Nonmedical information seeking amid conflicting health information: negative and positive effects on prostate cancer screening

This study investigates the impact of seeking information about the prostate-specific antigen (PSA) test on men’s PSA test use during a period of conflicting recommendations. Analyses used longitudinal survey data collected in 2005 and 2006 from a nationally representative sample of U.S. males aged 40–70 years (n = 777). Cross-sectionally, nonmedical information seeking was significantly associated with increased odds of having a PSA test in the past year (Time 1 odds ratio [OR] = 9.74, p < .01, 95% confidence interval [CI] = 4.37, 21.70; Time 2 OR = 5.78, p < .01, 95% CI = 3.17, 10.55). However, lagged analyses showed that among men who had a PSA at Time 1, active seeking is associated with reduced odds of later having a PSA test (OR = 0.33, p < .05, 95% CI = 0.13, 0.85). Participants who had not had a PSA test in the past year very rarely sought information about PSA tests. Information acquisition in an environment of conflicting recommendations may influence adoption of cancer screening behaviors.     

Employment status,gender and health in Spanish women

The present study analyzed relationships between employment status, gender role conformity, and health among adult Spanish women from a biopsychosocial approach. We first examined the potential relationship between employment status and conformity to feminine norms (CFNI), second, the relationship between employment status and general and psychological health, and finally, the relationship between CFNI and general and psychological health. Unemployed women (n = 103), employed women (n = 144), and full-time homemakers (n = 100) aged 18–70 yr completed a survey, including measures of psychological health (GHQ-12), general health (self-rated health), and CFNI. Data collection was conducted during 2014. Multiple logistic regression analyses produced odds ratios (OR) and 95 petrcent confidence intervals (CI) that showed that full-time homemakers were more likely to show higher levels of feminine norms conformity (OR = 2.04; 95 percent CI = 1.13–3.69; p = .017), although these differences were no longer significant when controlled for educational level. Unemployed women (OR = 3.27; 95 percent CI = 1.87–5.73; p < .001) and women who presented greater CFNI (OR = 1.56; 95 percent CI = 1.01–2.40; p = .044) were more likely to show psychological morbidity. Public health institutions should pay attention to the relevance of employment status and gender roles, given the relation of these factors to women’s health.     

Internet Access and Online Cancer Information Seeking Among Latino Immigrants From Safety Net Clinics

Internet use is widespread, but little is known about Internet use for cancer information among Latinos, especially those who rely on safety net clinics. The authors investigated access to and intended use of the Internet for cancer information among low income, immigrant Latinos predominately from Central and South America. A cross-sectional study of 1,273 Latinos 21 years and older attending safety net clinics or health fairs was conducted from June 2007 to November 2008. The authors used logistic regression models to evaluate associations of age, acculturation, psychosocial factors and other covariates with Internet access and intended use of the Internet for cancer information among those with access. Of the sample, 44% reported Internet access. Higher information self-efficacy and greater trust in the Internet were independently associated with Internet access (p = .05 and p < .001, respectively). Among those with access, 53.8% reported they intended to seek cancer help online if they needed information. Those with younger age and higher acculturation, education and self-efficacy had higher odds of intended Internet use for cancer information, considering covariates. In addition, those with high (vs. low) perceived risk of cancer (OR = 1.76; 95% CI [1.14, 2.73]; p = .01) and higher levels of trust in online health information (OR = 1.47 per one-point increase; 95% [CI 1.19, 1.82]; p = .0004) were more likely to intend to seek cancer information online. These findings that Internet access is fairly high in the immigrant Latino population and that the Internet is a trusted source of cancer information suggest that the Internet may be a channel for cancer control interventions.     

