WorldWideScience

Sample records for california health interview

  1. 76 FR 2398 - Submission for OMB Review; Comment Request; California Health Interview Survey Cancer Control...

    Science.gov (United States)

    2011-01-13

    ..., and human papillomavirus. Additionally, CHIS is designed to be comparable to the National Health... HUMAN SERVICES National Institutes of Health Submission for OMB Review; Comment Request; California Health Interview Survey Cancer Control Module (CHIS-CCM) 2011 (NCI) SUMMARY: Under the provisions of...

  2. 75 FR 69681 - Proposed Collection; Comment Request; California Health Interview Survey Cancer Control Module...

    Science.gov (United States)

    2010-11-15

    ..., diet, physical activity, obesity, and human papillomavirus. Additionally, CHIS is designed to be...] [FR Doc No: 2010-28648] DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; Comment Request; California Health Interview Survey Cancer Control Module (CHIS-CCM) 2011 (NCI...

  3. The Fruit & Vegetable Screener in the 2000 California Health Interview Survey: Definition of Acceptable Dietary Data Values

    Science.gov (United States)

    Data collected on the California Health Interview Survey (CHIS) Fruit and Vegetable Screener are coded as frequency and time unit - times per day, week, or month. The data contain some values that are very unlikely.

  4. The Fruit & Vegetable Screener in the 2000 California Health Interview Survey: Uses of Screener Estimates in CHIS

    Science.gov (United States)

    Dietary intake estimates from the California Health Interview Survey (CHIS) Fruit and Vegetable Screener are rough estimates of usual intake of fruits and vegetables. They are not as accurate as more detailed methods.

  5. Sociodemographic Correlates of Dietary Practices among Asian-Americans: Results from the California Health Interview Survey.

    Science.gov (United States)

    Sarwar, Evangel; Arias, Devin; Becerra, Benjamin J; Becerra, Monideepa Bhattacharya

    2015-12-01

    Studies show that Asian-American subgroups do not always meet dietary recommendations and are at high risk of cardiovascular diseases. The purpose of our research is to illustrate the various sociodemographic correlates of dietary habits for six subgroups of Asian-Americans in California. The 2005 California Health Interview Survey (CHIS) was utilized. A total of 3772 Asian-Americans were included in this study, with the largest subgroup being Chinese (n = 1280; N = 913,798). The outcome variable for this study was dietary behavior defined as consuming five or more fruits and vegetables per day (5-a-day), provided by CHIS. Univariate and multivariable regression analyses were conducted accounting for complex survey design. Being a female (Chinese, Filipina, Korean, and Vietnamese), not being married (Chinese), not being a college graduate (Chinese), living in poverty (South Asian), and speaking only English language at home (Chinese and Japanese) were associated with higher odds of not meeting a 5-a-day requirement. Results highlighted several sociodemographic correlates to not meeting 5-a-day requirement among six Asian-American subgroups. Targeted health promotion measures for such at-risk groups should be implemented to improve dietary practices.

  6. Age Differences in the Trends of Smoking Among California Adults: Results from the California Health Interview Survey 2001-2012.

    Science.gov (United States)

    Pan, Yue; Wang, Weize; Wang, Ke-Sheng; Moore, Kevin; Dunn, Erin; Huang, Shi; Feaster, Daniel J

    2015-12-01

    The aim is to study the trends of cigarette smoking from 2001 to 2012 using a California representative sample in the US. Data was taken from the California Health Interview Survey (CHIS) from 2001 to 2012, which is a population-based, biennial, random digit-dial telephone survey of the non-institutionalized population. The CHIS is the largest telephone survey in California and the largest state health survey in the US. 282,931 adults (n = 184,454 with age 18-60 and n = 98,477 with age >60) were included in the analysis. Data were weighted to be representative and adjusted for potential covariance and non-response biases. During 2001-2012, the prevalence of current smoking decreased from 18.86 to 15.4 % among adults age 18-60 (β = -0.8, p = 0.0041). As for adults age >60, the prevalence of current smoking trend decreased with variations, started from 9.66 % in 2001, slightly increased to 9.74 % in 2003, but then gradually decreased, falling to 8.18 % in 2012. In 2012, there was a 14 % reduction of daily smoking adults age 18-60 (OR 0.84, 95 % CI 0.76-0.93, p = 0.0006) compared to 2001, while no significant reduction of daily smoking was observed for those age >60. The reductions of smoking prevalence for adults younger than 60 are encouraging. However, there is a concern for smoking cessation rates among those older than 60 years of age, particularly for African Americans.

  7. Mental Illness Is Not Associated with Adherence to Colorectal Cancer Screening: Results from the California Health Interview Survey.

    Science.gov (United States)

    Siantz, Elizabeth; Wu, Brian; Shiroishi, Mark; Vora, Hita; Idos, Gregory

    2017-01-01

    Colorectal cancer is the second leading cause of cancer-specific death in the USA. Evidence suggests people with mental illness are less likely to receive preventive health services, including cancer screening. We hypothesized that mental illness is a risk factor for non-adherence to colorectal cancer-screening guidelines. We analyzed results of the 2007 California Health Interview Survey to test whether mental illness is a risk factor for non-adherence to colorectal cancer-screening recommendations among individuals age 50 or older (N = 15,535). This cross-sectional dataset is representative of California. Screening was defined as either fecal occult blood testing during the preceding year, sigmoidoscopy, or colonoscopy during the preceding 5 years. Mental illness was identified using the Kessler K6 screening tool. Associations were evaluated using weighted multivariate logistic regressions. Mental illness was not associated with colorectal cancer-screening adherence (OR 0.89; 95% CI 0.63-1.25). Risk factors for non-adherence included being female (OR 1.25; 95% CI 1.09-1.44), delaying accessing health care during the previous year (OR 1.89; 95% CI 1.56-2.29). Unlike previous studies, this study did not find a relationship between mental illness and colorectal cancer-screening adherence. This could be due to differences in study populations. State-specific healthcare policies involving care coordination for individuals with mental illness could also influence colorectal cancer-screening adherence in California.

  8. Same-sex legal marriage and psychological well-being: findings from the California Health Interview Survey.

    Science.gov (United States)

    Wight, Richard G; Leblanc, Allen J; Lee Badgett, M V

    2013-02-01

    We examined whether same-sex marriage was associated with nonspecific psychological distress among self-identified lesbian, gay, and bisexual adults, and whether it had the potential to offset mental health disparities between lesbian, gay, and bisexual persons and heterosexuals. Population-based data (weighted) were from the 2009 adult (aged 18-70 years) California Health Interview Survey. Within-group analysis of lesbian, gay, and bisexual persons included 1166 individuals (weighted proportion = 3.15%); within-group heterosexual analysis included 35 608 individuals (weighted proportion = 96.58%); and pooled analysis of lesbian, gay, and bisexual persons and heterosexuals included 36 774 individuals. Same-sex married lesbian, gay, and bisexual persons were significantly less distressed than lesbian, gay, and bisexual persons not in a legally recognized relationship; married heterosexuals were significantly less distressed than nonmarried heterosexuals. In adjusted pairwise comparisons, married heterosexuals had the lowest psychological distress, and lesbian, gay, and bisexual persons who were not in legalized relationships had the highest psychological distress (P same-sex married lesbian, gay, and bisexual persons, lesbian, gay, and bisexual persons in registered domestic partnerships, and heterosexuals. Being in a legally recognized same-sex relationship, marriage in particular, appeared to diminish mental health differentials between heterosexuals and lesbian, gay, and bisexual persons. Researchers must continue to examine potential health benefits of same-sex marriage, which is at least in part a public health issue.

  9. Obesogenic Dietary Practices of Latino and Asian Subgroups of Children in California: An Analysis of the California Health Interview Survey, 2007-2012.

    Science.gov (United States)

    Guerrero, Alma D; Ponce, Ninez A; Chung, Paul J

    2015-08-01

    We examined obesogenic dietary practices among Latino and Asian subgroups of children living in California. We analyzed 2007, 2009, and 2011-2012 California Health Interview Survey data to examine the differences in dietary practices among Mexican and non-Mexican Latino children and 7 ethnic subgroups of Asian children. We used multivariable regression to examine the sociodemographic factors associated with specific dietary practices. Latino subgroups of children had few differences in obesogenic dietary practices, whereas Asian subgroups of children exhibited significant differences in several obesogenic dietary practices. Korean and Filipino children were more likely than Chinese children to consume fast food and have low vegetable intake. Filipino children, followed by Japanese children, had the most obesogenic dietary practices compared with Chinese children, who along with South Asian children appeared to have the least obesogenic dietary practices. In general, income, education, and acculturation did not explain the dietary differences among Asian groups. Our findings suggest the need to disaggregate dietary profiles of Asian and Latino children and to consider nontraditional sociodemographic factors for messaging and counseling on healthy dietary practices among Asian populations.

  10. Association between Acculturation and Binge Drinking among Asian-Americans: Results from the California Health Interview Survey

    Directory of Open Access Journals (Sweden)

    Monideepa B. Becerra

    2013-01-01

    Full Text Available Objective. Evaluate the association between acculturation and binge drinking among six Asian-American subgroups. Methods. A cross-sectional analysis of public access adult portion of 2007, 2009, and 2011/2012 California Health Interview Survey data was conducted. Univariate and multivariable logistic regression analyses were utilized with any binge drinking in the past year as the outcome variable and language spoken at home and time in USA as proxy measures of acculturation. Results. A total of 1,631 Asian-Americans (N=665,195 were identified as binge drinkers. Binge drinking was positively associated with being first generation South Asian (OR=3.05, 95% CI=1.55, 5.98 and monolingual (English only Vietnamese (OR=3.00; 95% CI=1.58, 5.70, especially among females. Other factors associated with increased binge drinking were being female (Chinese only, not being current married (South Asian only, and being an ever smoker (all subgroups except South Asians. Conclusion. First generation South Asians and linguistically acculturated Vietnamese, especially females, are at an increased risk of binge drinking. Future studies and preventive measures should address the cultural basis of such health risk behaviors among Asian-American adults.

  11. National Health Interview Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian noninstitutionalized population of the United States...

  12. Help-seeking behaviors for serious psychological distress among individuals with diabetes mellitus: The California Health Interview Survey, 2011-2012.

    Science.gov (United States)

    Shin, Jinah K; Poltavskiy, Eduard; Kim, Tae Nyun; Hasan, Abdullah; Bang, Heejung

    2017-02-01

    To investigate patterns of and factors associated with help-seeking behaviors among individuals with diabetes mellitus (DM) and/or serious psychological distress (SPD). The analysis was conducted with the California Health Interview Survey (CHIS) 2011-2012 of 40,803 adults. Logistic regression was used to examine the associations between the multiple facilitating/preventing factors and outcome, guided by the Andersen's Health Care Utilization Model. The prevalence of DM and SPD were 10.9% and 3.4%, respectively, among participants in the survey. The participants with DM were more likely to experience SPD than those without DM (OR 1.46, 95% CI=1.11-1.91, p=0.006). Participants with combined DM and SPD, the most underserved, were less likely to perceive the need for mental health services and less likely to seek help, compared to those with only SPD. Need factors (SPD status and perceived need) were significantly associated with help-seeking behaviors for mental health, along with predisposing factors (age, gender, obesity, race, and employment), and enabling factors (insurance, English proficiency). Perceptions about need for seeking help seem to play an important role in receiving mental health services in addition to other predisposing or enabling factors. Identification of these factors may improve clinical outcomes related to DM and SPD. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  13. Household food insecurity as a determinant of overweight and obesity among low-income Hispanic subgroups: Data from the 2011-2012 California Health Interview Survey.

    Science.gov (United States)

    Smith, Teresa M; Colón-Ramos, Uriyoán; Pinard, Courtney A; Yaroch, Amy L

    2016-02-01

    An estimated 78% of Hispanics in the United States (US) are overweight or obese. Household food insecurity, a condition of limited or uncertain access to adequate food, has been associated with obesity rates among Hispanic adults in the US. However, the Hispanic group is multi-ethnic and therefore associations between obesity and food insecurity may not be constant across Hispanic country of origin subgroups. This study sought to determine if the association between obesity and food insecurity among Hispanics is modified by Hispanic ancestry across low-income (≤200% of poverty level) adults living in California. Data are from the cross-sectional 2011-12 California Health Interview Survey (n = 5498). Rates of overweight or obesity (BMI ≥ 25), Calfresh receipt (California's Supplemental Nutrition Assistance Program), and acculturation were examined for differences across subgroups. Weighted multiple logistic regressions examined if household food insecurity was significantly associated with overweight or obesity and modified by country of origin after controlling for age, education, marital status, country of birth (US vs. outside of US), language spoken at home, and Calfresh receipt (P obesity, food security, Calfresh receipt, country of birth, and language spoken at home. Results from the adjusted logistic regression models found that food insecurity was significantly associated with overweight or obesity among Mexican-American women (β (SE) = 0.22 (0.09), p = .014), but not Mexican-American men or Non-Mexican groups, suggesting Hispanic subgroups behave differently in their association between food insecurity and obesity. By highlighting these factors, we can promote targeted obesity prevention interventions, which may contribute to more effective behavior change and reduced chronic disease risk in this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Positive Health Psychology: An Interview with Shelley Taylor.

    Science.gov (United States)

    Rich, Grant Jewell

    2000-01-01

    Presents an interview with Shelley Taylor, a professor of Psychology at the University of California in Los Angles (California). Addresses topics such as how she became interested in psychology, the importance of health psychology in the curriculum, the ideal training for students in health psychology, and her work with "positive illusions." (CMK)

  15. Online Health Information-Seeking Behavior and Confidence in Filling Out Online Forms Among Latinos: A Cross-Sectional Analysis of the California Health Interview Survey, 2011-2012.

    Science.gov (United States)

    Gonzalez, Mariaelena; Sanders-Jackson, Ashley; Emory, Jason

    2016-07-04

    Health information is increasingly being disseminated online, but there is a knowledge gap between Latinos and non-Hispanic whites, particularly those whose English language proficiency is poor, in terms both of online health information-seeking behavior and computer literacy skills. This knowledge gap may also exist between US- and foreign-born Latinos. The specific aim of this study was to examine Internet use, online health information-seeking behavior, and confidence in filling out online forms among Latinos, particularly as it relates to health-risk behaviors. We then stratified our sample by nativity. We used the adult population file of the 2011-2012 California Health Interview Survey, analyzing Internet use, online health information-seeking behavior, and confidence in filling out online forms using binary logistic regression among Latinos and whites (N=27,289), Latinos (n=9506), and Latinos who use the Internet (n=6037). Foreign-born Latinos (OR 0.71, 95% CI 0.58-0.88, P=.002) have lower odds of engaging in online health information-seeking behavior, and higher odds (OR 2.90, 95% CI 2.07-4.06, Ponline forms compared to US-born Latinos. Correlates of online health information-seeking behavior and form confidence varied by nativity. Latinos, particularly foreign-born individuals, are at an increased risk of being left behind as the move to increase online content delivery and care expands. As online health information dissemination and online health portals become more popular, the impact of these sites on Latino gaps in coverage and care should be considered.

  16. Medicinal Cannabis in California: An Interview with Igor Grant, MD.

    Science.gov (United States)

    Piomelli, Daniele; Grant, Igor

    2016-01-01

    Dr. Igor Grant, MD, is distinguished professor and chair of psychiatry and director of the HIV Neurobehavioral Research Program and the Center for Medicinal Cannabis Research at the University of California, San Diego. Dr. Grant is a neuropsychiatrist who graduated from the University of British Columbia School of Medicine (1966), and received specialty training in psychiatry at the University of Pennsylvania (1967-1971), and additional training in neurology at the Institute of Neurology (1980-1981), London, U.K. Dr. Grant's academic interests focus on the effects of various diseases on brain and behavior, with an emphasis on translational studies in HIV, and drugs of abuse. He has contributed to ∼700 scholarly publications and is principal investigator of several NIH studies, including an NIDA P50 (Translational Methamphetamine AIDS Research Center-TMARC), and is codirector of the HIV Neurobehavioral Research Center (HNRC).

  17. Reliability of Multiple Mini-Interviews and traditional interviews within and between institutions: a study of five California medical schools

    Directory of Open Access Journals (Sweden)

    Anthony Jerant

    2017-11-01

    Full Text Available Abstract Background Many medical schools use admissions Multiple Mini-Interviews (MMIs rather than traditional interviews (TIs, partly because MMIs are thought to be more reliable. Yet prior studies examined single-school samples of candidates completing either an MMI or TI (not both. Using data from five California public medical schools, the authors examined the within- and between-school reliabilities of TIs and MMIs. Methods The analyses included applicants interviewing at ≥1 of the five schools during 2011–2013. Three schools employed TIs (TI1, TI2, TI3 and two employed MMIs (MMI1, MMI2. Mixed linear models accounting for nesting of observations within applicants examined standardized TI and MMI scores (mean = 0, SD = 1, adjusting for applicant socio-demographics, academic metrics, year, number of interviews, and interview date. Results A total of 4993 individuals (completing 7516 interviews [TI = 4137, MMI = 3379] interviewed at ≥1 school; 428 (14.5% interviewed at both MMI schools and 687 (20.2% at more than one TI school. Within schools, inter-interviewer consistency was generally qualitatively lower for TI1, TI2, and TI3 (Pearson’s r 0.07, 0.13, and 0.29, and Cronbach’s α, 0.40, 0.44, and 0.61, respectively than for MMI1 and MMI 2 (Cronbach’s α 0.68 and 0.60, respectively. Between schools, the adjusted intraclass correlation coefficient was 0.27 (95% CI 0.20–0.35 for TIs and 0.47 (95% CI 0.41–0.54 for MMIs. Conclusions Within and between-school reliability was qualitatively higher for MMIs than for TIs. Nonetheless, TI reliabilities were higher than anticipated from prior literature, suggesting TIs may not need to be abandoned on reliability grounds if other factors favor their use.

  18. Reliability of Multiple Mini-Interviews and traditional interviews within and between institutions: a study of five California medical schools.

    Science.gov (United States)

    Jerant, Anthony; Henderson, Mark C; Griffin, Erin; Rainwater, Julie A; Hall, Theodore R; Kelly, Carolyn J; Peterson, Ellena M; Wofsy, David; Franks, Peter

    2017-11-06

    Many medical schools use admissions Multiple Mini-Interviews (MMIs) rather than traditional interviews (TIs), partly because MMIs are thought to be more reliable. Yet prior studies examined single-school samples of candidates completing either an MMI or TI (not both). Using data from five California public medical schools, the authors examined the within- and between-school reliabilities of TIs and MMIs. The analyses included applicants interviewing at ≥1 of the five schools during 2011-2013. Three schools employed TIs (TI1, TI2, TI3) and two employed MMIs (MMI1, MMI2). Mixed linear models accounting for nesting of observations within applicants examined standardized TI and MMI scores (mean = 0, SD = 1), adjusting for applicant socio-demographics, academic metrics, year, number of interviews, and interview date. A total of 4993 individuals (completing 7516 interviews [TI = 4137, MMI = 3379]) interviewed at ≥1 school; 428 (14.5%) interviewed at both MMI schools and 687 (20.2%) at more than one TI school. Within schools, inter-interviewer consistency was generally qualitatively lower for TI1, TI2, and TI3 (Pearson's r 0.07, 0.13, and 0.29, and Cronbach's α, 0.40, 0.44, and 0.61, respectively) than for MMI1 and MMI 2 (Cronbach's α 0.68 and 0.60, respectively). Between schools, the adjusted intraclass correlation coefficient was 0.27 (95% CI 0.20-0.35) for TIs and 0.47 (95% CI 0.41-0.54) for MMIs. Within and between-school reliability was qualitatively higher for MMIs than for TIs. Nonetheless, TI reliabilities were higher than anticipated from prior literature, suggesting TIs may not need to be abandoned on reliability grounds if other factors favor their use.

  19. National Health Interview Survey (NHIS) - National Cardiovascular Disease Surveillance Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2001 forward. The National Health Interview Survey (NHIS) has monitored the health of the nation since 1957. NHIS data on a broad range of health topics are...

  20. Dental health literacy and California's clarion call.

    Science.gov (United States)

    Centore, Linda

    2012-04-01

    Demographic changes in California require a multicultural paradigm shift in oral health care. The shift encompasses attention to health literacy in all forms of communication: signage, oral and written communication, consent forms, postop instructions, and patient education materials. California dentists may find it necessary to adapt their practices to reflect community demographics and health literacy needs. This article provides a toolbox of recommendations to address these needs.

  1. Motivational interviewing: a useful approach to improving cardiovascular health?

    Science.gov (United States)

    Thompson, David R; Chair, Sek Y; Chan, Sally W; Astin, Felicity; Davidson, Patricia M; Ski, Chantal F

    2011-05-01

    To review and synthesise, systematically, the research findings regarding motivational interviewing and to inform education, research and practice in relation to cardiovascular health. Motivational interviewing is designed to engage ambivalent or resistant clients in the process of health behaviour change, and it has been widely used in different clinical conditions such as substance abuse, dietary adherence and smoking cessation. Motivational interviewing has also been proposed as a method for improving modifiable coronary heart disease risk factors of patients. Systematic review. Eligible studies published in 1999-2009 were identified from the following databases: CINAHL, Medline, PsycINFO, Cochrane Library, EBSCO, Web of Science, Embase and British Nursing Index. A manual search was conducted of bibliographies of the identified studies and relevant journals. Two researchers independently reviewed the studies. Four meta-analyses, one systematic review and three literature reviews of motivational interviewing and five primary studies of motivational interviewing pertaining to cardiovascular health were identified. Despite a dearth of primary studies in cardiovascular health settings, there appears to be strong evidence that motivational interviewing is an effective approach focusing on eliciting the person's intrinsic motivation for change of behaviour. Motivational interviewing is an effective approach to changing behaviour. It offers promise in improving cardiovascular health status. This review indicates that motivational interviewing is a useful method to help nurses improve health behaviour in people with coronary risk factors. © 2011 Blackwell Publishing Ltd.

  2. Interview

    DEFF Research Database (Denmark)

    Kvale, Steinar; Brinkmann, Svend

    Interviewet spiller en afgørende rolle i en stor del kvalitativ forskning. Men det er samtidig en kompleks disciplin, der rummer mange faldgruber og kræver fintfølende analytiske kompetencer. I denne bog giver Steinar Kvale og Svend Brinkmann en introduktion til de teoretiske og praktiske aspekte...... disciplin gennem en præsentation af dets syv stadier, hvor forfatterne klæder læseren fagligt på til at planlægge og foretage interviews....

  3. Investing in Alternative Fuel Infrastructure: Insights for California from Stakeholder Interviews: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Melaina, Marc; Muratori, Matteo; McLaren, Joyce; Schwabe, Paul

    2017-03-13

    Increased interest in the use of alternative transportation fuels, such as natural gas, hydrogen, and electricity, is being driven by heightened concern about the climate impacts of gasoline and diesel emissions and our dependence on finite oil resources. A key barrier to widespread adoption of low- and zero-emission passenger vehicles is the availability of refueling infrastructure. Recalling the 'chicken and egg' conundrum, limited adoption of alternative fuel vehicles increases the perceived risk of investments in refueling infrastructure, while lack of refueling infrastructure inhibits vehicle adoption. In this paper, we present the results of a study of the perceived risks and barriers to investment in alternative fuels infrastructure, based on interviews with industry experts and stakeholders. We cover barriers to infrastructure development for three alternative fuels for passenger vehicles: compressed natural gas, hydrogen, and electricity. As an early-mover in zero emission passenger vehicles, California provides the early market experience necessary to map the alternative fuel infrastructure business space. Results and insights identified in this study can be used to inform investment decisions, formulate incentive programs, and guide deployment plans for alternative fueling infrastructure in the U.S. and elsewhere.

  4. Distance interviews in the field of qualitative health research

    Directory of Open Access Journals (Sweden)

    Camila da Silva Gonçalo

    2013-12-01

    Full Text Available In this study, we aimed to present and discuss the results of a systematic literature review on the use of Distance Interviews (DI in qualitative health research. Searches were conducted in the PubMed and CINAHL databases and 37 references were included. Data were organized according to author, year of publication, journal title, and manuscript objective. The results revealed that the most recurrent theme was the comparison of Distance Interviews with other methods of data collection. Low cost, easier access to respondents, higher participation rates, and recruitment of volunteers were identified as the main benefits offered by DI. Distance Interviews were used for various purposes, from validation of instruments for data collection to diagnosis. We concluded that there is a need to expand on the theme explored in this article, because the incorporation of information and communication technologies in the healthcare field represents a valuable access route in capturing qualitative data.

  5. Issues in mHealth: findings from key informant interviews.

    Science.gov (United States)

    Whittaker, Robyn

    2012-10-02

    mHealth is enjoying considerable interest and private investment in the United States. A small but growing body of evidence indicates some promise in supporting healthy behavior change and self-management of long-term conditions. The unique benefits mobile phones bring to health initiatives, such as direct access to health information regardless of time or location, may create specific issues for the implementation of such initiatives. Other issues may be shared with general health information technology developments. To determine the important issues facing the implementation of mHealth from the perspective of those within the US health system and those working in mHealth in the United States. Semistructured interviews were conducted with 27 key informants from across the health and mHealth sectors in the United States. Interviewees were approached directly following an environmental scan of mHealth in the United States or recommendation by those working in mHealth. The most common issues were privacy and data security, funding, a lack of good examples of the efficacy and cost effectiveness of mHealth in practice, and the need for more high-quality research. The issues are outlined and categorized according to the environment within which they predominantly occur: policy and regulatory environments; the wireless industry; the health system; existing mHealth practice; and research. Many of these issues could be addressed by making the most of the current US health reform environment, developing a strategic and coordinated approach, and seeking to improve mHealth practice.

  6. Effects of Stigma and Discrimination Reduction Trainings Conducted Under the California Mental Health Services Authority: An Evaluation of Disability Rights California and Mental Health America of California Trainings

    OpenAIRE

    Cerully, Jennifer L.; Collins, Rebecca L.; Wong, Eunice C.; Roth, Elizabeth; Marks, Joyce; Yu, Jennifer

    2016-01-01

    Describes the methods and results of a RAND evaluation of stigma and discrimination reduction trainings delivered by two program partners, Disability Rights California and Mental Health America of California.

  7. Investigating internet use by mental health service users: interview study.

    Science.gov (United States)

    Powell, John; Clarke, Aileen

    2007-01-01

    The internet is an increasingly important source of mental health-related information, and has the potential to be harnessed as a tool to support self-care and informed decision-making. Yet little is known about the motivations and attitudes of users. We therefore undertook a qualitative interview study with a purposive sample of mental health service users with internet experience, to explore issues with respect to mental health-related internet use. One of the prime motivations for online mental health seekers was to find experiential information from other people with similar problems. This information allowed users to know they were not alone, and to instill hope that others in the same situation had recovered. Benefits of the internet as an information source included convenience, privacy and anonymity. Problems related more to misuse of the internet rather than concerns over inaccuracy. Such qualitative work is important in an emerging research area to understand internet use better.

  8. Zimbabwean diabetics' beliefs about health and illness: an interview study.

    Science.gov (United States)

    Hjelm, Katarina; Mufunda, Esther

    2010-05-12

    Diabetes mellitus (DM) is increasing globally, with the greatest increase in Africa and Asia. In Zimbabwe a threefold increase was shown in the 1990s. Health-related behaviour is important in maintaining health and is determined by individual beliefs about health and illness but has seen little study. The purpose of the study was to explore beliefs about health and illness that might affect self-care practice and health care seeking behaviour in persons diagnosed with DM, living in Zimbabwe. Exploratory study. Consecutive sample from a diabetes clinic at a central hospital. Semi-structured interviews were held with 21 persons aged 19-65 years. Data were analysed using qualitative content analysis. Health was described as freedom from disease and well-being, and individual factors such as compliance with advice received and drugs were considered important to promote health. A mixture of causes of DM, predominantly individual factors such as heredity, overweight and wrong diet in combination with supernatural factors such as fate, punishment from God and witchcraft were mentioned. Most respondents did not recognize the symptoms of DM when falling ill but related the problems to other diseases, e.g. HIV, malaria etc. Limited knowledge about DM and the body was indicated. Poor economy was mentioned as harmful to health and a consequence of DM because the need to buy expensive drugs, food and attend check-ups. Self-care was used to a limited extent but if used, a combination of individual measures, household remedies or herbs and religious acts such as prayers and holy water were frequently used, and in some cases health care professionals were consulted. Limited knowledge about DM, based on beliefs about health and illness including biomedical and traditional explanations related to the influence of supernatural forces, e.g. fate, God etc., were found, which affected patients' self-care and care-seeking behaviour. Strained economy was stated to be a factor of the

  9. Zimbabwean diabetics' beliefs about health and illness: an interview study

    Directory of Open Access Journals (Sweden)

    Mufunda Esther

    2010-05-01

    Full Text Available Abstract Background Diabetes mellitus (DM is increasing globally, with the greatest increase in Africa and Asia. In Zimbabwe a threefold increase was shown in the 1990s. Health-related behaviour is important in maintaining health and is determined by individual beliefs about health and illness but has seen little study. The purpose of the study was to explore beliefs about health and illness that might affect self-care practice and health care seeking behaviour in persons diagnosed with DM, living in Zimbabwe. Methods Exploratory study. Consecutive sample from a diabetes clinic at a central hospital. Semi-structured interviews were held with 21 persons aged 19-65 years. Data were analysed using qualitative content analysis. Results Health was described as freedom from disease and well-being, and individual factors such as compliance with advice received and drugs were considered important to promote health. A mixture of causes of DM, predominantly individual factors such as heredity, overweight and wrong diet in combination with supernatural factors such as fate, punishment from God and witchcraft were mentioned. Most respondents did not recognize the symptoms of DM when falling ill but related the problems to other diseases, e.g. HIV, malaria etc. Limited knowledge about DM and the body was indicated. Poor economy was mentioned as harmful to health and a consequence of DM because the need to buy expensive drugs, food and attend check-ups. Self-care was used to a limited extent but if used, a combination of individual measures, household remedies or herbs and religious acts such as prayers and holy water were frequently used, and in some cases health care professionals were consulted. Conclusions Limited knowledge about DM, based on beliefs about health and illness including biomedical and traditional explanations related to the influence of supernatural forces, e.g. fate, God etc., were found, which affected patients' self-care and care

  10. Health assessment of toluene in California drinking water

    Energy Technology Data Exchange (ETDEWEB)

    Reed, N.; Reed, W.; Beltran, L.; Li, R.; Encomienda, I.

    1989-03-08

    This report reviews existing literature pertinent to the health risk posed by the use of toluene-contaminated drinking water. Also included in the study is an estimate of the toluene exposure of California residents based on the most recent data on toluene concentrations in California drinking water supplies. The concentration of toluene in drinking water that may cause adverse health effects is delineated.

  11. Disruptive innovation: can health care learn from other industries? A conversation with Clayton M. Christensen. Interview by Mark D. Smith.

    Science.gov (United States)

    Christensen, Clayton M

    2007-01-01

    Clayton Christensen is one of America's most influential business thinkers and writers. A professor at Harvard Business School, Christensen is perhaps best known for his writings on disruptive innovation in such books as The Innovator's Dilemma and The Innovator's Solution. In this interview with the California HealthCare Foundation's Mark Smith, he argues that the answer for more affordable health care will come not from an injection of more funding but, rather, from innovations that aim to make more and more areas of care cheaper, simpler, and more in the hands of patients. Christensen has been an adviser to several new companies in health care.

  12. Herbal use among US elderly: 2002 National Health Interview Survey.

    Science.gov (United States)

    Bruno, Jeffrey J; Ellis, Jeffrey J

    2005-04-01

    Use of herbal products among the elderly is an important concern for healthcare professionals. The presence of polypharmacy and multiple comorbidities places the elderly at high risk for herb-drug and herb-disease interactions. Limited data exist regarding herbal use among the US elderly population. To evaluate the incidence of and attitudes toward herbal use in a nationally representative sample of US elderly patients >/=65 years of age. We performed a descriptive analysis of public domain data collected in the 2002 National Health Interview Survey. Statistical analyses were conducted through use of SUDAAN software with Taylor series linearization for variance estimation. Analysis of weighted data revealed that 12.9% +/- 0.5% (mean +/- SE) of US elderly people had used an herbal supplement within the past 12 months. Use was greatest among individuals 65-69 years of age, females, Hispanic and non-Hispanic ethnic minorities, and respondents with a greater income, higher education level, or more positive self-reported health status. Among elderly people purchasing over-the-counter and prescription drugs, herbal use was 13.9% +/- 0.6% and 12.8% +/- 0.6%, respectively. Glucosamine, echinacea, and garlic supplements represented the most common herbals used. Benefit from combined herbal and conventional therapy was the most common reason cited for use; however, 50.9% +/- 2.2% of users did not discuss herbal therapy with a medical professional. Several theoretical herb-disease interactions were identified. The use of herbal products among the US elderly has risen over the past 5 years, whereas discussion of such use with medical professionals remains suboptimal.

  13. Language of interview, self-rated health, and the other Latino health puzzle.

    Science.gov (United States)

    Viruell-Fuentes, Edna A; Morenoff, Jeffrey D; Williams, David R; House, James S

    2011-07-01

    We investigated whether the conventional Spanish translation of the self-rated health survey question helps explain why Latinos' self-rated health is worse than Whites' despite more objective health measures showing them to be as healthy as or healthier than are Whites. We analyzed the relationship between language of interview and self-rated health in the Chicago Community Adult Health Study (2001-2003) and the 2003 Behavioral Risk Factor Surveillance System. Being interviewed in Spanish was associated with significantly higher odds of rating health as fair or poor in both data sets. Moreover, adjusting for language of interview substantially reduced the gap between Whites and Latinos. Spanish-language interviewees were more likely to rate their health as fair (regular in Spanish) than as any other choice, and this preference was strongest when compared with categories representing better health (good, very good, and excellent). Our findings suggest that translation of the English word "fair" to regular induces Spanish-language respondents to report poorer health than they would in English. Self-rated health should be interpreted with caution, especially in racial/ethnic comparisons, and research should explore alternative translations.

  14. Why Employed Latinos Lack Health Insurance: A Study in California

    Science.gov (United States)

    Greenwald, Howard P.; O'Keefe, Suzanne; DiCamillo, Mark

    2005-01-01

    This article assesses the relative importance of several factors believed to reduce the likelihood of health insurance coverage among working Latinos in California, including cost, immigration history, availability of insurance, beliefs about insurance, and beliefs about health and health care. According to a survey of 1,000 randomly selected…

  15. Sexual and Reproductive Health Behaviors of California Community College Students

    Science.gov (United States)

    Trieu, Sang Leng; Bratton, Sally; Marshak, Helen Hopp

    2011-01-01

    Objective: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was…

  16. Methodological Considerations for Conducting Qualitative Interviews with Youth Receiving Mental Health Services

    Directory of Open Access Journals (Sweden)

    Kathryn K. DeRoche

    2008-08-01

    Full Text Available Use of qualitative interviews with individuals currently receiving mental health services has increased over the last decade in the United States due to the calls for system change that emphasizes individuals' perceptions of their own progress. However, interviews with youth receiving mental health services are rarely encountered. In this article, an overview of methodological considerations when conducting an interview inquiry with youth currently receiving mental health services will be discussed, incorporating suggestions from the published literature and our experiences with previous interview studies. Our theoretical definition of youth receiving mental health services along with six major areas of concern: appropriate interview questions, youth development of cognitive ability, ethical issues, power relationships, cultural competency, and methods of interview inquiry are discussed. Finally, other researchers are encouraged to investigate techniques for gathering rich data through interview research with youth experiencing mental health issues. URN: urn:nbn:de:0114-fqs0803178

  17. Immigration, health care access, and recent cancer tests among Mexican-Americans in California.

    Science.gov (United States)

    Breen, Nancy; Rao, Sowmya R; Meissner, Helen I

    2010-08-01

    Immigrants' lower rates of cancer testing may be due to lack of fluency in English and other skills and knowledge about navigating US health care markets, lack of access to health services, or both. We analyzed 9,079 Mexican-American respondents to the 2001 California Health Interview Survey (CHIS) grouped as born in the US, living in the US 10 or more years, or living in the US less than 10 years. The CHIS provides the largest Mexican-American sample in a US survey. Access to care meant having health insurance coverage and a usual source of care. English proficiency meant the respondent took the interview in English. Multivariate logistic regression was used to predict outcomes. Respondents reporting more time in the US were more likely to report access to medical care and to report getting a cancer screening exam. Regardless of time in the US, respondents reporting access had similar test rates. Regression results indicate that time in the US and primary language were not significant relative to use of cancer screening tests, but access to care was. Cancer screening tests that are covered by Every Woman Counts, California's breast and cervical cancer early detection program, had smaller gaps among groups than colorectal cancer screening which is not covered by a program. California is the only state with a survey able to monitor changes in small population groups. Understanding barriers specific to subgroups is key to developing appropriate policy and interventions to increase use of cancer screening exams.

  18. Disparities in Health Indicators for Latinas in California.

    Science.gov (United States)

    Baezconde-Garbanati, Lourdes; Portillo, Carmen J.; Garbanati, James Allen

    1999-01-01

    Analyzes health indicators for Latinas in rural and urban California. Discusses Latina demographics; causes of death; life expectancy; and profiles for breast cancer, cervical cancer, heart disease, diabetes, and AIDS. Examines Latina risk factors: poverty, high dropout rates, lack of health insurance, obesity, physical inactivity, low levels of…

  19. Mary Wakefield: Health Resources and Services Administrator. Interview.

    Science.gov (United States)

    Wakefield, Mary

    2014-06-01

    Dr. Mary Wakefield is the administrator of the Health Resources and Services Administration. She came from the University of North Dakota, where she directed the Center for Rural Health. She has served as director of the Center for Health Policy, Research and Ethics at George Mason University and has worked with the World Health Organization's Global Programme on AIDS in Geneva, Switzerland. She is a fellow in the American Academy of Nursing and was elected to the Institute of Medicine of the National Academies. A native of North Dakota, Wakefield holds a doctoral degree in nursing from the University of Texas.

  20. Interview: Health technology assessment in Asia: an emerging trend.

    Science.gov (United States)

    Yang, Bong-min

    2012-05-01

    Bong-min Yang, PhD (in economics), is Professor and former Dean of the School of Public Health at the Seoul National University, South Korea. Professor Yang has led research and written many papers in health economics and healthcare systems in Korea and Asia. His recent research and publications focus on the field of economic evaluation and outcomes research. He played a key role in the introduction of a formal health technology assessment system within Korean healthcare. He is currently serving as Executive Director, Institute of Health and Environment, Seoul National University. In addition to his research and publications, Professor Yang is Associate Editor for Journal of Comparative Effectiveness Research, is co-editor-in-chief for Value in Health Regional Issues, and is currently chair of the Management Advisory Board of Value in Health and a member of the editorial board of the Journal of Medical Economics. He has been a policy consultant to China, Japan, Indonesia, Hong Kong, Malaysia, Taiwan, Thailand and India. He has also worked as a short-term consultant at the WHO, ADB, UNDP and the World Bank. For the Korean government, he served as Chairperson of the Health Insurance Reform Committee, and Chairperson of the Drug Pricing and Reimbursement Committee. He is currently serving as Chair of the International Society of Pharmacoeconomics and Outcomes Research-Asia Consortium, and a member of the Board of Directors of the International Society of Pharmacoeconomics and Outcomes Research.

  1. Is e-mail communication a feasible method to interview young people with mental health problems?

    Science.gov (United States)

    Cleary, Michelle; Walter, Garry

    2011-08-01

    E-mail interviewing-not to be confused with "online surveying"-shows promise for researchers working with adolescent mental health populations as a data collection method. To explore potential advantages, constraints, and applications of e-mail interviewing as a research method for staff working with adolescent mental health populations. At face value, there appear to be several advantages to e-mail interviewing with young populations and further exploration of this method is warranted. © 2010 Wiley Periodicals, Inc.

  2. Interviewer gender and self-reported sexual behavior and mental health among male military personnel.

    Science.gov (United States)

    Chun, Helen; Tavarez, Maria I; Dann, Grace E; Anastario, Michael P

    2011-04-01

    To determine whether self-reported sexual behavior and mental health varied by interviewer gender in a population of male military personnel. Eight male and six female data collectors verbally administered structured interviews to 474 male Dominican military personnel stationed at border crossing zones in the Dominican Republic. Measurements included sexual behaviors and mental health. Respondents were less likely to report oral and vaginal sex to male interviewers, and were more likely to report sexual coercion and alcohol abuse to male interviewers. Respondents were more likely to report depression and post-traumatic stress disorder to female interviewers. Interviewer gender influenced the prevalence of sexual behaviors and mental health, which carries implications for future research in military personnel.

  3. Do Interviewers' Health Beliefs and Habits Modify Responses to Sensitive Questions? A study using Data Collected from Pregnant women by Means of Computer-assisted Telephone Interviews

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Olsen, Jørn

    2002-01-01

    the interviewers' education, age, or parity correlate with the answers they obtained. In these data gathered through computer-assisted telephone interviews, interviewer effects arising from variations in interviewers' health beliefs and personal habits were found to be negligible. Thorough training......If interviewers' personal habits or attitudes influence respondents' answers to given questions, this may lead to bias, which should be taken into consideration when analyzing data. The authors examined a potential interviewer effect in a study of pregnant women in which exposure data were obtained...

  4. [Experiences of undocumented Mexican migrant women when accessing sexual and reproductive health services in California, USA: a case study].

    Science.gov (United States)

    Deeb-Sossa, Natalia; Díaz Olavarrieta, Claudia; Juárez-Ramírez, Clara; García, Sandra G; Villalobos, Aremis

    2013-05-01

    This study focuses on the experience of Mexican women migrants in California, USA, with the use of formal health services for sexual and reproductive health issues. The authors used a qualitative interpretative approach with life histories, interviewing eight female users of healthcare services in California and seven key informants in Mexico and California. There were three main types of barriers to healthcare: immigration status, language, and gender. Participants reported long waiting times, discriminatory attitudes, and high cost of services. A combination of formal and informal healthcare services was common. The assessment of quality of care was closely related to undocumented immigration status. Social support networks are crucial to help solve healthcare issues. Quality of care should take intercultural health issues into account.

  5. Do interviewers health beliefs and habits modify responses to sensitive questions?

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Olsen, J.

    2002-01-01

    If interviewers' personal habits or attitudes influence respondents' answers to given questions, this may lead to bias, which should be taken into consideration when analyzing data. The authors examined a potential interviewer effect in a study of pregnant women in which exposure data were obtained...... of pregnancy were collected during the time period October 1, 1997-February 1, 1999. Overall, the authors found little evidence to suggest that interviewers' personal habits or attitudes toward smoking and alcohol consumption during pregnancy had consequences for the responses they obtained; neither did...... the interviewers' education, age, or parity correlate with the answers they obtained. In these data gathered through computer-assisted telephone interviews, interviewer effects arising from variations in interviewers' health beliefs and personal habits were found to be negligible. Thorough training...

  6. Health Disparities and Delayed Health care among Older Adults in California: A Perspective from Race, Ethnicity, and Immigration.

    Science.gov (United States)

    Du, Yan; Xu, Qingwen

    2016-09-01

    To examine racial/ethnic/immigration disparities in health and to investigate the relationships among race/ethnic/immigration status, delayed health care, and health of the elderly. Responses from 13,508 people aged 65 and above were analyzed based on the California Health Interview Survey (CHIS) 2011-2012. Key variables include race/ethnicity/immigration status, health outcome, and delayed health care. Age, gender, education, work status, and annual family income are used as covariates. The findings indicate that Whites (regardless of country of birth) and U.S.-born Asians enjoy better health than Latinos, African-Americans, and Foreign-born Asians. Foreign-born Asians and foreign-born Latinos have the poorest self-reported health and mental health, respectively. Delayed use of health care is negatively associated with both self-reported health and mental health status. Health disparities exist among older adult populations; the combined effects of minority and immigrant status can be approximated from the results in this study. Health care accessibility and the quality of care should be promoted in minority/immigrant populations. Public health nurses have a strong potential to aide in reducing health disparities among an aging American population that continues to exhibit increasing racial/ethnic diversity. © 2016 Wiley Periodicals, Inc.

  7. The interpreter as co-interviewer: the role of the interpreter during interviews in cross-language health research.

    Science.gov (United States)

    Suurmond, Jeanine; Woudstra, Anke; Essink-Bot, Marie-Louise

    2016-07-01

    Interviews with ethnic minority patients provide a rich source of data to understand their perspectives of disease and its management. Language barriers are, however, often a problem so interpreters need to be used. We explored the impact of the interpreter on cross-language interviews between researchers and respondents. Secondary analysis of four interviews between researchers and patients involving professional interpreters. Interpreters were actively involved and influenced the interview in several ways: they assumed the interviewer's communicative role, edited information; initiated information-seeking, took over control of the interview, and took over the respondent's role. While the interpreter supported the interviewer, they posed risks to the quality of the interview. Researchers need to be aware of the influence of interpreters. Researchers should instruct interpreters carefully about their roles though they may benefit from interpreters' strategies to support them. © The Author(s) 2016.

  8. Health Indicators for Older Sexual Minorities: National Health Interview Survey, 2013-2014.

    Science.gov (United States)

    Dragon, Christina N; Laffan, Alison M; Erdem, Erkan; Cahill, Sean R; Kenefick, Daniel; Ye, Jiahui; Haffer, Samuel C

    2017-12-01

    Advances in lesbian, gay, and bisexual (sexual minority [SM]) acceptance and equality have been made in the past decade. However, certain SM subgroups continue to be disadvantaged due to lack of data and, thus, lack of knowledge about these populations. Data for older sexual minorities are especially lacking and will be increasingly important as more sexual minorities enter older age. This research explores results from a nationally representative health survey to elucidate some health indicators for older sexual minorities. Data from the 2013 and 2014 National Health Interview Surveys (NHIS) were pooled for increased sample size, and established research methods were followed as recommended by prior NHIS sexual orientation studies. We conducted descriptive analyses on the differences between SM and heterosexual groups, aged 65 years and older, for 12 health indicators. Four out of the 12 health indicators were significantly different for sexual minorities, and three out of those four indicated positive health outcomes or behaviors when compared with heterosexuals. Sexual minorities were more than three times as likely to receive HIV testing as heterosexual peers. Sexual minorities were more likely to receive an influenza vaccination, and much more likely to report excellent or very good health, than their heterosexual peers. Sexual minorities were more than twice as likely to report binge drinking, which is consistent with prior research for adult sexual minorities. This analysis is the first to examine national data on health indicators for sexual minorities, aged 65 years and older, using NHIS data. As more surveys begin to collect SMdata and more years of data are collected by NHIS, a clearer picture of the health of older adult sexual minorities should emerge.

  9. Psychological Distress and Hypertension: Results from the National Health Interview Survey for 2004-2013

    National Research Council Canada - National Science Library

    Ojike, Nwakile; Sowers, James R; Seixas, Azizi; Ravenell, Joseph; Rodriguez-Figueroa, G; Awadallah, M; Zizi, F; Jean-Louis, Girardin; Ogedegbe, Olugbenga; McFarlane, Samy I

    2016-01-01

    .... We used data from the National Health Interview Survey for 2004-2013. Hypertension was self-reported and the 6-item Kessler Psychological Distress Scale was used to assess psychological distress (a score...

  10. What is a good health check? An interview study of health check providers' views and practices.

    Science.gov (United States)

    Stol, Yrrah H; Asscher, Eva C A; Schermer, Maartje H N

    2017-10-02

    Health checks identify (risk factors for) disease in people without symptoms. They may be offered by the government through population screenings and by other providers to individual users as 'personal health checks'. Health check providers' perspective of 'good' health checks may further the debate on the ethical evaluation and possible regulation of these personal health checks. In 2015, we interviewed twenty Dutch health check providers on criteria for 'good' health checks, and the role these criteria play in their practices. Providers unanimously formulate a number of minimal criteria: Checks must focus on (risk factors for) treatable/preventable disease; Tests must be reliable and clinically valid; Participation must be informed and voluntary; Checks should provide more benefits than harms; Governmental screenings should be cost-effective. Aspirational criteria mentioned were: Follow-up care should be provided; Providers should be skilled and experienced professionals that put the benefit of (potential) users first; Providers should take time and attention. Some criteria were contested: People should be free to test on any (risk factor for) disease; Health checks should only be performed in people at high risk for disease that are likely to implement health advice; Follow up care of privately funded tests should not drain on collective resources. Providers do not always fulfil their own criteria. Their reasons reveal conflicts between criteria, conflicts between criteria and other ethical values, and point to components in the (Dutch) organisation of health care that hinder an ethical provision of health checks. Moreover, providers consider informed consent a criterion that is hard to establish in practice. According to providers, personal health checks should meet the same criteria as population screenings, with the exception of cost-effectiveness. Providers do not always fulfil their own criteria. Results indicate that in thinking about the ethics of health

  11. Nurse versus community health worker identification of psychosocial risks in pregnancy through a structured interview.

    Science.gov (United States)

    Godecker, Amy L; Harrison, Patricia A; Sidebottom, Abbey C

    2013-11-01

    A structured psychosocial risk screening interview, the Prenatal Risk Overview, was administered to 733 women in prenatal care. Either a community health worker (CHW) or a registered nurse (RN) conducted the interview based on day of the week. A comparison of identified risk factors found no significant differences between study samples for six of 13 domains. For CHW interviews, significantly more participants were classified as Moderate/ High Risk for Depression, Lack of Telephone Access, Food Insecurity, and Housing Instability, and as High Risk for Lack of Social Support, Lack of Transportation Access, and Housing Instability. For RN interviews, significantly more participants were classified as High Risk for Alcohol Use. Community health workers successfully conducted psychosocial screening and elicited more self-reported risk than RNs, especially lack of basic needs. Comparing the hourly salary/ wage, the cost for CHWs was 56% lower than for RNs. Preliminary findings support use of paraprofessionals for structured screening interviews.

  12. Behavioral health assessments and interventions of residents and psychology trainees during dual interviewing: a descriptive study.

    Science.gov (United States)

    Porcerelli, John H; Fowler, Shannon L; Klassen, Brian; Murdoch, William; Thakur, Elyse R; Wright, Brandy E; Morris, Pierre

    2013-06-01

    Family medicine residents increasingly work collaboratively with psychology trainees. One type of collaborative experience involves dual interviewing of clinic patients. The goal of this observational study was to provide an initial description of what occurs during dual interviews as it relates to behavioral health assessments and interventions. Psychology trainees provided detailed descriptions of 550 collaborative patient encounters involving 348 patients from the Wayne State University/Crittenton Family Medicine Residency clinic. Psychology trainees coded the frequency of behavioral health assessments and interventions by the resident, psychology trainee, or both. Eighty percent of the encounters contained a behavioral health assessment, and 29% contained a behavioral health intervention. Most of these clinical activities were collaboratively done. Interestingly, residents and psychology trainees tended to provide different behavioral health interventions. Moreover, residents provided different behavioral health interventions in repeat dual interviews (n=202) as opposed to first-time visits (n=348), while psychology trainees did not. Little is known about the process of dual interviewing, and this study is an important first step in describing how residents and psychology trainees actually interact during these encounters. More research is needed about the impact of dual interviewing on residents' behavior.

  13. The interpreter as co-interviewer: the role of the interpreter during interviews in cross-language health research

    NARCIS (Netherlands)

    Suurmond, Jeanine; Woudstra, Anke; Essink-Bot, Marie-Louise

    2016-01-01

    Interviews with ethnic minority patients provide a rich source of data to understand their perspectives of disease and its management. Language barriers are, however, often a problem so interpreters need to be used. We explored the impact of the interpreter on cross-language interviews between

  14. Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009. Data from the National Health Interview Survey. Vital and Health Statistics. Series 10, Number 249. DHHS Publication No. (PHS) 2011-1577

    Science.gov (United States)

    Pleis, J. R.; Ward, B. W.; Lucas, J. W.

    2010-01-01

    Objectives: This report presents health statistics from the 2009 National Health Interview Survey (NHIS) for the civilian noninstitutionalized adult population, classified by sex, age, race and ethnicity, education, family income, poverty status, health insurance coverage, marital status, and place and region of residence. Estimates are presented…

  15. Methodological Aspects of Focus Groups in Health Research: Results of Qualitative Interviews With Focus Group Moderators.

    Science.gov (United States)

    Tausch, Anja P; Menold, Natalja

    2016-01-01

    Although focus groups are commonly used in health research to explore the perspectives of patients or health care professionals, few studies consider methodological aspects in this specific context. For this reason, we interviewed nine researchers who had conducted focus groups in the context of a project devoted to the development of an electronic personal health record. We performed qualitative content analysis on the interview data relating to recruitment, communication between the focus group participants, and appraisal of the focus group method. The interview data revealed aspects of the focus group method that are particularly relevant for health research and that should be considered in that context. They include, for example, the preferability of face-to-face recruitment, the necessity to allow participants in patient groups sufficient time to introduce themselves, and the use of methods such as participant-generated cards and prioritization.

  16. Mental health and food consumption among California children 5-11 years of age.

    Science.gov (United States)

    Banta, Jim E; Khoie-Mayer, Roxanne N; Somaiya, Chintan K; McKinney, Ogbochi; Segovia-Siapco, Gina

    2013-01-01

    The purpose of this research was to determine if poor mental health is associated with the intake of specific foods among California children. Secondary data analysis of the 2007 and 2009 California Health Interview Survey (CHIS) was conducted. Mental health was measured using a shortened version of the Strengths and Difficulties Questionnaire (SDQ). Dietary measures were self-reported servings of fruit, vegetables, 100% fruit juice, high sugar foods, soda/sweetened drinks, and French fries/fried potatoes consumed the previous day, as well as frequency of fast food consumed during the past week. Phone interviews were conducted via the CHIS on households in California. Data belonging to children (n = 11,190) ages 5-11 years whose parents completed the CHIS 2007 and 2009 random-dial telephone surveys was investigated. Of an estimated annual population of 3.7 million children, 180,000 (4.9%) had poor mental health. Children with poor mental health consumed more soda/sweetened drinks (0.60 vs 0.45 servings per day, p = 0.024), French fries/fried potatoes (0.27 vs 0.14 servings per day, p = 0.003), and fast food (2.02 vs 1.38 servings per week, p = 0.009) compared to children with good mental health. Mental health was not associated with other dietary measures. Adjusting for relevant socio-demographic characteristics, logistic regression found poor mental health to be significantly associated with any consumption of French fries/fried potatoes (odds ratio (OR) = 2.0, p = 0.001) or vegetables (OR 0.6, p = 0.005) on the previous day, and fast food two or more times in the past week (OR 1.7, p Children with poor mental health are more likely to consume calorie-dense but nutrient-poor foods compared to their counterparts. Intake of such foods may contribute to worse physical health as these children mature. © The Author(s) 2015.

  17. Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January -- June 2013

    Science.gov (United States)

    ... Arkansas, and Texas Washington, Oregon, California, Nevada, New Mexico, Arizona, Idaho, Utah, Colorado, Montana, Wyoming, Alaska, and ... obtaining needed medical care, influenza vaccination, pneumococcal vaccination, obesity, leisure-time physical activity, current smoking, alcohol consumption, ...

  18. [The semi-structured interview: at the border of public health and anthropology].

    Science.gov (United States)

    Imbert, Geneviève

    2010-09-01

    The interview is the tool for data collection the most used in the context of research conducted in health sciences, human sciences and social sciences. After completing some generalities about the different types of interviews, the focus is on semi-structured interview during its various stages including the processing and data analysis, this from the return of a lived experience of research in work on the border of the field of public health and that of anthropology. If this approach and contextualized the semistructured interview may a priori appear specific, the reader interested in the development of qualitative research in a humanistic perspective and the implementation of multidisciplinary strategies to ascertain its universal character.

  19. [Current evidence on the motivational interview in the approach to health care problems in primary care].

    Science.gov (United States)

    Bóveda Fontán, Julia; Pérula de Torres, Luis Ángel; Campiñez Navarro, Manuel; Bosch Fontcuberta, Josep M; Barragán Brun, Nieves; Prados Castillejo, Jose Antonio

    2013-11-01

    The motivational interview has been widely used as a clinical method to promote behavioural changes in patients, helping them to resolve their ambivalence to obtain their own motivations. In the present article, a review is made of the main meta-analyses and systematic and narrative reviews on the efficacy of the motivational interview in the primary health care environment. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  20. Understanding Factors that Influence Health Care Utilization Among Mixtec and Zapotec Women in a Farmworker Community in California.

    Science.gov (United States)

    Maxwell, Annette E; Young, Sandra; Moe, Emily; Bastani, Roshan; Wentzell, Emily

    2017-10-03

    This paper examines health care utilization among indigenous immigrants from Oaxaca, Mexico, who have settled in a farmworker community in southern California. In 2016, two trained Spanish-Mixteco and Spanish-Zapoteco bi-lingual interviewers conducted in-depth interviews with 44 indigenous women residing in Oxnard, California on issues that affect health care utilization. Interviews were conducted in Mixteco, Zapoteco and Spanish and were coded to identify structural, cultural, and provider-related barriers to health care utilization. Five bi-lingual Spanish-Mixteco indigenous interpreters employed at local clinics were also interviewed. Many women reported lack of health insurance, inability to pay, language barriers, long waiting times, rushed encounters with providers, and seeking western medical care only after home remedies did not work. However, several women were able to access routine health care services, often with support from indigenous interpreters employed at clinics. Interviews with five interpreters found that they provided assistance with interpretation during medical encounters and appointment making. They also educated patients about upcoming exams, identified low-cost services and insurance programs available to patients, assisted with paperwork and occasionally educated physicians on behalf of their patients. In addition to addressing barriers to health care access our findings suggest the importance of identifying and leveraging community assets, such as indigenous navigators, when developing programs for such underserved communities. Our findings can inform best practice in settings that provide health care to indigenous populations and may also apply to settings that provide health care to other immigrant communities that have very limited familiarity and contact with western health care.

  1. Interactional Alarms: Experts' Framing of Health Risks in Live Broadcast News Interviews.

    Science.gov (United States)

    Armon, Rony

    2017-08-23

    This study examined how experts frame health risks in real-time interactions with journalists. Though there is evidence that experts influence media framing of health risks, the ways they respond to journalists' agendas in real-time interactions have yet to be explored. This paper examines instances of risk assessment extracted from a corpus of news interviews to determine how expert assessments were requested and provided. The analysis reveals that experts rarely deliver their assessments neutrally but rather treat these exchanges as opportunities for framing or reframing the topic. Their framing is shown to be responsive to journalistic agendas and to those who experts understand to be accountable when their assessment is elicited. These findings suggest ways in which news interviews can be useful in health communication. The implications for experts, journalists, and public information officers who plan to use interviews for this purpose are discussed.

  2. Sleep duration and self-rated health: the national health interview survey 2008.

    Science.gov (United States)

    Shankar, Anoop; Charumathi, Sabanayagam; Kalidindi, Sita

    2011-09-01

    Self-rated health (SRH) has been shown to consistently predict overall mortality and cardiovascular mortality in several population-based studies across the world. Similarly sleep duration have been found to be associated with cardiovascular disease (CVD) and mortality. However, relatively few studies have examined the association between sleep duration and SRH, and the results have not been consistent. We conducted a cross-sectional study of n = 20,663 National Health Interview Survey 2008 participants ≥ 18 years of age (56.2% women). Sleep duration was categorized as ≤ 5 h, 6 h, 7 h, 8 h, and ≥ 9 h. The main outcome interest was fair/poor SRH (n = 3043). We found both short and long sleep duration to be independently associated with fair/poor SRH, independent of age, sex, race-ethnicity, smoking, alcohol intake, body mass index, physical activity, depression, diabetes mellitus, hypertension, and CVD. Compared with a sleep duration of 7 h (referent), the multivariate odds ratio (95% confidence interval) of fair/poor SRH was 2.29 (1.86-2.83), 1.68 (1.42-2.00), 1.38 (1.18-1.61), and 1.98 (1.63-2.40) for sleep duration ≤ 5, 6, 8, and ≥ 9 h. This association persisted in subgroup analyses by gender, race-ethnicity, and body mass index categories. Compared with sleep duration of 7 h, there was a positive association between both shorter and longer sleep duration and fair/poor self-rated health in a representative sample of US adults.

  3. The Hmong and Health Care in Merced County, California

    Directory of Open Access Journals (Sweden)

    Marilyn Mochel

    1998-01-01

    Full Text Available This article discusses the linguistic and cultural barriersthe Hmong encounter when they attempt to access the healthcare delivery system in Merced County, California. Thetheoretical portion of the article discusses the concepts ofculture, culture change, and some psychological issues thatresult from culture contact. Western biomedicine is viewed asa cultural system. Following this theoretical section, thecultural and linguistic barriers confronted by the Hmong whenthey attempt the access health care in Merced are discussedas well as some successful programs in the development ofculturally sensitive health care. These include the SoutheastAsian Surgical Coordination Team and the Culture Broker Team.The last part of the article covers, in some detail, amultidisciplinary program in cross-cultural health which isbeing implemented by health workers in Merced County.

  4. Sun protective behaviour in renal transplant recipients. A qualitative study based on individual interviews and the Health Belief Model

    DEFF Research Database (Denmark)

    Skiveren, Jette; Mortensen, Erik Lykke; Haedersdal, Merete

    2010-01-01

    . METHODS: A total of 10 RTRs were individually interviewed using a semi-structured interview guide (five women, five men). The interviews were conducted in Copenhagen in June 2008. Transcriptions of the interviews were subsequently analyzed using predefined concepts from the Health Belief Model. RESULTS...

  5. Health behaviors among people with epilepsy—Results from the 2010 National Health Interview Survey☆

    Science.gov (United States)

    Cui, Wanjun; Zack, Matthew M.; Kobau, Rosemarie; Helmers, Sandra L.

    2015-01-01

    Objectives This study aimed to estimate and compare the prevalence of selected health behavior—alcohol use, cigarette smoking, physical activity, and sufficient sleep—between people with and without a history of epilepsy in a large, nationally representative sample in the United States. Methods We used data from the 2010 cross-sectional National Health Interview Survey (NHIS) to compare the prevalence of each health behavior for people with and without epilepsy while adjusting for sex, age, race/ethnicity, and family income. We also further categorized those with epilepsy into active epilepsy and inactive epilepsy and calculated their corresponding prevalences. Results The percentages of adults with a history of epilepsy (50.1%, 95% CI = 45.1%–55.2%) and with active epilepsy (44.4%, 95% CI = 37.6%–51.5%) who were current alcohol drinkers were significantly lower than that of those without epilepsy (65.1%, 95% CI = 64.2%–66.0%). About 21.8% (95% CI = 18.1%–25.9%) of adults with epilepsy and 19.3% (95% CI = 18.7%–19.9%) of adults without epilepsy were current smokers. Adults with active epilepsy were significantly less likely than adults without epilepsy to report following recommended physical activity guidelines for Americans (35.2%, 95% CI = 28.8%–42.1% vs. 46.3%, 95% CI = 45.4%–47.2%) and to report walking for at least ten minutes during the seven days prior to being surveyed (39.6%, 95% CI = 32.3%–47.4% vs. 50.8%, 95% CI = 49.9%–51.7%). The percentage of individuals with active epilepsy (49.8%, 95% CI = 42.0%–57.7%) who reported sleeping an average of 7 or 8 h a day was significantly lower than that of those without epilepsy (61.9%, 95% CI = 61.2%–62.7%). Conclusions Because adults with epilepsy are significantly less likely than adults without epilepsy to engage in recommended levels of physical activity and to get the encouraged amount of sleep for optimal health and well-being, promoting more safe physical activity and improved sleep

  6. Health behaviors among people with epilepsy--results from the 2010 National Health Interview Survey.

    Science.gov (United States)

    Cui, Wanjun; Zack, Matthew M; Kobau, Rosemarie; Helmers, Sandra L

    2015-03-01

    This study aimed to estimate and compare the prevalence of selected health behavior-alcohol use, cigarette smoking, physical activity, and sufficient sleep-between people with and without a history of epilepsy in a large, nationally representative sample in the United States. We used data from the 2010 cross-sectional National Health Interview Survey (NHIS) to compare the prevalence of each health behavior for people with and without epilepsy while adjusting for sex, age, race/ethnicity, and family income. We also further categorized those with epilepsy into active epilepsy and inactive epilepsy and calculated their corresponding prevalences. The percentages of adults with a history of epilepsy (50.1%, 95% CI=45.1%-55.2%) and with active epilepsy (44.4%, 95% CI=37.6%-51.5%) who were current alcohol drinkers were significantly lower than that of those without epilepsy (65.1%, 95% CI=64.2%-66.0%). About 21.8% (95% CI=18.1%-25.9%) of adults with epilepsy and 19.3% (95% CI=18.7%-19.9%) of adults without epilepsy were current smokers. Adults with active epilepsy were significantly less likely than adults without epilepsy to report following recommended physical activity guidelines for Americans (35.2%, 95% CI=28.8%-42.1% vs. 46.3%, 95% CI=45.4%-47.2%) and to report walking for at least ten minutes during the seven days prior to being surveyed (39.6%, 95% CI=32.3%-47.4% vs. 50.8%, 95% CI=49.9%-51.7%). The percentage of individuals with active epilepsy (49.8%, 95% CI=42.0%-57.7%) who reported sleeping an average of 7 or 8h a day was significantly lower than that of those without epilepsy (61.9%, 95% CI=61.2%-62.7%). Because adults with epilepsy are significantly less likely than adults without epilepsy to engage in recommended levels of physical activity and to get the encouraged amount of sleep for optimal health and well-being, promoting more safe physical activity and improved sleep quality is necessary among adults with epilepsy. Ending tobacco use and maintaining low

  7. Health Literacy Innovations in California Community College Health Centers

    Science.gov (United States)

    Armenia, Joanne Elizabeth

    2013-01-01

    Limited health literacy is a national public health problem contributing to adverse health outcomes and increasing healthcare costs. Both health and educational systems are intervention points for improvement; however, there is paucity in empirical research regarding the role of educational systems. This needs assessment study explored health…

  8. Our Environment, Our Health: A Community-Based Participatory Environmental Health Survey in Richmond, California

    Science.gov (United States)

    Cohen, Alison; Lopez, Andrea; Malloy, Nile; Morello-Frosch, Rachel

    2012-01-01

    This study presents a health survey conducted by a community-based participatory research partnership between academic researchers and community organizers to consider environmental health and environmental justice issues in four neighborhoods of Richmond, California, a low-income community of color living along the fence line of a major oil…

  9. Impact of asylum interviews on the mental health of traumatized asylum seekers

    Directory of Open Access Journals (Sweden)

    Katrin Schock

    2015-09-01

    Full Text Available Background: Asylum interviews within the asylum procedure are associated with psychological stress for traumatized asylum seekers. This study investigates the impact of asylum interviews on the mental health in a sample of 40 traumatized asylum seekers. The comparison group consisted of refugees (N=10 that had not been invited to an asylum interview. Additionally, the moderating effects of trial-related variables such as perceived justice of the trial, stress of giving testimony, and stress of waiting for the asylum interview were examined. Method: Participants were assessed on average 10 days before (t1 and 16 days after (t2 the asylum interview. Chi-square tests for dichotomous and categorical variables were used to compare the descriptive statistics of the two groups. To investigate symptom changes from t1 to t2, paired t-tests were calculated. The magnitude of effects was measured by Cohen's effect size d within groups. Hierarchical regression analyses were conducted for demographic and trial variables predicting posttraumatic intrusions, avoidance, and hyperarousal. Results: Data showed a significant increase in posttraumatic intrusions and a significant decrease in posttraumatic avoidance and hyperarousal symptoms from t1 to t2. No significant symptom changes in the posttraumatic stress disorder subscales were found in the comparison group. The results of hierarchical regression analyses revealed perceived justice of the interview to predict the increase of intrusions and the number of experienced traumata and testimony stress to predict posttraumatic avoidance. Conclusions: The present findings underline the stressful impact of asylum interviews on traumatized refugees. They indicate that the asylum interview might decrease posttraumatic avoidance and trigger posttraumatic intrusions, thus highlight the importance of ensuring that the already vulnerable group of traumatized refugees needs to be treated with empathy during their asylum

  10. The Community Child Health Network Life Stress Interview: a brief chronic stress measure for community health research.

