The view from two worlds: The convergence of social network reports between mental health clients and their ties

Traditionally, concerns with the similarities and discrepancies between the reports of persons (or focal respondents) and their collaterals (or network ties/respondents) about the former's social support network is framed as a methodological concern. As individuals experience the devastating effects of illness, and especially as their cognitive capabilities or social perceptions may be impaired by mental health problems, these listings are seen as potentially problematic. While we share this concern, we expand the investigation of the comparison of network ties from focal and network respondents to consider the nature of differences. Using data from Wave I of the Indianapolis Network Mental Health Study, we target the "health matters" network of individuals making their first major contact with the city's largest public and voluntary facilities. Overall, we find that the networks on which "first timers" rely to discuss health matters are small, with both focal and network respondents mentioning four individuals on average. The overlap in ties mentioned is just over 2 people (or 56 percent), on average, and differ with regard to the number of friends and health care professionals mentioned. Ironically, listings are more accurate for focal respondents who have more serious mental illnesses or larger networks. The extent of overlap is lower for women focal respondents than men. In sum, while convergence is in a range considered acceptable in network studies, the substantive nature of discrepancies have interesting and important theoretical and clinical implications.     

Internalizing stigma associated with mental illness: findings from a general population survey in Jamaica.

OBJECTIVES: The culture of stigma associated with mental illness is particularly intense when persons who are normally victims of that stigmatization (mentally ill persons and their family members) themselves act negatively toward others whom they associate with mental illness. We attempt to determine the extent of this internalization and assimilation of stigmatizing attitudes, cognitions, and behaviors in persons who are at risk for such stigmatization in Jamaica. METHODS: Data from a 2006 national survey on mental health were analyzed. Demographic variables, the presence or absence of mental illness in respondents and in their family members, and responses pertaining to behaviors and attitudes toward mentally ill persons were examined. Subsamples (respondents with mental illness, respondents with a family member with mental illness, respondents with neither) were compared using the chi-square test. RESULTS: Respondents with family members with mental illness were less likely to demonstrate a number of different manifestations of stigmatization than others (P=0.009-0.019). Respondents with mental illness showed no difference in the demonstration of a number of different manifestations of stigmatization from other respondents (P=0.069-0.515). CONCLUSIONS: The small number of mentally ill respondents resulted in low statistical power for demonstrating differences between that subgroup and other respondents. The significantly more positive attitudes and behavior of respondents with family members with mental illness suggest that some benefit may be gained by creating more opportunities for the general public to interact with persons with mental illness.     

Caretaker's perceptions, attitudes and practices regarding childhood febrile illness and diarrhoeal diseases among riparian communities of Lake Victoria, Tanzania

Understanding community perceptions and attitudes towards childhood illness is important in developing appropriate interventions. A cross sectional survey was therefore, conducted in a riparian community of Lake Victoria basin in Tanzania to determine caretakers' perception, attitudes and practices on childhood malaria and diarrhoeal diseases. Among 336 caretakers interviewed, 61.1% (205) reported febrile illness in children within three months and 26.0% reported a diarrhoeal episode among children within two weeks before the survey. The majority of the respondents reported high fever (98.7%) and prostration (53.7%) as major symptoms of severe malaria. Convulsions were associated with high fever by only 13.7% of the respondents. Forty percent of the respondents attributed convulsions in children to either fever or malaria, and 24.4% correctly mentioned high fever or malaria. A health facility was the first point of care for childhood malaria for the majority (73%) of the respondents. In diarrhoeal diseases, prostration-weakness (67.7%) and dysentery (20.4%) were commonly reported among the respondents. Typical symptoms of severe dehydration (sunken eyes, loss of skin turgor, dry tears) were poorly recognised as characteristics of severe diarrhoeal diseases. Over 85% of the respondents practiced appropriate dietary measures or increased fluid intake for a child who had diarrhoea. Use of anti-diarrhoea (40.8%) and antibiotic medications (34.8%) were common in the treatment of diarrhoeal diseases. It is important that health education emphasizing recognitions of danger signs/symptoms of malaria and diarrhoeal diseases and their management is strengthened among riparian communities in Lake Victoria basin.     

