/survivors and that the issue is under-researched. There is an urgent need for further research including rigorous studies which contribute to a comprehensive understanding about the nature and extent of FT, disparities in experience, the impacts of FT on outcomes and potential solutions to alleviate FT and related problems.
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Affiliation(s)
- Tran T Ngan
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Tran H Tien
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang 10408, Korea
- Department of Pharmacy, University Medical Center Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Michael Donnelly
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Ciaran O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
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Harkko J, Sipilä N, Nordquist H, Lallukka T, Appelqvist-Schmidlechner K, Donnelly M, Kouvonen A. External context in individual placement and support implementation: a scoping review with abductive thematic analysis. Implement Sci 2023; 18:61. [PMID: 37946209 PMCID: PMC10636871 DOI: 10.1186/s13012-023-01316-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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/15/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Context including the external context may considerably affect the adoption, implementation, sustainment, and scale-up of evidence-based practices. We investigated external contextual features by conducting a scoping review of empirical research regarding the implementation of an evidence-based psychiatric or mental health vocational rehabilitation service called Individual Placement and Support (IPS). METHODS The protocol for the scoping review was registered with the Open Science Framework. We used the methodology by Joanna Briggs Institute for conducting the scoping review and reported it according to the PRISMA-ScR checklist. We searched 12 databases for research regarding 'Individual Placement and Support' or 'Evidence-Based Supported Employment'. We retained peer-reviewed empirical studies investigating external contextual factors and their impact on IPS implementation outcomes. We extracted data from the eligible articles and conducted descriptive and thematic analyses. RESULTS Fifty-nine original research papers met our eligibility requirements and were retained after reviewing 1124 titles and abstracts and 119 full texts. The analysis generated two main themes: (1) external contextual determinants of service delivery and (2) external systems influencing the evidence-to-practice process. The first main theme encompassed policies and laws, financing, and administratively instituted support resources, and organizational arrangements associated with external stakeholders that may facilitate or hinder the local implementation. The second main theme comprised strategies and actions used by different stakeholders to facilitate implementation locally or scale-up efforts at a system level. DISCUSSION Our scoping review illustrates the important role that external contextual factors play and how they may facilitate or hinder the implementation and scale-up of the IPS model across mental health services in different countries. Consideration of these factors by decision-makers in mental health and welfare services, planners, providers, and practitioners is likely to facilitate the development of effective strategies for bridging the evidence-practice gap in implementing the EBPs. Finally, the scoping review identified gaps in knowledge and offered suggestions for future research. TRIAL REGISTRATION Open Science Framework.
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Affiliation(s)
- Jaakko Harkko
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
| | - Noora Sipilä
- The Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hilla Nordquist
- South-Eastern Finland University of Applied Sciences, Kotka, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
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Aljohani M, Donnelly M, Al Sumaih I, O'Neill C. The relationship between region of residence, socio-demographic factors, and healthcare utilization among Saudi citizens: insights from the 2013 Saudi Health Interview Survey. Front Med (Lausanne) 2023; 10:1252340. [PMID: 38020173 PMCID: PMC10657865 DOI: 10.3389/fmed.2023.1252340] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Background There is a dearth of research on the nature and extent of variation in patterns of health service use in Saudi Arabia. This is an important gap in knowledge, given ongoing efforts to improve service provision and delivery. This study examined the relationship between the region of residence and socio-demographic factors and patterns of health service use in Saudi Arabia. Methods Data were taken from the 2013 Saudi Health Interview Survey (SHIS), a national multistage survey of individuals aged 15 years and above in Saudi Arabia. Data included measures of service use, respondent health, socio-demographic characteristics, and region or area of residence. Descriptive statistics, Chi-square tests, and multivariable logistic regression analyses were used to describe the data and examine the likelihood of a respondent visiting a doctor or healthcare professional in the preceding 12 months. In addition, the analyses examined the role of health and socio-demographic characteristics within selected regions. Results The increased likelihood of using health services in terms of visiting a doctor or healthcare professional was related to poor health status, being female, married, having a low income, and residing in particular regions. Respondents aged <65 and who lived furthest from service providers were less likely to visit a doctor or other health professionals (p < 0.01). Residents who lived in Riyadh, Al Medina, Baha, or Aseer demonstrated a higher likelihood of service utilization compared to respondents residing in other regions (p < 0.05). In sub-group analyses, there was variation between regions with respect to socio-demographic status and distance to service. Conclusion Region of residence and income level, in particular, may help to explain the likelihood of primary care use in Saudi Arabia and the distinct patterns of service use in relation to regional and socio-demographic characteristics. The relationship between regional variation in service utilization and the socio-demographic characteristics of respondents may reflect differences with respect to population need, enabling, and predisposing factors as represented in Anderson's Behavioral Model (ABM) of health service use. The findings from this study underscore the importance of considering region or area of residence when seeking to understand the utilization of health services, particularly primary care services.
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Affiliation(s)
- Motab Aljohani
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
- Public Health Department, College of Health Science, Saudi Electronic, Riyadh, Saudi Arabia
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Ibrahim Al Sumaih
- Medical Supportive Services, King Fahad Hospital, Ministry of Health, Hofuf, Saudi Arabia
| | - Ciaran O'Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
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Moore C, Donnelly M, Semple C, O'Neill C, McKenna G. Compliance with oral hygiene and dietary advice for the prevention of post-radiotherapy dental disease among head and neck cancer patients - a qualitative study. J Dent 2023; 138:104720. [PMID: 37741501 DOI: 10.1016/j.jdent.2023.104720] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 09/25/2023] Open
Abstract
OBJECTIVES To elicit head and neck cancer (HANC) patients' views about their oral health and to identify potential issues regarding compliance with clinical oral hygiene and dietary advice for the prevention of post-radiotherapy dental disease. METHODS A purposive sample of twelve HANC patients between 6- and 12-months post-radiotherapy were recruited to undergo a semi-structured interview with a qualitative researcher. A pre-piloted topic guide was used to frame each interview. Qualitative data were analysed via thematic analysis. RESULTS Data were categorised into four main themes - 'How HANC patients perceive oral health', 'Cancer diagnosis and cancer care pathway', 'Impact of oncology treatment (radiotherapy, surgery, and chemotherapy)', and 'Post-oncology treatment recovery', with 14 subthemes. Oral health was viewed as an important component of HANC patients' overall physical and mental health post-treatment. Patients' non-compliance with adequate oral hygiene practice was related to oral mucositis, a "burning" sensation associated with high fluoride toothpaste, forgotten or inconsistent clinical advice, and an inadequate supply of preventive oral hygiene products. The potentially highly cariogenic nature of prescribed nutritional supplements for patients at risk of malnutrition did not tend to be communicated to patients in advance of their prescription. CONCLUSIONS Adequate oral health is essential for the overall physical and mental well-being of post-treatment HANC patients. Non-compliance with preventive clinical advice increases the risk of post-treatment oral health deterioration and was related to miscommunication, inadequate supplies of oral hygiene products, and treatment-related oral discomfort. CLINICAL SIGNIFICANCE Post-treatment HANC patients are at increased risk of dental disease. Educational and behavioural techniques should be employed to enhance patients' compliance with clinical oral hygiene and dietary advice for the prevention of post-radiotherapy dental disease. Patients should be informed about the potentially highly cariogenic nature of nutritional supplements, and these patients should undergo frequent dental recall. Clinical advice regarding oral hygiene and dietary practices needs to be given consistently to HANC patients by different specialists of the HANC multidisciplinary team.
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Affiliation(s)
- Ciaran Moore
- Restorative Dentistry Department, School of Dentistry, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA; Institute of Clinical Sciences, Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital site, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA.
| | - Michael Donnelly
- Institute of Clinical Sciences, Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital site, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA.
| | - Cherith Semple
- School of Nursing and Paramedic Science, Ulster University, Belfast Campus, York Street, Belfast, BT15 1AP.
| | - Ciaran O'Neill
- Institute of Clinical Sciences, Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital site, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA.
| | - Gerald McKenna
- Restorative Dentistry Department, School of Dentistry, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA; Institute of Clinical Sciences, Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital site, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA.
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Al-Walah MA, Donnelly M, Cunningham C, Heron N. Which behaviour change techniques are associated with interventions that increase physical activity in pre-school children? A systematic review. BMC Public Health 2023; 23:2013. [PMID: 37845721 PMCID: PMC10580560 DOI: 10.1186/s12889-023-16885-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Insufficient physical activity (PA) is a significant risk factor that contributes to several health problems and there is a need to improve our understanding of how to increase PA, particularly among young children. This review (PROSPERO registration: CRD42022328841) investigated the relationship between behaviour change techniques (BCTs) and interventions that increased PA among pre-school children aged < 6 years old. METHODS Systematic searches of six databases were undertaken from inception to July 2022, updated in December 2022, to locate studies that evaluated interventions and reported a positive change in PA levels in children aged < 6 years old. RESULTS A total of 5,304 studies were screened, and 28 studies involving 10,605 subjects aged 2.5 to 5.9 years met the eligibility criteria. Each eligible study (n = 28) was independently appraised by two researchers using the Cochrane risk of bias tool. The BCT Taxonomy v1 and the Template for Intervention Description and Replication (TIDieR) guided the extraction and analysis of data, and this process led to the identification of 27 BCTs. CONCLUSIONS Potentially promising BCTs for increasing PA among young children included 'shaping knowledge,' 'antecedents,' 'goals and planning,' and 'comparison of behaviour.' Future PA interventions that target young children should consider integrating these promising BCTs into their programmes. However, such consideration needs to be tempered by the fact that most of the reviewed studies were deemed to have a high or unclear risk of bias and/or were limited with respect to the populations that they targeted. Further research using rigorous methodologies is required to establish a higher standard that addresses the needs of young children who are expected to have insufficient levels of physical activity.
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Affiliation(s)
- Mosfer A Al-Walah
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK.
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, 21974, Taif, Saudi Arabia.
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK
| | - Conor Cunningham
- School of Health Science, Ulster University, Northern Ireland, UK
| | - Neil Heron
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK
- School of Medicine, Keele University, England, UK
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Schliemann D, Jamil ASA, Mohan D, Tan MM, Cardwell CR, Ismail R, Taib NA, Su TT, Donnelly M. The development and evaluation of a mHealth, community education and navigation intervention to improve clinical breast examination uptake in Segamat Malaysia: A randomised controlled trial. PLoS One 2023; 18:e0288437. [PMID: 37796803 PMCID: PMC10553222 DOI: 10.1371/journal.pone.0288437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 06/25/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION Breast cancer (BC) screening uptake in Malaysia is low and a high number of cases present at a late stage. Community navigation and mobile health (mHealth) may increase screening attendance, particularly by women from rural communities. This randomized controlled study evaluated an intervention that used mHealth and community health workers to educate women about BC screening and navigate them to clinical breast examination (CBE) services in the context of the COVID-19 pandemic. METHODS Women aged 40-74 years, from Segamat, Malaysia, with a mobile phone number, who participated in the South East Asian Community Observatory health survey, (2018) were randomized to an intervention (IG) or comparison group (CG). The IG received a multi-component mHealth intervention, i.e. information about BC was provided through a website, and telephone calls and text messages from community health workers (CHWs) were used to raise BC awareness and navigate women to CBE services. The CG received no intervention other than the usual option to access opportunistic screening. Regression analyses were conducted to investigate between-group differences over time in uptake of screening and variable influences on CBE screening participation. RESULTS We recruited 483 women in total; 122/225 from the IG and 144/258 from the CG completed the baseline and follow-up survey. Uptake of CBE by the IG was 45.8% (103/225) whilst 3.5% (5/144) of women from the CG who completed the follow-up survey reported that they attended a CBE during the study period (adjusted OR 37.21, 95% CI 14.13; 98.00, p<0.001). All IG women with a positive CBE attended a follow-up mammogram (11/11). Attendance by IG women was lower among women with a household income ≥RM 4,850 (adjusted OR 0.48, 95% CI 0.20; 0.95, p = 0.038) compared to participants with a household income CONCLUSION The results suggested that the bespoke multicomponent mHealth intervention may be used to address the significant public health problem of low uptake of BC screening in rural Malaysia.