    Science.gov (United States)

    Tanner Stapleton, Lynlee R; Dunkel Schetter, Christine; Dooley, Larissa N; Guardino, Christine M; Huynh, Jan; Paek, Cynthia; Clark-Kauffman, Elizabeth; Schafer, Peter; Woolard, Richard; Lanzi, Robin Gaines

    2016-07-01

    Chronic stress is implicated in many theories as a contributor to a wide range of physical and mental health problems. The current study describes the development of a chronic stress measure that was based on the UCLA Life Stress Interview (LSI) and adapted in collaboration with community partners for use in a large community health study of low-income, ethnically diverse parents of infants in the USA (Community Child Health Network [CCHN]). We describe the instrument, its purpose and adaptations, implementation, and results of a reliability study in a subsample of the larger study cohort. Interviews with 272 mothers were included in the present study. Chronic stress was assessed using the CCHN LSI, an instrument designed for administration by trained community interviewers to assess four domains of chronic stress, each rated by interviewers. Significant correlations ranging from small to moderate in size between chronic stress scores on this measure, other measures of stress, biomarkers of allostatic load, and mental health provide initial evidence of construct and concurrent validity. Reliability data for interviewer ratings are also provided. This relatively brief interview (15 minutes) is available for use and may be a valuable tool for researchers seeking to measure chronic stress reliably and validly in future studies with time constraints.

  11. Physiotherapy students enhance awareness of motivational interviewing skills needed in health promotion

    DEFF Research Database (Denmark)

    Ringby, Betina

    Background Health professionals who are skilled at communicating are a prerequisite for providing services of high quality. Physiotherapists work within health promotion and support people in change of lifestyle. The aim of this project was to gain insight into physiotherapy students’ motivation...... to train their practical communication skills and what students learned after a training session. The theory of motivational interviewing and the Calgary Cambridge guide served as a basic framework. Methods Training was undergone as an audiovisual training session with an actor. 5th semester physiotherapy....... In the light of the present focus on communication as an important skill for health professionals, we hope the project can contribute to further didactic discussions around how to train communication skills in health professional education. Keywords: Communication. Motivational interviewing. Physiotherapy...

  12. Learning Motivational Interviewing: Exploring Primary Health Care Nurses' Training and Counselling Experiences

    Science.gov (United States)

    Soderlund, Lena Lindhe; Nilsen, Per; Kristensson, Margareta

    2008-01-01

    Objective: This article explores the training and counselling experiences of 20 nurses, aiming to identify key elements in the process of learning and applying motivational interviewing (MI) counselling skills with adherence to protocols. Setting/method: The nurses were recruited from 10 primary health care units in Ostergotland, Sweden. The study…

  13. Motivational Interviewing-Based Approaches in Dental Practice Settings May Improve Oral Health Behaviors and Outcomes.

    Science.gov (United States)

    Chi, Donald L

    2017-12-01

    Motivational interviewing in general dental practice: A review of the evidence. Kay EJ, Vascott D, Hocking A, Nield H. Br Dent J 2016; 221(12):785-91. National Institute for Health Care Excellence (UK) TYPE OF STUDY/DESIGN: Systematic review. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Cell-Phone Use and Self-Reported Hypertension: National Health Interview Survey 2008

    OpenAIRE

    Suresh, Sivaranjani; Sabanayagam, Charumathi; Kalidindi, Sita; Shankar, Anoop

    2011-01-01

    Background. Cell-phone usage has increased dramatically over the last decade, along with a rising public concern over the health effects of using this device. The association between cell-phone usage and hypertension has not been examined before. Methods. We analysed data from 21,135 adults aged ≥18 years who participated in the 2008 National Health Interview Survey. Based on reported cell-phone use, participants were categorized as cell-phone nonusers, predominantly landline users, dual user...

  15. The study design and characteristics of the Danish national health interview surveys

    DEFF Research Database (Denmark)

    Ekholm, Ola; Hesse, Ulrik; Davidsen, Michael

    2009-01-01

    AIMS: The Danish National Institute of Public Health, University of Southern Denmark has carried out national representative health interview surveys among adult Danes in 1987, 1994, 2000 and 2005. The aim of this study is to describe the characteristics of the design, including the response rate...... to the Danish population. However, these surveys are essential, as the information collected cannot be gathered by means of official statistical registers. Hence, efforts to increase the response rate will be important in the forthcoming surveys....

  16. Using the cognitive interviewing process to improve survey design by allied health: A qualitative study.

    Science.gov (United States)

    Howlett, Owen; McKinstry, Carol; Lannin, Natasha A

    2017-12-22

    Allied health professionals frequently use surveys to collect data for clinical practice and service improvement projects. Careful development and piloting of purpose-designed surveys is important to ensure intended measuring (that respondents correctly interpret survey items when responding). Cognitive interviewing is a specific technique that can improve the design of self-administered surveys. The aim of this study was to describe the use of the cognitive interviewing process to improve survey design, which involved a purpose-designed, online survey evaluating staff use of functional electrical stimulation. A qualitative study involving one round of cognitive interviewing with three occupational therapists and three physiotherapists. The cognitive interviewing process identified 11 issues with the draft survey, which could potentially influence the validity and quality of responses. The raised issues included difficulties with: processing the question to be able to respond, determining a response to the question, retrieving relevant information from memory and comprehending the written question. Twelve survey amendments were made following the cognitive interviewing process, comprising four additions, seven revisions and one correction. The cognitive interviewing process applied during the development of a purpose-designed survey enabled the identification of potential problems and informed revisions to the survey prior to its use. © 2017 Occupational Therapy Australia.

  17. Motivations for contributing to health-related articles on Wikipedia: an interview study.

    Science.gov (United States)

    Farič, Nuša; Potts, Henry W W

    2014-12-03

    Wikipedia is one of the most accessed sources of health information online. The current English-language Wikipedia contains more than 28,000 articles pertaining to health. The aim was to characterize individuals' motivations for contributing to health content on the English-language Wikipedia. A set of health-related articles were randomly selected and recent contributors invited to complete an online questionnaire and follow-up interview (by Skype, by email, or face-to-face). Interviews were transcribed and analyzed using thematic analysis and a realist grounded theory approach. A total of 32 Wikipedians (31 men) completed the questionnaire and 17 were interviewed. Those completing the questionnaire had a mean age of 39 (range 12-59) years; 16 had a postgraduate qualification, 10 had or were currently studying for an undergraduate qualification, 3 had no more than secondary education, and 3 were still in secondary education. In all, 15 were currently working in a health-related field (primarily clinicians). The median period for which they have been an active editing Wikipedia was 3-5 years. Of this group, 12 were in the United States, 6 were in the United Kingdom, 4 were in Canada, and the remainder from another 8 countries. Two-thirds spoke more than 1 language and 90% (29/32) were also active contributors in domains other than health. Wikipedians in this study were identified as health professionals, professionals with specific health interests, students, and individuals with health problems. Based on the interviews, their motivations for editing health-related content were summarized in 5 strongly interrelated categories: education (learning about subjects by editing articles), help (wanting to improve and maintain Wikipedia), responsibility (responsibility, often a professional responsibility, to provide good quality health information to readers), fulfillment (editing Wikipedia as a fun, relaxing, engaging, and rewarding activity), and positive attitude to

  18. Reporting Mental Health Symptoms: Breaking Down Barriers to Care with Virtual Human Interviewers

    Directory of Open Access Journals (Sweden)

    Gale M. Lucas

    2017-10-01

    Full Text Available A common barrier to healthcare for psychiatric conditions is the stigma associated with these disorders. Perceived stigma prevents many from reporting their symptoms. Stigma is a particularly pervasive problem among military service members, preventing them from reporting symptoms of combat-related conditions like posttraumatic stress disorder (PTSD. However, research shows (increased reporting by service members when anonymous assessments are used. For example, service members report more symptoms of PTSD when they anonymously answer the Post-Deployment Health Assessment (PDHA symptom checklist compared to the official PDHA, which is identifiable and linked to their military records. To investigate the factors that influence reporting of psychological symptoms by service members, we used a transformative technology: automated virtual humans that interview people about their symptoms. Such virtual human interviewers allow simultaneous use of two techniques for eliciting disclosure that would otherwise be incompatible; they afford anonymity while also building rapport. We examined whether virtual human interviewers could increase disclosure of mental health symptoms among active-duty service members that just returned from a year-long deployment in Afghanistan. Service members reported more symptoms during a conversation with a virtual human interviewer than on the official PDHA. They also reported more to a virtual human interviewer than on an anonymized PDHA. A second, larger sample of active-duty and former service members found a similar effect that approached statistical significance. Because respondents in both studies shared more with virtual human interviewers than an anonymized PDHA—even though both conditions control for stigma and ramifications for service members’ military records—virtual human interviewers that build rapport may provide a superior option to encourage reporting.

  19. The California Border Health Collaborative: A Strategy for Leading the Border to Better Health.

    Science.gov (United States)

    Matthews, Charles Edwards; Wooten, Wilma; Gomez, María Gudelia Rangel; Kozo, Justine; Fernandez, April; Ojeda, Victoria D

    2015-01-01

    There are hundreds of people and organizations working on border health issues in the California-Baja California border region trying to protect and improve health. These efforts are being conducted without a collaborative structure that integrates jurisdictions and organizations. Thus, there is a need to coordinate these organizations to work together and benefit from their collective effort and each other's best practices. The outcome of such an effort could effectively improve the health in the border region. The newly developed "California Border Health Collaborative" unites organizations and provides the leadership and collaborative culture to positively improve the health of the border region; it is referred to as the "Collaborative." This article describes the developmental process of this Collaborative, including partner engagement, governance, strategic planning, key elements for success, the roles of multi-level jurisdictions, and policy implications. This paper focuses on describing the preparation and processes that created the U.S./California side of this binational collaborative effort and is a strong reflection of the theory of border collaboration as described by Denman and De Sonora (1) in "Working beyond Borders: A Handbook for Transborder Projects in Health."

  20. Health effects of the 2003 Southern California wildfires on children.

    Science.gov (United States)

    Künzli, Nino; Avol, Ed; Wu, Jun; Gauderman, W James; Rappaport, Ed; Millstein, Joshua; Bennion, Jonathan; McConnell, Rob; Gilliland, Frank D; Berhane, Kiros; Lurmann, Fred; Winer, Arthur; Peters, John M

    2006-12-01

    In late October 2003, Southern California wildfires burned more than 3,000 km2. The wildfires produced heavy smoke that affected several communities participating in the University of Southern California Children's Health Study (CHS). To study the acute effects of fire smoke on the health of CHS participants. A questionnaire was used to assess smoke exposure and occurrence of symptoms among CHS high-school students (n = 873; age, 17-18 yr) and elementary-school children (n = 5,551; age, 6-7 yr), in a total of 16 communities. Estimates of particulate matter (PM10) concentrations during the 5 d with the highest fire activity were used to characterize community smoke level. All symptoms (nose, eyes, and throat irritations; cough; bronchitis; cold; wheezing; asthma attacks), medication usage, and physician visits were associated with individually reported exposure differences within communities. Risks increased monotonically with the number of reported smoky days. For most outcomes, reporting rates between communities were also associated with the fire-related PM10 levels. Associations tended to be strongest among those without asthma. Individuals with asthma were more likely to take preventive action, such as wearing masks or staying indoors during the fire. Exposure to wildfire smoke was associated with increased eye and respiratory symptoms, medication use, and physician visits.

  1. Training and calibration of interviewers for oral health literacy using the BREALD-30 in epidemiological studies.

    Science.gov (United States)

    Vilella, Karina Duarte; Assunção, Luciana Reichert da Silva; Junkes, Mônica Carmem; Menezes, José Vitor Nogara Borges de; Fraiz, Fabian Calixto; Ferreira, Fernanda de Morais

    2016-08-22

    The objective of this study was to describe an interviewer training and calibration method to evaluate oral health literacy using the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) in epidemiological studies. An experienced researcher (gold standard) conducted all training sessions. The interviewer training and calibration sessions included three different phases: theoretical training, practical training, and calibration. In the calibration phase, six interviewers (dentists) independently assessed 15 videos of individuals who had different levels of oral health literacy. Accuracy and reproducibility were evaluated using the kappa coefficient and the intraclass correlation coefficient (ICC). The percentage of agreement for each word in the instrument was also calculated. After training, the kappa values were higher than 0.911 and 0.893 for intra- and inter-rater agreement, respectively. When the results were analyzed separately for the different levels of literacy, the lowest agreement rate was found when evaluating the videos of individuals with low literacy (K = 0.871), but still within the range considered to be near-perfect agreement. The ICC values were higher than 0.990 and 0.975 for intra- and inter-rater agreement, respectively. The lowest percentage of agreement was 86.6% for the word "hipoplasia" (hypoplasia). This interviewer training and calibration method proved to be feasible and effective. Therefore, it can be used as a methodological tool in studies assessing oral health literacy using the BREALD-30.

  2. Examining the Association Between Temperature and Mental Health in California

    Science.gov (United States)

    Basu, R.; Gavin, L.; Pearson, D.; Malig, B. J.; Ebisu, K.

    2016-12-01

    Background: The association between temperature and morbidity from some specific causes has been well established. However, the association between temperature and mental health effects has not been examined closely, although those with mental illnesses may be susceptible to temperature. Methods: We obtained daily counts of emergency room visits and hospitalizations (ICD-9 codes) from the California Office of Statewide Health Planning and Development from 16 California climate zones from 2005 - 2013. Mean apparent temperature was determined by combining monitored temperature and humidity data from the US EPA, California Irrigation Management Information System, and the National Oceanic Atmospheric Administration and weighting monitor values by distance to zip code tabulation areas (ZCTA) and ZCTA populations in the same climate zone as each monitor. We used a two-stage hierarchical model to analyze this data, adjusted by the following independent variables: mean daily apparent temperature, holiday, day of the week, and a natural spline smoothing function of time. The regression was performed for both warm (5/1 - 10/31) and cold (11/1 - 4/30) seasons. Results were stratified by race/ethnicity and age group. Results: We observed an association between same-day mean apparent temperature and mental health outcomes during the warm and cold seasons. We also observed associations between temperature and suicide/self-injury and homicide/assault injury. A 10°F increase in mean apparent temperature was associated with a 4.98% [95% confidence interval, 3.73-6.23], 5.82% [4.34-7.30], and 7.43% [6.75-8.12], increase in mental health events, suicide, and homicide events during the warm season, respectively. Similar results were observed during the cold season. Effect modification by race/ethnic and age groups was observed for some outcomes for both seasons. Conclusions: Increase in mean apparent temperature was found to have same-day associations with several mental health

  3. Relationship between an interview-based health promotion program and cardiovascular risk factors at Japanese companies.

    Science.gov (United States)

    Shimizu, Takashi; Horiguchi, Itsuko; Kato, Tokiko; Nagata, Shoji

    2004-05-01

    The present study investigated the relationship between an interview-based health promotion program and cardiovascular risk factors at manufacturing companies. Excluding insufficient data and the workers who took medication prescribed by a physician in 1993, the subjects were six hundred and twenty-nine 18-55-yr-old employees who had been working at two manufacturing companies in Kyushu from 1993 to 1997. The intervention company introduced an interview-based health promotion program from 1993. The program consisted of health measuring, group education, and health interviewing all employees to help with their behavioral change. We subdivided the subjects into younger (18-34-yr-old) and older (35-55-yr-old) groups. We defined changing degree (Delta) with (the following data in 1997) minus (the initial data in 1993). With agreement of the subject companies, we compared the Delta of each item, including body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum total cholesterol (T-cho), serum aspartate aminotransaminase (AST), serum alanine aminotransferase (ALT), and serum gammaglutamyl transpeptidase (GGTP), in the intervention with that in the reference. BMI and SBP decreased significantly after the program in the under 35-yr-old intervention group. On the other hand, T-cho, AST, ALT, and GGTP decreased and HDL increased significantly after the program in the over 34-yr-old intervention group. Our results showed that the worksite health promotion had the potential to improve cardiovascular risk factors of Japanese employees.

  4. Public health on the railroad: William Freeman Snow and the California Sanitation Exhibit.

    Science.gov (United States)

    Keller, T M

    1997-11-01

    This paper describes the California Sanitation Exhibit, a railroad car outfitted for instruction in public health that toured California in 1909 and 1910. The sanitation exhibit used display models, photographs, and lectures to educate the public about tuberculosis and other infectious diseases, waste contamination, and the dangers of bad milk. The success of the exhibit, which reached 5% of the state's population, resulted in the appointment of its creator, William Freeman Snow, as secretary of the California State Board of Health.

  5. Using Health Games for Physical Therapy: An Interview with Ernie Medina, DrPH.

    Science.gov (United States)

    2012-08-01

    Dictionary.com defines catalyst as "a person or thing that precipitates an event or change." That certainly defines Ernie Medina, PhD, the subject of this month's Games for Health Journal interview. Dr. Medina is a blithe force in the use of health games, and his enthusiasm, creativity, commitment, and good nature are exciting and engaging. And, the catalytic role he is developing provides the much-needed link between patients who can benefit from health games and doctors looking for effective, high-compliance means for rehabilitation.

  6. Health Impact Assessment of an oil drilling project in California.

    Science.gov (United States)

    McCallum, Lindsay C; Souweine, Kathleen; McDaniel, Mary; Koppe, Bart; McFarland, Christine; Butler, Katherine; Ollson, Christopher A

    2016-01-01

    The Health Impact Assessment (HIA) was conducted to evaluate the potential community health implications of a proposed oil drilling and production project in Hermosa Beach, California. The HIA considered 17 determinants of health that fell under 6 major categories (i.e., air quality, water and soil quality, upset conditions, noise and light emissions, traffic, and community livability). This paper attempts to address some of the gaps within the HIA practice by presenting the methodological approach and results of this transparent, comprehensive HIA; specifically, the evaluation matrix and decision-making framework that have been developed for this HIA and form the basis of the evaluation and allow for a clear conclusion to be reached in respect of any given health determinant (i.e., positive, negative, neutral). There is a number of aspects of the project that may positively influence health (e.g., increased education funding, ability to enhance green space), and at the same time there have been potential negative effects identified (e.g., odor, blowouts, property values). Except for upset conditions, the negative health outcomes have been largely nuisance-related (e.g., odor, aesthetics) without irreversible health impacts. The majority of the health determinants, that had been examined, have revealed that the project would have no substantial effect on the health of the community. Using the newly developed methodology and based on established mitigation measures and additional recommendations provided in the HIA, the authors have concluded that the project will have no substantial effect on community health. This approach and methodology will assist practitioners, stakeholders and decision-makers in advancing the HIA as a useful, reproducible, and informative tool. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  7. Mental Health Workforce Change through Social Work Education: A California Case Study

    Science.gov (United States)

    Foster, Gwen; Morris, Meghan Brenna; Sirojudin, Sirojudin

    2013-01-01

    The 2004 California Mental Health Services Act requires large-scale system change in the public mental health system through a shift to recovery-oriented services for diverse populations. This article describes an innovative strategy for workforce recruitment and retention to create and sustain these systemic changes. The California Social Work…

  8. The Kaiser Permanente Northern California Adult Member Health Survey

    Science.gov (United States)

    Gordon, Nancy; Lin, Teresa

    2016-01-01

    Introduction The Kaiser Permanente Northern California (KPNC) Member Health Survey (MHS) is used to describe sociodemographic and health-related characteristics of the adult membership of this large, integrated health care delivery system to monitor trends over time, identify health disparities, and conduct research. Objective To provide an overview of the KPNC MHS and share findings that illustrate how survey statistics and data have been and can be used for research and programmatic purposes. Methods The MHS is a large-scale, institutional review board-approved survey of English-speaking KPNC adult members. The confidential survey has been conducted by mail triennially starting in 1993 with independent age-sex and geographically stratified random samples, with an option for online completion starting in 2005. The full survey sample and survey data are linkable at the individual level to Health Plan and geocoded data. Respondents are assigned weighting factors for their survey year and additional weighting factors for analysis of pooled survey data. Results Statistics from the 1999, 2002, 2005, 2008, and 2011 surveys show trends in sociodemographic and health-related characteristics and access to the Internet and e-mail for the adult membership aged 25 to 79 years and for 6 age-sex subgroups. Pooled data from the 2008 and 2011 surveys show many significant differences in these characteristics across the 5 largest race/ethnic groups in KPNC (non-Hispanic whites, blacks, Latinos, Filipinos, and Chinese). Conclusion The KPNC MHS has yielded unique insights and provides an opportunity for researchers and public health organizations outside of KPNC to leverage our survey-generated statistics and collaborate on epidemiologic and health services research studies. PMID:27548806

  9. A positive concept of health - interviews with patients and practitioners in an integrative medicine clinic.

    Science.gov (United States)

    Hunter, Jennifer; Marshall, Jack; Corcoran, Katherine; Leeder, Stephen; Phelps, Kerryn

    2013-11-01

    Using the phenomenography method, interviews with patients and practitioners were undertaken to explore their understanding of 'health that is more than the absence of disease'. The question was challenging and stimulating for all interviewees. A few were unable to conceptualise this positive definition of health, some perceived it as an optimum end-state, whereas others saw it as an ongoing process. Many positive attributes of health and its influencers were identified. The more advanced understandings of this concept were of a holistic, multidimensional, expansive state where the all dimensions of health are interdependent and positively reinforcing. The results affirmed that wellness is more than psychological wellbeing, 'happiness' and life satisfaction. Optimum physical and cognitive capacities along with spiritual, social and occupational wellness were equally as important. 'Energy and vitality' were sufficiently emphasised by patients and some practitioners to support the inclusion of the principles of vitalism in any discussion about health. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Palliative care in Germany from a public health perspective: qualitative expert interviews.

    Science.gov (United States)

    Behmann, Mareike; Lückmann, Sara Lena; Schneider, Nils

    2009-06-30

    Improving palliative care is a public health priority. However, little is known about the views of public health experts regarding the state of palliative care in Germany and the challenges facing it. The main aim of this pilot study was to gather information on the views of internationally experienced public health experts with regard to selected palliative care issues, with the focus on Germany, and to compare their views with those of specialist palliative care experts. Qualitative guided interviews were performed with ten experts (five from palliative care, five from public health). The interviews were analysed using qualitative content analysis. Older people and non-cancer patients were identified as target groups with a particular priority for palliative care. By contrast to the public health experts, the palliative care experts emphasized the need for rehabilitative measures for palliative patients and the possibilities of providing these. Significant barriers to the further establishment of palliative care were seen, amongst other things, in the powerful lobby groups and the federalism of the German health system. The findings suggest that from the experts' point of view (1) palliative care should focus on the needs of older people particularly in view of the demographic changes; (2) more attention should be paid to rehabilitative measures in palliative care; (3) rivalries among different stakeholders regarding their responsibilities and the allocation of financial resources have to be overcome in Germany.

  11. Palliative care in Germany from a public health perspective: qualitative expert interviews

    Directory of Open Access Journals (Sweden)

    Schneider Nils

    2009-06-01

    Full Text Available Abstract Background Improving palliative care is a public health priority. However, little is known about the views of public health experts regarding the state of palliative care in Germany and the challenges facing it. The main aim of this pilot study was to gather information on the views of internationally experienced public health experts with regard to selected palliative care issues, with the focus on Germany, and to compare their views with those of specialist palliative care experts. Qualitative guided interviews were performed with ten experts (five from palliative care, five from public health. The interviews were analysed using qualitative content analysis. Findings Older people and non-cancer patients were identified as target groups with a particular priority for palliative care. By contrast to the public health experts, the palliative care experts emphasized the need for rehabilitative measures for palliative patients and the possibilities of providing these. Significant barriers to the further establishment of palliative care were seen, amongst other things, in the powerful lobby groups and the federalism of the German health system. Conclusion The findings suggest that from the experts' point of view (1 palliative care should focus on the needs of older people particularly in view of the demographic changes; (2 more attention should be paid to rehabilitative measures in palliative care; (3 rivalries among different stakeholders regarding their responsibilities and the allocation of financial resources have to be overcome in Germany.

  12. Helping health professionals involved in cancer care acquire key interviewing skills--the impact of workshops.

    Science.gov (United States)

    Maguire, P; Booth, K; Elliott, C; Jones, B

    1996-08-01

    To assess the impact of workshops on key interviewing skills, 169 health professionals involved in cancer care interviewed a simulated patient immediately before and after the workshops and 6 months later. Each interview was audiotaped, transcribed and rated by trained raters using a newly developed rating system which permits an utterance by utterance analysis. The workshops led to significant increases in the use of three behaviours which promote patient disclosure of key concerns. Namely, open directive questions, questions with a psychological focus and clarification of psychological aspects. However, there was no increase in the use of educated guesses and empathic statements which promote disclosure of key problems and feelings. There were significant reductions in behaviours which inhibit disclosure including the use of questions with a physical focus, utterances clarifying physical aspects and the giving of advice prematurely. These significant gains were still evident 6 months later, but there had been some decline over time. There were also significant improvements in the ability of health professionals to elicit patients key problems. Before the workshop, 75 (44%) participants were able to identify at least 60% of their patients' main problems (a criterion of clinical competence) compared with 119 (70%) at 6-month follow-up, an increase in numbers of 59%. Before training, health professionals used as many behaviours which inhibit disclosure as those that promote it. This was unaffected by their professional discipline, prior training or age. It highlights the need for health professionals involved in cancer care to have training in these communication skills. We believe that more intensive group work in smaller groups which focuses on the feelings and attitudes of participants as well as their interviewing behaviour would lead to an increase in the use of educated guesses and empathy and better exploration of patients' feelings.

  13. Current status of health technology reassessment of non-drug technologies: survey and key informant interviews

    Directory of Open Access Journals (Sweden)

    Leggett Laura E

    2012-12-01

    Full Text Available Abstract Background Health Technology Reassessment (HTR is a structured, evidence-based assessment of the clinical, social, ethical and economic effects of a technology currently used in the health care system, to inform optimal use of that technology in comparison to its alternatives. Little is known about current international HTR practices. The objective of this research was to summarize experience-based information gathered from international experts on the development, initiation and implementation of a HTR program. Methods A mixed methods approach, using a survey and in-depth interviews, was adopted. The survey covered 8 concepts: prioritization/identification of potentially obsolete technologies; program development; implementation; mitigation; program championing; stakeholder engagement; monitoring; and reinvestment. Members of Health Technology Assessment International (HTAi and the International Network of Agencies for Health Technology Assessment (INAHTA formed the sampling frame. Participation was solicited via email and the survey was administered online using SurveyMonkey. Survey results were analyzed using descriptive statistics. To gather more in-depth knowledge, semi-structured interviews were conducted among organizations with active HTR programs. Interview questions were developed using the same 8 concepts. The hour-long interviews were recorded, transcribed and analyzed using constant comparative analysis. Results Ninety-five individuals responded to the survey: 49 were not discussing HTR, 21 were beginning to discuss HTR, nine were imminently developing a program, and 16 participants had programs and were completing reassessments. The survey results revealed that methods vary widely and that although HTR is a powerful tool, it is currently not being used to its full potential. Of the 16 with active programs, nine agreed to participate in follow-up interviews. Interview participants identified early and extensive stakeholder

  14. [Physical activity: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

    Science.gov (United States)

    Krug, S; Jordan, S; Mensink, G B M; Müters, S; Finger, J; Lampert, T

    2013-05-01

    Regular physical activity can have a positive effect on health at any age. Today's lifestyles, however, can often be characterised as sedentary. Therefore, the promotion of physical activity and sports has become an integral part of public health measures. The representative data of adults aged 18 to 79 years in Germany obtained from the "German Health Interview and Examination Survey for Adults" (DEGS1) provide an overview of self-estimated current physical activity behaviour. The results show that one third of the adult population claims to pay close attention to reaching a sufficient level of physical activity and one fourth participates in sports for at least 2 h/week on a regular basis. Thus, the percentage of adults regularly engaged in sports has increased compared to the previous "German National Health Interview and Examination Survey 1998". Still, four out of five adults do not achieve at least 2.5 h/week of moderate-intensity physical activity as recommended by the World Health Organisation. Consequently, future individual-level and population-level interventions should focus on target group-specific measures while continuing to promote regular physical activity in all segments of the population. An English full-text version of this article is available at SpringerLink as supplemental.

  15. The public health system response to the 2008 Sichuan province earthquake: a literature review and interviews.

    Science.gov (United States)

    Lin, Leesa; Ashkenazi, Isaac; Dorn, Barry C; Savoia, Elena

    2014-10-01

    This paper describes and analyses the public health system response to the deadly earthquake in Sichuan province, China, in May 2008. Drawing on an experiential learning project consisting of a literature review and field research, including a series of interviews with medical and public health professionals, policy-makers and first responders, a conceptual framework was developed to describe the response. This approach emphasises the pre-existing preparedness level of the medical and public health systems, as well as social, economic and geo-political factors that had an impact on mitigation efforts. This framework was used to conduct post-disaster analyses addressing major response issues and examining methods employed during the public health response to the disaster. This framework could be used to describe and analyse the emergency response to other disasters. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

  16. Narrative interviewing.

    Science.gov (United States)

    Anderson, Claire; Kirkpatrick, Susan

    2016-06-01

    Introduction Narrative interviews place the people being interviewed at the heart of a research study. They are a means of collecting people's own stories about their experiences of health and illness. Narrative interviews can help researchers to better understand people's experiences and behaviours. Narratives may come closer to representing the context and integrity of people's lives than more quantitative means of research. Methodology Researchers using narrative interview techniques do not set out with a fixed agenda, rather they tend to let the interviewee control the direction, content and pace of the interview. The paper describes the interview process and the suggested approach to analysis of narrative interviews, We draw on the example from a study that used series of narrative interviews about people's experiences of taking antidepressants. Limitations Some people may find it particularly challenging to tell their story to a researcher in this way rather than be asked a series of questions like in a television or radio interview. Narrative research like all qualitative research does not set out to be generalisable and may only involve a small set of interviews.

  17. Trends in visual acuity impairment in US adults: the 1986-1995 National Health Interview Survey.

    Science.gov (United States)

    Lee, David J; Gómez-Marín, Orlando; Lam, Byron L; Zheng, D Diane; Jané, Dulce M

    2004-04-01

    To assess 10-year trends in reported visual impairment. The National Health Interview Survey is a continuous multistage area probability survey of the US civilian noninstitutionalized population living at addressed dwellings. Adults within randomly selected households were administered a chronic conditions list that included questions about visual impairment. Proxy information on these conditions was obtained when household members were unavailable for interview. Complete data were available on 132 860 adults 18 years or older in survey years 1986 to 1995. Prevalence rates were adjusted for age and sample survey design. Annual age-adjusted rates of some visual impairment ranged from 3.6% to 4.6%. Rates of severe bilateral visual impairment ranged from 0.2% to 0.4%. There was some evidence for increasing rates of visual impairment among younger adults 18 to 39 years of age (annual increase, 0.03%; P =.03). However, there were no significant changes in reported visual impairment rates in older adults stratified into 10-year age groups. Data from the National Health Interview Survey provide no evidence that reported visual impairment rates are declining in the US noninstitutionalized population from 1986 to 1995. Additional treatment advances, greater use of existing treatments, including correcting refractive errors, and further reductions in risk factors for disabling eye diseases may be necessary before population-level reductions in visual impairment rates can be achieved.

  18. [Measurement of socioeconomic status in the German Health Interview and Examination Survey for Adults (DEGS1)].

    Science.gov (United States)

    Lampert, T; Kroll, L; Müters, S; Stolzenberg, H

    2013-05-01

    Socioeconomic status (SES) constitutes a central analysis category of epidemiological research and health reporting. As part of the German cardiovascular disease prevention study 1984-1991, a multi-dimensional aggregated index was developed for the purpose of measuring SES. This index continues to be used in numerous studies to this day. For the purpose of health monitoring at the Robert Koch Institute (RKI), the index was fundamentally revised following critical assessment. This article describes the basic concepts underlying the revision and how they were implemented in relation to the "German health interview and examination survey for adults" (DEGS1). In addition, the results of the age and sex-specific distribution of the values of the revised SES index and those relating to the connection with other measurements of socioeconomic status are reported. The results are based on the data of DEGS1 2012 and the German national health interview and examination survey 1998 (GNHIES98). An English full-text version of this article is available at SpringerLink as supplemental.

  19. Health Care Practitioners' perceptions of motivational interviewing training for facilitating behaviour change among patients.

    Science.gov (United States)

    Wiley, Erin J; Irwin, Jennifer D; Morrow, Don

    2012-01-01

    To investigate, qualitatively, practitioners' perceptions of a 1-day interactive and applied workshop in motivational interviewing (MI). Specifically, participants explored the training's usefulness in supporting perceptions of competence, confidence, and attitudes towards facilitating behaviour change among patients. Ten health practitioners including dieticians, pharmacists, nurses, and social workers participated in this qualitative pilot study. Participants received a 1-day (7.5 hour) workshop focused on MI. In-depth one-on-one interviews were conducted prior to the workshop and at 1 and 4 weeks post-training. Methods were employed throughout to ensure data trustworthiness. Pre-workshop themes about facilitating patient behaviour change included: persistence; advice-giving; behaviour change as hard work for practitioner; low perceived confidence and competence to help; barriers; and feelings of frustration. Post-workshop themes included a renewed inspiration and motivation to facilitate behaviour change; partnering with patients and giving less advice; experiencing a positive perceived impact on the patients; feeling that behaviour change is easier and less stressful; enjoying higher levels of competence and confidence; and being mindful of practitioner impact. Participation in the structured, interactive, and applied MI training was deemed effective by practitioners dealing with patient behaviour change. Allied health care practitioners are in a key position to facilitate health behaviour changes that contribute to behaviour-related illness. The integration of similar MI trainings for health practitioners should be further explored with a larger group.

  20. Mothers' perceptions of their health choices, related duties and responsibilities: A qualitative interview study.

    Science.gov (United States)

    Kangasniemi, Mari; Blomberg, Katja; Korhonen, Anne

    2015-11-01

    to describe mothers' perceptions of their health choices, related duties and responsibilities. descriptive exploratory study with qualitative research method. interviews conducted after the clients' regular health visits to one publicly provided maternity clinic in a southern city in Finland. 13 mothers aged between 21 and 40-years-old, who were pregnant or had given birth in the past four weeks. Six of participants were pregnant or had delivered for first time and it was the second to fourth pregnancy for the remainder. one-to-one semi-structured interviews using the inductive content analysis method. women reported increased responsibility for their health choices for themselves and their baby during pregnancy. However, their duties and responsibilities were seldom discussed at maternity clinics. The duty to reconsider their health choices was described as a predictor of commitment to their pregnancy and motherhood, but they recognised that it required sufficient knowledge to realise this. In addition, the mothers said their health choices changed from private to one of public interest during this period. health choices are connected to maternal duties and responsibilities, but they can sometimes lack clarity during this new phase of life. In future, more research should be conducted to study maternal duties and responsibilities in different contexts. findings highlight the skills of nurses and midwives at maternity clinics to discuss and support mothers' moral pondering during pregnancy. Although health choices in general are well recognised as a part of maternal counselling, these findings suggest a moral perspective should be incorporated into the advice that is provided. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Service user engagement: A co-created interview schedule exploring mental health recovery in young adults.

    Science.gov (United States)

    McCauley, Claire-Odile; McKenna, Hugh; Keeney, Sinead; McLaughlin, Derek

    2017-10-01

    The aim of this study was to co-create of an interview schedule exploring mental health recovery in collaboration with young adult service users. Service user involvement in research has been increasingly recognized as providing a vital authentic insight into mental health recovery. Engagement and collaboration with service users have facilitated the exploration of inaccessible or under-investigated aspects of the lived experience of mental health recovery, not only directing the trajectory of research, but making it relevant to their own contextual experience. A qualitative content analysis framework was employed in the co-creation of a semi-structured interview schedule through an engagement process with service users. Two separate engagement groups took place at the premises of the service user organizations, between January - February 2014. Miles and Huberman's analysis framework was chosen for this phase as it enabled the visual presentation of factors, concepts or variables and the established relationship between them. The lived experience of mental ill health in young adulthood and how this was understood by others was a particularly relevant theme for participants. Further themes were identified between the impact of painful experiences at this developmental life stage leading to a deeper understanding of others through finding meaning in their own mental health recovery journey. Our findings identified that suffering painful experiences is an integral aspect in the process of mental health recovery. This understanding has particular relevance to mental health nursing practice, ensuring the care delivered is cognizant of the suffering or painful experiences that young adults are encountering. © 2017 John Wiley & Sons Ltd.

  2. Ethnic politics, policy fragmentation, and dependent health care access in California.

    Science.gov (United States)

    Leichter, Howard

    2004-04-01

    One out of every six nonelderly Americans without health insurance lives in California. The problem of access to competent and dependable health care is especially problematic among the state's minority, and especially Hispanic, population. Because one-third of the country's Hispanics live in California, how this state deals with health access issues will affect the practice and progress toward universal care in the nation as a whole. Expanding health care access to California's dependent population will involve overcoming a number of well-known administrative and fiscal obstacles, including an underfunded, highly fragmented public health care system that has developed incrementally and incoherently over decades. However, a key to understanding the problem of access to health care in California involves a story of how ethnic conflict and partisan politics often conspire to deny or discourage access for eligible women and children.

  3. Effectiveness of motivational interviewing at improving oral health: a systematic review.

    Science.gov (United States)

    Cascaes, Andreia Morales; Bielemann, Renata Moraes; Clark, Valerie Lyn; Barros, Aluísio J D

    2014-02-01

    To analyze the effectiveness of motivational interviewing (MI) at improving oral health behaviors (oral hygiene habits, sugar consumption, dental services utilization or use of fluoride) and dental clinical outcomes (dental plaque, dental caries and periodontal status). A systematic search of PubMed, LILACS, SciELO, PsyINFO, Cochrane and Google Scholar bibliographic databases was conducted looking for intervention studies that investigated MI as the main approach to improving the oral health outcomes investigated. Of the 78 articles found, ten met the inclusion criteria, all based on randomized controlled trials. Most studies (n = 8) assessed multiple outcomes. Five interventions assessed the impact of MI on oral health behaviors and nine on clinical outcomes (three on dental caries, six on dental plaque, four on gingivitis and three on periodontal pockets). Better quality of evidence was provided by studies that investigated dental caries, which also had the largest population samples. The evidence of the effect of MI on improving oral health outcomes is conflicting. Four studies reported positive effects of MI on oral health outcomes whereas another four showed null effect. In two interventions, the actual difference between groups was not reported or able to be recalculated. We found inconclusive effectiveness for most oral health outcomes. We need more and better designed and reported interventions to fully assess the impact of MI on oral health and understand the appropriate dosage for the counseling interventions.

  4. Effectiveness of motivational interviewing at improving oral health: a systematic review

    Directory of Open Access Journals (Sweden)

    Andreia Morales Cascaes

    2014-02-01

    Full Text Available OBJECTIVE : To analyze the effectiveness of motivational interviewing (MI at improving oral health behaviors (oral hygiene habits, sugar consumption, dental services utilization or use of fluoride and dental clinical outcomes (dental plaque, dental caries and periodontal status. METHODS : A systematic search of PubMed, LILACS, SciELO, PsyINFO, Cochrane and Google Scholar bibliographic databases was conducted looking for intervention studies that investigated MI as the main approach to improving the oral health outcomes investigated. RESULTS : Of the 78 articles found, ten met the inclusion criteria, all based on randomized controlled trials. Most studies (n = 8 assessed multiple outcomes. Five interventions assessed the impact of MI on oral health behaviors and nine on clinical outcomes (three on dental caries, six on dental plaque, four on gingivitis and three on periodontal pockets. Better quality of evidence was provided by studies that investigated dental caries, which also had the largest population samples. The evidence of the effect of MI on improving oral health outcomes is conflicting. Four studies reported positive effects of MI on oral health outcomes whereas another four showed null effect. In two interventions, the actual difference between groups was not reported or able to be recalculated. CONCLUSIONS : We found inconclusive effectiveness for most oral health outcomes. We need more and better designed and reported interventions to fully assess the impact of MI on oral health and understand the appropriate dosage for the counseling interventions.

  5. Effectiveness of motivational interviewing at improving oral health: a systematic review

    Science.gov (United States)

    Cascaes, Andreia Morales; Bielemann, Renata Moraes; Clark, Valerie Lyn; Barros, Aluísio J D

    2014-01-01

    OBJECTIVE To analyze the effectiveness of motivational interviewing (MI) at improving oral health behaviors (oral hygiene habits, sugar consumption, dental services utilization or use of fluoride) and dental clinical outcomes (dental plaque, dental caries and periodontal status). METHODS A systematic search of PubMed, LILACS, SciELO, PsyINFO, Cochrane and Google Scholar bibliographic databases was conducted looking for intervention studies that investigated MI as the main approach to improving the oral health outcomes investigated. RESULTS Of the 78 articles found, ten met the inclusion criteria, all based on randomized controlled trials. Most studies (n = 8) assessed multiple outcomes. Five interventions assessed the impact of MI on oral health behaviors and nine on clinical outcomes (three on dental caries, six on dental plaque, four on gingivitis and three on periodontal pockets). Better quality of evidence was provided by studies that investigated dental caries, which also had the largest population samples. The evidence of the effect of MI on improving oral health outcomes is conflicting. Four studies reported positive effects of MI on oral health outcomes whereas another four showed null effect. In two interventions, the actual difference between groups was not reported or able to be recalculated. CONCLUSIONS We found inconclusive effectiveness for most oral health outcomes. We need more and better designed and reported interventions to fully assess the impact of MI on oral health and understand the appropriate dosage for the counseling interventions. PMID:24789647

  6. Health risk assessment of pentachlorophenol (pcp) in California drinking water. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Reed, N.R.; Reed, W.A.; Encomienda, I.; Beltran, L.; Araba-Owoyele, L.

    1990-03-08

    The purpose of the document is to review the toxicology of PCP and to estimate the exposure of California residents to PCP found in drinking water. The information provided will help the California Dept. of Health Services develop drinking water standards for PCP.

  7. Forest health monitoring in California, Oregon, and Washington: results and interpretation

    Science.gov (United States)

    Richard T. Busing

    2000-01-01

    From 1992 to 1997, standardized plots were established at about 500 sites in California, Oregon, and Washington as part of the national Forest Health Monitoring program. In California, 197 plots were established from 1992 to 1995; in Oregon and Washington, a total of 304 plots were established in 1997. Summarization of baseline data by state reveals similarities and...

  8. Acupuncture Use among American Adults: What Acupuncture Practitioners Can Learn from National Health Interview Survey 2007?

    Directory of Open Access Journals (Sweden)

    Yan Zhang

    2012-01-01

    Full Text Available This paper examined the National Health Interview Survey (NHIS 2007 and explored acupuncture users sociodemographics characteristics, reasons and the nature of acupuncture use, and the relationship of such use with conventional medical care. All individuals who completed adults core interviews (N = 23,393 were included. Three subsets of samples (nonuser, former user, and recent user were used in the analysis performed in Stata. Our findings revealed that ever acupuncture user (including former and recent user increased from 4.2% to 6.3% of the population, representing 8.19 million and 14.01 million users in 2002 and 2007, respectively. We expected this trend to continue. People not only used acupuncture as a complementary and alternative approach to conventional treatment for a specific health condition, but also used it as a preventive means to promote general health. Effectiveness and safety appeared not to be the main predictors of acupuncture use; rather, awareness, cost, and insurance coverage played a bigger role in decision making.

  9. The Fruit & Vegetable Screener in the 2000 California Health Interview Survey: Validation Results

    Science.gov (United States)

    In this study, multiple 24-hour recalls in conjunction with a measurement error model were used to assess validity. The screeners used in the EATS included additional foods and reported portion sizes.

  10. The Fruit & Vegetable Screener in the 2000 California Health Interview Survey: Scoring Procedures

    Science.gov (United States)

    Scoring procedures were developed to convert the individual respondent's screener responses to estimates of individual dietary intake for servings of fruits and vegetables using USDA's 1994-96 Continuing Survey of Food Intakes of Individuals (CSFII 94-96) dietary recall data.

  11. Women's childhood and adult adverse experiences, mental health, and binge drinking: The California Women's Health Survey

    Directory of Open Access Journals (Sweden)

    Pavao Joanne

    2008-06-01

    Full Text Available Abstract Background This study examined sociodemographic, physical and mental health, and adult and childhood adverse experiences associated with binge drinking in a representative sample of women in the State of California. Materials and methods Data were from the 2003 to 2004 (response rates of 72% and 74%, respectively California Women's Health Survey (CWHS, a population-based, random-digit-dial annual probability survey sponsored by the California Department of Health Services. The sample was 6,942 women aged 18 years or older. Results The prevalence of binge drinking was 9.3%. Poor physical health, and poorer mental health (i.e., symptoms of PTSD, anxiety, and depression, feeling overwhelmed by stress, were associated with binge drinking when demographics were controlled, as were adverse experiences in adulthood (intimate partner violence, having been physically or sexually assaulted, or having experienced the death of someone close and in childhood (living with someone abusing substances or mentally ill, or with a mother vicimized by violence, or having been physically or sexually assaulted. When adult mental health and adverse experiences were also controlled, having lived as a child with someone who abused substances or was mentally ill was associated with binge drinking. Associations between childhood adverse experiences and binge drinking could not be explained by women's poorer mental health status in adulthood. Conclusion Identifying characteristics of women who engage in binge drinking is a key step in prevention and intervention efforts. Binge drinking programs should consider comprehensive approaches that address women's mental health symptoms as well as circumstances in the childhood home.

  12. Geographic distribution of California mental health professionals in relation to sociodemographic characteristics.

    Science.gov (United States)

    Sharma, Ryan N; Casas, Rachel N; Crawford, Nicole M; Mills, Lauren N

    2017-10-01

    To determine whether geographic access to licensed mental health providers in California is a barrier for underserved populations. Data from the master file of the California Board of Psychology and Board of Behavioral Sciences were merged with U.S. Census data to determine the correlations between the concentration of providers and the corresponding sociodemographic characteristics of places in California. This article shows that the concentration of licensed mental health providers in the communities of California varies systematically with the racial, ethnic, age, education, and economic characteristics of those places. Specifically, licensed mental health providers are more concentrated in places that are wealthier, Whiter, older, and more educated. Policy and advocacy efforts in health service psychology can help assure more equitable distribution of mental health services. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Workplace Harassment and Morbidity Among US Adults: Results from the National Health Interview Survey.

    Science.gov (United States)

    Khubchandani, Jagdish; Price, James H

    2015-06-01

    Most research on workplace harassment originates from European countries.Prevalence of workplace harassment and associated morbidity has not been well studied in the United States. The purpose of this study was to assess in a sample of US workers the prevalence of workplace harassment and the psychological and physical health consequences of workplace harassment. The 2010 National Health Interview Survey data were analyzed in 2014 for this study. We computed the prevalence of workplace harassment, assessed the demographic and background characteristics of victims of harassment, and tested the association between harassment and selected health risk factors by using logistic regression analysis. Statistical significance was established as p workplace in the past 12 months. The odds of harassment were significantly higher for females (OR 1.47, p gender and distinct health risk patterns for men and women victims were observed. Workplace harassment in the US is associated with significant health risk factors and morbidity. Workplace policies and protocols can play a significant role in reducing harassment and the associated negative health outcomes.

  14. Using a Prompt Sheet to Improve the Reference Interview in a Health Telephone Helpline Service

    Directory of Open Access Journals (Sweden)

    Toni Price

    2007-09-01

    Full Text Available Objective‐ The study examined whether a prompt sheet improved the reference interview process for health information advisers working at NHS Direct, a 24‐hour telephone helpline that provides confidential health care advice for the public in England.Methods ‐ A randomised control trial was conducted at eight NHS Direct sites across England in 2003‐04. Newly recruited health information advisers (n=30, full and part‐time,were randomly allocated to a control group (n=15 or intervention group (n=15, and 26 completed the study. Existing health information advisers were involved in the planning and design of the intervention. The prompt sheet included prompts for demographic information, reason for call, condition/treatment plan, existing knowledge of caller, special needs of the caller, handling a call empathetically, and conclusion. Testing of reference interview expertise was done at the end of basic training, and two months later, using the same questions. The ten test questions were based on common questions received by NHS Direct. A relevance framework for possible responses was drawn up for each question for scoring test responses, with more relevant responses scoring higher than less relevant responses.Results‐ The average score of prompt (experimental and non‐prompt (control participants increased on the second test, for each of the 10 questions. The prompt group improved significantly more overall than the control group. There was variation within the groups. Sixteen health information advisers showed a net increase in their score over all ten questions (10 experimental group, six control group. The post‐test score for an individualon a particular question did sometimes decrease from the pre‐test score, but all 26 improved on at least one question. Previous call handler experience did not appear to influence the extent of improvement, but length and type of experience in the post may have an influence.Conclusion ‐ The

  15. Preconditions needed for establishing a trusting relationship during health counselling - an interview study.

    Science.gov (United States)

    Eriksson, Irene; Nilsson, Kerstin

    2008-09-01

    To examine the preconditions needed by district nurses to build a trusting relationship during health counselling of patients with hypertension. Trust has been found to be an important aspect of the patient-nurse relationship. Little research has focused on how trust is formed in patient-nurse relationships or the conditions the development process requires when working with health counselling; in particular not in relation to hypertension. Qualitative study. Qualitative data were collected through open-ended interviews with all (10) district nurses from three primary health care districts of western Sweden. All interviewees work with the health counselling of patients with hypertension. A latent content analysis was performed with thematic coding of the content of the interviews. The first theme that emerged from the analysis, the nurses' competence, describes the nurses' consciousness of their method of expression, both oral and non-verbal, as well as their pedagogical competence and their ability to be reliable in their profession. The second theme, the patient meeting, describes the continuity in the patient meeting and creating respectful communication. The results show an awareness of preconditions influencing building a trusting relationship. When creating a trusting relationship the communication and pedagogical competences of district nurses have considerable importance. Despite this awareness they state that it is easy to fall into a routinised way of working. The implications of this study might be used as support and guidance for district nurses when developing their competence in health counselling in relations to patients with hypertension. This knowledge is also important when planning for nurse-led clinics for this patient group.

  16. Valuation of transfusion-free living in MDS: results of health utility interviews with patients

    Directory of Open Access Journals (Sweden)

    Lübbert Michael

    2009-09-01

    Full Text Available Abstract Background This study measured how myelodysplastic syndrome (MDS patients value transfusion independence (TI, reduced transfusions (RT and transfusion-dependence (TD using health utility assessment methodology. Methods 47 MDS patients were interviewed, US (n = 8, France (n = 9, Germany (n = 9 and the UK (n = 21, to elicit the utility value of TI, RT and TD. Health states were developed based on literature; patient forum discussions; and were validated by a hematologist. Face-to-face interviews used the feeling thermometer Visual Analogue Scale (VAS and the Time Trade-Off (TTO method to value the health states on a 0 (dead to 1 (perfect health scale. Socio-demographic, clinical, and quality-of-life (EQ-5D characteristics were surveyed to describe the patient sample. Results and Discussion The mean age was 67 years (range: 29-83; 45% male, 70% retired; 40% had secondary/high school education, or higher (32%, and 79% lived with family, a partner or spouse, or friends. The mean time from MDS diagnosis was 5 years (range:1-23. Most patients (87% received previous transfusions and 49% had received a transfusion in the last 3 months. Mean EQ-5D index score was 0.78; patients reported at least some problem with mobility (45%, usual activities (40%, pain/discomfort (47%, and anxiety/depression (34%. Few patients had difficulty understanding the VAS (n = 3 and TTO (n = 4 exercises. Utility scores for TI were higher than for RT (0.84 vs. 0.77; p Conclusion Patients value TI, suggesting an important role for new treatments aiming to achieve greater TI in MDS. These results can be used in preference-based health economic evaluation of new MDS treatments, such as in future cost-utility studies.

  17. Linking emotional distress to unhealthy sleep duration: analysis of the 2009 National Health Interview Survey

    Directory of Open Access Journals (Sweden)

    Seixas AA

    2015-09-01

    Full Text Available Azizi A Seixas,1 Joao V Nunes,2 Collins O Airhihenbuwa,3 Natasha J Williams,1 Seithikurippu Ratnas Pandi-Perumal,1 Caryl C James,4 Girardin Jean-Louis11Center for Healthful Behavior Change, Department of Population Health, Division of Population Health, New York University School of Medicine, 2Sophie Davis School of Biomedical Education, City College of New York, New York, NY, USA; 3Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA; 4Department of Sociology, Psychology and Social Work, The University of the West Indies, Mona, JamaicaObjective: The objective of the study was to examine the independent association of emotional distress with unhealthy sleep duration (defined as <7 or >8 hours.Methods: Data from the 2009 National Health Interview Survey (NHIS, a cross-sectional household survey, were analyzed to investigate the associations of emotional distress with unhealthy sleep durations, adjusting for sociodemographic factors, health risks, and chronic diseases through hierarchical multiple logistic regression analysis.Participants: A total of 27,731 participants (age range 18–85 years from the NHIS 2009 dataset were interviewed.Measures: Unhealthy sleep duration is defined as sleep duration <7 or >8 hours, whereas healthy sleep is defined as sleep duration lasting for 7–8 hours. Emotional distress is based on the Kessler 6 Non-Specific Distress Battery, which assesses the frequency of feeling sad, nervous, restless, hopeless, worthless, and burdened, over a 30-day period.Results: Of the sample, 51.7% were female; 83.1% were white and 16.9% were black. Eleven percent experienced emotional distress and 37.6% reported unhealthy sleep. Adjusted logistic regression analysis revealed that individuals with emotional distress had 55% greater odds of reporting unhealthy sleep (odds ratio [OR] =1.55, 95% confidence interval [CI] =1.42, 1.68, P<0.001.Conclusion: Emotional distress, an important proxy for

  18. Interviews with Patients and Providers on Transgender and Gender Nonconforming Health Data Collection in the Electronic Health Record.

    Science.gov (United States)

    Dunne, M J; Raynor, Lewis A; Cottrell, Erika K; Pinnock, William J A

    2017-01-01

    Purpose: Meaningful use (MU) and Uniform Data Systems (UDSs) are calling for the collection of gender identity (GI) in electronic health record (EHR) systems; however, many transgender and nonconforming (TGNC) patients may not feel safe disclosing their GI and the data collection is not designed to guide care provision. This study explores the complexities surrounding the inclusion of GI in EHR data collection and how it can best serve patients and providers. Methods: Using a semistructured interview format, TGNC patients (n=7) and providers (n=5) who care for TGNC patients were asked about data collection procedures and the use of these data within community health centers in Oregon. Using a constant comparative data analysis methodology, interview transcripts were coded for emergent concepts until overlapping themes were identified. Results: Both patients and providers expressed a need for the EHR to expand upon MU and UDS-recommended fields to include current pronouns and name and gender identifiers in a forward-facing display to prevent misgendering by clinic staff and providers. Furthermore, they both cited the need for a broader range of birth-assigned sex and gender options. TGNC patients and providers disagreed on the scope of health information to be collected as well as who should be tasked with the data collection. Conclusion: These interviews offer us a glimpse into the structural difficulties of creating an EHR system that serves the needs of clinicians while providing safe and culturally competent care to TGNC patients.

  19. Physiotherapy students enhance awareness of motivational interviewing skills needed in health promotion

    DEFF Research Database (Denmark)

    Ringby, Betina

    questionnaire. 23 students completed the questionnaire (46%). A content analysis of data was made, themes categorized and developed. Findings Students expressed personal development and working with own cases as important motivational factors for coming to class. 83 % had read all or parts of the literature......Background Health professionals who are skilled at communicating are a prerequisite for providing services of high quality. Physiotherapists work within health promotion and support people in change of lifestyle. The aim of this project was to gain insight into physiotherapy students’ motivation...... to train their practical communication skills and what students learned after a training session. The theory of motivational interviewing and the Calgary Cambridge guide served as a basic framework. Methods Training was undergone as an audiovisual training session with an actor. 5th semester physiotherapy...

  20. Awareness of cancer susceptibility genetic testing: the 2000, 2005, and 2010 National Health Interview Surveys.

    Science.gov (United States)

    Mai, Phuong L; Vadaparampil, Susan Thomas; Breen, Nancy; McNeel, Timothy S; Wideroff, Louise; Graubard, Barry I

    2014-05-01

    Genetic testing for several cancer susceptibility syndromes is clinically available; however, existing data suggest limited population awareness of such tests. To examine awareness regarding cancer genetic testing in the U.S. population aged ≥25 years in the 2000, 2005, and 2010 National Health Interview Surveys. The weighted percentages of respondents aware of cancer genetic tests, and percent changes from 2000-2005 and 2005-2010, overall and by demographic, family history, and healthcare factors were calculated. Interactions were used to evaluate the patterns of change in awareness between 2005 and 2010 among subgroups within each factor. To evaluate associations with awareness in 2005 and 2010, percentages were adjusted for covariates using multiple logistic regression. The analysis was performed in 2012. Awareness decreased from 44.4% to 41.5% (ptesting in 2010. Notably, disparities persist for racial/ethnic minorities and individuals with limited health care access or income. Published by Elsevier Inc.

  1. Roles and responsibilities of pharmacists with respect to natural health products: key informant interviews.

    Science.gov (United States)

    Olatunde, Shade; Boon, Heather; Hirschkorn, Kristine; Welsh, Sandy; Bajcar, Jana

    2010-03-01

    Although many pharmacies sell natural health products (NHPs), there is no clear definition as to the roles and responsibilities (if any) of pharmacists with respect to these products. The purpose of this study was to explore pharmacy and stakeholder leaders' perceptions of pharmacists' professional NHP roles and responsibilities. Semi-structured key informant interviews were conducted with pharmacy leaders (n=17) and stakeholder (n=18) leaders representing consumers, complementary and alternative medicine practitioners, conventional health care practitioners, and industry across Canada. All participants believed a main NHP responsibility for pharmacists was in safety monitoring, although a one challenge identified in the interviews was pharmacists' general lack of NHP knowledge; however, stakeholder leaders did not expect pharmacists to be experts, but should have a basic level of knowledge about NHPs. Participants described pharmacists' professional roles and responsibilities for NHPs as similar to those for over-the-counter drugs; more awareness of existing NHP-related pharmacy policies is needed, and pharmacy owners/managers should provide additional training to ensure front-line pharmacists have appropriate knowledge of NHPs sold in the pharmacy. Copyright 2010 Elsevier Inc. All rights reserved.

  2. Contraceptive counselling of women seeking abortion - a qualitative interview study of health professionals' experiences.

    Science.gov (United States)

    Kilander, Helena; Salomonsson, Birgitta; Thor, Johan; Brynhildsen, Jan; Alehagen, Siw

    2017-02-01

    A substantial proportion of women who undergo an abortion continue afterwards without switching to more effective contraceptive use. Many subsequently have repeat unintended pregnancies. This study, therefore, aimed to identify and describe health professionalś experiences of providing contraceptive counselling to women seeking an abortion. We interviewed 21 health professionals (HPs), involved in contraceptive counselling of women seeking abortion at three differently sized hospitals in Sweden. The interviews were recorded and transcribed verbatim and analysed using conventional qualitative content analysis. Three clusters were identified: 'Complex counselling', 'Elements of counselling' and 'Finding a method'. HPs often experienced consultations including contraceptive counselling at the time of an abortion as complex, covering both pregnancy termination and contraceptive counselling. Women with vulnerabilities placed even greater demands on the HPs providing counselling. The HPs varied in their approaches when providing contraceptive counselling but also in their knowledge about certain contraception methods. HPs described challenges in finding out if women had found an effective method and in the practicalities of arranging intrauterine device (IUD) insertion post-abortion, when a woman asked for this method. HPs found it challenging to provide contraceptive counselling at the time of an abortion and to arrange access to IUDs post-abortion. There is a need to improve their counselling, their skills and their knowledge to prevent repeat unintended pregnancies.

  3. Payoffs for California College Students and Taxpayers from Investing in Student Mental Health.

    Science.gov (United States)

    Ashwood, J Scott; Stein, Bradley D; Briscombe, Brian; Sontag-Padilla, Lisa; Woodbridge, Michelle W; May, Elizabeth; Seelam, Rachana; Burnam, M Audrey

    2016-05-09

    Reports results of a survey to assess the impact of CalMHSA's investments in mental health programs at California public colleges and estimates the return on investment in terms of student use of treatment, graduation rates, and lifetime earnings.

  4. Provider perceptions and expectations of breast cancer posttreatment care: a University of California Athena Breast Health Network project.

    Science.gov (United States)

    Hahn, Erin E; Ganz, Patricia A; Melisko, Michelle E; Pierce, John P; von Friederichs-Fitzwater, Marlene; Lane, Karen T; Hiatt, Robert A

    2013-09-01

    The Athena Breast Health Network collaboration is a University of California system-wide project initiated with the intent to drive innovation in breast cancer prevention, screening, and treatment. This qualitative research examines provider perceptions and expectations of posttreatment breast cancer care across five network sites with the goal of better understanding provider behavior during the posttreatment phase of the cancer care trajectory. Investigators at each site conducted semi-structured interviews with oncology specialists and primary care providers (PCPs). Interviews used case study examples and open- and closed-ended questions on the delivery of posttreatment breast cancer care. Informant responses were manually recorded by the interviewer, compiled in a database, then coded and analyzed using NVivo 9 software. There were 39 key informants across the sites: 14 medical oncologists, 7 radiation oncologists, 11 surgeons, 3 oncology nurses, and 4 PCPs. Care coordination was a major unprompted theme identified in the interviews. There was a perceived need for greater care coordination across institutions in order to improve delivery of posttreatment health care services and a need for greater care coordination within oncology, particularly to help avoid duplication of follow-up care and services. Participants expect frequent follow-up visits and to use biomarker tests and advanced imaging services as part of routine surveillance care. Implementing survivorship care programs was perceived as a way to improve care delivery. These results identify a need for increased focus on care coordination during the posttreatment phase of breast cancer care within the University of California system and the potential for system and provider-level interventions that could help increase coordination of posttreatment care. Breast cancer survivors do not always receive evidence-based care. This research helps to better understand what motivates provider behavior during the

  5. Has this doctor-governor found the key to health reform?. Interview by Berkeley Rice.

    Science.gov (United States)

    Dean, H

    1993-02-22

    Under the leadership of internist Howard Dean, the nation's only physician-governor, Vermont is adopting a comprehensive health-care plan that will revolutionize the way the state's doctors practice medicine. As Vermont goes, so may the nation, for Dean is one of the key advisers to the Clinton administration on health-care reform. But if the Vermont plan serves as a model for the rest of the country, many doctors may find it a better pill to swallow. Among other things, it could mean that nearly all the state's physicians will, in effect, participate in a state-run HMO and be subject to global fees and budgets that will also cover hospitals (see opposite page). While the plan's specific provisions are still being debated, Dean's views have spread to other states and to the Clinton administration through his role as co-chairman of the National Governor's Association task force on health care. In a recent interview with Senior Associate Editor Berkeley Rice in the governor's office in Montpelier, Dean discussed Vermont's new health plan, its importance as a model for other states, and his unique perspective as physician-governor.

  6. Mental health nursing students' experiences of stress during training: a thematic analysis of qualitative interviews.

    Science.gov (United States)

    Galvin, J; Suominen, E; Morgan, C; O'Connell, E-J; Smith, A P

    2015-12-01

    What is known on the subject? Stress can impact students on mental health nurse training. This can have implications at the individual level (e.g. their own mental health) and at the level of the organization (e.g. sickness absence and attrition). What this paper adds to existing knowledge? We interviewed 12 mental health nursing students regarding the stress they experienced during training. Participants described how the academic demands can at times be unbearable during clinical placements. There were also issues with 'being a student' on some placements, with participants describing negative attitudes towards them from staff. The younger participants reported feeling overwhelmed on their initial placements and described some of the main challenges of mental health work for them. Raising concerns about the quality of care on wards was also described as particularly challenging for the students. What are the implications for practice? This paper can be useful to help training providers support mental health nursing students. Recommendations include reducing academic demands during clinical placements and extending and promoting existing support services beyond normal 9 am-5 pm working hours, even if these services are limited. Younger students could be better supported by being allocated to the more well-resourced placements in the early stages of their training. Raising awareness among staff of the tasks students can and cannot perform can help improve staff/student relations. Finally, students should be educated about the issues around raising concerns on placements to help the government's drive for a more open and transparent National Health Service (NHS). Previous studies investigating stress in nursing students focus on general nursing students or adopt quantitative measures. A qualitative study focusing specifically on mental health nursing students is required. One-to-one interviews were carried out with mental health nursing students (n = 12). Data were

  7. How many schools adopt interviews during the student admission process across the health professions in the United States of America?

    Directory of Open Access Journals (Sweden)

    Greer Glazer

    2016-02-01

    Full Text Available Health profession schools use interviews during the admissions process to identify certain non-cognitive skills that are needed for success in diverse, inter-professional settings. This study aimed to assess the use of interviews during the student admissions process across health disciplines at schools in the United States of America in 2014. The type and frequency of non-cognitive skills assessed were also evaluated. Descriptive methods were used to analyze a sample of interview rubrics collected as part of a national survey on admissions in the health professions, which surveyed 228 schools of medicine, dentistry, pharmacy, nursing, and public health. Of the 228 schools, 130 used interviews. The most desirable non-cognitive skills from 34 schools were identified as follows: communication skills (30, motivation (22, readiness for the profession (17, service (12, and problem-solving (12. Ten schools reported using the multiple mini-interview format, which may indicate potential for expanding this practice. Disparities in the use of interviewing across health professions should be verified to help schools adopt interviews during student admissions processes.

  8. Injury episodes and circumstances: National Health Interview Survey, 1997-2007.

    Science.gov (United States)

    Chen, Li Hui; Warner, Margaret; Fingerhut, Lois; Makuc, Diane

    2009-09-01

    The National Health Interview Survey (NHIS) provides estimates of nonfatal, medically attended injuries and poisonings occurring in the United States. The objectives of this report are to 1) document changes in the injury and poisoning section of NHIS from 1997 through 2007; 2) provide guidance on summarizing data across the 11-year study period; and 3) present detailed national estimates of nonfatal injury and poisoning episodes for the time period. NHIS samples the civilian, noninstitutionalized population of the United States living in households. NHIS data from the years 1997-2007 were used in this report. Some questions related to injury and poisoning episodes were modified in 2000 and 2004. During the period 1997-2004, many NHIS injury and poisoning questions were improved as a result of cognitive interviewing, data analysis, and feedback from interviewers and data users. Revisions to the NHIS injury and poisoning section pose some difficulties for trend analysis. However, some questions remained the same during the 11-year period, despite the questionnaire revisions. The injury and poisoning section has not been revised since 2004 and, where possible, analyses should be limited to 2004 and beyond. For analyses that require a longer time period, this report provides information on changes to questions and statistics that illustrate the effect of these changes on injury estimates. in 2007, the medically attended injury and poisoning episode rate among the U.S. civilian, noninstitutionalized population was 115.7 per 1,000 population. Despite differences in some questions during the period 1997-2007, NHIS data for these years show falls as the leading cause of injury and the home as the leading place that injury occurred.

