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...
The NHIS collects data on a broad range of health topics through personal household interviews. The results of NHIS provide data to track health status, health care access, and progress toward achieving national health objectives.
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...
Hupkens, C L; van den Berg, J; van der Zee, J
In order to study the value of national health interview surveys for national and international research and policy activities, this paper examines the existence and content of recent and future health interview surveys in the 15 member states of the European Union (EU), Norway, Iceland and Switzerland. National health interview surveys are performed in most countries, but not in Greece (only regional surveys), Luxembourg, Ireland and Iceland (only multi-purpose surveys). The health interview surveys in the other 14 countries provide regular data on the main health topics. Of the 14 health topics that are examined in this inventory seven are measured in all countries. Questions on health status (e.g. self-assessed health, long-term physical disability, and height and weight) and medical consumption (e.g. consultations with the general practitioner, GP) are often included. Lifestyle topics are less often included, except smoking habits, information about which is sought in all countries. Topics like diet and drugs/narcotics are more often included in special surveys than in general health interview surveys. Despite differences in the content, frequency and methodology of national health interview surveys in different countries, these surveys are a valuable source of information on the health of Europeans.
Hupkens, C.L.H.; Berg, J. van den; Zee, J. van der
In order to study the value of national health interview surveys for national and international research and policy activities, this paper examines the existence and content of recent and future health interview surveys in the 15 member states of the European Union (EU), Norway, Iceland and
Luckhaupt, Sara E; Sestito, John P
To describe data from the National Health Interview Survey (NHIS), both the annual core survey and periodic occupational health supplements (OHSs), available for examining national trends in worker health. The NHIS is an annual in-person household survey with a cross-sectional multistage clustered sample design to produce nationally representative health data. The 2010 NHIS included an OHS. Prevalence rates of various health conditions and health behaviors among workers based on multiple years of NHIS core data are available. In addition, the 2010 NHIS-OHS data provide prevalence rates of selected health conditions, work organization factors, and occupational exposures among US workers by industry and occupation. The publicly available NHIS data can be used to identify areas of concern for various industries and for benchmarking data from specific worker groups against national averages.
Kobau, R; Cui, W; Kadima, N; Zack, MM; Sajatovic, M; Kaiboriboon, K; Jobst, B
Objective This study provides population-based estimates of psychosocial health among U.S. adults with epilepsy from the 2010 National Health Interview Survey. Methods Multinomial logistic regression was used to estimate the prevalence of the following measures of psychosocial health among adults with and those without epilepsy: 1) the Kessler-6 scale of Serious Psychological Distress; 2) cognitive limitation; the extent of impairments associated with psychological problems; and work limitation; 3) Social participation; and 4) the Patient Reported Outcome Measurement Information System Global Health scale. Results Compared with adults without epilepsy, adults with epilepsy, especially those with active epilepsy, reported significantly worse psychological health, more cognitive impairment, difficulty in participating in some social activities, and reduced health-related quality of life (HRQOL). Conclusions These disparities in psychosocial health in U.S. adults with epilepsy serve as baseline national estimates of their HRQOL, consistent with Healthy People 2020 national objectives on HRQOL. PMID:25305435
Ward, Brian W; Dahlhamer, James M; Galinsky, Adena M; Joestl, Sarah S
To provide national estimates for indicators of health-related behaviors, health status, health care service utilization, and health care access by sexual orientation using data from the 2013 National Health Interview Survey (NHIS). NHIS is an annual multipurpose health survey conducted continuously throughout the year. Analyses were based on data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Differences in health-related behaviors, health status, health care service utilization, and health care access by sexual orientation were examined for adults aged 18-64, and separately for men and women. Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay or lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ''something else,'' stated ''I don't know the answer,'' or refused to provide an answer. Significant differences were found in health-related behaviors, health status, health care service utilization, and health care access among U.S. adults aged 18-64 who identified as straight, gay or lesbian, or bisexual. NHIS sexual orientation data can be used to track progress toward meeting the Healthy People 2020 goals and objectives related to the health of lesbian, gay, and bisexual persons. In addition, the data can be used to examine a wide range of health disparities among adults identifying as straight, gay or lesbian, or bisexual. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Dragon, Christina N; Laffan, Alison M; Erdem, Erkan; Cahill, Sean R; Kenefick, Daniel; Ye, Jiahui; Haffer, Samuel C
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.
Wilkinson, Joanne E.; Saper, Robert B.; Rosen, Amy K.; Welles, Seth L.; Culpepper, Larry
Background and Objectives Prayer for health (PFH) is common; in 2002, 35% of US adults prayed for their health. We examined the relationship of PFH and primary care visits, with a special focus on African American women, using data from the 2002 National Health Interview Survey (NHIS). Methods We used chi-square analyses to compare the demographic (age group, gender, race, region, marital status, educational level, ethnicity) and health-related covariates (alcohol use, smoking status, and selected medical conditions) between individuals who did and did not pray for their health in the past year. Univariate associations between PFH and visit to primary care provider (PCP), with Mantel-Haenszel adjustment for confounding, were determined. Multivariate regression was used to determine independent factors associated with PFH and PCP visit, with SUDAAN to adjust for the clustered survey design. Results Subjects who prayed were more likely to be female, older than 58, Black, Southern, separated, divorced or widowed, and nondrinkers. Subjects who prayed were also more likely to have seen a PCP within the past year. Black women who prayed were also more likely to see a PCP. Conclusions These findings suggest that people who pray for their health do so in addition to, not instead of, seeking primary care. This finding is maintained but with a smaller effect size, in Black women. PMID:18830839
Viana, Joseph; Grant, David; Cochran, Susan D.; Lee, Annie C.; Ponce, Ninez A.
Objectives. We explored changes in sexual orientation question item completion in a large statewide health survey. Methods. We used 2003 to 2011 California Health Interview Survey data to investigate sexual orientation item nonresponse and sexual minority self-identification trends in a cross-sectional sample representing the noninstitutionalized California household population aged 18 to 70 years (n = 182 812 adults). Results. Asians, Hispanics, limited-English-proficient respondents, and those interviewed in non-English languages showed the greatest declines in sexual orientation item nonresponse. Asian women, regardless of English-proficiency status, had the highest odds of item nonresponse. Spanish interviews produced more nonresponse than English interviews and Asian-language interviews produced less nonresponse when we controlled for demographic factors and survey cycle. Sexual minority self-identification increased in concert with the item nonresponse decline. Conclusions. Sexual orientation nonresponse declines and the increase in sexual minority identification suggest greater acceptability of sexual orientation assessment in surveys. Item nonresponse rate convergence among races/ethnicities, language proficiency groups, and interview languages shows that sexual orientation can be measured in surveys of diverse populations. PMID:25790399
Kjøller, Mette; Thoning, Henrik
BACKGROUND: The types and quantity of non-response in surveys influence the extent to which the results may be generalized. This study analysed trends in non-response in the Danish Health Interview Surveys from 1987 to 1994 and used the National Patient Registry to assess whether non-response bia......BACKGROUND: The types and quantity of non-response in surveys influence the extent to which the results may be generalized. This study analysed trends in non-response in the Danish Health Interview Surveys from 1987 to 1994 and used the National Patient Registry to assess whether non...... respondents before data collection but similar during and after data collection. The rate was higher during the whole period among ill or disabled non-respondents. Among people who could not be contacted during the data collection period a higher admission rate was only found immediately before and during...
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
Pleis, J. R.; Ward, B. W.; Lucas, J. W.
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…
Suresh, Sivaranjani; Sabanayagam, Charumathi; Kalidindi, Sita; Shankar, Anoop
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...
Parker, JD; Kravets, N; Woodruff, TJ
Objective This report describes the linkage between the National Health Interview Survey (NHIS) and air monitoring data from the U.S. Environmental Protection Agency (EPA). There have been few linkages of these data sources, partly because of restrictions on releasing geographic detail from NHIS on public-use files in order to protect participant confidentiality. Methods Pollution exposures for NHIS respondents were calculated by averaging the annual average exposure estimates from EPA air mo...
Velden, J. van der; Abrahamse, H.P.H.; Donker, G.; Steen, J. van der; Sonsbeek, J.L.A. van; Bos, G.A.M. van den
This study examines the concurrent validity of a list of chronic conditions used in health interview surveys. The results regarding the prevalence of chronic diseases from three health interview surveys, carried out in The Netherlands during the 1980s, were compared. In addition, the results for
The 2002, 2007, and 2012 complementary medicine questionnaires fielded on the National Health Interview Survey provide the most comprehensive data on complementary medicine available for the United States. They filled the void for large-scale, nationally representative, publicly available datasets on the out-of-pocket costs, prevalence, and reasons for use of complementary medicine in the U.S. Despite their wide use, this is the first article describing the multi-faceted and largely qualitative processes undertaken to develop the surveys. We hope this in-depth description enables policy makers and researchers to better judge the content validity and utility of the questionnaires and their resultant publications. PMID:24267412
The interviewing study data in the title were initially contained in the official request of Hiroshima City and Prefecture, which had been presented to MHLW (Ministry of Health, Labor and Welfare) in 2010, concerning spread of previously defined A-bomb exposed regions and were statistically reanalyzed based on the requirement of the consequent MHLW council. The data were originally derived from the questionnaire in 2008 about the health attitude survey by Hiroshima authorities, from which 892 survivors had received the interview together with self-writing, and answers of 869 parsons (524 males) were finally subjected to the present reanalysis. Measures of the interview involved the SF-36 (Medical Outcome Study Short Form 36-item Health Survey) for QOL, GHQ28 (General Health Questionnaire 28-item) for screening of neurosis/depression, and CAPS (Clinician Administered PTSD Scale) for diagnosis of PTSD (post traumatic stress disorder), etc. These measures were analyzed along with classes of A-bomb experience with adjustment factors of sex, age and income by multiple-/multivariate logistic-regression. It was found that measures were tended to be worse in groups experiencing the black rain without effects of adjustment factors, which was similar to groups experiencing the heavier rainfall; however, these results were statistically insignificant. (T.T.)
Krug, S; Jordan, S; Mensink, G B M; Müters, S; Finger, J; Lampert, T
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.
Calzo, Jerel P; Mays, Vickie M; Björkenstam, Charlotte; Björkenstam, Emma; Kosidou, Kyriaki; Cochran, Susan D
Debate persists about whether parental sexual orientation affects children's well-being. This study utilized information from the 2013 to 2015 U.S., population-based National Health Interview Survey to examine associations between parental sexual orientation and children's well-being. Parents reported their children's (aged 4-17 years old, N = 21,103) emotional and mental health difficulties using the short form Strengths and Difficulties Questionnaire (SDQ). Children of bisexual parents had higher SDQ scores than children of heterosexual parents. Adjusting for parental psychological distress (a minority stress indicator) eliminated this difference. Children of lesbian and gay parents did not differ from children of heterosexual parents in emotional and mental health difficulties, yet, the results among children of bisexual parents warrant more research examining the impact of minority stress on families. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.
Ramos, Alberto R; Wallace, Douglas M; Williams, Natasha J; Spence, David Warren; Pandi-Perumal, Seithikurippu Ratnas; Zizi, Ferdinand; Jean-Louis, Girardin
Visual impairment (VI) is associated with increased mortality and health factors such as depression and cardiovascular disease. Epidemiologic studies consistently show associations between sleep duration with adverse health outcomes, but these have not systematically considered the influence of VI. The aim of this study was to ascertain the independent association between VI and sleep duration using the National Health Interview Survey (NHIS) data. We also examined whether race/ethnicity influenced these associations independently of sociodemographic and medical characteristics. Our analysis was based on the 2009 NHIS, providing valid sleep and vision data for 29,815 participants. The NHIS is a cross-sectional household interview survey utilizing a multistage area probability design. Trained personnel from the US census bureau gathered data during face-to-face interview and obtained socio-demographic, self-reported habitual sleep duration and physician-diagnosed chronic conditions. The mean age of the sample was 48 years and 56% were female. Short sleep and long sleep durations were reported by 49% and 23% of the participants, respectively. Visual impairment was observed in 10%. Multivariate-adjusted logistic regression models showed significant associations between VI and short sleep (OR = 1.6, 95% CI = 1.5-1.9 and long sleep durations (OR = 1.6, 95% CI = 1.3-1.9). These associations persisted in multivariate models stratified by race-ethnic groups. Visual impairment was associated with both short and long sleep durations. Analysis of epidemiologic sleep data should consider visual impairment as an important factor likely to influence the amount of sleep experienced habitually.
Gindi, Renee; Cohen, Robin A.
Objectives Using linked administrative data, to validate Medicare coverage estimates among adults aged 65 or older from the National Health Interview Survey (NHIS), and to assess the impact of a recently added Medicare probe question on the validity of these estimates. Data sources Linked 2005 NHIS and Master Beneficiary Record and Payment History Update System files from the Social Security Administration (SSA). Study design We compared Medicare coverage reported on NHIS with “benchmark” benefit records from SSA. Principal findings With the addition of the probe question, more reports of coverage were captured, and the agreement between the NHIS-reported coverage and SSA records increased from 88% to 95%. Few additional overreports were observed. Conclusions Increased accuracy of the Medicare coverage status of NHIS participants was achieved with the Medicare probe question. Though some misclassification remains, data users interested in Medicare coverage as an outcome or correlate can use this survey measure with confidence. PMID:24800138
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.
Nolan Vikki G
Full Text Available Abstract Background The purpose of this study was to determine whether the National Health Interview Survey is a useful source to identify informative families for genetic studies of birth defects. Methods The 1994/1995 National Health Interview Survey (NHIS was used to identify households where individuals with two or more birth defects reside. Four groups of households were identified: 1 single non-familial (one individual with one birth defect; 2 single familial (more than one individual with one birth defect; 3 multiple non-familial (one individual with more than one birth defect, and 4 multiple familial (more than one individual with more than one birth defect. The March 2000 U.S. Census on households was used to estimate the total number of households in which there are individuals with birth defects. Results Of a total of 28,094 households and surveyed about birth defects and impairments, 1,083 single non-familial, 55 multiple non-familial, 54 single familial, and 8 multiple familial households were identified. Based on the 2000 U.S. census, it is estimated that there are 4,472,385 households where at least one person has one birth defect in the United States and in 234,846 of them there are at least two affected individuals. Western states had the highest prevalence rates. Conclusions Population-based methods, such as the NHIS, are modestly useful to identify the number and the regions where candidate families for genetic studies of birth defects reside. Clinic based studies and birth defects surveillance systems that collect family history offer better probability of ascertainment.
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
Ekholm, Ola; Gundgaard, Jens; Rasmussen, Niels K R
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...... 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.......: Data derives from The Danish Health Interview Survey 2000 (face-to-face interview) and The Funen County Health Survey 2000/2001 (telephone interview). Data on all invited individuals were obtained from administrative registers and linked to survey data at individual level. Multiple logistic regression...
Ruiz Cantero, María Teresa; Papí Gálvez, Natalia; Carbrera Ruiz, Virginia; Ruiz Martínez, Ana; Alvarez-Dardet Díaz, Carlos
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.
Khubchandani, Jagdish; Price, James H
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 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.
Pure, Elise; Terhorst, Lauren; Baker, Nancy
The use of manual therapies (chiropractic manipulation, massage) and movement therapies (yoga, tai chi) by people with arthritis may relate to their personal characteristics, and the reported emotional and physical health outcomes may differ by type of therapy. To describe personal characteristics and predictors of manual and movement therapy use for people with arthritis, and to compare the use of manual versus movement therapy to improve physical and emotional health outcomes for people with arthritis. CAM respondents with arthritis were identified from the 2012 National Health Interview Survey (n = 8229). Data were analyzed to determine the overall percentages of CAM users, and to examine the associations between use/nonuse using multivariable linear regressions. White, well-educated, physically active females were more likely to use both types of therapy. Movement therapy users reported positive emotional health outcomes twice as much as manual therapy users and 10% more reported positive physical health outcomes. While both movement and manual therapies can have positive effects on people with arthritis, it appears that active therapies are more beneficial than passive therapies. Copyright © 2018 Elsevier Ltd. All rights reserved.
Johnson, Kimberly J; Lee, S Hannah
The present study investigated how volunteering was influenced by individual resources and social capital among four racial/ethnic groups of adults aged 50 and older. The data came from the California Health Interview Survey, a statewide sample that includes non-Hispanic Whites ( n = 18,927), non-Hispanic Asians ( n = 2,428), non-Hispanic Blacks ( n = 1,265), and Hispanics ( n = 3,799). Logistic regression models of volunteering were estimated to explore the effects of human and social capital within and across the racial/ethnic groups. Compared to Whites, racial/ethnic minority adults volunteered less. Although education was a significant predictor of volunteering across all groups, the findings indicated group-specific factors related to human and social capital. Results showed similarities and differences associated with volunteer participation among diverse racial/ethnic groups. The findings underscore the importance of understanding ways of creating inclusive opportunities for civic engagement among an increasingly diverse population.
Sauer, Ann Goding; Liu, Benmei; Siegel, Rebecca L; Jemal, Ahmedin; Fedewa, Stacey A
Cancer screening prevalence from the Behavioral Risk Factor Surveillance System (BRFSS), designed to provide state-level estimates, and the National Health Interview Survey (NHIS), designed to provide national estimates, are used to measure progress in cancer control. A detailed description of the extent to which recent cancer screening estimates vary by key demographic characteristics has not been previously described. We examined national prevalence estimates for recommended breast, cervical, and colorectal cancer screening using data from the 2012 and 2014 BRFSS and the 2010 and 2013 NHIS. Treating the NHIS estimates as the reference, direct differences (DD) were calculated by subtracting NHIS estimates from BRFSS estimates. Relative differences were computed by dividing the DD by the NHIS estimates. Two-sample t-tests (2-tails), were performed to test for statistically significant differences. BRFSS screening estimates were higher than those from NHIS for breast (78.4% versus 72.5%; DD=5.9%, pNHIS, each survey has a unique and important role in providing information to track cancer screening utilization among various populations. Awareness of these differences and their potential causes is important when comparing the surveys and determining the best application for each data source. Copyright © 2017 Elsevier Inc. All rights reserved.
Elliott, John O; Lu, Bo; Moore, J Layne; McAuley, James W; Long, Lucretia
Based on the 2005 California Health Interview Survey, persons with a history of epilepsy report lower educational attainment, lower annual income, and poorer health status, similar to other state-based epidemiological surveys. Previous studies have found persons with epilepsy exercise less and smoke more than the nonepilepsy population. The medical literature has also shown that antiepileptic drugs may cause nutritional deficiencies. Persons with a history of epilepsy in the 2005 CHIS report they walk more for transportation, drink more soda, and eat less salad than the nonepilepsy population. Exercise and dietary behaviors at recommended levels have been found to reduce mortality from many comorbid conditions such as cardiovascular disease, stroke, depression, anxiety, and osteoporosis for which persons with epilepsy are at increased risk. Health professionals in the epilepsy field should step up their efforts to engage patients in health promotion, especially in the areas of exercise, diet, and smoking cessation.
Drieskens, Sabine; Demarest, Stefaan; D'Hoker, Nicola; Ortiz, Barbara; Tafforeau, Jean
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. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Asfaw, Abay G; Chang, Chia C; Ray, Tapas K
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.
Patel, Minal R; Leo, Harvey L; Baptist, Alan P; Cao, Yanyun; Brown, Randall W
More Americans are managing multiple chronic conditions (MCCs), and trends are particularly alarming in youth. The purpose of this study was to examine the prevalence and distribution of 9 chronic conditions in children and adolescents with and without asthma, and adverse asthma outcomes associated with having MCCs. Cross-sectional interview data from the National Health Interview Survey were analyzed (N = 66,790) between 2007 and 2012 in youth 0 to 17 years of age. Bivariate analysis methods and multivariate generalized linear regression were used to examine associations. Five percent of children with asthma had 1 or more coexisting health conditions. The prevalence of 1 or more comorbidities was greater among those with asthma than those without (5.07% [95% CI: 4.5-5.6] vs. 2.73% [95% CI: 2.6-2.9]). Those with asthma were twice as likely to have co-occurring hypertension (prevalence ratio [PR] = 2.2 [95% CI: 1.5-3.2]) and arthritis (PR = 2.7 [95% CI: 1.8-4.0]) compared with those without asthma. Every additional chronic condition with asthma was associated with a greater likelihood of an asthma attack (PR = 1.1 [95% CI: 1.0-1.2]), all-cause emergency department visits (PR = 1.3 [95% CI: 1.1-1.5]), and missed school days (PR = 2.3 [95% CI: 1.7-3.2]). Children and adolescents with asthma in the US who suffer from MCCs have increased asthma symptoms, missed school days, and all-cause emergency department visits. Further research on optimal management strategies for this group is needed. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Wang, Yueyan; Ponce, Ninez A; Wang, Pan; Opsomer, Jean D; Yu, Hongjian
We propose a method to meet challenges in generating health estimates for granular geographic areas in which the survey sample size is extremely small. Our generalized linear mixed model predicts health outcomes using both individual-level and neighborhood-level predictors. The model's feature of nonparametric smoothing function on neighborhood-level variables better captures the association between neighborhood environment and the outcome. Using 2011 to 2012 data from the California Health Interview Survey, we demonstrate an empirical application of this method to estimate the fraction of residents without health insurance for Zip Code Tabulation Areas (ZCTAs). Our method generated stable estimates of uninsurance for 1519 of 1765 ZCTAs (86%) in California. For some areas with great socioeconomic diversity across adjacent neighborhoods, such as Los Angeles County, the modeled uninsured estimates revealed much heterogeneity among geographically adjacent ZCTAs. The proposed method can increase the value of health surveys by providing modeled estimates for health data at a granular geographic level. It can account for variations in health outcomes at the neighborhood level as a result of both socioeconomic characteristics and geographic locations.
Suresh, Sivaranjani; Sabanayagam, Charumathi; Kalidindi, Sita; Shankar, Anoop
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 users of cell phone and landline, and predominantly cell-phone users. The main outcome of interest was self-reported physician-diagnosed hypertension (n = 6,793). Results. 43.5% of the participants were cell-phone nonusers, while 13.8% were predominantly cell-phone users. We found that cell-phone use was inversely associated with hypertension, independent of age, sex, race/ethnicity, smoking, alcohol consumption, education, body mass index (BMI), and physical activity. Compared to cell-phone nonusers, the multivariable odds ratio (95% confidence interval) of hypertension was 0.86 (0.75-0.98, P trend = .005) among predominantly cell-phone users. This inverse association between cell-phone use and hypertension was stronger in women, those aged <60 years, whites, and those with BMI <25 kg/m(2). Conclusion. We found that cell-phone usage was protectively associated with self-reported hypertension in a nationally representative sample of US adults.
Newsome, Valerie; Seixas, Azizi; Iwelunmor, Juliet; Zizi, Ferdinand; Kothare, Sanjeev; Jean-Louis, Girardin
While sleep disturbance has been related to a number of negative health outcomes, few studies have examined the relationship between place of birth and sleep duration among individuals living in the US. Data for 416,152 adult participants in the 2000-2013 National Health Interview Survey (NHIS), who provided self-reported hours of sleep and place of birth were examined. Associations were explored between healthy sleep (7-8 h), referenced to unhealthy sleep (8 h), and place of birth using multivariate logistic regression analysis. The mean age of the sample was 47.4 ± 0.03 years; 56% were female. Of the respondents, 61.5% reported experiencing healthy sleep, 81.5% reported being born in the US and 18.5% were foreign-born adults. Descriptive statistics revealed that Indian Subcontinent-born respondents (71.7%) were more likely to report healthy sleep compared to US-born respondents (OR = 1.53, 95% CI = 1.37-1.71, p < 0.001), whereas African-born respondents (43.5%) were least likely to report healthy sleep (OR = 0.78, 95% CI = 0.70-0.87, p < 0.001). These findings suggest that place of birth should be considered in the assessment of risk factors for unhealthy sleep.
Ward, Brian W; Ridolfo, Heather; Creamer, Lauren; Gray, Caroline
The 1994-1995 National Health Interview Survey on Disability (NHIS-D) has been one of the most unique and important data sources for studying disability, impairment, and health in the United States. In celebration of the NHIS-D's twenty-year anniversary, we created an extensive bibliography (n=212) of research that has used these data.
Ward, Brian W.; Ridolfo, Heather; Creamer, Lauren; Gray, Caroline
The 1994–1995 National Health Interview Survey on Disability (NHIS-D) has been one of the most unique and important data sources for studying disability, impairment, and health in the United States. In celebration of the NHIS-D’s twenty-year anniversary, we created an extensive bibliography (n=212) of research that has used these data. PMID:26640424
Ward, Brian W.; Ridolfo, Heather; Creamer, Lauren; Gray, Caroline
The 1994–1995 National Health Interview Survey on Disability (NHIS-D) has been one of the most unique and important data sources for studying disability, impairment, and health in the United States. In celebration of the NHIS-D’s twenty-year anniversary, we created an extensive bibliography (n=212) of research that has used these data.
Full Text Available Abstract Background Medical pluralism (MP can be defined as the employment of more than one medical system or the use of both conventional and complementary and alternative medicine (CAM for health and illness. A population-based survey and linkage with medical records was conducted to investigate MP amongst the Taiwanese population. Previous research suggests an increasing use of CAM worldwide. Methods We collected demographic data, socioeconomic information, and details about lifestyle and health behaviours from the 2001 Taiwan National Health Interview Survey. The medical records of interviewees were obtained from National Health Insurance claims data with informed consent. In this study, MP was defined as using both Western medicine and traditional Chinese medicine (TCM services in 2001. The odds ratio (OR and 95% confidence interval (CI were estimated for factors associated with adopting MP in univariate and multiple logistic regression. Results Among 12,604 eligible participants, 32.5% adopted MP. Being female (OR = 1.44, 95% CI = 1.30 - 1.61 and young (OR = 1.38, 95% CI = 1.15 - 1.66 were factors associated with adopting MP in the multiple logistic regression. People with healthy lifestyles (OR = 1.35, 95% CI = 1.19 - 1.53 were more likely to adopt MP than those with unhealthy lifestyles. Compared with people who had not used folk therapy within the past month, people who used folk therapy were more likely to adopt MP. The OR of adopting MP was higher in people who lived in highly urbanised areas as compared with those living in areas with a low degree of urbanisation. Living in an area with a high density of TCM physicians (OR = 2.19, 95% CI = 1.69 - 2.84 was the strongest predictor for adopting MP. Conclusion MP is common in Taiwan. Sociodemographic factors, unhealthy lifestyle, use of folk therapy, and living in areas with a high density of TCM physicians are all associated with MP. People who had factors associated with the adoption
Armour, Brian S; Courtney-Long, Elizabeth; Campbell, Vincent A; Wethington, Holly R
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 < .001). Movement difficulties were the most common disabilities among obese men and women, affecting 25.3% of men and 37.9% of women. This research contributes to the literature on obesity by including disability as a demographic in characterizing people by 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.
Mai, Phuong L; Vadaparampil, Susan Thomas; Breen, Nancy; McNeel, Timothy S; Wideroff, Louise; Graubard, Barry I
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% (pAwareness increased between 2005 and 2010 in most subgroups, particularly among individuals in the South (pinteraction=0.03) or with a usual place of care (pinteraction=0.01). In 2005 and 2010, awareness was positively associated with personal or family cancer history and high perceived cancer risk, and inversely associated with racial/ethnic minorities, age 25-39 or ≥60 years, male gender, lower education and income levels, public or no health insurance, and no provider contact in 12 months. Despite improvement from 2005 to 2010, ≤50% of the U.S. adult population was aware of cancer genetic testing in 2010. Notably, disparities persist for racial/ethnic minorities and individuals with limited health care access or income. Published by Elsevier Inc.
Grzywacz, Joseph G; Suerken, Cynthia K; Quandt, Sara A; Bell, Ronny A; Lang, Wei; Arcury, Thomas A
To compare complementary and alternative medicine (CAM) use among adults 65 and older with and without self-reported anxiety or depression, and to investigate the prevalence and predictors of CAM use for treatment by persons with anxiety or depression. Cross-sectional survey. Computer-assisted interviews conducted in participants' homes. Subjects included 5827 adults aged 65 and older who participated in the 2002 National Health Interview Survey including the Alternative Health Supplement. None. Overall use of CAM, use of four categories of CAM, and use of 20 CAM modalities. CAM use for treatment of any health condition, and CAM use to treat mental health. Eighty-one and seven tenths percent (81.7%) of older adults with self-reported anxiety or depression who used CAM in the past year, whereas 64.6% of older adults without these conditions used CAM. Differences in CAM use were driven by elevated use of spiritual practices, relaxation techniques, and use of nonvitamin, nonmineral natural products by patients with symptoms of mental conditions. Fewer than 20% of CAM users with self-reported anxiety or depression used CAM for their mental health. Few personal and health-related factors predicted CAM use for treatment among older adults with self-reported anxiety or depression. Older adults with self-reported anxiety or depression were more likely to use spiritual practices, relaxation techniques, and nonvitamin, nonmineral natural products than elders in good mental health. However, for the majority of older adults with self-reported anxiety or depression, CAM was used for purposes other than treating mental health.
Kwon, Simona C; Han, Benjamin H; Kranick, Julie A; Wyatt, Laura C; Blaum, Caroline S; Yi, Stella S; Trinh-Shevrin, Chau
Research suggests that fall risk among older adults varies by racial/ethnic groups; however, few studies have examined fall risk among Hispanics and Asian American older adults. Using 2011-2012 California Health Interview Survey data, this study examines falling ≥2 times in the past year by racial/ethnic groups (Asian Americans, Hispanics, and Blacks) aged ≥65, adjusting for socio-demographic characteristics, body mass index, co-morbidities, and functional limitations. A secondary analysis examines differences in fall risk by English language proficiency and race/ethnicity among Asian Americans and Hispanics. Asian Americans were significantly less likely to fall compared to non-Hispanic whites, individuals with ≥2 chronic diseases were significantly more likely to fall than individuals with fall risk, when adjusting for all factors. African Americans and Hispanics did not differ significantly from non-Hispanic whites. Analysis adjusting for race/ethnicity and English language proficiency found that limited English proficient Asian Americans were significantly less likely to fall compared to non-Hispanic whites, individuals with ≥2 chronic diseases were significantly more likely to fall than individuals with fall risk, when adjusting for all factors. No differences were found when examining by racial/ethnic and English proficient/limited English proficient groups. Further research is needed to explore factors associated with fall risks across racial/ethnic groups. Culturally relevant and targeted interventions are needed to prevent falls and subsequent injuries in the increasingly diverse aging population in the USA.
Paul, Prabasaj; Carlson, Susan A; Carroll, Dianna D; Berrigan, David; Fulton, Janet E
Walking, the most commonly reported physical activity among U.S. adults, is undertaken in various domains, including transportation and leisure. This study examined prevalence, bout length, and mean amount of walking in the last week for transportation and leisure, by selected characteristics. Self-reported data from the 2010 National Health Interview Survey (N = 24,017) were analyzed. Prevalence of transportation walking was 29.4% (95% CI: 28.6%-30.3%) and of leisure walking was 50.0% (95% CI: 49.1%-51.0%). Prevalence of transportation walking was higher among men; prevalence of leisure walking was higher among women. Most (52.4%) transportation walking bouts were 10 to 15 minutes; leisure walking bouts were distributed more evenly (28.0%, 10-15 minutes; 17.1%, 41-60 minutes). Mean time spent in transportation walking was higher among men, decreased with increasing BMI, and varied by race/ethnicity and region of residence. Mean time spent leisure walking increased with increasing age and with decreasing BMI. Demographic correlates and patterns of walking differ by domain. Interventions focusing on either leisure or transportation walking should consider correlates for the specific walking domain. Assessing prevalence, bout length, and mean time of walking for transportation and leisure separately allows for more comprehensive surveillance of walking.
Davis, R M; Boyd, G M; Schoenborn, C A
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.
Full Text Available 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.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.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.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.
... from 2010 to 2013 were also evaluated using logistic regression analysis. State-specific health insurance estimates are ... coverage options; compare health insurance plans based on cost, benefits, and other important features; choose a plan; ...
Gonzales, Felisa A; Willis, Gordon B; Breen, Nancy; Yan, Ting; Cronin, Kathy A; Taplin, Stephen H; Yu, Mandi
Background: Using the National Health Interview Survey (NHIS), we examined the effect of question wording on estimates of past-year mammography among racially/ethnically diverse women ages 40-49 and 50-74 without a history of breast cancer. Methods: Data from one-part ("Have you had a mammogram during the past 12 months?") and two-part ("Have you ever had a mammogram"; "When did you have your most recent mammogram?") mammography history questions administered in the 2008, 2011, and 2013 NHIS were analyzed. χ 2 tests provided estimates of changes in mammography when question wording was either the same (two-part question) or differed (two-part question followed by one-part question) in the two survey years compared. Crosstabulations and regression models assessed the type, extent, and correlates of inconsistent responses to the two questions in 2013. Results: Reports of past-year mammography were slightly higher in years when the one-part question was asked than when the two-part question was asked. Nearly 10% of women provided inconsistent responses to the two questions asked in 2013. Black women ages 50 to 74 [adjusted OR (aOR), 1.50; 95% confidence interval (CI), 1.16-1.93] and women ages 40-49 in poor health (aOR, 2.22; 95% CI, 1.09-4.52) had higher odds of inconsistent responses; women without a usual source of care had lower odds (40-49: aOR, 0.42; 95% CI, 0.21-0.85; 50-74: aOR, 0.42; 95% CI, 0.24-0.74). Conclusions: Self-reports of mammography are sensitive to question wording. Researchers should use equivalent questions that have been designed to minimize response biases such as telescoping and social desirability. Impact: Trend analyses relying on differently worded questions may be misleading and conceal disparities. Cancer Epidemiol Biomarkers Prev; 26(11); 1611-8. ©2017 AACR . ©2017 American Association for Cancer Research.
Gwenyth R Wallen
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.
Schiller, Jeannine S.
Preventing and ameliorating chronic conditions has long been a priority in the United States; however, the increasing recognition that people often have multiple chronic conditions (MCC) has added a layer of complexity with which to contend. The objective of this study was to present the prevalence of MCC and the most common MCC dyads/triads by selected demographic characteristics. We used respondent-reported data from the 2010 National Health Interview Survey (NHIS) to study the US adult civilian noninstitutionalized population aged 18 years or older (n = 27,157). We categorized adults as having 0 to 1, 2 to 3, or 4 or more of the following chronic conditions: hypertension, coronary heart disease, stroke, diabetes, cancer, arthritis, hepatitis, weak or failing kidneys, chronic obstructive pulmonary disease, or current asthma. We then generated descriptive estimates and tested for significant differences. Twenty-six percent of adults have MCC; the prevalence of MCC has increased from 21.8% in 2001 to 26.0% in 2010. The prevalence of MCC significantly increased with age, was significantly higher among women than men and among non-Hispanic white and non-Hispanic black adults than Hispanic adults. The most common dyad identified was arthritis and hypertension, and the combination of arthritis, hypertension, and diabetes was the most common triad. The findings of this study contribute information to the field of MCC research. The NHIS can be used to identify population subgroups most likely to have MCC and potentially lead to clinical guidelines for people with more common MCC combinations. PMID:23618545
Bigelow, Robin T; Semenov, Yevgeniy R; du Lac, Sascha; Hoffman, Howard J; Agrawal, Yuri
Patients with vestibular disease have been observed to have concomitant cognitive and psychiatric dysfunction. We evaluated the association between vestibular vertigo, cognitive impairment and psychiatric conditions in a nationally representative sample of US adults. We performed a cross-sectional analysis using the 2008 National Health Interview Survey (NHIS), which included a Balance and Dizziness Supplement, and questions about cognitive function and psychiatric comorbidity. We evaluated the association between vestibular vertigo, cognitive impairment (memory loss, difficulty concentrating, confusion) and psychiatric diagnoses (depression, anxiety and panic disorder). We observed an 8.4% 1-year prevalence of vestibular vertigo among US adults. In adjusted analyses, individuals with vestibular vertigo had an eightfold increased odds of 'serious difficulty concentrating or remembering' (OR 8.3, 95% CI 4.8 to 14.6) and a fourfold increased odds of activity limitation due to difficulty remembering or confusion (OR 3.9, 95% CI 3.1 to 5.0) relative to the rest of the US adults. Individuals with vestibular vertigo also had a threefold increased odds of depression (OR 3.4, 95% CI 2.9 to 3.9), anxiety (OR 3.2, 95% CI 2.8 to 3.6) and panic disorder (OR 3.4, 95% CI 2.9 to 4.0). Our findings indicate that vestibular impairment is associated with increased risk of cognitive and psychiatric comorbidity. The vestibular system is anatomically connected with widespread regions of the cerebral cortex, hippocampus and amygdala. Loss of vestibular inputs may lead to impairment of these cognitive and affective circuits. Further longitudinal research is required to determine if these associations are causal. 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/
Marti-Pastor, Marc; Perez, Gloria; German, Danielle; Pont, Angels; Garin, Olatz; Alonso, Jordi; Gotsens, Mercè; Ferrer, Montse
Studies on health-related quality of life (HRQoL) inequalities according to sexual orientation are scarce. The aim of this study was to assess HRQoL inequalities between lesbian, gay, and bisexual (LGB) people and heterosexuals in the 2011 Barcelona population, to describe the extent to which sociodemographic characteristics, health-related behaviors, and chronic conditions could explain such inequalities, and to understand if they are sexual orientation inequities. In the 2011 Barcelona Health Interview Survey 3277 adults answered the EQ-5D, which measures five dimensions of HRQoL summarized into a single utility index (1 = perfect health, 0 = death). To assess HRQoL differences by sexual orientation we constructed Tobit models for the EQ-5D index, and Poisson regression models for the EQ-5D dimensions. In both cases, nested models were constructed to assess the mediator role of selected variables. After adjusting by socio-demographic variables, the LGB group presented a significantly lower EQ-5D index than heterosexuals, and higher prevalence ratios of problems in physical EQ-5D dimensions among both genders: adjusted prevalence ratio (aPR) = 1.70 for mobility (p = 0.046) and 2.11 for usual activities (p = 0.019). Differences in mental dimensions were only observed among men: aPR = 3.15 for pain/discomfort (p = 0.003) and 2.49 for anxiety/depression (p = 0.030). All these differences by sexual orientation disappeared after adding chronic conditions and health-related behaviors in the models. The LGB population presented worse HRQoL than heterosexuals in the EQ-5D index and most dimensions. Chronic conditions, health-related behaviors and gender play a major role in explaining HRQoL differences by sexual orientation. These findings support the need of including sexual orientation into the global agenda of health inequities.
Full Text Available Studies on health-related quality of life (HRQoL inequalities according to sexual orientation are scarce. The aim of this study was to assess HRQoL inequalities between lesbian, gay, and bisexual (LGB people and heterosexuals in the 2011 Barcelona population, to describe the extent to which sociodemographic characteristics, health-related behaviors, and chronic conditions could explain such inequalities, and to understand if they are sexual orientation inequities.In the 2011 Barcelona Health Interview Survey 3277 adults answered the EQ-5D, which measures five dimensions of HRQoL summarized into a single utility index (1 = perfect health, 0 = death. To assess HRQoL differences by sexual orientation we constructed Tobit models for the EQ-5D index, and Poisson regression models for the EQ-5D dimensions. In both cases, nested models were constructed to assess the mediator role of selected variables.After adjusting by socio-demographic variables, the LGB group presented a significantly lower EQ-5D index than heterosexuals, and higher prevalence ratios of problems in physical EQ-5D dimensions among both genders: adjusted prevalence ratio (aPR = 1.70 for mobility (p = 0.046 and 2.11 for usual activities (p = 0.019. Differences in mental dimensions were only observed among men: aPR = 3.15 for pain/discomfort (p = 0.003 and 2.49 for anxiety/depression (p = 0.030. All these differences by sexual orientation disappeared after adding chronic conditions and health-related behaviors in the models.The LGB population presented worse HRQoL than heterosexuals in the EQ-5D index and most dimensions. Chronic conditions, health-related behaviors and gender play a major role in explaining HRQoL differences by sexual orientation. These findings support the need of including sexual orientation into the global agenda of health inequities.
Full Text Available Abstract Background The aim of this report is to describe the main characteristics of the design, including response rates, of the Cornella Health Interview Survey Follow-up Study. Methods The original cohort consisted of 2,500 subjects (1,263 women and 1,237 men interviewed as part of the 1994 Cornella Health Interview Study. A record linkage to update the address and vital status of the cohort members was carried out using, first a deterministic method, and secondly a probabilistic one, based on each subject's first name and surnames. Subsequently, we attempted to locate the cohort members to conduct the phone follow-up interviews. A pilot study was carried out to test the overall feasibility and to modify some procedures before the field work began. Results After record linkage, 2,468 (98.7% subjects were successfully traced. Of these, 91 (3.6% were deceased, 259 (10.3% had moved to other towns, and 50 (2.0% had neither renewed their last municipal census documents nor declared having moved. After using different strategies to track and to retain cohort members, we traced 92% of the CHIS participants. From them, 1,605 subjects answered the follow-up questionnaire. Conclusion The computerized record linkage maximized the success of the follow-up that was carried out 7 years after the baseline interview. The pilot study was useful to increase the efficiency in tracing and interviewing the respondents.
Schieve, Laura A.; Gonzalez, Vanessa; Boulet, Sheree L.; Visser, Susanna N.; Rice, Catherine E.; Braun, Kim Van Naarden; Boyle, Coleen A.
Studies document various associated health risks for children with developmental disabilities (DDs). Further study is needed by disability type. Using the 2006-2010 National Health Interview Surveys, we assessed the prevalence of numerous medical conditions (e.g. asthma, frequent diarrhea/colitis, seizures), health care use measures (e.g. seeing a…
Lee, David J; Fleming, Lora E; Gómez-Marín, Orlando; LeBlanc, William G; Arheart, Kristopher L; Caban, Alberto J; Christ, Sharon L; Chung-Bridges, Katherine; Pitman, Terry
The objective of this study was to rank U.S. occupations by worker morbidity. From 1986 through 1994, morbidity information was collected on over 410,000 U.S. workers who participated in the National Health Interview Survey, an annual household survey representative of the U.S. civilian noninstitutionalized population. A multivariate adjusted logistic regression morbidity summary score was created for each worker group based on seven indicators: days of restricted activity, bedrest, and missed work in the previous 2 weeks; doctor visits and hospitalizations in the previous 12 months; reported health conditions; and health status. Worker groups reporting the greatest morbidity included social workers, inspectors, postal clerks, psychologists, and grinding machine operators; worker groups reporting the least morbidity included dentists, pilots, physicians, pharmacists, and dietitians. These findings aid in the identification of worker groups that require increased attention for morbidity research and prevention.
Hoffmann, Robert; Houben, Robin; Krause, Laura; Kamtsiuris, Panagiotis; Gößwald, Antje
Background The implementation of an Internet option in an existing public health interview survey using a mixed-mode design is attractive because of lower costs and faster data availability. Additionally, mixed-mode surveys can increase response rates and improve sample composition. However, mixed-mode designs can increase the risk of measurement error (mode effects). Objective This study aimed to determine whether the prevalence rates or mean values of self- and parent-reported health indicators for children and adolescents aged 0-17 years differ between self-administered paper-based questionnaires (SAQ-paper) and self-administered Web-based questionnaires (SAQ-Web), as well as between a single-mode control group and different mixed-mode groups. Methods Data were collected for a methodological pilot of the third wave of the "German Health Interview and Examination Survey for Children and Adolescents". Questionnaires were completed by parents or adolescents. A population-based sample of 11,140 children and adolescents aged 0-17 years was randomly allocated to 4 survey designs—a single-mode control group with paper-and-pencil questionnaires only (n=970 parents, n=343 adolescents)—and 3 mixed-mode designs, all of which offered Web-based questionnaire options. In the concurrent mixed-mode design, both questionnaires were offered at the same time (n=946 parents, n=290 adolescents); in the sequential mixed-mode design, the SAQ-Web was sent first, followed by the paper questionnaire along with a reminder (n=854 parents, n=269 adolescents); and in the preselect mixed-mode design, both options were offered and the respondents were asked to request the desired type of questionnaire (n=698 parents, n=292 adolescents). In total, 3468 questionnaires of parents of children aged 0-17 years (SAQ-Web: n=708; SAQ-paper: n=2760) and 1194 questionnaires of adolescents aged 11-17 years (SAQ-Web: n=299; SAQ-paper: n=895) were analyzed. Sociodemographic characteristics and a broad
Strom, Mark A; Silverberg, Jonathan I
To determine if eczema is associated with an increased risk of a speech disorder. We analyzed data on 354,416 children and adolescents from 19 US population-based cohorts: the 2003-2004 and 2007-2008 National Survey of Children's Health and 1997-2013 National Health Interview Survey, each prospective, questionnaire-based cohorts. In multivariate survey logistic regression models adjusting for sociodemographics and comorbid allergic disease, eczema was significantly associated with higher odds of speech disorder in 12 of 19 cohorts (P speech disorder in children with eczema was 4.7% (95% CI 4.5%-5.0%) compared with 2.2% (95% CI 2.2%-2.3%) in children without eczema. In pooled multivariate analysis, eczema was associated with increased odds of speech disorder (aOR [95% CI] 1.81 [1.57-2.05], P speech disorder. History of eczema was associated with moderate (2.35 [1.34-4.10], P = .003) and severe (2.28 [1.11-4.72], P = .03) speech disorder. Finally, significant interactions were found, such that children with both eczema and attention deficit disorder with or without hyperactivity or sleep disturbance had vastly increased risk of speech disorders than either by itself. Pediatric eczema may be associated with increased risk of speech disorder. Further, prospective studies are needed to characterize the exact nature of this association. Copyright © 2016 Elsevier Inc. All rights reserved.
