HIV-Related Knowledge and Practices among Asian and African Migrants Living in Australia: Results from a Cross-Sectional Survey and Qualitative Study

Australian HIV notification rates are higher for people born in Northeast Asia, Southeast Asia and sub-Saharan Africa compared to Australian-born people. The Migrant Blood-Borne Virus and Sexual Health Survey represents the first attempt to build the national evidence base regarding HIV knowledge, risk behaviors and testing among migrants in Australia. To inform survey development, preliminary qualitative research was conducted with a convenience sample of n = 23 migrants. A survey was developed with reference to the qualitative data and existing survey instruments. Non-probability sampling of adults born in Northeast Asia, Southeast Asia and sub-Saharan Africa was undertaken (n = 1489), and descriptive and bivariate analyses of data were conducted. Knowledge of pre-exposure prophylaxis was low (15.59%), and condom use at last sexual encounter was reported by 56.63% of respondents engaging in casual sex, and 51.80% of respondents reported multiple sexual partners. Less than one-third (31.33%) of respondents reported testing for any sexually transmitted infection or blood-borne virus in the previous two years and, of these, less than half (45.95%) tested for HIV. Confusion surrounding HIV testing practices was reported. These findings identify policy interventions and service improvements critically needed to reduce widening disparities regarding HIV in Australia

Patient participation in decision making: views of health professionals caring for people with colorectal cancer

Aim. The aim of this study was to explore views on patient participation in decision making, as described by health professionals caring for people with colorectal cancer. Background. Patient participation in health-care decision making is on the policy agenda at an international level. However, many aspects of cancer care and treatment are complex and it is unclear how health professionals view their role as promoters of patient participation. Design. A qualitative exploratory study. Methods. In depth interviews with 35 health professionals in clinical practice. Data were analysed using thematic content analysis, assisted by a computer software package for analysis of qualitative data (N-VIVO). Results. Choices in relation to surgical treatment were viewed as limited. Although it was perceived that patients could be more involved in decisions related to adjuvant treatment, providing information on various chemotherapy regimes was challenging. It was acknowledged that patients could be involved in treatment choices but there was far less clarity concerning aspects of physical and psychological care. Age was a factor when determining which patients should be offered treatment choices. Conclusion. The availability and presentation of choices to patients is context specific and tailored to the preferences of individuals. If health professionals focus only on aspects of decision making related to treatment, the potential for shared partnerships with patients in relation to choices about physical and psychological care may be lost. This may be particularly pertinent for nurses and allied professions who engage with patients throughout the illness trajectory. Relevance to clinical practice. Policy makers should arguably appreciate that health professionals have an awareness of current thinking on patient participation, but may find policy recommendations challenging to implement in clinical practice when faced with the individual needs and preferences of patients and the complexities and uncertainties of disease management

Accelerometer-assessed physical activity and sedentary time among colon cancer survivors: associations with psychological health outcomes

Purpose: The purpose of this study was to determine associations of objectively assessed moderate-to-vigorous intensity physical activity (MVPA) and sedentary time with psychological health outcomes including depression symptoms, anxiety symptoms, and overall satisfaction with life in colon cancer survivors. Methods: Colon cancer survivors (N = 180) from Alberta, Canada (n = 91), and Western Australia (n  = 89) completed a mailed survey that assessed depression symptom severity, state anxiety, and satisfaction with life (SWL). Sedentary time and MVPA were assessed using the Actigraph® GT3X+ accelerometer (60-s epochs) via a 7-day monitoring protocol. MVPA and sedentary time were corrected for wear time and then examined as quartiles (Q). Multivariate analysis of variance was used to examine associations of MVPA and sedentary time with psychological health. Results: There was a significant association between psychological health outcomes and objectively assessed MVPA [Wilks’ λ = 0.886, F(3382.2) = 2.156, p = 0.024] that suggested a small and significant association between MVPA and SWL (p = 0.032). A significant multivariate analysis of variance (MANOVA) [Wilks’ λ = 0.945, F(3159) = 3.1, p = 0.028] suggested participants meeting guidelines reported significantly fewer anxiety symptoms (M diff = −1.23, p = 0.027) and higher perceptions of SWL (M diff = 3.0, p = 0.008). No significant associations emerged for sedentary time [Wilks’ λ = 0.956, F(9382.3) = 0.788, p = 0.628].Conclusions: Contrary to previously published research using self-reports, objectively assessed MVPA and sedentary time were not associated with depression symptoms. Objectively assessed MVPA was associated with SWL and anxiety outcomes in colon cancer survivors. Implications for Cancer Survivors: Colon cancer survivors should continue to engage in regular and sustained MVPA for the accrual of psychological health benefits