1
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Mahfoud F, Mancia G, Schmieder RE, Ruilope L, Narkiewicz K, Schlaich M, Williams B, Ribichini F, Weil J, Almerri K, Sharif F, Lauder L, Wanten M, Fahy M, Böhm M. Outcomes Following Radiofrequency Renal Denervation According to Antihypertensive Medications: Subgroup Analysis of the Global SYMPLICITY Registry DEFINE. Hypertension 2023. [PMID: 37317866 DOI: 10.1161/hypertensionaha.123.21283] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND The Global SYMPLICITY Registry DEFINE investigates radiofrequency renal denervation (RDN) in a broad range of patients with hypertension. We evaluated whether the number or type of antihypertensive medications were associated with increased long-term blood pressure (BP) reductions and cardiovascular outcomes following radiofrequency RDN. METHODS Patients underwent radiofrequency RDN and were categorized by baseline number (0-3 and ≥4) and different combinations of medication classes. BP changes were compared between groups through 36 months. Individual and composite major adverse cardiovascular events were analyzed. RESULTS Of 2746 evaluable patients, 18% were prescribed 0 to 3 and 82% prescribed ≥4 classes. At 36 months, office systolic BP significantly decreased (P<0.0001) by -19.0±28.3 and -16.2±28.6 mm Hg in the 0 to 3 and ≥4 class groups, respectively. Twenty-four-hour mean systolic BP significantly decreased (P<0.0001) by -10.7±19.7 and -8.9±20.5 mm Hg, respectively. BP reduction was similar between the medication subgroups. Antihypertensive medication classes decreased from 4.6±1.4 to 4.3±1.5 (P<0.0001). Most decreased (31%) or had no changes (47%) to the number of medications, while 22% increased. The number of baseline antihypertensive medication classes was inversely related to the change in prescribed classes at 36 months (P<0.001). Cardiovascular event rates were generally low. More patients in the ≥4 compared with 0 to 3 medication classes had myocardial infarction at 36 months (2.8% versus 0.3%; P=0.009). CONCLUSIONS Radiofrequency RDN reduced BP safely through 36 months, independent of the number and type of baseline antihypertensive medication classes. More patients decreased than increased their number of medications. Radiofrequency RDN is a safe and effective adjunctive therapy regardless of antihypertensive medication regimen. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT01534299.
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Affiliation(s)
- Felix Mahfoud
- Saarland University Hospital, Homburg, Germany (F.M., L.L., M.B.)
| | | | | | - Luis Ruilope
- Hospital Universitario 12 de Octubre and CIBERCV and School of Doctoral Studies and Research, Universidad Europea de Madrid, Spain (L.R.)
| | | | - Markus Schlaich
- Dobney Hypertension Centre, Medical School-Royal Perth Hospital Unit, The University of Western Australia (M.S.)
| | - Bryan Williams
- University College London and National Institute for Health Research University College London Hospitals Biomedical Research Centre, United Kingdom (B.W.)
| | - Flavio Ribichini
- Azienda Ospedaliera Universitaria Integrata Verona, Italy (F.R.)
| | | | | | - Faisal Sharif
- University Hospital Galway and National University of Ireland Galway (F.S.)
| | - Lucas Lauder
- Saarland University Hospital, Homburg, Germany (F.M., L.L., M.B.)
| | | | | | - Michael Böhm
- Saarland University Hospital, Homburg, Germany (F.M., L.L., M.B.)
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2
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Schlaich MP. Time in Target Range: the Future of Assessing Adequacy of Blood Pressure Control? Hypertension 2023; 80:314-315. [PMID: 36652530 DOI: 10.1161/hypertensionaha.122.20355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Markus P Schlaich
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit/Medical Research Foundation, University of Western Australia, Perth, Australia; Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, Australia; and Neurovascular Hypertension & Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
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3
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Paluch AE, Bajpai S, Ballin M, Bassett DR, Buford TW, Carnethon MR, Chernofsky A, Dooley EE, Ekelund U, Evenson KR, Galuska DA, Jefferis BJ, Kong L, Kraus WE, Larson MG, Lee IM, Matthews CE, Newton RL, Nordström A, Nordström P, Palta P, Patel AV, Pettee Gabriel K, Pieper CF, Pompeii L, Rees-Punia E, Spartano NL, Vasan RS, Whincup PH, Yang S, Fulton JE. Prospective Association of Daily Steps With Cardiovascular Disease: A Harmonized Meta-Analysis. Circulation 2023; 147:122-131. [PMID: 36537288 PMCID: PMC9839547 DOI: 10.1161/circulationaha.122.061288] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Taking fewer than the widely promoted "10 000 steps per day" has recently been associated with lower risk of all-cause mortality. The relationship of steps and cardiovascular disease (CVD) risk remains poorly described. A meta-analysis examining the dose-response relationship between steps per day and CVD can help inform clinical and public health guidelines. METHODS Eight prospective studies (20 152 adults [ie, ≥18 years of age]) were included with device-measured steps and participants followed for CVD events. Studies quantified steps per day and CVD events were defined as fatal and nonfatal coronary heart disease, stroke, and heart failure. Cox proportional hazards regression analyses were completed using study-specific quartiles and hazard ratios (HR) and 95% CI were meta-analyzed with inverse-variance-weighted random effects models. RESULTS The mean age of participants was 63.2±12.4 years and 52% were women. The mean follow-up was 6.2 years (123 209 person-years), with a total of 1523 CVD events (12.4 per 1000 participant-years) reported. There was a significant difference in the association of steps per day and CVD between older (ie, ≥60 years of age) and younger adults (ie, <60 years of age). For older adults, the HR for quartile 2 was 0.80 (95% CI, 0.69 to 0.93), 0.62 for quartile 3 (95% CI, 0.52 to 0.74), and 0.51 for quartile 4 (95% CI, 0.41 to 0.63) compared with the lowest quartile. For younger adults, the HR for quartile 2 was 0.79 (95% CI, 0.46 to 1.35), 0.90 for quartile 3 (95% CI, 0.64 to 1.25), and 0.95 for quartile 4 (95% CI, 0.61 to 1.48) compared with the lowest quartile. Restricted cubic splines demonstrated a nonlinear association whereby more steps were associated with decreased risk of CVD among older adults. CONCLUSIONS For older adults, taking more daily steps was associated with a progressively decreased risk of CVD. Monitoring and promoting steps per day is a simple metric for clinician-patient communication and population health to reduce the risk of CVD.
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Affiliation(s)
- Amanda E Paluch
- Department of Kinesiology, Institute for Applied Life Sciences, University of Massachusetts Amherst (A.E.P., S.B., L.K.)
| | - Shivangi Bajpai
- Department of Kinesiology, Institute for Applied Life Sciences, University of Massachusetts Amherst (A.E.P., S.B., L.K.)
| | - Marcel Ballin
- Departments of Community Medicine and Rehabilitation, Unit of Geriatric Medicine (M.B., A.N., P.N.), Umeå University, Sweden
| | - David R Bassett
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville (D.R.B.), University of Alabama at Birmingham
| | - Thomas W Buford
- Departments of Medicine, Division of Gerontology/Geriatrics/Palliative Care (T.W.B.), University of Alabama at Birmingham
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham VA Medical Center, AL (T.W.B.)
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.R.C.)
| | - Ariel Chernofsky
- Department of Biostatistics, Boston University, MA (A.C., M.G.L.)
| | - Erin E Dooley
- Epidemiology (E.E.D.' K.P.G.), University of Alabama at Birmingham
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo (U.E.)
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo (U.E.)
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill (K.R.E.)
| | - Deborah A Galuska
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA (D.A.G., J.E.F.)
| | - Barbara J Jefferis
- Department of Primary Care and Population Health, University College London Medical School, London, United Kingdom (B.J.J.)
| | - Lingsong Kong
- Department of Kinesiology, Institute for Applied Life Sciences, University of Massachusetts Amherst (A.E.P., S.B., L.K.)
| | - William E Kraus
- Duke Molecular Physiology Institute, Durham, NC (W.E.K.)
- Department of Medicine, Duke University, Durham, NC (W.E.K., C.F.P.)
| | - Martin G Larson
- Department of Biostatistics, Boston University, MA (A.C., M.G.L.)
| | - I-Min Lee
- Brigham and Women's Hospital, Harvard Medical School and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (I-M.L.)
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD (C.E.M.)
| | - Robert L Newton
- Pennington Biomedical Research Center, Baton Rouge, LA (R.L.N., S.Y.)
| | - Anna Nordström
- Departments of Community Medicine and Rehabilitation, Unit of Geriatric Medicine (M.B., A.N., P.N.), Umeå University, Sweden
- Public Health and Clinical Medicine, Section of Sustainable Health (A.N.), Umeå University, Sweden
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø (A.N.)
| | - Peter Nordström
- Departments of Community Medicine and Rehabilitation, Unit of Geriatric Medicine (M.B., A.N., P.N.), Umeå University, Sweden
| | - Priya Palta
- Department of Medicine, Columbia University, New York (P.P.)
| | - Alpa V Patel
- American Cancer Society, Population Science Department, Atlanta, GA (A.V.P., E.R-P.)
| | | | - Carl F Pieper
- Department of Medicine, Duke University, Durham, NC (W.E.K., C.F.P.)
| | - Lisa Pompeii
- Department of Pediatrics, Center for Epidemiology and Population Health, Baylor College of Medicine, Houston, TX (L.P.)
| | - Erika Rees-Punia
- American Cancer Society, Population Science Department, Atlanta, GA (A.V.P., E.R-P.)
| | - Nicole L Spartano
- Departments of Endocrinology, Diabetes, Nutrition and Weight Management (N.L.S.), Boston University School of Medicine, MA
| | - Ramachandran S Vasan
- Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, MA
- Department of Medicine and Epidemiology, Boston University School of Public Health, MA (R.S.V.)
| | - Peter H Whincup
- Population Health Research Institute, St George's' University of London, United Kingdom (P.H.W.)
| | - Shengping Yang
- Pennington Biomedical Research Center, Baton Rouge, LA (R.L.N., S.Y.)
| | - Janet E Fulton
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA (D.A.G., J.E.F.)
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Klaassen AE, Kapanen AI, Zed PJ, Conklin AI. Setting Goals to Reduce Cardiovascular Risk: A Retrospective Chart Review of a Pharmacist-Led Initiative in the Workplace. Int J Environ Res Public Health 2023; 20:846. [PMID: 36613168 PMCID: PMC9820010 DOI: 10.3390/ijerph20010846] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/11/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Background: Cardiovascular diseases (CVD) are the second leading cause of death in Canada with many modifiable risk factors. Pharmacists at a Canadian university delivered a novel CVD risk management program, which included goal-setting and medication management. Aim: This study aimed to describe what CVD prevention goals are composed of in a workplace CVD risk reduction program, and how might these goals change over time. Methods: A longitudinal, descriptive qualitative study using a retrospective chart review of clinical care plans for 15 patients enrolled in a CVD prevention program. Data across 6 visits were extracted from charts (n = 5413 words) recorded from May 2019-November 2020 and analyzed using quantitative content analysis and descriptive statistics. Results: Behavioural goals were most popular among patients and were more likely to change over the 12-month follow-up period, compared to health measure goals. Behavioural goals included goals around diet, physical activity (PA), smoking, medication, sleep and alcohol; health measure goals centered on weight measures, blood pressure (BP) and blood lipid levels. The most common behavioural goals set by patients were for diet (n = 11) and PA (n = 9). Over time, goals around PA, medication, alcohol and weight were adapted while others were added (e.g. diet) and some only continued. Patients experienced a number of barriers to their goal(s) which informed how they adapted their goal(s). These included environmental limitations (including COVID-19) and work-related time constraints. Conclusions: This study found CVD goal-setting in the pharmacist-led workplace wellness program was complex and evolved over time, with goals added and/or adapted. More detailed qualitative research could provide further insights into the patient-provider goal-setting experience in workplace CVD prevention.
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Affiliation(s)
- Alicia E. Klaassen
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Anita I. Kapanen
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Peter J. Zed
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Annalijn I. Conklin
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul’s Hospital, Vancouver, BC V6Z IY6, Canada
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Heger I, Deckers K, de Vugt M, Verhey F, Oenema A, van Boxtel M, Köhler S. Using mHealth for Primary Prevention of Dementia: A Proof-of-Concept Study on Usage Patterns, Appreciation, and Beliefs and Attitudes Regarding Prevention. J Alzheimers Dis 2023; 94:935-948. [PMID: 37355903 PMCID: PMC10473134 DOI: 10.3233/jad-230225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Health- and lifestyle factors account for a substantial part of all dementia cases, which opens the opportunity for primary prevention. However, the required behavioral change is complex and involves targeting multiple risk factors. mHealth interventions can potentially contribute to improving motivation in a low-cost and scalable way. OBJECTIVE To explore usage patterns, appreciation, and beliefs and attitudes regarding dementia risk reduction during the use of the MyBraincoach mobile app. METHODS Participants were community-dwelling middle-aged adults from the Netherlands and used either the standard (education) or extended (education+motivational triggers) app version for three months. Two panel studies were combined in this paper. Chi-square tests, t-tests and linear mixed models were used, adjusted for age, sex, and education. RESULTS Of all participants (n = 299, 50.2% male), 167 (55.9%) had installed the app. The most reported reason for non-use was technical problems (47%). Those who used the app were at baseline already more positive about dementia risk reduction than those who did not use the app. Of all users who completed the evaluation (n = 102), 78.4% (n = 80) stated that the app provided a positive approach towards brain health and 80.4% (n = 82) felt better informed. Younger (<60y) and lower educated participants evaluated the app most positively. CONCLUSION Usage of the app was low, but users showed more positive beliefs and attitudes regarding dementia risk reduction. Most users evaluated the app positively and stated to have gained knowledge on the topic. Improving the use of the app must keep high priority in future studies.