Concepts of illness causation and attitudes to health care among older people in the Republic of Ireland

Fifty-one older people (26 of them women) in the Republic of Ireland were interviewed using a semi-structured schedule on their health and illness experiences at three different time points in their lives; as children, as young adults and presently. Of particular interest were their views about the causes of heart disease, cancer and tuberculosis and their experiences of the prevailing health care system during their lifetime. Participants were recruited by letter from a database of respondents to a previous national quantitative survey of older people. Of 247 people originally contacted 127 (51%) responded by letter and 51 of these took part in the interview study. Data were analysed according to principles of content analysis using NUDIST software. Reported ideas about causes of illnesses were multicausal. These were categorised as behavioural, biological, psychosocial or other explanations. While respondents placed most emphasis on behavioural explanations, this was accompanied by more complex views and critical questioning of formal health education messages. There was a strong allegiance to current biomedical concepts and practices. This appeared to be explained in part by reported negative experiences of health care treatments during childhood, particularly in hospitals, now perceived to be much improved. Advances in biomedicine were discussed with accounts of benefits received or observed by participants. An analysis of the history of health services in Ireland suggests that some of the attitudes reported reflect the experiences of the respondents as a generation rather than as older people per se and hence highlights the impact of public policy on people's experiences of and attitudes toward health and health care systems.     

Public knowledge and attitudes regarding public health inspections of restaurants

BACKGROUND: Foodborne diseases cause 76 million illnesses in the U.S. each year, and almost half of all money spent on food is spent in restaurants. Restaurant inspections are a critical public health intervention for the prevention of foodborne disease. METHODS: A telephone survey of randomly selected Tennessee residents aged > or =18 was performed. Data were collected on respondents' demographics, knowledge, attitudes, and expectations regarding restaurant inspections. RESULTS: Of 2000 respondents, 97% were aware that restaurants are inspected regularly by the health department. More than half of the respondents believed that inspections should be performed at least 12 times per year; only one third were aware that inspections currently occur only twice per year in Tennessee. More than one third of the respondents considered an inspection score of > or =90 acceptable for a restaurant at which they would eat; the mean score in Tennessee is 82. When presented with a variety of scenarios, an overwhelming number of respondents felt that public health responses to safety violations should be far more draconian than they actually are. Survey answers did not differ consistently based on respondents' race, gender, or history of having worked in a restaurant. CONCLUSIONS: This study identified a number of public misconceptions and unrealistically high expectations of the public health restaurant-inspection system. It is important to improve consumers' understanding of inspection scores and the limitations of regulatory inspections, as well as the role of such inspections in disease prevention.     

Continuing-education needs of public health educators: their perspectives.

The objective of the study described in this article was to determine the perceived continuing-education needs of employed public health educators. A three-wave mailing of a questionnaire was sent to a national sample of 500 public health educators who were asked to rate their preparation on 41 subcompetencies. Of 299 returned surveys (63%), 149 indicated that they were not currently practicing public health educators. Thus, analysis was based on 150 respondents. Six subcompetencies were perceived by 25% or more of the respondents as topics in which they needed more training. Health educators reported a need for continuing education, focused primarily on administration and evaluation of programs and applying appropriate research principles. Furthermore, the public health educators overwhelmingly preferred to attend a conference or workshop (85%) as their method of obtaining further continuing education. Health education programs and professional organizations need to take note of the identified continuing-education needs when developing future educational programs to adequately update health educators.     

Are there socioeconomic differences in responses to a commonly used self report measure of chronic illness?

BACKGROUND: Single questions on self-reported morbidity are commonly used in social or health surveys. It has been suggested that these may underestimate socioeconomic gradients in health because more disadvantaged social groups may have higher thresholds for defining illness. Method Face-to-face interviews by research nurses with community-based respondents in the West of Scotland, using a specially designed suite of prompts following up on responses to the UK General Household Survey (GHS) long-standing illness question. Participants were 858 respondents born in the early 1930s and 852 respondents born in the early 1950s (mean age at interview 59 and 40, respectively) classified by occupational social class and area deprivation. RESULTS: Adjusted for age and sex, the Relative Index of Inequality (RII) for reporting any condition in response to the GHS question was 2.14 (95% CIs 1.49-3.08) for social class and 2.01 (1.41-2.87) for Depcat. Among those not reporting any conditions to the GHS question, the RII for reporting conditions to any further prompts was 1.54 (0.87-2.70) for social class and 0.86 (0.50-1.46) for Depcat. The RIIs for reporting any condition after the initial question and all prompts were 2.16 (1.40-3.33) for social class and 1.50 (0.98-2.29) for Depcat. Across a range of conditions defined as more serious, and conditions classified by different ICD categories, socioeconomic status (SES) gradients after the initial question and all prompts were similar to, or less steep than, those produced by the GHS question alone. CONCLUSIONS: These data do not support the hypothesis that poorer social groups are more stoical and more likely to need detailed prompting in order to elicit morbidity. Nor do they support the hypothesis that SES gradients in morbidity are underestimated by using the GHS question rather than more detailed questioning. This suggests that responses to this type of question can be used in epidemiology and health needs assessment without major socioeconomic bias.     