  9. Environmental Survey preliminary report, Laboratory for Energy-Related Health Research, Davis, California

    Energy Technology Data Exchange (ETDEWEB)

    1988-03-01

    This report presents the preliminary findings from the first phase of the Survey of the United States Department of Energy (DOE) Laboratory for Energy-Related Health Research (LEHR) at the University of California, Davis (UC Davis), conducted November 16 through 20, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the LEHR. The Survey covers all environmental media and all areas of environmental regulation, and is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations at the LEHR and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by a DOE National Laboratory or a support contractor. When completed, the results will be incorporated into the Environmental Survey Interim Report for the LEHR at UC Davis. The Interim Report will reflect the final determinations of the LEHR Survey. 75 refs., 26 figs., 23 tabs.

  10. Is a Health Interview Survey an appropriate tool to assess domestic violence?

    Science.gov (United States)

    Drieskens, Sabine; Demarest, Stefaan; D'Hoker, Nicola; Ortiz, Barbara; Tafforeau, Jean

    2017-10-01

    The aim of this study is to assess if a Health Interview Survey (HIS) targeting the general population is an appropriate tool to collect valid data on domestic violence. Studying item non-response on the question on domestic violence and its association with socio-demographic and health characteristics compared with victims of domestic violence can contribute to this. Cross-sectional data from the Belgian HIS 2013 were analysed. A question whether the perpetrator of a violent event was a member of the respondents' household was embedded in a general topic on violence in the self-administered questionnaire. This study is limited to people aged 15+ that at least completed the first question of this topic. Socio-demographic characteristics of item non-respondents and of victims of domestic violence were explored and the association with health status was assessed through ORs calculated via logistic regression. The year prevalence of domestic violence is 1.1%. Although the question on domestic violence yields a high level of non-response (62%), this does not hinder the further completion of the questionnaire. When compared with victims of domestic violence, those not responding on the question on the perpetrator have better (mental) health. When compared with those not being victim of domestic violence, victims report poorer physical and mental health. An HIS can be an appropriate tool to assess domestic violence in the general population and its association with health. However, a solution should be found for the high item non-response on the question on the perpetrator of the violent event.

  11. Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98)

    National Research Council Canada - National Science Library

    Finger, Jonas D; Tylleskär, Thorkild; Lampert, Thomas; Mensink, Gert B M

    2012-01-01

    We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98...

  12. Elementary school-aged children's reports of their health: a cognitive interviewing study.

    Science.gov (United States)

    Rebok, G; Riley, A; Forrest, C; Starfield, B; Green, B; Robertson, J; Tambor, E

    2001-01-01

    There are no standard methods for assessing the quality of young children's perceptions of their health and well-being and their ability to comprehend the tasks involved in reporting their health. This research involved three cross-sectional studies using cognitive interviews of 5-11-year-old children (N = 114) to determine their ability to respond to various presentations of pictorially illustrated questions about their health. The samples had a predominance of children in the 5-7-year-old range and families of lower and middle socio-economic status. The research questions in Study 1 involved children's ability to convert their health experiences into scaled responses and relate them to illustrated items (n = 35); Study 2 focused on the type of response format most effectively used by children (n = 19); and Study 3 involved testing children's understanding of health-related terms and use of a specific recall period (n = 60). The results of Study 1 showed that children identified with the cartoon drawing of a child depicted in the illustrated items, typically responding that the child was at or near their own age and of the same gender, with no differences related to race. Study 2 results indicated that children responded effectively to circles of graduated sizes to indicate their response and preferred them to same-size circles or a visual analogue scale. Tests of three-, four-, and five-point response formats demonstrated that children could use them all without confusion. In Study 3, expected age-related differences in understanding were obtained. In fact, the 5-year-old children were unable to understand a sufficient number of items to adequately describe their health. Virtually all children 8 years of age and older were able to fully understand the key terms and presentation of items, used the full five-point range of response options, and accurately used a 4-week recall period. Six- and seven-year-olds were more likely than older children to use only the

  13. An evaluation of training in motivational interviewing for nurses in child health services.

    Science.gov (United States)

    Bohman, Benjamin; Forsberg, Lars; Ghaderi, Ata; Rasmussen, Finn

    2013-05-01

    Acquiring proficiency in motivational interviewing (MI) may be more difficult than generally believed, and training research suggests that the standard one-time workshop format may be insufficient. Although nurses represent one of the professions that have received most training in MI, training in this group has rarely been systematically evaluated using objective behavioral measures. To evaluate an enhanced MI training program, comprising a 3.5-day workshop, systematic feedback on MI performance, and four sessions of supervision on practice samples. Nurses (n = 36) in Swedish child health services were trained in MI. Skillfulness in MI was assessed using the Motivational Interviewing Treatment Integrity (MITI) Code. Effects of training were compared to beginning proficiency thresholds. Participants did not reach beginning proficiency thresholds on any of the indicators of proficiency and effect sizes were small. The present study adds to a growing body of literature suggesting that the current standard MI training format may not provide practitioners with enough skillfulness. Moreover, the results indicate that even enhanced training, including systematic feedback and supervision, may not be sufficient. Suggestions for improved MI training are made.

  14. High alcohol consumption in Germany: results of the German National Health Interview and Examination Survey 1998.

    Science.gov (United States)

    Burger, Martina; Mensink, Gert B M

    2004-10-01

    To analyse the alcohol consumption behaviour of the German adult population, with a focus on the characteristics of persons drinking more than the tolerable upper alcohol intake level (TUAL) of 10-12 g day(-1) for healthy adult women and 20-24 g day(-1) for healthy adult men. For the German National Health Interview and Examination Survey 1998, a representative sample of free-living adults was drawn. A total of 7124 participants were interviewed comprehensively about their sociodemographic background, lifestyle and eating habits including alcohol consumption. A sub-sample of 4030 women and men, 18-79 years old, who were involved in the integrated German Nutrition Survey. About 16% of women and 31% of men had mean alcohol consumption above the TUAL. Among other factors, the inclination to exceed the TUAL was related to middle-age, high socio-economic status, smoking and use of soft drugs. Among both women and men, a high proportion of persons drinking above the TUAL was observed among those consuming low amounts of soft drinks, fruit, poultry, milk products, bread and cake/biscuits. Women preferred to drink wine, whereas men preferred to drink beer. Many Germans have an alcohol consumption level above the TUAL and thus are supposed to be at increased risk for alcohol-associated diseases.

  15. Can accurate data on birthweight be obtained from health interview surveys?

    Science.gov (United States)

    Robles, A; Goldman, N

    1999-10-01

    Because hospital records rarely exist for a representative sample of the population in developing countries, researchers frequently rely on birthweight data from surveys. Yet, the quality of these data has rarely been evaluated. This study explores the accuracy of birthweight information in six demographic and health surveys in Latin America conducted in the early 1990s: two in Guatemala, and one each in Bolivia, Costa Rica, El Salvador and Peru. The quality of the birthweight reports is assessed by examining the plausibility of estimates of the proportion of newborns reported to have been weighed and estimates derived from the numerical weights, by characteristics of the delivery and maternal education. The estimates suggest that a substantial proportion of women whose newborns were probably never weighed report a birthweight. For all of the surveys, with the possible exception of Costa Rica, the average birthweights appear to be too high, and the estimates of the prevalence of low birthweight too low. In addition, the data reveal anomalous patterns, such as higher birthweights for home as compared with hospital deliveries. These findings suggest that estimates of low birthweight derived from surveys in developing countries are likely to portray an overly optimistic picture of children's and women's health status. More information about the underlying source of these data are needed not only to provide additional insight into the degree of error characterizing existing estimates, but also to improve data collection strategies in future health interview surveys.

  16. Estimating disability prevalence among adults by body mass index: 2003-2009 National Health Interview Survey.

    Science.gov (United States)

    Armour, Brian S; Courtney-Long, Elizabeth; Campbell, Vincent A; Wethington, Holly R

    2012-01-01

    Obesity is associated with adverse health outcomes in people with and without disabilities; however, little is known about disability prevalence among people who are obese. The purpose of this study was to determine the prevalence and type of disability among obese adults in the United States. We analyzed pooled data from sample adult modules of the 2003-2009 National Health Interview Survey (NHIS) to obtain national prevalence estimates of disability, disability type, and obesity by using 30 questions that screened for activity limitations, vision and hearing impairment, and cognitive, movement, and emotional difficulties. We stratified disability prevalence by category of body mass index (BMI, measured as kg/m(2)): underweight, less than 18.5; normal weight, 18.5 to 24.9; overweight, 25.0 to 29.9; and obese, 30.0 or higher. Among the 25.3% of adult men and 24.6% of women in our pooled sample who were obese, 35.2% and 46.9%, respectively, reported a disability. In contrast, 26.7% of men and 26.8% women of normal weight reported a disability. Disability was much higher among obese women than among obese men (46.9% vs 35.2%, P body mass index. Because of the high prevalence of disability among those who are obese, public health programs should consider the needs of those with disabilities when designing obesity prevention and treatment programs.

  17. The effectiveness of motivational interviewing for health behaviour change in primary care settings: a systematic review.

    Science.gov (United States)

    Morton, Katie; Beauchamp, Mark; Prothero, Anna; Joyce, Lauren; Saunders, Laura; Spencer-Bowdage, Sarah; Dancy, Bernadette; Pedlar, Charles

    2015-01-01

    Motivational interviewing (MI) is a patient-centred approach to behaviour change that was originally developed in the addiction field but has increasingly been applied to public health settings with a focus on health promotion. The purpose of this review was to examine the evidence base for MI interventions in primary care settings with non-clinical populations to achieve behaviour change for physical activity, dietary behaviours and/or alcohol intake. We also sought to explore the specific behaviour change techniques included in MI interventions within primary care. Electronic databases were searched for relevant articles and 33 papers met inclusion criteria and were included. Approximately 50% of the included studies (n = 18) demonstrated positive effects in relation to health behaviour change. The efficacy of MI approaches is unclear given the inconsistency of MI descriptions and intervention components. Furthermore, research designs that do not isolate the effects of MI make it difficult to determine the effectiveness of such approaches. We offer a number of recommendations for researchers and practitioners seeking to include MI within behaviour change interventions to help improve the quality of the research and the effectiveness of MI-based interventions within primary care settings.

  18. [The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): data management].

    Science.gov (United States)

    Dölle, R; Schaffrath Rosario, A; Stolzenberg, H

    2007-01-01

    In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), comprehensive, nationwide representative data on the state of health of children and adolescents were collected for the first time. During the 3-year data collection phase of the survey, 17,641 subjects were examined and interviewed and approx. 1,500 items were recorded. Data management was not limited to survey data collection, administration and quality assurance alone, but also comprised the provision of tools for the management and control of process data, as well as for managing survey-specific business processes. In the context of the KiGGS study, numerous components for supporting the extensive and complex processes were developed for the study staff. Here the primary focus was on subject and sample point administration, scheduling, sampling, reporting, field logistics and laboratory data management. Thanks to the computer-based processing of routine tasks involved in the organisation of the field work, ease of work and project progress control were enhanced significantly. To some extent, KiGGS-specific components have already been used in other studies and only minor adaptations were needed for the transfer. The main emphasis with regards to survey data management was on the standardisation of methods for data processing, data control and data cleaning. Here, a wealth of previous experiences was available as a starting point. The established quality assurance methods were standardised to a large extent and partly automated and complemented by data base tools for the management and documentation of survey instruments and quality assurance measures. All these measures combined made it possible to provide data users with a controlled and cleaned final data set, including a detailed documentation.

  19. Health Literacy as a Social Determinant of Health in Asian American Immigrants: Findings from a Population-Based Survey in California.

    Science.gov (United States)

    Lee, Hee Yun; Rhee, Taeho Greg; Kim, Nam Keol; Ahluwalia, Jasjit S

    2015-08-01

    Asian American immigrants have a lower level of health literacy than non-Latino whites, but their level of health literacy and its impact on health outcomes may differ among subgroups. We investigated the level of health literacy across five subgroups of Asian American immigrants and explored the association between health literacy and self-rated health status and symptoms of depression. We utilized a cross-sectional survey research design and a population-based sampling strategy using the 2007 California Health Interview Survey (CHIS). We sampled 30,615 non-Latino whites and 3,053 Asian American immigrants (1,058 Chinese, 598 Koreans, 534 Filipinos, 416 South Asians, and 447 Vietnamese). We used two questions as proxy measures to assess the level of health literacy in non-Latino whites and in both aggregated and disaggregated Asian American immigrant groups. We then investigated the effect of health literacy on two main health outcomes: self-rated health status and depression symptoms. The level of health literacy varied across the five subgroups of Asian American immigrants. Chinese, Korean, and Vietnamese groups had the lowest levels of health literacy, while Filipinos showed the highest level. Health literacy was positively correlated with health status in Chinese and Korean immigrants, and negatively correlated with depression symptoms in Korean and South Asian immigrants. We found heterogeneity in health literacy among Asian American immigrants and found that health literacy had varying associations with health outcomes. The aggregated Asian American immigrant group results may mask the true health disparities that each Asian American immigrant group faces. Koreans were the only group found to have a significant association between the proxy for health literacy and both health outcomes. Further research is needed to better understand the causes of heterogeneity and to investigate health literacy as a critical determinant of immigrant health.

  20. Mechanisms of motivational interviewing in health promotion: a Bayesian mediation analysis

    Directory of Open Access Journals (Sweden)

    Pirlott Angela G

    2012-06-01

    Full Text Available Abstract Background Counselor behaviors that mediate the efficacy of motivational interviewing (MI are not well understood, especially when applied to health behavior promotion. We hypothesized that client change talk mediates the relationship between counselor variables and subsequent client behavior change. Methods Purposeful sampling identified individuals from a prospective randomized worksite trial using an MI intervention to promote firefighters’ healthy diet and regular exercise that increased dietary intake of fruits and vegetables (n = 21 or did not increase intake of fruits and vegetables (n = 22. MI interactions were coded using the Motivational Interviewing Skill Code (MISC 2.1 to categorize counselor and firefighter verbal utterances. Both Bayesian and frequentist mediation analyses were used to investigate whether client change talk mediated the relationship between counselor skills and behavior change. Results Counselors’ global spirit, empathy, and direction and MI-consistent behavioral counts (e.g., reflections, open questions, affirmations, emphasize control significantly correlated with firefighters’ total client change talk utterances (rs = 0.42, 0.40, 0.30, and 0.61, respectively, which correlated significantly with their fruit and vegetable intake increase (r = 0.33. Both Bayesian and frequentist mediation analyses demonstrated that findings were consistent with hypotheses, such that total client change talk mediated the relationship between counselor’s skills—MI-consistent behaviors [Bayesian mediated effect: αβ = .06 (.03, 95% CI = .02, .12] and MI spirit [Bayesian mediated effect: αβ = .06 (.03, 95% CI = .01, .13]—and increased fruit and vegetable consumption. Conclusion Motivational interviewing is a resource- and time-intensive intervention, and is currently being applied in many arenas. Previous research has identified the importance of counselor behaviors and client

  1. Health-care access among adults with epilepsy: The U.S. National Health Interview Survey, 2010 and 2013✩

    Science.gov (United States)

    Thurman, David J.; Kobau, Rosemarie; Luo, Yao-Hua; Helmers, Sandra L.; Zack, Matthew M.

    2017-01-01

    Introduction Community-based and other epidemiologic studies within the United States have identified substantial disparities in health care among adults with epilepsy. However, few data analyses addressing their health-care access are representative of the entire United States. This study aimed to examine national survey data about adults with epilepsy and to identify barriers to their health care. Materials and methods We analyzed data from U.S. adults in the 2010 and the 2013 National Health Interview Surveys, multistage probability samples with supplemental questions on epilepsy. We defined active epilepsy as a history of physician-diagnosed epilepsy either currently under treatment or accompanied by seizures during the preceding year. We employed SAS-callable SUDAAN software to obtain weighted estimates of population proportions and rate ratios (RRs) adjusted for sex, age, and race/ethnicity. Results Compared to adults reporting no history of epilepsy, adults reporting active epilepsy were significantly more likely to be insured under Medicaid (RR = 3.58) and less likely to have private health insurance (RR = 0.58). Adults with active epilepsy were also less likely to be employed (RR = 0.53) and much more likely to report being disabled (RR = 6.14). They experience greater barriers to health-care access including an inability to afford medication (RR = 2.40), mental health care (RR = 3.23), eyeglasses (RR = 2.36), or dental care (RR = 1.98) and are more likely to report transportation as a barrier to health care (RR = 5.28). Conclusions These reported substantial disparities in, and barriers to, access to health care for adults with active epilepsy are amenable to intervention. PMID:26627980

  2. Are chronic diseases related to height? Results from the Portuguese National Health Interview Survey.

    Science.gov (United States)

    Perelman, Julian

    2014-12-01

    This paper analyze the association between height and chronic diseases in Portugal and the extent to which this relationship is mediated by education. The sample upon which the analysis is based comprised those participants in the 2005/2006 Portuguese National Health Interview Survey (n=28,433) aged 25-79. Logistic regressions measured the association of height with ten chronic diseases, adjusting for age, lifestyle, education, and other socioeconomic factors. Among women, an additional centimeter in stature significantly decreased the prevalence of asthma, chronic pain, and acute cardiac disease, by 0.057, 0.221, and 0.033 percentage points, respectively. Also, mental disorders were significantly less prevalent in the last quartile of height. Among men, an additional centimeter in height was associated with a 0.074 lower prevalence of asthma, and men in the last quartile of height were significantly less at risk of acute cardiovascular disease. There was no significant association between height and the risk of diabetes, high blood pressure, cancer, and pulmonary diseases. As for the impact of education, women with a tertiary level were on average 5.3cm taller than those with no schooling; among men, the difference was almost 9cm. Adjusting for education reduced the height-related excess risk of ill health by 36% on average among men, and by 7% among women. The analysis indicates that there is a significant association of height with several chronic conditions, and that education plays a mediating role in the height-health connection. By emphasizing the role of height and education as determinants of chronic conditions, this paper also highlights the role of conditions related to childhood health and socioeconomic background. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. [Gender systems and/in the Spanish National Health Interview Survey].

    Science.gov (United States)

    Ruiz Cantero, María Teresa; Papí Gálvez, Natalia; Carbrera Ruiz, Virginia; Ruiz Martínez, Ana; Alvarez-Dardet Díaz, Carlos

    2006-01-01

    To analyze the Spanish National Health Interview Survey (NHIS) from a gender perspective, with special emphasis on gender division of labor. We analyzed the 2003 Spanish NHIS from the perspective of the levels of gender observation, with gender understood as: a) the basis of social norms (responsibilities by sex, health risks, and problems related to masculine/feminine roles); b) the organizer of the social structure: gender division of labor, work overload, vertical/horizontal segregation, time spent in activities according to social times, access to resources), and c) a component of individual identity (conflicts due to multiple roles, body image dissatisfaction, self-esteem, self-perceived recognition of the work performed, assimilation of the sexual gender role, sex differences in health conditions). The Spanish NHIS is centered on the main provider, referred to in masculine grammatical form. Gender division of domestic labor is identified only by a general question. When using the concept of main activity for productive or reproductive work, the survey requires respondents to evaluate them and select only one, thus losing information and hampering analysis of the impact of an overload of work on health. Information on time used for reproductive work and leisure is not solicited. Assaults (intentional) and accidents (non-intentional) are combined in the same question, thus preventing research on gender-related violence. The Spanish NHIS includes the variable of sex, but its more descriptive than analytic focus limits gender analysis. The survey allows specific circumstances of employment-related inequalities between sexes to be measured, but does not completely allow other indicators of gender inequalities, such as the situation of housewives or work overload, to be measured.

  4. [Motivational interviewing use for promoting health behavior: an approach of doctor/patient relationship].

    Science.gov (United States)

    Benarous, X; Legrand, C; Consoli, S M

    2014-05-01

    Many situations in common medical practice, especially in chronic diseases, require patients to be mobilized for health behavior decisions: for daily intake of an antihypertensive drug, performing a mammography for cancer screening, as well as adopting new diet habits in diabetes. Ability to initiate a health behavior depends on several parameters. Some of them are related to the patient, his personality, his illness and treatment's perception; others directly rely on the physician, his attitude and his communication style during the visit, independently of patient's level of resistance to change. Motivational interviewing (MI) is a communication technique, first developed for patients presenting a substance abuse disorder, to explore their ambivalence, overcome their resistances and give them the willingness of a better self-care. Its general principles and basic techniques can be applied by every practitioner and deserve to be better known, given that scientific literature provides evidence for generalizing it in a variety of medical conditions, in structured patient education programs as well as in usual follow-up, for which time is generally restricted. This article provides an overview of MI recent applications and argues for its diffusion in everyday medical practice. Copyright © 2013. Published by Elsevier SAS.

  5. [Socioeconomic status and health: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

    Science.gov (United States)

    Lampert, T; Kroll, L E; von der Lippe, E; Müters, S; Stolzenberg, H

    2013-05-01

    The analysis focuses on the connection between socioeconomic status (SES) and five health outcomes in the 18 to 79-year-old population of Germany. It uses data from the "German Health Interview and Examination Survey for Adults" (DEGS1) which the Robert Koch Institute conducted in the period from 2008 to 2011 (n=8152). Socioeconomic status is recorded via a multidimensional index which includes information on education attainment, occupational status and household income. The results show that persons with a low socioeconomic status have a self-rated health status which is worse than that of persons with a medium or high socioeconomic status, and that they have diabetes more frequently. They also have a higher risk of depressive symptoms, obesity and physical inactivity. The results illustrate that health chances and the risk of illness are still very socially uneven distributed, thus emphasising the significance of political interventions to reduce health inequalities. An English full-text version of this article is available at SpringerLink as supplemental.

  6. Effect of the California tobacco control program on personal health care expenditures.

    Directory of Open Access Journals (Sweden)

    James M Lightwood

    2008-08-01

    Full Text Available Large state tobacco control programs have been shown to reduce smoking and would be expected to affect health care costs. We investigate the effect of California's large-scale tobacco control program on aggregate personal health care expenditures in the state.Cointegrating regressions were used to predict (1 the difference in per capita cigarette consumption between California and 38 control states as a function of the difference in cumulative expenditures of the California and control state tobacco control programs, and (2 the relationship between the difference in cigarette consumption and the difference in per capita personal health expenditures between the control states and California between 1980 and 2004. Between 1989 (when it started and 2004, the California program was associated with $86 billion (2004 US dollars (95% confidence interval [CI] $28 billion to $151 billion lower health care expenditures than would have been expected without the program. This reduction grew over time, reaching 7.3% (95% CI 2.7%-12.1% of total health care expenditures in 2004.A strong tobacco control program is not only associated with reduced smoking, but also with reductions in health care expenditures.

  7. Racial disparity trends in children's dental visits: US National Health Interview Survey, 1964-2010.

    Science.gov (United States)

    Isong, Inyang A; Soobader, Mah-J; Fisher-Owens, Susan A; Weintraub, Jane A; Gansky, Stuart A; Platt, Larry J; Newacheck, Paul W

    2012-08-01

    Research that has repeatedly documented marked racial/ethnic disparities in US children's receipt of dental care at single time points or brief periods has lacked a historical policy perspective, which provides insight into how these disparities have evolved over time. Our objective was to examine the im-pact of national health policies on African American and white children's receipt of dental care from 1964 to 2010. We analyzed data on race and dental care utilization for children aged 2 to 17 years from the 1964, 1976, 1989, 1999, and 2010 National Health Interview Survey. Dependent variables were as follows: child's receipt of a dental visit in the previous 12 months and child's history of never having had a dental visit. Primary independent variable was race (African American/white). We calculated sample prevalences, and χ(2) tests compared African American/white prevalences by year. We age-standardized estimates to the 2000 US Census. The percentage of African American and white children in the United States without a dental visit in the previous 12 months declined significantly from 52.4% in 1964 to 21.7% in 2010, whereas the percentage of children who had never had a dental visit declined significantly (P children's dental utilization rates, whereas large and statistically significant in 1964, attenuated and became nonsignificant by 2010. We demonstrate a dramatic narrowing of African American/white disparities in 2 measures of children's receipt of dental services from 1964 to 2010. Yet, much more needs to be done before persistent racial disparities in children's oral health status are eliminated.

  8. Seizing the moment: California's opportunity to prevent nutrition-related health disparities in low-income Asian American population.

    Science.gov (United States)

    Harrison, Gail G; Kagawa-Singer, Marjorie; Foerster, Susan B; Lee, Henry; Pham Kim, Loan; Nguyen, Tu-Uyen; Fernandez-Ami, Allyn; Quinn, Valerie; Bal, Dileep G

    2005-12-15

    Asian Americans and Pacific Islanders (AAPI) have the fastest growing rate of overweight and obese children. Aggressive programs are urgently needed to prevent unhealthy acculturation-related changes in diet and physical activity and to promote the healthier aspects of traditional lifestyle habits. We conducted focus groups and key informant interviews to explore knowledge, attitudes, dietary practices, and physical activity levels among three low-income Asian American ethnic groups, Chinese, Vietnamese, and Hmong, in California. Content analysis was used to identify similarities and differences among the groups. Several common health beliefs clearly emerged. Participants noted the importance of fresh (not frozen) fruit and vegetable consumption and physical activity for general health. The concept of good health included having a harmonious family, balance, and mental and emotional stability. All groups also expressed the general belief that specific foods have hot or cold properties and are part of the Yin/Yang belief system common to Asian cultures. The lure of fast food, children's adoption of American eating habits, and long work hours were identified as barriers to a healthy, more traditional lifestyle. A California campaign for Asian Americans using multilevel strategies is recommended to counter the alarming rise of obesity among AAPI youth. Strategies directed to individual, community, and policy levels should emphasize maintenance of healthy traditional diets, informed selection of mainstream U.S. foods, and promotion of active lifestyles to prevent an impending burden from cancer and nutrition-related chronic diseases in AAPI populations. Cancer 2005. (c) 2005 American Cancer Society.

  9. Failing Health: Pesticide Use in California Schools. CPR Series Report.

    Science.gov (United States)

    Kaplan, Jonathan; Marquardt, Sandra; Barber, Wendy

    This report presents a statewide assessment of pesticides used in California's school system. Of the 46 school districts responding to the statewide survey, 40 claimed using one or more of 27 particularly hazardous pesticides that can cause cancer, affect the reproductive system, mimic the endocrine system, or act as nerve toxins. Forty-three…

  10. Developing and Validating a Tablet Version of an Illness Explanatory Model Interview for a Public Health Survey in Pune, India

    Science.gov (United States)

    Giduthuri, Joseph G.; Maire, Nicolas; Joseph, Saju; Kudale, Abhay; Schaetti, Christian; Sundaram, Neisha; Schindler, Christian; Weiss, Mitchell G.

    2014-01-01

    Background Mobile electronic devices are replacing paper-based instruments and questionnaires for epidemiological and public health research. The elimination of a data-entry step after an interview is a notable advantage over paper, saving investigator time, decreasing the time lags in managing and analyzing data, and potentially improving the data quality by removing the error-prone data-entry step. Research has not yet provided adequate evidence, however, to substantiate the claim of fewer errors for computerized interviews. Methodology We developed an Android-based illness explanatory interview for influenza vaccine acceptance and tested the instrument in a field study in Pune, India, for feasibility and acceptability. Error rates for tablet and paper were compared with reference to the voice recording of the interview as gold standard to assess discrepancies. We also examined the preference of interviewers for the classical paper-based or the electronic version of the interview and compared the costs of research with both data collection devices. Results In 95 interviews with household respondents, total error rates with paper and tablet devices were nearly the same (2.01% and 1.99% respectively). Most interviewers indicated no preference for a particular device; but those with a preference opted for tablets. The initial investment in tablet-based interviews was higher compared to paper, while the recurring costs per interview were lower with the use of tablets. Conclusion An Android-based tablet version of a complex interview was developed and successfully validated. Advantages were not compromised by increased errors, and field research assistants with a preference preferred the Android device. Use of tablets may be more costly than paper for small samples and less costly for large studies. PMID:25233212

  11. Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California

    NARCIS (Netherlands)

    Meltem Daysal, N.

    2012-01-01

    Abstract: In this paper, I examine the impact of uninsured patients on the health of the insured, focusing on one health outcome - the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California

  12. Health Care among the Kumiai Indians of Baja California, Mexico: Structural and Social Barriers

    Science.gov (United States)

    Fleuriet, K. Jill

    2009-01-01

    In this article, the author documents the illness and health care problems facing indigenous communities in Baja California, Mexico, by using ethnographic data from research she conducted from 1999 to 2001 with rural, indigenous Kumiai and with their primary health care providers in urban Ensenada. The author contends that barriers to care are…

  13. Workplace mistreatment and sickness absenteeism from work: results from the 2010 National Health Interview survey.

    Science.gov (United States)

    Asfaw, Abay G; Chang, Chia C; Ray, Tapas K

    2014-02-01

    This study examined the association between workplace mistreatment and occurrence, duration, and costs of sickness absenteeism. We used the 2010 National Health Interview Survey and considered 13,807 employed adult respondents. We used a zero-inflated negative binomial (zinb) model to examine the association between exposure to workplace mistreatment and the occurrence and number of workdays missed due to illness/injury in the preceding 12 months. In 2010, 7.6% of US workers employed at the time of the survey reported having been mistreated at their workplace. Both occurrence and duration of sickness absence were higher for mistreated than for non-mistreated workers. The zinb results showed that being mistreated was associated with a 42% increase in the number of missed workdays, controlling for covariates. The marginal effect analysis showed that lost workdays differed by 2.45 days between mistreated and non-mistreated workers. This implies that workplace mistreatment was associated with $4.1 billion, or 5.5%, of sickness absenteeism costs in 2010. Workplace mistreatment is associated with sickness absence in the United States. While a causal relationship could not be established due to the cross-sectional design of the study, this study reveals the economic importance of developing workplace mistreatment prevention strategies. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  14. 'Common courtesy' and the elimination of passive smoking. Results of the 1987 National Health Interview Survey.

    Science.gov (United States)

    Davis, R M; Boyd, G M; Schoenborn, C A

    1990-04-25

    The tobacco industry recommends "common courtesy" as the solution to potential conflicts over smoking in public places and as an alternative to policies that restrict or ban smoking. Specifically, the industry suggests that nonsmokers "mention annoyances in a pleasant and friendly manner" and that smokers ask others, "Do you mind if I smoke?" We analyzed data for 22,000 adults who responded to the 1987 National Health Interview Survey of Cancer Epidemiology and Control to determine if common courtesy is being used in passive-smoking situations. Almost half (47%) of smokers said they light up inside public places without asking if others mind. When someone lights up a cigarette inside a public place, only 4% of nonsmokers ask the person not to smoke despite the fact that most nonsmokers consider secondhand smoke harmful and annoying. We compared these data with similar data collected by the Roper Organization in the 1970s and found that smokers today are less likely to smoke inside public places. However, nonsmokers' actions in response to secondhand smoke have changed very little. These findings show that the common courtesy approach endorsed by the tobacco industry is unlikely, by itself, to eliminate exposure to environmental tobacco smoke. Though no one would oppose the use of common courtesy, we conclude that legislative or administrative mechanisms are the only effective strategies to eliminate passive smoking.

  15. Public Funds Account for Over 70 Percent of Health Care Spending in California.

    OpenAIRE

    Sorensen, A; Nonzee, NJ; Kominski, GF

    2016-01-01

    In California, personal health care expenditures are estimated to total more than $367 billion in 2016. Approximately 71 percent of these expenditures will be paid for with public funds (i.e., taxpayer dollars). This estimated contribution of public funds to health care expenditures is much higher than estimates that include only major health insurance programs such as Medicare and Medicaid. Several additional public funding sources also contribute to health care expenditures in the state, in...

  16. Association of Sleep Duration with Stroke in Diabetic Patients: Analysis of the National Health Interview Survey.

    Science.gov (United States)

    Akinseye, Oluwaseun A; Ojike, Nwakile I; Akinseye, Leah I; Dhandapany, Perundurai S; Pandi-Perumal, Seithikurippu R

    2016-03-01

    Habitual sleep duration is increasingly being recognized as an important risk factor for stroke. We sought to describe the association between sleep duration and stroke in a cohort of individuals with diabetes. Data from the National Health Interview Survey for the years 2004-2013 were used. Only those answering "yes" to the question "Have you EVER been told by a doctor or other health professional that you have diabetes or sugar diabetes?" were included in the analysis. Sleep duration was categorized as short (≤6 hours), normal (7-8 hours), or long (≥9 hours). Self-reported diagnosis of stroke was the main outcome of interest. A total number of 26,364 self-reported diabetic individuals provided data for analysis. Stroke was reported in 9.1% of short sleepers, 16.1% of long sleepers, and 8.3% of normative sleepers (P sleep and stroke became nonsignificant after multivariate adjustment (OR = 1.15, 95% CI: .95-1.40, P = .16) except in white participants. The association between long sleep duration and stroke persisted (OR = 1.46, 95% CI: 1.16-1.84, P = .01), especially in males (OR = 1.62, 95% CI: 1.14-2.28) and in white participants (OR = 1.97, 95% CI: 1.47-2.65). In diabetic patients, abnormal sleep duration was associated with increased risk of stroke, and this association varied among different sex and ethnic groups. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  17. The effect of health, socio-economic position, and mode of data collection on non-response in health interview surveys

    DEFF Research Database (Denmark)

    Ekholm, Ola; Gundgaard, Jens; Rasmussen, Niels K R

    2010-01-01

    AIMS: To investigate the relationship between potential explanatory factors (socio-economic factors and health) and non-response in two general population health interview surveys (face-to-face and telephone), and to compare the effects of the two interview modes on non-response patterns. METHODS...... generally associated with non-response in both modes of interview. The non-response rate was high among persons with low socio-economic position. No significant associations between health and non-response were found. CONCLUSIONS: Health status does not play a systematic role for non-response rates...... in health interview surveys, but the non-response rate is higher in lower socio-economic groups. Analyses of non-response should be performed to understand the implications of survey findings....

  18. Prevalence and impact of bilateral vestibular hypofunction: results from the 2008 US National Health Interview Survey.

    Science.gov (United States)

    Ward, Bryan K; Agrawal, Yuri; Hoffman, Howard J; Carey, John P; Della Santina, Charles C

    2013-08-01

    Profound bilateral vestibular hypofunction (BVH) causes disabling oscillopsia, chronic disequilibrium, and postural instability, but little is known about its epidemiology and impact. To assess prevalence and functional impact of BVH in the US adult population. National cross-sectional survey using a national database and corollary validation study. Adult respondents to the 2008 Balance and Dizziness Supplement to the US National Health Interview Survey (N = 21 782). Prevalence of BVH, socioeconomic and quality-of-life impact of BVH, and fall risk. Criteria for the survey-based diagnosis of BVH included all of the following: presence of visual blurring with head movement; unsteadiness; difficulty walking in darkness or unsteady surfaces and in a straight path; and symptoms being at least "a big problem" and present for at least 1 year, in the absence of other neurologic conditions or eye pathologic conditions affecting vision. Adjusted national estimates from this survey indicate the prevalence of BVH in 2008 was 28 per 100 000 US adults (64 046 Americans). Of the participants with BVH, 44% reported changing their driving habits because of their symptoms, 56% reported reduced participation in social activities, and 58% reported difficulties with activities of daily living. Respondents with BVH had a 31-fold increase in the odds of falling in multivariate analyses compared with all respondents, with 25% reporting a recent fall-related injury. As estimated by the presence of specific symptoms in a nationally representative survey, BVH has considerable socioeconomic and quality-of-life impacts and significantly increases fall risk. These data support the need for new therapeutic strategies for BVH, including vestibular rehabilitation and implantable vestibular prostheses.

  19. Motivational Interviewing support for a behavioral health internet intervention for drivers with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Karen S. Ingersoll

    2015-05-01

    Full Text Available While Internet interventions can improve health behaviors, their impact is limited by program adherence. Supporting program adherence through telephone counseling may be useful, but there have been few direct tests of the impact of support. We describe a Telephone Motivational Interviewing (MI intervention targeting adherence to an Internet intervention for drivers with Type 1 Diabetes, DD.com, and compare completion of intervention benchmarks by those randomized to DD.com plus MI vs. DD.com only. The goal of the pre-intervention MI session was to increase the participant's motivation to complete the Internet intervention and all its assignments, while the goal of the post-treatment MI session was to plan for maintaining changes made during the intervention. Sessions were semi-structured and partially scripted to maximize consistency. MI Fidelity was coded using a standard coding system, the MITI. We examined the effects of MI support vs. no support on number of days from enrollment to program benchmarks. Results show that MI sessions were provided with good fidelity. Users who received MI support completed some program benchmarks such as Core 4 (t176 df = −2.25; p < .03 and 11 of 12 monthly driving diaries significantly sooner, but support did not significantly affect time to intervention completion (t177 df = −1.69; p < .10 or rates of completion. These data suggest that there is little benefit to therapist guidance for Internet interventions including automated email prompts and other automated minimal supports, but that a booster MI session may enhance collection of follow-up data.

  20. The Prevalence and Characteristics of Fibromyalgia in the 2012 National Health Interview Survey

    Science.gov (United States)

    Walitt, Brian; Nahin, Richard L.; Katz, Robert S.; Bergman, Martin J.; Wolfe, Frederick

    2015-01-01

    Background Most knowledge of fibromyalgia comes from the clinical setting, where healthcare-seeking behavior and selection issues influence study results. The characteristics of fibromyalgia in the general population have not been studied in detail. Methods We developed and tested surrogate study specific criteria for fibromyalgia in rheumatology practices using variables from the US National Health Interview Survey (NHIS) and the modification (for surveys) of the 2010 American College of Rheumatology (ACR) preliminary fibromyalgia criteria. The surrogate criteria were applied to the 2012 NHIS and identified persons who satisfied criteria from symptom data. The NHIS weighted sample of 8446 persons represents 225.7 million US adults. Results Fibromyalgia was identified in 1.75% (95% CI 1.42, 2.07), or 3.94 million persons. However, 73% of identified cases self-reported a physician’s diagnosis other than fibromyalgia. Identified cases had high levels of self-reported pain, non-pain symptoms, comorbidity, psychological distress, medical costs, Social Security and work disability. Caseness was associated with gender, education, ethnicity, citizenship and unhealthy behaviors. Demographics, behaviors, and comorbidity were predictive of case status. Examination of the surrogate polysymptomatic distress scale (PSD) of the 2010 ACR criteria found fibromyalgia symptoms extending through the full length of the scale. Conclusions Persons identified with criteria-based fibromyalgia have severe symptoms, but most (73%) have not received a clinical diagnosis of fibromyalgia. The association of fibromyalgia-like symptoms over the full length of the PSD scale with physiological as well as mental stressors suggests PSD may be a universal response variable rather than one restricted to fibromyalgia. PMID:26379048

  1. Child Care Health Connections. A Health and Safety Newsletter for California Child Care Professionals. Volume 21, Number 1. January-February 2008

    Science.gov (United States)

    Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Turner, Debra, Ed.

    2008-01-01

    "Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment…

  2. Provider perceptions and expectations of breast cancer post-treatment care: A University of California Athena Breast Health Network project

    Science.gov (United States)

    Hahn, Erin E.; Ganz, Patricia A.; Melisko, Michelle; Pierce, John; von Friederichs-Fitzwater, Marlene; Lane, Karen; Hiatt, Robert

    2013-01-01

    Purpose The Athena Breast Health Network collaboration is a University of California system-wide project initiated with the intent to drive innovation in breast cancer prevention, screening and treatment. This qualitative research examines provider perceptions and expectations of post-treatment breast cancer care across five Network sites with the goal of better understanding provider behavior during the post-treatment phase of the cancer care trajectory. Methods Investigators at each site conducted semi-structured interviews with oncology specialists and primary care providers (PCPs). Interviews used case study examples and open- and closed-ended questions on the delivery of post-treatment breast cancer care. Informant responses were manually recorded by the interviewer, compiled in a database, then coded and analyzed using NVivo 9 software. Results There were 39 key informants across the sites: 14 medical oncologists, 7 radiation oncologists, 11 surgeons, 3 oncology nurses, and 4 PCPs. Care coordination was a major unprompted theme identified in the interviews. There was a perceived need for greater care coordination across institutions in order to improve delivery of post-treatment health care services and a need for greater care coordination within oncology, particularly to help avoid duplication of follow-up care and services. Participants expect frequent follow-up visits and to use biomarker tests and advanced imaging services as part of routine surveillance care. Implementing survivorship care programs was perceived as a way to improve care delivery. Conclusions These results identify a need for increased focus on care coordination during the post-treatment phase of breast cancer care within the UC system, and the potential for system and provider level interventions that could help increase coordination of post-treatment care. Implications for Cancer Survivors Breast cancer survivors do not always receive evidence-based care. This research helps to better

  3. Prevalence of Unmet Health Care needs and description of health care-seeking behavior among displaced people after the 2007 California wildfires.

    Science.gov (United States)

    Jenkins, J Lee; Hsu, Edbert B; Sauer, Lauren M; Hsieh, Yu-Hsiang; Kirsch, Thomas D

    2009-06-01

    The southern California wildfires in autumn 2007 resulted in widespread disruption and one of the largest evacuations in the state's history. This study aims to identify unmet medical needs and health care-seeking patterns as well as prevalence of acute and chronic disease among displaced people following the southern California wildfires. These data can be used to increase the accuracy, and therefore capacity, of the medical response. A team of emergency physicians, nurses, and epidemiologists conducted surveys of heads of households at shelters and local assistance centers in San Diego and Riverside counties for 3 days beginning 10 days postdisaster. All households present in shelters on the day of the survey were interviewed, and at the local assistance centers, a 2-stage sampling method was used that included selecting a sample size proportionate to the number of registered visits to that site compared with all sites followed by a convenience sampling of people who were not actively being aided by local assistance center personnel. The survey covered demographics; needs following the wildfires (shelter, food, water, and health care); acute health symptoms; chronic health conditions; access to health care; and access to prescription medications. Among the 175 households eligible, 161 (92.0%) households participated. Within the 47 households that reported a health care need since evacuation, 13 (27.7%) did not receive care that met their perceived need. Need for prescription medication was reported by 47 (29.2%) households, and 20 (42.6%) of those households did not feel that their need for prescription medication had been met. Mental health needs were reported by 14 (8.7%) households with 7 of these (50.0%) reporting unmet needs. At least 1 family member per household left prescription medication behind during evacuation in 46 households (28.6%), and 1 family member in 48 households (29.8%) saw a health care provider since their evacuation. Most people sought

  4. Prevalence estimates of asthma or COPD from a health interview survey and from general practitioner registration: what's the difference.

    NARCIS (Netherlands)

    Mohangoo, A.D.; Linden, M.W. van der; Schellevis, F.G.; Raat, H.

    2006-01-01

    BACKGROUND: The aim of this study was to compare prevalence estimates of asthma or chronic obstructive pulmonary disease (COPD) derived from self-report in a health interview survey and from general practitioners' (GPs') medical records, and to explain any differences. METHODS: the presence of

  5. Evolution of socioeconomic inequalities in smoking: results from the Portuguese national health interview surveys.

    Science.gov (United States)

    Alves, Joana; Kunst, Anton E; Perelman, Julian

    2015-03-31

    Southern European countries were traditionally characterized by a higher prevalence of smoking among high socioeconomic groups. Though, recent studies show a reversal of inequalities in Italy and Spain, for example. We investigated whether this evolution also applied to Portugal by describing the evolution of socioeconomic inequalities in smoking between 1987 and 2006. We used data from the four Portuguese national health interview surveys (N = 120,140) carried out so far. Socioeconomic status was measured by the educational and income levels of respondents. Socioeconomic inequalities were measured through Odds Ratios (OR), Relative Inequality Indexes (RII), and Concentration Indexes (CI) on being current, ever, and former smoker, adjusting for sex and age. Analyses were performed separately for men and women, and for different birth cohorts. Among men, smoking was initially more concentrated in high-socioeconomic status individuals (RII = 0.84, 95% Confidence Intervals [95% CI] 0.76-0.93, 1987) but this pattern reversed in the last survey (RII = 1.49, 95% CI 1.34-1.65, 2005/6). Indeed, higher cessation rates were observed among high-socioeconomic groups among all respondents (RII = 0.89, 95% CI 0.84-0.95), coupled with higher initiation rates among the worse-off in younger cohorts (RII = 1.18, 95% CI 1.05-1.31, for youngest generation, 2005/6). Among women, the richer and more educated smoked more in all surveys (RII = 0.21, 95% CI 0.16-0.27, 2005/6), despite being also more likely to quit (RII = 0.41, 95% CI 0.30-0.55). The pattern among women evolved towards a reduction of inequality, which however remained favourable to the worse-off. Inequalities have been increasingly unfavourable to the worse-off in Portugal, although better-off women are still more likely to smoke. Worrisome inequality trends have been observed among the youngest generations, which call for the rapid implementation of equity-oriented tobacco control policies.

  6. A forest health inventory assessment of red fir (Abies magnifica) in upper montane California

    Science.gov (United States)

    Leif Mortenson; Andrew N. Gray; David C. Shaw

    2015-01-01

    We investigated the forest health of red fir (Abies magnifica) and how it compared with commonly-associated species Jeffrey pine (Pinus jeffreyi), lodgepole pine (Pinus contorta) and white fir (Abies concolor) in the upper montane forests of California. We evaluated tree mortality rates...

  7. Payoffs for California College Students and Taxpayers from Investing in Student Mental Health

    Science.gov (United States)

    Ashwood, J. Scott; Stein, Bradley D.; Briscombe, Brian; Sontag-Padilla, Lisa; Woodbridge, Michelle W.; May, Elizabeth; Seelam, Rachana; Burnam, M. Audrey

    2016-01-01

    Abstract Reports results of a survey to assess the impact of CalMHSA's investments in mental health programs at California public colleges and estimates the return on investment in terms of student use of treatment, graduation rates, and lifetime earnings. PMID:28083421

  8. Public Health-Related Impacts of Climate Change inCalifornia

    Energy Technology Data Exchange (ETDEWEB)

    Drechsler, D.M.; Motallebi, N.; Kleeman, M.; Cayan, D.; Hayhoe,K.; Kalkstein, L.S.; Miller, N.L.; Jin, J.; VanCuren, R.A.

    2005-12-01

    In June 2005 Governor Arnold Schwarzenegger issued Executive Order S-3-05 that set greenhouse gas emission reduction targets for California, and directed the Secretary of the California Environmental Protection Agency to report to the governor and the State legislature by January 2006 and biannually thereafter on the impacts to California of global warming, including impacts to water supply, public health, agriculture, the coastline, and forestry, and to prepare and report on mitigation and adaptation plans to combat these impacts. This report is a part of the report to the governor and legislature, and focuses on public health impacts that have been associated with climate change. Considerable evidence suggests that average ambient temperature is increasing worldwide, that temperatures will continue to increase into the future, and that global warming will result in changes to many aspects of climate, including temperature, humidity, and precipitation (McMichael and Githeko, 2001). It is expected that California will experience changes in both temperature and precipitation under current trends. Many of the changes in climate projected for California could have ramifications for public health (McMichael and Githeko, 2001), and this document summarizes the impacts judged most likely to occur in California, based on a review of available peer-reviewed scientific literature and new modeling and statistical analyses. The impacts identified as most significant to public health in California include mortality and morbidity related to temperature, air pollution, vector and water-borne diseases, and wildfires. There is considerable complexity underlying the health of a population with many contributing factors including biological, ecological, social, political, and geographical. In addition, the relationship between climate change and changes in public health is difficult to predict for the most part, although more detailed information is available on temperature

  9. The role of topic, interviewee and question in predicting rich interview data in the field of health research.

    Science.gov (United States)

    Ogden, Jane; Cornwell, Danielle

    2010-11-01

    Although texts recommend the generation of rich data from interviews, no empirical evidence base exists for achieving this. This study aimed to operationalise richness and to assess which components of the interview (for example, topic, interviewee, question) were predictive. A total of 400 interview questions and their corresponding responses were selected from 10 qualitative studies in the area of health identified from university colleagues and the UK Data Archive database. The analysis used the text analysis program, Linguistic Inquiry and Word Count, and additional rating scales. Richness was operationalised along five dimensions. 'Length of response' was predicted by a personal, less specific or positive topic, not being a layperson, later questions, open or double questions; 'personal richness' was predicted by being a healthy participant and questions about the past and future; 'analytical responses' were predicted by a personal or less specific topic, not being a layperson, later questions, questions relating to insight and causation; 'action responses' were predicted by a less specific topic, not being a layperson, being healthy, later and open questions. The model for 'descriptive richness' was not significant. Overall, open questions, located later on and framed in the present or past tense, tended to be most predictive of richness. This could inform improvements in interview technique. © 2010 The Authors. Sociology of Health & Illness © 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  10. California Diploma Project Technical Report II: Alignment Study--Alignment Study of the Health Sciences and Medical Technology Draft Standards and California's Exit Level Common Core State Standards

    Science.gov (United States)

    McGaughy, Charis; de Gonzalez, Alicia

    2012-01-01

    The California Department of Education is in the process of revising the Career and Technical Education (CTE) Model Curriculum Standards. The Educational Policy Improvement Center (EPIC) conducted an investigation of the draft version of the Health Sciences and Medical Technology Standards (Health Science). The purpose of the study is to…

  11. Laboratory for Energy-Related Health Research (LEHR) University of California at Davis, California. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-09-01

    This Annual Site Environmental Report for the Laboratory for Energy-Related Health Research (LEHR) Site (the Site) includes 1996 environmental monitoring data for Site air, soil, ground water, surface water, storm water and ambient radiation. DOE operation of LEHR as a functioning research location ceased in 1989, after the completion of three decades of research on the health effects of low-level radiation exposure (primarily strontium-90 and radium-226), using beagles to simulate effects on human health. During 1996, the U.S. Department of Energy (DOE) conducted activities at the Site in support of Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) Environmental remediation and the decontamination and decommissioning (D&D) of Site buildings. Extensive environmental data were collected in 1996 to evaluate appropriate remedial actions for the Site.

  12. German health interview and examination survey for adults (DEGS) - design, objectives and implementation of the first data collection wave.

    Science.gov (United States)

    Scheidt-Nave, Christa; Kamtsiuris, Panagiotis; Gößwald, Antje; Hölling, Heike; Lange, Michael; Busch, Markus A; Dahm, Stefan; Dölle, Rüdiger; Ellert, Ute; Fuchs, Judith; Hapke, Ulfert; Heidemann, Christin; Knopf, Hildtraud; Laussmann, Detlef; Mensink, Gert B M; Neuhauser, Hannelore; Richter, Almut; Sass, Anke-Christine; Rosario, Angelika Schaffrath; Stolzenberg, Heribert; Thamm, Michael; Kurth, Bärbel-Maria

    2012-09-01

    The German Health Interview and Examination Survey for Adults (DEGS) is part of the recently established national health monitoring conducted by the Robert Koch Institute. DEGS combines a nationally representative periodic health survey and a longitudinal study based on follow-up of survey participants. Funding is provided by the German Ministry of Health and supplemented for specific research topics from other sources. The first DEGS wave of data collection (DEGS1) extended from November 2008 to December 2011. Overall, 8152 men and women participated. Of these, 3959 persons already participated in the German National Health Interview and Examination Survey 1998 (GNHIES98) at which time they were 18-79 years of age. Another 4193 persons 18-79 years of age were recruited for DEGS1 in 2008-2011 based on two-stage stratified random sampling from local population registries. Health data and context variables were collected using standardized computer assisted personal interviews, self-administered questionnaires, and standardized measurements and tests. In order to keep survey results representative for the population aged 18-79 years, results will be weighted by survey-specific weighting factors considering sampling and drop-out probabilities as well as deviations between the design-weighted net sample and German population statistics 2010. DEGS aims to establish a nationally representative data base on health of adults in Germany. This health data platform will be used for continuous health reporting and health care research. The results will help to support health policy planning and evaluation. Repeated cross-sectional surveys will permit analyses of time trends in morbidity, functional capacity levels, disability, and health risks and resources. Follow-up of study participants will provide the opportunity to study trajectories of health and disability. A special focus lies on chronic diseases including asthma, allergies, cardiovascular conditions, diabetes

  13. German health interview and examination survey for adults (DEGS - design, objectives and implementation of the first data collection wave

    Directory of Open Access Journals (Sweden)

    Scheidt-Nave Christa

    2012-09-01

    Full Text Available Abstract Background The German Health Interview and Examination Survey for Adults (DEGS is part of the recently established national health monitoring conducted by the Robert Koch Institute. DEGS combines a nationally representative periodic health survey and a longitudinal study based on follow-up of survey participants. Funding is provided by the German Ministry of Health and supplemented for specific research topics from other sources. Methods/design The first DEGS wave of data collection (DEGS1 extended from November 2008 to December 2011. Overall, 8152 men and women participated. Of these, 3959 persons already participated in the German National Health Interview and Examination Survey 1998 (GNHIES98 at which time they were 18–79 years of age. Another 4193 persons 18–79 years of age were recruited for DEGS1 in 2008–2011 based on two-stage stratified random sampling from local population registries. Health data and context variables were collected using standardized computer assisted personal interviews, self-administered questionnaires, and standardized measurements and tests. In order to keep survey results representative for the population aged 18–79 years, results will be weighted by survey-specific weighting factors considering sampling and drop-out probabilities as well as deviations between the design-weighted net sample and German population statistics 2010. Discussion DEGS aims to establish a nationally representative data base on health of adults in Germany. This health data platform will be used for continuous health reporting and health care research. The results will help to support health policy planning and evaluation. Repeated cross-sectional surveys will permit analyses of time trends in morbidity, functional capacity levels, disability, and health risks and resources. Follow-up of study participants will provide the opportunity to study trajectories of health and disability. A special focus lies on chronic

  14. Vitalum study design: RCT evaluating the efficacy of tailored print communication and telephone motivational interviewing on multiple health behaviors

    Directory of Open Access Journals (Sweden)

    Severens Johan L

    2008-06-01

    Full Text Available Abstract Background A large proportion of adults fail to meet public health guidelines for physical activity as well as fruit, vegetable and fat intake. Interventions are needed to improve these health behaviors. Both computer tailoring and motivational interviewing have shown themselves to be promising techniques for health behavior change. The Vitalum project aims to compare the efficacy of these techniques in improving the health behaviors of adults aged 45–70. This paper describes the design of the Vitalum study. Methods/Design Dutch general medical practices (N = 23 were recruited via a registration network or by personal invitation. The participants were then enrolled through these general practices using an invitational letter. They (n = 2,881 received a written baseline questionnaire to assess health behaviors, and potential psychosocial and socio-demographic behavioral determinants. A power analysis indicated that 1,600 participants who were failing to meet the guidelines for physical activity and either fruit or vegetable consumption were needed. Eligible participants were stratified based on hypertension status and randomized into one of four intervention groups: tailored print communication, telephone motivational interviewing, combined, and control. The first two groups either received four letters or took part in four interviews, whereas the combined group received two letters and took part in two interviews in turns at 5, 13, 30 and 43 weeks after returning the baseline questionnaire. Each letter and interview focused on physical activity or nutrition behavior. The participants also took part in a telephone survey 25 weeks after baseline to gather new information for tailoring. There were two follow-up questionnaires, at 47 and 73 weeks after baseline, to measure short- and long-term effects. The control group received a tailored letter after the last posttest. The process, efficacy and cost-effectiveness of the interventions

  15. Vitalum study design: RCT evaluating the efficacy of tailored print communication and telephone motivational interviewing on multiple health behaviors.

    Science.gov (United States)

    van Keulen, Hilde M; Mesters, Ilse; Brug, Johannes; Ausems, Marlein; Campbell, Marci; Resnicow, Ken; Zwietering, Paul J; van Breukelen, Gerard; van Mechelen, Willem; Severens, Johan L; de Vries, Hein

    2008-06-19

    A large proportion of adults fail to meet public health guidelines for physical activity as well as fruit, vegetable and fat intake. Interventions are needed to improve these health behaviors. Both computer tailoring and motivational interviewing have shown themselves to be promising techniques for health behavior change. The Vitalum project aims to compare the efficacy of these techniques in improving the health behaviors of adults aged 45-70. This paper describes the design of the Vitalum study. Dutch general medical practices (N = 23) were recruited via a registration network or by personal invitation. The participants were then enrolled through these general practices using an invitational letter. They (n = 2,881) received a written baseline questionnaire to assess health behaviors, and potential psychosocial and socio-demographic behavioral determinants. A power analysis indicated that 1,600 participants who were failing to meet the guidelines for physical activity and either fruit or vegetable consumption were needed. Eligible participants were stratified based on hypertension status and randomized into one of four intervention groups: tailored print communication, telephone motivational interviewing, combined, and control. The first two groups either received four letters or took part in four interviews, whereas the combined group received two letters and took part in two interviews in turns at 5, 13, 30 and 43 weeks after returning the baseline questionnaire. Each letter and interview focused on physical activity or nutrition behavior. The participants also took part in a telephone survey 25 weeks after baseline to gather new information for tailoring. There were two follow-up questionnaires, at 47 and 73 weeks after baseline, to measure short- and long-term effects. The control group received a tailored letter after the last posttest. The process, efficacy and cost-effectiveness of the interventions will be examined by means of multilevel mixed regression

  16. Psychiatric Comorbidity in Autism Spectrum Disorder: Correspondence between Mental Health Clinician Report and Structured Parent Interview

    Science.gov (United States)

    Stadnick, Nicole; Chlebowski, Colby; Baker-Ericzén, Mary; Dyson, Margaret; Garland, Ann; Brookman-Frazee, Lauren

    2017-01-01

    Publicly funded mental health services are critical in caring for children with autism spectrum disorder. Accurate identification of psychiatric comorbidity is necessary for effective mental health treatment. Little is known about psychiatric diagnosis for this population in routine mental health care. This study (1) examined correspondence…

  17. Health professionals perceive teamwork with relatives as an obstacle in their daily work - a focus group interview

    DEFF Research Database (Denmark)

    Laursen, Jannie; Broholm, Malene; Rosenberg, Jacob

    2017-01-01

    of this teamwork. Methods: The study was descriptive and exploratory and had a qualitative design with a phenomenological/hermeneutic orientation for the interviews. Focus group was the chosen methodology. The study comprised 19 health professionals in four focus groups. Results: Two themes emerged from...... makes it difficult for them to integrate relatives more and see them as participants in a natural teamwork for the benefit of the patient....

  18. Public Funds Account for Over 70 Percent of Health Care Spending in California.

    Science.gov (United States)

    Sorensen, Andrea; Nonzee, Narissa J; Kominski, Gerald F

    2016-08-01

    In California, personal health care expenditures are estimated to total more than $367 billion in 2016. Approximately 71 percent of these expenditures will be paid for with public funds (i.e., taxpayer dollars). This estimated contribution of public funds to health care expenditures is much higher than estimates that include only major health insurance programs such as Medicare and Medicaid. Several additional public funding sources also contribute to health care expenditures in the state, including government spending for public employee health benefits, tax subsidies for employer-sponsored insurance and the Affordable Care Act (ACA) insurance exchange, and county health care expenditures. As health care reform continues to take effect, it will be important to monitor the public versus private contributions to state health care expenditures to ensure that funds are being distributed both efficiently and equitably.

  19. Engaging Community Leaders in the Development of a Cardiovascular Health Behavior Survey Using Focus Group–Based Cognitive Interviewing

    Directory of Open Access Journals (Sweden)

    Gwenyth R Wallen

    2017-04-01

    Full Text Available Establishing the validity of health behavior surveys used in community-based participatory research (CBPR in diverse populations is often overlooked. A novel, group-based cognitive interviewing method was used to obtain qualitative data for tailoring a survey instrument designed to identify barriers to improved cardiovascular health in at-risk populations in Washington, DC. A focus group–based cognitive interview was conducted to assess item comprehension, recall, and interpretation and to establish the initial content validity of the survey. Thematic analysis of verbatim transcripts yielded 5 main themes for which participants (n = 8 suggested survey modifications, including survey item improvements, suggestions for additional items, community-specific issues, changes in the skip logic of the survey items, and the identification of typographical errors. Population-specific modifications were made, including the development of more culturally appropriate questions relevant to the community. Group-based cognitive interviewing provided an efficient and effective method for piloting a cardiovascular health survey instrument using CBPR.

  20. Controlling for race/ethnicity: a comparison of California commercial health plans CAHPS scores to NCBD benchmarks

    Directory of Open Access Journals (Sweden)

    Lopez Rebeca A

    2010-01-01

    Full Text Available Abstract Background Because California has higher managed care penetration and the race/ethnicity of Californians differs from the rest of the United States, we tested the hypothesis that California's lower health plan Consumer Assessment of Healthcare Providers and Systems (CAHPS® survey results are attributable to the state's racial/ethnic composition. Methods California CAHPS survey responses for commercial health plans were compared to national responses for five selected measures: three global ratings of doctor, health plan and health care, and two composite scores regarding doctor communication and staff courtesy, respect, and helpfulness. We used the 2005 National CAHPS 3.0 Benchmarking Database to assess patient experiences of care. Multiple stepwise logistic regression was used to see if patient experience ratings based on CAHPS responses in California commercial health plans differed from all other states combined. Results CAHPS patient experience responses in California were not significantly different than the rest of the nation after adjusting for age, general health rating, individual health plan, education, time in health plan, race/ethnicity, and gender. Both California and national patient experience scores varied by race/ethnicity. In both California and the rest of the nation Blacks tended to be more satisfied, while Asians were less satisfied. Conclusions California commercial health plan enrollees rate their experiences of care similarly to enrollees in the rest of the nation when seven different variables including race/ethnicity are considered. These findings support accounting for more than just age, gender and general health rating before comparing health plans from one state to another. Reporting on race/ethnicity disparities in member experiences of care could raise awareness and increase accountability for reducing these racial and ethnic disparities.

  1. Interviewer versus self-administered health-related quality of life questionnaires - Does it matter?

    Directory of Open Access Journals (Sweden)

    Ackatz Lori E

    2011-05-01

    Full Text Available Abstract Background Patient-reported outcomes are measured in many epidemiologic studies using self- or interviewer-administered questionnaires. While in some studies differences between these administration formats were observed, other studies did not show statistically significant differences important to patients. Since the evidence about the effect of administration format is inconsistent and mainly available from cross-sectional studies our aim was to assess the effects of different administration formats on repeated measurements of patient-reported outcomes in participants with AIDS enrolled in the Longitudinal Study of Ocular Complications of AIDS. Methods We included participants enrolled in the Longitudinal Study of Ocular Complications in AIDS (LSOCA who completed the Medical Outcome Study [MOS] -HIV questionnaire, the EuroQol, the Feeling Thermometer and the Visual Function Questionnaire (VFQ 25 every six months thereafter using self- or interviewer-administration. A large print questionnaire was available for participants with visual impairment. Considering all measurements over time and adjusting for patient and study site characteristics we used linear models to compare HRQL scores (all scores from 0-100 between administration formats. We defined adjusted differences of ≥0.2 standard deviations [SD] to be quantitatively meaningful. Results We included 2,261 participants (80.6% males with a median of 43.1 years of age at enrolment who provided data on 23,420 study visits. The self-administered MOS-HIV, Feeling Thermometer and EuroQol were used in 70% of all visits and the VFQ-25 in 80%. For eight domains of the MOS-HIV differences between the interviewer- and self- administered format were Conclusions Our large study provides evidence that administration formats do not have a meaningful effect on repeated measurements of patient-reported outcomes. As a consequence, longitudinal studies may not need to consider the effect of

  2. On the history of medicine in the United States, theory, health insurance, and psychiatry: an interview with Charles Rosenberg

    Directory of Open Access Journals (Sweden)

    Charles Rosenberg

    Full Text Available Abstract An interview with Charles Rosenberg conducted by Rafael Mantovani in November 2013 that addressed four topics. It first focused on the way in which Rosenberg perceived trends and directions in historical research on medicine in the United States during the second half of the twentieth century. The second focus was on his experience with other important historians who wrote about public health. Thirdly, he discussed his impressions about the current debate on health policy in his country. Finally, the last part explores some themes related to psychiatry and behavior control that have appeared in a number of his articles.

  3. On the history of medicine in the United States, theory, health insurance, and psychiatry: an interview with Charles Rosenberg.

    Science.gov (United States)

    Rosenberg, Charles; Mantovani, Rafael

    2016-01-01

    An interview with Charles Rosenberg conducted by Rafael Mantovani in November 2013 that addressed four topics. It first focused on the way in which Rosenberg perceived trends and directions in historical research on medicine in the United States during the second half of the twentieth century. The second focus was on his experience with other important historians who wrote about public health. Thirdly, he discussed his impressions about the current debate on health policy in his country. Finally, the last part explores some themes related to psychiatry and behavior control that have appeared in a number of his articles.

  4. Confirming mental health care in acute psychiatric wards, as narrated by persons experiencing psychotic illness: an interview study.

    Science.gov (United States)

    Sebergsen, Karina; Norberg, Astrid; Talseth, Anne-Grethe

    2016-01-01

    It is important that mental health nurses meet the safety, security and care needs of persons suffering from psychotic illness to enhance these persons' likelihood of feeling better during their time in acute psychiatric wards. Certain persons in care describe nurses' mental health care as positive, whereas others report negative experiences and express a desire for improvements. There is limited research on how persons with psychotic illness experience nurses' mental health care acts and how such acts help these persons feel better. Therefore, the aim of this study was to explore, describe and understand how the mental health nurses in acute psychiatric wards provide care that helps persons who experienced psychotic illness to feel better, as narrated by these persons. This study had a qualitative design; 12 persons participated in qualitative interviews. The interviews were transcribed, content analysed and interpreted using Martin Buber's concept of confirmation. The results of this study show three categories of confirming mental health care that describe what helped the participants to feel better step-by-step: first, being confirmed as a person experiencing psychotic illness in need of endurance; second, being confirmed as a person experiencing psychotic illness in need of decreased psychotic symptoms; and third, being confirmed as a person experiencing psychotic illness in need of support in daily life. The underlying meaning of the categories and of subcategories were interpreted and formulated as the theme; confirming mental health care to persons experiencing psychotic illness. Confirming mental health care acts seem to help persons to feel better in a step-wise manner during psychotic illness. Nurses' openness and sensitivity to the changing care needs of persons who suffer from psychotic illness create moments of confirmation within caring acts that concretely help the persons to feel better and that may enhance their health. The results show the

  5. Changing the health care system: a professional education program for Hispanic leaders in California.

    Science.gov (United States)

    Greenwald, H P; DeVries, R A; Dickstein, D A

    2001-01-01

    This article reports characteristics and evaluation findings on a program aimed at promoting change in California's health care system by training minority managers and policy specialists. Between 1990 and 1992, 30 Hispanic college graduates enrolled in the University of Southern California's Hispanic Leadership Program. Funded in part by the W. K. Kellogg Foundation, this program led to award of the Master of Health Administration degree and involved students in a series of community workshops. Evaluation took place via alumni surveys and focus groups. Although four individuals failed to complete the program, nearly all others entered careers potentially leading to positions of influence in health care delivery. Graduates indicated that they possessed most of the skills they considered necessary to help improve services to Hispanic people. All had taken concrete action toward this objective. Experience with the program has provided lessons valuable for conducting efforts of this kind, the principal one being that success requires substantial human and material resources. Long-term follow-up will be necessary to assess the program's ultimate impact on California's health care system.