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Affiliation(s)
- Irene Heger
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Anke Oenema
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute Maastricht, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Martin van Boxtel
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Rezabeigi Davarani E, Farahmandnia H, Khanjani N, Nekoei-Moghadam M. The viewpoints of residents of Kerman, Iran regarding the challenges and barriers of preparing households against earthquakes: A theory-guided qualitative content analysis. Front Public Health 2022; 10:1036311. [PMID: 36504991 PMCID: PMC9730698 DOI: 10.3389/fpubh.2022.1036311] [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: 09/04/2022] [Accepted: 11/07/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Earthquakes cause a lot of damage and casualties. For various reasons, most households are not prepared for earthquakes. This study aims to identify the challenges and barriers to households' preparedness against earthquakes from the viewpoint of Kerman residents. Methods This qualitative-directed content analysis study was conducted from December 2021 to May 2022 in the city of Kerman in southeast Iran. Data was collected by purposive sampling through in-depth and semi-structured individual face-to-face interviews with 48 households. Results After multiple rounds of analyzing and summarizing the data based on the social-cognitive theory and taking into consideration similarities and differences, five main categories and 19 subcategories created based on the results of data analysis and including (1) Challenges related to cognitive factors (2) Challenges related to behavioral factors (3) Challenges related to the physical environment (4) Challenges related to the social environment and (5) Challenges related to financial factors. Conclusion Although the participants listed many challenges and barriers in different fields, in order to overcome the barriers and challenges of preparing households for an earthquake, the support of the authorities and the cooperation of the residents are necessary.
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Affiliation(s)
- Esmat Rezabeigi Davarani
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hojjat Farahmandnia
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,*Correspondence: Hojjat Farahmandnia
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahmood Nekoei-Moghadam
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Sufrate-Sorzano T, Pérez J, Juárez-Vela R, Garrote-Cámara M, de Viñaspre RR, Molina-Luque F, Santolalla-Arnedo I. Umbrella review of nursing interventions NIC for the treatment and prevention of suicidal behavior. Int J Nurs Knowl 2022. [PMID: 35997164 DOI: 10.1111/2047-3095.12392] [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: 04/28/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this umbrella review was to determine the most effective nursing interventions for the prevention and management of suicidal behavior. In order to do so, the review identifies interventions from the Nursing Interventions Classifications taxonomy with evidence to this end. METHODS A systematic search was conducted for systematic reviews included in the PubMed, CINAHL, Cochrane, Scopus, Web of Knowledge, and Joanna Briggs Institute databases between January 1, 2011 and May 1, 2020. FINDINGS The review is made up of 21 systematic reviews. In order to carefully analyze the interventions described, these were coded into categories, grouping the interventions into those based on psychological therapy, interventions related to pharmacotherapy, interventions related to the professional relationship between health professional and patient, and interventions aimed at the general public. CONCLUSIONS Nursing interventions for suicide risk management are prevalent in the scientific literature and are shown to be effective for patients with suicidal ideation or suicide attempts. Prevention and treatment of suicidal behavior require the provision of coping tools, behavioral interventions that directly address suicidal thoughts and behaviors, and support through therapeutic partnerships, among others. IMPLICATIONS FOR NURSING PRACTICE This paper synthesizes the most current evidence on the most effective Nursing Interventions Classifications interventions for the treatment and prevention of suicidal behavior. It provides nursing practitioners with a comprehensive review of the therapeutic interventions with the best evidence and is useful for the development of clinical guidelines and protocols, as well as for the development of health policies and plans.
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Affiliation(s)
- Teresa Sufrate-Sorzano
- Research Unit on Health System Sustainability (GISSOS), Biomedical Research Center of La Rioja (CIBIR) Logroño, Logroño, Spain.,Department of Nursing, GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - Jesús Pérez
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Raúl Juárez-Vela
- Research Unit on Health System Sustainability (GISSOS), Biomedical Research Center of La Rioja (CIBIR) Logroño, Logroño, Spain.,Department of Nursing, GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - MaríaElena Garrote-Cámara
- Research Unit on Health System Sustainability (GISSOS), Biomedical Research Center of La Rioja (CIBIR) Logroño, Logroño, Spain
| | - Regina Ruiz de Viñaspre
- Research Unit on Health System Sustainability (GISSOS), Biomedical Research Center of La Rioja (CIBIR) Logroño, Logroño, Spain
| | - Fidel Molina-Luque
- Faculty of Education, Psychology and Social Work, University of Lleida, Lleida, Spain.,Group for the Study of Society, Health, Education and Culture (GESEC). University of Lleida, Lleida, Spain.,Research Institute in Social and Territorial Development (INDEST), University of Lleida, Lleida, Spain
| | - Iván Santolalla-Arnedo
- Research Unit on Health System Sustainability (GISSOS), Biomedical Research Center of La Rioja (CIBIR) Logroño, Logroño, Spain.,Department of Nursing, GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
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8
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Abstract
Home radon testing is a primary lung cancer prevention strategy, yet the majority of Americans have not tested their home. This descriptive, ecological study uses 54,683 observed radon values collected in Kentucky homes from 1996 to 2016 to examine the association of county-level social determinants of health and environmental exposures on home radon testing rates. Multivariate linear regression analysis indicates that as median home value, rurality, and radon risk potential increased, counties experienced an increase in annual home radon testing rates. As adult smoking prevalence increased, counties experienced a decrease in annual rates of residential radon testing. These findings indicate that counties with low median home values, high adult smoking prevalence, and high incidence of lung cancer may benefit most from prevention interventions aimed at promoting home radon testing, adopting radon- and smoke-free home policies, and integrating radon risk reduction messaging into tobacco cessation and lung cancer screening programs.
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Affiliation(s)
| | - Mary Kay Rayens
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Amanda Wiggins
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Ellen J. Hahn
- College of Nursing, University of Kentucky, Lexington, KY, USA
- College of Public Health, University of Kentucky, Lexington, KY, USA
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9
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Postma JM, Odom-Maryon T, Rappold AG, Haverkamp H, Amiri S, Bindler R, Whicker J, Walden V. Promoting risk reduction among young adults with asthma during wildfire smoke: A feasibility study. Public Health Nurs 2022; 39:405-414. [PMID: 34636066 PMCID: PMC8930445 DOI: 10.1111/phn.12986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/16/2021] [Accepted: 09/22/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE(S) This study explored the feasibility, acceptability, preliminary impact, and functionality of two risk reduction mobile application (app) interventions on asthma outcomes as compared to a control arm during wildfire season. DESIGN Three-arm, 8-week randomized clinical trial. SAMPLE Sixty-seven young adults with asthma were enrolled. MEASUREMENTS The Asthma Control Test, forced expiratory volume in one second (FEV1 ) and the System Usability Scale were measured at baseline, 4, and 8 weeks. The Research Attitude Scale was administered at 8 weeks. Twenty participants from the two intervention arms completed an optional survey and six were interviewed after completing the study. INTERVENTION Both intervention arms could access Smoke Sense Urbanova, an app that supports reducing risks from breathing wildfire smoke. The Smoke Sense Urbanova Plus arm also monitored their daily FEV1 , received air quality notifications, and accessed preventive tips and a message board. RESULTS Most participants agreed the app and spirometer were usable and their privacy and confidentiality were maintained. No adverse events were reported. CONCLUSIONS Participant-identified recommendations will support intervention refinement and testing. This research supports asthma self-management tools that public health nurses and community health workers can recommend for at-risk populations.
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Affiliation(s)
- Julie Marie Postma
- Professor, Associate Dean for Research, Washington State University College of Nursing, Spokane, Washington, USA
| | - Tamara Odom-Maryon
- Research Professor, Washington State University College of Nursing, Spokane, Washington, USA
| | - Ana G. Rappold
- Center for Public Health and Environmental Assessment, Branch Chief, Clinical Research BranchOffice of Research and DevelopmentUnited States Environmental Protection Agency (U.S. EPA), Durham, North Carolina, USA
| | - Hans Haverkamp
- Associate Professor, Washington State University Elson S. Floyd College of Medicine, Spokane, Washington, USA
| | - Solmaz Amiri
- Assistant Research Professor, Washington State University Elson S. Floyd College of Medicine, Department of Medical Education and Clinical Sciences, Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington, USA
| | - Ross Bindler
- Research Coordinator, Washington State University College of Nursing, Spokane, Washington, USA
| | | | - Von Walden
- Professor, Washington State University Voiland College of Engineering and Architecture, Pullman, Washington, USA
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10
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Choe Y, Kim H, Choi Y. Willingness to pay for travel insurance as a risk reduction behavior: health-related risk perception after the outbreak of COVID-19. Serv Bus 2022. [PMCID: PMC8794043 DOI: 10.1007/s11628-022-00479-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
This study aims to identify the effects of health-related risk perception and sociodemographic characteristics on the willingness to pay (WTP) for travel insurance as a risk reduction behavior following the outbreak of COVID-19. Through the application of a double-bounded dichotomous choice contingent valuation method, this study found several determinants for travel insurance price (i.e., risk perception toward traveling, perception about the influence of COVID-19, past travel insurance purchase experience, age, and education). The mean WTP was estimated to be approximately KRW 11,700 (USD 10.23). Several theoretical and managerial implications regarding risk perception and travel insurance are discussed.
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Affiliation(s)
- Yeongbae Choe
- Department of Tourism Management, College of Social Sciences, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si, Gyeonggi-do 13120 Republic of Korea
| | - Hyesun Kim
- Department of Hotel and Tourism Management, Woosong University, 171 Dongdaejeon-ro, Dong-gu, Daejeon, 34606 Republic of Korea
| | - Youngjoon Choi
- Department of International Office Administration, College of Science and Industry Convergence, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, Republic of Korea
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11
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Shrader CH, Arroyo-Flores J, Stoler J, Skvoretz J, Carrico A, Doblecki-Lewis S, Kanamori M. The Association Between Social and Spatial Closeness With PrEP Conversations Among Latino Men Who Have Sex With Men. J Acquir Immune Defic Syndr 2021; 88:366-375. [PMID: 34342298 PMCID: PMC8556301 DOI: 10.1097/qai.0000000000002777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/22/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND US Latino men who have sex with men (LMSM) are a group at highest risk for HIV. One driver of HIV among LMSM is inadequate access to pre-exposure prophylaxis (PrEP) information. The social network theory of homophily suggests that sharing similar sociodemographic factors could influence PrEP conversations within networks. This study aimed to determine how the effects of homophily across sociodemographic, immigration, cultural, and PrEP-related factors are associated with PrEP-related communication. SETTING This study was conducted in Miami-Dade County, FL. METHODS Data collected between August 2018 and October 2019 included 10 sociocentric friendship groups of 13 LMSM (N = 130). Participants were recruited using respondent-driven sampling by a community-based organization in Miami. We used the multiple regression quadratic assignment procedure to identify the effects of homophily and relationship characteristics on PrEP-related conversations using R software. RESULTS More frequent PrEP-related conversations were associated with dyadic friendships characterized by homophily on knowledge of PrEP effectiveness, heterophily on depressive symptom severity, home addresses proximity, friend closeness, and interaction frequency. Past PrEP-related conversation frequency also increased based on heterophily on the Latino cultural value of familism (ie, emotional support to family). Racial homophily, heterophily on severity of depressive symptoms, home addresses proximity, friendship closeness, and frequency of interactions increased likelihood to encourage a friend to use PrEP. DISCUSSION Social and spatial closeness and homophily play a role in PrEP-related conversations. Information from social networks contextualized in geographic settings can be elucidated to contribute toward the design of novel opportunities to end HIV.
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Affiliation(s)
- Cho-Hee Shrader
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Juan Arroyo-Flores
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Justin Stoler
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Geography, College of Arts and Sciences, University of Miami, Coral Gables, FL, USA
| | - John Skvoretz
- Department of Sociology, University of South Florida, Tampa, FL, USA
| | - Adam Carrico
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Mariano Kanamori
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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12
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Choo J, Park S, Noh S. Associations of COVID-19 Knowledge and Risk Perception with the Full Adoption of Preventive Behaviors in Seoul. Int J Environ Res Public Health 2021; 18:12102. [PMID: 34831866 PMCID: PMC8623986 DOI: 10.3390/ijerph182212102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/13/2021] [Accepted: 11/17/2021] [Indexed: 11/17/2022]
Abstract
This study explores the levels of COVID-19 knowledge, risk perception, and preventive behavior practice in Seoul, to determine whether knowledge and risk perception are significantly associated with the full adoption of preventive behaviors, for the delivery of a customized public campaign to Seoul's citizens. A total of 3000 Seoul residents participated in this study through an online questionnaire survey. They had a mean score of 84.6 for COVID-19 knowledge (range: 0-100 points) and 4.2 (range: 1-7 points) for risk perception. Of the participants, 33.4% practiced full adoption of all three preventive behaviors: hand hygiene, wearing a face mask, and social distancing; wearing a face mask was practiced the most (81.0%). Women significantly adopted these three preventive behaviors more often compared with men. Both COVID-19 knowledge and risk perception were found to be significantly associated with the full adoption of preventive behaviors; however, this association differed by the type of preventive behavior. This indicates that city-level information on the levels of COVID-19 knowledge, risk perception, and preventive behaviors should be clearly and periodically communicated among public officers and healthcare professionals to continually raise the public's awareness of the full adoption of non-pharmaceutical preventive behaviors.
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Affiliation(s)
- Jina Choo
- College of Nursing, Korea University, Seoul 02841, Korea; (S.P.); (S.N.)
- Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul 02841, Korea
- Expert Group on Health Promotion for the Seoul Metropolitan City, Seoul 02841, Korea
| | - Sooyeon Park
- College of Nursing, Korea University, Seoul 02841, Korea; (S.P.); (S.N.)
- Expert Group on Health Promotion for the Seoul Metropolitan City, Seoul 02841, Korea
| | - Songwhi Noh
- College of Nursing, Korea University, Seoul 02841, Korea; (S.P.); (S.N.)
- Expert Group on Health Promotion for the Seoul Metropolitan City, Seoul 02841, Korea
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13
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Chandu VC, Baddam VRR, Mupparapu M, Marella Y. Vaccination induced complacency in adherence to COVID-19 precautionary measures among oral health care professionals in India and the United States: a retrospective pretest-posttest design. Hum Vaccin Immunother 2021; 17:5105-5113. [PMID: 34613854 DOI: 10.1080/21645515.2021.1978794] [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] [Indexed: 10/20/2022] Open
Abstract
In the context of the COVID-19 pandemic, vaccination-induced behavioral complacency in adherence to COVID-19 appropriate behavior emerged as a significant concern. This study was conducted among a convenience sample of 540 oral health care professionals in India and the United States. This was a retrospective pretest-post-test design, a choice to eliminate response-shift bias, where the participants responded online on their adherence or otherwise to COVID-19 precautionary measures before and after vaccination. The difference between post-test and retrospective pretest scores was used in assessing the magnitude of complacency demonstrated by the individual as a function of getting vaccinated, and the process was validated using exploratory factor analysis (EFA) with principal axis factoring and confirmatory factor analysis (CFA) on two randomly split subsets of the overall sample. It was observed that there had been a decline in the adherence to all the considered COVID-19 precautionary measures from the time before vaccination to the time of achievement of the fully vaccinated status. EFA performed on the randomly split sub sample of 240 subjects returned a two factor solution with five items in factor 1 and seven items in factor 2. Items in both the factors demonstrated adequate internal consistency in reliability analysis (Cronbach's alpha 0.84 and 0.82, respectively). The two factor solution obtained in EFA demonstrated good model fit in CFA [RMSEA (90%CI) - 0.077 (0.063-0.092); TLI - 0.872; CFI - 0.897; SRMR - 0.056]. These results highlight the vaccination-induced complacency in observing COVID-19 appropriate behavior among oral health professionals in India and the United States.
