Objectives: There are disparities in the uptake of HPV vaccine among racial/ethnic minority women. The strongest predictor of HPV vaccine uptake among adult women is health care provider (HCP) recommendation; however, it is unclear how issues relating to race/ethnicity may mitigate these recommendations. Research shows that racial/ethnic and gender concordance between a patient and HCP can improve patient satisfaction, access and quality of care. If concordance contributes to improved patient-provider interactions, then it may be a factor in patient decisions regarding HPV vaccination. The objectives of this study were to (1) explore gender and ethnicity HCP preference regarding HPV vaccination among unvaccinated; and (2) understand factors associated with those preferences.
Design: Unvaccinated Latina college students (n?=?187) completed a survey that assessed HCP preferences, medical mistrust, cultural assimilation and HPV vaccine recommendation. Logistic regression models evaluated associations between above variables with HPV knowledge and preference for a female and/or Latina HCP.
Results: Most respondents had health insurance (71%), a regular HCP (64%), were US-born (67%), with foreign-born parents (74%). Thirty-four percent and 18% agreed that they would be more likely to get the HPV vaccine if the recommending HCP was female and Latino, respectively. Latina women reporting higher medical mistrust preferred a HPV vaccine recommendation from a Latino/a provider.
Conclusions: Latinas’ preferences regarding gender and ethnicity of their HCPs may affect patient-provider interactions. Increasing diversity and cultural awareness among HCPs, and providing linguistically and culturally-appropriate information may decrease patient-provider mistrust, increase uptake of the HPV vaccine, and decrease persistent cervical cancer disparities. 相似文献
The recent report from the United Kingdom (UK) All-Party Parliamentary Group on Arts, Health and Wellbeing is receiving widespread publicity across the media. Newspaper articles and social media posts espouse the benefits and importance of employing creative arts within the health domain, citing the report as proof of this. The report is inclusive of the entire range of arts practices, while its recommendations relate in the most part to UK policy and systems. The focus of this article is specific to visual arts practices and art therapy (art-for-health), but may have relevance across arts modalities and approaches (arts and health). This article questions the approach to the evidence taken in the report, and highlights the need for rigour, balance and impartiality in conducting research and presenting evidence. A case is made for the use of formal systematic reviews as appropriate ways to develop the evidence base. Another suggestion is a request for more explicit consideration of the ideological commitments underpinning beliefs about purpose and value within art therapy and the wider arts and health arena. 相似文献
BackgroundAdults with complex congenital heart disease (CHD) show reduced aerobic exercise capacity and impaired skeletal muscle function compared with healthy peers. Peripheral muscle factors are presumed to be important contributors to the aerobic capacity, but the mechanisms are poorly understood. The aim of the present study was to investigate differences between adults with CHD and controls in muscle oxygenation kinetics at rest, and during and after exercise.MethodsSeventy-four patients with complex CHD (mean age 35.6 ± 14.3 years, female n = 22) were recruited. Seventy-four age- and sex-matched subjects were recruited as controls. Muscle oxygenation was successfully determined on the anterior portion of the deltoid muscle using near-infrared spectroscopy in 65 patients and 71 controls. Measurements were made at rest, during isotonic shoulder flexions (0-90°) to exhaustion, and during recovery.ResultsThe patients with CHD performed fewer shoulder flexions (40 ± 17 vs 69 ± 40; P < 0.001), had lower muscle oxygen saturation (StO2) at rest (58 ± 18% vs 69 ± 18%; P < 0.001), slower desaturation rate at exercise onset (?9.7 ± 5.9 vs ?15.1 ± 6.5% StO2 × 3.5 s?1, P <0.001), and slower resaturation rate post exercise (4.0 ± 2.7 vs 5.4 ± 3.6% StO2 × 3.5 s?1; P = 0.009) compared with the controls.ConclusionsIn comparison with age- and sex-matched controls, adults with complex CHD had slower oxygenation kinetics. This altered skeletal muscle metabolism might contribute to the impaired skeletal muscle endurance capacity shown and thereby also to the reduced aerobic capacity in this population. 相似文献
Mental health is a major public health priority, particularly among refugees worldwide. The United Nations Relief and Works Agency for Palestine Refugees (UNRWA) started to integrate mental health and psychosocial support (MHPSS) into its primary health-care services in Jordan in late 2017. This baseline study aimed to assess the knowledge, attitudes, practices, and perceived barriers among UNRWA health staff regarding the implementation of the MHPSS programme.
