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Rigal L, Sarkhanova L, Mourey P, Paquet S, Ringa V, Panjo H, Gautier C, Falcoff H. Impact of a patient reminder letter from their general practitioners on influenza vaccination: A quasi-experimental study in Paris, France. Eur J Gen Pract 2023; 29:2232546. [PMID: 37530613 PMCID: PMC10399464 DOI: 10.1080/13814788.2023.2232546] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Seasonal influenza vaccination coverage levels remain too low in many countries. OBJECTIVES This study aimed to evaluate the impact of a reminder letter from their general practitioner (GP) on patients' influenza vaccination. METHODS Eligible patients for this controlled non-randomised study were the vulnerable categories targeted by the 2019-2020 national health insurance fund (NHIF) vaccination campaign, on the lists of 14 GPs from three practices in Paris (France) and unvaccinated on January 2, 2020 (mid-campaign). The choice of practices and assigning five GPs to the intervention arm were made for convenience. At mid-campaign, GPs in the intervention arm sent a standardised letter reminding each eligible patient to be vaccinated. In the control arm, GPs worked as usual. The intervention effect, calculated from the NHIF databases, was estimated by the difference between the groups in their vaccination coverage at the end of the campaign, with a linear mixed model adjusted for age, sex, chronic disease (at the patient level) and medical practice (at the GP level). RESULTS The vaccination coverage at the end of the campaign was 14.7% in the intervention group (n = 317) and 1.7% in the control group (n = 493): a difference of 13.1% points (95% confidence interval [9.0-17.2], number needed to send 7.7). At the campaign's end, vaccination coverage among patients from the lists of GPs in the intervention arm was 62.7%, and 46.2% among patients from the control-arm GP lists. CONCLUSION Reminder letters could help increase influenza vaccination coverage.
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Affiliation(s)
- Laurent Rigal
- Paris-Saclay University, UVSQ, CESP, INSERM, Villejuif, France
- General Practice Department, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - Louciné Sarkhanova
- General Practice Department, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - Pascaline Mourey
- General Practice Department, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - Sylvain Paquet
- Paris-Saclay University, UVSQ, CESP, INSERM, Villejuif, France
- General Practice Department, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - Virginie Ringa
- Paris-Saclay University, UVSQ, CESP, INSERM, Villejuif, France
| | - Henri Panjo
- Paris-Saclay University, UVSQ, CESP, INSERM, Villejuif, France
| | | | - Hector Falcoff
- CPTS Paris 13, Paris, France
- SFTG Recherche, Paris, France
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Sassenou J, Ringa V, Zins M, Ozguler A, Paquet S, Panjo H, Franck JE, Menvielle G, Rigal L. Combined influence of immigration status and income on cervical cancer screening uptake. Prev Med Rep 2023; 36:102363. [PMID: 37732022 PMCID: PMC10507147 DOI: 10.1016/j.pmedr.2023.102363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 07/10/2023] [Accepted: 08/04/2023] [Indexed: 09/22/2023] Open
Abstract
The regular performance of Pap tests for cervical cancer screening reduces this disease's incidence and mortality. Income inequalities have been reported for this screening, partly because in some countries women must advance or even pay out-of-pocket costs. Because immigrant status is also associated with low Pap test uptake, we aimed to analyze the combined impact of immigrant status and low income on cervical cancer underscreening. This study, based on the French CONSTANCES cohort, uses data from the cohort questionnaires and linked health insurance fund data about Pap test reimbursement. To measure income inequalities in screening, we calculated a Slope Index of Inequality (SII) by linear regression, taking into account the migration status of participants. The majority of the 70,614 women included in the analysis were not immigrants (80.2%), while 12.9% were second-generation immigrants, and 6.9% first-generation immigrants. The proportion of underscreening increased with immigrant status, from 19.5% among nonimmigrants to 23.6% among the second generation, and 26.5% among the first (P < 0.01). The proportion of underscreening also increased as income level decreased. The income gradient rose significantly from 14% among nonimmigrants to 21% in second-generation immigrants and 19% in the first generation (P < 0.01). Among first-generation migrants, the shorter the duration of residence, the higher the SII. Women who are first- or second-generation immigrants are simultaneously underscreened and subject to a more unfavorable economic gradient than native French women born to native French parents. The accumulation of several negative factors could be particularly unfavorable to screening uptake.
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Affiliation(s)
- Jeanne Sassenou
- Centre for Research in Epidemiology and Population Health (CESP), Inserm U1018, Université Paris-Saclay, Villejuif, France
| | - Virginie Ringa
- Centre for Research in Epidemiology and Population Health (CESP), Inserm U1018, Université Paris-Saclay, Villejuif, France
| | - Marie Zins
- National Institute for Health and Medical Research (Inserm), Population-based Epidemiologic Cohorts Units, UMS 011, Villejuif, France
| | - Anna Ozguler
- National Institute for Health and Medical Research (Inserm), Population-based Epidemiologic Cohorts Units, UMS 011, Villejuif, France
| | - Sylvain Paquet
- Centre for Research in Epidemiology and Population Health (CESP), Inserm U1018, Université Paris-Saclay, Villejuif, France
| | - Henri Panjo
- Centre for Research in Epidemiology and Population Health (CESP), Inserm U1018, Université Paris-Saclay, Villejuif, France
| | | | - Gwenn Menvielle
- Sorbonne University, National Institute for Health and Medical Research (Inserm), Institut Pierre-Louis Epidémiologie et Santé Publique, Paris, France
| | - Laurent Rigal
- Centre for Research in Epidemiology and Population Health (CESP), Inserm U1018, Université Paris-Saclay, Villejuif, France
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Paquet S, Sassenou J, Ringa V, Czernichow S, Zins M, Ozguler A, Rigal L. Women with type 2 diabetes have LDL cholesterol levels higher than those of men, regardless of their treatment and their cardiovascular risk level. Nutr Metab Cardiovasc Dis 2023; 33:1254-1262. [PMID: 37088650 DOI: 10.1016/j.numecd.2023.03.015] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 02/14/2023] [Accepted: 03/20/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND AND AIMS Several works have shown that control of the principal cardiovascular risk factors, especially LDL-C, is poorer among women with type 2 diabetes than men with this disease. Our objectives were to compare the statin treatments and LDL-C levels between men and women with type 2 diabetes, according to the potency of the statin they take, while taking their cardiovascular risk level into account. METHOD AND RESULTS This is a descriptive cross-sectional study within the French CONSTANCES cohort. At inclusion, each individual completed several self-administered questionnaires. Data were then matched to their health insurance fund reimbursement data. The study population comprises cohort members with pharmacologically treated type 2 diabetes. We identified 2541 individuals with type 2 diabetes; 2214 had an available LDL-C value. In the total sample, treatment by statins did not differ between men and women, while the women had a higher mean LCL-C level than men. The analyses stratified by cardiovascular risk showed that women at very high cardiovascular risk received significantly less frequent statin delivery than men (OR = 0.72 [0.56-0.92]; p = 0.01). At the same time, women received the same rate of high-potency statins as men. Women taking equivalently potent statins had significantly higher LDL-C levels than men did. CONCLUSION For the same cardiovascular risk level and the same statin treatment, women had an LDL-C level higher than that of men. They thus present a residual cardiovascular risk that justifies intensification of their statin treatment if tolerance allows.
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Affiliation(s)
- Sylvain Paquet
- Department of General Practice, University of Paris-Saclay, Paris, France; CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, Université Paris-Saclay, équipe soins primaires et prévention, Villejuif, France.
| | - Jeanne Sassenou
- Department of General Practice, University of Paris-Saclay, Paris, France; CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, Université Paris-Saclay, équipe soins primaires et prévention, Villejuif, France.
| | - Virginie Ringa
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, Université Paris-Saclay, équipe soins primaires et prévention, Villejuif, France.
| | - Sébastien Czernichow
- Université de Paris, Paris, France; AP-HP, Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1153, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Paris, France.
| | - Marie Zins
- Inserm, Population-based Epidemiologic Cohorts Units, UMS 011, Villejuif, France.
| | - Anna Ozguler
- Inserm, Population-based Epidemiologic Cohorts Units, UMS 011, Villejuif, France.
| | - Laurent Rigal
- Department of General Practice, University of Paris-Saclay, Paris, France; CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, Université Paris-Saclay, équipe soins primaires et prévention, Villejuif, France.
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Le Noan-Lainé M, Artaud F, Ndoadoumgue AL, Ozguler A, Cœuret-Pellicer M, Ringa V, Elbaz A, Canonico M. Characteristics of reproductive history, use of exogenous hormones and walking speed among women: Data from the CONSTANCES French Cohort Study. Maturitas 2023; 170:42-50. [PMID: 36773499 DOI: 10.1016/j.maturitas.2023.01.008] [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: 09/06/2022] [Revised: 12/15/2022] [Accepted: 01/09/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVE To investigate the cross-sectional associations of reproductive history and use of exogenous hormones with fast walking speed (WS) in women. STUDY DESIGN Between 2012 and 2020, 33,892 French women aged 45 years or more, recruited at health centers, underwent physical function tests and self-reported information on reproductive history and use of exogenous hormones. Linear mixed models with the center as random intercept were used to estimate the association of exposures with WS. MAIN OUTCOME MEASURES Fast WS. RESULTS Mean WS was 172.2 cm/s. WS increased with age at menarche (β+1y = 0.23, 95 % confidence interval = 0.05 to 0.40), age at first birth (β+1y = 0.20, 95 % CI = 0.13 to 0.27) and duration of breastfeeding (βfor ≥10 vs ≤5months = 1.38; 95 % CI = 0.39 to 2.36). In addition, parity was quadratically associated with WS, with women with 3 children having the highest WS (p for U-shaped relationship < 0.01). Menopausal status had no impact on WS but age at menopause was positively associated with WS (β+5y = 0.52, 95 % CI = 0.17 to 0.87) and partly explained the deleterious impact of artificial menopause on WS. WS increased with reproductive lifetime duration (β+5y = 0.49, 95 % CI = 0.16 to 0.83) and decreased with time since onset of menopause (β+5y = -0.65, 95 % CI = -0.99 to -0.31). By contrast, there was no association of WS with oral contraception and postmenopausal hormone therapy. CONCLUSION Our findings suggest that reproductive life characteristics may be associated with WS and timing of exposure could play a role.
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Affiliation(s)
- Maryline Le Noan-Lainé
- Université Paris-Saclay, UVSQ, Inserm UMR1018, Équipe "Exposome, hérédité, cancer et santé", CESP, 94807 Villejuif, France
| | - Fanny Artaud
- Université Paris-Saclay, UVSQ, Inserm UMR1018, Équipe "Exposome, hérédité, cancer et santé", CESP, 94807 Villejuif, France
| | - Aude Laetitia Ndoadoumgue
- Université Paris-Saclay, UVSQ, Inserm UMR1018, Équipe "Exposome, hérédité, cancer et santé", CESP, 94807 Villejuif, France
| | - Anna Ozguler
- Inserm, UMS011, Population-Based Epidemiologic Cohorts, 94807 Villejuif, France
| | | | - Virginie Ringa
- Université Paris-Saclay, UVSQ, Inserm UMR1018, Équipe "Soins primaires et prévention", CESP, 94807 Villejuif, France
| | - Alexis Elbaz
- Université Paris-Saclay, UVSQ, Inserm UMR1018, Équipe "Exposome, hérédité, cancer et santé", CESP, 94807 Villejuif, France
| | - Marianne Canonico
- Université Paris-Saclay, UVSQ, Inserm UMR1018, Équipe "Exposome, hérédité, cancer et santé", CESP, 94807 Villejuif, France.
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Ousseine YM, Allaire C, Ringa V, Lydie N, Velter A. Health Literacy as a Mediator of the Relationship Between Socioeconomic Position and Pre-Exposure Prophylaxis Uptake Among Men Who Have Sex with Men Living in France. Health Lit Res Pract 2023; 7:e61-e70. [PMID: 36888986 PMCID: PMC9991084 DOI: 10.3928/24748307-20230224-01] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND In recent decades, several research studies have mentioned a potential mediating effect of health literacy (HL) on the relationship between socioeconomic position and health prevention behaviors. However, no study to date has investigated this hypothesis on HIV prevention behaviors. OBJECTIVE The present study aimed to evaluate whether HL mediates the relationship between socioeconomic status (SES) and pre-exposure prophylaxis (PrEP) uptake in men who have sex with men (MSM). METHODS The study is based on data collected in the Enquête Rapport au Sexe [report to sex] 2019 survey, an anonymous, self-administered online cross-sectional survey in France conducted between February 16, 2019 and March 31, 2019. Data on education level and perceived financial situation were used as measures of SES, whereas HL was assessed from the Health Literacy Questionnaire's "ability to actively engage with health care providers" scale. Mediation analyses were performed with a model-based causal moderated mediation analysis package in R software. Analyses were adjusted for age, place of residence, marital status, and social support. KEY RESULTS The study sample included 13,629 MSM. Median age was 32 years. The majority had an education level higher than upper secondary school (78%) and an adequate HL level (73%). Almost two-thirds perceived their financial situation as comfortable (62%). Overall, PrEP uptake was low (9.5%). The analyses did not show a mediating effect of HL on the relationship between education and PrEP uptake. However, a total mediation effect of HL was observed on the relationship between perceived financial situation and uptake. CONCLUSIONS In the context of PrEP uptake, MSM ability to actively engage with health care providers may offset the effect of a difficult financial situation. In the current French context, where PrEP is now also available in general practitioner settings, this result could inform the development of training and support policies for health professionals and the way in which sexual health issues are addressed in consultations. [HLRP: Health Literacy Research and Practice. 2023;7(1):e61-e70.].
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Affiliation(s)
- Youssoufa M. Ousseine
- Address correspondence to Youssoufa M. Ousseine, MPH, PhD, Department of Prevention and Health Promotion, Santé publique France, 12, rue du val d'Osne, 94415 Saint Maurice Cedex, France;
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Bouissiere A, Laperrouse M, Panjo H, Ringa V, Rigal L, Letrilliart L. General practitioner gender and use of diagnostic procedures: a French cross-sectional study in training practices. BMJ Open 2022; 12:e054486. [PMID: 35523487 PMCID: PMC9083381 DOI: 10.1136/bmjopen-2021-054486] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The acceleration in the number of female doctors has led to questions about differences in how men and women practice medicine. The aim of this study was to assess the influence of general practitioner (GP) gender on the use of the three main categories of diagnostic procedures-clinical examinations, laboratory tests and imaging investigations. DESIGN Cross-sectional nationwide multicentre study. SETTING French training general practices. PARTICIPANTS The patient sample included all the voluntary patients over a cumulative period of 5 days per office between November 2011 and April 2012. The GP sample included 85 males and 43 females. METHODS 54 interns in general practice, observing their GP supervisors, collected data about the characteristics of GPs and consultations, as well as the health problems managed during the visit and the processes of care associated with them. Using hierarchical multilevel mixed-effect logistic regression models, we performed multivariable analyses to assess differences in each of the three main categories of diagnostic procedures, and two specific multivariable analyses for each category, distinguishing screening from diagnostic or follow-up procedures. We searched for interactions between GP gender and patient gender or type of health problem managed. RESULTS This analysis of 45 582 health problems managed in 20 613 consultations showed that female GPs performed more clinical examinations than male GPs, both for screening (OR 1.75; 95% CI 1.19 to 2.58) and for diagnostic or follow-up purposes (OR 1.41; 95% CI 1.08 to 1.84). Female GPs also ordered laboratory tests for diagnostic or follow-up purposes more frequently (OR 1.21; 95% CI 1.03 to 1.43). Female GPs performed even more clinical examinations than male GPs to diagnose or follow-up injuries (OR 1.69; 95% CI 1.19 to 2.40). CONCLUSION Further research on the appropriateness of diagnostic procedures is required to determine to what extent these differences are related to underuse or overuse.