Bartlett, D L; Ezzati-Rice, T M; Stokley, S; Zhao, Z
The National Immunization Survey (NIS) and the National Health Interview Survey (NHIS) produce national coverage estimates for children aged 19 months to 35 months. The NIS is a cost-effective, random-digit-dialing telephone survey that produces national and state-level vaccination coverage estimates. The National Immunization Provider Record Check Study (NIPRCS) is conducted in conjunction with the annual NHIS, which is a face-to-face household survey. As the NIS is a telephone survey, potential coverage bias exists as the survey excludes children living in nontelephone households. To assess the validity of estimates of vaccine coverage from the NIS, we compared 1995 and 1996 NIS national estimates with results from the NHIS/NIPRCS for the same years. Both the NIS and the NHIS/NIPRCS produce similar results. The NHIS/NIPRCS supports the findings of the NIS.
Mauz, Elvira; Hoffmann, Robert; Houben, Robin; Krause, Laura; Kamtsiuris, Panagiotis; Gößwald, Antje
The implementation of an Internet option in an existing public health interview survey using a mixed-mode design is attractive because of lower costs and faster data availability. Additionally, mixed-mode surveys can increase response rates and improve sample composition. However, mixed-mode designs can increase the risk of measurement error (mode effects). This study aimed to determine whether the prevalence rates or mean values of self- and parent-reported health indicators for children and adolescents aged 0-17 years differ between self-administered paper-based questionnaires (SAQ-paper) and self-administered Web-based questionnaires (SAQ-Web), as well as between a single-mode control group and different mixed-mode groups. Data were collected for a methodological pilot of the third wave of the "German Health Interview and Examination Survey for Children and Adolescents". Questionnaires were completed by parents or adolescents. A population-based sample of 11,140 children and adolescents aged 0-17 years was randomly allocated to 4 survey designs-a single-mode control group with paper-and-pencil questionnaires only (n=970 parents, n=343 adolescents)-and 3 mixed-mode designs, all of which offered Web-based questionnaire options. In the concurrent mixed-mode design, both questionnaires were offered at the same time (n=946 parents, n=290 adolescents); in the sequential mixed-mode design, the SAQ-Web was sent first, followed by the paper questionnaire along with a reminder (n=854 parents, n=269 adolescents); and in the preselect mixed-mode design, both options were offered and the respondents were asked to request the desired type of questionnaire (n=698 parents, n=292 adolescents). In total, 3468 questionnaires of parents of children aged 0-17 years (SAQ-Web: n=708; SAQ-paper: n=2760) and 1194 questionnaires of adolescents aged 11-17 years (SAQ-Web: n=299; SAQ-paper: n=895) were analyzed. Sociodemographic characteristics and a broad range of health indicators for
Calvert, Geoffrey M.; Luckhaupt, Sara E.; Sussell, Aaron; Dahlhamer, James M.; Ward, Brian W.
Objective Assess the national prevalence of current workplace exposure to potential skin hazards, secondhand smoke (SHS), and outdoor work among various industry and occupation groups. Also, assess the national prevalence of chronic workplace exposure to vapors, gas, dust, and fumes (VGDF) among these groups. Methods Data were obtained from the 2010 National Health Interview Survey (NHIS). NHIS is a multistage probability sample survey of the civilian non-institutionalized population of the US. Prevalence rates and their variances were calculated using SUDAAN to account for the complex NHIS sample design. Results The data for 2010 were available for 17,524 adults who worked in the 12 months that preceded interview. The highest prevalence rates of hazardous workplace exposures were typically in agriculture, mining, and construction. The prevalence rate of frequent handling of or skin contact with chemicals, and of non-smokers frequently exposed to SHS at work was highest in mining and construction. Outdoor work was most common in agriculture (85%), construction (73%), and mining (65%). Finally, frequent occupational exposure to VGDF was most common among mining (67%), agriculture (53%), and construction workers (51%). Conclusion We identified industries and occupations with the highest prevalence of potentially hazardous workplace exposures, and provided targets for investigation and intervention activities. PMID:22821700
Gómez-Marín, O; Fleming, L E; Lee, D J; LeBlanc, W; Zheng, D; Ma, F; Jané, D; Pitman, T; Caban, A
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.
Phillips Carl V
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.
Zubrick Stephen R
Full Text Available Abstract Background It is well established that smoking rates in people with common mental disorders such as anxiety or depressive disorders are much higher than in people without mental disorders. It is less clear whether people with these mental disorders want to quit smoking, attempt to quit smoking or successfully quit smoking at the same rate as people without such disorders. Methods We used data from the 2005 Cancer Control Supplement to the United States National Health Interview Survey to explore the relationship between psychological distress as measured using the K6 scale and smoking cessation, by comparing current smokers who had tried unsuccessfully to quit in the previous 12 months to people able to quit for at least 7 to 24 months prior to the survey. We also used data from the 2007 Australian National Survey of Mental Health and Wellbeing to examine the relationship between psychological distress (K6 scores and duration of mental illness. Results The majority of people with high K6 psychological distress scores also meet diagnostic criteria for mental disorders, and over 90% of these people had first onset of mental disorder more than 2 years prior to the survey. We found that people with high levels of non-specific psychological distress were more likely to be current smokers. They were as likely as people with low levels of psychological distress to report wanting to quit smoking, trying to quit smoking, and to have used smoking cessation aids. However, they were significantly less likely to have quit smoking. Conclusions The strong association between K6 psychological distress scores and mental disorders of long duration suggests that the K6 measure is a useful proxy for ongoing mental health problems. As people with anxiety and depressive disorders make up a large proportion of adult smokers in the US, attention to the role of these disorders in smoking behaviours may be a useful area of further investigation for tobacco
Wight, Richard G; Leblanc, Allen J; Lee Badgett, M V
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 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.
Boden, L I; Hall, J A; Levenstein, C; Punnett, L
In a study conducted to determine if the existence of a joint labor-management health and safety committee (HSC) was correlated with either the number of Occupational Safety and Health Administration (OSHA) complaints or hazardousness, as measured by OSHA serious citations, virtually no effect could be detected in a sample of 127 Massachusetts manufacturing firms. At a sample of 13 firms, interviews of HSC members were conducted. Committee attributes and perceptions about committee effectiveness were compared with the number of OSHA complaints and serious citations. There were fewer complaints and fewer serious citations at firms with HSCs that were perceived as effective. Results of the study suggest that the objective attributes of the committee may be less important to its success than the commitment of management and labor to solving workplace safety problems.
McElfish, Pearl A; Long, Christopher R; Payakachat, Nalin; Felix, Holly; Bursac, Zoran; Rowland, Brett; Hudson, Jonell S; Narcisse, Marie-Rachelle
Adherence to medication treatment plans is important for chronic disease (CD) management. Cost-related nonadherence (CRN) puts patients at risk for complications. Native Hawaiians and Pacific Islanders (NHPI) suffer from high rates of CD and socioeconomic disparities that could increase CRN behaviors. Examine factors related to CRN to medication treatment plans within an understudied population. Using 2014 NHPI-National Health Interview Survey data, we examined CRN among a nationally representative sample of NHPI adults. Bonferroni-adjusted Wald test and multivariable logistic regression were performed to examine associations among financial burden-related factors, CD status, and CRN. Across CD status, NHPI engaged in CRN behaviors had, on an average, increased levels of perceived financial stress, financial insecurity with health care, and food insecurity compared with adults in the total NHPI population. Regression analysis indicated perceived financial stress [adjusted odds ratio (AOR)=1.16; 95% confidence intervals (CI), 1.10-1.22], financial insecurity with health care (AOR=1.96; 95% CI, 1.32-2.90), and food insecurity (AOR=1.30; 95% CI, 1.06-1.61) all increase the odds of CRN among those with CD. We also found significant associations between perceived financial stress (AOR=1.15; 95% CI, 1.09-1.20), financial insecurity with health care (AOR=1.59; 95% CI, 1.19-2.12), and food insecurity (AOR=1.31; 95% CI, 1.04-1.65) and request for lower cost medication. This study demonstrated health-related and non-health-related financial burdens can influence CRN behaviors. It is important for health care providers to collect and use data about the social determinants of health to better inform their conversations about medication adherence and prevent CRN.
Demarest, Stefaan; Molenberghs, Geert; Van der Heyden, Johan; Gisle, Lydia; Van Oyen, Herman; de Waleffe, Sandrine; Van Hal, Guido
Substitution of non-participating households is used in the Belgian Health Interview Survey (BHIS) as a method to obtain the predefined net sample size. Yet, possible effects of applying substitution on response rates and health estimates remain uncertain. In this article, the process of substitution with its impact on response rates and health estimates is assessed. The response rates (RR)-both at household and individual level-according to the sampling criteria were calculated for each stage of the substitution process, together with the individual accrual rate (AR). Unweighted and weighted health estimates were calculated before and after applying substitution. Of the 10,468 members of 4878 initial households, 5904 members (RRind: 56.4%) of 2707 households (RRhh: 55.5%) participated. For the three successive (matched) substitutes, the RR dropped to 45%. The composition of the net sample resembles the one of the initial samples. Applying substitution did not produce any important distorting effects on the estimates. Applying substitution leads to an increase in non-participation, but does not impact the estimations.
Brucker, Debra L
Prior research has suggested that young adults with disabilities face economic, health and social disadvantage. Food security, an area of disadvantage that can influence overall health, has not been fully explored for this population. To examine levels of food security between young adults with and without disabilities, controlling for individual characteristics. Logistic regression analysis of a nationally representative sample of young adults (age 18-25) (n = 32,795) with and without disabilities, using pooled data form the 2011-2013 National Health Interview Survey. Young adults with disabilities have significantly higher odds (OR: 2.58, p young adults without disabilities, even when controlling for individual characteristics. Odds of living in a household that is food insecure are particularly high (OR: 5.35, p young adults with high levels of psychological distress, controlling for other factors. Young adults with disabilities have increased odds of living in a household that is food insecure. This study has important policy and community program implications. Copyright © 2016 Elsevier Inc. All rights reserved.
Farnacio, Yvonne; Pratt, Michael E; Marshall, Elizabeth G; Graber, Judith M
Psychosocial hazards in the workplace may adversely impact occupational and general health, including injury risk. Among 16,417 adult workers in the 2010 National Health Interview Survey Occupational Health Supplement, weighted prevalence estimates were calculated for work-related injuries (WRI) and any injuries. The association between injury and psychosocial occupational hazards (job insecurity, work-family imbalance, hostile work environment) was assessed adjusting for sociodemographic and occupational factors. WRI prevalence was 0.65% (n = 99); any injury prevalence was 2.46% (n = 427). In multivariable models job insecurity, work-family imbalance, and hostile work environment were each positively associated with WRI prevalence (odds ratio [OR]: 1.60, 95% CI: 0.97-2.65; OR: 1.69, 95% CI 0.96-2.89; and 2.01, 95% CI 0.94-4.33, respectively). Stressful working conditions may contribute to injuries. There is need for ongoing surveillance of occupational psychosocial risk factors and further study of their relationship with injury.
Ussery, Emily N; Carlson, Susan A; Whitfield, Geoffrey P; Watson, Kathleen B; Berrigan, David; Fulton, Janet E
Physical activity confers considerable health benefits, but only half of U.S. adults report participating in levels of aerobic physical activity consistent with guidelines (1,2). Step It Up! The Surgeon General's Call to Action to Promote Walking and Walkable Communities identified walking as an important public health strategy to increase physical activity levels (3). A previous report showed that the self-reported prevalence of walking for transportation or leisure increased by 6 percentage points from 2005 to 2010 (4), but it is unknown whether this increase has been sustained. CDC analyzed National Health Interview Survey (NHIS) data from 2005 (26,551 respondents), 2010 (23,313), and 2015 (28,877) to evaluate trends in the age-adjusted prevalence of self-reported walking among adults aged ≥18 years. The prevalence of walking increased steadily among women, from 57.3% in 2005, to 62.5% in 2010, and to 65.1% in 2015 (significant linear trend). Among men, a significant linear increase in reported walking was observed, from 54.3% in 2005, to 61.8% in 2010, and to 62.8% in 2015, although the increase stalled between 2010 and 2015 (significant linear and quadratic trends). Community design policies and practices that encourage pedestrian activity and programs tailored to the needs of specific population subgroups remain important strategies for promoting walking (3).
Ndetan, Harrison; Evans, Marion Willard; Bae, Sejong; Felini, Martha; Rupert, Ronald; Singh, Karan P
The recommendations of health care providers have been shown to be a predictor of future healthy behaviors. However, patient adherence to these recommendations may differ based upon the type of health care professional providing the information. This study explored patient compliance in the United States over a 12-month period and contracted the patient response to recommendations given by chiropractors versus medical doctors. Multiple logistic regression models were used for analyses of data from the Sample Adult Core component of the 2006 National Health Interview Survey (n = 24 275). Analyses were performed separately for recommendation and compliance of weight loss, increase exercise, and diet change by health profession subtype (chiropractor and medical doctor). About 30.5% of the respondents reported receiving advice from their provider. Among these, 88.0% indicated they complied with the advice they received. Patients who were advised were more likely to comply (odds ratio [OR] [95% CI], 10.41[9.34-11.24]). Adjusting for seeing a physical therapist, age, and body mass index, chiropractors were less likely to advice patients compared to medical doctors (OR [95% CI], 0.38 [0.30-0.50]). In general, there was a 21% increased odds that patients who received and complied with health promotion advice from their health care provider would report an improved health status (OR [95% CI], 1.21 [1.10-1.33]) compared with those who did not comply or were not advised. Chiropractors in the United States give health promotion recommendation to their patients but are less likely to do so than general medical doctors. Patients tend to comply with health providers' recommendations and those who do report better health. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.
Qin, Zijian; Baccaglini, Lorena
Falls in the geriatric population are a major public health issue. With the anticipated aging of the population, falls are expected to increase nationally and globally. We estimated the prevalence and determinants of falls in adults aged ≥65 years and calculated the proportion of elderly who fell and made lifestyle changes as a result of professional recommendations. We included adults aged ≥65 years from the 2011-2012 California Health Interview Survey (CHIS) and categorized them into two groups based on whether or not they had had at least two falls in the previous 12 months. We performed logistic regression analysis adjusted for the complex survey design to determine risk factors for falls and compare the odds of receiving professional recommendations among elderly with vs. without falls. Of an estimated 4.3 million eligible elderly participants in the CHIS (2011-2012), an estimated 527,340 (12.2%) fell multiple times in the previous 12 months. Of those, 204,890 (38.9%) were told how to avoid falls by a physician and 211,355 (40.1%) received medical treatment, although fewer than 41.0% had made related preventive changes to avoid future falls. Falls were associated with older age, less walking, and poorer physical or mental health. Non-Asians had higher odds of falling compared with Asians (adjusted odds ratio = 1.69, 95% confidence interval 1.16, 2.45). Most participants reported changing medications, home, or daily routines on their own initiative rather than after professional recommendations. Patients with a history of falls did not consistently receive professional recommendations on fall prevention-related lifestyle or living condition changes. Given the high likelihood of a serious fall, future interventions should focus on involving primary care physicians in active preventive efforts before a fall occurs.
Objectives Falls in the geriatric population are a major public health issue. With the anticipated aging of the population, falls are expected to increase nationally and globally. We estimated the prevalence and determinants of falls in adults aged ≥65 years and calculated the proportion of elderly who fell and made lifestyle changes as a result of professional recommendations. Methods We included adults aged ≥65 years from the 2011–2012 California Health Interview Survey (CHIS) and categorized them into two groups based on whether or not they had had at least two falls in the previous 12 months. We performed logistic regression analysis adjusted for the complex survey design to determine risk factors for falls and compare the odds of receiving professional recommendations among elderly with vs. without falls. Results Of an estimated 4.3 million eligible elderly participants in the CHIS (2011–2012), an estimated 527,340 (12.2%) fell multiple times in the previous 12 months. Of those, 204,890 (38.9%) were told how to avoid falls by a physician and 211,355 (40.1%) received medical treatment, although fewer than 41.0% had made related preventive changes to avoid future falls. Falls were associated with older age, less walking, and poorer physical or mental health. Non-Asians had higher odds of falling compared with Asians (adjusted odds ratio = 1.69, 95% confidence interval 1.16, 2.45). Most participants reported changing medications, home, or daily routines on their own initiative rather than after professional recommendations. Conclusion Patients with a history of falls did not consistently receive professional recommendations on fall prevention-related lifestyle or living condition changes. Given the high likelihood of a serious fall, future interventions should focus on involving primary care physicians in active preventive efforts before a fall occurs. PMID:26957668
Daphne C. Watkins
Full Text Available 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.
Luckhaupt, Sara E.; Dahlhamer, James M.; Ward, Brian W.; Sweeney, Marie H.; Sestito, John P.; Calvert, Geoffrey M.
Background Patterns of prevalence and work-relatedness of carpal tunnel syndrome (CTS) among workers offer clues about risk factors and targets for prevention. Methods Data from an occupational health supplement to the 2010 National Health Interview Survey were used to estimate the prevalence of self-reported clinician-diagnosed CTS overall and by demographic characteristics. The proportion of these cases self-reported to have been attributed to work by clinicians was also examined overall and by demographic characteristics. In addition, the distribution of industry and occupation (I&O) categories to which work-related cases of CTS were attributed was compared to the distribution of I&O categories of employment among current/recent workers. Results Data were available for 27,157 adults, including 17,524 current/recent workers. The overall lifetime prevalence of clinician-diagnosed CTS among current/recent workers was 6.7%. The 12-month prevalence was 3.1%, representing approximately 4.8 million workers with current CTS; 67.1% of these cases were attributed to work by clinicians, with overrepresentation of certain I&O categories. Conclusions CTS affected almost 5 million U.S. workers in 2010, with prevalence varying by demographic characteristics and I&O. PMID:22495886
Morris, Megan A; Meier, Sarah K; Griffin, Joan M; Branda, Megan E; Phelan, Sean M
Communication disabilities, including speech, language and voice disabilities, can significantly impact a person's quality of life, employment and health status. Despite this, little is known about the prevalence and etiology of communication disabilities in the general adult population. To assess the prevalence and etiology of communication disabilities in a nationally representative adult sample. We conducted a cross-sectional study and analyzed the responses of non-institutionalized adults to the Sample Adult Core questionnaire within the 2012 National Health Interview Survey. We used respondents' self-report of having a speech, language or voice disability within the past year and receiving a diagnosis for one of these communication disabilities, as well as the etiology of their communication disability. We additionally examined the responses by subgroups, including sex, age, race and ethnicity, and geographical area. In 2012 approximately 10% of the US adult population reported a communication disability, while only 2% of adults reported receiving a diagnosis. The rates of speech, language and voice disabilities and diagnoses varied across gender, race/ethnicity and geographic groups. The most common response for the etiology of a communication disability was "something else." Improved understanding of population prevalence and etiologies of communication disabilities will assist in appropriately directing rehabilitation and medical services; potentially reducing the burden of communication disabilities. Copyright © 2016 Elsevier Inc. All rights reserved.
A comparison of prevalence estimates for selected health indicators and chronic diseases or conditions from the Behavioral Risk Factor Surveillance System, the National Health Interview Survey, and the National Health and Nutrition Examination Survey, 2007-2008.
Li, Chaoyang; Balluz, Lina S; Ford, Earl S; Okoro, Catherine A; Zhao, Guixiang; Pierannunzi, Carol
To compare the prevalence estimates of selected health indicators and chronic diseases or conditions among three national health surveys in the United States. Data from adults aged 18 years or older who participated in the Behavioral Risk Factor Surveillance System (BRFSS) in 2007 and 2008 (n=807,524), the National Health Interview Survey (NHIS) in 2007 and 2008 (n=44,262), and the National Health and Nutrition Examination Survey (NHANES) during 2007 and 2008 (n=5871) were analyzed. The prevalence estimates of current smoking, obesity, hypertension, and no health insurance were similar across the three surveys, with absolute differences ranging from 0.7% to 3.9% (relative differences: 2.3% to 20.2%). The prevalence estimate of poor or fair health from BRFSS was similar to that from NHANES, but higher than that from NHIS. The prevalence estimates of diabetes, coronary heart disease, and stroke were similar across the three surveys, with absolute differences ranging from 0.0% to 0.8% (relative differences: 0.2% to 17.1%). While the BRFSS continues to provide invaluable health information at state and local level, it is reassuring to observe consistency in the prevalence estimates of key health indicators of similar caliber between BRFSS and other national surveys. Published by Elsevier Inc.
Chih, Hui Jun; Liang, Wenbin
Background Reduced funding to public health care systems during economic downturns is a common phenomenon around the world. The effect of health care cost on family members of the patients has not been established. This paper aims to explore the relationship between affordability of health care and vulnerability of family members to distress levels. Methods Data of a total of 262,843 participants were obtained from 17 waves (1997?2013) of the United States National Health Interview Survey. Mu...
Holman, Dawn M; Berkowitz, Zahava; Guy, Gery P; Hartman, Anne M; Perna, Frank M
To examine the association between demographic and behavioral characteristics and sunburn among U.S. adults. We used 2010 National Health Interview Survey data (N=24,970) to conduct multivariable logistic regressions examining associations with having 1 or more sunburns in the past year and having 4 or more sunburns in the past year. Overall, 37.1% of adults experienced sunburn in the past year. The adjusted prevalence of sunburn was particularly common among adults aged 18-29years (52.0%), those who repeatedly burn or freckle after 2weeks in the sun (45.9%), whites (44.3%), indoor tanners (44.1%), those with a family history of melanoma (43.9%), and those who are US-born (39.5%). Physical activity, alcohol consumption, and overweight/obesity were positively associated with sunburn (all Psunburn (P=0.35). Among those who were sunburned in the past year, 12.1% experienced 4 or more sunburns. Sunburn is common, particularly among younger adults, those with a more sun-sensitive skin type, whites, those with a family history of melanoma, the highly physically active, and indoor tanners. Efforts are needed to facilitate sun-safety during outdoor recreation, improve the consistency of sun protection practices, and prevent sunburn, particularly among these subgroups. Published by Elsevier Inc.
Young, Marielle C; Gerber, Monica W; Ash, Tayla; Horan, Christine M; Taveras, Elsie M
Native Hawaiians and Pacific Islanders (NHPIs) have the lowest attainment of healthy sleep duration among all racial and ethnic groups in the United States. We examined associations of neighborhood social cohesion with sleep duration and quality. Cross-sectional analysis of 2,464 adults in the NHPI National Health Interview Survey (2014). Neighborhood social cohesion was categorized as a continuous and categorical variable into low (15) according to tertiles of the distribution of responses. We used multinomial logistic regression to examine the adjusted odds ratio of short and long sleep duration relative to intermediate sleep duration. We used binary logistic regression for dichotomous sleep quality outcomes. Sleep outcomes were modeled as categorical variables. 40% of the cohort reported short (9 hours) duration. Mean (SE, range) social cohesion score was 12.4 units (0.11, 4-16) and 23% reported low social cohesion. In multivariable models, each 1 SD decrease in neighborhood social cohesion score was associated with higher odds of short sleep duration (OR: 1.14, 95% CI: 1.02, 1.29). Additionally, low social cohesion was associated with increased odds of short sleep duration (OR: 1.53, 95% CI: 1.10, 2.13). No associations between neighborhood social cohesion and having trouble falling or staying asleep and feeling well rested were found. Low neighborhood social cohesion is associated with short sleep duration in NHPIs.
Lee, David J; Fleming, Lora E; Leblanc, William G; Arheart, Kristopher L; Chung-Bridges, Katherine; Christ, Sharon L; Caban, Alberto J; Pitman, Terry
The objective of this study was to assess the risk of lung cancer mortality in a nationally representative sample of U.S. workers by occupation. National Death Index linkage identified 1812 lung cancer deaths among 143,863 workers who participated in the 1987, 1988, and 1990-1994 National Health Interview Surveys. Current and former smoking status was predictive of lung cancer mortality (hazard ratio [HR] = 15.1 and 3.8, respectively). Occupations with significantly higher risk for age- and smoking-adjusted lung cancer mortality included heating/air/refrigeration mechanics (HR = 3.0); not specified mechanics and repairers (HR = 2.8); financial records processing occupations (HR = 1.8); freight, stock, and materials handlers (HR = 1.5); and precision production occupations (HR = 1.4). Although tobacco use continues to be the single most important risk factor for lung cancer mortality, occupational exposure to lung carcinogens should be targeted as well to further reduce the burden of lung cancer.
Utz Rebecca L
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.
Joseph G Giduthuri
Full Text Available 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.
Lombardi, David A; Folkard, Simon; Willetts, Joanna L; Smith, Gordon S
The impact on health and safety of the combination of chronic sleep deficits and extended working hours has received worldwide attention. Using the National Health Interview Survey (NHIS), an in-person household survey using a multistage, stratified, clustered sample design representing the US civilian, non-institutionalized population, the authors estimated the effect of total daily self-reported sleep time and weekly working hours on the risk of a work-related injury. During the survey period 2004-2008, 177,576 persons (ages 18-74) sampled within households reported that they worked at a paid job the previous week and reported their total weekly work hours. A randomly selected adult in each household (n = 75,718) was asked to report his/her usual (average) total daily sleep hours the prior week; complete responses were obtained for 74,415 (98.3%) workers. Weighted annualized work-related injury rates were then estimated across a priori defined categories of both average total daily sleep hours and weekly working hours. To account for the complex sampling design, weighted multiple logistic regression was used to independently estimate the risk of a work-related injury for categories of usual daily sleep duration and weekly working hours, controlling for important covariates and potential confounders of age, sex, race/ethnicity, education, type of pay, industry, occupation (proxy for job risk), body mass index, and the interaction between sleep duration and work hours. Based on the inclusion criteria, there were an estimated 129,950,376 workers annually at risk and 3,634,446 work-related medically treated injury episodes (overall injury rate 2.80/100 workers). Unadjusted annualized injury rates/100 workers across weekly work hours were 2.03 (60 h). With regards to self-reported daily sleep time, the estimated annualized injury rates/100 workers were 7.89 (10 h). After controlling for weekly work hours, and aforementioned covariates, significant increases in risk/1
Zhang, Yan; Lauche, Romy; Sibbritt, David; Olaniran, Bolanle; Cook, Ronald; Adams, Jon
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%, PHIT 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 in terms of sociodemographic and health characteristics
Older adults are the most frequent and heaviest users of health services in the United States; however, previous research on older adults' use of health information technology (HIT) has not examined the possible association of HIT use among older adults with their use of health services. This study examined the relationship between US older adults' use of health services and their use of the Internet for health-related activities, controlling for socioeconomic characteristics and aging-related limitations in sensory and cognitive function. It also examined gender differences in the pattern of association between the types of health services used and HIT use. The data for this study were drawn from the 2009 US National Health Interview Survey (NHIS), which was the first nationally representative household survey to collect data on HIT (Internet) use. First, the rates of lifetime and 12-month HIT use among sample adults (n = 27,731) by age group (18-29 to 85 and over) were analyzed. Second, bivariate analysis of sociodemographic characteristics, health status, and health service use by HIT use status among those aged 65 or older (n = 5294) was conducted. Finally, multivariate binary logistic regression analysis was used to test the study hypotheses with 12-month HIT use as the dependent variable and 12-month health service uses among the age group 65 or older as possible correlates. The rates of HIT use were significantly lower among the age groups 65 or older compared with the younger age groups, although the age group 55 to 64 was not different from those younger. The rates of HIT use decreased from 32.2% in the age group 65 to 74 to 14.5% in the age group 75 to 84 and 4.9% in the 85 and older age group. For both genders, having seen or talked to a general practitioner increased the odds of HIT use. However, having seen or talked to a medical specialist, eye doctor, or physical therapist/occupational therapist (PT/OT) were significantly associated with HIT use only
Koo, Malcolm; Lu, Ming-Chi; Lin, Shih-Chun
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, Pused 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.
Finger, Jonas D; Tafforeau, Jean; Gisle, Lydia; Oja, Leila; Ziese, Thomas; Thelen, Juergen; Mensink, Gert B M; Lange, Cornelia
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.
Park, Sohyun; Onufrak, Stephen; Blanck, Heidi M; Sherry, Bettylou
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
Stokley, Shannon; Cullen, Karen A; Kennedy, Allison; Bardenheier, Barbara H
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 > or = 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage. 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 > or = 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. 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 < 0.001) and pneumococcal (40% vs 33%; p-value < 0.001) vaccines but were not significantly different for hepatitis B (60% vs 56%; p-value = 0.36). Among non-priority adults, recent CAM users had significantly higher unadjusted and adjusted vaccination coverage levels compared to non-CAM users for all three vaccines (p-values < 0.001). 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
Steppuhn, Henriette; Langen, Ute; Mueters, Stephan; Dahm, Stefan; Knopf, Hildtraud; Keil, Thomas; Scheidt-Nave, Christa
In Germany, population-wide data on adherence to national asthma management guidelines are lacking, and performance measures (PM) for quality assurance in asthma care are systematically monitored for patients with German national asthma disease management program (DMP) enrollment only. We used national health survey data to assess variation in asthma care PM with respect to patient characteristics and care context, including DMP enrollment. Among adults 18-79 years with self-reported physician-diagnosed asthma in the past 12 months identified from a recent German National Health Interview Survey (GEDA 2010: N = 1096) and the German National Health interview and Examination Survey 2008-2011 (DEGS1: N = 333), variation in asthma care PM was analyzed using logistic regression analysis. Overall, 38.4% (95% confidence interval: 32.5-44.6%) of adults with asthma were on current inhaled corticosteroid therapy. Regarding non-drug asthma management, low coverage was observed for inhaler technique monitoring (35.2%; 31.2-39.3%) and for provision of an asthma management plan (27.3%; 24.2-30.7%), particularly among those with low education. Specific PM were more complete among persons with than without asthma DMP enrollment (adjusted odds ratios ranging up to 10.19; 5.23-19.86), even if asthma patients were regularly followed in a different care context. Guideline adherence appears to be suboptimal, particularly with respect to PM related to patient counseling. Barriers to the translation of recommendations into practice need to be identified and continuous monitoring of asthma care PM at the population level needs to be established.
Cornelio, C. I.; García, M.; Schiaffino, Anna; Borràs Andrés, Josep Maria; Nieto, F. Javier; Fernández Muñoz, Esteve
Aim: To describe changes in leisure time and occupational physical activity status in an urban Mediterranean population-based cohort, and to evaluate sociodemographic, health-related and lifestyle correlates of such changes. Methods: Data for this study come from the Cornellè Health Interview Survey Follow-Up Study, a prospective cohort study of a representative sample (n¿=¿2500) of the population. Participants in the analysis reported here include 1246 subjects (567 men and 679 women) who ha...
Finger, Jonas D; Tylleskär, Thorkild; Lampert, Thomas; Mensink, Gert B M
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
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 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.
Pócs, Dávid; Hamvai, Csaba; Kelemen, Oguz
Public health data show that early mortality in Hungary could be prevented by smoking cessation, reduced alcohol consumption, regular exercise, healthy diet and increased adherence. Doctor-patient encounters often highlight these aspects of health behavior. There is evidence that health behavior change is driven by internal motivation rather than external influence. This finding has led to the concept of motivational interview, which is a person-centered, goal-oriented approach to counselling. The doctor asks targeted questions to elicit the patient's motivations, strengths, internal resources, and to focus the interview around these. The quality and quantity of the patient's change talk is related to better outcomes. In addition, the interview allows the patient to express ambivalent feelings and doubts about the change. The doctor should use various communication strategies to resolve this ambivalence. Furthermore, establishing a good doctor-patient relationship is the cornerstone of the motivational interview. An optimal relationship can evoke change talk and reduce the patient's resistance, which can also result in a better outcome. The goal of the motivational interview is to focus on the 'why' to change health behavior rather than the 'how', and to utilize internal motivation instead of persuasion. This is the reason why motivational interview has become a widely-accepted evidence based approach. Orv Hetil. 2017; 158(34): 1331-1337.
Vannoni, F; Burgio, A; Quattrociocchi, L; Costa, G; Faggiano, F
In this paper social differences in health, analysed by different dimensions (perceived health, chronic diseases, functional deficits and disability) and social differences in lifestyle, in particular smoking habit and use of health services for the prevention of some female tumours, are described. The study is based on the data collected in the National Interview Survey on Health Status and Use of Health Care Services, conducted by ISTAT in the 1994. The analysis has been performed separately for males and females, computing Prevalence Rate Ratios (PRR) standardized by age. Educational level and social class, based on Schizzerotto's classification, have been used as determinants of differences in health and lifestyle. Unfavourable perception of health status and most of chronic diseases, referred as diagnosed by a doctor, show an increasing prevalence with decreasing educational level. Less striking differences are observed in the occurrence of injuries and in the restriction of daily life activities caused by diseases. A lower educational level corresponds to a regular increase in the proportion of disabled subjects. Females show higher differences than males in overweight and underweight prevalences in favour of more educated. Smoking habit shows an inverse correlation with education in males and a direct correlation in females, while attempts to quit smoking are more common among more educated individuals. Among women, the tendency to use screening tests for the prevention of some tumours is directly proportional to the educational level. Similar findings were obtained using the social class, with small bourgeoisie and working class showing similar excess risks, compared to bourgeoisie. This study found significant social inequalities in health status and in lifestyle in Italian population in 1994. The discussion argues that in absence of preventive interventions on disadvantaged groups of the population an increase of social differences in health is
Amante, Daniel J; Hogan, Timothy P; Pagoto, Sherry L; English, Thomas M; Lapane, Kate L
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
Irvin, Veronica L.; Sun, Qiankun; Breen, Nancy
Abstract Purpose: This study explored the utility of the California Health Interview Survey (CHIS) to compare health-related outcomes among gay men, lesbians, and heterosexuals who reported being in a legally recognized partnership. Methods: We regressed sexual identity and marriage/legally recognized partnership status on seven different outcomes related to health insurance coverage, medical services access and use, and general health and well-being using CHIS data collected between 2009 and 2013. Results: There were 1432 respondents who identified as gay, lesbian, or homosexual, and 67,746 who identified as heterosexual. The percentage of participants who reported being married/legally partnered was 54.06% for heterosexual women, 52.93% for heterosexual men, 38.83% for lesbians, and 23.56% for gay men. Legally partnered/married gay and lesbian respondents were more likely to have health insurance and use healthcare than their counterparts not in such partnerships; few trends were statistically significant. Gay men in legally recognized partnerships were more likely than their heterosexual counterparts to report continuous health insurance coverage, a usual medical care source, and at least one provider visit within the past 12 months. We found statistically significant poorer health status outcomes among lesbians in legally recognized partnerships compared to married heterosexual women. Conclusions: Lesbians in legally recognized partnerships did not fare as well as married heterosexual women. Gay men in legally recognized partnerships fared better than married heterosexual men on some measures. CHIS questionnaire structures limited our sample and analyses. We recommend that CHIS and other researchers ask partnered status-, marriage-, and sexual identity-related questions en bloc to ensure more robust representation, analyses, recommendations, and policy resolutions. PMID:28207297
Mauz, Elvira; von der Lippe, Elena; Allen, Jennifer; Schilling, Ralph; Müters, Stephan; Hoebel, Jens; Schmich, Patrick; Wetzstein, Matthias; Kamtsiuris, Panagiotis; Lange, Cornelia
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
Graaf, R. de; Have, M.L. ten; Dorsselaer, S.A.F.M. van; Schoemaker, C.G.; Vollebergh, W.A.M.
Little is known about the emotional responses of participants in community surveys to standardised psychiatric interviews like the Composite International Diagnostic Interview (CIDI). This study investigates the proportion of subjects responding negatively or positively to the CIDI, and identifies
Eszter Anna Janka
Full Text Available The Roma population is typified by a poor and, due to difficulties in ethnicity assessment, poorly documented health status. We aimed to compare the usefulness of self-reporting and observer-reporting in Roma classification for surveys investigating differences between Roma and non-Roma populations. Both self-reporting and observer-reporting of Roma ethnicity were applied in a population-based health interview survey. A questionnaire was completed by 1849 people aged 18–64 years; this questionnaire provided information on 52 indicators (morbidity, functionality, lifestyle, social capital, accidents, healthcare use indicators. Multivariate logistic regression models controlling for age, sex, education and employment were used to produce indicators for differences between the self-reported Roma (N = 124 and non-Roma (N = 1725 populations, as well as between observer-reported Roma (N = 179 and non-Roma populations (N = 1670. Differences between interviewer-reported and self-reported individuals of Roma ethnicity in statistical inferences were observed for only seven indicators. The self-reporting approach was more sensitive for two indicators, and the observer-reported assessment for five indicators. Based on our results, the self-reported identity can be considered as a useful approach, and the application of observer-reporting cannot considerably increase the usefulness of a survey, because the differences between Roma and non-Roma individuals are much bigger than the differences between indicators produced by self-reported or observer-reported data on individuals of Roma ethnicity.
Janka, Eszter Anna; Vincze, Ferenc; Ádány, Róza; Sándor, János
The Roma population is typified by a poor and, due to difficulties in ethnicity assessment, poorly documented health status. We aimed to compare the usefulness of self-reporting and observer-reporting in Roma classification for surveys investigating differences between Roma and non-Roma populations. Both self-reporting and observer-reporting of Roma ethnicity were applied in a population-based health interview survey. A questionnaire was completed by 1849 people aged 18-64 years; this questionnaire provided information on 52 indicators (morbidity, functionality, lifestyle, social capital, accidents, healthcare use) indicators. Multivariate logistic regression models controlling for age, sex, education and employment were used to produce indicators for differences between the self-reported Roma ( N = 124) and non-Roma ( N = 1725) populations, as well as between observer-reported Roma ( N = 179) and non-Roma populations ( N = 1670). Differences between interviewer-reported and self-reported individuals of Roma ethnicity in statistical inferences were observed for only seven indicators. The self-reporting approach was more sensitive for two indicators, and the observer-reported assessment for five indicators. Based on our results, the self-reported identity can be considered as a useful approach, and the application of observer-reporting cannot considerably increase the usefulness of a survey, because the differences between Roma and non-Roma individuals are much bigger than the differences between indicators produced by self-reported or observer-reported data on individuals of Roma ethnicity.
Tak, SangWoo; Calvert, Geoffrey M
To estimate the national burden of hearing difficulty among workers in US industries and occupations. Data on 130,102 employed National Health Interview Survey respondents between the ages of 18 to 65 years who were interviewed between 1997 and 2003 were analyzed to estimate the population prevalence, adjusted prevalence ratios, and fractions of hearing difficulty attributable to employment. The estimated population prevalence of hearing difficulty was 11.4% (24% attributable to employment). The adjusted prevalence ratios of hearing difficulty were highest for railroads, mining, and primary metal manufacturing industry. Occupations with increased risk of hearing difficulty were mechanics/repairers, machine operators, and transportation equipment operators. Hearing difficulty was differentially distributed across various industries. In industries with high rates, employers and workers should take preventive action to reduce the risk of occupational hearing loss.
Mazurek, Jacek M; Syamlal, Girija
In 2010, an estimated 8.2% of U.S. adults had current asthma, and among these persons, 49.1% had had an asthma attack during the past year (1). Workplace exposures can cause asthma in a previously healthy worker or can trigger asthma exacerbations in workers with current asthma* (2). To assess the industry- and occupation-specific prevalence of current asthma, asthma attacks, and asthma-related emergency department (ED) visits among working adults, CDC analyzed 2011-2016 National Health Interview Survey (NHIS) data for participants aged ≥18 years who, at the time of the survey, were employed at some time during the 12 months preceding the interview. During 2011-2016, 6.8% of adults (11 million) employed at any time in the past 12 months had current asthma; among those, 44.7% experienced an asthma attack, and 9.9% had an asthma-related ED visit in the previous year. Current asthma prevalence was highest among workers in the health care and social assistance industry (8.8%) and in health care support occupations (8.8%). The increased prevalence of current asthma, asthma attacks, and asthma-related ED visits in certain industries and occupations might indicate increased risks for these health outcomes associated with workplace exposures. These findings might assist health care and public health professionals in identifying workers in industries and occupations with a high prevalence of current asthma, asthma attacks, and asthma-related ED visits who should be evaluated for possible work-related asthma. Guidelines intended to promote effective management of work-related asthma are available (2,3).
Thompson, Frances E; McNeel, Timothy S; Dowling, Emily C; Midthune, Douglas; Morrissette, Meredith; Zeruto, Christopher A
The consumption of added sugars (eg, white sugar, brown sugar, and high-fructose corn syrup) displaces nutrient-dense foods in the diet. The intake of added sugars in the United States is excessive. Little is known about the predictors of added sugar intake. To examine the independent relationships of socioeconomic status and race/ethnicity with added sugar intake, and to evaluate the consistency of relationships using a short instrument to those from a different survey using more precise dietary assessment. Cross-sectional, nationally representative, interviewer-administered survey. Adults (aged > or = 18 years) participating in the 2005 US National Health Interview Survey Cancer Control Supplement responding to four added sugars questions (n=28,948). The intake of added sugars was estimated using validated scoring algorithms. Multivariate analysis incorporating sample weights and design effects was conducted. Least squares means and confidence intervals, and significance tests using Wald F statistics are presented. Analyses were stratified by sex and controlled for potential confounders. The intake of added sugars was higher among men than women and inversely related to age, educational status, and family income. Asian Americans had the lowest intake and Hispanics the next lowest intake. Among men, African Americans had the highest intake, although whites and American Indians/Alaskan Natives also had high intakes. Among women, African Americans and American Indians/Alaskan Natives had the highest intakes. Intake of added sugars was inversely related to educational attainment in whites, African Americans, Hispanic men, and American Indians/Alaskan Native men, but was unrelated in Asian Americans. These findings were generally consistent with relationships in National Health and Nutrition Examination Survey 2003-2004 (using one or two 24-hour dietary recalls). Race/ethnicity, family income, and educational status are independently associated with intake of added
Zhang, Yan; Dennis, Jeff A; Leach, Matthew J; Bishop, Felicity L; Cramer, Holger; Chung, Vincent C H; Moore, Craig; Lauche, Romy; Cook, Ron; Sibbritt, David; Adams, Jon
Given the safety concerns regarding pharmacological agents, and the considerable impact of headache and migraine on the sufferer's quality of life, many people seek other treatment options beyond conventional medication and care to address their symptoms; this includes complementary and alternative medicine (CAM). Some CAM interventions have shown promising results in clinical trials of headache and migraine management. Nonetheless, there has been little research exploring the reasons for using CAM, and the types of CAM used, among this population. The study aimed to answer the following questions: (1) Which CAM modalities are used most frequently among migraine/headache sufferers? and (2) What are the self-reported reasons for CAM use among migraine/headache sufferers? This secondary analysis of data from the 2012 U.S. NHIS (a national cross-sectional survey) examined the use of CAM among migraine/headache sufferers, including the main reasons related to CAM use. Data were weighted and analyzed using STATA 14.0. The sample of 34,525 adults included 6558 (18.7%) headache/migraine sufferers. Of the headache/migraine sufferers, a substantial proportion (37.6%, n = 2427) used CAM for various conditions; however, CAM use specifically for headache/migraine was much less prevalent (3.3%, n = 216). Of those who used CAM for headache/migraine, about half used CAM in conjunction with prescription (47.8%, n = 100) or over-the-counter medication (55.1%, n = 113). As severity of headache/migraine increased so did the likelihood of using CAM (severe migraine odds ratio [OR] = 2.32; 95% confidence interval [CI]: 1.41, 3.82; both recurring headache/severe migraine OR = 3.36; 95% CI: 2.08, 5.43; when compared to those with recurring headache only). The most frequently used CAM modality among all headache/migraine sufferers (N = 6558) was manipulative therapy (22.0%, n = 1317), herbal supplementation (21.7%, n = 1389) and mind-body therapy (17
Harder, Henrik; Christensen, Cecilie Breinholm; Jensen, Maria Vestergaard
Background and purpose The Aalborg Survey consists of four independent parts: a web, GPS and an interview based survey and a literature study, which together form a consistent investigation and research into use of urban space, and specifically into young people’s use of urban space: what young...... people do in urban spaces, where they are in the urban spaces and when the young people are in the urban spaces. The answers to these questions form the framework and enable further academic discussions and conclusions in relation to the overall research project Diverse Urban Spaces (DUS). The primary......) and the research focus within the cluster of Mobility and Tracking Technologies (MoTT), AAU. Summary / Part 3 - Interview Based Survey The 3rd part of the DUS research project has been carried out during the fall of 2009 and the summer and fall of 2010 as an interview based survey of 18 selected participants (nine...
