“It Takes a (Healthy) Village to Raise a Child:” A Case for Integrating Public Health and Social Work Research to Eliminate Health Disparities

Issue Editor, Heather H. Goltz, introduces Volume 17, Issue 1 of the Journal of Family Strengths

A Rare Family: Exploring Genetic Literacy in an Online Support Group

Healthy People 2020 and the Institute of Medicine (IOM) define health literacy as the “degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.” Essential components of health literacy include oral and print literacy, numeracy, and cultural and conceptual knowledge; the latter is influenced by sociodemographic factors and cultural understandings and approaches to concepts such as healthcare. Genetic literacy, a form of health literacy, may be defined as the knowledge, skills and attitudes necessary to individual understanding of genetic information, and genetic-based health, behavior, technology and services, making it a vital component of sexual and reproductive decision-making. The current qualitative research study employed holistic-content and narrative analysis of secondary data (electronic or e-mail posts) from an online support group for individuals affected by a genetic disorder in order to to gain additional insights into specific psychosocial and environmental variables that affect individual genetic literacy, related perceptions of genetic risk, and sexual and reproductive decision-making. Findings from the study indicate that online health-related support groups can evolve into a socially-constructed “family” of individuals affected by specific disorders. Within this online family, members find others who can identify with their feelings and experiences. Like biological families of origin, this “familial” context may then exert particularly strong influences on members’ social and health decision-making via co-constructed cultural and conceptual knowledge of the disorder. Further qualitative research needs to be performed to understand the positive and negative impact that participation in a collective consciousness might have on individual genetic literacy necessary for making sensitive decisions such as those involved in sexual and reproductive health. Implications for education and counseling are discussed

Developing Professional Identity and Networks at Conferences

Professional conferences play an important role in the development of health behavior researchers. These venues are essential for applying academic coursework and advancing or strengthening skills in professional settings. Attending meetings enables students and early career scholars to interact with researchers and practitioners in the field for the purposes of sharing research findings, discussing practice strategies, and exploring career options through networking opportunities. Conference experiences can be enhanced by proper planning and execution before, during, and after the event. This editorial provides recommendations to junior conference attendees related to a variety of topics including time management, presentation etiquette, networking, locating mentors, and post-meeting follow-up procedures

Critical Issues: Defining and Debunking Misconceptions in Health, Education, Criminal Justice, and Social Work/Social Services

The University of Houston Downtown Committee for the Journal of Family Strengths introduces Volume 18, Issue 1: Critical Issues: Defining and Debunking Misconceptions in Health, Education, Criminal Justice, and Social Work/Social Services

Changes in Sexual Roles and Quality of Life for Gay Men after Prostate Cancer: Challenges for Sexual Health Providers

Introduction Gay men with prostate cancer ( GMPCa ) may have differential health‐related quality of life ( HRQOL ) and sexual health outcomes than heterosexual men with prostate cancer ( PCa ), but existing information is based on clinical experience and small studies. Aims Our goals were to: (i) describe HRQOL and examine changes in sexual functioning and bother; (ii) explore the psychosocial aspects of sexual health after PCa ; and (iii) examine whether there were significant differences on HRQOL and sexual behavior between GMPCa and published norms. Methods A convenience sample of GMPCa completed validated disease‐specific and general measures of HRQOL , ejaculatory function and bother, fear of cancer recurrence, and satisfaction with prostate cancer care. Measures of self‐efficacy for PCa management, illness intrusiveness, and disclosure of sexual orientation were also completed. Where possible, scores were compared against published norms. Main Outcome Measures Main outcome measures were self‐reported sexual functioning and bother on the E xpanded P rostate C ancer I ndex. Results Compared with norms, GMPCa reported significantly worse functioning and more severe bother scores on urinary, bowel, hormonal symptom scales ( P s < 0.015–0.0001), worse mental health functioning ( P  < 0.0001), greater fear of cancer recurrence ( P  < 0.0001), and were more dissatisfied with their PCa medical care. However, GMPCa reported better sexual functioning scores ( P  < 0.002) compared with norms. Many of the observed differences met criteria for clinical significance. Physical functioning HRQOL and sexual bother scores were similar to that of published samples. GMPCa tended to be more “out” about their sexual orientation than other samples of gay men. Conclusions GMPCa reported substantial changes in sexual functioning after PCa treatment. They also reported significantly worse disease‐specific and general HRQOL , fear of recurrence, and were less satisfied with their medical care than other published PCa samples. Sexual health providers must have an awareness of the unique functional and HRQOL differences between gay and heterosexual men with PCa. Hart TL, Coon DW, Kowalkowski MA, Zhang K, Hersom JI, Goltz HH, Wittmann DA, and Latini DM. Changes in sexual roles and quality of life for gay men after prostate cancer: Challenges for sexual health providers. J Sex Med 2014;11:2308–2317.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108360/1/jsm12598.pd