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Affiliation(s)
- Amandine Bouissiere
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Marine Laperrouse
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Henri Panjo
- INSERM CESP, Université Paris-Saclay, Saint-Aubin, France
- Unité Santé et droits sexuels et reproductifs, INED, Paris, France
| | - Virginie Ringa
- INSERM CESP, Université Paris-Saclay, Saint-Aubin, France
- Unité Santé et droits sexuels et reproductifs, INED, Paris, France
| | - Laurent Rigal
- INSERM CESP, Université Paris-Saclay, Saint-Aubin, France
- Unité Santé et droits sexuels et reproductifs, INED, Paris, France
| | - Laurent Letrilliart
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Villeurbanne, France
- Research on Healthcare Performance (RESHAPE), INSERM, Lyon, France
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Degremont A, Kerbrat S, Balusson F, Jonville-Bera AP, Ringa V, Travers D, Tillaut H, Leray E, Oger E, Birben A, Polard E. Prescribing Trends for Valproate Among Pregnant Women: A Cross-sectional Study in 2013 and 2016 Using the French Health Insurance Database. Neurology 2022; 98:e2163-e2173. [PMID: 35379759 DOI: 10.1212/wnl.0000000000200260] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 02/04/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We aimed to describe the prescribing trends for sodium valproate (VPA) and alternative drugs during and around pregnancy, comparing 2016 (after the recommendations on valproate for women were reinforced by the EMA) to 2013 (before the recommendations). METHODS Using the French National Health Insurance Database, a cross-sectional study was carried out in 2013 and in 2016, including women who became pregnant and had at least one reimbursement claim for VPA in the two years prior to pregnancy or during pregnancy. Exposure to VPA and its alternatives was then measured for each quarter, in the two years before pregnancy (pre-conception), during pregnancy and in the year after pregnancy (post-partum). RESULTS Among pregnant women with epilepsy (N=2,607 pregnancies), the proportion exposed to VPA during pregnancy decreased from 26.4% to 9.3% between 2013 and 2016, alongside an increase in lamotrigine and levetiracetam use. Among pregnant women with bipolar disorder (N=4,278 pregnancies), the proportion of women exposed during pregnancy decreased from 3.7% in 2013 to 1.9% in 2016, without any switch to alternative drugs. In both populations, less than one third had consulted a specialist before pregnancy. CONCLUSION As recommended by the EMA, a change in practice over the period 2013-2016 was observed, with fewer women exposed to VPA during pregnancy and before pregnancy. However, in 2016, a large number of women were exposed to VPA in the first trimester of pregnancy (N=471), which could suggest that the timing of pregnancy should be better planned whenever possible.
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Affiliation(s)
- Adeline Degremont
- Pharmaco-vigilance, Pharmaco-epidemiology and Drug Information Centre, Department of Clinical Pharmacology, CHU de Rennes, Rennes, France .,EA 7449 REPERES 'Pharmaco-epidemiology and Health Services Research', Univ Rennes, Rennes, France
| | - Sandrine Kerbrat
- EA 7449 REPERES 'Pharmaco-epidemiology and Health Services Research', Univ Rennes, Rennes, France
| | - Frédéric Balusson
- Pharmaco-vigilance, Pharmaco-epidemiology and Drug Information Centre, Department of Clinical Pharmacology, CHU de Rennes, Rennes, France.,EA 7449 REPERES 'Pharmaco-epidemiology and Health Services Research', Univ Rennes, Rennes, France
| | - Annie Pierre Jonville-Bera
- Pharmaco-vigilance and Drug Information Centre, Department of Pharmaco-surveillance, CHU de Tours, Tours, France
| | - Virginie Ringa
- INSERM CESP (Centre de recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Villejuif, France
| | - David Travers
- Department of Psychiatry, CHU de Rennes, Rennes, France
| | - Hélène Tillaut
- Department of Health Epidemiology and biostatistics for decision-making in public health, EHESP (School for Public Health), Rennes, France
| | - Emmanuelle Leray
- Department of Health Epidemiology and biostatistics for decision-making in public health, EHESP (School for Public Health), Rennes, France
| | - Emmanuel Oger
- Pharmaco-vigilance, Pharmaco-epidemiology and Drug Information Centre, Department of Clinical Pharmacology, CHU de Rennes, Rennes, France.,EA 7449 REPERES 'Pharmaco-epidemiology and Health Services Research', Univ Rennes, Rennes, France
| | - Arnaud Birben
- Epilepsy unit, Department of Neurology, CHU de Rennes, Rennes, France.,INSERM 1099, Signal and Image Processing Laboratory, Univ Rennes, Rennes, France
| | - Elisabeth Polard
- Pharmaco-vigilance, Pharmaco-epidemiology and Drug Information Centre, Department of Clinical Pharmacology, CHU de Rennes, Rennes, France.,EA 7449 REPERES 'Pharmaco-epidemiology and Health Services Research', Univ Rennes, Rennes, France
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Rouquette A, Rigal L, Mancini J, Guillemin F, van den Broucke S, Allaire C, Azogui-Levy S, Ringa V, Hassler C. Health Literacy throughout adolescence: Invariance and validity study of three measurement scales in the general population. Patient Educ Couns 2022; 105:996-1003. [PMID: 34384639 DOI: 10.1016/j.pec.2021.07.044] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 06/05/2021] [Accepted: 07/27/2021] [Indexed: 05/05/2023]
Abstract
OBJECTIVE To simultaneously investigate the psychometric properties of three recently developed health literacy measurement scales throughout adolescence in the general population. METHODS French versions of the Health Literacy for School-Aged Children (HLSAC, unidimensional) scale, the Health Literacy Assessment Scale for Adolescents (HAS-A, multidimensional) and the 16-item European Health Literacy Survey questionnaire (HLS-EU-Q16, unidimensional) were completed by 1 444 adolescents in 8th, 9th, 11th grade in general school and 11-12th grade in vocational school. Psychometric properties were studied using confirmatory factor analysis, McDonald's omega coefficient and hypothesis testing. RESULTS Structural validity was acceptable (HLS-EU-Q16) to good (HAS-A and HLSAC), no measurement invariance issue was found and internal consistency was acceptable for the three scales (0.68-0.84). Convergent validity was low (Pearson correlation coefficients<0.5) and the only scale for which results were in agreement with a priori hypotheses was the HLSAC. CONCLUSIONS Our results were supportive of the use of HLSAC to assess health literacy during adolescence but the HAS-A, with a slightly better structural validity, can also be promoted due to its three measured dimensions. PRACTICE IMPLICATIONS The use of these scales in practice will help to focus on health literacy, a critical factor for prevention and health promotion in adolescence.
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Affiliation(s)
- Alexandra Rouquette
- Paris-Saclay University, UVSQ, Inserm, CESP, Paris, France; APHP Paris-Saclay, Epidemiology and Public Health Department, Le Kremlin-Bicêtre, France.
| | - Laurent Rigal
- Paris-Saclay University, UVSQ, Inserm, CESP, Villejuif, France; Paris-Saclay University, Medicine Faculty, General Practice Department, Le Kremlin-Bicêtre, France.
| | - Julien Mancini
- Aix Marseille University, Inserm, IRD, SESSTIM, Cancer, Biomedicine & Society group, Marseille, France; APHM, BIOSTIC, Timone Hospital, Marseille, France.
| | - Francis Guillemin
- CHRU-Nancy, INSERM, Lorraine University, CIC 1433 Clinical Epidemiology, Vandoeuvre-les-Nancy, France; Lorraine University, APEMAC, Vandœuvre-lès-Nancy, France.
| | - Stephan van den Broucke
- Psychological science Research Institute, Louvain Catholic University, Louvain-la-Neuve, Belgium.
| | | | - Sylvie Azogui-Levy
- Department of Dental Public Health, Faculty of Dentistry, Paris Diderot University, Paris, France; Education and Health Practices Laboratory (LEPS) (EA 3412), UFR SMBH, Paris 13 University, Sorbonne Paris Cité, Bobigny, France.
| | - Virginie Ringa
- Paris-Saclay University, UVSQ, Inserm, CESP, Villejuif, France.
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Degremont A, Polard E, Kerbrat S, Grimaud O, Jonville-Béra AP, Ringa V, Travers D, Oger E, Biraben A, Nowak E. Impact of recommendations on sodium valproate prescription among women with epilepsy: An interrupted time-series study. Epilepsy Behav 2021; 125:108449. [PMID: 34839242 DOI: 10.1016/j.yebeh.2021.108449] [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: 10/01/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The European Medicines Agency (EMA) has developed risk minimization measures (RMMs) to reduce the use of the teratogenic drug, sodium valproate (VPA). The objective was to assess the impact of these RMMs among females with epilepsy in France. METHODS We used data from the French National Health Insurance Database (SNDS), including 114,936 females aged under 50, with a reimbursement claim for an antiepileptic drug from January 2011 to December 2017, and identified as people with epilepsy. We used a controlled interrupted time series stratifying on age: girls (0-14 years old) and women of childbearing age (15-49 years), and with 129,917 males as controls. RESULTS VPA prevalent use among girls and women of childbearing age with epilepsy decreased significantly after the issue of the RMMs (trend changes of, respectively, -5 and -4 users per 1000 females at-risk per quarter in comparison to the control group). We did not detect any significant change in VPA incident use. CONCLUSIONS VPA use decreased over the study period among females with epilepsy but there were still 317 women and 206 girls started on VPA therapy VPA in 2017 (8 per 1000 at-risk and 18 per 1000, respectively). This suggests that either the measures should be strengthened or that the lowest level of VPA use has been reached. In this context, the introduction of a new RMM (in 2018) needs to be evaluated.
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Affiliation(s)
- Adeline Degremont
- Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre, Department of Clinical Pharmacology, CHU de Rennes, 35033 Rennes, France; Univ Rennes, EA 7449 REPERES 'Pharmacoepidemiology and Health Services Research', 35000 Rennes, France.
| | - Elisabeth Polard
- Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre, Department of Clinical Pharmacology, CHU de Rennes, 35033 Rennes, France; Univ Rennes, EA 7449 REPERES 'Pharmacoepidemiology and Health Services Research', 35000 Rennes, France
| | - Sandrine Kerbrat
- Univ Rennes, EA 7449 REPERES 'Pharmacoepidemiology and Health Services Research', 35000 Rennes, France
| | - Olivier Grimaud
- Ecole des Hautes Etudes en Sante Publique, 35000 Rennes, France
| | - Annie-Pierre Jonville-Béra
- Pharmacovigilance and Drug Information Centre, Department of Pharmacosurveillance, CHU de Tours, 37044 Tours, France
| | - Virginie Ringa
- INSERM, Univ Paris-Saclay, Univ Paris-Sud, UVSQ, CESP, Villejuif, France
| | - David Travers
- Psychiatry Department, Department of Psychiatry, CHU Rennes, Rennes, France
| | - Emmanuel Oger
- Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre, Department of Clinical Pharmacology, CHU de Rennes, 35033 Rennes, France; Univ Rennes, EA 7449 REPERES 'Pharmacoepidemiology and Health Services Research', 35000 Rennes, France
| | - Arnaud Biraben
- Epilepsy Unit, Neurology Department, Rennes University Hospital and INSERM 1099, Signal and Image Processing Laboratory, University of Rennes 1, France
| | - Emmanuel Nowak
- CHU de Brest et Université Européenne de Bretagne, Université de Brest, INSERM CIC 1412, IFR 148, France
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Delpech R, Poncet L, Gautier A, Panjo H, Ourabah R, Mourey P, Baumhauer M, Pendola-Luchel I, Ringa V, Rigal L. The role of organization of care in GPs' prevention practice. Prim Health Care Res Dev 2021; 22:e74. [PMID: 34796821 PMCID: PMC8628563 DOI: 10.1017/s1463423621000694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/01/2020] [Revised: 07/25/2021] [Accepted: 10/17/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND General practitioners (GPs) do not systematically include preventive recommendations in their practice, and some characteristics of health care organization are associated with more systematic prevention. But the characteristics of health care organization may act in a nonuniform manner depending on the type of preventive care. Thus, one characteristic can be positively associated with one type of preventive care and negatively associated with another. Our aim was to investigate the association between health care organization in general practice and different areas of preventive care (immunization and addiction prevention), in search of nonuniform associations. METHODS We used a representative survey of 1,813 French GPs conducted in 2009. Four preventive care practices were studied: immunization through flu and HPV vaccination, and prevention of addictive behaviors concerning tobacco and alcohol use.Characteristics of GPs' health care organization and the social context of their practice were collected (spatial accessibility to GPs and socioeconomic level of the area of practice). We constructed mixed models to study associations and interactions between the organization variables and preventive care. RESULTS Four out of five characteristics of GPs' organization have uneven impacts on different types of preventive care (p-interaction < 10-4). For example, number of daily consultations is associated with better immunization prevention but with poorer prevention counseling in addictive behaviors. In contrast, working with digital medical files is uniformly associated with both types of preventive care (OR = 1.29 [1.15-1.45]; P < 10-4). CONCLUSION An approach centered on specific types of preventive care should help deepen our understanding of prevention and possibly help to identify a new typology for preventive care.
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Affiliation(s)
- Raphaëlle Delpech
- Department of General Practice, University of Paris-Saclay, Paris, France
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
| | - Lorraine Poncet
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
| | | | - Henri Panjo
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
- Institut National d’Études Démographiques (INED), Paris, France
| | - Rissane Ourabah
- Department of General Practice, University of Paris-Saclay, Paris, France
| | - Pascaline Mourey
- Department of General Practice, University of Paris-Saclay, Paris, France
| | - Mathilde Baumhauer
- Department of General Practice, University of Paris-Saclay, Paris, France
| | | | - Virginie Ringa
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
- Institut National d’Études Démographiques (INED), Paris, France
| | - Laurent Rigal
- Department of General Practice, University of Paris-Saclay, Paris, France
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
- Institut National d’Études Démographiques (INED), Paris, France
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11
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Aranda E, Franck JE, Ringa V, Sassenou J, Coeuret-Pellicer M, Rigal L, Menvielle G. Social inequalities in participation in cancer screening: does the mode of data collection matter? The CONSTANCES cohort. Eur J Public Health 2021; 31:602-608. [PMID: 34233352 DOI: 10.1093/eurpub/ckab055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Self-reported data are prone to item non-response and misreporting. We investigated to what extent the use of self-reported data for participation in breast (BCS) and cervical cancer screening (CCS) impacted socioeconomic inequalities in cancer screening participation. METHODS We used data from a large population-based survey including information on cancer screening from self-reported questionnaire and administrative records (n = 14 122 for BCS, n = 27 120 CCS). For educational level, occupation class and household income per capita, we assessed the accuracy of self-reporting using sensitivity, specificity and both positive and negative predictive value. In addition, we estimated to what extent the use of self-reported data modified the magnitude of socioeconomic differences in BCS and CCS participation with age-adjusted non-screening rate difference, odds ratios and relative indices of inequality. RESULTS Although women with a high socioeconomic position were more prone to report a date for BCS and CCS in questionnaires, they were also more prone to over-declare their participation in CCS if they had not undergone a screening test within the recommended time frame. The use of self-reported cancer screening data, when compared with administrative records, did not impact the magnitude of social differences in BCS participation but led to an overestimation of the social differences in CCS participation. This was due to misreporting rather than to item non-response. CONCLUSIONS Women's socioeconomic position is associated with missingness and the accuracy of self-reported BCS and CCS participation. Social inequalities in cancer screening participation based on self-reports are likely to be overestimated for CCS.