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Affiliation(s)
- Désirée Schliemann
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Aminatul Saadiah Abdul Jamil
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
- Faculty of Science and Technology, Health Industry Technology, Islamic Science University of Malaysia, Nilai, Malaysia
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Min Min Tan
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Christopher R. Cardwell
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Roshidi Ismail
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Nur Aishah Taib
- Department of Surgery, Faculty of Medicine, UM Cancer Research Institute, University of Malaya, Kuala Lumpur, Malaysia
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Michael Donnelly
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
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Elshahat S, Moffat T, Morshed M, Alkhawaldeh H, Madani K, Mohamed A, Nadeem N, Emira S, Newbold KB, Donnelly M. A Scoping Review of the Relationship Between Physical Activity and Mental Health Among Immigrants in Western Countries: An Integrated Bio-Psycho-Socio-Cultural Lens. J Immigr Minor Health 2023; 25:1137-1151. [PMID: 37402074 DOI: 10.1007/s10903-023-01518-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/05/2023]
Abstract
Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners.
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Affiliation(s)
- Sarah Elshahat
- Faculty of Social Sciences, McMaster University, Chester New Hall, Hamilton, ON, Ontario, L8S 4L9, Canada.
| | - Tina Moffat
- Faculty of Social Sciences, McMaster University, Chester New Hall, Hamilton, ON, Ontario, L8S 4L9, Canada
| | - Mahira Morshed
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | | | - Keon Madani
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
| | - Aya Mohamed
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Naya Nadeem
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Sara Emira
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - K Bruce Newbold
- School of Earth, Environment & Society, McMaster University, Hamilton, ON, Canada
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, UK
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Su TT, Adekunjo FO, Schliemann D, Cardwell CR, Htay MNN, Dahlui M, Loh SY, Champion VL, Donnelly M. Testing the validity of a new scale designed to assess beliefs and perceptions about colorectal cancer and colorectal cancer screening in Malaysia: a principal component analysis. BMJ Open 2023; 13:e072166. [PMID: 37652591 PMCID: PMC10476116 DOI: 10.1136/bmjopen-2023-072166] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/31/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVE To conduct a cultural adaptation and validation of the Champion Health Belief Model Scale (CHBMS) for colorectal cancer (CRC) screening (CHBMS-CRC-M) in order to assess and investigate perceptions and beliefs about CRC screening in Malaysia. DESIGNS AND PARTICIPANTS The results from an evidence synthesis and the outcomes from an expert panel discussion were used to shape CHBMS scale content into an assessment of beliefs about CRC screening (CHBMS-CRC). This questionnaire assessment was translated into the official language of Malaysia. An initial study tested the face validity of the new scale or questionnaire with 30 men and women from various ethnic groups. Factorial or structural validity was investigated in a community sample of 954 multiethnic Malaysians. SETTING Selangor state, Malaysia. RESULTS The new scale was culturally acceptable to the three main ethnic groups in Malaysia and achieved good face validity. Cronbach's alpha coefficients ranged from 0.66 to 0.93, indicating moderate to good internal consistency. Items relating to perceived susceptibility to CRC 'loaded' on Factor 1 (with loadings scoring above 0.90); perceived benefits of CRC screening items loaded on factor 2 and were correlated strongly (loadings ranged between 0.63 and 0.83) and perceived barriers (PBA) to CRC screening (PBA) items loaded on factor 3 (range 0.30-0.72). CONCLUSION The newly developed CHBMS-CRC-M fills an important gap by providing a robust scale with which to investigate and assess CRC screening beliefs and contribute to efforts to enhance CRC screening uptake and early detection of CRC in Malaysia and in other Malay-speaking communities in the region.
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Affiliation(s)
- Tin Tin Su
- South East Asia Community Observatory (SEACO), Jeffery Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
- Centre for Pooulation Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Felix Oluyemi Adekunjo
- Department of Economics, Faculty of Social Sciences, Lagos State University, Lagos, Nigeria
| | - Desiree Schliemann
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Christopher R Cardwell
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Mila Nu Nu Htay
- Centre for Pooulation Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia
| | - Maznah Dahlui
- Centre for Pooulation Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Research Development and Innovation, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Siew Yim Loh
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Michael Donnelly
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
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Cooper JA, Murphy S, Kirk R, O’Reilly D, Donnelly M. Record linkage studies of primary care utilisation after release from prison: A scoping review protocol. PLoS One 2023; 18:e0289218. [PMID: 37624760 PMCID: PMC10456167 DOI: 10.1371/journal.pone.0289218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/13/2023] [Indexed: 08/27/2023] Open
Abstract
INTRODUCTION There is a need to improve the implementation and provision of continuity of care between prison and community in order that people who have been in prison and have a history of low engagement with services or who are vulnerable receive appropriate and timely health care and treatment. Observational studies using record linkage have investigated continuity of care after release from prison but this type of research evidence has not been synthesised. OBJECTIVE This paper presents a protocol designed to review record linkage studies about primary care utilisation after prison release in order to inform future research and guide service organisation and delivery towards people who are at-risk following release from prison. METHODS This scoping review will follow the framework by Arksey and O'Malley (5 stages) and guidance developed by the Joanna Briggs Institute (JBI). MEDLINE, EMBASE and Web of Science Core Collection will be searched (January 2012-March 2023) using terms relating to (i) 'former prisoners' and (ii) 'primary care'. The review will focus on observational studies that have investigated this topic using linked data from two or more sources. Two authors will independently screen titles and abstracts (step 1) and full publications (step 2) using predefined eligibility criteria. Data will be extracted from included publications using a piloted data charting form. This review will map the findings in this research area by methodology, key findings and gaps in research, and current evidence will be synthesised narratively given the expected considerable heterogeneity across studies. DISCUSSION This review is part of a work programme on health in prison (Administrative Data Research Centre, Northern Ireland). This work may be used to inform future research, policy and practice. Findings will be shared with stakeholders, published in a peer-reviewed journal and presented at relevant conferences. Ethical approval is not required.
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Affiliation(s)
- Janine A. Cooper
- Centre for Public Health, Queen’s University Belfast, Royal Hospitals Site, Belfast, United Kingdom
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen’s University Belfast, Royal Hospitals Site, Belfast, United Kingdom
| | - Siobhan Murphy
- Centre for Public Health, Queen’s University Belfast, Royal Hospitals Site, Belfast, United Kingdom
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen’s University Belfast, Royal Hospitals Site, Belfast, United Kingdom
| | - Richard Kirk
- South Eastern Health and Social Care Trust, Ulster Hospital, Dundonald, United Kingdom
| | - Dermot O’Reilly
- Centre for Public Health, Queen’s University Belfast, Royal Hospitals Site, Belfast, United Kingdom
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen’s University Belfast, Royal Hospitals Site, Belfast, United Kingdom
| | - Michael Donnelly
- Centre for Public Health, Queen’s University Belfast, Royal Hospitals Site, Belfast, United Kingdom
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen’s University Belfast, Royal Hospitals Site, Belfast, United Kingdom
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Tan MM, Jamil ASA, Ismail R, Donnelly M, Su TT. Breast cancer and breast cancer screening use-beliefs and behaviours in a nationwide study in Malaysia. BMC Public Health 2023; 23:1319. [PMID: 37430228 DOI: 10.1186/s12889-023-16227-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/30/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Many upper-middle-income countries (UMICs), including Malaysia, continue to face low breast cancer (BC) screening rates and patients with delayed presentation of BC. This study investigated the role of beliefs about BC and use of screening (e.g. beliefs about whether or not screening reduced the possibility of dying from BC). METHODS A nationwide cross-sectional study was conducted in which a total of 813 women (aged ≥ 40 years old) were randomly selected and surveyed using the validated Awareness and Beliefs about Cancer (ABC) measure. The association between BC screening use, sociodemographic characteristics, and negative beliefs about BC screening were analysed using stepwise Poisson regressions. RESULTS Seven out of ten Malaysian women believed that BC screening was necessary only when experiencing cancer symptoms. Women > 50 years and from households with more than one car or motorcycle were 1.6 times more likely to attend a mammogram or a clinical breast examination (mammogram: Prevalence Ratio (PR) = 1.60, 95% Confidence Interval (CI) = 1.19-2.14, Clinical Breast Examination (CBE): PR = 1.61, 95% CI = 1.29-1.99). About 23% of women expected to feel anxious about attending BC screening, leading them to avoid the procedure. Women who held negative beliefs about BC screening were 37% less likely to attend a mammogram (PR = 0.63, 95% CI = 0.42-0.94) and 24% less likely to seek a CBE (PR = 0.75, 95% CI = 0.60-0.95). CONCLUSIONS Public health strategies or behaviour interventions targeting negative beliefs about BC screening among Malaysian women may increase uptake and reduce late presentation and advanced-stage cancer. Insights from the study suggest that women under 50 years, in the lower income group without a car or motorcycle ownership, and of Malay or Indian ethnicity (compared to Chinese-Malay) are more likely to hold beliefs inhibiting BC screening.
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Affiliation(s)
- Min Min Tan
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia
| | - Aminatul Saadiah Abdul Jamil
- Health Industry Technology Programme, Faculty of Science and Technology, Universiti Sains Islam Malaysia, Negeri Sembilan, Malaysia
| | - Roshidi Ismail
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Northern Ireland, UK.
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia.
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
- Centre for Public Health, Queen's University Belfast, Northern Ireland, UK.
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Nguyen DT, Donnelly M, Van Hoang M, O'Neill C. The case for individualised public health interventions: Smoking prevalence and inequalities in Northern Ireland 1985-2015. Health Policy 2023; 135:104879. [PMID: 37441920 DOI: 10.1016/j.healthpol.2023.104879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND While smoking prevalence in high income countries has declined over time, socioeconomic inequalities in smoking have widened. This study is one of the few studies to examine the longitudinal pattern of income-related smoking inequalities and only the second using concentration indices in its analysis. METHOD Income-related smoking inequalities were measured using concentration indices using the Northern Ireland Continuous Household Survey data. Smoking inequalities were compared quantitatively and visually across three periods: 1985-1995, 1997-2005 and 2007-2015. Joinpoint analysis was used to measure the overall time trend of smoking inequalities. Subgroup analysis was used to examine the nature of change in smoking inequalities across population sub-groups. FINDINGS Throughout 1985-2015, smoking was more concentrated among the poor (standard concentration index of-0·131, p < 0·001). While prevalence declined sharply across population, income-related inequalities increased sharply in general and within subgroups. Income-related smoking inequalities were significantly larger among high educated group and those who were employed. No structural break was observed with respect to the adoption of any specific policy measures over the period. CONCLUSION Current approaches to tobacco control may be ill-suited to addressing smoking inequalities and may indeed be counterproductive. More tailored approaches that address the specific needs of population sub-groups or more draconian approaches such as extensions to prohibition may be required to reduce prevalence further while avoiding a widening of inequalities.
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Affiliation(s)
- Duyen Thuy Nguyen
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Institute of Clinical Science Block A, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom; Center for Population Health Sciences, Hanoi University of Public Health, no 1A Duc Thang street, North Tu Liem district, Hanoi 100000, Vietnam.
| | - Michael Donnelly
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Institute of Clinical Science Block A, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom
| | - Minh Van Hoang
- Center for Population Health Sciences, Hanoi University of Public Health, no 1A Duc Thang street, North Tu Liem district, Hanoi 100000, Vietnam
| | - Ciaran O'Neill
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Institute of Clinical Science Block A, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom
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Cooper JA, Onyeka I, Cardwell C, Paterson E, Kirk R, O'Reilly D, Donnelly M. Record linkage studies of drug-related deaths among adults who were released from prison to the community: a scoping review. BMC Public Health 2023; 23:826. [PMID: 37147595 PMCID: PMC10161544 DOI: 10.1186/s12889-023-15673-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/13/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND There are public health concerns about an increased risk of mortality after release from prison. The objectives of this scoping review were to investigate, map and summarise evidence from record linkage studies about drug-related deaths among former adult prisoners. METHODS MEDLINE, EMBASE, PsychINFO and Web of Science were searched for studies (January 2011- September 2021) using keywords/index headings. Two authors independently screened all titles and abstracts using inclusion and exclusion criteria and subsequently screened full publications. Discrepancies were discussed with a third author. One author extracted data from all included publications using a data charting form. A second author independently extracted data from approximately one-third of the publications. Data were entered into Microsoft Excel sheets and cleaned for analysis. Standardised mortality ratios (SMRs) were pooled (where possible) using a random-effects DerSimonian-Laird model in STATA. RESULTS A total of 3680 publications were screened by title and abstract, and 109 publications were fully screened; 45 publications were included. The pooled drug-related SMR was 27.07 (95%CI 13.32- 55.02; I 2 = 93.99%) for the first two weeks (4 studies), 10.17 (95%CI 3.74-27.66; I 2 = 83.83%) for the first 3-4 weeks (3 studies) and 15.58 (95%CI 7.05-34.40; I 2 = 97.99%) for the first 1 year after release (3 studies) and 6.99 (95%CI 4.13-11.83; I 2 = 99.14%) for any time after release (5 studies). However, the estimates varied markedly between studies. There was considerable heterogeneity in terms of study design, study size, location, methodology and findings. Only four studies reported the use of a quality assessment checklist/technique. CONCLUSIONS This scoping review found an increased risk of drug-related death after release from prison, particularly during the first two weeks after release, though drug-related mortality risk remained elevated for the first year among former prisoners. Evidence synthesis was limited as only a small number of studies were suitable for pooled analyses for SMRs due to inconsistencies in study design and methodology.