Socio-demographic disparities in knowledge,practices, and ability to comply with COVID-19 public health measures in Canada

ObjectivesThe effectiveness of public health interventions for mitigation of the COVID-19 pandemic depends on individual attitudes, compliance, and the level of support available to allow for compliance with these measures. The aim of this study was to describe attitudes and behaviours towards the Canadian COVID-19 public health response, and identify risk-modifying behaviours based on socio-demographic characteristics.MethodsA cross-sectional online survey was administered in May 2020 to members of a paid panel representative of the Canadian population by age, gender, official language, and region of residence. A total of 4981 respondents provided responses for indicators of self-reported risk perceptions, attitudes, and behaviours towards COVID-19 public health measures.ResultsMore than 90% of respondents reported confidence in the ability to comply with a variety of public health measures. However, only 51% reported preparedness for illness in terms of expectation to work if sick or access to paid sick days. Risk perceptions, attitudes, and behaviours varied by demographic variables. Men, younger age groups, and those in the paid workforce were less likely to consider public health measures to be effective, and had less confidence in their ability to comply. Approximately 80% of respondents reported that parents provided childcare and 52% reported that parents in the workforce provided childcare while schools were closed.ConclusionPolicies to help address issues of public adherence include targeted messaging for men and younger age groups, social supports for those who need to self-isolate, changes in workplace policies to discourage presenteeism, and provincially co-ordinated masking and safe school policies.Supplementary InformationThe online version contains supplementary material available at 10.17269/s41997-021-00501-y.Keywords: COVID-19, Attitude, Behaviour, Risk perception, Survey     

The use of herbal and other non-vitamin, non-mineral supplements among pre- and post-menopausal women in Ontario

BACKGROUND: Herbal or other non-vitamin, non-mineral (NVNM) supplements are used by many Canadians, and are of public health significance given potential health effects. The majority of supplement users are women, yet there are limited data on their pattern of use. Ontario women were surveyed about their use of NVNM supplements, including those for women's health, and characteristics associated with use were examined. METHODS: 3,423 randomly selected Ontario households were telephoned to identify eligible women (25-65 years). Of the 1,741 identified, 800 agreed to participate and were mailed a self-administered questionnaire querying NVNM supplement use and health-related characteristics. Prevalence of use, duration, and reasons for use were calculated; distributions of respondent characteristics were tabulated and associations with supplement use were assessed. RESULTS: 478 women (27%) completed questionnaires; 64% reported ever, and 34% reported current use of NVNM supplements. Echinacea was the most frequently used, followed by evening primrose, garlic, and camomile; supplements were used for less than one year. Alleviation of symptoms and prevention of illness were two primary reasons for taking NVNM supplements. 49% reported ever, and 37% reported current use of supplements for women's health, and for reasons similar to other NVNM supplements. High body mass index (> or =30.0 kg/m2) was associated with more supplement use, and visiting a physiotherapist in the past year was associated with less. CONCLUSION: Findings suggest a high level of NVNM supplement use among Ontario women, possibly associated with certain health-related characteristics. This has important public health implications considering possible benefits and/or interactions with conventional medications.     

Access and utilisation of healthcare services in rural Tanzania: A comparison of public and non-public facilities using quality,equity, and trust dimensions

This study compared the access and utilisation of health services in public and non-public health facilities in terms of quality, equity and trust in the Mbarali district, Tanzania. Interviews, focus group discussions, and informal discussions were used to generate data. Of the 1836 respondents, 1157 and 679 respondents sought healthcare services on their last visit at public or non-public health facilities, respectively. While 45.5% rated the quality of services to be good in both types of facilities, reported medicine shortages were more pronounced among those who visited public rather than non-public health facilities (OR?=?1.7, 95% CI 1.4, 2.1). Respondents who visited public facilities were 4.9 times less likely than those who visited non-public facilities to emphasise the influence of cost in accessing and utilising health care (OR?=?4.9, CI 3.9–6.1). A significant difference was also found in the provider–client relationship satisfaction level between non-public (89.1%) and public facilities (74.7%) (OR?=?2.8, CI: 1.5–5.0), indicating a level of lower trust in the later. Revised strategies are needed to ensure availability of medicines in public facilities, which are used by the majority of the population, while strengthening private–public partnerships to harmonise healthcare costs.     

