Introduction: While childrearing can enhance mothers' psychological well-being, parenting can also increase mental stress for mothers with young children, which is considered a risk factor for child maltreatment. A lack of social capital reportedly influences mothers' parenting, but few studies have investigated the effects of social capital on the perception of mental stress and well-being associated with childrearing among mothers with young children. Therefore, we investigated the effects of lower perceived neighborhood trust and support on higher mental stress and/or lower well-being associated with childrearing among Japanese mothers with children aged 2 to 3 years.
Methods: A total of 570 mothers with children (aged 2-3 years) in nursery school were invited to join the survey. The childrearing perspective scale for mothers (CPS-M97) was used to evaluate mothers' perceptions of mental stress and well-being associated with childrearing. Odds ratios (ORs) reflecting lower satisfaction/fulfillment scores (ie, well-being) and/or higher burdened/anxious scores (ie, mental stress) associated with perceived social capital levels were analyzed, after adjusting for confounding factors.
Results: The OR for lower satisfaction/fulfillment scores was significantly higher (OR = 1.77) for mothers with lower neighborhood trust. Significantly increased ORs for higher burdened/anxious scores were found in mothers with lower neighborhood trust (OR = 1.50) and support (OR = 1.49). The ORs for poor mental status, with lower satisfaction/fulfillment scores and higher burdened/anxious scores, were significantly increased in mothers with lower neighborhood trust (OR = 1.96) and lower neighborhood support (OR = 2.10).
Conclusions: Higher social capital was associated with higher psychological well-being and/or lower mental stress in Japanese childrearing mothers. These results suggest that enhancing social capital is necessary to facilitate successful parenting that contributes to the prevention of child maltreatment.
{"title":"The Effects of Neighborhood Trust and Support on Parenting Stress of Mothers With Young Children in Japan.","authors":"Noriko Kaneko, Muneko Nishijo, Keiko Agawa, Kazuko Ishigaki, Yoshikazu Nishino","doi":"10.1177/21501319241237056","DOIUrl":"10.1177/21501319241237056","url":null,"abstract":"<p><strong>Introduction: </strong>While childrearing can enhance mothers' psychological well-being, parenting can also increase mental stress for mothers with young children, which is considered a risk factor for child maltreatment. A lack of social capital reportedly influences mothers' parenting, but few studies have investigated the effects of social capital on the perception of mental stress and well-being associated with childrearing among mothers with young children. Therefore, we investigated the effects of lower perceived neighborhood trust and support on higher mental stress and/or lower well-being associated with childrearing among Japanese mothers with children aged 2 to 3 years.</p><p><strong>Methods: </strong>A total of 570 mothers with children (aged 2-3 years) in nursery school were invited to join the survey. The childrearing perspective scale for mothers (CPS-M97) was used to evaluate mothers' perceptions of mental stress and well-being associated with childrearing. Odds ratios (ORs) reflecting lower satisfaction/fulfillment scores (ie, well-being) and/or higher burdened/anxious scores (ie, mental stress) associated with perceived social capital levels were analyzed, after adjusting for confounding factors.</p><p><strong>Results: </strong>The OR for lower satisfaction/fulfillment scores was significantly higher (OR = 1.77) for mothers with lower neighborhood trust. Significantly increased ORs for higher burdened/anxious scores were found in mothers with lower neighborhood trust (OR = 1.50) and support (OR = 1.49). The ORs for poor mental status, with lower satisfaction/fulfillment scores and higher burdened/anxious scores, were significantly increased in mothers with lower neighborhood trust (OR = 1.96) and lower neighborhood support (OR = 2.10).</p><p><strong>Conclusions: </strong>Higher social capital was associated with higher psychological well-being and/or lower mental stress in Japanese childrearing mothers. These results suggest that enhancing social capital is necessary to facilitate successful parenting that contributes to the prevention of child maltreatment.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10943704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1177/21501319241255542
Florence J Dallo, Kyrah K Brown, Adebola Obembe, Tiffany Kindratt
Objective: To estimate and compare the proportion of foreign-born Middle Eastern/North African (MENA) children without health insurance, public, or private insurance to foreign- and US-born White and US-born MENA children.
Methods: Using 2000 to 2018 National Health Interview Survey data (N = 311 961 children) and 2015 to 2019 American Community Survey data (n = 1 892 255 children), we ran multivariable logistic regression to test the association between region of birth among non-Hispanic White children (independent variable) and health insurance coverage types (dependent variables).