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Affiliation(s)
- Janine A Cooper
- Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK.
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK.
| | - Ifeoma Onyeka
- Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
- Present address: Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield, UK
| | - Christopher Cardwell
- Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
| | - Euan Paterson
- Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
| | - Richard Kirk
- Healthcare in Prison, South Eastern Health and Social Care Trust, Dundonald, UK
| | - Dermot O'Reilly
- Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
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Stanley C, Lennon D, Moriarty F, Sheridan GA, Nagle M, Foley A, Moran C, Donnelly M. The association between weather warnings and hip fractures in the Republic of Ireland. Arch Osteoporos 2023; 18:53. [PMID: 37084122 PMCID: PMC10121515 DOI: 10.1007/s11657-023-01243-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
This study examined the relationship between hip fractures and weather warnings with the hypothesis higher rates of fractures occur during warnings. National hip fracture database and weather warning records were utilised. Higher rates of hip fractures were found with severe warnings. This has implications for planning in future severe warnings. BACKGROUND Hip fractures represent a significant burden on the Irish Health system with 3666 in 2020. The Irish National Meteorological Service operates a colour coded warning system. Yellow being least severe, while orange represents weather with capacity to impact individuals in affected areas and red represents advice to protect themselves and property. Previous studies investigated the seasonality of hip fractures, which remains but none have investigated the relationship between weather warnings and rates of hip fractures. The hypothesis was that increasing weather warnings would be associated with increased hip fractures. The aim was to investigate the relationship between weather warnings and hip fractures in the Republic of Ireland. METHODS Comparison of national weather warning archives from 2013 to 2019 to Fracture Database records. Reviews assessed whether fractures occurred on days a weather warning was in place in the individual's local county. A statistical analysis of warning features and their relationship to hip fractures was then performed. Fractures and weather warnings were stratified by county with both a panel and case crossover analysis performed. RESULTS There was a tendency towards increased incidence of hip fractures with weather warnings in adjusted analysis (IRR 1.02; 95%CI 0.99-1.06; p-value 0.123). Orange warnings were associated with a statistically higher incidence of fractures (IRR 1.06; 1.01-1.12; p-value 0.026). In both panel and case crossover analysis, both orange and yellow warnings were associated with fractures. Red warnings were associated with a lower incidence of fracture on day of warning (adjusted incidence rate ratio 0.92; 0.70-1.22; p-value 0.569) but a higher incidence on the following day (adjusted incidence rate ratio 1.14; 0.88-1.46; p-value 0.313). CONCLUSION An increased incidence of hip fractures appears to occur during weather warnings. Consideration should be given when preparing for periods of extreme weather, ensuring sufficiently resources.
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Affiliation(s)
- Ciarán Stanley
- Department of Trauma and Orthopaedics, Beaumont Hospital, Dublin 9, Ireland.
| | - David Lennon
- Department of Trauma and Orthopaedics, Beaumont Hospital, Dublin 9, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gerard A Sheridan
- Department of Trauma and Orthopaedics, Beaumont Hospital, Dublin 9, Ireland
| | - Matthew Nagle
- Department of Trauma and Orthopaedics, University Hospital Limerick, Limerick, Ireland
| | - Alexandra Foley
- Department of Trauma and Orthopaedics, Beaumont Hospital, Dublin 9, Ireland
| | - Conor Moran
- Department of Trauma and Orthopaedics, University Hospital Limerick, Limerick, Ireland
| | - Michael Donnelly
- Department of Trauma and Orthopaedics, Beaumont Hospital, Dublin 9, Ireland
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Ngan TT, Ramanathan K, Saleh MRBM, Schliemann D, Ibrahim Tamin NSB, Su TT, Donnelly M, O'Neill C. Budget impact analysis of a home-based colorectal cancer screening programme in Malaysia. BMJ Open 2023; 13:e066925. [PMID: 36944471 PMCID: PMC10032398 DOI: 10.1136/bmjopen-2022-066925] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 03/13/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES The 2020-2022 research project 'Colorectal Cancer Screening Intervention for Malaysia' (CRC-SIM) evaluated the implementation of a home-based CRC screening pilot in Segamat District. This budget impact analysis (BIA) assessed the expected changes in health expenditure of the Malaysian Ministry of Health budget in the scenario where the pilot programme was implemented nationwide vs current opportunistic screening. DESIGN Budget impact analysis. Assumptions and costs in the opportunistic and novel CRC screening scenarios were derived from a previous evaluation of opportunistic CRC screening in community health clinics across Malaysia and the CRC-SIM research project, respectively. SETTING National level (with supplement analysis for district level). The BIA was conducted from the viewpoint of the federal government and estimated the annual financial impact over a period of 5 years. RESULTS The total annual cost of the current practice of opportunistic screening was RM1 584 321 (~I$1 099 460) of which 80% (RM1 274 690 or ~I$884 587) was expended on the provision of opportunistic CRC to adults who availed of the service. Regarding the implementation of national CRC screening programme, the net budget impact in the first year was estimated to be RM107 631 959 (~I$74 692 546) and to reach RM148 485 812 (~I$103 043 589) in the fifth year based on an assumed increased uptake of 5% annually. The costs were calculated to be sensitive to the probability of adults who were contactable, eligible and agreeable to participating in the programme. CONCLUSIONS Results from the BIA provided direct and explicit estimates of the budget changes to when implementing a population-based national CRC screening programme to aid decision making by health services planners and commissioners in Malaysia about whether such programme is affordable within given their budget constraint. The study also illustrates the use and value of the BIA approach in low-income and middle-income countries and resource-constrained settings.
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Affiliation(s)
- Tran Thu Ngan
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Kogila Ramanathan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
- South East Asia Community Observatory, Monash University Malaysia, Selangor, Malaysia
| | | | | | | | - Tin Tin Su
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
- South East Asia Community Observatory, Monash University Malaysia, Selangor, Malaysia
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Ciaran O'Neill
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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21
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Udd-granat L, Lahti J, Donnelly M, Treanor C, Pirkola SP, Lallukka T, Kouvonen A. Internet-delivered cognitive behavioral therapy (iCBT) for common mental disorders and subsequent sickness absence: a systematic review and meta-analysis. Scand J Public Health 2023; 51:137-147. [PMID: 35120414 PMCID: PMC9903245 DOI: 10.1177/14034948221075016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Indexed: 02/04/2023]
Abstract
AIM The study aimed to critically review and synthesize the best available evidence about the effectiveness of therapist-guided internet-delivered cognitive behavioral therapy (iCBT) in terms of reducing sickness absence (SA). METHODS We searched Medline (PubMed), Embase, PsycInfo, CINAHL, and Cochrane Central (up to November 2020) for English language peer-reviewed papers that described randomized controlled trials of therapist-guided iCBT compared with usual treatment for SA in adults with common mental disorders. Eligible studies were assessed with the Cochrane Risk of Bias 1 tool, meta-analysis was conducted using a random-effects model, and standardized mean differences (SMD) with 95% confidence intervals (CI) were reported. A subgroup analysis investigated potential moderating variables (diagnosis, SA at baseline, and estimated accuracy of self-report). RESULTS We identified 2788 references, of which 68 remained after the completion of the systematic screening process. A hand search of reference lists yielded no additional studies. The full texts of these 68 studies were appraised critically, and 11 were deemed to be suitable for a meta-analysis. SA was similar for iCBT and usual treatment groups (SMD: 0.02, 95% CI, -0.08 to 0.11), and remained similar even after the removal of two studies in which the recall time was over 3 months (SMD: 0.00, -0.11 to 0.12). Similar SA levels in intervention and control groups at 6-month and 12-month follow-up were observed in studies of participants with depression symptoms. CONCLUSIONS
iCBT did not appear to be effective in terms of reducing (largely self-assessed) SA in adults with common mental disorders. There is a need to improve the method and consistency of assessing SA.
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Affiliation(s)
- Lina Udd-granat
- Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Jouni Lahti
- Faculty of Social Sciences, University of Helsinki, Finland
| | - Michael Donnelly
- Centre for Public Health, Queen’s University Belfast, Northern Ireland
| | - Charlene Treanor
- Centre for Public Health, Queen’s University Belfast, Northern Ireland
| | - Sami P. Pirkola
- Faculty of Social Sciences, Tampere University, Finland,Department of Psychiatry, Tampere University Central Hospital, Finland
| | - Tea Lallukka
- Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Finland,Centre for Public Health, Queen’s University Belfast, Northern Ireland,Anne Kouvonen, University of Helsinki, PO Box 54, 00014 Helsinki, Finland. E-mail:
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22
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Fagan S, Donnelly M, Clancy A, Regan M, Maher AM, Ryan C, Armitage S, Shah M, Sheehan P, Mannion C, Gallagher O, Foran R, Devine C, Love B. P17 National antimicrobial point prevalence survey in adult inpatient mental health facilities in Ireland. JAC Antimicrob Resist 2023. [DOI: 10.1093/jacamr/dlac133.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Abstract
Background
Antimicrobial use in mental health inpatient settings has not been extensively examined in Ireland. The Healthcare-Associated Infection and Antimicrobial Use in Long-Term Care Facilities (HALT) study 2016 found that Irish long-term care facilities caring for residents with psychiatric conditions had an antimicrobial prevalence rate of 7.7%, higher than the European average of 4.9%. National community antimicrobial prescribing guidelines are available at www.antibioticprescribing.ie. In addition, a preferred antibiotic initiative for community settings advocates prescribers to choose ‘Green’ (preferred) antibiotics over ‘Red’ (reserved) agents. Reserved agents are considered to have more adverse effects, drug interactions and potential for development of antimicrobial resistance. The patient safety implications of antimicrobial stewardship along with an ageing population, and potential drug–drug interactions between many antimicrobials and psychotropic medications prompted a review of antimicrobial use practices in mental health services.
Methods
A sample of adult inpatient mental health facilities (MHF) operated by the state's Health Service Executive (HSE) were surveyed by community antimicrobial pharmacists (AMPs) between November 2021 and January 2022. AMPs reviewed patients’ medication charts for systemic antimicrobial prescriptions in the previous 30 days in addition to medical notes and laboratory results (where available). Adherence to HSE National community antimicrobial guidelines and the systems and structures in place to support antimicrobial stewardship were assessed.
Results
In total, 1003 patients in 51 MHFs were surveyed. At the time of survey, 6.3% (n=66) patients were on a systemic antimicrobial and 15% (n=153) had received a systemic antimicrobial within the previous 30 days. Prophylaxis accounted for 50% of antibiotic use (3.3% of all patients), with the most common indication being the prevention of urinary tract infection (UTI) (58%). Prophylaxis duration exceeded six months in 61% of prescriptions. The median duration of treatment courses was seven days. The proportion of ‘Green’ (preferred) antimicrobials versus ‘Red’ (reserved) antimicrobials was 58% versus 38%. Co-amoxiclav, a ‘Red’ agent was the most commonly prescribed antibiotic for treatment of infection (31%). Adherence with choice of antimicrobial agent as per national antimicrobial guidelines was 76%; adherence of dosing regimen was 75% and adherence with recommended duration was 46%. The main themes for non-adherence with choice of agent were use of unnecessarily broad spectrum agents, nitrofurantoin prescribed in renal impairment and inappropriate formulation of nitrofurantoin chosen. Dipstick urinalysis was performed routinely (on admission and/or at designated intervals) for persons asymptomatic of UTI in 53% (n=27) of MHFs.
