Investigating lupus retention in care to inform interventions for disparities reduction: an observational cohort study.

BACKGROUND:Systemic lupus erythematous (SLE) disproportionately impacts patients of color and socioeconomically disadvantaged patients. Similar disparities in HIV were reduced through a World Health Organization-endorsed Care Continuum strategy targeting "retention in care," defined as having at least two annual visits or viral load lab tests. Using similar definitions, this study aimed to examine predictors of lupus retention in care, to develop an SLE Care Continuum and inform interventions to reduce disparities. We hypothesized that Black patients and those residing in disadvantaged neighborhoods would have lower retention in care. METHODS:Abstractors manually validated 545 potential adult cases with SLE codes in 2013-2014 using 1997 American College of Rheumatology (ACR) or 2012 Systemic Lupus Erythematosus International Collaborating Clinics (SLICC) criteria. We identified 397 SLE patients who met ACR or SLICC criteria for definite lupus, had at least one baseline rheumatology visit, and were alive through 2015. Retention in care was defined as having two ambulatory rheumatology visits or SLE labs (e.g., complement tests) during the outcome year 2015, analogous to HIV retention definitions. Explanatory variables included age, sex, race, ethnicity, smoking status, neighborhood area deprivation index (ADI), number of SLE criteria, and nephritis. We used multivariable logistic regression to test our hypothesis and model predictors of SLE retention in care. RESULTS:Among 397 SLE patients, 91% were female, 56% White, 39% Black, and 5% Hispanic. Notably, 51% of Black versus 5% of White SLE patients resided in the most disadvantaged ADI neighborhood quartile. Overall, 60% met visit-defined retention and 27% met complement lab-defined retention in 2015. Retention was 59% lower for patients in the most disadvantaged neighborhood quartile (adjusted OR 0.41, CI 0.18, 0.93). No statistical difference was seen based on age, sex, race, or ethnicity. More SLE criteria and non-smoking predicted greater retention. CONCLUSIONS:Disadvantaged neighborhood residence was the strongest factor predicting poor SLE retention in care. Future interventions could geo-target disadvantaged neighborhoods and design retention programs with vulnerable populations to improve retention in care and reduce SLE outcome disparities

Socio-economic Determinants of Agripreneurship Choice among Youths in Ebonyi State, Nigeria

ABSTRACT The current down turn in the global oil sector has necessitated the quest for alternative means of wealth creation through effective engagement of youths in agripreneurship. However, the socio-economic determinants of agripreneurship choice among youths in Ebonyi State, Nigeria seem not to have been empirically established. The study adopted a multistage sampling technique in eliciting data from one hundred and eighty youth agripreneurs using structured questionnaires. The study also employed both descriptive and inferential statistics to realize the objectives. The result showed that about 60% of the youth agripreneurs in Ebonyi State, Nigeria were males who are within the mean active age of 27 years and earn a mean annual income of N77, 333 on average household size of five 5 persons. The most revealed agripreneurial choices of the youths were farm production (crop and livestock production), farm input supply, agro-processing, and marketing/distribution. The probit regression analysis result revealed that with the Pearson Goodness-of-fit of 1148.799 which was statistically significant at 1% (P<0.01), and the Pseudo R2 value of 0.058, the socio-economic characteristics of youth has strong significant effect on the agripreneurial choice among the youth. Based on the findings, the study recommended for agripreneurship education and training at all levels to ensure capacity building among the youth for diverse agro-enterprises

Socio-economic Determinants of Agripreneurship Choice among Youths in Ebonyi State, Nigeria