  6. The health care professionals' perspectives of collaboration in rehabilitation - an interview study.

    Science.gov (United States)

    Kraft, Mia; Blomberg, Karin; Hedman, Ann-Marie Rydholm

    2014-09-01

    In previous literature, it has been recognised that the extent to which different healthcare professionals collaborate may affect both the quality and safety of care, and patient outcomes. Collaboration appears to be an essential part of professional practice, yet there is a lack of knowledge and understanding of collaboration in the context of short-term care units. Therefore, this study was undertaken to better understand how professionals in this context view collaboration. To describe collaboration in rehabilitation from the perspective of healthcare professionals. Qualitative interviews were conducted with ten healthcare professionals, including: occupational therapists, physiotherapists and nurses, who worked in three different short-term care settings. The interviews were transcribed, and qualitative content analysis was used. Four categories, all of which included both positive and negative descriptions of collaboration, were identified: (i) Crossing professional and organisational boundaries (ii) Awareness of own professional identity (iii) Information and knowledge transfer and (iv) Balancing between patient, system and process. The findings indicate the importance of leadership and organisational structures for stimulating communication, and promoting collaboration between team members. In addition, working as a professional in short-term care requires individual skills in collaboration efforts, including awareness of one's own professional identity. Opportunities for supervision could be one way to increase individuals' awareness of their own role in the team. © 2013 Blackwell Publishing Ltd.

  7. Interviewing Key Informants: Strategic Planning for a Global Public Health Management Program

    Science.gov (United States)

    Kun, Karen E.; Kassim, Anisa; Howze, Elizabeth; MacDonald, Goldie

    2013-01-01

    The Centers for Disease Control and Prevention's Sustainable Management Development Program (SMDP) partners with low- and middle-resource countries to develop management capacity so that effective global public health programs can be implemented and better health outcomes can be achieved. The program's impact however, was variable. Hence, there…

  8. Application of audio computer-assisted self-interviews to collect self-reported health data: an overview.

    Science.gov (United States)

    Brown, J L; Swartzendruber, A; DiClemente, R J

    2013-01-01

    For assessment of sensitive health behaviors (e.g., sexual behavior, violent behaviors, substance use), research is typically limited to an examination of self-reports of past behavior. Audio computer-assisted self-interviews (ACASI) may enhance the validity of self-report data in research and clinical settings by reducing measurement bias. This paper provides an introduction to ACASI for collection of self-reported health data. The potential benefits and cost-effectiveness of ACASI use in research and clinical settings are reviewed. We then review the theoretical underpinnings that may underlie differential reporting of health behaviors between assessment modalities. Next, we highlight studies that have investigated differences in self-reported health behaviors between assessment modalities. Lastly, we summarize potential applications of ACASI assessments within clinical settings. © 2013 S. Karger AG, Basel.

  9. Designing health insurance market constructs for shared responsibility: insights from California.

    Science.gov (United States)

    Curtis, Rick; Neuschler, Ed

    2009-01-01

    Moving toward universal participation in health insurance using a "shared responsibility" approach requires new, more accessible, and more efficient ways for people who are not offered employer coverage to obtain coverage. California's recent health reform plan-which failed to pass-incorporated individual market reform and choice-pool constructs to achieve critically important risk spreading, assure solvency, and reduce cost shifts. These measures, as well as the considerations that led to their design, offer important insights for health reform at the federal level.

  10. The Mental Health Status of Single-Parent Community College Students in California.

    Science.gov (United States)

    Shenoy, Divya P; Lee, Christine; Trieu, Sang Leng

    2016-01-01

    Single-parenting students face unique challenges that may adversely affect their mental health, which have not been explored in community college settings. The authors conducted secondary analysis of Spring 2013 data from the American College Health Association-National College Health Assessment to examine difficulties facing single-parent community college students and the association between single parenting and negative mental health (depression, self-injury, suicide attempt). Participants were 6,832 California community college students, of whom 309 were single parents. Demographic and mental health data were characterized using univariate descriptive analyses. Bivariate analyses determined whether single parents differed from other students regarding negative mental health or traumatic/difficult events. Finances, family, and relationship difficulties disproportionally affected single parents, who reported nearly twice as many suicide attempts as their counterparts (5.3% vs. 2.7%; p students face a higher prevalence of mental health stressors than other community college students.

  11. The 'millionaires tax' and mental health policy in California.

    Science.gov (United States)

    Feldman, Saul

    2009-01-01

    Despite long-standing and widespread opposition to new taxes, in 2004 Californians approved a so-called millionaires tax, levied on those with taxable net income over $1 million. The proceeds, estimated to be $700 million to $1 billion per year, can only be spent on improving mental health services for people with or at risk of a disabling mental disorder. Progress has been made in access to services, prevention programs, supported housing, and integrating mental health with the other human services. Challenges include a complex administrative structure, a paucity of change agents, a less-than-robust oversight and accountability process, and high public expectations.

  12. Health professional and community perspectives on reducing barriers to accessing specialist health care in metropolitan Aboriginal communities: A semi-structured interview study.

    Science.gov (United States)

    Young, Christian; Tong, Allison; Gunasekera, Hasantha; Sherriff, Simone; Kalucy, Deanna; Fernando, Peter; Craig, Jonathan C

    2017-03-01

    To describe the perspectives of health professionals and communities on an innovative health service delivery project, Hearing EAr health and Language Services (HEALS). HEALS was a government funded initiative to improve access to specialist ear, nose and throat and speech pathology services for Aboriginal families living in metropolitan areas. Semi-structured interviews were conducted with 21 health-care professionals (clinicians, health service managers and Aboriginal health workers) and 16 care givers of children who participated in HEALS. Interviews took place at four Aboriginal Community Controlled Health Services in metropolitan Australia or by telephone. Interview transcripts were analysed thematically. We identified five major themes: leveraging partnerships (building on collaborative research, integrating and expanding existing networks, engaging the Aboriginal community), intrinsic and extrinsic motivation (seizing opportunities for altruism, empowered by collegiality, taking pride in achievements), removing common barriers (circumventing waiting times and cost, providing culturally appropriate services, raising awareness), strategic service delivery (proactive service delivery, encouraging flexibility and innovation, offering convenience and support), and service shortfall (pressured timeframes, desire for more sustainable services). HEALS facilitated improved health-care access by providing prompt, no-cost services that were strategically targeted to address multiple barriers. HEALS' model of care was built upon strong pre-existing research partnerships, the knowledge and support of five Aboriginal Community Controlled Health Services, and the willingness and motivation of local health-care professionals to help Close the Gap. HEALS highlights the importance of tailoring health services to the needs of Aboriginal families, and provides a framework for other health service delivery initiatives. © 2016 Paediatrics and Child Health Division (The Royal

  13. How participants report their health status: cognitive interviews of self-rated health across race/ethnicity, gender, age, and educational attainment

    Directory of Open Access Journals (Sweden)

    Dana Garbarski

    2017-10-01

    Full Text Available Abstract Background Self-rated health (SRH is widely used to measure subjective health. Yet it is unclear what underlies health ratings, with implications for understanding the validity of SRH overall and across sociodemographic characteristics. We analyze participants’ explanations of how they formulated their SRH answer in addition to which health factors they considered and examine group differences in these processes. Methods Cognitive interviews were conducted with 64 participants in a convenience quota sample crossing dimensions of race/ethnicity (white, Latino, black, American Indian, gender, age, and education. Participants rated their health then described their thoughts when answering SRH. We coded participants’ answers in an inductive, iterative, and systematic process from interview transcripts, developing analytic categories (i.e., themes and subdimensions within. We examined whether the presence of each dimension of an analytic category varied across sociodemographic groups. Results Our qualitative analysis led to the identification and classification of various subdimensions of the following analytic categories: types of health factors mentioned, valence of health factors, temporality of health factors, conditional health statements, and descriptions and definitions of health. We found differences across groups in some types of health factors mentioned—corresponding, conflicting, or novel with respect to prior research. Furthermore, we also documented various processes through which respondents integrate seemingly disparate health factors to formulate an answer through valence and conditional health statements. Finally, we found some evidence of sociodemographic group differences with respect to types of health factors mentioned, valence of health factors, and conditional health statements, highlighting avenues for future research. Conclusion This study provides a description of how participants rate their general health

  14. How participants report their health status: cognitive interviews of self-rated health across race/ethnicity, gender, age, and educational attainment.

    Science.gov (United States)

    Garbarski, Dana; Dykema, Jennifer; Croes, Kenneth D; Edwards, Dorothy F

    2017-10-04

    Self-rated health (SRH) is widely used to measure subjective health. Yet it is unclear what underlies health ratings, with implications for understanding the validity of SRH overall and across sociodemographic characteristics. We analyze participants' explanations of how they formulated their SRH answer in addition to which health factors they considered and examine group differences in these processes. Cognitive interviews were conducted with 64 participants in a convenience quota sample crossing dimensions of race/ethnicity (white, Latino, black, American Indian), gender, age, and education. Participants rated their health then described their thoughts when answering SRH. We coded participants' answers in an inductive, iterative, and systematic process from interview transcripts, developing analytic categories (i.e., themes) and subdimensions within. We examined whether the presence of each dimension of an analytic category varied across sociodemographic groups. Our qualitative analysis led to the identification and classification of various subdimensions of the following analytic categories: types of health factors mentioned, valence of health factors, temporality of health factors, conditional health statements, and descriptions and definitions of health. We found differences across groups in some types of health factors mentioned-corresponding, conflicting, or novel with respect to prior research. Furthermore, we also documented various processes through which respondents integrate seemingly disparate health factors to formulate an answer through valence and conditional health statements. Finally, we found some evidence of sociodemographic group differences with respect to types of health factors mentioned, valence of health factors, and conditional health statements, highlighting avenues for future research. This study provides a description of how participants rate their general health status and highlights potential differences in these processes across

  15. Generational status and duration of residence predict diabetes prevalence among Latinos: the California Men's Health Study.

    Science.gov (United States)

    Ahmed, Ameena T; Quinn, Virginia P; Caan, Bette; Sternfeld, Barbara; Haque, Reina; Van Den Eeden, Stephen K

    2009-10-19

    Diabetes disproportionately affects Latinos. However, examining Latinos as one group obscures important intra-group differences. This study examined how generational status, duration of US residence, and language preference are associated with diabetes prevalence and to what extent these explain the higher prevalence among Latinos. We determined nativity, duration of US residence, language preference, and diabetes prevalence among 11 817 Latino, 6109 black, and 52 184 white participants in the California Men's Health Study. We combined generational status and residence duration into a single migration status variable with levels: > or = third generation; second generation; and immigrant living in the US for > 25, 16-25, 11-15, or Generational status and residence duration were associated with diabetes prevalence among middle-aged Latino men in California. As the Latino population grows, the burden of diabetes-associated disease is likely to increase and demands public health attention.

  16. California's historic effort to reduce the stigma of mental illness: the Mental Health Services Act.

    Science.gov (United States)

    Clark, Wayne; Welch, Stephanie N; Berry, Sandra H; Collentine, Ann M; Collins, Rebecca; Lebron, Dorthy; Shearer, Amy L

    2013-05-01

    In a historic effort to reduce the stigma of mental illness, California voters approved the Mental Health Services Act in 2004. The law funds a comprehensive statewide prevention initiative that places stigma and discrimination reduction at its center, with 25 projects providing interventions at the institutional, societal, and individual levels. Stakeholders selected specific strategies from the research-based California Strategic Plan on Reducing Stigma and Discrimination. Strategies range from social marketing to increase public knowledge to capacity building at the local level, including training that emphasizes participation by consumers of mental health services and cultural competence. Collectively, these strategies aim to foster permanent change in the public perception of mental illness and in the individual experience of stigma. We examined the context, planning, programming, and evaluation of this effort.

  17. Francis Omaswa: From cardiothoracic surgeon to village health advocate. Interview by Charles Wendo.

    Science.gov (United States)

    Omaswa, Francis

    2004-04-01

    Uganda's Director General of Health Services, Prof. Francis Omaswa says that abolition of user fees in his country has enabled more people to access health services. "Development partners now agree that it was a mistake to require people to pay for health services. the rest of the world should go that way" From high tech practice in the UK and Nairobi, Prof Omaswa established a model rural operation theatre in a poor rural area in Ngora, Eastern Uganda that became the envy of East Africa. He established model village health teams to provide the backbone of a district health system. When he became the head of Uganda's ministry of health he pushed for these teams country wide. This, together with President Museveni's open and multi sectoral approach to the HIV/AIDS epidemic, has contributed to Uganda's success story: HIV prevalence rates have plummeted from 30% to 5%. Charles Wendo caught up with him and gives a rare glimpse into this remarkable son of Africa: surgeon, public health advocate with rare leadership skills.

  18. Predicting Consumer Effort in Finding and Paying for Health Care: Expert Interviews and Claims Data Analysis.

    Science.gov (United States)

    Long, Sandra; Monsen, Karen A; Pieczkiewicz, David; Wolfson, Julian; Khairat, Saif

    2017-10-12

    For consumers to accept and use a health care information system, it must be easy to use, and the consumer must perceive it as being free from effort. Finding health care providers and paying for care are tasks that must be done to access treatment. These tasks require effort on the part of the consumer and can be frustrating when the goal of the consumer is primarily to receive treatments for better health. The aim of this study was to determine the factors that result in consumer effort when finding accessible health care. Having an understanding of these factors will help define requirements when designing health information systems. A panel of 12 subject matter experts was consulted and the data from 60 million medical claims were used to determine the factors contributing to effort. Approximately 60 million claims were processed by the health care insurance organization in a 12-month duration with the population defined. Over 292 million diagnoses from claims were used to validate the panel input. The results of the study showed that the number of people in the consumer's household, number of visits to providers outside the consumer's insurance network, number of adjusted and denied medical claims, and number of consumer inquiries are a proxy for the level of effort in finding and paying for care. The effort level, so measured and weighted per expert panel recommendations, differed by diagnosis. This study provides an understanding of how consumers must put forth effort when engaging with a health care system to access care. For higher satisfaction and acceptance results, health care payers ideally will design and develop systems that facilitate an understanding of how to avoid denied claims, educate on the payment of claims to avoid adjustments, and quickly find providers of affordable care.

  19. Potential role of complementary and alternative health care providers in chronic disease prevention and health promotion: an analysis of National Health Interview Survey data.

    Science.gov (United States)

    Hawk, Cheryl; Ndetan, Harrison; Evans, Marion Willard

    2012-01-01

    To make a preliminary assessment of the potential role of the most frequently used licensed or certified United States complementary and alternative medicine (CAM) providers in chronic disease prevention and health promotion. This was a secondary analysis of the 2007 United States National Health Interview Survey (NHIS), the most recent to include CAM use. The Adult Core Sample, Person and Adult Complementary and Alternative Medicine data files were included. NHIS's complete survey design structure (strata, cluster and survey weights) was applied in generating national population estimates for CAM usage. Chiropractic or osteopathic manipulation (8.4%) and massage (8.1%) were most commonly used; acupuncture was used by 1.4% and naturopathy by 0.3% of respondents. Substantial proportions of respondents reported using CAM for wellness and disease prevention, and informed their medical physician of use. Fifty-four percent were overweight or obese, 22.0% physically inactive, and 17.4% smokers; 18.0% reported hypertension, 19.6% high cholesterol, and 9.1% prediabetes or diabetes. CAM users present with risk factors which are priority public health issues. This implies a need to train CAM providers in evidence-based health promotion counseling. CAM encounters may provide opportunities to coordinate health promotion and prevention messages with patients' primary care providers. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Public Access and Use of Health Research: An Exploratory Study of the National Institutes of Health (NIH) Public Access Policy Using Interviews and Surveys of Health Personnel

    Science.gov (United States)

    Willinsky, John; Maggio, Lauren

    2011-01-01

    Background In 2008, the National Institutes of Health (NIH) Public Access Policy mandated open access for publications resulting from NIH funding (following a 12-month embargo). The large increase in access to research that will take place in the years to come has potential implications for evidence-based practice (EBP) and lifelong learning for health personnel. Objective This study assesses health personnel’s current use of research to establish whether grounds exist for expecting, preparing for, and further measuring the impact of the NIH Public Access Policy on health care quality and outcomes in light of time constraints and existing information resources. Methods In all, 14 interviews and 90 surveys of health personnel were conducted at a community-based clinic and an independent teaching hospital in 2010. Health personnel were asked about the research sources they consulted and the frequency with which they consulted these sources, as well as motivation and search strategies used to locate articles, perceived level of access to research, and knowledge of the NIH Public Access Policy. Results In terms of current access to health information, 65% (57/88) of the health personnel reported being satisfied, while 32% (28/88) reported feeling underserved. Among the sources health personnel reported that they relied upon and consulted weekly, 83% (73/88) reported turning to colleagues, 77% (67/87) reported using synthesized information resources (eg, UpToDate and Cochrane Systematic Reviews), while 32% (28/88) reported that they consulted primary research literature. The dominant resources health personnel consulted when actively searching for health information were Google and Wikipedia, while 27% (24/89) reported using PubMed weekly. The most prevalent reason given for accessing research on a weekly basis, reported by 35% (31/88) of survey respondents, was to help a specific patient, while 31% (26/84) were motivated by general interest in research. Conclusions

  1. A qualitative interview study exploring pregnant women’s and health professionals’ attitudes to external cephalic version

    Science.gov (United States)

    2013-01-01

    Background Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV) and how they want to give birth if the baby remains breech, either by planned caesarean section (CS) or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. Methods We carried out semi-structured interviews with pregnant women with a breech presentation (n=11) and health professionals who manage breech presentation (n=11) recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Results Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women’s attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals’ attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Conclusions Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the differences between evidence

  2. A qualitative interview study exploring pregnant women’s and health professionals’ attitudes to external cephalic version

    Directory of Open Access Journals (Sweden)

    Say Rebecca

    2013-01-01

    Full Text Available Abstract Background Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV and how they want to give birth if the baby remains breech, either by planned caesarean section (CS or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. Methods We carried out semi-structured interviews with pregnant women with a breech presentation (n=11 and health professionals who manage breech presentation (n=11 recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Results Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women’s attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals’ attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Conclusions Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the

  3. An ethnographic study of Latino preschool children's oral health in rural California: Intersections among family, community, provider and regulatory sectors

    Directory of Open Access Journals (Sweden)

    Horton Sarah B

    2008-03-01

    Full Text Available Abstract Background Latino children experience a higher prevalence of caries than do children in any other racial/ethnic group in the US. This paper examines the intersections among four societal sectors or contexts of care which contribute to oral health disparities for low-income, preschool Latino1 children in rural California. Methods Findings are reported from an ethnographic investigation, conducted in 2005–2006, of family, community, professional/dental and policy/regulatory sectors or contexts of care that play central roles in creating or sustaining low income, rural children's poor oral health status. The study community of around 9,000 people, predominantly of Mexican-American origin, was located in California's agricultural Central Valley. Observations in homes, community facilities, and dental offices within the region were supplemented by in-depth interviews with 30 key informants (such as dental professionals, health educators, child welfare agents, clinic administrators and regulatory agents and 47 primary caregivers (mothers of children at least one of whom was under 6 years of age. Results Caregivers did not always recognize visible signs of caries among their children, nor respond quickly unless children also complained of pain. Fluctuating seasonal eligibility for public health insurance intersected with limited community infrastructure and civic amenities, including lack of public transportation, to create difficulties in access to care. The non-fluoridated municipal water supply is not widely consumed because of fears about pesticide pollution. If the dentist brought children into the clinic for multiple visits, this caused the accompanying parent hardship and occasionally resulted in the loss of his or her job. Few general dentists had received specific training in how to handle young patients. Children's dental fear and poor provider-parent communication were exacerbated by a scarcity of dentists willing to serve rural

  4. Chronic effects of air pollution on respiratory health in Southern California children: findings from the Southern California Children's Health Study.

    Science.gov (United States)

    Chen, Zhanghua; Salam, Muhammad T; Eckel, Sandrah P; Breton, Carrie V; Gilliland, Frank D

    2015-01-01

    Outdoor air pollution is one of the leading contributors to adverse respiratory health outcomes in urban areas around the world. Children are highly sensitive to the adverse effects of air pollution due to their rapidly growing lungs, incomplete immune and metabolic functions, patterns of ventilation and high levels of outdoor activity. The Children's Health Study (CHS) is a continuing series of longitudinal studies that first began in 1993 and has focused on demonstrating the chronic impacts of air pollution on respiratory illnesses from early childhood through adolescence. A large body of evidence from the CHS has documented that exposures to both regional ambient air and traffic-related pollutants are associated with increased asthma prevalence, new-onset asthma, risk of bronchitis and wheezing, deficits of lung function growth, and airway inflammation. These associations may be modulated by key genes involved in oxidative-nitrosative stress pathways via gene-environment interactions. Despite successful efforts to reduce pollution over the past 40 years, air pollution at the current levels still brings many challenges to public health. To further ameliorate adverse health effects attributable to air pollution, many more toxic pollutants may require regulation and control of motor vehicle emissions and other combustion sources may need to be strengthened. Individual interventions based on personal susceptibility may be needed to protect children's health while control measures are being implemented.

  5. Health, hygiene and safety in the workplace and the MARS interview

    CERN Multimedia

    François Angerand

    2012-01-01

    The MARS exercise provides a unique opportunity for exchange between staff members and their supervisors.  It is also an opportunity to review workplace health, hygiene and safety issues, and in particular to identify occupational risks to which the staff member may be exposed. That information can also be used to identify and arrange for safety training, and to agree on the personal protective equipment that may be required.   CERN's Medical Service can use the identified occupational risks to verify that the state of health of each member of the personnel is compatible with the work assigned, which is one of the Service's responsibilities. Part 4 of the 2012 MARS form ("Aspects related to health, safety and working conditions") will therefore have a new box, which should be checked to confirm that the staff member and the supervisor have identified occupational risks using form OHS 0-0-3. The safety courses should be listed under "Development...

  6. David Brailer on a private-public health information technology infrastructure. Interview by Susan V. White.

    Science.gov (United States)

    Brailer, David

    2004-01-01

    David Brailer, MD PhD, was appointed the first National Health Information Technology Coordinator by the U.S. Department of Health and Human Services Secretary Tommy Thompson on May 6, 2004. As National Coordinator he is to execute President Bush's Executive Order of April 27, 2004, calling for widespread deployment of health information technology (HIT) within 10 years. Dr. Brailer is an authority on clinical data sharing, local health information exchanges, and the use of peer-to-peer technologies in healthcare. He is a leader in the strategy and financing of quality and efficiency in healthcare, with a particular emphasis on HIT and health systems management. Previously, Dr. Brailer was a Senior Fellow at the Health Technology Center in San Francisco, advising a variety of regional and national data-sharing projects and several major corporations about the role of IT in improving the quality of healthcare. Dr. Brailer recently completed 10 years as Chairman and CEO of CareScience, Inc., a provider of care management services and Internet-based solutions that help reduce medical errors and improve physician and hospital-based performance. Dr. Brailer holds doctoral degrees in both medicine and economics. While in medical school, he was a Charles A. Dana Scholar at the University of Pennsylvania School of Medicine and the first recipient of the National Library of Medicine Martin Epstein Award for his work in expert systems. Dr. Brailer was among the first medical students to serve on the Board of Trustees of the American Medical Association.

  7. Experiences with tele-health follow-up in patients with rheumatoid arthritis: a qualitative interview study

    DEFF Research Database (Denmark)

    Raunsbæk Knudsen, Line; Thurah, Annette De; Lomborg, Kirsten

    2017-01-01

    OBJECTIVE: The aim was to explore the experiences of a patient-reported outcome (PRO)-based tele-health follow-up from the perspective of patients with rheumatoid arthritis (RA) and their experiences of increasing their active role and responsibility for disease control in particular. METHODS......: Adopting a strategy of interpretive description, we conducted individual, semi-structured interviews with 15 RA patients participating in a tele-health follow-up. Participants were selected purposively and consecutive from both genders and with various ages, disease durations and disease severity....... The analysis was inductive with a constant comparative approach. First, we identified the main themes conveying the participants' experiences. Then, we constructed patient typologies to explain different perspectives on the tele-health follow-up. RESULTS: Five themes covered the participants' experiences: 'A...

  8. Internet use and looking up information online in adults with epilepsy varies by epilepsy status--2013 National Health Interview Survey.

    Science.gov (United States)

    Us Centers For Disease Control And Prevention Epilepsy Program

    2016-01-01

    We estimated US national prevalences of Internet use and looking up health information online among adults with epilepsy and those without, overall (age-standardized) and by three age groups (18-44, 45-59, and ≥60years) using the 2013 National Health Interview Survey. Results showed that both overall and across all age groups, a significantly lower percentage of adults with active epilepsy reported using the Internet compared with that of adults without epilepsy. However, among Internet users, the percentage of looking up health information online did not differ by epilepsy status or age. Ensuring access to the Internet and encouraging use of quality, secure, and easy-to-access resources and e-tools might help adults with epilepsy to optimize their self-management and improve their quality of life. Published by Elsevier Inc.

  9. Prejudice and Health Anxiety about Radiation Exposure from Second-Generation Atomic Bomb Survivors: Results from a Qualitative Interview Study

    Directory of Open Access Journals (Sweden)

    Yuka Kamite

    2017-08-01

    Full Text Available The effect of atomic bomb radiation exposure on the survivors and their children has been a worrisome problem since soon after the 1945 Hiroshima and Nagasaki bombings. Researchers have examined physical and genetic effects; however, no research has focused on second-generation survivors’ (SGS psychological effects. Consequently, this study shed light on the SGS’ experience of discrimination and prejudice and their anxiety concerning the genetic effects of radiation exposure. This study utilized semi-structured interviews with 14 SGS (10 women, mean age = 56 ± 6.25 years, range = 46–68 years. Data were analyzed using a modified version of the grounded theory approach. Three categories were extracted: low awareness as an SGS, no health anxiety regarding the effect of radiation, and health anxiety regarding the effect of radiation. The results did not reveal that SGS who grew up in the bombed areas experienced discrimination or prejudice. They had little health anxiety from childhood to adolescence. In this study, some of the SGS developed health anxiety about their third-generation children, but only among female participants. Perhaps the transgenerational transmission of anxiety concerning the genetic effects of radiation exposure causes stress, particularly among women with children. However, a change was seen in adulthood health anxiety regarding the effects of radiation, suggesting the possibility that changes in the psychological experiences of SGS can be observed throughout their lifetimes and that their own health status, and that of their children, the third-generation survivors, affects their health anxiety regarding radiation.

  10. Comparison of Health and Health Risk Factors Between Lesbian, Gay, and Bisexual Adults and Heterosexual Adults in the United States: Results From the National Health Interview Survey.

    Science.gov (United States)

    Gonzales, Gilbert; Przedworski, Julia; Henning-Smith, Carrie

    2016-09-01

    Previous studies identified disparities in health and health risk factors among lesbian, gay, and bisexual (LGB) adults, but prior investigations have been confined to samples not representative of the US adult population or have been limited in size or geographic scope. For the first time in its long history, the 2013 and 2014 National Health Interview Survey included a question on sexual orientation, providing health information on sexual minorities from one of the nation's leading health surveys. To compare health and health risk factors between LGB adults and heterosexual adults in the United States. Data from the nationally representative 2013 and 2014 National Health Interview Survey were used to compare health outcomes among lesbian (n = 525), gay (n = 624), and bisexual (n = 515) adults who were 18 years or older and their heterosexual peers (n = 67 150) using logistic regression. Self-rated health, functional status, chronic conditions, psychological distress, alcohol consumption, and cigarette use. The study cohort comprised 68 814 participants. Their mean (SD) age was 46.8 (11.8) years, and 51.8% (38 063 of 68 814) were female. After controlling for sociodemographic characteristics, gay men were more likely to report severe psychological distress (odds ratio [OR], 2.82; 95% CI, 1.55-5.14), heavy drinking (OR, 1.97; 95% CI, 1.08-3.58), and moderate smoking (OR, 1.98; 95% CI, 1.39-2.81) than heterosexual men; bisexual men were more likely to report severe psychological distress (OR, 4.70; 95% CI, 1.77-12.52), heavy drinking (OR, 3.15; 95% CI, 1.22-8.16), and heavy smoking (OR, 2.10; 95% CI, 1.08-4.10) than heterosexual men; lesbian women were more likely to report moderate psychological distress (OR, 1.34; 95% CI, 1.02-1.76), poor or fair health (OR, 1.91; 95% CI, 1.24-2.95), multiple chronic conditions (OR, 1.58; 95% CI, 1.12-2.22), heavy drinking (OR, 2.63; 95% CI, 1.54-4.50), and heavy smoking (OR, 2.29; 95% CI, 1.36-3.88) than

  11. Online encyclopedia provides free health info for all. Interview by Fiona Fleck.

    Science.gov (United States)

    Heilman, James

    2013-01-01

    Within a decade, Wikipedia has become one of the most popular health-content web sites in the world. James Heilman talks to Fiona Fleck about how the once free-wheeling website is moving closer to a formal publication model.

  12. Comparison of In-Person and Online Motivational Interviewing-Based Health Coaching.

    Science.gov (United States)

    Bus, Kathryn; Peyer, Karissa L; Bai, Yang; Ellingson, Laura D; Welk, Gregory J

    2017-12-01

    Health coaching is a common approach for promoting lifestyle changes, but little is known about the effectiveness of different delivery methods. The purpose of this study was to evaluate the effectiveness of in-person versus online health coaching when used as part of a facilitated behavior change program. To increase translatability, the study used a naturalistic design that enabled participants to self-select the coaching delivery method (Group) as well as the target behavior (diet, physical activity, or weight management). Regardless of group, participants were provided with a behavior-based monitoring device and guided to use it by the health coach. A sample of 92 adults participated and 86 completed pre-post evaluations to assess behavior change strategies and posttest outcome measurements for their specific goal. Two-way (Group × Time) analyses of variance were used to evaluate changes in behavioral strategies. Intent-to-treat regression analyses were used to compare postintervention outcomes for groups. The in-person group had significantly higher Healthy Eating Index scores than the online group ( p .05). The results support the use of health coaching for promoting behavior change and suggest that online coaching may be equally effective as in-person methods.

  13. The characteristics and motivations of online health information seekers: cross-sectional survey and qualitative interview study.

    Science.gov (United States)

    Powell, John; Inglis, Nadia; Ronnie, Jennifer; Large, Shirley

    2011-02-23

    Most households in the United Kingdom have Internet access, and health-related Internet use is increasing. The National Health Service (NHS) Direct website is the major UK provider of online health information. Our objective was to identify the characteristics and motivations of online health information seekers accessing the NHS Direct website, and to examine the benefits and challenges of the health Internet. We undertook an online questionnaire survey, offered to users of the NHS Direct website. A subsample of survey respondents participated in in-depth, semistructured, qualitative interviews by telephone or instant messaging/email. Questionnaire results were analyzed using chi-square statistics. Thematic coding with constant comparison was used for interview transcript analysis. In total 792 respondents completed some or all of the survey: 71.2% (534/750 with data available) were aged under 45 years, 67.4% (511/758) were female, and 37.7% (286/759) had university-level qualifications. They sought information for themselves (545/781, 69.8%), someone else (172/781, 22.0%), or both (64/781, 8.2%). Women were more likely than men to seek help for someone else or both themselves and someone else (168/509 vs 61/242, χ(2) (2) = 6.35, P = .04). Prior consultation with a health professional was reported by 44.9% (346/770), although this was less common in younger age groups (anonymity. Various challenges were discussed but no prominent theme emerged. Navigating online health information and determining what to trust was regarded as a "common sense" activity, and brand recognition was important. Specific comments about NHS Direct included the perception that the online service was integrated with traditional service provision. This study supports a model of evolutionary rather than revolutionary change in online health information use. Given increasing resource constraints, the health care community needs to seek ways of promoting efficient and appropriate health

  14. Comparison of the mental health of female adult film performers and other young women in California.

    Science.gov (United States)

    Grudzen, Corita R; Meeker, Daniella; Torres, Jacqueline M; Du, Qingling; Morrison, R Sean; Andersen, Ronald M; Gelberg, Lillian

    2011-06-01

    This study compared self-reported mental health status and current depression of female adult film performers and other young women. A cross-sectional structured online survey adapted from the California Women's Health Survey (CWHS) was self-administered to a convenience sample of 134 current female adult film performers via the Internet. Bivariate and multivariate analyses were used to compare data for these women with data for 1,773 women of similar ages who responded to the 2007 CWHS. Main outcome measures were self-reported mental health status, measured with the Behavioral Risk Factor Surveillance Survey core-instrument quality-of-life questions, and current depression, measured with the Patient Health Questionnaire-8. Performers reported a mean of 7.2 days of poor mental health in the past 30 days, compared with 4.8 days for CWHS respondents, and 33% met criteria for current depression, compared with 13% of CWHS respondents (pfilm performers were more likely to have been victims of forced sex (37% compared with 13% of CWHS respondents), to have lived in poverty (24% and 12%), and to have been placed in foster care (21% and 4%) (pfilm performers have significantly worse mental health and higher rates of depression than other California women of similar ages.

  15. Comparison of Health Information Technology Use Between American Adults With and Without Chronic Health Conditions: Findings From The National Health Interview Survey 2012.

    Science.gov (United States)

    Zhang, Yan; Lauche, Romy; Sibbritt, David; Olaniran, Bolanle; Cook, Ronald; Adams, Jon

    2017-10-05

    Health information technology (HIT) is utilized by people with different chronic conditions such as diabetes and hypertension. However, there has been no comparison of HIT use between persons without a chronic condition, with one chronic condition, and multiple (≥2) chronic conditions (MCCs). The aim of the study was to assess the difference in HIT use between persons without a chronic condition, with one chronic condition, and with MCCs, to describe the characteristics of HIT use among those with chronic conditions and to identify the predictors of HIT use of the persons with one chronic condition and MCCs. A secondary data analysis was conducted in spring 2017 using the National Health Interview Survey (NHIS) 2012 Family Core and Sample Adult Core datasets that yielded 34,525 respondents aged 18 years and older. Measures included overall HIT use (ie, any use of the following five HIT on the Internet: seeking health information, ordering prescription, making appointment, emailing health provider, and using health chat groups), as well as sociodemographic and health-related characteristics. Sociodemographic and health characteristics were compared between HIT users and nonusers among those who reported having at least one chronic condition using chi-square tests. Independent predictors of HIT use were identified using multiple logistic regression analyses for those with one chronic condition, with MCCs, and without a chronic condition. Analyses were weighted and performed at significance level of .005. In 2012, adults with one health chronic condition (raw count 4147/8551, weighted percentage 48.54%) was significantly higher than among those with MCCs (3816/9637, 39.55%) and those with none of chronic condition (7254/16,337, 44.40%, P<.001). Seeking health information was the most prevalent HIT use. Chi-square tests revealed that among adults with chronic conditions, those who used HIT were significantly different from their counterpart peers who did not use HIT

  16. Timeline interviews

    DEFF Research Database (Denmark)

    Adriansen, Hanne Kirstine

    2012-01-01

    The aim of this paper is to explain and discuss timeline interviews as a method for doing life history research. It is a ‘how to’ article explaining the strengths and weaknesses of using a timeline when conducting qualitative interviews. The method allows the interviewee to participate...... in the reporting of the interview which may give raise to ownership and sharing of the analytical power in the interview situation. Exactly for this reason, it may not be the most appropriate method for interviewing elites or for conducting insider interviews where positionality can be at play. The use...... of the timeline should not lead the nterviewer or the interviewee to assume linearity and coherence; it is an rganising principle for the events. It provides an opportunity for linking the story with the wider social, political and environmental context during the interview. hile the method is very suitable...

  17. Guadalupe corridor transportation project asbestos health risk assessment, San Jose, California.

    Science.gov (United States)

    Steiner, W E; Koehler, J L; Popenuck, W W

    1990-04-01

    A study was conducted to assess health risks and identify a set of appropriate mitigation measures to control airborne emissions of natural asbestos from construction of the Guadalupe Corridor Transportation Project, a highway and light-rail construction project in San Jose, California. This study supported a state-mandated Environmental Impact Report. Communication Hill, along the project route, is known to contain natural chrysotile asbestos-bearing rock. The study described in this paper estimated potential asbestos emissions, identified and evaluated mitigation measures, and evaluated air pathway exposure and health risks. With mitigation, estimated risks were found to be acceptable by the regulatory agency, and construction proceeded.

  18. [Science in the service of human and environmental health: interview with chemist, geneticist, and environmentalist Flávio Lewgoy].

    Science.gov (United States)

    Lewgoy, Flávio; Pereira, Elenita Malta

    2017-01-01

    Interview with chemist and geneticist Flávio Lewgoy, who was also an expert criminal and environmental investigator. Lewgoy was at the center of important struggles for human health and environmental quality in Rio Grande do Sul, and was one of the people behind state (1982) and federal (1989) laws governing pesticide use. He believed he had a duty to use scientific knowledge to support his positions on environmental activism and saw this activity as an ethical commitment, a way of paying back society for the education he received in public institutions.

  19. Racial disparity trends in children's dental visits: US National Health Interview Survey, 1964-2010

    OpenAIRE

    Isong, IA; Soobader, MJ; Fisher-Owens, SA; Weintraub, JA; Gansky, SA; Platt, LJ; Newacheck, PW

    2012-01-01

    BACKGROUND AND OBJECTIVE: Research that has repeatedly documented marked racial/ethnic disparities in US children's receipt of dental care at single time points or brief periods has lacked a historical policy perspective, which provides insight into how these disparities have evolved over time. Our objective was to examine the impact of national health policies on African American and white children's receipt of dental care from 1964 to 2010. METHODS: We analyzed data on race and dental care ...

  20. Food insecurity and intimate partner violence against women: results from the California Women's Health Survey.

    Science.gov (United States)

    Ricks, Joni L; Cochran, Susan D; Arah, Onyebuchi A; Williams, John K; Seeman, Teresa E

    2016-04-01

    To investigate the association between food insecurity and intimate partner violence in a population-based sample of heterosexual women. Logistic regression was used to evaluate the association between three levels of food insecurity and intimate partner violence. Data from 6 years of the California Women's Health Survey. Randomly selected women (n 16 562) aged 18 years and older from the State of California, USA. We found: (i) that African-American women had a higher prevalence of food insecurity and were more likely to report severe intimate partner violence; (ii) a strong positive association between food insecurity and intimate partner violence; (iii) evidence of effect modification of the association between food insecurity and intimate partner violence by marital status; and (iv) higher odds of intimate partner violence among those reporting more severe food insecurity. Food insecurity is an important risk indicator for intimate partner violence among women. Understanding the factors that put women, especially minority women, at greatest risk facilitates intervention development.

  1. The mental health module (BELLA study) within the German Health Interview and Examination Survey of Children and Adolescents (KiGGS): study design and methods.

    Science.gov (United States)

    Ravens-Sieberer, Ulrike; Kurth, Bärbel-Maria

    2008-12-01

    The BELLA study on mental health and well-being in children and adolescents is the mental health module of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The cross-sectional KiGGS survey collected comprehensive data on the health status of 17,641 children and adolescents, aged 0-17 years, living in Germany. The survey included physical examinations and tests, questionnaires filled in by parents and equivalent questionnaires for children aged 11 years or older. A computer-assisted personal interview was conducted by study physicians, and various laboratory tests, e.g. on blood and urine samples, were performed. The longitudinal BELLA study collected initial cross-sectional data from a representative KiGGS sub-sample of families with children aged 7-17 years. Of the 4,199 randomly selected families invited to participate in the BELLA study, 2,863 took part. A total of 48.5% of the participating children and adolescents were girls, 51.5% were boys. Within the BELLA study, trained interviewers conducted standardised telephone interviews with one parent and also the child, if it was at least 11 years old. Afterwards the families received additional questionnaires. The interviews and questionnaires included various standardised and ICD-10-oriented instruments examining overall mental health problems and associated burden, depression, anxiety, attention deficit-/hyperactivity and conduct disorders. Furthermore they covered a broad spectrum of aspects related to mental health and well-being, such as risk and protective factors and health-related quality of life. An analysis of the non-responders showed that the families who agreed to participate form a representative sample with respect to the German population. The sample deviated only slightly from the KiGGS sample structure regarding socioeconomic status and regarding parent-reported mental health problems. No such difference was observed for the children's self-reported mental

  2. Exploring men's and women's experiences of depression and engagement with health professionals: more similarities than differences? A qualitative interview study

    Directory of Open Access Journals (Sweden)

    Ziebland Sue

    2007-07-01

    Full Text Available Abstract Background It is argued that the ways in which women express emotional distress mean that they are more likely to be diagnosed with depression, while men's relative lack of articulacy means their depression is hidden. This may have consequences for communicating with health professionals. The purpose of this analysis was to explore how men and women with depression articulate their emotional distress, and examine whether there are gender differences or similarities in the strategies that respondents found useful when engaging with health professionals. Methods In-depth qualitative interviews with 22 women and 16 men in the UK who identified themselves as having had depression, recruited through general practitioners, psychiatrists and support groups. Results We found gender similarities and gender differences in our sample. Both men and women found it difficult to recognise and articulate mental health problems and this had consequences for their ability to communicate with health professionals. Key gender differences noted were that men tended to value skills which helped them to talk while women valued listening skills in health professionals, and that men emphasised the importance of getting practical results from talking therapies in their narratives, as opposed to other forms of therapy which they conceptualised as 'just talking'. We also found diversity among women and among men; some respondents valued a close personal relationship with health professionals, while others felt that this personal relationship was a barrier to communication and preferred 'talking to a stranger'. Conclusion Our findings suggest that there is not a straightforward relationship between gender and engagement with health professionals for people with depression. Health professionals need to be sensitive to patients who have difficulties in expressing emotional distress and critical of gender stereotypes which suggest that women invariably find it easy to

  3. Exploring men's and women's experiences of depression and engagement with health professionals: more similarities than differences? A qualitative interview study.

    Science.gov (United States)

    Emslie, Carol; Ridge, Damien; Ziebland, Sue; Hunt, Kate

    2007-07-24

    It is argued that the ways in which women express emotional distress mean that they are more likely to be diagnosed with depression, while men's relative lack of articulacy means their depression is hidden. This may have consequences for communicating with health professionals. The purpose of this analysis was to explore how men and women with depression articulate their emotional distress, and examine whether there are gender differences or similarities in the strategies that respondents found useful when engaging with health professionals. In-depth qualitative interviews with 22 women and 16 men in the UK who identified themselves as having had depression, recruited through general practitioners, psychiatrists and support groups. We found gender similarities and gender differences in our sample. Both men and women found it difficult to recognise and articulate mental health problems and this had consequences for their ability to communicate with health professionals. Key gender differences noted were that men tended to value skills which helped them to talk while women valued listening skills in health professionals, and that men emphasised the importance of getting practical results from talking therapies in their narratives, as opposed to other forms of therapy which they conceptualised as 'just talking'. We also found diversity among women and among men; some respondents valued a close personal relationship with health professionals, while others felt that this personal relationship was a barrier to communication and preferred 'talking to a stranger'. Our findings suggest that there is not a straightforward relationship between gender and engagement with health professionals for people with depression. Health professionals need to be sensitive to patients who have difficulties in expressing emotional distress and critical of gender stereotypes which suggest that women invariably find it easy to express emotional distress and men invariably find it difficult

  4. International mental health advocacy organizations: an interview with Norman Sartorius by John A. Talbott.

    Science.gov (United States)

    Sartorius, Norman; Talbott, John A

    2011-08-01

    International professional and nonprofessional associations and organizations could be immensely useful in the promotion of mental health and in the control of mental disorders. Unfortunately, their potential is not always used. Organizations go through periods of crisis and often vegetate for sometime until somebody resuscitates them. The impact of a good leader or leadership group lasts for a few years. A great achievement would be to structure associations in a manner that will ensure their stability and continuous contributions even when their leaders are weak.

  5. Human-Centered Design as an Approach for Place-Based Innovation in Public Health: A Case Study from Oakland, California.

    Science.gov (United States)

    Vechakul, Jessica; Shrimali, Bina Patel; Sandhu, Jaspal S

    2015-12-01

    This case study provides a high-level overview of the human-centered design (HCD) or "design thinking" process and its relevance to public health. The Best Babies Zone (BBZ) initiative is a multi-year project aimed at reducing inequities in infant mortality rates. In 2012, BBZ launched pilot programs in three US cities: Cincinnati, Ohio; New Orleans, Louisiana; and Oakland, California. The Alameda County Public Health Department (ACPHD), the lead for the Oakland BBZ site, identified HCD as a promising approach for addressing the social and economic conditions that are important drivers of health inequities. HCD is a process for creating innovative products, services, and strategies that prioritizes the needs of the intended population. ACPHD partnered with the Gobee Group (a social innovation design consultancy) to develop the Design Sprint. The Design Sprint was a 12-week pilot in which 14 professionals from nine organizations used the HCD process to develop concepts for stimulating a vibrant local economy in the Oakland Best Babies Zone. Thirty- to sixty-minute semi-structured interviews were conducted with all 14 individuals involved in the Design Sprint. With the exception of one interview, the interviews were audio-recorded, transcribed, and inductively coded to identify themes. Our experience suggests that HCD can: enhance community engagement; expedite the timeframe for challenge identification, program design, and implementation; and create innovative programs that address complex challenges.

  6. Health, hygiene and safety in the workplace and the MARS interview

    CERN Multimedia

    2012-01-01

    The MARS exercise provides a unique opportunity for exchange between staff members and their supervisors. It is also an opportunity to review workplace health, hygiene and safety issues, and in particular to identify occupational risks to which the staff member may be exposed. That information can also be used to identify and arrange for safety training, and to agree on the personal protective equipment that may be required.   Please remember that it is stipulated in Article 4.3 of Safety Code A1 that: “The member of the personnel concerned and the Group Leader are responsible for updating the questionnaire on occupational hazards. (…) The Group Leader is also responsible for ensuring that his personnel do not undertake work forbidden by a medical decision.” CERN’s Medical Service can use the identi­fied occupational risks to verify that the state of health of each member of the personnel is compatible with the work assigned, which is one of the S...

  7. Introduction to Reference Sources in the Health Sciences: an interview with Jo Anne Boorkman, Jeffrey T. Huber and Fred W. Roper. Interview by Elizabeth Connor.

    Science.gov (United States)

    Boorkman, Jo Anne; Huber, Jeffrey T; Roper, Fred W

    2005-01-01

    Few works serve as solid a framework for the field of health sciences librarianship or provide as many insights and detailed knowledge as Introduction to Reference Sources in the Health Sciences. Now in its fourth edition, the book's editors and contributors represent an impressive range of experience, expertise, and subject knowledge appreciated by practicing librarians in a variety of settings and by students of health sciences librarianship. Jo Anne Boorkman, Jeffrey T. Huber, and Fred W. Roper answered a series of questions about the latest edition of this seminal work, and offered opinions about reference works, services, and librarians.

  8. Understanding health care provider barriers to hospital affiliated medical fitness center facility referral: a questionnaire survey and semi structured interviews.

    Science.gov (United States)

    Smock, Carissa; Alemagno, Sonia

    2017-08-03

    The purpose of this study is to understand health care provider barriers to referring patients to Medical Fitness Center Facilities within an affiliated teaching hospital system using referral of diabetic services as an example. The aims of this study include: (1) to assess health care providers' awareness and use of facilities, (2) to determine barriers to referring patients to facilities, (3) identify current and needed resources and/or changes to increase referral to facilities. A 20-item electronic survey and requests for semi-structured interviews were administered to hospital system directors and managers (n = 51). Directors and managers instructed physicians and staff to complete the survey and interviews as applicable. Perceived barriers, knowledge, utilization, and referral of patients to Medical Fitness Center Facilities were collected and examined. Descriptive statistics were generated regarding practice characteristics, provider characteristics, and referral. Of the health care providers surveyed and interviewed (n = 25) 40% indicated verbally suggesting use of facilities, 24% provided a flyer about the facilities. No respondents indicated that they directly referred patients to the facilities. However, 16% referred patients to other locations for physical activity - including their own department's management and prevention services. 20% do not refer to Medical Fitness Center Facilities or any other lifestyle programs/locations. Lack of time (92%) and lack of standard guidelines and operating procedures (88%) are barriers to referral. All respondents indicated a strong ability to refer patients to Medical Fitness Center Facilities if given education about referral programs available as well as standard clinical guidelines and protocol for delivery. The results of this study indicate that, although few healthcare providers are currently referring patients to Medical Fitness Center Facilities, health care providers with an affiliated Medical Fitness

  9. Participants' use of enacted scenes in research interviews: A method for reflexive analysis in health and social care.

    Science.gov (United States)

    James, Deborah Michelle; Pilnick, Alison; Hall, Alex; Collins, Luke

    2016-02-01

    In our study of a workforce intervention within a health and social care context we found that participants who took part in longitudinal research interviews were commonly enacting scenes from their work during one-to-one interviews. Scenes were defined as portions of the interviews in which participants directly quoted the speech of at least two actors. Our analysis in this paper focuses on these enacted scenes, and compares the content of them before and after the intervention. We found that, whilst the tensions between consistency and change, and change management, were common topics for scene enactment in both pre and post-intervention data, following the intervention participants were much more likely to present themselves as active agents in that change. Post-intervention enacted scenes also showed participants' reports of taking a service user perspective, and a focus on their interactions with service users that had been absent from pre-intervention data. In addition, descriptions of positive feeling and emotions were present in the post-intervention enacted scenes. We suggest that this analysis confirms the importance of enacted scenes as an analytic resource, and that this importance goes beyond their utility in identifying the impact of this specific intervention. Given the congruence between the themes prominent in enacted scenes, and those which emerged from a more extensive qualitative analysis of these data, we argue that enacted scenes may also be of wider methodological importance. The possibility of using scene enactment as an approach to the validation of inductive analysis in health and social care settings could provide a useful methodological resource in settings where longitudinal ethnographic observation of frontline care staff is impossible or impractical. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Palliative care for cancer patients in a primary health care setting:Bereaved relatives' experience, a qualitative group interview study

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Olesen, Frede; Jensen, Anders Bonde

    2008-01-01

    care setting to explore barriers and facilitators for delivery of good palliative home care. Methods: Three focus group interviews with fourteen bereaved relatives in Aarhus County, Denmark. Results: Three main categories of experience were identified: 1) The health professionals' management, where...... a need to optimize was found. 2) Shared care, which was lacking. 3) The relatives' role, which needs an extra focus. Conclusion: Relatives experience insufficient palliative care mainly due to organizational and cultural problems among professionals. Palliative care in primary care in general needs......Background: Knowledge about the quality and organisation of care to terminally ill cancer patients with a relatives' view in a primary health care setting is limited. The aim of the study is to analyse experiences and preferences of bereaved relatives to terminally ill cancer patients in a primary...

  11. Computer-assisted audiovisual health history self-interviewing. Results of the pilot study of the Hoxworth Quality Donor System.

    Science.gov (United States)

    Zuck, T F; Cumming, P D; Wallace, E L

    2001-12-01

    The safety of blood for transfusion depends, in part, on the reliability of the health history given by volunteer blood donors. To improve reliability, a pilot study evaluated the use of an interactive computer-based audiovisual donor interviewing system at a typical midwestern blood center in the United States. An interactive video screening system was tested in a community donor center environment on 395 volunteer blood donors. Of the donors using the system, 277 completed surveys regarding their acceptance of and opinions about the system. The study showed that an interactive computer-based audiovisual donor screening system was an effective means of conducting the donor health history. The majority of donors found the system understandable and favored the system over a face-to-face interview. Further, most donors indicated that they would be more likely to return if they were to be screened by such a system. Interactive computer-based audiovisual blood donor screening is useful and well accepted by donors; it may prevent a majority of errors and accidents that are reportable to the FDA; and it may contribute to increased safety and availability of the blood supply.

  12. STD control: a key issue for reproductive health. An interview with Professor David Mabey.

    Science.gov (United States)

    1996-03-01

    Treatable bacterial sexually transmitted diseases (STDs) are disappearing in many parts of North America and northern Europe, where single-dose antibiotic treatments are available; however, in many parts of Africa and other parts of the developing world, STDs are among the leading health problems. 20% of adults attending government clinics seek treatment for a STD. Many patients go to private clinics, traditional practitioners, pharmacists, and quacks. Government facilities treat 1 million cases of STD a year in Zimbabwe (population, 10 million). Professor David Mabey of the London School of Hygiene and Tropical Medicine states that STDs are more common in developing countries because: 1) young adults who are most at risk form a greater proportion of the population; 2) urban drift and the large migratory labor force create and use prostitutes; and 3) treatment, if available, is unaffordable. Since the effect of health education and condom promotion is, to date, unclear, and diagnostic tests for STDs are often unfeasible in Africa, Mabey suggests using syndromic treatment, in which patients are treated for all the common causes of their collection of symptoms. Although some believe an infection can be diagnosed based on clinical evidence alone, Mabey states highly experienced clinicians have been shown to be correct only 70% of the time in their diagnosis of genital ulcers. A Tanzanian study has shown that the introduction of a syndromic treatment program using nurses and medical assistants reduced the rate of increase of human immunodeficiency virus (HIV) by 42%, in comparison to nearby communities where no new treatment program was introduced. Mabey stresses the importance of screening for syphilis in pregnancy and notification of partners. Pressure should be brought on national governments and international donors to subsidize STD treatment. Attendance at STD clinics previously fell when fees were introduced.

  13. Translation of interviews from a source language to a target language: examining issues in cross-cultural health care research.

    Science.gov (United States)

    Al-Amer, Rasmieh; Ramjan, Lucie; Glew, Paul; Darwish, Maram; Salamonson, Yenna

    2015-05-01

    To illuminate translation practice in cross-language interview in health care research and its impact on the construction of the data. Globalisation and changing patterns of migration have created changes to the world's demography; this has presented challenges for overarching social domains, specifically, in the health sector. Providing ethno-cultural health services is a timely and central facet in an ever-increasingly diverse world. Nursing and other health sectors employ cross-language research to provide knowledge and understanding of the needs of minority groups, which underpins cultural-sensitive care services. However, when cultural and linguistic differences exist, they pose unique complexities for cross-cultural health care research; particularly in qualitative research where narrative data are central for communication as most participants prefer to tell their story in their native language. Consequently, translation is often unavoidable in order to make a respondent's narrative vivid and comprehensible, yet, there is no consensus about how researchers should address this vital issue. An integrative literature review. PubMed and CINAHL databases were searched for relevant studies published before January 2014, and hand searched reference lists of studies were selected. This review of cross-language health care studies highlighted three major themes, which identify factors often reported to affect the translation and production of data in cross-language research: (1) translation style; (2) translators; and (3) trustworthiness of the data. A plan detailing the translation process and analysis of health care data must be determined from the study outset to ensure credibility is maintained. A transparent and systematic approach in reporting the translation process not only enhances the integrity of the findings but also provides overall rigour and auditability. It is important that minority groups have a voice in health care research which, if accurately

  14. Attitudes and preferences on the use of mobile health technology and health games for self-management: interviews with older adults on anticoagulation therapy.

    Science.gov (United States)

    Lee, Jung-Ah; Nguyen, Annie Lu; Berg, Jill; Amin, Alpesh; Bachman, Mark; Guo, Yuqing; Evangelista, Lorraine

    2014-07-23

    Older adults are at substantial risk for cardiovascular disorders that may require anticoagulation therapy. Those on warfarin therapy report dissatisfaction and reduced quality of life (QOL) resulting from the treatment. Advances in the area of mobile health (mHealth) technology have resulted in the design and development of new patient-centric models for the provision of personalized health care services to improve care delivery. However, there is a paucity of research examining the effectiveness of mHealth tools on knowledge, attitudes, and patient satisfaction with treatment, as well as self-management, adherence to therapy, and QOL in older adults with chronic illness conditions requiring long-term warfarin therapy. The objective of the study was to explore the attitudes and preferences of older adults on warfarin therapy regarding the use of mHealth technology and health games to gain skills for self-management. We conducted group and individual interviews with patients (60 years or older) on warfarin therapy at two anticoagulation clinics affiliated with an academic medical center. We held 4 group and 2 individual interviews, resulting in 11 patient participants and 2 family caregiver participants. We used structured questions on three topic areas including medication self-management strategies, mHealth technology use, and health games for exercise. We demonstrated some commercial health apps related to medication management, vitamin K content of food, and a videogame for balance exercise. Discussions were audiotaped and transcribed verbatim. Common themes were drawn using content analysis. The participants reported awareness of the importance of staying on schedule with warfarin therapy. They also acknowledged that negative experiences of friends or family members who were taking warfarin influenced their desire to keep on schedule with warfarin therapy. In addition, the participants expressed that the use of mHealth technology may be helpful for medication

  15. Physical and mental health status of survivors of multiple cancer diagnoses: findings from the National Health Interview Survey.

    Science.gov (United States)

    Andrykowski, Michael A

    2012-07-15

    Little research has identified the physical and mental health status of survivors of multiple primary cancer diagnoses. By using data from the population-based 2009 National Health Information Survey, 154 survivors of multiple primary cancer diagnoses, 1427 survivors of a single cancer diagnosis, and 25,004 individuals without a history of cancer diagnosis were identified. The multiple cancer group was compared with the single cancer and no cancer groups with regard to physical and mental health status using analysis of covariance and binary logistic regression. Relative to the no cancer group, the multiple cancer group reported significantly poorer mental health status, greater lifetime, recent, and current prevalence of a variety of medical conditions and comorbidities, and more health-related disability. Although observed group differences between the multiple cancer and single cancer groups were less pronounced than those between the multiple cancer and no cancer groups, a consistent pattern was also evident; the multiple cancer group reported significantly poorer status relative to the single cancer group across a range of mental and physical health and illness-related disability indices. Diagnosis of 2 or more primary cancers (excluding nonmelanoma skin cancers) is associated with increased risk for poorer physical and mental health status over and above that associated with diagnosis of a single primary cancer. Survivors of multiple and single primary cancer diagnoses should be considered as distinct subgroups, and increased attention should be devoted to the unique status and needs of survivors of multiple primary cancer diagnoses. Copyright © 2011 American Cancer Society.

  16. Acute and chronic disability among U.S. farmers and pesticide applicators: the National Health Interview Survey (NHIS).

    Science.gov (United States)

    Gómez-Marín, O; Fleming, L E; Lee, D J; LeBlanc, W; Zheng, D; Ma, F; Jané, D; Pitman, T; Caban, A

    2004-11-01

    The National Health Interview Survey (NHIS) is a multipurpose household survey of the U.S. civilian non-institutionalized population conducted annually since 1957. From 1986 to 1994, over 450,000 U.S. workers, age 18 years and older, participated in a probability sampling of the entire non-institutionalized U.S. population; variables collected included a range of measures of acute and chronic disability. The objective of the present study was to assess predictors of health status, and acute and chronic disability for farmers and pesticide applicators (pesticide-exposed workers) compared to all other U.S. workers using the 1986-1994 NHIS. After adjustment for sample weights and design effects using SUDAAN, several measures of acute and chronic disability and health status were modeled with multiple logistic regression. Farmers (n = 9576) were significantly older compared to all other U.S. workers (n = 453,219) and pesticide applicators (n = 180). Farmers and pesticide applicators had a higher proportion of males, whites, and Hispanics and were less educated. After adjusting for age, gender, race-ethnicity, and education, compared to all other workers, farmers were significantly less likely to report acute and chronic disability and health conditions, while pesticide applicators were more likely to report chronic disability, health conditions, and poor health. Given the cross-sectional nature of the data and the significant job demands of farming, both leading to a relative healthy worker effect, the present results indicate that at any point in time, farmers report less acute and chronic disability, compared to other U.S. workers, whereas pesticide applicators report similar or poorer health.

  17. Women's health research in the last four decades. Interview by Natasha Leeson.

    Science.gov (United States)

    Weiss, Gerson

    2014-01-01

    on Research on Women's Health. Dr Weiss conducts an active clinical practice both in gynecology and reproductive endocrinology and infertility at his institution.

  18. A comparative study on the effectiveness of one-way printed communication versus videophone interactive interviews on health promotion.

    Science.gov (United States)

    Homma, Satoki; Imamura, Haruhiko; Nakamura, Toru; Fujimura, Kaori; Ito, Yoshihiro; Maeda, Yuji; Kaneko, Ikuyo

    2016-01-01

    We performed a comparative study of a health education programme that was delivered either through one-way communication with printed media, or through interactive videophone interviews. We aimed to ascertain which mode of counselling, when used in combination with telemonitoring, is more effective at lifestyle modification intended to improve health status. Participants, who were residents of Kurihara city in Miyagi prefecture, Japan, were randomized into two groups: one group received individualized monthly documented reports (n = 33; 22 females; average age: 67.2 years), and the other received interactive videophone communication (n = 35; 22 females; average age: 65.1 years) for three months. Telemonitoring was conducted on both groups, using a pedometer, weighing scale and a sphygmomanometer. Pre- and post-intervention, anthropometric measurements and blood tests were performed; the participants also completed self-administered questionnaires. The two groups showed similar degrees of health status improvement and satisfaction levels. However, the participants in the videophone group were more aware of improvements in their lifestyles than were the participants in the document group. The individualized printed communication programme was less time-consuming compared to videophone communication. Further studies are needed to formulate a balanced protocol for a counselling-cum-telemonitoring programme that provides optimal health improvement and cost performance with the available human resources. © The Author(s) 2015.

  19. Pre-test of questions on health-related resource use and expenditure, using behaviour coding and cognitive interviewing techniques.

    Science.gov (United States)

    Chernyak, Nadja; Ernsting, Corinna; Icks, Andrea

    2012-09-06

    Validated instruments collecting data on health-related resource use are lacking, but required, for example, to investigate predictors of healthcare use or for health economic evaluation.The objective of the study was to develop, test and refine a questionnaire collecting data on health-related resource use and expenditure in patients with diabetes. The questionnaire was tested in 43 patients with diabetes mellitus types 1 and 2 in Germany. Response behaviour suggestive of problems with questions (item non-response, request for clarification, comments, inadequate answer, "don't know") was systematically registered. Cognitive interviews focusing on information retrieval and comprehension problems were carried out. Many participants had difficulties answering questions pertaining to frequency of visits to the general practitioner (26%), time spent receiving healthcare services (39%), regular medication currently taken (35%) and out of pocket expenditure on medication (42%). These difficulties seem to result mainly from poor memory. A number of comprehension problems were established and relevant questions were revised accordingly. The questionnaire on health-related resource use and expenditure for use in diabetes research in Germany was developed and refined after careful testing. Ideally, the questionnaire should be externally validated for different modes of administration and recall periods within a variety of populations.

  20. Factors Affecting Mental Health Service Utilization Among California Public College and University Students.

    Science.gov (United States)

    Sontag-Padilla, Lisa; Woodbridge, Michelle W; Mendelsohn, Joshua; D'Amico, Elizabeth J; Osilla, Karen Chan; Jaycox, Lisa H; Eberhart, Nicole K; Burnam, Audrey M; Stein, Bradley D

    2016-08-01

    Unmet need for mental health treatment among college students is a significant public health issue. Despite having access to campus mental health providers and insurance to cover services, many college students do not receive necessary services. This study examined factors influencing college students' use of mental health services. Online survey data for 33,943 students and 14,018 staff and faculty at 39 college campuses in California were analyzed by using logistic regressions examining the association between students' use of mental health services and student characteristics, campus environment, and the presence of a formal network of campus mental health clinics. Nineteen percent of students reported current serious psychological distress in the past 30 days, and 11% reported significant mental health-related academic impairment in the past year. Twenty percent reported using mental health services while at their current college, 10% by using campus services and 10% off-campus services. Students on campuses with a formal network of mental health clinics were more likely than students at community colleges to receive mental health services (odds ratio [OR] range=1.68-1.69), particularly campus services (OR=3.47-5.72). Students on campuses that are supportive of mental health issues were more likely to receive mental health services (OR=1.22), particularly on campus (OR=1.65). Students with active (versus low) coping skills were consistently more likely to use mental health services. Establishing more campus mental health clinics, fostering supportive campus environments, and increasing students' coping skills may reduce unmet need for mental health services among college students.

  1. The incidence of hypertension and its risk factors in the German adult population: results from the German National Health Interview and Examination Survey 1998 and the German Health Interview and Examination Survey for Adults 2008-2011.

    Science.gov (United States)

    Diederichs, Claudia; Neuhauser, Hannelore

    2017-02-01

    To analyze incident hypertension and its risk factors based on 11.9 years follow-up of a recent National Examination Survey cohort in Germany. Out of 7124 participants of the German National Health Interview and Examination Survey 1998 (GNHIES98), 640 had died at follow-up 2008-2011 and 3045 were reexamined as part of the German Health Interview and Examination Survey for Adults 2008-2011 (DEGS1). Baseline and follow-up included standardized blood pressure (BP) measurements. Hypertension was defined as BP of at least 140/90 mmHg or intake of antihypertensive medication in participants with known hypertension. Out of 2231 GNHIES98-DEGS1 participants aged 18-79 years without hypertension in 1998, 26.2% developed hypertension within a mean of 11.9 (range 10.0-14.1) years (men 29.0%, women 23.4%). In univariate analysis, hypertension incidence was positively associated with age, BMI, initial BP levels, pulse pressure, and alcohol consumption. Comorbidities such as diabetes and hyperlipidemia increased the chance to develop hypertension. In the multivariate model, initial SBP and DBP levels had the strongest influence on the development of future hypertension (7% increase in men and 5% in women per mmHg SBP). The percentage of aware, treated, and controlled hypertensive patients were 75.8, 62.1, and 50.3% in men and 83.8, 73.3, and 59.0% in women. The high 11.9-year incidence in all age groups points to the lifelong potential for prevention of hypertension.

  2. California Men's Health Study (CMHS: a multiethnic cohort in a managed care setting

    Directory of Open Access Journals (Sweden)

    Sadler Marianne C

    2006-06-01

    Full Text Available Abstract Background We established a male, multiethnic cohort primarily to study prostate cancer etiology and secondarily to study the etiologies of other cancer and non-cancer conditions. Methods/Design Eligible participants were 45-to-69 year old males who were members of a large, prepaid health plan in California. Participants completed two surveys on-line or on paper in 2002 – 2003. Survey content included demographics; family, medical, and cancer screening history; sexuality and sexual development; lifestyle (diet, physical activity, and smoking; prescription and non-prescription drugs; and herbal supplements. We linked study data with clinical data, including laboratory, hospitalization, and cancer data, from electronic health plan files. We recruited 84,170 participants, approximately 40% from minority populations and over 5,000 who identified themselves as other than heterosexual. We observed a wide range of education (53% completed less than college and income. PSA testing rates (75% overall were highest among black participants. Body mass index (BMI (median 27.2 was highest for blacks and Latinos and lowest for Asians, and showed 80.6% agreement with BMI from clinical data sources. The sensitivity and specificity can be assessed by comparing self-reported data, such as PSA testing, diabetes, and history of cancer, to health plan data. We anticipate that nearly 1,500 prostate cancer diagnoses will occur within five years of cohort inception. Discussion A wide variety of epidemiologic, health services, and outcomes research utilizing a rich array of electronic, biological, and clinical resources is possible within this multiethnic cohort. The California Men's Health Study and other cohorts nested within comprehensive health delivery systems can make important contributions in the area of men's health.