Racial and Ethnic Disparities in Potentially Avoidable Delivery Complications Among Pregnant Medicaid Beneficiaries in South Carolina

Objectives: To examine race and ethnicity differences in accessibility and effectiveness of health care during pregnancy. Methods: Data were 26,866 year 2000 Medicaid-insured deliveries from the South Carolina Office of Research and Statistics, and Area Resource File. The access indicator was Potentially Avoidable Maternity Complications (PAMCs). PAMC risks can be reduced through prenatal care, such as infection screening and treatment, and healthy behaviors it promotes. We compared PAMC risks of Blacks, Hispanics, and Whites. Analyses included PAMC rates, Chi-square, t-tests, multilevel logistic regression. Risks were estimated for ages 10–17, and 18+. Results: At ages 10–17 (n=2691), Blacks and Hispanics had notably higher unadjusted and adjusted PAMC risks (adjusted odds ratios, ORs, 2.26, p < .001; 3.29, p < .05, respectively). At ages 18+, adjusted odds for Hispanics were about half those of Whites (p < .05). Adjusted odds for adult Blacks and Whites did not differ. This may be due to controlling for many risk factors that are more prevalent among Blacks: Single, disabled, poverty, diabetes, hypertension, rurality; however, unadjusted PAMC prevalence also did not differ greatly (3.9 for Blacks, 3.4 for Whites, p < .1). Adjusted risks were high for adults with diabetes (OR 2.40, p < .001) and all rural women (teen OR 4.02, p < .05; adult OR 1.83, p < .001). Conclusions: Young Blacks and Hispanics have notably higher risks of delivery outcomes indicating less access to prenatal care of reasonable quality. Policies to reduce PAMCs in Medicaid should address needs of young Blacks and Hispanics; enhance diabetes treatment for adult women; and address rural access barriers for all women.     

Identifiable Characteristics and Potentially Malleable Beliefs Predict Stigmatizing Attributions Toward Persons With Alzheimer’s Disease Dementia: Results of a Survey of the U.S. General Public

The general public’s views can influence whether people with Alzheimer’s disease (AD) experience stigma. The purpose of this study was to understand what characteristics in the general public are associated with stigmatizing attributions. A random sample of adults from the general population read a vignette about a man with mild Alzheimer’s disease dementia and completed a modified Family Stigma in Alzheimer’s Disease Scale (FS-ADS). Multivariable ordered logistic regressions were used to examine relationships between personal characteristics and FS-ADS ratings. Older respondents expected that persons with AD would receive less support (OR = 0.82, p = .001), have social interactions limited by others (OR = 1.13, p = .04), and face institutional discrimination (OR = 1.13, p = .04). Females reported stronger feelings of pity (OR = 1.57, p = .03) and weaker reactions to negative aesthetic features (OR = 0.67, p = .05). Those who believed strongly that AD was a mental illness rated symptoms more severely (OR = 1.78, p = .007). Identifiable characteristics and beliefs in the general public are related to stigmatizing attributions toward AD. To reduce AD stigma, public health messaging campaigns can tailor information to subpopulations, recognizable by their age, gender, and beliefs.     

Psychosocial Correlates of Health Literacy Among Older Patients With Coronary Heart Disease

This study examined psychosocial correlates of health literacy (HL) scores among older patients with coronary heart disease (CHD). A cross-sectional survey assessed psychosocial factors relating to the following: self-efficacy (i.e., perception of ability to perform a specified behavior) for diet, exercise, medication, and for a future attempt to quit smoking; social support; social stigma; appointment attendance; knowledge of heart problems; and understanding of health information. Health literacy was measured by the Rapid Estimate of Adult Literacy in Medicine (REALM). Of 321 patients, 70 had a REALM score in the low HL range (<60). When adjusting for demographics, a lower REALM score was significantly associated with reports of increased difficulty understanding health information (p < .001), less knowledge of heart problems (p = .002), increased discomfort about asking for explanations of health information (p = .014), less support with discussing health problems (p = .020). Patients with CHD and low HL are likely to face psychosocial challenges when managing their health problems. In order to encourage these individuals to seek help, health professionals need to be aware of the psychosocial characteristics of patients with low HL. These individuals may need behavioral support to increase both their self-efficacy and their understanding of their medical condition.     