Conclusions
This PPS established antimicrobial use practices in HSE MHFs and identified opportunities for improvement relating to the safe and optimal use of antimicrobials. Key national recommendations from this survey were:
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Affiliation(s)
- S Fagan
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - M Donnelly
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - A Clancy
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - M Regan
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - A M Maher
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - C Ryan
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - S Armitage
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - M Shah
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - P Sheehan
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - C Mannion
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - O Gallagher
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - R Foran
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - C Devine
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
| | - B Love
- HSE Community Antimicrobial Pharmacists , Community Operations , Ireland
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Shah M, Clancy A, Regan M, Maher AM, Armitage S, Ryan C, Mannion C, Sheehan P, Gallagher O, Foran R, Fagan S, Donnelly M, Love B. O02 Improving antimicrobial use in HSE older persons residential care facilities. JAC Antimicrob Resist 2023. [DOI: 10.1093/jacamr/dlac133.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Abstract
Background
Antimicrobial use in Irish older persons residential care facilities (OP RCFs) is higher than in other European countries. In 2020/21, for the first time, an antimicrobial pharmacist (AMP) was appointed to each community healthcare organization (CHO) to monitor, develop and promote antimicrobial stewardship in community settings.
Objectives
To establish baseline antibiotic use, develop antimicrobial stewardship tools for OP RCFs, promote best practice in relation to antimicrobial stewardship (AMS) and monitor trends in antimicrobial use in HSE (state-run) OP RCFs.
Methods
A baseline point prevalence survey (PPS) of antimicrobial use was conducted across all HSE OP RCFs between October 2020 and August 2021. Following the survey, key national recommendations and AMS resources were developed in collaboration with the national Antimicrobial Resistance and Infection Control Programme. Feedback was provided to participating facilities by CHO AMPs with antimicrobial stewardship support and education for nursing and medical staff. In September 2021, monthly monitoring of antibiotic use was established in HSE OP RCFs in collaboration with local managers, to capture the proportion of antibiotics used for prophylaxis or treatment each month.
Results
A baseline PPS of antimicrobial use in 2020/21 showed that 11.9% (528/4446) of residents were on a systemic antibiotic, with 6.3% on antibiotic prophylaxis. Urinary tract infection accounted for 51% of antibiotic prescriptions. Following the baseline PPS, CHO AMPs developed an AMS toolkit for OP RCFs, engaged with nursing and medical staff to communicate PPS results, AMS resources and support implementation of AMS recommendations. Subsequently, monthly self-reporting of antimicrobial use in HSE OP RCFs was commenced in September 2021 and showed a sustained decrease in antimicrobial use with 7.9% residents on an antibiotic in Quarter 2 2022, with 2.7% on antibiotic prophylaxis.
Conclusions
Newly appointed CHO AMPs have successfully promoted AMS across HSE OP RCFs. Following audit, feedback, education, development and promotion of antimicrobial stewardship resources, there was a sustained decrease in the proportion of residents on antibiotics used for treatment and prophylaxis of infection.
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Affiliation(s)
- M Shah
- HSE Community Operations , Ireland
| | - A Clancy
- HSE Community Operations , Ireland
| | - M Regan
- HSE Community Operations , Ireland
| | | | | | - C Ryan
- HSE Community Operations , Ireland
| | | | | | | | - R Foran
- HSE Community Operations , Ireland
| | - S Fagan
- HSE Community Operations , Ireland
| | | | - B Love
- HSE Community Operations , Ireland
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Schliemann D, Ramanathan K, Ibrahim Tamin NSB, O'Neill C, Cardwell CR, Ismail R, Kassim Z, Kee F, Su TT, Donnelly M. Implementation of a home-based colorectal cancer screening intervention in Malaysia (CRC-SIM). BMC Cancer 2023; 23:22. [PMID: 36609260 PMCID: PMC9817284 DOI: 10.1186/s12885-022-10487-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/26/2022] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION The Colorectal Cancer Screening Intervention for Malaysia (CRC-SIM) was a CRC study of home-based testing designed to improve low screening uptake using the immunochemical fecal occult blood test (iFOBT) in Malaysia. METHODS This quasi-experimental study was informed by the Implementation Research Logic Model and evaluated with the RE-AIM framework. Trained data collectors recruited by phone, randomly selected, asymptomatic adults aged 50-75 years from Segamat District, who previously completed a health census form for the South East Asia Community Observatory (SEACO). Participants were posted an iFOBT kit and asked to return a photo of the completed test for screening by health care professionals. A regression analysis of evaluation data was conducted to identify which variables were associated with the outcome indicators of 'study participation' and 'iFOBT completion' and the CRC-SIM was evaluated in terms of its appropriateness, feasibility and acceptability. RESULTS Seven hundred forty-seven eligible adults (52%) agreed to participate in this study and received an iFOBT kit. Participation was significantly lower amongst Chinese Malaysians (adjusted OR 0.45, 95% CI 0.35 - 0.59, p<0.001) compared to Malays and amongst participants from the rural sub-district (Gemereh) (adjusted OR 0.71, 95% CI 0.54 - 0.92, p=0.011) compared to the urban sub-district (Sungai Segamat). Less than half of participants (42%, n=311/747) completed the iFOBT. Test-kit completion was significantly higher amongst Chinese Malaysians (adjusted OR 3.15, 95% CI 2.11 - 4.69, p<0.001) and lower amongst participants with a monthly household income ≥RM 4,850 (adjusted OR 0.58, 95% CI 0.39 - 0.87, p=0.009) compared to participants with a lower household income. The main reported reason for non-participation was 'not interested' (58.6%) and main implementation challenges related to invalid photographs from participants and engaging iFOBT positive participants in further clinic consultations and procedures. CONCLUSION Home-testing for CRC (test completion) appeared to be acceptable to only around one-fifth of the target population in Malaysia. However, mindful of the challenging circumstances surrounding the pandemic, the CRC-SIM merits consideration by public health planners as a method of increasing screening in Malaysia, and other low- and middle-income countries.
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Affiliation(s)
- Désirée Schliemann
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK.
| | - Kogila Ramanathan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Petaling Jaya, Malaysia
| | | | - Ciaran O'Neill
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Christopher R Cardwell
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Roshidi Ismail
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Petaling Jaya, Malaysia
| | - Zaid Kassim
- Segamat District Health Office, Johor, Malaysia
| | - Frank Kee
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Tin Tin Su
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Petaling Jaya, Malaysia
| | - Michael Donnelly
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
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Ngan TT, Browne S, Goodwin M, Van Minh H, Donnelly M, O'Neill C. Cost-effectiveness of clinical breast examination screening programme among HER2-positive breast cancer patients: a modelling study. Breast Cancer 2023; 30:68-76. [PMID: 36028594 DOI: 10.1007/s12282-022-01398-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/22/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE For many low- and middle-income countries (LMICs), breast cancer (BC) screening based on mammography is not a viable option. Clinical breast examination (CBE) may represent a pragmatic and cost-effective alternative. This paper examines the cost-effectiveness of CBE screening programme among a patient group for whom its cost-effectiveness is likely to be least evident (HER2-positive patients) and discuss the wider implications for BC screening in LMICs. METHODS A Markov model was used to examine clinical and economic outcomes over a life-time horizon from the patient, public payer, and healthcare sector perspective. HER2-positive patients entered the model at either disease-free survival or metastatic BC state. The downstaging effect of CBE determined the starting probabilities in the no-screening and screening scenarios. The model used a monthly cycle length, with half-cycle correction. Costs and outcomes were discounted at 1.5% annually. RESULTS Compared with no-screening, the cost-effectiveness ratio (ICER) per quality-adjusted life-year gained for the CBE screening programme was $1801, $2381, and $4179 from three mentioned perspectives, respectively. The finding of cost-effectiveness remained robust to a range of sensitivity analyses. The parameters to which ICERs are most sensitive are average age of cohorts, reduction in proportion of metastatic patients at diagnosis, cost of CBE, and BC detection rate of the programme. CONCLUSION For HER2-positive patients and compared with no-screening, CBE screening programme in Vietnam is cost-effective from all investigated perspectives. CBE is a 'good value' intervention and should be considered for implementation throughout Vietnam as well as in LMICs where mammography is not feasible.
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Affiliation(s)
- Tran T Ngan
- Centre for Public Health, Queen's University Belfast, Belfast, UK. .,Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.
| | | | | | - Hoang Van Minh
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Ciaran O'Neill
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Ramanathan K, Schliemann D, Binti Ibrahim Tamin NS, Mohan D, Donnelly M, Su TT. Facilitators and barriers to colorectal cancer screening using the immunochemical faecal occult blood test among an average-risk population in semi-rural Malaysia: A qualitative study. PLoS One 2022; 17:e0279489. [PMID: 36580458 PMCID: PMC9799312 DOI: 10.1371/journal.pone.0279489] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/07/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) incidence in Malaysia is increasing, and most CRC patients are diagnosed at a late stage. This study investigated participant awareness of CRC and their perceptions and views about CRC screening, barriers, benefits, and facilitators towards CRC screening participation as well as health-seeking behaviour and the use of preventative health services. METHOD Eleven focus group discussions (FGDs) were conducted with a purposive sample of 89 participants aged > 50 from the major ethnic groups in the Segamat District, Johor State. FGDs were audiotaped, transcribed verbatim, and translated into English. Data were analysed using thematic analysis. RESULTS We identified trust in doctors as a key reason for whether or not to seek health care. Generally, the participants had low awareness of CRC sign/symptoms and screening. Emotional and logistic concerns about sending a stool sample to a clinic emerged as the main barriers to screening. Simplified illustrated instructions about stool collection in Malay, Chinese and Tamil, free screening at health clinics and reminders to complete the iFOBT test were perceived to facilitate engagement in screening, and posited as strategies that were likely to increase iFOBT uptake. CONCLUSION Primary care physicians play a crucial role in terms of reducing patient's misperceptions, recommending screening to patients, enhancing attendance, and improving uptake of CRC screening. There is a need for further research to investigate ways in which to reduce identified barriers and implement and test potential facilitative strategies as well as examine adherence by doctors to clinical guidelines about CRC screening.
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Affiliation(s)
- Kogila Ramanathan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
| | - Désirée Schliemann
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | | | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
| | - Michael Donnelly
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- * E-mail: (MD); (TTS)
| | - Tin Tin Su
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
- * E-mail: (MD); (TTS)
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Aljohani M, Donnelly M, O’Neill C. Changes in public satisfaction with GP services in Britain between 1998 and 2019: a repeated cross-sectional analysis of attitudinal data. BMC Prim Care 2022; 23:83. [PMID: 35436843 PMCID: PMC9014779 DOI: 10.1186/s12875-022-01696-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Between 1998 and 2019, the structure and process of general practitioner services in Britain underwent a series of reforms and experienced distinct funding environments. This paper examines changes in satisfaction with GP services over time against this backdrop.
Methods
Data were extracted from the British Social Attitudes Survey for the period 1998–2019. Logistic regression analyses investigated changes in overall satisfaction and among specific population sub-groups differentiated by socio-demographic characteristics whilst taking account of time trend and interaction effects between sub-group membership and time trend.
Results
Sustained and significant changes in satisfaction coincided closely with changes to the funding environment. Distinct patterns were evident among sub-groups. Satisfaction appeared to fall more sharply during austerity for low income groups, older people and people who had fewer formal qualifications/years in education.
Conclusion
While a series of policy initiatives were adopted over the period examined, public satisfaction seemed to move in a manner consistent with levels of government expenditure rather than exhibiting distinct breaks that coincided with policy initiatives. As services recover from the pandemic it will be necessary to invest in a significant and sustained way to rebuild public satisfaction.