Maske, Ulrike E; Riedel-Heller, Steffi G; Seiffert, Ingeburg; Jacobi, Frank; Hapke, Ulfert
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.
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
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
Woo, Bongki; Wang, Kaipeng; Tran, Thanh
Racial and ethnic minorities often suffer from poorer health than Whites given their exposure to more stressors and fewer resources that buffer the effects of stress. Given that alcohol is often consumed to alleviate the negative moods, the present study hypothesized that psychological distress may impact the involvement in binge drinking differently across racial and ethnic groups. We used data from the California Health Interview Survey (CHIS) from 2007 to 2012. The sample consisted of 130,556 adults including African Americans (N=6541), Asians (N=13,508), Latinos (N=18,128), and Whites (N=92,379). Binary logistic regression analysis was used with consideration for complex survey design. The results indicated that psychological distress was significantly associated with binge drinking across all racial and ethnic groups. However, this association differed by race and ethnicity adjusting for age, gender, marital status, education, poverty, and employment status. The results revealed that psychological distress had the largest effect on binge drinking for Asian Americans, particularly Filipinos and South Asians, compared to Whites. This study highlights the importance of examining racial and ethnic differences in the impacts of psychological distress on alcohol consumption. Future research is needed to better understand the potential factors that mediate the effects of psychological distress on binge drinking specific to each racial and ethnic group in order to develop culturally sensitive interventions and hence decrease the alcohol-related racial health disparities. Copyright Â© 2016 Elsevier Ltd. All rights reserved.
Muntaner, Carles; Borrell, Carme; Solà, Judit; Marí-Dell'Olmo, Marc; Chung, Haejoo; Rodríguez-Sanz, Maica; Benach, Joan; Rocha, Kátia B; Ng, Edwin
The aim of this study is to test the effects of neo-Marxian social class and potential mediators such as labor market position, work organization, material deprivation, and health behaviors on all-cause mortality. The authors use longitudinal data from the Barcelona 2000 Health Interview Survey (N=7526), with follow-up interviews through the municipal census in 2008 (95.97% response rate). Using data on relations of property, organizational power, and education, the study groups social classes according to Wright's scheme: capitalists, petit bourgeoisie, managers, supervisors, and skilled, semi-skilled, and unskilled workers. Findings indicate that social class, measured as relations of control over productive assets, is an important predictor of mortality among working-class men but not women. Workers (hazard ratio = 1.60; 95% confidence interval, 1.10-2.35) but also managers and small employers had a higher risk of death compared with capitalists. The extensive use of conventional gradient measures of social stratification has neglected sociological measures of social class conceptualized as relations of control over productive assets. This concept is capable of explaining how social inequalities are generated. To confirm the protective effect of the capitalist class position and the "contradictory class location hypothesis," additional efforts are needed to properly measure class among low-level supervisors, capitalists, managers, and small employers.
Peipins Lucy A
Full Text Available Abstract Background Preventive health care services, such as cancer screening can be particularly vulnerable to a lack of paid leave from work since care is not being sought for illness or symptoms. We first describe the prevalence of paid sick leave by broad occupational categories and then examine the association between access to paid sick leave and cancer testing and medical care-seeking in the U.S. workforce. Methods Data from the 2008 National Health Interview survey were analyzed by using paid sick leave status and other health-related factors to describe the proportion of U.S. workers undergoing mammography, Pap testing, endoscopy, fecal occult blood test (FOBT, and medical-care seeking. Results More than 48 million individuals (38% in an estimated U.S. working population of 127 million did not have paid sick leave in 2008. The percentage of workers who underwent mammography, Pap test, endoscopy at recommended intervals, had seen a doctor during the previous 12 months or had at least one visit to a health care provider during the previous 12 months was significantly higher among those with paid sick leave compared with those without sick leave after controlling for sociodemographic and health-care-related factors. Conclusions Lack of paid sick leave appears to be a potential barrier to obtaining preventive medical care and is a societal benefit that is potentially amenable to change.
Tully, Phillip J; Baune, Bernhard T
This study aims to examine whether specific anxiety disorder comorbidity alters the purported association between depression and specific cardiovascular diseases (CVDs). In 4,181 representative German participants of the general population, 12-month prevalence of psychiatric disorders was assessed through the Composite International Diagnostic Interview and CVDs by physician verified diagnosis. Adjusting for conventional risk factors logistic regression analyzed the association between CVDs (peripheral vascular disease (PVD), hypertension, cerebrovascular disease and heart disease) and combinations of comorbidity between depression and anxiety disorder types (panic disorder, specific phobia, social phobia and generalized anxiety). There were 770 cases of hypertension (18.4 %), 763 cases of cerebrovascular disease (18.2 %), 748 cases of PVD (17.9 %), and 1,087 cases of CVD (26.0 %). In adjusted analyses phobia comorbid with depression was associated with cerebrovascular disease (odds ratio (OR) 1.61; 95 % confidence interval (CI) 1.04-2.50) as was panic disorder (OR 2.89; 95 % CI 1.47-5.69). PVD was significantly associated with panic disorder (adjusted OR 2.97; 95 % CI 1.55-5.69). Panic disorder was associated with CVDs (adjusted OR 2.28; 95 % CI 1.09-4.77) as was phobia (adjusted OR 1.35; 95 % CI 1.04-1.78). Classification of anxiety and depression according to comorbidity groups showed discrete effects for panic disorder and specific phobia with CVDs, independent from covariates and depression.
Us Centers For Disease Control And Prevention Epilepsy Program
People with active epilepsy are those who reported being told that they have epilepsy or a seizure disorder and either take antiseizure medication or have had a seizure during the past 12months. We used combined 2010 and 2013 National Health Interview Survey (NHIS) data on US adults with active epilepsy to examine whether taking medications and seizure frequency differed by sex, age, race/ethnicity, and reported or imputed annual family income. Of adults with active epilepsy, 45.5% reported taking medication and having at least one seizure, 41.3% reported taking medication and having no seizures, and 13.2% reported not taking any medication and having at least one seizure. About one-half of adults with active epilepsy and seizures have annual family incomes of less than $25,000. Promoting self-management supports and improved access to specialty care may reduce the burden of uncontrolled seizures in adults with epilepsy. Published by Elsevier Inc.
Chih, Hui Jun; Liang, Wenbin
Reduced funding to public health care systems during economic downturns is a common phenomenon around the world. The effect of health care cost on family members of the patients has not been established. This paper aims to explore the relationship between affordability of health care and vulnerability of family members to distress levels. Data of a total of 262,843 participants were obtained from 17 waves (1997-2013) of the United States National Health Interview Survey. Multinomial logistic regression was used to investigate psychological distress level as a result of having family members who experienced unmet medical needs due to cost. Among participants without family members who experienced unmet needs for medical care due to cost, risks of having 'moderate' (score of 5-12) or 'serious' (score of 13 or above) level of psychological distress were 1.0% and 11.5%, respectively. Risks of having 'moderate' or 'serious' level of psychological distress were 3.1% and 23.4%, respectively among participants with family members who experienced unmet needs. The adjusted relative risk ratio of 'moderate' and 'serious', as compared to 'normal' level of psychological distress, were 1.58 (95% confidence interval: 1.47-1.69) and 2.09 (95% confidence interval: 1.78-2.45) if one's family members experienced unmet medical needs. Unmet medical needs due to cost increases risk of distress levels experienced by family members. Careful planning and adequate funding to public health care system could be implemented to prevent any unnecessary detrimental effect on mental health among family members of the unwell and any further increment of the prevalence of mental illnesses. This recommendation aligns with the World Health Organization Mental Health Action Plan 2013-2020.
Full Text Available Background. In 1990s, complementary and alternative medicine (CAM, including use of herbs and supplements, gained popularity in the United States. However, more recent surveys suggest that demand for herbs and supplements has stabilized. Objective. This study examined the prevalence, patterns, and changes in herb and supplement use among the US adults, using the 2002, 2007, and 2012 National Health Interview Surveys (NHIS. Methods. Weighted population estimates were derived from three complementary and alternative medicine supplements to the NHIS. Prevalence rates for herb and supplement use were compared, using Wald chi-square tests to measure changes between years. Results. An estimated 40.6 million US adults reported herb and supplement use in 2012. However, the rate of herb and supplement use dropped from 18.9% in 2002 to 17.9% in 2007 and 2012 (P<0.05. This decline in use was more pronounced among women, racial or ethnic minorities, and adults with low incomes. Conclusion. Herb and supplements use remains common in the USA, but adult use rates are on the decline. It is still important for health care providers to ask patients about herb and supplement use.
Wu, Chung-Hsuen; Wang, Chi-Chuan; Kennedy, Jae
Past national surveys indicate that use of herbs and dietary supplements rose rapidly in the United States during the 1990s and early 2000s. Additional research is needed to determine whether this growth rate and associated patterns of use have persisted over time. The objectives of this study were: (1) to assess population and subpopulation changes in rates of herb and supplement use; and (2) to assess changes in rates of disclosure of herb and supplement use to conventional medical providers. This study used data from the 2002 (n = 30,427) and 2007 (n = 22,657) Adult Complementary and Alternative Medicine File to the National Health Interview Survey (NHIS). Weighted group and subgroup comparisons used the Wald χ(2) tests to compare differences in herb and supplement use between 2002 and 2007. The number of adults in the United States that ever used herbs or supplements grew slightly, from 50.6 million in 2002 to 55.1 million in 2007. However, the proportion of adults who reported use of herbs or supplements in the past 12 months dropped significantly: from 18.9% in 2002 to 17.9% in 2007 (P minorities also reported a significant decline in recent use. The proportion of respondents that disclosed herb or supplement use to their physician or another conventional medical professional rose, from 33.4% in 2002 to 45.4% in 2007. However, <1% of recent herb and supplement users disclosed this use to their pharmacist. Limitations of this research are that the 2 national data sets were not directly comparable and that questionnaires in the 2 surveys assessed were not identical. Herbal preparations and dietary supplements remain popular in the United States, but the user population and patterns of use are changing. Ongoing surveillance of this health behavior is a public health priority. Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.
Alterman, Toni; Luckhaupt, Sara E.; Dahlhamer, James M.; Ward, Brian W.; Calvert, Geoffrey M.
Background Surveillance is needed to capture work organization characteristics and to identify their trends. Methods Data from the 2010 National Health Interview Survey (NHIS) were used to calculate prevalence rates for four work organization characteristics (long work hours, non-standard work arrangements, temporary positions, and alternative shifts) overall, and by demographic characteristics, and industry and occupation of current/recent employment. Results Data were available for 27,157 adults, of which 65% were current/recent workers. Among adults who worked in the past 12 months, 18.7% worked 48 hr or more per week, 7.2% worked 60 hr or more per week, 18.7% had non-standard work arrangements, 7.2% were in temporary positions, and 28.7% worked an alternative shift. Conclusions Prevalence rates of work organization characteristics are provided. These national estimates can be used to help occupational health professionals and employers to identify emerging occupational safety and health risks, allow researchers to examine associations with health, and use the data for benchmarking. PMID:22911666
Eltoum, Isam A; Roberson, Janie
The frequently cited number of 50 million annual Papanicolaou cervical screening (Pap) tests performed in the US was based on the National Health Interview Survey (NHIS) of the 1980s. Since then, monumental changes have occurred. More change will soon follow when primary human papilloma virus (HPV) testing and/or HPV vaccine delivery are fully accepted and implemented. The objectives of this study were 1) to estimate the total annual Pap tests performed in the US based on recent NHIS surveys, and 2) to estimate the potential change in the total annual Pap volume produced by changing demographics, reduced screening frequency, HPV testing, and the HPV vaccine. In the NHIS 2000 and NHIS 2005, women were asked to report the frequency of their Pap tests for the 6 years prior to the interview and to report whether they had abnormal findings. The authors analyzed the survey respondents answers to these questions by using SAS Survey Procedures (SAS Institute, NC). The results were stratified by age, and the total national volume was then extrapolated from a similarly stratified 2000 US census. The projected increase of total Pap tests for the next 25 years was determined by using the projected census data. Potential reductions of Pap tests performed secondarily to HPV testing of women >30 years old and of HPV vaccination were also determined. Based on NHIS 2000 and NHIS 2005, 66 million (95% CI, 65-68) and 65 million (95% CI, 64-67) Pap tests were performed in the US, respectively. Had HPV testing been performed in women older than 30 years who had both negative HPV and negative 3-year Pap tests, then 30% (95% CI, 29-32%) of Pap tests would not have been performed. If both HPV testing and vaccination are performed, the total number of Pap tests performed annually is predicted to be reduced by 43% (95% CI, 35-38%). Therefore, despite an expected increase in the population of women eligible for Pap tests, the total number will likely decrease substantially in the future
Lampert, T; Sygusch, R; Schlack, R
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.
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.
Kobau, Rosemarie; Cui, Wanjun; Zack, Matthew M
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.
Association of elevated blood pressure with low distress and good quality of life: results from the nationwide representative German Health Interview and Examination Survey for Children and Adolescents.
Berendes, Angela; Meyer, Thomas; Hulpke-Wette, Martin; Herrmann-Lingen, Christoph
Quality of life is often impaired in patients with known hypertension, but it is less or not at all reduced in people unaware of their elevated blood pressure. Some studies have even shown less self-rated distress in adults with elevated blood pressure. In this substudy of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KIGGS), we addressed the question whether, also in adolescents, hypertensive blood pressure is linked to levels of distress and quality of life. Study participants aged 11 to 17 years (N = 7688) received standardized measurements of blood pressure, quality of life (using the Children's Quality of Life Questionnaire), and distress (Strengths and Difficulties Questionnaire). Elevated blood pressure was twice as frequent as expected, with 10.7% (n = 825) above published age-, sex- and height-adjusted 95th percentiles. Hypertensive participants were more likely to be obese and to report on adverse health behaviors, but they showed better academic success than did normotensive participants. Elevated blood pressure was significantly and positively associated with higher self- and parent-rated quality of life (for both, p ≤ .006), less hyperactivity (for both, p parent-rated emotional (p pressure to better well-being and low distress can partly be explained by the absence of confounding physical comorbidity and the unawareness of being hypertensive. It also corresponds to earlier research suggesting a bidirectional relationship with repressed emotions leading to elevated blood pressure and, furthermore, elevated blood pressure serving as a potential stress buffer.
Fang, Jing; George, Mary G.; Gindi, Renee M.; Hong, Yuling; Yang, Quanhe; Ayala, Carma; Ward, Brian W.; Loustalot, Fleetwood
Current guidelines recommend that adults with atherosclerotic cardiovascular disease take low-dose aspirin or other antiplatelet medications as secondary prevention of recurrent cardiovascular events. Yet, no national level assessment of low-dose aspirin use for secondary prevention of cardiovascular disease has been reported among a community-based population. Using data from the 2012 National Health Interview Survey, we assessed low-dose aspirin use among those with atherosclerotic cardiovascular disease. We estimated the prevalence ratios of low-dose aspirin use, adjusting for sociodemographic status, health insurance, and cardiovascular risk factors. Among those with atherosclerotic cardiovascular disease (n=3,068), 76% had been instructed to take aspirin, and 88% of those were following this advice. Of those not advised, 11% took aspirin on this own. Overall, 70% were taking aspirin (including those who followed their health care provider's advice and those who were not advised but took aspirin on their own). Logistic regression models showed that women, non-Hispanic blacks and Hispanics, those aged 40–64 years, with a high school education or with some college, or with fewer cardiovascular disease risk factors were less likely to take aspirin than men, non-Hispanic whites, those aged ≥65 years, with a college education or higher, or with all four selected cardiovascular disease risk factors, respectively. Additional analyses conducted among those with coronary heart disease only (n=2,007) showed similar patterns. In conclusion, use of low-dose aspirin for secondary prevention was 70%, with high reported adherence to health care providers' advice to take low-dose aspirin (88%), and significant variability within subgroups. PMID:25670639
Baumeister, Sebastian E; Ricci, Cristian; Kohler, Simone; Fischer, Beate; Töpfer, Christine; Finger, Jonas D; Leitzmann, Michael F
The current study examined the reliability and validity of the European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ), a novel questionnaire for the surveillance of physical activity (PA) during work, transportation, leisure time, sports, health-enhancing and muscle-strengthening activities over a typical week. Reliability was assessed by administering the 8-item questionnaire twice to a population-based sample of 123 participants aged 15-79 years at a 30-day interval. Concurrent (inter-method) validity was examined in 140 participants by comparisons with self-report (International Physical Activity Questionnaire-Long Form (IPAQ-LF), 7-day Physical Activity Record (PAR), and objective criterion measures (GT3X+ accelerometer, physical work capacity at 75% (PWC(75%)) from submaximal cycle ergometer test, hand grip strength). The EHIS-PAQ showed acceptable reliability, with a median intraclass correlation coefficient across PA domains of 0.55 (range 0.43-0.73). Compared to the GT3X+ (counts/minutes/day), the EHIS-PAQ underestimated moderate-to-vigorous PA (median difference -11.7, p-value = 0.054). Spearman correlation coefficients (ρ) for validity were moderate-to-strong (ρ's > 0.41) for work-related PA (IPAQ = 0.64, GT3X + =0.43, grip strength = 0.48), transportation-related PA (IPAQ = 0.62, GT3X + =0.43), walking (IPAQ = 0.58), and health-enhancing PA (IPAQ = 0.58, PAR = 0.64, GT3X + =0.44, PWC(75%) = 0.48), and fair-to-poor (ρ's PAQ showed good evidence for reliability and validity for the measurement of PA levels at work, during transportation and health-enhancing PA.
Full Text Available 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
Syamlal, Girija; Mazurek, Jacek M; Hendricks, Scott A; Jamal, Ahmed
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%. 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. 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. 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. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco . This work is written by (a) US Government employee(s) and is in the public domain in the US.
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Lee, Jie-Min; Hwang, Tsorng-Chyi; Ye, Chun-Yuan; Chen, Sheng-Hong
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. 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. 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 dollars 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. 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.
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.
Commodore-Mensah, Yvonne; Ukonu, Nwakaego; Obisesan, Olawunmi; Aboagye, Jonathan Kumi; Agyemang, Charles; Reilly, Carolyn M; Dunbar, Sandra B; Okosun, Ike S
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 income ratio, age, and sex, immigrants residing in the United States for ≥10 years were more likely to be overweight/obese (odds ratio [OR], 1.19; 95% CI, 1.10-1.29), 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 <10 years. In an ethnically diverse sample of US immigrants, 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.
LOUIE, GRANT H.; TEKTONIDOU, MARIA G.; CABAN-MARTINEZ, ALBERTO J.; WARD, MICHAEL M.
Objective To examine the prevalence of sleep disturbances in adults with arthritis in a nationally representative sample, mediators of sleep difficulties, and subgroups of individuals with arthritis at greatest risk. Methods Using data on US adults ages ≥18 years participating in the 2007 National Health Interview Survey, we computed the prevalence of 3 measures of sleep disturbance (insomnia, excessive daytime sleepiness, and sleep duration arthritis. We used logistic regression analysis to examine if the association of arthritis and sleep disturbances was independent of sociodemographic characteristics and comorbidities, and to identify potential mediators. We used classification trees to identify subgroups at higher risk. Results The adjusted prevalence of insomnia was higher among adults with arthritis than those without arthritis (23.1% versus 16.4%; P arthritis were more likely than those without arthritis to report insomnia (unadjusted odds ratio 2.92, 95% confidence interval 2.68 –3.17), but adjustment for sociodemographic characteristics and comorbidities attenuated this association. Joint pain and limitation due to pain mediated the association between arthritis and insomnia. Among adults with arthritis, those with depression and anxiety were at highest risk for sleep disturbance. Results for excessive daytime sleepiness and sleep duration arthritis, and is mediated by joint pain and limitation due to pain. Among individuals with arthritis, those with depression and anxiety are at greatest risk. PMID:20890980
Holman, Dawn M.; Berkowitz, Zahava; Guy, Gery P.; Hartman, Anne M.; Perna, Frank M.
Objective To examine the association between demographic and behavioral characteristics and sunburn among U.S. adults. Method We used 2010 National Health Interview Survey data (N = 24,970) to conduct multivariable logistic regressions examining associations with having 1 or more sunburns in the past year and having 4 or more sunburns in the past year. Results Overall, 37.1% of adults experienced sunburn in the past year. The adjusted prevalence of sunburn was particularly common among adults aged 18–29 years (52.0%), those who repeatedly burn or freckle after 2 weeks in the sun (45.9%), whites (44.3%), indoor tanners (44.1%), those with a family history of melanoma (43.9%), and those who are US-born (39.5%). Physical activity, alcohol consumption, and overweight/obesity were positively associated with sunburn (all P sunburn (P = 0.35). Among those who were sunburned in the past year, 12.1% experienced 4 or more sunburns. Conclusion Sunburn is common, particularly among younger adults, those with a more sun-sensitive skin type, whites, those with a family history of melanoma, the highly physically active, and indoor tanners. Efforts are needed to facilitate sun-safety during outdoor recreation, improve the consistency of sun protection practices, and prevent sunburn, particularly among these subgroups. PMID:24589442
Laz, Tabassum H; Rahman, Mahbubur; Berenson, Abbey B
Human papillomavirus (HPV) vaccine uptake among young adult women has been reported to be very low. The authors conducted this study to provide an update on HPV vaccine uptake among 18- to 26-year-old women. The authors used the National Health Interview Survey 2010 data to estimate HPV vaccine coverage and their correlates. Overall, 22.7% of women initiated (≥1 dose) and 12.7% completed the vaccine (≥3 doses). Thus, about 56% of women who initiated the vaccine completed it. Multivariate logistic regression analyses showed that younger age, unmarried status, Papanicolaou test, influenza vaccine, lifetime vaccines, and HPV vaccine awareness were positively associated with receiving ≥1 and ≥3 doses. In addition, uninsured women were less likely to receive ≥1 dose (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.28-0.84), and blacks (OR, 0.48; 95% CI, 0.23-0.99) and women with a family income women were not interested in future vaccination. Among those who were interested, >76.4% preferred to receive it free or at a lower cost, whereas 20% would pay the full cost of the vaccine. One in 8 women completed the 3-dose HPV vaccine. Educational and vaccine financing programs are needed to improve the uptake among low-income minority women who are at increased risk for cervical cancer. Copyright © 2012 American Cancer Society.
Chan-Golston, Alec M; Friedlander, Scott; Glik, Deborah C; Prelip, Michael L; Belin, Thomas R; Brookmeyer, Ron; Santos, Robert; Chen, Jie; Ortega, Alexander N
The employment of professional interviewers from academic survey centers to conduct surveys has been standard practice. Because one goal of community-engaged research is to provide professional skills to community residents, this paper considers whether employing locally trained lay interviewers from within the community may be as effective as employing interviewers from an academic survey center with regard to unit and item nonresponse rates and cost. To study a nutrition-focused intervention, 1035 in-person household interviews were conducted in East Los Angeles and Boyle Heights, 503 of which were completed by lay community interviewers. A chi-square test was used to assess differences in unit nonresponse rates between professional and community interviewers and Welch's t tests were used to assess differences in item nonresponse rates. A cost comparison analysis between the two interviewer groups was also conducted. Interviewers from the academic survey center had lower unit nonresponse rates than the lay community interviewers (16.2% vs. 23.3%; p < 0.01). However, the item nonresponse rates were lower for the community interviewers than the professional interviewers (1.4% vs. 3.3%; p < 0.01). Community interviewers cost approximately $415.38 per survey whereas professional interviewers cost approximately $537.29 per survey. With a lower cost per completed survey and lower item nonresponse rates, lay community interviewers are a viable alternative to professional interviewers for fieldwork in community-based research. Additional research is needed to assess other important aspects of data quality interviewer such as interviewer effects and response error.
Yang, Haiou; Haldeman, Scott; Lu, Ming-Lun; Baker, Dean
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 United States. The data used for this cross-sectional study came from the 2010 National Health Interview Survey, which was designed to collect data on health conditions and related risk factors 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 (nonstandard work arrangements and alternative shifts) were also examined. The prevalence of self-reported low back pain in the previous 3 months among workers in the United States 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 nonstandard work arrangements were more likely to report low back pain. Women who worked 41 to 45 hours per week and younger workers who worked >60 hours per week had an increased risk for low back pain. Workers from several occupation groups, including male health care practitioners, female and younger health care support workers, and female farming, fishing, and forestry workers, had an increased risk of
Bardenheier Barbara H
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
Opper, E; Worth, A; Wagner, M; Bös, K
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.
Utilization of medical and health-related services among school-age children and adolescents with special health care needs (1994 National Health Interview Survey on Disability [NHIS-D] Baseline Data).
Weller, Wendy E; Minkovitz, Cynthia S; Anderson, Gerard F
To determine how sociodemographic factors and type of insurance influence use of medical and health-related services by children with special health care needs (CSHCN), after controlling for need. A cross-sectional analysis of 1994 National Health Interview Disability Survey was conducted. Children between 5 and 17 years were identified as chronically ill according to the Questionnaire for Identifying Children with Chronic Conditions (n = 3061). Independent variables included child and family characteristics categorized as predisposing, enabling, and need. Dependent variables included use of 4 medical or 7 health-related services. Most children (88.7%) had seen a physician; 23.9% had an emergency department visit, 11.4% had a mental health outpatient visit, and 6.4% were hospitalized. Health-related service use ranged from <5.0% (transportation and social work) to 65.1% (medical care coordination); 20% to 30% of children used the remaining services (therapeutic, assistive devices, nonmedical care coordination, housing modifications). In fully adjusted logistic models, children with public insurance were significantly more likely than privately insured children to use 2 of the 4 medical services and 5 of the 7 health-related services. Non-Hispanic black children and children from less educated families were significantly less likely to use many of the services examined. In 1994, factors in addition to need influenced medical and health-related service use by CSHCN. Differences in the scope of benefits covered by public insurance compared with private insurance may influence utilization of medical and especially health-related services. Attention is needed to ensure that CSHCN who are racial/ethnic minorities or are from less educated families have access to needed services. Future studies should determine whether these patterns have changed over time.
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.
Wong, D N; Fan, W
E-cigarette use is not only prevalent among adolescents but is growing at an alarming rate. This study sought to determine e-cigarette use prevalence and its relation to alcohol use as a potential gateway drug, and how this may differ by sex and ethnicity in a multi-ethnic sample of California adolescents. Cross-sectional survey. We included data from 1806 adolescents (weighted to 3.0 million) aged 12-17 in the 2014 and 2015 California Health Interview Survey (CHIS) cycles. The prevalence of e-cigarette use was calculated within sex and ethnic groups and the prevalence of alcohol use according to e-cigarette use was also examined with sample weighting providing population estimates. Multiple logistic regression models were built to predict the odds of using alcohol from e-cigarette use status adjusted for sociodemographic and other characteristics. The prevalence of e-cigarette use was 9.1% (projected to 0.3 million) overall in California adolescents but highest in boys among non-Hispanic Whites (15.1%) and in Asian girls (13.3%). Among e-cigarette users, 61.3% of boys and 71.0% of girls reported using alcohol as well. The logistic regression odds of alcohol use, adjusted for age, ethnicity, body mass index, cigarette smoking status, socioeconomic status, parents' education level, and insurance status among e-cigarettes users (compared with non-users) was 9.2 in girls and 3.1 in boys (both P < 0.01). Asians/others, non-Hispanic whites and Hispanics were similarly at increased odds: 17.8, 5.4, and 3.0, respectively (P < 0.01 for Asians/others and for whites) of using alcohol compared with their non-e-cigarette using counterparts, respectively. Attention needs to be paid to the high prevalence of e-cigarette smoking as well as its potential as a gateway drug for alcohol drinking in adolescents, especially among girls and Asians. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
[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)].
Krug, S; Jekauc, D; Poethko-Müller, C; Woll, A; Schlaud, M
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.
María Teresa Ruiz Cantero
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
Greenlee, Heather; Shi, Zaixing; Sardo Molmenti, Christine L; Rundle, Andrew; Tsai, Wei Yann
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 history of cancer compared with those without a history of cancer (all P for interaction < .001). The estimated rate of annual increase in 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 < .001). In subgroup analyses, populations with the highest rates of increasing 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.
Chen, Chiung M; Yoon, Young-Hee
Acute alcohol consumption is known to be a risk factor for fall injuries. The study sought to determine whether usual alcohol consumption increases the risk for nonfatal fall injuries. Data from 289,187 sample adults in the 2004-2013 U.S. National Health Interview Surveys were analyzed. Of these, 3,368 (∼1%) reported a total of 3,579 fall-injury episodes requiring medical consultation in the past 3 months. Latent class analysis based on four contextual indicators identified four ecological subtypes of fall injury within two age groups (18-49 and 50+). Five drinking patterns (i.e., lifetime abstainer, former drinker, low-risk drinker, increased-risk drinker, and highest-risk drinker) were categorized according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) low-risk drinking guidelines. Controlling for potential confounders, negative binomial regression estimated the adjusted rates of any type and subtypes of fall injury, by gender, for each drinking pattern relative to lifetime abstainer. Compared with lifetime abstainers, the adjusted rate of any fall injury for adults ages 18-49 was significantly higher among highest-risk drinkers (men: incidence rate ratio [IRR] = 2.59, 95% confidence interval [CI] [1.60, 4.20]; women: IRR = 1.90, 95% CI [1.24, 2.91]) and increased-risk drinkers (men: IRR = 1.94, 95% CI [1.25, 3.00]; women: IRR = 1.51, 95% CI [1.11, 2.07]). Furthermore, highest-risk drinkers had higher adjusted rates of either leisure- or sports-related fall injuries than lifetime abstainers. Alcohol consumption exceeding NIAAA's low-risk drinking guidelines is associated with elevated rates of nonfatal fall injuries. Findings underscore the importance of adhering to these recommendations.
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.
Smith, Teresa M; Colón-Ramos, Uriyoán; Pinard, Courtney A; Yaroch, Amy L
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.
Yang, Haiou; Haldeman, Scott; Lu, Ming-Lun; Baker, Dean
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
Finger, Jonas D; Varnaccia, Gianni; Tylleskär, Thorkild; Lampert, Thomas; Mensink, Gert B M
The positive association between parental socioeconomic position (PSEP) and health among adolescents may be partly explained by dietary behaviour. We investigated the associations between fruit intake, vegetable intake, energy-dense food intake, the Healthy Nutrition Score for Kids and Youth (HuSKY) and parental education in a nationwide, cluster-randomized sample of adolescents in Germany. The German Health Interview and Examination Survey for Children and Adolescents 2003-2006 (KiGGS) included 17,641 individuals aged 0-17 years and their parents. Complete information on relevant variables was available for 6359 individuals in the 11-17 age group. The associations between nutrition indicators and parental education were analysed separately for boys and girls, using multivariate logistic regression analysis. Odds ratios (ORs) adjusted for age, region, income, occupation, physical activity and weight status related variables, were calculated for the associations between parental education and nutrition indicators. After full adjustment, higher parental education level was associated with lower energy-dense food intake - with an OR of 1.3 (95 % CI 1.0-1.7) for boys with secondary educated parents and 1.8 (1.4-2.3) for boys with tertiary educated parents compared to boys with primary educated parents; the corresponding ORs for girls were 1.2 (0.9-1.5) and 1.6 (1.2-2.2). Higher parental education was associated with higher fruit intake - with an OR of 1.3 (1.0-1.7) for boys with secondary educated parents and 2.0 (1.5-2.7) for boys with tertiary educated parents compared to boys with primary educated parents; the corresponding ORs for girls were 1.0 (0.8-1.4) and 1.5 (1.0-2.1). Among boys and girls with tertiary educated parents compared to those with primary educated parents an OR of 1.3 (CI boys: 1.0-1.7, CI girls: 1.0-1.6) was observed for high vegetable intake. Among boys with tertiary educated parents compared to boys with primary educated parents an OR of 1.6 (1
Byrd, Doratha A; Agurs-Collins, Tanya; Berrigan, David; Lee, Richard; Thompson, Frances E
This paper reports racial/ethnic differences in mean dietary and alcohol intake, physical activity, and body mass index (BMI) among cancer survivors and examines adherence to the American Cancer Society and the US Dietary Guidelines for Americans. Data are from the cross-sectional 2005 and 2010 National Health Interview Surveys (NHIS). The total sample of cancer survivors (N = 3367) included non-Hispanic Whites (NHW; N = 2698), non-Hispanic Blacks (NHBs; N = 379), and Hispanics (N = 290). We compared mean reported dietary intake, moderate/vigorous physical activity, and BMI among racial/ethnic groups. Predicted marginals and multivariate logistic regression analysis were used to compare prevalence of non-adherence with recommendations among groups. Among the three racial/ethnic groups, Hispanics had the highest mean intake of vegetables, fiber, and calcium (p = 0.0003; p < 0.0001; p = 0.001). In the logistic regression model adjusting for sociodemographic covariates, smoking and BMI, Hispanics had lower non-adherence to fiber guidelines (OR = 0.38; CI = 0.24-0.58) than NHWs. NHBs had significantly higher non-adherence to vegetable guidelines (OR = 1.63; CI = 1.07-2.47). NHBs and Hispanics had lower non-adherence with alcohol guidelines than NHWs (OR = 0.35 and 0.38; CI = 0.18-0.69 and 0.19-0.76, respectively). NHBs and Hispanics were more likely to be overweight/obese (OR = 1.66 and 1.57; CI = 1.24-2.23 and CI = 1.11-2.21, respectively). There are racial/ethnic differences in certain health behaviors of cancer survivors. However, non-adherence to guidelines is high in all three racial/ethnic groups. Achieving the recommended guidelines for diet, physical activity, and a healthy BMI is a concern for all cancer survivors, indicating the need for intervention among this growing group of at-risk individuals.
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
Dunning, Kari; LeMasters, Grace K
While survey studies have examined bias much is unknown regarding specific subpopulations, especially women workers. A population based phone, Internet, and mail survey of workplace falls during pregnancy was undertaken. Participation by industry and occupation and survey approach and bias, reliability, and incomplete data were examined. Of the 3,997 women surveyed, 71% were employed during their pregnancy. Internet responders were most likely to be employed while pregnant and to report a workplace fall at 8.8% compared to 5.8% and 6.1% for mail and phone respondents. Internet responders had the most missing employment data with company name missing for 17.9% compared to 1.3% for phone responders. Mail surveys were best for recruiting those employed in eight of nine industries, and this was especially true for service occupations. To decrease bias and increase participation, mixed approaches may be useful with particular attention for collecting occupational data. Am. J. Ind. Med. 52:105-112, 2009. (c) 2008 Wiley-Liss, Inc.
Nahin Richard L
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
Dijkstra, W.; Ongena, Y.P.
Interaction analysis was used to analyze a total of 14,265 question-answer sequences of (Q-A Sequences) 80 questions that originated from two face-to-face and three telephone surveys. The analysis was directed towards the causes and effects of particular interactional problems. Our results showed
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.
Lee, Ji Hyun; Giovenco, Danielle; Operario, Don
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.
Alcohol use disorders are related to many negative health, emotional, societal, and economic consequences. These disorders are often difficult to treat because individuals suffering from them tend to be ambivalent about and resistant to change. Motivational interviewing (MI) provides healthcare prov...
The exit interview and survey are means for identifying organizational problems, including diversity issues, through individuals separating from the organization, who are in a unique position to supply candid feedback...
Full Text Available The article reports the findings of a survey among 440 teachers of English in Estonia who participate in the oral proficiency interview of the national examination in the English language as interviewers. Examining the results of the questionnaire statement by statement, the study reveals that interviewer behavioural patterns emerge during the interview, some of them threatening its validity.The understanding of interviewer competence is very diverse among the interviewers and the degree to which they adhere to the standards defined for the interviewers of national examination in the English langage in Estonia is sometimes quite low. The interviewers are often unable to separate their role as an interviewer from being a teacher; they transfer their teaching behaviour to the interviewing situation. The teachers have difficulties with identification of appropriate accommodation strategies as well as controlling the extent of interaction between the interviewer and the assessor. The authors suggest a number of interviewer training strategies to combat the problems. DOI: http://dx.doi.org/10.5128/ERYa9.08
Paprott, Rebecca; Mensink, Gert B M; Schulze, Matthias B; Thiele, Silke; Mühlenbruch, Kristin; Scheidt-Nave, Christa; Heidemann, Christin
Objective Over time, prevalence changes in individual diabetes risk factors have been observed for Germany and other European countries. We aimed to investigate the temporal change of a summary measure of type 2 diabetes risk in Germany. Design Comparison of data from two cross-sectional surveys that are about 12 years apart. Setting Two nationwide health examination surveys representative for the non-institutionalised population aged 18–79 years in Germany. Participants The study included participants without diagnosed diabetes from the national health examination surveys in 1997–1999 (n=6457) and 2008–2011 (n=6095). Outcome measures Predicted 5-year type 2 diabetes risk was calculated using the German Diabetes Risk Score (GDRS), which considers information on age, anthropometry, lifestyle factors, hypertension and family history of diabetes. Results Between the two survey periods, the overall age- and sex-standardised predicted 5-year risk of type 2 diabetes decreased by 27% from 1.5% (95% CI 1.4% to 1.6%) to 1.1% (1.0% to 1.2%). The decrease in red meat intake and waist circumference had the highest impact on the overall decrease in diabetes risk. In stratified analyses, diabetes risk decreased among both sexes and within strata of age and body mass index. Diabetes risk also decreased among highly educated persons, but remained unchanged among persons with a middle or low educational level. Conclusions Monitoring type 2 diabetes risk by a summary measure such as the GDRS could essentially contribute to interpret the dynamics in diabetes epidemiology. PMID:28694339
Paprott, Rebecca; Mensink, Gert B M; Schulze, Matthias B; Thiele, Silke; Mühlenbruch, Kristin; Scheidt-Nave, Christa; Heidemann, Christin
Over time, prevalence changes in individual diabetes risk factors have been observed for Germany and other European countries. We aimed to investigate the temporal change of a summary measure of type 2 diabetes risk in Germany. Comparison of data from two cross-sectional surveys that are about 12 years apart. Two nationwide health examination surveys representative for the non-institutionalised population aged 18-79 years in Germany. The study included participants without diagnosed diabetes from the national health examination surveys in 1997-1999 (n=6457) and 2008-2011 (n=6095). Predicted 5-year type 2 diabetes risk was calculated using the German Diabetes Risk Score (GDRS), which considers information on age, anthropometry, lifestyle factors, hypertension and family history of diabetes. Between the two survey periods, the overall age- and sex-standardised predicted 5-year risk of type 2 diabetes decreased by 27% from 1.5% (95% CI 1.4% to 1.6%) to 1.1% (1.0% to 1.2%). The decrease in red meat intake and waist circumference had the highest impact on the overall decrease in diabetes risk. In stratified analyses, diabetes risk decreased among both sexes and within strata of age and body mass index. Diabetes risk also decreased among highly educated persons, but remained unchanged among persons with a middle or low educational level. Monitoring type 2 diabetes risk by a summary measure such as the GDRS could essentially contribute to interpret the dynamics in diabetes epidemiology. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Schlack, R; Hapke, U; Maske, U; Busch, M; Cohrs, S
Sleep disturbances are associated with a variety of physical and mental health disorders and cause high direct and indirect economic costs. The aim of this study was to report the frequency and distribution of problems of sleep onset and maintaining sleep, sleep quality, effective sleep time, and the consumption of sleeping pills in the adult population in Germany. During the 4 weeks prior to the interview, about one third of the respondents reported potentially clinically relevant problems initiating or maintaining sleep; about one-fifth reported poor quality of sleep. When additionally considering impairments during the daytime such as daytime fatigue or exhaustion, a prevalence of 5.7 % for an insomnia syndrome was found. Women were twice as likely to be affected by insomnia-syndrome as men. Significant age differences were not seen. Persons with low socioeconomic status had an increased risk of insomnia (OR: 3.44) as did people residing in West Germany (OR: 1.53). Women with low socioeconomic status (OR: 4.12) and West German men (OR: 1.79) were more affected. The results illustrate the considerable public health relevance of insomnia-related sleep disturbances. An English full-text version of this article is available at SpringerLink as supplemental.
Paprott, Rebecca; Mühlenbruch, Kristin; Mensink, Gert B M; Thiele, Silke; Schulze, Matthias B; Scheidt-Nave, Christa; Heidemann, Christin
Objective To evaluate the German Diabetes Risk Score (GDRS) among the general adult German population for prediction of incident type 2 diabetes and detection of prevalent undiagnosed diabetes. Methods The longitudinal sample for prediction of incident diagnosed type 2 diabetes included 3625 persons who participated both in the examination survey in 1997–1999 and the examination survey in 2008–2011. Incident diagnosed type 2 diabetes was defined as first-time physician diagnosis or antidiabetic medication during 5 years of follow-up excluding potential incident type 1 and gestational diabetes. The cross-sectional sample for detection of prevalent undiagnosed diabetes included 6048 participants without diagnosed diabetes of the examination survey in 2008–2011. Prevalent undiagnosed diabetes was defined as glycated haemoglobin ≥6.5% (48 mmol/mol). We assessed discrimination as area under the receiver operating characteristic curve (ROC-AUC (95% CI)) and calibration through calibration plots. Results In longitudinal analyses, 82 subjects with incident diagnosed type 2 diabetes were identified after 5 years of follow-up. For prediction of incident diagnosed diabetes, the GDRS yielded an ROC-AUC of 0.87 (0.83 to 0.90). Calibration plots indicated excellent prediction for low diabetes risk and overestimation for intermediate and high diabetes risk. When considering the entire follow-up period of 11.9 years (ROC-AUC: 0.84 (0.82 to 0.86)) and including incident undiagnosed diabetes (ROC-AUC: 0.81 (0.78 to 0.84)), discrimination decreased somewhat. A previously simplified paper version of the GDRS yielded a similar predictive ability (ROC-AUC: 0.86 (0.82 to 0.89)). In cross-sectional analyses, 128 subjects with undiagnosed diabetes were identified. For detection of prevalent undiagnosed diabetes, the ROC-AUC was 0.84 (0.81 to 0.86). Again, the simplified version yielded a similar result (ROC-AUC: 0.83 (0.80 to 0.86)). Conclusions The GDRS might be applied
Fairley, Christopher K; Sze, Jun Kit; Vodstrcil, Lenka A; Chen, Marcus Y
This review describes the published information on what constitutes the elements of a core sexual history and the use of computer-assisted self interviewing (CASI) within sexually transmitted disease clinics. We searched OVID Medline from 1990 to February 2010 using the terms "computer assisted interviewing" and "sex," and to identify published articles on a core sexual history, we used the term "core sexual history." Since 1990, 3 published articles used a combination of expert consensus, formal clinician surveys, and the Delphi technique to decide on what questions form a core sexual health history. Sexual health histories from 4 countries mostly ask about the sex of the partners, the number of partners (although the time period varies), the types of sex (oral, anal, and vaginal) and condom use, pregnancy intent, and contraceptive methods. Five published studies in the United States, Australia, and the United Kingdom compared CASI with in person interviews in sexually transmitted disease clinics. In general, CASI identified higher risk behavior more commonly than clinician interviews, although there were substantial differences between studies. CASI was found to be highly acceptable and individuals felt it allowed more honest reporting. Currently, there are insufficient data to determine whether CASI results in differences in sexually transmitted infection testing, diagnosis, or treatment or if CASI improves the quality of sexual health care or its efficiency. The potential public health advantages of the widespread use of CASI are discussed.