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Affiliation(s)
- Ezequiel Aranda
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Research Team in Social Epidemiology, Paris, France
| | - Jeanna-Eve Franck
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Research Team in Social Epidemiology, Paris, France
| | - Virginie Ringa
- CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health Team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France.,Ined, Paris, France
| | - Jeanne Sassenou
- CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health Team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France.,Ined, Paris, France
| | - Mireille Coeuret-Pellicer
- Inserm, Versailles Saint Quentin en Yvelines University, UMS 011 "Epidemiological Population-Based Cohorts Unit", Villejuif, France
| | - Laurent Rigal
- CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health Team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France.,Ined, Paris, France
| | - Gwenn Menvielle
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Research Team in Social Epidemiology, Paris, France
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12
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Poncet L, Panjo H, Ringa V, Andro A. Do vulnerable groups access prevention services? Cervical cancer screening and HIV testing among homeless migrant women in the Paris metropolitan area. PLoS One 2021; 16:e0255900. [PMID: 34388200 PMCID: PMC8363022 DOI: 10.1371/journal.pone.0255900] [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: 02/09/2021] [Accepted: 07/26/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Homeless migrant women, facing adverse living conditions and barriers to legal status, are at risk of cervical cancer, HIV infection and may encounter barriers to screening services. We investigate factors associated with each screening in a population of migrant women in France and aim to determine the mean time since last HIV testing according to duration of residence in France. Methods We use data from the DSAFHIR study (Rights and Health of Migrant Women in Emergency Housing) investigating health and migration experience of homeless migrant women housed in emergency housing hotels in the Paris Metropolitan area in 2017. We computed multivariate logistic regression models to investigate no lifetime cervical cancer screening (CCS) and no lifetime HIV test. We used linear regression models to analyze time since last HIV test. Results We included 469 women. 46% of respondents had no lifetime CCS, 31% had no lifetime HIV test. Both screenings were associated with educational attainment and French proficiency. Compared with duration of residence < 1 year, duration ≥ 7 years was associated with a lower likelihood of no lifetime CCS (adjusted Odd Ratio = 0.17; 95% CI = 0.07–0.39). Compared to women born in North Africa, women born in West (aOR = 0.15; 95% CI = 0.07–0.33) and East Africa (aOR = 0.06; 95% CI = 0.02–0.20) were less likely to have no lifetime HIV test. Time since last HIV test increased for each additional year spent in France (coef = 0.21; 95% CI = 0.09, 0.33). Conclusion While access to CCS remains poor for recent migrants, HIV testing is more likely to occur shortly after migration.
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Affiliation(s)
- Lorraine Poncet
- UVSQ, Univ. Paris-Sud, Inserm, Primary Care and Prevention Team, CESP, Université Paris-Saclay, Villejuif, France
- French Collaborative Institute on Migration, Paris, France
- * E-mail:
| | - Henri Panjo
- UVSQ, Univ. Paris-Sud, Inserm, Primary Care and Prevention Team, CESP, Université Paris-Saclay, Villejuif, France
| | - Virginie Ringa
- UVSQ, Univ. Paris-Sud, Inserm, Primary Care and Prevention Team, CESP, Université Paris-Saclay, Villejuif, France
| | - Armelle Andro
- French Collaborative Institute on Migration, Paris, France
- Institute of Demography, Université Paris I Pantheon-Sorbonne, Paris, France
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13
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Poncet L, Panjo H, Schmitz T, Luton D, Mandelbrot L, Estellat C, Andro A, Ringa V, Azria E. Gestational weight gain in a migration context: are migrant women more at risk of inadequate or excessive weight gain during pregnancy? J Epidemiol Community Health 2021; 76:230-238. [PMID: 34389663 DOI: 10.1136/jech-2021-216619] [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: 02/09/2021] [Accepted: 07/20/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Inadequate or excessive gestational weight gain (GWG) is associated with adverse maternal and neonatal outcomes. Little is known on adequacy of GWG in migrant women. This study investigates whether migrant women in France are at higher risk of inadequate or excessive GWG, and what characteristics are associated with GWG in migrant and non-migrant groups. METHODS We used data from the PreCARE multicentric prospective cohort (N=10 419). The study includes 5403 women with singleton deliveries, with non-migrant (n=2656) and migrant (n=2747) status. We used multinomial logistic regression, adjusting for maternal age and parity, to investigate the association of migrant status, socioeconomic status-related variables and GWG. In stratified analyses, we identified factors associated with GWG in both groups. RESULTS Compared with non-migrant women, migrant women had increased risk of inadequate GWG (adjusted odds ratio (aOR) 1.18; 95% CI 1.03 to 1.34). Non-migrant women with foreign origins had increased risk of excessive GWG (aOR 1.58; 95% CI 1.30 to 1.92). Women born in Sub-Saharan Africa had increased risk of both inadequate and excessive GWG. Regardless of migration status, women with lower education and women who did not start pregnancy with a normal weight were less likely to gain adequately. Inadequate prenatal care was associated with inadequate GWG only among non-migrant women. CONCLUSION Migrant women are at higher risk of inadequate GWG.
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Affiliation(s)
- Lorraine Poncet
- CESP Primary Care and Prevention Team, Université Paris-Saclay, UVSQ, Université Paris-Sud, INSERM, Villejuif, France .,French Collaborative Institute on Migrations, France, Paris, France
| | - Henri Panjo
- CESP Primary Care and Prevention Team, Université Paris-Saclay, UVSQ, Université Paris-Sud, INSERM, Villejuif, France
| | - Thomas Schmitz
- Obstetrical, Perinatal and Pediatric Epidemiology (EPOPé research team), DHU Risks in Pregnancy, Paris Descartes University, 53 Avenue de l'Observatoire, INSERM U1153, Paris, France.,Department of Obstetrics and Gynecology, Hopital Universitaire Mere-enfant Robert-Debre, Paris, France
| | - Dominique Luton
- Department of Obstetrics and Gynecology, DHU Risks in Pregnancy, Hopital Bichat - Claude-Bernard, Paris, France
| | - Laurent Mandelbrot
- Department of Obstetrics and Gynecology, DHU Risks in Pregnancy, Hopital Louis-Mourier, Colombes, France
| | - Candice Estellat
- Department of Biostatistics, Public Health and Medical Information, Clinical research unit, Pharmacoepidemiology center, Hopital Universitaire Pitie Salpetriere, Paris, France
| | - Armelle Andro
- French Collaborative Institute on Migrations, France, Paris, France.,Institute of demography research center, Université Paris 1 Panthéon-Sorbonne, Paris, France
| | - Virginie Ringa
- CESP Primary Care and Prevention Team, Université Paris-Saclay, UVSQ, Université Paris-Sud, INSERM, Villejuif, France
| | - Elie Azria
- Obstetrical, Perinatal and Pediatric Epidemiology (EPOPé research team), DHU Risks in Pregnancy, Paris Descartes University, 53 Avenue de l'Observatoire, INSERM U1153, Paris, France.,Department of Obstetrics, Groupe hospitalier Paris Saint-Joseph, Paris, France
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14
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Abstract
Migrant women in industrialised countries experience high caesarean section (CS) rates but little is known about the effect of a previous delivery in the host country. This study set out to investigate this effect among migrant women in France, using data from the DSAFHIR study on healthcare access of migrant women living in emergency housing hotels, collected in the Paris Metropolitan area in 2017. Respondents reported life-long history of deliveries. We focused on deliveries occurring in France in 2000–2017: 370 deliveries reported by 242 respondents. We conducted chi-square tests and multivariate logistic regressions, adjusting for the clustering of deliveries among respondents by computing standard errors allowing for intragroup correlation. Mode of delivery was associated with duration of residence among multiparous women with no prior CS, with a higher CS rate with shorter duration of residence (16% vs. 7%, p = 0.04). In this group, a previous delivery in France was associated with a lower CS rate (5% vs. 16%, p = 0.008). In multivariate analysis, compared with women with previous birth in France, women giving birth in France for the first time had a higher risk of CS, regardless of duration of residence (aOR = 4.0, 95% CI = 1.3–12.1 for respondents with short duration of residence, aOR = 4.7, 95% CI = 1.2–18.0 for respondents with longer duration of residence). Efforts directed at decreasing the CS rate among migrant women should target women giving birth in the host country for the first time.
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Affiliation(s)
- Lorraine Poncet
- PhD Candidate in Public Health, Université Paris-Saclay (INSERM), UVSQ, Univ. Paris-Sud, Inserm, Primary Care and Prevention Team, CESP Villejuif, France; French Collaborative Institute on Migration, Paris, France
| | - Henri Panjo
- Research Engineer, Université Paris-Saclay (INSERM), UVSQ, Univ. Paris-Sud, Inserm, Primary Care and Prevention Team, CESP Villejuif, France
| | - Armelle Andro
- Professor, Institute of Demography, Université Paris I Pantheon-Sorbonne, Paris, France; French Collaborative Institute on Migration, Paris, France
| | - Virginie Ringa
- Researcher (INSERM), Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Primary Care and Prevention Team, CESP Villejuif, France
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15
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Roland N, Leon C, du Roscoat E, Panjo H, Saurel-Cubizolles MJ, Ringa V. Witnessing interparental violence in childhood and symptoms of depression in adulthood: data from the 2017 French Health Barometer. Fam Pract 2021; 38:306-312. [PMID: 33251547 DOI: 10.1093/fampra/cmaa127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Every year, it is estimated that 143 000 French children are exposed to interparental violence (IPV). This exposure may have deleterious lifelong impact on mental health. OBJECTIVE To investigate the associations between exposure to IPV in childhood and, as adults, the presence of depressive symptoms during the past year, suicidal thoughts and lifetime suicide attempt. METHODS Our study is based on data from the 2017 French Health Barometer, a general population cross-sectional phone survey. 25 319 adults living in Metropolitan France responded. Data were weighted to obtain a representative sample of the French population. Associations between childhood exposure to IPV and each of three outcomes in adulthood-symptoms of depression, suicidal ideation in the past year and lifetime suicide attempt-were studied by calculating odds ratios (ORs) and their 95% confidence intervals (CIs), stratifying by sex and using multivariate models (logistic regression). RESULTS After adjustment for age, social variables, negative life events in childhood and lifetime history of sexual violence, reporting witnessed IPV is significantly associated with the presence of symptoms of depression during the past 12 months (aORmen = 1.88, 95% CI = 1.49-2.38, and aORwomen = 2.00, 1.72-2.32), suicidal thoughts in the past 12 months (aORmen = 1.97, 1.48-2.64, and aORwomen = 2.35, 1.89-2.93), and at least one lifetime suicide attempt (aORmen =2.39, 1.83-3.11 and aORwomen = 2.66, 2.25-3.16). CONCLUSION Associations shown between a history of exposure to IPV and three mental health indicators in adulthood underline the need to study the lifelong impact of IPV.
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Affiliation(s)
- Noemie Roland
- Institut national de la santé et de la recherche médicale (French Institute of Medical Research), CESP (Epidemiology and Population Health Research Center), UMR 1018 'Gender, Sexuality, Health', Paris Sud University, Villejuif, France
- EPI-PHARE Team, ANSM (French National Agency for Medicines and Health Products Safety), Saint-Denis, France
| | - Christophe Leon
- Santé Publique France (the National Public Health Agency), Saint-Maurice, France
| | | | - Henri Panjo
- Institut national de la santé et de la recherche médicale (French Institute of Medical Research), CESP (Epidemiology and Population Health Research Center), UMR 1018 'Gender, Sexuality, Health', Paris Sud University, Villejuif, France
| | - Marie-Josephe Saurel-Cubizolles
- Institut national de la santé et de la recherche médicale UMR 1153 Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Virginie Ringa
- Institut national de la santé et de la recherche médicale (French Institute of Medical Research), CESP (Epidemiology and Population Health Research Center), UMR 1018 'Gender, Sexuality, Health', Paris Sud University, Villejuif, France
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16
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Margueritte F, Fritel X, Zins M, Goldberg M, Panjo H, Fauconnier A, Ringa V. The Underestimated Prevalence of Neglected Chronic Pelvic Pain in Women, a Nationwide Cross-Sectional Study in France. J Clin Med 2021; 10:jcm10112481. [PMID: 34205077 PMCID: PMC8199870 DOI: 10.3390/jcm10112481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/18/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022] Open
Abstract
Dysmenorrhoea, dyspareunia, and non-menstrual chronic pelvic pain (NMCPP) are symptoms that are probably underreported and neglected. This study aimed to assess the prevalence and overlapping relations between these symptoms among a general population of French women of reproductive age. A cross-sectional study among the nationwide CONSTANCES cohort study recruiting a representative sample of women within different French areas was constructed. Women aged 18–49 years (n = 21,287) who reported periods in the previous three months and experienced intercourse at least once were asked about prevalence of three types of chronic pelvic pain: mild, moderate and severe dysmenorrhea; dyspareunia assessed according to its frequency; NMCPP from a binary question. Between the start of 2012 through the end of 2017, 21,287 women were enrolled, 39.8% of them (95% confidence interval (CI), 39.2–40.5) reported moderate to severe dysmenorrhea; 20.3% (95% CI, 18.7–21.9) of the youngest group (18–24 years) reported severe dysmenorrhea. Dyspareunia was reported to happen often or always by 7.9% (95% CI, 7.5–8.2) and peaked among the youngest women at 12.8% (95% CI, 11.5–14.1). NMCPP was reported by 17.0% (95% CI, 16.5–17.5). Moreover, 7.5% (95% CI, 6.4–8.6) of the women reported two or more types of severe or frequent pain. More attention should be paid to this substantial proportion (7.5%) of French women of reproductive age who experience multiple, severe and frequent pelvic pain symptoms.
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Affiliation(s)
- François Margueritte
- Centre for Research in Epidemiology and Population Health, INSERM U1018, Gender, Health Sexuality Team, 16 Avenue Paul Vaillant Couturier, 94800 Villejuif, France; (X.F.); (H.P.); (V.R.)
- INSERM CIC 1402, Université de Poitiers, CHU de Poitiers, 86000 Poitiers, France
- Population-Based Epidemiological Cohorts-INSERM, Paris Saclay University, UVSQ, 94800 Villejuif, France; (M.Z.); (M.G.)
- Department of Gynaecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, 10 Rue du Champ Gaillard, 78103 Poissy, France;
- Correspondence: ; Tel.: +33-67-473-5-602
| | - Xavier Fritel
- Centre for Research in Epidemiology and Population Health, INSERM U1018, Gender, Health Sexuality Team, 16 Avenue Paul Vaillant Couturier, 94800 Villejuif, France; (X.F.); (H.P.); (V.R.)
- INSERM CIC 1402, Université de Poitiers, CHU de Poitiers, 86000 Poitiers, France
| | - Marie Zins
- Population-Based Epidemiological Cohorts-INSERM, Paris Saclay University, UVSQ, 94800 Villejuif, France; (M.Z.); (M.G.)
- Population-Based Epidemiological Cohorts-INSERM, Université de Paris, 75006 Paris, France
| | - Marcel Goldberg
- Population-Based Epidemiological Cohorts-INSERM, Paris Saclay University, UVSQ, 94800 Villejuif, France; (M.Z.); (M.G.)
- Population-Based Epidemiological Cohorts-INSERM, Université de Paris, 75006 Paris, France
| | - Henri Panjo
- Centre for Research in Epidemiology and Population Health, INSERM U1018, Gender, Health Sexuality Team, 16 Avenue Paul Vaillant Couturier, 94800 Villejuif, France; (X.F.); (H.P.); (V.R.)
| | - Arnaud Fauconnier
- Department of Gynaecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, 10 Rue du Champ Gaillard, 78103 Poissy, France;
- Research Unit 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, Paris-Saclay University, UVSQ, 78180 Montigny-le-Bretonneux, France
| | - Virginie Ringa
- Centre for Research in Epidemiology and Population Health, INSERM U1018, Gender, Health Sexuality Team, 16 Avenue Paul Vaillant Couturier, 94800 Villejuif, France; (X.F.); (H.P.); (V.R.)