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Clancy A, Regan M, Armitage S, Shah M, Mannion C, Gallagher O, Foran R, Fagan S, Donnelly M, Love B. 88 NATIONAL ANTIMICROBIAL POINT PREVALENCE SURVEY IN HSE OLDER PERSONS RESIDENTIAL CARE FACILITIES (OPS-RCFS). Age Ageing 2022. [DOI: 10.1093/ageing/afac218.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The HALT study in 2016 found that residents in Irish OPS RCFs were twice as likely to be on systemic antimicrobial compared with European average (10% v 5%). National antibiotic prescribing guidelines are available at www.antibioticprescribing.ie and prescribers are encouraged to choose ‘green’ (preferred) over ‘red’ (reserved) agents. HSE Community Antimicrobial Pharmacists (AMPs) have been employed since 2020. We aimed to establish the quality and quantity of antimicrobial prescribing in OPS-RCFs to inform antimicrobial stewardship activities.
Methods
All residents in HSE OPS-RCFs were surveyed between October 2020 and August 2021. AMPs reviewed all medication charts for systemic antimicrobials prescribed within previous 30 days. Medical notes +/- laboratory results were reviewed for persons on antimicrobials. Adherence to guidelines was assessed and information obtained on practices related to antimicrobial use.
Results
The survey included 4,448 individuals in 121 OPS RCFs. 12% were on systemic antimicrobial at time of survey. 27% received an antimicrobial in the previous 30 days. 50% of antibiotic use on survey day was for prophylaxis (6.3% of all residents). Prophylaxis exceeded 6 months in 66% persons, and 12 months in 57%. There was high usage of green versus red agents (65% vs 30%). Co-amoxiclav (red) was most commonly prescribed antimicrobial to treat infection (19%). 42% of sites reported routine use of dipstick urinalysis to support diagnosis of UTI in asymptomatic residents. 36% of sites did not have onsite electronic laboratory access. 61% of facilities did not record residents’ pneumococcal vaccination status.
Conclusion
Key national recommendations: Review all UTI prophylaxis within 6 months of initiation with view to de-prescribing.Cease routine use of dipstick urinalysis to support diagnosis of UTI for asymptomatic persons.Electronic access to laboratory results on-site required to support timely decision-making.All staff should be aware of the national antimicrobial guidelines.Pneumococcal vaccine status should be determined, and provided as necessary.
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Affiliation(s)
- A Clancy
- HSE Community Healthcare: Quality, Safety and Service Improvement, CHO1 , Ireland
| | - M Regan
- HSE Community Healthcare: Quality, Safety and Service Improvement, CHO2 , Ireland
| | - S Armitage
- HSE Community Healthcare: Quality, Safety and Service Improvement, CHO3 , Ireland
| | - M Shah
- HSE Community Healthcare: Quality, Safety and Service Improvement, CHO4 , Ireland
| | - C Mannion
- HSE Community Healthcare: Quality, Safety and Service Improvement, CHO5 , Ireland
| | - O Gallagher
- HSE Community Healthcare: Quality, Safety and Service Improvement, CHO6 , Ireland
| | - R Foran
- HSE Community Healthcare: Quality, Safety and Service Improvement, CHO7 , Ireland
| | - S Fagan
- HSE Community Healthcare: Quality, Safety and Service Improvement, CHO8 , Ireland
| | - M Donnelly
- HSE Community Healthcare: Quality, Safety and Service Improvement, CHO9 , Ireland
| | - B Love
- HSE Community Healthcare: Quality, Safety and Service Improvement, Chief Pharmacist , Ireland
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O’Connor SR, Treanor C, Ward E, Wickens RA, O’Connell A, Culliford LA, Rogers CA, Gidman EA, Peto T, Knox PC, Burton BJL, Lotery AJ, Sivaprasad S, Reeves BC, Hogg RE, Donnelly M. Patient Acceptability of Home Monitoring for Neovascular Age-Related Macular Degeneration Reactivation: A Qualitative Study. Int J Environ Res Public Health 2022; 19:13714. [PMID: 36294292 PMCID: PMC9603709 DOI: 10.3390/ijerph192013714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Neovascular age-related macular degeneration (nAMD) is a chronic, progressive condition and the commonest cause of visual disability in older adults. This study formed part of a diagnostic test accuracy study to quantify the ability of three index home monitoring (HM) tests (one paper-based and two digital tests) to identify reactivation in nAMD. The aim of this qualitative research was to investigate patients' or participants' views about acceptability and explore adherence to weekly HM. Semi-structured interviews were held with 78/297 participants (26%), with close family members (n = 11) and with healthcare professionals involved in training participants in HM procedures (n = 9) (n = 98 in total). A directed thematic analytical approach was applied to the data using a deductive and inductive coding framework informed by theories of technology acceptance. Five themes emerged related to: 1. The role of HM; 2. Suitability of procedures and instruments; 3. Experience of HM; 4. Feasibility of HM in usual practice; and 5. Impediments to patient acceptability of HM. Various factors influenced acceptability including a patient's understanding about the purpose of monitoring. While initial training and ongoing support were regarded as essential for overcoming unfamiliarity with use of digital technology, patients viewed HM as relatively straightforward and non-burdensome. There is a need for further research about how use of performance feedback, level of support and nature of tailoring might facilitate further the implementation of routinely conducted HM. Home monitoring was acceptable to patients and they recognised its potential to reduce clinic visits during non-active treatment phases. Findings have implications for implementation of digital HM in the care of older people with nAMD and other long-term conditions.
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Affiliation(s)
- Seán R. O’Connor
- School of Psychology, Queen’s University of Belfast, Belfast BT7 1NN, UK
| | - Charlene Treanor
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
| | - Elizabeth Ward
- Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
| | - Robin A. Wickens
- Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
- Southampton Clinical Trials Unit, University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - Abby O’Connell
- Exeter Clinical Trials Unit (EXECTU), University of Exeter, St. Lukes Campus, Exeter EX1 2LT, UK
| | - Lucy A. Culliford
- Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
| | - Chris A. Rogers
- Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
| | - Eleanor A. Gidman
- Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
| | - Tunde Peto
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
| | - Paul C. Knox
- Department of Eye and Vision Science, University of Liverpool, Liverpool L7 8TX, UK
| | | | - Andrew J. Lotery
- Department of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
| | - Barnaby C. Reeves
- Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
| | - Ruth E. Hogg
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
| | - Michael Donnelly
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
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Gillanders SL, Walsh M, Naudé A, Smyth D, Donnelly M. Hurling and Camogie Related Blunt Laryngeal Trauma. Ir Med J 2022; 115:676. [PMID: 36920415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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31
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Jallow M, Bonfield S, Kurtidu C, Baldwin DR, Black G, Brain KE, Donnelly M, Janes SM, McCutchan G, Robb KA, Ruparel M, Van Os S, Quaife SL. Decision Support Tools for Low-Dose CT Lung Cancer Screening: A Scoping Review of Information Content, Format, and Presentation Methods. Chest 2022; 162:930-941. [PMID: 34922933 PMCID: PMC9562440 DOI: 10.1016/j.chest.2021.12.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/08/2021] [Accepted: 12/08/2021] [Indexed: 11/21/2022] Open
Abstract
Several countries mandate informed or shared decision-making for low-dose CT (LDCT) lung cancer screening, but knowledge is limited about the type of information and presentation techniques used to support decision-making in practice. This review aimed to characterize the content, format, mode, and presentation methods of decision support tools (DSTs) for LDCT lung cancer screening. DSTs reported within peer-reviewed articles (January 2000-April 2021) were identified systematically from PubMed, PsycInfo, EMBASE, and CINAHL Plus. Inclusion criteria revolved around the development or evaluation of a resource or tool intended to support individual or shared decision-making for LDCT lung cancer screening. The data-charting and extraction framework was based on the International Patient Decision Aids Standards instrument and Template for Intervention Description and Reporting. Extracted data were organized within two categories: (1) study characteristics and context, format, and mode of DST use and (2) DST content and presentation methods. This review identified 22 DSTs in paper, video, or electronic formats across 26 articles. Most DSTs (n = 13) focused on knowledge exchange, whereas seven used interactive techniques to support values clarification (eg, Likert scales) and nine DSTs guided deliberation (eg, suggested discussion topics). The DSTs addressed similar topics, but the detail, quantification of probability, and presentation methods varied considerably. None described all the potential screening harms and results. The heterogeneity in DST design may affect the quality of decision-making, particularly for participants with lower literacy and numeracy. Evidence-based consensus guidelines for DST content and presentation methods should be developed collaboratively with screening-eligible adults.
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Affiliation(s)
- Mbasan Jallow
- Research Department of Behavioural Science and Health, University College London, London, England
| | - Stefanie Bonfield
- Research Department of Behavioural Science and Health, University College London, London, England; Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England
| | - Clara Kurtidu
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - David R Baldwin
- Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, City Hospital, Nottingham, England
| | - Georgia Black
- Department of Applied Health Research, University College London, London, England
| | - Kate E Brain
- Division of Population Medicine, Cardiff University, Cardiff, Wales
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Samuel M Janes
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, England
| | - Grace McCutchan
- Division of Population Medicine, Cardiff University, Cardiff, Wales
| | - Kathryn A Robb
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Mamta Ruparel
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, England
| | - Sandra Van Os
- Department of Applied Health Research, University College London, London, England
| | - Samantha L Quaife
- Research Department of Behavioural Science and Health, University College London, London, England; Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England.
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Htay MNN, Dahlui M, Schliemann D, Loh SY, Ibrahim Tamin NSB, Somasundaram S, Donnelly M, Su TT. Women's health beliefs and uptake of breast cancer screening in Malaysia. Eur J Cancer Care (Engl) 2022; 31:e13675. [PMID: 35946147 DOI: 10.1111/ecc.13675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/04/2022] [Accepted: 06/21/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study investigated women's health beliefs, the use of breast cancer (BC) screening services, and the factors that potentially influence uptake of screening. METHODS Face-to-face interviews were conducted with a randomly selected community sample of 992 women (>40 years old) in Selangor State, Malaysia. RESULTS Approximately 35% of women received a clinical breast examination (CBE) and 27% had a mammogram within the last 1 to 2 years. The regression analyses indicated that Chinese ethnicity has higher perceived susceptibility to BC compared to Malay ethnicity (mean 7.74, SD: 2.75; 95% CI 0.09, 1.03) whilst a lower perceived susceptibility was observed in women aged ≥70 years (mean 6.67, SD: 3.01; 95% CI -1.66, -0.24) compared to women aged 40-49 years. Indian Malaysian women (mean 16.87, SD: 2.59; 95% CI 0.12, 1.01) and women who had received a CBE (mean 16.10, SD:2.35; 95% CI 0.18, 0.89) were more likely to have higher perceived benefits scoring. Indian ethnicity, secondary education and tertiary education, top 20% income group, past history of CBE and mammogram uptake were significantly associated with lower barriers scoring. CONCLUSIONS There is a need to target BC screening uptake improvement programmes towards communities in which women experience disadvantages related to income, education, employment, and, in particular, to tailor programmes to take into consideration differences between ethnic groups regarding their beliefs about cancer screening.
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Affiliation(s)
- Mila Nu Nu Htay
- Centre for Population Health (CePH), Department of Social and Preventive, Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia
| | - Maznah Dahlui
- Centre for Population Health (CePH), Department of Social and Preventive, Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Désirée Schliemann
- Centre for Public Health and UKCRC, Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Siew Yim Loh
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - Michael Donnelly
- Centre for Public Health and UKCRC, Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Tin Tin Su
- Centre for Population Health (CePH), Department of Social and Preventive, Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,South East Asia Community Observatory (SEACO) and Global Public Health, Jeffery Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
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Schliemann D, Ramanathan K, Ibrahim Tamin NSB, O'Neill C, Cardwell CR, Ismail R, Nanu P, Mohd Ghazali ANB, Kee F, Su TT, Donnelly M. Implementation of a colorectal cancer screening intervention in Malaysia (CRC-SIM) in the context of a pandemic: study protocol. BMJ Open 2022; 12:e058420. [PMID: 36581978 PMCID: PMC9438210 DOI: 10.1136/bmjopen-2021-058420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Colorectal cancer (CRC) is the second most common cancer in Malaysia and cases are often detected late. Improving screening uptake is key in down-staging cancer and improving patient outcomes. The aim of this study is to develop, implement and evaluate an intervention to improve CRC screening uptake in Malaysia in the context of the COVID-19 pandemic. The evaluation will include ascertaining the budgetary impact of implementing and delivering the intervention. METHODS AND ANALYSIS The implementation research logic model guided the development of the study and implementation outcome measures were informed by the 'Reach, Effectiveness, Adoption, Implementation and Maintenance' (RE-AIM) framework. This CRC screening intervention for Malaysia uses home-testing and digital, small media, communication to improve CRC screening uptake. A sample of 780 people aged 50-75 years living in Segamat district, Malaysia, will be selected randomly from the South East Asia Community Observatory (SEACO) database. Participants will receive a screening pack as well as a WhatsApp video of a local doctor to undertake a stool test safely and to send a photo of the test result to a confidential mobile number. SEACO staff will inform participants of their result. Quantitative data about follow-up clinic attendance, subsequent hospital tests and outcomes will be collected. Logistic regression will be used to investigate variables that influence screening completion and we will conduct a budget impact-analysis of the intervention and its implementation. Qualitative data about intervention implementation from the perspective of participants and stakeholders will be analysed thematically. ETHICS AND DISSEMINATION Ethics approval has been granted by Monash University Human Research Ethics Committee (MUHREC ID: 29107) and the Medical Review and Ethics Committee (Reference: 21-02045-O7G(2)). Results will be disseminated through publications, conferences and community engagement activities. TRIAL REGISTRATION NUMBER National Medical Research Register Malaysia: 21-02045-O7G(2).