Area level deprivation is an independent determinant of prevalent type 2 diabetes and obesity at the national level in Germany. Results from the National Telephone Health Interview Surveys 'German Health Update' GEDA 2009 and 2010.
Full Text Available OBJECTIVE: There is increasing evidence that prevention programmes for type 2 diabetes mellitus (T2DM and obesity need to consider individual and regional risk factors. Our objective is to assess the independent association of area level deprivation with T2DM and obesity controlling for individual risk factors in a large study covering the whole of Germany. METHODS: We combined data from two consecutive waves of the national health interview survey 'GEDA' conducted by the Robert Koch Institute in 2009 and 2010. Data collection was based on computer-assisted telephone interviews. After exclusion of participants <30 years of age and those with missing responses, we included n=33,690 participants in our analyses. The outcome variables were the 12-month prevalence of known T2DM and the prevalence of obesity (BMI ≥ 30 kg/m(2. We also controlled for age, sex, BMI, smoking, sport, living with a partner and education. Area level deprivation of the districts was defined by the German Index of Multiple Deprivation. Logistic multilevel regression models were performed using the software SAS 9.2. RESULTS: Of all men and women living in the most deprived areas, 8.6% had T2DM and 16.9% were obese (least deprived areas: 5.8% for T2DM and 13.7% for obesity. For women, higher area level deprivation and lower educational level were both independently associated with higher T2DM and obesity prevalence [highest area level deprivation: OR 1.28 (95% CI: 1.05-1.55 for T2DM and OR 1.28 (95% CI: 1.10-1.49 for obesity]. For men, a similar association was only found for obesity [OR 1.20 (95% CI: 1.02-1.41], but not for T2DM. CONCLUSION: Area level deprivation is an independent, important determinant of T2DM and obesity prevalence in Germany. Identifying and targeting specific area-based risk factors should be considered an essential public health issue relevant to increasing the effectiveness of diabetes and obesity prevention.
Sugarbaker, Larry; Coray, Kevin E.; Poore, Barbara
The purpose of this study was to receive customer feedback and to understand data and information requirements for The National Map. This report provides results and findings from interviews and surveys and will guide policy and operations decisions about data and information requirements leading to the development of a 5-year strategic plan for the National Geospatial Program. These findings are based on feedback from approximately 2,200 customers between February and August 2008. The U.S. Geological Survey (USGS) conducted more than 160 interviews with 200 individuals. The American Society for Photogrammetry and Remote Sensing (ASPRS) and the International Map Trade Association (IMTA) surveyed their memberships and received feedback from over 400 members. The Environmental Systems Research Institute (ESRI) received feedback from over 1,600 of its U.S.-based software users through an online survey sent to customers attending the ESRI International User Conference in the summer of 2008. The results of these surveys were shared with the USGS and have been included in this report.
71 farm households in contaminated areas of Sweden were interviewed at visits to farms, where measurements of the contamination of pastures and fields had been made. The aim of the survey was to find out what remedial actions had been taken by the farmers, what their appreciation of the information from authorities was, how the Chernobyl accident had affected their situation, and if they were prepared to take similar actions in case of a new accident. 15 refs
Brucker, Debra L.; Nord, Derek
People with intellectual or developmental disabilities (IDD) face higher levels of poverty than others, which can lead to concerns regarding areas of well-being, such as food security. Young adults with IDD who are, in many cases, transitioning from the system of educational, health care, and income supports of their youth into the adult world may…
Data from seven studies sponsored by the National Cancer Institute (NCI) were used to determine current rates of breast cancer screening and to identify the characteristics of and reasons for women not being screened. All seven studies were population-based surveys of women aged 50 to 74 years without breast cancer. While over 90% of non-Hispanic white respondents had regular sources of medical care, 46% to 76% had a clinical breast examination within the previous year, and only 25% to 41% had a mammogram. Less educated and poorer women had fewer mammograms. The two most common reasons women gave for never having had a mammogram were that they did not known they needed it and that their physician had not recommended it. Many physicians may have overlooked the opportunity to recommend mammography for older women when performing a clinical breast examination and to educate their patients about the benefit of screening mammography
This book sheds light on verbal interaction problems in survey interviews. It is shown how behavior coding, i.e., coding the utterances of interviewer and respondent while they are answering survey questions, can be used to detect interactional problems. Several empirical studies using behavior
More than 40% of those not taking antiseizure medication with recent seizures reported that epilepsy or its treatment interfered with their recent activities, 2010 and 2013 US National Health Interview Surveys.
Kobau, Rosemarie; Cui, Wanjun; Zack, Matthew M
From the combined 2010 and 2013 National Health Interview Surveys, we estimated US national age-standardized prevalence of adults with active epilepsy who reported that a nervous system/sensory organ condition caused a limitation (e.g., walking; memory; or physical, mental, or emotional problems) and, separately, that epilepsy interfered with their activities (e.g., working, schooling, or socializing) during the 30days preceding the survey. Sixty-one percent of adults who took antiseizure medication and had recent seizures and 51% of those who took medication and had no seizures reported having limitations caused by a nervous system/sensory organ condition. Sixty-two percent of adults who took antiseizure medication and had recent seizures and 20% of those who took medication and had no seizures reported that epilepsy or its treatment interfered with their recent activities. Forty-one percent of those who did not take medication and had recent seizures also reported that epilepsy interfered with their activities. To reduce activity limitations in people with epilepsy, health and social service providers can ensure that adequate policies and practices that promote access to high quality care and social participation are in effect in organizations and communities. Published by Elsevier Inc.
Millennium Challenge Corporation — The main objective of the 2011 Health Facility Survey (HFS) was to establish a baseline for informing the Health Project performance indicators on health facilities,...
Determinants of agreement between self-reported and parent-assessed quality of life for children in Germany-results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS
Full Text Available Abstract Background The aim of this study is to quantify the level of agreement between self-reporting and proxy-assessment of children's health-related quality of life using KINDL-R in a large population based study in Germany and to identify factors which are associated with agreement. Methods The German Health Interview and Examination Survey for Children and Adolescents included the KINDL-R questionnaire on health-related quality of life. 6388 children and adolescents filled in the questionnaire while their parents answered the proxy version. Means and standard deviation for the self- and proxy ratings, and also the Pearson und Intra-Class correlation coefficients for the absolute agreement were calculated. The relationship between other variables and parent-child agreement were determined by means of logistic regression. Results In the 'Physical', 'Self-esteem' and 'School' dimension and for the 'Total' score, the parents significantly overestimated the quality of life of their child. In contrast, the quality of life of the children in the dimensions 'Psychological well-being' and 'Family' were considerably underestimated by the parents. The proportion of parent-child ratings in agreement (difference Conclusions Our study shows that parental reports cannot adequately replace self-assessment for 11-17 year olds. In view of the different underlying perspectives, the parental assessments should where possible only be regarded as providing supplementary information.
Buttery, A K; Du, Y; Busch, M A; Fuchs, J; Gaertner, B; Knopf, H; Scheidt-Nave, C
This study examines changes in physical functioning among adults aged 50-79 years in Germany based on data from two German National Health Interview and Examination Surveys conducted in 1997-1999 (GNHIES98) and 2008-2011 (DEGS1). Using cross-sectional data from the two surveys (GNHIES98, n = 2884 and DEGS1, n = 3732), we examined changes in self-reported physical functioning scores (Short Form-36 physical functioning subscale (SF-36 PF)) by sex and age groups (50-64 and 65-79 years). Covariables included educational level, living alone, nine chronic diseases, polypharmacy (≥5 prescribed medicines), body mass index, sports activity, smoking and alcohol consumption. Multimorbidity was defined as ≥2 chronic diseases. Multivariable models were fitted to examine consistency of changes in physical functioning among certain subgroups and to assess changes in mean SF-36 PF scores, adjusting for changes in covariables between surveys. Mean physical functioning increased among adults aged 50-79 years between surveys in unadjusted analyses, but this change was not as marked among men aged 65-79 years who experienced rising obesity (20.6 to 31.5%, p = 0.004) and diabetes (13.0 to 20.0%, p = 0.014). Prevalence of multimorbidity and polypharmacy use increased among men and women aged 65-79 years. In sex and age specific multivariable analyses, changes in physical functioning over time were consistent across subgroups. Gains in physical functioning were explained by improved education, lower body mass index and improved health-related behaviours (smoking, alcohol consumption, sports activity) in women, but less so among men. Physical functioning improved in Germany among adults aged 50-79 years. Improvements in the population 65-79 years were less evident among men than women, despite increases in multimorbidity prevalence among both sexes. Changes in health behaviours over time differed between sexes and help explain variations in physical functioning
[Differences in subjective health, mental health, and health behavior among 11- to 17-year-olds at secondary schools in Germany : Results of the German health interview and examination survey for children and adolescents: first follow-up (KiGGS Wave 1)].
Waldhauer, Julia; Kuntz, Benjamin; Lampert, Thomas
Social inequalities in health can already be found among children and adolescents to the disadvantage of socially deprived population groups. This paper aims to detect, whether differences in subjective health, mental health and health behavior among young people are due to the secondary school type attended and whether these associations exist independently of the family's socioeconomic position (SEP). The data basis was the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 1, 2009-2012). Data of 11- to 17-year-old girls and boys (n = 4665) who attend different types of secondary schools in Germany were analyzed. The dependent variables were self-rated health, findings of the Strengths and Difficulties Questionnaire (SDQ) for the detection of psychological abnormalities, as well as self-reported information regarding leisure sport, tobacco, and alcohol consumption. Prevalence and odds ratios (ORs) based on logistic regressions are shown. For the majority of the examined indicators, it can be shown that adolescents in lower secondary schools are more likely to report worse self-rated health and mental problems and engage in unhealthy behavior than peers in grammar schools ("Gymnasium"). The differences decrease after controlling for family's SEP but mostly remain statistically significant. Adolescents who don't attend grammar schools are most strongly disadvantaged in terms of inattention/hyperactivity for both gender (OR: 2.29 [1.70-3.08]), smoking among girls (2.91 [1.85-4.57]) and physical inactivity (no leisure sport) among boys (OR: 2.71 [1.85-3.95]). Unequal health opportunities should be viewed in relation to people's living conditions. For adolescents, school constitutes an important setting for learning, experience, and health. The results indicate divergent needs of school-based health promotion and prevention regarding differences among gender and type of school.
Socioeconomic Status, Smoking, Alcohol use, Physical Activity, and Dietary Behavior as Determinants of Obesity and Body Mass Index in the United States: Findings from the National Health Interview Survey
Raees A. Shaikh, MD, MPH
Full Text Available Objectives: The aim of this research was to study the socio-demographic and behavioral determinants of obesity and Body Mass Index (BMI in the United States, using a nationally representative sample. Methods: We used data from the 2010 US National Health Interview Survey. Analyses were limited to adults 18 years and older (N=23,434. Multivariate regression analyses were conducted to estimate the associations between covariates and obesity and BMI. Results: Overall, 28.1% in the sample were obese and the mean BMI was 27.6 kg/m2 . In adjusted models, we found that older age, non-Hispanic Black race, lower education and income levels, Midwestern and Southern region of residence, former smoking, infrequent alcohol use, physical inactivity, consumption of less fruits, vegetables, brown rice and more cheese, fried potato and meat, were associated with obesity. These factors were also associated with higher BMI, along with male gender and higher consumption of meat, fried potatoes and cheese. Conclusions and Global Health Implications: The association of many of the socio-demographic and behavioral factors with obesity and higher BMI found in our study was consistent with previous findings. Persistence of such associations suggest a need for better understanding of the underlying mechanism as well as for evaluation of the current programs and policies targeted at reducing the obesity burden in the United States. In view of the rising global obesity epidemic, especially in the low- and middle-income countries, our findings could help guide development of effective health and social policies and programs aimed at reducing the obesity burden in other parts of the world.
Association du personnel
New column in ECHO The editorial team would like to give the âﾜpeople at CERNâ the chance to have their say. Through regular interviews, it wishes to highlight the particularities of those who help CERN remain a centre of excellence.
Racial and ethnic disparities in fruit and vegetable consumption have been widely studied in the USA. While previous studies focused on the differences of fruit and vegetable availability between racial groups, the equivalence of the association between consumption and availability across racial groups has been rarely examined. The purpose of this study was to investigate the relationship between availability of fruits and vegetables and their consumption across racial groups. The 2011-2012 California Health Interview Survey data (N = 36,302) were used for the study. Results of negative binomial regression show that the association between perceived availability of fruits and vegetables on consumption differs significantly between non-Hispanic Whites, Hispanics, Blacks, and Asians: (1) the association between fruit consumption and availability is only significant for non-Hispanic Whites (IRR = 1.303, 95 % CI 1.188, 1.429), and (2) the association between vegetable consumption and availability is only significant for non-Hispanic Whites (IRR = 1.242, 95 % CI 1.152, 1.340) and Hispanics (IRR = 1.141, 95 % CI 1.025, 1.271). This study highlights the importance of interventions that emphasize not only potential access but also social and cultural factors that relate to realized access to healthy food.
Sorkin, Dara H; Biegler, Kelly A; Billimek, John
Older Hispanic Americans are a rapidly growing minority group who are disproportionately affected by diabetes mellitus and obesity. Given the importance of physical activity, particularly leisure-time activity, in the management of diabetes mellitus and obesity, the current study examined ethnic and sex differences in walking for transportation, leisure-time walking, moderate activity (not including walking), and vigorous activity between Hispanic and non-Hispanic white (NHW) older adults (age 55 and older) using the 2009 California Health Interview Survey, a population-based survey representative of California's noninstitutionalized population. The total sample consisted of 21,702 participants (20,148 NHW (7,968 men, 12,180 women) and 1,554 Hispanic (609 men, 945 women)). Multivariable logistic and linear regression analyses were adjusted for sociodemographic characteristics. The findings revealed that Hispanic men and women were significantly less likely to engage in self-reported leisure-time walking and vigorous activity than NHW men (adjusted odds ratio (aOR) = 0.71, 95% confidence interval (CI) = 0.51-0.99) and women (aOR = 0.60, 95% CI = 0.42-0.87). Regardless of ethnic group, men were more likely than women to engage in self-reported walking for transportation (aOR = 0.71, 95% CI = 0.58-0.87), moderate activity (aOR = 0.68, 95% CI = 0.57-0.81), and vigorous activity (aOR = 0.58, 95% CI = 0.50-0.68). All types of self-reported physical activity were associated with lower body mass index (BMI; P activity (P activity (P activities reported the lowest BMIs. The findings highlight the importance of emphasizing walking in efforts to increase moderate and vigorous activity, particularly for older women. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.
David L Nordstrom
Full Text Available The aim of this paper is to introduce novice researchers to surveys as a method of data collection. It starts with the definition of a survey, its major purposes and types as well as changes in the goals surveys have helped to achieve over time. Advantages and disadvantages of surveys over population censuses and medical examinations are discussed. Approaches to questionnaire construction are introduced along with properties that questionnaires are evaluated for. Modes of administration, sample size issues, and data analysis approaches are also introduced. The primer is illustrated with examples of surveys conducted in different countries with various public health purposes.
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....
Mariana Cristina Lobato dos Santos Ribeiro Silva
Full Text Available The 15-minute family interview is a condensed form of the Calgary Family Assessment and Intervention Models (CFAM and CFIM that aims to contribute to the establishment of a therapeutic relationship between nurses and family and to implement interventions to promote health and suffering relief, even during brief interactions. This study investigated the experience of nurses from the Family Health Strategy (FHS who used the 15-minute interview on postpartum home. The qualitative research was conducted in three stages: participants' training program, utilization of the 15-minute family interview by participants, and interviews with nurses. The data were collected through semi-structured interviews with eight nurses. The thematic analysis revealed two main themes: dealing with the challenge of a new practice and evaluating the assignment. This work shows that this tool can be used to deepen relationships between nurses and families in the Family Health Strategy.
Lombardi, David A; Wirtz, Anna; Willetts, Joanna L; Folkard, Simon
Fatigue has been linked to adverse safety outcomes, and poor quality or decreased sleep has been associated with obesity (higher body mass index, BMI). Additionally, higher BMI is related to an increased risk for injury; however, it is unclear whether BMI modifies the effect of short sleep or has an independent effect on work-related injury risk. To answer this question, the authors examined the risk of a work-related injury as a function of total daily sleep time and BMI using the US National Health Interview Survey (NHIS). The NHIS is an in-person household survey using a multistage, stratified, clustered sample design representing the US civilian population. Data were pooled for the 7-yr survey period from 2004 to 2010 for 101 891 "employed" adult subjects (51.7%; 41.1 ± yrs of age [mean ± SEM]) with data on both sleep and BMI. Weighted annualized work-related injury rates were estimated across a priori defined categories of BMI: healthy weight (BMI: work-related injury. The initial model examined the interaction among daily sleep duration and BMI, controlling for weekly working hours, age, sex, race/ethnicity, education, type of pay, industry, and occupation. No significant interaction was found between usual daily sleep duration and BMI (p = .72); thus, the interaction term of the final logistic model included these two variables as independent predictors of injury, along with the aforementioned covariates. Statistically significant covariates (p ≤ .05) included age, sex, weekly work hours, occupation, and if the worker was paid hourly. The lowest categories of usual sleep duration (7-8 h did not significantly elevate risk. The adjusted injury risk odds ratio (OR) for a worker with a usual daily sleep of work-related injury risk for reduced sleep regardless of worker's body mass. However, being an overweight worker also increases work-injury risk regardless of usual daily sleep duration. The independent additive risk of these factors on work
[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].
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
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.
Occurrence and co-occurrence of types of complementary and alternative medicine use by age, gender, ethnicity, and education among adults in the United States: the 2002 National Health Interview Survey (NHIS).
Neiberg, Rebecca H; Aickin, Mikel; Grzywacz, Joseph G; Lang, Wei; Quandt, Sara A; Bell, Ronny A; Arcury, Thomas A
There are widespread assumptions that a large proportion of American adults use a variety of complementary and alternative medicine (CAM) therapies. The goal of this study is to explore the clustering or linkages among CAM categories in the general population. Linkset analysis and data from the 2002 National Health Interview Survey (NHIS) were used to address two specific aims. First, the dominant linkages of CAM categories used by the same individual were delineated, and population estimates were generated of the percentage of American adults using different linksets of CAM categories. Second, it was determined whether dominant linkages of CAM modalities differ by age, gender, ethnicity, and education. Linkset analysis, a method of estimating co-occurrence beyond chance, was used on data from the 2002 NHIS (N = 29,862) to identify possible sets of CAM use. Most adults use CAM therapies from a single category. Approximately 20% of adults combined two CAM categories, with the combination of mind-body therapies and biologically based therapies estimated to be most common. Only 5% of adults use therapies representing three or more CAM categories. Combining therapies across multiple CAM categories was more common among those 46-64, women, whites, and those with a college education. The results of this study allow researchers to refine descriptions of CAM use in the adult population. Most adults do not use a wide assortment of CAM; most use therapies within a single CAM category. Sets of CAM use were found to differ by age, gender, ethnicity, and education in ways consistent with previous research.
Background The positive association between parental socio-economic position (PSEP) and health among adolescents may be partly explained by physical activity behaviour. We investigated the associations between physical activity, aerobic fitness and PSEP in a population based sample of German adolescents. Methods 5,251 participants, aged 11–17 years, in the German Health Interview and Examination Survey for Children and Adolescents 2003–2006 (KiGGS) underwent a sub-maximal cycle ergometer test and completed a questionnaire obtaining information on physical activity and media use. The associations between physical activity, media use, aerobic fitness and PSEP were analysed with multivariate logistic regression models for boys and girls separately. Odds ratios (ORs) of PSEP (education, occupation and income) on the outcomes were calculated adjusted for age, region, and other influencing factors. Results Parental education was more strongly associated with the outcome variables than parental occupation and income. After adjusting for age and region, a higher parental education level was associated with better aerobic fitness – with an OR of 1.5 (95% CI 1.2-1.9) for girls whose parents had secondary education and 1.9 (1.4-2.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 1.3 (1.0-1.6) and 1.6 (1.2-2.1), respectively. Higher parental education level was associated with lower media use: an OR of 2.1 (1.5-3.0) for girls whose parents had secondary education and 2.7 (1.8-4.1) for girls whose parents had primary education compared to girls whose parents had tertiary education. The corresponding ORs for boys were 1.5 (1.2-1.9) and 1.9 (1.5-2.5), respectively. Higher parental education level was associated with a higher physical activity level only among girls: an OR of 1.3 (1.0-1.6) for girls whose parents had secondary education and 1.2 (0.9-1.5) for girls whose parents had
Finger, Jonas D; Mensink, Gert B M; Banzer, Winfried; Lampert, Thomas; Tylleskär, Thorkild
The positive association between parental socio-economic position (PSEP) and health among adolescents may be partly explained by physical activity behaviour. We investigated the associations between physical activity, aerobic fitness and PSEP in a population based sample of German adolescents. 5,251 participants, aged 11-17 years, in the German Health Interview and Examination Survey for Children and Adolescents 2003-2006 (KiGGS) underwent a sub-maximal cycle ergometer test and completed a questionnaire obtaining information on physical activity and media use. The associations between physical activity, media use, aerobic fitness and PSEP were analysed with multivariate logistic regression models for boys and girls separately. Odds ratios (ORs) of PSEP (education, occupation and income) on the outcomes were calculated adjusted for age, region, and other influencing factors. Parental education was more strongly associated with the outcome variables than parental occupation and income. After adjusting for age and region, a higher parental education level was associated with better aerobic fitness - with an OR of 1.5 (95% CI 1.2-1.9) for girls whose parents had secondary education and 1.9 (1.4-2.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 1.3 (1.0-1.6) and 1.6 (1.2-2.1), respectively. Higher parental education level was associated with lower media use: an OR of 2.1 (1.5-3.0) for girls whose parents had secondary education and 2.7 (1.8-4.1) for girls whose parents had primary education compared to girls whose parents had tertiary education. The corresponding ORs for boys were 1.5 (1.2-1.9) and 1.9 (1.5-2.5), respectively. Higher parental education level was associated with a higher physical activity level only among girls: an OR of 1.3 (1.0-1.6) for girls whose parents had secondary education and 1.2 (0.9-1.5) for girls whose parents had tertiary education compared to girls
Le, Linh Cu; Vu, Lan T H
Globally, population surveys on HIV/AIDS and other sensitive topics have been using audio computer-assisted self interview for many years. This interview technique, however, is still new to Vietnam and little is known about its application and impact in general population surveys. One plausible hypothesis is that residents of Vietnam interviewed using this technique may provide a higher response rate and be more willing to reveal their true behaviors than if interviewed with traditional methods. This study aims to compare audio computer-assisted self interview with traditional face-to-face personal interview and self-administered interview with regard to rates of refusal and affirmative responses to questions on sensitive topics related to HIV/AIDS. In June 2010, a randomized study was conducted in three cities (Ha Noi, Da Nan and Can Tho), using a sample of 4049 residents aged 15 to 49 years. Respondents were randomly assigned to one of three interviewing methods: audio computer-assisted self interview, personal face-to-face interview, and self-administered paper interview. Instead of providing answers directly to interviewer questions as with traditional methods, audio computer-assisted self-interview respondents read the questions displayed on a laptop screen, while listening to the questions through audio headphones, then entered responses using a laptop keyboard. A MySQL database was used for data management and SPSS statistical package version 18 used for data analysis with bivariate and multivariate statistical techniques. Rates of high risk behaviors and mean values of continuous variables were compared for the three data collection methods. Audio computer-assisted self interview showed advantages over comparison techniques, achieving lower refusal rates and reporting higher prevalence of some sensitive and risk behaviors (perhaps indication of more truthful answers). Premarital sex was reported by 20.4% in the audio computer-assisted self-interview survey
This podcast gives an overview of the health survey ATSDR is conducting of more than 300,000 people who lived or worked at Camp Lejeune or Camp Pendleton in the 1970s and 1980s. Created: 8/30/2011 by Agency for Toxic Substances and Disease Registry (ATSDR). Date Released: 8/30/2011.
... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Expiring Information Collection, Interview... collection request (ICR), Office of Management and Budget (OMB) Control No. 3206- 0106, for the Interview[email protected] . SUPPLEMENTARY INFORMATION: The Interview Survey Form, INV 10, is a questionnaire that OPM...
Full Text Available This study analyses the pragmatic aspects of intracultural management of TV interview in Japanese. In particular, it investigates how speakers, in order to achieve their communication goals, often melt together their sociopragmatic values with an unconventional use of language. From a didactic point of view, this observation proves to be particularly significant since it helps to reduce the boundary between a pedagogical approach too often linked to models of syntactic-grammatical correctness and a more recent one which tries to come as close as possible to actual interactional models by promoting awareness of intralingual communication strategies, and reducing sociopragmatic, pragmalinguistic and intercultural mistakes by foreign/second language learners. From a methodological perspective, the presentation intends to clarify the inner dynamics of pragmatic management of the interview with the following goals: a intercepting intracultural dynamics of content management and feedbacks through a bottom up approach by utilizing transcription techniques of CA; b extracting and isolating those key concepts apt to describe TV interview features in Japanese without imposing them through a top-down model; c stimulating a reflection that goes beyond the analysis of language itself in order to understand the iconic, paralinguistic and extralinguistic aspects of communication.
... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Information Collection; Interview Survey Form (INV 10) AGENCY: U.S. Office of Personnel Management. ACTION: 60-Day Notice and request for... request (ICR), Office of Management and Budget (OMB) Control No. 3206-0106, Interview Survey Form (INV 10...
Braverman, Marc T.
The effects of using volunteer interviewers on respondent cooperation in telephone surveys were studied, using data on 241 interviews, 99 refusals, and 251 non-contacts. A random, national survey on public knowledge of and attitudes toward a county 4-H youth services program indicated respondent cooperation for professional program staff and…
Lang, Frieder R.; John, Dennis; Lüdtke, Oliver; Schupp, Jürgen; Wagner, Gert G.
We examined measurement invariance and age-related robustness of a short 15-item Big Five Inventory (BFI–S) of personality dimensions, which is well suited for applications in large-scale multidisciplinary surveys. The BFI–S was assessed in three different interviewing conditions: computer-assisted or paper-assisted face-to-face interviewing, computer-assisted telephone interviewing, and a self-administered questionnaire. Randomized probability samples from a large-scale German panel survey a...
Thacker, Alice; Abdelnoor, Adam; Anderson, Claire; White, Sarah; Hollins, Sheila
Feeding and swallowing impairments are key predictors of increased morbidity and mortality in adults with learning disabilities. This postal survey and interview study sought to identify risk factors in adults with learning disabilities who have histories of choking. A total of 2000 questionnaires were sent to carers of all adults with learning disabilities registered as service users by three local health authorities. (A 'service user' may be using any specialist learning disability health or social care facility with day, residential or therapeutic services). Of the 674 service users for whom surveys were returned, 47 were living in hospital, 396 were living in residential or group homes and 208 were living with relatives, or in their own homes. Eighteen subjects who had reported serious or repeated episodes of choking were interviewed in depth in their residences or workplaces. Responses were subjected to frequency analyses. Personal characteristics were analysed. Choking patterns were differentiated by food texture. A total of 34% of questionnaires on 674 service users were returned; 42% of respondents reported one or more choking episodes. There was a significantly greater occurrence of choking among people with more severe learning disability, with Down syndrome, people who had an incomplete dentition or were taking a greater number of psychotropic drugs. Antisocial eating habits learnt in institutional settings presented an additional choking hazard for some individuals. Choking is a serious hazard for many adults with learning disabilities. This study establishes many of the characteristics associated with swallowing problems in this population. Clinicians and carers should benefit from awareness of these predictors, leading to better management of eating behaviours and habits. A choking and swallowing risk assessment should be included in routine health assessments of adults with learning disability, paying especial attention to the condition of a person
This report presents the test plan for developing, conducting, and analyzing surveys, interviews, and focus groups for evaluating the Minnesota Urban Partnership Agreement (UPA) under the United States Department of Transportation (U.S. DOT) UPA Prog...
Ongena, Y.P.; Dijkstra, W.
In this paper we provide a model of interviewer-respondent interaction in survey interviews. Our model is primarily focused on the occurrence of problems within this interaction that seem likely to affect data quality. Both conversational principles and cognitive processes, especially where they do
Petrosoniak, Andrew; McCarthy, Anne; Varpio, Lara
The purpose of this study was to explore the complexities (including harms and benefits) of international health electives (IHEs) involving medical trainees. This exploration contributes to the ongoing debate about the goals and implications of IHEs for medical trainees. This qualitative study used anonymous, one-to-one, semi-structured interviews. All participants had previous international health experiences. Between September 2007 and March 2008, we interviewed a convenience sample of health care professionals (n=10) and medical trainees (n=10). Using a modified grounded theory methodology, we carried out cycles of data analysis in conjunction with data collection in an iterative and constant comparison process. The study's thematic structure was finalised when theme saturation was achieved. Participants described IHEs in both negative and positive terms. IHEs were described as unsustained short-term contributions that lacked clear educational objectives and failed to address local community needs. Ethical dilemmas were described as IHE challenges. Participants reflected that many IHEs included aspects of medical tourism and the majority of participants described the IHE in negative terms. However, a few participants acknowledged the benefits of the IHE. Specifically, it was seen as an introduction to a career in global health and as a potential foundation for more sustainable projects with positive host community impacts. Finally, despite similar understandings among participants, self-awareness of medical tourism was low. International health electives may include potential harms and benefits for both the trainee and the host community. Educational institutions should encourage and support structured IHEs for trainee participation. We recommend that faculties of medicine and global health educators establish pre-departure training courses for trainees and that IHE opportunities have sufficient structures in place to mitigate the negative effects of medical
Wildy, Helen; Clarke, Simon
This paper provides an example of the application of the cognitive interview, a qualitative tool for pre-testing a survey instrument to check its cognitive validity, that is, whether the items mean to respondents what they mean to the item designers. The instrument is the survey used in the final phase of the International Study of Principal…
David L Nordstrom; David L Nordstrom
The aim of this paper is to introduce novice researchers to surveys as a method of data collection. It starts with the definition of a survey, its major purposes and types as well as changes in the goals surveys have helped to achieve over time. Advantages and disadvantages of surveys over population censuses and medical examinations are discussed. Approaches to questionnaire construction are introduced along with properties that questionnaires are evaluated for. Modes of administration, sam...
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
Westert, G.P.; Schellevis, F.G.
Aim: To compare prevalence of conditions and health inequalities in one study population using two methods of data collection: health interview survey and GP registration of consultations. Methods: Data is from the Second Dutch Survey of General Practice, using a multistage sampling design with
Purpose — The paper is analysing the effect of adding a web survey to a traditional telephone-based national travel survey by asking the respondents to check in on the web and answer the questions there (Computer Assisted Web Interview, CAWI). If they are not participating by web they are as usual...... called by telephone (Computer Assisted Telephone Interview, CATI). Design/methodology/approach — Multivariate regression analyses are used to analyse the difference in response rates by the two media and to analyse if respondents’ answering by the two media have different travel patterns. Findings...... — The analyses show that web interviews are saving money, even though a more intensive post-processing is necessary. The analyses seem to show that the CAWI is resulting in a more careful answering which results in more trips reported. A CAWI is increasing the participation of children in the survey...
Lang, Frieder R; John, Dennis; Lüdtke, Oliver; Schupp, Jürgen; Wagner, Gert G
We examined measurement invariance and age-related robustness of a short 15-item Big Five Inventory (BFI-S) of personality dimensions, which is well suited for applications in large-scale multidisciplinary surveys. The BFI-S was assessed in three different interviewing conditions: computer-assisted or paper-assisted face-to-face interviewing, computer-assisted telephone interviewing, and a self-administered questionnaire. Randomized probability samples from a large-scale German panel survey and a related probability telephone study were used in order to test method effects on self-report measures of personality characteristics across early, middle, and late adulthood. Exploratory structural equation modeling was used in order to test for measurement invariance of the five-factor model of personality trait domains across different assessment methods. For the short inventory, findings suggest strong robustness of self-report measures of personality dimensions among young and middle-aged adults. In old age, telephone interviewing was associated with greater distortions in reliable personality assessment. It is concluded that the greater mental workload of telephone interviewing limits the reliability of self-report personality assessment. Face-to-face surveys and self-administrated questionnaire completion are clearly better suited than phone surveys when personality traits in age-heterogeneous samples are assessed.
Glazer, Greer; Startsman, Laura F; Bankston, Karen; Michaels, Julia; Danek, Jennifer C; Fair, Malika
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.
The survey purpose, methods, and statistical methods are presented. Results are discussed according to: area differences in background variables, area differences in health variables, area differences in annoyance reactions, and comparison of symptom frequencies with age, smoking, and drinking. Included in appendices are tables of data, enumeration forms, the questionnaire, interviewer cards, and interviewer instructions. (MHR)
Abele, Misoo; Brown, Julie; Ibrahim, Hicham; Jha, Manish K
The authors report on the current status of motivational interviewing education and training director attitudes about providing it to psychiatry residents. Training directors of general, child/adolescent and addiction psychiatry training programs were invited to participate in an anonymous online survey. Of the 333 training directors who were invited to participate, 66 of 168 (39.3%) general, 41 of 121 (33.9%) child/adolescent, and 19 of 44 (43.2%) addiction psychiatry training directors completed the survey. The authors found that 90.9% of general, 80.5% of child/adolescent, and 100% of addiction psychiatry training programs provided motivational interviewing education. Most programs used multiple educational opportunities; the three most common opportunities were didactics, clinical practice with formal supervision, and self-directed reading. Most training directors believed that motivational interviewing was an important skill for general psychiatrists. The authors also found that 83.3% of general, 87.8% of child/adolescent, and 94.7% of addiction psychiatry training directors reported that motivational interviewing should be taught during general psychiatry residency. Motivational interviewing skills are considered important for general psychiatrists and widely offered by training programs. Competency in motivational interviewing skills should be considered as a graduation requirement in general psychiatry training programs.
Ongena, Yfke P.; Dijkstra, Wil
In this paper we provide a model of interviewer–respondent interaction in survey interviews. Our model is primarily focused on the occurrence of problems within this interaction that seem likely to affect data quality. Both conversational principles and cognitive processes, especially where they do
Heiervang, Einar; Goodman, Robert
Web-based surveys may have advantages related to the speed and cost of data collection as well as data quality. However, they may be biased by low and selective participation. We predicted that such biases would distort point-estimates such as average symptom level or prevalence but not patterns of associations with putative risk-factors. A structured psychiatric interview was administered to parents in two successive surveys of child mental health. In 2003, parents were interviewed face-to-face, whereas in 2006 they completed the interview online. In both surveys, interviews were preceded by paper questionnaires covering child and family characteristics. The rate of parents logging onto the web site was comparable to the response rate for face-to-face interviews, but the rate of full response (completing all sections of the interview) was much lower for web-based interviews. Full response was less frequent for non-traditional families, immigrant parents, and less educated parents. Participation bias affected point estimates of psychopathology but had little effect on associations with putative risk factors. The time and cost of full web-based interviews was only a quarter of that for face-to-face interviews. Web-based surveys may be performed faster and at lower cost than more traditional approaches with personal interviews. Selective participation seems a particular threat to point estimates of psychopathology, while patterns of associations are more robust.
Kessler, Ronald C; Haro, Josep Maria; Heeringa, Steven G; Pennell, Beth-Ellen; Ustün, T Bedirhan
To present an overview of the World Health Organization World Mental Health (WMH) Survey Initiative. The discussion draws on knowledge gleaned from the authors' participation as principals in WMH. WMH has carried out community epidemiological surveys in more than two dozen countries with more than 200,000 completed interviews. Additional surveys are in progress. Clinical reappraisal studies embedded in WMH surveys have been used to develop imputation rules to adjust prevalence estimates for within- and between-country variation in accuracy. WMH interviews include detailed information about sub-threshold manifestations to address the problem of rigid categorical diagnoses not applying equally to all countries. Investigations are now underway of targeted substantive issues. Despite inevitable limitations imposed by existing diagnostic systems and variable expertise in participating countries, WMH has produced an unprecedented amount of high-quality data on the general population cross-national epidemiology of mental disorders. WMH collaborators are in thoughtful and subtle investigations of cross-national variation in validity of diagnostic assessments and a wide range of important substantive topics. Recognizing that WMH is not definitive, finally, insights from this round of surveys are being used to carry out methodological studies aimed at improving the quality of future investigations.
Aquilino, W S
This research investigated the use of telephone versus face-to-face interviewing to gather data on the use of tobacco, alcohol, and illicit drugs. Telephone and personal drug use surveys of the 18-34 year-old household population were conducted in the state of New Jersey in 1986-1987. Survey modes were compared in terms of unit and item nonresponse rates, sample coverage, and levels of self-reported drug use. Results showed that the telephone survey achieved response rates lower than the personal survey, but comparable to telephone surveys of less threatening topics. Item nonresponse to sensitive drug questions was lower by phone than with the self-administered answer sheets in the personal mode. The exclusion of households without telephones in the telephone survey is a potential source of bias, and may lead to underestimation of alcohol and drug use for minority populations. After controlling for telephone status, the telephone survey furnished significantly lower drug use estimates on several indicators than the personal survey, with the largest mode differences found for Blacks.
Sparrevohn, Claus Reedtz
on interviewed-based surveys where fishers are asked to recall harvest within a given timeframe. However, the importance of whether fishers are requested to provide figures in weight or number is unresolved. Therefore, a recall survey aiming at estimating recreational harvest was designed, such that respondents...... could report harvest using either weight or numbers. It was found that: (1) a preference for reporting in numbers dominated; (2) reported mean individual weight of fish caught, differed between units preferences; and (3) when an estimate of total harvest in weight are calculated, these difference could...
Full Text Available To identify and understand, through data from multiple sources, some of the factors that affect authors' and editors' decisions to use reporting guidelines in the publication of health research.Mixed methods study comprising an online survey and semi-structured interviews with a sample of authors (online survey: n = 56; response rate = 32%; semi-structured interviews: n = 5 and journal editors (online survey: n = 43; response rate = 27%; semi-structured interviews: n = 6 involved in publishing health and medical research. Participants were recruited from an earlier study examining the effectiveness of the TREND reporting guideline.Four types of factors interacted to affect authors' and editors' likelihood of reporting guideline use; individual (e.g., having multiple reasons for use of reporting guidelines; the professional culture in which people work; environmental (e.g., policies of journals; and, practical (e.g., having time to use reporting guidelines. Having multiple reasons for using reporting guidelines was a particularly salient factor in facilitating reporting guidelines use for both groups of participants.Improving the completeness and consistency of reporting of research studies is critical to the integrity and synthesis of health research. The use of reporting guidelines offers one potentially efficient and effective means for achieving this, but decisions to use (or not use reporting guidelines take many factors into account. These findings could be used to inform future studies that might, for example, test the factors that we have identified within a wider theoretical framework for understanding changes in professional practices. The use of reporting guidelines by senior professionals appears to shape the expectations of what constitutes best practice and can be assimilated into the culture of a field or discipline. Without evidence of effectiveness of reporting guidelines, and sustained, multifaceted efforts to improve reporting
MOTOHASHI Kazuyuki; UEDA Yoji; MINO Motoyasu
Japanese firms, having to face global innovation competition and business reorganization targeting emerging markets in the world, are actively engaged in open innovation. In this paper, an interview survey conducted on nine large Japanese manufacturers provides the new trends in open and global innovation. They include (1) establishment of a dedicated function of open innovation, (2) open approach for the whole process of new business development, (3) strategic alliance activities, (4) collab...
Frey, Andy J.; Cloud, Richard N.; Lee, Jon; Small, Jason W.; Seeley, John R.; Feil, Edward G.; Walker, Hill M.; Golly, Annemieke
In recent years, the science of developing and implementing interventions addressing school-related risk factors has produced many advances. This article addresses the promise of a cross-disciplinary practice approach known as motivational interviewing in school settings. Specifically, the supporting evidence as well as the process and principles…
Interview with Randall Packard, William H. Welch Professor of the History of Medicine at The Johns Hopkins University and co-editor of the Bulletin of the History of Medicine. Speaking about his academic career, his activities as an editor, and his main works, Professor Packard addresses the topics of health and disease in the history of Africa; the relation between disease eradication programs and the ideology of development; the malaria eradication program; medicine, international health, and colonialism; academic production in the history of medicine in the Anglo-Saxon world; and the dynamics of scientific publishing in the field of the history of medicine.
Brobeck, Elisabeth; Bergh, Håkan; Odencrants, Sigrid; Hildingh, Cathrine
The aim of the study was to describe primary healthcare nurses' experiences with motivational interviewing as a method for health promotion practice. A person's lifestyle has a major effect on his or her health. Motivational interviewing is one way of working with lifestyle changes in health promotion practice. The basic plan of motivational interviewing is to help people understand their lifestyle problems and make positive lifestyle changes. Motivational interviewing has been proven to be more effective than conventional methods in increasing patient motivation. This study has a descriptive design and uses a qualitative method. Twenty nurses who worked in primary health care and actively used motivational interviewing in their work were interviewed. Qualitative content analysis was used to process the data. The primary healthcare nurses' experiences with motivational interviewing as a method of health promotion practice demonstrate that motivational interviewing is a demanding, enriching and useful method that promotes awareness and guidance in the care relationship. The results also show that motivational interviewing is a valuable tool for primary healthcare nurses' health promotion practice. This study shows that motivational interviewing places several different demands on nurses who use this method. Those who work with motivational interviewing must make an effort to incorporate this new method to avoid falling back into the former practice of simply giving advice. Maintaining an open mind while implementing motivational interviewing in real healthcare settings is crucial for nurses to increase this method's effectiveness. The nurses in the study had a positive experience with motivational interviewing, which can contribute to the increased use, adaption and development of motivational interviewing among primary healthcare professionals. Increased motivational interviewing knowledge and skills would also contribute to promotion of health lifestyle practices
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.
Catlin, Anita; Ford, Marilee; Maloney, Carrie
A movement worldwide, and specifically new to our hospital, is the implementation of Patient- and Family-Centered Care. We were unsure, however, what the needs were of our patients' families. This triangulated study, on a 28-bed oncology unit, studied family members at the bedside. We asked family members what their needs were in a three-step process (open-ended interview, use of the Draw a Bridge art therapy technique, and the Family Inventory of Needs survey). Nineteen interviews revealed needs for physical comfort, emotional support, cultural sensitivity, recognition of help provided by family members and improved pain management. Art therapy revealed the stress of caregiving and helped to uncover unmet needs for interviewers to explore. The FIN identified that care at home after discharge was a major worry. Knowledge of family members' needs while a loved one is in the hospital allows for planning and provision of modalities to assist them in their caregiving. © The Author(s) 2015.
Patten, Scott B; Adair, Carol E; Williams, Jeanne Va; Brant, Rollin; Wang, Jian Li; Casebeer, Ann; Beauséjour, Pierre
Mental health is an emerging priority for health surveillance. It has not been determined that the existing data sources can adequately meet surveillance needs. The objective of this project was to explore the use of telephone surveys as a means of collecting supplementary surveillance information. A computer-assisted telephone interview was administered to 5,400 subjects in Alberta. The interview included a set of brief, validated measures for evaluating mental disorder prevalence and related variables. The individual subject response rate was 78 percent, but a substantial number of refusals occurred at the initial household contact. The age and sex distribution of the study sample differed from that of the provincial population prior to weighting. Prevalence proportions did not vary substantially across administrative health regions. There is a potential role for telephone data collection in mental health surveillance, but these results highlight some associated methodological challenges. They also draw into question the importance of regional variation in mental disorder prevalence--which might otherwise have been a key advantage of telephone survey methodologies.
