The relationships between health beliefs and utilization of free health examinations in older people living in a community setting in Taiwan

OBJECTIVE: To examine the influence of demographics and the health beliefs of older people on uptake of a free annual health examination administered by the Twu-Tyan Bureau of Sanitation (TTBS), Pingtung, Taiwan. BACKGROUND: The free health examination is a preventive intervention with potential to detect illness. This programme for older people aged 65 years and over, has been available free in some areas since 1980. METHOD: A stratified random systematic sample of 200 men and women over 65 years was selected and consisted of 100 individuals who had undertaken the free health examination and 100 who had not. A 17-item Health Belief Scale (HBS) was used to glean information on their health beliefs and uptake of a free health examination. FINDINGS: It was found that those with higher education and higher economic status had a greater uptake. Family support was also found to influence take-up. A statistically significant difference was found between the health beliefs of users and nonusers. Users perceived a higher level of seriousness and susceptibility to ill health than nonusers. CONCLUSIONS: A number of practical pointers are given that might help clinicians increase uptake rates in such health promotion programmes. These encompass understanding the influence of key demographical and social factors, perceived susceptibility, severity and benefits of the intervention, barriers to attendance and self-efficacy.     

Infant formula feeding practices associated with rapid weight gain: A systematic review

Excess or rapid weight gain during the first 2 years of life is associated with an increased risk of later childhood and adult overweight and obesity. When compared with breastfed infants, formula fed infants are more likely to experience excess or rapid weight gain, and this increased risk in formula fed infant populations may be due to a number of different mechanisms. These mechanisms include the nutrient composition of the formula and the way formula is prepared and provided to infants. This systematic literature review examines the association between formula feeding practice and excess or rapid weight gain. This review explores these different mechanisms and provides practical recommendations for best practice formula feeding to reduce rapid weight gain. Eighteen studies are included in this review. The findings are complicated by the challenges in study design and accuracy of measurements. Nevertheless, there are some potential recommendations for best practice formula feeding that may reduce excess or rapid weight gain, such as providing formula with lower protein content, not adding cereals into bottles, not putting a baby to bed with a bottle, and not overfeeding formula. Although further well designed studies are required before more firm recommendations can be made.     

Who We Seek and What We Eat? Sources of Food Choice Inspirations and Their Associations with Adult Dietary Patterns before and during the COVID-19 Lockdown in New Zealand

Research shows the shaping of food choices often occurs at home, with the family widely recognised as significant in food decisions. However, in this digital age, our eating habits and decision-making processes are also determined by smartphone apps, celebrity chefs, and social media. The ‘COVID Kai Survey’ online questionnaire assessed cooking and shopping behaviours among New Zealanders during the 2020 COVID-19 ‘lockdown’ using a cross-sectional study design. This paper examines how sources of food choice inspirations (cooking-related advice and the reasons for recipe selection) are related to dietary patterns before and during the lockdown. Of the 2977 participants, those influenced by nutrition and health experts (50.9% before; 53.9% during the lockdown) scored higher for the healthy dietary pattern. Participants influenced by family and friends (35% before; 29% during the lockdown) had significantly higher scores for the healthy and the meat dietary patterns, whereas participants influenced by celebrity cooks (3.8% before; 5.2% during the lockdown) had significantly higher scores in the meat dietary pattern. There was no evidence that associations differed before and during the lockdown. The lockdown was related to modified food choice inspiration sources, notably an increase in ‘comforting’ recipes as a reason for recipe selection (75.8%), associated with higher scoring in the unhealthy dietary pattern during the lockdown. The lockdown in New Zealand saw an average decrease in nutritional quality of diets in the ‘COVID Kai Survey’, which could be partly explained by changes in food choice inspiration sources.     

Stakeholder experiences of using online spatial data visualisation tools for local public health decision support: A qualitative study

The distribution of food outlets within towns and cities and the provision of active travel infrastructure have been associated with health behaviours that can contribute to obesity risk. Decision-makers describe a lack of local data and research evidence as a barrier to policy adoption to improve the public's health. Online spatial data visualisation tools created by researchers can help to bridge this gap. We explored stakeholder experiences of using such tools for decision-support, with a focus on facilitators and barriers to use. We conducted 16 qualitative interviews with Public Health, Planning and Transport Planning professionals, who had used two recently-developed tools. Participants described the importance of tools being open access; their use in “story-telling”, particularly to non-experts; and more broadly their use even when imperfect. They expressed that ‘robustness’ of underpinning data was important, however this was not easily defined. Participants employed personal heuristics, principally based on endorsement and developer credibility, to determine suitability for use. We present key learning points for future developers to maximise engagement and impact.     