Preferred health information sources: An examination of vulnerable middle-aged and older women

Background. Women are the greatest consumers of health information. Despite this fact, little is known about middle-aged and older women’s preferred sources for health information. Objectives. This study aims to: (1) identify preferred sources of health-related information among middle-aged and older women; and (2) examine sociodemographics, family/household characteristics, health status, and health-related behaviors associated with their preferred sources for health information. Methods. Data were collected from 3,946 middle-age and older women using a randomized multimodal survey of households in an eight-county region of Texas. Frequencies, Pearson’s chi-squares and one-way ANOVA were used to examine relationships to the respondent’s preferred sources of health information and assess differences among variables. Multinomial logistic regression was performed to compare factors associated with participants’ preferred source of receiving health-related messages. Results. Most participants preferred receiving health information from healthcare providers (62.7%), followed by the internet (13.5%), mass media (12.2%), and family/friends (11.6%). Women who were older, Non-Hispanic/Latino African American, living in rural areas, who had more chronic conditions, who were overweight or obese, and had consulted a doctor in the past 12 months were significantly less likely to prefer internet-based health messages to receiving health information from healthcare providers. In contrast, participants residing with children ages 5 years and younger were more likely to prefer receiving health information from family and friends than from healthcare providers. Conclusion: Although provider-patient communication was preferred, a variety of channels may be needed to disseminate accurate and reliable health messages to middle-aged and older women

Factors Associated with Four Sexual Behaviors among Married/Partnered Women Ages 60 and Older in the United States

Women ages 60 and older vary in sexual behaviors. This study examined the prevalence of vaginal intercourse, outercourse, and receipt and performance of oral sex reported among 461 married/partnered women age ≥ 60 years in the United States and factors associated with these four sexual behaviors. Using data from the National Social Life, Health, and Aging Project, associations between participants’ socio-demographics, health indicators, sexual perceptions, communication, and sexual behaviors were examined. In the past year, 53.6% reported having vaginal intercourse, 56.0% outercourse, and 21.7% receiving and 20.6% performing oral sex. Women with depressive symptomology were less likely to report intercourse and outercourse (p &lt; 0.05). Women endorsing pleasurable sex as necessary to maintain relationships were more likely to report all four behaviors (p &lt; 0.01). Women who communicated openly with partners were more likely to report intercourse (p = 0.002), outercourse (p = 0.001), and performing oral sex (p = 0.025). Findings may inform strategies about positive sex perceptions and strengthening partner communication

Associations of practical, emotional, and physical problems with psychosocial distress among cancer patients.