Burkill, Sarah; Couper, Mick P; Conrad, Frederick; Clifton, Soazig; Tanton, Clare; Phelps, Andrew; Datta, Jessica; Mercer, Catherine H; Sonnenberg, Pam; Prah, Philip; Mitchell, Kirstin R; Wellings, Kaye; Johnson, Anne M; Copas, Andrew J
Background Nonprobability Web surveys using volunteer panels can provide a relatively cheap and quick alternative to traditional health and epidemiological surveys. However, concerns have been raised about their representativeness. Objective The aim was to compare results from different Web panels with a population-based probability sample survey (n=8969 aged 18-44 years) that used computer-assisted self-interview (CASI) for sensitive behaviors, the third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Methods Natsal-3 questions were included on 4 nonprobability Web panel surveys (n=2000 to 2099), 2 using basic quotas based on age and sex, and 2 using modified quotas based on additional variables related to key estimates. Results for sociodemographic characteristics were compared with external benchmarks and for sexual behaviors and opinions with Natsal-3. Odds ratios (ORs) were used to express differences between the benchmark data and each survey for each variable of interest. A summary measure of survey performance was the average absolute OR across variables. Another summary measure was the number of key estimates for which the survey differed significantly (at the 5% level) from the benchmarks. Results For sociodemographic variables, the Web surveys were less representative of the general population than Natsal-3. For example, for men, the average absolute OR for Natsal-3 was 1.14, whereas for the Web surveys the average absolute ORs ranged from 1.86 to 2.30. For all Web surveys, approximately two-thirds of the key estimates of sexual behaviors were different from Natsal-3 and the average absolute ORs ranged from 1.32 to 1.98. Differences were appreciable even for questions asked by CASI in Natsal-3. No single Web survey performed consistently better than any other did. Modified quotas slightly improved results for men, but not for women. Conclusions Consistent with studies from other countries on less sensitive topics, volunteer Web
Jäckle, Annette; Lynn, Peter; Sinibaldi, Jennifer; Tipping, Sarah
"This paper examines the role of interviewers' experience, attitudes, personality traits and inter-personal skills in determining survey co-operation, conditional on contact. The authors take the perspective that these characteristics influence interviewers' behavior and hence influence the doorstep interaction between interviewer and sample member. Previous studies of the association between doorstep behavior and co-operation have not directly addressed the role of personality traits and int...
Basch, C E
The purpose of this article is to increase awareness about and stimulate interest in using focus group interviews, a qualitative research technique, to advance the state-of-the-art of education and learning about health. After a brief discussion of small group process in health education, features of focus group interviews are presented, and a theoretical framework for planning a focus group study is summarized. Then, literature describing traditional and health-related applications of focus group interviews is reviewed and a synthesis of methodological limitations and advantages of this technique is presented. Implications are discussed regarding: need for more inductive qualitative research in health education; utility of focus group interviews for research and for formative and summative evaluation of health education programs; applicability of marketing research to understanding and influencing consumer behavior, despite notable distinctions between educational initiatives and marketing; and need for professional preparation faculty to consider increasing emphasis on qualitative research methods.
Ziegenfuss Jeanette Y
Full Text Available Abstract Background Using a different mode of contact on the final follow-up to survey non-respondents is an identified strategy to increase response rates. This study was designed to determine if a reminder phone call or a phone interview as a final mode of contact to a mailed survey works better to increase response rates and which strategy is more cost effective. Methods A randomized study was embedded within a survey study of individuals treated with ulcerative colitis conducted in March 2009 in Olmsted County, Minnesota. After two mail contacts, non-respondents were randomly assigned to either a reminder telephone call or a telephone interview. Average cost per completed interview and response rates were compared between the two experimental conditions. Results The response rate in the reminder group and the interview did not differ where we considered both a completed survey and a signed form a complete (24% vs. 29%, p = 0.08. However, if such a signed form was not required, there was a substantial advantage to completing the interview over the phone (24% vs. 43%, p Conclusions The additional cost of completing an interview is worth it when an additional signed form is not required of the respondent. However, when such a signed form is required, offering an interview instead of a reminder phone call as a follow up to non-respondents does not increase response rates enough to outweigh the additional costs.
Hawkins, Jemma L.; Bravo, Paulina; Gobat, Nina; Rollnick, Stephen; Jerzembek, Gabrielle; Whitehead, Sarah; Chanon, Sue; Kelson, Mark; Adams, Orla; Murphy, Simon
Objective: In the light of the shortcomings of curriculum-based health promotion in secondary schools, group motivational interviewing provides a potential alternative approach. This two-phase study set out to establish the key components, feasibility and acceptability of a group motivational interviewing intervention, focused on alcohol…
Stol, Yrrah H; Asscher, Eva C A; Schermer, Maartje H N
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
U.S. Department of Health & Human Services — 1999-2000 forward. The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of...
Sandfort, T.G.M.; Bakker, F.; Schellevis, F.G.; Vanwesenbeeck, I.
OBJECTIVES: We sought to determine whether sexual orientation is related to mental and physical health and health behaviors in the general population. METHODS: Data was derived from a health interview survey that was part of the second Dutch National Survey of General Practice, carried out in 2001
Hirabayashi, Kyoko; Kawano, Noriyuki; Ohtaki, Megu; Harada, Yuka; Hoshi, Masaharu; Hadara, Hironori; Muldagaliyev, Talgat; Apsalikov, Kazbek
The purpose of the present paper is to examine the aftereffects of radiation exposure on residents of villages near the Semipalatinsk Nuclear Test Site (SNTS) in Kazakhstan. Our Hiroshima University (Japan) research team began field research in 2002 by means of health assessments conducted via interviews. We focus on persons who responded to questions concerning their medical conditions and symptoms. In this paper, we summarize and analyze, using multiple linear logistic regression analysis, the answers obtained by questionnaire survey. The results show: 31% of the residents reported that they felt bad or were in very poor health. Residents living in villages having higher radiation levels were more likely to report having poor or very poor health, minor complaints such as loss of sleep, headaches, nighttime sweating and swollen arms or legs, and the need for nursing care in performing activities of daily living. Symptoms reported by over 40% of the respondents included high blood pressure, heart disease and arthralgia/lower back pain/arthritis. Our results suggest that radiation exposure in the Semipalatinsk area is one of the causes of poor health in general among residents. There is also a possibility that radiation exposure has influenced the incidence of some specific medical conditions. (author)
Hirabayashi, Kyoko; Kawano, Noriyuki; Ohtaki, Megu; Harada, Yuka; Harada, Hironori; Muldagaliyev, Talgat; Apsalikov, Kazbek; Hoshi, Masaharu
The purpose of the present paper is to examine the aftereffects of radiation exposure on residents of villages near the Semipalatinsk Nuclear Test Site (SNTS) in Kazakhstan. Our Hiroshima University (Japan) research team began field research in 2002 by means of health assessments conducted via interviews. We focus on persons who responded to questions concerning their medical conditions and symptoms. In this paper, we summarize and analyze, using multiple linear logistic regression analysis, the answers obtained by questionnaire survey. The results show: (1) 31% of the residents reported that they felt bad or were in very poor health. (2) Residents living in villages having higher radiation levels were more likely to report having poor or very poor health, minor complaints such as loss of sleep, headaches, nighttime sweating and swollen arms or legs, and the need for nursing care in performing activities of daily living. (3) Symptoms reported by over 40% of the respondents included high blood pressure, heart disease and arthralgia/ lower back pain/ arthritis. Our results suggest that radiation exposure in the Semipalatinsk area is one of the causes of poor health in general among residents. There is also a possibility that radiation exposure has influenced the incidence of some specific medical conditions.
Carbone, Elena T; Campbell, Marci K; Honess-Morreale, Lauren
The effectiveness of dietary surveys and educational messages is dependent in part on how well the target audience's information processing needs and abilities are addressed. Use of pilot testing is helpful; however, problems with wording and language are often not revealed. Cognitive interview techniques offer 1 approach to assist dietitians in understanding how audiences process information. With this method, respondents are led through a survey or message and asked to paraphrase items; discuss thoughts, feelings, and ideas that come to mind; and suggest alternative wording. As part of a US Department of Agriculture-funded nutrition education project, 23 cognitive interviews were conducted among technical community college students in North Carolina. Interview findings informed the development of tailored computer messages and survey questions. Better understanding of respondents' cognitive processes significantly improved the language and approach used in this intervention. Interview data indicated 4 problem areas: vague or ineffective instructions, confusing questions and response options, variable interpretation of terms, and misinterpretation of dietary recommendations. Interviews also provided insight into the meaning of diet-related stages of change. These findings concur with previous research suggesting that cognitive interview techniques are a valuable tool in the formative evaluation and development of nutrition surveys and materials.
Milton, Alyssa C; Ellis, Louise A; Davenport, Tracey A; Burns, Jane M; Hickie, Ian B
Web-based self-report surveying has increased in popularity, as it can rapidly yield large samples at a low cost. Despite this increase in popularity, in the area of youth mental health, there is a distinct lack of research comparing the results of Web-based self-report surveys with the more traditional and widely accepted computer-assisted telephone interviewing (CATI). The Second Australian Young and Well National Survey 2014 sought to compare differences in respondent response patterns using matched items on CATI versus a Web-based self-report survey. The aim of this study was to examine whether responses varied as a result of item sensitivity, that is, the item's susceptibility to exaggeration on underreporting and to assess whether certain subgroups demonstrated this effect to a greater extent. A subsample of young people aged 16 to 25 years (N=101), recruited through the Second Australian Young and Well National Survey 2014, completed the identical items on two occasions: via CATI and via Web-based self-report survey. Respondents also rated perceived item sensitivity. When comparing CATI with the Web-based self-report survey, a Wilcoxon signed-rank analysis showed that respondents answered 14 of the 42 matched items in a significantly different way. Significant variation in responses (CATI vs Web-based) was more frequent if the item was also rated by the respondents as highly sensitive in nature. Specifically, 63% (5/8) of the high sensitivity items, 43% (3/7) of the neutral sensitivity items, and 0% (0/4) of the low sensitivity items were answered in a significantly different manner by respondents when comparing their matched CATI and Web-based question responses. The items that were perceived as highly sensitive by respondents and demonstrated response variability included the following: sexting activities, body image concerns, experience of diagnosis, and suicidal ideation. For high sensitivity items, a regression analysis showed respondents who were male
Buers, C.; Triemstra, M.; Bloemendal, E.; Zwijnenberg, N.C.; Hendriks, M.; Delnoij, D.M.J.
This mixed-methods study uses both cognitive interviewing and a quantitative field test to provide empirical evidence on the value of cognitive interviewing for questionnaire development. Ten interviews were conducted with a questionnaire on patient experiences with cataract surgery (75-item
Davenport, Tracey A; Burns, Jane M; Hickie, Ian B
Background Web-based self-report surveying has increased in popularity, as it can rapidly yield large samples at a low cost. Despite this increase in popularity, in the area of youth mental health, there is a distinct lack of research comparing the results of Web-based self-report surveys with the more traditional and widely accepted computer-assisted telephone interviewing (CATI). Objective The Second Australian Young and Well National Survey 2014 sought to compare differences in respondent response patterns using matched items on CATI versus a Web-based self-report survey. The aim of this study was to examine whether responses varied as a result of item sensitivity, that is, the item’s susceptibility to exaggeration on underreporting and to assess whether certain subgroups demonstrated this effect to a greater extent. Methods A subsample of young people aged 16 to 25 years (N=101), recruited through the Second Australian Young and Well National Survey 2014, completed the identical items on two occasions: via CATI and via Web-based self-report survey. Respondents also rated perceived item sensitivity. Results When comparing CATI with the Web-based self-report survey, a Wilcoxon signed-rank analysis showed that respondents answered 14 of the 42 matched items in a significantly different way. Significant variation in responses (CATI vs Web-based) was more frequent if the item was also rated by the respondents as highly sensitive in nature. Specifically, 63% (5/8) of the high sensitivity items, 43% (3/7) of the neutral sensitivity items, and 0% (0/4) of the low sensitivity items were answered in a significantly different manner by respondents when comparing their matched CATI and Web-based question responses. The items that were perceived as highly sensitive by respondents and demonstrated response variability included the following: sexting activities, body image concerns, experience of diagnosis, and suicidal ideation. For high sensitivity items, a regression
Full Text Available This paper examines the role of interviewers' experience, attitudes, personality traits and inter-personal skills in determining survey co-operation, conditional on contact. We take the perspective that these characteristics influence interviewers' behaviour and hence influence the doorstep interaction between interviewer and sample member. Previous studies of the association between doorstep behaviour and co-operation have not directly addressed the role of personality traits and inter-personal skills and most have been based on small samples of interviewers. We use a large sample of 842 face-to-face interviewers working for a major survey institute and analyse co-operation outcomes for over 100,000 cases contacted by those interviewers over a 13-month period. We find evidence of effects of experience, attitudes, personality traits and inter-personal skills on co-operation rates. Several of the effects of attitudes and inter-personal skills are explained by differences in experience, though some independent effects remain. The role of attitudes, personality and skills seems to be greatest for the least experienced interviewers.
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.
Full Text Available Objective: To identify the most effective survey interview method for measuring risk behavior among young adults in the Dominican Republic. Methods: 1200 young adults were randomized to one of four different survey interview methods: two interviewer-assisted methods [face-to-face interview (FTFI, and computer-assisted telephone interview (CATI], and two self-administered methods [self-administered interview (SAI, and audio computer-assisted, self-administered interview (ACASI]. Youth were asked about a wide range of youth-specific risk behaviors, including violence, substance use, as well as sexual and reproductive health. Quality of data collected was examined by looking at how the survey was administered, including identifying two sources of errors that typically threaten data quality11 This study assumes that bias does not change with sample size. In order to increase the sample size, the data collection period was extended, leaving everything else unchanged. It is, therefore, assumed that the decreasing effects of the learning curve are negligible.: (i errors at the individual level with regards to survey methodology performance and cognitive difficulties [measured with the Response Consistency Index (RCI]; and (ii errors at the aggregate level (how desirability bias, interviewer gender, and interview privacy settings affect responses. Results: No statistically significant differences in participant non-response rates were found at the individual level across all survey interview methods. At the individual question level, self-completion methods generated higher non-response and error rates than assisted methods. The SAI method showed the poorest performance of all four methods in terms of non-response rate (1.6%22 Percentage of data with non-response values at the question level. and RCI (83.0%.At the aggregate level, the prevalence of several key risk indicators was statistically significant between methods. Using means-adjustment for
Bóveda Fontán, Julia; Pérula de Torres, Luis Ángel; Campiñez Navarro, Manuel; Bosch Fontcuberta, Josep M; Barragán Brun, Nieves; Prados Castillejo, Jose Antonio
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.
Ken Lee appointed to the staff of the Nuffield Centre, University of Leeds, as Lecturer in Health Economics in 1970. He is now Senior Lecturer and Director of the Master's Programme in Health Service Studies. His main teaching interests are in health planning and health economics, and he has carried out research and written extensively on approaches to health economics, health planning and management, care of the elderly, primary health care, health financing, and emergency health services.
U.S. Department of Health & Human Services — The Medicare Health Outcomes Survey (HOS) identifiable data files are comprised of the entire national sample for a given 2-year cohort (including both respondents...
U.S. Department of Health & Human Services — The Medicare Health Outcomes Survey (HOS) limited data sets (LDS) are comprised of the entire national sample for a given 2-year cohort (including both respondents...
Romero-Martínez, Martín; Shamah-Levy, Teresa; Cuevas-Nasu, Lucía; Gómez-Humarán, Ignacio Méndez; Gaona-Pineda, Elsa Berenice; Gómez-Acosta, Luz María; Rivera-Dommarco, Juan Ángel; Hernández-Ávila, Mauricio
Describe the design methodology of the halfway health and nutrition national survey (Ensanut-MC) 2016. The Ensanut-MC is a national probabilistic survey whose objective population are the inhabitants of private households in Mexico. The sample size was determined to make inferences on the urban and rural areas in four regions. Describes main design elements: target population, topics of study, sampling procedure, measurement procedure and logistics organization. A final sample of 9 479 completed household interviews, and a sample of 16 591 individual interviews. The response rate for households was 77.9%, and the response rate for individuals was 91.9%. The Ensanut-MC probabilistic design allows valid statistical inferences about interest parameters for Mexico´s public health and nutrition, specifically on overweight, obesity and diabetes mellitus. Updated information also supports the monitoring, updating and formulation of new policies and priority programs.
The National Employer Health Insurance Survey (NEHIS) was developed to produce estimates on employer-sponsored health insurance data in the United States. The NEHIS was the first Federal survey to represent all employers in the United States by State and obtain information on all...
Full Text Available Background: With the development of economy and urbanization, methods of child-feeding have significantly changed in China over the past three decades. However, little is known about breastfeeding in China since 2009. This study aims to update information on the prevalence of breastfeeding in China. Methods: Data were obtained from the first Health Service Household Interview Survey of Hunan Province, China. Of 24,282 respondents, 1659 were aged five years or younger. We ran multivariable logistic regression to examine the impact of urban/rural setting, gender, age and household income per capita on the use of breastfeeding. Results: A total of 79.4% of children aged 5 years or younger had been breastfed at some point and 44.9% been breastfed exclusively in the first 6 months of life. After controlling for setting urban/rural setting, gender and child age, children from households with average family income were more likely to be breastfed than those from households with the lowest family income (adjusted odds ratio: 2.28. Children from households with higher and the highest family income were less likely to be exclusively breastfed in the first 6 months of life compared to those from households with the lowest family income (adjusted odds ratio: 0.51 and 0.68, respectively. Conclusions: It is encouraging that the prevalence of exclusive breastfeeding for infants in the first 6 months of life in Hunan Province, China is approaching the goal of 50% proposed by the World Health Organization (WHO. Nevertheless, more efforts are needed to further promote exclusive breastfeeding in the first 6 months after birth.
Nichols, Mary Ellen
This study examined whether user satisfaction with library services is affected by certain objective and subjective librarian behaviors exhibited during the reference interview. A patron survey was conducted during July 1993 in three branches of Cuyahoga County Public Library, located in northeastern Ohio. The sample was determined by the patrons…
Lavis, John N; Oxman, Andrew D; Moynihan, Ray; Paulsen, Elizabeth J
Only a small number of previous efforts to describe the experiences of organizations that produce clinical practice guidelines (CPGs), undertake health technology assessments (HTAs), or directly support the use of research evidence in developing health policy (i.e., government support units, or GSUs) have relied on interviews and then only with HTA agencies. Interviews offer the potential for capturing experiences in great depth, particularly the experiences of organizations that may be under-represented in surveys. We purposively sampled organizations from among those who completed a questionnaire in the first phase of our three-phase study, developed and piloted a semi-structured interview guide, and conducted the interviews by telephone, audio-taped them, and took notes simultaneously. Binary or categorical responses to more structured questions were counted when possible. Themes were identified from among responses to semi-structured questions using a constant comparative method of analysis. Illustrative quotations were identified to supplement the narrative description of the themes. We interviewed the director (or his or her nominee) in 25 organizations, of which 12 were GSUs. Using rigorous methods that are systematic and transparent (sometimes shortened to 'being evidence-based') was the most commonly cited strength among all organizations. GSUs more consistently described their close links with policymakers as a strength, whereas organizations producing CPGs, HTAs, or both had conflicting viewpoints about such close links. With few exceptions, all types of organizations tended to focus largely on weaknesses in implementation, rather than strengths. The advice offered to those trying to establish similar organizations include: 1) collaborate with other organizations; 2) establish strong links with policymakers and stakeholders; 3) be independent and manage conflicts of interest; 4) build capacity; 5) use good methods and be transparent; 6) start small and
Sparrevohn, Claus Reedtz; Storr-Paulsen, Marie
Using interview-based recall surveys to estimate cod Gadus morhua and eel Anguilla anguilla harvest in Danish recreational fishing. – ICES Journal of Marine Science, 69: 323–330.Marine recreational fishing is a popular outdoor activity in Denmark, practised by both anglers and passive gear fishers....... However, the impact on the targeted stocks is unknown, so to estimate the 2009 harvest of cod Gadus morhua and eel Anguilla anguilla, two separate interview-based surveys were initiated and carried out in 2009/2010. The first recall survey exclusively targeted fishers who had been issued......, in certain areas, the recreational harvest of cod accounted for more than 30% of the total yield. The majority (81%) of the recreational cod harvest was taken by anglers. Eels, however, are almost exclusively caught with passive gear (fykenets) and a total of 104 t year−1 was harvested, which corresponds...
Axelsson, Erland; Andersson, Erik; Ljótsson, Brjánn; Wallhed Finn, Daniel; Hedman, Erik
Somatic symptom disorder (SSD) and illness anxiety disorder (IAD) are two new diagnoses introduced in the DSM-5. There is a need for reliable instruments to facilitate the assessment of these disorders. We therefore developed a structured diagnostic interview, the Health Preoccupation Diagnostic Interview (HPDI), which we hypothesized would reliably differentiate between SSD, IAD, and no diagnosis. Persons with clinically significant health anxiety (n = 52) and healthy controls (n = 52) were interviewed using the HPDI. Diagnoses were then compared with those made by an independent assessor, who listened to audio recordings of the interviews. Ratings generally indicated moderate to almost perfect inter-rater agreement, as illustrated by an overall Cohen's κ of .85. Disagreements primarily concerned (a) the severity of somatic symptoms, (b) the differential diagnosis of panic disorder, and (c) SSD specifiers. We conclude that the HPDI can be used to reliably diagnose DSM-5 SSD and IAD.
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
Wang, Ya-Ching; Griffiths, Jane; Grande, Gunn
This article presents the qualitative findings of a mixed-methods study that explored factors influencing lesbians' breast health-care behavior and intentions. A total of 37 semi-structured face-to-face interviews were conducted among women who self-identified as lesbians or women who partnered with the same gender who were aged 20 years or above in four areas of Taiwan (North, Central, South, and East Taiwan) between August 2012 and October 2012. Interviews were audio recorded with participants' consent. The interviews were analyzed using constant comparative analysis with Nvivo audio-coding support. Four themes were identified to be strongly associated with the lesbians' breast health-care behavior and their intentions, namely, gender identity, gender role expression, partners' support, and concerns about health-care providers' reactions. Important barriers to the women's breast health-care behavior and intentions were masculine identity ("T-identity" in Taiwan), masculine appearance, concerns about health-care providers' lack of knowledge of multiple gender diversity, and their attitudes toward lesbians. Conversely, their partners' support was a factor facilitating the women's breast health-care behavior and intentions, particularly for the T-identity lesbians. These findings suggest the significance of and need for culturally competent care and are important for improving Taiwanese lesbians' breast health.
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
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.
Ж В Пузанова
Full Text Available The quality of sociological data is the problem that cannot lose relevance in the works of methodologists and practicing sociologists for decades. Procedures and techniques for the improvement of the quality of information for all type of survey methods are developing. The purpose of the article is to inform the interviewers conducting semi-structured or unstructured interviews of the recommendations developed on the basis of the theory of psychotypes (by V.V. Ponomarenko. This technology will allow to improve the quality of sociological data. Identification of the psychotype of the respondent and his emotional reactions to different sensitive topics during the interview are the basis of this technology. Emotional reactions can be traced by nonverbal cues (facial expressions, gestures and poses and interpreted by the technology of the analysis of nonverbal reactions developed and approved earlier. During the multi-stage experiment, the reactions significant in the course of interview were traced and analyzed - irritation, surprise, sadness, contempt, joy, fear, disgust, stress/discomfort, doubt/indecision, manifestations of mental processes. At the first phase, representatives of ‘ideal types’ of each psychotype were selected by an abridged psychological test and external diagnostics based on sensitive topics. As a result, the recommendations for a semi-structured interview were formulated. To use this technique, it is necessary to test an interviewee before the interview by the abridged psychological technique (in case there are doubts after the visual diagnostics. According to the psychotype the interviewer pays attention to the sensitive topics of the in-terview, and during the interview can reformulate the open-ended questions to reduce the sensitivity of significant topics for each respondent.
Buckley, Kelsey; Karr, Samantha; Nisly, Sarah A; Kelley, Kristi
To evaluate the impact of student pharmacist participation in a mock interview session on confidence level and preparation regarding residency interview skills. The study setting was a mock interview session, held in conjunction with student programming at the American College of Clinical Pharmacy (ACCP) Annual Meeting. Prior to the mock interview session, final year student pharmacists seeking residency program placement were asked to complete a pre-session survey assessing confidence level for residency interviews. Each student pharmacist participated in up to three mock interviews. A post-session survey evaluating confidence level was then administered to consenting participants. Following the American Society for Health-System Pharmacists (ASHP) Pharmacy Resident Matching Program (RMP), a post-match electronic survey was sent to study participants to determine their perception of the influence of the mock interview session on achieving successful interactions during residency interviews. A total of 59 student pharmacists participated in the mock interview session and completed the pre-session survey. Participants completing the post-session survey (88%, n = 52) unanimously reported an enhanced confidence in interviewing skills following the session. Thirty responders reported a program match rate of 83%. Approximately 97% (n = 29) of the respondents agreed or strongly agreed that the questions asked during the mock interview session were reflective of questions asked during residency interviews. Lessons learned from this mock interview session can be applied to PGY1 residency mock interview sessions held locally, regionally, and nationally. Students participating in the ACCP Mock Interview Session recognized the importance of the interview component in obtaining a postgraduate year 1 (PGY1) pharmacy residency. Copyright © 2017 Elsevier Inc. All rights reserved.
Farič, Nuša; Potts, Henry W W
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
Gale M. Lucas
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.
Bennett, Rachel E.; Boulos, David; Garber, Bryan G.; Jetly, Rakesh; Sareen, Jitender
Objective: The 2013 Canadian Forces Mental Health Survey (CFMHS) collected detailed information on mental health problems, their impacts, occupational and nonoccupational determinants of mental health, and the use of mental health services from a random sample of 8200 serving personnel. The objective of this article is to provide a firm scientific foundation for understanding and interpreting the CFMHS findings. Methods: This narrative review first provides a snapshot of the Canadian Armed Forces (CAF), focusing on 2 key determinants of mental health: the deployment of more than 40,000 personnel in support of the mission in Afghanistan and the extensive renewal of the CAF mental health system. The findings of recent population-based CAF mental health research are reviewed, with a focus on findings from the very similar mental health survey done in 2002. Finally, key aspects of the methods of the 2013 CFMHS are presented. Results: The findings of 20 peer-reviewed publications using the 2002 mental health survey data are reviewed, along with those of 25 publications from other major CAF mental health research projects executed over the past decade. Conclusions: More than a decade of population-based mental health research in the CAF has provided a detailed picture of its mental health and use of mental health services. This knowledge base and the homology of the 2013 survey with the 2002 CAF survey and general population surveys in 2002 and 2012 will provide an unusual opportunity to use the CFMHS to situate mental health in the CAF in a historical and societal perspective. PMID:27270738
Karras, Bryant T.; Tufano, James T.
This paper describes the development process of an evaluation framework for describing and comparing web survey tools. We believe that this approach will help shape the design, development, deployment, and evaluation of population-based health interventions. A conceptual framework for describing and evaluating web survey systems will enable the…
Full Text Available The purpose of this research work is to evaluate the effects which some factors could have on articles publication regarding survey interviewer characteristics. For this, the author studied the existing literature from the various fields in which articles on survey interviewer characteristics has been published and which can be found in online articles database. The analysis was performed on 243 articles achieved by researchers in the time period 1949-2012. Using statistical software R and applying multilevel regression model, the results showed that the time period when the studied articles are made and the interaction between the number of authors and the number of pages affect the most their publication in journals with a certain level of impact factor.
Methods for Conducting a Large-Scale GPS-Only Survey of Households: Past Household Travel Surveys (HTS) in the United States have only piloted small subsamples of Global Positioning Systems (GPS) completes compared with 1-2 day self-reported travel i...
Mahfoud, Ziyad; Ghandour, Lilian; Ghandour, Blanche; Mokdad, Ali H.; Sibai, Abla M.
Findings on the reliability and cost-effectiveness of the use of cellular phones vis-à-vis face-to-face interviews in investigating health behaviors and conditions are presented for a national epidemiological sample from Lebanon. Using self-reported responses on identical questions, percentage agreement, ? statistics, and McNemar's test were used…
Wallin, Anne-Marie; Ahlström, Gerd
Being diagnosed as having a chronic disease gives rise to emotions. Beliefs about health are culturally constructed and affect people's decisions regarding treatment. No studies have been reported that focus on the health beliefs of immigrants of Somalian origin with diabetes and how these people experiences the diagnosis. Therefore the aim of the present study was to investigate how immigrants from Somalia living in Sweden experienced receiving the diagnosis and describe their beliefs about health. The sample consisted of 19 adults with diabetes born in Somalia and now living in Sweden who were interviewed with the aid of an interpreter. The interviews were subjected to qualitative content analysis. From the analysis of what the participants said about their experiences of the diagnosis there emerged three themes: 'Existential brooding', 'Avoiding the diagnosis' and 'Accepting what is fated'. Three themes also emerged from the analysis of what they said about beliefs about health: 'Health as absence of disease', 'Health as general well-being' and 'Fated by a higher power'. A major finding was that women when they communicated their experiences regarding the diagnosis and health beliefs made more use of supernatural beliefs than men did. The participants, irrespective of gender, did not immediately respond with shock or other strong emotion when they received the diagnosis. The study provides health-care staff with knowledge concerning a minority group's experiences of being diagnosed as having diabetes and their beliefs about health. The findings indicate that men and women differ in how they experiences the diagnosis and how they described their health beliefs. The quality improvement of health education and nursing for patients with diabetes calls for consideration of the variation of beliefs related to cultural background and gender.
Zaky, Hassan H M; Khattab, Hind A S; Galal, Dina
This study assesses the quality of reproductive health services using client satisfaction exit interviews among three groups of primary health care units run by the Ministry of Health and Population of Egypt. Each group applied a different model of intervention. The Ministry will use the results in assessing its reproductive health component in the health sector reform program, and benefits from the strengths of other models of intervention. The sample was selected in two stages. First, a stratified random sampling procedure was used to select the health units. Then the sample of female clients in each health unit was selected using the systematic random approach, whereby one in every two women visiting the unit was approached. All women in the sample coming for reproductive health services were included in the analysis. The results showed that reproductive health beneficiaries at the units implementing the new health sector reform program were more satisfied with the quality of services. Still there were various areas where clients showed significant dissatisfaction, such as waiting time, interior furnishings, cleanliness of the units and consultation time. The study showed that the staff of these units did not provide a conductive social environment as other interventions did. A significant proportion of women expressed their intention to go to private physicians owing to their flexible working hours and variety specializations. Beneficiaries were generally more satisfied with the quality of health services after attending the reformed units than the other types of units, but the generalization did not fully apply. Areas of weakness are identified.
Brandt, Carl Joakim; Søgaard, Gabrielle Isidora; Clemensen, Jane; Sndergaard, Jens; Nielsen, Jesper Bo
Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior for their patients and themselves. A total of 10 (5 female and 5 male) GPs were recruited by purposive sampling, aged 38 to 69 years (mean 51 years), of which 4 had an urban uptake of patients and 6 a rural uptake. All of them worked in the region of Southern Denmark where GPs typically work alone or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices to help patients challenged with lifestyle issues and themselves. We also interviewed how they treated lifestyle-challenged patients in general and how they imagined eHealth could be used in the future. All GPs had smartphones or tablets, and everyone communicated on a daily basis with patients about disease and medicine via their electronic health record and the internet. We identified 3 themes concerning the use of eHealth: (1) how eHealth is used for patients; (2) general practitioners' own experience with improving lifestyle and eHealth support; and (3) relevant coaching techniques for transformation into eHealth. GPs used eHealth frequently for themselves but only infrequently for their patients. GPs are familiar with behavioral change techniques and are ready to use them in eHealth if they are used to
We want to learn from university students about your experiences and perspectives on mental health and well-being in the context of being a student. Your input can help us develop evidence-based intervention programs that can help address the mental health needs of students. This survey should take 15-20 minutes to complete.
Paladini, Luciana; Hodder, Rick; Cecchini, Isabella; Bellia, Vincenzo; Incalzi, Raffaele Antonelli
Dyspnoea is the most common symptom associated with poor quality of life in patients affected by Chronic Obstructive Pulmonary Disease (COPD). While COPD severity is commonly staged by lung function, the Medical Research Council (MRC) dyspnoea scale has been proposed as a more clinically meaningful method of quantifying disease severity in COPD. We wished to assess whether this scale might also be useful during telephone surveys as a simple surrogate marker of perceived health status in elderly patients with COPD. We conducted a comprehensive health status assessment by telephone survey of 200 elderly patients who had a physician diagnosis of COPD. The telephone survey contained 71 items and explored such domains as educational level, financial status, living arrangements and social contacts, co-morbid illness, and the severity and the impact of COPD on health status. Patients were categorized according to the reported MRC score: mild dyspnoea (MRC scale of 1), moderate dyspnoea (MRC scale of 2 and 3), or severe dyspnoea (MRC of 4 and 5). Deterioration in most of the recorded indicators of health status correlated with an increasingly severe MRC score. This was most evident for instrumental activities of daily living (IADL), perceived health and emotional status, pain-related limitations, limitations in social life, hospital admissions in preceding year and prevalence of most co-morbidities. The MRC dyspnoea scale is a reliable index of disease severity and health status in elderly COPD patients which should prove useful for remote monitoring of COPD and for rating health status for epidemiological purposes.
Sommers, Benjamin D; Arntson, Emily; Kenney, Genevieve M; Epstein, Arnold M
Background The Affordable Care Act (ACA) dramatically expands Medicaid in 2014 in participating states. Meanwhile, six states have already expanded Medicaid since 2010 to some or all of the low-income adults targeted under health reform. We undertook an in-depth exploration of these six “early-expander” states—California, Connecticut, the District of Columbia, Minnesota, New Jersey, and Washington—through interviews with high-ranking Medicaid officials. Methods We conducted semi-structured interviews with 11 high-ranking Medicaid officials in six states and analyzed the interviews using qualitative methods. Interviews explored enrollment outreach, stakeholder involvement, impact on beneficiaries, utilization and costs, implementation challenges, and potential lessons for 2014. Two investigators independently analyzed interview transcripts and iteratively refined the codebook until reaching consensus. Results We identified several themes. First, these expansions built upon pre-existing state-funded insurance programs for the poor. Second, predictions about costs and enrollment were challenging, indicating the uncertainty in projections for 2014. Other themes included greater than anticipated need for behavioral health services in the expansion population, administrative challenges of expansions, and persistent barriers to enrollment and access after expanding eligibility—though officials overall felt the expansions increased access for beneficiaries. Finally, political context—support or opposition from stakeholders and voters—plays a critical role in shaping the success of Medicaid expansions. Conclusions Early Medicaid expansions under the ACA offer important lessons to federal and state policymakers as the 2014 expansions approach. While the context of each state’s expansion is unique, key shared experiences were significant implementation challenges and opportunities for expanding access to needed services. PMID:24834369
This document presents the results of the Bolivia Demographic and Health Survey (DHS), or Encuesta Nacional de Demografia y Salud 1998, conducted by the Instituto Nacional de Estadistica, La Paz, Bolivia, within the framework of the DHS Program of Macro International. Data were collected from 12,109 households and complete interviews were conducted with 11,187 women aged 15-49. A male survey was also conducted, which collected data from 3780 men aged 15-64. The information collected include the following: 1) general characteristics of the population, 2) fertility, 3) fertility preferences, 4) current contraceptive use, 5) contraception, 6) marital and contraceptive status, 7) postpartum variables, 8) infant mortality, 9) health: disease prevention and treatment, and 10) nutritional status: anthropometric measures.
Full Text Available In the age of digital technology, as teens seem to be constantly connected online, via social media, and through mobile applications, it is no surprise that they increasingly turn to digital media to answer their health questions. This study is the first of its kind to survey a large, nationally-representative sample of teens to investigate how they use the newest digital technologies, including mobile apps, social networking sites, electronic gaming and wearable devices, to explore health topics. The survey covered the types of health topics teens most frequently search for, which technologies they are most likely to use and how they use them, and whether they report having changed their behaviors due to digital health information. In addition, this survey explores how the digital divide continues to impact adolescents. Results of this study indicate that teens are concerned about many health issues, ranging from fitness, sexual activity, drugs, hygiene as well as mental health and stress. As teens virtually always have a digital device at their fingertips, it is clear that public health interventions and informational campaigns must be tailored to reflect the ways that teens currently navigate digital health information and the health challenges that concern them most.
Greenfield, David; Hinchcliff, Reece; Hogden, Anne; Mumford, Virginia; Debono, Deborah; Pawsey, Marjorie; Westbrook, Johanna; Braithwaite, Jeffrey
The study aim was to investigate the understandings and concerns of stakeholders regarding the evolution of health service accreditation programs in Australia. Stakeholder representatives from programs in the primary, acute and aged care sectors participated in semi-structured interviews. Across 2011-12 there were 47 group and individual interviews involving 258 participants. Interviews lasted, on average, 1 h, and were digitally recorded and transcribed. Transcriptions were analysed using textual referencing software. Four significant issues were considered to have directed the evolution of accreditation programs: altering underlying program philosophies; shifting of program content focus and details; different surveying expectations and experiences and the influence of external contextual factors upon accreditation programs. Three accreditation program models were noted by participants: regulatory compliance; continuous quality improvement and a hybrid model, incorporating elements of these two. Respondents noted the compatibility or incommensurability of the first two models. Participation in a program was reportedly experienced as ranging on a survey continuum from "malicious compliance" to "performance audits" to "quality improvement journeys". Wider contextual factors, in particular, political and community expectations, and associated media reporting, were considered significant influences on the operation and evolution of programs. A hybrid accreditation model was noted to have evolved. The hybrid model promotes minimum standards and continuous quality improvement, through examining the structure and processes of organisations and the outcomes of care. The hybrid model appears to be directing organisational and professional attention to enhance their safety cultures. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Anderson, Claire; Kirkpatrick, Susan
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.
Full Text Available Abstract Background A number of significant chemical incidents occur in the UK each year and may require Emergency Departments (EDs to receive and manage contaminated casualties. Previously UK EDs have been found to be under-prepared for this, but since October 2005 acute hospital Trusts have had a statutory responsibility to maintain decontamination capacity. We aimed to evaluate the level of preparedness of Emergency Departments in North West England for managing chemical incidents. Methods A face-to-face semi-structured interview was carried out with the Nurse Manager or a nominated deputy in all 18 Emergency Departments in the Region. Results 16/18 departments had a written chemical incident plan but only 7 had the plan available at interview. All had a designated decontamination area but only 11 felt that they were adequately equipped. 12/18 had a current training programme for chemical incident management and 3 had no staff trained in decontamination. 13/18 could contain contaminated water from casualty decontamination and 6 could provide shelter for casualties before decontamination. Conclusion We have identified major inconsistencies in the preparedness of North West Emergency Departments for managing chemical incidents. Nationally recognized standards on incident planning, facilities, equipment and procedures need to be agreed and implemented with adequate resources. Issues of environmental safety and patient dignity and comfort should also be addressed.
Y. Stol (Yrrah); E.C.A. Asscher (Eva); M.H.N. Schermer (Maartje)
markdownabstract__Background:__ 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'
Borrud, Lori; Chiappa, Michele M; Burt, Vicki L; Gahche, Jaime; Zipf, George; Johnson, Clifford L; Dohrmann, Sylvia M
In October 2008, the federal government issued its first-ever Physical Activity Guidelines for Americans to provide science-based guidance on the types and amounts of physical activity that provide substantial health benefits for Americans (1). Guidelines for children and adolescents recommend 60 minutes or more of aerobic, muscle-strengthening, or bone-strengthening physical activity daily (1). While the number of children in the United States who meet the recommendations in the Physical Activity Guidelines is unknown, the percentage that is physically active in the United States may be declining. No recent national data exist on the fitness levels of children and adolescents. The National Health and Nutrition Examination Survey's (NHANES) National Youth Fitness Survey (NNYFS) was conducted in 2012 and collected data on physical activity and fitness levels for U.S. children and adolescents aged 3-15 years. The objective of NNYFS was to provide national-level estimates of the physical activity and fitness levels of children, based on interview and physical examination data. Results from the survey are intended to contribute to the development of policies and programs to improve youth fitness nationally. The data also may be used in the development of national reference standards for measures of fitness and physical activity. Methods The NNYFS survey design used the design for NHANES, which is a multistage probability sample of the civilian noninstitutionalized resident population of the United States. NNYFS consisted of a household interview and a physical activity and fitness examination in a mobile examination center. A total of 1,640 children and adolescents aged 3-15 were interviewed, and 1,576 were examined. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Ali, Habiba I; Jarrar, Amjad H; Abo-El-Enen, Mostafa; Al Shamsi, Mariam; Al Ashqar, Huda
Increasing the healthfulness of campus food environments is an important step in promoting healthful food choices among college students. This study explored university students' suggestions on promoting healthful food choices from campus vending machines. It also examined factors influencing students' food choices from vending machines. Peer-led semi-structured individual interviews were conducted with 43 undergraduate students (33 females and 10 males) recruited from students enrolled in an introductory nutrition course in a large national university in the United Arab Emirates. Interviews were audiotaped, transcribed, and coded to generate themes using N-Vivo software. Accessibility, peer influence, and busy schedules were the main factors influencing students' food choices from campus vending machines. Participants expressed the need to improve the nutritional quality of the food items sold in the campus vending machines. Recommendations for students' nutrition educational activities included placing nutrition tips on or beside the vending machines and using active learning methods, such as competitions on nutrition knowledge. The results of this study have useful applications in improving the campus food environment and nutrition education opportunities at the university to assist students in making healthful food choices.
McCauley, Claire-Odile; McKenna, Hugh; Keeney, Sinead; McLaughlin, Derek
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.
Kangasniemi, Mari; Blomberg, Katja; Korhonen, Anne
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.
contains information on the First and Second Malaysian Family Life Surveys conducted in 1976-1977 and in 1988-1989. Subsequent information about the...2] A10. How many rupiah per liter is the price of fuel in this village/subdistrict? The price of fuel is the retail price used in this...Main crops mean crops that are cultivated by many local people. Type of vegetables and fruits, such as: tomato, orange juice, apple, Chinese cabbage
Say, Rebecca; Thomson, Richard; Robson, Stephen; Exley, Catherine
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. 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. 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. 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-based information about ECV and lay beliefs
Richard L. Reece, MD, interviewed John Danaher, MD, MBA, on August 16, 2000, to discuss how his new company is preparing for the perfect storm--the looming convergence of demanding consumers, defined contributions, and Internet-based health plans. He describes how his firm is putting financial and clinical tools in the hands of consumers and physicians, so consumers can be more enlightened in their health care choices. Danaher says, "We're not about buying goods and services online. We are transforming the way consumers buy health care and seek insurance. We're trying to be a 401 k where people get on, knowing their risk profile and return horizons. We aim to motivate consumers to be proactive in making health care choices. How do we make consumers responsible and motivated enough to take control of managing their health care costs? How well we articulate this call to consumer action will be the key to our success."
Andreia Morales Cascaes
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.
M, Schoo A; S, Lawn; E, Rudnik; C, Litt J
Many undergraduate and graduate-entry health science curricula have incorporated training in motivational interviewing (MI). However, to effectively teach skills that will remain with students after they graduate is challenging. The aims of this study were to find out self-assessed MI skills of health students and whether reflecting on the results can promote transformative learning. Thirty-six Australian occupational therapy and physiotherapy students were taught the principles of MI, asked to conduct a motivational interview, transcribe it, self-rate it using the Motivational Interviewing Treatment Integrity (MITI) tool and reflect on the experience. Student MI skills were measured using the reported MITI subscores. Student assignments and a focus group discussion were analysed to explore the student experience using the MITI tool and self-reflection to improve their understanding of MI principles. Students found MI challenging, although identified the MITI tool as useful for promoting self-reflection and to isolate MI skills. Students self-assessed their MI skills as competent and higher than scores expected from beginners. The results inform educational programs on how MI skills can be developed for health professional students and can result in transformative learning. Students may over-state their MI skills and strategies to reduce this, including peer review, are discussed. Structured self-reflection, using tools such as the MITI can promote awareness of MI skills and compliment didactic teaching methods.
Batra, Manu; Shah, Aasim Farooq; Virtanen, Jorma I
Early childhood caries (ECC) continues to affect children worldwide. In India, primary health centers (PHCs) comprises the primary tier where Accredited Social Health Activist (ASHA) provide integrated curative and preventive health care. The aim of the study was to pilot test the integration of oral health in primary health care through motivational interviewing (MI) for mothers of young children provided by ASHAs. The pilot study was conducted in Kashipur, Uttarakhand. From the six PHCs in Kashipur, three were randomly selected, one each was assigned to MI group, traditional health education group, and control group. From 60 mothers with 8-12 months child, ASHAs of all three groups gathered mother's knowledge regarding child's oral health using close-ended questionnaire and diagnosed clinical risk markers of ECC in children and ASHAs of Group A and B imparted the oral health education as per their training. The comparison of ASHA's performances on the MI training competency pre- and post-test showed an overall average of 74% improvement in post-test scores. Interexaminer reliability of the parallel clinical measurements by 6 ASHAs and the investigator for the maxillary central incisors showed 93% of agreement for both dental plaque and dental caries assessment with 0.86 and 0.89 kappa values, respectively. The health education through MI is feasible and can be cost-effective by utilization of ASHAs at PHCs to provide the oral health education to mothers which will in turn improve the oral health status of children.