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Affiliation(s)
- Viswa Chaitanya Chandu
- Department of Public Health Dentistry, Government Dental College and Hospital, Vijayawada, India
| | | | - Mel Mupparapu
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| | - Yamuna Marella
- Department of Periodontology, SIBAR Institute of Dental Sciences, Guntur, India
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14
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Snow-Hill NL, Donenberg G, Feil EG, Smith DR, Floyd BR, Leve C. A Technology-Based Training Tool for a Health Promotion and Sex Education Program for Justice-Involved Youth: Development and Usability Study. JMIR Form Res 2021; 5:e31185. [PMID: 34591028 PMCID: PMC8517818 DOI: 10.2196/31185] [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: 06/11/2021] [Revised: 08/12/2021] [Accepted: 08/24/2021] [Indexed: 11/23/2022] Open
Abstract
Background Justice-involved youth are especially vulnerable to mental health distress, substance misuse, and risky sexual activity, amplifying the need for evidence-based programs (EBPs). Yet, uptake of EBPs in the justice system is challenging because staff training is costly in time and effort. Hence, justice-involved youth experience increasing health disparities despite the availability of EBPs. Objective To counter these challenges, this study develops and pilot-tests a prototype of a technology-based training tool that teaches juvenile justice staff to deliver a uniquely tailored EBP for justice-involved youth—PHAT (Preventing HIV/AIDS Among Teens) Life. PHAT Life is a comprehensive sex education, mental health, and substance use EBP collaboratively designed and tested with guidance from key stakeholders and community members. The training tool addresses implementation barriers that impede uptake and sustainment of EBPs, including staff training and support and implementation costs. Methods Staff (n=11) from two juvenile justice settings pilot-tested the technology-based training tool, which included five modules. Participants completed measures of HIV and sexually transmitted infection (STI) knowledge, sex education confidence, and implementation outcomes such as training satisfaction, adoption, implementation, acceptability, appropriateness, and sustainability. PHAT Life trainers assessed fidelity through two activity role plays participants submitted upon completing the training modules. Results Participants demonstrated increases in HIV and STI knowledge (t10=3.07; P=.01), and were very satisfied (mean 4.42, SD 0.36) with the training tool and the PHAT Life curriculum. They believed that the training tool and curriculum could be adopted, implemented, and sustained within their settings as an appropriate and acceptable intervention and training. Conclusions Overall, the results from this pilot test demonstrate feasibility and support continuing efforts toward completing the training tool and evaluating it within a fully powered randomized controlled trial. Ultimately, this study will provide a scalable option for disseminating an EBP and offers a more cost-effective and sustainable way to train staff in an EBP.
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Affiliation(s)
- Nyssa L Snow-Hill
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Geri Donenberg
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | | | | | - Brenikki R Floyd
- School of Public Health, University of Illinois at Chicago, Chicago, IL, United States
| | - Craig Leve
- Influents Innovations, Eugene, OR, United States
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15
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Ferro D, Prista-Leão B, Costa A, Silva-Pinto A, Abreu C, Sá MJ. Infectious Risk Mitigation in Patients with Multiple Sclerosis under Disease-Modifying Therapies - the Experience of a Collaborative Neurology-Infectious Diseases Approach. J Cent Nerv Syst Dis 2021; 13:11795735211042188. [PMID: 34526834 PMCID: PMC8436289 DOI: 10.1177/11795735211042188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 08/07/2021] [Indexed: 11/25/2022] Open
Abstract
Background Multiple sclerosis treatment has changed in the last years with the emergence of new disease-modifying therapies (DMTs). Despite a better efficacy profile, these drugs raise concerns about infectious risk, which needs to be mitigated. Objective To analyze the results of a systematic collaborative approach between Neurology and Infectious Diseases (ID) Departments in the management of infectious risk and complications in MS patients treated with DMT. Methods Retrospective collection of MS patients’ demographic and clinical data from clinical records of MS and ID outpatient clinics (2011–2017). Results We included 149 patients: most had evidence of previous contact with Herpesviridae, and half of them were not immune to hepatitis A and B viruses (HAV and HBV). Vaccines for HAV, HBV, and Streptococcus pneumoniae were administered in 91%, 78%, and 88% of non-immune patients, respectively. JC virus serology monitoring prevented natalizumab (NTZ) initiation or prompted its switch in 34/122 patients. Forty patients had latent tuberculosis, in which 88% were treated. Infectious events occurred in 33 patients, mostly mild urinary, respiratory, and herpes virus group infections. Only three patients required inpatient care. Conclusion Facing the expansion of the new DMT, we highlight the benefits of an interdisciplinary approach for safer use of the chosen treatment.
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Affiliation(s)
- Daniela Ferro
- MS Clinic, Neurology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.,Faculty of Medicine of University of Porto, Porto, Portugal
| | - Beatriz Prista-Leão
- Faculty of Medicine of University of Porto, Porto, Portugal.,Infectious Diseases Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Andreia Costa
- MS Clinic, Neurology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.,Faculty of Medicine of University of Porto, Porto, Portugal
| | - André Silva-Pinto
- Faculty of Medicine of University of Porto, Porto, Portugal.,Infectious Diseases Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Cândida Abreu
- Faculty of Medicine of University of Porto, Porto, Portugal.,Infectious Diseases Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Maria José Sá
- MS Clinic, Neurology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.,FP-ENAS (UFP Energy, Environment and Health Research Unit), University Fernando Pessoa, Porto, Portugal
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16
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Postma JM, Oneal G, Odom-Maryon T, Barbosa-Leiker C, Marko T, Butterfield P. Adapting and Testing the Self-Efficacy in Environmental Risk Reduction Instrument Among Spanish-Speaking Populations. J Nurs Meas 2021; 29:556-569. [PMID: 34518405 DOI: 10.1891/jnm-d-19-00112] [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] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to adapt and test the Self-Efficacy in Environmental Risk Reduction instrument in a Spanish-speaking population. METHODS Harkness' model of cross-cultural survey design was used to adapt the instrument. We sampled 95 adult, Spanish speakers from a federally qualified health clinic. Exploratory factor analysis with maximum likelihood estimation was used to analyze the factor structure. RESULTS A 1-factor model provided the best fit to the data. The latent construct of the instrument is household environmental health self-efficacy. All items loaded higher than 0.610, indicating each item explains at least 36% variance in the latent construct. Cronbach's alpha indicates the scale has high internal consistency (α = .92). CONCLUSIONS Respondents conceptualize self-Efficacy in Environmental Risk Reduction as practical solutions to minimize household risks.
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Affiliation(s)
| | - Gail Oneal
- Washington State University College of Nursing, Spokane, Washington, DC
| | | | | | - Tara Marko
- Washington State University College of Nursing, Spokane, Washington, DC
| | - Patricia Butterfield
- Washington State University Elson S. Floyd College of Medicine, Spokane, Washington, DC
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17
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Nelson DA, Deuster PA, O'Connor FG, Edgeworth DB, Kurina LM. An investigation of sickle cell trait, body mass index, and fitness in relation to venous thromboembolism among African American adults. J Thromb Haemost 2021; 19:2216-2224. [PMID: 34105875 DOI: 10.1111/jth.15422] [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] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/26/2021] [Accepted: 06/01/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The relationships of sickle cell trait (SCT), body mass index (BMI), and physical fitness to venous thromboembolism (VTE) in young adults have received little attention. OBJECTIVES To test for associations among SCT, BMI, fitness, and VTE. PATIENTS/METHODS We conducted a retrospective cohort study of 48,316 SCT-tested, African American individuals in the US Army during 2011-14. We used Cox proportional hazards models to compute adjusted hazards of deep vein thrombosis (DVT) and pulmonary embolism (PE) associated with selected factors. RESULTS Incidence rates of DVT and PE were 1.09 and 0.91 cases per 1000 person-years, respectively. Adjusted hazard ratios (aHRs) for DVT for men and women with SCT were 0.9 (95% confidence interval [CI]: 0.4-2.0; P = .711) and 1.51 (CI: 0.7-3.2; P = .274), respectively. aHRs for PE for SCT+ men and women were 1.1 (CI: 0.5-2.4; P = .773) and 1.2 (CI: 0.5-3.1; P = .650), respectively. Low physical fitness was associated with DVT and PE in women (DVT aHR =3.1; CI: 1.4-6.5; P = .004; PE aHR =4.6; CI: 2.1-9.9; P < .001) and DVT in men (aHR =2.2; CI: 1.0-4.6; P = .048). Recent weight gain of 1 or more BMI points was associated with DVT in men (aHR =1.8; CI: 1.1-2.8; P = .017). CONCLUSIONS We found no evidence of increased VTE risk associated with SCT in this population. However, lower fitness levels and BMI increases were so associated.
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Affiliation(s)
- D Alan Nelson
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
- Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA
| | - Patricia A Deuster
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Francis G O'Connor
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Daniel B Edgeworth
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Lianne M Kurina
- Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA
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18
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Sharma A, Paredes-Vincent A, Kahle EM. Awareness, Utilization, and Preferences for Traditional and Contemporary HIV Prevention Strategies Among Facebook and Instagram-Using MSM in the United States. J Int Assoc Provid AIDS Care 2021; 20:23259582211024770. [PMID: 34132144 PMCID: PMC8212379 DOI: 10.1177/23259582211024770] [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] [Indexed: 12/30/2022] Open
Abstract
HIV prevention research among men who have sex with men (MSM) has traditionally
focused on individual risk reduction strategies. Our study evaluated awareness,
utilization, and preferences for 10 complementary HIV prevention strategies
among 1,286 MSM recruited via Facebook and Instagram from June-August 2018. Ages
ranged from 18-85 years, and the majority were non-Hispanic white (n = 1,019,
79.24%), college-educated (n = 819, 63.69%), gay-identifying (n = 1,074,
83.51%), and partnered (n = 808, 62.83%). Post-exposure prophylaxis was the
least familiar option, and engaging in sexual activities other than anal sex was
the most utilized option. Progressively older and bisexual-identifying MSM were
less likely, but those with higher educational levels and easy access to local
HIV resources were more likely to be aware of and to be utilizing a greater
number of strategies. Additionally, Hispanic MSM were less likely to be aware
of, and those in a “closed” relationship were less likely to be utilizing a
greater number of strategies. In a subset of 775 multiple strategy users,
pre-exposure prophylaxis, regularly testing for HIV, and limiting the number of
sex partners emerged as the most preferred options. Combination intervention
packages for MSM should be tailored to personal circumstances, including sexual
orientation, relationship characteristics and access to local HIV resources.
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Affiliation(s)
- Akshay Sharma
- Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA.,Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Ariana Paredes-Vincent
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Erin M Kahle
- Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA.,Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
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19
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Abstract
BACKGROUND Hypertension control is a crucial measure to reduce cardiovascular (CV) risk, and blood pressure (BP) treatment targets have been recently revised to address this issue. However, achieving the recommended goal may be challenging. OBJECTIVE We aimed to assess the prevalence of uncontrolled hypertension, according to the US hypertension guidelines, among elderly participants in an Italian nationwide epidemiological survey, the relevant clinical correlates, and the agreement with the application of the European guidelines. METHODS Elderly (≥65y) volunteers enrolled in an Italian nationwide survey underwent BP measurement using standard protocols. Uncontrolled hypertension was defined as BP≥130/80 mmHg. Agreement of this definition with those from European guidelines (≥140/90 mmHg; ≥140/80 mmHg) was tested using Cohen's kappa. Selfreported information on modifiable/non-modifiable CV risk factors was also collected. RESULTS Of the 13,162 treated hypertensive elderly, 69.8% had uncontrolled hypertension. They tended to be overweight/obese men with diabetes. Overall agreement between US and European guidelines was poor to good (κ = 0.289, p<0.001 and κ = 0.691, p<0.001 based on the 140/90 and 140/80 mmHg threshold, respectively). Elderly participants with controlled hypertension were more likely to report a history of CV or chronic kidney disease. No difference in lifestyle habits was observed by BP control status. CONCLUSION Real-world data identify limited concordance between guidelines in terms of BP target achievement among older hypertensive Italians and highlights the need to spread awareness of the CV risk, especially in the presence of diabetes and obesity.
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Affiliation(s)
- Del Pinto Rita
- University of L'Aquila, Department of Life, Health and Environmental Sciences, San Salvatore Hospita, (the Italian Society of Hypertension)l, L'Aquila, Italy
| | - Mirela Dobre
- Department of Medicine, Division of Nephrology and Hypertension, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio 44106, United States
| | | | - Claudio Ferri
- University of L'Aquila, Department of Life, Health and Environmental Sciences, San Salvatore Hospita, (the Italian Society of Hypertension)l, L'Aquila, Italy
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20
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Barone Gibbs B, Hivert MF, Jerome GJ, Kraus WE, Rosenkranz SK, Schorr EN, Spartano NL, Lobelo F. Physical Activity as a Critical Component of First-Line Treatment for Elevated Blood Pressure or Cholesterol: Who, What, and How?: A Scientific Statement From the American Heart Association. Hypertension 2021; 78:e26-e37. [PMID: 34074137 DOI: 10.1161/hyp.0000000000000196] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Current guidelines published by the American Heart Association and the American College of Cardiology broadly recommend lifestyle approaches to prevent and treat elevated blood pressure and cholesterol. For patients with mildly or moderately elevated blood pressure and blood cholesterol, lifestyle-only approaches are the first line of therapy. The purpose of this scientific statement is to: (1) highlight the mild-moderate-risk patient groups indicated for lifestyle-only treatment for elevated blood pressure or cholesterol; (2) describe recommendations, average effects, and additional considerations when prescribing lifestyle treatment with physical activity; and (3) provide guidance and resources for clinicians to assess, prescribe, counsel, and refer to support increased physical activity in their patients. An estimated 21% and 28% to 37% of US adults, respectively, have mild-moderate-risk blood pressure and cholesterol and should receive lifestyle-only as first-line treatment. Of the recommended lifestyle changes, increasing physical activity has extensive benefits, including improving both blood pressure and blood cholesterol, that are comparable, superior, or complementary to other healthy lifestyle changes. Physical activity assessment and prescription are an excellent lifestyle behavior treatment option for all patients, including for the large population of mild-moderate-risk patients with elevated blood pressure and blood cholesterol.