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Affiliation(s)
- Désirée Schliemann
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Kogila Ramanathan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | | | - Ciaran O'Neill
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Christopher R Cardwell
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Roshidi Ismail
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Prathibha Nanu
- Surgical Department, Hospital Segamat, Segamat, Malaysia
| | | | - Frank Kee
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Tin Tin Su
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Michael Donnelly
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
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Su TT, Donnelly M. Improving breast and colorectal cancer screening uptake in Malaysia. Eur J Cancer Care (Engl) 2022; 31:e13593. [PMID: 35396774 DOI: 10.1111/ecc.13593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/28/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Tin Tin Su
- South East Asia Community Observatory (SEACO) and Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Michael Donnelly
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
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Cooper J, Onyeka I, Paterson E, O'Reilly D, Kirk R, Donnelly M. Record linkage studies of drug-related deaths among former adult prisoners who have been released to the community: a scoping review. Int J Popul Data Sci 2022. [DOI: 10.23889/ijpds.v7i3.2044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
ObjectivesSubstance use disorders are common in prisoners before they are admitted to prison. Epidemiological studies have demonstrated an increased risk of death following release from prison. The aim of this scoping review is to identify, map and summarise evidence from record linkage studies about drug-related deaths among former adult prisoners.
ApproachWe followed the framework for conducting scoping reviews by Arksey and O’Malley, and guidance by the Joanna Briggs Institute. MEDLINE, EMBASE, PsychINFO and Web of Science were searched for studies from January 2011 to September 2021 using keywords and index headings relating to ‘mortality’, ‘drugs’ and ‘ex-prisoner’. Two authors independently screened titles and abstracts for eligibility using pre-defined inclusion criteria. Full publication screening for inclusion was performed independently by two authors. Two authors tested the charting form and are independently extracting information from the eligible publications using this form. There were no geographical restrictions but non-English language papers were excluded.
ResultsFollowing the removal of duplicates, 3680 publications were screened using title and abstract. Full text publications were subsequently screened for eligibility. A total of 48 publications have been included in this review. Publications may be added from a search of reference lists. Two authors are performing data extraction and data will be presented and analysed in relation to answering the following scoping review questions:
What is the scope of the literature on record linkage studies of drug-related deaths among former adult prisoners who have been released to the community?
How is research conducted on this topic?
What methodologies are used?
What are the findings in relation to mortality?
Where are the knowledge gaps on this topic?
ConclusionThis review will help identify and profile at risk former prisoners, contribute to potential interventions, and inform future research and policy. Where possible, evidence will be reported about the time period to death after prison release and the specific drugs related to mortality.
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Cooper J, O'Reilly D, Kirk R, Kelly T, Gibbs R, Donnelly M. A project designed to examine, for the first time, the health records of adult prisoners in Northern Ireland and their linkage to other available health data: the test case of prisoner post-release mortality risk. Int J Popul Data Sci 2022. [DOI: 10.23889/ijpds.v7i3.2057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
A project designed to examine, for the first time, the health records of adult prisoners in Northern Ireland and their linkage to other available health data: the test case of prisoner post-release mortality risk
ObjectivesThe linkage of routinely collected administrative data for research purposes has the potential to improve knowledge and public benefit. We describe a novel data linkage study between the Northern Ireland (NI) Healthcare in Prisons and Business Services Organisation (BSO). This work is undertaken within the Administrative Data Research Centre-NI (ADRC-NI).
ApproachThis joint project between ADRC-NI Queen’s University Belfast and NI Healthcare in Prisons (South Eastern Health and Social Care Trust) will test linkage of prisoner health records to health data held in the BSO and the potential to generate a population-based cohort for a retrospective analysis of prisoner health (2012-2021) that will attempt to characterise prisoners according to socio-demographic, health and committal factors, compare post-release mortality rates with a reference group from the NI population using indirect standardisation and estimate post-release mortality risk using Cox proportional hazards models.
ResultsUsing novel data-linkages, a dataset will be created to examine the health of prisoners (and former prisoners) in NI. Ethics and governance approvals are in place for this data-linkage. The linkage will be undertaken via the Honest Broker Service (HBS) in NI and the dataset will be accessed in the safe setting at the BSO. The processes involved, experiences including significant delays or difficulties, and recommendations for future data-linkage studies will be discussed. In addition, a key deliverable of this project will be an assessment of access and linkage capabilities of the prisoner health data, with metadata created and made available to future researchers. In addition, we plan to present preliminary results relating to the test research question.
ConclusionWe will describe the processes involved and first-hand research experience in the development of a novel data-linkage project, in addition we will detail access and linkage capabilities in relation to this new dataset to examine health in prisoners (and former prisoners) in NI.
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Schliemann D, Tan MM, Hoe WMK, Mohan D, Taib NA, Donnelly M, Su TT. mHealth Interventions to Improve Cancer Screening and Early Detection: Scoping Review of Reviews. J Med Internet Res 2022; 24:e36316. [PMID: 35969450 PMCID: PMC9425170 DOI: 10.2196/36316] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 01/13/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cancer screening provision in resource-constrained settings tends to be opportunistic, and uptake tends to be low, leading to delayed presentation and treatment and poor survival. OBJECTIVE The aim of this study was to identify, review, map, and summarize findings from different types of literature reviews on the use of mobile health (mHealth) technologies to improve the uptake of cancer screening. METHODS The review methodology was guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Ovid MEDLINE, PyscINFO, and Embase were searched from inception to May 2021. The eligible criteria included reviews that focused on studies of interventions that used mobile phone devices to promote and deliver cancer screening and described the effectiveness or implementation of mHealth intervention outcomes. Key data fields such as study aims, types of cancer, mHealth formats, and outcomes were extracted, and the data were analyzed to address the objective of the review. RESULTS Our initial search identified 1981 titles, of which 12 (0.61%) reviews met the inclusion criteria (systematic reviews: n=6, 50%; scoping reviews: n=4, 33%; rapid reviews: n=1, 8%; narrative reviews: n=1, 8%). Most (57/67, 85%) of the interventions targeted breast and cervical cancer awareness and screening uptake. The most commonly used mHealth technologies for increasing cancer screening uptake were SMS text messages and telephone calls. Overall, mHealth interventions increased knowledge about screening and had high acceptance among participants. The likelihood of achieving improved uptake-related outcomes increased when interventions used >1 mode of communication (telephone reminders, physical invitation letters, and educational pamphlets) together with mHealth. CONCLUSIONS mHealth interventions increase cancer screening uptake, although multiple modes used in combination seem to be more effective.
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Affiliation(s)
- Désirée Schliemann
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Min Min Tan
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Subang Jaya, Malaysia.,Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Wilfred Mok Kok Hoe
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Subang Jaya, Malaysia.,Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Nur Aishah Taib
- Department of Surgery, Faculty of Medicine, University Malaya Cancer Research Institute, University of Malaya, Kuala Lumpur, Malaysia
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Tin Tin Su
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.,South East Asia Community Observatory (SEACO), Monash University Malaysia, Subang Jaya, Malaysia.,Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
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Jallow M, Black G, van Os S, Baldwin DR, Brain KE, Donnelly M, Janes SM, Kurtidu C, McCutchan G, Robb KA, Ruparel M, Quaife SL. Acceptability of a standalone written leaflet for the National Health Service for England Targeted Lung Health Check Programme: A concurrent, think-aloud study. Health Expect 2022; 25:1776-1788. [PMID: 35475542 PMCID: PMC9327842 DOI: 10.1111/hex.13520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Many countries are introducing low-dose computed tomography screening programmes for people at high risk of lung cancer. Effective communication strategies that convey risks and benefits, including unfamiliar concepts and outcome probabilities based on population risk, are critical to achieving informed choice and mitigating inequalities in uptake. METHODS This study investigated the acceptability of an aspect of NHS England's communication strategy in the form of a leaflet that was used to invite and inform eligible adults about the Targeted Lung Health Check (TLHC) programme. Acceptability was assessed in terms of how individuals engaged with, comprehended and responded to the leaflet. Semi-structured, 'think aloud' interviews were conducted remotely with 40 UK screening-naïve current and former smokers (aged 55-73). The verbatim transcripts were analysed thematically using a coding framework based on the Dual Process Theory of cognition. RESULTS The leaflet helped participants understand the principles and procedures of screening and fostered cautiously favourable intentions. Three themes captured the main results of the data analysis: (1) Response-participants experienced anxiety about screening results and further investigations, but the involvement of specialist healthcare professionals was reassuring; (2) Engagement-participants were rapidly drawn to information about lung cancer prevalence, and benefits of screening, but deliberated slowly about early diagnosis, risks of screening and less familiar symptoms of lung cancer; (3) Comprehension-participants understood the main principles of the TLHC programme, but some were confused by its rationale and eligibility criteria. Radiation risks, abnormal screening results and numerical probabilities of screening outcomes were hard to understand. CONCLUSION The TLHC information leaflet appeared to be acceptable to the target population. There is scope to improve aspects of comprehension and engagement in ways that would support informed choice as a distributed process in lung cancer screening. PATIENT OR PUBLIC CONTRIBUTION The insight and perspectives of patient representatives directly informed and improved the design and conduct of this study.
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Affiliation(s)
- Mbasan Jallow
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Georgia Black
- Department of Applied Health ResearchUniversity College LondonLondonUK
| | - Sandra van Os
- Department of Applied Health ResearchUniversity College LondonLondonUK
| | - David R. Baldwin
- Department of Respiratory MedicineNottingham University Hospitals NHS Trust, City HospitalNottinghamUK
| | - Kate E. Brain
- Division of Population MedicineCardiff UniversityCardiffUK
| | | | - Samuel M. Janes
- Lungs for Living Research Centre, UCL Respiratory, Division of MedicineUniversity College LondonLondonUK
| | - Clara Kurtidu
- Institute of Health and WellbeingUniversity of GlasgowGlasgowUK
| | | | - Kathryn A. Robb
- Institute of Health and WellbeingUniversity of GlasgowGlasgowUK
| | - Mamta Ruparel
- Lungs for Living Research Centre, UCL Respiratory, Division of MedicineUniversity College LondonLondonUK
| | - Samantha L. Quaife
- Wolfson Institute of Population Health, Barts and The London School of Medicine and DentistryQueen Mary University of LondonLondonUK
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Ngan TT, Jenkins C, Minh HV, Donnelly M, O’Neill C. Breast cancer screening practices among Vietnamese women and factors associated with clinical breast examination uptake. PLoS One 2022; 17:e0269228. [PMID: 35622840 PMCID: PMC9140272 DOI: 10.1371/journal.pone.0269228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background
This study examined current breast cancer (BC) screening practices among Vietnamese women and the factors associated with the uptake of clinical breast examination (CBE).
Methods
A total of 508 women aged 30–74 years in Hanoi completed a knowledge-attitude-practice (KAP) survey in 2019 including validated measures of breast cancer awareness (Breast-CAM) and health beliefs (Champion’s Health Belief Model Scale). Descriptive statistics, χ2, and ANOVA tests were used to analyse KAP responses across groups with different sociodemographic characteristics. A logistic regression model assessed the associations of knowledge, beliefs, and sociodemographic characteristics with CBE uptake.