Kim, Hyojin; Park, Sun-Young; Bozeman, Ingrid
While the Internet is a popular source of health information, health seekers' inadequate skills to locate and discern quality information pose a potential threat to their healthcare decision-making. We aimed to examine health information search and appraisal behaviours among young, heavy users of the Internet. In study 1, we observed and interviewed 11 college students about their search strategies and evaluation of websites. In study 2, three health experts evaluated two websites selected as the best information sources in study 1. Familiarity with health websites and confidence in search strategies were major factors affecting search and evaluation behaviours. Website quality was mostly judged by aesthetics and peripheral cues of source credibility and message credibility. In contrast to users' favourable website evaluation, the experts judged the websites to be inappropriate and untrustworthy. Our results highlight a critical need to provide young health seekers with resources and training that are specifically geared toward health information search and appraisal. The role of health seekers' knowledge and involvement with the health issue in search effort and success warrants future research. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.
Ellen Wartella; Vicky Rideout; Heather Montague; Leanne Beaudoin-Ryan; Alexis Lauricella
In the age of digital technology, as teens seem to be constantly connected online, via social media, and through mobile applications, it is no surprise that they increasingly turn to digital media to answer their health questions. This study is the first of its kind to survey a large, nationally-representative sample of teens to investigate how they use the newest digital technologies, including mobile apps, social networking sites, electronic gaming and wearable devices, to explore health...
Spencer, N J; Penlington, E
Community child health medical audit is established in most districts surveyed. A minority have integrated audit with hospital paediatric units. Very few districts use an external auditor. Subject audit is preferred to individual performance audit and school health services were the most common services subjected to medical audit. The need for integrated audit and audit forms suitable for use in the community services is discussed.
Eriksson, Irene; Nilsson, Kerstin
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.
Hackett, Julia; Thorneloe, Rachael; Side, Lucy; Wolf, Michael; Horne, Rob; Cuzick, Jack; Smith, Samuel G
Uptake of preventive therapy for women at increased breast cancer risk in England is unknown following the introduction of UK clinical guidelines in 2013. Preventive therapy could create socioeconomic inequalities in cancer incidence if it is more readily accepted by particular socio-demographic groups. In this multicentre study, we investigated uptake of tamoxifen and evaluated socio-demographic and clinical factors associated with initiation. We explored women's experiences of treatment decision-making using qualitative interview data. Between September 2015 and December 2016, women (n = 732) attending an appointment at one of 20 centres in England to discuss breast cancer risk were approached to complete a survey containing socio-demographic details and nulliparity. Of the baseline survey respondents (n = 408/732, 55.7% response rate), self-reported uptake of tamoxifen at 3-month follow-up was reported in 258 (63.2%). Sixteen women participated in semi-structured interviews. One in seven (38/258 = 14.7%) women initiated tamoxifen. Women who had children were more likely to report use of tamoxifen than those without children (OR = 5.26; 95%CI: 1.13-24.49, p = 0.035). Interview data suggested that women weigh up risks and benefits of tamoxifen within the context of familial commitments, with exposure to significant other's beliefs and experiences of cancer and medication a basis for their decision. Uptake of tamoxifen is low in clinical practice. There were no socio-demographic differences in uptake, suggesting that the introduction of breast cancer preventive therapy is unlikely to create socioeconomic inequalities in cancer incidence. Women's decision-making was influenced by familial priorities, particularly having children.
Andersson, Kerstin; Furhoff, Anna-Karin; Nordenram, Gunilla; Wårdh, Inger
The purpose of this study was to explore general medical practitioners' (GPs) perceptions of the oral health of their elderly patients. The design was a qualitative study based on individual in-depth interviews with GPs. The criterion for inclusion in the study was that the GP was a specialist in family medicine working in a primary health care centre (PHCC:s) in the county of Stockholm. The participants took part in the study after informed consent. Eleven GPs were interviewed. The interview started with semi-structured questions about the respondents' clinical presentation of their elderly patients', e.g. medication, medical treatment and socioeconomic status. The interview concluded with questions about the respondents' experiences of and perceptions of the oral health of their patients. This process started with the first interview and proceeded with successive interviews until no new relevant information was forthcoming. The initial semi-structured part of the interview guide was analysed for content with special reference to descriptive answers. The final open questions were analysed by a method inspired by grounded theory (GT) and comprised three stages: open coding, axial coding and selective coding. In the GT influenced analysis process, three categories, health perspective, working conditions and cultural differences, each in turn containing subcategories, were identified and labelled. The most significant category, cultural differences, was identified as the core category, explaining the central meaning of the respondents' perceptions of the oral health of their elderly patients. The GPs in this study showed little or no awareness of the oral health of their elderly patients. The interviews disclosed several contributing factors. Barriers to closer integration of oral and general health in the elderly were identified. There existed a cultural gap between the disciplines of dentistry and medicine, which does not enhance and may be detrimental to the
Michelle L Patterson PhD, RPsych
Full Text Available Underlying the daily lives of people with experiences of homelessness and mental illness is a complex interplay of individual and structural factors that perpetuate cycles of inequity. The introduction of novel methodological combinations within qualitative research has the potential to advance knowledge regarding the experience of health equity by such individuals and to clarify the relationship between these experiences and broader structural inequities. To explore the lived experience of inequity, we present a thematic analysis of narrative interviews in conjunction with timelines from 31 adults experiencing homelessness and mental illness. Use of these methods together enabled a novel and expanded appreciation for the varied ways in which differential access to the social determinants of health influences the trajectories and experiences of inequity for people who are homeless and mentally ill. The further utility of these methods for better understanding the experience of inequity is explored and implications for research, policy, and practice are discussed.
Olatunde, Shade; Boon, Heather; Hirschkorn, Kristine; Welsh, Sandy; Bajcar, Jana
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.
Petrova, Tatjana; Kavookjian, Jan; Madson, Michael B; Dagley, John; Shannon, David; McDonough, Sharon K
Motivational interviewing (MI) has demonstrated a significant impact as an intervention strategy for addiction management, change in lifestyle behaviors, and adherence to prescribed medication and other treatments. Key elements to studying MI include training in MI of professionals who will use it, assessment of skills acquisition in trainees, and the use of a validated skills assessment tool. The purpose of this research project was to develop a psychometrically valid and reliable tool that has been designed to assess MI skills competence in health care provider trainees. The goal was to develop an assessment tool that would evaluate the acquisition and use of specific MI skills and principles, as well as the quality of the patient-provider therapeutic alliance in brief health care encounters. To address this purpose, specific steps were followed, beginning with a literature review. This review contributed to the development of relevant conceptual and operational definitions, selecting a scaling technique and response format, and methods for analyzing validity and reliability. Internal consistency reliability was established on 88 video recorded interactions. The inter-rater and test-retest reliability were established using randomly selected 18 from the 88 interactions. The assessment tool Motivational Interviewing Skills for Health Care Encounters (MISHCE) and a manual for use of the tool were developed. Validity and reliability of MISHCE were examined. Face and content validity were supported with well-defined conceptual and operational definitions and feedback from an expert panel. Reliability was established through internal consistency, inter-rater reliability, and test-retest reliability. The overall internal consistency reliability (Cronbach's alpha) for all fifteen items was 0.75. MISHCE demonstrated good inter-rater reliability and good to excellent test-retest reliability. MISHCE assesses the health provider's level of knowledge and skills in brief
Oak Ridge Institute for Science and Education
This annual survey collects 2006 data on the number of health physics degrees awarded as well as the number of students enrolled in health physics academic programs. Thirty universities offer health physics degrees; all responded to the survey
Full Text Available Objective. Describe the design methodology of the halfway health and nutrition national survey (Ensanut-MC 2016. Materials and methods. The Ensanut-MC is a national probabilistic survey whose objective population are the inhabitants of private households in Mexico. The sample size was determined to make inferences on the urban and rural areas in four regions. Describes main design elements: target population, topics of study, sampling procedure, measurement procedure and logistics organization. Results. A final sample of 9 479 completed household interviews, and a sample of 16 591 individual interviews. The response rate for households was 77.9%, and the response rate for individuals was 91.9%. Conclusions. The Ensanut-MC probabilistic design allows valid statistical inferences about interest parameters for Mexico´s public health and nutrition, specifically on overweight, obesity and diabetes mellitus. Updated information also supports the monitoring, updating and formulation of new policies and priority programs.
Full Text Available Iranian Mental Health Survey (IranMHS was conducted to assess the twelve-month prevalence and severity of psychiatric disorders in the Iranian adult population and to determine the pattern of health care utilization and cost of services. IranMHS is a cross-sectional national household survey with face-to-face interviews as the main data collection method. The study was carried out between January and June 2011. A three-stage probability sampling was applied for the selection of a representative sample from the non-institutionalized population aged 15 to 64. The primary instrument utilized for assessing the prevalence of mental disorders was the Persian version of Composite International Diagnosis Interview, version 2.1. The instruments for assessing the service and cost of mental illness were developed by the research team. The response rate was 86.2%, and a total of 7886 individuals participated in the study. Sampling weights were the joint product of inverse probability of unit selection, non-response weights and post-stratification weights. This paper presents an overview of the study design, fieldwork organization and procedures, weightings and analysis. The strengths and limitations of the study are also discussed.
Andrade, Flávia Reis de; Narvai, Paulo Capel; Montagner, Miguel Ângelo
To analyze the ethics of in vivo calibration, using the discourse of the administrators of the National Oral Health Survey (SBBrasil 2010) as a starting point. This is a qualitative research involving semi-structured individual interviews with 12 members of the Steering Group and Technical Advisory Committee of the Ministry of Health, and two coordinators, one State and the other Municipal. The discourse of the collective subject technique was used for data analysis. When asked about the experiences of SBBrasil 2010, which included ethical aspects, respondents identified the forms of standardization and training of teams who collected field data. For them, there is little scientific evidence to ethically support the way the training stage, including calibration, is carried out in oral health epidemiological surveys, as a certain unease can be predicted in participants of these studies. The ethics of a research also derives from its methodological rigor; the training process; and calibration in particular, is a fundamental technical and ethical requirement in surveys such as the SBBrasil 2010. The unease of the volunteers in face of test repetition does not ethically invalidate the in vivo calibration, but mechanisms to minimize it must be developed.
Hanewinkel, R; Wewel, M; Stephan, C; Isensee, B; Wiborg, G
Conception, implementation and evaluation of a risk-reducing and health-promoting brief intervention addressed to unemployed. Control-group-study with repeated measurement. 131 unemployed took part in the intervention group and 95 persons were matched according to age and sex and served as a reference group. The intervention group were recruited via flyers, press articles and several institutions, the reference group via the journal of a health insurance company. The reference group received a questionnaire twice assessing the same health-related variables as the intervention group. In the intervention group, life style-related variables - eating habits, exercising, smoking, alcohol consumption - were assessed via questionnaire. In a one-hour counselling session based on Motivational Interviewing, participants received an individual feedback on their results of the questionnaire, including a comparison against standards and a review of their personal risks and negative consequences as well as advice and recommendations, while the decision for or against a behaviour change was left to the participant. 85.2 % of the participants of the intervention reported that the counselling met their expectations, and 86.2 % would recommend the intervention to a friend. Statistically significant effects for the intervention group compared to the control group from pre- to post-measurement could be shown for alcohol consumption, eating habits, and exercise (p healthy life-style and that it might sensitize participants regarding their subjective state of health. The results of the pilot study will have to be substantiated by further studies.
Thomson, Louise; Schneider, Justine; Hare Duke, Laurie
The purpose of the study was to explore unregistered health care staff's perceptions of 12 hour shifts on work performance and patient care. Many unregistered health care staff work 12 hour shifts, but it is unclear whether these are compatible with good quality care or work performance. Twenty five health care assistants from a range of care settings with experience of working 12 hour shifts took part in interviews or focus groups. A wide range of views emerged on the perceived impact of 12 hour shifts in different settings. Negative outcomes were perceived to occur when 12 hour shifts were combined with short-staffing, consecutive long shifts, high work demands, insufficient breaks and working with unfamiliar colleagues. Positive outcomes were perceived to be more likely in a context of control over shift patterns, sufficient staffing levels, and a supportive team climate. The perceived relationship between 12 hour shifts and patient care and work performance varies by patient context and wider workplace factors, but largely focuses on the ability to deliver relational aspects of care. Nursing managers need to consider the role of other workplace factors, such as shift patterns and breaks, when implementing 12 hour shifts with unregistered health care staff. © 2017 John Wiley & Sons Ltd.
Lotz, Julia D; Jox, Ralf J; Borasio, Gian Domenico; Führer, Monika
Pediatric advance care planning differs from the adult setting in several aspects, including patients' diagnoses, minor age, and questionable capacity to consent. So far, research has largely neglected the professionals' perspective. We aimed to investigate the attitudes and needs of health care professionals with regard to pediatric advance care planning. This is a qualitative interview study with experts in pediatric end-of-life care. A qualitative content analysis was performed. We conducted 17 semi-structured interviews with health care professionals caring for severely ill children/adolescents, from different professions, care settings, and institutions. Perceived problems with pediatric advance care planning relate to professionals' discomfort and uncertainty regarding end-of-life decisions and advance directives. Conflicts may arise between physicians and non-medical care providers because both avoid taking responsibility for treatment limitations according to a minor's advance directive. Nevertheless, pediatric advance care planning is perceived as helpful by providing an action plan for everyone and ensuring that patient/parent wishes are respected. Important requirements for pediatric advance care planning were identified as follows: repeated discussions and shared decision-making with the family, a qualified facilitator who ensures continuity throughout the whole process, multi-professional conferences, as well as professional education on advance care planning. Despite a perceived need for pediatric advance care planning, several barriers to its implementation were identified. The results remain to be verified in a larger cohort of health care professionals. Future research should focus on developing and testing strategies for overcoming the existing barriers. © The Author(s) 2014.
Galvin, J; Suominen, E; Morgan, C; O'Connell, E-J; Smith, A P
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
Full Text Available Introduction: Early childhood caries (ECC continues to affect children worldwide. In India, primary health centers (PHCs comprises the primary tier where Accredited Social Health Activist (ASHA provide integrated curative and preventive health care. The aim of the study was to pilot test the integration of oral health in primary health care through motivational interviewing (MI for mothers of young children provided by ASHAs. Subjects and Methods: The pilot study was conducted in Kashipur, Uttarakhand. From the six PHCs in Kashipur, three were randomly selected, one each was assigned to MI group, traditional health education group, and control group. From 60 mothers with 8–12 months child, ASHAs of all three groups gathered mother's knowledge regarding child's oral health using close-ended questionnaire and diagnosed clinical risk markers of ECC in children and ASHAs of Group A and B imparted the oral health education as per their training. Results: The comparison of ASHA's performances on the MI training competency pre- and post-test showed an overall average of 74% improvement in post–test scores. Interexaminer reliability of the parallel clinical measurements by 6 ASHAs and the investigator for the maxillary central incisors showed 93% of agreement for both dental plaque and dental caries assessment with 0.86 and 0.89 kappa values, respectively. Conclusion: The health education through MI is feasible and can be cost-effective by utilization of ASHAs at PHCs to provide the oral health education to mothers which will in turn improve the oral health status of children.
Sørensen, Kristine; Pelikan, Jürgen M; Röthlin, Florian; Ganahl, Kristin; Slonska, Zofia; Doyle, Gerardine; Fullam, James; Kondilis, Barbara; Agrafiotis, Demosthenes; Uiters, Ellen; Falcon, Maria; Mensing, Monika; Tchamov, Kancho; van den Broucke, Stephan; Brand, Helmut
Health literacy concerns the capacities of people to meet the complex demands of health in modern society. In spite of the growing attention for the concept among European health policymakers, researchers and practitioners, information about the status of health literacy in Europe remains scarce. This article presents selected findings from the first European comparative survey on health literacy in populations. The European health literacy survey (HLS-EU) was conducted in eight countries: Austria, Bulgaria, Germany, Greece, Ireland, the Netherlands, Poland and Spain (n = 1000 per country, n = 8000 total sample). Data collection was based on Eurobarometer standards and the implementation of the HLS-EU-Q (questionnaire) in computer-assisted or paper-assisted personal interviews. The HLS-EU-Q constructed four levels of health literacy: insufficient, problematic, sufficient and excellent. At least 1 in 10 (12%) respondents showed insufficient health literacy and almost 1 in 2 (47%) had limited (insufficient or problematic) health literacy. However, the distribution of levels differed substantially across countries (29-62%). Subgroups within the population, defined by financial deprivation, low social status, low education or old age, had higher proportions of people with limited health literacy, suggesting the presence of a social gradient which was also confirmed by raw bivariate correlations and a multivariate linear regression model. Limited health literacy represents an important challenge for health policies and practices across Europe, but to a different degree for different countries. The social gradient in health literacy must be taken into account when developing public health strategies to improve health equity in Europe. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.
Williams, Jessica Roberts; Blais, Marissa Puckett; Banks, Duren; Dusablon, Tracy; Williams, Weston O; Hennessy, Kevin D
The purpose of this study is to concurrently examine the impact of individual and organizational characteristics on the decision to adopt the evidence-based practice (EBP) motivational interviewing (MI) among directors and staff (n = 311) in community health organizations (n = 92). Results from hierarchical linear modeling indicated that, at the individual level, attitudes toward EBPs and race each predicted directors' decisions to adopt, while gender predicted staff's decisionmaking. At the organizational level, organizational climate was inversely associated with both staff's and directors' decisions to adopt MI. Organizational barriers to implementing EBPs and use of reading materials and treatment manuals were related to directors' decision to adopt. Type of organization and staff attributes were associated with staff's decision to adopt. These findings underscore the need to tailor dissemination and implementation strategies to address differences between directors and staff in the adoption of EBPs.
Morton, Katie; Beauchamp, Mark; Prothero, Anna; Joyce, Lauren; Saunders, Laura; Spencer-Bowdage, Sarah; Dancy, Bernadette; Pedlar, Charles
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.
Qayumi, Karim; Pachev, George; Zheng, Bin; Ziv, Amitai; Koval, Valentyna; Badiei, Sadia; Cheng, Adam
Simulation is rapidly penetrating the terrain of health care education and has gained growing acceptance as an educational method and patient safety tool. Despite this, the state of simulation in health care education has not yet been evaluated on a global scale. In this project, we studied the global status of simulation in health care education by determining the degree of financial support, infrastructure, manpower, information technology capabilities, engagement of groups of learners, and research and scholarly activities, as well as the barriers, strengths, opportunities for growth, and other aspects of simulation in health care education. We utilized a two-stage process, including an online survey and a site visit that included interviews and debriefings. Forty-two simulation centers worldwide participated in this study, the results of which show that despite enormous interest and enthusiasm in the health care community, use of simulation in health care education is limited to specific areas and is not a budgeted item in many institutions. Absence of a sustainable business model, as well as sufficient financial support in terms of budget, infrastructure, manpower, research, and scholarly activities, slows down the movement of simulation. Specific recommendations are made based on current findings to support simulation in the next developmental stages. PMID:25489254
Gardening has been reported as being beneficial for mental well-being for vulnerable populations since 2000. However, little is known concerning its role in the general population. Therefore, the aim of the present study was to investigate the relationship of gardening and mental health in adults in a countrywide and population-based setting. Data was retrieved from and analysed in the Scottish Health Survey, 2012-2013. Information on demographics, lifestyle factors, gardening engagement, and adult mental health by General Health Questionnaire was obtained by household interview. Statistical analyses including chi-square test, t-test and survey-weighted logistic and multi-nominal regression modelling were performed. Of 9709 Scottish adults aged 16-99, 5 531 (57.0%) people did not do any gardening or building work in the last four weeks. A total of 888 (9.2%) people reported poor self-rated health. Gardening was associated with adult mental health in people both with or without heart conditions including ability to concentrate, feeling playing a useful part in things, feeling capable of making decisions, thinking of self as worthless, feeling reasonably happy, etc. General adults with or without heart conditions could benefit from engaging with gardening or building work. Future public health programmes promoting such activity should be encouraged in order to optimise adult mental health.
Meekers, D; Ogada, E A
Reproductive health programmes often need exit surveys and population-based surveys for monitoring and evaluation. This study investigates why such studies produce discrepant estimates of condom use, sexual behaviour and condom brand knowledge, and discusses the implications for future use of exit surveys for programme monitoring. Logistic regression is used to explain differences between a household survey of 1295 persons and an exit survey among a random sample of 2550 consumers at retail outlets in RWANDA: Discrepancies in ever use of condoms and risky sexual behaviours are due to differences in socioeconomic status of the two samples. After controls, exit surveys at most outlet types have the same results as the household survey. Only exit surveys at bars, nightclubs and hotels yield significantly different estimates. However, the above-average knowledge of Prudence Plus condoms in the exit interviews is not attributable to socioeconomic or demographic variables, most likely because respondents have seen the product at the outlets. Information about condom use and sexual behaviour obtained from exit surveys appears as accurate as that obtained through household surveys. Nevertheless, exit surveys must be used cautiously. Because exit surveys may include wealthier and better-educated respondents, they are not representative of the general population. The composition of exit survey samples should be validated through existing household surveys. Comparisons across survey types are generally unadvisable, unless they control for sample differences. When generalizing to the population at large is not needed (e.g. for studies aimed at identifying the characteristics and behaviour of users of particular products or services), exit surveys can provide an appropriate alternative to household surveys.
Tveten, U.; Garder, K.
This report was originally written as a chapter of a report entitled 'Air pollution effects of electric power generation, a literature survey', written jointly by the Norwegian Institute for Air Research (NILU) and the Institutt for Atomenergi (IFA). (INIS RN242406). A survey is presented of the health effects of radiation. It has not, however, been the intention of the authors to make a complete list of all the literature relevant to this subject. The NILU/IFA report was meant as a first step towards a method of comparing the health effects of electric power generation by fission, gas and oil. Consequently information relevant to quantification of the health effects on humans has been selected. It is pointed out that quantitative information on the health effects of low radiation and dose rates, as are relevant to routine releases, does not exist for humans. The convention of linear extrapolation from higher doses and dose rates is used worldwide, but it is felt by most that the estimates are conservative. As an example of the use of the current best estimates, a calculation of normal release radiation doses is performed. (Auth.)
Full Text Available Abstract Background The Breast Health Surveys, conducted by the National Breast Cancer Centre (NBCC in 1996 and 2003, are designed to gain insight into the knowledge, attitudes and behaviours of a nationally representative sample of Australian women on issues relevant to breast cancer. In this article, we focus on major aspects of the design and present results on respondents' knowledge about mammographic screening. Methods The 2003 BHS surveyed English-speaking Australian women aged 30–69 without a history of breast cancer using computer-assisted telephone interviewing. Questions covered the following themes: knowledge and perceptions about incidence, mortality and risk; knowledge and behaviour regarding early detection, symptoms and diagnosis; mammographic screening; treatment; and accessibility and availability of information and services. Respondents were selected using a complex sample design involving stratification. Sample weights against Australian population benchmarks were used in all statistical analyses. Means and proportions for the entire population and by age group and area of residence were calculated. Statistical tests were conducted using a level of significance of 0.01. Results Of the 3,144 respondents who consented to being interviewed, 138 (4.4% had a previous diagnosis of breast cancer and were excluded leaving 3,006 completed interviews eligible for analysis. A majority of respondents (61.1% reported ever having had a mammogram and 29.1% identified mammography as being the best way of finding breast cancer. A majority of women (85.9% had heard of the BreastScreen Australia (BSA program, the national mammographic screening program providing free biennial screening mammograms, with 94.5% believing that BSA attendance was available regardless of the presence or absence of symptoms. There have been substantial gains in women's knowledge about mammographic screening over the seven years between the two surveys. Conclusion The
Villanueva, Elmer V; Jones, Sandra; Nehill, Caroline; Favelle, Simone; Steel, David; Iverson, Donald; Zorbas, Helen
The Breast Health Surveys, conducted by the National Breast Cancer Centre (NBCC) in 1996 and 2003, are designed to gain insight into the knowledge, attitudes and behaviours of a nationally representative sample of Australian women on issues relevant to breast cancer. In this article, we focus on major aspects of the design and present results on respondents' knowledge about mammographic screening. The 2003 BHS surveyed English-speaking Australian women aged 30-69 without a history of breast cancer using computer-assisted telephone interviewing. Questions covered the following themes: knowledge and perceptions about incidence, mortality and risk; knowledge and behaviour regarding early detection, symptoms and diagnosis; mammographic screening; treatment; and accessibility and availability of information and services. Respondents were selected using a complex sample design involving stratification. Sample weights against Australian population benchmarks were used in all statistical analyses. Means and proportions for the entire population and by age group and area of residence were calculated. Statistical tests were conducted using a level of significance of 0.01. Of the 3,144 respondents who consented to being interviewed, 138 (4.4%) had a previous diagnosis of breast cancer and were excluded leaving 3,006 completed interviews eligible for analysis. A majority of respondents (61.1%) reported ever having had a mammogram and 29.1% identified mammography as being the best way of finding breast cancer. A majority of women (85.9%) had heard of the BreastScreen Australia (BSA) program, the national mammographic screening program providing free biennial screening mammograms, with 94.5% believing that BSA attendance was available regardless of the presence or absence of symptoms. There have been substantial gains in women's knowledge about mammographic screening over the seven years between the two surveys. The NBCC Breast Health Surveys provide a valuable picture of the
U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is an annual survey designed to collect statistical information on the numbers and characteristics of all known...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) measures the prevalence and correlates of drug...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) measures the prevalence and correlates of drug...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) measures the prevalence and correlates of drug...
Arrivillaga, Marcela; Aristizabal, Juan Carlos; Pérez, Mauricio; Estrada, Victoria Eugenia
The aim of this study was to design and validate a health services access survey for households in Colombia to provide a methodological tool that allows the country to accumulate evidence of real-life access conditions experienced by the Colombian population. A validation study with experts and a pilot study were performed. It was conducted in the municipality of Jamundi, located in the department of Valle del Cauca, Colombia. Probabilistic, multistage and stratified cluster sampling was carried out. The final sample was 215 households. The survey was composed of 63 questions divided into five modules: socio-demographic profile of the head of the household or adult informant, household socioeconomic profile, access to preventive services, access to curative and rehabilitative services and household out of pocket expenditure. In descriptive terms, the promotion of preventive services only reached 44%; the use of these services was always highest among children younger than one year old and up to the age of ten. The perceived need for emergency medical care and hospitalisation was between 82% and 85%, but 36% perceived the quality of care to be low or very low. Delays were experienced in medical visits with GPs and specialists. The designed survey is valid, relevant and representative of access to health services in Colombia. Empirically, the pilot showed institutional weaknesses in a municipality of the country, indicating that health coverage does not in practice mean real and effective access to health services. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Barry, Heather E; Campbell, John L; Asprey, Anthea; Richards, Suzanne H
English National Quality Requirements mandate out-of-hours primary care services to routinely audit patient experience, but do not state how it should be done. We explored how providers collect patient feedback data and use it to inform service provision. We also explored staff views on the utility of out-of-hours questions from the English General Practice Patient Survey (GPPS). A qualitative study was conducted with 31 staff (comprising service managers, general practitioners and administrators) from 11 out-of-hours primary care providers in England, UK. Staff responsible for patient experience audits within their service were sampled and data collected via face-to-face semistructured interviews. Although most providers regularly audited their patients' experiences by using patient surveys, many participants expressed a strong preference for additional qualitative feedback. Staff provided examples of small changes to service delivery resulting from patient feedback, but service-wide changes were not instigated. Perceptions that patients lacked sufficient understanding of the urgent care system in which out-of-hours primary care services operate were common and a barrier to using feedback to enable change. Participants recognised the value of using patient experience feedback to benchmark services, but perceived weaknesses in the out-of-hours items from the GPPS led them to question the validity of using these data for benchmarking in its current form. The lack of clarity around how out-of-hours providers should audit patient experience hinders the utility of the National Quality Requirements. Although surveys were common, patient feedback data had only a limited role in service change. Data derived from the GPPS may be used to benchmark service providers, but refinement of the out-of-hours items is needed. 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/.
Aday, Lu Ann; Cornelius, Llewellyn Joseph
... and Carrying Out the Survey 311 14 Preparing the Data for Analysis 340 15 Planning and Implementing the Analysis of the Data 360 16 Writing the Research Report 391 Resource A: Personal Interview Sur...
Andersen, Anne-Marie Nybo; Olsen, J.
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...... through computer-assisted telephone interviews. The authors compared interviewer characteristics for 34 interviewers with the responses they obtained in 12,910 interviews carried out for the Danish National Birth Cohort Study. Response data on smoking and alcohol consumption in the first trimester...... 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...
Roth Marilyn A
Full Text Available Abstract Background Health-related data at local level could be provided by supplementing national health surveys with local boosts. Self-completion surveys are less costly than interviews, enabling larger samples to be achieved for a given cost. However, even when the same questions are asked with the same wording, responses to survey questions may vary by mode of data collection. These measurement differences need to be investigated further. Methods The Health Survey for England in London ('Core' and a London Boost survey ('Boost' used identical sampling strategies but different modes of data collection. Some data were collected by face-to-face interview in the Core and by self-completion in the Boost; other data were collected by self-completion questionnaire in both, but the context differed. Results were compared by mode of data collection using two approaches. The first examined differences in results that remained after adjusting the samples for differences in response. The second compared results after using propensity score matching to reduce any differences in sample composition. Results There were no significant differences between the two samples for prevalence of some variables including long-term illness, limiting long-term illness, current rates of smoking, whether participants drank alcohol, and how often they usually drank. However, there were a number of differences, some quite large, between some key measures including: general health, GHQ12 score, portions of fruit and vegetables consumed, levels of physical activity, and, to a lesser extent, smoking consumption, the number of alcohol units reported consumed on the heaviest day of drinking in the last week and perceived social support (among women only. Conclusion Survey mode and context can both affect the responses given. The effect is largest for complex question modules but was also seen for identical self-completion questions. Some data collected by interview and self
Renn, McCartney; Steffen, Lori
Students and faculty from a Midwestern college conducted a neighborhood community needs assessment in an impoverished area of a Peruvian city to identify health needs of residents. Students interviewed residents in their homes, asking about the need for medical, dental, and ophthalmic care and screening for chronic conditions such as diabetes, heart disease, and tuberculosis. The survey provided necessary information to medical mission workers and allowed students to directly observe family living conditions while assessing psychosocial needs of the families interviewed. The challenges of this survey included differing expectations, language barriers, recruiting neighborhood volunteers, safety risks to students, and mistrust by neighborhood residents.
Patel, Harshida; Schaufelberger, Maria; Begley, Cecily; Berg, Marie
Peripartum cardiomyopathy is often associated with severe heart failure occurring towards the end of pregnancy or in the months following birth with debilitating, exhausting and frightening symptoms requiring person-centered care. The aim of this study was to explore women's experiences of health care while being diagnosed with peripartum cardiomyopathy. Qualitative interviews were conducted with 19 women with peripartum cardiomyopathy in Sweden, following consent. Data were analysed using qualitative content analysis. Confirmability was ensured by peer-debriefing, and an audit trail was kept to establish the credibility of the study. The main theme in the experience of health care was, 'Exacerbated Suffering', expressed in three subthemes; 'not being cared about', 'not being cared for' and 'not feeling secure.' The suffering was present in relation to the illness with failing health symptoms, but most of all in relation to not being taken seriously and adequately cared for by healthcare professionals. Women felt they were on an assembly line in midwives' routine work where knowledge about peripartum cardiomyopathy was lacking and they showed distrust and dissatisfaction with care related to negligence and indifference experienced from healthcare professionals. Feelings of being alone and lost were prominent and related to a sense of insecurity, distress and uneasiness. This study shows a knowledge gap of peripartum cardiomyopathy in maternity care personnel. This is alarming as the deprecation of symptoms and missed diagnosis of peripartum cardiomyopathy can lead to life-threatening consequences. To prompt timely diagnosis and avoid unnecessary suffering it is important to listen seriously to, and respect, women's narratives and act on expressions of symptoms of peripartum cardiomyopathy, even those overlapping normal pregnancy symptoms.
Full Text Available Abstract Background Healthcare-seeking behaviour in patients with diabetes mellitus (DM has been investigated to a limited extent, and not in developing countries. Switches between different health sectors may interrupt glycaemic control, affecting health. The aim of the study was to explore healthcare-seeking behaviour, including use of complementary alternative medicine (CAM and traditional healers, in Ugandans diagnosed with DM. Further, to study whether gender influenced healthcare-seeking behaviour. Methods This is a descriptive study with a snowball sample from a community in Uganda. Semi-structured interviews were held with 16 women and 8 men, aged 25-70. Data were analysed by qualitative content analysis. Results Healthcare was mainly sought among doctors and nurses in the professional sector because of severe symptoms related to DM and/or glycaemic control. Females more often focused on follow-up of DM and chronic pain in joints, while males described fewer problems. Among those who felt that healthcare had failed, most had turned to traditional healers in the folk sector for prescription of herbs or food supplements, more so in women than men. Males more often turned to private for-profit clinics while females more often used free governmental institutions. Conclusions Healthcare was mainly sought from nurses and physicians in the professional sector and females used more free-of-charge governmental institutions. Perceived failure in health care to manage DM or related complications led many, particularly women, to seek alternative treatment from CAM practitioners in the folk sector. Living conditions, including healthcare organisation and gender, seemed to influence healthcare seeking, but further studies are needed.
Dietrich, Thomas; Culler, Corinna; Garcia, Raul I; Henshaw, Michelle M
The authors evaluated racial/ethnic differences and their socioeconomic determinants in the oral health status of U.S. children, as reported by parents. The authors used interview data from the 2003 National Survey of Children's Health, a large representative survey of U.S. children. They calculated weighted, nationally representative prevalence estimates for non-Hispanic whites, non-Hispanic blacks and Hispanics, and they used logistic regression to explore the association between parents' reports of fair or poor oral health and various socioeconomic determinants of oral health. The results showed significant racial/ethnic differences in parental reports of fair or poor oral health, with prevalences of 6.5 percent for non-Hispanic whites, 12.0 percent for non-Hispanic blacks and 23.4 percent for Hispanics. Although adjustments for family socioeconomic status (poverty level and education) partially explained these racial/ethnic disparities, Hispanics still were twice as likely as non-Hispanic whites to report their children's oral health as fair or poor, independent of socioeconomic status. The authors did find differences in preventive-care attitudes among groups. However, in multivariate models, such differences did not explain the disparities. Significant racial/ethnic disparities exist in parental reports of their children's oral health, with Hispanics being the most disadvantaged group. Disparities appear to exist independent of preventive-care attitudes and socioeconomic status.
The purpose of research interviews is to obtain information from different respondents in order to answer a research question. The two main types of research interviews are standardized survey interviews and open interviews. The information obtained should meet scientific requirements. These
Lebrun-Harris, Lydie A; Baggett, Travis P; Jenkins, Darlene M; Sripipatana, Alek; Sharma, Ravi; Hayashi, A Seiji; Daly, Charles A; Ngo-Metzger, Quyen
Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n = 2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR = 1.98, 95 percent CI: 1.24–3.16) and twice the odds of having an ED visit in the past year (OR = 2.00, 95 percent CI: 1.37–2.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use. PMID:23134588
Arulananthan, C.; Hanifa, Sabibullah Mohamed
Healthcare is an imperative key field of research, where individuals or groups can be engaged in the self-tracking of any kind of biological, physical, behavioral, or environmental information. In a massive health care data, the valuable information is hidden. The quantity of the available unstructured data has been expanding on an exponential scale. The newly developing Disruptive Technologies can handle many challenges that face data analysis and ability to extract valuable information via data analytics. Connected Wellness in Healthcare would retrieve patient’s physiological, pathological and behavioral parameters through sensors to perform inner workings of human body analysis. Disruptive technologies can take us from a reactive illness-driven to a proactive wellness-driven system in health care. It is need to be strive and create a smart health system towards wellness-driven instead of being illness-driven, today’s biggest problem in health care. Wellness-driven-analytics application help to promote healthiest living environment called “Smart Health”, deliver empower based quality of living. The contributions of this survey reveals and opens (touches uncovered areas) the possible doors in the line of research on smart health and its computing technologies.
Zipf, George; Chiappa, Michele; Porter, Kathryn S; Ostchega, Yechiam; Lewis, Brenda G; Dostal, Jennifer
Background-Starting in 1999, the National Health and Nutrition Examination Survey (NHANES) became a continuous, ongoing annual survey of the noninstitutionalized civilian resident population of the United States. A continuous survey allowed content to change to meet emerging needs. Objective-This report describes how NHANES for 1999-2010 was designed and implemented. NHANES is a national survey designed to provide national estimates on various health-related topics. Methods-The survey used in-person face-to-face interviews and physical examinations for data collection. Approximately 5,000 people per year participated in NHANES. The 5,000 people surveyed each year are representative of the entire U.S. population. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Chukwu, Emeka; Garg, Lalit; Eze, Godson
Nigeria contributes only 2% to the world's population, accounts for 10% of the global maternal death burden. Health care at primary health centers, the lowest level of public health care, is far below optimal in quality and grossly inadequate in coverage. Private primary health facilities attempt to fill this gap but at additional costs to the client. More than 65% Nigerians still pay out of pocket for health services. Meanwhile, the use of mobile phones and related services has risen geometrically in recent years in Nigeria, and their adoption into health care is an enterprise worth exploring. The purpose of this study was to document costs associated with a mobile technology-supported, community-based health insurance scheme. This analytic cross-sectional survey used a hybrid of mixed methods stakeholder interviews coupled with prototype throw-away software development to gather data from 50 public primary health facilities and 50 private primary care centers in Abuja, Nigeria. Data gathered documents costs relevant for a reliable and sustainable mobile-supported health insurance system. Clients and health workers were interviewed using structured questionnaires on services provided and cost of those services. Trained interviewers conducted the structured interviews, and 1 client and 1 health worker were interviewed per health facility. Clinic expenditure was analyzed to include personnel, fixed equipment, medical consumables, and operation costs. Key informant interviews included a midmanagement staff of a health-management organization, an officer-level staff member of a mobile network operator, and a mobile money agent. All the 200 respondents indicated willingness to use the proposed system. Differences in the cost of services between public and private facilities were analyzed at 95% confidence level (Phealth care facilities is significantly higher than at public primary health care facilities. Key informant interviews with a health management organizations
Eckersberger, Elisabeth; Pearson, Erin; Andersen, Kathryn; Hossain, Altaf; Footman, Katharine; Biswas, Kamal Kanti; Nuremowla, Sadid; Reiss, Kate
Abortions are restricted in Bangladesh, but menstrual regulation is an approved alternative, defined as a procedure of regulating the menstrual cycle when menstruation is absent for a short duration. Use of contraception after menstrual regulation can reduce subsequent unintended pregnancy, but in Bangladesh, the contraceptive method mix is dominated by short-term methods, which have higher discontinuation and failure rates. Mobile phones are a channel via which menstrual regulation clients could be offered contraceptive support after leaving the clinic. This study aimed to support the development of a mobile phone intervention to support postmenstrual regulation family planning use in Bangladesh. It explored what family planning information women want to receive after having a menstrual regulation procedure, whether they would like to receive this information via their mobile phone, and if so, what their preferences are for the way in which it is delivered. We conducted participatory interviews with 24 menstrual regulation clients in Dhaka and Sylhet divisions in Bangladesh. Women were recruited from facilities in urban and peri-urban areas, which included public sector clinics supported by Ipas, an international nongovernmental organization (NGO), and NGO clinics run by Marie Stopes. Main themes covered in the interviews were factors affecting the use of contraception, what information and support women want after their menstrual regulation procedure, how respondents would prefer to receive information about contraception, and other key issues for mobile health (mHealth) interventions, such as language and privacy. As part of the in-depth interviews, women were shown and played 6 different messages about contraception on the research assistant's phone, which they were given to operate, and were then asked to give feedback. Women were open to both receiving messages about family planning methods on their mobile phones and talking to a counselor about family
Deci, Edward L; Ryan, Richard M
The papers of this special issue have the dual focus of reviewing research, especially clinical trials, testing self-determination theory (SDT) and of discussing the relations between SDT and motivational interviewing (MI). Notably, trials are reviewed that examined interventions either for behaviors such as physical activity and smoking cessation, or for outcomes such as weight loss. Although interventions were based on and intended to test the SDT health-behavior-change model, authors also pointed out that they drew techniques from MI in developing the interventions. The current paper refers to these studies and also clarifies the meaning of autonomy, which is central to SDT and has been shown to be important for effective change. We clarify that the dimension of autonomy versus control is conceptually orthogonal to the dimension of independence versus dependence, and we emphasize that autonomy or volition, not independence, is the important antecedent of effective change. Finally, we point out that SDT and MI have had much in common for each has emphasized autonomy. However, a recent MI article seems to have changed MI's emphasis from autonomy to change talk as the key ingredient for change. We suggest that change talk is likely to be an element of effective change only to the degree that the change talk is autonomously enacted and that practitioners facilitate change talk in an autonomy supportive way.
Deci Edward L
Full Text Available Abstract The papers of this special issue have the dual focus of reviewing research, especially clinical trials, testing self-determination theory (SDT and of discussing the relations between SDT and motivational interviewing (MI. Notably, trials are reviewed that examined interventions either for behaviors such as physical activity and smoking cessation, or for outcomes such as weight loss. Although interventions were based on and intended to test the SDT health-behavior-change model, authors also pointed out that they drew techniques from MI in developing the interventions. The current paper refers to these studies and also clarifies the meaning of autonomy, which is central to SDT and has been shown to be important for effective change. We clarify that the dimension of autonomy versus control is conceptually orthogonal to the dimension of independence versus dependence, and we emphasize that autonomy or volition, not independence, is the important antecedent of effective change. Finally, we point out that SDT and MI have had much in common for each has emphasized autonomy. However, a recent MI article seems to have changed MI's emphasis from autonomy to change talk as the key ingredient for change. We suggest that change talk is likely to be an element of effective change only to the degree that the change talk is autonomously enacted and that practitioners facilitate change talk in an autonomy supportive way.
Sheridan, Nicolette F; Kenealy, Timothy W; Connolly, Martin J; Mahony, Faith; Barber, P Alan; Boyd, Mary Anne; Carswell, Peter; Clinton, Janet; Devlin, Gerard; Doughty, Robert; Dyall, Lorna; Kerse, Ngaire; Kolbe, John; Lawrenson, Ross; Moffitt, Allan
In all countries people experience different social circumstances that result in avoidable differences in health. In New Zealand, Māori, Pacific peoples, and those with lower socioeconomic status experience higher levels of chronic illness, which is the leading cause of mortality, morbidity and inequitable health outcomes. Whilst the health system can enable a fairer distribution of good health, limited national data is available to measure health equity. Therefore, we sought to find out whether health services in New Zealand were equitable by measuring the level of development of components of chronic care management systems across district health boards. Variation in provision by geography, condition or ethnicity can be interpreted as inequitable. A national survey of district health boards (DHBs) was undertaken on macro approaches to chronic condition management with detail on cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke and diabetes. Additional data from expert informant interviews on program reach and the cultural needs of Māori and Pacific peoples was sought. Survey data were analyzed on dimensions of health equity relevant to strategic planning and program delivery. Results are presented as descriptive statistics and free text. Interviews were transcribed and NVivo 8 software supported a general inductive approach to identify common themes. Survey responses were received from the majority of DHBs (15/21), some PHOs (21/84) and 31 expert informants. Measuring, monitoring and targeting equity is not systematically undertaken. The Health Equity Assessment Tool is used in strategic planning but not in decisions about implementing or monitoring disease programs. Variable implementation of evidence-based practices in disease management and multiple funding streams made program implementation difficult. Equity for Māori is embedded in policy, this is not so for other ethnic groups or by geography. Populations
Full Text Available Abstract Introduction In all countries people experience different social circumstances that result in avoidable differences in health. In New Zealand, Māori, Pacific peoples, and those with lower socioeconomic status experience higher levels of chronic illness, which is the leading cause of mortality, morbidity and inequitable health outcomes. Whilst the health system can enable a fairer distribution of good health, limited national data is available to measure health equity. Therefore, we sought to find out whether health services in New Zealand were equitable by measuring the level of development of components of chronic care management systems across district health boards. Variation in provision by geography, condition or ethnicity can be interpreted as inequitable. Methods A national survey of district health boards (DHBs was undertaken on macro approaches to chronic condition management with detail on cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke and diabetes. Additional data from expert informant interviews on program reach and the cultural needs of Māori and Pacific peoples was sought. Survey data were analyzed on dimensions of health equity relevant to strategic planning and program delivery. Results are presented as descriptive statistics and free text. Interviews were transcribed and NVivo 8 software supported a general inductive approach to identify common themes. Results Survey responses were received from the majority of DHBs (15/21, some PHOs (21/84 and 31 expert informants. Measuring, monitoring and targeting equity is not systematically undertaken. The Health Equity Assessment Tool is used in strategic planning but not in decisions about implementing or monitoring disease programs. Variable implementation of evidence-based practices in disease management and multiple funding streams made program implementation difficult. Equity for Māori is embedded in policy, this is not so
Koenen, K C; Ratanatharathorn, A; Ng, L; McLaughlin, K A; Bromet, E J; Stein, D J; Karam, E G; Meron Ruscio, A; Benjet, C; Scott, K; Atwoli, L; Petukhova, M; Lim, C C W; Aguilar-Gaxiola, S; Al-Hamzawi, A; Alonso, J; Bunting, B; Ciutan, M; de Girolamo, G; Degenhardt, L; Gureje, O; Haro, J M; Huang, Y; Kawakami, N; Lee, S; Navarro-Mateu, F; Pennell, B-E; Piazza, M; Sampson, N; Ten Have, M; Torres, Y; Viana, M C; Williams, D; Xavier, M; Kessler, R C
Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking. Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics. The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed. PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.