Adequacy of Treatment for Serious Mental Illness in the United States

OBJECTIVES: The purpose of this study was to assess the prevalence and correlates of treatment for serious mental illness. METHODS: Data were derived from the National Comorbidity Survey, a cross-sectional, nationally representative household survey assessing the presence and correlates of mental disorders and treatments. Crude and adjusted likelihoods of receiving treatment for serious mental illness in the previous 12 months were calculated. RESULTS: Forty percent of respondents with serious mental illness had received treatment in the previous year. Of those receiving treatment, 38.9% received care that could be considered at least minimally adequate, resulting in 15.3% of all respondents with serious mental illness receiving minimally adequate treatment. Predictors of not receiving minimally adequate treatment included being a young adult or an African American, residing in the South, being diagnosed as having a psychotic disorder, and being treated in the general medical sector. CONCLUSIONS: Inadequate treatment of serious mental illness is an enormous public health problem. Public policies and cost-effective interventions are needed to improve both access to treatment and quality of treatment.     

Exploring a public health perspective on pedestrian planning

A pedestrian plan is a public document that explains a community's vision and goals for future pedestrian activity. This study explored whether involvement by public health professionals in the development of pedestrian plans was associated with certain characteristics of the plan (vision, goals, identified programs, and evaluation). This study identified, collected, and analyzed content of all pedestrian plans in North Carolina through 2008. Among the 46 plans, 39% reported involvement by public health professionals in their development. Overall, 72% of pedestrian plans included a vision statement; health was mentioned four times and quality of life was mentioned five times. Slightly more than half (52%) of the plans included goals to improve public health. Plans that involved public health professionals more often included the type of physical activity, safety, or education program. Only 22% of all pedestrian plans included a proposal to evaluate their implementation. Plans that included public health professionals were less likely to include an evaluation proposal (11%) compared with those that did not involve public health professionals (21%). Public health professionals are encouraged to seek involvement in the pedestrian planning process, particularly in the areas of health program development, implementation, and evaluation.     

山东省青岛市市南区基本公共卫生服务重点人群健康知识知晓率和满意度调查

目的了解山东省青岛市市南区基本公共卫生服务重点人群健康知识知晓情况和满意度。方法从3家社区卫生服务中心采用分层随机抽样抽取493名调查对象进行问卷调查。结果重点人群的平均健康知识知晓率为69.66%（95%CI：68.09-71.22）;各项基本公共卫生服务的平均满意度为93.50%,其中老年人管理服务和重性精神病管理服务满意度偏低,分别为81.11%和85.25%,其余6项基本公共卫生服务满意度较高,均超过90%。结论青岛市市南区国家基本公共卫生服务取得了较好的成效,但仍需加强健康教育工作以及对老年人和重性精神病患者的管理服务。     

福州城区家长对社区卫生机构及儿童医疗服务评价分析

目的 了解福建省福州城区儿童家长对社区卫生机构与儿童医疗服务的评价及其影响因素.方法 于2017年8-10月抽取福州城区936名14岁以下儿童家长为调查对象,运用logistic回归分析影响家长对儿童医疗服务满意度因素.结果 儿童患常见病时,家长仍倾向于省市级医疗机构就诊,选择比例达68.06％;对于首选社区卫生机构为...     

Self-reported illness and risk behaviours amongst Canadian travellers while abroad.

403 travellers who attended The University of Calgary International Travel Clinic between August 1, 1987 and June 1, 1988, were asked to return a questionnaire detailing health, illness and risk factors while abroad. Of the 296 respondents, most travelled for fewer than 6 weeks time; destinations were primarily areas where chloroquine-resistant Plasmodium falciparum had been reported. Diarrhea was experienced by 57.3% of respondents; eating food purchased from street vendors was found to be a significant risk factor. Travellers who made trips exceeding 60 days' duration were significantly more likely to experience skin rashes, fevers or diarrhea, although it could not be determined whether this was due to their higher likelihood of undertaking high-risk behaviours, or to a higher number of person-days at risk. The findings of this high rate of illness while abroad underscores the need for specific advice on appropriate risk avoidance behaviours when pre-travel medical visits occur. Further prospective studies to determine effectiveness of such advice, and the patterns of illness based on person-days at risk, are required.     

Diabetes and Hypertension in Congolese Church Personnel: An Emerging Epidemic?