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17
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Mignot S, Ringa V, Vigoureux S, Zins M, Panjo H, Saulnier PJ, Fritel X. Correlates of premature pap test screening, under 25 years old: analysis of data from the CONSTANCES cohort study. BMC Public Health 2021; 21:595. [PMID: 33765986 PMCID: PMC7993455 DOI: 10.1186/s12889-021-10603-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 03/10/2021] [Indexed: 12/05/2022] Open
Abstract
Background Many countries currently recommend that screening for cervical cancer begin at the age of 25 years. Premature screening (before that age) could lead to unnecessary follow-up examinations and procedures that turn out to be useless. Our objective is to ascertain if the use of particular contraceptive methods are associated with premature screening. Methods This cross-sectional study based on the CONSTANCES cohort enabled us to include 4297 women younger than 25 years. The factors associated with premature screening were modeled by logistic regression. Missing data were handled by multiple imputations. The multivariate analyses were adjusted for sex life, social and demographic characteristics, and health status. Results Nearly half (48.5%) the women younger than 25 years had already undergone premature screening. Women not using contraceptives (aOR 0.3, 95% CI 0.3–0.5) and those using nonmedicalized contraceptives (condom, spermicide, etc.) (aOR 0.5, 95% CI 0.4–0.6) had premature screening less often than women using birth control pills. Higher risks of premature screening were observed in 20-year-old women (aOR 2.7, 95% CI 2.2–3.3) and in those with more than 5 lifetime partners (aOR 2.5, 95% CI 2.0–3.1), compared respectively with women who were younger and those with 5 or fewer lifetime partners. Conclusion Young women using contraceptives that require a doctor’s prescription are exposed to premature screening more often than those not using contraception and those with nonmedicalized contraceptives.
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Affiliation(s)
- Stéphanie Mignot
- Department of General Practice, University of Poitiers, France: 3 rue de la Milétrie, 86000, Poitiers, France.
| | - Virginie Ringa
- CESP Centre for research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health team, University Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, Ined, France
| | - Solène Vigoureux
- CESP Centre for research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health team, University Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, Ined, France.,Obstetrics & Gynecology department, Hôpital Bicêtre, GHU Sud, AP-HP, Faculty of Medicine, Univ of Paris Sud, F-94276, Le Kremlin Bicêtre, France
| | - Marie Zins
- Epidemiological Population-Based Cohorts Unit, INSERM UMS 11,Villejuif, France, University of Paris-Descartes, Paris, France
| | - Henri Panjo
- CESP Centre for research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health team, University Paris-Saclay, University Paris-Sud, UVSQ, Villejuif, Ined, France
| | - Pierre-Jean Saulnier
- Clinical Investigation Centre CIC1402 INSERM, School of Medicine, Poitiers University, CHU Poitiers (University Hospital), 86000, Poitiers, France
| | - Xavier Fritel
- Clinical Research Centree CIC1402, INSERM, Department of Obstetrics, Gynecology, and Reproductive Medicine Poitiers University Hospital Centre, University of Poitiers, Poitiers, France
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18
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Patrice C, Delpech R, Panjo H, Falcoff H, Saurel-Cubizolles MJ, Ringa V, Rigal L. Differences based on patient gender in the management of hypertension: a multilevel analysis. J Hum Hypertens 2021; 35:1109-1117. [PMID: 33504976 DOI: 10.1038/s41371-020-00450-y] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 10/22/2020] [Accepted: 11/10/2020] [Indexed: 11/09/2022]
Abstract
The objective of our study was to investigate differences in the management of men and women treated for hypertension while considering the gender of their physicians. We used the data from the cross-sectional Paris Prevention in General Practice survey, where 59 randomly recruited general practitioners (42 men and 19 women) from the Paris metropolitan area enroled every patient aged 25-79 years taking antihypertensive medication and seen during a 2-week period (520 men and 666 women) in 2005-6. The presence in the medical files of six items recommended for hypertension management (blood pressure measurement, smoking status, cholesterol, creatinine, fasting blood glucose and electrocardiogram) was analysed with mixed models with random intercepts and adjusted for patient and physician characteristics. We found that the presence of all items was lower in the records of female than male patients (3.9 vs. 6.9%, p = 0.01), as was the percentage of items present (58.5 vs. 64.2%, p = 0.003). The latter gender difference was substantially more marked when the physician was a man (69.3 vs. 63.4%, p = 0.0002) rather than a woman (63.5 vs. 61.0%, p = 0.46). Although all guidelines recommend the same management for both genders, the practices of male physicians in hypertension management appear to differ according to patient gender although those of women doctors do not. Male physicians must be made aware of how their gender influences their practices.
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Affiliation(s)
- Colinne Patrice
- Université Paris-Saclay, Univ. Paris-Sud, Département de Médecine Générale, 94270, Le Kremlin-Bicêtre, France. .,Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France. .,Institut national d'études démographiques (INED), F-75020, Paris, France.
| | - Raphaëlle Delpech
- Université Paris-Saclay, Univ. Paris-Sud, Département de Médecine Générale, 94270, Le Kremlin-Bicêtre, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France.,Institut national d'études démographiques (INED), F-75020, Paris, France
| | - Henri Panjo
- Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France.,Institut national d'études démographiques (INED), F-75020, Paris, France
| | - Hector Falcoff
- Société de Formation Thérapeutique du Généraliste (SFTG), Paris, France
| | | | - Virginie Ringa
- Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France.,Institut national d'études démographiques (INED), F-75020, Paris, France
| | - Laurent Rigal
- Université Paris-Saclay, Univ. Paris-Sud, Département de Médecine Générale, 94270, Le Kremlin-Bicêtre, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France.,Institut national d'études démographiques (INED), F-75020, Paris, France
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19
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Tran TVT, Franck JE, Cœuret-Pellicer M, Rigal L, Ringa V, Menvielle G. Combined Effect of Health Status and Primary Care Use on Participation in Cancer Screening: The CONSTANCES Cohort. Women's Health Reports 2020; 1:511-520. [PMID: 35982989 PMCID: PMC9380874 DOI: 10.1089/whr.2020.0096] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 11/15/2022]
Abstract
Background: The combined association between primary care utilization and health status with breast cancer screening (BCS) and cervical cancer screening (CCS) remains unclear. Our aim was to identify women's profiles based on their health status and primary care utilization and study their associated adherence to BCS and CCS recommendations. Methods: Using data from the cohort of people visiting health screening centers (CONSTANCES) in France (2012–2015), we first identified women's profiles based on their health status (self-perceived health, physical, and mental health) and primary care utilization (visit to the General Practitioner [GP], uptake of blood tests) using a multiple correspondence analysis and a hierarchical cluster analysis. We then investigated the association of these profiles to BCS and CCS using logistic regression models adjusted for age, smoking status, sociodemographic and socioeconomic characteristics, and the regularity of gynecologist consultation. Results: We identified five distinct profiles of women with contrasted participation in BCS (n = 14,122) and CCS (n = 27,120). In multivariate analyses, cancer screening participation increased from women with very good health and poor primary care utilization, to those with poor health and frequent visits to the GP, and those with very good health and average primary care utilization. The most favorable profiles regarding cancer screening rates were women with average-to-poor health and regular visits to the GP and uptake of blood tests. Conclusions: Our results suggest that policies aiming at increasing cancer screening participation should simultaneously account for women's use of primary care and health and consider more specific subgroups than what is usually done. Further research should investigate factors motivating cancer screening practice, such as women's beliefs regarding cancer screening and women's psychological characteristics.
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Affiliation(s)
- Thi-Van-Trinh Tran
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Jeanna-Eve Franck
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Mireille Cœuret-Pellicer
- Inserm-Versailles Saint Quentinen Yvelines University, UMS 011 “Epidemiological Population-Based Cohorts Unit,” Villejuif, France
| | - Laurent Rigal
- CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health Team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France
- Ined, Paris, France
| | - Virginie Ringa
- CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health Team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France
- Ined, Paris, France
| | - Gwenn Menvielle
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
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20
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Le Guen M, Rouzaud-Cornabas M, Panjo H, Rigal L, Ringa V, Moreau C. The French pill scare and the reshaping of social inequalities in access to medical contraceptives. SSM Popul Health 2020; 11:100606. [PMID: 32551357 PMCID: PMC7292912 DOI: 10.1016/j.ssmph.2020.100606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 11/13/2022] Open
Abstract
While the consequences of various "pill scares" have been relatively well-documented in the public health literature revealing a drop in pill use and a rise in unplanned pregnancies and abortion rates, researchers rarely considered that these controversies would affect women contraceptive practices differently according to their social background. Indeed, social differentiations in reaction to "pill scares" could contribute to reinforce the social gradient in the use of contraceptive methods and choice of visiting the health professionals who prescribe them. These could contribute to an increase in health inequalities on access to contraceptive methods. Using data from three state nationally representative cross-sectional surveys conducted in France in 2010, 2013 and 2016, we studied the changes in women's contraceptive uses around the French "pill scare" that occurred in 2012-2013. We focused on the changes in the use of all contraceptives available under medical prescription (called medical contraceptives) on one hand, and on each specific method (pill, IUD, implant, patch or vaginal ring, and female sterilization) on the other hand according to the women's social background. We saw a social gradient in contraceptives changes. The decline in the use of contraceptive methods available under medical prescription was particularly marked for women from lower and higher classes in which we observe a decrease in pill use between 2010 and 2013, whereas it was observed only between 2013 and 2016 among middle class women. Moreover, while some women from upper class shifted from pill to IUD between 2010 and 2013, this was not the case for their less privileged counterparts. As a consequence, it seems that the French "pill scare" led to the reshaping of social inequalities in access to medical contraceptives.
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Affiliation(s)
- Mireille Le Guen
- Centre for Demographic Research, Université catholique de Louvain, Place Montesquieu 1, L2.08.03, B-1348 Louvain-la-Neuve, Belgium
- Soins primaires et prévention, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, F-94807 Villejuif, France
- Institut National d’Études démographiques, 9 Cours des Humanités, F-93300 Aubervilliers, France
| | - Mylène Rouzaud-Cornabas
- Soins primaires et prévention, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, F-94807 Villejuif, France
| | - Henri Panjo
- Soins primaires et prévention, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, F-94807 Villejuif, France
| | - Laurent Rigal
- Soins primaires et prévention, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, F-94807 Villejuif, France
- Institut National d’Études démographiques, 9 Cours des Humanités, F-93300 Aubervilliers, France
| | - Virginie Ringa
- Soins primaires et prévention, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, F-94807 Villejuif, France
- Institut National d’Études démographiques, 9 Cours des Humanités, F-93300 Aubervilliers, France
| | - Caroline Moreau
- Soins primaires et prévention, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, F-94807 Villejuif, France
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, Maryland, 21205, USA
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21
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Charles T, Campagne-Loiseau S, Cosson M, Ferry P, Saussine C, Lucot JP, Salet-Lizee D, Barussaud ML, Boisramé T, Carlier-Guérin C, Debodinance P, Deffieux X, Pizzoferrato AC, Curinier S, Ragot S, Ringa V, De Tayrac R, Fauconnier A, Fritel X. Complications after perineal surgery (with or without implantation of material): First results of the French multicenter observatory VIGIMESH after 1873 inclusions. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33670-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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22
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Delpech R, Bloy G, Panjo H, Falcoff H, Ringa V, Rigal L. Physicians' preventive practices: more frequently performed for male patients and by female physicians. BMC Health Serv Res 2020; 20:331. [PMID: 32312327 PMCID: PMC7168941 DOI: 10.1186/s12913-020-05136-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 02/18/2019] [Accepted: 03/20/2020] [Indexed: 01/01/2023] Open
Abstract
Background We sought to analyze gender differences in General Practitioners’ (GP) preventive practices: variations according to the GP’s and the patient’s genders, separately and combined, and the homogeneity of GPs’ practices according to gender. Methods Fifty-two general practitioners volunteered to participate in a cross-sectional study. A sample of 70 patients (stratified by gender) aged 40–70 years was randomly chosen from each GP’s patient panel. Information extracted from the medical files was used to describe the GPs’ preventive practices for each patient: measurements of weight, waist circumference, glucose, and cholesterol; inquiry and counseling about smoking, alcohol consumption, diet, and physical activity, and dates of cervical smears and mammographies. An aggregate preventive score was calculated to assess the percentage of these practices performed by each GP for patients overall and by gender. Mixed models were used to test for gender differences. Results Questionnaires were collected in 2008–2009 for 71% of the 3640 patients and analyzed in June 2017. Male patients and female GPs were associated with the most frequent performance of many types of preventive care. The aggregate preventive score was higher for male patients (OR = 1.60, 95% CI 1.47–1.75) and female GPs (OR = 1.35, 95% CI 1.05–1.73). There was no combined effect of the genders of the two protagonists. Female patients of male GPs appeared to receive preventive care least frequently and female GPs to deliver preventive care more consistently than their male colleagues. Conclusion Physicians need to be aware of these differences, for both patient gender and their own.
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Affiliation(s)
- Raphaëlle Delpech
- General Practice Department, Université Paris-Saclay, Le Kremlin Bicêtre, France.
| | - Géraldine Bloy
- LEDi, EA 7467, University of Burgundy Franche-Comté, Dijon, France
| | - Henri Panjo
- CESP, INSERM, Paris-Saclay University, Paris-Sud University, UVSQ, Villejuif, France.,Institut National d'Études Démographiques (INED), Paris, France
| | - Hector Falcoff
- Société de Formation Thérapeutique du Généraliste, Paris, France
| | - Virginie Ringa
- CESP, INSERM, Paris-Saclay University, Paris-Sud University, UVSQ, Villejuif, France.,Institut National d'Études Démographiques (INED), Paris, France
| | - Laurent Rigal
- General Practice Department, Université Paris-Saclay, Le Kremlin Bicêtre, France.,CESP, INSERM, Paris-Saclay University, Paris-Sud University, UVSQ, Villejuif, France.,Institut National d'Études Démographiques (INED), Paris, France
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23
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Franck JE, Ringa V, Rigal L, Sassenou J, Cœuret-Pellicer M, Chauvin P, Menvielle G. Patterns of gynaecological check-up and their association with body mass index within the CONSTANCES cohort. J Med Screen 2020; 28:10-17. [PMID: 32279590 DOI: 10.1177/0969141320914323] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To investigate the relationship between patterns of gynaecological check-up and body mass index while accounting for various determinants of health care use. METHODS Sequence analysis and clustering were used to highlight patterns of gynaecological check-up, which included the regularity of breast and cervical cancer screening and visits to the gynaecologist over four years, among 6182 women aged 54-65 included in the CONSTANCES cohort between 2013 and 2015 in France. Multinomial logistic regressions were used to study the association between these patterns and women's body mass index. RESULTS We identified four patterns of gynaecological check-up, from (A) no or inappropriate check-up (20%) to (D) almost one visit to the gynaecologist every year, overscreening for cervical cancer and frequent use of opportunistic breast cancer screening (12%). From patterns A to D, the proportion of obese women decreased and that of women with normal body mass index increased. Obese and overweight women underwent more breast than cervical cancer screening and were less often overscreened than normal weight women. These differences were only partly explained by the lower socioeconomic situation of overweight and obese women. Beyond the financial barrier, the screening modality and the type of exam may play a role. Among women who were screened for cervical cancer, obese and overweight women were less often screened by a gynaecologist. CONCLUSION Further efforts should be made to enhance the take-up of screening among obese women who are deterred by the healthcare system.