Williams, R R; Stegens, N L; Goldsmith, J R
From the Third National Cancer Survey (TNCS) Interview Study of 7,518 incident cases, lifetime histories of occupations and industries were studied for associations with specific cancer sites and types while controlling for age, sex, race, education, use of cigarettes or alcohol, and geographic location. Lung cancer patients were found more often than expected among several categories including trucking, air transportation, wholesaling, painting, building construction, building maintenance, and manufacturing (furniture, transportation equipment, and food products). Controlling for cigarette smoking did not change these associations. Leukemia and multiple myeloma were associated with sales personnel of both sexes, whereas lymphomas and Hodgkin's disease were excessive among women working in the medical industry. Other associations included rectal cancer with several retail industries; prostate cancer with ministers, farmers, plumbers, and coal miners; malignant melanoma with school teachers; and invasive cervical cancer with women working in hotels and restaurants. Breast cancer patients were more common among women who were teachers or other professionals and who worked in business and finance (even after controlling for education). Many other findings are presented in detailed tables. Results are reported mainly as a research resource for use by other investigators doing work in this field. Suggestions are given for future studies.
Bercovitz, Anita; Moss, Abigail J; Sengupta, Manisha; Harris-Kojetin, Lauren D; Squillace, Marie R; Emily, Rosenoff; Branden, Laura
This report provides an overview of the National Home Health Aide Survey (NHHAS), the first national probability survey of home health aides. NHHAS was designed to provide national estimates of home health aides who provided assistance in activities of daily living (ADLs) and were directly employed by agencies that provide home health and/or hospice care. This report discusses the need for and objectives of the survey, the design process, the survey methods, and data availability. METHODS NHHAS, a multistage probability sample survey, was conducted as a supplement to the 2007 National Home and Hospice Care Survey (NHHCS). Agencies providing home health and/or hospice care were sampled, and then aides employed by these agencies were sampled and interviewed by telephone. Survey topics included recruitment, training, job history, family life, client relations, work-related injuries, and demographics. NHHAS was virtually identical to the 2004 National Nursing Assistant Survey of certified nursing assistants employed in sampled nursing homes with minor changes to account for differences in workplace environment and responsibilities. RESULTS From September 2007 to April 2008, interviews were completed with 3,416 aides. A public-use data file that contains the interview responses, sampling weights, and design variables is available. The NHHAS overall response rate weighted by the inverse of the probability of selection was 41 percent. This rate is the product of the weighted first-stage agency response rate of 57 percent (i.e., weighted response rate of 59 percent for agency participation in NHHCS times the weighted response rate of 97 percent for agencies participating in NHHCS that also participated in NHHAS) and the weighted second-stage aide response rate of 72 percent to NHHAS.
Santin, G; Bénézet, L; Geoffroy-Perez, B; Bouyer, J; Guéguen, A
The decline in participation rates in surveys, including epidemiological surveillance surveys, has become a real concern since it may increase nonresponse bias. The aim of this study is to estimate the contribution of a complementary survey among a subsample of nonrespondents, and the additional contribution of paradata in correcting for nonresponse bias in an occupational health surveillance survey. In 2010, 10,000 workers were randomly selected and sent a postal questionnaire. Sociodemographic data were available for the whole sample. After data collection of the questionnaires, a complementary survey among a random subsample of 500 nonrespondents was performed using a questionnaire administered by an interviewer. Paradata were collected for the complete subsample of the complementary survey. Nonresponse bias in the initial sample and in the combined samples were assessed using variables from administrative databases available for the whole sample, not subject to differential measurement errors. Corrected prevalences by reweighting technique were estimated by first using the initial survey alone and then the initial and complementary surveys combined, under several assumptions regarding the missing data process. Results were compared by computing relative errors. The response rates of the initial and complementary surveys were 23.6% and 62.6%, respectively. For the initial and the combined surveys, the relative errors decreased after correction for nonresponse on sociodemographic variables. For the combined surveys without paradata, relative errors decreased compared with the initial survey. The contribution of the paradata was weak. When a complex descriptive survey has a low response rate, a short complementary survey among nonrespondents with a protocol which aims to maximize the response rates, is useful. The contribution of sociodemographic variables in correcting for nonresponse bias is important whereas the additional contribution of paradata in
U.S. Department of Health & Human Services — The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in...
Full Text Available The extension of universal health service insurance to national populations is a relatively new phenomenon. Since 1995, the Israeli National Health Insurance Law (NHIL has provided universal health services to every resident, but the effect of this law on health and health services among minorities has not been examined sufficiently. The goals of this study were to track some of the first changes engendered by the NHIL among the Negev Bedouin Arabs to examine the effects of universal health care services. Methods included analysis of historical and health policy documents, three field appraisals of health care services (1994, 1995, 1999, a region-wide interview survey of Negev Bedouins (1997, and key informant interviews. For the interview survey, a sample of 515 households was chosen from different Bedouin localities representing major sedentarization stages. Results showed that prior to the NHIL, a substantial proportion of the Negev Bedouins were uninsured with limited, locally available health service. Since 1995, health services, particularly primary care clinics and health manpower, have dramatically expanded. The initial expansion appears to have been a marketing ploy, but real improvements have occurred. There was a high level of health service utilization among the Bedouins in the Negev, especially private medical services, hospitals, and night ambulatory medical services. The NHIL brought change to the structure of health services in Israel, namely the institution of a national health system based on proportional allocation of resources (based on size and age and open competition in the provision of quality health care. The expansion of the pool of potential members engendered by the new universal coverage had profound effects on the Health Funds' attitudes towards Negev Bedouins. In addition, real consumer choice was introduced for the first time. Although all the health care needs of this rapidly growing population have yet to be met
Andersen, Anne-Marie Nybo; Olsen, Jørn
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...... through computer-assisted telephone interviews. The authors compared interviewer characteristics for 34 interviewers with the responses they obtained in 12,910 interviews carried out for the Danish National Birth Cohort Study. Response data on smoking and alcohol consumption in the first trimester...... 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...
Karen S. Ingersoll
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.
Lenihan, I. M.A. [Western Regional Hospital Board, Glasgow (United Kingdom); Smith, H. [University of Glasgow, Glasgow (United Kingdom)
The technique of activation analysis has useful and distinctive applications, not yet fully recognized or exploited, in public health. Three areas of usefulness may be recognized. 1. Industrial hygiene. Activation analysis offers a simple and efficient method for assessing and controlling occupational hazards associated with the handling of toxic materials, such as compounds of arsenic and of mercury. Examination of hair and nail samples, taken at six-monthly intervals, will yield a surprising amount of information regarding the influence on occupational exposure of individual variation in working habits, and inadequacy or non-observance of hygienic rules and other prescribed safety measures. 2. Epidemiology. The advantage conferred by activation analysis lies in the possibility of rapid and accurate estimation of trace element concentrations in small samples of tissue or other materials, such as can readily be obtained from population groups large enough to be statistically significant. Surveys of this kind have interesting potentialities in relation to dental caries, cancer, cirrhosis of the liver and heart disease. 3. Recognition of essential trace elements. Surveys of trace element concentrations suggest that the variability of tissue levels among members of a population is smaller for essential trace elements than for non-essential elements. It is possible also that tissue levels show a normal distribution for essential elements and a log-normal distribution for non-essential elements. (author)
Kessler, Ronald C; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Benjet, Corina; Bromet, Evelyn J; Cardoso, Graça; Degenhardt, Louisa; de Girolamo, Giovanni; Dinolova, Rumyana V; Ferry, Finola; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Huang, Yueqin; Karam, Elie G; Kawakami, Norito; Lee, Sing; Lepine, Jean-Pierre; Levinson, Daphna; Navarro-Mateu, Fernando; Pennell, Beth-Ellen; Piazza, Marina; Posada-Villa, José; Scott, Kate M; Stein, Dan J; Ten Have, Margreet; Torres, Yolanda; Viana, Maria Carmen; Petukhova, Maria V; Sampson, Nancy A; Zaslavsky, Alan M; Koenen, Karestan C
Background : Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their 'worst.' Objective : To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD. Method : WMH Surveys in 24 countries (n = 68,894) assessed 29 lifetime traumas and evaluated PTSD twice for each respondent: once for the 'worst' lifetime trauma and separately for a randomly-selected trauma with weighting to adjust for individual differences in trauma exposures. PTSD onset-persistence was evaluated with the WHO Composite International Diagnostic Interview. Results : In total, 70.4% of respondents experienced lifetime traumas, with exposure averaging 3.2 traumas per capita. Substantial between-trauma differences were found in PTSD onset but less in persistence. Traumas involving interpersonal violence had highest risk. Burden of PTSD, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, was 77.7 person-years/100 respondents. The trauma types with highest proportions of this burden were rape (13.1%), other sexual assault (15.1%), being stalked (9.8%), and unexpected death of a loved one (11.6%). The first three of these four represent relatively uncommon traumas with high PTSD risk and the last a very common trauma with low PTSD risk. The broad category of intimate partner sexual violence accounted for nearly 42.7% of all person-years with PTSD. Prior trauma history predicted both future trauma exposure and future PTSD risk. Conclusions : Trauma exposure is common throughout the world, unequally distributed, and differential across trauma types with respect to PTSD risk. Although a substantial minority of PTSD cases remits
Poirier, Maria K; Clark, Matthew M; Cerhan, Jane H; Pruthi, Sandhya; Geda, Yonas E; Dale, Lowell C
To examine the effectiveness of motivational interviewing training on improving medical students' knowledge of and confidence in their ability to counsel patients regarding health behavior change. In the spring of 2002, 42 first-year medical students participated in a counseling course on health behavior change. Three small groups focused on learning and practicing motivational interviewing techniques using brief lectures, interactive class activities, student role-plays, and simulated patients. Students completed an identical precourse and postcourse questionnaire that measured their confidence and knowledge regarding counseling skills in health behavior change. The medical students reported improved confidence in their understanding of motivational interviewing after participation in the course (very confident, 77%) compared with before the course (very confident, 2%). Each of the 8 confidence items were compared before and after the course using a signed rank test. All comparisons indicated a significant improvement (P improvement; 31% of students answered all the questions correctly before the course, and 56% answered all the questions correctly after the course (P = .004). These results show that teaching motivational interviewing techniques to first-year medical students can enhance student confidence in and knowledge of providing counseling to patients regarding health behavior change.
Neergaard, Mette Asbjørn; Olesen, Frede; Jensen, Anders Bonde
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...
Donald Elisburg has spent his career advocating on behalf of workers. Trained as a labor lawyer, Mr. Elisburg has legal, legislative, policy development, and executive management experience in the fields of labor standards, workers' compensation, environmental and occupational safety and health, wages and hours, and employment and training. In the interview, Elisburg shares his insights on how to move a bureaucracy to advance worker health and safety and workers' rights.
Beydoun, Hind A.; Beydoun, May A.; Jeng, Hueiwang Anna; Zonderman, Alan B.; Eid, Shaker M.
Study Objectives: To evaluate bisphenol-A (BPA) level and its relationship to sleep adequacy in a nationally representative sample of U.S. adults. Methods: A population-based cross-sectional study was conducted using 2005–2010 National Health and Nutrition Examination Survey whereby data were collected using in-person interviews, physical examination and laboratory testing. BPA level was measured in urine samples and analyzed as loge-transformed variable and in quartiles ( 8 h); (Bisphenol-A and sleep adequacy among adults in the National Health and Nutrition Examination Surveys. SLEEP 2016;39(2):467–476. PMID:26446109
Ben-Ezra, Menachem; Palgi, Yuval; Aviel, Or; Dubiner, Yonit; Evelyn Baruch; Soffer, Yechiel; Shrira, Amit
Collecting mental health data during disaster is a difficult task. The aim of this study was to compare reported sensitive information regarding the disaster and general questions on physical or psychological functioning between social network (Facebook) interview and face-to-face interview after the 2011 Fukushima nuclear disaster. Data were collected from a battery of self-reported questionnaires. The questionnaires were administered to 133 face-to-face participants and to 40 Facebook interviewees, during March-April 2011. The face-to-face interview group showed a significantly higher level of posttraumatic stress disorder (PTSD) symptoms and elevated risk for clinical level of PTSD and reported more worries about another disaster, lower life satisfaction, less perceived social support and lower self-rated health than the Facebook group. Our data may suggest that the reliability of internet surveys is jeopardized during extreme conditions such as large-scale disasters as it tends to underestimate the reactions to such events. This indicates the discrepancy from data collected in situ to data collected using social networks. The implications of these results are discussed. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Carlos, E A Coimbra
The current configuration of indigenous peoples' health in Brazil results from a complex historical trajectory, responsible for major delays for this population segment in the countrywide social advances seen in recent decades, particularly in the fields of health, education, housing, and sanitation. The main focus of this contribution is to review synthetically a selection of the main results of the First National Survey of Indigenous People's Health and Nutrition, conducted in the period 2008-2009, which visited 113 villages across the Brazil and interviewed 6,692 women and 6,128 children. Among the results, emphasis is given to the observed poor sanitation conditions in villages, high prevalence of chronic malnutrition, anemia, diarrhea, and acute respiratory infections in children, and the emergence of non-communicable chronic diseases in women. The scenario depicted by this survey requires urgent critical review of indigenous health policy in order to better meet the health needs of Brazil's indigenous population.
Trotman, Gylynthia E; Mackey, Eleanor; Tefera, Eshetu; Gomez-Lobo, Veronica
To explore parental and adolescent views on the confidential interview in the gynecologic setting and compare adolescent reported risk-taking behaviors with parental perception. Anonymous surveys were administered separately to parents/guardians and adolescents between the ages of 11-17. Information pertaining to the patient's Tanner stage and reason for visit was obtained from the provider. This first phase served as the usual care group. In the second phase of the study, surveys were once again distributed after a brief educational intervention. Linear regression analysis, Wilcoxon rank sum test, and Fisher exact test were used where appropriate. Pediatric and Adolescent Gynecology clinics in two tertiary hospitals INTERVENTION: Brief educational handout on key concepts of the confidential interview MAIN OUTCOME MEASURES: Parental perception of the confidential interview and adolescent risk- taking behaviors RESULTS: A total of 248 surveys were included in the final analysis, which accounts for 62 adolescent and parent/guardian pairs in each group. The majority of parents and adolescents reported perceived benefit to the confidential interview. However, parents were less likely to rate benefits of private time specifically for their own adolescent and less than half of parents believed that adolescents should have access to private time in the gynecologic setting. Both parents/guardians and adolescents feared that the confidential interview would limit the parent's ability to take part in decision-making. The low support for confidential time for their adolescent was not different in the usual care group as compared to the intervention group, although there was a trend toward parental acceptance with increased adolescent age. Adolescents were consistently more likely to report more risk-taking behaviors than their parents perceived. There is a discord between parental perception and adolescent reports of risk taking behaviors. This is coupled with a lack of
Boice, J.D. Jr.; Mandel, J.S.; Doody, M.M.; Yoder, R.C.; McGowan, R.
A health survey of more than 143,000 radiologic technologists is described. The population was identified from the 1982 computerized files of the American Registry of Radiologic Technologists, which was established in 1926. Inactive members were traced to obtain current addresses or death notifications. More than 6000 technologists were reported to have died. For all registrants who were alive when located, a detailed 16-page questionnaire was sent, covering occupational histories, medical conditions, and other personal and lifestyle characteristics. Nonrespondents were contacted by telephone to complete an abbreviated questionnaire. More than 104,000 responses were obtained. Most technologists were female (76%), white (93%), and employed for an average of 12 years; 37% attended college, and approximately 50% never smoked cigarettes. Radiation exposure information was sought from employer records and commercial dosimetry companies. Technologists employed for the longest times had the highest estimated cumulative exposures, with approximately 9% with exposures greater than 5 cGy. There was a high correlation between cumulative occupational exposure and personal exposure to medical radiographs, related, in part, to the association of both factors with attained age. It is interesting that 10% of all technologists allowed others to practice taking radiographs on them during their training. Nearly 4% of the respondents reported having some type of cancer, mainly of the skin (1517), breast (665), and cervix (726). Prospective surveys will monitor cancer mortality rates through use of the National Death Index and cancer incidence through periodic mailings of questionnaires. This is the only occupational study of radiation employees who are primarily women and should provide new information on the possible risks associated with relatively low levels of exposure
Link, Michael W; Battaglia, Michael P; Frankel, Martin R; Osborn, Larry; Mokdad, Ali H
Use of random-digit dialing (RDD) for conducting health surveys is increasingly problematic because of declining participation rates and eroding frame coverage. Alternative survey modes and sampling frames may improve response rates and increase the validity of survey estimates. In a 2005 pilot study conducted in six states as part of the Behavioral Risk Factor Surveillance System, the authors administered a mail survey to selected household members sampled from addresses in a US Postal Service database. The authors compared estimates based on data from the completed mail surveys (n = 3,010) with those from the Behavioral Risk Factor Surveillance System telephone surveys (n = 18,780). The mail survey data appeared reasonably complete, and estimates based on data from the two survey modes were largely equivalent. Differences found, such as differences in the estimated prevalences of binge drinking (mail = 20.3%, telephone = 13.1%) or behaviors linked to human immunodeficiency virus transmission (mail = 7.1%, telephone = 4.2%), were consistent with previous research showing that, for questions about sensitive behaviors, self-administered surveys generally produce higher estimates than interviewer-administered surveys. The mail survey also provided access to cell-phone-only households and households without telephones, which cannot be reached by means of standard RDD surveys.
Giacomini, Mita; Hurley, Jeremiah; DeJean, Deirdre
To investigate how participants in an economic resource allocation survey construct notions of fairness. Qualitative interview study guided by interpretive grounded theory methods. Qualitative interviews were conducted with volunteer university- (n=39) and community-based (n =7) economic survey participants. INTERVENTION OR MAIN VARIABLES STUDIED: We explored how participants constructed meanings to guide or explain fair survey choices, focusing on rationales, imagery and additional desired information not provided in the survey scenarios. Data were transcribed and coded into qualitative categories. Analysis iterated with data collection iterated through three waves of interviews. Participants compared the survey dilemmas to domains outside the health system. Most compared them with other micro-level, inter-personal sharing tasks. Participants raised several fairness-relevant factors beyond need or capacity to benefit. These included age, weight, poverty, access to other options and personal responsibility for illness; illness duration, curability or seriousness; life expectancy; possibilities for sharing; awareness of other's needs; and ability to explain allocations to those affected. They also articulated a fairness principle little considered by equity theories: that everybody must get something and nobody should get nothing. Lay criteria for judging fairness are myriad. Simple scenarios may be used to investigate lay commitments to abstract principles. Although principles are the focus of analysis and inference, participants may solve simplified dilemmas by imputing extraneous features to the problem or applying unanticipated principles. These possibilities should be taken into account in the design of resource allocation surveys eliciting the views of the public. © 2012 John Wiley & Sons Ltd.
Ghandour, Reem M; Jones, Jessica R; Lebrun-Harris, Lydie A; Minnaert, Jessica; Blumberg, Stephen J; Fields, Jason; Bethell, Christina; Kogan, Michael D
Introduction Since 2001, the Health Resources and Services Administration's Maternal and Child Health Bureau (HRSA MCHB) has funded and directed the National Survey of Children's Health (NSCH) and the National Survey of Children with Special Health Care Needs (NS-CSHCN), unique sources of national and state-level data on child health and health care. Between 2012 and 2015, HRSA MCHB redesigned the surveys, combining content into a single survey, and shifting from a periodic interviewer-assisted telephone survey to an annual self-administered web/paper-based survey utilizing an address-based sampling frame. Methods The U.S. Census Bureau fielded the redesigned NSCH using a random sample of addresses drawn from the Census Master Address File, supplemented with a unique administrative flag to identify households most likely to include children. Data were collected June 2016-February 2017 using a multi-mode design, encouraging web-based responses while allowing for paper mail-in responses. A parent/caregiver knowledgeable about the child's health completed an age-appropriate questionnaire. Experiments on incentives, branding, and contact strategies were conducted. Results Data were released in September 2017. The final sample size was 50,212 children; the overall weighted response rate was 40.7%. Comparison of 2016 estimates to those from previous survey iterations are not appropriate due to sampling and mode changes. Discussion The NSCH remains an invaluable data source for key measures of child health and attendant health care system, family, and community factors. The redesigned survey extended the utility of this resource while seeking a balance between previous strengths and innovations now possible.
Abraham, Traci H; Koenig, Christopher J; Zamora, Kara; Hill, Coleen; Uddo, Madeline; Kelly, Adam P; Hamilton, Michelle F; Curran, Geoffrey M; Pyne, Jeffrey M; Seal, Karen H
Most chronic illness management occurs outside clinics and hospitals, in the everyday lives of individuals. We use data from semi-structured interviews with 37 veterans from Southeastern Louisiana and Northern California to illustrate how "health work" for mental health concerns are shaped by place. Using health work as an orienting concept for analysis, we discerned variation between the two study sites in how Veterans used interacting with the natural environment, cultivating time alone, and religious practice to manage their mental health and well-being. Through these findings, we advocate for a situated notion of health work that is mindful of how health-related behaviors are shaped by place and the attributes that constitute place. Published by Elsevier Ltd.
Borup, Ina K.
Public health, health promotion, empowerment, experiental learning, HBSC, health survey, qualitative interviews, grounded theory, school children, adolescents, health dialogue, school health nurse......Public health, health promotion, empowerment, experiental learning, HBSC, health survey, qualitative interviews, grounded theory, school children, adolescents, health dialogue, school health nurse...
U.S. Department of Health & Human Services — A list of VHA hospitals with inpatient experience of care survey data. The VA SHEP uses the same questions as the Hospital Consumer Assessment of Health Providers...
Sirio Rossano Secondo Cividino
Full Text Available The work in the agricultural sector has taken on a fundamental role in the last decades, due to the still too high rate of fatal injuries, workplace accidents, and dangerous occurrences reported each year. The average old age of agricultural machinery is one of the main issues at stake in Italy. Numerous safety problems stem from that; therefore, two surveys were conducted in two different periods, on current levels of work safety in agriculture in relation to agricultural machinery’s age and efficiency, and to show the levels of actual implementation of the Italian legislation on safety and health at work in the agricultural sector. The surveys were carried out, considering a sample of 161 farms located in the region Friuli Venezia Giulia (North-East of Italy. The research highlights the most significant difficulties the sample of farms considered have in enforcing the law. One hand, sanitary surveillance and workers’ information and training represent the main deficiencies and weakest points in family farms. Moreover, family farms do not generally provide the proper documentation concerning health and safety at workplaces, when they award the contract to other companies. On the other hand, lack of maintenance program for machinery and equipment, and of emergency plans and participation of workers’ health and safety representative, are the most common issues in farms with employees. Several difficulties are also evident in planning workers’ training programs. Furthermore, the company physician’s task is often limited to medical controls, so that he is not involved in risk assessment and training. Interviews in heterogeneous samples of farms have shown meaningful outcomes, which have subsequently been used to implement new databases and guidelines for Health and Safety Experts and courses in the field of Work Safety in agriculture. In conclusion, although the legislation making training courses for tractor operators and tractor
Xie, Yan-ming; Liao, Xing
It is not finally concluded how to standardize the use of qualitative research in the world. Qualitative researchers disagree with each other about this issue. As we know, there have been a large number of articles written in different ways about qualitative research due to the "flexibility", one of its features. Qualitative research is quite different from quantitative research which is easy to control its quality and quality assessment. A series of criteria has been set up for quantitative research. However qualitative research needs to be improved in these aspects, in which qualitative interviews are mostly used at home and abroad at present. Hence, it becomes an important and urgent issue for qualitative researchers to standardly control and assess the quality of qualitative interview.
Oakley Browne, Mark A; Wells, J Elisabeth; McGee, Magnus A
To estimate the 12 month and lifetime use of health services for mental health problems. A nationwide face-to-face household survey carried out in 2003-2004. A fully structured diagnostic interview, the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) was used. There were 12 992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper, the outcomes reported are 12 month and lifetime health service use for mental health and substance use problems. Of the population, 13.4% had a visit for a mental health reason in the 12 months before interview. Of all 12 month cases of mental disorder, 38.9% had a mental health visit to a health or non-health-care provider in the past 12 months. Of these 12 month cases, 16.4% had contact with a mental health specialist, 28.3% with a general medical provider, 4.8% within the human services sector and 6.9% with a complementary or alternative medicine practitioner. Most people with lifetime disorders eventually made contact if their disorder continued. However, the percentages seeking help at the age of onset were small for most disorders and several disorders had large percentages who never sought help. The median duration of delay until contact varies from 1 year for major depressive disorder to 38 years for specific phobias. A significant unmet need for treatment for people with mental disorder exists in the New Zealand community, as in other comparable countries.
Schatz, Bruce R
At the core of the healthcare crisis is fundamental lack of actionable data. Such data could stratify individuals within populations to predict which persons have which outcomes. If baselines existed for all variations of all conditions, then managing health could be improved by matching the measuring of individuals to their cohort in the population. The scale required for complete baselines involves effective National Surveys of Population Health (NSPH). Traditionally, these have been focused upon acute medicine, measuring people to contain the spread of epidemics. In recent decades, the focus has moved to chronic conditions as well, which require smaller measures over longer times. NSPH have long utilized quality of life questionnaires. Mobile Health Monitors, where computing technologies eliminate manual administration, provide richer data sets for health measurement. Older technologies of telephone interviews will be replaced by newer technologies of smartphone sensors to provide deeper individual measures at more frequent timings across larger-sized populations. Such continuous data can provide personal health records, supporting treatment guidelines specialized for population cohorts. Evidence-based medicine will become feasible by leveraging hundreds of millions of persons carrying mobile devices interacting with Internet-scale services for Big Data Analytics.
Stadnick, Nicole; Chlebowski, Colby; Baker-Ericzén, Mary; Dyson, Margaret; Garland, Ann; Brookman-Frazee, Lauren
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…
Alime Selcuk Tosun
Full Text Available Precautions taken in early stages of diabetes mellitus are more beneficial in terms of quality of life. The risk of Type 2 diabetes mellitus has been shown to be reduced at rates up to 58% or its emergence may be delayed with healthy lifestyle changes in different studies. Transtheoretical model and motivational interview method are especially used to increase the adaptation of individuals to disease management and to change behaviours about diabetes mellitus for decreasing or preventing the harmful effects of diabetes mellitus in studies conducted with individuals with Type 2 diabetes mellitus. Interventions using motivational interview method based on transtheoretical model demonstrated that a general improvement in glycaemic control and in physical activity level can be achieved and significant progress has been made during the stage of change. Motivational interview method based on transtheoretical model is an easy and efficient counselling method to reach behavioural change. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(1: 32-41
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
Laursen, Jannie; Broholm, Malene; Rosenberg, Jacob
Health professionals must often balance between different rationalities within the hospital organisation. Having adequate time with patients, shorter waiting time and the ability to greater professional autonomy have been shown to help provide a higher quality of care. Empathy and sympathy appear to be crucial components for the health professionals and their relationship to patients. The aim of this study was to explore health professionals' experiences of relatives to critically ill patients in order to identify aspects that may facilitate a better understanding of this teamwork. 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. Two themes emerged from the interviews: the hospital culture does not integrate relatives, and health professionals felt that relatives took their resources and saw them as an obstacle in their daily work. Health professionals felt divided between the system and the individual sphere, which makes it difficult for them to integrate relatives more and see them as participants in a natural teamwork for the benefit of the patient. © 2016 Nordic College of Caring Science.
The 2014 survey includes degrees granted between September 1, 2013 and August 31, 2014. Enrollment information refers to the fall term 2014. Twenty-two academic programs were included in the survey universe, with all 22 programs providing data. Since 2009, data for two health physics programs located in engineering departments are also included in the nuclear engineering survey. The enrollments and degrees data includes students majoring in health physics or in an option program equivalent to a major.
Savinainen, Minna; Oksa, Panu
In Finland, workplace surveys are used to identify and assess health risks and problems caused by work and make suggestions for continuous improvement of the work environment. With the aid of the workplace survey, occupational health services can be tailored to a company. The aims of this study were to determine how occupational health professionals gather data via the workplace survey and the effect survey results have on companies. A total of 259 occupational health nurses and 108 occupational health physicians responded to the questionnaire: 84.2% were women and 15.8% were men. The mean age of the respondents was 48.8 years (range, 26 to 65 years). Usually occupational health nurses and foremen and sometimes occupational health physicians and occupational safety and health representatives initiate the workplace survey. More than 90% of the surveys were followed by action proposals, and about 50% of these were implemented. The proposals implemented most often concerned personal protective equipment and less often leadership. Survey respondents should have both the opportunity and the authority to affect resources, the work environment, work arrangements, and tools. Teamwork among occupational health and safety professionals, management, and employees is vital for cost-effectively solving today's complex problems at workplaces around the globe. Copyright 2011, SLACK Incorporated.
Rosenberg, Charles; Mantovani, Rafael
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.
Ackatz Lori E
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
Kun, Karen E.; Kassim, Anisa; Howze, Elizabeth; MacDonald, Goldie
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…
Buus, Niels; Delgado, Cynthia; Traynor, Michael; Gonge, Henrik
This present study is a report of an interview study exploring personal views on participating in group clinical supervision among mental health nursing staff members who do not participate in supervision. There is a paucity of empirical research on resistance to supervision, which has traditionally been theorized as a supervisee's maladaptive coping with anxiety in the supervision process. The aim of the present study was to examine resistance to group clinical supervision by interviewing nurses who did not participate in supervision. In 2015, we conducted semistructured interviews with 24 Danish mental health nursing staff members who had been observed not to participate in supervision in two periods of 3 months. Interviews were audio-recorded and subjected to discourse analysis. We constructed two discursive positions taken by the informants: (i) 'forced non-participation', where an informant was in favour of supervision, but presented practical reasons for not participating; and (ii) 'deliberate rejection', where an informant intentionally chose to not to participate in supervision. Furthermore, we described two typical themes drawn upon by informants in their positioning: 'difficulties related to participating in supervision' and 'limited need for and benefits from supervision'. The findings indicated that group clinical supervision extended a space for group discussion that generated or accentuated anxiety because of already-existing conflicts and a fundamental lack of trust between group members. Many informants perceived group clinical supervision as an unacceptable intrusion, which could indicate a need for developing more acceptable types of post-registration clinical education and reflective practice for this group. © 2017 Australian College of Mental Health Nurses Inc.
Raunsbæk Knudsen, Line; Thurah, Annette De; Lomborg, Kirsten
the patients' different needs, wishes and abilities to take part in tele-health follow-up. Our findings reveal a need for more insight into how tele-health follow-up could be integrated in routine clinical practice, paying special attention to how reluctant patients may be supported.......: 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...
de Azevedo Marques, João Mazzoncini; Zuardi, Antonio W
To evaluate the validity and applicability of the Mini International Neuropsychiatric Interview (MINI) used by family medicine residents in primary health care (PHC) in Brazil. Training for administrating the MINI was given as part of a broad psychiatry education program. Interviews were held with 120 PHC patients who were at least 15 years old. MINI was administered by 25 resident physicians, while the Structured Clinical Interview for Diagnosis (SCID) was administered by a psychiatrist blind to patients' results on the MINI, and the diagnoses on both interviews were compared. The resident physicians answered questions on the applicability of the MINI. Concordance levels for any mental disorder, the broader current diagnostic categories and the most common specific diagnoses were analyzed. Kappa coefficients ranged between 0.65 and 0.85; sensitivity, between 0.75 and 0.92; specificity, between 0.90 and 0.99; positive predictive values (PPV), between 0.60 and 0.86; negative predictive values (NPV), between 0.92 and 0.99; and accuracy, between 0.88 and 0.98. The resident physicians considered MINI comprehensibility and clinical relevance satisfactory. These good psychometric results in a real-world setting may be related to a special training program, which is more frequent, intensive and diversified. In these conditions, the MINI is a useful tool for general practitioners.
Stansfeld, Stephen Alfred; Rasul, F R; Head, J; Singleton, N
To measure the prevalence of common mental disorder (CMD) by occupation in a representative sample of Great Britain and to identify occupations with increased and decreased risk of CMD. A cross-sectional interview-based survey was carried out including 5,497 working male and female respondents, 16-64 years from a stratified random survey of private households in Britain. Occupations were classified by the Standard Occupational Classification (SOC) into four groups: major, sub-major, minor and constituent unit groups. Common Mental Disorder was measured by the Revised Clinical Interview Schedule. Major SOC groups with higher prevalence of common mental disorder included clerical and secretarial, sales, and personal and protective services whereas craft and related, 'other' professional occupations and plant and machine operatives had lower prevalence compared to 13% overall prevalence in all adults. In sub-major SOC groups managers and administrators, teaching professionals, clerical and secretarial, 'other' sales and personal service occupations had higher prevalence whereas many professional and skilled occupations had lower prevalence. Specific SOC unit groups with higher prevalence included primary and secondary teachers, welfare community, youth workers, security staff, waiters, bar staff, nurse auxiliaries and care assistants. General managers in government and large organizations (OR=2.79, 95% CI 1.41-5.54), managers in transport and storing (OR=2.44, 95% CI 1.18-5.03), buyers and mobile sales persons (OR=2.48, 95% CI 1.09-5.60), sales occupations (NES) (OR=2.78, 95% CI 1.25-6.19) and clerks (NES) (OR=2.71, 95% CI 1.59-4.61) had increased risk of common mental disorder relative to specialist managers adjusting for social and financial factors and physical ill-health. Occupations with higher risk of common mental disorder may be typified by high levels of job demands, especially emotional demands and lack of job security. The reasons why occupations have low
Garbarski, Dana; Dykema, Jennifer; Croes, Kenneth D; Edwards, Dorothy F
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
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
Full Text Available In 2017, Australia celebrates 50 years since the 1967 referendum, when more than 90% of Australians voted to amend the constitution to allow the national government to create laws for Indigenous people and include them in the census. We spoke with the Honourable Ken Wyatt, the Minister for Indigenous Health and the Minister for Aged Care, about what has occurred over the past 50 years in Indigenous health from a political perspective, and what we have learnt to improve health outcomes in the future.
Paula Cristina Brolezi de Sousa
Full Text Available The objective of this study was to compare the completion rates and performance of the Brazilian version of the Oral Health Impact Profile (OHIP14 when applied as an interview or in its original self-reported form. A convenience sample of 74 adult patients was selected in a Dental Clinic (University of Araras, Brazil. One examiner administered the instrument in both formats to participants with an interval of 2 weeks between each administration. Data about dental health condition and socioeconomic status were collected and associated with total OHIP14 scores in both formats using linear regression analyses. No differences were found in the total scores and in each subscale of the OHIP14 according to the form of administration. Higher values of completion were found in the interview format. More severe impacts were recorded in the interview format than in the questionnaire format. Higher values of total OHIP-14 scores in both formats were related to the presence of dental caries. Total OHIP14 scores were not influenced by the method of administration. However, the use of the OHIP14 in the questionnaire format may result in lower completion rates and loss of data.
Long, Sandra; Monsen, Karen A; Pieczkiewicz, David; Wolfson, Julian; Khairat, Saif
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. ©Sandra Long, Karen A. Monsen, David Pieczkiewicz, Julian Wolfson, Saif Khairat. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 12.10.2017.
Andresen, Kristoffer; Laursen, Jannie; Rosenberg, Jacob
Young researchers may experience difficulties when writing scientific articles for publication in biomedical journals. Various methods may facilitate the writing process including outlining the paper before the actual writing and using dictation instead of writing the first draft. The aim of this study was to investigate the experiences and difficulties for young, experienced researchers when writing articles using a detailed outline and dictation of the first draft. We used qualitative focus group interviews and the study was reported according to the COnsolidated criteria for REporting Qualitative research guideline. Participants were sampled from a group of researchers participating in a writing retreat/course. The interviews were recorded on a digital recorder and transcribed. The text was analyzed according to content analysis and coded and condensed into themes and subthemes. Groups of participants were added until data saturation was reached. A total of 14 researchers participated (9 women and 5 men). Their clinical experience was median (range) of 6 (1-11) years since graduation from medical school. Two themes arose during the analyses of the data: "Process guidance with the outline as the map" and "arrival at dictation." The outline was used in the preparation phase leading up to the day of dictation and was used in collaboration with co-authors and supervisors. The participants found it to be a useful tool for preparing the manuscript and dictating their initial first full draft. Experienced young researchers found beneficial effects of using a structured outline to prepare for dictation of scientific articles. The outline was a tool that would develop in close collaboration with co-authors and mentors. With dictation, a full first draft of a manuscript can be produced in a few hours. Participants positively evaluated this structured and reproducible way of producing scientific articles.
Shahnazi, Hossein; Daniali, Seyede Shahrbanoo; Sharifirad, Gholamreza
Background: Due to the importance of health care organizations with significant responsibility for prevention and care, assessment of job satisfaction among health care staff is essential. Quality of health services will be decreased provided they are not satisfied. Materials and Methods: This study was a cross-sectional analysis of health care staff in Khomeinishahr (centers, buildings, and networks) If they had at least 6 months work experience, they could enter the study. Data included a t...
Little is known about the characteristics of US children who are dietary supplement users. We described the prevalence and predictors of and reasons for giving children dietary supplements. The study included children <18 y of age who participated in the Complementary and Alternative Medicine supple...
Ekholm, O; Strandberg-Larsen, K; Christensen, K
To select a simple method for assessing alcohol consumption and to compare how different reference periods and response categories influence the self-reported frequency of binge drinking.......To select a simple method for assessing alcohol consumption and to compare how different reference periods and response categories influence the self-reported frequency of binge drinking....
Huay-Zong Law, MD
Conclusions: This study is the first to demonstrate an association between CTS and migraine headache. Longitudinal and genetic studies with physician verification of migraine headaches and CTS are needed to further define this association.
... annual burden hours requested are 2,177 (see Table 1). There are no Capital Costs, Operating Costs, and/or Maintenance Costs to report. Table 1--Estimates of Annualized Hour Burden Average time Type of... Control Module (CHIS-CCM) 2011. Type of [[Page 2399
Results. 43.5% of the participants were cell-phone nonusers, while 13.8% were predominantly cell-phone users. We found that cell-phone use was inversely associated with hypertension, independent of age, sex, race/ethnicity, smoking, alcohol consumption, education, body mass index (BMI, and physical activity. Compared to cell-phone nonusers, the multivariable odds ratio (95% confidence interval of hypertension was 0.86 (0.75–0.98, P trend = .005 among predominantly cell-phone users. This inverse association between cell-phone use and hypertension was stronger in women, those aged <60 years, whites, and those with BMI <25 kg/m2. Conclusion. We found that cell-phone usage was protectively associated with self-reported hypertension in a nationally representative sample of US adults.
Dietary intake estimates derived from the Multifactor Screener are rough estimates of usual intake of fruits and vegetables, fiber, calcium, servings of dairy, and added sugar. These estimates are not as accurate as those from more detailed methods (e.g., 24-hour recalls).
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
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
Collecting Practice-level Data in a Changing Physician Office-based Ambulatory Care Environment: A Pilot Study Examining the Physician induction interview Component of the National Ambulatory Medical Care Survey.
Halley, Meghan C; Rendle, Katharine A; Gugerty, Brian; Lau, Denys T; Luft, Harold S; Gillespie, Katherine A
Objective This report examines ways to improve National Ambulatory Medical Care Survey (NAMCS) data on practice and physician characteristics in multispecialty group practices. Methods From February to April 2013, the National Center for Health Statistics (NCHS) conducted a pilot study to observe the collection of the NAMCS physician interview information component in a large multispecialty group practice. Nine physicians were randomly sampled using standard NAMCS recruitment procedures; eight were eligible and agreed to participate. Using standard protocols, three field representatives conducted NAMCS physician induction interviews (PIIs) while trained ethnographers observed and audio recorded the interviews. Transcripts and field notes were analyzed to identify recurrent issues in the data collection process. Results The majority of the NAMCS items appeared to have been easily answered by the physician respondents. Among the items that appeared to be difficult to answer, three themes emerged: (a) physician respondents demonstrated an inconsistent understanding of "location" in responding to questions; (b) lack of familiarity with administrative matters made certain questions difficult for physicians to answer; and (c) certain primary care‑oriented questions were not relevant to specialty care providers. Conclusions Some PII survey questions were challenging for physicians in a multispecialty practice setting. Improving the design and administration of NAMCS data collection is part of NCHS' continuous quality improvement process. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
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...
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.
Jun, M; Peterson, R T; Zsidisin, G A
The identification and measurement of service quality are critical factors that are responsible for customer satisfaction. This article identifies 11 attributes that define quality of care and patient satisfaction and reveals various gaps among the patient, physician, and administrator groups in the perceived importance of those dimensions. Managerial implications for patient-focused health care are discussed.
Bean, Melanie K; Biskobing, Diane; Francis, Gary L; Wickham, Edmond
Despite the importance of lifestyle change in disease management and the growing evidence supporting motivational interviewing (MI) as an effective counseling method to promote behavioral change, to date there are few published reports about MI training in graduate medical education. The study aimed to pilot the feasibility and effectiveness of a brief MI training intervention for endocrinology fellows and other providers. We used a pretest/posttest design to evaluate a brief MI training for 5 endocrinology fellows and 9 other providers. All participants completed subjective assessments of perceived confidence and beliefs about behavioral counseling at pretest and posttest. Objective assessment of MI was conducted using fellows' audiotaped patient encounters, which were coded using a validated tool for adherence to MI before and after the training. Paired t tests examined changes in objective and subjective assessments. The training intervention was well received and feasible in the endocrinology setting. At posttest, participants reported increased endorsement of the MI spirit and improved confidence in MI skills. Objective assessment revealed relative improvements in MI skills across several domains. However, most domains, as assessed by a validated tool, did not reach competency level after the training intervention. Although more intensive training may be needed to develop MI competence, the results of our pilot study suggest that brief, targeted MI training has short-term efficacy and is well received by endocrinology fellows and other providers.
Auerbach, R P; Alonso, J; Axinn, W G; Cuijpers, P; Ebert, D D; Green, J G; Hwang, I; Kessler, R C; Liu, H; Mortier, P; Nock, M K; Pinder-Amaker, S; Sampson, N A; Aguilar-Gaxiola, S; Al-Hamzawi, A; Andrade, L H; Benjet, C; Caldas-de-Almeida, J M; Demyttenaere, K; Florescu, S; de Girolamo, G; Gureje, O; Haro, J M; Karam, E G; Kiejna, A; Kovess-Masfety, V; Lee, S; McGrath, J J; O'Neill, S; Pennell, B-E; Scott, K; Ten Have, M; Torres, Y; Zaslavsky, A M; Zarkov, Z; Bruffaerts, R
Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1572) and non-students in the same age range (18-22 years; n = 4178), including non-students who recently left college without graduating (n = 702) based on surveys in 21 countries (four low/lower-middle income, five upper-middle-income, one lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioral and substance disorders were assessed with the Composite International Diagnostic Interview (CIDI). One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders; 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.