The objectives of this study were (1) to examine the prevalence of diabetes and hypertension among church personnel in North-Eastern Democratic Republic of Congo, and (2) to identify socio-demographic factors and health behaviors that are associated with these outcomes. Data for this study were obtained from a sample of 670 pastors and their wives, and other church workers in North-Eastern Congo in 2014/2015. Pearson chi square and binary logistic regression analyses were conducted with diabetes status and hypertension as outcome variables. A little over one in ten respondents (11.3?%; n?=?76) were diabetic. Of the 76 respondents with diabetes, 49, or approximately two-thirds (64?%) were aged 50 and over. Of the respondents aged 70 and above, 85.5?% were found to be hypertensive. Adjusting for all other predictors, respondents who were older, market women/homemakers, and those who used vehicles as opposed to walking or biking as their means of transport were more likely to be diabetic. Also, respondents who were older or overweight were more likely to have hypertension. The paper discusses the results and their implication for public health policy on diabetes prevention, particularly among older individuals who are religious workers in Africa.     

星级宾馆客人公共场所被动吸烟认知现况调查

目的了解宾馆客人对上海公共场所控烟状况和被动吸烟认知态度,为上海制定控烟政策与法规提供依据,并为今后开展公共场所控烟干预提供基础数据。方法通过目的性抽样,在上海市长宁区抽取13家四星级以上涉外宾馆,对中外客人811人进行问卷调查。结果62．1％的客人认为上海公共场所吸烟情况严重。酒吧、火车站、餐厅成为宾馆客人评价被动吸烟最为严重的公共场所。有72．9％的客人赞成上海应该在公共场所完全禁烟。《上海市公共场所禁止吸烟暂行条例》在中国大陆与非中国大陆客人中的知晓率不足半数。多因素分析结果表明：不吸烟者和所在地区执行无烟政策者更赞成公共场所完全禁烟政策,其OR值分别达4．42（95％CI：2．58—7．58）和3．92（95％CI：2．03～7．56）,中年组（30～49岁）更赞成上海公共场所完全禁烟政策,其OR值为1．81（95％CI：1．01～3．26）。75．8％的客人同意“公共场所无烟会提升城市的形象”,54．8％的客人表示在上海实施公共场所完全禁烟会更愿意来上海,28．0％表示不受影响。结论目前上海公共场所被动吸烟状况仍然存在,在上海现有的控烟规定不足以创建室内清新环境,维护国际性大都市的形象,亟需有效的控烟立法。     

Sociodemographic and psychological correlates of actual and desired weight insufficiency in the general population

A secondary analysis of data from a survey of physical and mental health in the general population was conducted in order to identify sociodemographic and psychological correlates of actual and desired weight insufficiency. In multiple logistic regression analyses, characteristics of respondents whose actual weight, desired weight, or both was insufficient according to Body Mass Index categories were compared to characteristics of respondents whose actual or desired weight was sufficient. Results showed a strong resemblance between weight insufficiency and pre-clinical eating disorders: those of insufficient actual and/or desired weight tended to be younger, female, and to manifest considerable psychological distress, as measured by the Psychiatric Symptom Index and a General Well-Being Schedule. Desired weight insufficiency was more important in this pattern than was actual weight, as those whose current weight was sufficient but who desired an insufficient weight had greater distress and suicidal ideation and attempts. These results, along with the high prevalence of both desired and actual weight insufficiency, underscore the importance of underweight as a public health problem.     

The critical appraisal of focus group research articles

Objectives: To determine whether the three mailings routinely used by researchers for epidemiological surveys are useful and appropriate, by comparing social characteristics and selected disease histories to find out if there are differences between individuals responding at different times.

Methods: Social characteristics and selected disease histories of 11,797 British women still under general practitioner observation in the Royal College of General Practitioners' Oral Contraception Study were compared. The women aged 40-78 at December 1992 were sent health survey questionnaires via their general practitioners between November 1994 and July 1995.

Results: Significant differences in the characteristics of first, second and third mailing respondents and non-respondents were found for smoking habits, social class, parity, area of residence, further contact, bronchitis, hysterectomy and mental illness. First mailing respondents were more likely to be from a non-manual social class, have a parity of less than three, live in England, and be happy to be contacted again, but were less likely to have had bronchitis or mental illness and were less likely to have been smokers at the time of recruitment than second mailing respondents. A comparison of second and third mailing respondents on the above factors showed no significant differences between the two groups.

Conclusions: The inclusion of third mailing respondents did not significantly change the social or health characteristic profile of the cohort and suggests that the effort and resources expended in carrying out a third mailing may not be justified.