ABSTRACT The current down turn in the global oil sector has necessitated the quest for alternative means of wealth creation through effective engagement of youths in agripreneurship. However, the socio-economic determinants of agripreneurship choice among youths in Ebonyi State, Nigeria seem not to have been empirically established. The study adopted a multistage sampling technique in eliciting data from one hundred and eighty youth agripreneurs using structured questionnaires. The study also employed both descriptive and inferential statistics to realize the objectives. The result showed that about 60% of the youth agripreneurs in Ebonyi State, Nigeria were males who are within the mean active age of 27 years and earn a mean annual income of N77, 333 on average household size of five 5 persons. The most revealed agripreneurial choices of the youths were farm production (crop and livestock production), farm input supply, agro-processing, and marketing/distribution. The probit regression analysis result revealed that with the Pearson Goodness-of-fit of 1148.799 which was statistically significant at 1% (P<0.01), and the Pseudo R2 value of 0.058, the socio-economic characteristics of youth has strong significant effect on the agripreneurial choice among the youth. Based on the findings, the study recommended for agripreneurship education and training at all levels to ensure capacity building among the youth for diverse agro-enterprises

Socio-economic Determinants of Agripreneurship Choice among Youths in Ebonyi State, Nigeria

ABSTRACT The current down turn in the global oil sector has necessitated the quest for alternative means of wealth creation through effective engagement of youths in agripreneurship. However, the socio-economic determinants of agripreneurship choice among youths in Ebonyi State, Nigeria seem not to have been empirically established. The study adopted a multistage sampling technique in eliciting data from one hundred and eighty youth agripreneurs using structured questionnaires. The study also employed both descriptive and inferential statistics to realize the objectives. The result showed that about 60% of the youth agripreneurs in Ebonyi State, Nigeria were males who are within the mean active age of 27 years and earn a mean annual income of N77, 333 on average household size of five 5 persons. The most revealed agripreneurial choices of the youths were farm production (crop and livestock production), farm input supply, agro-processing, and marketing/distribution. The probit regression analysis result revealed that with the Pearson Goodness-of-fit of 1148.799 which was statistically significant at 1% (P<0.01), and the Pseudo R2 value of 0.058, the socio-economic characteristics of youth has strong significant effect on the agripreneurial choice among the youth. Based on the findings, the study recommended for agripreneurship education and training at all levels to ensure capacity building among the youth for diverse agro-enterprises

Extension Agents’ Use of Mobile Phone Applications for Agricultural Extension Service Delivery in Ebonyi State Agricultural Development Programme, Nigeria

This study assessed field extension agents’ utilization of mobile apps for extension service delivery in Ebonyi State Agricultural Development Programme (EBADP). The study employed quantitative research design involving 100 Field Extension Agents who were administered with structure and validated questionnaire. Descriptive statistical tools were employed in the analysis of data generated. The result of the analysis shows that the most utilized mobile apps for extension service delivery were Whatsapp (76%) and facebook (53%). Lowland rice production (65%), cassava/maize/vegetable production (58%), and upland rice production (47%) were the most recommended packages of crop production component that was extended using mobile apps in EBADP. However, these apps were highly underutilized for extension services due to constraints such as unavailability of network coverage in rural area (84%), lack of institutional policy for application of mobile apps in extension service (75%), low ownership of smartphones among farmers (73%), poor framers’ knowledgability on the use of mobile apps (67%), poor internet connectivity (66%), unstable electricity (64%), and lack/inadequate training programmes on mobile apps use for extension services (48%). The study recommended that government should initiate e-extension policy, making mobile apps extension services mandatory for public extension organization; extension organization should develop specific mobile apps that will support extension service delivery; and organizing training programmes for extension agents on the use of mobile apps for extension service delivery

Extension Agents’ Use of Mobile Phone Applications for Agricultural Extension Service Delivery in Ebonyi State Agricultural Development Programme, Nigeria

This study assessed field extension agents’ utilization of mobile apps for extension service delivery in Ebonyi State Agricultural Development Programme (EBADP). The study employed quantitative research design involving 100 Field Extension Agents who were administered with structure and validated questionnaire. Descriptive statistical tools were employed in the analysis of data generated. The result of the analysis shows that the most utilized mobile apps for extension service delivery were Whatsapp (76%) and facebook (53%). Lowland rice production (65%), cassava/maize/vegetable production (58%), and upland rice production (47%) were the most recommended packages of crop production component that was extended using mobile apps in EBADP. However, these apps were highly underutilized for extension services due to constraints such as unavailability of network coverage in rural area (84%), lack of institutional policy for application of mobile apps in extension service (75%), low ownership of smartphones among farmers (73%), poor framers’ knowledgability on the use of mobile apps (67%), poor internet connectivity (66%), unstable electricity (64%), and lack/inadequate training programmes on mobile apps use for extension services (48%). The study recommended that government should initiate e-extension policy, making mobile apps extension services mandatory for public extension organization; extension organization should develop specific mobile apps that will support extension service delivery; and organizing training programmes for extension agents on the use of mobile apps for extension service delivery