Underinsurance in Children with Special Health Care Needs: The Impact of Definition on Findings

To identify differences in groups of children with special healthcare needs (CSHCN) identified as underinsured by two alternate definitions and discuss implications for policy decisions based on using one definition over another. Secondary data from the National Survey of CSHCN 2005/2006 were analyzed. Only CSHCN who were continuously-insured for 12 months were included in analyses. We identified groups of underinsured CSHCN using two general definitions (“economic” and “attitudinal”) and three mutually-exclusive groups (identified by both definitions, identified by attitudinal but not economic, and identified by economic but not attitudinal). Key variables included demographics and condition characteristics. Different underinsurance rates were identified [attitudinal = 30.9 % (n = 11,470); economic = 22.7 % (n = 8,447)] with fair agreement by kappa score (κ = 0.3194; Z = 65.91; p > 0.0001). Differences across mutually-exclusive groups included family income ≥400 % FPL (attitudinal only = 34.2 %, economic only = 16.3 %, both = 18.4 %; p < 0.001) and high severity (attitudinal only = 42.5 %, economic only = 68.5 %, both = 69.9 %; p < 0.001). CSHCN who needed equipment/supplies/home health (OR = 1.31, p < 0.001) had increased odds of being identified as underinsured by the economic, but not attitudinal definition. CSHCN with private insurance had increased odds of being identified by attitudinal only or both definitions, but not by economic only (AO: OR = 1.41, p < 0.001; BOTH: OR = 2.36, p < 0.001). Despite overlap between the two definitions, choosing either one excludes some CSHCN, potentially underestimating the extent of underinsurance and masking important findings related to specific conditions characteristics. A definition that comprehensively identifies and describes underinsurance is vital to translating health insurance coverage expansion into benefit packages that meet complex health and service needs.     

English language YouTube videos as a source of lead poisoning-related information: a cross-sectional study

Exposure to lead is detrimental to children’s development. YouTube is a form of social media through which people may learn about lead poisoning. The aim of this cross-sectional study was to analyze the variation in lead poisoning-related YouTube contents between different video sources. The 100 most viewed lead poisoning-related videos were manually coded, among which, 50 were consumer-generated, 19 were created by health care professionals, and 31 were news. The 100 videos had a total of more than 8.9 million views, with news videos accounting for 63% of those views. The odds of mentioning what lead poisoning is, how to remove lead, and specifically mentioning the danger in ages 1–5 because of rapid growth among videos created by health care professionals were 7.28 times (Odds ratio, OR = 7.28, 95% CI, 2.09, 25.37, p = 0.002); 6.83 times (OR = 6.83, 95% CI, 2.05, 22.75, p = 0.002) and 9.14 times (OR = 9.14, CI, 2.05, 40.70, p = 0.004) that of consumer-generated videos, respectively. In this study, professional videos had more accurate information regarding lead but their videos were less likely to be viewed compared to consumer-generated videos and news videos. If professional videos about lead poisoning can attract more viewers, more people would be better informed and could possibly influence policy agendas, thereby helping communities being affected by lead exposure.     

Determinants of hand dermatitis,urticaria and loss of skin barrier function in professional cleaners in New Zealand

This study assessed the risk of dermatitis, urticaria and loss of skin barrier function in 425 cleaners and 281 reference workers (retail workers and bus drivers). Symptoms, atopy and skin barrier function were assessed by questionnaire, skin prick tests, and measurement of transepidermal water loss. Cleaners had an increased risk of current (past 3 months) hand/arm dermatitis (14.8% vs. 10.0%; OR = 1.9, p < 0.05) and urticaria (11% vs. 5.3%; OR = 2.4, p < 0.05) and were more likely to have dermatitis as adults (17.6% vs. 11.4%; OR = 1.8, p < 0.05). The risk of atopy was not increased, but associations with symptoms were more pronounced in atopics. Transepidermal water loss was significantly higher in cleaners. Wet-work was a significant risk factor for dermatitis and hand washing and drying significantly reduced the risk of urticaria. In conclusion, cleaners have an increased risk of hand/arm dermatitis, urticaria and loss of skin barrier function.     