  3. Engaging new migrants in infectious disease screening: a qualitative semi-structured interview study of UK migrant community health-care leads

    National Research Council Canada - National Science Library

    Seedat, Farah; Hargreaves, Sally; Friedland, Jonathan S

    2014-01-01

    .... We undertook a qualitative semi-structured interview study of migrant community health-care leads representing dominant new migrant groups in London, UK, to explore their views around barriers...

  4. Engaging New Migrants in Infectious Disease Screening: A Qualitative Semi-Structured Interview Study of UK Migrant Community Health-Care Leads: e108261

    National Research Council Canada - National Science Library

    Farah Seedat; Sally Hargreaves; Jonathan S Friedland

    2014-01-01

    .... We undertook a qualitative semi-structured interview study of migrant community health-care leads representing dominant new migrant groups in London, UK, to explore their views around barriers...

  5. Social determinants of health in the Mixtec and Zapotec community in Ventura County, California.

    Science.gov (United States)

    Maxwell, Annette E; Young, Sandra; Crespi, Catherine M; Vega, Roena Rabelo; Cayetano, Reggie T; Bastani, Roshan

    2015-02-03

    There are an estimated 165,000 indigenous Mexicans living in California, including Mixtec and Zapotec immigrant farm workers. Because many of these immigrants speak only their native non-written languages, there is little information about the needs of this community. An academic-community partnership research team developed a survey to assess basic needs that are known to be social determinants of health in the Mixtec and Zapotec community in Ventura County. In summer 2013, Spanish-Mixteco and Spanish-Zapoteco bilingual promotoras conducted surveys in Spanish, Mixteco and Zapoteco in the greater Oxnard area in Ventura County, California to assess the following basic needs: ability of adults and children to obtain health services; household needs regarding work opportunities, food, housing, transportation, safety and education; and discrimination. Independent variables included respondent characteristics such as age, gender, marital status, living part of the year in another city, and household characteristics such as Spanish spoken in the household, number of household members and number of health care providers/agencies used. Several sets of analyses examined the relationship between basic needs and independent variables. Respondents (N = 989) reported insufficient employment opportunities (74%), food for the family (59%) or housing (48%), lack of transportation (59%), and discrimination or bullying (34%). Most reported access to medical care for children (90%), but only 57% of respondents were able to get health care for themselves. Many basic needs in the Mixtec and Zapotec community in Ventura County are unmet. It will require many different resources and services to address the needs of this community and to overcome longstanding inequities that are experienced by immigrant farm workers. Our findings will guide the development of future health programs and will serve as a baseline to evaluate the impact of services to improve the health conditions in this

  6. How do health service professionals consider human factors when purchasing interactive medical devices? A qualitative interview study.

    Science.gov (United States)

    Vincent, Christopher James; Blandford, Ann

    2017-03-01

    We present findings of a UK study into how those involved in purchasing interactive medical devices go about evaluating usability, the challenges that arise, and opportunities for improvement. The study focused on procurement of infusion devices because these are used by various professionals across healthcare. A semi-structured interview study was carried out involving a range of stakeholders (20 in total) involved in or impacted by medical device procurement. Data was analysed using thematic analysis, a qualitative method designed to support the identification, analysis and reporting of patterns. In principle, health service purchasing was found to accommodate consideration of equipment usability. In practice, the evaluation process was driven primarily by engineering standards; assessment of local needs did not accommodate substantive assessment of usability; and choice was limited by the availability of equipment on the marketplace. We discuss ways in which purchasing could be improved through techniques that account for social circumstances. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Experiences of the Swedish healthcare system: an interview study with refugees in need of long-term health care.

    Science.gov (United States)

    Razavi, Monireh Farsi; Falk, Lars; Björn, Åke; Wilhelmsson, Susan

    2011-05-01

    Refugees needing long-term health care must adapt to new healthcare systems. The aim of this study was to examine the viewpoints of nine refugees in a county in Sweden, with a known chronic disease or functional impairment requiring long-term medical care, on their contacts with care providers regarding treatment and personal needs. Semi-structured interviews with nine individuals and/or their next of kin. Inductive content analysis was used to identify experiences. ''Care organisations/resources'' and ''professional competence'' were the categories extracted. Participants felt cared for due to accessibility to and regular appointments with the same care provider. Visiting different clinics contributed to a negative experience and lack of trust. The staff 's interest in participants' lives and health contributed to a sense of professionalism. Most participants said the problems experienced were not related to their backgrounds as refugees. Many patients did not fully understand which clinic they were attending or the purpose of the care that the specific clinic provided. Some lacked knowledge of their disease. Health care was perceived as equal to other Swedish citizens and problems experienced were not explained by refugee backgrounds. Lack of information from care providers and being sent to various levels of care created feelings of a lack of overall medical responsibility.

  8. Human papillomavirus vaccine initiation and awareness: U.S. young men in the 2010 National Health Interview Survey.

    Science.gov (United States)

    Lu, Peng-jun; Williams, Walter W; Li, Jun; Dorell, Christina; Yankey, David; Kepka, Deanna; Dunne, Eileen F

    2013-04-01

    In 2009, the quadrivalent human papillomavirus (HPV) vaccine was licensed by the U.S. Food and Drug Administration for use in men/boys aged 9-26 years. In 2009, the Advisory Committee on Immunization Practices (ACIP) provided a permissive recommendation allowing HPV vaccine administration to this group. To assess HPV vaccination initiation and coverage, evaluate awareness of HPV and HPV vaccine, and identify factors independently associated with such awareness among men aged 18-26 years. Data from the 2010 National Health Interview Survey were analyzed in 2011. In 2010, HPV vaccination initiation among men aged 18-26 years was 1.1%. Among the 1741 men interviewed in this age group, nearly half had heard of HPV (51.8%). Overall, about one third of these men had heard of the HPV vaccine (34.8%). Factors independently associated with a higher likelihood of awareness of both HPV and HPV vaccine among men aged 18-26 years included having non-Hispanic white race/ethnicity; a higher education level; a U.S. birthplace; more physician contacts; private health insurance; received other vaccines; and reported risk behaviors related to sexually transmitted diseases, including HIV. HPV vaccination initiation among men aged 18-26 years in 2010 was low. HPV and HPV vaccine awareness were also low, and messages in this area directed to men are needed. Since ACIP published a recommendation for routine use of HPV4 among men/boys in December 2011, continued monitoring of HPV vaccination uptake among men aged 18-26 years is useful for evaluating the vaccination campaigns, and planning and implementing strategies to increase coverage. Published by Elsevier Inc.

  9. One-stop shopping: efforts to integrate physical and behavioral health care in five California community health centers.

    Science.gov (United States)

    Pourat, Nadereh; Hadler, Max W; Dixon, Brittany; Brindis, Claire

    2015-01-01

    More than 70 percent of behavioral health conditions are first diagnosed in the primary care setting. Yet physical and behavioral health care are typically provided separately, compelling many vulnerable patients to navigate the complexities of two separate systems of care. This policy brief examines five community health centers (CHCs) in California that have taken preliminary steps toward creating "one-stop shopping" for both physical and behavioral health care. The steps taken to increase integration by the CHCs include employing behavioral health providers, using a single electronic health record that includes both physical and behavioral health data, transforming the physical space, and developing mechanisms for effective transition of patients between providers. The findings emphasize the importance of changes to Medi-Cal reimbursement policies to promote same-day visits, as well as the importance of cultural changes to integrate behavioral health. They also highlight the need for comprehensive tools to assess and promote integration and to identify solutions for the most challenging activities required to achieve full integration.

  10. Impacts of casinos on key pathways to health: qualitative findings from American Indian gaming communities in California.

    Science.gov (United States)

    Kodish, Stephen R; Gittelsohn, Joel; Oddo, Vanessa M; Jones-Smith, Jessica C

    2016-07-22

    Three decades ago, casino gaming on sovereign American Indian lands was legalized with differential economic and social implications. While casinos have improved the incomes of tribal communities, there have been both positive and negative findings in relation to health impacts. We sought to understand the perceived pathways by which casinos impact individual and community health through voices of the community. We conducted semi-structured, interviews with tribal leaders (n =12) and tribal members (n =24) from tribal communities (n = 23) representing different regions of California. We inductively analyzed textual data drawing from Grounded Theory, first using line-by-line coding to identify analytic categories from emergent themes in consideration of the study objective. Then, focused codes were applied to identify salient themes, which we represented through exemplar quotes and an overall conceptual framework. Data were managed and coded using Dedoose software. American Indian-owned casinos are perceived to influence the health of tribal communities through three pathways: 1) improving the tribal economy 2) altering the built environment, and 3) disrupting the the social landscape. Forming these pathways are a series of interrelated health determinants. Improvement of the tribal economy, through both job creation for tribal members and improved tribal cash flow, was perceived by participants to both influence health. Specifically, improved cash flow has resulted in new wellness programs, community centers, places for recreation, and improved social services. Higher disposable incomes have led to better financial stability, increased access to healthy food, and more opportunities for physical activity. Yet, higher disposable incomes were perceived to also contribute to negative health behaviors, most notably increased drug and alcohol abuse. Casinos were also perceived to alter built environments, resulting in increased availability and access to unhealthy

  11. Impacts of casinos on key pathways to health: qualitative findings from American Indian gaming communities in California

    Directory of Open Access Journals (Sweden)

    Stephen R. Kodish

    2016-07-01

    Full Text Available Abstract Background Three decades ago, casino gaming on sovereign American Indian lands was legalized with differential economic and social implications. While casinos have improved the incomes of tribal communities, there have been both positive and negative findings in relation to health impacts. We sought to understand the perceived pathways by which casinos impact individual and community health through voices of the community. Methods We conducted semi-structured, interviews with tribal leaders (n =12 and tribal members (n =24 from tribal communities (n = 23 representing different regions of California. We inductively analyzed textual data drawing from Grounded Theory, first using line-by-line coding to identify analytic categories from emergent themes in consideration of the study objective. Then, focused codes were applied to identify salient themes, which we represented through exemplar quotes and an overall conceptual framework. Data were managed and coded using Dedoose software. Results American Indian-owned casinos are perceived to influence the health of tribal communities through three pathways: 1 improving the tribal economy 2 altering the built environment, and 3 disrupting the the social landscape. Forming these pathways are a series of interrelated health determinants. Improvement of the tribal economy, through both job creation for tribal members and improved tribal cash flow, was perceived by participants to both influence health. Specifically, improved cash flow has resulted in new wellness programs, community centers, places for recreation, and improved social services. Higher disposable incomes have led to better financial stability, increased access to healthy food, and more opportunities for physical activity. Yet, higher disposable incomes were perceived to also contribute to negative health behaviors, most notably increased drug and alcohol abuse. Casinos were also perceived to alter built environments, resulting in

  12. Prevention of Filipino Youth Behavioral Health Disparities: Identifying Barriers and Facilitators to Participating in "Incredible Years," an Evidence-Based Parenting Intervention, Los Angeles, California, 2012.

    Science.gov (United States)

    Flores, Nicole; Supan, Jocelyn; Kreutzer, Cary B; Samson, Allan; Coffey, Dean M; Javier, Joyce R

    2015-10-22

    Evidence-based interventions for training parents are proven to prevent onset and escalation of childhood mental health problems. However, participation in such programs is low, especially among hard-to-reach, underserved populations such as Filipino Americans. Filipinos, the largest Asian subgroup in California, have significant behavioral health disparities compared with non-Hispanic whites and other Asian subgroups. The purpose of this study was to learn about Filipinos' barriers and facilitators to participating in "Incredible Years" (IY), a parenting program. We conducted 4 focus groups in Los Angeles, California, in 2012; the groups consisted of 20 Filipino parents of children aged 6 to 12 years who recently completed the IY parenting program, which was offered as a prevention workshop. Three reviewers, including two co-authors (A.S., J.J.) and a research assistant used content analysis to independently code the interview transcripts and extract subthemes. Grounded theory analytic methods were used to analyze interview transcripts. Parents' perceived benefits of participation in IY were learning more effective parenting techniques, networking with other parents, improved spousal relationships, and improvements in their children's behavior. Parents' most common motivating factor for enrollment in IY was to improve their parenting skills and their relationships with their children. The most common barriers to participation were being uncomfortable sharing problems with others and the fear of being stigmatized by others judging their parenting skills. Participants said that parent testimonials would be the most effective way to promote IY. Many recommended outreach at schools, pediatricians' offices, and churches. Increasing Filipino American parent enrollment in IY in culturally relevant ways will reduce the incidence of mental health disorders among children in this growing population.

  13. Impacts of Urban Water Conservation Strategies on Energy, Greenhouse Gas Emissions, and Health: Southern California as a Case Study.

    Science.gov (United States)

    Sokolow, Sharona; Godwin, Hilary; Cole, Brian L

    2016-05-01

    To determine how urban water conservation strategies in California cities can affect water and energy conservation efforts, reduce greenhouse gas emissions, and benefit public health. We expanded upon our 2014 health impact assessment of California's urban water conservation strategies by comparing the status quo to 2 options with the greatest potential impact on the interrelated issues of water and energy in California: (1) banning landscape irrigation and (2) expanding alternative water sources (e.g., desalination, recycled water). Among the water conservation strategies evaluated, expanded use of recycled water stood out as the water conservation strategy with potential to reduce water use, energy use, and greenhouse gas emissions, with relatively small negative impacts for the public's health. Although the suitability of recycled water for urban uses depends on local climate, geography, current infrastructure, and finances, analyses similar to that presented here can help guide water policy decisions in cities across the globe facing challenges of supplying clean, sustainable water to urban populations.

  14. Predictors of Internet use for health information among male and female Internet users: Findings from the 2009 Taiwan National Health Interview Survey.

    Science.gov (United States)

    Koo, Malcolm; Lu, Ming-Chi; Lin, Shih-Chun

    2016-10-01

    The Internet is an increasingly important source of health information for the general population. Both preventive health behavior and Internet use are known to be different between men and women. However, few studies have compared predictors of Internet use for health information between the sexes. To investigate the prevalence and predictors of Internet use for health information among male and female adult Internet users using data from a population-based survey in Taiwan. Respondents between the ages of 20-65 years were identified from the dataset of the 2009 Taiwan National Health Interview Survey. The outcome variable of the study, the utilization of the Internet for health information, was ascertained by asking whether the respondent had ever used the Internet to search for health information or obtain health services. Univariate and multivariate logistic regression analyses were conducted separately for men and women to evaluate factors associated with the use of Internet for health information. Of the 2741 adults aged 20-65 years who had ever used the Internet, 1766 (64.4%) of them had used it for health information or services. Multivariate logistic regression analyses showed that a higher educational level (adjusted odds ratio [AOR]=3.60, Phealth status of extremely good, very good, or good (AOR=1.34, P=0.022), and had used Western medicine services in the past month (AOR=1.51, P=0.005) were significantly associated with health information use in male Internet users. On the other hand, age between 20-44.9 years (AOR=1.87, PInternet users. This secondary data analysis of a representative sample of Taiwan population revealed that a similar but not identical set of independent factors was associated with the use of Internet for health information between male and female Internet users. Copyright © 2016. Published by Elsevier Ireland Ltd.

  15. Palliative care for cancer patients in a primary health care setting: Bereaved relatives' experience, a qualitative group interview study

    Directory of Open Access Journals (Sweden)

    Jensen Anders

    2008-01-01

    Full Text Available Abstract Background Knowledge about the quality and organisation of care to terminally ill cancer patients with a relatives' view in a primary health care setting is limited. The aim of the study is to analyse experiences and preferences of bereaved relatives to terminally ill cancer patients in a primary care setting to explore barriers and facilitators for delivery of good palliative home care. Methods Three focus group interviews with fourteen bereaved relatives in Aarhus County, Denmark. Results Three main categories of experience were identified: 1 The health professionals' management, where a need to optimize was found. 2 Shared care, which was lacking. 3 The relatives' role, which needs an extra focus. Conclusion Relatives experience insufficient palliative care mainly due to organizational and cultural problems among professionals. Palliative care in primary care in general needs improvement and attention should be drawn to the "professionalization" of the relatives and the need to strike a balance between their needs, wishes and resources in end-of-life care and bereavement.

  16. Race, ethnicity, and self-reported hypertension: analysis of data from the National Health Interview Survey, 1997-2005.

    Science.gov (United States)

    Borrell, Luisa N

    2009-02-01

    I estimated the association between race and self-reported hypertension among Hispanics and non-Hispanics and determined whether this association was stronger among non-Hispanics. With data from the 1997-2005 National Health Interview Survey, I used logistic regression to estimate the strength of the association between race/ethnicity and self-reported hypertension among US adults. The overall prevalence of self-reported hypertension was 24.5%, with lower prevalence among Hispanics (16.7%) than among non-Hispanics (25.2%; P < .01). Blacks, regardless of ethnicity, had the highest prevalence. Compared with non-Hispanic Whites, non-Hispanic Blacks had 48% (odds ratio [OR] = 1.48; 95% confidence interval [CI] = 1.41, 1.55) greater odds of reporting hypertension; Hispanic Whites had 23% (OR = 0.81; 95% CI = 0.76, 0.88) lower odds. There was no difference in the strength of the association between race and self-reported hypertension observed among non-Hispanics (OR for Blacks = 1.47) and among Hispanics (OR for Blacks = 1.20; for interaction, P = 0.43). The previously reported hypertension advantage of Hispanics holds for Hispanic Whites only. As Hispanics continue their rapid growth in the United States, race may have important implications on their disease burden, because most US health disparities are driven by race and its socially patterned experiences.

  17. Age and Gender Differences in Psychological Distress among African Americans and Whites: Findings from the 2016 National Health Interview Survey.

    Science.gov (United States)

    Watkins, Daphne C; Johnson, Natasha C

    2018-01-17

    Previous studies report a race and mental health paradox: Whites score higher on measures of major depression compared to African Americans, but the opposite is true for psychological distress (i.e., African Americans score higher on distress measures compared to Whites). Independently, race, age, and gender outcomes for psychological distress are well documented in the literature. However, there is relatively little research on how psychological distress interferes with the lives of African Americans and Whites at the intersection of their various race, age, and gender identities. This study uses data from the 2016 National Health Interview Survey to examine age and gender differences in psychological distress and how much psychological distress interferes with the lives of African Americans and Whites. Our study findings are contrary to the paradox such that young White women (M = 3.36, SD = 1.14) and middle-aged White men (M = 2.55, SD = 3.97) experienced higher psychological distress than all other race, age, and gender groups. Psychological distress interference was relatively high among the high distress groups, except for older African American men (M = 1.73, SD = 1.05) and young African American women (M = 1.93, SD = 0.95). Implications for studies that consider cultural experiences of psychological distress, and how it impacts different demographic groups are discussed.

  18. Factors Influencing California Dental Hygienists' Involvement in School-Based Oral Health Programs.

    Science.gov (United States)

    Conklin, Katherine V; Essex, Gwen; Rowe, Dorothy J

    2016-08-01

    To assess the influence of community oral health experiences during entry-level dental hygiene education on participation in community oral health events after graduation and the facilitators and barriers experienced by dental hygienists in participating in these programs. A 27-item survey, consisting of items related to community oral health experiences during and after entry-level education, was distributed by the California Dental Hygienists' Association to all dental hygienists whose email addresses were in their database. Frequencies of participants' responses to each survey item were calculated. Chi-square analysis was performed to identify significant relationships among variables. Response rate was 8%, with 513 out of the 6,248 contacted having responded. Additionally, 95% of the respondents had participated, as entry-level students, in community oral health experiences such as school-based oral health educational programs. Respondents agreed that participation in these programs was valuable to their professional development and encouraged them to participate after graduation; both these variables were related (pconflict with work (61%), family time commitment (52%), and no knowledge of existing programs (24%). Dental hygienists' involvement in school-based oral health programs is enhanced by their community experiences as a dental hygiene student. Barriers and facilitators need to be addressed to increase the number of programs and participants so that more children can benefit. Copyright © 2016 The American Dental Hygienists’ Association.

  19. Proficiency in Motivational Interviewing among Nurses in Child Health Services Following Workshop and Supervision with Systematic Feedback.

    Directory of Open Access Journals (Sweden)

    Johanna Enö Persson

    Full Text Available Research on training in motivational interviewing (MI has shown eroding skills after workshops not followed by additional training input (supervision/coaching. There is a need for more research evaluating different types and lengths of post-workshop training with follow-up periods extending six months. This study is an extension of a previous evaluation of the level of proficiency in MI after workshop and four sessions of supervision among nurses in Swedish child health services.To explore the level of MI proficiency among nurses participating in an intervention to prevent childhood obesity (n = 33, after receiving five additional sessions of supervision including feedback on observed practice, as well as level of proficiency at follow-up.Level of proficiency was measured 4 and 12 months after completed supervision using recorded practice samples coded according to the Motivational Interviewing Treatment Integrity (MITI Code. Potential predictors of outcome were investigated.Proficiency remained on the same levels after nine sessions of supervision as after four sessions, and was generally low. The percentage of nurses reaching the proficiency level ranged from 18.2 to 54.5% across indicators. MI-spirit had increased significantly at follow-up, and the rest of the indicators remained on the same levels. No predictors of outcome were found.Comprehensive training programs with prolonged post-workshop supervision and feedback on observed practice may help to sustain but not improve participants' proficiency in MI. Potential explanations to the results and suggestions for future research are discussed.

  20. Correlates of depressive symptoms in late middle-aged Taiwanese women: findings from the 2009 Taiwan National Health Interview Survey.

    Science.gov (United States)

    Tsai, Kun-Wei; Lin, Shih-Chun; Koo, Malcolm

    2017-11-09

    Previous studies have shown that depressive symptoms in middle-aged women were associated with a number of factors such as climacteric symptoms. Nevertheless, studies based on population-based data with a wide range of potential correlates are still scarce. Therefore, the aim of this study was to investigate the correlates of depressive symptoms in late middle-aged Taiwanese women using data from a nationally-representative, population-based survey. Women aged 50.0-65.0 years were identified from the dataset of the 2009 Taiwan National Health Interview Survey. The outcome measure was depressive symptoms in the past week, evaluated using the Center for Epidemiologic Studies Short Depression Scale (CES-D 10) with a cut-off score of 10 or greater. Univariate and multiple logistic regression analyses were used to evaluate the correlates of depressive symptoms. The mean age of the 533 respondents was 56.7 years. Depressive symptoms were present in 53 respondents (9.9%). Multiple logistic regression analysis revealed that an education level of elementary school or below (adjusted odds ratio [AOR] = 3.19, P = 0.003), nulliparity (AOR = 8.10, P = 0.001), living alone (AOR = 5.47, P = 0.003), never having worked (AOR = 4.14, P = 0.008), lack of regular exercise (AOR = 3.01, P = 0.003), a perceived health status of fair or bad (AOR = 4.34, P depressive symptoms in late middle-aged Taiwanese women. Findings from this secondary analysis of a population-based survey suggested independent associations of somatic climacteric symptoms, and a number of socio-demographic and health-related factors with depressive symptoms in late middle-aged Taiwanese women.

  1. Philosophical Hermeneutic Interviewing

    Directory of Open Access Journals (Sweden)

    Roxanne K. Vandermause PhD, RN

    2011-12-01

    Full Text Available This article describes, exemplifies and discusses the use of the philosophical hermeneutic interview and its distinguishing characteristics. Excerpts of interviews from a philosophical hermeneutic study are used to show how this particular phenomenological tradition is applied to research inquiry. The purpose of the article is to lay out the foundational background for philosophical hermeneutics in a way that clarifies its unique approach to interviewing and its usefulness for advancing health care knowledge. Implications for health care research and practice are addressed.

  2. Motivational interviewing

    DEFF Research Database (Denmark)

    Karlsen, Kamilla; Humaidan, Peter; Sørensen, Lise H

    2013-01-01

    of motivational interviewing (intervention group, n = 110), 64 received motivational support by phone or e-mail only and 13 women did not wish any motivational support (control group, n = 77). The mean weight loss and decrease in BMI was greater in the intervention group compared with the control group (9.3 kg...

  3. School Health Services for Children with Special Health Care Needs in California

    Science.gov (United States)

    Baker, Dian L.; Hebbeler, Kathleen; Davis-Alldritt, Linda; Anderson, Lori S.; Knauer, Heather

    2015-01-01

    Children with special health care needs (CSHCN) are at risk for school failure when their health needs are not met. Current studies have identified a strong connection between school success and health. This study attempted to determine (a) how schools meet the direct service health needs of children and (b) who provides those services. The study…

  4. Gender differences in mental health problems among adolescents and the role of social support: results from the Belgian health interview surveys 2008 and 2013.

    Science.gov (United States)

    Van Droogenbroeck, Filip; Spruyt, Bram; Keppens, Gil

    2018-01-10

    To investigate how social support relates to mental health problems for Belgian late adolescents and young adults 15-25 years of age. Additionally, we examine changes in mental health problems between 2008 and 2013 and investigate gender differences. Multivariate analysis of variance was used to investigate (1) psychological distress, (2) anxiety and (3) depression among 713 boys and 720 girls taken from two successive waves (2008 and 2013) of a representative sample of the Belgian population (Belgian Health Interview survey). Psychological distress was measured by the General Health Questionnaire, anxiety and depression by the Symptom Check-List-90-Revised. Gender differences were found for psychological distress, anxiety and depression with girls reporting significantly higher scores than boys. Multivariate analysis of variance (MANOVA) revealed that adolescents who are dissatisfied with their social contacts and experience poor social support reported more psychological distress, anxiety and depression. In addition, young adult boys (20-25 years of age) were more likely to experience psychological distress when compared to late adolescent boys (15-19 years of age). Finally, the prevalence of anxiety and depression increased substantially between 2008 and 2013 for girls and to a lesser extent for boys. Especially girls and young people with poor social support experience mental health problems more frequently than boys and those with strong social support. Improving social support among young people may serve as a protective buffer to mental health problems.

  5. Association between workplace psychosocial factors and mental health in Black, Hispanic, and White women: Cross-sectional findings from the National Health Interview Survey.

    Science.gov (United States)

    Mutambudzi, Miriam

    2017-01-01

    Research evaluating the relation of workplace psychosocial factors to mental health among U.S. women of different racial/ethnic backgrounds is limited. This study investigated the relationship between work-related psychosocial factors and mental health among non-Hispanic Black, Hispanic, and non-Hispanic White women using data from the 2010 National Health Interview Survey. Independent variables of interest included job insecurity, workplace harassment, and work-family conflict (WFC). Multiple Poisson regression models were used to examine the associations between the outcome and independent variables. The prevalence of unfavorable mental health was highest among non-Hispanic Black women (36%) compared to Hispanic (34%) and non-Hispanic White (30%) women. A higher proportion of non-Hispanic Black women reported WFC compared to Hispanics and non-Hispanic Whites (χ(2) = 15.50, p workplace harassment did not differ significantly by race/ethnicity. Odds of unfavorable mental health were significantly higher for women reporting psychosocial work factors. Unexpectedly, a greater association between psychosocial work factors and unfavorable mental health was observed among non-Hispanic White women compared to non-White women; however, caution should be taken in interpreting these cross-sectional results. Future studies should investigate temporal associations and additional psychosocial variables that were not available for use in the current study.

  6. Informing public policy toward binational health insurance: empirical evidence from California.

    Science.gov (United States)

    Fulton, Brent D; Galárraga, Omar; Dow, William H

    2013-01-01

    To estimate reimbursement rate differences between Mexico and US based physicians reimbursed by a binational health insurance (BHI) plan and US payers, respectively; and show the relationship between plan benefit designs and health care utilization in Mexico. Data include 33,841 and 53,909 HMO enrollees in California from Sistemas Médicos Nacionales (SIMNSA) and Salud con Health Net, respectively. We use descriptive statistical methods. SIMNSA's physician reimbursement rates averaged 50.7% (95% CI: 34.5%-67.0%) of Medi-Cal's, 28.3% (95% CI: 19.6%-37.0%) of Medicare's, and 22% of US private plans'. Each year, 99.4% of SIMNSA enrollees but only 0.1% of Salud con Health Net enrollees obtained care in Mexico. SIMNSA only covers emergency and urgent care in the US, while Salud con Health Net covers comprehensive care with higher patient cost sharing than in Mexico. To realize potential savings, plans need strong incentives to increase utilization in Mexico.

  7. Using the eSexual Health Clinic to access chlamydia treatment and care via the internet: a qualitative interview study.

    Science.gov (United States)

    Aicken, Catherine R H; Sutcliffe, Lorna J; Gibbs, Jo; Tickle, Laura J; Hone, Kate; Harding-Esch, Emma M; Mercer, Catherine H; Sonnenberg, Pam; Sadiq, S Tariq; Estcourt, Claudia S; Shahmanesh, Maryam

    2017-10-07

    We developed the eSexual Health Clinic (eSHC), an innovative, complex clinical and public health intervention, embedded within a specialist sexual health service. Patients with genital chlamydia access their results online and are offered medical management via an automated online clinical consultation, leading to antibiotic collection from community pharmacy. A telephone helpline, staffed by Sexual Health Advisers, is available to support patients and direct them to conventional services if appropriate. We sought to understand how patients used this ehealth intervention. Within exploratory studies of the eSHC (2014-2015), we conducted in-depth interviews with a purposive sample of 36 patients diagnosed with chlamydia, who had chosen to use the eSHC (age 18-35, 20 female, 16 male). Thematic analysis was conducted. Participants described choosing to use this ehealth intervention to obtain treatment rapidly, conveniently and privately, within busy lifestyles that hindered clinic access. They described completing the online consultation promptly, discreetly and with ease. The information provided online was considered comprehensive, reassuring and helpful, but some overlooked it in their haste to obtain treatment. Participants generally described being able to collect treatment from pharmacies discreetly and promptly, but for some, poor awareness of the eSHC by pharmacy staff undermined their ability to do this. Those unsuitable for remote management, who were directed to clinic, described frustration and concern about health implications and clinic attendance. However, the helpline was a highly valued source of information, assistance and support. The eSHC is a promising adjunct to traditional care. Its users have high expectations for convenience, speed and privacy, which may be compromised when transitioning from online to face-to-face elements of the eSHC. Managing expectations and improving implementation of the pharmacy process, could improve their experiences

  8. Generational status and duration of residence predict diabetes prevalence among Latinos: the California Men's Health Study

    Directory of Open Access Journals (Sweden)

    Sternfeld Barbara

    2009-10-01

    Full Text Available Abstract Background Diabetes disproportionately affects Latinos. However, examining Latinos as one group obscures important intra-group differences. This study examined how generational status, duration of US residence, and language preference are associated with diabetes prevalence and to what extent these explain the higher prevalence among Latinos. Methods We determined nativity, duration of US residence, language preference, and diabetes prevalence among 11 817 Latino, 6109 black, and 52 184 white participants in the California Men's Health Study. We combined generational status and residence duration into a single migration status variable with levels: ≥ third generation; second generation; and immigrant living in the US for > 25, 16-25, 11-15, or ≤ 10 years. Language preference was defined as language in which the participant took the survey. Logistic regression models were specified to assess the associations of dependent variables with prevalent diabetes. Results Diabetes prevalence was 22%, 23%, and 11% among Latinos, blacks, and whites, respectively. In age-adjusted models, we observed a gradient of risk of diabetes by migration status among Latinos. Further adjustment for socioeconomic status, obesity and health behaviors only partially attenuated this gradient. Language preference was a weak predictor of prevalent diabetes in some models and not significant in others. In multivariate models, we found that odds of diabetes were higher among US-born Latinos than US-born blacks. Conclusion Generational status and residence duration were associated with diabetes prevalence among middle-aged Latino men in California. As the Latino population grows, the burden of diabetes-associated disease is likely to increase and demands public health attention.

  9. Use of dietary supplements by female seniors in a large Northern California health plan

    Directory of Open Access Journals (Sweden)

    Schaffer Donna M

    2005-02-01

    Full Text Available Abstract Background Women aged ≥ 65 years are high utilizers of prescription and over-the-counter medications, and many of these women are also taking dietary supplements. Dietary supplement use by older women is a concern because of possible side effects and drug-supplement interactions. The primary aim of this study was to provide a comprehensive picture of dietary supplement use among older women in a large health plan in Northern California, USA, to raise awareness among health care providers and pharmacists about the need for implementing structural and educational interventions to minimize adverse consequences of self-directed supplement use. A secondary aim was to raise awareness about how the focus on use of herbals and megavitamins that has occurred in most surveys of complementary and alternative therapy use results in a significant underestimate of the proportion of older women who are using all types of dietary supplements for the same purposes. Methods We used data about use of different vitamin/mineral (VM supplements and nonvitamin, nonmineral (NVNM supplements, including herbals, from a 1999 general health survey mailed to a random sample of adult members of a large Northern California health plan to estimate prevalence of and characteristics associated with supplement use among women aged 65–84 (n = 3,109. Results Based on weighted data, 84% had in the past 12 months used >1 dietary supplement, 82% a VM, 59% a supplement other than just multivitamin or calcium, 32% an NVNM, and 25% an herbal. Compared to white, nonHispanic women, African-Americans and Latinas were significantly less likely to use VM and NVNM supplements and Asian/Pacific Islanders were less likely to use NVNM supplements. Higher education was strongly associated with use of an NVNM supplement. Prevalence did not differ by number of prescription medications taken. Among white, nonHispanic women, multiple logistic regression models showed that college

  10. Self reported health status, and health service contact, of illicit drug users aged 50 and over: a qualitative interview study in Merseyside, United Kingdom

    Directory of Open Access Journals (Sweden)

    Duffy Paul

    2009-10-01

    Full Text Available Abstract Background The populations of industrialised countries are ageing; as this occurs, those who continue to use alcohol and illicit drugs age also. While alcohol use among older people is well documented, use of illicit drugs continues to be perceived as behaviour of young people and is a neglected area of research. This is the first published qualitative research on the experiences of older drug users in the United Kingdom. Methods Semi-structured interviews were conducted in Merseyside, in 2008, with drug users aged 50 and over recruited through drug treatment services. Interviews were recorded and transcribed and analysed thematically. Only health status and health service contact are reported here. Results Nine men and one woman were interviewed (age range: 54 to 61 years; all but one had been using drugs continuously or intermittently for at least 30 years. Interviewees exhibited high levels of physical and mental morbidity; hepatitis C was particularly prevalent. Injecting-related damage to arm veins resulted in interviewees switching to riskier injecting practices. Poor mental health was evident and interviewees described their lives as depressing. The death of drug-using friends was a common theme and social isolation was apparent. Interviewees also described a deterioration of memory. Generic healthcare was not always perceived as optimal, while issues relating to drug specific services were similar to those arising among younger cohorts of drug users, for example, complaints about inadequate doses of prescribed medication. Conclusion The concurrent effects of drug use and ageing are not well understood but are thought to exacerbate, or accelerate the onset of, medical conditions which are more prevalent in older age. Here, interviewees had poor physical and mental health but low expectations of health services. Older drug users who are not in contact with services are likely to have greater unmet needs. The number of drug users

  11. Annual Interviews

    CERN Multimedia

    Human Resources Department

    2005-01-01

    Annex II, page 1, Section 3 of the Administrative Circular no. 26 (Rev. 5) states that "The annual interview shall usually take place between 15 November of the reference year and 15 February of the following year." Following the meeting of the Executive Board on 7 December 2004 and the meeting of the Standing Concertation Committee on 19 January 2005, it has been decided, for the advancement exercise of 2005, to extend this period until 15 March 2005. Human Resources Department Tel. 73566

  12. A procedure to correct proxy-reported weight in the National Health Interview Survey, 1976–2002

    Directory of Open Access Journals (Sweden)

    Utz Rebecca L

    2009-01-01

    Full Text Available Abstract Background Data from the National Health Interview Survey (NHIS show a larger-than-expected increase in mean BMI between 1996 and 1997. Proxy-reports of height and weight were discontinued as part of the 1997 NHIS redesign, suggesting that the sharp increase between 1996 and 1997 may be artifactual. Methods We merged NHIS data from 1976–2002 into a single database consisting of approximately 1.7 million adults aged 18 and over. The analysis consisted of two parts: First, we estimated the magnitude of BMI differences by reporting status (i.e., self-reported versus proxy-reported height and weight. Second, we developed a procedure to correct biases in BMI introduced by reporting status. Results Our analyses confirmed that proxy-reports of weight tended to be biased downward, with the degree of bias varying by race, sex, and other characteristics. We developed a correction procedure to minimize BMI underestimation associated with proxy-reporting, substantially reducing the larger-than-expected increase found in NHIS data between 1996 and 1997. Conclusion It is imperative that researchers who use reported estimates of height and weight think carefully about flaws in their data and how existing correction procedures might fail to account for them. The development of this particular correction procedure represents an important step toward improving the quality of BMI estimates in a widely used source of epidemiologic data.

  13. Smoking Characteristics of Adults With Selected Lifetime Mental Illnesses: Results From the 2007 National Health Interview Survey

    Science.gov (United States)

    McKnight-Eily, Lela R.; Davis, Shane P.; Dube, Shanta R.

    2010-01-01

    Objectives. We estimated smoking prevalence, frequency, intensity, and cessation attempts among US adults with selected diagnosed lifetime mental illnesses. Methods. We used data from the 2007 National Health Interview Survey on 23 393 noninstitutionalized US adults to obtain age-adjusted estimates of smoking prevalence, frequency, intensity, and cessation attempts for adults screened as having serious psychological distress and persons self-reporting bipolar disorder, schizophrenia, attention deficit disorder or hyperactivity, dementia, or phobias or fears. Results. The age-adjusted smoking prevalence of adults with mental illness or serious psychological distress ranged from 34.3% (phobias or fears) to 59.1% (schizophrenia) compared with 18.3% of adults with no such illness. Smoking prevalence increased with the number of comorbid mental illnesses. Cessation attempts among persons with diagnosed mental illness or serious psychological distress were comparable to attempts among adults without mental illnesses or distress; however, lower quit ratios were observed among adults with these diagnoses, indicating lower success in quitting. Conclusions. The prevalence of current smoking was higher among persons with mental illnesses than among adults without mental illnesses. Our findings stress the need for prevention and cessation efforts targeting adults with mental illnesses. PMID:20966369

  14. Mental distress and health care use among survivors of adolescent and young adult cancer: A cross-sectional analysis of the National Health Interview Survey.

    Science.gov (United States)

    Kaul, Sapna; Avila, Jaqueline C; Mutambudzi, Miriam; Russell, Heidi; Kirchhoff, Anne C; Schwartz, Cindy L

    2017-03-01

    The current study was conducted to examine the prevalence and correlates of mental distress among survivors of adolescent and young adult (AYA) cancer and a comparison group. A total of 875 AYA cancer survivors who were diagnosed between the ages of 15 and 39 years and who were at least 5 years from their initial diagnosis were identified from the 2013 and 2014 National Health Interview Surveys. A comparison group was created. The Kessler nonspecific mental/psychological distress scale was used to examine none/low, moderate, and severe distress. The issues of whether individuals talked to mental health professionals within the previous year and if they could afford mental health care also were examined. Variables (ie, demographics, behavioral [eg, smoking status], comorbidity, and mental health visits) associated with distress among the 2 groups were identified using multinomial logistic regressions. Survivors reported mental distress more often than the comparison group (moderate: 23.2% vs 16.9%; and severe: 8.4% vs 3.0% [Pmental health care more often (6.4% vs 2.3%; P = .002). Moreover, 74.7% and 52.2% of survivors, respectively, with moderate and severe distress had not talked to a mental health professional. Contrary to the comparison group, survivors who were current smokers reported severe distress more often compared with nonsmokers (relative risk, 3.59; 95% confidence interval, 1.46-8.84 [P = .01]). Having public and no insurance versus private insurance and report of sleep-related trouble within the previous week were found to be associated with greater distress among survivors. AYA cancer survivors are more likely to demonstrate mental distress than individuals without cancer. Nevertheless, few survivors may be receiving professional mental health services. Survivors need greater access to mental health screening and counseling to address the current gaps in care delivery. Cancer 2017;123:869-78. © 2016 American Cancer Society. © 2016 American

  15. Switching to smokeless tobacco as a smoking cessation method: evidence from the 2000 National Health Interview Survey

    Directory of Open Access Journals (Sweden)

    Phillips Carl V

    2008-05-01

    Full Text Available Abstract Background Although smokeless tobacco (ST use has played a major role in the low smoking prevalence among Swedish men, there is little information at the population level about ST as a smoking cessation aid in the U.S. Methods We used the 2000 National Health Interview Survey to derive population estimates for the number of smokers who had tried twelve methods in their most recent quit attempt, and for the numbers and proportions who were former or current smokers at the time of the survey. Results An estimated 359,000 men switched to smokeless tobacco in their most recent quit attempt. This method had the highest proportion of successes among those attempting it (73%, representing 261,000 successful quitters (switchers. In comparison, the nicotine patch was used by an estimated 2.9 million men in their most recent quit attempt, and almost one million (35% were former smokers at the time of the survey. Of the 964,000 men using nicotine gum, about 323,000 (34% became former smokers. Of the 98,000 men who used the nicotine inhaler, 27,000 quit successfully (28%. None of the estimated 14,000 men who tried the nicotine nasal spray became former smokers. Forty-two percent of switchers also reported quitting smoking all at once, which was higher than among former smokers who used medications (8–19%. Although 40% of switchers quit smoking less than 5 years before the survey, 21% quit over 20 years earlier. Forty-six percent of switchers were current ST users at the time of the survey. Conclusion Switching to ST compares very favorably with pharmaceutical nicotine as a quit-smoking aid among American men, despite the fact that few smokers know that the switch provides almost all of the health benefits of complete tobacco abstinence. The results of this study show that tobacco harm reduction is a viable cessation option for American smokers.

  16. California teachers perceive school gardens as an effective nutritional tool to promote healthful eating habits.

    Science.gov (United States)

    Graham, Heather; Zidenberg-Cherr, Sheri

    2005-11-01

    This study assessed elementary school teachers' perceived attitudes and barriers associated with school gardens, as well as the purpose and use of gardens in schools, specifically in relation to the link between gardens and nutrition. The questionnaire was mailed to California fourth-grade teachers at schools with gardens (N = 1,665). The response rate was 36% (n = 592). Teachers perceived the garden to be somewhat to very effective at enhancing academic performance, physical activity, language arts, and healthful eating habits. Nutrition was taught with the use of the garden by 47% of responding teachers. This research provides evidence for needed standards-based curricula materials and teacher training in relation to gardening and nutrition. The results from this study will contribute to development of needed resources and methods by which to encourage the use of gardens and nutrition education in schools.

  17. A Guide for Foodservice Education; Health Care; Community Care and School Feeding in California. Dietetic Service Supervision Curriculum Guide.

    Science.gov (United States)

    Schickling, Clarice; And Others

    This curriculum guide is intended to help California community college educators understand and develop a vocational program in health care, community care, and school food service. It establishes the general need for such a program, and provides guidelines to help educators determine if there is a need for such a program in their geographic…

  18. Use of Skype in interviews: the impact of the medium in a study of mental health nurses.

    Science.gov (United States)

    Oates, Jennifer

    2015-03-01

    To discuss the use of Skype as a medium for undertaking semi-structured interviews. Internet-based research is becoming increasingly popular, as communication using the internet takes a bigger role in our working and personal lives. Technology such as Skype allows research encounters with people across geographical divides. The semi-structured interview is a social encounter with a set of norms and expectations for both parties ( Doody and Noonan 2012 ). Proceedings must take account of the social context of both semi-structured interviews per se, and that of internet mediated communication. The findings of the qualitative phase of a mixed-methods study are compared with other reports comparing the use of Skype with face-to-face and telephone interviews. This paper is a methodological discussion of the use of Skype as an online research methodology. Choosing Skype as a means of interviewing may affect the characteristics of participants and decisions about consent. Rapport, sensitivity and collaboration may be addressed differently in Skype interviews compared with face-to-face interviews. Skype offers researchers the opportunity to reach a geographical spread of participants more safely, cheaply and quickly than face-to-face meetings. Rapport, sensitivity and degrees of collaboration can be achieved using this medium. The use of Skype as a medium for semi-structured interview research is better understood. This paper contributes to the growing body of literature on the use of the internet as a medium for research by nurses.

  19. The Border Health Consortium of the Californias—Forming a Binational (California–Baja California Entity to Address the Health of a Border Region: A Case Study

    Directory of Open Access Journals (Sweden)

    Justine Kozo

    2018-01-01

    Full Text Available The California–Baja California border region is one of the most frequently traversed areas in the world with a shared population, environment, and health concerns. The Border Health Consortium of the Californias (the “Consortium” was formed in 2013 to bring together leadership working in the areas of public health, health care, academia, government, and the non-profit sector, with the goal of aligning efforts to improve health outcomes in the region. The Consortium utilizes a Collective Impact framework which supports a shared vision for a healthy border region, mutually reinforcing activities among member organizations and work groups, and a binational executive committee that ensures continuous communication and progress toward meeting its goals. The Consortium is comprised of four binational work groups which address human immunodeficiency virus, tuberculosis, obesity, and mental health, all mutual priorities in the border region. The Consortium holds two general binational meetings each year alternating between California and Baja California. The work groups meet regularly to share information, resources and provide binational training opportunities. Since inception, the Consortium has been successful in strengthening binational communication, coordination, and collaboration by providing an opportunity for individuals to meet one another, learn about each other systems, and foster meaningful relationships. With binational leadership support and commitment, the Consortium could certainly be replicated in other border jurisdictions both nationally and internationally. The present article describes the background, methodology, accomplishments, challenges, and lessons learned in forming the Consortium.

  20. Access to care and use of the Internet to search for health information: results from the US National Health Interview Survey.

    Science.gov (United States)

    Amante, Daniel J; Hogan, Timothy P; Pagoto, Sherry L; English, Thomas M; Lapane, Kate L

    2015-04-29

    The insurance mandate of the Affordable Care Act has increased the number of people with health coverage in the United States. There is speculation that this increase in the number of insured could make accessing health care services more difficult. Those who are unable to access care in a timely manner may use the Internet to search for information needed to answer their health questions. The aim was to determine whether difficulty accessing health care services for reasons unrelated to insurance coverage is associated with increased use of the Internet to obtain health information. Survey data from 32,139 adults in the 2011 National Health Interview Study (NHIS) were used in this study. The exposure for this analysis was reporting difficulty accessing health care services or delaying getting care for a reason unrelated to insurance status. To define this exposure, we examined 8 questions that asked whether different access problems occurred during the previous 12 months. The outcome for this analysis, health information technology (HIT) use, was captured by examining 2 questions that asked survey respondents if they used an online health chat room or searched the Internet to obtain health information in the previous 12 months. Several multinomial logistic regressions estimating the odds of using HIT for each reported access difficulty were conducted to accomplish the study objective. Of a survey population of 32,139 adults, more than 15.90% (n=5109) reported experiencing at least one access to care barrier, whereas 3.63% (1168/32,139) reported using online health chat rooms and 43.55% (13,997/32,139) reported searching the Internet for health information. Adults who reported difficulty accessing health care services for reasons unrelated to their health insurance coverage had greater odds of using the Internet to obtain health information. Those who reported delaying getting care because they could not get an appointment soon enough (OR 2.2, 95% CI 1.9-2.5), were

  1. Women in post-trafficking services in moldova: diagnostic interviews over two time periods to assess returning women's mental health

    Directory of Open Access Journals (Sweden)

    Gorceag Lilia T

    2011-04-01

    Full Text Available Abstract Background Trafficking in women is a widespread human rights violation commonly associated with poor mental health. Yet, to date, no studies have used psychiatric diagnostic assessment to identify common forms of mental distress among survivors returning to their home country. Methods A longitudinal study was conducted of women aged 18 and over who returned to Moldova between December 2007 and December 2008 registered by the International Organisation for Migration as a survivor of human trafficking. Psychiatric diagnoses in women at a mean of 6 months after return (range 2-12 months were made by a trained Moldavian psychiatrist using the Structured Clinical Interview for DSM-IV, and compared with diagnoses recorded in the same women within 5 days of return. We described the socio-demographic characteristics of the women in the sample including both pre and post-trafficking information. We then described the distribution of mental health diagnoses recorded during the crisis intervention phase (1-5 days after return and the re-integration phase (2-12 months after return. We compared diagnoses at the patient level between the two time points by tabulating the diagnoses and carrying out a kappa test of agreement and the Stuart-Maxwell test for marginal homogeneity (an extension of the McNemar test to kxk table. Results 120/176 (68% eligible women participated. At 2-12 months after their return, 54% met criteria for at least one psychiatric diagnoses comprising post-traumatic stress disorder (PTSD alone (16%; co-morbid PTSD (20%; other anxiety or mood disorder (18%. 85% of women who had been diagnosed in the crisis phase with co-morbid PTSD or with another anxiety or mood disorder sustained a diagnosis of any psychiatric disorder when followed up during rehabilitation. Conclusions Trafficked women returning to their country of origin are likely to suffer serious psychological distress that may endure well beyond the time they return. Women

  2. [Care work in the health sector based on the psychodynamics of work and the care perspective: An interview with Pascale Molinier].

    Science.gov (United States)

    Wlosko, Miriam; Ros, Cecilia

    2015-09-01

    This interview with Pascale Molinier was carried out in Buenos Aires in October 2014, in the context of activities organized by the Health and Work Program at the Department of Community Health of the Universidad Nacional de Lanús, Argentina. The interview explores the relationship between work and subjectivation, examining the role of work in the structuring of the psyche, in the dynamics of pleasure and suffering, and in the construction of gender identities. "Feminized" work - that of nurses, caregivers and maids, among others - is examined from a "care" perspective, analyzing its intrinsic invisibility and impossibility of being quantified and measured, which makes it a challenge to management-based logic.

  3. Monitoring health effects of wildfires using the biosense system--San Diego County, California, October 2007.

    Science.gov (United States)

    2008-07-11

    During October 21-26, 2007, wildfires consumed hundreds of thousands of acres and forced the evacuation of more than 300,000 persons in San Diego County, California. During large-scale emergencies, data are needed to assess health effects, plan response, and evaluate response adequacy. This report describes some of the health effects of the wildfires based on data from the CDC BioSense system, which receives emergency department (ED) patient chief complaint information and physician diagnosis codes from six hospitals in San Diego County. Analysis of these data indicated that ED visits for respiratory disease, especially those associated with dyspnea and asthma, increased during a 5-day fire period compared with the preceding 20 weekdays. For the six hospitals combined, visits for dyspnea increased from 48.6 to 72.6 per day, and visits with diagnoses of asthma increased from 21.7 to 40.4 per day. Local, state, and federal public health personnel should continue collaborative efforts to expand and

  4. Reaching High-Need Youth Populations With Evidence-Based Sexual Health Education in California.

    Science.gov (United States)

    Campa, Mary I; Leff, Sarah Z; Tufts, Margaret

    2018-02-01

    To explore the programmatic reach and experience of high-need adolescents who received sexual health education in 3 distinct implementation settings (targeted-prevention settings, traditional schools, and alternative schools) through a statewide sexual health education program. Data are from youth surveys collected between September 2013 and December 2014 in the California Personal Responsibility Education Program. A sample of high-need participants (n = 747) provided data to examine the impact of implementation setting on reach and program experience. Implementation in targeted-prevention settings was equal to or more effective at providing a positive program experience for high-need participants. More than 5 times as many high-need participants were served in targeted-prevention settings compared with traditional schools. Reaching the same number of high-need participants served in targeted-prevention settings over 15 months would take nearly 7 years of programming in traditional schools. To maximize the reach and experience of high-need youth populations receiving sexual health education, state and local agencies should consider the importance of implementation setting. Targeted resources and efforts should be directed toward high-need young people by expanding beyond traditional school settings.

  5. Prevalence and Impact of Bilateral Vestibular Hypofunction: Results from the 2008 United States National Health Interview Survey

    Science.gov (United States)

    Ward, Bryan K; Agrawal, Yuri; Hoffman, Howard J.; Carey, John P; Della Santina, Charles C.

    2016-01-01

    Objective Profound bilateral vestibular hypofunction (BVH) causes disabling oscillopsia, chronic disequilibrium and postural instability. Our aim was to assess prevalence and functional impact of BVH in the U.S. adult population. Study Design National cross-sectional survey and corollary validation study. Setting National database Patients Adult participants in the 2008 Balance and Dizziness Supplement to the United States National Health Interview Survey (NHIS), (n=21,782). Intervention Survey-based diagnosis of BVH, all of the following: presence of visual blurring with head movement, unsteadiness, difficulty walking in darkness/unsteady surfaces and in a straight path, symptoms being at least “a big problem” and present for at least 1 year, in the absence of other neurologic conditions or eye pathology affecting vision. Main Outcome Measures Prevalence of BVH, socioeconomic and quality-of-life impact of BVH, and fall risk. Results Adjusted national estimates from this survey indicate the prevalence of BVH in 2008 was 28/100,000 U.S. adults (64,046 Americans). 44% of participants with BVH reported changing their driving habits because of their symptoms, 56% reported reduced participation in social activities, and 58% reported difficulties with activities of daily living. Respondents with BVH had a 31-fold increase in the odds of falling in multivariate analyses compared to all respondents, with 25% reporting a recent fall-related injury. Conclusions BVH, as estimated by the presence of specific symptoms in a nationally representative survey, has considerable socioeconomic and quality-of-life impacts and significantly increases fall risk. These data support the need for new therapeutic strategies for BVH, including vestibular rehabilitation and implantable vestibular prostheses. PMID:23949355

  6. Non-prescription syringe sales in California: a qualitative examination of practices among 12 local health jurisdictions.

    Science.gov (United States)

    Rose, Valerie J; Backes, Glenn; Martinez, Alexis; McFarland, Willi

    2010-07-01

    Legislation permitting non-prescription syringe sales (NPSS) was passed in 2004 in California as a structural intervention designed to expand access to syringes for injection drug users. As of December 2009, 19 of California's 61 local health jurisdictions (LHJs) have approved policies to authorize pharmacies to sell non-prescription syringes. The legislation faces termination in 2010 if current evaluation efforts fail to demonstrate outcomes defined in the legislation. Using qualitative methods, we examined the systems and procedures associated with implementation; identified facilitators and barriers to implementation among 12 LHJs, and documented the role of public health in initiating and sustaining local programs. We identified consistent activities that led to policy implementation among LHJs and discovered several barriers that were associated with failure to implement local programs. Factors leading to NPSS were public health leadership; an inclusive planning process, marketing the program as a public health initiative; learning from others' efforts, successes, and failures; and identifying acceptable syringe disposal options in advance of program implementation. Health departments that were confronted with political and moral arguments lost momentum and ultimately assigned a lower priority to the initiative citing the loss of powerful public health advocates or a lack of human resources. Additional barriers were law enforcement, elected officials, and pharmacy opposition, and failure to resolve syringe disposal options to the satisfaction of important stakeholders. The lessons learned in this study should provide useful guidance for the remaining LHJs in California without NPSS programs.

  7. Health-related characteristics and preferred methods of receiving health education according to dominant language among Latinos Aged 25 to 64 in a large Northern California health plan

    Directory of Open Access Journals (Sweden)

    Iribarren Carlos

    2008-09-01

    Full Text Available Abstract Background Latinos are a fast growing segment of the U.S. health care population. Acculturation factors, including English fluency, result in an ethnic group heterogeneous with regard to SES, health practices, and health education needs. This study examined how demographic and health-related characteristics of Spanish-dominant (SD, Bilingual (BIL, and English-dominant (ED Latino men and women aged 25–64 differed among members of a large Northern California health plan. Methods This observational study was based on data from cohorts of 171 SD (requiring an interpreter, 181 BIL, and 734 ED Latinos aged 25–64 who responded to random sample health plan member surveys conducted 2005–2006. Language groups were compared separately by gender on education, income, behavioral health risks (smoking, obesity, exercise frequency, dietary practices, health beliefs, health status (overall health and emotional health, diabetes, hypertension, high cholesterol, heartburn/acid reflux, back pain, depression, computer and Internet access, and health education modality preferences. Results Compared with ED Latinos, higher percentages of the SD and BIL groups had very low educational attainment and low income. While groups were similar in prevalence of diabetes, hypertension, and high cholesterol, SD were less likely than ED Latinos to rate overall health and emotional well-being as good, very good, or excellent and more likely to report heartburn and back pain (women only. The groups were similar with regard to smoking and obesity, but among women, SD were more likely to be physically inactive than ED, and BIL were less likely than SD and ED groups to eat Conclusion There are important differences among Latinos of different English language proficiency with regard to education, income, health status, health behaviors, IT access, and health education modality preferences that ought to be considered when planning and implementing health programs for this

  8. Characteristics associated with consumption of sports and energy drinks among US adults: National Health Interview Survey, 2010.

    Science.gov (United States)

    Park, Sohyun; Onufrak, Stephen; Blanck, Heidi M; Sherry, Bettylou

    2013-01-01

    Sales of sports and energy drinks have increased dramatically, but there is limited information on regular consumers of sports and energy drinks. Characteristics associated with sports and energy drink intake were examined among a sample representing the civilian noninstitutionalized US adult population. The 2010 National Health Interview Survey data for 25,492 adults (18 years of age or older; 48% males) were used. Nationwide, 31.3% of adults were sports and energy drink consumers during the past 7 days, with 21.5% consuming sports and energy drinks one or more times per week and 11.5% consuming sports and energy drinks three or more times per week. Based on multivariable logistic regression, younger adults, males, non-Hispanic blacks and Hispanics, not-married individuals, adults with higher family income, those who lived in the South or West, adults who engaged in leisure-time physical activity, current smokers, and individuals whose satisfaction with their social activities/relationships was excellent had significantly higher odds for drinking sports and energy drinks one or more times per week. In this model, the factor most strongly associated with weekly sports and energy drink consumption was age (odds ratio [OR]=10.70 for 18- to 24-year-olds, OR=6.40 for 25- to 39-year-olds, OR=3.17 for 40- to 59-year-olds vs 60 years or older). Lower odds for consuming sports and energy drinks one or more times per week were associated with other/multiracial (OR=0.80 vs non-Hispanic white) and obesity (OR=0.87 vs underweight/normal weight). Separate modeling of the association between other beverage intake and sports and energy drink intake showed that higher intake of regular soda, sweetened coffee/tea drinks, fruit drinks, milk, 100% fruit juice, and alcohol were significantly associated with greater odds for drinking sports and energy drinks one or more times per week. These findings can help medical care providers and public health officials identify adults most in

  9. Embracing Comprehensive Mental Health and Social Services Programs to Serve Children Under California's Mental Health Services Act.

    Science.gov (United States)

    Cordell, Katharan D; Snowden, Lonnie R

    2017-03-01

    Authorized under California's Mental Health Services Act (MHSA) of 2004, full service partnership (FSP) programs address social welfare and other human service needs of seriously mentally ill adults and children who are especially socially and economically vulnerable or who are untreated or insufficiently treated. Because FSP enrollment should reflect greater individual and community distress, we investigated whether counties' enrollment of children into FSPs came from mental health system caseloads with higher crisis use, assessed trauma and substance abuse problems; and from counties which had more foster care placement, more child poverty, lower median household incomes and more unemployment. We addressed these questions in 36 counties over 34 quarters after MHSA's onset. Results indicated greater FSP enrollment for children was associated with higher county unemployment and foster care placement rates and with mental health systems which had increasing children's crisis rates over the study period. These findings suggest that underservice and community adversity prompt officials to adopt and make greater use of children's FSP programming, in keeping with MHSA's intensions.

  10. Assessment of levels of hospice care coverage offered to commercial managed care plan members in California: implications for the California Health Insurance Exchange.

    Science.gov (United States)

    Chung, Kyusuk; Jahng, Joelle; Petrosyan, Syuzanna; Kim, Soo In; Yim, Victoria

    2015-06-01

    The implementation of the Affordable Care Act that provides for the expansion of affordable insurance to uninsured individuals and small businesses, coupled with the provision of mandated hospice coverage, is expected to increase the enrollment of the terminally ill younger population in hospice care. We surveyed health insurance companies that offer managed care plans in the 2014 California health insurance exchange and large hospice agencies that provided hospice care to privately insured patients in 2011. Compared with Medicare and Medicaid hospice benefits, hospice benefits for privately insured patients, particularly those enrolled in managed care plans, varied widely. Mandating hospice care alone may not be sufficient to ensure that individuals enrolled in different managed care plans receive the same level of coverage. © The Author(s) 2014.

  11. How Have You Been? or ¿Como estás?: Does Language of Interview Influences Self-Rated Health Among Hispanic Subgroups?

    Science.gov (United States)

    Santos-Lozada, Alexis R; Martinez, Matthew J

    2017-06-08

    This paper reports language differences in poor/fair self-rated health (SRH) among adults from six Hispanic groups in the United States. Data are from the cross-sectional 1997-2013 National Health Interview Survey (NHIS). The total sample of Hispanic adults with valid information for the variables considered in the study (n = 156,374) included Mexican-Americans (Mex-Am; n = 43,628), Mexicans (n = 55,057), Puerto Ricans (n = 14,631), Cubans (n = 8,041), Dominicans (from Dominican Republican, n = 4,359) and Other Hispanics (n = 30,658). We compared percentage of the population that reported poor/fair SRH among Hispanic individuals by language of interview and across origins using bivariate tests of association. Multivariable logistic regression analysis was used to study the odds of reporting poor/fair SRH based on language among the overall population and each group. Among the six Hispanic origins Puerto Ricans (15.92%), Cubans (16.36%) and Dominicans (15.32%) reported poor/fair SRH at higher levels than the overall sample (12.32%). In the logistic regression model adjusting potential covariates, those interviewed in Spanish were at higher odds of reporting poor/fair SRH than those interviewed in English (OR = 1.47, p origin for reporting poor/fair SRH, and also by language of interview. Achieving accurate measurement of health status among Hispanics is a concern for all researchers, in particular those who study differences in health status by race/ethnicity in the United States. Future, research should account for Hispanic background and language of interviews.

  12. Effects of the goldspotted oak borer, Agrilus auroguttatus, on the health of coast live oak, Quercus agrifolia, in southern California before and after treatment with two systemic insecticides

    Science.gov (United States)

    Yigen Chen; Mary L. Flint; Tom W. Coleman; Joseph J. Doccola; Donald M. Grosman; David L. Wood; Steven J. Seybold

    2015-01-01

    The invasive goldspotted oak borer, Agrilus auroguttatus (Coleoptera: Buprestidae), is threatening the health and survival of oak trees in San Diego County, California (Flint and others 2013). The primary oak species colonized and killed in this area include coast live oak (Quercus agrifolia), California black oak (...

  13. ACASI and Face-to-Face Interviews Yield Inconsistent Estimates of Domestic Violence among Women in India: The Samata Health Study 2005-2009

    Science.gov (United States)

    Rathod, Sujit D.; Minnis, Alexandra M.; Subbiah, Kalyani; Krishnan, Suneeta

    2011-01-01

    Background: Audio computer-assisted self-interviews (ACASI) are increasingly used in health research to improve the accuracy of data on sensitive behaviors. However, evidence is limited on its use among low-income populations in countries like India and for measurement of sensitive issues such as domestic violence. Method: We compared reports of…

  14. Drinking context and intimate partner violence: evidence from the California community health study of couples.

    Science.gov (United States)

    Cunradi, Carol B; Mair, Christina; Todd, Michael; Remer, Lillian

    2012-09-01

    Couples in which one or both partners is a heavy or problem drinker are at elevated risk for intimate partner violence (IPV), yet little is known about the extent to which each partner's drinking in different contexts (volume consumed per setting in bars, parties, at home, or in public places) increases the likelihood that partner aggression will occur. This study examined associations between the volume consumed in different settings by each partner and the occurrence and frequency of IPV. We obtained a geographic sample of married or cohabiting couples residing in 50 medium to large California cities. Cross-sectional survey data were collected via confidential telephone interviews (60% response rate). Logistic and negative binomial regression analyses were based on 1,585 couples who provided information about past-12-month IPV, drinking contexts (number of times attended, proportion of drinking occasions when attended, average number of drinks), frequency of intoxication, and psychosocial and demographic factors. Drinking context-IPV associations for each partner were adjusted for the other partner's volume for that context and other covariates. Male partner's volume per setting for bars and parks or public places was associated with the occurrence and frequency of male-to-female IPV and female-to-male IPV. Male's volume per setting for quiet evening at home was associated with the occurrence of female-to-male IPV; female partner's volume for this setting was associated with the frequency of male-to-female IPV and female-to-male IPV. Among couples in the general population, each partner's drinking in certain contexts is an independent risk factor for the occurrence and frequency of partner aggression.

  15. Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98).

    Science.gov (United States)

    Finger, Jonas D; Tylleskär, Thorkild; Lampert, Thomas; Mensink, Gert B M

    2012-12-15

    We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined. The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables. After adjusting for age and region, a higher education level was associated with more leisure-time activity - with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1.6 (1.2-2.1), respectively

  16. Psychometric properties of the Spanish version of two mental health outcome measures: World Health Organization Disability Assessment Schedule II and Lehman's Quality Of Life Interview.

    Science.gov (United States)

    Chávez, Ligia M; Canino, Glorisa; Negrón, Gisela; Shrout, Patrick E; Matías-Carrelo, Leida E; Aguilar-Gaxiola, Sergio; Hoppe, Sue

    2005-09-01

    This study presents data on the cultural adaptation to Latino populations of two outcome measures that respond to the need for developing comprehensive instruments for outcome assessments in minority populations. We examined the psychometric properties of outcome measures designed to assess impairment in functioning, and quality of life. Impairment in functioning was measured with the Disability Assessment Schedule II (WHO-DASII) developed by the World Health Organization (1997) and quality of life was measured with A. F. Lehman's (A. F. Lehman, 1983; A. F. Lehman, 1988) shortened Quality of Life Interview (QOLI). Spanish speaking consumers (N = 198) from Fresno (CA), San Antonio (TX) and San Juan (PR) participated in this study. They were recruited from both mental health outpatient clinics and primary care rural clinics. The WHO-DASII showed good to excellent internal consistency in all sites (alpha = .72 to .97) except for one subscale (Self-Care alpha = .47). Test-retest reliability estimates were mostly moderate to substantial (.57 to .83), again with one exception, the Self-Care subscale (.46). For the QOLI internal consistency ranged from .34 to .98 and test-retest reliability ranged from .40 to .86 across all sites. An initial validation strategy using both known-groups and concurrent validity produced promising evidence of the construct validity of both measures. The Spanish versions of the WHO-DASII and the QOLI lend support to the translation and adaptation process to which these instruments were subjected.

  17. Persistent digital divide in access to and use of the Internet as a resource for health information: Results from a California population-based study.