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21
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Seong BH, Hong CY. Does Risk Awareness of COVID-19 Affect Visits to National Parks? Analyzing the Tourist Decision-Making Process Using the Theory of Planned Behavior. Int J Environ Res Public Health 2021; 18:ijerph18105081. [PMID: 34064920 PMCID: PMC8151032 DOI: 10.3390/ijerph18105081] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/07/2021] [Accepted: 05/09/2021] [Indexed: 11/18/2022]
Abstract
This study aimed to determine whether risk awareness of coronavirus disease (COVID-19) affects visits to national parks. We analyzed the tourist decision-making process during the current pandemic using the theory of planned behavior as a framework, adding variables relevant to the pandemic, such as risk perception and risk reduction behavior, to the model. Based on a literature review, we developed a research model describing the impact relationship between risk perception, the theory of planned behavior, and risk reduction behavior and tested nine hypotheses. Results of a survey of 555 visitors to two national parks supported eight of the nine hypotheses. Although the results are limited, they reaffirm the usefulness of the theory of planned behavior in explaining tourism behavior. This work is significant in that we would be able to extend the scope of subsequent research beyond a discussion of the direct effects on optimistic perceptions (bias) and risk reduction behavior as well as visit intention, by explaining the probability even in unprecedented crises such as COVID-19. Humans may be negotiating the constraints (COVID-19) or embodied tourism need through the personal bias. Furthermore, we discuss the theoretical implications of the results for tourism behavior research.
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Affiliation(s)
| | - Chang-Yu Hong
- Division of Global & Interdisciplinary Studies, Pukyong National University, Busan 48513, Korea
- Correspondence: ; Tel.: +82-51-629-5623
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22
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Fraticelli L, Kleitz O, Claustre C, Eydoux N, Peiretti A, Tazarourte K, Bonnefoy-Cudraz E, Dussart C, El Khoury C. Comparison of the pathways of care and life courses between first-time ST-elevation myocardial infarction (STEMI) and STEMI with prior MI: findings from the OSCAR registry. BMJ Open 2020; 10:e038773. [PMID: 33154054 PMCID: PMC7646338 DOI: 10.1136/bmjopen-2020-038773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES We hypothesised that patients having experienced one coronary event in their life were susceptible to present differences in their pathways of care and within 1 year of their life courses. We aimed to compare pathways between first-time ST-elevation myocardial infarction (STEMI) and STEMI with prior myocardial infarction (MI). DESIGN A retrospective observational study based on the Observatoire des Syndromes Coronariens Aigus du réseau RESCUe (OSCAR) registry collecting all suspected STEMI from 10 percutaneous coronary intervention centres in France. SETTING All patients with STEMI from 2013 to 2017 were included (N=6306 with 5423 first-time STEMI and 883 STEMI with prior MI). We provided a matching analysis by propensity score based on cardiovascular risk factors. PARTICIPANTS We defined first-time STEMI as STEMI occurring at the inclusion date, and STEMI with prior MI as STEMI with a history of MI prior to the inclusion date. RESULTS Patients with first-time STEMI and patients with STEMI with prior MI were equally treated during hospitalisation and at discharge. At 12 months, patients with first-time STEMI had a lower adherence to BASIC treatment (ie, beta-blocker, antiplatelet therapy, statin and converting enzyme inhibitor) (48.11% vs 58.58%, p=0.0167), more frequently completed the cardiac rehabilitation programme (44.33% vs 31.72%, p=0.0029), more frequently changed their lifestyle behaviours; more frequently practiced daily physical activity (48.11% vs 35.82%, p=0.0043) and more frequently stopped smoking at admission (69.39% vs 55.00%, p=0.0524). The estimated mortality was higher for patients with STEMI with prior MI at 1 month (p=0.0100), 6 months (p=0.0500) and 1 year (p=0.0600). CONCLUSIONS We provided an exhaustive overview of the real-life clinical practice conditions of STEMI management. The patients with STEMI with prior MI presented an optimised use of prehospital resources, which was probably due to their previous experience, and showed a better adherence to drug therapy compared with patients with first-time STEMI. TRIAL REGISTRATION NUMBER Commission Nationale de l'Informatique et des Libertés (number 2 013 090 v0).
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Affiliation(s)
- Laurie Fraticelli
- RESCUe-RESUVal network, Hospital Center Lucien Hussel, Vienne, France
- Laboratory Systemic Health Care, EA 4129, University of Lyon 1, Lyon, France
| | - Olivier Kleitz
- RESCUe-RESUVal network, Hospital Center Lucien Hussel, Vienne, France
| | - Clément Claustre
- RESCUe-RESUVal network, Hospital Center Lucien Hussel, Vienne, France
| | - Nicolas Eydoux
- RESCUe-RESUVal network, Hospital Center Lucien Hussel, Vienne, France
| | | | - Karim Tazarourte
- Department of Emergency Medicine and SAMU, Hospital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- HESPER EA 7425, Claude Bernard Lyon 1 University, Lyon, France
| | - Eric Bonnefoy-Cudraz
- Cardiology intensive care unit, Hospital Louis Pradel, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Claude Dussart
- Laboratory Systemic Health Care, EA 4129, University of Lyon 1, Lyon, France
| | - Carlos El Khoury
- HESPER EA 7425, Claude Bernard Lyon 1 University, Lyon, France
- Clinical Research Unit and Emergency Department, Médipôle Lyon-Villeurbanne, Villeurbanne, France
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Yaffe K, Barnes DE, Rosenberg D, Dublin S, Kaup AR, Ludman EJ, Vittinghoff E, Peltz CB, Renz AD, Adams KJ, Larson EB. Systematic Multi-Domain Alzheimer's Risk Reduction Trial (SMARRT): Study Protocol. J Alzheimers Dis 2020; 70:S207-S220. [PMID: 30475764 PMCID: PMC6639147 DOI: 10.3233/jad-180634] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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] [Indexed: 11/15/2022]
Abstract
This article describes the protocol for the Systematic Multi-domain Alzheimer's Risk Reduction Trial (SMARRT), a single-blind randomized pilot trial to test a personalized, pragmatic, multi-domain Alzheimer's disease (AD) risk reduction intervention in a US integrated healthcare delivery system. Study participants will be 200 higher-risk older adults (age 70-89 years with subjective cognitive complaints, low normal performance on cognitive screen, and ≥ two modifiable risk factors targeted by our intervention) who will be recruited from selected primary care clinics of Kaiser Permanente Washington, oversampling people with non-white race or Hispanic ethnicity. Study participants will be randomly assigned to a two-year Alzheimer's risk reduction intervention (SMARRT) or a Health Education (HE) control. Randomization will be stratified by clinic, race/ethnicity (non-Hispanic white versus non-white or Hispanic), and age (70-79, 80-89). Participants randomized to the SMARRT group will work with a behavioral coach and nurse to develop a personalized plan related to their risk factors (poorly controlled hypertension, diabetes with evidence of hyper or hypoglycemia, depressive symptoms, poor sleep quality, contraindicated medications, physical inactivity, low cognitive stimulation, social isolation, poor diet, smoking). Participants in the HE control group will be mailed general health education information about these risk factors for AD. The primary outcome is two-year cognitive change on a cognitive test composite score. Secondary outcomes include: 1) improvement in targeted risk factors, 2) individual cognitive domain composite scores, 3) physical performance, 4) functional ability, 5) quality of life, and 6) incidence of mild cognitive impairment, AD, and dementia. Primary and secondary outcomes will be assessed in both groups at baseline and 6, 12, 18, and 24 months.
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Affiliation(s)
- Kristine Yaffe
- University of California, San Francisco, San Francisco, CA, USA.,San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Deborah E Barnes
- University of California, San Francisco, San Francisco, CA, USA.,San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Dori Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Sascha Dublin
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Allison R Kaup
- University of California, San Francisco, San Francisco, CA, USA.,San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Evette J Ludman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Carrie B Peltz
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Anne D Renz
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Kristin J Adams
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
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24
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Davis T, DiClemente RJ, Prietula M. Using ADAPT-ITT to Modify a Telephone-Based HIV Prevention Intervention for SMS Delivery: Formative Study. JMIR Form Res 2020; 4:e22485. [PMID: 32831178 PMCID: PMC7576465 DOI: 10.2196/22485] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/18/2020] [Accepted: 08/23/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND African American adolescent females are disproportionately affected by sexually transmitted infections (STIs) and HIV. Given the elevated risk of STIs and HIV in African American women, there is an urgent need to identify innovative strategies to enhance the adoption and maintenance of STI and HIV preventive behaviors. Texting is a promising technology for creating preventive maintenance interventions (PMIs) that extend the efficacy of the original intervention. However, little guidance in public health literature is available for developing this type of application. OBJECTIVE This paper describes a formative pilot study that incorporates user experience methods to design and test PMI texts for Afiya, an original evidence-based intervention (EBI) specifically designed for African American adolescent females. This study aims to describe the adaptation process of health educator-led phone calling to text-based communication. METHODS The formative process followed the assessment, decision, adaptation, production, topical experts-integration, training, testing (ADAPT-ITT) framework for adapting EBIs and using them in a new setting, for a new target population or a modified intervention strategy. This study presents the details of how the phases of the ADAPT-ITT framework were applied to the design of the adaptation. An advisory board was constituted from the target population, consisting of 6 African American women aged 18-24 years, participating in formative activities for 12 weeks, and involving components of the PMI design. As Afiya included a telephone-based PMI, developers of the original Afiya phone scripts crafted the initial design of the SMS-based texts and texting protocol. The advisory board participated in the 1-day Afiya workshop, followed by 4 weeks of texting PMI messages and a midcourse focus group, followed by 4 more weeks of texting PMI messages, ultimately ending with a final focus group. At the advisory board's request, this phase included an optional, additional week of text-based PMI messages. RESULTS The methods provided a rich source of data and insights into the fundamental issues involved when constructing SMS-based PMI for this target population and for this EBI. Prior contact and context are essential as the health educator was identified as a key persona in the process and the messages were situated in the original (workshop) context. Narrative adaptations for personas emerged from advisory board discussions. Suggestions on how to expand the PMI to current, specific social contexts indicated that the use of narrative analysis is warranted. CONCLUSIONS The use of existing EBIs incorporating telephone-based PMI scripts facilitated the initial design of the texts, with a subsequent narrative analysis of the advisory board data providing additional adjustments given the actual context. Additional examination of the advisory board feedback revealed that personas would offer insight into and opportunities for a persona-specific modification of texting narratives.
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Affiliation(s)
- Teaniese Davis
- Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA, United States
| | - Ralph Joseph DiClemente
- Department of Social & Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Michael Prietula
- Goizueta Business School & Hubert Department of Global Health, Emory University, Atlanta, GA, United States
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25
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Anstey KJ, Cherbuin N, Kim S, McMaster M, D'Este C, Lautenschlager N, Rebok G, McRae I, Torres SJ, Cox KL, Pond CD. An Internet-Based Intervention Augmented With a Diet and Physical Activity Consultation to Decrease the Risk of Dementia in At-Risk Adults in a Primary Care Setting: Pragmatic Randomized Controlled Trial. J Med Internet Res 2020; 22:e19431. [PMID: 32969833 PMCID: PMC7545332 DOI: 10.2196/19431] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is a need to develop interventions to reduce the risk of dementia in the community by addressing lifestyle factors and chronic diseases over the adult life course. OBJECTIVE This study aims to evaluate a multidomain dementia risk reduction intervention, Body Brain Life in General Practice (BBL-GP), targeting at-risk adults in primary care. METHODS A pragmatic, parallel, three-arm randomized trial involving 125 adults aged 18 years or older (86/125, 68.8% female) with a BMI of ≥25 kg/m2 or a chronic health condition recruited from general practices was conducted. The arms included (1) BBL-GP, a web-based intervention augmented with an in-person diet and physical activity consultation; (2) a single clinician-led group, Lifestyle Modification Program (LMP); and (3) a web-based control. The primary outcome was the Australian National University Alzheimer Disease Risk Index Short Form (ANU-ADRI-SF). RESULTS Baseline assessments were conducted on 128 participants. A total of 125 participants were randomized to 3 groups (BBL-GP=42, LMP=41, and control=42). At immediate, week 18, week 36, and week 62 follow-ups, the completion rates were 43% (18/42), 57% (24/42), 48% (20/42), and 48% (20/42), respectively, for the BBL-GP group; 71% (29/41), 68% (28/41), 68% (28/41), and 51% (21/41), respectively, for the LMP group; and 62% (26/42), 69% (29/42), 60% (25/42), and 60% (25/42), respectively, for the control group. The primary outcome of the ANU-ADRI-SF score was lower for the BBL-GP group than the control group at all follow-ups. These comparisons were all significant at the 5% level for estimates adjusted for baseline differences (immediate: difference in means -3.86, 95% CI -6.81 to -0.90, P=.01; week 18: difference in means -4.05, 95% CI -6.81 to -1.28, P<.001; week 36: difference in means -4.99, 95% CI -8.04 to -1.94, P<.001; and week 62: difference in means -4.62, 95% CI -7.62 to -1.62, P<.001). CONCLUSIONS A web-based multidomain dementia risk reduction program augmented with allied health consultations administered within the general practice context can reduce dementia risk exposure for at least 15 months. This study was limited by a small sample size, and replication on a larger sample with longer follow-up will strengthen the results. TRIAL REGISTRATION Australian clinical trials registration number (ACTRN): 12616000868482; https://anzctr.org.au/ACTRN12616000868482.aspx.