The Impacts of Health Insurance Coverage on Access to Healthcare in Children Entering Kindergarten

To examine access to healthcare and health outcomes for kindergartners as they relate to insurance status and type. For the 2008, 2009, and 2010 school years, surveys were distributed to parents with a child entering kindergarten in the state of Nevada. Surveys asked parents to provide information about their child concerning their insurance status, routine medical care, medical conditions, and health behaviors. Compared to their insured peers, uninsured kindergartners were less likely to have had a check-up in the previous 12 months (p < .001; OR 6.14; 95 % CI 5.77–6.53), have a primary physician (p < .001; OR 14.32; 95 % CI 13.49–15.20), or have seen a dentist (p < .001; OR 3.93; 95 % CI 3.70–4.16), and were more likely to have a reported unmet medical need (p < .001; OR 2.60; 95 % CI 2.19–3.07). Additionally, compared to children with private insurance, those children with public insurance were less likely to have had a check-up (p < .001; OR 1.73; 95 % CI 1.59–1.89), have a primary care provider (p < .001; OR 3.87; 95 % CI 3.55–4.21), and were more likely to have unmet medical needs (p < .001; OR 2.27; 95 % CI 1.83–2.81). For children in early development—a deeply critical period—insurance status and type are predictors of important access to healthcare variables.     

The Association of Health Literacy with Physical Activity and Nutritional Behavior in Older Adults,and Its Social Cognitive Mediators

ABSTRACT

Inadequate health literacy is a common problem among older adults and is associated with poor health outcomes. Insight into the association between health literacy and health behaviors may support interventions to mitigate the effects of inadequate health literacy. The authors assessed the association of health literacy with physical activity and nutritional behavior in community-dwelling older adults. The authors also assessed whether the associations between health literacy and health behaviors are mediated by social cognitive factors. Data from a study among community-dwelling older adults (55 years and older) in a relatively deprived area in The Netherlands were used (baseline n = 643, response: 43%). The authors obtained data on health literacy, physical activity, fruit and vegetable consumption, and potential social cognitive mediators (attitude, self-efficacy, and risk perception). After adjustment for confounders, inadequate health literacy was marginally significantly associated with poor compliance with guidelines for physical activity (OR = 1.52, p = .053) but not with poor compliance with guidelines for fruit and vegetable consumption (OR = 1.20, p = .46). Self-efficacy explained 32% of the association between health literacy and compliance with physical activity guidelines. Further research may focus on self-efficacy as a target for interventions to mitigate the negative effects of inadequate health literacy.     

South African abortion attitudes from 2007-2016: the roles of religiosity and attitudes toward sexuality and gender equality

ABSTRACT

Abortion is legal in South Africa, but negative abortion attitudes remain common and are poorly understood. We used nationally representative South African Social Attitudes Survey data to analyze abortion attitudes in the case of fetal anomaly and in the case of poverty from 2007 to 2016 (n = 20,711; ages = 16+). We measured correlations between abortion attitudes and these important predictors: religiosity, attitudes about premarital sex, attitudes about preferential hiring and promotion of women, and attitudes toward family gender roles. Abortion acceptability for poverty increased over time (b = 0.05, p < .001), but not for fetal anomaly (b = ?0.008, p = .284). Highly religious South Africans reported lower abortion acceptability in both cases (Odds Ratio (OR)_anomaly = 0.85, p = .015; OR_poverty = 0.84, p = .02). Premarital sex acceptability strongly and positively predicted abortion acceptability (OR_anomaly = 2.63, p < .001; OR_poverty = 2.46, p < .001). Attitudes about preferential hiring and promotion of women were not associated with abortion attitudes, but favorable attitudes about working mothers were positively associated with abortion acceptability for fetal anomaly ((OR_anomaly = 1.09, p = .01; OR_poverty = 1.02, p = .641)). Results suggest negative abortion attitudes remain common in South Africa and are closely tied to religiosity, traditional ideologies about sexuality, and gender role expectations about motherhood.     