OBJECTIVE: To better understand the relationship between cancer patient distress and psychosocial variables, including problem types, to improve ability to predict and address psychosocial need. METHODS: A variation of National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) was administered and collected at four sites from an Integrated Network Cancer Program (INCP). The presence of moderate/severe distress was examined relative to patient demographics, disease characteristics, and psychosocial problems. RESULTS: Distress scores were positively correlated with all problem counts. For every count increase of practical, emotional, and physical problems, and for every cancer stage increase the odds of reporting a moderate/severe distress score was significantly higher. Relative to patients with one cancer treatment type, patients with three cancer treatment types were significantly less likely to report moderate/severe distress. CONCLUSION: Problem count could be a useful indicator for clinical intervention. Stage and number of treatment types may also be considered clinically relevant distress predictors

Social Determinants Contribute to Disparities in Test Positivity, Morbidity and Mortality: Data from a Multi-Ethnic Cohort of 1094 GU Cancer Patients Undergoing Assessment for COVID-19

Background: The COVID-19 pandemic exploits existing inequalities in the social determinants of health (SDOH) that influence disease burden and access to healthcare. The role of health behaviours and socioeconomic status in genitourinary (GU) malignancy has also been highlighted. Our aim was to evaluate predictors of patient-level and neighbourhood-level factors contributing to disparities in COVID-19 outcomes in GU cancer patients. Methods: Demographic information and co-morbidities for patients screened for COVID-19 across the Mount Sinai Health System (MSHS) up to 10 June 2020 were included. Descriptive analyses and ensemble feature selection were performed to describe the relationships between these predictors and the outcomes of positive SARS-CoV-2 RT-PCR test, COVID-19-related hospitalisation, intubation and death. Results: Out of 47,379 tested individuals, 1094 had a history of GU cancer diagnosis; of these, 192 tested positive for SARS-CoV-2. Ensemble feature selection identified social determinants including zip code, race/ethnicity, age, smoking status and English as the preferred first language—being the majority of significant predictors for each of this study’s four COVID-19-related outcomes: a positive test, hospitalisation, intubation and death. Patient and neighbourhood level SDOH including zip code/ NYC borough, age, race/ethnicity, smoking status, and English as preferred language are amongst the most significant predictors of these clinically relevant outcomes for COVID-19 patients. Conclusion: Our results highlight the importance of these SDOH and the need to integrate SDOH in patient electronic medical records (EMR) with the goal to identify at-risk groups. This study’s results have implications for COVID-19 research priorities, public health goals, and policy implementations

Social Determinants Contribute to Disparities in Test Positivity, Morbidity and Mortality: Data from a Multi-Ethnic Cohort of 1094 GU Cancer Patients Undergoing Assessment for COVID-19

Background: The COVID-19 pandemic exploits existing inequalities in the social determinants of health (SDOH) that influence disease burden and access to healthcare. The role of health behaviours and socioeconomic status in genitourinary (GU) malignancy has also been highlighted. Our aim was to evaluate predictors of patient-level and neighbourhood-level factors contributing to disparities in COVID-19 outcomes in GU cancer patients. Methods: Demographic information and co-morbidities for patients screened for COVID-19 across the Mount Sinai Health System (MSHS) up to 10 June 2020 were included. Descriptive analyses and ensemble feature selection were performed to describe the relationships between these predictors and the outcomes of positive SARS-CoV-2 RT-PCR test, COVID-19-related hospitalisation, intubation and death. Results: Out of 47,379 tested individuals, 1094 had a history of GU cancer diagnosis; of these, 192 tested positive for SARS-CoV-2. Ensemble feature selection identified social determinants including zip code, race/ethnicity, age, smoking status and English as the preferred first language&mdash;being the majority of significant predictors for each of this study&rsquo;s four COVID-19-related outcomes: a positive test, hospitalisation, intubation and death. Patient and neighbourhood level SDOH including zip code/ NYC borough, age, race/ethnicity, smoking status, and English as preferred language are amongst the most significant predictors of these clinically relevant outcomes for COVID-19 patients. Conclusion: Our results highlight the importance of these SDOH and the need to integrate SDOH in patient electronic medical records (EMR) with the goal to identify at-risk groups. This study&rsquo;s results have implications for COVID-19 research priorities, public health goals, and policy implementations