Neighborhood Factors that Contribute to Alcohol Use and Loneliness in HIV Positive Patients

Background: Neighborhood factors contribute to substance abuse and increased health risk behavior. Alcohol use has adverse consequences as it may interfere with antiretroviral medication adherence. In addition, studies have shown that those who are HIV positive have decreased social network size, limited social support, and social isolation as well as decreased treatment adherence. It is hypothesized that participants with high neighborhood density of alcohol outlets combined with increased feelings of loneliness will be more likely to drink. Methods: Participants included 85 patients from an HIV treatment clinic in Jacksonville. Interviewer-administered measures included the Alcohol Use Disorders Identification Test (AUDIT) and UCLA Loneliness Scale. Geographical Information Systems was used to map participant residential area and surrounding neighborhood factors. This study collected cross-sectional, retrospective data. Multi-linear regression using UCLA scores and geographic alcohol outlets availability were used as predictors of drinking behavior. Results: UCLA scores (β = 0.088, p = .012) and number of alcohol outlets (β = 0.040, p = .028) were significant predictors of AUDIT scores. UCLA scores and number of alcohol outlets accounted for 10.4% (R2 = .104) of variance of AUDIT scores. Conclusion: There was co-occurrence of alcohol use and self-reported loneliness among patients currently in treatment for HIV. There also appears to be a relationship with neighborhood factors, alcohol use, and loneliness but further research is needed

Social vs. practical problems in attaining a colonoscopy: Different patient profiles?

Background: Colonoscopy is an effective procedure for identifying precancerous polyps and cancerous lesions, but it is unlike other cancer screening tools in that it requires sedation and thus assistance from at least one other individual. The intent of this paper was to identify logistical problems in completing the colonoscopy and to examine their relationships with sociodemographic characteristics. Methods: All eligible patients (n = 2500) from two academic-affiliated colonoscopy centers (one free standing, one hospital-based) were invited to participate in an onsite, pre-colonoscopy survey; patients agreeing to participate (n = 1841, RR = 73.6%) received a $5.00 gift card. Multiple correspondence analysis (MCA) was used to identify the underlying dimensional structure of the problems. Bivariate statistics were performed to compare demographic variables and health literacy levels among patients reporting problems. Multivariate logistic regression with a backwards conditional solution was used to determine the demographic variables independently associated with problems. Results: Multiple correspondence analyses indicated two dimensions of problems (social and practical). Using logistic regression, social problems (e.g., finding someone to accompany the patient) were associated with not living in the same home as the driver, not working due to disability, and younger age. Practical problems (e.g., making an appointment) were associated with “other” minority race, poorer health, lower health literacy, and younger age. Conclusion: Patients experience different problems completing the colonoscopy based on socio-demographics. Particularly at risk are patients who find it difficult to navigate the system, are of younger age, or who may have smaller social networks

Un análisis cuantitativo del uso de Plaguicidas en los campesinos colombianos: percepción del control y la confianza en este uso

ABSTRACT: This study aims to explore how campesino non pesticide users differ in their knowledge, attitudes and beliefs, and perceptions of control and confidence surrounding pesticide use compared to pesticide users. Methodology: we collected 79 questionnaires with adult (male and female) rural agricultural campesinos in San Cristobal, Antioquia, Colombia. We examined the campesinos’ perceptions on pesticides’ harm for human health and the environment, as well as their beliefs, attitudes, perceived control, and perceived confidence related to pesticide use. Results: The findings differed between two campesino groups sampled: pesticide users and agroecological adherents. Pesticide users showed lower perceptions of pesticide harm for human health and the environment, lower perceived control about stopping pesticide use (an increase of one unit in control decreases the logit of using pesticides by 74%), and lower confidence about stopping pesticide use than agroecological adherents (an increase of one unit in confidence decreases the logit of using pesticides by 64%). Discussion: Several individual factors influence the occupational safety and health of campesinos, including perceived control and confidence. We recommend that future public health and educational interventions should improve safety training and confidence so campesinos can gain control of the process for implementing behavioral change related to pesticide use reduction.RESUMEN: Este estudio pretende explorar como los campesinos no usuarios de plaguicidas difieren en su conocimiento, actitudes y creencias y percepciones de control y confianza en torno al uso de plaguicidas comparado con usuarios de plaguicidas. Metodología: Colectamos 79 cuestionarios con hombres y mujeres adultas que son campesinos agricultores en San Cristóbal, Antioquia, Colombia. Examinamos las percepciones de estos campesinos sobre el daño de los plaguicidas sobre la salud humana y el medio ambiente. También se exploraron sus creencias, actitudes, percepciones de control y confianza relacionadas con el uso de los plaguicidas. Resultados: Los hallazgos difieren entre los dos grupos de campesinos muestreados: usuarios y no usuarios de plaguicidas. Los usuarios de pesticidas experimentaron menores percepciones del daño de los plaguicidas sobre la salud humana y el medio ambiente, menor percepción del control acerca de parar el uso de plaguicidas (el incremento de una unidad en control disminuyó el logit de usar pesticidas en un 74%), y menor confianza acerca de parar el uso de pesticidas comparado con los no usuarios de plaguicidas (el aumento de una unidad en la confianza, disminuyó el logit de usar pesticidas en un 64%). Discusión: Varios factores individuales influencian la salud ocupacional y la salud de los campesinos incluyendo la percepción del control y la confianza. Recomendamos que futuras intervenciones educativas en salud pública aumenten el entrenamiento sobre prácticas seguras y la confianza. Así los campesinos pueden ganar control en el proceso de implementar cambios en su comportamiento relacionado con la reducción del uso de pesticidas