Development and Validation of the Chinese Health Literacy Scale for Chronic Care

This study aims to develop and test the psychometric properties of the Chinese Health Literacy Scale for Chronic Care (CHLCC). This is a methodological study with a sample of 262 patients 65 years of age and older who had chronic illnesses. Pearson's correlation, independent sample t tests, and analyses of variance were used. The CHLCC showed a significant positive correlation with Chinese literacy levels (r = 0.80; p < .001) but was negatively correlated with age (r =?0.31; p <.001). Respondents who were male (t =4.34; p <.001) and who had reached Grade 12 or higher in school (F = 51.80; p <.001) had higher CHLCC scores than did their counterparts. Individuals with high levels of health literacy had fewer hospitalizations than did their counterparts (β =?0.31; incidence rate ratio = 0.73; p <.05). The CHLCC also displayed good internal reliability (Cronbach'sα =0.91) and good test–retest reliability (intraclass correlation coefficient = 0.77; p <.01). The CHLCC is a valid and reliable measure for assessing health literacy among Chinese patients with chronic illness. The scale could be used by practitioners before implementing health promotion and education.     

Energy Drink Consumption and Associated Health Behaviors Among University Students in an Urban Setting

The objective of this study is to describe energy drink consumption and health behaviors among college students attending a predominantly minority university. Undergraduate and graduate students attending a private, minority-serving university were invited to participate in an online survey between September 2009 and August 2010. Out of 2,500 students, 407 participated yielding a response of 16 %. Analysis assessed energy drink consumption as well as participation in sport activities and high-risk behaviors. Energy drink consumption is significantly related with drinking alcohol to inebriation and driving (r = .14, p < .05) and to riding with a drunk driver (r = .15, p < .05). Athletes were more likely to engage in drinking alcohol to inebriation and driving F (1, 186) = 6.12, p < .02. Energy drink consumption is a common practice among racial minority university students. Tailored health promotion strategies and interventions are needed to address misconceptions of energy drink and alcohol mixing.     

The Long Live Kids Campaign: Awareness of Campaign Messages

Media interventions are one strategy used to promote physical activity, but little is known about their effectiveness with children. As part of a larger evaluation, the purpose of this study was to assess the short-term effect of a private industry sponsored media literacy campaign, Long Live Kids, aimed at children in Canada. Specifically, we investigated children's awareness of the campaign and its correlates. Using a cohort design, a national sample (N = 331, male = 171; mean age = 10.81, SD = 0.99) completed a telephone survey two weeks prior to the campaign release, and again 1 year later. Only 3% of the children were able to recall the Long Live Kids campaign unprompted and 57% had prompted recall. Logistic regression found family income (Wald χ² = 11.06, p < .05), and free-time physical activity (Wald χ² = 5.67, p < .01) significantly predicted campaign awareness. Active children (≥3 days/week) were twice as likely to have recalled the campaign compared with inactive children (<3 days/week), whereas children living in high-income households (>$60,000/yr) were between 3.5 to 5 times more likely to have campaign recall compared with children living in a low-income households (<$20,000/yr). These findings suggest that media campaigns developed by industry may have a role in promoting physical activity to children although our findings identified a knowledge gap between children living in high- and low-income households. Future research needs to examine how children become aware of such media campaigns and how this mediated information is being used by children.     

Emotional Tone of Ontario Newspaper Articles on the Health Effects of Industrial Wind Turbines Before and After Policy Change

Newspapers are often a primary source of health information for the public about emerging technologies. Information in newspapers can amplify or attenuate readers’ perceptions of health risk depending on how it is presented. Five geographically distinct wind energy installations in Ontario, Canada were identified, and newspapers published in their surrounding communities were systematically searched for articles on health effects from industrial wind turbines from May 2007 to April 2011. The authors retrieved 421 articles from 13 community, 2 provincial, and 2 national newspapers. To measure the emotional tone of the articles, the authors used a list of negative and positive words, informed from previous studies as well as from a random sample of newspaper articles included in this study. The majority of newspaper articles (64.6%, n = 272) emphasized negative rather than positive/neutral tone, with community newspapers publishing a higher proportion of negative articles than provincial or national newspapers, χ²(2) = 15.1, p < .001. Articles were more likely to be negative when published 2 years after compared with 2 years before provincial legislation to reduce dependence on fossil fuels (the Green Energy Act), χ²(3) = 9.7, p < .05. Repeated public exposure to negative newspaper content may heighten readers’ health risk perceptions about wind energy.     