    Science.gov (United States)

    Nguyen, Amy; Mosadeghi, Sasan; Almario, Christopher V

    2017-07-01

    Access to the Internet has grown dramatically over the past two decades. Using data from a population-based survey, we aimed to determine the prevalence and predictors of (i) access to the Internet, and (ii) use of the Internet to search for health information. We analyzed data from the 2011-12 California Health Interview Survey (CHIS) and included all individuals 18 years of age and older. Our outcomes were (i) prior use of the Internet, and (ii) use of the Internet to find health or medical information within the past year. We performed survey-weighted logistic regression models on our outcomes to adjust for potentially confounding demographic and socioeconomic factors. Our study included an unweighted and survey-weighted sample of 42,935 and 27,796,484 individuals, respectively. We found that 81.5% of the weighted sample reported having previously used the Internet. Among Internet users, 64.5% stated that they used the Internet within the past year to find health or medical information. Racial/ethnic minorities, older individuals, and those who lived in lower income households and rural areas were less likely to have access to and use the Internet to search for health information. Conversely, English-proficiency and increasing levels of education were positively associated with online health information-seeking. We found that most Californians have access to and use the Internet to search for health information, but still noted a persistent digital divide. Interventions to narrow the divide are needed, otherwise this may lead to a continued widening of existing healthcare disparities. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. CalEnviroScreen 1.0 (CES) Group, California, 2013, California EPA and Office of Environmental Health Hazard Assessment

    Data.gov (United States)

    U.S. Environmental Protection Agency — Developed jointly by the Agency and the Office of Environmental Health Hazard Assessment (OEHHA), the tool uses data about 11 types of pollution and environmental...

  19. Southern California Particle Center

    Data.gov (United States)

    Federal Laboratory Consortium — At the Southern California Particle Center, center researchers will investigate the underlying mechanisms that produce the health effects associated with exposure to...

  20. Development of the European Health Interview Survey - Physical Activity Questionnaire (EHIS-PAQ) to monitor physical activity in the European Union.

    Science.gov (United States)

    Finger, Jonas D; Tafforeau, Jean; Gisle, Lydia; Oja, Leila; Ziese, Thomas; Thelen, Juergen; Mensink, Gert B M; Lange, Cornelia

    2015-01-01

    A domain-specific physical activity questionnaire (EHIS-PAQ) was developed in the framework of the second wave of the European Health Interview Survey (EHIS). This article presents the EHIS-PAQ and describes its development and evaluation processes. Research institutes from Belgium, Estonia and Germany participated in the Improvement of the EHIS (ImpEHIS) Grant project issued by Eurostat. The instrument development process comprised a non-systematic literature review and a systematic HIS/HES database search for physical activity survey questions. The developed EHIS-PAQ proposal was reviewed by survey experts. Cognitive testing of the EHIS-PAQ was conducted in Estonia and Germany. The EHIS-PAQ was further tested in a pilot survey in Belgium, Estonia and Germany in different modes of data collection, face-to-face paper and pencil interview (PAPI) and computer assisted telephone interview (CATI). The EHIS-PAQ is a rather pragmatic tool aiming to evaluate how far the population is physically active in specific public health relevant settings. It assesses work-related, transport-related and leisure-time physical activity in a typical week. Cognitive testing revealed that the EHIS-PAQ worked as intended. The pilot testing showed the feasibility of using the EHIS-PAQ in an international health interview survey setting in Europe. It will be implemented in all 28 European Union Member States via European Union implementing regulation in the period between 2013 and 2015. This will be a first opportunity to get comparable data on domain-specific physical activity in all 28 EU MS and to publish indicators at the EU level. The EHIS-PAQ is a short, domain-specific PA questionnaire based on PA questions which have been used in large-scale health interview surveys before. It was designed by considering the respondents' perspective in answering PA questions.

  1. DATA SONIFICATION, FROM PHYSICS TO HEALTH - Interview to Domenico Vicinanza and Genevieve Williams, Anglia Ruskin University, Cambridge.

    CERN Multimedia

    2016-01-01

    In this interview, recorded during the 2016 ICTR-PHE conference organized by CERN in Geneva at the International Conference Centre (CICG) in February, Dr. Domenico Vicinanza and Genevieve Williams describe the use of music and sound as tools for scientific investigation, with specific reference to biomedical sciences and show sonifications in action in a practical demonstration carried pout on physicist musician Chiara Mariotti.

  2. Shared decision making and motivational interviewing: achieving patient-centered care across the spectrum of health care problems

    NARCIS (Netherlands)

    Elwyn, G.; Dehlendorf, C.; Epstein, R.M.; Marrin, K.; White, J.; Frosch, D.L.

    2014-01-01

    Patient-centered care requires different approaches depending on the clinical situation. Motivational interviewing and shared decision making provide practical and well-described methods to accomplish patient-centered care in the context of situations where medical evidence supports specific

  3. The evolution of women's primary health care in california: the role of the obstetrician/gynecologist.

    Science.gov (United States)

    Dickerson, V M.

    2001-05-01

    The role of the obstetrician/gynecologist as the primary health care provider for women has evolved rapidly in the past decade. There has not always been agreement in the specialty about the directions in which it should proceed. In particular, a cognitive dissonance has arisen regarding the primary care role for any one physician. Just as there are strong advocates,1,2 so are there dissentients.3,4 Access to care for women and patient choice of physician are universally acknowledged as desirable and central to the issue. The often acrimonious debate derives from more theoretical constructs of subspecialty identity and integrity, economics, dilution of specialty training, and educational barriers to successful implementation. The practical, salutary implications of primary care obstetrician/gynecologists have infrequently been evaluated in any formalized fashion. Five years ago, the State of California designated obstetrician/gynecologists as primary care physicians. This paper is a retrospective analysis of how the designation was achieved and the subsequent experience of the specialty over this period of time.

  4. Barriers to sexual health care: a survey of Iranian-American physicians in California, USA.

    Science.gov (United States)

    Rashidian, Mitra; Minichiello, Victor; Knutsen, Synnove F; Ghamsary, Mark

    2016-07-15

    Despite increasing numbers of Iranian-American physicians practicing in the United States, little is known about the barriers that may impact them as providers of sexual health care. This is an important topic as discussions of sexual topics are generally considered a taboo among Iranians. We aimed to identify barriers experienced by Iranian-American physicians that inhibit their willingness to engage in discussions of sexual health care with patients. In 2013, a self-administrated questionnaire was sent to 1,550 Iranian-American physicians in California. Questions included demographics of the physicians as well as their perception of challenges in discussing various sexual health topics with their patients. Factor analysis: Principal components approach with a Varimax rotation was used to detect latent factors within the data that may help explain possible barriers to discussion of sexual health among physicians. The analysis was performed on 11 items, specifically focused on possible barriers, to detect a possible relationship between correlated variables within the data to produce a set of uncorrelated variables (factors). The overall response rate was 23 %. Data revealed specific barriers regarding sexual history taking, discussing STIs and sexual dysfunctions with patients based on their gender, and age. Three factors were identified as internally consistent (Cronbach's alpha = 0.82 to 0.91): (i) embarrassment, (ii) cultural and religious, (iii) lack of time and financial constraint. Significant associations were found between these 3 factors and some variables such as: country of medical graduation, religious affiliation, birthplace, age, and gender. Our findings are the first to identify possible barriers among Iranian-American physicians in delivering effective sexual health care to patients. Additional studies from Iranian-American physicians as well as from other foreign-born/subpopulation of US physicians populations and mainstream US physicians are

  5. 'Competent persons who can treat you with competence, as simple as that' - an interview study with transgender people on their experiences of meeting health care professionals.

    Science.gov (United States)

    Lindroth, Malin

    2016-12-01

    With a focus on sexual health and rights, this study describes how transgender people experience meetings with health care professionals. Transgender people face prejudice and discrimination worldwide. Little is known of their experiences in sexual health-promoting settings. Within a descriptive design, 20 persons aged 18-74 and identifying as transgender and nonbinary were interviewed. The results were analysed with constructivist grounded theory. Disrespect among health care professionals is the core category connected to the experiences in the result; transgender people experience estrangement, expectations and eviction in different sexual health-promoting settings. Transgender knowledge needs to be increased in general, in both specialised transgender health care and many other health care settings, to prevent transgender peoples' experiences of estrangement. Moreover, an increased knowledge of, and respect for, sexual health and rights is needed to prevent transgender peoples' exposure to gender binary, cis- and heteronormative expectations. In addition, access to sexual health care is essential following gender-confirmatory care as well to avoid transgender peoples' experiences of eviction from the health care system. Nurses have an important role to play in striving for equity and justice within health care. This study describes how health care professionals appear to be disrespectful and suggestions of how this can be avoided are made. © 2016 John Wiley & Sons Ltd.

  6. Developing citizen report cards for primary health care in low and middle-income countries: Results from cognitive interviews in rural Tajikistan.

    Directory of Open Access Journals (Sweden)

    Sebastian Bauhoff

    Full Text Available Citizen report cards on health care providers have been identified as a potential means to increase citizen engagement, provider accountability and health systems performance. Research in high-income settings indicates that the wording, presentation and display of performance information are critical to achieve these goals. However, there are limited insights on developing effective report card designs for middle- and low-income settings. We conducted cognitive interviews to assess consumers' understanding, interpretation of and preferences for displaying information for a health care report card in rural Tajikistan. We recruited a convenience sample of 40 citizens (20 women and 20 men aged 18-45 from rural areas of two provinces of Tajikistan (Soghd and Khatlon oblasts. The interview protocol was adapted from the model of cognitive interviews used in social science research to improve survey questionnaires. We used multivariate regression to assess understanding and interpretation of the report card; chi2 tests to assess differences in preferences for displaying information; and tests of proportions to assess the preferred comparison group. Respondents understood the main idea of the report card and are not confused by the indicators or display. However, many respondents had difficulties making comparisons, and when asked to identify worst-performing services. Respondents preferred detailed rankings using school grades, comparisons of their local clinic with the regional or national average performance, and the use of color in the report card. We found some heterogeneity across the two provinces. Overall, our findings are promising regarding the citizens' comprehension of health care report cards in rural Tajikistan, while underscoring the challenges of effectively providing health care performance information to communities. Cognitive interviews and iterative testing can support an effective implementation of reporting initiatives.

  7. Developing citizen report cards for primary health care in low and middle-income countries: Results from cognitive interviews in rural Tajikistan.

    Science.gov (United States)

    Bauhoff, Sebastian; Rabinovich, Lila; Mayer, Lauren A

    2017-01-01

    Citizen report cards on health care providers have been identified as a potential means to increase citizen engagement, provider accountability and health systems performance. Research in high-income settings indicates that the wording, presentation and display of performance information are critical to achieve these goals. However, there are limited insights on developing effective report card designs for middle- and low-income settings. We conducted cognitive interviews to assess consumers' understanding, interpretation of and preferences for displaying information for a health care report card in rural Tajikistan. We recruited a convenience sample of 40 citizens (20 women and 20 men aged 18-45) from rural areas of two provinces of Tajikistan (Soghd and Khatlon oblasts). The interview protocol was adapted from the model of cognitive interviews used in social science research to improve survey questionnaires. We used multivariate regression to assess understanding and interpretation of the report card; chi2 tests to assess differences in preferences for displaying information; and tests of proportions to assess the preferred comparison group. Respondents understood the main idea of the report card and are not confused by the indicators or display. However, many respondents had difficulties making comparisons, and when asked to identify worst-performing services. Respondents preferred detailed rankings using school grades, comparisons of their local clinic with the regional or national average performance, and the use of color in the report card. We found some heterogeneity across the two provinces. Overall, our findings are promising regarding the citizens' comprehension of health care report cards in rural Tajikistan, while underscoring the challenges of effectively providing health care performance information to communities. Cognitive interviews and iterative testing can support an effective implementation of reporting initiatives.

  8. Differential respiratory health effects from the 2008 northern California wildfires: A spatiotemporal approach.

    Science.gov (United States)

    Reid, Colleen E; Jerrett, Michael; Tager, Ira B; Petersen, Maya L; Mann, Jennifer K; Balmes, John R

    2016-10-01

    We investigated health effects associated with fine particulate matter during a long-lived, large wildfire complex in northern California in the summer of 2008. We estimated exposure to PM2.5 for each day using an exposure prediction model created through data-adaptive machine learning methods from a large set of spatiotemporal data sets. We then used Poisson generalized estimating equations to calculate the effect of exposure to 24-hour average PM2.5 on cardiovascular and respiratory hospitalizations and ED visits. We further assessed effect modification by sex, age, and area-level socioeconomic status (SES). We observed a linear increase in risk for asthma hospitalizations (RR=1.07, 95% CI=(1.05, 1.10) per 5µg/m(3) increase) and asthma ED visits (RR=1.06, 95% CI=(1.05, 1.07) per 5µg/m(3) increase) with increasing PM2.5 during the wildfires. ED visits for chronic obstructive pulmonary disease (COPD) were associated with PM2.5 during the fires (RR=1.02 (95% CI=(1.01, 1.04) per 5µg/m(3) increase) and this effect was significantly different from that found before the fires but not after. We did not find consistent effects of wildfire smoke on other health outcomes. The effect of PM2.5 during the wildfire period was more pronounced in women compared to men and in adults, ages 20-64, compared to children and adults 65 or older. We also found some effect modification by area-level median income for respiratory ED visits during the wildfires, with the highest effects observed in the ZIP codes with the lowest median income. Using a novel spatiotemporal exposure model, we found some evidence of differential susceptibility to exposure to wildfire smoke. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Health effects and related standards for fossil-fuel and geothermal power plants. Volume 6 of health and safety impacts of nuclear, geothermal, and fossil-fuel electric generation in California. [In California

    Energy Technology Data Exchange (ETDEWEB)

    Case, G.D.; Bertolli, T.A.; Bodington, J.C.; Choy, T.A.; Nero, A.V.

    1977-01-01

    This report reviews health effects and related standards for fossil-fuel and geothermal power plants, emphasizing impacts which may occur through emissions into the atmosphere, and treating other impacts briefly. Federal regulations as well as California state and local regulations are reviewed. Emissions are characterized by power plant type, including: coal-fired, oil-fired, gas-fired, combined cycle and advanced fossil-fuel plants; and liquid and vapor geothermal systems. Dispersion and transformation of emissions are treated. The state of knowledge of health effects, based on epidemiological, physiological, and biomedical studies, is reviewed.

  10. Hmong Food Helps Us Remember Who We Are: Perspectives of Food Culture and Health among Hmong Women with Young Children

    Science.gov (United States)

    Vue, Wa; Wolff, Cindy; Goto, Keiko

    2011-01-01

    Objective: To examine perspectives on food habits, acculturation, and health among Hmong women with young children in northern California. Methods: Qualitative interviews were conducted with 15 Hmong mothers with young children in a low-income community of northern California. The interviews were transcribed and coded based on the principles of…

  11. Exploring eHealth Ethics and Multi-Morbidity: Protocol for an Interview and Focus Group Study of Patient and Health Care Provider Views and Experiences of Using Digital Media for Health Purposes

    Science.gov (United States)

    Adam, Paul; Li, Linda C; McDonald, Michael; Backman, Catherine L

    2013-01-01

    Background eHealth is a broad term referring to the application of information and communication technologies in the health sector, ranging from health records to medical consultations (telemedicine) and multiple forms of health education, support, and tools. By providing increased and anytime access to information, opportunities to exchange experiences with others, and self-management support, eHealth has been heralded as transformational. It has the potential to accelerate the shift from traditional "passive patient" to an informed, engaged, and empowered "patient as partner," equipped to take part in shared decision-making, and take personal responsibility for self-managing their illness. Objective The objective of our study is to examine how people with chronic illness use eHealth in their daily lives, how it affects patient-provider relationships, and the ethical and practical ramifications for patients, providers, and service delivery. Methods This two-phase qualitative study is ongoing. We will purposively sample 60-70 participants in British Columbia, Canada. To be eligible, patient participants have to have arthritis and at least one other chronic health condition; health care providers (HCPs) need a caseload of patients with multi-morbidity (>25%). To date we have recruited 36 participants (18 patients, 18 HCPs). The participants attended 7 focus groups (FGs), 4 with patients and 3 with rehabilitation professionals and physicians. We interviewed 4 HCPs who were unable to attend a FG. In phase 2, we will build on FG findings and conduct 20-24 interviews with equal numbers of patients and HCPs (rehabilitation professionals and physicians). As in the FGs conducted in phase I, the interviews will use a semistructured, but flexible, discussion guide. All discussions are being audiotaped and transcribed verbatim. Constant comparisons and a narrative approach guides the analyses. A relational ethics conceptual lens is being applied to the data to identify

  12. Length of Residence in the United States is Associated With a Higher Prevalence of Cardiometabolic Risk Factors in Immigrants: A Contemporary Analysis of the National Health Interview Survey

    OpenAIRE

    Commodore?Mensah, Yvonne; Ukonu, Nwakaego; Obisesan, Olawunmi; Aboagye, Jonathan Kumi; Agyemang, Charles; Reilly, Carolyn M.; Dunbar, Sandra B.; Okosun, Ike S.

    2016-01-01

    Background Cardiometabolic risk (CMR) factors including hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia are high among United States ethnic minorities, and the immigrant population continues to burgeon. Methods and Results Hypothesizing that acculturation (length of residence) would be associated with a higher prevalence of CMR factors, the authors analyzed data on 54, 984 US immigrants in the 2010?2014 National Health Interview Surveys. The main predictor was length o...

  13. The effect of cigarette price increase on the cigarette consumption in Taiwan: evidence from the National Health Interview Surveys on cigarette consumption

    OpenAIRE

    Ye Chun-Yuan; Hwang Tsorng-Chyi; Lee Jie-Min; Chen Sheng-Hong

    2004-01-01

    Abstract Background This study uses cigarette price elasticity to evaluate the effect of a new excise tax increase on cigarette consumption and to investigate responses from various types of smokers. Methods Our sample consisted of current smokers between 17 and 69 years old interviewed during an annual face-to-face survey conducted by Taiwan National Health Research Institutes between 2000 to 2003. We used Ordinary Least Squares (OLS) procedure to estimate double logarithmic function of ciga...

  14. Efficacy of Motivational Interviewing in Conjunction with Caries Risk Assessment (MICRA) Programmes in Improving the Dental Health Status of Preschool Children: A Randomised Controlled Trial.

    Science.gov (United States)

    Saengtipbovorn, Saruta

    To assess the efficacy of motivational interviewing in conjuction with a caries risk assessment (MICRA) programme to improve the dental health status of preschool children. A randomised controlled trial was conducted among 214 parents or caregivers and their children at Health Centre 54, Bangkok, Thailand, from September 2015 to February 2016. The participants were randomised to the intervention and the control groups (107 participants per group). At baseline, the intervention group received a caries risk assessment, individual counseling by using motivational interviewing, and oral hygiene instruction. The intervention group received reinforcement education and individual counseling by motivational interviewing every 3 months. The control group received a routine programme. Participants were assessed at baseline, 3 months, and 6 months for plaque index and caries. The data were analysed by using descriptive statistics, the chi-squared test, Fisher's exact test, t-test, repeated-measures ANOVA, and negative binomial distribution. After the 6-month follow-up, participants in the intervention group had a significantly lower plaque index, non-cavitated plus cavitated carious lesions, and cavitated carious lesions when compared to the control group. The intervention group had a lower caries incidence, non-cavitated plus cavitated carious lesions (1.81 times) and cavitated carious lesions (2.04 times) than the control group. The combination of motivational interviewing and caries risk assessment in one programme decreased early childhood caries in preschool children. It is not known whether the effects are due to the motivational interviewing, the caries risk assessment, or the combination of both.

  15. Radioactive Cesium from Fukushima Japan Detected in Bluefin Tuna off California: Implications for Public Health and for Tracking Migration

    Directory of Open Access Journals (Sweden)

    Fisher N. S.

    2013-04-01

    Full Text Available Bluefin tuna are highly migratory pelagic fish. Pacific bluefin tuna are spawned in waters off Japan and some juveniles migrate across the Pacific to waters off California. Bluefin that had recently migrated and caught in waters off San Diego, California in August 2011 were found to have 134Cs and 137Cs in their muscle tissue, at concentrations that could only have come from the Fukushima nuclear reactor in Japan. Bluefin tuna caught 3 years earlier off San Diego and yellowfin tuna that are resident to the eastern Pacific had no 134Cs and only background levels of 137Cs. The radioactivity in tuna attributable to these Cs isotopes was only 2.8% of that from the naturally occurring 40K, suggesting that consumption of these fish poses little risk to public health. The presence of these isotopes in animal tissues can be used to discern migratory routes and timing for those animals that use the western Pacific.

  16. Tobacco Use in California: An Evaluation of the Tobacco Control Program, 1989-1993. A Report to the California Department of Health Services

    OpenAIRE

    Pierce, JP; Evans, N.; Farkas, AJ; Cavin, SW; Berry, C.; Kramer, M.; Kealey, S.; Rosenbrook, B; W. Choi; Kaplan, RM; University of California, San Diego; Cancer Prevention and Control Program

    1994-01-01

    TOBACCO USE IN CALIFORNIA DETAILED FINDINGS SUMMARIZED BY CHAPTER Chapter 4. ASSESSING PROGRESS TOWARD PROGRAM GOALS 1. Between 1990 and 1993, the proportion of California children and nonsmoking workers who were protected from ETS exposure increased substantially. 2. Cigarette consumption in California declined by an estimated 13.7% following the passage of Proposition 99 and the mandated increase in excise tax on cigarette products. This accelerated decline in consumption lasted approximate...

  17. Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews.

    Science.gov (United States)

    Atwine, Fortunate; Hultsjö, Sally; Albin, Björn; Hjelm, Katarina

    2015-01-01

    Health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The aim of the study was to explore health-care seeking behaviour among persons with type 2 diabetes to understand reasons for using therapies offered by traditional healers. Descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39-72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups. Reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends. The pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care.

  18. California community water systems inventory dataset, 2010

    Data.gov (United States)

    California Environmental Health Tracking Program — This data set contains information about all Community Water Systems in California. Data are derived from California Office of Drinking Water (ODW) Water Quality...

  19. Quantifying the health impacts of future changes in temperature in California.

    Science.gov (United States)

    Ostro, Bart; Rauch, Stephen; Green, Shelley

    2011-11-01

    Several epidemiological studies demonstrate associations between high summer temperatures and increased mortality. However, the quantitative implications of projected future increases in temperature have not been well characterized. This study quantifies the effects of projected future temperatures on both mortality and morbidity in California, including the potential effects of mitigation. We first estimated the association between temperature and mortality for populations close to weather stations throughout the state. These dose-response estimates for mortality were then combined with local measures of current and projected changes in population, and projected changes in temperature, using a baseline of average temperatures from 1961 to 1990, for the years 2025 and 2050. The latter were based on two greenhouse gas emissions scenarios (A2 and B1) developed for the Intergovernmental Panel on Climate Change. In addition, we assessed the impacts of future adaptation through use of air conditioners. Several sensitivity analyses were conducted to determine the likely range of estimates. These analyses indicate that for the high emissions scenario, the central estimate of annual premature mortality ranges from 2100 to 4300 for the year 2025 and from 6700 to 11,300 for 2050. The highest estimates are from the models that use age-specific dose-response functions, while the low estimates are from the models that adjust for ozone. Estimates using the low emissions scenario are roughly half of these estimates. Mitigation based on our estimates of the effects of 10% and 20% increase in air conditioner use would generate reductions of 16% and 33% in the years 2025 and 2050, respectively. Our estimates suggest significant public health impacts associated with future projected increases in temperature. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Screening for Mental Health Problems in Adults with Learning Disabilities Using the Mini PAS-ADD Interview

    Science.gov (United States)

    Devine, Maurice; Taggart, Laurence; McLornian, Paula

    2010-01-01

    Prevalence rates vary considerably regarding the mental health of people with learning disabilities. This variation is a consequence of the assessment methods used to identify such clinical conditions and also different populations studied. The aim of this study was to screen for mental health problems in adults with mild-to-moderate learning…

  1. Adults with an epilepsy history fare significantly worse on positive mental and physical health than adults with other common chronic conditions-Estimates from the 2010 National Health Interview Survey and Patient Reported Outcome Measurement System (PROMIS) Global Health Scale.

    Science.gov (United States)

    Kobau, Rosemarie; Cui, Wanjun; Zack, Matthew M

    2017-07-01

    Healthy People 2020, a national health promotion initiative, calls for increasing the proportion of U.S. adults who self-report good or better health. The Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health Scale (GHS) was identified as a reliable and valid set of items of self-reported physical and mental health to monitor these two domains across the decade. The purpose of this study was to examine the percentage of adults with an epilepsy history who met the Healthy People 2020 target for self-reported good or better health and to compare these percentages to adults with history of other common chronic conditions. Using the 2010 National Health Interview Survey, we compared and estimated the age-standardized prevalence of reporting good or better physical and mental health among adults with five selected chronic conditions including epilepsy, diabetes, heart disease, cancer, and hypertension. We examined response patterns for physical and mental health scale among adults with these five conditions. The percentages of adults with epilepsy who reported good or better physical health (52%) or mental health (54%) were significantly below the Healthy People 2020 target estimate of 80% for both outcomes. Significantly smaller percentages of adults with an epilepsy history reported good or better physical health than adults with heart disease, cancer, or hypertension. Significantly smaller percentages of adults with an epilepsy history reported good or better mental health than adults with all other four conditions. Health and social service providers can implement and enhance existing evidence-based clinical interventions and public health programs and strategies shown to improve outcomes in epilepsy. These estimates can be used to assess improvements in the Healthy People 2020 Health-Related Quality of Life and Well-Being Objective throughout the decade. Published by Elsevier Inc.

  2. Using Qualitative Comparative Analysis of Key Informant Interviews in Health Services Research: Enhancing a Study of Adjuvant Therapy Use in Breast Cancer Care.

    Science.gov (United States)

    McAlearney, Ann Scheck; Walker, Daniel; Moss, Alexandra D; Bickell, Nina A

    2016-04-01

    Qualitative comparative analysis (QCA) is a methodology created to address causal complexity in social sciences research by preserving the objectivity of quantitative data analysis without losing detail inherent in qualitative research. However, its use in health services research (HSR) is limited, and questions remain about its application in this context. To explore the strengths and weaknesses of using QCA for HSR. Using data from semistructured interviews conducted as part of a multiple case study about adjuvant treatment underuse among underserved breast cancer patients, findings were compared using qualitative approaches with and without QCA to identify strengths, challenges, and opportunities presented by QCA. Ninety administrative and clinical key informants interviewed across 10 NYC area safety net hospitals. Transcribed interviews were coded by 3 investigators using an iterative and interactive approach. Codes were calibrated for QCA, as well as examined using qualitative analysis without QCA. Relative to traditional qualitative analysis, QCA strengths include: (1) addressing causal complexity, (2) results presentation as pathways as opposed to a list, (3) identification of necessary conditions, (4) the option of fuzzy-set calibrations, and (5) QCA-specific parameters of fit that allow researchers to compare outcome pathways. Weaknesses include: (1) few guidelines and examples exist for calibrating interview data, (2) not designed to create predictive models, and (3) unidirectionality. Through its presentation of results as pathways, QCA can highlight factors most important for production of an outcome. This strength can yield unique benefits for HSR not available through other methods.

  3. Improving care for people with heart failure in Uganda: serial in-depth interviews with patients' and their health care professionals.

    Science.gov (United States)

    Namukwaya, Elizabeth; Grant, Liz; Downing, Julia; Leng, Mhoira; Murray, Scott A

    2017-05-25

    The short prognosis of patients with advanced heart failure (HF) and the associated multidimensional distress as illustrated in literature from high income countries necessitates the integration of palliative care into the care of advanced HF patients to address these needs and improve their quality of life. These needs, which are subjective, have not been described from the patients' and health care professionals'(HPs) view point in the Ugandan setting, a low income country with a different socio-cultural context. This study aimed at bridging this gap in knowledge by eliciting patients' and HPs' views of HF patients' needs over the course of their illness to enable generalists, cardiologists and palliative care clinicians to develop guidelines to provide patient-centred realistic care in Uganda. Serial qualitative in-depth interviews were conducted with HF patients who were purposively sampled and recruited in Mulago National Referral Hospital (MNRH) until thematic saturation. In-depth interviews were conducted at three time points with intervals of 3 month between interviews over the course of their illness in the hospital and their home context. One-off interviews were conducted with HPs that manage HF in MNRH. We used a grounded theory approach in data analysis. The Uganda National Council of science and technology approved the research. Forty-eight interviews were conducted with 21 patients and their carers and eight interviews with their HPs. Multidimensional needs including physical, psychological, social, spiritual and information needs were identified. These highlighted the underpinning need to have normal functioning, control, to cope and adapt to a changed life and to find meaning. Spiritual needs were less recognised by HPs than the other multidimensional needs. Information needs were commonly unmet. Patients and HPs suggested improvements in care that were congruent with the recommendations in chronic disease care and the six pillars of the WHO

  4. 'One Medicine - One Health' interview with Ronald M. Davis, MD, President of the American Medical Association, 14 May 2008.

    Science.gov (United States)

    Kahn, Laura H

    2009-01-01

    A brief account is presented of the unique historical background leading up to the American Medical Association (AMA) adopting a landmark 'One Health' resolution in June 2007. The historic 'One Health' liaison between the American Veterinary Medical Association (AVMA) and AMA was fostered by collaboration between Roger Mahr and Ron Davis when they were both serving as Presidents of their respective organisations. This cooperative relationship resulted in what has been referred to as the 'One Health initiative' in the United States. National and global implementation is the goal.

  5. The invisible work of personal health information management among people with multiple chronic conditions: qualitative interview study among patients and providers.

    Science.gov (United States)

    Ancker, Jessica S; Witteman, Holly O; Hafeez, Baria; Provencher, Thierry; Van de Graaf, Mary; Wei, Esther

    2015-06-04

    A critical problem for patients with chronic conditions who see multiple health care providers is incomplete or inaccurate information, which can contribute to lack of care coordination, low quality of care, and medical errors. As part of a larger project on applications of consumer health information technology (HIT) and barriers to its use, we conducted a semistructured interview study with patients with multiple chronic conditions (MCC) with the objective of exploring their role in managing their personal health information. Semistructured interviews were conducted with patients and providers. Patients were eligible if they had multiple chronic conditions and were in regular care with one of two medical organizations in New York City; health care providers were eligible if they had experience caring for patients with multiple chronic conditions. Analysis was conducted from a grounded theory perspective, and recruitment was concluded when saturation was achieved. A total of 22 patients and 7 providers were interviewed; patients had an average of 3.5 (SD 1.5) chronic conditions and reported having regular relationships with an average of 5 providers. Four major themes arose: (1) Responsibility for managing medical information: some patients perceived information management and sharing as the responsibility of health care providers; others—particularly those who had had bad experiences in the past—took primary responsibility for information sharing; (2) What information should be shared: although privacy concerns did influence some patients' perceptions of sharing of medical data, decisions about what to share were also heavily influenced by their understanding of health and disease and by the degree to which they understood the health care system; (3) Methods and tools varied: those patients who did take an active role in managing their records used a variety of electronic tools, paper tools, and memory; and (4) Information management as invisible work

  6. Could the Health Decline of Prehistoric California Indians be Related to Exposure to Polycyclic Aromatic Hydrocarbons (PAHs) from Natural Bitumen?

    Science.gov (United States)

    Sholts, Sabrina B.; Erlandson, Jon M.; Gjerdrum, Thor; Westerholm, Roger

    2011-01-01

    Background: The negative health effects of polycyclic aromatic hydrocarbons (PAHs) are well established for modern human populations but have so far not been studied in prehistoric contexts. PAHs are the main component of fossil bitumen, a naturally occurring material used by past societies such as the Chumash Indians in California as an adhesive, as a waterproofing agent, and for medicinal purposes. The rich archaeological and ethnohistoric record of the coastal Chumash suggests that they were exposed to multiple uptake pathways of bituminous PAHs, including direct contact, fume inhalation, and oral uptake from contaminated water and seafood. Objectives: We investigated the possibility that PAHs from natural bitumen compromised the health of the prehistoric Chumash Indians in California. Conclusions: Exposure of the ancient Chumash Indians to toxic PAHs appears to have gradually increased across a period of 7,500 years because of an increased use of bitumen in the Chumash technology, together with a dietary shift toward PAH-contaminated marine food. Skeletal analysis indicates a concurrent population health decline that may be related to PAH uptake. However, establishing such a connection is virtually impossible without knowing the actual exposure levels experienced by these populations. Future methodological research may provide techniques for determining PAH levels in ancient skeletal material, which would open new avenues for research on the health of prehistoric populations and on the long-term effects of human PAH exposure. PMID:21596651

  7. Mixing modes in a population-based interview survey: comparison of a sequential and a concurrent mixed-mode design for public health research.

    Science.gov (United States)

    Mauz, Elvira; von der Lippe, Elena; Allen, Jennifer; Schilling, Ralph; Müters, Stephan; Hoebel, Jens; Schmich, Patrick; Wetzstein, Matthias; Kamtsiuris, Panagiotis; Lange, Cornelia

    2018-01-01

    Population-based surveys currently face the problem of decreasing response rates. Mixed-mode designs are now being implemented more often to account for this, to improve sample composition and to reduce overall costs. This study examines whether a concurrent or sequential mixed-mode design achieves better results on a number of indicators of survey quality. Data were obtained from a population-based health interview survey of adults in Germany that was conducted as a methodological pilot study as part of the German Health Update (GEDA). Participants were randomly allocated to one of two surveys; each of the surveys had a different design. In the concurrent mixed-mode design ( n  = 617) two types of self-administered questionnaires (SAQ-Web and SAQ-Paper) and computer-assisted telephone interviewing were offered simultaneously to the respondents along with the invitation to participate. In the sequential mixed-mode design ( n  = 561), SAQ-Web was initially provided, followed by SAQ-Paper, with an option for a telephone interview being sent out together with the reminders at a later date. Finally, this study compared the response rates, sample composition, health indicators, item non-response, the scope of fieldwork and the costs of both designs. No systematic differences were identified between the two mixed-mode designs in terms of response rates, the socio-demographic characteristics of the achieved samples, or the prevalence rates of the health indicators under study. The sequential design gained a higher rate of online respondents. Very few telephone interviews were conducted for either design. With regard to data quality, the sequential design (which had more online respondents) showed less item non-response. There were minor differences between the designs in terms of their costs. Postage and printing costs were lower in the concurrent design, but labour costs were lower in the sequential design. No differences in health indicators were found between

  8. What are the physical and psychological health effects of suicide bereavement on family members? Protocol for an observational and interview mixed-methods study in Ireland.

    Science.gov (United States)

    Spillane, Ailbhe; Larkin, Celine; Corcoran, Paul; Matvienko-Sikar, Karen; Arensman, Ella

    2017-03-30

    Research indicates that experiencing the suicide of a relative can have a significant impact on family members' emotional health. However, research incorporating the impact of suicide bereavement on family members' physical health is sparse. This paper details the protocol for a mixed-methods study of suicide-bereaved family members. The study will primarily examine the physical and mental health needs of those bereaved by suicide. A secondary objective of the study is to describe the support service needs of family members bereaved by suicide. A mixed-methods approach, using semistructured interviews and self-report questionnaires, will be used. Interviews will be conducted with a group of 15-20 relatives who experienced suicide bereavement. This protocol will follow the COREQ checklist criteria for the reporting of qualitative research interviews. Thematic analysis will be used to examine experiences and impact of bereavement on psychological and physical health. Self-report quantitative data on well-being will be analysed using descriptive statistics. Ethical approval to conduct this study has been granted from the Clinical Research Ethics Committee of the Cork Teaching Hospitals. Pseudonyms will be given to participants to protect anonymity. It will be explained to participants that participation in the study is voluntary and they have to right to withdraw at any time. The findings of this research will be disseminated to regional, national and international audiences through publication in peer-reviewed international journals and presentations at scientific conferences. This research also forms part of a PhD thesis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. [Prevalence and temporal trend of known diabetes mellitus: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

    Science.gov (United States)

    Heidemann, C; Du, Y; Schubert, I; Rathmann, W; Scheidt-Nave, C

    2013-05-01

    The first wave of the "German Health Interview and Examination Survey for Adults" (DEGS1, 2008-2011) allows for up-to-date, representative prevalence estimates of known diabetes amongst the 18- to 79-year-old resident population of Germany. Temporal trends can be shown by comparing the survey findings with those of the "German National Health Interview and Examination Survey 1998" (GNHIES98). The definition of known diabetes was based on self-reports in physician-administered interviews that asked respondents if they had ever been diagnosed with diabetes by a doctor or were on anti-diabetic medication. Overall, diabetes had been diagnosed in 7.2 % of the adults (7.4 % of the women; 7.0 % of the men). The prevalence increased substantially with advancing age and was higher in persons of low than of high socioeconomic status. Prevalence varied depending on the type of health insurance held and was highest amongst those insured with AOK health insurance funds. In comparison with GNHIES98, there was a 38 % increase in prevalence, of which approximately one third is to be attributed to demographic ageing. In the context of other nationwide studies, the results indicate a figure of at least 4.6 million 18- to 79-year-olds having been diagnosed with diabetes at some point. Planned analyses of undiagnosed diabetes will contribute to the interpretation of the observed increase in the prevalence of known diabetes. An English full-text version of this article is available at SpringerLink as supplemental.

  10. Understanding School Health Environment through Interviews with Key Stakeholders in Lao PDR, Mongolia, Nepal and Sri Lanka

    Science.gov (United States)

    Park, Sohyun; Lee, Eun Young; Gittelsohn, Joel; Nkala, Denis; Choi, Bo Youl

    2015-01-01

    Studies on health promoting schools (HPS) in low- and middle-income countries (LMICs) are scarce. To contribute to the development of HPS in these countries, we conducted formative research to understand the school environment in Lao PDR, Mongolia, Nepal, and Sri Lanka. Forty-three teachers, 10 government workers and 5 parents participated in…

  11. Does uninsurance affect the health outcomes of the insured? Evidence from heart attack patients in California

    NARCIS (Netherlands)

    Meltem Daysal, N.

    2012-01-01

    In this paper, I examine the impact of uninsured patients on the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California (1999–2006). My results indicate that uninsured patients have an economically

  12. Medicaid Spending Differences for Child/Youth Community-Based Care in California's Decentralized Public Mental Health System.

    Science.gov (United States)

    Vanneman, Megan E; Snowden, Lonnie R; Dow, William H

    2018-01-01

    This study evaluated spending differences across counties during the decade after California decentralized its public mental health system. Medicaid data for 0-25 year olds using mental health services were collapsed to the county-year level (n = 627). Multivariate models with county fixed effects were used to predict per capita spending for community-based mental health care. While counties increased their spending over time, those with relatively low initial expenditures per user continued to spend less than counties with historically higher spending levels. Spending differences per user were most noticeable in counties with larger racial/ethnic minority populations that also had historically lower spending levels.

  13. Health and safety impacts of nuclear, geothermal, and fossil-fuel electric generation in California. Volume 4. Radiological emergency response planning for nuclear power plants in California

    Energy Technology Data Exchange (ETDEWEB)

    Yen, W.W.S.

    1977-01-01

    This report reviews the state of emergency response planning for nuclear power plants in California. Attention is given to the role of Federal agencies, particularly the Nuclear Regulatory Commission, in planning for both on and off site emergency measures and to the role of State and local agencies for off site planning. The relationship between these various authorities is considered. Existing emergency plans for nuclear power plants operating or being constructed in California are summarized. The developing role of the California Energy Resources Conservation and Development Commission is examined.

  14. [Prevalence and Comorbidity of Self-Reported Diagnosis of Burnout Syndrome in the General Population - Results of the German Health Interview and Examination Survey for Adults (DEGS1)].

    Science.gov (United States)

    Maske, Ulrike E; Riedel-Heller, Steffi G; Seiffert, Ingeburg; Jacobi, Frank; Hapke, Ulfert

    2016-01-01

    Objective: To determine the prevalence and comorbid mental disorders of self-reported diagnosis of burnout syndrome in the general population of Germany. Methods: In the German Health Interview and Examination Survey (DEGS1) self-reported diagnosis of a burnout syndrome made by a physician or psychotherapist was assessed in a standardized interview (N = 7987). For N = 4483 mental disorders were determined with the Composite International Diagnostic Interview (CIDI). Weighted lifetime and 12-month prevalences were calculated. Results: Lifetime prevalence of diagnosed burnout syndrome was 4.2 % (women 5.2 %, men 3.3 %), 12-month prevalence was 1.5 % (women 1.9 %, men 1.1 %). Highest prevalences were found in 40 - 59 year olds, in people with middle and high socio-economic status and in women with low and men with high social support. Among the 12-month cases, 70.9 % had at least one DSM-IV disorder. Associations were found for the diagnosis of burnout syndrome with somatoform, affective and anxiety disorders. Conclusion: The diagnosis of burnout syndrome is less frequently given and reported than expected. People with a burnout diagnosis often have a manifest mental disorder. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Nursing intervention by telephone interviews of patients aged over 65 years after total hip replacement improves health status: a randomised clinical trial Nursing intervention by telephone interviews of patients aged over 65 years after total hip replacement improves health status: a randomised

    DEFF Research Database (Denmark)

    Hørdam, Britta

    2010-01-01

    Nursing intervention by telephone interviews of patients aged over 65 years after total hip replacement improves health status: a randomised clinical trial Objective: We hypothesised that all areas of health status after total hip replacement could be improved in patients aged over 65 years...... postoperatively was carried out. Sample: 180 patients aged 65 years and over were randomised 4 weeks preoperatively to either control or intervention groups. Measurements: both groups received conventional surgical treatment, but the intervention group was interviewed by telephone 2 and 10 weeks after surgery....... Patients were given counselling within eight main dimensions with reference to their postoperative situation. Results: All patients experienced improvement in health status. The intervention significantly reduced the time patients needed to reach their habitual levels in three of eight areas...

  16. [Factors and prosesses associated with weight loss in male workers in a specific health guidance program. A qualitative analysis of in-depth interviews].

    Science.gov (United States)

    Hayashi, Fumi; Akamatsu, Rie; Ebina, Ryoko; Nishimura, Setsuko; Okuyama, Megumi; Matsuoka, Yukiyo; Nakamura, Masakazu; Sakane, Naoki; Adachi, Yoshiko; Takemi, Yukari

    2012-03-01

    A qualitative analysis was conducted to identify factors important for weight loss through a specific health guidance program and to understand the processes that were crucial in achieving success. Twenty-six male workers aged 41-59 years from five corporate health insurance societies in four prefectures who had lost > or = 4% weight by attending the six-month specific health guidance program were invited to participate in the in-depth interviews. Data were collected between October and December 2009. We audio taped the 30-minute interviews and performed qualitative analysis on the transcripts using a grounded theory. The discussion by the expert panel strengthened the validity of the analysis. The mean age was 49.9 +/- 5.6 years, and the average weight loss was 6.8 +/- 2.5%. All subjects were somewhat concerned about their health status and body shape before the first appointment, but two major prosesses, "critical feeling" and "sense of obligation," were identified after the first appointment. We also identified innovative efforts in all subjects during the process. Those who reported a "sense of obligation" at the beginning and those who had a negative perception during the program were found to have higher risks of weight rebound after the program was over. We considered personality, values, attitudes toward the program, and support from both family and workplace as the intervening conditions for behavior modification. Since everyone aged 40-74 years with a certain risk of metabolic syndromes is obligated by law to participate in the specific health guidance program, weight loss is challenging for those who are not motivated enough to change their behaviors. Therefore, the initial assessment of one's motivations, followed by interventions taken in consideration of one's lifestyle and social background, are crucial for the success of a weight loss program, as is the use of a client-centered approach.

  17. [Sociodemographic characteristics in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) - operationalisation and public health significance, taking as an example the assessment of general state of health].

    Science.gov (United States)

    Lange, M; Kamtsiuris, P; Lange, C; Schaffrath Rosario, A; Stolzenberg, H; Lampert, T

    2007-01-01

    The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) was conducted from May 2003 to May 2006 by the Robert Koch Institute in 167 communities representative of Germany. By collecting comprehensive and nationally representative data on the health status of children and adolescents aged 0 to 17 years, the study aimed to fill a longstanding evidence gap. Data from 17,641 study participants will be analysed in a timely and systematic manner by the Robert Koch Institute. Initially mainly descriptive analyses as presented in the current special issue on the KiGGS study, provide information on the distribution of main health characteristics according to sociodemographic key variables, including age, sex, region of residence (former East/West Germany), social status, and migrant background. We report here the rationale for a standard set of stratifying variables and the operationalisation of composite variables. Furthermore, we illustrate the public health relevance of the observed group differences using the example of an important health indicator: parents' evaluation of their children's general state of health.

  18. Motivational Interviewing by School Nurses

    DEFF Research Database (Denmark)

    Bonde, Ane; Bentsen, Peter; Hindhede, Anette Lykke

    and children of different ages. When used for child obesity prevention, motivational interviewing was connected with dilemmas which should not be left to the individual nurse but be handled in practice by the school health service management. It is suggested to distinguish carefully between obesity prevention...... a prevention strategy targeting children with a high risk of obesity with an intervention conducted by school nurses using motivational interviewing.Motivational interviewing is a counselling method to bring about behavioural change (Miller and Rollnick 1995). Effect has been documented for a range of problem...... for what data told about motivational interviewing. Next, specifically according to the keywords of the motivational interviewing spirit and techniques. Key results : The study showed that the motivational interviewing spirit and techniques are integrated, inseparable, and adapted by the school nurses...

  19. Validity of an interviewer-administered patient health questionnaire-9 to screen for depression in HIV-infected patients in Cameroon.

    Science.gov (United States)

    Pence, Brian W; Gaynes, Bradley N; Atashili, Julius; O'Donnell, Julie K; Tayong, Gladys; Kats, Dmitry; Whetten, Rachel; Whetten, Kathryn; Njamnshi, Alfred K; Ndumbe, Peter M

    2012-12-20

    In high-income countries, depression is prevalent in HIV patients and is associated with lower medication adherence and clinical outcomes. Emerging evidence from low-income countries supports similar relationships. Yet little research has validated rapid depression screening tools integrated into routine HIV clinical care. Using qualitative methods, we adapted the Patient Health Questionnaire-9 (PHQ-9) depression screening instrument for use with Cameroonian patients. We then conducted a cross-sectional validity study comparing an interviewer-administered PHQ-9 to the reference standard Composite International Diagnostic Interview in 400 patients on antiretroviral therapy attending a regional HIV treatment center in Bamenda, Cameroon. The prevalence of major depressive disorder (MDD) in the past month was 3% (n=11 cases). Using a standard cutoff score of ≥10 as a positive depression screen, the PHQ-9 had estimated sensitivity of 27% (95% confidence interval: 6-61%) and specificity of 94% (91-96%), corresponding to positive and negative likelihood ratios of 4.5 and 0.8. There was little evidence of variation in specificity by gender, number of HIV symptoms, or result of a dementia screen. The low prevalence of MDD yielded very imprecise sensitivity estimates. Although the PHQ-9 was developed as a self-administered tool, we assessed an interviewer-administered version due to the literacy level of the target population. The PHQ-9 demonstrated high specificity but apparently low sensitivity for detecting MDD in this sample of HIV patients in Cameroon. Formative work to define the performance of proven screening tools in new settings remains important as research on mental health expands in low-income countries. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. Quality of primary care for resettled refugees in the Netherlands with chronic mental and physical health problems: a cross-sectional analysis of medical records and interview data.

    Science.gov (United States)

    van Melle, Marije A; Lamkaddem, Majda; Stuiver, Martijn M; Gerritsen, Annette A M; Devillé, Walter L J M; Essink-Bot, Marie-Louise

    2014-09-23

    A high prevalence of mental and physical ill health among refugees resettled in the Netherlands has been reported. With this study we aim to assess the quality of primary healthcare for resettled refugees in the Netherlands with chronic mental and non-communicable health problems, we examined: a) general practitioners' (GP) recognition of common mental disorders (CMD) (depression and anxiety, and post-traumatic stress disorder (PTSD) symptoms); b) patients' awareness of diabetes type II (DMII) and hypertension (HT); and c) GPs' adherence to guidelines for CMD, DMII and HT. From 172 refugees resettled in the Netherlands, interview data (2010-2011) and medical records (n = 106), were examined. Inclusion was based on medical record diagnoses for DMII and HT, and on questionnaire-based CMD measures (Hopkins Symptom Checklist for depression and anxiety; Harvard Trauma Questionnaire for PTSD). GP recognition of CMD was calculated as the number of CMD cases registered in the medical record compared with those found in interviews. Patient awareness of HT and DMII was scored as the percentage of subjects diagnosed by the GP who reported their condition during the interview. GPs' adherence to guidelines for CMD, DMII and HT was measured using established indicators. We identified 37 resettled refugees with CMD of which 18 (49%) had been recognised by the GP. We identified 16 refugees with DMII and 14 with HT from the medical record; 24 (80%) were aware of their condition. Thirty-five out of these 53 (66%) resettled refugees with chronic mental and non-communicable disorders received guideline-adherent treatment. This study shows that awareness in resettled refugees of GP diagnosed DMII and HT is high, whereas GP recognition of CMD and overall guideline adherence are moderate.

  1. Self-reported health-related quality of life in persons with HIV infection: results from a multi-site interview project

    Directory of Open Access Journals (Sweden)

    Nakashima Allyn K

    2003-04-01

    Full Text Available Abstract Background To examine demographic and behavioral associations with self-reported health-related quality of life (HRQOL among persons with HIV infection or AIDS. Methods Analysis of interviews with persons ≥ 18 years of age reported through routine disease surveillance with HIV infection or AIDS to nine state and local health departments from January 1995 through December 1996. Scales were constructed from validated measures of HRQOL, and mean scores were calculated (lower scores signified poorer HRQOL. Measures of HRQOL included Overall Health, Pain, Physical Functioning, Role Functioning, Social Functioning, Mental Health, Energy/Fatigue, and Cognitive Functioning. Differences in HRQOL were examined by various demographic and behavioral factors, including taking antiretroviral medication. Results HRQOL data were available for 3778 persons. Factors associated with lower HRQOL scores included older age, female sex, black or Hispanic race/ethnicity, injection drug use, lower education and income, no private health insurance, and lower CD4 count. In multivariate analysis, lower CD4 count was the factor most consistently associated with lower HRQOL. Taking antiretroviral medication was not associated with differences in HRQOL regardless of CD4 count. Conclusions Perception of HRQOL varied in a population with HIV infection or AIDS. On most HRQOL measures, lower CD4 count was associated with lower HRQOL. Measurement of HRQOL can assist in understanding the long-term effects of disease and treatment on persons with HIV.

  2. Is it worth it? Patient and public views on the impact of their involvement in health research and its assessment: a UK-based qualitative interview study.

    Science.gov (United States)

    Crocker, Joanna C; Boylan, Anne-Marie; Bostock, Jennifer; Locock, Louise

    2017-06-01

    There are mounting calls for robust, critical evaluation of the impact of patient and public involvement (PPI) in health research. However, questions remain about how to assess its impact, and whether it should be assessed at all. The debate has thus far been dominated by professionals. To explore the views of PPI contributors involved in health research regarding the impact of PPI on research, whether and how it should be assessed. Qualitative interview study. Thirty-eight PPI contributors involved in health research across the UK. Participants felt that PPI has a beneficial impact on health research. They described various impactful roles, which we conceptualize as the 'expert in lived experience', the 'creative outsider', the 'free challenger', the 'bridger', the 'motivator' and the 'passive presence'. Participants generally supported assessing the impact of PPI, while acknowledging the challenges and concerns about the appropriateness and feasibility of measurement. They expressed a range of views about what impacts should be assessed, by whom and how. Individual feedback on impact was seen as an important driver of improved impact and motivation to stay involved. While there appears to be widespread support for PPI impact assessment among PPI contributors, their views on what to assess and how are diverse. PPI contributors should be involved as equal partners in debates and decisions about these issues. Individual feedback on impact may increase PPI contributors' potential impact and their motivation to stay involved. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  3. California Bioregions

    Data.gov (United States)

    California Department of Resources — California regions developed by the Inter-agency Natural Areas Coordinating Committee (INACC) were digitized from a 1:1,200,000 California Department of Fish and...

  4. Environmental and Environmental-Health Implications of the USGS SAFRR California Tsunami Scenario

    Science.gov (United States)

    Plumlee, G. S.; Morman, S. A.; San Juan, C. A.

    2013-12-01

    The California Tsunami Scenario models the impacts of a hypothetical yet plausible tsunami caused by an earthquake offshore from the Alaskan Peninsula. Here, we interpret plausible tsunami-related contamination, environmental impacts, potential for human exposures to contaminants and hazardous materials, and implications for remediation and recovery. Inundation-related damages to major ports, boat yards, and many marinas could release complex debris, crude oil, various fuel types, other petroleum products, some liquid bulk cargo and dry bulk cargo, and diverse other pollutants into nearby coastal marine environments and onshore in the inundation zone. Tsunami-induced erosion of contaminated harbor bottom sediments could re-expose previously sequestered metal and organic pollutants (e.g., organotin, DDT). Inundation-related damage to many older buildings could produce complex debris containing lead paint, asbestos, pesticides, and other legacy contaminants. Intermingled household debris and externally derived debris and sediments would be left in flooded buildings. Post tsunami, mold would likely develop in inundated houses, buildings, and debris piles. Tsunamigenic fires in spilled oil, debris, cargo, vehicles, vegetation, and residential, commercial, or industrial buildings and their contents would produce potentially toxic gases and smoke, airborne ash, and residual ash/debris containing caustic alkali solids, metal toxicants, asbestos, and various organic toxicants. Inundation of and damage to wastewater treatment plants in many coastal cities could release raw sewage containing fecal solids, pathogens, and waste chemicals, as well as chemicals used to treat wastewaters. Tsunami-related physical damages, debris, and contamination could have short- and longer-term impacts on the environment and the health of coastal marine and terrestrial ecosystems. Marine habitats in intertidal zones, marshes, sloughs, and lagoons could be damaged by erosion or sedimentation

  5. Use of focus group interviews with public health nurses to identify the efforts of and challenges faced by branches of the Japan Health Insurance Association to achieve good performance of the Specific Health Guidance initiatives.

    Science.gov (United States)

    Hayashi, Fumi; Ozawa, Keiko; Kawabata, Teruko; Takemi, Yukari

    2016-01-01

    Objectives Aiming at improvement of the Japan Health Insurance Association's Specific Health Guidance initiatives and human resource development, we conducted a qualitative study to clarify the features necessary for and the challenges hindering the achievement of good performance of the initiatives.Methods From November 2014 to January 2015, we conducted 10 focus group interviews, each 90 minutes long, with 64 public health nurses from 10 Japan Health Insurance Association branches. In addition, self-administered questionnaires were administered to obtain the participants' basic characteristics. After we excluded one group for failing to meet our performance targets, we divided the remaining nine focus groups according to two patterns: Maintenance and Progress. The four focus groups fitting the Maintenance pattern had a well-established track record, and the five focus groups fitting the Progress pattern had a track record of good growth. Using open coding of the interview transcripts, we extracted efforts or needs in two domains, individual and branch, Then, we placed codes in eight main categories: [quality], [general practice], [dietary guidance practice], [success factor], [branch system], [training and skill development], [approach to the member office], and [past efforts]. We further extracted important subcategories based on their rates of appearance within branches.Results Data from 56 female public health nurses working at nine branches were included in the analysis. With respect to the individual domain, subcategories such as "building rapport," "creating the physical environment," and "taking the initiative in evaluating one's own lifestyle" in the 〈high emphasis〉 segment of the [general practice] category were common to both patterns. In addition, "increasing opportunities for training" and "enhancement of training program content" were found for both patterns in relation to the 〈demand〉 segment of the [training and skill development

  6. Responding to Young People’s Health Risks in Primary Care: A Cluster Randomised Trial of Training Clinicians in Screening and Motivational Interviewing

    Science.gov (United States)

    Sanci, Lena; Chondros, Patty; Sawyer, Susan; Pirkis, Jane; Ozer, Elizabeth; Hegarty, Kelsey; Yang, Fan; Grabsch, Brenda; Shiell, Alan; Cahill, Helen; Ambresin, Anne-Emmanuelle; Patterson, Elizabeth; Patton, George

    2015-01-01

    Objective To evaluate the effectiveness of a complex intervention implementing best practice guidelines recommending clinicians screen and counsel young people across multiple psychosocial risk factors, on clinicians’ detection of health risks and patients’ risk taking behaviour, compared to a didactic seminar on young people’s health. Design Pragmatic cluster randomised trial where volunteer general practices were stratified by postcode advantage or disadvantage score and billing type (private, free national health, community health centre), then randomised into either intervention or comparison arms using a computer generated random sequence. Three months post-intervention, patients were recruited from all practices post-consultation for a Computer Assisted Telephone Interview and followed up three and 12 months later. Researchers recruiting, consenting and interviewing patients and patients themselves were masked to allocation status; clinicians were not. Setting General practices in metropolitan and rural Victoria, Australia Participants General practices with at least one interested clinician (general practitioner or nurse) and their 14–24 year old patients. Intervention This complex intervention was designed using evidence based practice in learning and change in clinician behaviour and general practice systems, and included best practice approaches to motivating change in adolescent risk taking behaviours. The intervention involved training clinicians (nine hours) in health risk screening, use of a screening tool and motivational interviewing; training all practice staff (receptionists and clinicians) in engaging youth; provision of feedback to clinicians of patients’ risk data; and two practice visits to support new screening and referral resources. Comparison clinicians received one didactic educational seminar (three hours) on engaging youth and health risk screening. Outcome Measures Primary outcomes were patient report of (1) clinician

  7. Responding to Young People's Health Risks in Primary Care: A Cluster Randomised Trial of Training Clinicians in Screening and Motivational Interviewing.

    Science.gov (United States)

    Sanci, Lena; Chondros, Patty; Sawyer, Susan; Pirkis, Jane; Ozer, Elizabeth; Hegarty, Kelsey; Yang, Fan; Grabsch, Brenda; Shiell, Alan; Cahill, Helen; Ambresin, Anne-Emmanuelle; Patterson, Elizabeth; Patton, George

    2015-01-01

    To evaluate the effectiveness of a complex intervention implementing best practice guidelines recommending clinicians screen and counsel young people across multiple psychosocial risk factors, on clinicians' detection of health risks and patients' risk taking behaviour, compared to a didactic seminar on young people's health. Pragmatic cluster randomised trial where volunteer general practices were stratified by postcode advantage or disadvantage score and billing type (private, free national health, community health centre), then randomised into either intervention or comparison arms using a computer generated random sequence. Three months post-intervention, patients were recruited from all practices post-consultation for a Computer Assisted Telephone Interview and followed up three and 12 months later. Researchers recruiting, consenting and interviewing patients and patients themselves were masked to allocation status; clinicians were not. General practices in metropolitan and rural Victoria, Australia. General practices with at least one interested clinician (general practitioner or nurse) and their 14-24 year old patients. This complex intervention was designed using evidence based practice in learning and change in clinician behaviour and general practice systems, and included best practice approaches to motivating change in adolescent risk taking behaviours. The intervention involved training clinicians (nine hours) in health risk screening, use of a screening tool and motivational interviewing; training all practice staff (receptionists and clinicians) in engaging youth; provision of feedback to clinicians of patients' risk data; and two practice visits to support new screening and referral resources. Comparison clinicians received one didactic educational seminar (three hours) on engaging youth and health risk screening. Primary outcomes were patient report of (1) clinician detection of at least one of six health risk behaviours (tobacco, alcohol and

  8. Responding to Young People's Health Risks in Primary Care: A Cluster Randomised Trial of Training Clinicians in Screening and Motivational Interviewing.

    Directory of Open Access Journals (Sweden)

    Lena Sanci

    Full Text Available To evaluate the effectiveness of a complex intervention implementing best practice guidelines recommending clinicians screen and counsel young people across multiple psychosocial risk factors, on clinicians' detection of health risks and patients' risk taking behaviour, compared to a didactic seminar on young people's health.Pragmatic cluster randomised trial where volunteer general practices were stratified by postcode advantage or disadvantage score and billing type (private, free national health, community health centre, then randomised into either intervention or comparison arms using a computer generated random sequence. Three months post-intervention, patients were recruited from all practices post-consultation for a Computer Assisted Telephone Interview and followed up three and 12 months later. Researchers recruiting, consenting and interviewing patients and patients themselves were masked to allocation status; clinicians were not.General practices in metropolitan and rural Victoria, Australia.General practices with at least one interested clinician (general practitioner or nurse and their 14-24 year old patients.This complex intervention was designed using evidence based practice in learning and change in clinician behaviour and general practice systems, and included best practice approaches to motivating change in adolescent risk taking behaviours. The intervention involved training clinicians (nine hours in health risk screening, use of a screening tool and motivational interviewing; training all practice staff (receptionists and clinicians in engaging youth; provision of feedback to clinicians of patients' risk data; and two practice visits to support new screening and referral resources. Comparison clinicians received one didactic educational seminar (three hours on engaging youth and health risk screening.Primary outcomes were patient report of (1 clinician detection of at least one of six health risk behaviours (tobacco, alcohol

  9. Measuring the Prevalence of Diagnosed Chronic Obstructive Pulmonary Disease in the United States Using Data From the 2012-2014 National Health Interview Survey.

    Science.gov (United States)

    Ward, Brian W; Nugent, Colleen N; Blumberg, Stephen J; Vahratian, Anjel

    This study, measuring the prevalence of chronic obstructive pulmonary disease (COPD), examined (1) whether a single survey question asking explicitly about diagnosed COPD is sufficient to identify US adults with COPD and (2) how this measure compares with estimating COPD prevalence using survey questions on diagnosed emphysema and/or chronic bronchitis and all 3 survey questions together. We used data from the 2012-2014 National Health Interview Survey to examine different measures of prevalence among 7211 US adults who reported a diagnosed respiratory condition (ie, emphysema, chronic bronchitis, and/or COPD). We estimated a significantly higher prevalence of COPD by using a measure accounting for all 3 diagnoses (6.1%; 95% CI, 5.9%-6.3%) than by using a measure of COPD diagnosis only (3.0%; 95% CI, 2.8%-3.1%) or a measure of emphysema and/or chronic bronchitis diagnoses (4.7%; 95% CI, 4.6%-4.9%). This pattern was significant among all subgroups examined except for non-Hispanic Asian adults. The percentage difference between measures of COPD was larger among certain subgroups (adults aged 18-39, Hispanic adults, and never smokers); additional analyses showed that this difference resulted from a large proportion of adults in these subgroups reporting a diagnosis of chronic bronchitis only. With the use of self- or patient-reported health survey data such as the National Health Interview Survey, it is recommended that a measure asking respondents only about COPD diagnosis is not adequate for estimating the prevalence of COPD. Instead, a measure accounting for diagnoses of emphysema, chronic bronchitis, and/or COPD may be a better measure. Additional analyses should explore the reliability and validation of survey questions related to COPD, with special attention toward questions on chronic bronchitis.

  10. Cognitive interviewing of bereaved relatives to improve the measurement of health outcomes and care utilisation at the end of life in a mortality followback survey.

    Science.gov (United States)

    Gomes, Barbara; McCrone, Paul; Hall, Sue; Riley, Julia; Koffman, Jonathan; Higginson, Irene J

    2013-10-01

    The evaluation of end of life care via bereaved relatives is increasingly common. We aimed to improve the measurement of health outcomes and care utilisation at the end of life with this population. A cross-sectional study of 20 bereaved relatives of cancer patients was conducted. In phase I, nine underwent a cognitive interview for 65-150 min using five measures: Client Service Receipt Inventory, Life Before Death survey care satisfaction items, Palliative care Outcome Scale (POS), EQ-5D and Core Bereavement Items (CBI). In phase II, items/scales were revised and tested with a further 11 participants. Content analysis explored information processing and errors. All 20 participants understood most questions despite finding them demanding and intense. Judging the accuracy of information and formulating final answers posed more difficulties than recalling facts. Uncertainty and missing data on care utilisation were often due to estimating averages; consequently categories were introduced. Participants perceived the care satisfaction rating scale to be positively biased; a very poor category was added. POS was seen to ask relevant but sometimes difficult questions, whilst the EQ-5D produced fewer missing data but lacked intermediate categories. CBI had terms that participants felt were unfamiliar, unrealistic, unclear or too strong; hence, we changed to the Texas Revised Inventory of Grief (with no problems identified). Cognitive interviewing helped select measures and make changes that improved the measurement of health outcomes and care utilisation at the end of life with bereaved relatives. The use of both generic and specific health measures and cost measurement in bereavement is encouraged.

  11. The acceptability among health researchers and clinicians of social media to translate research evidence to clinical practice: mixed-methods survey and interview study.

    Science.gov (United States)

    Tunnecliff, Jacqueline; Ilic, Dragan; Morgan, Prue; Keating, Jennifer; Gaida, James E; Clearihan, Lynette; Sadasivan, Sivalal; Davies, David; Ganesh, Shankar; Mohanty, Patitapaban; Weiner, John; Reynolds, John; Maloney, Stephen

    2015-05-20

    Establishing and promoting connections between health researchers and health professional clinicians may help translate research evidence to clinical practice. Social media may have the capacity to enhance these connections. The aim of this study was to explore health researchers' and clinicians' current use of social media and their beliefs and attitudes towards the use of social media for communicating research evidence. This study used a mixed-methods approach to obtain qualitative and quantitative data. Participation was open to health researchers and clinicians. Data regarding demographic details, current use of social media, and beliefs and attitudes towards the use of social media for professional purposes were obtained through an anonymous Web-based survey. The survey was distributed via email to research centers, educational and clinical institutions, and health professional associations in Australia, India, and Malaysia. Consenting participants were stratified by country and role and selected at random for semistructured telephone interviews to explore themes arising from the survey. A total of 856 participants completed the questionnaire with 125 participants declining to participate, resulting in a response rate of 87.3%. 69 interviews were conducted with participants from Australia, India, and Malaysia. Social media was used for recreation by 89.2% (749/840) of participants and for professional purposes by 80.0% (682/852) of participants. Significant associations were found between frequency of professional social media use and age, gender, country of residence, and graduate status. Over a quarter (26.9%, 229/852) of participants used social media for obtaining research evidence, and 15.0% (128/852) of participants used social media for disseminating research evidence. Most participants (95.9%, 810/845) felt there was a role for social media in disseminating or obtaining research evidence. Over half of the participants (449/842, 53.3%) felt they had a

  12. Perspectives of key stakeholders regarding task shifting of care for HIV patients in Mozambique: a qualitative interview-based study with Ministry of Health leaders, clinicians, and donors.

    Science.gov (United States)

    Rustagi, Alison S; Manjate, Rosa Marlene; Gloyd, Stephen; John-Stewart, Grace; Micek, Mark; Gimbel, Sarah; Sherr, Kenneth

    2015-04-01

    Task shifting is a common strategy to deliver antiretroviral therapy (ART) in resource-limited settings and is safe and effective if implemented appropriately. Consensus among stakeholders is necessary to formulate clear national policies that maintain high-quality care. We sought to understand key stakeholders' opinions regarding task shifting of HIV care in Mozambique and to characterize which specific tasks stakeholders considered appropriate for specific cadres of health workers. National and provincial Ministry of Health leaders, representatives from donor and non-governmental organizations (NGOs), and clinicians providing HIV care were intentionally selected to represent diverse viewpoints. Using open- and closed-ended questions, interviewees were asked about their general support of task shifting, its potential advantages and disadvantages, and whether each of seven cadres of non-physician health workers should perform each of eight tasks related to ART provision. Responses were tallied overall and stratified by current job category. Interviews were conducted between November 2007 and June 2008. Of 62 stakeholders interviewed, 44% held leadership positions in the Ministry of Health, 44% were clinicians providing HIV care, and 13% were donors or employed by NGOs; 89% held a medical degree. Stakeholders were highly supportive of physician assistants performing simple ART-related tasks and unanimous in opposing community health workers providing any ART-related services. The most commonly cited motives to implement task shifting were to increase ART access, decrease physician workload, and decrease patient wait time, whereas chief concerns included reduced quality of care and poor training and supervision. Support for task shifting was higher among clinicians than policy and programme leaders for three specific task/cadre combinations: general mid-level nurses to initiate ART in adults (supported by 75% of clinicians vs. 41% of non-clinicians) and in pregnant

  13. Health Behaviors among Baby Boomer Informal Caregivers

    Science.gov (United States)

    Hoffman, Geoffrey J.; Lee, Jihey; Mendez-Luck, Carolyn A.