Socio-cultural influences on the transmission of HIV among gay men in rural China

Bisexual behaviours are relatively common among men who have sex with men in China. This pilot study aims to reveal the complex processes through which such men manage their sexuality, family responsibilities and sexual behaviours in a rural Chinese setting. A total of 15 men who have sex with men were recruited by purposive sampling. Face-to-face in-depth interviews were conducted to explore participants’ views about their sexual experiences and practices. The Chinese traditional moral code, family values and gender roles that form the crucial components of Confucianism were reflected in the participants’ efforts to maintain familial and social harmony through a compromised form of sexual partnership. Most study participants demonstrated a mixed experience of social stigma, sexual naiveté and ignorance of HIV and sexually transmitted infections (STIs). Under cultural and family pressure, men who have sex with men entered heterosexual marriages with the intention of maintaining a balance between their collectivist (familial) obligations and their individualistic (same-sex sexual) desires. However, the opaque nature of their concurrent sexual relationships may endanger their personal health and accelerate HIV and STI transmission. Reducing the stigma and social prejudice associated with male same-sex sexual relations is essential for any culturally sensitive HIV-prevention programme to succeed in rural China.     

‘Because I’ve been extremely careful’: HIV seroconversion,responsibility, citizenship and the neo-liberal drug-using subject

In this article, we examine how injection drug users who do not attribute their HIV infection to engaging in HIV risk behaviours take up and critique discourses of individual responsibility and citizenship relating to HIV risk and HIV prevention. We draw on data from a study in Vancouver, Canada (2006–2009) in which we interviewed individuals living with HIV who had a history of injection drug use. In this paper, we focus on six cases studies of participants who did not attribute their HIV infection to engaging in HIV risk behaviours. We found that in striving to present themselves as responsible HIV citizens who did not engage in HIV risk behaviours, these participants drew on individually focused HIV prevention discourses. By identifying themselves in these ways, they were able to present themselves as ‘deserving’ HIV citizens and avoid the blame associated with being HIV positive. However, in rejecting the view that they and their risk behaviours were to blame for their HIV infection and by developing an explanation that drew on broader social, structural and historical factors, these individuals were developing a tentative critique of focus on individual responsibility in HIV transmission as opposed to dangers of infection arising from the socio-economic environment. By framing the risk of infection in environmental rather than individual risk-behaviour terms, these individuals redistributed responsibility to reflect the social-structural realities of their lives. In this article, we reflect on the implications of these findings for public health measures such as risk prevention messages. We argue that it is important that such messages are not restricted to individual risk prevention but also include a focus of broader shared responsibilities of HIV.     

Participation and Citizenship of Elderly Persons

Abstract

In the article the participation of the aged users and their relatives in a local health care and social service system will be discussed. How is their citizenship defined at the grass roots level? The research data were gathered during a case management project of the action research type in a Finnish rural municipality. The data of this study consist of 13 theme interviews: five elderly persons as care receivers and eight caregivers. The research approach is a dialogue between data based analysis and conceptual reasoning.

Citizenship rights and obligations and participation should be defined flexibly and individually in the context of the local health care and social services. In the research data the elderly persons and their caregivers described participation in multiple ways. The modes of participation vary from passive and active disengagement from the process to contacting, negotiating, cooperating, and demanding     

Trends in health screening participation and lifestyle behaviours after participation in a free,access‐enhanced screening intervention in a low‐income Singaporean rental‐flat community

Our objective was to evaluate the impact of an access‐enhanced health screening intervention on screening adherence in a rental‐flat community. In Singapore, public rental flats provide heavily subsidised rentals for the needy who cannot afford to own their own homes; with a majority of Singaporeans (≥85%) staying in owner‐occupied public housing. We observed trends in health screening adherence and health behaviours among residents of a multi‐ethnic public rental‐flat community in Singapore from 2013 to 2017, after participation in a free, access‐enhanced multi‐modality screening programme in 2011. Residents staying in neighbouring owner‐occupied housing who participated in the same screening programme served as a basis of comparison. A total of 478 rental‐flat residents and 505 owner‐occupied flat residents participated. In the rental‐flat community, hypertension screening rates improved from 18.3% (24/131) in 2013, to 61.2% (52/85) in 2015 and 44.2% (34/77) in 2017 (p < .001). For diabetes, rates improved from 26.2% (43/164) → 47.0% (54/115) → 49.5% (45/91; p < .001). For dyslipidaemia screening, rates improved from 18.2% (31/170) → 39.6% (38/96) → 47.5% (38/80; p < .001). In the owner‐occupied community (n = 505), screening rates largely remained stagnant (hypertension: 52.2% → 75.0% → 54.5%, p = .059; diabetes: 66.0% → 56.5% → 66.7%, p = .434; dyslipidaemia: 53.1% → 50.0% → 57.1%, p = .818). In the rental‐flat community, unhealthy behaviours increased from 2013 to 2017, with higher proportions of overweight (30.4% → 24.8% → 52.1%, p < .001), higher smoking (11.7% → 36.9% → 32.5%, p < .001) and higher drinking rates (1.4% → 0.7% → 8.1%, p < .001). This shift was also reflected in the owner‐occupied community, with higher percentages of overweight and higher drinking rates (p < .001).