Physical Activity Related Information Sources Predict Physical Activity Behaviors in Adults with Type 2 Diabetes

Physical activity (PA) is a key management strategy for type 2 diabetes. Despite the known benefits, PA levels are low. Whether the low level of PA is related to lack of knowledge or support is not fully understood. This study was conducted to describe where and how often adults with type 2 diabetes receive and seek information related to PA and examine the relationships between the source and quality of PA information with PA behaviors. A series of questions related to the source and quality of PA information were added to a baseline survey distributed to the participants (N = 244) of the Canadian Aerobic and Resistance Training in Diabetes (CARED) study. Physicians and television were found to be the main sources of PA-related information. In our cross-sectional model, sources of PA-related information other than that from health care professionals explained 14% (p = .05) and 16% (p < .05) of the variance for aerobic-based and resistance training behaviors and 22% (p < .01) and 15% (p < .05) for these behaviors in our longitudinal model. Physical activity (PA)-related information is widely available to adults with type 2 diabetes. Neither the quantity nor the quality of the PA information provided by health care professionals predicted PA behavior. These data provide further insight into the modes with which PA can be promoted to adults with type 2 diabetes.     

Sociocultural hegemony,gendered identity,and use of traditional and complementary medicine in Ghana

ABSTRACT

This study investigated gender differences in the use of traditional and complementary medicine (TCM) in Ghana. Using an interviewer-administered questionnaire, we collected data from March to June 2013 from 324 randomly sampled adults in the Ashanti region. The prevalence of TCM use in the prior 12 months was 86 percent. Females constituted the majority (61 percent) of TCM users. Female TCM users were more likely than male users to have had only a basic education, been traders (p ? .0001), and have health insurance (p ? .05). Using multiple logistic regression, TCM use was associated with urban residence for females (odds ratio [OR] = 7.82; 95 percent confidence interval [CI]: 1.28–47.83) but negatively related for males (OR = 0.032; 95 percent CI: 0.002–0.63). Being self-employed was associated with TCM use among males (OR = 7.62; 95 percent CI: 1.22–47.60), while females’ TCM use was associated with higher income (OR = 3.72; 95 percent CI: 1.21–11.48) and perceived efficacy of TCM (OR = 5.60; 95 percent CI: 1.78–17.64). The African sociocultural structure vests household decision-making power in men but apparently not regarding TCM use, and the factors associated with TCM use largely differed by gender. These findings provide ingredients for effective health policy planning and evaluation. Adoption and modernization of TCM should apply a gendered lens.     

Fear,Sadness and Hope: Which Emotions Maximize Impact of Anti-Tobacco Mass Media Advertisements among Lower and Higher SES Groups?

Emotive anti-tobacco advertisements can increase quitting. Discrete emotion theories suggest evoking fear may be more effective than sadness; less research has focused on hope. A weekly cross-sectional survey of smokers and recent quitters (N = 7683) measured past-month quit attempts. The main predictor was level of exposure to four different types of anti-tobacco advertisements broadcast in the two months prior to quit attempts: advertisements predominantly evoking fear, sadness, hope, or evoking multiple negative emotions (i.e., fear, guilt, and/or sadness). Greater exposure to fear-evoking advertisements (OR = 2.16, p < .01) increased odds of making a quit attempt and showed similar effectiveness among those in lower and higher SES areas. Greater exposure to advertisements evoking multiple negative emotions increased quit attempts (OR = 1.70, p < .01), but interactions indicated this was driven by those in lower SES, but not higher SES areas. Greater exposure to hope-evoking advertisements enhanced effects of fear-evoking advertisements among those in higher SES, but not lower SES areas. Findings suggest to be maximally effective across the whole population avoid messages evoking sadness and use messages eliciting fear. If the aim is to specifically motivate those living in lower SES areas where smoking rates are higher, multiple negative emotion messages, but not hope-evoking messages, may also be effective.