Results: In the NHIS and ACS, foreign-born MENA children had higher odds of being uninsured (NHIS OR = 1.50, 95%CI = 1.10-2.05; ACS OR = 2.11, 95%CI = 1.88-2.37) compared to US-born White children. In the ACS, foreign-born MENA children had 2.11 times higher odds (95%CI = 1.83-2.45) of being uninsured compared to US-born MENA children.
Conclusion: Our findings have implications for the health status of foreign-born MENA children, who are currently more likely to be uninsured. Strategies such as interventions to increase health insurance enrollment, updating enrollment forms to capture race, ethnicity, and nativity can aid in identifying and monitoring key disparities among MENA children.
{"title":"Disparities in Health Insurance Among Middle Eastern and North African American Children in the US.","authors":"Florence J Dallo, Kyrah K Brown, Adebola Obembe, Tiffany Kindratt","doi":"10.1177/21501319241255542","DOIUrl":"10.1177/21501319241255542","url":null,"abstract":"<p><strong>Objective: </strong>To estimate and compare the proportion of foreign-born Middle Eastern/North African (MENA) children without health insurance, public, or private insurance to foreign- and US-born White and US-born MENA children.</p><p><strong>Methods: </strong>Using 2000 to 2018 National Health Interview Survey data (N = 311 961 children) and 2015 to 2019 American Community Survey data (n = 1 892 255 children), we ran multivariable logistic regression to test the association between region of birth among non-Hispanic White children (independent variable) and health insurance coverage types (dependent variables).</p><p><strong>Results: </strong>In the NHIS and ACS, foreign-born MENA children had higher odds of being uninsured (NHIS OR = 1.50, 95%CI = 1.10-2.05; ACS OR = 2.11, 95%CI = 1.88-2.37) compared to US-born White children. In the ACS, foreign-born MENA children had 2.11 times higher odds (95%CI = 1.83-2.45) of being uninsured compared to US-born MENA children.</p><p><strong>Conclusion: </strong>Our findings have implications for the health status of foreign-born MENA children, who are currently more likely to be uninsured. Strategies such as interventions to increase health insurance enrollment, updating enrollment forms to capture race, ethnicity, and nativity can aid in identifying and monitoring key disparities among MENA children.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141069522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1177/21501319241278874
Nathalie Huguet, Heather Holderness, Cirila Estela Vasquez Guzman, Miguel Marino, John Heintzman
Cancer is the top leading cause of death among Latino people. Lack of health insurance is a significant contributor to inadequate cancer detection and treatment. Despite healthcare policy expansions such as the Affordable Care Act, Latino people persistently maintain the highest uninsured rate among any ethnic and racial group in the US, especially among Latino individuals who are immigrants or part of a mixed immigration status household. Recognizing that immigration status is a critical factor in the ability of Latino community members to seek health insurance and access healthcare services, a few US states and the District of Columbia have implemented policies that have expanded coverage to children and adults regardless of immigration status. Expansion of Medicaid eligibility regardless of immigration status may significantly benefit Latino communities, however the facilitators and barriers to enrolling in these programs need to be evaluated to ensure reach and achieve health equity across the cancer control continuum for all Latinos.