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Affiliation(s)
- Jeanna-Eve Franck
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Virginie Ringa
- CESP Centre for Research in Epidemiology and Population Health, Gender, Sexuality and Health team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France. Ined, Paris, France
| | - Laurent Rigal
- CESP Centre for Research in Epidemiology and Population Health, Gender, Sexuality and Health team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France. Ined, Paris, France
| | - Jeanne Sassenou
- CESP Centre for Research in Epidemiology and Population Health, Gender, Sexuality and Health team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France. Ined, Paris, France
| | - Mireille Cœuret-Pellicer
- Inserm-Versailles Saint Quentin en Yvelines University, "Epidemiological Population-Based Cohorts Unit", Villejuif, France
| | - Pierre Chauvin
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Gwenn Menvielle
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
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24
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Legendre G, Fritel X, Panjo H, Zins M, Ringa V. Incidence and remission of stress, urge, and mixed urinary incontinence in midlife and older women: A longitudinal cohort study. Neurourol Urodyn 2019; 39:650-657. [DOI: 10.1002/nau.24237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/05/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Guillaume Legendre
- CESP‐INSERM, U1018, Team 7, Genre, Sexual and Reproductive Health, Paris‐Sud University, Paris‐Saclay University, UVSQ, INSERM Villejuif Cedex France
- Department of Obstetrics and Gynecology Angers University Hospital Angers Cedex France
| | - Xavier Fritel
- CESP‐INSERM, U1018, Team 7, Genre, Sexual and Reproductive Health, Paris‐Sud University, Paris‐Saclay University, UVSQ, INSERM Villejuif Cedex France
- INSERM CIC1402 Poitiers University Hospital Poitiers France
| | - Henri Panjo
- CESP‐INSERM, U1018, Team 7, Genre, Sexual and Reproductive Health, Paris‐Sud University, Paris‐Saclay University, UVSQ, INSERM Villejuif Cedex France
| | - Marie Zins
- CESP‐INSERM, U1018, Research Platform “Cohorts in Population” Paris‐Sud University Paris‐Saclay University, UVSQ, INSERM Villejuif Cedex France
| | - Virginie Ringa
- CESP‐INSERM, U1018, Team 7, Genre, Sexual and Reproductive Health, Paris‐Sud University, Paris‐Saclay University, UVSQ, INSERM Villejuif Cedex France
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25
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Sassenou J, Rigal L, Ringa V. Immigration status and cervical test screening: more underscreening and inequality social health. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.245] [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
Introduction
In France, public health authorities recommend cervical cancer screening (CCS) by a Pap test every 3 years for all sexually active women aged 25 to 65 years. Socioeconomic inequalities are observed in CCS and disparities in screening practices according to immigration status has been reported. The aim of this study was to compare income inequalities in cervical screening depending on immigration status.
Methods
The study was based on the 2012-2016 baseline data in the Constances cohort (N = 28905 women). Delayed CCS was defined by having last CCS for more 3 years. The main independant variables were monthly household income and immigration status. The women’s origin was divided into the following categories: French women born to two French parents (French origin), French women born to at least one foreign parent (immigrant origin), and women born to two foreign parent (immigrants). Immigrants were divided into two categories: women with French or not nationality (naturalized or foreign immigrant). The slope index inequality (SII) was computed to measure the income inequality in CCS non-adherence. Interaction test was used to compare SII depending on immigration status. We used imputation model.
Results
We confirmed the existence of a gradient with respect to migration origin for delaying CCS (21,9 % women of French origin, 26,5 % women of immigrant origin, 28,8 % immigrant, p < 10-4). More income inequalities were observed depending on immigration status (SII French origin= 0,17 [0,16-0,18], SII immigrant origin= 0,28 [0,24-0,32], SII immigrant = 0,27 [0,25-0,31], p interaction <0,001). Among immigrant women, we observed difference in social inequalities depending on French nationality (SII naturalized= 0,19 [0,15-0,23], SII foreign immigrant= 0,35 [0,30-0,40], p interaction <10-4).
Conclusions
French women of immigrant origin and immigrant women are underscreened and social inequalities are stronger among them than French women of French origin.
Key messages
French women of immigrant origin and immigrant women are less detected for cervical cancer screening than French women. French women of immigrant origin and immigrant women are detected for cervical cancer screening with more social inequalities than French women of french origin.
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Affiliation(s)
| | - L Rigal
- 1018, INSERM, Villejuif, France
| | - V Ringa
- 1018, INSERM, Villejuif, France
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26
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Charles T, Campagne Loiseau S, Cosson M, Ferry P, Saussine C, Lucot J, Salet-Lizee D, Barussaud M, Boisramé T, Carlier-Guérin C, Debodinance J, Deffieux X, Hummel M, Pizzoferrato A, Ragot S, Ringa V, De Tayrac R, Fauconnier A, Fritel X. Complications après chirurgie du périnée (avec ou sans implantation de matériel) : premiers résultats de l’observatoire multicentrique français VIGIMESH après 1873 inclusions. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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27
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Fritel X, Campagne‐Loiseau S, Cosson M, Ferry P, Saussine C, Lucot J, Salet‐Lizee D, Barussaud M, Boisramé T, Carlier‐Guérin C, Charles T, Debodinance P, Deffieux X, Pizzoferrato A, Curinier S, Ragot S, Ringa V, Tayrac R, Fauconnier A. Complications after pelvic floor repair surgery (with and without mesh): short‐term incidence after 1873 inclusions in the French VIGI‐MESH registry. BJOG 2019; 127:88-97. [DOI: 10.1111/1471-0528.15956] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2019] [Indexed: 11/29/2022]
Affiliation(s)
- X Fritel
- INSERM CIC 1402 CHU de Poitiers Service de gynécologie‐obstétrique Université de Poitiers Poitiers France
- CESP Inserm U1018 Paris France
| | | | - M Cosson
- CHU de Lille Service de gynécologie‐obstétrique Université de Lille Lille France
| | - P Ferry
- CH de La Rochelle Service de gynécologie‐obstétrique La Rochelle France
| | - C Saussine
- CHU de Strasbourg Service d’urologie Université de Strasbourg Strasbourg France
| | - J‐P Lucot
- Hôpital Saint‐Vincent‐de‐Paul Service de gynécologie‐obstétrique Lille France
| | - D Salet‐Lizee
- Groupe Hospitalier Diaconesses‐Croix‐Saint‐Simon Service de gynécologie Paris France
| | - M‐L Barussaud
- CHU de Poitiers Service de chirurgie viscérale Poitiers France
| | - T Boisramé
- CHU de Strasbourg Service de gynécologie‐obstétrique Strasbourg France
| | - C Carlier‐Guérin
- CH de Châtellerault Service de gynécologie‐obstétrique Châtellerault France
| | - T Charles
- CHU de Poitiers Service d’urologie Poitiers France
| | - P Debodinance
- CH de Dunkerque Service de gynécologie‐obstétrique Dunkerque France
| | - X Deffieux
- APHP Antoine‐Béclère Service de gynécologie‐obstétrique Université Paris‐Sud Clamart France
| | | | - S Curinier
- CHU Estaing Service de gynécologie‐obstétrique Clermont‐Ferrand France
| | - S Ragot
- INSERM CIC 1402 Université de Poitiers Poitiers France
| | - V Ringa
- CESP Inserm U1018 Paris France
| | - R Tayrac
- CHU Carémeau Service de gynécologie‐obstétrique Université de Nîmes Nîmes France
| | - A Fauconnier
- CHI Poissy‐Saint‐Germain Service de gynécologie‐obstétrique UVSQ Poissy France
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Maj C, Poncet L, Panjo H, Gautier A, Chauvin P, Menvielle G, Cadot E, Ringa V, Rigal L. General practitioners who never perform Pap smear: the medical offer and the socio-economic context around their office could limit their involvement in cervical cancer screening. BMC Fam Pract 2019; 20:114. [PMID: 31416425 PMCID: PMC6694570 DOI: 10.1186/s12875-019-1004-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/31/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND In France, with the growing scarcity of gynecologists and a globally low and socially differentiated coverage of cervical cancer screening (CCS), general practitioners (GPs) are valuable resources to improve screening services for women. Still all GPs do not perform Pap smears. In order to promote this screening among GPs, the characteristics of physicians who never perform CCS should be more precisely specified. Besides already-known individual characteristics, the contextual aspects of the physicians' office, such as gynecologist density in the area, could shape GPs gynecological activities. METHODS To analyze county (département) characteristics of GPs' office associated with no performance of CCS, we used a representative sample of 1063 French GPs conducted in 2009 and we constructed mixed models with two levels, GP and county. RESULTS Almost 35% (n = 369) of the GPs declared never performing CCS. GPs working in counties with a poor GP-density per inhabitants were more likely to perform CCS (odds ratio (OR) = 0.52 for each increase of density by 1 GP per 10,000 inhabitants, 95% confidence interval (CI) = 0.37-0.74). On the contrary, GPs working in counties with an easier access to a gynecologist were more likely not to perform CCS (OR = 1.06 for each increase of density by 1 gynecologist per 100,000 women, 95%CI = 1.03-1.10 and OR = 2.02 if the first gynecologist is reachable in less than 15 min, 95%CI = 1.20-3.41) as well as GPs working in areas with a poverty rate above the national average (OR = 1.66, 95%CI = 1.09-2.54). These contextual characteristics explain most of the differences between counties concerning rates of not performing CCS. CONCLUSIONS Specific programs should be developed for GPs working in contexts unfavorable to their involvement in CCS.
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Affiliation(s)
- Chiara Maj
- General Practice Department, Univ Paris-Sud, Le Kremlin Bicêtre, France
| | - Lorraine Poncet
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, University of Paris-Sud, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
- Ined, Paris, France
| | - Henri Panjo
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, University of Paris-Sud, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
- Ined, Paris, France
| | | | - Pierre Chauvin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Department of Social Epidemiology, Paris, F75012, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Department of Social Epidemiology, Paris, F75012, France
| | - Emmanuelle Cadot
- IRD - Hydrosciences UMR 5569, Montpellier University, Montpellier, F-34090, France
| | - Virginie Ringa
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, University of Paris-Sud, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
- Ined, Paris, France
| | - Laurent Rigal
- General Practice Department, Univ Paris-Sud, Le Kremlin Bicêtre, France.
- CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, University of Paris-Sud, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France.
- Ined, Paris, France.
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Mignot S, Ringa V, Vigoureux S, Zins M, Panjo H, Saulnier PJ, Fritel X. Pap tests for cervical cancer screening test and contraception: analysis of data from the CONSTANCES cohort study. BMC Cancer 2019; 19:317. [PMID: 30952209 PMCID: PMC6451274 DOI: 10.1186/s12885-019-5477-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 03/14/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In France, a Pap test for cervical cancer screening is recommended every three years for all sexually active women aged 25 to 65 years. Modes of contraception (any or no contraception, with or without a visit to a physician, and with or without a gynecological examination) may influence adhesion to screening: women who use intrauterine device (IUD) should be more up to date with their cervical cancer screening more often than those using other means of contraception. Our objectives were to analyze the association between modes of contraception and Pap tests for screening. METHODS This cross sectional study is based on the CONSTANCES cohort enabled us to include 16,764 women aged 25-50 years. The factors associated with adhesion to cervical cancer screening (defined by a report of a Pap test within the previous 3 years) was modeled by logistic regression. Missing data were imputed by using multiple imputations. The multivariate analyses were adjusted for sex life, social and demographic characteristics, and health status. RESULTS Overall, 11.2% (1875) of the women reported that they were overdue for Pap test screening. In the multivariate analysis there was no significant difference between women using an IUD and those pills or implant of pap test overdue ORa:0.9 CI95% [0.8-1.1], ORa 1.3 CI95% [0.7-2.7] respectively. Women not using contraceptives and those using non-medical contraceptives (condoms, spermicides, etc.) were overdue more often ORa: 2.6 CI95% [2.2-3.0] and ORa: 1.8 CI95% [1.6-2.1] respectively than those using an IUD. CONCLUSION Women seeing medical professionals for contraception are more likely to have Pap tests.
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Affiliation(s)
- Stéphanie Mignot
- Department of General Practice, University of Poitiers, France: 3 rue de la Milétrie, 86000 Poitiers, France
| | - Virginie Ringa
- CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France
| | - Solène Vigoureux
- CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France
- Ined, Paris, France
- Obstetrics & Gynecology Department, Hôpital Bicêtre, GHU Sud, AP-HP, Faculty of Medicine, University of Paris Sud, F-94276 Le Kremlin Bicêtre, France
| | - Marie Zins
- Epidemiological Population-Based Cohorts Unit, INSERM UMS 11, Villejuif, France
- University of Paris-Descartes, Paris, France
| | - Henri Panjo
- CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health team, University of Paris-Saclay, University of Paris-Sud, UVSQ, Villejuif, France
- Ined, Paris, France
| | - Pierre-Jean Saulnier
- Clinical Research Centree CIC1402, INSERM, Department of Obstetrics, Gynecology, and Reproductive Medicine Poitiers University Hospital Centre, University of Poitiers, Poitiers, France
| | - Xavier Fritel
- Clinical Research Centree CIC1402, INSERM, Department of Obstetrics, Gynecology, and Reproductive Medicine Poitiers University Hospital Centre, University of Poitiers, Poitiers, France
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Al-Salameh A, Chanson P, Bucher S, Ringa V, Becquemont L. Cardiovascular Disease in Type 2 Diabetes: A Review of Sex-Related Differences in Predisposition and Prevention. Mayo Clin Proc 2019; 94:287-308. [PMID: 30711127 DOI: 10.1016/j.mayocp.2018.08.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 07/24/2018] [Accepted: 08/06/2018] [Indexed: 12/31/2022]
Abstract
Type 2 diabetes mellitus is a major risk factor for cardiovascular disease. However, compiled data suggest that type 2 diabetes affects the risk of cardiovascular disease differentially according to sex. In recent years, large meta-analyses have confirmed that women with type 2 diabetes have a higher relative risk of incident coronary heart disease, fatal coronary heart disease, and stroke compared with their male counterparts. The reasons for these disparities are not completely elucidated. A greater burden of cardiometabolic risk in women was proposed as a partial explanation. Indeed, several studies suggest that women experience a larger deterioration in major cardiovascular risk factors and put on more weight than do men during their transition from normoglycemia to overt type 2 diabetes. This excess weight is associated with higher levels of biomarkers of endothelial dysfunction, inflammation, and procoagulant state. Moreover, sex differences in the prescription and use of some cardiovascular drugs may compound an "existing" disparity. We searched PubMed for articles published in English and French, by using the following terms: ("cardiovascular diseases") AND ("diabetes mellitus") AND ("sex disparity" OR "sex differences" OR "sex related differences" OR "sex-related differences" OR "sex disparities"). In this article, we review the available literature on the sex aspects of primary and secondary prevention of cardiovascular disease in people with type 2 diabetes, in the predisposition to cardiovascular disease in those people, and in the control of diabetes and associated cardiovascular risk factors.
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Affiliation(s)
- Abdallah Al-Salameh
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), Université Paris-Sud, Université Paris-Saclay, INSERM, Villejuif, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Le Kremlin-Bicêtre, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Centre de Recherche Clinique Paris-Sud, Le Kremlin-Bicêtre, France.
| | - Philippe Chanson
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Le Kremlin-Bicêtre, France; Faculté de Médecine, Université Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France; INSERM U1185, Faculté de Médecine, Université Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Sophie Bucher
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), Université Paris-Sud, Université Paris-Saclay, INSERM, Villejuif, France; General Practice Department, Paris-Sud Faculty of Medicine, Paris-Sud University, Le Kremlin-Bicêtre, France
| | - Virginie Ringa
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), Université Paris-Sud, Université Paris-Saclay, INSERM, Villejuif, France
| | - Laurent Becquemont
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), Université Paris-Sud, Université Paris-Saclay, INSERM, Villejuif, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Centre de Recherche Clinique Paris-Sud, Le Kremlin-Bicêtre, France; Pharmacology Department, Paris-Sud Faculty of Medicine, Paris-Sud University, Le Kremlin-Bicêtre, France
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Crampe-Casnabet C, Franck JE, Ringa V, Coeuret-Pellicer M, Chauvin P, Menvielle G. Role of obesity in differences in cervical cancer screening rates by migration history. The CONSTANCES survey. Cancer Epidemiol 2018; 58:98-103. [PMID: 30530110 DOI: 10.1016/j.canep.2018.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 06/15/2018] [Revised: 11/02/2018] [Accepted: 11/27/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Immigrant women often have lower cervical cancer screening (CCS) rates, tend to have a higher body mass index (BMI) and may be more vulnerable to BMI-related stigmatization. Our aim was to assess the role of BMI in differences in CCS rates by migration history. METHODS Analyses were based on the 2012-2015 inclusion data (n = 27,226) for the population-based CONSTANCES cohort, including detailed, self-reported information on demographics and socioeconomic characteristics, migration history, health behaviours, health, and health care use. Measured BMI (underweight (<18.5), normal-weight (18.5-25), overweight (25-30), obese (>30)) was collected. Poisson regression models with robust variance were conducted to assess the contribution of BMI to differences in CCS rates by migration history, and analyses stratified by BMI were done. Multiple imputations were performed. RESULTS The CCS rates ranged from 87% among French-born women with two French parents to 86% among French-born women with at least one parent of foreign origin, 82% among naturalized immigrants and 74% among non-naturalized immigrants. After adjusting for covariates, non-naturalized immigrants showed an 11% (95% CI: 8%-14%) lower CCS rate than French-born women with two French parents. Adjusting for BMI did not change the estimates. When stratifying by BMI category, non-naturalized immigrants showed an 11% (7%-14%) lower CCS rate then French-born with two French parents when normal weight, a 9% (2%-16%) lower CCS rate when overweight, and an 18% (5%-30%) lower CCS rate when obese. CONCLUSION Migration history and BMI jointly impact CCS rates. They were lower among all non-naturalized immigrants, particularly those who were obese.