Results
Only 18% of respondents were aware of BC signs, risk factors, and screening modalities although 63% had previously received BC screening. CBE was the most common screening modality with an uptake of 51%. A significantly higher proportion of urban residents compared with rural residents (32% vs 18%, Chi-square test, p = 0.04) received mammography. Unlike mammography, CBE uptake was not associated with sociodemographic characteristics (i.e., residence area/education level/occupation/household monthly income/possession of health insurance). CBE uptake was associated with BC knowledge (OR = 2.44, 95%CI: 1.37–4.32), perceived susceptibility to BC (OR = 1.15, 95%CI: 1.05–1.25), and perceived barriers to accessing CBE (OR = 0.88, 95%CI: 0.84–0.92).
Conclusion
The study points to the need for public health education and promotion interventions to address low levels of awareness about BC and to increase uptake of BC screening in Vietnam in advance of screening programme planning and implementation. It also suggests that screening programmes using CBE are promising given current engagement and the absence of socio-demographic disparities.
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Affiliation(s)
- Tran Thu Ngan
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
- * E-mail:
| | - Chris Jenkins
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Hoang Van Minh
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Michael Donnelly
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Ciaran O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
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Schliemann D, Hoe WMK, Mohan D, Allotey P, Reidpath DD, Tan MM, Taib NAM, Donnelly M, Su TT. Challenges and opportunities for breast cancer early detection among rural dwelling women in Segamat District, Malaysia: A qualitative study. PLoS One 2022; 17:e0267308. [PMID: 35594267 PMCID: PMC9122189 DOI: 10.1371/journal.pone.0267308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/05/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Breast cancer patients in low- and middle-income countries often present at an advanced stage. This qualitative study elicited views regarding the challenges and opportunities for breast cancer screening and early detection among women in a low-income semi-rural community in Segamat district, Malaysia. METHODS Individual semi-structured interviews with 22 people (health professionals, cancer survivors, community volunteers and member from a non-governmental organization) and four focus group discussions (n = 22 participants) with women from a local community were conducted. All participants were purposively sampled and female residents registered with the South East Asia Community Observatory aged ≥40 years were eligible to participate in the focus group discussions. Data were transcribed verbatim and analyzed using thematic analysis. RESULTS The thematic analysis illuminated barriers, challenges and opportunities across six domains: (i) personal experiences and barriers to help-seeking as well as financial and travel access barriers; (ii) primary care challenges (related to delivering clinical breast examination and teaching breast-self-examination); (iii) secondary care challenges (related to mammogram services); (iv) disconnection between secondary and primary care breast cancer screening pathways; and (v) opportunities to improve breast cancer early detection relating to community civil service society activities (i.e. awareness raising, support groups, addressing stigma/embarrassment and encouraging husbands to support women) and vi) links between public healthcare personnel and community (i.e. improving breast self-examination education, clinical breast examination provision and subsidised mammograms). CONCLUSION The results point to a variety of reasons for low uptake and, therefore, to the complex nature of improving breast cancer screening and early detection. There is a need to adopt a systems approach to address this complexity and to take account of the socio-cultural context of communities in order, in turn, to strengthen cancer control policy and practices in Malaysia.
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Affiliation(s)
- Désirée Schliemann
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Wilfred Mok Kok Hoe
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Segamat, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Pascale Allotey
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | | | - Min Min Tan
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Segamat, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Nur Aishah Mohd Taib
- Faculty of Medicine, Department of Surgery, Universiti Malaya Cancer Research Institute, University of Malaya, Kuala Lumpur, Malaysia
| | - Michael Donnelly
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Tin Tin Su
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Segamat, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
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Brown FL, Bosqui T, Elias J, Farah S, Mayya A, Abo Nakkoul D, Walsh B, Chreif S, Einein A, Meksassi B, Abi Saad R, Naal H, Ghossainy ME, Donnelly M, Betancourt TS, Carr A, Puffer E, El Chammay R, Jordans MJD. Family systemic psychosocial support for at-risk adolescents in Lebanon: study protocol for a multi-site randomised controlled trial. Trials 2022; 23:327. [PMID: 35436976 PMCID: PMC9014280 DOI: 10.1186/s13063-022-06284-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Adolescents growing up in communities characterised by adversity face multiple risk factors for poor mental health and wellbeing. There is currently a scarcity of research on effective approaches for preventing and treating psychological distress in this population, particularly in humanitarian settings. The powerful impact of the home environment and family support is well known; however, approaches targeting the family are seldom developed or evaluated in such settings. We developed a brief family systemic psychosocial support intervention to be delivered through existing child protection systems with non-specialist facilitators. This paper outlines the study protocol for a randomised controlled trial of the intervention in Lebanon. Methods We will conduct a single-blind hybrid effectiveness-implementation multi-site RCT comparing the locally developed systemic family intervention to a waitlist control group for families residing in vulnerable regions in North Lebanon and Beqaa governorates (including families of Syrian, Palestinian, and Lebanese backgrounds). Outcomes on a range of family, adolescent, and caregiver measures will be assessed at baseline (T0) and post-intervention (T1), and at a 3-month follow-up for the treatment arm (T2). Families will be eligible for the trial if they are identified by implementing organisations as being medium-to-high risk for child protection concerns and have one or more adolescent aged 12–17 who demonstrates significant psychological distress on a self-report brief screening tool. Families will be randomly assigned to a treatment or a waitlist control condition. Families in the waitlist condition will receive a group version of the programme after completion of the study, to allow us to assess feasibility, acceptability, and preliminary indications of intervention effects of this modality. The primary outcome is reduction in overall adolescent-reported psychological distress over time, with post-intervention (T1) as the primary endpoint. Secondary adolescent-reported outcomes include family functioning, psychosocial wellbeing, and emotional regulation difficulties. Secondary caregiver-reported outcomes include parenting style, family functioning, psychological distress, and emotional regulation difficulties. Discussion This trial will provide the first assessment of the effectiveness of the family systemic psychosocial support intervention for use in Lebanon, with important implications for the use of systemic, low-cost, non-specialist interventions for this age range. Trial registration Local registry: National Mental Health Program, Ministry of Public Health, Lebanese Republic. Registered on 19 October 2021 Lebanese Clinical Trial Registry LBCTR2021104870. Registered on 13 October 2021 Global registry: ISRCTN ISRCTN13751677. Registered on 1 November 2021
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McLister C, Moore C, Harkness SM, O'Neill C, Donnelly M, McKenna G. Appropriateness of tooth replacement strategies for adult patients in the United Kingdom with reduced dentitions – a modified Delphi analysis. J Dent 2022; 122:104125. [DOI: 10.1016/j.jdent.2022.104125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/28/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022] Open
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Cooper JA, Onyeka I, O'Reilly D, Kirk R, Donnelly M. Record linkage studies of drug-related deaths among former adult prisoners who have been released to the community: a scoping review protocol. BMJ Open 2022; 12:e056598. [PMID: 35351720 PMCID: PMC8966574 DOI: 10.1136/bmjopen-2021-056598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Prisoners often have a complex mix of health and care needs including needs relating to mental and physical ill-health conditions. In addition, substance use disorders are common in prisoners. The transition between prison and community poses risks in terms of a disruption to treatment and care and a deterioration in health. Studies have demonstrated an increased risk of drug-related deaths among former prisoners during the first weeks following release from custody. The aim of this scoping review is to provide an up-to-date account of evidence from record linkage studies about drug-related deaths among former adult prisoners. METHODS AND ANALYSIS This is a protocol for a scoping review. The framework for conducting scoping reviews by Arksey and O'Malley, in addition to the methodology and guidance developed by the Joanna Briggs Institute (JBI) and the JBI Collaboration will be followed. MEDLINE, EMBASE, PsychINFO and Web of Science will be searched for studies from 2011 to 2021 using search terms relating to 'mortality', 'drugs' and 'ex-prisoner'. A preliminary search in MEDLINE identified at least 473 potentially eligible papers. Two authors will independently screen all titles and abstracts for eligibility using the inclusion and exclusion criteria. There will be no geographical restrictions but non-English language papers will be excluded. Data will be extracted using a piloted customised charting form and the findings will be mapped (guided by the population, concept and context inclusion criteria) and grouped by main conceptual categories (including methodology, key findings and gaps in the research). DISCUSSION, ETHICS AND DISSEMINATION This scoping review will identify, map and summarise publicly available sources of research and therefore does not require ethical approval. The results will inform our empirical investigation of ex-prisoner mortality as well as being shared with key stakeholders, disseminated in a peer-reviewed journal and presented at relevant conferences.
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Affiliation(s)
- Janine A Cooper
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Belfast, UK
| | - Ifeoma Onyeka
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Belfast, UK
| | - Dermot O'Reilly
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Belfast, UK
| | - Richard Kirk
- South Eastern Health and Social Care Trust, Ulster Hospital, Dundonald, UK
| | - Michael Donnelly
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Belfast, UK
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Al-Sumaih I, Donnelly M, O'Neill C. Sociodemographic characteristics of patients and their use of post-bariatric contouring surgery in the US. BMC Health Serv Res 2022; 22:308. [PMID: 35255893 PMCID: PMC8900300 DOI: 10.1186/s12913-022-07692-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 02/17/2022] [Indexed: 11/29/2022] Open
Abstract
Background Expansion of healthcare insurance coverage to bariatric surgeries has led to an increased demand from patients for post-bariatric contouring surgeries. This study examined the relationship between the use of contouring procedures on post-bariatric surgery patients, clinical need and sociodemographic factors. Methods Data were extracted from the Healthcare Cost and Utilization Project (HCUP) Nationwide Ambulatory Surgery Sample (NASS) regarding hospital-owned ambulatory surgical centres in the US. Episodes without missing values relating to patients, 18 years old or above were the primary unit of analysis. Episodes were excluded if the field regarding expected payer was reported as “no charge.” The primary outcome was the likelihood of panniculectomy, abdominoplasty, and mastopexy among post-bariatric surgery patients; and the degree to which uptake of these types of contouring surgery were associated with age, gender, median households’ income, expected payer, patient’s location, and comorbidity. Results A total of 66,368 weighted episodes of care received by patients who had had bariatric surgery were extracted (54,684 female [82.4%]; mean age, 51.3 [SD, 12.1]; 6219 episodes had contouring surgeries [9.37%]). Panniculectomy was the most common post-bariatric contouring procedure (3.68%). Uptake of post-bariatric contouring procedures was associated with age, sex, payment type, area-based measures of median household income, and patient location. Compared to Medicare insured patients, the odds of receiving contouring surgery among self-payers were 1.82 (95% CI, 1.47 to 2.26) for panniculectomy, 14.79 (95% CI, 12.19 to 17.93) for abdominoplasty and 47.97 (95% CI, 32.76 to 70.24) for mastopexy. Rank order of comorbidity profiles also differed between insured and self-paying recipients of contouring surgery. Conclusions Insurance status of bariatric surgery patients and their sex were strongly associated with receipt of a range of contouring procedures. Self-payments were associated with a doubling of the odds of having panniculectomy and an increase in the odds to approximately 14 times for abdominoplasty and 48 times for mastopexy. Thus, access to contouring surgery by post-bariatric patients may be disproportionately dependent on personal preference supported by ability to pay rather than clinical need. Further research is needed to examine the impact of contouring or delayed/denied contouring on health status. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07692-1.
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Affiliation(s)
- Ibrahim Al-Sumaih
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Sciences, Queen's University Belfast, Block B, Royal Victoria Hospital, Belfast, UK, BT12 6BA, UK. .,Ministry of Health, Riyadh, Saudi Arabia.