{"title":"Achieving Cancer Equity by Improving Health Insurance Access for All Latinos.","authors":"Nathalie Huguet, Heather Holderness, Cirila Estela Vasquez Guzman, Miguel Marino, John Heintzman","doi":"10.1177/21501319241278874","DOIUrl":"10.1177/21501319241278874","url":null,"abstract":"<p><p>Cancer is the top leading cause of death among Latino people. Lack of health insurance is a significant contributor to inadequate cancer detection and treatment. Despite healthcare policy expansions such as the Affordable Care Act, Latino people persistently maintain the highest uninsured rate among any ethnic and racial group in the US, especially among Latino individuals who are immigrants or part of a mixed immigration status household. Recognizing that immigration status is a critical factor in the ability of Latino community members to seek health insurance and access healthcare services, a few US states and the District of Columbia have implemented policies that have expanded coverage to children and adults regardless of immigration status. Expansion of Medicaid eligibility regardless of immigration status may significantly benefit Latino communities, however the facilitators and barriers to enrolling in these programs need to be evaluated to ensure reach and achieve health equity across the cancer control continuum for all Latinos.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1177/21501319241274308
Saskia Spiess, Robert Owens, Elizabeth Charron, Mario DeMarco, Mirela Feurdean, Karen Gold, Kathryn Murray, Nicholas Schenk, Kirsten Stoesser, Pauline Thomas, Emmanuel Adediran, Elena Gardner, Katherine Fortenberry, Thomas Carl Whittaker, Dominik Ose
The United States (US) is experiencing a maternal health crisis, with high rates of maternal morbidity and mortality. The US has the highest rates of pregnancy-related mortality among industrialized nations. Maternal mortality has more than quadrupled over the last decades. Rural areas and minoritized populations are disproportionately affected. Increased pregnancy-care workforce with greater participation from family medicine, greater collaborative care, and adequate postpartum care could prevent many maternal deaths. However, more than 40% of birthing people in the US receive no postpartum care. No singular solutions can address the complex contributors to the current situation, and efforts to address the crisis must address workforce shortages and improve care during and after pregnancy. This essay explores the role family medicine (FM) can play in addressing the crisis. We discuss pregnancy care training in FM residencies as well as the threats posed by financial and medico-legal climates to the maternal health workforce. We explore how collaborative care models and comprehensive postpartum care may impact the maternal health workforce. Efforts and resources devoted to high impact solutions for which FM has considerable autonomy, including collaborative and postpartum care, are likely to have greatest impact.
{"title":"The Role of Family Medicine in Addressing the Maternal Health Crisis in the United States.","authors":"Saskia Spiess, Robert Owens, Elizabeth Charron, Mario DeMarco, Mirela Feurdean, Karen Gold, Kathryn Murray, Nicholas Schenk, Kirsten Stoesser, Pauline Thomas, Emmanuel Adediran, Elena Gardner, Katherine Fortenberry, Thomas Carl Whittaker, Dominik Ose","doi":"10.1177/21501319241274308","DOIUrl":"10.1177/21501319241274308","url":null,"abstract":"<p><p>The United States (US) is experiencing a maternal health crisis, with high rates of maternal morbidity and mortality. The US has the highest rates of pregnancy-related mortality among industrialized nations. Maternal mortality has more than quadrupled over the last decades. Rural areas and minoritized populations are disproportionately affected. Increased pregnancy-care workforce with greater participation from family medicine, greater collaborative care, and adequate postpartum care could prevent many maternal deaths. However, more than 40% of birthing people in the US receive no postpartum care. No singular solutions can address the complex contributors to the current situation, and efforts to address the crisis must address workforce shortages and improve care during and after pregnancy. This essay explores the role family medicine (FM) can play in addressing the crisis. We discuss pregnancy care training in FM residencies as well as the threats posed by financial and medico-legal climates to the maternal health workforce. We explore how collaborative care models and comprehensive postpartum care may impact the maternal health workforce. Efforts and resources devoted to high impact solutions for which FM has considerable autonomy, including collaborative and postpartum care, are likely to have greatest impact.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11382238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1177/21501319241280905
Sunday Azagba, Todd Ebling, Alperen Korkmaz, Jessica King Jensen, Fares Qeadan, Mark Hall
This study examines the association between state laws limiting local control (preemption laws) and local smoke-free policies. We utilized policy data from the American Nonsmokers' Rights Foundation. The primary outcome variable is the presence of a "100% smoke-free policy," across any of 4 indoor settings: workplaces, restaurants, bars, and gaming venues. We employed generalized structural equation modeling to investigate the relationship between state laws pre-empting smoke-free indoor air regulation and local adoption of policies requiring smoke-free air in any public venues, or for specific venues, adjusting for sociodemographic characteristics. Our findings reveal a significant association between state preemption laws and the presence of a local 100% smoke-free indoor policy as of 2023. In states with preemption laws, cities were less likely to have a 100% smoke-free indoor policy at any venue than cities in states without preemption laws (OR = 0.07, 95% CI = 0.05-0.10). When considering specific smoke-free venues, cities in states with preemption laws were less likely to have a 100% smoke-free indoor policy covering workplaces (OR = 0.05, 95% CI = 0.03-0.09), restaurants (OR = 0.04, 95% CI = 0.02-0.07), bars (OR = 0.04, 95% CI = 0.03-0.08), and gaming venues (OR = 0.03, 95% CI = 0.01-0.09) compared to cities in states without preemption laws. Our study suggests that state preemption laws limit local decision-making and the implementation of public health policies focused on tobacco harms.