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Affiliation(s)
- Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, Australia.,Neuroscience Research Australia, Sydney, Australia.,Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
| | - Sarang Kim
- Wicking Dementia Resaerch & Education Centre, University of Tasmania, Hobart, Australia
| | - Mitchell McMaster
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
| | - Catherine D'Este
- National Centre for Epidemiology and Public Health, Australian National University, Canberra, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Nicola Lautenschlager
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Australia
| | - George Rebok
- Johns Hopkins Centre on Aging and Health, Johns Hopkins University, Baltimore, MD, United States
| | - Ian McRae
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
| | - Susan J Torres
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Kay L Cox
- Medical School, University of Western Australia, Perth, Australia
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26
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Thilsing T, Sonderlund AL, Sondergaard J, Svensson NH, Christensen JR, Thomsen JL, Hvidt NC, Larsen LB. Changes in Health-Risk Behavior, Body Mass Index, Mental Well-Being, and Risk Status Following Participation in a Stepwise Web-Based and Face-to-Face Intervention for Prevention of Lifestyle-Related Diseases: Nonrandomized Follow-Up Cohort Study. JMIR Public Health Surveill 2020; 6:e16083. [PMID: 32673269 PMCID: PMC7380905 DOI: 10.2196/16083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 03/10/2020] [Accepted: 04/12/2020] [Indexed: 01/18/2023] Open
Abstract
Background Recent evidence suggests the effectiveness of stepwise, targeted approaches for the prevention of lifestyle-related diseases with combinations of web-based and face-to-face interventions showing promising results. Objective This paper reports on 1-year changes in health-risk behaviors, BMI, self-rated health, mental well-being, and risk of disease at 1-year follow-up after participation in a stepwise intervention that targeted persons at high risk of disease and persons with health-risk behavior. To this end, we distinguish between participants who took up the full intervention (web-based plus face-to-face) and those who received only the web-based intervention. Methods The Early Detection and Prevention (Danish acronym: TOF) pilot study was conducted as a nonrandomized, 1-year follow-up intervention study in two municipalities in the Region of Southern Denmark. A total of 9400 citizens born between 1957 and 1986 (aged 29 to 60 years) were randomly sampled from participating general practitioner (GP) patient-list systems and were invited to take part in the study. Participants were subsequently stratified into risk groups based on their responses to a questionnaire on health-risk behavior and data from their GP’s electronic patient record (EPR) system. All participants received a digital personal health profile with individualized information on current health-risk behavior and targeted advice on relevant health-risk behavior changes. In addition, patients at high risk of disease, as indicated by their digital health profile, were offered a targeted intervention at their GP. Patients who were not deemed at high risk of disease but who exhibited health-risk behaviors were offered a targeted intervention at their municipal health center (MHC). At 1-year follow-up, health-risk behaviors, self-rated health, BMI, and mental well-being were reassessed by questionnaire, and current information on diagnoses and medical treatment was retrieved from the EPRs. Results Of 598 patients at high risk of disease or with health-risk behavior, 135 took up the targeted intervention at their GP or MHC and 463 received the personal health profile only. From baseline to 1-year follow-up, the number of patients with unhealthy eating habits decreased, mean mental well-being increased, and smoking prevalence decreased in patients who had received the digital personal health profile alone. Among patients who took up the targeted intervention, unhealthy eating habits and sedentary lifestyles decreased and significant reductions in mean BMI were observed. At 1-year follow up, no health-risk behaviors were detected among 17.4% of patients who at baseline had exhibited health-risk behaviors or high risk of disease. Conclusions A stepwise targeted preventive approach using web-based and face-to-face elements may lead to favorable lifestyle changes. Specifically, a web-based approach may improve smoking and eating habits and mental well-being, whereas supplementary face-to-face interventions may be necessary to improve exercise habits and BMI. Trial Registration ClinicalTrials.gov NCT02797392; https://clinicaltrials.gov/ct2/show/NCT02797392 International Registered Report Identifier (IRRID) RR2-10.1186/s12875-018-0820-8
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Affiliation(s)
- Trine Thilsing
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Anders Larrabee Sonderlund
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jens Sondergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Nanna Herning Svensson
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Janus Laust Thomsen
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lars Bruun Larsen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Carmack C, Roncancio AM, Gerecht L, Ansari M. Perceived partner beliefs about condoms and self-efficacy communication within the context of the theory of gender and power. J Community Psychol 2020; 48:1424-1437. [PMID: 32168397 DOI: 10.1002/jcop.22337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 05/25/2023]
Abstract
The theory of gender and power provides a unique framework for understanding condom use by accounting for distinct challenges faced by minority women in particular. This study examined whether self-efficacy about condom use communication (SECC) and perceived partner's beliefs about condom (PPBC) use had an influence on condom use frequency; and whether these associations varied by gender. A sample of 252 African-American college students (101 males and 151 females) completed a confidential online survey assessing SECC, PPBC, and condom use behavior. SECC and PPBC showed significant associations with condom use behavior. Furthermore, there was a gender interaction effect with PPBC on condom use behavior. As PPBC increases toward positive associations about condom use, condom use behavior increased significantly more for females (B = 0.42; p = .02) as compared to males (B = 0.26; p = .19). This study supports the need to teach young women effective communication skills in order for them to accurately assess what their partner thinks about condom-related behaviors; and ultimately not allow partner discouragement to influence their decisions to use condoms. Interventions aimed at reducing risky sexual behavior on predominantly Black college campuses, in particular, may benefit from directly addressing relationship power and focusing on building self-efficacy in communicating condom use.
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Affiliation(s)
- Chakema Carmack
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, Texas
| | - Angelica M Roncancio
- Health and Behavioral Science, College of Humanities and Social Sciences, Houston, Texas
| | - Lena Gerecht
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, Texas
| | - Mohammed Ansari
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, Texas
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Kwon SA, Yoo HJ, Song E. Korean Consumers' Recognition of Risks Depending on the Provision of Safety Information for Chemical Products. Int J Environ Res Public Health 2020; 17:E1207. [PMID: 32069985 DOI: 10.3390/ijerph17041207] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/09/2020] [Accepted: 02/09/2020] [Indexed: 12/17/2022]
Abstract
After the 2011 “Oxy accident” involving deaths from humidifier disinfectants, Korean consumers’ anxiety about chemical products has risen. To provide timely, appropriate information to consumers, we must understand their risk recognition and explore methods of safety information provision. We investigated Korean consumers’ level of risk perception for chemical products depending on the provision of safety information and other factors. We conducted an online survey for 10 days with 600 adult Korean consumer participants and analyzed seven factors: catastrophic potential, controllability, familiarity, fear, scientific knowledge, and risk for future generations. Our results showed that married women over 30 perceived chemical products as higher risk, but when information was provided on how to use products safely, catastrophic potential, controllability, fear, scientific knowledge, as well as risk perception, increased significantly. When only risk diagnosis information was provided, catastrophic potential, fear, and risk for future generations remained static, but familiarity had a negative effect (R^2 = 0.586). Age and scientific knowledge affected the recognition of risk when safe risk management methods were provided (R^2 = 0.587). Risk controllability did not have any effect on risk perception. These results suggest that providing information about avoiding or dealing with risks has a positive effect on consumers’ risk perception.
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Affiliation(s)
- Pedro L Valenzuela
- Department of Systems Biology, University of Alcalá, Madrid, Spain (P.L.V.)
| | - Luis M Ruilope
- Hypertension Unit and Cardiorenal Translational Laboratory (L.M.R.)
| | - Alejandro Lucia
- Research Institute of the Hospital 12 de Octubre ("i+12") and CIBER de fragilidad y envejecimiento saludable (CIBERFES), Madrid, Spain (A.L.).,Faculty of Sport Sciences, Universidad Europea de Madrid, Spain (A.L.)
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30
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Akyol MA, Zehirlioğlu L, Erünal M, Mert H, Hatipoğlu NŞ, Küçükgüçlü Ö. Determining Middle-Aged and Older Adults' Health Beliefs to Change Lifestyle and Health Behavior for Dementia Risk Reduction. Am J Alzheimers Dis Other Demen 2020; 35:1533317519898996. [PMID: 32048860 PMCID: PMC10624097 DOI: 10.1177/1533317519898996] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Indexed: 12/11/2022]
Abstract
BACKGROUND Global population is getting older and the prevalence of dementia continuously increases. Understanding the related health beliefs is bound to enable lifestyle-based interventions that maximize public engagement in dementia risk reduction behaviors. The aim of this study was to determine health beliefs on dementia prevention behaviors and lifestyle changes and to determine the factors influencing these beliefs among middle-aged and older people in Turkey. MATERIALS AND METHODS This descriptive and cross-sectional study was conducted with 284 individuals aged 40 years and older, using nonprobability convenience sampling. Data were collected using a demographic characteristic form and the Turkish version of the Motivation for Changing Lifestyle and Health Behavior for Reducing the Risk of Dementia scale. The study utilized the value, mean, percentage frequency distribution, correlation, independent t test, and the one-way analysis of variance test. RESULTS The mean age of the participants included in the study was 56.99 ± 12.05, 68.7% of individuals were males. The mean education years of the participants were 11.22 ± 4.55. The majority (72.2%) of participants expressed subjective memory complaints. Presence of family history of dementia was 28.2%. Age, gender, education years, subjective memory complaints, presence family history of dementia, prior experience as a caregiver of dementia, and willingness to know their own risk were determined as essential factors that influence several health belief factors related to dementia risk reduction. CONCLUSION Our findings indicate that males, older adults, and lower-educated and income are priority groups that should be guided for lifestyle and behavioral changes regarding dementia risk reduction.
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Affiliation(s)
- Merve Aliye Akyol
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Izmir, Turkey
- Internal Medicine Nursing Doctorate Programme, Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Lemye Zehirlioğlu
- Internal Medicine Nursing Doctorate Programme, Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Merve Erünal
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Izmir, Turkey
- Internal Medicine Nursing Doctorate Programme, Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Hatice Mert
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Izmir, Turkey
| | - Nur Şehnaz Hatipoğlu
- Ministry of Health, Konak 24th MF. Özsaruhan Primary Care Clinic, Izmir, Turkey
- Elderly Health Doctorate Programme, Institute of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Özlem Küçükgüçlü
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Izmir, Turkey
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Abstract
OBJECTIVE The aim of this systematic review is to investigate the community-based academic partnership roles in disaster risk management. METHODS The assessment of the documents was conducted by reviewing abstracts and full papers of the available studies, which provided considerable background and promoted knowledge in academic interventional roles in disaster risk management. The articles were searched with a wide range of key words related to the research topic. The studies included the research available between 2000 and September 2017 in the English language. The selection of articles was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. RESULTS Of 997 articles, we selected 12 full-text articles that met the criteria for the final review based on the study objective. The results show that, although universities can play multidirectional roles in disaster risk management phases, the development of the academic partnership potential and collaboration for disaster risk management and disaster risk reduction for stakeholders is necessary. CONCLUSION The universities' potential in providing sufficient disaster health literacy is not currently considered important enough in communities.Therefore, the proper context-bound models of development based on a community's skills and universities' potential should receive more attention.
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Affiliation(s)
- Bahar Seifi
- Department of Health in Emergencies and Disasters, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Hesam Seyedin
- Department of Health in Emergencies and Disasters, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ghader Ghanizadeh
- Environmental Health Engineering, Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Suarnianti, Martiana T, Haskas Y. Analyzing the Effect of Organizational Factors on Reducing the Disease Transmission Risk in Nurses using an AIDS Risk Reduction Model. J Glob Infect Dis 2019; 11:93-101. [PMID: 31543650 PMCID: PMC6733188 DOI: 10.4103/jgid.jgid_128_18] [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] [Indexed: 11/25/2022] Open
Abstract
Aims: Nurses are one of the health workers who face a high risk of contracting a disease at their workplace. The officers who are inconsistent in maintaining standard precautions when treating patients render nurses to be exposed to infectious disease. Settings and Design: This was an analytic observational study with a longitudinal design. Materials and Methods: This study was carried out in two Provincial B Type Government Hospitals, namely, Labuang Baji Provincial Regional Hospital and Makassar Haji Regional General Hospital, in Makassar City, with a sample size of 104 respondents. The data were subjected to ANOVA test to determine the effect of organizational factors on reducing the risk of AIDS risk reduction model-based disease transmission. Results: The results of this study indicate that the organizational factors do not affect the labeling of nurses related to the reduction of the risk of disease transmission (b = 0.086, ρ = 0.379). The organizational factors influence nurses commitment related to the reduction of the risk of disease transmission (b = 0.328, ρ = <0.001) and also their enactment related to the reduction of the risk of disease transmission (b = 0.199, ρ = 0.030). Conclusions: The organizational factors related to the reduction of the risk of disease transmission affect the action of nurses to reduce the risk (enactment) through the commitment. These organizational factors also affect the labeling of nurses as individuals who are at a risk of contracting a disease so as to facilitate the adoption of a behavior to reduce the risk of disease transmission in hospital.
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Affiliation(s)
- Suarnianti
- Department of Nursing, Nani Hasanuddin Health Sciences Institute, Makassar, Indonesia
| | - Tri Martiana
- Department of Occupational Health and Safety, Faculty of Public Health, Airlangga University, Surabaya, Indonesia
| | - Yusran Haskas
- Department of Nursing, Nani Hasanuddin Health Sciences Institute, Makassar, Indonesia
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Lima TCRM, da Silva DG, Barreto IDDC, Oliveira JC, Oliveira LCS, Arcelino LAM, Oliveira JC, Sousa ACS, Barreto Filho JAS. Quality of Intra-Hospital Nutritional Counseling in Patients with STEMI in the Public and Private Health Networks of Sergipe: The VICTIM Register. Arq Bras Cardiol 2019; 113:260-269. [PMID: 31340237 PMCID: PMC6777890 DOI: 10.5935/abc.20190124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 06/25/2018] [Revised: 10/08/2018] [Accepted: 10/24/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Having appropriate dietary habits is part of the recommendations after ST-Elevation Myocardial Infarction (STEMI), however, the quality of intra-hospital nutritional counselling in the different health services has been minimally explored. OBJECTIVE To evaluate the quality of intra-hospital nutritional counselling among patients with STEMI in the public and private health systems in Sergipe. METHODS A cross-sectional, with data from the Via Crucis for the Treatment of Myocardial Infarction (VICTIM) Register, conducted from April to November of 2017, with individuals aged ≥ 18 years diagnosed with STEMI, in one public health service hospital and three private hospitals. The occurrence and quality of nutritional counselling were analyzed based on current guidelines and the administration of questionnaires. A significance level of 0.05 was adopted. RESULTS A total of 188 patients were analyzed; 80.3% were from the public health service facility. Among the interviewees, 57.6% of the public health service, and 70.3% of the private hospital patients received intra-hospital nutritional counselling (p = 0.191). The documentation of this practice, in medical records, was lower in the public service (2.6% vs. 37.8%, p < 0.001). A predominance of restrictive orientations was found in the public and private sectors, mainly regarding salt and fat, 52.3% and 70.3% respectively (p = 0.064). Patients from the private service were more counselling to introduce of cardioprotective foods, mainly fruit, vegetable/legume consumption (48.6% vs. 13.2%, p < 0.001). Among those who received counselling, nutritional knowledge was higher in the private sector (68.2% vs. 26.3%, p < 0.001). CONCLUSION The intra-hospital nutritional counselling provided to patients with STEMI, in Sergipe, still presents poor quality in both services, especially in the public health system.