    2012-01-01

    Purpose of the Study: This study examines health-risk behaviors among "Baby Boomer" caregivers and non-caregivers. Design and Methods: Data from the 2009 California Health Interview Survey of the state's non-institutionalized population provided individual-level, caregiving, and health behavior characteristics for 5,688 informal…

  14. Child and Interviewer Race in Forensic Interviewing.

    Science.gov (United States)

    Fisher, Amy K; Mackey, Tomiko D; Langendoen, Carol; Barnard, Marie

    2016-10-01

    The purpose of this study was to examine the potential effect of child race and interviewer race on forensic interviewing outcomes. The results of the regression analysis indicated that child race and interviewer race had a significant effect on interview outcome category (no findings, inconclusive, or findings consistent with sexual abuse). Furthermore, the results indicate that the interaction of child and interviewer race had predictive value for rates of findings consistent with sexual abuse but not in the direction predicted. Cross-race dyads had significantly higher rates of interview outcomes consistent with sexual abuse. These findings suggest that more research into the effect of race on disclosure of child sexual abuse is needed.

  15. Engaging new migrants in infectious disease screening: a qualitative semi-structured interview study of UK migrant community health-care leads.

    Directory of Open Access Journals (Sweden)

    Farah Seedat

    Full Text Available Migration to Europe - and in particular the UK - has risen dramatically in the past decades, with implications for public health services. Migrants have increased vulnerability to infectious diseases (70% of TB cases and 60% HIV cases are in migrants and face multiple barriers to healthcare. There is currently considerable debate as to the optimum approach to infectious disease screening in this often hard-to-reach group, and an urgent need for innovative approaches. Little research has focused on the specific experience of new migrants, nor sought their views on ways forward. We undertook a qualitative semi-structured interview study of migrant community health-care leads representing dominant new migrant groups in London, UK, to explore their views around barriers to screening, acceptability of screening, and innovative approaches to screening for four key diseases (HIV, TB, hepatitis B, and hepatitis C. Participants unanimously agreed that current screening models are not perceived to be widely accessible to new migrant communities. Dominant barriers that discourage uptake of screening include disease-related stigma present in their own communities and services being perceived as non-migrant friendly. New migrants are likely to be disproportionately affected by these barriers, with implications for health status. Screening is certainly acceptable to new migrants, however, services need to be developed to become more community-based, proactive, and to work more closely with community organisations; findings that mirror the views of migrants and health-care providers in Europe and internationally. Awareness raising about the benefits of screening within new migrant communities is critical. One innovative approach proposed by participants is a community-based package of health screening combining all key diseases into one general health check-up, to lessen the associated stigma. Further research is needed to develop evidence-based community

  16. Honey bee (Apis mellifera) colony health and pathogen composition in migratory beekeeping operations involved in California almond pollination.

    Science.gov (United States)

    Glenny, William; Cavigli, Ian; Daughenbaugh, Katie F; Radford, Rosemarie; Kegley, Susan E; Flenniken, Michelle L

    2017-01-01

    Honey bees are important pollinators of agricultural crops. Pathogens and other factors have been implicated in high annual losses of honey bee colonies in North America and some European countries. To further investigate the relationship between multiple factors, including pathogen prevalence and abundance and colony health, we monitored commercially managed migratory honey bee colonies involved in California almond pollination in 2014. At each sampling event, honey bee colony health was assessed, using colony population size as a proxy for health, and the prevalence and abundance of seven honey bee pathogens was evaluated using PCR and quantitative PCR, respectively. In this sample cohort, pathogen prevalence and abundance did not correlate with colony health, but did correlate with the date of sampling. In general, pathogen prevalence (i.e., the number of specific pathogens harbored within a colony) was lower early in the year (January-March) and was greater in the summer, with peak prevalence occurring in June. Pathogen abundance in individual honey bee colonies varied throughout the year and was strongly associated with the sampling date, and was influenced by beekeeping operation, colony health, and mite infestation level. Together, data from this and other observational cohort studies that monitor individual honey bee colonies and precisely account for sampling date (i.e., day of year) will lead to a better understanding of the influence of pathogens on colony mortality and the effects of other factors on these associations.

  17. Honey bee (Apis mellifera colony health and pathogen composition in migratory beekeeping operations involved in California almond pollination.

    Directory of Open Access Journals (Sweden)

    William Glenny

    Full Text Available Honey bees are important pollinators of agricultural crops. Pathogens and other factors have been implicated in high annual losses of honey bee colonies in North America and some European countries. To further investigate the relationship between multiple factors, including pathogen prevalence and abundance and colony health, we monitored commercially managed migratory honey bee colonies involved in California almond pollination in 2014. At each sampling event, honey bee colony health was assessed, using colony population size as a proxy for health, and the prevalence and abundance of seven honey bee pathogens was evaluated using PCR and quantitative PCR, respectively. In this sample cohort, pathogen prevalence and abundance did not correlate with colony health, but did correlate with the date of sampling. In general, pathogen prevalence (i.e., the number of specific pathogens harbored within a colony was lower early in the year (January-March and was greater in the summer, with peak prevalence occurring in June. Pathogen abundance in individual honey bee colonies varied throughout the year and was strongly associated with the sampling date, and was influenced by beekeeping operation, colony health, and mite infestation level. Together, data from this and other observational cohort studies that monitor individual honey bee colonies and precisely account for sampling date (i.e., day of year will lead to a better understanding of the influence of pathogens on colony mortality and the effects of other factors on these associations.

  18. Honey bee (Apis mellifera) colony health and pathogen composition in migratory beekeeping operations involved in California almond pollination

    Science.gov (United States)

    Daughenbaugh, Katie F.; Radford, Rosemarie; Kegley, Susan E.

    2017-01-01

    Honey bees are important pollinators of agricultural crops. Pathogens and other factors have been implicated in high annual losses of honey bee colonies in North America and some European countries. To further investigate the relationship between multiple factors, including pathogen prevalence and abundance and colony health, we monitored commercially managed migratory honey bee colonies involved in California almond pollination in 2014. At each sampling event, honey bee colony health was assessed, using colony population size as a proxy for health, and the prevalence and abundance of seven honey bee pathogens was evaluated using PCR and quantitative PCR, respectively. In this sample cohort, pathogen prevalence and abundance did not correlate with colony health, but did correlate with the date of sampling. In general, pathogen prevalence (i.e., the number of specific pathogens harbored within a colony) was lower early in the year (January—March) and was greater in the summer, with peak prevalence occurring in June. Pathogen abundance in individual honey bee colonies varied throughout the year and was strongly associated with the sampling date, and was influenced by beekeeping operation, colony health, and mite infestation level. Together, data from this and other observational cohort studies that monitor individual honey bee colonies and precisely account for sampling date (i.e., day of year) will lead to a better understanding of the influence of pathogens on colony mortality and the effects of other factors on these associations. PMID:28817641

  19. The temporomandibular joint of California sea lions (Zalophus californianus): part 1 - characterisation in health and disease.

    Science.gov (United States)

    Arzi, B; Murphy, M K; Leale, D M; Vapniarsky-Arzi, N; Verstraete, F J M

    2015-01-01

    This study aimed to characterise the histologic, biomechanical and biochemical properties of the temporomandibular joint (TMJ) of California sea lions. In addition, we sought to identify structure-function relationships and to characterise TMJ lesions found in this species. Temporomandibular joints from fresh cadaver heads (n=14) of California sea lions acquired from strandings were examined macroscopically and microscopically. The specimens were also evaluated for their mechanical and biochemical properties. Furthermore, if TMJ arthritic changes were present, joint characteristics were described and compared to healthy joints. Five male and 9 female specimens demonstrated macroscopically normal fibrocartilaginous articular surfaces and fibrous discs in the TMJ. Out of the 9 female specimens, 4 specimens had TMJ lesions were seen either in the articular surface or the disc. Histologically, these pathologic specimens demonstrated subchondral bone defects, cartilage irregularities and inflammatory cell infiltrates. The normal TMJ discs did not exhibit significant direction dependence in tensile stiffness or strength in the rostrocaudal direction compared with the mediolateral direction among normal discs or discs from affected joints. The TMJ discs were not found to be anisotropic in tensile properties. This feature was further supported by randomly oriented collagen fibres as seen by electron microscopy. Furthermore, no significant differences were detected in biochemical composition of the discs dependent upon population. The TMJ and its disc of the California sea lion exhibit similarities but also differences compared to other mammals with regards to structure-function relationships. A fibrous TMJ disc rich in collagen with minimal glycosaminoglycan content was characterised, and random fibre organisation was associated with isotropic mechanical properties in the central region of the disc. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Face-to-face individual counseling and online group motivational interviewing in improving oral health: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Gao, Xiaoli; Lo, Edward Chin-Man; McGrath, Colman; Ho, Samuel Mun-Yin

    2015-09-18

    Motivational interviewing (MI) has great potential in changing health-related behaviors. In addition to delivery in face-to-face individual counseling, MI can be delivered through online groups, a method that is particularly appealing to adolescents and may offer several benefits. This randomized controlled trial compares the effectiveness of prevailing health education (HE), face-to-face individual MI and online group MI in improving adolescents' oral health behaviors (diet and toothbrushing) and in preventing dental caries and periodontal diseases. In each of Hong Kong's main districts (Hong Kong Island, Kowloon and the New Territories), three secondary schools will be recruited and randomly assigned to three groups (HE, face-to-face individual MI, and online group MI). A total of 495 adolescents (aged 12 to 13 years) with unfavorable oral health behaviors ("snacking twice or more a day" and/or "brushing teeth less than twice a day") will be recruited: 165 in each group. Two dental hygienists will be trained to deliver the interventions. HE will be provided through an oral health talk. Participants in the "face-to-face individual MI" group will join a one-on-one counseling session. For "online group MI," participants will form groups of 6 to 8 and join a synchronous text-based online counseling session. At baseline and after 6, 12 and 24 months, clinical outcomes (caries increment and gingival health) and oral health self-efficacy and behaviors (toothbrushing and snacking) will be recorded through an oral examination and a questionnaire, respectively. Effectiveness of the interventions will be evaluated and compared. The primary outcomes will be the "number of new carious surfaces" and "gingival bleeding score" (% of surfaces with gingival bleeding). The secondary outcomes will be changes in oral health self-efficacy and behaviors (toothbrushing and snacking frequencies). A preliminary economic evaluation and a process evaluation will be included to analyze the

  1. Health and Economic Effects of Two Proposals to Increase the California State Cigarette Excise Tax

    OpenAIRE

    Ong, Michael MD, Ph.D.; Alamar, Benjamin Ph.D.; Glantz, Stanton A. Ph.D.

    2003-01-01

    • Governor Gray Davis has proposed a $1.10 increase in the cigarette tax and Assembly Speaker Herb Wesson has proposed a $2.13 increase in the cigarette tax. • The state's Tobacco Education and Research Oversight Committee has noted that the California Tobacco Control Program has ceased to be competitive with the tobacco industry and recommended that $200 million from any tobacco tax increase be used to reinvigorate the Program; doing so would require 20 cents per pack to be allocate...

  2. Prevalence of Smoking and Obesity Among U.S. Cancer Survivors: Estimates From the National Health Interview Survey, 2008-2012.

    Science.gov (United States)

    Shoemaker, Meredith L; White, Mary C; Hawkins, Nikki A; Hayes, Nikki S

    2016-07-01

    To describe smoking and obesity prevalence among male and female cancer survivors in the United States.
. Cross-sectional survey.
. Household interviews.
. 9,753 survey respondents who reported ever having a malignancy, excluding nonmelanoma skin cancers. 
. Data from the National Health Interview Survey (2008-2012) were used to calculate weighted smoking status prevalence estimates. Cross-tabulations of smoking and weight status were produced, along with Wald chi-square tests and linear contrasts.
. Cancer history, smoking status, obesity status, gender, age, and age at diagnosis.
. Seventeen percent of cancer survivors reported current smoking. Female survivors had higher rates of current smoking than males, particularly in the youngest age category. Male survivors who currently smoked had lower obesity prevalence rates than males who previously smoked or never smoked. Among female survivors, 31% were obese and no significant differences were seen in obesity prevalence by smoking status for all ages combined. 
. The findings highlight the variation in smoking status and weight by age and gender. Smoking interventions may need to be targeted to address barriers specific to subgroups of cancer survivors.
. Nurses can be instrumental in ensuring that survivors receive comprehensive approaches to address both weight and tobacco use to avoid trading one risk for another.

  3. Cigarette Smoking Trends Among U.S. Working Adult by Industry and Occupation: Findings From the 2004–2012 National Health Interview Survey

    Science.gov (United States)

    Syamlal, Girija; Mazurek, Jacek M.; Hendricks, Scott A.; Jamal, Ahmed

    2015-01-01

    Objective To examine trends in age-adjusted cigarette smoking prevalence among working adults by industry and occupation during 2004–2012, and to project those prevalences and compare them to the 2020 Healthy People objective (TU-1) to reduce cigarette smoking prevalence to ≤12%. Methods We analyzed the 2004–2012 National Health Interview Survey (NHIS) data. Respondents were aged ≥18 years working in the week prior to the interview. Temporal changes in cigarette smoking prevalence were assessed using logistic regression. We used the regression model to extrapolate to the period 2013–2020. Results Overall, an estimated 19.0% of working adults smoked cigarettes: 22.4% in 2004 to 18.1% in 2012. The largest declines were among workers in the education services (6.5%) industry and in the life, physical, and social science (9.7%) occupations. The smallest declines were among workers in the real estate and rental and leasing (0.9%) industry and the legal (0.4%) occupations. The 2020 projected smoking prevalences in 15 of 21 industry groups and 13 of the 23 occupation groups were greater than the 2020 Healthy People goal. Conclusions During 2004–2012, smoking prevalence declined in the majority of industry and occupation groups. The decline rate varied by industry and occupation groups. Projections suggest that certain groups may not reach the 2020 Healthy People goal. Consequently, smoking cessation, prevention, and intervention efforts may need to be revised and strengthened, particularly in specific occupational groups. PMID:25239956

  4. Mental Health, Binge Drinking, and Antihypertension Medication Adherence

    Science.gov (United States)

    Banta, Jim E.; Haskard, Kelly B.; Haviland, Mark G.; Williams, Summer L.; Werner, Leonard S.; Anderson, Donald L.; DiMatteo, M. Robin

    2009-01-01

    Objectives: To evaluate the relationship between self-reported mental health and binge drinking, as well as health status, sociodemographic, social support, economic resource, and health care access indicators to antihypertension medication adherence. Method: Analysis of 2003 California Health Interview Survey data. Results: Having poor mental…

  5. Length of Residence in the United States is Associated With a Higher Prevalence of Cardiometabolic Risk Factors in Immigrants: A Contemporary Analysis of the National Health Interview Survey.

    Science.gov (United States)

    Commodore-Mensah, Yvonne; Ukonu, Nwakaego; Obisesan, Olawunmi; Aboagye, Jonathan Kumi; Agyemang, Charles; Reilly, Carolyn M; Dunbar, Sandra B; Okosun, Ike S

    2016-11-04

    Cardiometabolic risk (CMR) factors including hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia are high among United States ethnic minorities, and the immigrant population continues to burgeon. Hypothesizing that acculturation (length of residence) would be associated with a higher prevalence of CMR factors, the authors analyzed data on 54, 984 US immigrants in the 2010-2014 National Health Interview Surveys. The main predictor was length of residence. The outcomes were hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia. The authors used multivariable logistic regression to examine the association between length of US residence and these CMR factors.The mean (SE) age of the patients was 43 (0.12) years and half were women. Participants residing in the United States for ≥10 years were more likely to have health insurance than those with diabetic (OR, 1.43; 95% CI, 1.17-1.73), and hypertensive (OR, 1.18; 95% CI, 1.05-1.32) than those residing in the United States for acculturation was associated with CMR factors. Culturally tailored public health strategies should be developed in US immigrant populations to reduce CMR. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  6. University of Southern California

    Data.gov (United States)

    Federal Laboratory Consortium — The focus of the University of Southern California (USC) Children''s Environmental Health Center is to develop a better understanding of how host susceptibility and...

  7. The "Something Else" of Sexual Orientation: Measuring Sexual Identities of Older Lesbian and Bisexual Women Using National Health Interview Survey Questions.

    Science.gov (United States)

    Eliason, Michele J; Radix, Asa; McElroy, Jane A; Garbers, Samantha; Haynes, Suzanne G

    2016-07-07

    Terminology related to sexuality and gender is constantly evolving, and multiple factors are at play when individuals answer questions on surveys. We examined patterns of responding to the National Health Interview Survey (NHIS) sexual identity questions in a multisite health intervention study for lesbian and bisexual women aged 40 to 84 years. Of 376 participants, 80% (n = 301) chose "lesbian or gay," 13% (n = 49) selected "bisexual," 7% (n = 25) indicated "something else," and 1 participant chose "don't know the answer." In response to the follow-up question for women who said "something else" or "don't know," most (n = 17) indicated that they were "not straight, but identify with another label." One participant chose "transgender, transsexual, or gender variant," five chose "You do not use labels to identify yourself," and three chose "you mean something else." Lesbian, bisexual, and "something else" groups were compared across demographic and health-related measures. Women who reported their sexual identity as "something else" were younger, more likely to have a disability, more likely to be in a relationship with a male partner, and had lower mental health quality of life than women who reported their sexual identity as lesbian or bisexual. Respondents who answer "something else" pose challenges to analysis and interpretation of data, but should not be discarded from samples. Instead, they may represent a subset of the community that views sexuality and gender as fluid and dynamic concepts, not to be defined by a single label. Further study of the various subsets of "something else" is warranted, along with reconsideration of the NHIS question options. Copyright © 2016 Jacobs Institute of Women's Health. All rights reserved.

  8. [Use of electronic media in adolescence. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)].

    Science.gov (United States)

    Lampert, T; Sygusch, R; Schlack, R

    2007-01-01

    The use of electronic media is playing an ever greater role in adolescents' recreational behaviour. From the point of view of the health sciences, one question which arises is the extent to which intensive media use is detrimental to physical activity and adolescents' health development. The data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which were evaluated with a focus on 11-17-year-olds, confirm this heavy use of electronic media. However, there are distinct group-specific differences. For example, boys spend more time than girls on computers, the internet and games consoles, whereas girls more often listen to music and use their mobile phones. Watching television and videos is equally popular among girls and boys. Adolescents of low social status or a low level of school education use electronic media far more frequently and for longer times, especially television and video, games consoles and mobile phones. The same is true of boys and girls from the former states of the GDR and for boys (but not girls) with a background of migration. A connection to physical activity has been established for adolescents who spend more than five hours a day using electronic media. Moreover, this group of heavy users is more often affected by adiposity. The results of the KiGGS study, which are in line with earlier research findings, thus demonstrate that the use of electronic media is also of relevance from the point of view of public health and should be included in investigations into the health of children and adolescents.

  9. [Relationship between physical activity and health in children and adolescents. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) and the "Motorik-Modul" (MoMo)].

    Science.gov (United States)

    Krug, S; Jekauc, D; Poethko-Müller, C; Woll, A; Schlaud, M

    2012-01-01

    The question of whether physical activity is associated with positive aspects of health becomes increasingly more important in the light of the health status in today's children and adolescents and due to the changing lifestyle with respect to everyday activity. The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) collected the first set of nationwide representative cross-sectional data to examine the relationship between health and physical activity. Taking sociodemographic parameters into consideration, the results suggest a positive association between self-estimated general health and several types of physical activity. The results vary with respect to gender and type of physical activity. For methodological reasons, causal conclusions can only be drawn after longitudinal data of the second wave of KiGGS are available.

  10. Mental and physical health-related quality of life among U.S. cancer survivors: population estimates from the 2010 National Health Interview Survey

    National Research Council Canada - National Science Library

    Weaver, Kathryn E; Forsythe, Laura P; Reeve, Bryce B; Alfano, Catherine M; Rodriguez, Juan L; Sabatino, Susan A; Hawkins, Nikki A; Rowland, Julia H

    2012-01-01

    Despite extensive data on health-related quality of life (HRQOL) among cancer survivors, we do not yet have an estimate of the percentage of survivors with poor mental and physical HRQOL compared with population norms...

  11. Health benefits of reducing sugar-sweetened beverage intake in high risk populations of California: results from the cardiovascular disease (CVD policy model.

    Directory of Open Access Journals (Sweden)

    Tekeshe A Mekonnen

    Full Text Available Consumption of sugar-sweetened beverage (SSB has risen over the past two decades, with over 10 million Californians drinking one or more SSB per day. High SSB intake is associated with risk of type 2 diabetes, obesity, hypertension, and coronary heart disease (CHD. Reduction of SSB intake and the potential impact on health outcomes in California and among racial, ethnic, and low-income sub-groups has not been quantified.We projected the impact of reduced SSB consumption on health outcomes among all Californians and California subpopulations from 2013 to 2022. We used the CVD Policy Model - CA, an established computer simulation of diabetes and heart disease adapted to California. We modeled a reduction in SSB intake by 10-20% as has been projected to result from proposed penny-per-ounce excise tax on SSB and modeled varying effects of this reduction on health parameters including body mass index, blood pressure, and diabetes risk. We projected avoided cases of diabetes and CHD, and associated health care cost savings in 2012 US dollars.Over the next decade, a 10-20% SSB consumption reduction is projected to result in a 1.8-3.4% decline in the new cases of diabetes and an additional drop of 0.5-1% in incident CHD cases and 0.5-0.9% in total myocardial infarctions. The greatest reductions are expected in African Americans, Mexican Americans, and those with limited income regardless of race and ethnicity. This reduction in SSB consumption is projected to yield $320-620 million in medical cost savings associated with diabetes cases averted and an additional savings of $14-27 million in diabetes-related CHD costs avoided.A reduction of SSB consumption could yield substantial population health benefits and cost savings for California. In particular, racial, ethnic, and low-income subgroups of California could reap the greatest health benefits.

  12. Assessing the Impact of School-Based Health Centers on Academic Achievement and College Preparation Efforts: Using Propensity Score Matching to Assess School-Level Data in California

    Science.gov (United States)

    Bersamin, Melina; Garbers, Samantha; Gaarde, Jenna; Santelli, John

    2016-01-01

    This study examines the association between school-based health center (SBHC) presence and school-wide measures of academic achievement and college preparation efforts. Publicly available educational and demographic data from 810 California public high schools were linked to a list of schools with an SBHC. Propensity score matching, a method to…

  13. The Effect of Requiring Private Employers to Extend Health Benefit Eligibility to Same-Sex Partners of Employees: Evidence from California

    Science.gov (United States)

    Buchmueller, Thomas C.; Carpenter, Christopher S.

    2012-01-01

    Health disparities related to sexual orientation are well documented and may be due to unequal access to a partner's employer-sponsored insurance (ESI). We provide the literature's first evaluation of legislation enacted by California in 2005 that required private employers within the state to treat employees in committed same-sex relationships in…

  14. Internet accessibility and usage among urban adolescents in Southern California: implications for web-based health research.

    Science.gov (United States)

    Sun, Ping; Unger, Jennifer B; Palmer, Paula H; Gallaher, Peggy; Chou, Chih-Ping; Baezconde-Garbanati, Lourdes; Sussman, Steve; Johnson, C Anderson

    2005-10-01

    The World Wide Web (WWW) poses a distinct capability to offer interventions tailored to the individual's characteristics. To fine tune the tailoring process, studies are needed to explore how Internet accessibility and usage are related to demographic, psychosocial, behavioral, and other health related characteristics. This study was based on a cross-sectional survey conducted on 2373 7th grade students of various ethnic groups in Southern California. Measures of Internet use included Internet use at school or at home, Email use, chat-room use, and Internet favoring. Logistic regressions were conducted to assess the associations between Internet uses with selected demographic, psychosocial, behavioral variables and self-reported health statuses. The proportion of students who could access the Internet at school or home was 90% and 40%, separately. Nearly all (99%) of the respondents could access the Internet either at school or at home. Higher SES and Asian ethnicity were associated with higher internet use. Among those who could access the Internet and after adjusting for the selected demographic and psychosocial variables, depression was positively related with chat-room use and using the Internet longer than 1 hour per day at home, and hostility was positively related with Internet favoring (All ORs = 1.2 for +1 STD, p 4.0, p < 0.05). Self-reported health problems were associated with higher levels of Internet use at home but lower levels of Internet use at school. More physical activity was related to more email use (OR = 1.3 for +1 STD), chat room use (OR = 1.2 for +1 STD), and at school ever Internet use (OR = 1.2 for +1 STD, all p < 0.05). Body mass index was not related to any of the Internet use-related measures. In this ethnically diverse sample of Southern California 7(th) grade students, 99% could access the Internet at school and/or at home. This suggests that the Internet is already a potential venue for large scale health communication studies

  15. Associations between inadequate sleep and obesity in the US adult population: analysis of the national health interview survey (1977-2009).

    Science.gov (United States)

    Jean-Louis, Girardin; Williams, Natasha J; Sarpong, Daniel; Pandey, Abhishek; Youngstedt, Shawn; Zizi, Ferdinand; Ogedegbe, Gbenga

    2014-03-29

    Epidemiologic studies show a curvilinear relationship between inadequate sleep ( 8 hours) and obesity (Body Mass Index > 30 kg/m2), which have enormous public health impact. Using data from the National Health Interview Survey, an ongoing nationally representative cross-sectional study of non-institutionalized US adults (≥18 years) (1977 through 2009), we examined the hypothesis that inadequate sleep is independently related to overweight/obesity, with adjustment for socio-demographic, health risk, and medical factors. Self- reported data on health risks, physician-diagnosed medical conditions, sleep duration, and body weight and height were used. Prevalence of overweight and obesity increased from 31.2% to 36.9% and 10.2% to 27.7%, respectively. Whereas prevalence of very short sleep (sleep (5-6 hours) has increased from 1.7% to 2.4% and from 19.7% to 26.7%, it decreased from 11.6% to 7.8% for long sleep. According to multivariate-adjusted multinomial regression analyses, odds of overweight and obesity associated with very short sleep and short sleep increased significantly from 1977 to 2009. Odds of overweight and obesity conferred by long sleep did not show consistent and significant increases over the years. Analyses based on aggregated data showed very short sleepers had 30% greater odds of being overweight or were twice as likely to be obese, relative to 7-8 hour sleepers. Likewise, short sleepers had 20% greater odds of being overweight or 57% greater odds of being obese. Long sleepers had 20% greater odds of being obese, but no greater odds of being overweight. Our findings support the hypothesis that prevalence of very short and short sleep has gradually increased over the last 32 years. Inadequate sleep was associated with overweight and obesity for each available year.

  16. Does uninsurance affect the health outcomes of the insured? Evidence from heart attack patients in California.

    Science.gov (United States)

    Daysal, N Meltem

    2012-07-01

    In this paper, I examine the impact of uninsured patients on the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California (1999-2006). My results indicate that uninsured patients have an economically significant effect that increases the mortality rate of insured heart attack patients. I show that these results are not driven by alternative explanations, including reverse causality, patient composition effects, sample selection or unobserved trends and that they are robust to a host of specification checks. The primary channel for the observed spillover effects is increased hospital uncompensated care costs. Although data limitations constrain my capacity to check how hospitals change their provision of care to insured heart attack patients in response to reduced revenues, the evidence I have suggests a modest increase in the quantity of cardiac services without a corresponding increase in hospital staff. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Public Health Benefits of End-Use Electrical Energy Efficiency in California: An Exploratory Study

    Energy Technology Data Exchange (ETDEWEB)

    McKone, Thomas E.; Lobscheid, A.B.

    2006-06-01

    This study assesses for California how increasing end-use electrical energy efficiency from installing residential insulation impacts exposures and disease burden from power-plant pollutant emissions. Installation of fiberglass attic insulation in the nearly 3 million electricity-heated homes throughout California is used as a case study. The pollutants nitrous oxides (NO{sub x}), sulfur dioxide (SO{sub 2}), fine particulate matter (PM2.5), benzo(a)pyrene, benzene, and naphthalene are selected for the assessment. Exposure is characterized separately for rural and urban environments using the CalTOX model, which is a key input to the US Environmental Protection Agency (EPA) Tool for the Reduction and Assessment of Chemicals and other environmental Impacts (TRACI). The output of CalTOX provides for urban and rural populations emissions-to-intake factors, which are expressed as an individual intake fraction (iFi). The typical iFi from power plant emissions are on the order of 10{sup -13} (g intake per g emitted) in urban and rural regions. The cumulative (rural and urban) product of emissions, population, and iFi is combined with toxic effects factors to determine human damage factors (HDFs). HDF are expressed as disability adjusted life years (DALYs) per kilogram pollutant emitted. The HDF approach is applied to the insulation case study. Upgrading existing residential insulation to US Department of Energy (DOE) recommended levels eliminates over the assmned 50-year lifetime of the insulation an estimated 1000 DALYs from power-plant emissions per million tonne (Mt) of insulation installed, mostly from the elimination of PM2.5 emissions. In comparison, the estimated burden from the manufacture of this insulation in DALYs per Mt is roughly four orders of magnitude lower than that avoided.

  18. Female respondent acceptance of computer-assisted personal interviewing (CAPI) for maternal, newborn and child health coverage surveys in rural Uganda.

    Science.gov (United States)

    Mercader, Hannah Faye G; Kabakyenga, Jerome; Katuruba, David Tumusiime; Hobbs, Amy J; Brenner, Jennifer L

    2017-02-01

    High maternal and child mortality continues in low- and middle-income countries (LMIC). Measurement of maternal, newborn and child health (MNCH) coverage indicators often involves an expensive, complex, and lengthy household data collection process that is especially difficult in less-resourced settings. Computer-assisted personal interviewing (CAPI) has been proposed as a cost-effective and efficient alternative to traditional paper-and-pencil interviewing (PAPI). However, the literature on respondent-level acceptance of CAPI in LMIC has reported mixed outcomes. This is the first study to prospectively examine female respondent acceptance of CAPI and its influencing factors for MNCH data collection in rural Southwest Uganda. Eighteen women aged 15-49 years were randomly selected from 3 rural villages to participate. Each respondent was administered a Women's Questionnaire with half of the survey questions asked using PAPI techniques and the other half using CAPI. Following this PAPI/CAPI exposure, semi-structured focus group discussions (FGDs) assessed respondent attitudes towards PAPI versus CAPI. FGD data analysis involved an immersion/crystallization method (thematic narrative analysis). The sixteen FGD respondents had a median age of 27 (interquartile range: 24.8, 32.3) years old. The majority (62.5%) had only primary level education. Most respondents (68.8%) owned or regularly used a mobile phone or computer. Few respondents (31.3%) had previously seen but not used a tablet computer. Overall, FGDs revealed CAPI acceptance and the factors influencing CAPI acceptability were 'familiarity', 'data confidentiality and security', 'data accuracy', and 'modernization and development'. Female survey respondents in our rural Southwest Ugandan setting found CAPI to be acceptable. Global health planners and implementers considering CAPI for health coverage survey data collection should accommodate influencing factors during survey planning in order to maximize and

  19. Assessing the Viability of Social Media for Disseminating Evidence-Based Nutrition Practice Guideline Through Content Analysis of Twitter Messages and Health Professional Interviews: An Observational Study.

    Science.gov (United States)

    Hand, Rosa K; Kenne, Deric; Wolfram, Taylor M; Abram, Jenica K; Fleming, Michael

    2016-11-15

    Given the high penetration of social media use, social media has been proposed as a method for the dissemination of information to health professionals and patients. This study explored the potential for social media dissemination of the Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline (EBNPG) for Heart Failure (HF). The objectives were to (1) describe the existing social media content on HF, including message content, source, and target audience, and (2) describe the attitude of physicians and registered dietitian nutritionists (RDNs) who care for outpatient HF patients toward the use of social media as a method to obtain information for themselves and to share this information with patients. The methods were divided into 2 parts. Part 1 involved conducting a content analysis of tweets related to HF, which were downloaded from Twitonomy and assigned codes for message content (19 codes), source (9 codes), and target audience (9 codes); code frequency was described. A comparison in the popularity of tweets (those marked as favorites or retweeted) based on applied codes was made using t tests. Part 2 involved conducting phone interviews with RDNs and physicians to describe health professionals' attitude toward the use of social media to communicate general health information and information specifically related to the HF EBNPG. Interviews were transcribed and coded; exemplar quotes representing frequent themes are presented. The sample included 294 original tweets with the hashtag "#heartfailure." The most frequent message content codes were "HF awareness" (166/294, 56.5%) and "patient support" (97/294, 33.0%). The most frequent source codes were "professional, government, patient advocacy organization, or charity" (112/277, 40.4%) and "patient or family" (105/277, 37.9%). The most frequent target audience codes were "unable to identify" (111/277, 40.1%) and "other" (55/277, 19.9%). Significant differences were found in the popularity of

  20. Racial and ethnic disparities associated with knowledge of symptoms of heart attack and use of 911: National Health Interview Survey, 2001.

    Science.gov (United States)

    McGruder, Henraya E; Greenlund, Kurt J; Malarcher, Ann M; Antoine, Theresa L; Croft, Janet B; Zheng, Zhi-Jie

    2008-01-01

    Heart attacks are more prevalent among Hispanics and Blacks than among Whites. Bystanders must be able to recognize heart attack symptoms and activate the emergency response system in order to receive time-dependent therapies that increase survival. This study estimated racial/ethnic disparities in awareness of heart attack symptoms in a sample of the US population. We evaluated data from 33,059 adult participants in the 2001 National Health Interview Survey. Respondents indicated their awareness of five heart attack symptoms and the need to call 911 in the presence of such symptoms. Hispanics and Blacks were less likely to recognize each heart attack symptom than were Whites (Pheart attack symptoms and report that they would call 911 than were Whites (45.8%), Blacks (36.1%), respondents aged 45-64 years (47.7%) and >65 years (43.9%), and those with a high school education (41.0%) or more (45.6%). In multivariate logistic regression analyses, Blacks (OR .73, 95% CI .66-.80) and Hispanics (OR .49, 95% CI .45-.54) were less likely than were Whites to recognize all five heart attack symptoms and the need to call 911 if someone had these symptoms. One Healthy People 2010 goal is to eliminate health disparities. Racial/ethnic disparities exist in knowledge of heart attack symptoms and the need to call 911. Special educational efforts should focus on Black and Hispanic populations and highlight the importance of symptoms and time-dependent therapies.

  1. THE PREVALENCE OF OBESITY AND OBESITY-RELATED HEALTH CONDITIONS IN A LARGE MULTIETHNIC COHORT OF YOUNG ADULTS IN CALIFORNIA

    Science.gov (United States)

    Koebnick, Corinna; Smith, Ning; Huang, Karl; Martinez, Mayra; Clancy, Heather A.; Kushi, Lawrence H.

    2012-01-01

    Purpose To identify population groups that are most susceptible to obesity-related health conditions at young age. Methods For this population-based cross-sectional study, measured weight and height, diagnosis, laboratory, and drug prescription information were extracted from electronic medical records of 1,819,205 patients aged 20–39 years enrolled in two integrated health plans in California 2007–2009. Results Overall, 29.9% of young adults were obese. Extreme obesity (BMI ≥ 40 kg/m2) was observed in 6.1% of women and 4.5% of men. The adjusted relative risk for diabetes, hypertension, dyslipidemia, and the metabolic syndrome increased sharply for those individuals with a BMI ≥ 40, with the sharpest increase in the adjusted relative risk for hypertension and metabolic syndrome. The association between weight class and dyslipidemia, hypertension and metabolic syndrome but not diabetes was stronger among 20.0–29.9 year olds compared to 30.0–39.9 year olds (p for interaction: obese, the association between obesity-related health conditions was stronger in younger individuals. Hispanics and Blacks are also more likely to be obese, including extreme obesity, putting them at an elevated risk for premature cardiovascular disease and some cancers relative to non-Hispanic whites. PMID:22766471

  2. Binational public policies: health social marketing event in migration Mexico and United States of America

    OpenAIRE

    García González, Janet

    2013-01-01

    The aim is to reflect on the differences and points of agreement arising from the comparative analysis of US strategies for Mexican migrant health and social marketing, by researchers at the Department of Public Health Services of California, the Binational Health Office Border / University of California and the Autonomous University of Puebla. Material and Methods: The design is qualitative, the collection technique applied structured interviews to 21 key informants, officials of health inst...

  3. Religion, assessment and the problem of 'normative uncertainty' for mental health student nurses: a critical incident-informed qualitative interview study.

    Science.gov (United States)

    Bassett, A M; Baker, C; Cross, S

    2015-10-01

    There is limited research around how mental health (MH) student nurses interpret and differentiate between people's religious and cultural beliefs and the existence of psychopathological symptomatology and experiences. Here we focus on one cultural issue that arose from research exploring how MH student nurses approach and interpret religion and culture in their practice - that is, the difficulties in determining the clinical significance of the religious beliefs and experiences expressed by the people they care for. While problems with establishing the cultural boundaries of normality in clinical assessments are an important area of debate in cultural psychiatry, it remains a peripheral issue in MH nurse education. An anthropologically informed qualitative research design underpinned 'critical incident' (CI)-focused ethnographic interviews with 36 second and third-year MH nursing field students and seven undergraduate MH branch lecturers. Follow up focus groups were also carried out. Interview transcripts were subject to thematic analysis. Four subthemes were identified under the broad theme of the clinical significance of religious-type expression and experience: (1) identifying the difference between delusions and religious belief; (2) identifying whether an experience was hallucination or religious experience; (3) the clinical implications of such challenges; and (4) applying religion-specific knowledge. There are clinical implications that may result from the difficulties with assessing the clinical significance of religious beliefs and experiences, identified in both our research and within international cultural psychiatry literature and research. Misinterpretation and therefore wrongly assessing someone's experience as pathological is a significant concern. It is suggested that CI analysis could be adapted to help nurses, nursing students and nurse educators recognize the religious dimensions of mental distress, particularly those that then potentially

  4. 21st Century California Water Storage Strategies

    Directory of Open Access Journals (Sweden)

    Barry Nelson

    2017-12-01

    Full Text Available https://doi.org/10.15447/sfews.2017v15iss4art1The goal of this paper is to analyze storage projects constructed and planned in California since 1980, in contrast with storage constructed before that date. As a result of California’s highly variable climate, storage is an essential tool for agricultural and urban water users. Today, the state regulates approximately 1,250 reservoirs, with a combined storage of 42 million acre-feet. Federal agencies regulate approximately 200 additional reservoirs. The vast majority of this surface storage was constructed before 1978, when New Melones Dam, the last large on-stream water supply reservoir in California, was completed. The role of storage in meeting future needs remains a high-profile issue in the California water debate. For example, funding for new storage was the largest item in Proposition 1, the most recent water bond voters approved. This analysis included a review of existing literature, such as the California Department of Water Resources Division of Dam Safety database, California Water Commission documents about new storage proposals, water agency documents, and interviews with water agency staff and others. Water managers face dramatically different conditions today, in comparison to conditions before 1980. These conditions have led to new approaches to water storage that represent a dramatic departure from past storage projects. During the past 37 years, a wide range of new water storage strategies have been planned and implemented. These facilities have created a combined new storage capacity greater than that of Lake Shasta, California’s largest reservoir. These new storage strategies suggest the need to revisit the fundamental definition of water storage. With limited potential for new storage drawing from the state’s rivers, California must choose storage projects wisely. By learning from successful strategies in recent decades, decision-makers can make better storage investment

  5. Patterns of Health Information Technology Use according to Sexual Orientation among US Adults Aged 50 and Older: Findings from a National Representative Sample-National Health Interview Survey 2013-2014.

    Science.gov (United States)

    Lee, Ji Hyun; Giovenco, Danielle; Operario, Don

    2017-08-01

    Health disparities among sexual minority adults ages 50 and older have been documented. Factors such as lifetime discrimination and internalized stigma may deter sexual minority individuals from seeking health services. Several studies suggest that health information technology may facilitate health education and outreach to populations whose health behaviors are affected by stigma such as older sexual minority people. This study examined the role of sexual minority identity as a factor that is associated with health information technology use. Data from the 2013-2014 National Health Interview Survey (NHIS) were analyzed. Multivariate logistic regressions were used to compare the odds of using technology as a resource for health information between sexual minority versus heterosexual US adults aged 50 and older. Adjusting for sociodemographic variables and health variables, sexual minority participants had increased odds of using computers to look up health information on the Internet (OR = 2.01, 95% CI 1.53-2.64), using computers to fill a prescription (OR = 1.97, 95% CI 1.36-2.85), and using computers to communicate with health-care provider by e-mail (OR = 2.13, 95% CI 1.55-2.92), compared with heterosexuals. Findings reveal greater use of health information technology among older sexual minority adults when compared to their heterosexual counterparts. While sensitive, competent providers and culturally appropriate prevention services are essential to meeting the needs of aging sexual minority populations, health information technology use may be an innovative means of reducing disparities in information access as structural changes are implemented.

  6. Chiropractic or osteopathic manipulation for children in the United States: an analysis of data from the 2007 National Health Interview Survey.

    Science.gov (United States)

    Ndetan, Harrison; Evans, Marion Willard; Hawk, Cheryl; Walker, Clark

    2012-04-01

    The aim of this study was to describe use of chiropractic and/or osteopathic manipulation by children in the United States along with the specific health conditions for which they sought care. The study was a secondary data analysis of the National Health Interview Survey 2007, Child Alternative Medicine file as well as the Child Core Sample. National population estimates were generated for reported use of chiropractic or osteopathic manipulation (C/OM) by children for specific health conditions. Odds ratios (OR) and 95% confidence intervals (CI) were generated from binary logistic regression models that assessed the likelihood that children of specific characteristics would use this therapy. National estimates indicated that 2.3 million children (2.3%) in the United States had used C/OM in 2007. C/OM was the most common complementary and alternative medicine procedure. Children aged 12-18 years were more likely to have seen these providers than were younger age groups (OR=3.4 [95% CI, 2.1-5.5]). Homeopathy (1.2%), massage (1.0), and naturopathy (0.3%) were the next most common procedures. The most common complaints were back and neck pain. Other conditions for which children were seen included other musculoskeletal conditions, sinusitis, allergies, and nonmigraine headaches. Racial categories did not differ significantly regarding use of manipulation, but those children with both mother and father in the household were more likely to have used this form of care (OR=1.7 [95% CI, 1.1-2.6]). C/OM is primarily used for back and neck pain, which is increasing in prevalence in children. Teens are more likely to use it than are younger children.

  7. The effect of cigarette price increase on the cigarette consumption in Taiwan: evidence from the National Health Interview Surveys on cigarette consumption

    Directory of Open Access Journals (Sweden)

    Ye Chun-Yuan

    2004-12-01

    Full Text Available Abstract Background This study uses cigarette price elasticity to evaluate the effect of a new excise tax increase on cigarette consumption and to investigate responses from various types of smokers. Methods Our sample consisted of current smokers between 17 and 69 years old interviewed during an annual face-to-face survey conducted by Taiwan National Health Research Institutes between 2000 to 2003. We used Ordinary Least Squares (OLS procedure to estimate double logarithmic function of cigarette demand and cigarette price elasticity. Results In 2002, after Taiwan had enacted the new tax scheme, cigarette price elasticity in Taiwan was found to be -0.5274. The new tax scheme brought about an average annual 13.27 packs/person (10.5% reduction in cigarette consumption. Using the cigarette price elasticity estimate from -0.309 in 2003, we calculated that if the Health and Welfare Tax were increased by another NT$ 3 per pack and cigarette producers shifted this increase to the consumers, cigarette consumption would be reduced by 2.47 packs/person (2.2%. The value of the estimated cigarette price elasticity is smaller than one, meaning that the tax will not only reduce cigarette consumption but it will also generate additional tax revenues. Male smokers who had no income or who smoked light cigarettes were found to be more responsive to changes in cigarette price. Conclusions An additional tax added to the cost of cigarettes would bring about a reduction in cigarette consumption and increased tax revenues. It would also help reduce incidents smoking-related illnesses. The additional tax revenues generated by the tax increase could be used to offset the current financial deficiency of Taiwan's National Health Insurance program and provide better public services.

  8. Practice patterns in the delivery of radiation therapy after mastectomy among the University of California Athena Breast Health Network.

    Science.gov (United States)

    Mayadev, Jyoti; Einck, John; Elson, Sarah; Rugo, Hope; Hwang, Shelley; Bold, Richard; Daroui, Parima; McCloskey, Susan; Yashar, Catheryn; Kim, Danny; Fowble, Barbara

    2015-02-01

    Practice patterns vary with the planning and delivery of PMRT. In our investigation we examined practice patterns in the use of chest wall bolus and a boost among the Athena Breast Health Network (Athena). Athena is a collaboration among the 5 University of California Medical Centers that aims to integrate clinical care and research. From February 2011 to June 2011, all physicians specializing in the multidisciplinary treatment of breast cancer were invited to take a Web-based practice patterns survey. Sixty-two of the 239 questions focused on radiation therapy practice environment, decision-making processes, and treatment management, including the use of a bolus or boost in PMRT. Ninety-two percent of the radiation oncologists specializing in breast cancer completed the survey. All of the responders use a material to increase the surface dose to the chest wall during PMRT. Materials used included brass mesh, commercial bolus, and custom-designed wax bolus. Fifty percent used tissue equivalent superflab bolus. Fifty-five percent of the respondents routinely use a boost to the chest wall in PMRT. Eighteen percent give a boost depending on the margin status, and 3 of 11 (27%) do not use a boost. Our investigation documents practice pattern variation for the use of a PMRT boost and the use of chest wall bolus among the University of California breast cancer radiation oncologists. Further understanding of the practice pattern variation will help guide clinicians in our cancer centers to a more uniform approach in the delivery of PMRT. Published by Elsevier Inc.

  9. Three-Quarters of Persons in the US Population Reporting a Clinical Diagnosis of Fibromyalgia Do Not Satisfy Fibromyalgia Criteria: The 2012 National Health Interview Survey.

    Science.gov (United States)

    Walitt, Brian; Katz, Robert S; Bergman, Martin J; Wolfe, Frederick

    2016-01-01

    Although fibromyalgia criteria have been in effect for decades, little is known about how the fibromyalgia diagnosis is applied and understood by clinicians and patients. We used the National Health Interview Survey (NHIS) to determine the prevalence of self-reported clinician diagnosed fibromyalgia and then compared demographics, symptoms, disability and medical utilization measures of persons with a clinical diagnosis of fibromyalgia that did not meet diagnostic criteria (false-positive or prior [F/P] fibromyalgia) to persons with and without criteria-positive fibromyalgia. The National Health Interview Survey (NHIS) collected information about both clinical diagnosis and symptoms of fibromyalgia that was appropriately weighted to represent 225,726,257 US adults. Surrogate NHIS diagnostic criteria for fibromyalgia were developed based on the level of polysymptomatic distress (PSD) as characterized in the 2011 modified American College of Rheumatology criteria (ACR) for fibromyalgia. Persons with F/P fibromyalgia were compared with persons who do not have fibromyalgia and those meeting surrogate NHIS fibromyalgia criteria. Of the 1.78% of persons reporting a clinical diagnosis, 73.5% did not meet NHIS fibromyalgia criteria. The prevalence of F/P fibromyalgia is 1.3%. F/P fibromyalgia is associated with a mild degree of polysymptomatic distress (NHIS PSD score 6.2) and characterized by frequent but not widespread pain and insomnia. Measures of work disability and medical utilization in F/P fibromyalgia were equal to that seen with NHIS criteria positive fibromyalgia and were 6-7x greater in F/P fibromyalgia than in non-fibromyalgia persons. F/P fibromyalgia was best predicted by being female (Odds Ratio [OR] 8.81), married (OR 3.27), and white (OR 1.96). In contrast, being a white, married woman was only modestly predictive of NHIS (criteria positive) fibromyalgia (OR 2.1). The majority of clinically diagnosed fibromyalgia cases in the US do not reach levels of

  10. Health Hazard Evaluation Report HETA 91-395-2244, Veterans Administration Medical Center, Los Angeles, California

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, J.E.; Miller, A.

    1992-08-01

    In response to a request from an employee of the Veterans Administration Medical Center (SIC-8062), Los Angeles, California, an investigation was undertaken of exposures to chemicals in the laboratory department, excessive heat and humidity in the kitchen area of the dietetics department, and carbon-monoxide (630080) exposures inside the building. In three of five personal breathing zone samples taken in the histopathology laboratory, formaldehyde (50000) was detected at concentrations up to 0.17 part per million (ppm) and it was also present in all four of the area air samples at concentrations up to 1.1ppm. The predominant symptoms associated with work in the laboratory included occasional headaches and nose/throat irritation. Mild episodes of dermal irritation and rash were also reported. All carbon-monoxide levels were less than 5ppm. In the kitchens, relative humidity levels were below the recommended range. Temperatures were above the range of temperatures recommended for a medium level of work. The authors conclude that a potential carcinogenic risk existed for workers in laboratories which use formaldehyde. The authors recommend specific measures to lower the risk of formaldehyde exposures in the laboratory.

  11. California K-12 School and Community Collaborations: Facilitators, Challenges, and Impact on Student Mental Health

    Science.gov (United States)

    Woodbridge, Michelle W.; Yu, Jennifer; Goldweber, Asha; Golan, Shari; Stein, Bradley D.

    2015-01-01

    Across the education, public health, and human and social services arenas, there has been renewed interest in bringing agency representatives together to work on the promotion of student mental health and wellness. When effective, it is believed that collaboration among agencies can build cross-system partnerships, improve referral processes and…

  12. Examining Lead Exposures in California through State-Issued Health Alerts for Food Contamination and an Exposure-Based Candy Testing Program.

    Science.gov (United States)

    Handley, Margaret A; Nelson, Kali; Sanford, Eric; Clarity, Cassidy; Emmons-Bell, Sophia; Gorukanti, Anuhandra; Kennelly, Patrick

    2017-10-26

    In California, the annual number of children under age 6 y of age with blood lead levels (BLL) ≥10μg/dL is estimated at over 1,000 cases, and up to 10,000 cases when BLL between 4.5 and 9.5 μg/dL are included. State-issued health alerts for food contamination provide one strategy for tracking sources of food-related lead exposures. As well, California passed legislation in 2006 for the Food and Drug Branch (FDB) of the state health department to test and identify lead in candy. This report presents health alert data from California over a 14-y period, compares data before and after the candy testing program began, and examines country of origin, ZIP code data, and time from candy testing to release of health alerts for lead-contaminated candies for 2011-2012. After 2007, health alerts issued for lead in candy and food increased significantly. Analysis of candy-testing data indicated that multiple counties and ZIP codes were affected. Seventeen candies with high lead concentrations were identified, resulting in rapid dissemination (lead exposures from state-based food and candy testing programs provides an opportunity to identify and immediately act to remove nonpaint sources of lead affecting children. https://doi.org/10.1289/EHP2582.

  13. Total Mercury in Squalid Callista Megapitaria squalida from the SW Gulf of California, Mexico: Tissue Distribution and Human Health Risk.

    Science.gov (United States)

    Romo-Piñera, Abril K; Escobar-Sánchez, Ofelia; Ruelas-Inzunza, Jorge; Frías-Espericueta, Martín G

    2018-01-15

    We evaluated the total Hg concentration in different tissues of squalid callista Megapitaria squalida in order to measure Hg distribution in tissue and to estimate human health risk. Samples were obtained by free diving in the SW Gulf of California, Mexico. Concentrations are given on a wet weight basis. A total of 89 squalid callista specimens were obtained, presenting an average Hg concentration of 0.07 ± 0.04 µg g-1. There were no significant differences (p > 0.05) in Hg concentration between tissues (visceral mass = 0.09 ± 0.08 µg g-1; mantle = 0.06 ± 0.07 µg g-1; muscle = 0.06 ± 0.04 µg g-1). The low Hg values found in squalid callista and its low risk quotient (HQ = 0.03) suggest that the consumption of squalid callista does not represent a human health risk. However, HQ calculated using MeHg was > 1, it which could indicate a potential risk related to consumption of clams.

  14. Cross-Jurisdictional Sharing for Emergency Management-Related Public Health: Exploring the Experiences of Tribes and Counties in California

    Directory of Open Access Journals (Sweden)

    Maureen A. Wimsatt

    2017-09-01

    Full Text Available Each American Indian tribe is unique in several ways, including in its relationships with local governments and risk for emergencies. Cross-jurisdictional sharing (CJS arrangements are encouraged between tribes and counties for emergency management-related population health, but researchers have not yet explored CJS experiences of tribes and counties for emergency management. This investigation used collaboration theory and a CJS spectrum framework to assess the scope and prevalence of tribe–county CJS arrangements for emergency management in California as well as preconditions to CJS. Mixed-methods survey results indicate that tribes and counties have varied CJS arrangements, but many are informal or customary. Preconditions to CJS include tribe–county agreement about having CJS, views of the CJS relationship, barriers to CJS, and jurisdictional strengths and weaknesses in developing CJS arrangements. Areas for public health intervention include funding programs that build tribal capacity in emergency management, reduce cross-jurisdictional disagreement, and promote ongoing tribe–county relationships as a precursor to formal CJS arrangements. Study strengths, limitations, and future directions are also discussed.

  15. Cross-Jurisdictional Sharing for Emergency Management-Related Public Health: Exploring the Experiences of Tribes and Counties in California.

    Science.gov (United States)

    Wimsatt, Maureen A

    2017-01-01

    Each American Indian tribe is unique in several ways, including in its relationships with local governments and risk for emergencies. Cross-jurisdictional sharing (CJS) arrangements are encouraged between tribes and counties for emergency management-related population health, but researchers have not yet explored CJS experiences of tribes and counties for emergency management. This investigation used collaboration theory and a CJS spectrum framework to assess the scope and prevalence of tribe-county CJS arrangements for emergency management in California as well as preconditions to CJS. Mixed-methods survey results indicate that tribes and counties have varied CJS arrangements, but many are informal or customary. Preconditions to CJS include tribe-county agreement about having CJS, views of the CJS relationship, barriers to CJS, and jurisdictional strengths and weaknesses in developing CJS arrangements. Areas for public health intervention include funding programs that build tribal capacity in emergency management, reduce cross-jurisdictional disagreement, and promote ongoing tribe-county relationships as a precursor to formal CJS arrangements. Study strengths, limitations, and future directions are also discussed.

  16. [Body measurements of children and adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)].

    Science.gov (United States)

    Stolzenberg, H; Kahl, H; Bergmann, K E

    2007-01-01

    In the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS), a number of anthropometric parameters were assessed in a standardised way in 17,641 boys and girls. To this end, body weight and height, head circumference and upper arm length, as well as two skinfold thicknesses (triceps, subscapular) were measured for the entire age range (0-12 years); starting from 6 years of age, elbow breadth and from 11 years of age waist and hip circumference were measured in addition. For all parameters, means with confidence intervals are reported per age (in years) and gender. Median graphs depict the changes with increasing age according to gender for each body measurement. The complex age-related anthropometric developments along with significant gender specificity show the full range of the dynamic physical development in boys and girls. Based on skinfold measurement data, the body fat percentage was estimated. Thickness and location of the skinfolds, as well as the calculated waist-to-hip ratio is used as an indicator for gender-specific fat distribution. Using the frame index, it is attempted to estimate skeletal robustness. For the anthropometric parameters studied, hardly any regional differences were found. However, head circumference, frame index and all parameters strongly associated with body fat show a significant social status gradient. Children and adolescents with migration background have on average a lower height, larger waist circumference and higher percentage of body fat.

  17. Association between chronic stress and blood pressure: findings from the German Health Interview and Examination Survey for Adults 2008-2011.

    Science.gov (United States)

    Hassoun, Lina; Herrmann-Lingen, Christoph; Hapke, Ulfert; Neuhauser, Hannelore; Scheidt-Nave, Christa; Meyer, Thomas

    2015-06-01

    The magnitude of the contribution of psychosocial stressors to the development of hypertension remains controversial. Using data from the population-based, nationwide German Health Interview and Examination Survey for Adults, we investigated the relationship between objectively measured and subjectively perceived stressors and blood pressure (BP). The study sample comprised 3352 participants not taking antihypertensive medication, for whom data on stress exposure and resting BP measurements were available. The Trier Inventory for the Assessment of Chronic Stress screening scale (TICS-SSCS) was used as a measurement of self-perceived chronic stress, and work-related stress was assessed using the recently developed occupational Overall Job Index. On the basis of bivariate tests, TICS-SSCS was negatively associated with both systolic (β-coefficient [B] = -0.16, standard error = 0.03, p stress is associated with higher BP levels, whereas the exposure to objective stressors was unrelated to BP. These findings suggest that stress perception and objective stressors influence BP regulation via different biobehavioral pathways.

  18. 'New' and distributed leadership in quality and safety in health care, or 'old' and hierarchical? An interview study with strategic stakeholders.

    Science.gov (United States)

    McKee, Lorna; Charles, Kathryn; Dixon-Woods, Mary; Willars, Janet; Martin, Graham

    2013-10-01

    We aimed to explore the views of strategic level stakeholders on leadership for quality and safety in the UK National Health Service. We interviewed 107 stakeholders with close involvement in quality and safety as professionals, managers, policy makers or commentators. Analysis was based on the constant comparative method. Participants identified the crucial role of leadership in ensuring safe, high quality care. Consistent with the academic literature, participants distinguished between traditional hierarchical 'concentrated' leadership associated with particular positions, and distributed leadership involving those with particular skills and abilities across multiple institutional levels. They clearly and explicitly saw a role for distributed leadership, emphasizing that all staff had responsibility for leading on patient safety and quality. They described the particular value of leadership coalitions between managers and clinicians. However, concern was expressed that distributed leadership could mean confusion about who was in charge, and that at national level it risked creating a vacuum of authority, mixed messages, and conflicting expectations and demands. Participants also argued that hierarchically based leadership was needed to complement distributed leadership, not least to provide focus, practical support and expertise, and managerial clout. Strategic level stakeholders see the most effective form of leadership for quality and safety as one that blends distributed and concentrated leadership. Policy and academic prescriptions about leadership may benefit from the sophisticated and pragmatic know-how of insiders who work in organizations that remain permeated by traditional structures, cleavages and power relationships.

  19. Multiple Chronic Conditions and Use of Complementary and Alternative Medicine Among US Adults: Results From the 2012 National Health Interview Survey.

    Science.gov (United States)

    Falci, Laura; Shi, Zaixing; Greenlee, Heather

    2016-05-05

    More than 25% of American adults report having 2 or more chronic conditions. People with chronic conditions often use complementary and alternative medicine (CAM) for self-care and disease management, despite a limited evidence base. Data from the 2012 National Health Interview Survey (NHIS) (n = 33,557) were analyzed to assess associations between presence of multiple chronic conditions (n = 13) and CAM use, using multivariable relative risk and linear regressions weighted for complex NHIS sampling. CAM use was defined as self-reported use of one or more of 16 therapies in the previous 12 months. Chronic conditions were common. US adults reported one (22.3%) or 2 or more (33.8%) conditions. Many used at least one form of CAM. Multivitamins, multiminerals, or both (52.7%); vitamins (34.8%); and minerals (28.4%) were the most common. Compared with adults with no conditions, adults with 2 or more conditions were more likely to use multivitamins or multiminerals or both, vitamins, minerals, nonvitamins or herbs, mind-body therapies, chiropractic or osteopathic manipulation, massage, movement therapies, special diets, acupuncture, naturopathy, or some combination of these therapies (P <.003). People with multiple chronic conditions have a high prevalence of CAM use. Longitudinal studies are needed to understand the association between CAM use and chronic disease prevention and treatment.

  20. Racial and Ethnic Disparities in Dietary Intake among California Children.

    Science.gov (United States)

    Guerrero, Alma D; Chung, Paul J

    2016-03-01

    The prevalence of childhood obesity among racial and ethnic minority groups is high. Multiple factors affect the development of childhood obesity, including dietary practices. To examine the racial and ethnic differences in reported dietary practices among the largest minority groups of California children. Data from the 2007 and 2009 California Health Interview Survey were analyzed using multivariate regression with survey weights to examine how race, ethnicity, sociodemographic characteristics, and child factors were associated with specific dietary practices. The sample included 15,902 children aged 2 to 11 years. In multivariate regressions, substantial differences in fruit juice, fruit, vegetable, sugar-sweetened beverages, sweets, and fast-food consumption were found among the major racial and ethnic groups of children. Asians regardless of interview language were more likely than whites to have low vegetable intake consumption (Asians English interview odds ratio [OR] 1.20, 95% CI 1.01 to 1.43; Asians non-English-interview OR 2.09, 95% CI 1.23 to 3.57) and low fruit consumption (Asians English interview OR 1.69, 95% CI 1.41 to 2.03; Asians non-English interview OR 3.04, 95% CI 2.00 to 4.6). Latinos regardless of interview language were also more likely than whites to have high fruit juice (Latinos English interview OR 1.54, 95% CI 1.28 to 1.84 and Latinos non-English interview OR 1.29, 95% CI 1.02 to 1.62) and fast-food consumption (Latinos English interview OR 1.74, 95% CI 1.46 to 2.08 and Latinos non-English interview OR 1.48, 95% CI 1.16 to 1.91); but Latinos were less likely than whites to consume sweets (Latinos English interview OR 0.81, 95% CI 0.66 to 0.99 and Latinos non-English interview OR 0.56, 95% CI 1.16 to 1.91). Significant racial and ethnic differences exist in the dietary practices of California children. Increased fruit and vegetable consumption appears to be associated with parent education but not income. Our findings suggest that

  1. [The module "Motorik" in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Motor fitness and physical activity of children and young people].

    Science.gov (United States)

    Opper, E; Worth, A; Wagner, M; Bös, K

    2007-01-01

    Motor fitness and physical activity are important aspects of a healthy development in childhood and adolescence. However, the assessment of motor fitness and physical activity is not subject to standardized criteria; furthermore, the samples investigated do not provide a representative image of the whole population. Therefore, the existing data only allow very limited statements on the state and development of motor fitness and physical activity. The "Motorik" module, as part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), offers nationwide representative data on the motor fitness and physical activity of children and adolescents for the first time. Besides the baseline-analysis, another aim is to analyse the complex relationship between motor fitness, physical activity and health. Motor fitness, based on the systematisation of motor abilities, was assessed using a test profile. The test profile consists of 11 items measuring cardiorespiratory fitness, strength, coordination and mobility. Physical activity was assessed using a questionnaire containing 51 items on the duration, intensity and frequency of physical activity in everyday life, during leisure time, at school and in sports clubs. The above-mentioned questionnaire subtopics were supplemented by questions on the weekly prevalence of at least 60 minutes of daily physical activity, on material and local conditions, as well as on cognition and motivation for physical activity. In the years 2004 to 2006, the motor fitness and physical activity of 4,529 children and young people between the ages of 4 and 17 years was investigated on 168 sample points in the context of the "Motorik" module. Half of the children and adolescents investigated belong to the middle class, approximately 15% have a background of migration. The majority of the subjects come from small towns, about a quarter live in the city, less than 20% are settled in rural areas.

  2. Validity of EQ-5D in general population of Taiwan: results of the 2009 National Health Interview and Drug Abuse Survey of Taiwan.

    Science.gov (United States)

    Yu, Sheng-Tsung; Chang, Hsing-Yi; Yao, Kai-Ping; Lin, Yu-Hsuan; Hurng, Baai-Shyun

    2015-10-01

    The aim of this study was to examine the validity of the EuroQOL five dimensions questionnaire (EQ-5D) using a nationally representative data from the National Health Interview Survey (NHIS) through comparison with short-form 36 (SF-36). Data for this study came from the 2009 NHIS in Taiwan. The study sample was the 4007 participants aged 20-64 years who completed the survey. We used SUDAAN 10.0 (SAS-Callable) to carry out weighed estimation and statistical inference. The EQ index was estimated using norm values from a Taiwanese study as well as from Japan and the United Kingdom (UK). The SF-36 score was standardized using American norm values. In terms of concurrent validity, the EQ-5D met the five hypotheses. The results did not fulfill hypothesis that women would have lower visual analogue scale (EQ-VAS) scores. In terms of discriminant validity, the EQ-5D fulfilled two hypotheses. Our results approached but did not fulfill hypothesis that there would be a weak association between the physical and psychological dimensions of the EQ-5D and the mental component summary score of the SF-36. Results were comparable regardless of whether the Japanese or UK norm value sets were used. We were able to fulfill many, not all of our validity hypotheses regardless of whether the established Japanese or UK norm value sets or the Taiwanese norm values were used. The EQ-5D is an effective and simple instrument for assessing health-related quality of life of general population in Taiwan.

  3. Hypertension and diabetes prevalence among U.S. Hispanics by country of origin: the National Health Interview Survey 2000-2005.

    Science.gov (United States)

    Pabon-Nau, Lina P; Cohen, Amy; Meigs, James B; Grant, Richard W

    2010-08-01

    Despite their diverse cultural origins, Hispanics in the US are generally studied as a single ethnic group. 1) Assess demographic and disease-related differences among U.S. Hispanics by country of origin, and 2) Examine the mediating roles of socioeconomic status and acculturation on disease prevalence in these subgroups. Using data from the 2000-2005 National Health Interview Survey (NHIS), we compared characteristics of Mexican-Americans with Hispanics originally from: Mexico, Puerto Rico, Central/South America, Cuba, and Dominican Republic (n = 31,240). We stratified the analysis by foreign versus US-born Hispanic subgroups and modeled hypertension and diabetes prevalence, adjusting for demographic and acculturation differences. The six Hispanic subgroups were significantly diverse in all measured variables. Prevalence of hypertension (32%) and diabetes (15%) was highest in foreign-born Puerto Ricans. After adjusting for age, BMI, smoking, socioeconomic status and acculturation in foreign-born Hispanics, Puerto Ricans (OR = 1.76 [95% CI: 1.23, 2.50], p = 0.002) and Dominicans (OR = 1.93 [1.24, 3.00], p = 0.004), had higher prevalence of hypertension relative to Mexican-Americans. Adjusted diabetes prevalence among foreign-born Hispanics was half or less in Cubans (OR = 0.42 [0.25, 0.68] p diabetes prevalence compared to Mexican-Americans in adjusted models. The prevalence of hypertension and diabetes varies significantly among Hispanics by country of origin. Health disparities research should include representation from all Hispanic subgroups.

  4. Social class, race/ethnicity and all-cause mortality in the US: longitudinal results from the 1986-1994 National Health Interview Survey.