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Affiliation(s)
- Cyrielle Crampe-Casnabet
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Department of social epidemiology, F75012 Paris, France.
| | - Jeanna-Eve Franck
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Department of social epidemiology, F75012 Paris, France.
| | - Virginie Ringa
- CESP, INSERM U1018, Univ Paris-Saclay, Univ Paris-Sud, UVSQ, Villejuif, France.
| | - Mireille Coeuret-Pellicer
- Inserm, Population-based Epidemiologic Cohorts Unit, UMS 011, Villejuif, France; University of Versailles St-Quentin, UMRS 1018, Villejuif, France.
| | - Pierre Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Department of social epidemiology, F75012 Paris, France.
| | - Gwenn Menvielle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Department of social epidemiology, F75012 Paris, France.
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Rouquette A, Nadot T, Labitrie P, Van den Broucke S, Mancini J, Rigal L, Ringa V. Validity and measurement invariance across sex, age, and education level of the French short versions of the European Health Literacy Survey Questionnaire. PLoS One 2018; 13:e0208091. [PMID: 30521552 PMCID: PMC6283623 DOI: 10.1371/journal.pone.0208091] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 11/12/2018] [Indexed: 01/23/2023] Open
Abstract
Background Short versions of the European Health Literacy Survey (HLS-EU) questionnaire are increasingly used to measure and compare health literacy (HL) in populations worldwide. As no validated versions of these questionnaires have thus far appeared in French, this study aimed to study the psychometric properties of the French translation of the 16- and 6-item short versions (HLS-EU-Q16 and HLS-EU-Q6), including their measurement invariance across sex, age, and education level. Methods A consensual French version of the HLS-EU-Q16 and HLS-EU-Q6 was developed by following the current recommendations for transcultural questionnaire adaptation. It was then completed by 317 patients recruited in waiting rooms of general practitioners in the Paris area (France). Structural validity was studied with the Rasch model for the HLS-EU-Q16 and confirmatory factorial analysis (CFA) for the HLS-EU-Q6. Concurrent and convergent validity, respectively, were assessed by scores on the Functional Communicative Critical Health Literacy (FCCHL) questionnaire and the physicians’ evaluations of their patient’s HL. Results The 16 items of the HLS-EU-Q16 were Rasch homogenous but meaningful differential item functioning (DIF) was found across sex, age, and/or education level for eight items. The CFA model fit for the HLS-EU-Q6 was poor. The overall scores for both HLS-EU short versions correlated poorly with the FCCHL scores. Similarly, HL levels defined using either short-version score did not agree with physicians’ HL assessments. Conclusion The French version of the HLS-EU-Q16 has acceptable psychometric properties, despite meaningful DIF for age, sex and education level and a poor discriminative power among subjects with average to high HL level. We recommend its use to measure HL in populations with sufficient reading skills to discriminate between subjects with low to average HL. Also, sensitivity analyses should be performed to evaluate the potential measurement bias due to DIF. Our results did not demonstrate the validity of the HLS-EU-Q6.
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Affiliation(s)
- Alexandra Rouquette
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- AP-HP, Bicêtre Hôpitaux Universitaires Paris Sud, Public Health and Epidemiology Department, Le Kremlin-Bicêtre, France
| | - Théotime Nadot
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Pierre Labitrie
- Université Paris-Saclay, Univ. Paris-Sud, General Practice Department, Le Kremlin-Bicêtre, France
| | | | - Julien Mancini
- Aix-Marseille Univ, INSERM, IRD, UMR1252, SESSTIM, “Cancers, Biomedicine & Society” group, Marseille, France
- APHM, Timone Hospital, Public Health Department (BIOSTIC), Marseille, France
| | - Laurent Rigal
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Université Paris-Saclay, Univ. Paris-Sud, General Practice Department, Le Kremlin-Bicêtre, France
- Institut National d’Etudes Démographiques (INED), Paris, France
- * E-mail:
| | - Virginie Ringa
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Institut National d’Etudes Démographiques (INED), Paris, France
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Casanova L, Ringa V, Chatelard S, Paquet S, Pendola-Luchel I, Panjo H, Bideau C, Deflesselle E, Delpech R, Bloy G, Rigal L. Corrigendum: Level of agreement between physician and patient assessment of non-medical health factors. Fam Pract 2018; 35:638. [PMID: 29659803 DOI: 10.1093/fampra/cmy025] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Al-Salameh A, Bucher S, Bauduceau B, Benattar-Zibi L, Berrut G, Bertin P, Corruble E, Danchin N, Derumeaux G, Doucet J, Falissard B, Forette F, Hanon O, Ourabah R, Pasquier F, Pinget M, Becquemont L, Ringa V. Sex Differences in the Occurrence of Major Clinical Events in Elderly People with Type 2 Diabetes Mellitus Followed up in the General Practice. Exp Clin Endocrinol Diabetes 2018; 128:311-318. [PMID: 30134475 DOI: 10.1055/a-0662-5923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIMS The main aim of the present work was to assess if sex influences the occurrence of major clinical events in elderly people with type 2 diabetes followed up in the primary care. METHODS 983 subjects aged ≥65years with type 2 diabetes were included by 213 general practitioners and followed up prospectively for three years. Major clinical events were recorded every six month. The first endpoint was a composite of all-cause death and major vascular events (acute coronary syndrome, non-fatal stroke or transient ischemic attack, or revascularization for peripheral artery disease). The second endpoint was all-cause hospitalization. The occurrence of each endpoint was analyzed in order to estimate the role of sex and determine other predictors of major clinical events. RESULTS At baseline, women were older than men but they had a lower prevalence of coexisting diseases (cardiovascular disease and cancer) and equivalent diabetes control (Glycated hemoglobin A1C: 6.9%±0.9 vs. 7.0%±1.1). Over the follow-up period, women were at lower risk to develop the composite endpoint (HR 0.60, 95% CI 0.40-0.91, p=0.016) and the hospitalization endpoint (OR 0.71, 95% CI 0.52-0.96, p=0.029). Coexisting diseases, functional ability and concomitant medications emerged as significant predictors of both endpoints. CONCLUSIONS Elderly women with well-controlled type 2 diabetes were less likely to experience major clinical events than their male counterparts. More studies are needed to determine the reasons for the higher hospitalization rate in men.
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Affiliation(s)
- Abdallah Al-Salameh
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine - Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Centre de Recherche Clinique Paris-Sud, Le Kremlin-Bicêtre, France
| | - Sophie Bucher
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine - Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France.,General Practice Department, Paris-Sud Faculty of Medicine, Paris-Sud University, Le Kremlin-Bicêtre, France
| | | | | | - Gilles Berrut
- Clinical Gerontology, Nantes University Hospital, Nantes, France
| | - Philippe Bertin
- Rheumatology Department, Limoges University Hospital, Limoges, France
| | - Emmanuelle Corruble
- INSERM U 1178, Paris-Sud Faculty of Medicine, Paris-Sud University, Psychiatry Department, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Nicolas Danchin
- Cardiology department, Hôpital Européen Georges Pompidou, Paris, France
| | - Geneviève Derumeaux
- Cardiovascular Functional Exploration, Louis-Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - Jean Doucet
- Internal Medicine, Geriatrics and Therapeutics, Saint-Julien University Hospital, Rouen University, Rouen, France
| | - Bruno Falissard
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine - Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France
| | - Françoise Forette
- Paris Descartes University, National Foundation of Gerontology, Paris, France
| | - Olivier Hanon
- Paris Descartes University, EA 4468, Assistance Publique-Hôpitaux de Paris, Broca Hospital, Geriatrics Department, Paris, France
| | - Rissane Ourabah
- General Practice Department, Paris-Sud Faculty of Medicine, Paris-Sud University, Le Kremlin-Bicêtre, France
| | - Florence Pasquier
- University of Lille Nord de France, UDSL, EA 1046, Lille University Hospital, Lille, France
| | - Michel Pinget
- Endocrinology, Diabetes and Nutrition-Related Diseases, Strasbourg University Hospital and the European Centre for the Study of Diabetes (CeeD), University of Strasbourg, Strasbourg, France
| | - Laurent Becquemont
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine - Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Centre de Recherche Clinique Paris-Sud, Le Kremlin-Bicêtre, France.,University Paris-Sud Faculty of Medicine, Pharmacology Department and Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Virginie Ringa
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine - Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France
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Al-Salameh A, Bucher S, Bauduceau B, Benattar-Zibi L, Berrut G, Bertin P, Corruble E, Danchin N, Derumeaux G, Doucet J, Falissard B, Forette F, Hanon O, Ourabah R, Pasquier F, Pinget M, Ringa V, Becquemont L. Gender-Related Differences in the Control of Cardiovascular Risk Factors in Primary Care for Elderly Patients With Type 2 Diabetes: A Cohort Study. Can J Diabetes 2018; 42:365-371.e2. [DOI: 10.1016/j.jcjd.2017.08.248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 07/17/2017] [Accepted: 08/28/2017] [Indexed: 12/11/2022]
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Casanova L, Ringa V, Chatelard S, Paquet S, Pendola-Luchel I, Panjo H, Bideau C, Deflesselle E, Delpech R, Bloy G, Rigal L. Level of agreement between physician and patient assessment of non-medical health factors. Fam Pract 2018; 35:488-494. [PMID: 29385435 DOI: 10.1093/fampra/cmx141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND GPs need to consider assorted relevant non-medical factors, such as family or work situations or health insurance coverage, to determine appropriate patient care. If GPs' knowledge of these factors varies according to patients' social position, less advantaged patients might receive poorer care, resulting in the perpetuation of social inequalities in health. OBJECTIVE To assess social disparities in GPs' knowledge of non-medical factors relevant to patient care. METHODS Observational survey of GPs who supervise internships in the Paris metropolitan area. Each of the 52 enrolled GPs randomly selected 70 patients from their patient list. Their knowledge of five relevant factors (coverage by publicly funded free health insurance, or by supplementary health insurance, living with a partner, social support and employment status) was analysed as the agreement between the patients' and GPs' answers to matching questions. Occupational, educational and financial disparities were estimated with multilevel models adjusted for age, sex, chronic disease and GP-patient relationship. RESULTS Agreement varied according to the factor considered from 66% to 91%. The global agreement score (percentage of agreement for all five factors) was 72%. Social disparities and often gradients, disfavouring the less well-off patients, were observed for each factor considered. Social gradients were most marked according to perceived financial situation and for health insurance coverage. CONCLUSION GPs must be particularly attentive toward their least advantaged patients, to be aware of the relevant non-medical factors that affect these patients' health and care, and thus provide management adapted to each individual's personal situation.
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Affiliation(s)
- Ludovic Casanova
- Aix Marseille University, Department of general practice, Marseille, France
| | - Virginie Ringa
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Institut National d'Etudes Démographiques (INED), Paris, France
| | - Sophia Chatelard
- General practice department, UFR santé, La Tronche Cedex, France
| | - Sylvain Paquet
- General Practice Department, Fac. de médecine - Univ. Paris-Sud, Le Kremlin-Bice^tre, France
| | - Isabelle Pendola-Luchel
- General Practice Department, Fac. de médecine - Univ. Paris-Sud, Le Kremlin-Bice^tre, France
| | - Henri Panjo
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Institut National d'Etudes Démographiques (INED), Paris, France
| | - Camille Bideau
- General Practice Department, Fac. de médecine - Univ. Paris-Sud, Le Kremlin-Bice^tre, France
| | - Eric Deflesselle
- General Practice Department, Fac. de médecine - Univ. Paris-Sud, Le Kremlin-Bice^tre, France
| | - Raphaëlle Delpech
- General Practice Department, Fac. de médecine - Univ. Paris-Sud, Le Kremlin-Bice^tre, France
| | - Géraldine Bloy
- LEDi, Université de Bourgogne et de Franche Comté, Dijon, France
| | - Laurent Rigal
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,Institut National d'Etudes Démographiques (INED), Paris, France.,General Practice Department, Fac. de médecine - Univ. Paris-Sud, Le Kremlin-Bicêtre, France
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Thebault JL, Ringa V, Panjo H, Bloy G, Falcoff H, Rigal L. Accumulation of unhealthy behaviors: Marked social inequalities in men and women. Prev Med Rep 2018; 12:1-5. [PMID: 30116703 PMCID: PMC6084013 DOI: 10.1016/j.pmedr.2018.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 01/30/2018] [Revised: 07/19/2018] [Accepted: 07/21/2018] [Indexed: 11/25/2022] Open
Abstract
The objective of this study was to compare the accumulation of unhealthy behaviors at the bottom of the social scale in men and women and, secondarily, to compare social and gender-based inequalities. Fifty-two general practitioners from the Paris area volunteered to participate. A sample of 70 patients (stratified by gender) aged 40–74 years was randomly chosen from each physician's patient panel and asked to complete a questionnaire about their social position and health behaviors: tobacco and alcohol use, unhealthy diet, and physical inactivity. Mixed Poisson models were used to describe, with relative risks (RRs) and relative inequality indexes (RIIs), the social inequalities in the accumulation of these four unhealthy behaviors. In 2008–2009, 71% of the 3640 patients returned their questionnaires. Men had an average of 1.59 of the 4 unhealthy behaviors we studied, and women 1.35 (RR = 1.18; 95% CI [1.11–1.25]). The mean number of unhealthy behaviors increased significantly for both genders from the top to the bottom of the social scale. The order of magnitude of RIIs was similar among men and women, ranging from 1.33 (occupational RII among women, 95% CI [1.11–1.60]) through 1.69 (financial RII among women, 95% CI [1.43–1.99]). None of the interaction tests between gender and social position was significant. The social inequalities had significantly wider amplitudes than those between genders for two of the three indicators of social position. The amplitude of social gradients related to unhealthy behaviors was similar between men and women and exceeded the gender inequality between them.