Extension Agents’ Use of Mobile Phone Applications for Agricultural Extension Service Delivery in Ebonyi State Agricultural Development Programme, Nigeria

This study assessed field extension agents’ utilization of mobile apps for extension service delivery in Ebonyi State Agricultural Development Programme (EBADP). The study employed quantitative research design involving 100 Field Extension Agents who were administered with structure and validated questionnaire. Descriptive statistical tools were employed in the analysis of data generated. The result of the analysis shows that the most utilized mobile apps for extension service delivery were Whatsapp (76%) and facebook (53%). Lowland rice production (65%), cassava/maize/vegetable production (58%), and upland rice production (47%) were the most recommended packages of crop production component that was extended using mobile apps in EBADP. However, these apps were highly underutilized for extension services due to constraints such as unavailability of network coverage in rural area (84%), lack of institutional policy for application of mobile apps in extension service (75%), low ownership of smartphones among farmers (73%), poor framers’ knowledgability on the use of mobile apps (67%), poor internet connectivity (66%), unstable electricity (64%), and lack/inadequate training programmes on mobile apps use for extension services (48%). The study recommended that government should initiate e-extension policy, making mobile apps extension services mandatory for public extension organization; extension organization should develop specific mobile apps that will support extension service delivery; and organizing training programmes for extension agents on the use of mobile apps for extension service delivery

Investigating lupus retention in care to inform interventions for disparities reduction: an observational cohort study.

BACKGROUND:Systemic lupus erythematous (SLE) disproportionately impacts patients of color and socioeconomically disadvantaged patients. Similar disparities in HIV were reduced through a World Health Organization-endorsed Care Continuum strategy targeting "retention in care," defined as having at least two annual visits or viral load lab tests. Using similar definitions, this study aimed to examine predictors of lupus retention in care, to develop an SLE Care Continuum and inform interventions to reduce disparities. We hypothesized that Black patients and those residing in disadvantaged neighborhoods would have lower retention in care. METHODS:Abstractors manually validated 545 potential adult cases with SLE codes in 2013-2014 using 1997 American College of Rheumatology (ACR) or 2012 Systemic Lupus Erythematosus International Collaborating Clinics (SLICC) criteria. We identified 397 SLE patients who met ACR or SLICC criteria for definite lupus, had at least one baseline rheumatology visit, and were alive through 2015. Retention in care was defined as having two ambulatory rheumatology visits or SLE labs (e.g., complement tests) during the outcome year 2015, analogous to HIV retention definitions. Explanatory variables included age, sex, race, ethnicity, smoking status, neighborhood area deprivation index (ADI), number of SLE criteria, and nephritis. We used multivariable logistic regression to test our hypothesis and model predictors of SLE retention in care. RESULTS:Among 397 SLE patients, 91% were female, 56% White, 39% Black, and 5% Hispanic. Notably, 51% of Black versus 5% of White SLE patients resided in the most disadvantaged ADI neighborhood quartile. Overall, 60% met visit-defined retention and 27% met complement lab-defined retention in 2015. Retention was 59% lower for patients in the most disadvantaged neighborhood quartile (adjusted OR 0.41, CI 0.18, 0.93). No statistical difference was seen based on age, sex, race, or ethnicity. More SLE criteria and non-smoking predicted greater retention. CONCLUSIONS:Disadvantaged neighborhood residence was the strongest factor predicting poor SLE retention in care. Future interventions could geo-target disadvantaged neighborhoods and design retention programs with vulnerable populations to improve retention in care and reduce SLE outcome disparities