    Science.gov (United States)

    Muntaner, Carles; Hadden, Wilbur C; Kravets, Nataliya

    2004-01-01

    Occupational social class has become a leading indicator of social inequalities in health. In the US, economic sectors are distinct with respect to wages, benefits, job security, promotion ladders and working conditions. The growing economic sector of self-employed workers is characterized by lower wages and benefits, and greater job insecurity. Little attention has been given to the association between economic sector measures of social class and all-cause mortality, and there have been no studies of mortality among the self-employed. To determine risk of death associated with economic sector social class, this study entails a longitudinal analysis of the National Health Interview Survey (NHIS), an annual household survey representative of the US population for the period 1986-1994 (n = 377,129). The sample includes 201,566 men and 175,563 women, aged 24-65 years of age, in the civilian labor force. Non- professionals are at higher risk of death than professionals across all sectors and self-employed professionals are at higher risk of death than professionals employed in government and production. Additional social class differences are accounted for by age, race, gender and marital status. Results are also partially explained by income. After controlling for income, Black professionals did not show a lower risk of death than Black non-professionals and self-employed Hispanic professionals had a higher risk of death than Hispanic professionals employed in the private sector. Given the growth of self-employment in the US, the noted increased risk of death among self-employed professionals merits further investigation and monitoring.

  5. Adult vaccination coverage levels among users of complementary/alternative medicine – results from the 2002 National Health Interview Survey (NHIS

    Directory of Open Access Journals (Sweden)

    Bardenheier Barbara H

    2008-02-01

    Full Text Available Abstract Background While many Complementary/Alternative Medicine (CAM practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged ≥ 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage. Methods Data from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever, and ≥ 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics. Results Overall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value Conclusion Vaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue monitoring CAM use and its possible influence on receipt of immunizations among adults. Since adult vaccination coverage levels remain below Healthy People 2010 goals, it may be beneficial to work with CAM practitioners to promote adult vaccines as preventive services in

  6. California: Environmental Health Coalition Clean Ports, Healthy Communities in San Diego (A Former EPA CARE Project)

    Science.gov (United States)

    The Environmental Health Coalition (EHC) is a recipient of a CARE Level II cooperative agreement grant. The Clean Ports, Healthy Communities in San Diego targets the Barrio Logan and Old Town National City areas located along San Diego Bay.

  7. Profile Interview: Prof. Rob Moodie

    African Journals Online (AJOL)

    health leaders such as Jonathan Mann and Daniel Tarantola. We moved back ... We were starting to slow down our moves by then and we ... Profile Interview: Prof. Rob Moodie. “Get up. Do good. Be good. Be.” foundation to use a tax on tobacco to buy out and replace tobacco industry sponsorship in sports and the arts, and.

  8. An Analysis of Health Impacts Associated with Pollutant Response to Changes in Emissions In Different Regions of Central California

    Science.gov (United States)

    Tran, C.; Tanrikulu, S.; Beaver, S.; Hilken, H.

    2011-12-01

    Exposure to ozone and particulate matter has been shown to have considerable human health impacts. Currently major air basins of central California such as the San Francisco Bay Area (SFBA), Sacramento area, and the San Joaquin Valley (SJV) are all designated as in nonattainment of the Federal 8-hour ozone and 24-hour PM2.5 standards, despite California's comprehensive emission control programs for the last fifty years. Although these programs were very effective, decreasing anthropogenic emissions 40 to 50 percent in the region from 1990 to 2010 alone, the ambient response of pollutants was mixed and varied among these three interconnected regions. The purpose of this work was to investigate differences in each region's human health impact response to changes in emissions using the US EPA's BenMAP program. Inputs to BenMAP were prepared using the CMAQ model. Ambient concentrations were simulated for 2005. Then, anthropogenic emissions were reduced 10 to 60 percent across the board in 10 percent increments for the purpose of assessing pollutant responses to changes in emissions. BenMAP was run for each emission reduction scenario. The BenMAP results were normalized by county population to enable comparisons among counties that ranged from rural and agricultural to urban and densely populated. In all regions, the benefits of direct PM emission reductions were greater than those of similar precursor reductions. With respect to mortality rates, direct PM reductions produced the largest benefits in Nevada, Stanislaus, Tuolumne, and San Francisco Counties. For a 40 percent reduction in emissions, reductions in annual mortality rates ranged from 120 to 140 per million for these counties. Precursor emission reductions' benefits were maximized at the southern end of SJV, with Tulare showing the maximum reduction of around 83 mortalities per million. Monetized benefits of avoided mortalities as a result of direct PM emission reductions were significantly higher in

  9. Interview as intraviews

    DEFF Research Database (Denmark)

    Petersen, Kit Stender

    2014-01-01

    do not merely refer to passive entities but must be understood as matter that matters. To illustrate my points I will analyse how bringing a puppet with me to interviews with 4-6 year old children seemed to interfere with the interview situation creating unforeseen diversions in ways that influenced......In this article I will illustrate how our understanding of the interview situation changes when we rethink it with some of the concepts from Karen Barad’s notion of agential realism. With concepts such as ‘apparatuses’, ‘phenomena‘, ‘intra-action’ and ‘material-discursive’ (Barad, 2007) it becomes...... possible to focus more extensively on how matter matters in the interview situation. Re-thinking the interview as an intraview1, I argue that Barad’s concepts will enhance our awareness not only of how the researcher affects the interview but also of how certain kinds of materiality in interview situations...

  10. Coding interview questions concepts, problems, interview questions

    CERN Document Server

    Karumanchi, Narasimha

    2016-01-01

    Peeling Data Structures and Algorithms: * Programming puzzles for interviews * Campus Preparation * Degree/Masters Course Preparation * Instructor’s * GATE Preparation * Big job hunters: Microsoft, Google, Amazon, Yahoo, Flip Kart, Adobe, IBM Labs, Citrix, Mentor Graphics, NetApp, Oracle, Webaroo, De-Shaw, Success Factors, Face book, McAfee and many more * Reference Manual for working people

  11. Health of resettled Iraqi refugees --- San Diego County, California, October 2007-September 2009.

    Science.gov (United States)

    2010-12-17

    In recent years, Iraqi refugees have been resettling in the United States in large numbers, with approximately 28,000 arrivals during October 2007-September 2009 (federal fiscal years [FYs] 2008 and 2009). All refugees undergo a required medical examination before departure to the United States to prevent importation of communicable diseases, including active tuberculosis (TB), as prescribed by CDC Technical Instructions. CDC also recommends that refugees receive a more comprehensive medical assessment after arrival, which typically occurs within the first 90 days of arrival. To describe the health profile of resettled Iraqi refugees, post-arrival medical assessment data were reviewed for 5,100 Iraqi refugees who underwent full or partial assessments at the San Diego County refugee health clinic during FYs 2008 and 2009. Among 4,923 screened refugees aged >1 year, 692 (14.1%) had latent tuberculosis infection (LTBI); among 3,047 screened adult refugees aged >18 years, 751 (24.6%) were classified as obese; and among 2,704 screened adult refugees, 410 (15.2%) were hypertensive. Although infectious illness has been the traditional focus of refugee medical screening, a high prevalence of chronic, noninfectious conditions that could lead to serious morbidity was observed among Iraqi refugees. Public health agencies should be aware of the potentially diverse health profiles of resettling refugee groups. Medical assessment of arriving refugee populations, with timely collection and review of health data, enables early detection, treatment, and follow-up of conditions, and can help public health agencies develop and set priorities for population-specific health interventions and guidelines.

  12. [Physical and psychological violence perpetration and violent victimisation in the German adult population: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

    Science.gov (United States)

    Schlack, R; Rüdel, J; Karger, A; Hölling, H

    2013-05-01

    Violence is of considerable relevance to Public Health. It was the aim of the violence screening implemented as part of the"German Health Interview and Examination Survey for Adults" (DEGS1) to assess data on physical and psychological violence in various social environments (partnership, family, workplace, public space). For the first time as part of a nationally representative health survey, the data was collected from the perspective of victim and perpetrator both among women and men. The study population was comprised of 5939 participants aged between 18 and 64 years. Approximately every 20th participant reported being the victim of physical violence in the preceding 12 months, men significantly more frequently than women. With regard to the frequency of being the perpetrator of physical violence (overall prevalence 3.7 %) there were no significant differences between the sexes. Psychological victimisation was reported by every fifth participant and overall perpetrating psychological violence was reported by every tenth. Women tended to be more frequent the victims but they were also significantly more frequently the perpetrators of both physical and psychological violence in the domestic area (partnership, family). In contrast, men more frequently report being both the perpetrator and the victim of violence in the workplace and in the public space. Young adults between 18 and 29 years as well as persons of low socioeconomic status were consistently more frequently affected by violence although there were exceptions with regard to psychological violent victimisation. More than three-quarters of the victims of physical violence reported being greatly or extremely affected in their well-being by the violence and in the case of psychological violence the rate was about approximately 60%. Overall, the traumatic experience as a consequence of experiencing physical and psychological violence was considerably higher, especially in the case of domestic violence

  13. Low Back Pain Prevalence and Related Workplace Psychosocial Risk Factors: A Study Using Data From the 2010 National Health Interview Survey

    Science.gov (United States)

    Yang, Haiou; Haldeman, Scott; Lu, Ming-Lun; Baker, Dean

    2017-01-01

    Objectives The objectives of this study were to estimate prevalence of low back pain, to investigate associations between low back pain and a set of emerging workplace risk factors and to identify worker groups with an increased vulnerability for low back pain in the US. Methods The data used for this study came from the 2010 National Health Interview Survey (NHIS), which was designed to collect data on health conditions and related risk factors obtained from the US civilian population. The variance estimation method was used to compute weighted data for prevalence of low back pain. Multivariable logistic regression analyses stratified by sex and age were performed to determine the odds ratios (ORs) and the 95% Confidence Interval (CI) for low back pain. The examined work-related psychosocial risk factors included work-family imbalance, exposure to a hostile work environment and job insecurity. Work hours, occupation and other work organizational factors (non-standard work arrangements and alternative shifts) were also examined. Results The prevalence rate of self-reported low back pain in previous three months among workers in the U.S. was 25.7% in 2010. Female or older workers were at increased risk of experiencing low back pain. We found significant associations between low back pain and a set of psychosocial factors, including work-family imbalance (OR 1.27, CI 1.15–1.41), exposure to hostile work (OR 1.39, CI 1.25–1.55), and job insecurity (OR 1.44, CI 1.24–1.67), while controlling for demographic characteristics and other health related factors. Older workers who had non-standard work arrangements were more likely to report low back pain. Females who worked 41–45 hours per week and younger workers who worked over 60 hours per week had an increased risk for low back pain. Workers from several occupation groups, including, male healthcare practitioners, female and younger healthcare support workers, and female farming, fishing and forestry workers had

  14. Fresh-cow handling practices and methods for identification of health disorders on 45 dairy farms in California.

    Science.gov (United States)

    Espadamala, A; Pallarés, P; Lago, A; Silva-Del-Río, N

    2016-11-01

    The aim of the present study was to describe fresh-cow handling practices and techniques used during fresh cow evaluations to identify postpartum health disorders on 45 dairy farms in California ranging from 450 to 9,500 cows. Fresh cow practices were surveyed regarding (a) grouping and housing, (b) scheduling and work organization, (c) screening for health disorders, and (d) physical examination methods. Information was collected based on cow-side observations and responses from fresh cow evaluators. Cows were housed in the fresh cow pen for 3 to 14 (20%), 15 to 30 (49%), or >31 (31%) d in milk. Fresh cow evaluations were performed daily (78%), 6 times a week (11%), 2 to 5 times a week (9%), or were not routinely performed (2%). There was significant correlation between the duration of fresh cow evaluations and the number of cows housed in the fresh pen. Across all farms, the duration of evaluations ranged from 5 to 240 min, with an average of 16 s spent per cow. During fresh cow checks, evaluators always looked for abnormal vaginal discharge, retained fetal membranes, and down cows. Dairies evaluated appetite based on rumen fill (11%), reduction of feed in the feed bunk (20%), rumination sensors (2%), or a combination of these (29%). Milk yield was evaluated based on udder fill at fresh cow checks (40%), milk flow during milking (11%), milk yield records collected by milk meters (2%), or a combination of udder fill and milk meters (5%). Depressed attitude was evaluated on 64% of the dairies. Health-monitoring exams for early detection of metritis were implemented on 42% of the dairies based on rectal examination (13%), rectal temperature (22%), or both (7%). Dairies implementing health-monitoring exams took longer to perform fresh cow evaluations. Physical examination methods such as rectal examination, auscultation, rectal temperature evaluation, and cow-side ketosis tests were used on 76, 67, 38, and 9% of dairies, respectively. Across dairies, we found large

  15. Successful interviewing and selection strategies for patient-centered care delivery.

    Science.gov (United States)

    Dann, D; Miller, B; Hobbs, M; Gentzsch, P; Pierson, C

    1995-03-01

    St. Jude Medical Center, a Sisters of St. Joseph Health System Corporation in Fullerton California, in their efforts at work redesign, realized that the success of a patient-centered care delivery system largely depended upon successful selection of the most suitable team members. The interviewing and selection process used at St. Jude Medical Center includes a structured interview process with integration of both situational and behavioral styles in conjunction with objective rating scales and values driven questions. A common thread woven into the hiring criteria for all levels of personnel in the patient-centered care delivery model was creativity, adaptability, interpersonal skills and compatibility of values. Additionally, the clinical competence of the caregiver within the scope of practice/responsibility was essential for their expanded role. Management and leadership abilities for the managers are also addressed in the interview and selection process to provide the best team members for the overall success of the patient-care redesign.

  16. Effects of Ingratiation, Touch, and Use of Name on Evaluation of Job Applicants and Interviewers

    Science.gov (United States)

    Staneski, Richard A.; And Others

    1977-01-01

    Videotapes were made of male actors playing the roles of interviewers and job applicants in an interview for the position of research assistant. Behaviors of interviewers can influence perceptions of job applicants as well as perceptions of interviewers. Presented at the Western Psychological Association, Anaheim, California, 1973. (Author)

  17. A Three Decade Evolution to Transdisciplinary Research: Community Health Research in California-Mexico Border Communities

    Science.gov (United States)

    Elder, John P.; Ayala, Guadalupe X.; McKenzie, Thomas L.; Litrownik, Alan J.; Gallo, Linda C.; Arredondo, Elva M.; Talavera, Gregory A.; Kaplan, Robert M.

    2013-01-01

    Background The Institute for Behavioral and Community Health (IBACH) is a transdisciplinary organization with a team-oriented approach to the translation of research to practice and policy within the context of behavioral medicine. Objectives This paper tracks the growth of IBACH — in the context of evolving multi-university transdisciplinary research efforts — from a behavioral medicine research focus to community approaches to disease prevention and control, ultimately specializing in Latino health research and practice. We describe how this growth was informed by our partnerships with community members and organizations, and training a diverse array of students and young professionals. Methods Since 1982, IBACH’s research has evolved to address a greater breadth of factors associated with health and well-being. This was driven by our strong community focus and emphasis on collaborations, the diversity of our investigative teams, and our emphasis on training. Although behavioral science still forms the core of IBACH’s scientific orientation, research efforts extend beyond those traditionally examined. Conclusions IBACH’s “team science” successes have been fueled by a specific population emphasis making IBACH one of the nation’s leaders in Latino health behavior research. PMID:25435566

  18. Health and Safety Plan Data Item A009. Hamilton Army Airfield, Novato, California

    Science.gov (United States)

    1990-11-01

    physical exam include medical history, medical examination, vision, audiometry, spirometry , and electrocardiogram. The laboratory analysis includes... spirometry , a measure of the respiratory system status. No personnel may be assigned to the use of, or withdraw from stock, any respira- tory protective...health. These limits are determined either from animal studies or from epidemiological data. Unfortunately, animal studies can only approximate human

  19. Clinic-based nutrition and lifestyle counseling for Hispanic women delivered by community health workers: design of the California WISEWOMAN study.

    Science.gov (United States)

    Farrell, Maureen A; Hayashi, Toshi; Loo, Ryan K; Rocha, David A; Sanders, Charlene; Hernandez, Marianne; Will, Julie C

    2009-05-01

    The Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program in California, named Heart of the Family, implements and evaluates the effectiveness of lifestyle interventions to improve nutrition and physical activity while reducing cardiovascular disease (CVD) risk factors among low-income, uninsured or underinsured Hispanic women aged 40-64 who participate in the Cancer Detection Programs: Every Woman Counts (CDP:EWP). This paper reports the study design and baseline findings of the California WISEWOMAN program. Heart of the Family, a within-site randomized controlled study at four community health centers in Los Angeles and San Diego, featured a unique set of strategies meeting the state population in implementing a California WISEWOMAN program. The program exclusively targeted Hispanic women who are at risk of developing CVD, provided lifestyle intervention using a validated intervention material in Spanish and English to motivate behavioral changes, and used bilingual (English and Spanish) community health workers (CHWs) to provide individually based face-to-face counseling. Women meeting enrollment criteria were randomly assigned either to an enhanced intervention group (EIG), who received lifestyle intervention, or usual care group (UCG), who received the usual care for elevated blood pressure or cholesterol. A total of 1093 women enrolled between January 2006 and August 2006. Demographic and baseline CVD risk profiles are similar in both groups. Some notable characteristics of the California participants are lower smoking rate (5%), higher average body mass index (BMI) (31.9), and a significantly higher percentage with less than high school education (70%). With its unique study design and large number of enrolls, Heart of the Family will enable future public health efforts to better meet the health needs of Hispanic women by addressing education levels, economic considerations, and cultural and linguistic needs.

  20. Trends in Obesity Prevalence in Adults With a History of Cancer: Results From the US National Health Interview Survey, 1997 to 2014.

    Science.gov (United States)

    Greenlee, Heather; Shi, Zaixing; Sardo Molmenti, Christine L; Rundle, Andrew; Tsai, Wei Yann

    2016-09-10

    Obesity after a diagnosis of specific cancers has been associated with worse prognosis. We examined the trend in obesity prevalence among cancer survivors in the United States in the past two decades and compared trends with those of adults without a history of cancer. This was a population-based nationally representative sample of 538,969 noninstitutionalized US adults 18 to 85 years old with and without a history of cancer who participated in annual cross-sectional National Health Interview Surveys from 1997 to 2014. Obesity was defined as body mass index ≥ 30 kg/m(2) for non-Asians and body mass index ≥ 27.5 kg/m(2) for Asians. Among 32,447 cancer survivors identified, the most common cancer diagnoses were breast (n = 6,948), prostate (n = 3,984), and colorectal (n = 2,546). From 1997 to 2014, the prevalence of obesity increased from 22.4% to 31.7% in cancer survivors and from 20.9% to 29.5% in adults without a history of cancer (P for trend obesity prevalence was higher in women and men with a history of cancer compared with those without a history of cancer (all P for interaction obesity prevalence was 3.1% in female and 3.7% in male colorectal cancer survivors, 3.0% in breast cancer survivors, and 2.1% in prostate cancer survivors (all P obesity burden were colorectal cancer survivors, breast cancer survivors, and non-Hispanic blacks. From 1997 to 2014, obesity increased more rapidly among adult cancer survivors compared with the general population. Colorectal and breast cancer survivors and non-Hispanic blacks were identified as being at the highest risk for obesity. © 2016 by American Society of Clinical Oncology.

  1. Age, puberty, body dissatisfaction, and physical activity decline in adolescents. Results of the German Health Interview and Examination Survey (KiGGS

    Directory of Open Access Journals (Sweden)

    Finne Emily

    2011-10-01

    Full Text Available Abstract Background Physical activity (PA shows a marked decline during adolescence. Some studies have pointed to pubertal status or timing as possible PA determinants in this age group. Furthermore, it was supposed that the impact of pubertal changes on PA might be mediated by psychological variables like body dissatisfaction (BDS. Methods The 11- to 17-year-old subsample of the German Health Interview and Examination Survey (KiGGS was used (n = 6 813; 51.3% male, response rate = 66.6%. Through sex-specific sequential multinomial logistic regressions we analysed the univariate and independent associations of chronological age, absolute pubertal status, relative pubertal timing, and BDS with the frequency of PA. Results Chronological age showed a significantly negative association with PA in both sexes, independent of puberty. The odds of inactivity in contrast to nearly daily PA increased about 70% in boys and 35% in girls for each year of age, respectively. Adjusted for age and other possible confounders, inactivity was significantly less likely for boys in late pubertal stages (OR = 0.27, 95% CI = 0.09-0.78. The risk of inactivity was more than doubled in boys maturing earlier than peers in terms of relative pubertal timing (OR = 2.20, 95% CI = 1.36-3.56. No clear significant puberty effects were found in girls, but the inactivity was more likely for those with irregular menstruation (OR = 1.71, 95% CI = 1.06-2.75. BDS also contributed to the prediction of PA in both sexes. It partially mediated puberty effects in boys but not in girls. Conclusions Overall, chronological age was a far more important predictor of PA in German adolescents than absolute pubertal status or relative pubertal timing. Further possible explanatory variables like sociocultural influences, social support or increasing time requirements for education should be analysed in conjunction with chronological age in future studies.

  2. Racial and Ethnic Heterogeneity in Self-Reported Diabetes Prevalence Trends Across Hispanic Subgroups, National Health Interview Survey, 1997–2012

    Science.gov (United States)

    Mincey, Krista D.; Ackermann, Nicole; Milam, Laurel; Goodman, Melody S.; Colditz, Graham A.

    2016-01-01

    Introduction We examined racial/ethnic heterogeneity in self-reported diabetes prevalence over 15 years. Methods We used National Health Interview Survey data for 1997 through 2012 on 452,845 adults aged 18 years or older. Annual self-reported diabetes prevalence was estimated by race/ethnicity and education. We tested for trends over time by education and race/ethnicity. We also analyzed racial/ethnic and education trends in average annual prevalence. Results During the 15 years studied, diabetes prevalence differed significantly by race/ethnicity (P < .001) and by Hispanic subgroup (P < .001). Among participants with less than a high school education, the 5-year trend in diabetes prevalence was highest among Cubans and Cuban Americans (β5YR = 4.8, P = .002), Puerto Ricans (β5YR = 2.2, P = .06), non-Hispanic blacks (β5YR = 2.2, P < .001), and non-Hispanic whites (β5YR = 2.1, P < .001). Among participants with more than a high school education, non-Hispanic blacks had the highest average annual prevalence (5.5%) and Puerto Ricans had the highest 5-year trend in annual diabetes prevalence (β5YR = 2.6, P = .001). Conclusions In this representative sample of US adults, results show ethnic variations in diabetes prevalence. The prevalence of diabetes is higher among Hispanics than among non-Hispanic whites, unevenly distributed across Hispanic subgroups, and more pronounced over time and by education. Findings support disaggregation of data for racial/ethnic populations in the United States to monitor trends in diabetes disparities and the use of targeted, culturally appropriate interventions to prevent diabetes. PMID:26796518

  3. Life-history interviews

    DEFF Research Database (Denmark)

    Adriansen, Hanne Kirstine

    2010-01-01

    My first encounter with life history research was during my Ph.D. research. This concerned a multi-method study of nomadic mobility in Senegal. One method stood out as yielding the most interesting and in-depth data: life story interviews using a time line. I made interviews with the head...... of the nomadic households and during these I came to understand the use of mobility in a complex context of continuity and change, identity and belonging in the Fulani community. Time line interviews became one of my favourite tool in the years to follow, a tool used both for my research in various settings...... of a time line for making life story interviews. I decided that the lack of authoritative literature should not omit me from teaching my students how to make a time line interview. After an introduction, they had to use the tool for making an interview each other concerning their learning journey to DPU...

  4. Interview of Terry Doyle

    CERN Multimedia

    CERN Video productions

    2012-01-01

    An Interview with Terry Doyle, Director of Corporate Development, Nokia. This is part of a series of interviews organized by the SMS Interest Group of Strategy Practice, as part of the preparation for the 2013 SMS Special conference at Lake Geneva which is co-sponsored by ATLAS/CERN. For more information: http://geneva.strategicmanagement.net The purpose of the interviews is to provide input for academics, business practitioners and consultants about fundamental questions of strategy in enterprises.

  5. Det kvalitative interview

    DEFF Research Database (Denmark)

    Brinkmann, Svend

    Bogen begynder med en teoretisk funderet introduktion til det kvalitative interview gennem en skildring af de mange forskellige måder, hvorpå samtaler er blevet brugt til produktion af viden. Opmærksomheden henledes specielt på de komplementære positioner, der kendetegner det oplevelsesfokuserede...... interview (fænomenologiske positioner) og det sprogfokuserede interview (diskursorienterede positioner), som henholdsvis fokuserer på interviewsamtalen som rapporter (om interviewpersonens oplevelser) og redegørelser (foranlediget af interviewsituationen). De følgende kapitler omhandler forskellige måder...... forskningsresultater baseret på kvalitative interview....

  6. Burden of Cardiovascular Disease among Multi-Racial and Ethnic Populations in the United States: An Update from the National Health Interview Surveys

    Directory of Open Access Journals (Sweden)

    Longjian eLiu

    2014-11-01

    Full Text Available Purpose: The study aimed to provide new evidence of health disparities in cardiovascular disease (CVD and diabetes mellitus (DM, and to examine their associations with lifestyle-related risk factors across the U.S. multi-racial and ethnic groups. Methods: The analysis included a randomized population sample of 68,321 subjects aged ≥18 years old who participated in the U.S. 2012 and 2013 National Health Interview Surveys. Hypertension, coronary heart disease (CHD, stroke and DM were classified according to participants’ self-report of physician diagnosis. Assessments of risk factors were measured using standard survey instruments. Associations of risk factors with hypertension, CHD, stroke and DM were analyzed using univariable and multivariable analysis methods. Results: Non-Hispanic (NH-Blacks had significantly higher odds of hypertension, stroke and DM, while NH-Asians and Hispanics had significantly lower odds of stroke and higher odds of stroke and higher odds of DM than NH-Whites (p<0.001. NH-Whites had higher odds of CHD than NH-Black, NH-Asians and Hispanics (p<0.001. Increased body weight, cigarette smoking and physical inactivity were significantly associated with increased odds of hypertension, CHD, stroke and DM (p<0.001. However, the strengths of associations between lifestyle-related factors and the study outcomes were different across racial and ethnic groups. NH-Asians with BMI ≥30 kg/m2 had the highest odds ratios (OR, 95%CI for hypertension (5.37, 4.01-7.18, CHD (2.93, 1.90-4.52 and stroke (2.23, 1.08-4.61, and had the second highest odd ratios for DM (3.78, 2.68-5.35 than NH-Whites, NH-Blacks and Hispanics. Conclusion: CVD and DM disproportionately affect the U.S. multi-racial and ethnic population. Although lifestyle-related risk factors are significantly associated with increased odds of CVD and DM, the impacts of risk factors on the study outcomes are different by race and ethnicity.

  7. Computer assisted self interviewing in a sexual health clinic as part of routine clinical care; impact on service and patient and clinician views.

    Directory of Open Access Journals (Sweden)

    Lenka A Vodstrcil

    Full Text Available BACKGROUND: Computer assisted self interviewing (CASI has been used at the Melbourne Sexual Health Centre (MSHC since 2008 for obtaining sexual history and identifying patients' risk factors for sexually transmitted infections (STIs. We aimed to evaluate the impact of CASI operating at MSHC. METHODOLOGY/PRINCIPAL FINDINGS: The proportion of patients who decline to answer questions using CASI was determined. We then compared consultation times and STI-testing rates during comparable CASI and non-CASI operating periods. Patients and staff completed anonymous questionnaires about their experience with CASI. 14,190 patients completed CASI during the audit period. Men were more likely than women to decline questions about the number of partners they had of the opposite sex (4.4% v 3.6%, p=0.05 and same sex (8.9% v 0%, p<0.001. One third (34% of HIV-positive men declined the number of partners they had and 11-17% declined questions about condom use. Women were more likely than men to decline to answer questions about condom use (2.9% v 2.3%, p=0.05. There was no difference in the mean consultation times during CASI and non-CASI operating periods (p≥0.17. Only the proportion of women tested for chlamydia differed between the CASI and non-CASI period (84% v 88% respectively, p<0.01. 267 patients completed the survey about CASI. Most (72% men and 69% women were comfortable using the computer and reported that all their answers were accurate (76% men and 71% women. Half preferred CASI but 18% would have preferred a clinician to have asked the questions. 39 clinicians completed the staff survey. Clinicians felt that for some STI risk factors (range 11%-44%, face-to-face questioning was more accurate than CASI. Only 5% were unsatisfied with CASI. CONCLUSIONS: We have demonstrated that CASI is acceptable to both patients and clinicians in a sexual health setting and does not adversely affect various measures of clinical output.

  8. Indonesian infertility patients' health seeking behaviour and patterns of access to biomedical infertility care: an interviewer administered survey conducted in three clinics.

    Science.gov (United States)

    Bennett, Linda Rae; Wiweko, Budi; Hinting, Aucky; Adnyana, I B Putra; Pangestu, Mulyoto

    2012-09-28

    Indonesia has high levels of biological need for infertility treatment, great sociological and psychological demand for children, and yet existing infertility services are underutilized. Access to adequate comprehensive reproductive health services, including infertility care, is a basic reproductive right regardless of the economic circumstances in which individuals are born into. Thus, identifying and implementing strategies to improve access to assisted reproductive technology (ART) in Indonesia is imperative. The principle objectives of this article are to improve our understanding of infertility patients' patterns of health seeking behaviour and their patterns of access to infertility treatment in Indonesia, in order to highlight the possibilities for improving access. An interviewer-administered survey was conducted with 212 female infertility patients recruited through three Indonesian infertility clinics between July and September 2011. Participants were self-selected and data was subject to descriptive statistical analysis. Patients identified a number of barriers to access, including: low confidence in infertility treatment and high rates of switching between providers due to perceived treatment failure; the number and location of clinics; the lack of a well established referral system; the cost of treatment; and patients also experienced fear of receiving a diagnosis of sterility, of vaginal examinations and of embarrassment. Women's age of marriage and the timing of their initial presentation to gynaecologists were not found to be barriers to timely access to infertility care. The findings based on the responses of 212 female infertility patients indicated four key areas of opportunity for improving access to infertility care. Firstly, greater patient education about the nature and progression of infertility care was required among this group of women. Secondly, increased resources in terms of the number and distribution of infertility clinics would

  9. Indonesian infertility patients’ health seeking behaviour and patterns of access to biomedical infertility care: an interviewer administered survey conducted in three clinics

    Science.gov (United States)

    2012-01-01

    Background Indonesia has high levels of biological need for infertility treatment, great sociological and psychological demand for children, and yet existing infertility services are underutilized. Access to adequate comprehensive reproductive health services, including infertility care, is a basic reproductive right regardless of the economic circumstances in which individuals are born into. Thus, identifying and implementing strategies to improve access to assisted reproductive technology (ART) in Indonesia is imperative. The principle objectives of this article are to improve our understanding of infertility patients’ patterns of health seeking behaviour and their patterns of access to infertility treatment in Indonesia, in order to highlight the possibilities for improving access. Methods An interviewer-administered survey was conducted with 212 female infertility patients recruited through three Indonesian infertility clinics between July and September 2011. Participants were self-selected and data was subject to descriptive statistical analysis. Results Patients identified a number of barriers to access, including: low confidence in infertility treatment and high rates of switching between providers due to perceived treatment failure; the number and location of clinics; the lack of a well established referral system; the cost of treatment; and patients also experienced fear of receiving a diagnosis of sterility, of vaginal examinations and of embarrassment. Women’s age of marriage and the timing of their initial presentation to gynaecologists were not found to be barriers to timely access to infertility care. Conclusions The findings based on the responses of 212 female infertility patients indicated four key areas of opportunity for improving access to infertility care. Firstly, greater patient education about the nature and progression of infertility care was required among this group of women. Secondly, increased resources in terms of the number and

  10. Los sistemas de género y/en la Encuesta Nacional de Salud Gender systems and/in the Spanish National Health Interview Survey

    Directory of Open Access Journals (Sweden)

    María Teresa Ruiz Cantero

    2006-12-01

    Full Text Available Objetivo: Analizar la Encuesta Nacional de Salud (ENS desde la perspectiva de géneros, con especial énfasis en la división sexual del trabajo. Métodos: Análisis del contenido de la ENS-2003 desde la perspectiva del género, entendiéndolo como: a base de normas sociales: responsabilidades por sexo, riesgos y problemas de salud según los roles masculinos/femeninos; b organizador de la estructura social: división sexual del trabajo, doble carga, segregación horizontal/vertical, dedicación (horas a tareas según tiempos sociales, acceso a recursos, y c componente de la identidad individual: conflictos por múltiples roles, insatisfacción con la imagen corporal, autoestima, autopercepción, reconocimiento del trabajo, asimilación sexual de género, problemas de salud por diferencias sexuales. Resultados: La ENS gira alrededor del sustentador principal, en masculino. La división sexual del trabajo doméstico se identifica con sólo una pregunta general. Al utilizar el concepto «actividad principal para empleo o trabajo reproductivo», la encuesta induce a valorarla, jerarquizarla y seleccionar una; en consecuencia, se pierde información, lo que dificulta el análisis del impacto de la doble carga en la salud. No se pregunta por horas de trabajo reproductivo y ocio. En una misma pregunta se mezclan agresiones (intencionales y accidentes (no intencionales lo que imposibilita el estudio de la violencia de género. Conclusiones: La ENS recoge la variable sexo, pero su enfoque, más descriptivo que explicativo, limita su perspectiva de género. Se pueden medir situaciones concretas de desigualdad entre hombres y mujeres relativas al trabajo remunerado, pero no es posible determinar completamente otros indicadores de desigualdad social entre ambos sexos, como la situación de las amas de casa y de doble jornada.Objective: To analyze the Spanish National Health Interview Survey (NHIS from a gender perspective, with special emphasis on gender

  11. Creativity in ethnographic interviews

    DEFF Research Database (Denmark)

    Kauffmann, Lene Teglhus

    2014-01-01

    to describe their everyday work life. By employing a methodological framework focusing on reflexive processes, interviews became consensual interactions, and the content of the interviews turned out to be analyses, interpretations and meaning making, that is, knowledge production. Interpretation and meaning...

  12. Questions in Reference Interviews.

    Science.gov (United States)

    White, Marilyn Domas

    1998-01-01

    Characterizes the questioning behavior in reference interviews preceding delegated online searches of bibliographic databases and relates it to questioning behavior in other types of interviews/settings. Compares questions asked by the information specialist and those asked by the client; findings show the information specialist dominates the…

  13. Interview, observation og dokumentanalyse

    DEFF Research Database (Denmark)

    Lindstrøm, Maria Duclos

    2014-01-01

    Kapitlet giver et eksempel på hvordan man indenfor en mixed methods-tradition (metodekombination) kan kombinere interviews, dokumentanalyse og etnografiske observationer.......Kapitlet giver et eksempel på hvordan man indenfor en mixed methods-tradition (metodekombination) kan kombinere interviews, dokumentanalyse og etnografiske observationer....

  14. Interview with Danny Kaplan

    Science.gov (United States)

    Rossman, Allan; Kaplan, Danny

    2017-01-01

    Danny Kaplan is DeWitt Wallace Professor of Mathematics and Computer Science at Macalester College. He received Macalester's Excellence in teaching Award in 2006 and the CAUSE/USCOTS Lifetime Achievement Award in 2017. This interview took place via email on March 4-June 17, 2017. Topics covered in the interview include: (1) the current state of…

  15. Literacy and Informational Interviews

    Science.gov (United States)

    Decarie, Christina

    2010-01-01

    Informational interviews are valuable tools for improving writing, editing, and interviewing skills, and they are also extremely valuable in improving the soft skills that are valued by employers, such as confidence, adaptability, the ability to set and keep deadlines, the ability to manage risk, and so on. These soft skills, this article argues,…

  16. Doing Dirty Interviewing

    DEFF Research Database (Denmark)

    Lippke, Lena; Tanggaard, Lene

    in the position of a psychologist with past experiences within supervision and consultation/coaching. The framing of the interview was build around the theme “My role in keeping students out from dropping out of the Vocational Educational Training College.” We will discuss how both the interviewer...

  17. Disease severity is associated with the use of complementary medicine to treat or manage type-2 diabetes: data from the 2002 and 2007 National Health Interview Survey

    Directory of Open Access Journals (Sweden)

    Nahin Richard L

    2012-10-01

    Full Text Available Abstract Background The overall prevalence of complementary medicine (CM use among adults in the United States with diabetes has been examined both in representative national samples and in more restricted populations. However, none of these earlier studies attempted to identify predictors of CM use to treat diabetes among the populations sampled, nor looked for a relationship between CM use and diabetes severity. Methods Combining data from the 2002 and 2007 National Health Interview Survey (NHIS, we constructed a nationally representative sample of 3,978 U.S. adults aged ≥18 years with self-reported diabetes. Both the 2002 and 2007 NHIS contained extensive questions on the use of CM. We used logistic regression to examine the association between diabetes severity and overall CM use, as well as the use of specific categories of CM. Results In adults with type-2 diabetes, 30.9% used CM for any reason, but only 3.4% used CM to treat or manage their type-2 diabetes versus 7.1% of those with type-1 diabetes. Among those using CM to treat/manage their type-2 diabetes, 77% used both CM and conventional prescription medicine for their diabetes. The most prevalent types of CM therapies used were diet-based interventions (35.19%, S.E. 5.11 and non-vitamin/non-mineral dietary supplements (33.74%, S.E. 5.07. After controlling for sociodemographic factors, we found that, based on a count of measures of diabetes severity, persons with the most severe diabetes had nearly twice the odds of using CM as those with less severe disease (OR=1.9, 95%CI 1.2-3.01. Persons who had diabetes 10 years or more (OR=1.66, 95%CI 1.04-3.66 and those that had a functional limitation resulting from their diabetes (OR=1.74, 95%CI 1.09-2.8 had greater odds of using CM than those not reporting these measures. No significant associations were observed between overall CM use and other individual measures of diabetes severity: use of diabetic medications, weak or failing kidneys

  18. Veterinary school admission interviews, part 1: literature overview.

    Science.gov (United States)

    Turnwald, G H; Spafford, M M; Edwards, J C

    2001-01-01

    An analysis of the admission interview used by schools in four health professions (veterinary medicine, allopathic medicine, optometry, and dentistry) portrays a largely similar approach to selection interviews: INTERVIEW USE: At least 80% of schools interview applicants. For schools that offer interviews, at least 40% of candidates are interviewed (a strong academic profile is the number one determinant of receiving an interview offer). The interview is one of the three most important selection tools used by schools. Less than 26% of schools fix the interview's weight in the selection process (fixed weights range from 31% to 35%). INTERVIEW PURPOSE AND CONTENT: The most common purposes of the interview are to (1) gather information, (2) make decisions, (3) verify information provided in other parts of the application, (4) recruit candidates, and/or (5) promote public relations. The most common characteristics and skills interviewers are interested in assessing are motivation for the profession, interpersonal skills, and communication skills. The desire to assess cognitive ability with the interview (>25% of schools) is surprising in view of the use of other selection tools (e.g., GPA). INTERVIEW FORMAT: Medical schools are more likely to offer two interviews per candidate, while optometry schools are more likely to offer one interview per candidate. Individual interviews (one interviewer, one candidate) are the predominant format among medical schools, while panel interviews (more than one interviewer, one candidate) are the most common format among optometry schools. The duration of the interview is 30 to 45 minutes. Interview questions most often address facts and knowledge, hypothetical situations, and the ability to meet program requirements. Most interviews do not meet the criteria for a structured interview, which has demonstrated greater validity and reliability than semi-structured or unstructured interviews. INTERVIEWERS: Interviewers are most likely to

  19. Transitioning from Clinical to Qualitative Research Interviewing

    Directory of Open Access Journals (Sweden)

    Matthew R. Hunt BSc (PT, PhD

    2011-09-01

    Full Text Available In this paper one aspect of the transition that must be made by experienced clinicians who become involved in conducting qualitative health research is examined, specifically, the differences between clinical and research interviewing. A clinician who is skillful and comfortable carrying out a clinical interview may not initially apprehend the important differences between these categories and contexts of interviewing. This situation can lead to difficulties and diminished quality of data collection because the purpose, techniques and orientation of a qualitative research interview are distinct from those of the clinical interview. Appreciation of these differences between interview contexts and genres, and strategies for addressing challenges associated with these differences, can help clinician researchers to become successful qualitative interviewers.

  20. California Air Basins

    Data.gov (United States)

    California Department of Resources — Air ResourcesCalifornia Air Resources BoardThe following datasets are from the California Air Resources Board: * arb_california_airbasins - California Air BasinsThe...

  1. Interview mit Hagen Keller

    OpenAIRE

    Guglielmotti, Paola; Isabella, Giovanni; Tiziana LAZZARI; Varanini, Gian Maria

    2008-01-01

    The first part of this interview addresses the cultural, social and political milieu that shaped Hagen Keller’s education in Germany, the relations with both his mentor Gerd Tellenbach and the other scholars; the approach to prosopography to understand the power structures. Then the interview examines the Roman experience in the Sixties (a scientific and also human one); the book Adelsherrschaft und ständische Gesellschaft and the debate that has attracted; the relationship between local hist...

  2. Interview with Yakov Sinai

    DEFF Research Database (Denmark)

    Raussen, Martin; Skau, Christian

    2015-01-01

    Yakov Sinai is the recipient of the 2014 Abel Prize of the Norvegian Academy of Science and Letters. The interview was originally published in the September 2014 issue of the Newsletter of the European Mathematical Society.......Yakov Sinai is the recipient of the 2014 Abel Prize of the Norvegian Academy of Science and Letters. The interview was originally published in the September 2014 issue of the Newsletter of the European Mathematical Society....

  3. Key Elements of a Successful Multi-System Collaboration for School-Based Mental Health: In-Depth Interviews with District and Agency Administrators

    Science.gov (United States)

    Powers, Joelle D.; Edwards, Jeffrey D.; Blackman, Kate F.; Wegmann, Kate M.

    2013-01-01

    The alarming number of youth with unmet mental health needs in the US is a significant social problem. The pilot school-based mental health project described here established an innovative multi-system partnership between an urban school district, a public mental health agency, and a local university to better meet the mental health needs of youth…

  4. From homeless to hopeless and healthless?: the health impacts of housing challenges among former foster care youth transitioning to adulthood in California.

    Science.gov (United States)

    Yen, Irene H; Hammond, Wizdom Powell; Kushel, Margot B

    2009-01-01

    A childhood history of placement in the foster care system makes the emerging adult period more complicated and problematic in a variety of ways including meeting basic needs, such as housing and health. We conducted focus groups with 31 former foster youth in San Francisco and Oakland, California to explore their housing and health care circumstances since "aging out" of the foster care system. Five key themes were identified: 1) housing circumstances have direct and indirect impacts on access to health care; 2) housing instability can impede the flow of information between social services staff and youth; 3) housing circumstances and health care differed for men and women; 4) service agency rules and structures may be developmentally mismatched with participant needs; and 5) emerging adults experience repercussions of institutional life including the suspicion of authority and mistrust of medical providers.

  5. Creating a Culturally Appropriate Web-Based Behavioral Intervention for American Indian/Alaska Native Women in Southern California: The Healthy Women Healthy Native Nation Study

    Science.gov (United States)

    Gorman, Jessica R.; Clapp, John D.; Calac, Daniel; Kolander, Chelsea; Nyquist, Corinna; Chambers, Christina D.

    2013-01-01

    Health disparities in fetal alcohol spectrum disorders (FASD) are of high importance to American Indian/Alaska Native (AI/AN) communities. We conducted focus groups and interviews with 21 AI/AN women and key informants in Southern California to modify a brief, Web-based program for screening and prevention of prenatal alcohol use. This process…

  6. Experiences From a Web- and App-Based Workplace Health Promotion Intervention Among Employees in the Social and Health Care Sector Based on Use-Data and Qualitative Interviews

    Science.gov (United States)

    Larsen, Thomas Meinert; Holm, Lotte

    2017-01-01

    Background An increasing number of Web- and app-based tools for health promotion are being developed at the moment. The ambition is generally to reach out to a larger part of the population and to help users improve their lifestyle and develop healthier habits, and thereby improve their health status. However, the positive effects are generally modest. To understand why the effects are modest, further investigation into the participants’ experiences and the social aspects of using Web- and app-based health promotion tools is needed. Objective The objectives of this study were to investigate the motivation behind taking part in and using a Web- and app-based health promotion tool (SoSu-life) at the workplace and to explore the participants’ experiences with using the tool. Methods Qualitative interviews with 26 participants who participated in a 38-week randomized controlled trial of a workplace Web- and app-based tool for health promotion were conducted. Data were supplemented with tracking the frequency of use. The basic features of the tool investigated in the trial were self-reporting of diet and exercise, personalized feedback, suggestions for activities and programs, practical tips and tricks, and a series of social features designed to support and build interactions among the participants at the workplace. Results The respondents reported typically one of the two reasons for signing up to participate in the study: either a personal wish to attain some health benefits or the more social reason that participants did not want to miss out on the social interaction with colleagues. Peer pressure from colleagues had made some participants to sign up even though they did not believe they had an unhealthy behavior. Of the total of 355 participants in the intervention group, 203 (57.2%) left the intervention before it ended. Of the remaining participants, most did not use the tool after the competition at the end of the initial 16-week period. The actual number of

  7. Future prospects for compression ignition fuel in California : fuel-related implications of possible pathways to mitigation of public health threats.

    Energy Technology Data Exchange (ETDEWEB)

    Eberhardt, J. J.; Rote, D. M.; Saricks, C. L.; Stodolsky, F.

    1999-04-08

    This paper documents methods and results of an investigation of the options for and year 2010 consequences of possible new limitations on the use of diesel fuel in California, USA. California's Air Resources Board will undertake a risk management process to determine steps necessary to protect the health and safety of the public from carcinogenic species resident on diesel combustion exhaust particles. Environmental activist groups continue to call for the elimination of diesel fuel in California and other populous states. It is the declared intention of CARB not to ban or restrict diesel fuel, per se, at this time. Thus, two ''mid-course'' strategies now appear feasible: (1) Increased penetration of natural gas, LPG, and possibly lower alcohols into the transportation fuels market, to the extent that some Cl applications would revert to spark-ignition (SI) engines. (2) New specifications requiring diesel fuel reformulation based on more detailed investigation of exhaust products of individual diesel fuel constituents.

  8. Interview with Gavin Butt

    DEFF Research Database (Denmark)

    Hasse Jørgensen, Stina; Alexandra Sofie, Jönsson

    2008-01-01

    We have interviewed Gavin Butt about his research interest in the cross-field between performance and performativity in the visual arts: queer theory, queer cultures and their histories, post-second world war U.S. art, contemporary art and critical theory.......We have interviewed Gavin Butt about his research interest in the cross-field between performance and performativity in the visual arts: queer theory, queer cultures and their histories, post-second world war U.S. art, contemporary art and critical theory....

  9. Associations between trace elements and clinical health parameters in the North Pacific loggerhead sea turtle (Caretta caretta) from Baja California Sur, Mexico.

    Science.gov (United States)

    Ley-Quiñónez, César Paúl; Rossi-Lafferriere, Natalia Alejandra; Espinoza-Carreon, Teresa Leticia; Hart, Catherine Edwina; Peckham, Sherwood Hoyt; Aguirre, Alfredo Alonso; Zavala-Norzagaray, Alan Alfredo

    2017-04-01

    This study investigated selected trace elements toxicity in sea turtles Caretta caretta population from Baja California Sur (BCS), Mexico, by analyzing associations among Zn, Se, Cu, As, Cd, Ni, Mn, Pb, and Hg with various biochemical parameters (packed cell volume, leukocytes, and selected blood parameters), and whether their concentrations could have an impact on the health status of sea turtles. Blood samples from 22 loggerhead (C. caretta) sea turtles from BCS, Mexico, were collected for trace elements on biochemistry parameter analyses. Significant associations among trace element levels and the biochemistry parameters were found: Cd vs ALP (R 2 = 0.874, p ˂ 0.001), As vs ALP (R 2 = 0.656, p ˂ 0.001), Mn vs ALP (R 2 = 0.834, p ˂ 0.001), and Ni vs LDH (R 2 = 0.587, p ˂ 0.001). This study is the first report of the biochemical parameters of the North Pacific loggerhead sea turtle (C. caretta) from Baja California Sur, Mexico, and it is the first to observe several associations with toxic and essential trace elements. Our study reinforces the usefulness of blood for the monitoring of the levels of contaminating elements and the results suggest that, based on the associations with health clinical parameters, high levels of Cd and As could be representing a risk to the North Pacific loggerhead population health.

  10. Is Nonsmoking Dangerous to the Health of Restaurants? The Effect of California's Indoor Smoking Ban on Restaurant Revenues

    Science.gov (United States)

    Stolzenberg, Lisa; D'Alessio, Stewart J.

    2007-01-01

    The state of California passed the Smoke-Free Workplace Act on January 1, 1995. This legislation effectively banned indoor smoking in all public and private workplaces including restaurants. Many restaurant owners, especially owners of restaurants that served alcohol, opposed the ban for fear that their businesses would be affected adversely…

  11. The environment modifies the relationship between social networks and secondhand smoke exposure among Korean nonsmokers in Seoul and California.

    Science.gov (United States)

    Allem, Jon-Patrick; Ayers, John W; Unger, Jennifer B; Vollinger, Robert E; Latkin, Carl; Juon, Hee-Soon; Park, Hae-Ryun; Paik, Hee-Young; Hofstetter, C Richard; Hovell, Melbourne F

    2015-03-01

    This study compared risks of secondhand smoke exposure (SHSe) among Korean nonsmokers in Seoul, South Korea and California, United States. Social networks were hypothesized to contain more smokers in Seoul than in California, and smokers were hypothesized to produce more secondhand smoke in Seoul than California, as Seoul's policies and norms are less restrictive. Telephone interviews were conducted with Korean adults in Seoul (N = 500) and California (N = 2830). In all, 69% (95% confidence interval [CI] = 64-74) of Koreans and 31% (95% CI = 29-33) of Korean Americans reported any SHSe. A total of 44% (95% CI = 40-47) of Korean family members smoked versus 29% (95% CI = 28-30) of Korean American family members (t = 7.84, P Network interventions in combination with policies and/or health campaigns may help reduce SHSe globally. © 2012 APJPH.

  12. Lack of Adoption of a Mobile App to Support Patient Self-Management of Diabetes and Hypertension in a Federally Qualified Health Center: Interview Analysis of Staff and Patients in a Failed Randomized Trial.

    Science.gov (United States)

    Thies, Kathleen; Anderson, Daren; Cramer, Benjamin

    2017-10-03

    Thousands of mobile health (mHealth) apps have been developed to support patients' management of their health, but the effectiveness of many of the apps remains unclear. While mHealth apps appear to hold promise for improving the self-management of chronic conditions across populations, failure to balance the system demands of the app with the needs, interests, or resources of the end users can undermine consumers' adoption of these technologies. The original aim of this study was to evaluate the effectiveness of a commercial mHealth app in improving clinical outcomes for adult patients in a Federally Qualified Health Center (FQHC) with uncontrolled diabetes and/or hypertension. Patients entered clinical data into the app, which also supported messaging between patients and providers. After a 4-month period of vigorous recruitment, the trial was suspended due to low enrollment and inconsistent use of the app by enrolled patients. The project aim was changed to understanding why the trial was unsuccessful. We used the user-task-context (eUTC) usability framework to develop a set of interview questions for patients and staff who were involved in the trial. All interviews were done by phone and lasted 20 to 30 minutes. Interviews were not recorded. There was a poor fit between the app, end users, and recruitment and treatment approaches in our setting. Usability testing might have revealed this prior to launch but was not an option. There was not sufficient time during routine care for clinical staff to familiarize patients with the app or to check clinical data and messages, which are unreimbursed activities. Some patients did not use the app appropriately. The lack of integration with the electronic health record (EHR) was cited as a problem for both patients and staff who also said the app was just one more thing to attend to. This brief trial underscores the pitfalls in the utilization of mHealth apps. Effective use of mHealth tools requires a good fit between the

  13. Interviewing media workers

    Directory of Open Access Journals (Sweden)

    Heike Graf

    2010-11-01

    Full Text Available The focus of this article is on the use of Niklas Luhmann’s systems theoretical approach in order to analyse interviews conducted with media workers concerning their experiences of ethnic diversity in newsrooms. Applying systems theory means constructing the interview as a social system and seeing the “data” as observations produced by the observer and not as representations of a reality. The first part of the article describes the interview methodology and the second part provides examples, from the current study, of how systems theory can be applied in order to analyse interviews. Using a difference-theoretical approach means looking at the distinctions the informants make when talking about their experiences. These main guiding distinctions can be summarised as immigrant background/competence as well as advantage/competence. Using the guiding distinction of inclusion/exclusion when interpreting the interviewees’ statements, the interdependencies of mechanisms of inclusion and exclusion in newsrooms related to ethnic background can be examined.

  14. Interviewing the moderator

    DEFF Research Database (Denmark)

    Traulsen, Janine Morgall; Almarsdóttir, Anna Birna; Björnsdóttir, Ingunn

    2004-01-01

    There has been an upsurge of academic interest in using focus groups (FGs) as a main or stand-alone qualitative method. In this article, the authors introduce a recently developed ancillary method to FGs called interviewing the moderator. The method is employed immediately after an FG and consists...

  15. Interview without a subject

    DEFF Research Database (Denmark)

    Rittenhofer, Iris

    2010-01-01

    for the accomplishment of interviews. The paper focuses on a discussion of theoretical and methodological considerations of design, approach and research strategy. These discussions are specified in relation to a project on gender and ethnicity in cultural encounters at Universities. In the paper, I introduce a research...

  16. Interview with Srinivasa Varadhan

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 17; Issue 9. Interview with Srinivasa Varadhan. S Varadhan R Sujatha. Face to Face Volume 17 Issue 9 September 2012 pp 903-912. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/017/09/0903-0912 ...

  17. The Reference Interview

    Science.gov (United States)

    King, Geraldine B.

    1972-01-01

    Good reference librarians need to be good interviewers. Unfortunately most librarians have not learned to use the technique of open questions to obtain information about the user and what he is looking for. Examples of open and closed questions with typical responses are given. (4 references) (DH)

  18. Interview with Pierre Deligne

    DEFF Research Database (Denmark)

    Raussen, Martin; Skau, Christian

    2014-01-01

    Pierre Deligne is the recipient of the 2013 Abel Prize of the Norwegian Academy of Science and Letters. This interview was conducted in May 2013 in conjunction with the Abel Prize celebration. The article originally appeared in the September 2013 issue of the Newsletter of the European Mathematical...

  19. Interview With Shelley Harwayne.

    Science.gov (United States)

    Albers, Peggy; Koshewa, Allen

    2003-01-01

    Interviews Shelley Harwayne, founder of the Manhattan New School, who has been named one of 10 new regional superintendents for New York City's public school system. Explains that Shelley's work is renowned in literacy. Discusses leadership, diversity, teaching, and professional development. (PM)

  20. TECHNOS Interview: Esther Dyson.

    Science.gov (United States)

    Raney, Mardell

    1997-01-01

    This interview with Esther Dyson, who is president and owner of EDventure Holdings which focuses on emerging information technology worldwide, discusses personal responsibility for technology; government's role; content ownership and intellectual property; Internet development; education and computers; parents' role in education; teacher…

  1. Interview with Dennis Pearl

    Science.gov (United States)

    Rossman, Allan; Pearl, Dennis

    2017-01-01

    Dennis Pearl is Professor of Statistics at Pennsylvania State University and Director of the Consortium for the Advancement of Undergraduate Statistics Education (CAUSE). He is a Fellow of the American Statistical Association. This interview took place via email on November 18-29, 2016, and provides Dennis Pearl's background story, which describes…

  2. Het cultureel interview

    NARCIS (Netherlands)

    Martine Lammertink; prof Berno van Meijel

    2014-01-01

    In Nurse Academy verscheen het volgende artikel met Martine Lammertink van PsyQ / Parnassia Groep als eerste auteur:Lammertink, M. & van Meijel, B. (2014). Het cultureel interview. Nurse Academy GGZ, 3, 32 - 35. Ook Robert Meijburg, opleider Parnassia Groep, en Diana Polhuis, Hoofdopleider GGZ-VS,

  3. 'Complex' but coping: experience of symptoms of tuberculosis and health care seeking behaviours - a qualitative interview study of urban risk groups, London, UK

    OpenAIRE

    Craig, G. M.; Joly, L.; Zumla, A

    2014-01-01

    Background\\ud Tuberculosis awareness, grounded in social cognition models of health care seeking behaviour, relies on the ability of individuals to recognise symptoms, assess their risk and access health care (passive case finding). There is scant published research into the health actions of ‘hard-to-reach’ groups with tuberculosis, who represent approximately 17% of the London TB caseload. This study aimed to analyse patients’ knowledge of tuberculosis, their experiences of symptoms and the...

  4. Experiencias de mujeres mexicanas migrantes indocumentadas en California, Estados Unidos, en su acceso a los servicios de salud sexual y reproductiva: estudio de caso Experiências de mulheres mexicanas migrantes sem documentação na Califórnia, Estados Unidos, no acesso aos serviços de saúde sexual e reprodutiva: estudo de caso Experiences of undocumented Mexican migrant women when accessing sexual and reproductive health services in California, USA: a case study

    Directory of Open Access Journals (Sweden)

    Sandra G. García

    2013-05-01

    ção das enfermidades. Deve-se incorporar a perspectiva intercultural nos serviços de saúde.This study focuses on the experience of Mexican women migrants in California, USA, with the use of formal health services for sexual and reproductive health issues. The authors used a qualitative interpretative approach with life histories, interviewing eight female users of healthcare services in California and seven key informants in Mexico and California. There were three main types of barriers to healthcare: immigration status, language, and gender. Participants reported long waiting times, discriminatory attitudes, and high cost of services. A combination of formal and informal healthcare services was common. The assessment of quality of care was closely related to undocumented immigration status. Social support networks are crucial to help solve healthcare issues. Quality of care should take intercultural health issues into account.

  5. Motivational Interviewing among HIV Health Care Providers: Challenges and opportunities to enhance engagement and retention in care in Buenos Aires, Argentina

    Science.gov (United States)

    Bofill, Lina; Weiss, Stephen M; Lucas, Mar; Bordato, Alejandra; Dorigo, Analia; Fernandez-Cabanillas, Graciela; Aristegui, Ines; Lopez, Maria; Waldrop-Valverde, Drenna; Jones, Deborah

    2016-01-01

    Providers’ response to Motivational Interviewing (MI) to improve engagement and retention in care among challenging patients with HIV in Argentina were evaluated. 12 HIV care physicians participated and video recordings pre- and post-MI training were obtained. One week post-training 11/12 participants were committed to using MI strategies during consult session. 9/12 participants demonstrated appropriate utilization of MI techniques and increased adherence focused discussion and care (t = 3.59, p = .006). MI appears to be a viable strategy to enhance engagement and retention in challenging HIV patients. PMID:26056148

  6. Health care for children with diabetes mellitus from low-income families in Ontario and California: a population-based cohort study

    Science.gov (United States)

    Kaiser, Sunitha V.; Sundaram, Vandana; Cohen, Eyal; Shulman, Rayzel; Guan, Jun; Sanders, Lee; Guttmann, Astrid

    2016-01-01

    Background: Children with diabetes mellitus in low-income families have poor outcomes, but little is known as to how this relates to healthcare system structure. Our objective was to gain insight into how best to structure health systems to serve these children by describing their health care use in 2 health system models: a Canadian model, with an organized diabetes care network that includes generalists, and an American model, with targeted support services for children from low-income families. Methods: We performed a population-based retrospective cohort study involving children aged 1-17 years with type 1 diabetes mellitus. We used administrative data from between 2009 and 2012 from the California Children's Services program and Ontario. We used Ontario Drug Benefit Program enrolment to identify children from low-income families. Proportions of children receiving 2 or more routine diabetes visits per year were compared using χ2 tests, and diabetes-complication hospital admission rates were compared using direct standardization. Results: More California children from low-income families (n = 4922) received routine care for diabetes from pediatric endocrinologists (63.9% v. 26.9%, p < 0.001) and used insulin pumps (22.8% v. 16.4%, p < 0.001) than Ontario children (n = 2050).California children from low-income families were less likely than Ontario children to receive 2 visits for routine diabetes care per year (64.7% v. 75.7%, p < 0.001), and had slightly higher per-patient year hospital admission rates for diabetes complications (absolute differences 0.02, 95% confidence interval [CI] 0.02-0.02, for boys; 0.03, 95% CI 0.03-0.03, for girls). Interpretation: Ontario children from low-income families received more routine diabetes care than did California children from low-income families. Both groups of children had clinically comparable rates of hospital admission for diabetes complications. Diabetes care networks that integrate generalists may play a role in

  7. Cultural adaptation of the Latin American version of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI) (v 3.0) for use in Spain.

    Science.gov (United States)

    Navarro-Mateu, Fernando; Morán-Sánchez, Inés; Alonso, Jordi; Tormo, Ma José; Pujalte, Ma Luisa; Garriga, Ascensión; Aguilar-Gaxiola, Sergio; Navarro, Carmen

    2013-01-01

    To develop a Spanish version of the WHO-Composite International Diagnostic Interview (WHO-CIDI) applicable to Spain, through cultural adaptation of its most recent Latin American (LA v 20.0) version. A 1-week training course on the WHO-CIDI was provided by certified trainers. An expert panel reviewed the LA version, identified words or expressions that needed to be adapted to the cultural or linguistic norms for Spain, and proposed alternative expressions that were agreed on through consensus. The entire process was supervised and approved by a member of the WHO-CIDI Editorial Committee. The changes were incorporated into a Computer Assisted Personal Interview (CAPI) format and the feasibility and administration time were pilot tested in a convenience sample of 32 volunteers. A total of 372 questions were slightly modified (almost 7% of approximately 5000 questions in the survey) and incorporated into the CAPI version of the WHO-CIDI. Most of the changes were minor - but important - linguistic adaptations, and others were related to specific Spanish institutions and currency. In the pilot study, the instrument's mean completion administration time was 2h and 10min, with an interquartile range from 1.5 to nearly 3h. All the changes made were tested and officially approved. The Latin American version of the WHO-CIDI was successfully adapted and pilot-tested in its computerized format and is now ready for use in Spain. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  8. Quality of primary care for resettled refugees in the Netherlands with chronic mental and physical health problems: a cross-sectional analysis of medical records and interview data

    NARCIS (Netherlands)

    van Melle, M.A.; Lamkaddem, M.; Stuiver, M.M.; Gerritsen, A.A.M.; Devillé, W.L.J.M.; Essink-Bot, M.-L.

    2014-01-01

    Background: A high prevalence of mental and physical ill health among refugees resettled in the Netherlands has been reported. With this study we aim to assess the quality of primary healthcare for resettled refugees in the Netherlands with chronic mental and non-communicable health problems, we

  9. Quality of primary care for resettled refugees in the Netherlands with chronic mental and physical health problems: a cross-sectional analysis of medical records and interview data.

    NARCIS (Netherlands)

    Melle, M.A. van; Lamkaddem, M.; Stuiver, M.M.; Gerritsen, A.A.M.; Devillé, W.L.J.M.; Essink-Bot, M.L.

    2014-01-01

    Background: A high prevalence of mental and physical ill health among refugees resettled in the Netherlands has been reported. With this study we aim to assess the quality of primary healthcare for resettled refugees in the Netherlands with chronic mental and non-communicable health problems, we

  10. Engaging families through motivational interviewing.

    Science.gov (United States)

    Williams, Adrienne A; Wright, Katherine S

    2014-10-01

    Helping parents change key behaviors may reduce the risk of child maltreatment. However, traditional provider-centered approaches to working with the parents of pediatric patients may increase resistance to behavioral change. Motivational interviewing (MI) is a patient-centered communication technique that helps address problems of provider-centered approaches. In this article, evidence for use of MI to address several risk factors for child maltreatment is reviewed, including parental substance abuse, partner violence, depression treatment, harsh punishment, and parental management of children's health. Fundamental components of MI that may be incorporated into clinical practice are presented. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. [Sensitivity and specificity between the Composite International Diagnostic Interview Version 3.0 (World Mental Health, CIDI) and the Standardised Clinical Evaluation version I (SCID-I) in a mental health survey of the city of Medellin, 2012].

    Science.gov (United States)

    Montoya Gonzalez, Laura Elisa; Restrepo Bernal, Diana Patricia; Mejía-Montoya, Roberto; Bareño-Silva, José; Sierra-Hincapié, Gloria; Torres de Galvis, Yolanda; Marulanda-Restrepo, Daniel; Gómez-Sierra, Natalia; Gaviria-Arbeláez, Silvia

    2016-01-01

    In order to address the mental health problems of the Colombian population it is necessary to have diagnostic tools (local and international) that are valid, easy to apply, and comparable. To compare the sensitivity and specificity between the CIDI 3.0 and the SCID-I for major depressive disorder, bipolar I and II disorder, and substance dependence disorder. Cross-sectional study comparing the life prevalence of three mental disorders in 100 subjects using the CIDI 3.0 and the SCID-I. The study was approved by the Institutional Ethics Committee. The two diagnostic interviews were performed that measured by sensitivity, specificity, positive predictive value and negative predictive value with confidence intervals of 95%. The SPSS version 21.0 software was used for data analysis. The median age was 43.5 years, with an interquartile interval of 30 years. The highest sensitivity (Se) and specificity (Sp) was observed for drug dependence diagnosis - with 80%, (95%CI, 34.94-100), and 98.46 (95%CI, 94.7-100), respectively. SCID-I and CIDI 3.0 showed different levels of sensitivity and specificity for the three disorders studied with: high for substance dependence disorder, moderate for bipolar disorder I and II, and low for major depressive disorder. Copyright © 2015 Asociación Colombiana de Psiquiatría. All rights reserved.

  12. Environmental assessment for the decommissioning and decontamination of contaminated facilities at the Laboratory for Energy-Related Health Research University of California, Davis

    Energy Technology Data Exchange (ETDEWEB)

    1992-09-01

    The Laboratory for Energy-Related Health Research (LEHR) was established in 1958 at its present location by the Atomic Energy Commission. Research at LEHR originally focused on the health effects from chronic exposures to radionuclides, primarily strontium 90 and radium 226, using beagles to simulate radiation effects on humans. In 1988, pursuant to a memorandum of agreement between the US Department of Energy (DOE) and the University of California, DOE`s Office of Energy Research decided to close out the research program, shut down LEHR, and turn the facilities and site over to the University of California, Davis (UCD) after remediation. The decontamination and decommissioning (D&D) of LEHR will be managed by the San Francisco Operations Office (SF) under DOE`s Environmental Restoration Program. This environmental assessment (EA) addresses the D&D of four site buildings and a tank trailer, and the removal of the on-site cobalt 60 (Co-60) source. Future activities at the site will include D&D of the Imhoff building and the outdoor dog pens, and may include remediation of underground tanks, and the landfill and radioactive disposal trenches. The remaining buildings on the LEHR site are not contaminated. The environmental impacts of the future activities cannot be determined at this time because the extent of contamination has not yet been ascertained. The impacts of these future activities (including the cumulative impacts of the future activities and those addressed in this EA) will be addressed in future National Environmental Policy Act (NEPA) documentation.

  13. Amalia Ballarino s interview

    CERN Multimedia

    2014-01-01

    Interview to Amalia Ballarino (CERN, TE) on the development of new electric power cables based on the superconducting mater