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Sciences, Queen's University Belfast, Block B, Royal Victoria Hospital, Belfast, UK, BT12 6BA, UK
| | - Ciaran O'Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Sciences, Queen's University Belfast, Block B, Royal Victoria Hospital, Belfast, UK, BT12 6BA, UK
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Ngan TT, Mai VQ, Van Minh H, Donnelly M, O'Neill C. Health-related quality of life among breast cancer patients compared to cancer survivors and age-matched women in the general population in Vietnam. Qual Life Res 2022; 31:777-787. [PMID: 34541610 PMCID: PMC8921138 DOI: 10.1007/s11136-021-02997-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 09/09/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE This study compared the health-related quality of life (HRQoL) of breast cancer (BC) patients, survivors, and age-matched women from the general population in Vietnam to address the paucity of HRQoL research and contribute to the robust assessment of BC screening and care in Vietnam. METHODS The standardised EQ-5D-5L instrument was incorporated in an online survey and a hospital-based face-to-face survey, and together with data from the Vietnam EQ-5D-5L norms study. χ2 tests assessed EQ-5D health profile associations and a Tobit regression model investigated the association between overall health status (EQ-VAS/utility scores) and sociodemographic and clinical characteristics. RESULTS A total of 309 participants (107 patients undergoing treatment and 202 survivors who had completed treatment) provided usable responses. The dimensions that affected mostly the HRQoL of women with BC were pain/discomfort and anxiety/depression. Current patients and survivors differed significantly regarding HRQoL dimensions of mobility, self-care, usual activities, and anxiety/depression. Their health utilities were 0.74 and 0.84, respectively, compared with 0.91 for age-matched Vietnamese women in the general population (p < 0.001). Treatment status (survivor vs patient), younger age, higher monthly household income, and higher education levels were associated with higher health utility. CONCLUSIONS The results point to unmet needs in mental health support and well-being and for attention to be given to the development of a biopsychosocial system of cancer diagnosis, treatment, and care. The results will also inform future assessments of the comparative value for money of interventions intended to impact on breast cancer in Vietnam.
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Affiliation(s)
- Tran Thu Ngan
- Centre for Public Health, Queen's University Belfast, Belfast, UK.
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.
| | - Vu Quynh Mai
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
- Department of Epidemiology and Global Health, Umea University, Umea, Sweden
| | - Hoang Van Minh
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Ciaran O'Neill
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Htay MNN, Dahlui M, Schliemann D, Cardwell CR, Loh SY, Ibrahim Tamin NSB, Somasundaram S, Donnelly M, Su TT. Changing Health Beliefs about Breast Cancer Screening among Women in Multi-Ethnic Malaysia. Int J Environ Res Public Health 2022; 19:1618. [PMID: 35162641 PMCID: PMC8835215 DOI: 10.3390/ijerph19031618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 01/27/2023]
Abstract
This study evaluated the impact of the 'Be Cancer Alert' mass media campaign for breast cancer (BCAC-BC) in terms of changes to women's health beliefs regarding BC susceptibility and the benefits and barriers of breast cancer screening in Malaysia. Pre- and post-campaign surveys evaluated changes in health beliefs among women aged 40 years and above (n = 676). The perceived susceptibility to breast cancer was significantly higher at follow-up (mean ± SD: 7.30 ± 2.77 vs. 7.63 ± 2.58, p = 0.008) whereas the mean score for the perceived benefits of undertaking screening was high at baseline and follow-up (16.34 ± 2.36 vs. 15.95 ± 2.07, p = 0.001). The perceptions or beliefs about barriers to screening did not change significantly (31.70 ± 8.26 vs. 31.77 ± 7.63, p = 0.841). Regression analyses indicated that mean scores for the barriers subscale were significantly lower among Chinese women (-2.61, 95% CI -4.67, -0.55, p = 0.013) compared to Malay, and among single compared to married women (-2.40, 95% CI -4.60, -0.21, p = 0.032) after adjustment for other demographic variables and past screening history. Malaysian women appeared to already have positive perceptions before the BCAC-BC mass media campaign about the benefits of BC screening. However, the campaign appeared to be linked to both an increased awareness of the susceptibility to breast cancer and to positive beliefs that countered emotional barriers to screening, particularly among single women and Chinese-Malay women.
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Affiliation(s)
- Mila Nu Nu Htay
- Centre of Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Department of Community Medicine, Manipal University College Malaysia, Manipal Academy of Higher Education (MAHE), Melaka 75150, Malaysia
| | - Maznah Dahlui
- Centre of Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Désirée Schliemann
- Centre for Public Health and UKCRC, Centre of Excellence for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK; (D.S.); (C.R.C.); (M.D.)
| | - Christopher R. Cardwell
- Centre for Public Health and UKCRC, Centre of Excellence for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK; (D.S.); (C.R.C.); (M.D.)
| | - Siew Yim Loh
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | | | | | - Michael Donnelly
- Centre for Public Health and UKCRC, Centre of Excellence for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK; (D.S.); (C.R.C.); (M.D.)
| | - Tin Tin Su
- Centre of Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
- South East Asia Community Observatory (SEACO) and Global Public Health, Jeffery Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia
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Abstract
BACKGROUND There is a paucity of research on the cost of breast cancer (BC) treatment from the patient's perspective in Vietnam. METHODS Individual-level data about out-of-pocket (OOP) expenditures on use of services were collected from women treated for BC (n = 202) using an online survey and a face-to-face interview at two tertiary hospitals in 2019. Total expenditures on diagnosis and initial BC treatment were presented in terms of the mean, standard deviation, and range for each type of service use. A generalised linear model (GLM) was used to assess the relationship between total cost and socio-demographic characteristics. RESULTS 19.3% of respondents had stage 0/I BC, 68.8% had stage II, 9.4% had stage III, none had stage IV. The most expensive OOP elements were targeted therapy with mean cost equal to 649.5 million VND ($28,025) and chemotherapy at 36.5 million VND ($1575). Mean total OOP cost related to diagnosis and initial BC treatment (excluding targeted therapy cost) was 61.8 million VND ($2667). The mean OOP costs among patients with stage II and III BC were, respectively, 66 and 148% higher than stage 0/I. CONCLUSIONS BC patients in Vietnam incur significant OOP costs. The cost of BC treatment was driven by the use of therapies and presentation stage at diagnosis. It is likely that OOP costs of BC patients would be reduced by earlier detection through raised awareness and screening programmes and by providing a higher insurance reimbursement rate for targeted therapy.
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Affiliation(s)
- Tran Thu Ngan
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.
| | - Nguyen Bao Ngoc
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Hoang Van Minh
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Ciaran O'Neill
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
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O'Connor SR, Kee F, Thompson DR, Cupples ME, Donnelly M, Heron N. A review of the quality and content of mobile apps to support lifestyle modifications following a transient ischaemic attack or 'minor' stroke. Digit Health 2021; 7:20552076211065271. [PMID: 34950500 PMCID: PMC8689637 DOI: 10.1177/20552076211065271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/19/2021] [Indexed: 12/27/2022] Open
Abstract
Objective Secondary prevention is recommended to reduce cardiovascular risk after transient ischaemic attack (TIA) or ‘minor’ stroke. Mobile health interventions can provide accessible, cost-effective approaches to address modifiable risk factors, such as physical inactivity, hypertension and being overweight. The objective of this study was to evaluate the quality of apps for supporting lifestyle change following a TIA or ‘minor’ stroke. Methods Systematic searches of Google Play and the Apple Store were carried out to identify mobile apps released between 1 November 2019 and 1 October 2021. Keywords were used including stroke, TIA, lifestyle, prevention and recovery. Quality was assessed using the Mobile Application Rating Scale (MARS). Common components were identified with the Behaviour Change Technique (BCT) Taxonomy. Descriptive statistics were used to summarize the performance results for each app. Results Searches identified 2545 potential apps. Thirty remained after removing duplicates and screening titles and descriptions. Six were eligible after full review of their content. All apps included at least one BCT (range: 1–16 BCTs). The most frequent BCTs included ‘information about health consequences’ (n = 5/6), ‘verbal or visual communication from a credible source’ (n = 4/6) and ‘action planning’ (n = 4/6). The mean MARS score was 2.57/5 (SD: 0.51; range: 1.78–3.36). No apps were of ‘good’ overall quality (scoring more than 4/5). Conclusions This is the first review of mobile health interventions for this population. Only a small number of apps were available. None were targeted specifically at people with a TIA or ‘minor’ stroke. Overall quality was low. Further work is needed to develop and test accessible, user designed, and evidence-informed digital interventions in this population.
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Affiliation(s)
- Seán R O'Connor
- School of Psychology, Queen's University Belfast, Belfast, UK
| | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Neil Heron
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,School of Primary, Community and Social Care, Keele University, Staffordshire, UK
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Al-Sumaih I, Donnelly M, O’Neill C. The use of finite mixture models to examine the serum 25(OH)D levels among Saudis. PLoS One 2021; 16:e0260748. [PMID: 34847185 PMCID: PMC8631613 DOI: 10.1371/journal.pone.0260748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 11/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recorded serum 25(OH)D in survey data varies with observed and unobserved respondent characteristics. The aim of this study was to expose latent population sub-groups and examine variation across groups regarding relationships between serum 25(OH)D and observable characteristics. METHODS This study explored the role of unobserved heterogeneity on associations between surveyed 25(OH)D and various factors using a sample (n = 2,641) extracted from the Saudi Health Interview Survey (2013). Linear regression and finite mixture models (FMM) were estimated and compared. The number of latent classes in the FMM was chosen based on BIC score. RESULT Three latent classes were identified. Class I (39.82%), class II (41.03%), and class III (19.15%) with mean 25(OH)D levels of 22.79, 34.88, and 57.45 ng/ml respectively. Distinct patterns of associations with nutrition, behaviour and socio-demographic variables were recorded across classes that were not revealed in pooled linear regression. CONCLUSION FMM has the potential to provide additional insights on the relationship between 25(OH)D levels and observable characteristics. It should be more widely considered as a method of investigation in this area.
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Affiliation(s)
- Ibrahim Al-Sumaih
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- Ministry of Health, Riyadh, Saudi Arabia
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Ciaran O’Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
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McHale C, Fallon A, Donnelly M, Dookhy J, McGuinn C, Domsa M, McNally D, Tobin F, Kennelly S. 140 FAMILY DEMENTIA SUPPORT TRAINING—AN INTEGRATED CARE APPROACH. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
There are approximately 64,000 people living with a diagnosis of dementia in Ireland. This number is expected to double to 150,000 by 2045. The growing need for post diagnostic support has been accentuated by the fact that we are living through an unprecedented Pandemic. Our Dementia Training Network identified the need for a localised educational resource for families supporting those diagnosed with dementia across our service.
Methods
Following a successful pilot in association with the Alzheimer’s Society of Ireland, staff from the Specialist Memory Service, Integrated Care Team, and Primary Care created a service-informed 6 week course aimed at supporting families. A focus group preceded the first course to establish preferred content. The course delivered education on Dementia; Post Diagnostic Steps; Communication; Non cognitive symptoms; Nutrition & hydration; Assistive Technology; Forward planning and Self-care. The multi-dimensional nature of staff delivering the course creates a rich tapestry of advice and information. All staff involved work together to identify, refer and support families living with dementia in the local area. The group takes place in an accessible location and time which accommodates families. Each course attendee completes a questionnaire prior to and after commencing the group. The level of satisfaction will be measured following every course.
Results
By the end of 2021, the group will have delivered education and support to 36 families. The automatic referral of all families to this resource will assist in building up confidence to support and enhance self-care. The combined participants from the catchment area will become a network of families joined together on their journey.
Conclusion
This innovative service collaboration enhances the integrated nature of the Post Diagnostic Care pathway. The Integrated care approach has served to enrich the programme and allow for timely support and advice regarding localised supports.
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Affiliation(s)
- C McHale
- Tallaght University Hospital , Dublin, Ireland
- Trinity College Dublin , Dublin, Ireland
| | - A Fallon
- Tallaght University Hospital , Dublin, Ireland
- Trinity College Dublin , Dublin, Ireland
| | - M Donnelly
- Occupational Therapy, HSE , Dublin, Ireland
| | - J Dookhy
- Tallaght University Hospital , Dublin, Ireland
- Trinity College Dublin , Dublin, Ireland
| | - C McGuinn
- Integrated Care Team , CHO7, Dublin, Ireland
| | - M Domsa
- Integrated Care Team , CHO7, Dublin, Ireland
| | - D McNally
- Integrated Care Team , CHO7, Dublin, Ireland
| | - F Tobin
- Tallaght University Hospital , Dublin, Ireland
| | - S Kennelly
- Tallaght University Hospital , Dublin, Ireland
- Trinity College Dublin , Dublin, Ireland
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