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Affiliation(s)
- Jean-Laurent Thebault
- Université Sorbonne Paris Cité, Université Paris Descartes, Département de médecine générale, Paris, France
| | - Virginie Ringa
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.,Institut National d'Etudes Démographiques (INED), Paris, France
| | - Henri Panjo
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.,Institut National d'Etudes Démographiques (INED), Paris, France
| | | | - Hector Falcoff
- Société de Formation Thérapeutique du Généraliste (SFTG), Paris, France
| | - Laurent Rigal
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.,Institut National d'Etudes Démographiques (INED), Paris, France.,Université Paris-Saclay, Univ. Paris-Sud, General Practice Department, Le Kremlin-Bicêtre, France
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Bucher S, Al-Salameh A, Panjo H, Becquemont L, Ringa V. Looking younger, dying later: General practitioners' intuitive clinical impression predicts mortality. Prev Med 2018; 111:28-34. [PMID: 29474849 DOI: 10.1016/j.ypmed.2018.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 01/29/2018] [Accepted: 02/19/2018] [Indexed: 10/18/2022]
Affiliation(s)
- Sophie Bucher
- General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France; CESP, INSERM U1018, INED, Université Paris-Saclay, Université Parie-Sud, UVSQ, Villejuif, France.
| | - Abdallah Al-Salameh
- CESP, INSERM U1018, INED, Université Paris-Saclay, Université Parie-Sud, UVSQ, Villejuif, France; Pharmacology Department, Faculty of Medicine Paris-Sud, University Paris Sud, UMR 1184, CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, INSERM Center for immunology of viral infections and autoimmune diseases, Assistance Publique-Hôpitaux de Paris, Hopital Bicêtre, Le Kremlin Bicêtre, France
| | - Henri Panjo
- CESP, INSERM U1018, INED, Université Paris-Saclay, Université Parie-Sud, UVSQ, Villejuif, France
| | - Laurent Becquemont
- Pharmacology Department, Faculty of Medicine Paris-Sud, University Paris Sud, UMR 1184, CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, INSERM Center for immunology of viral infections and autoimmune diseases, Assistance Publique-Hôpitaux de Paris, Hopital Bicêtre, Le Kremlin Bicêtre, France
| | - Virginie Ringa
- CESP, INSERM U1018, INED, Université Paris-Saclay, Université Parie-Sud, UVSQ, Villejuif, France
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Ousseine YM, Rouquette A, Bouhnik AD, Rigal L, Ringa V, Smith A'B, Mancini J. Validation of the French version of the Functional, Communicative and Critical Health Literacy scale (FCCHL). J Patient Rep Outcomes 2018; 2:3. [PMID: 29757319 PMCID: PMC5934921 DOI: 10.1186/s41687-018-0027-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 08/09/2017] [Accepted: 01/04/2018] [Indexed: 11/10/2022] Open
Abstract
Background Health literacy is a key asset, defined as the capacity to acquire, understand and use information in ways which promote and maintain good health. Objectives To assess the reliability and validity of the French translation of the Functional, Communicative and Critical Health Literacy (FCCHL) scale. Methods/participants A cross-sectional survey using an online questionnaire was proposed to all members of Seintinelles association. Exploratory and confirmatory factorial analyses were conducted. Results Data from 2342 respondents (45.8% had cancer history) were analysed. The FCCHL scale was well-accepted (missing value by item ≤0.7%). Factor analysis revealed an acceptable fit of three-factor model (comparative fit index = 0.922, root mean square error of approximation = 0.065 and standardized root mean square residual = 0.052). The FCCHL showed satisfactory reliability (α = 0.77) and scalar invariance was reached for education and deprivation, but not for age. Known group validity was verified as mean scale scores differed according to education, deprivation and age, as expected. Conclusion The French version of the FCCHL provides a brief reliable and valid measure to explore the dimensions of health literacy. It could be used by health professionals to screen for health literacy level in order to develop this skill and to tailor health communication. Electronic supplementary material The online version of this article (10.1186/s41687-018-0027-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Youssoufa M Ousseine
- 1Aix-Marseille Univ, INSERM, IRD, UMR912, SESSTIM, Institut Paoli-Calmettes, "Cancers, Biomedicine & Society" group, 232, Bd Ste Marguerite, BP 156, 13273 Marseille Cedex 9, France
| | - Alexandra Rouquette
- 2Public Health and Epidemiology Department, APHP, Bicêtre Hospital, Le Kremlin-Bicêtre, France.,Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Le Kremlin Bicêtre, France
| | - Anne-Déborah Bouhnik
- 1Aix-Marseille Univ, INSERM, IRD, UMR912, SESSTIM, Institut Paoli-Calmettes, "Cancers, Biomedicine & Society" group, 232, Bd Ste Marguerite, BP 156, 13273 Marseille Cedex 9, France
| | - Laurent Rigal
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Le Kremlin Bicêtre, France
| | - Virginie Ringa
- 2Public Health and Epidemiology Department, APHP, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Allan 'Ben' Smith
- 4Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research & South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW Australia.,5Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, Sydney, Australia
| | - Julien Mancini
- 1Aix-Marseille Univ, INSERM, IRD, UMR912, SESSTIM, Institut Paoli-Calmettes, "Cancers, Biomedicine & Society" group, 232, Bd Ste Marguerite, BP 156, 13273 Marseille Cedex 9, France.,6APHM, Timone Hospital, Public Health Department (BIOSTIC), Marseille, France
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Lemogne C, Turinici M, Panjo H, Ngo C, Canoui‐Poitrine F, Chauvet‐Gelinier J, Limosin F, Consoli SM, Goldberg M, Zins M, Ringa V. Personality and breast cancer screening in women of the GAZEL cohort study. Cancer Med 2018; 7:515-524. [PMID: 29277970 PMCID: PMC5806114 DOI: 10.1002/cam4.1268] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/25/2017] [Accepted: 10/19/2017] [Indexed: 12/24/2022] Open
Abstract
The potential benefit of breast cancer screening is mitigated by the risk of false positives and overdiagnosis, thus advocating for a more personalized approach, based on the individual benefit-harm balance. Since personality might influence the women's appraisal of this balance, this prospective observational cohort study examined whether it could influence mammography use. A total of 2691 postmenopausal women of the GAZEL Cohort Study completed the Bortner Type A Rating Scale and the Buss and Durkee Hostility Inventory in 1993. Associations between personality scores and subsequent mammography use, self-reported through up to five triennial follow-up questionnaires, were estimated with Odds Ratio (OR) and 95% confidence interval (CI) with logistic mixed model regressions, adjusting for age, occupational grade, marital status, family history of breast cancer, age at menarche, age at first delivery, gynecological follow-up, hormone therapy use, and depressive symptoms. Individual propensity scores were used to weight the analyses to control for potential selection biases. More than 90% of the participants completed at least two follow-up questionnaires. Type A personality, but not hostility, was associated with mammography use in both univariate (crude OR [95% CI]: 1.62 [1.24-2.11], P < 0.001) and multivariate analyses (OR [95% CI]: 1.46 [1.13-1.90], P < 0.01). Type A personality traits (i.e., sense of time urgency, high job involvement, competitiveness) independently predicted mammography use among postmenopausal women. While paying more attention to the adherence of women with low levels of these traits, clinicians may help those with higher levels to better consider the risks of false positives and overdiagnosis.
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Affiliation(s)
- Cédric Lemogne
- Faculté de MédecineSorbonne Paris CitéUniversité Paris DescartesParisFrance
- Psychiatry departmentParis‐Ouest University HospitalsAP‐HPParisFrance
- Inserm, U894ParisFrance
| | - Monica Turinici
- Psychiatry departmentParis‐Ouest University HospitalsAP‐HPParisFrance
| | - Henri Panjo
- UVSQCESP, Inserm, INEDUniversité Paris‐SaclayUniv. Paris‐Sudle Kremlin‐BicêtreFrance
| | - Charlotte Ngo
- Faculté de MédecineSorbonne Paris CitéUniversité Paris DescartesParisFrance
- Gynecologic Surgery DepartmentParis‐Ouest University HospitalsAP‐HPParisFrance
| | - Florence Canoui‐Poitrine
- Public Health departmentHenri‐Mondor HospitalAP‐HPCréteilFrance
- UPEC, DHU A‐TVB, IMRB, EA7376 CEpiA (Clinical Epidemiology And Ageing)Paris‐Est UniversityF‐94000CréteilFrance
| | - Jean‐Christophe Chauvet‐Gelinier
- Psychiatry unitNeurosciences department, Marion buildingCHU Le BocageDijonFrance
- Laboratory of psychopathology and medical psychology (IFR 100)Bourgogne UniversityDijonFrance
| | - Frédéric Limosin
- Faculté de MédecineSorbonne Paris CitéUniversité Paris DescartesParisFrance
- Psychiatry departmentParis‐Ouest University HospitalsAP‐HPParisFrance
- Inserm, U894ParisFrance
| | - Silla M. Consoli
- Faculté de MédecineSorbonne Paris CitéUniversité Paris DescartesParisFrance
- Psychiatry departmentParis‐Ouest University HospitalsAP‐HPParisFrance
| | - Marcel Goldberg
- Inserm, UMS 011Population‐based Epidemiological CohortsVillejuifFrance
- Inserm, UMR 1168, VIMAVillejuifFrance
| | - Marie Zins
- Inserm, UMS 011Population‐based Epidemiological CohortsVillejuifFrance
- Inserm, UMR 1168, VIMAVillejuifFrance
| | - Virginie Ringa
- UVSQCESP, Inserm, INEDUniversité Paris‐SaclayUniv. Paris‐Sudle Kremlin‐BicêtreFrance
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Vigoureux S, Bajos N, Ringa V. Effect of Parent-Daughter Communication about Sex on the Use of Less Effective Contraception among Women from Ages 15-24 Years in France. J Pediatr Adolesc Gynecol 2018; 31:33-39. [PMID: 28807735 DOI: 10.1016/j.jpag.2017.08.003] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/27/2017] [Accepted: 08/07/2017] [Indexed: 11/29/2022]
Abstract
STUDY OBJECTIVE Most women begin sexual activity as teenagers but nearly 20% of women in France younger than 25 years rely on less effective contraceptive methods (condoms or methods such as withdrawal or periodic abstinence). We sought to analyze the association with less effective contraception among women aged 15-24 years in France and communication about sex and contraception with their parents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: The analyses focused on 713 sexually active women who did not currently want a child, were using contraception, and were interviewed in 2010 in a national cross-sectional probability survey (FEcondité CONtraception Dysfonctions sexuelles [FECOND]) when they were 15-24 years old. Associations between the use of less effective contraception, social and demographic characteristics, sexual activity, health characteristics, and communication with parents and friends about sexuality and contraception were tested with logistic regression models according to age group. RESULTS AND CONCLUSION Less effective contraception (condoms, and barrier or natural methods) is used more often by younger women: 27.5% of 15- to 19-year-old women and 14.7% of 20- to 24-year-old women (P < .001). After adjustment for demographic characteristics and aspects of their sex lives (regularity and frequency of intercourse), women who reported difficulty discussing contraception and sex with their mothers at age 15 years were more likely than those with easier communication to use less effective contraception (for those 15-19 years, odds ratio = 1.97; 95% confidence interval, 0.94-4.10, and for those 20-24 years, odds ratio = 2.36; 95% confidence interval, 1.31-4.26). Difficulty in communicating with their parents, especially their mothers, about sex, is associated with young women's choice of less effective contraception.
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Affiliation(s)
- Solène Vigoureux
- Université Paris-Saclay, Univ Paris-Sud, UVSQ, CESP Centre for research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health team, Kremlin-Bicêtre, France; Ined, Paris, France; Service de Gynécologie Obstétrique, Hôpital Bicêtre, GHU Sud, AP-HP, Faculty of Medicine, Univ Paris Sud F-94276, Le Kremlin Bicêtre, France.
| | - Nathalie Bajos
- Université Paris-Saclay, Univ Paris-Sud, UVSQ, CESP Centre for research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health team, Kremlin-Bicêtre, France; Ined, Paris, France
| | - Virginie Ringa
- Université Paris-Saclay, Univ Paris-Sud, UVSQ, CESP Centre for research in Epidemiology and Population Health, U1018, Gender, Sexuality and Health team, Kremlin-Bicêtre, France; Ined, Paris, France
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Araujo M, Franck JE, Cadot E, Gautier A, Chauvin P, Rigal L, Ringa V, Menvielle G. Contextual determinants of participation in cervical cancer screening in France, 2010. Cancer Epidemiol 2017; 48:117-123. [PMID: 28482191 DOI: 10.1016/j.canep.2017.04.014] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 04/03/2017] [Accepted: 04/25/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Some contextual factors associated with participation in cervical cancer screening are reported in the literature, but few studies have examined their combined effect. Our objective was to assess the role of contextual characteristics, separately and in combination, in participation in cervical cancer screening in France. METHODS Marginal Poisson regression models - taking into account the correlation between women in a given commune - were conducted using data from the Baromètre Santé 2010 survey. The characteristics of the commune of residence of the women studied were the potential spatial accessibility to general practitioners (GP) and gynecologists, the agglomeration category, and the socioeconomic level. RESULTS The analyses were performed in 3380 women, 88.2% of whom were up to date with their cervical cancer screening. Once the individual characteristics were taken into account, the screening participation rate was similar in all the communes, with the exception of those with poor access to a gynecologist and good access to a GP, where the rate was 6% lower (95%CI: 0.5-11%) than in the communes with good access to both GP and gynecologist. The same association with accessibility was observed in small agglomerations. Compared to women living in the more advantaged communes, the screening participation rate was 8% (2-12%) lower in those living in the more disadvantaged ones, except when accessibility to both types of physician was high. DISCUSSION We observed an association between potential spatial accessibility to care in women's residential communities and their cervical cancer screening practices, in particular in small agglomerations, rural communes, and more disadvantaged communes.
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Affiliation(s)
- Mélanie Araujo
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012 Paris, France.
| | - Jeanna-Eve Franck
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012 Paris, France.
| | | | - Arnaud Gautier
- Santé Publique France, French national public health agency, F-94415 Saint-Maurice, France.
| | - Pierre Chauvin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012 Paris, France.
| | - Laurent Rigal
- INSERM, Epidemiology and Population Health Research Centre (CESP), U1018, Gender, Sexuality and Health Team, F-94276 Le Kremlin-Bicêtre, France; Univ Paris-Sud, UMRS 1018, F-94276 Le Kremlin-Bicêtre, France; INED, F-75012 Paris, France.
| | - Virginie Ringa
- INSERM, Epidemiology and Population Health Research Centre (CESP), U1018, Gender, Sexuality and Health Team, F-94276 Le Kremlin-Bicêtre, France; Univ Paris-Sud, UMRS 1018, F-94276 Le Kremlin-Bicêtre, France; INED, F-75012 Paris, France.
| | - Gwenn Menvielle
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012 Paris, France.
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Bucher S, Maury A, Rosso J, de Chanaud N, Bloy G, Pendola-Luchel I, Delpech R, Paquet S, Falcoff H, Ringa V, Rigal L. Time and feasibility of prevention in primary care. Fam Pract 2017; 34:49-56. [PMID: 28122923 DOI: 10.1093/fampra/cmw108] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Prevention is an essential task in primary care. According to primary care physicians (PCPs),lack of time is one of the principal obstacles to its performance. OBJECTIVE To assess the feasibility of prevention in terms of time by estimating the time necessary to perform all of the preventive care recommended, separately from the PCPs and patient's perspectives, and to compare them to the amount of time available. METHODS A review of the literature identified the prevention procedures recommended in France, the duration of each procedure and its recommended frequency, as well as PCPs' consultation time. A hypothetical patient panel size of 1000 patients, representative of the French population, served as the basis for our calculations of the annual time necessary for prevention for a PCP. The prevention time from the patient's perspective was estimated from data collected from a previous study of a panel of 3556 patients. RESULTS For PCPs, the annual time necessary for all of the required preventive care was 250 hours, or 20% of their total patient time. For a patient, the annual time required for prevention during encounters with a PCP ranged from 9.7 to 26.4 minutes per year. The mean total encounter time was 75.9 minutes per year. Nearly 73% of patients had a prevention-to-care time ratio exceeding 15%. CONCLUSION Feasibility thus differs substantially between patients. These differences correspond especially to disparities in the annual care time used by each patient. Specific solutions should be developed according to the patients' utilization of care.