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Affiliation(s)
| | | | | | - Jussiely Cunha Oliveira
- Universidade Federal de Sergipe - Programa de
Pós-Graduação em Enfermagem, São
Cristóvão, SE - Brazil
- Universidade Tiradentes, Aracaju, SE - Brazil
| | - Laís Costa Souza Oliveira
- Universidade Federal de Sergipe - Programa de
Pós-Graduação em Ciências da Saúde, São
Cristóvão, SE - Brazil
- Hospital Primavera, Aracaju, SE - Brazil
| | | | - Jeferson Cunha Oliveira
- Universidade Federal de Sergipe - Programa de
Pós-Graduação em Ciências da Saúde, São
Cristóvão, SE - Brazil
- Hospital Primavera, Aracaju, SE - Brazil
| | - Antônio Carlos Sobral Sousa
- Universidade Federal de Sergipe - Programa de
Pós-Graduação em Ciências da Saúde, São
Cristóvão, SE - Brazil
- Universidade Federal de Sergipe - Departamento de Medicina,
São Cristóvão, SE - Brazil
- Fundação São Lucas - Centro de Ensino e
Pesquisa, Aracaju, SE - Brazil
| | - José Augusto Soares Barreto Filho
- Universidade Federal de Sergipe - Programa de
Pós-Graduação em Ciências da Saúde, São
Cristóvão, SE - Brazil
- Universidade Federal de Sergipe - Departamento de Medicina,
São Cristóvão, SE - Brazil
- Fundação São Lucas - Centro de Ensino e
Pesquisa, Aracaju, SE - Brazil
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Jayasree B, Stalin P. Efficacy of behavior change communication using mobile calls on glycemic control among Type 2 diabetic patients in an urban area of Pondicherry, South India: A randomized controlled trial. J Educ Health Promot 2019; 8:92. [PMID: 31143809 PMCID: PMC6532356 DOI: 10.4103/jehp.jehp_247_18] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 12/21/2018] [Indexed: 06/09/2023]
Abstract
CONTEXT Lifestyle modifications play a major role in controlling blood glucose levels among diabetes mellitus for the prevention of its complications. Mobile phones can be used as an efficient tool for improving the healthy lifestyle through health education. AIMS The aim of the study is to measure the efficacy of behavior change communication using mobile calls in controlling blood sugar levels, increasing medication adherence, healthy diet, and physical activity among diabetic patients. SETTINGS AND DESIGN A randomized controlled trial was conducted in an urban area of Pondicherry between 50 (25 per arm) type 2 diabetes patients. SUBJECTS AND METHODS All participants were interviewed using a structured questionnaire. Fasting blood glucose (FBG) was measured. Single-time health education was given to both groups. The intervention group received a mobile phone calls reminders thrice weekly for 2 months. Changes in FBG, diet, physical activities, and adherence to medications were assessed after 2 months. STATISTICAL ANALYSIS USED Means and proportions were calculated. Chi-square test and paired t-test were used to calculate the P value. RESULTS FBG increased significantly in the control group by 25.6 mg/dl (P = 0.03), whereas it was only 6.5 mg/dl in the intervention group (P = 0.56). Adherence to medications was increased significantly in both interventions (+21%) and control (+19%) groups. Number of fruits intake days per week (+1, P = 0.01) and fruits serving per day (+0.5, P = 0.00) have increased significantly in the intervention group. Recreational physical activity was increased in the intervention group but not statistically significant. CONCLUSION Our study findings suggest that mobile phone calls might help to improve glycemic control. It also suggests that it could improve the adherence to medications and intake of fruits. In the future, studies with large sample size and longer intervention need to be conducted.
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Affiliation(s)
- B. Jayasree
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - P. Stalin
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
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Shook E, Curtis A, Curtis J, Gibson G, Vander Horst A, Little V, Woolverton C. Assessing the Geographic Context of Risk Perception and Behavioral Response to Potential Ebola Exposure. Int J Environ Res Public Health 2019; 16:E831. [PMID: 30866474 DOI: 10.3390/ijerph16050831] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 11/23/2022]
Abstract
The 2014–2016 Ebola Virus Disease (EVD) epidemic outbreak reached over 28,000 cases and totaled over 11,000 deaths with 4 confirmed cases in the United States, which sparked widespread public concern about nationwide spread of EVD. Concern was elevated in locations connected to the infected people, which included Kent State University in Kent, Ohio. This threat of exposure enabled a unique opportunity to assess self-reported knowledge about EVD, risk perception, and behavior response to EVD. Unlike existing studies, which often survey one point in time across geographically coarse scales, this work offers insights into the geographic context of risk perception and behavior at finer-grained spatial and temporal scales. We report results from 3138 respondents comprised of faculty, staff, and students at two time periods. Results reveal increased EVD knowledge, decreased risk perception, and reduction in protective actions during this time. Faculty had the lowest perceived risk, followed by staff and then students, suggesting the role of education in this outcome. However, the most impactful result is the proof-of-concept for this study design to be deployed in the midst of a disease outbreak. Such geographically targeted and temporally dynamic surveys distributed during an outbreak can show where and when risk perception and behaviors change, which can provide policy-makers with rapid results that can shape intervention practices.
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Wright K, Fisher C, Rising C, Burke-Garcia A, Afanaseva D, Cai X. Partnering With Mommy Bloggers to Disseminate Breast Cancer Risk Information: Social Media Intervention. J Med Internet Res 2019; 21:e12441. [PMID: 30843866 PMCID: PMC6427105 DOI: 10.2196/12441] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 12/11/2018] [Accepted: 12/14/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Women are concerned about reducing their breast cancer risk, particularly if they have daughters. Social media platforms, such as blogs written by mothers, are increasingly being recognized as a channel that women use to make personal and family health-related decisions. Government initiatives (eg, Interagency Breast Cancer and Environmental Research Coordinating Committee) and researchers have called for scientists and the community to partner and disseminate scientifically and community-informed environmental risk information. OBJECTIVE We developed and evaluated a blog intervention to disseminate breast cancer and environmental risk information to mothers. We teamed with mommy bloggers to disseminate a message that we developed and tailored for mothers and daughters based on scientific evidence from the Breast Cancer and the Environment Research Program (BCERP). We posited that the intervention would influence women's exposure to, acceptance of, and beliefs about environmental risks while promoting their intention to adopt risk-reducing behaviors. METHODS Using a quasi-experimental design, we recruited 75 mommy bloggers to disseminate the breast cancer risk message on their respective blogs and examined the impact of the intervention on (1) readers exposed to the intervention (n=445) and (2) readers not exposed to the intervention (comparison group; n=353). RESULTS Following the intervention, blog reader scores indicating exposure to the breast cancer risk and prevention information were greater than scores of blog readers who were not exposed (or did not recall seeing the message; mean 3.92, SD 0.85 and mean 3.45, SD 0.92, respectively; P<.001). Readers who recalled the intervention messages also had higher breast cancer risk and prevention information satisfaction scores compared with readers who did not see (or recall) the messages (mean 3.97, SD 0.75 and mean 3.57, SD 0.94, respectively; P<.001). Blog readers who recalled seeing the intervention messages were significantly more likely to share the breast cancer risk and prevention information they read, with their daughters specifically, than readers who did not recall seeing them (χ21=8.1; P=.004). Those who recalled seeing the intervention messages reported significantly higher breast cancer risk and prevention information influence scores, indicative of behavioral intentions, than participants who did not recall seeing them (mean 11.22, SD 2.93 and mean 10.14, SD 3.24, respectively; P=.003). Most women ranked Facebook as their first choice for receiving breast cancer risk information. CONCLUSIONS Results indicated that blog readers who were exposed to (and specifically recalled) the BCERP-adapted intervention messages from mommy bloggers had higher breast cancer risk and prevention information exposure scores and higher breast cancer risk and prevention information satisfaction and influence scores than those who did not see (or recall) them. Mommy bloggers may be important opinion leaders for some women and key to enhancing the messaging, delivery, and impact of environmental breast cancer risk information on mothers.
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Affiliation(s)
- Kevin Wright
- George Mason University, Fairfax, VA, United States
| | - Carla Fisher
- University of Florida, UF Health Cancer Center, Gainesville, FL, United States
| | | | | | | | - Xiaomei Cai
- George Mason University, Fairfax, VA, United States
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Morita PP, Yeung MS, Ferrone M, Taite AK, Madeley C, Stevens Lavigne A, To T, Lougheed MD, Gupta S, Day AG, Cafazzo JA, Licskai C. A Patient-Centered Mobile Health System That Supports Asthma Self-Management (breathe): Design, Development, and Utilization. JMIR Mhealth Uhealth 2019; 7:e10956. [PMID: 30688654 PMCID: PMC6369424 DOI: 10.2196/10956] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/02/2018] [Accepted: 09/27/2018] [Indexed: 01/14/2023] Open
Abstract
Background Uncontrolled asthma poses substantial negative personal and health system impacts. Web-based technologies, including smartphones, are novel means to enable evidence-based care and improve patient outcomes. Objective The aim of this study was to design, develop, and assess the utilization of an asthma collaborative self-management (CSM) platform (breathe) using content based on international evidence-based clinical guidelines. Methods We designed and developed breathe as a Web-based mobile health (mHealth) platform accessible on smartphones, tablets, or desktop with user-centered design methods and International Organization for Standardization–certified quality development processes. Moreover, breathe was envisioned as a multifunctional, CSM mHealth platform, with content based on international clinical practice guidelines and compliant with national privacy and security specifications. The system enabled CSM (patient, provider, and breathe) and self-monitoring of asthma patients through (1) assessment of asthma control, (2) real-time access to a dynamic asthma action plan, (3) access to real-time environmental conditions, and (4) risk-reduction messaging. The data collection protocol collected user data for 12 months, with clinic visits at baseline and 6 and 12 months. Utilization outcomes included user interactions with the platform, user impressions, self-reported medication use, asthma symptom profile, reported peak flow measurement, and the delivery and impact of email reminders. Results We enrolled 138 patients with a mean age of 45.3 years to receive the breathe intervention. Majority were female (100/138, 72.5%), had a smartphone (92/138, 66.7%), and had a mean Asthma Control Test score of 18.3 (SD 4.9). A majority reported that breathe helped in the management of their asthma. Moreover, breathe scored 71.1 (SD 18.9) on the System Usability Scale. Overall, 123 patients had complete usage analytics datasets. The platform sent 7.96 reminder emails per patient per week (pppw), patients accessed breathe 3.08 times, journaled symptoms 2.56 times, reported medication usage 0.30 times, and reported peak flow measurements 0.92 times pppw. Furthermore, breathe calculated patients’ action plan zone of control 2.72 times pppw, with patients being in the green (well-controlled) zone in 47.71% (8300/17,396) of the total calculations. Usage analysis showed that 67.5% (83/123) of the participants used the app at week 4 and only 57.7% (71/123) by week 45. Physician visits, email reminders, and aged 50 years and above were associated with higher utilization. Conclusions Individuals with asthma reported good usability and high satisfaction levels, reacted to breathe notifications, and had confidence in the platform’s assessment of asthma control. Strong utilization was seen at the intervention’s initiation, followed by a rapid reduction in use. Patient reminders, physician visits, and being aged 50 years and above were associated with higher utilization. Trial Registration ClinicalTrials.gov NCT01964469; https://clinicaltrials.gov/ct2/show/NCT01964469
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Affiliation(s)
- Plinio Pelegrini Morita
- School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
| | - Melanie S Yeung
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
| | | | - Ann K Taite
- Kingston General Health Research Institute, Kingston, ON, Canada.,Asthma Research Unit, Kingston Health Sciences Center, Kingston General Hospital Research Institute, Kingston, ON, Canada
| | | | | | - Teresa To
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - M Diane Lougheed
- Kingston General Health Research Institute, Kingston, ON, Canada.,Asthma Research Unit, Kingston Health Sciences Center, Kingston General Hospital Research Institute, Kingston, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Samir Gupta
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Andrew G Day
- Kingston General Health Research Institute, Kingston, ON, Canada
| | - Joseph A Cafazzo
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Christopher Licskai
- Western University, London, ON, Canada.,London Health Sciences, Victoria Hospital, London, ON, Canada
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Farotimi AA, Ajao EO, Nwozichi CU, Ademuyiwa IY. Effect of Training on Knowledge, Perception and Risk Reduction Regarding Infection Control among Nurses in Selected Teaching Hospitals in Nigeria. Iran J Nurs Midwifery Res 2018; 23:471-477. [PMID: 30386398 PMCID: PMC6178574 DOI: 10.4103/ijnmr.ijnmr_208_17] [Citation(s) in RCA: 6] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Healthcare workers, especially nurses, are at a high risk of infection. By complying with infection control measures, a lot of infections can be prevented. This study examined the effects of a training program on knowledge, perception, and risk reduction regarding infection control among nurses. Materials and Methods: This study adopted a pretest–posttest quasi-experimental design. The samples consisted of 87 participants comprising 42 nurses in the experimental group and 45 nurses in the control group. The instruments used for data collection were a questionnaire on knowledge about infection control and a questionnaire on perception about infection control. Results: Findings showed that the mean (SD) age in the experimental group was 34.92 (8.99) whereas that of the control group was 47.43 (6.60). The mean (SD) years of experience in the experimental group was 10.42 (9.95) years whereas in the control group it was 21.89 (8.72) years. Findings further revealed that 26 participants (62.90%) in the postintervention group had high knowledge level compared to the preintervention where none had high knowledge. A significant difference was observed between the mean perception score on infection control in the experimental and control groups (t = 17.12; p = 0.001). Conclusions: This study has shown that a training program is very effective and that all nurses should be exposed to infection control training to equip them with the necessary knowledge and skills with which to fight against the spread of infection in the healthcare setting.