Methods
The UNRWA Health Programme conducted a cross-sectional study of a sample of 220 out of the 390 male and female doctors, dentists, nurses, and midwives who work at 16 of the 25 UNRWA health centres in Jordan during November, 2017. Individuals on duty at the health centres on the day of the survey were included. The 16 health centres were selected based on their size and accessibility to surveyors (reflecting proximity to Amman, and the size of population served). Of the selected health centres, seven were large, seven were medium, and two were small according to the UNRWA classification of health centres (based on the number of medical doctors). A validated self-administered questionnaire was used. Ethics approval was granted by the UNRWA Health Programme ethics committee, and informed written consent was obtained from all participants. Data analysis was performed using SPSS (version 22).
Findings
Of the participants, 73% (161 of 220) believed that their knowledge of MHPSS programmes was insufficient, with no significant difference (p=0·116) between different categories of staff. Furthermore, 88% (194 of 220) said that they needed more training, 67% (147 of 220) reported that the number of mental health cases is increasing, and 50% (110 of 220) that dealing with these cases is difficult. Reflecting on the past 12 months, 31% of staff (69 out of 220) reported meeting between one and ten children, and 45% (100 out of 220) reported meeting between one and ten adults suspected of having mental illnesses. The most suspected condition was depression (84%; 150 of 220), followed by epilepsy (64%; 140 of 220). The main perceived barriers to implementation included the limited availability of MHPSS policies (87%; 192 of 220), MH professionals (86%; 190 of 220), resources (86%; 189 out of 220), and lack of privacy (14%; 31 out of 220).
Interpretation
Most health staff had positive attitudes towards MHPSS programme implementation but felt they lacked the required knowledge. There is a need for training and clear technical guidelines. Perceived barriers to MHPSS programme implementation need to be tackled with a structured plan of action.
Funding
The UNRWA Health Programme, UNRWA Headquarters, Amman, Jordan. 相似文献
To describe the relationship between psychosocial factors and mental health among housekeepers.
Methods
A cross-sectional study was conducted nearby all the housekeepers of Farhat-Hached teaching hospital of Sousse (Tunisia). After their oral consent, employees completed a self-administrated questionnaire including socio-demographic and lifestyle data, the Job Content Questionnaire (JCQ) evaluating psychological stress at work and the Hopkins Symptoms Checklist (HSCL-25) studying mental health.
Results
Overall, 136 cleaners were enrolled in the study, corresponding to a response rate of 89.5%. The mean age was 41.9 ± 7.7 years. According to the demand control model, 26.5% of the participants were in the situation of job-strain. The study of HSCL-25 scales revealed a positive mental health disorders in 50% of cases. The study of the psychosocial factors revealed a correlation between job-strain and urban origin (P = 0.007), high psychological demand and seniority in the cleaning sector (P = 0.030) and low decision latitude and the night work (P = 0.015). The mental health association were associated with unmarried status (P = 0.006), high psychological demand (P < 0.001), active employees (P = 0.037), and iso-strain (P = 0.013). Mental disorders were associated with a high psychological demand in the presence of a high decision latitude (OR = 9.2 [2.8–30.8]) and a job-strain in the presence of low social support (OR = 3.5 [1.2–10.4]).
Conclusion
Psychosocial factors can deteriorate seriously the mental health of workers. Their identification is the most important step in any efficient preventive strategy. 相似文献
A substantial and growing body of literature explores health disparities in radiology and imaging. The term “health disparities” refers to health differences related to disadvantages experienced by vulnerable populations, often caused by underlying social determinants of health. As such, health disparities are often closely tied to issues of social justice. Radiologists can work to reduce health disparities in different ways, including through supporting education, diversity and inclusion efforts, disparities research, and advocacy. 相似文献