Khang, Young-Ho; Cho, Sung-Il; Yang, Seungmi; Lee, Moo-Song
This study examined the socioeconomic differentials for the health and health related behaviors among South Korean middle school students. A nationwide cross-sectional interview survey of 3,449 middle school second-grade students and their parents was conducted using a stratified multi-stage cluster sampling method. The response rate was 93.3%. The socioeconomic position indicators were based on self-reported information from the students and their parents: parental education, father's occupational class, monthly family income, out-of-pocket expenditure for education, housing ownership, educational expectations, educational performance and the perceived economic hardships. The outcome variables that were measured were also based on the self-reported information from the students. The health measures included self-rated health conditions, psychological or mental problems, the feelings of loneliness at school, the overall satisfaction of life and the perceived level of stress. The health related behaviors included were smoking, alcohol drinking, sexual intercourse, violence, bullying and verbal and physical abuse by parents. Socioeconomic differences for the health and health related behaviors were found among the eighth grade boys and girls of South Korea. However, the pattern varied with gender, the socioeconomic position indicators and the outcome measures. The prevalence rates of the overall dissatisfaction with life for both genders differed according to most of the eight socioeconomic position indicators. All the health measures were significantly different according to the perceived economic hardship. However, the socioeconomic differences in the self-rated health conditions and the psychosocial or mental problems were not clear. The students having higher socioeconomic position tended to be a perpetrator of bullying while those students with lower socioeconomic position were more likely to be a victim. The perceived economic hardships predicted the health
Andrade, L. H.; Alonso, J.; Mneimneh, Z.; Wells, J. E.; Al-Hamzawi, A.; Borges, G.; Bromet, E.; Bruffaerts, R.; de Girolamo, G.; de Graaf, R.; Florescu, S.; Gureje, O.; Hinkov, H. R.; Hu, C.; Huang, Y.; Hwang, I.; Jin, R.; Karam, E. G.; Kovess-Masfety, V.; Levinson, D.; Matschinger, H.; O’Neill, S.; Posada-Villa, J.; Sagar, R.; Sampson, N. A.; Sasu, C.; Stein, D.; Takeshima, T.; Viana, M. C.; Xavier, M.; Kessler, R. C.
Background To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders. Methods Data are from the WHO World Mental Health (WMH) Surveys. Representative household samples were interviewed face-to-face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n= 63,678) and analyzed at different levels of clinical severity. Results Among those with a DSM-IV disorder in the past twelve months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. Desire to handle the problem on one’s own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers both to initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment dropout (39.3%) followed by negative experiences with treatment providers (26.9% of respondents with severe disorders). Conclusions Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide. PMID:23931656
Borup, Ina K.
Public health, health promotion, empowerment, experiential learning, health behaviour in school-aged children (HBSC), health survey, qualitative interviews, grounded theory, school children......Public health, health promotion, empowerment, experiential learning, health behaviour in school-aged children (HBSC), health survey, qualitative interviews, grounded theory, school children...
Adriansen, Hanne Kirstine
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...... for life story research, it can also be used for ther types of studies where interviews are made....... 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...
Juel Kynde, Anette
We aimed to explore beliefs about physical health from the perspective of patients with concurrent mental illness and substance use and to explore how a health promotion intervention influenced their personal agency for changing health-related behaviour. Our findings were that patients' beliefs w...
Online Learning for Mobile Technology Applications in Health Surveys. In light of ... to develop a globally accessible asynchronous Internet-based training packaged backed by a real-time coaching service. Project ID. 105932. Project status.
Tuberculosis (TB) is a very global disease; there are over 9 million new incidences of TB every year with the vast majority of cases emerging in the developing world. As one of three major diseases associated with poverty it affects the areas where poverty is most prevalent, notably Asia and Africa. While the incidence rate has been slowly declining in the developed world it continues to pose a major health threat to even the most developed nations. To demonstrate the global, and persistent, nature of TB we asked Dr Mario Raviglione, Director of the World Health Organization's Stop TB Department to provide an analysis on the current TB situation in the United Kingdom and comment on what measures should be taken to alleviate the issue of TB in one of the world's richest countries.
suggested by the teachers. Students emphasized the importance of the learning environment being safe, appreciative and inclusive. All 23 students stated that they learned from playing, observing and/or giving feedback. Learnings were focused around personal issues such as seeing one self and others from......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...... 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...
Fitzgerald, Niamh; Molloy, Heather; MacDonald, Fiona; McCambridge, Jim
Few studies of the implementation of alcohol brief interventions (ABI) have been conducted in community settings such as mental health, social work and criminal justice teams. This qualitative interview study sought to explore the impact of training on ABI delivery by staff from a variety of such teams. Fifteen semi-structured telephone interviews were carried out with trained practitioners and with managers to explore the use of, perceived need for and approaches to ABI delivery and recording with clients, and compatibility of ABIs with current practice. Interviews were analysed thematically using an inductive approach. Very few practitioners reported delivery of any ABIs following training primarily because they felt ABIs to be inappropriate for their clients. According to practitioners, this was either because they drank too much or too little to benefit. Practitioners reported a range of current activities relating to alcohol, and some felt that their knowledge and confidence were improved following training. One practitioner reported ABI delivery and was considered a training success, while expectations of ABIs did not fit with current practice including assessment procedures for the remainder. Identified barriers to ABI delivery included issues relating to individual practitioners, their teams, current practice and the ABI model. They are likely to be best addressed by strategic team- and setting-specific approaches to implementation, of which training is only one part. © 2014 The Authors. Drug and Alcohol Review published by Wiley Publishing Asia Pty Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.
Yasumura, Seiji; Hosoya, Mitsuaki; Yamashita, Shunichi; Kamiya, Kenji; Abe, Masafumi; Akashi, Makoto; Kodama, Kazunori; Ozasa, Kotaro
The accidents that occurred at the Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake on 11 March 2011 have resulted in long-term, ongoing anxiety among the residents of Fukushima, Japan. Soon after the disaster, Fukushima Prefecture launched the Fukushima Health Management Survey to investigate long-term low-dose radiation exposure caused by the accident. Fukushima Medical University took the lead in planning and implementing this survey. The primary purposes of this survey are to monitor the long-term health of residents, promote their future well-being, and confirm whether long-term low-dose radiation exposure has health effects. This report describes the rationale and implementation of the Fukushima Health Management Survey. This cohort study enrolled all people living in Fukushima Prefecture after the earthquake and comprises a basic survey and 4 detailed surveys. The basic survey is to estimate levels of external radiation exposure among all 2.05 million residents. It should be noted that internal radiation levels were estimated by Fukushima Prefecture using whole-body counters. The detailed surveys comprise a thyroid ultrasound examination for all Fukushima children aged 18 years or younger, a comprehensive health check for all residents from the evacuation zones, an assessment of mental health and lifestyles of all residents from the evacuation zones, and recording of all pregnancies and births among all women in the prefecture who were pregnant on 11 March. All data have been entered into a database and will be used to support the residents and analyze the health effects of radiation. The low response rate (<30%) to the basic survey complicates the estimation of health effects. There have been no cases of malignancy to date among 38 114 children who received thyroid ultrasound examinations. The importance of mental health care was revealed by the mental health and lifestyle survey and the pregnancy and birth survey. This long
Rohlfs, Izabella; Borrell, Carme; Artazcoz, Lucia; Escribà-Agüir, Vicenta
Most studies into social determinants of health conducted in Spain based on data from health surveys have focused on social class inequalities. This paper aims to review the progressive incorporation of gender perspective and sex differences into health surveys in Spain, and to suggest design, data collection and analytical proposals as well as to make policy proposals. Changes introduced into health surveys in Spain since 1995 to incorporate gender perspective are examined, and proposals for the future are made, which would permit the analysis of differences in health between women and men as a result of biology or because of gender inequalities. The introduction of gender perspective in health surveys requires the incorporation of questions related to family setting and reproductive work, workplace and society in general to detect gender differences and inequalities (for example, domestic work, intimate partner violence, discrimination, contract type or working hours). Health indicators reflecting differential morbidity and taking into account the different life cycle stages must also be incorporated. Analyses ought to be disaggregated by sex and interpretation of results must consider the complex theoretical frameworks explaining the differences in health between men and women based on sex differences and those related to gender. Analysis of survey data ought to consider the impact of social, political and cultural constructs of each society. Any significant modification in procedures for collection of data relevant to the study of gender will require systematic coordination between institutions generating the data and researchers who are trained in and sensitive to the topic.
Valenzuela, M S; Herold, J M; Morris, L; López, I M
In 1988 a survey was carried out in order to obtain information on knowledge about reproduction, sexual activity, attitudes, and use of contraceptive methods among residents between 15 and 24 years of age in Greater Santiago. For this purpose, a multistage, self-weighted, non-replacement probability sample was chosen from the entire Santiago urban area. After 2,898 households were visited, 865 women and 800 men were selected and interviewed. For the interview, a questionnaire with 156 questions was developed; many questions were similar to those included in similar surveys in Brazil and Guatemala. The interviewers were professionals who had received prior training. Although 75% of the interviewees had attended sex education classes, they had erroneous ideas on various basic subjects. Sixty-nine percent of the women interviewed had undergone menarche before attending these classes. In addition, 35.4% of the women and 65.0% of the men had had sexual relations prior to marriage, and less than 20% had used any contraceptive method. More than 60% of the interviewees who had children had conceived them before marrying. These findings point up the necessity of offering sex education classes for children and young people, as well as facilitating their access to family planning services, in order to decrease the number of illegitimate and unwanted children that are born in Chile.
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
Tan, Ziying; Liu, Xingyun; Liu, Xiaoqian; Cheng, Qijin; Zhu, Tingshao
While Web-based interventions can be efficacious, engaging a target population's attention remains challenging. We argue that strategies to draw such a population's attention should be tailored to meet its needs. Increasing user engagement in online suicide intervention development requires feedback from this group to prevent people who have suicide ideation from seeking treatment. The goal of this study was to solicit feedback on the acceptability of the content of messaging from social media users with suicide ideation. To overcome the common concern of lack of engagement in online interventions and to ensure effective learning from the message, this research employs a customized design of both content and length of the message. In study 1, 17 participants suffering from suicide ideation were recruited. The first (n=8) group conversed with a professional suicide intervention doctor about its attitudes and suggestions for a direct message intervention. To ensure the reliability and consistency of the result, an identical interview was conducted for the second group (n=9). Based on the collected data, questionnaires about this intervention were formed. Study 2 recruited 4222 microblog users with suicide ideation via the Internet. The results of the group interviews in study 1 yielded little difference regarding the interview results; this difference may relate to the 2 groups' varied perceptions of direct message design. However, most participants reported that they would be most drawn to an intervention where they knew that the account was reliable. Out of 4222 microblog users, we received responses from 725 with completed questionnaires; 78.62% (570/725) participants were not opposed to online suicide intervention and they valued the link for extra suicide intervention information as long as the account appeared to be trustworthy. Their attitudes toward the intervention and the account were similar to those from study 1, and 3 important elements were found
Lawrence, P; Fulbrook, P; Somerset, S; Schulz, P
WHAT IS KNOWN ON THE SUBJECT?: Despite differences between samples, some literature reviews have suggested that MI is effective in enhancing treatment attendance for individuals with mental health issues. Little is known regarding the effects of MI as a pre-treatment on individuals who are not seeking treatment for mental health issues. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This systematic review of the literature and meta-analysis demonstrates that MI is most beneficial for individuals who are not seeking mental health treatment. MI represents an opportunity for health promotion when patients are unmotivated but may otherwise be amenable to an intervention. MI is effective as a pre-treatment intervention to motivate individuals to attend further post-MI treatment and counselling. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: MI is a process and a useful tool for clinicians in all therapeutic interactions, to motivate their patients to seek further assistance for mental heath issues. Health promotion and encouragement to attend further treatment sessions can be facilitated through telephone contact. Introduction The stages of change model suggests that individuals seeking treatment are in the "preparation" or the "action" stage of change, which is the desired outcome of successful Motivational Interviewing (MI) interventions. MI is known to enhance treatment attendance among individuals with mental health problems. Aim This study examined the published research on MI as a pre-treatment to enhance attendance among individuals treatment-seeking and non-treatment-seeking for mental health issues. Methods Fourteen randomized controlled trials were identified, and MI efficacy was examined dichotomously: attendance or non-attendance for post-MI therapy. Subgroup analysis investigated treatment-seeking and non-treatment-seeking groups. Results Despite wide variations in sample sizes, blinding and monitoring, intervention fidelity was absent in the majority of published
Mittereder, Felicitas; Durow, Jen; West, Brady T.; Kreuter, Frauke; Conrad, Frederick G.
Standardized interviewing (SI) and conversational interviewing are two approaches to collect survey data that differ in how interviewers address respondent confusion. This article examines interviewer-respondent interactions that occur during these two techniques, focusing on requests for and provisions of clarification. The data derive from an…
The link of duration of TV and/or screen watching and chronic health conditions by subtypes is unclear. Therefore, the relationship between TV and/or screen watching hours and cardiovascular, respiratory, mental and psychiatric health and well-being (happiness) was assessed in an independent population-based survey to identify correlations of various hours with health conditions. Data was retrieved from the Scottish Health Survey, 2012-2013. Information on demographics, lifestyle factors, self-reported health conditions and TV and/or screen watching duration in both Scottish adults and children was collected by annual household interviews. Chi-square test and survey weighted logistic and multi-nominal modelling were performed. 5527 (57.0%) Scottish adults aged 16-99 watched TV and/or screen daily for 3 + h on average. There was a trend toward more hypertension, angina, stroke, diabetes, chronic obstructive pulmonary disease and poor self-rated health and mental health. Reporting watching TV and/or screen for 4 + h, for 5 + h and for 8 + h was associated with higher rates of heart attack, heart murmur or other heart troubles and abnormal heart rhythms, respectively. 414 (20.7%) Scottish children aged 4-12 watched TV and/or screen for 3h or more. They tended to have poor self-rated health and life difficulties perceived as emotional and behavioural problems. There were associations between various hours of TV and/or screen watching (3+h) and poor health observed both in Scottish adults and children. Future educational and public health programmes minimising TV and/or screen watching in order to protect cardiovascular, respiratory, mental and psychiatric health might be considered. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Macdonald, Graham G; Townsend, Anne F; Adam, Paul; Li, Linda C; Kerr, Sheila; McDonald, Michael; Backman, Catherine L
eHealth is a broad term referring to the application of information and communication technologies in the health sector, ranging from health records to telemedicine and multiple forms of health education and digital 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 created a group of informed, engaged, and empowered patients as partners, equipped to take part in shared decision making and effectively self-manage chronic illness. Less attention has been given to health care professionals' (HCPs) experiences of the role of eHealth in patient encounters. The objective of this study was to examine HCPs' perspectives on how eHealth affects their relationships with patients living with multiple chronic conditions, as well as its ethical and practical ramifications. We interviewed HCPs about their experiences with eHealth and its impact on the office visit. Eligible participants needed to report a caseload of ≥25% of patients with multimorbidity to address issues of managing complex chronic conditions and coordination of care. We used a semistructured discussion guide for in-depth interviews, and follow-up interviews served to clarify and expand upon initial discussions. Constant comparisons and a narrative approach guided the analyses, and a relational ethics conceptual lens was applied to the data to identify emergent themes. A total of 12 physicians and nurses (6 male, 6 female; median years of practice=13) participated. eHealth tools most frequently described were Web-based educational resources for patients and Web-based resources for HCPs such as curated scientific summaries on diagnostic criteria, clinical therapies, and dosage calculators. Analysis centered on a grand theme of the two-way conversation between HCPs and patients, which addresses a general recentering of the ethical relationship between HCPs and
Keturah R. Faurot
Full Text Available Although dietary supplement use is common, its assessment is challenging, especially among ethnic minority populations such as Hispanics/Latinos. Using the Hispanic Community Health Study/Study of Latinos (HCHS/SOL (n = 16,415, this report compares two strategies for capturing dietary supplement use over a 30-day period: a medication-based inventory and a nutrition-based dietary supplement interview. Age-standardized prevalence was calculated across multiple dietary supplement definitions, adjusted with survey/nonresponse weights. The prevalence of dietary supplement use was substantially higher as measured in the dietary supplement interview, compared to the medication inventory: for total dietary supplements (39% vs 26%, respectively, for nonvitamin, nonmineral supplements (24% vs 12%, and for botanicals (9.2% vs 4.5%. Concordance between the two assessments was fair to moderate (Cohen's kappa: 0.31–0.52. Among women, inclusion of botanical teas increased the prevalence of botanical supplement use from 7% to 15%. Supplement assessment that includes queries about botanical teas yields more information about patient supplement use.
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...
Full Text Available Including questions about sexual health in the annual Health Survey for England (HSE provides opportunities for regular measurement of key public health indicators, augmenting Britain's decennial National Survey of Sexual Attitudes and Lifestyles (Natsal. However, contextual and methodological differences may limit comparability of the findings. We examine the extent of these differences between HSE 2010 and Natsal-3 and investigate their impact on parameter estimates.Complex survey analyses of data from men and women in the 2010 HSE (n = 2,782 men and 3,588 women and Natsal-3 undertaken 2010-2012 (n = 4,882 men and 6,869 women aged 16-69y and resident in England, both using probability sampling, compared their characteristics, the amount of non-response to, and estimates from, sexual health questions. Both surveys used self-completion for the sexual behaviour questions but this was via computer-assisted self-interview (CASI in Natsal-3 and a pen-and-paper questionnaire in HSE 2010.The surveys achieved similar response rates, both around 60%, and demographic profiles largely consistent with the census, although HSE participants tended to be less educated, and reported worse general health, than Natsal-3 participants. Item non-response to the sexual health questions was typically higher in HSE 2010 (range: 9-18% relative to Natsal-3 (all <5%. Prevalence estimates for sexual risk behaviours and STI-related indicators were generally slightly lower in HSE 2010 than Natsal-3.While a relatively high response to sexual health questions in HSE 2010 demonstrates the feasibility of asking such questions in a general health survey, differences with Natsal-3 do exist. These are likely due to the HSE's context as a general health survey and methodological limitations such as its current use of pen-and-paper questionnaires. Methodological developments to the HSE should be considered so that its data can be interpreted in combination with those from dedicated
Finley, G Allen
G Allen Finley talks to Roshaine Gunawardana, Commissioning Editor: Dr Allen Finley is a pediatric anesthesiologist who has worked for over 20 years in pain research and management. He is Professor of Anesthesia and Psychology at Dalhousie University (NS, Canada), and holds the inaugural Dr Stewart Wenning Chair in Pediatric Pain Management at the IWK Health Centre in Halifax. He has published over 100 papers in peer-reviewed journals and has lectured widely, with more than 230 invited presentations on six continents. He started the PEDIATRIC-PAIN e-mail discussion list in 1993, bringing together pain researchers and clinicians from over 40 countries. His own research and educational projects have recently taken him to Jordan, Thailand, China, Brazil and elsewhere. His main interest is pain service development and advocacy for improved pain care for children around the world, and he is co-leader of the ChildKind International Initiative.
Al-Amer, Rasmieh; Ramjan, Lucie; Glew, Paul; Darwish, Maram; Salamonson, Yenna
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
Radin, Dagmar; Dzakula, Aleksandar; Benkovic, Vanesa
To compare the results of a series of public opinion surveys on experiences with the health care sector in Croatia conducted in the time of elections and to analyze whether political party affiliation had any influence on issues of priority ranking. The surveys were conducted during 2005, 2007, and 2009. They were administered through a Computer Assisted Telephone Interviewing method to representative samples of Croatian population and were statistically weighted according to sex, age, level of education, and political party affiliation. The random sampling of the person within the household was done using the table of random numbers. Health and health care system was the most important issue (58%) during the 2007 parliamentary election and the second most important issue during the 2005 and 2009 elections (46% and 28%). In the 2007 election, health care was viewed as most important by women, respondents with lower education levels, and respondents with lower income. In 2005, the most important health care issues were corruption and lack of funding (45% and 43%, respectively), in 2007 poor organization and lack of funding (43% and 42%, respectively), and in 2009 lack of funding and corruption (51% and 45%, respectively). Health and health care system were consistently among the top two issues in all elections from 2005 to 2009. The top three most important health care sector issues were corruption, poor organization, and lack of funding. This indicates that political parties should include solutions to these issues in their health care policymaking.
Radin, Dagmar; Džakula, Aleksandar; Benković, Vanesa
Aim To compare the results of a series of public opinion surveys on experiences with the health care sector in Croatia conducted in the time of elections and to analyze whether political party affiliation had any influence on issues of priority ranking. Methods The surveys were conducted during 2005, 2007, and 2009. They were administered through a Computer Assisted Telephone Interviewing method to representative samples of Croatian population and were statistically weighted according to sex, age, level of education, and political party affiliation. The random sampling of the person within the household was done using the table of random numbers. Results Health and health care system was the most important issue (58%) during the 2007 parliamentary election and the second most important issue during the 2005 and 2009 elections (46% and 28%). In the 2007 election, health care was viewed as most important by women, respondents with lower education levels, and respondents with lower income. In 2005, the most important health care issues were corruption and lack of funding (45% and 43%, respectively), in 2007 poor organization and lack of funding (43% and 42%, respectively), and in 2009 lack of funding and corruption (51% and 45%, respectively). Conclusion Health and health care system were consistently among the top two issues in all elections from 2005 to 2009. The top three most important health care sector issues were corruption, poor organization, and lack of funding. This indicates that political parties should include solutions to these issues in their health care policymaking. PMID:21990075
Ejem, Deborah; Nicholas Dionne-Odom, J; Turkman, Yasemin; Knight, Sara; Willis, Dan; Kaufman, Peter; Bakitas, Marie
Women with metastatic breast cancer (MBC) face numerous, complex treatment and advance care planning (ACP) decisions. Our aim was to develop a better understanding of women with MBC's decision-making preferences overtime and relative to specific types of decisions. Convergent, parallel mixed-methods study. Participants completed the Control Preferences Scale (CPS) and a semi-structured interview of decision-making experiences at enrollment (T1; n=22) and when facing a decision or 3 months later (T2; n=19). We categorized women's decision-making experience descriptions into one of the CPS decisional styles and compared them to their CPS response. We constructed an analytic grid that aligned the interview-determined treatment and ACP decisional preferences with the CPS categories at T1 and T2 and calculated Cohen's kappa coefficient and congruence percentages. Participants (n=22) were White (100%), averaged 62 years, married (54%), retired (45%), and had a bachelor's degree (45%). Congruence between CPS response and interview-determined treatment preferences at T1 was 32% (kappa=0.083) and 33% (kappa=0.120) at T2. Congruence between CPS survey response and interview-determined ACP preferences at T1 was 22.7% (kappa =0.092) at T1 and 11% (kappa = 0.011) at T2. Although women selected a "shared" treatment decision-making style using the CPS validated tool, when interviewed their descriptions generally reflected a passive process in which they followed the oncologists' treatment suggestions. Future research should explore whether the incongruence between stated and actual decision-making style is a function of misinterpreting the CPS choices or a true inconsistency that could lead to adverse consequences such as decisional regret. This article is protected by copyright. All rights reserved.
Depaoli, Sarah; Tiemensma, Jitske; Felt, John M
The multidimensional graded response model, an item response theory (IRT) model, can be used to improve the assessment of surveys, even when sample sizes are restricted. Typically, health-based survey development utilizes classical statistical techniques (e.g. reliability and factor analysis). In a review of four prominent journals within the field of Health Psychology, we found that IRT-based models were used in less than 10% of the studies examining scale development or assessment. However, implementing IRT-based methods can provide more details about individual survey items, which is useful when determining the final item content of surveys. An example using a quality of life survey for Cushing's syndrome (CushingQoL) highlights the main components for implementing the multidimensional graded response model. Patients with Cushing's syndrome (n = 397) completed the CushingQoL. Results from the multidimensional graded response model supported a 2-subscale scoring process for the survey. All items were deemed as worthy contributors to the survey. The graded response model can accommodate unidimensional or multidimensional scales, be used with relatively lower sample sizes, and is implemented in free software (example code provided in online Appendix). Use of this model can help to improve the quality of health-based scales being developed within the Health Sciences.
Kabaghe, Alinune N; Phiri, Mphatso D; Phiri, Kamija S; van Vugt, Michèle
Prompt and effective malaria treatment are key in reducing transmission, disease severity and mortality. With the current scale-up of artemisinin-based combination therapy (ACT) coverage, there is need to focus on challenges affecting implementation of the intervention. Routine indicators focus on utilization and coverage, neglecting implementation quality. A health system in rural Malawi was assessed for uncomplicated malaria treatment implementation in children. A cross-sectional health facility survey was conducted in six health centres around the Majete Wildlife Reserve in Chikwawa district using a health system effectiveness approach to assess uncomplicated malaria treatment implementation. Interviews with health facility personnel and exit interviews with guardians of 120 children under 5 years were conducted. Health workers appropriately prescribed an ACT and did not prescribe an ACT to 73% (95% CI 63-84%) of malaria rapid diagnostic test (RDT) positive and 98% (95% CI 96-100%) RDT negative children, respectively. However, 24% (95% CI 13-37%) of children receiving artemisinin-lumefantrine had an inappropriate dose by weight. Health facility findings included inadequate number of personnel (average: 2.1 health workers per 10,000 population), anti-malarial drug stock-outs or not supplied, and inconsistent health information records. Guardians of 59% (95% CI 51-69%) of children presented within 24 h of onset of child's symptoms. The survey presents an approach for assessing treatment effectiveness, highlighting bottlenecks which coverage indicators are incapable of detecting, and which may reduce quality and effectiveness of malaria treatment. Health service provider practices in prescribing and dosing anti-malarial drugs, due to drug stock-outs or high patient load, risk development of drug resistance, treatment failure and exposure to adverse effects.
Tiffany K. Gill
Full Text Available Abstract Background Feeling angry about their health status may influence disease progression in individuals, creating a greater burden on the health care system. Identifying associations between different variables and feeling angry about health status may assist health professionals to improve health outcomes. This study used path analysis to explore findings from a population-based survey, informed by qualitative descriptions obtained from focus groups, to determine the prevalence of health-related anger within the community and variables associated with reporting health-related anger. Methods A population-based Computer Assisted Telephone Interview (CATI survey of 3003 randomly selected adults Australia-wide was conducted to examine the prevalence of health-related anger. A wide range of other covariates were included in the survey. Multivariable logistic regression and path analysis were undertaken to identify the relationships between different variables associated with feeling angry about the health status of people, to explore the direction of these associations and as a consequence of the results, consider implications for health service use and delivery. Results Overall, 18.5 % of the population reported feeling angry about their health “some of the time”, “most of the time” or “all of the time”. People who felt angry about their health were more likely to have a severe health condition, at least one chronic condition, high psychological distress, fair to poor health status, and needed to adjust their daily lives because of a health condition. Having a tertiary level education was protective. Receiving some form of social support, usually from a support group, and not always doing as advised by a doctor, were also associated with a higher likelihood of being angry about their health. Conclusions People living with significant health problems are more likely to feel angry about their health. The path between illness and
Lee, Jung-Ah; Nguyen, Annie Lu; Berg, Jill; Amin, Alpesh; Bachman, Mark; Guo, Yuqing; Evangelista, Lorraine
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
Wong-Parodi, Gabrielle; Dias, M Beatrice; Taylor, Michael
Air quality affects us all and is a rapidly growing concern in the 21st century. We spend the majority of our lives indoors and can be exposed to a number of pollutants smaller than 2.5 microns (particulate matter, PM 2.5 ) resulting in detrimental health effects. Indoor air quality sensors have the potential to provide people with the information they need to understand their risk and take steps to reduce their exposure. One such sensor is the Speck sensor developed at the Community Robotics, Education and Technology Empowerment Lab at Carnegie Mellon University. This sensor provides users with continuous real-time and historical PM 2.5 information, a Web-based platform where people can track their PM 2.5 levels over time and learn about ways to reduce their exposure, and a venue (blog post) for the user community to exchange information. Little is known about how the use of such monitors affects people's knowledge, attitudes, and behaviors with respect to indoor air pollution. The aim of this study was to assess whether using the sensor changes what people know and do about indoor air pollution. We conducted 2 studies. In the first study, we recruited 276 Pittsburgh residents online and through local branches of the Carnegie Library of Pittsburgh, where the Speck sensor was made available by the researchers in the library catalog. Participants completed a 10- to 15-min survey on air pollution knowledge (its health impact, sources, and mitigation options), perceptions of indoor air quality, confidence in mitigation, current behaviors toward air quality, and personal empowerment and creativity in the spring and summer of 2016. In our second study, we surveyed 26 Pittsburgh residents in summer 2016 who checked out the Speck sensor for 3 weeks on the same measures assessed in the first study, with additional questions about the perception and use of the sensor. Follow-up interviews were conducted with a subset of those who used the Speck sensor. A series of paired t
Full Text Available Health expectancies are key indicators for monitoring the health of populations, as well as for informing debates about compression or expansion of morbidity. However, current methodologies for estimating them are not entirely satisfactory. They are either of limited applicability because of high data requirements (the multistate method or based on questionable assumptions (the Sullivan method. This paper proposes a new method, called the "intercensal" method, which relies on the multistate framework but uses widely available data. The method uses age-specific proportions "healthy" at two successive, independent cross-sectional health surveys, and, together with information on general mortality, solves for the set of transition probabilities that produces the observed sequence of proportions healthy. The system is solved by making realistic parametric assumptions about the age patterns of transition probabilities. Using data from the Health and Retirement Survey (HRS and from the National Health Interview Survey (NHIS, the method is tested against both the multistate method and the Sullivan method. We conclude that the intercensal approach is a promising framework for the indirect estimation of health expectancies.
Full Text Available Abstract Background This study explores the psychological, socio-cultural and economic consequences of infertility on couples' life. The purpose of this research is to improve knowledge about the potentially serious implications of infertility in the South of Vietnam. Methods This study included 118 infertile couples who filled in questionnaires and 28 men and women who were interviewed. Results Data of the questionnaire show men and women do not differ in their responses and attitudes towards infertility. Almost one-third of the participants require psychological support. Interviewees experience secrecy, social pressure and economic hardship. Conclusion Offspring are very important to Vietnamese couples. Their future depends on children. Family plays an important role in the experiences of the infertile couple. Economic consequences are a particular distressing factor. There is a need for psychological counselling in the treatment of infertile couples in the South of Vietnam. It should be realised that in developing countries, despite overpopulation, unwanted childlessness is an important social and economical burden that needs attention.
Homma, Satoki; Imamura, Haruhiko; Nakamura, Toru; Fujimura, Kaori; Ito, Yoshihiro; Maeda, Yuji; Kaneko, Ikuyo
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.
This survey focuses on the WH and S (Work Health and Safety) practices in Australia and relates them with those in Pakistan. It also highlights the planned areas of work required on WH and S in cotton ginning industry of Pakistan. This article is one a series of research studies that will inform a broader approach development. The aim of the survey was to design a standardized health and safety Act for cotton ginning industry of Pakistan and to help ginners meet their due industry obligations under the model WH and S Act. The first component of the research study survey was to review the relevant Australian work and safety model as this provides a framework to protect the health, safety and welfare of all employees at work and of other people who might be affected by the job. The second aspect of the research study survey concerned site visits to cotton gins with the support of Australian Centre for Agricultural Health and Safety, Moree, NSW. During these visits the existing ginning process in terms of WH and S were reviewed. Informal interviews were also conducted with Gin Managers and Ginning Experts regarding WH and S in the Australian cotton ginning industry. (author)
Gagliardi, Anna R; Dobrow, Mark J
Collaboration among researchers and research users, or integrated knowledge translation (IKT), enhances the relevance and uptake of evidence into policy and practice. However, it is not widely practiced and, even when well-resourced, desired impacts may not be achieved. Given that large-scale investment is not the norm, further research is needed to identify how IKT can be optimized. Interviews were conducted with researchers and research users (clinicians, managers) in a health care delivery (HCDO) and health care monitoring (HCMO) organization that differed in size and infrastructure, and were IKT-naïve. Basic qualitative description was used. Participants were asked about IKT activities and challenges, and recommendations for optimizing IKT. Data were analysed inductively using constant comparative technique. Forty-three interviews were conducted (28 HCDO, 15 HCMO) with 13 researchers, 8 clinicians, and 22 managers. Little to no IKT took place. Participants articulated similar challenges and recommendations revealing that a considerable number of changes were needed at the organizational, professional and individual levels. Given the IKT-absent state of participating organizations, this research identified a core set of conditions which must be addressed to prepare an environment conducive to IKT. These conditions were compiled into a framework by which organizations can plan for, or evaluate their capacity for IKT. The IKT capacity framework is relevant for organizations in which there is no current IKT activity. Use of the IKT framework may result in more organizations that are ready to initiate and establish IKT, perhaps ultimately leading to more, and higher-quality collaboration for health system innovation. Further research is needed to confirm these findings in other organizations not yet resourced for, or undertaking IKT, and to explore the resource implications and mechanisms for establishing the conditions identified here as essential to preparing for
Hospital construction is a significant event in any health system. The financial implications are great, especially at a time of shrinking capital resources. Personnel are affected, as are the processes to perform their tasks. Often, new facilities are catalysts that change organizational culture; it has been clearly shown that new facilities have a positive impact on patient satisfaction scores. The members of the C-suite of a hospital/health system play important roles in construction projects. However, no one is more critical to the success of such major endeavors than the chief executive officer (CEO). The CEO sets the tone for the project, giving direction to the design and construction process that may have implications for the rest of the organization. Palomar Pomerado Health (PPH) is the largest public health district in California. In 2002, the PPH governing board authorized the creation of a new facility master plan for the district, which included the construction of a replacement facility for its tertiary care trauma center. The new Palomar Medical Center is slated to open in August 2012. HERD had the opportunity to speak with PPH CEO Michael H. Covert on the role of the CEO in the building of this "fable hospital".
Shahnazi, Hossein; Daniali, Seyede Shahrbanoo; Sharifirad, Gholamreza
Due to the importance of health care organizations with significant responsibility for prevention and care, assessment of job satisfaction among health care staff is essential. Quality of health services will be decreased provided they are not satisfied. This study was a cross-sectional analysis of health care staff in Khomeinishahr (centers, buildings, and networks) If they had at least 6 months work experience, they could enter the study. Data included a two-part questionnaire with a standardized questionnaire, demographic variables, and Smith job descriptive index, which is a questionnaire with six domains. Reliability was obtained for each domain and its validity was reported 0.93. The results showed an overall satisfaction score averages 43.55 ± 12.8 (from 100). Job satisfaction score was not significantly different between the sexes. However, within the current attitude toward job satisfaction, men scores was better than women (P = 0.001). Highest score in job satisfaction was related to relationships with colleagues and lowest score was related to the income, benefits, and job promotion. The more the years of work, the less the job satisfaction was. The attitude toward the current job had a direct relationship with income (P = 0.01). There was a significant inverse relationship between educational level and job satisfaction in domains promotion, income, and benefits (P = 0.01). The staff with higher education levels was less satisfied with income and job promotion qualification. Managers should focus on job qualification to increase job satisfaction and improve the quality of work.
Costich, Julia F; Honoré, Peggy A; Scutchfield, F Douglas
The work reported here builds on the identification of public health financial management practice competencies by a national expert panel. The next logical step was to provide a validity check for the competencies and identify priority areas for educational programming. We developed a survey for local public health finance officers based on the public health finance competencies and field tested it with a convenience sample of officials. We asked respondents to indicate the importance of each competency area and the need for training to improve performance; we also requested information regarding respondent education, jurisdiction size, and additional comments. Our local agency survey sample drew on the respondent list from the National Association of County and City Health Officials 2005 local health department survey, stratified by agency size and limited to jurisdiction populations of 25,000 to 1,000,000. Identifying appropriate respondents was a major challenge. The survey was fielded electronically, yielding 112 responses from 30 states. The areas identified as most important and needing most additional training were knowledge of budget activities, financial data interpretation and communication, and ability to assess and correct the organization's financial status. The majority of respondents had some postbaccalaureate education. Many provided additional comments and recommendations. Health department finance officers demonstrated a high level of general agreement regarding the importance of finance competencies in public health and the need for training. The findings point to a critical need for additional training opportunities that are accessible, cost-effective, and targeted to individual needs.
Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek
Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. In April-May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. At the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case management, facilities must at minimum have
Lamichhane, Babu Ram; Subedi, Naresh; Pokheral, Chiranjibi Prasad; Dhakal, Maheshwar; Acharya, Krishna Prasad; Pradhan, Narendra Man Babu; Smith, James L. David; Malla, Sabita; Thakuri, Bishnu Singh; Yackulic, Charles B.
Understanding how wide-ranging animals use landscapes in which human use is highly heterogeneous is important for determining patterns of human–wildlife conflict and designing mitigation strategies. Here, we show how biological sign surveys in forested components of a human-dominated landscape can be combined with human interviews in agricultural portions of a landscape to provide a full picture of seasonal use of different landscape components by wide-ranging animals and resulting human–wildlife conflict. We selected Asian elephants (Elephas maximus) in Nepal to illustrate this approach. Asian elephants are threatened throughout their geographic range, and there are large gaps in our understanding of their landscape-scale habitat use. We identified all potential elephant habitat in Nepal and divided the potential habitat into sampling units based on a 10 km by 10 km grid. Forested areas within grids were surveyed for signs of elephant use, and local villagers were interviewed regarding elephant use of agricultural areas and instances of conflict. Data were analyzed using single-season and multi-season (dynamic) occupancy models. A single-season occupancy model applied to data from 139 partially or wholly forested grid cells estimated that 0.57 of grid cells were used by elephants. Dynamic occupancy models fit to data from interviews across 158 grid cells estimated that monthly use of non-forested, human-dominated areas over the preceding year varied between 0.43 and 0.82 with a minimum in February and maximum in October. Seasonal patterns of crop raiding by elephants coincided with monthly elephant use of human-dominated areas, and serious instances of human–wildlife conflict were common. Efforts to mitigate human–elephant conflict in Nepal are likely to be most effective if they are concentrated during August through December when elephant use of human-dominated landscapes and human–elephant conflict are most common.
Bramlett, Matthew D; Blumberg, Stephen J; Ormson, A Elizabeth; George, Jacquelyn M; Williams, Kim L; Frasier, Alicia M; Skalland, Benjamin J; Santos, Kathleen B; Vsetecka, Danielle M; Morrison, Heather M; Pedlow, Steven; Wang, Fang
This report presents the development, plan, and operation of the 2009-2010 National Survey of Children with Special Health Care Needs, a module of the State and Local Area Integrated Telephone Survey. The survey is conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. This survey was designed to produce national and state-specific prevalence estimates of children with special health care needs (CSHCN), to describe the types of services that they need and use, and to assess aspects of the system of care for CSHCN. A random-digit-dial sample of households with children under age 18 years was constructed for each of the 50 states and the District of Columbia. The sampling frame consisted of landline phone numbers and cellular(cell) phone numbers of households that reported a cell-phone-only or cell-phone-mainly status. Children in identified households were screened for special health care needs. If CSHCN were identified in the household, a detailed interview was conducted for one randomly selected child with special health care needs. Respondents were parents or guardians who knew about the children's health and health care. A total of 196,159 household screening interviews were completed from July 2009 through March 2011, resulting in 40,242 completed special-needs interviews, including 2,991 from cell-phone interviews. The weighted overall response rate was 43.7% for the landline sample, 15.2% for the cell-phone sample, and 25.5% overall. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Rodriguez, Viviana; Moreno, Socorro; Camacho, Jhon; Gómez-Restrepo, Carlos; de Santacruz, Cecilia; Rodriguez, Maria Nelcy; Tamayo Martínez, Nathalie
Population surveys on mental health are performed as part of the inputs required for the creation, implementation and evaluation of policies related to mental health, worldwide, and as an initiative of the World Health Organisation (WHO). was held The fourth National Survey of Mental Health (ENSM 2015) was carried out during the first half of 2015 on a representative sample of 2,727 children between 7 and 11 years of age, 1,754 adolescents, and 10, 870 adults who were selected throughout the country. To describe the selection and definition of the tools used to measure mental health (including social cognition and violence), problems, mental disorders, and the evaluation of health states, as well as to describe the process used to develop the data collection tools finally used. The measurement of mental disorders in children was performed using the Diagnostic Interview Schedule for Children (DISC), and the Composite International Diagnostic Interview (CIDI) was used for adolescents and adults. For the remaining components evaluated in the survey, a search was conducted on the tools used at a national and international level. The selection of the toos used for the evaluation was based on the questions made by each tool, as well as the scientific validity that could be obtained from the results. In some cases the complete tool (as published) was used, in other cases the tools were constructed unifying parts of different ones, or questions were written based on the concepts or characteristics to be measured. Subsequently, a validation of content, concept and semantic of every tool was carried out, including the CIDI and DISC. The resulting tools were used on a group of people with different characteristics. It was noted that further clarification was necessary for some people to fully understand what was being asked. Because the collection of all the information in the survey would be computer assisted, a stream format was generated to guide the implementation in
Bygren, L O; Konlaan, B B; Johansson, S E
To investigate the possible influence of attendance at cultural events, reading books or periodicals, making music or singing in a choir as determinants for survival. A simple random sample was drawn of 15,198 individuals aged 16-74 years. Of these, 85% (12,982) were interviewed by trained non-medical interviewers between 1982 and 1983 about cultural activities. They were followed up with respect to survival until 31 December 1991. Swedish interview survey of living conditions comprising a random sample of the adult Swedish population. 12,675 people interviewed between 1982 and 1983. Survival of subjects after controlling for eight confounding variables: age, sex, education level, income, long term disease, social network, smoking, and physical exercise. 6,301 men and 6,374 women were followed up; 533 men and 314 women died during this period. The control variables influenced survival in the expected directions except for social network for men; a significant negative effective was found when the analysis was made separately for men and women. We found an influence on mortality when the eight control variables were controlled for in people who rarely attended events compared with those attending most often, the relative risk being 1.57 (95% confidence interval 1.18 to 2.09). Attendance at cultural events may have a positive influence on survival. Long term follow up of large samples with confounders that are well controlled for and with the cultural stimulation more highly specified should be used to try to falsify the hypothesis before experiments start.
Mindell, Jennifer S; Moody, Alison; Vecino-Ortiz, Andres I; Alfaro, Tania; Frenz, Patricia; Scholes, Shaun; Gonzalez, Silvia A; Margozzini, Paula; de Oliveira, Cesar; Sanchez Romero, Luz Maria; Alvarado, Andres; Cabrera, Sebastián; Sarmiento, Olga L; Triana, Camilo A; Barquera, Simón
Comparability of population surveys across countries is key to appraising trends in population health. Achieving this requires deep understanding of the methods used in these surveys to examine the extent to which the measurements are comparable. In this study, we obtained detailed protocols of 8 nationally representative surveys from 2007-2013 from Brazil, Chile, Colombia, Mexico, the United Kingdom (England and Scotland), and the United States-countries that that differ in economic and inequity indicators. Data were collected on sampling frame, sample selection procedures, recruitment, data collection methods, content of interview and examination modules, and measurement protocols. We also assessed their adherence to the World Health Organization's "STEPwise Approach to Surveillance" framework for population health surveys. The surveys, which included half a million participants, were highly comparable on sampling methodology, survey questions, and anthropometric measurements. Heterogeneity was found for physical activity questionnaires and biological samples collection. The common age range included by the surveys was adults aged 18-64 years. The methods used in these surveys were similar enough to enable comparative analyses of the data across the 7 countries. This comparability is crucial in assessing and comparing national and subgroup population health, and to assisting the transfer of research and policy knowledge across countries. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Babac, Ana; Frank, Martin; Pauer, Frédéric; Litzkendorf, Svenja; Rosenfeldt, Daniel; Lührs, Verena; Biehl, Lisa; Hartz, Tobias; Storf, Holger; Schauer, Franziska; Wagner, Thomas O F; Graf von der Schulenburg, J-Matthias
Rare diseases are, by definition, very serious and chronic diseases with a high negative impact on quality of life. Approximately 350 million people worldwide live with rare diseases. The resulting high disease burden triggers health information search, but helpful, high-quality, and up-to-date information is often hard to find. Therefore, the improvement of health information provision has been integrated in many national plans for rare diseases, discussing the telephone as one access option. In this context, this study examines the need for a telephone service offering information for people affected by rare diseases, their relatives, and physicians. In total, 107 individuals participated in a qualitative interview study conducted in Germany. Sixty-eight individuals suffering from a rare disease or related to somebody with rare diseases and 39 health care professionals took part. Individual interviews were conducted using a standardized semi-structured questionnaire. Interviews were an