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Affiliation(s)
- Adekunbi Abosede Farotimi
- Department of Adult Health Nursing, Babcock University School of Nursing, Ilishan-Remo, Ogun State, Nigeria
| | - Ezekiel Olasunkanmi Ajao
- Department of Community Health Nursing, Babcock University School of Nursing, Ilishan-Remo, Ogun State, Nigeria
| | | | - Iyabo Yewande Ademuyiwa
- Department of Nursing, Faculty of Clinical Sciences, University of Lagos, Lagos State, Nigeria
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Thato R, Daengsaard E, Sukrak N. The Effect of a Brief HIV Prevention Program on Risk Reduction Behaviors Among Thai Men Diagnosed With Sexually Transmitted Infections. Asian Nurs Res (Korean Soc Nurs Sci) 2018; 12:265-272. [PMID: 30342223 DOI: 10.1016/j.anr.2018.10.003] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 10/05/2018] [Accepted: 10/08/2018] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Men diagnosed with sexually transmitted infections (STIs) are at greater risk for Human Immunodeficiency Virus (HIV) infection and STIs reinfection. This study aimed to test the effectiveness of a brief human immunodeficiency virus (B-HIV) prevention program on HIV and sexually transmitted infection (STI) knowledge, perceived benefits of condom use, risk reduction self-efficacy, risk reduction behaviors, and reinfection rate among Thai men with STIs. METHODS A quasi-experimental design was conducted. Participants were selected from men with STI symptoms. They were randomly assigned to a B-HIV prevention program or usual care, 100 each. The program consisted of 3 modules. Key messages for HIV prevention were sent weekly through Line. Outcomes were HIV and STI knowledge, perceived benefits of condom use, risk reduction self-efficacy, risk reduction behaviors (condom use, the number of sexual partners, and condomless sex), and STI reinfection rate. Independent t-test and binary logistic regression were performed. RESULTS The B-HIV prevention program significantly increased HIV and STI knowledge and resulted in perception of greater benefits from condoms and greater risk reduction self-efficacy. Program participants used condoms more frequently with many types of partners, especially with casual partners and sex workers. The intervention group practiced condomless sex less frequently than the control group. The program did not improve participants' condom use with lovers/steady partners and did not decrease the number of sexual partners and STI reinfection rate at 3-month follow-up. CONCLUSIONS A B-HIV prevention program could reduce the risk of HIV infection among male clients with current STIs by enhancing their condom use with casual partners and sex workers. Strategies to improve condom use with lovers/steady partners among this high-risk population is needed.
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Affiliation(s)
- Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand.
| | - Ekkachai Daengsaard
- General Male Clinic, Bangrak STIs Cluster, Bureau of AIDS, TB, and STIs, Ministry of Public Health, Bangkok, Thailand
| | - Nutthavit Sukrak
- General Male Clinic, Bangrak STIs Cluster, Bureau of AIDS, TB, and STIs, Ministry of Public Health, Bangkok, Thailand
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Bott N, Kumar S, Krebs C, Glenn JM, Madero EN, Juusola JL. A Remote Intervention to Prevent or Delay Cognitive Impairment in Older Adults: Design, Recruitment, and Baseline Characteristics of the Virtual Cognitive Health (VC Health) Study. JMIR Res Protoc 2018; 7:e11368. [PMID: 30104186 PMCID: PMC6111147 DOI: 10.2196/11368] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 07/23/2018] [Indexed: 12/31/2022] Open
Abstract
Background A growing body of evidence supports the use of lifestyle interventions for preventing or delaying the onset of Alzheimer disease and other forms of dementia in at-risk individuals. The development of internet-delivered programs would increase the scalability and reach of these interventions, but requires validation to ensure similar effectiveness to brick-and-mortar options. Objective We describe the study design, recruitment process, and baseline participant characteristics of the sample in the Virtual Cognitive Health (VC Health) study. Future analyses will assess the impact of the remotely delivered lifestyle intervention on (1) cognitive function, (2) depression and anxiety, and (3) various lifestyle behaviors, including diet, exercise, and sleep, in a cohort of older adults with subjective memory decline. Additional analyses will explore feasibility outcomes, as well as the participants’ engagement patterns with the program. Methods Older adults (aged 60-75 years) with subjective memory decline as measured by the Subjective Cognitive Decline 9-item (SCD-9) questionnaire, and who reported feeling worried about their memory decline, were eligible to participate in this single-arm pre-post study. All participants enrolled in the yearlong digital intervention, which consists of health coach-guided lifestyle change for improving diet, exercise, sleep, stress, and cognition. All components of this study were conducted remotely, including the collection of data and the administration of the intervention. We assessed participants at baseline, 12 weeks, 24 weeks, and 52 weeks with online surveys and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) test. We will conduct intention-to-treat analysis on all outcomes. Results A total of 85 participants enrolled in the intervention and 82 are included in the study sample (3 participants withdrew). The study cohort of 82 participants comprises 61 (74%) female, 72 (88%) white, and 64 (78%) overweight or obese participants, and 55 (67%) have at least a college degree. The average baseline RBANS score was 95.9 (SD 11.1), which is within age-adjusted norms. The average SCD-9 score was 6.0 (SD 2.0), indicating minor subjective cognitive impairment at the beginning of the study. The average baseline Generalized Anxiety Disorder 7-item scale score was 6.2 (SD 4.5), and the average Patient Health Questionnaire 9-item score was 8.5 (SD 4.9), indicating mild levels of anxiety and depression at baseline. Conclusions Internet-delivered lifestyle interventions are a scalable solution for the prevention or delay of Alzheimer disease. The results of this study will provide the first evidence for the effectiveness of a fully remote intervention and lay the groundwork for future investigations. Trial Registration ClinicalTrials.gov NCT02969460; http://clinicaltrials.gov/ct2/show/NCT02969460 (Archived by WebCite at http://www.webcitation.org/71LkYAkSh) Registered Report Identifier RR1-10.2196/11368
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Affiliation(s)
- Nicholas Bott
- Department of Medicine, School of Medicine, Stanford University, Stanford, CA, United States.,Neurotrack Technologies, Inc, Redwood City, CA, United States
| | | | - Caitlyn Krebs
- Neurotrack Technologies, Inc, Redwood City, CA, United States
| | - Jordan M Glenn
- Neurotrack Technologies, Inc, Redwood City, CA, United States
| | - Erica N Madero
- Neurotrack Technologies, Inc, Redwood City, CA, United States
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Xiong L, Li J, Xia T, Hu X, Wang Y, Sun M, Tang M. Risk Reduction Behaviors Regarding PM 2.5 Exposure among Outdoor Exercisers in the Nanjing Metropolitan Area, China. Int J Environ Res Public Health 2018; 15:E1728. [PMID: 30103552 DOI: 10.3390/ijerph15081728] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/20/2018] [Accepted: 08/07/2018] [Indexed: 01/12/2023]
Abstract
Aims: This study aimed to describe risk reduction behaviors regarding ambient particulate matter with a diameter of 2.5 μm or less (PM2.5) among outdoor exercisers and to explore potential factors influencing those behaviors in the urban area of Nanjing, China. Method: A cross-sectional convenience sample survey was conducted among 302 outdoor exercisers in May 2015. Descriptive analysis was used to describe demographics, outdoor physical activity patterns, knowledge of PM2.5 and risk reduction behaviors. Multivariate logistic regression analysis was then used to explore factors that influence the adoption of risk reduction behaviors. Results: The most common behavior to reduce PM2.5 exposure was minimizing the times for opening windows on hazy days (75.5%), and the least common one was using air purifiers (19.3%). Two thirds of respondents indicated that they wore face masks when going outside in the haze (59.5%), but only 13.6% of them would wear professional antismog face masks. Participants adopting risk reduction behaviors regarding PM2.5 exposure tended to be females, 50–60 year-olds, those with higher levels of knowledge about PM2.5 and those who had children. Conclusions: These findings indicate the importance of improving knowledge about PM2.5 among outdoor exercisers. Educational interventions should also be necessary to guide the public to take appropriate precautionary measures when undertaking outdoor exercise in high PM2.5 pollution areas.
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Sharma A, Kahle EM, Sullivan SP, Stephenson R. Birth Cohort Variations Across Functional Knowledge of HIV Prevention Strategies, Perceived Risk, and HIV-Associated Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in the United States. Am J Mens Health 2018; 12:1824-1834. [PMID: 30051744 PMCID: PMC6199423 DOI: 10.1177/1557988318790875] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Indexed: 11/17/2022] Open
Abstract
Gay, bisexual, and other men who have sex with men (GBMSM) in the United States remain heavily impacted by HIV. The purpose of this study was to describe intergenerational differences in functional knowledge of HIV prevention strategies, perceived risk, recent condomless anal sex (CAS), and HIV testing behavior. Eight hundred sexually active GBMSM were recruited via Facebook from August to September 2015, and administered a Web-based survey which included 12 multiple-choice questions to elicit data regarding functional knowledge of different HIV prevention approaches (e.g., condom use, pre-exposure prophylaxis post-exposure prophylaxis, treatment as prevention, circumcision). Cumulative logit and multivariable logistic models were formulated to examine birth cohort variations across four analytic outcomes. Younger generations were significantly more knowledgeable, as were GBMSM with higher education. Non-Hispanic non-White GBMSM and those reporting a bisexual/other sexual orientation had lower functional knowledge. Younger generations were equally concerned about contracting HIV as their older counterparts. Perceived risk was significantly higher among non-Hispanic non-White and Hispanic GBMSM, but lower among those with higher education and those in a relationship. Finally, birth cohort variations with respect to engaging in CAS with ≥2 men in the past 3 months and testing for HIV in the past year were not markedly pronounced. Younger GBMSM might be more knowledgeable about HIV prevention strategies compared to their predecessors, but are equally concerned about contracting HIV. Researchers and practitioners should consider intergenerational and other demographic differences while designing multifaceted HIV prevention programs for GBMSM.
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Affiliation(s)
- Akshay Sharma
- 1 Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA.,2 Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Erin M Kahle
- 1 Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA.,2 Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Stephen P Sullivan
- 1 Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA.,2 Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Rob Stephenson
- 1 Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA.,2 Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
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Luther M, Gardiner F, Lenson S, Caldicott D, Harris R, Sabet R, Malloy M, Perkins J. An Effective Risk Minimization Strategy Applied to an Outdoor Music Festival: A Multi-Agency Approach. Prehosp Disaster Med 2018; 33:220-4. [PMID: 29560844 DOI: 10.1017/S1049023X18000195] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Specific Event Identifiers a. Event type: Outdoor music festival. b. Event onset date: December 3, 2016. c. Location of event: Regatta Point, Commonwealth Park. d. Geographical coordinates: Canberra, Australian Capital Territory (ACT), Australia (-35.289002, 149.131957, 600m). e. Dates and times of observation in latitude, longitude, and elevation: December 3, 2016, 11:00-23:00. f. Response type: Event medical support. Abstract Introduction Young adult patrons are vulnerable to risk-taking behavior, including drug taking, at outdoor music festivals. Therefore, the aim of this field report is to discuss the on-site medical response during a music festival, and subsequently highlight observed strategies aimed at minimizing substance abuse harm. METHOD The observed outdoor music festival was held in Canberra (Australian Capital Territory [ACT], Australia) during the early summer of 2016, with an attendance of 23,008 patrons. First aid and on-site medical treatment data were gained from the relevant treatment area and service. RESULTS The integrated first aid service provided support to 292 patients. Final analysis consisted of 286 patients' records, with 119 (41.6%) males and 167 (58.4%) females. Results from this report indicated that drug intoxication was an observed event issue, with 15 (5.1%) treated on site and 13 emergency department (ED) presentations, primarily related to trauma or medical conditions requiring further diagnostics. CONCLUSION This report details an important public health need, which could be met by providing a coordinated approach, including a robust on-site medical service, accepting intrinsic risk-taking behavior. This may include on-site drug-checking, providing reliable information on drug content with associated education. Luther M , Gardiner F , Lenson S , Caldicott D , Harris R , Sabet R , Malloy M , Perkins J . An effective risk minimization strategy applied to an outdoor music festival: a multi-agency approach. Prehosp Disaster Med. 2018;33(2):220-224.
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Choo CC, Burton AAD. Mobile Phone Apps for Behavioral Interventions for At-Risk Drinkers in Australia: Literature Review. JMIR Mhealth Uhealth 2018; 6:e18. [PMID: 29439946 PMCID: PMC5829458 DOI: 10.2196/mhealth.6832] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 10/17/2016] [Revised: 06/07/2017] [Accepted: 10/09/2017] [Indexed: 01/02/2023] Open
Abstract
Background The mobile technology era has ushered in the use of mobile phone apps for behavioral intervention for at-risk drinkers. Objective Our objective was to review recent research relevant to mobile phone apps that can be used for behavioral intervention for at-risk drinkers in Australia. Methods The inclusion criteria for this review were articles published in peer-reviewed journals from 2001 to 2017 with use of the search terms “smartphone application,” “alcohol,” “substance,” “behavioural intervention,” “electronic health,” and “mobile health.” Results In total, we identified 103 abstracts, screened 90 articles, and assessed 50 full-text articles that fit the inclusion criteria for eligibility. We included 19 articles in this review. Conclusions This review highlighted the paucity of evidence-based and empirically validated research into effective mobile phone apps that can be used for behavioral interventions with at-risk drinkers in Australia.
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Affiliation(s)
- Carol C Choo
- College of Healthcare Sciences, James Cook University, Singapore, Singapore
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Butler KM, Rayens MK, Wiggins AT, Rademacher KB, Hahn EJ. Association of Smoking in the Home With Lung Cancer Worry, Perceived Risk, and Synergistic Risk. Oncol Nurs Forum 2018; 44:E55-E63. [PMID: 28222077 DOI: 10.1188/17.onf.e55-e63] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine the association of smoking in the home with lung cancer worry, perceived risk, and synergistic risk, controlling for sociodemographics, family history of lung cancer, and health-related self-concept. The hypothesis is that participants with smoking in the home would have higher scores for lung cancer worry, perceived risk, and synergistic risk.
. DESIGN Cross-sectional baseline survey.
. SETTING Participants recruited from an outpatient clinic and pharmacy at University of Kentucky HealthCare, an academic medical center.