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Affiliation(s)
- Sophie Bucher
- INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, University of Paris-Sud, Le Kremlin-Bicêtre, France, .,General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France
| | - Arnaud Maury
- Department of general practice, Sorbonne Paris Cité, Paris Descartes University, Paris, France and
| | - Julie Rosso
- Department of general practice, Sorbonne Paris Cité, Paris Descartes University, Paris, France and
| | - Nicolas de Chanaud
- Department of general practice, Sorbonne Paris Cité, Paris Descartes University, Paris, France and
| | - Géraldine Bloy
- LEDi, Université de Bourgogne, UMR Cnrs 6307 Inserm 1200, Dijon, France
| | - Isabelle Pendola-Luchel
- General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France
| | - Raphaëlle Delpech
- General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France
| | - Sylvain Paquet
- General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France
| | - Hector Falcoff
- Department of general practice, Sorbonne Paris Cité, Paris Descartes University, Paris, France and
| | - Virginie Ringa
- INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, University of Paris-Sud, Le Kremlin-Bicêtre, France
| | - Laurent Rigal
- INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, University of Paris-Sud, Le Kremlin-Bicêtre, France.,General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France
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Bucher S, Panjo H, Al-Salameh A, Bauduceau B, Benattar-Zibi L, Bertin P, Berrut G, Corruble E, Danchin N, Derumeaux G, Doucet J, Falissard B, Forette F, Hanon O, Ourabah R, Pasquier F, Piedvache C, Pinget M, Becquemont L, Ringa V. Relationship between achieved personalized glycaemic targets and monitoring of clinical events in elderly diabetic patients. Diabetes Metab 2017; 43:59-68. [PMID: 27316980 DOI: 10.1016/j.diabet.2016.05.008] [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] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 04/29/2016] [Accepted: 05/14/2016] [Indexed: 06/06/2023]
Abstract
AIM Recent guidelines for the management of type 2 diabetes (T2DM) in the elderly recommend adjusting the therapeutic target (HbA1c) according to the patient's health. Our study aimed to explore the association between achieving the recommended personalized HbA1c target and the occurrence of major clinical events under real-life conditions. METHODS The T2DM S.AGES cohort was a prospective multicentre study into which 213 general practitioners recruited 983 non-institutionalized T2DM patients aged>65 years. The recommended personalized HbA1c targets were<7%, <8% and <9% for healthy, ill and very ill patients, respectively. Major clinical events (death from any cause, major vascular events and/or hospitalization) were recorded during the 3-year follow-up. Mixed-effects logistic regression models were used for the analyses. RESULTS Of the 747 patients analyzed at baseline, 551 (76.8%) were at their recommended personalized HbA1c target. During follow-up, 391 patients (52.3%) experienced a major clinical event. Of the patients who did not achieve their personalized HbA1c target (compared with those who did), the risk (OR) of a major clinical event was 0.95 (95% CI: 0.69-1.31; P=0.76). The risk of death, major vascular event and hospitalization were 0.88 (95% CI: 0.40-1.94; P=0.75), 1.14 (95% CI: 0.7-1.83; P=0.59) and 0.84 (95% CI: 0.60-1.18; P=0.32), respectively. CONCLUSION Over a 3-year follow-up period, our results showed no difference in risk of a major clinical event among patients, regardless of whether or not they achieved their personalized recommended HbA1c target. These results need to be confirmed before implementing a more permissive strategy for treating T2DM in elderly patients.
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Affiliation(s)
- S Bucher
- CESP, Inserm, University Paris-Sud, UVSQ, University Paris-Saclay, 94275 Kremlin-Bicêtre, France; General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, 63, rue Gabriel-Peri, 94275 Le Kremlin-Bicêtre, France.
| | - H Panjo
- CESP, Inserm, University Paris-Sud, UVSQ, University Paris-Saclay, 94275 Kremlin-Bicêtre, France
| | - A Al-Salameh
- Pharmacology Department, Faculty of Medicine Paris-Sud, University Paris Sud, UMR 1184, CEA, DSV/iMETI, Division of Immuno-virology, IDMIT, Inserm Center for immunology of viral infections and autoimmune diseases, Assistance publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - B Bauduceau
- Endocrinology department, Begin hospital, Saint-Mandé, France
| | | | - P Bertin
- Rheumatology Department, Limoges University Hospital, Limoges, France
| | - G Berrut
- Clinical Gerontology, Nantes University Hospital, Nantes, France
| | - E Corruble
- Inserm U 1178, Paris-Sud Faculty of Medicine, University of Paris-Sud, Psychiatry Department, Bicêtre University Hospital, Assistance publique-Hôpitaux de Paris, Le Kremlin- Bicêtre, France
| | - N Danchin
- HEGP, Coronary Diseases, Paris, France
| | - G Derumeaux
- Cardiovascular Functional Exploration, Louis-Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - J Doucet
- Internal medicine, Geriatry and therapeutics, Saint-Julien university Hospital, Rouen University, Rouen, France
| | - B Falissard
- CESP, Inserm, University Paris-Sud, UVSQ, University Paris-Saclay, 94800 Villejuif, France
| | - F Forette
- University of Paris Descartes, National Foundation of Gerontology, Paris, France
| | - O Hanon
- University of Paris Descartes, EA 4468, Assistance publique-Hôpitaux de Paris, Broca Hospital, Geriatrics Department, Paris, France
| | - R Ourabah
- General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, 63, rue Gabriel-Peri, 94275 Le Kremlin-Bicêtre, France
| | - F Pasquier
- University of Lille Nord de France, UDSL, EA 1046, CHU de Lille, Lille, France
| | - C Piedvache
- Pharmacology Department, Faculty of Medicine Paris-Sud, University Paris Sud, UMR 1184, CEA, DSV/iMETI, Division of Immuno-virology, IDMIT, Inserm Center for immunology of viral infections and autoimmune diseases, Assistance publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - M Pinget
- Endocrinology, Diabetes and Nutrition-Related Diseases (NUDE Unit), Strasbourg University Hospital and the European Centre for the Study of Diabetes (CeeD), University of Strasbourg, Strasbourg, France
| | - L Becquemont
- Pharmacology Department, Faculty of Medicine Paris-Sud, University Paris Sud, UMR 1184, CEA, DSV/iMETI, Division of Immuno-virology, IDMIT, Inserm Center for immunology of viral infections and autoimmune diseases, Assistance publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - V Ringa
- CESP, Inserm, University Paris-Sud, UVSQ, University Paris-Saclay, 94275 Kremlin-Bicêtre, France
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Bucher S, Panjo H, Al-Salameh A, Bauduceau B, Benattar-Zibi L, Bertin P, Berrut G, Corruble E, Danchin N, Derumeaux G, Doucet J, Falissard B, Forette F, Hanon O, Ourabah R, Pasquier F, Piedvache C, Pinget M, Becquemont L, Ringa V. Atteinte de la cible thérapeutique personnalisée et la survenue d’événements cliniques chez des patients âgés diabétiques. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Delpech R, Ringa V, Falcoff H, Rigal L. Primary prevention of cardiovascular disease: More patient gender-based differences in risk evaluation among male general practitioners. Eur J Prev Cardiol 2016; 23:1831-1838. [PMID: 27330021 DOI: 10.1177/2047487316648476] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 01/07/2016] [Accepted: 04/18/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Our objective was to analyse general practitioner (GP) cardiovascular risk assessment of patients for primary prevention while considering the gender of both the GP and the patient. METHODS This study consisted of an observational survey of GPs who were internship supervisors in the Paris metropolitan area. Each of 52 volunteer GPs completed a self-administered questionnaire regarding their own characteristics and randomly selected 70 patients from their patient list. Dependent variables from the patient files included the presence of information about risk factors necessary to assess the patient's cardiovascular risk according to the French scale and the Systematic COronary Risk Evaluation (SCORE) scale. Analyses used mixed logistic models with a random intercept and adjusted for patient and physician characteristics. RESULTS Both cardiovascular risk scales could be assessed less frequently in women than in men (odds ratio (OR) = 0.64 (95% confidence interval (CI): 0.5-0.8) for the French scale and OR = 0.63 (95% CI: 0.5-0.8) for the SCORE scale). These gender differences were less substantial when the patients were seen by female (for the SCORE scale OR = 0.72 (95% CI: 0.5-1.01)) compared with male physicians (OR = 0.56 (95% CI: 0.4-0.7)). The patients who were least well assessed for cardiovascular risk were women seen by male physicians. CONCLUSION Even before the onset of cardiovascular disease, women patients receive less satisfactory preventative management than men do, and these differences are even more marked when the physician is a man. More attention to the influence of gender stereotypes is needed in medical training in order to combat the inequalities that they cause.
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Affiliation(s)
| | - Virginie Ringa
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, Gender, Health Sexuality Team, Villejuif, France
| | - Hector Falcoff
- Department of General Practice, Sorbonne Paris Cité, Paris Descartes University, Paris, France.,Société de Formation Thérapeutique du Généraliste, Paris, France
| | - Laurent Rigal
- Department of General Practice, Paris-Sud University, France.,INSERM, Centre for Research in Epidemiology and Population Health, U1018, Gender, Health Sexuality Team, Villejuif, France
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Vigoureux S, Blondel B, Ringa V, Saurel-Cubizolles MJ. Occupational, social and medical characteristics of early prenatal leave in France. Eur J Public Health 2016; 26:1022-1027. [PMID: 27259720 DOI: 10.1093/eurpub/ckw072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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
BACKGROUND In France, most women of childbearing age work. The prenatal leave law in France protects women during pregnancy and their employment. We aimed to describe how long before delivery women stopped working and analyse the association between occupational, social and medical factors and early prenatal leave (before 24 weeks' gestation). METHODS The sample was extracted from the 2010 French National Perinatal Survey. Women were interviewed in French maternity units during a 1-week period. We focused on all women with a singleton live birth who were working during pregnancy (n = 10 149). Women were interviewed between delivery and discharge to collect information on employment, date of leave, sociodemographic and medical characteristics. RESULTS Among women who worked during pregnancy, 27.5% reported early occupational leave (before 24 weeks' gestation). Early occupational leave was more frequent among women with unstable jobs (fixed-term vs. non-fixed-term contract: adjusted odds ratio aOR = 1.60 [95% confidence interval 1.40-1.84]) and with less-qualified occupational categories (manual workers vs. managers and upper-intellectual positions: aOR = 2.96 [2.30-3.82]), even after adjusting for sociodemographic and other employment characteristics. Women with a pathological or at risk pregnancy left work earlier than other women. After stratification on type of pregnancy there was still a higher rate of early leave for women with less qualified occupational group. CONCLUSION In France, social vulnerability of pregnant women, linked to low sociodemographic situation or low occupational categories, is associated with early leave during pregnancy, even after stratification on type of pregnancy.
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Affiliation(s)
- Solène Vigoureux
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, 75014 Paris, France
| | - Béatrice Blondel
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, 75014 Paris, France
| | - Virginie Ringa
- INSERM UMR 1018, CESP Centre for Research in Epidemiology and Population Health, Gender, Sexuality and Health Team, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Kremlin-Bicêtre F-94276, France.,Institut National d'Etudes Démographiques (INED), F-75020 Paris, France
| | - Marie-Josèphe Saurel-Cubizolles
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, 75014 Paris, France
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Rigal L, Ringa V, Panjo H. Les inégalités sociales relatives au dépistage du cancer du col utérin se construisent à chacune des étapes menant au dépistage. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2015.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Bedretdinova D, Fritel X, Zins M, Ringa V. The Effect of Urinary Incontinence on Health-related Quality of Life: Is It Similar in Men and Women? Urology 2016; 91:83-9. [PMID: 26827846 DOI: 10.1016/j.urology.2015.12.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 11/23/2015] [Accepted: 12/03/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the association between self-reported urinary incontinence (UI) and health-related quality of life (HRQoL) in men and women while taking chronic comorbidities into account, on the hypothesis that UI might negatively affect HRQoL differently in each sex. METHODS In 2006, a total of 10,723 men (aged 57-67 years) and 3777 women (aged 52-67 years) participating in the GAZEL cohort (www.gazel.inserm.fr) completed a self-administered questionnaire including the Nottingham Health Profile to assess HRQoL. UI was defined as self-reported involuntary loss of urine in the past 12 months. Adjusted logistic regression models were fitted to estimate the association between impaired HRQoL and UI, taking age, chronic conditions, and other confounders into account. For each QoL dimension, we compared the strength of the associations between UI and HRQoL between the sexes by tests of interaction. RESULTS Women were more likely than men to report both UI (13.9% vs 2.7%) and impaired HRQoL. UI was associated with impaired HRQoL in both sexes, mainly in the dimensions of energy (OR = 3.17 in men [95% CI 2.49-4.04] and 2.11 in women [1.75-2.54]), social isolation (OR = 2.29 in men [1.74-3.02] and 1.75 in women [1.44-2.12]), and physical mobility (OR = 2.05 in men [1.62-2.60] and 2.27 in women [1.88-2.74]). There were no significant interactions between the sexes after adjustment. CONCLUSION UI was associated negatively with HRQoL in both sexes, mostly in the dimensions of energy, social isolation, and physical mobility. The association was similar in men and women after we took age, sociodemographic characteristics, and chronic diseases into account. The cross-sectional design of the analysis prevents any conclusion that UI induced an impairment of HRQoL, and no causal relation can be inferred.
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Affiliation(s)
- Dina Bedretdinova
- Paris-Saclay, Paris-Sud, and Versailles-Saint-Quentin Universities, Center for Research in Epidemiology and Population Health, French National Institute of Health and Medical Research, Le Kremlin-Bicêtre, France; Doctoral School of Public Health, UMRS 1018, F-94276 Le Kremlin-Bicêtre, France; French School of Public Health (EHESP), Rennes, France; The French Institute for Demographic Studies, Paris, France.
| | - Xavier Fritel
- Paris-Saclay, Paris-Sud, and Versailles-Saint-Quentin Universities, Center for Research in Epidemiology and Population Health, French National Institute of Health and Medical Research, Le Kremlin-Bicêtre, France; The French Institute for Demographic Studies, Paris, France; Obstetrics-Gynecology and Reproductive Medicine, Poitiers University, Clinical Investigation Center 1402, Poitiers University Hospital, Poitiers, France
| | - Marie Zins
- Paris-Saclay, Paris-Sud, and Versailles-Saint-Quentin Universities, Center for Research in Epidemiology and Population Health, French National Institute of Health and Medical Research, Villejuif, France
| | - Virginie Ringa
- Paris-Saclay, Paris-Sud, and Versailles-Saint-Quentin Universities, Center for Research in Epidemiology and Population Health, French National Institute of Health and Medical Research, Le Kremlin-Bicêtre, France; The French Institute for Demographic Studies, Paris, France; Obstetrics-Gynecology and Reproductive Medicine, Poitiers University, Clinical Investigation Center 1402, Poitiers University Hospital, Poitiers, France
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Casanova L, Ringa V, Bloy G, Falcoff H, Rigal L. Factors associated with GPs' knowledge of their patients' socio-economic circumstances: a multilevel analysis. Fam Pract 2015; 32:652-8. [PMID: 26311704 DOI: 10.1093/fampra/cmv068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To determine appropriate management for individual patients, GPs are supposed to use their knowledge of the patient's socio-economic circumstances. OBJECTIVE To analyse factors associated with GPs' knowledge of these circumstances. METHODS Observational survey of GPs who were internship supervisors in the Paris metropolitan area. Each of 52 volunteer GPs completed a self-administered questionnaire about their own characteristics and randomly selected 70 patients from their patient list. Their knowledge was analysed as the agreement between the patients' and GPs' responses to questions about the patients' socio-economic characteristics in questionnaires completed by both groups. The association between agreement and the GPs' characteristics was analysed with a multilevel model adjusted for age, sex and the duration of the GP-patient relationship. RESULTS Agreement varied according to the socio-economic characteristics considered (from 51% to 90%) and between GPs. Globally, the GPs overestimated their patients' socio-economic level. GP characteristics associated with better agreement were sex (female), long consultations, the use of paper records or an automatic reminder system and participation in continuing medical education and in meetings to discuss difficult cases. CONCLUSION Knowledge of some patient characteristics, such as their complementary health insurance coverage or perceived financial situation, should be improved because their overestimation may lead to care that is too expensive and thus result in the patients' abandonment of the treatment. Besides determining ways to help GPs to organize their work more effectively, it is important to study methods to help doctors identify their patients' social-economic circumstances more accurately in daily practice.
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Affiliation(s)
- Ludovic Casanova
- Aix Marseille University, Department of general practice, Marseille
| | - Virginie Ringa
- Inserm, Centre for research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, Villejuif, Paris-Sud University, UMRS 1018, Villejuif, Ined, Paris
| | - Géraldine Bloy
- LEDi, University of Burgundy, UMR CNRS 6307, Inserm U1200, Dijon
| | - Hector Falcoff
- Sorbonne Paris Cité, Paris Descartes University, Department of General Practice, Paris and Société de Formation Thérapeutique du Généraliste, Paris, France
| | - Laurent Rigal
- Inserm, Centre for research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, Villejuif, Paris-Sud University, UMRS 1018, Villejuif, Ined, Paris, Sorbonne Paris Cité, Paris Descartes University, Department of General Practice, Paris and
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