Evaluating preferences for colorectal cancer screening in individuals under age 50 using the Analytic Hierarchy Process

In 2021, the United States Preventive Services Task Force updated their recommendation, stating that individuals ages 45-49 should initiate screening for colorectal cancer. Since several screening strategies are recommended, making a shared decision involves including an individual’s preferences. Few studies have included individuals under age 50. In this study, we use a multicriteria decision analysis technique called the Analytic Hierarchy Process to explore preferences for screening strategies and evaluate whether preferences vary by age. Participants evaluated a hierarchy with 3 decision alternatives (colonoscopy, fecal immunochemical test, and computed tomography colonography), 3 criteria (test effectiveness, the screening plan, and features of the test) and 7 sub-criteria. We used the linear fit method to calculate consistency ratios and the eigenvector method for group preferences. We conducted sensitivity analysis to assess whether results are robust to change and tested differences in preferences by participant variables using chi-square and analysis of variance. Of the 579 individuals surveyed, 556 (96%) provided complete responses to the AHP portion of the survey. Of these, 247 participants gave responses consistent enough (CR < 0.18) to be included in the final analysis. Participants that were either white or have lower health literacy were more likely to be excluded due to inconsistency. Colonoscopy was the preferred strategy in those < 50 and fecal immunochemical test was preferred by those over age 50 (p = 0.002). These results were consistent when we restricted analysis to individuals ages 45-55 (p = 0.011). Participants rated test effectiveness as the most important criteria for making their decision (weight = 0.555). Sensitivity analysis showed our results were robust to shifts in criteria and sub-criteria weights. We reveal potential differences in preferences for screening strategies by age that could influence the adoption of screening programs to include individuals under age 50. Researchers and practitioners should consider at-home interventions using the Analytic Hierarchy Process to assist with the formulation of preferences that are key to shared decision-making. The costs associated with different preferences for screening strategies should be explored further if limited resources must be allocated to screen individuals ages 45-49.https://doi.org/10.1186/s12913-021-06705-

Methodological issues and research strategies in the study of coping with cancer

We explore methodological issues and research strategies and applications in the study of coping with cancer. The major points are addressed within the context of the transactional, or process, model of stress and coping offered by Lazarus and Folkman. Three features of this model are discussed: (a) a focus on what individuals are actually doing and thinking in stressful transactions as opposed to what they usually do or would do; (b) an emphasis on assessing coping behavior in relation to a specific context and; (c) attention to the dynamic nature of coping behavior. We outline each of these three features and discuss its implications for research on coping with cancer; particular attention is given to specific measurement strategies and substantive research questions.We also consider the utility of research on coping with cancer for the design and implementation of coping interventions for individuals with cancer.neoplasms coping methodology

Kenyan in-school youths\u27 level of understanding of abstinence, being faithful, and consistent condom use terms: Implications for HIV-prevention programs

Kenyan in-school youth ages 13–19 years (N = 1,375) were surveyed before an HIV-prevention intervention was implemented. As part of the survey, students wrote their definitions of the terms abstinence, being faithful, and consistent condom use. These definitions were qualitatively analyzed by determining recurrent themes, developing a codebook, and having two coders code the responses. The entire definition was assigned an overall code of fully comprehended, partly comprehended, did not comprehend, or no response in comparison to the conventional definition of the term. Overall, 48 percent fully comprehended abstinence, 20 percent fully comprehended being faithful, and 7 percent fully comprehended consistent condom use

A quantitative analysis of Colombian campesinos’ use of pesticides: perceived control and confidence in this use

Objective: this study aims to explore how campesino non pesticide users differ in their knowledge, attitudes and beliefs, and perceptions of control and confidence surrounding pesticide use compared to pesticide users. Methodology: we collected 79 questionnaires with adult (male and female) rural agricultural campesinos in San Cristobal, Antioquia, Colombia. We examined the campesinos’ perceptions on pesticides’ harm for human health and the environment, as well as their beliefs, attitudes, perceived control, and perceived confidence related to pesticide use. Results: The findings differed between two campesino groups sampled: pesticide users and agroecological adherents. Pesticide users showed lower perceptions of pesticide harm for human health and the environment, lower perceived control about stopping pesticide use (an increase of one unit in control decreases the logit of using pesticides by 74%), and lower confidence about stopping pesticide use than agroecological adherents (an increase of one unit in confidence decreases the logit of using pesticides by 64%). Discussion: Several individual factors influence the occupational safety and health of campesinos, including perceived control and confidence. We recommend that future public health and educational interventions should improve safety training and confidence so campesinos can gain control of the process for implementing behavioral change related to pesticide use reduction