. SAMPLE 515 homeowners from a larger randomized, controlled trial aimed at reducing exposure to radon and secondhand smoke (SHS).
. METHODS Homeowners were selected via quota sampling so that about half would have a smoker or smokers in the home.
. MAIN RESEARCH VARIABLES Lung cancer worry and perceived risk; perception of synergistic risk of radon and SHS exposure; demographics.
. FINDINGS Participants with smoking in the home had higher rates of lung cancer worry and perceived risk. In addition, those with less education and a family history of lung cancer and who were current smokers had higher lung cancer worry and perceived lung cancer risk scores. Predictors of perception of synergistic risk were marital status and health-related self-concept.
. CONCLUSIONS Homeowners with smoking in the home, less education, and a family history of lung cancer had greater lung cancer worry and perceived lung cancer risk. Lung cancer risk reduction interventions with vulnerable populations are needed.
. IMPLICATIONS FOR NURSING Nurses are in a unique position to target high-risk populations and identify opportunities to create teachable moments to reduce environmental risks of radon and tobacco smoke exposure.
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Glowacka M, Yardley L, Stone N, Graham CA. Feasibility and Preliminary Effectiveness of the Homework Intervention Strategy (eHIS) Program to Enhance Male Condom Use: Research Protocol. JMIR Res Protoc 2018; 7:e1. [PMID: 29295809 PMCID: PMC5770577 DOI: 10.2196/resprot.7937] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/30/2017] [Accepted: 08/30/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although condoms are effective in reducing the risk of sexually transmitted infections (STIs) and unintended pregnancy, they are still often not used consistently and correctly. Negative impact on sensation and pleasure, ruining the mood, causing problems with maintaining erection, and condom slippage or breakage are some of the reasons given by men explaining why they do not want to use condoms. Although many interventions promoting condom use exist, some of them delivered online are complex and time- and resource-intensive. The Homework Intervention Strategy (eHIS) program, adapted from the existing face-to-face Kinsey Institute Homework Intervention Strategy (KIHIS) program, aims to address these issues by encouraging men to focus on sensation and pleasure when trying different types of condoms and lubricants in a low-pressure situation (on their own, without a partner present). OBJECTIVE The objectives of this study are to assess the feasibility, acceptability, and users' engagement with the eHIS program, its preliminary effectiveness in increasing condom use frequency and consistency, as well as the feasibility of the program's evaluation approach, including choice of measures and participant recruitment and retaining strategies (primary outcomes). Secondary outcomes include condom use experience, condom use attitudes, condom use self-efficacy, condom use errors and problems, and condom fit-and-feel. All of these will be analyzed in the context of participants' demographics, sexual history, and previous condom use. METHODS The study has a pre-post-test, within-subjects design. Men aged 18 to 69 and living in the United Kingdom are recruited through posters, leaflets, social media, and emails. Study participants are asked to complete T1 (baseline) measures before entering the eHIS website. After completing the T1 measures, they can order a free condoms and lubricants kit and have access to the eHIS website for 4 weeks. During that time they are asked to practice using different types of condoms and lubricants on their own in a no-pressure situation. Following T1, participants are asked to complete the T2 and T3 measures at 4 and 10 weeks, respectively. RESULTS Data collection for the study is completed. Data analysis is in progress and is expected to be completed by February 2018. CONCLUSIONS This brief, home-based, self-guided program may lead to increased consistent and correct condom use. Online delivery can make the program an easily accessible and low-cost health promotion intervention, which has the potential to reach a wide and diverse audience. If results of the current study show the program's feasibility and preliminary effectiveness in changing condom use related outcomes, a larger scale randomized controlled trial (RCT) will be conducted. TRIAL REGISTRATION Research Registry: researchregistry2325; http://www.researchregistry.com/browse-the-registry.html# home/registrationdetails/58da6cad1d7ab0314337d076/ (Archived by WebCite at http://www.webcitation.org/6vXs6S9XW).
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Affiliation(s)
- Marta Glowacka
- Department of Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom
| | - Lucy Yardley
- Department of Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom
| | - Nicole Stone
- Department of Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom
| | - Cynthia A Graham
- Department of Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom
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Frates EP, Xiao RC, Sannidhi D, McBride Y, McCargo T, Stern TA. A Web-Based Lifestyle Medicine Curriculum: Facilitating Education About Lifestyle Medicine, Behavioral Change, and Health Care Outcomes. JMIR Med Educ 2017; 3:e14. [PMID: 28893726 PMCID: PMC5613210 DOI: 10.2196/mededu.7587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/21/2017] [Accepted: 07/22/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Lifestyle medicine is the science and application of healthy lifestyles as interventions for the prevention and treatment of disease, and has gained significant momentum as a specialty in recent years. College is a critical time for maintenance and acquisition of healthy habits. Longer-term, more intensive web-based and in-person lifestyle medicine interventions can have a positive effect. Students who are exposed to components of lifestyle medicine in their education have improvements in their health behaviors. A semester-long undergraduate course focused on lifestyle medicine can be a useful intervention to help adopt and sustain healthy habits. OBJECTIVE To describe a novel, evidence based curriculum for a course teaching the concepts of Lifestyle Medicine based on a web-based course offered at the Harvard Extension School. METHODS The course was delivered in a web-based format. The Lifestyle Medicine course used evidence based principles to guide students toward a "coach approach" to behavior change, increasing their self-efficacy regarding various lifestyle-related preventive behaviors. Students are made to understand the cultural trends and national guidelines that have shaped lifestyle medicine recommendations relating to behaviors. They are encouraged to engage in behavior change. Course topics include physical activity, nutrition, addiction, sleep, stress, and lifestyle coaching and counseling. The course addressed all of the American College of Preventive Medicine/American College of Lifestyle Medicine competencies save for the competency of office systems and technologies to support lifestyle medicine counseling. RESULTS The course was well-received, earning a ranking of 4.9/5 at the school. CONCLUSIONS A novel, semester-long course on Lifestyle Medicine at the Harvard Extension School is described. Student evaluations suggest the course was well-received. Further research is needed to evaluate whether such a course empowers students to adopt behavior changes.
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Affiliation(s)
- Elizabeth Pegg Frates
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States
- Harvard Medical School, Harvard University, Boston, MA, United States
| | - Ryan C Xiao
- Harvard Medical School, Harvard University, Boston, MA, United States
| | - Deepa Sannidhi
- Division of Family Medicine, Department of Family and Preventative Medicine, University of California San Diego, La Jolla, CA, United States
| | - Yasamina McBride
- Harvard Extension School, Harvard University, Cambridge, MA, United States
| | - Tracie McCargo
- Harvard Extension School, Harvard University, Cambridge, MA, United States
| | - Theodore A Stern
- Harvard Medical School, Harvard University, Boston, MA, United States
- Massachusetts General Hospital, Boston, MA, United States
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Hespanhol LC, van Mechelen W, Verhagen E. Effectiveness of online tailored advice to prevent running-related injuries and promote preventive behaviour in Dutch trail runners: a pragmatic randomised controlled trial. Br J Sports Med 2017; 52:851-858. [PMID: 28855183 DOI: 10.1136/bjsports-2016-097025] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Trail running is popular worldwide, but there is no preventive intervention for running-related injury (RRI). AIM To evaluate the effectiveness of adding online tailored advice (TrailS6 ) to general advice on (1) the prevention of RRIs and (2) the determinants and actual preventive behaviour in Dutch trail runners. METHODS Two-arm randomised controlled trial over 6 months. 232 trail runners were randomly assigned to an intervention or control group. All participants received online general advice on RRI prevention 1 week after baseline. Every 2 weeks, participants in the intervention group received specific advice tailored to their RRI status. The control group received no further intervention. Bayesian mixed models were used to analyse the data. RESULTS Trail runners in the intervention group sustained 13% fewer RRIs compared with those in the control group after 6 months of follow-up (absolute risk difference -13.1%, 95% Bayesian highest posterior credible interval (95% BCI) -23.3 to -3.1). A preventive benefit was observed in one out of eight trail runners who had received the online tailored advice for 6 months (number needed to treat 8, 95% BCI 3 to 22). No significant between-group difference was observed on the determinants and actual preventive behaviours. CONCLUSIONS Online tailored advice prevented RRIs among Dutch trail runners. Therefore, online tailored advice may be used as a preventive component in multicomponent RRI prevention programmes. No effect was observed on determinants and actual preventive behaviours. TRIAL REGISTRATION NUMBER The Netherlands National Trial Register (NTR5431).
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Affiliation(s)
- Luiz Carlos Hespanhol
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Department of Physiotherapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Willem van Mechelen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Faculty of Health and Behavioural Sciences, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Australian Centre for Research into Injury in Sport and Its Prevention, Federation University Australia, Ballarat, Victoria, Australia
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Sanders SA, Crosby RA, Milhausen RR, Graham CA, Tirmizi A, Yarber WL, Beauchamps L, Mena L. Women's willingness to experiment with condoms and lubricants: A study of women residing in a high HIV seroprevalence area. Int J STD AIDS 2017; 29:367-374. [PMID: 28828904 DOI: 10.1177/0956462417727690] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 11/16/2022]
Abstract
The objective of this study was to investigate women's willingness to experiment with new condoms and lubricants, in order to inform condom promotion in a city with high rates of poverty and HIV. One hundred and seventy-three women (85.9% Black) sexually transmitted infection clinic attendees in Jackson, Mississippi, United States completed a questionnaire assessing willingness to experiment with condoms and lubricants and sexual pleasure and lubrication in relation to last condom use. Most women were willing to: (1) experiment with new types of condoms and lubricants to increase their sexual pleasure, (2) touch/handle these products in the absence of a partner, and (3) suggest experimenting with new condoms and lubricants to a sex partner. Previous positive sexual experiences with lubricant during condom use predicted willingness. The role women may play in male condom use should not be underestimated. Clinicians may benefit women by encouraging them to try new types of condoms and lubricants to find products consistent with sexual pleasure.
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Affiliation(s)
- Stephanie A Sanders
- 1 Department of Gender Studies, 1771 Indiana University, Bloomington , IN, USA.,2 The Kinsey Institute, 1771 Indiana University, Bloomington , IN, USA
| | - Richard A Crosby
- 2 The Kinsey Institute, 1771 Indiana University, Bloomington , IN, USA.,3 College of Public Health at the University of Kentucky, Lexington, KY, USA.,4 21693 University of Mississippi Medical Center , Jackson, MS, USA
| | - Robin R Milhausen
- 2 The Kinsey Institute, 1771 Indiana University, Bloomington , IN, USA.,5 Department of Family Relations and Applied Nutrition, 3653 University of Guelph , Guelph, Canada
| | - Cynthia A Graham
- 2 The Kinsey Institute, 1771 Indiana University, Bloomington , IN, USA.,6 Department of Psychology, Southampton University, Southampton, UK
| | - Amir Tirmizi
- 4 21693 University of Mississippi Medical Center , Jackson, MS, USA
| | - William L Yarber
- 2 The Kinsey Institute, 1771 Indiana University, Bloomington , IN, USA.,7 Department of Applied Health Science, 1771 Indiana University, Bloomington , IN, USA
| | - Laura Beauchamps
- 4 21693 University of Mississippi Medical Center , Jackson, MS, USA
| | - Leandro Mena
- 4 21693 University of Mississippi Medical Center , Jackson, MS, USA
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Sharma A, Sullivan SP, Stephenson RB. Detailed Knowledge About HIV Epidemiology and Transmission Dynamics and Their Associations With Preventive and Risk Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in the United States. JMIR Public Health Surveill 2017; 3:e11. [PMID: 28264795 PMCID: PMC5359415 DOI: 10.2196/publichealth.7255] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 02/06/2017] [Accepted: 02/08/2017] [Indexed: 11/13/2022] Open
Abstract
Background Gay, bisexual, and other men who have sex with men (GBMSM) in the United States remain disproportionately affected by human immunodeficiency virus (HIV). Yet their testing frequency is suboptimal and condomless anal sex (CAS) is increasing. Behavioral theories posit that information about HIV is a pivotal construct in individual risk reduction. However, measurements of knowledge have traditionally focused on ever hearing about HIV and being aware of the most common routes of spread. Objective Using a national Web-based sample of sexually active GBMSM, we sought to (1) quantify levels of detailed knowledge about HIV epidemiology and transmission dynamics, (2) describe variations in detailed knowledge levels across demographic strata, and (3) evaluate potential associations of increasing levels of detailed knowledge with HIV testing in the past year and engaging in CAS with a male partner in the past 3 months. Methods GBMSM were recruited through a social networking website (Facebook) from August to September 2015 and asked 17 knowledge-based questions pertaining to the following 2 domains using a Web-based survey: HIV epidemiology (9 questions including statistics on incidence, prevalence, and distribution) and HIV transmission dynamics (8 questions including modes of spread and per-act transmission probabilities). Ordinal domain-specific indices of detailed knowledge were created for each respondent by summing their number of correct responses. Separate cumulative logit models were used to identify factors independently associated with each index, and multivariable logistic regression models were used to characterize associations with HIV testing history and recently engaging in CAS. Results Of the 1064 participants in our study, only half (49.62%, 528/1064) had been tested for HIV in the past year, and almost half (47.84%, 509/1064) had engaged in CAS with a male partner in the past 3 months. Majority scored 3 of 9 epidemiology questions correct (26.88%, 286/1064) and 5 of 8 transmission dynamics questions correct (25.00%, 266/1064). Participants younger than 35 years, of non-Hispanic non-white or Hispanic race and ethnicity, with lower educational levels, and who reported a sexual orientation other than homosexual or gay were significantly less knowledgeable about HIV transmission dynamics. Increasing levels of knowledge about this domain were independently associated with testing in the past year (adjusted odds ratio for each additional correct response: 1.10, 95% CI 1.01-1.20) but not with recent CAS. Increasing knowledge about HIV epidemiology was not associated with either outcome. Conclusions Increasing detailed knowledge about HIV epidemiology might not be as important as educating sexually active GBMSM regarding transmission dynamics. Researchers and practitioners designing prevention messages targeting GBMSM should bear in mind that not all knowledge is equal and that some aspects might have a greater positive impact than others. Future research to identify influential content and contemporary modes of delivery is needed.
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Affiliation(s)
- Akshay Sharma
- Center for Sexuality and Health Disparities, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Stephen P Sullivan
- Center for Sexuality and Health Disparities, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Rob B Stephenson
- Center for Sexuality and Health Disparities, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, United States
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