本研究探讨了限制地方控制权的州法律(优先权法律)与地方无烟政策之间的关联。我们利用了美国非吸烟者权利基金会(American Nonsmokers' Rights Foundation)提供的政策数据。主要结果变量是在工作场所、餐馆、酒吧和游戏场所这 4 种室内环境中是否存在 "100% 无烟政策"。我们采用了广义结构方程模型来研究州法律对室内无烟空气法规的优先权与地方采纳要求在任何公共场所或特定场所实行无烟空气政策之间的关系,并对社会人口特征进行了调整。我们的研究结果表明,各州的免责法律与地方在 2023 年之前实行 100% 室内无烟政策之间存在着重要的关联。在有法律豁免的州,与没有法律豁免的州相比,城市在任何场所实行100%室内无烟政策的可能性都较低(OR = 0.07, 95% CI = 0.05-0.10)。当考虑到具体的无烟场所时,与没有立法豁免州的城市相比,立法豁免州的城市在工作场所(OR = 0.05,95% CI = 0.03-0.09)、餐馆(OR = 0.04,95% CI = 0.02-0.07)、酒吧(OR = 0.04,95% CI = 0.03-0.08)和游戏场所(OR = 0.03,95% CI = 0.01-0.09)实行100%室内无烟政策的可能性较低。我们的研究表明,各州的豁免法限制了地方决策和以烟草危害为重点的公共卫生政策的实施。
{"title":"An Association Between State Laws Limiting Local Control and Community Smoke-Free Indoor Air in the United States.","authors":"Sunday Azagba, Todd Ebling, Alperen Korkmaz, Jessica King Jensen, Fares Qeadan, Mark Hall","doi":"10.1177/21501319241280905","DOIUrl":"https://doi.org/10.1177/21501319241280905","url":null,"abstract":"<p><p>This study examines the association between state laws limiting local control (preemption laws) and local smoke-free policies. We utilized policy data from the American Nonsmokers' Rights Foundation. The primary outcome variable is the presence of a \"100% smoke-free policy,\" across any of 4 indoor settings: workplaces, restaurants, bars, and gaming venues. We employed generalized structural equation modeling to investigate the relationship between state laws pre-empting smoke-free indoor air regulation and local adoption of policies requiring smoke-free air in any public venues, or for specific venues, adjusting for sociodemographic characteristics. Our findings reveal a significant association between state preemption laws and the presence of a local 100% smoke-free indoor policy as of 2023. In states with preemption laws, cities were less likely to have a 100% smoke-free indoor policy at any venue than cities in states without preemption laws (OR = 0.07, 95% CI = 0.05-0.10). When considering specific smoke-free venues, cities in states with preemption laws were less likely to have a 100% smoke-free indoor policy covering workplaces (OR = 0.05, 95% CI = 0.03-0.09), restaurants (OR = 0.04, 95% CI = 0.02-0.07), bars (OR = 0.04, 95% CI = 0.03-0.08), and gaming venues (OR = 0.03, 95% CI = 0.01-0.09) compared to cities in states without preemption laws. Our study suggests that state preemption laws limit local decision-making and the implementation of public health policies focused on tobacco harms.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11403690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Context: Aging and increasing comorbidities in the population are leading to more complex care for patients and primary healthcare providers. Community organizations (COs) may play a role in the services offered to support patients with chronic diseases (PCDs) but there are currently no clear guidelines to support primary healthcare providers in linking patients to COs.
Objectives: The aim of this study was to describe the role of primary healthcare providers regarding linking PCDs to COs by: (1) describing linking activities; and (2) identifying the main facilitators and barriers associated with these activities.
Methods: This scoping review was based on the Arksey and O'Malley method, completed by Levac, Colquhoun, and O'Brien. Related keywords were used in 7 databases to search relevant studies. After the initial screening, 135 full texts were assessed for eligibility by 2 reviewers using inclusion/exclusion criteria. Empirical studies describing activities performed by primary healthcare providers in linking PCDs to COs or describing facilitators or barriers to linking activities were included. Studies describing activities linking to other services than COs or located in emergency departments were excluded.
Results: In total, 28 studies were included. Information reported in the studies was classified into 8 main linking activities: capacity development, patient identification, assessment, information, planning, referral, follow-up, and collaboration. Facilitators and barriers to these activities were related to intrapersonal characteristics of providers and patients, professional practice, work environment, relationships, and external influences. Healthcare providers' involvement was often adapted according to their field of practice.
Conclusion: This scoping review details the role of primary healthcare providers when linking PCDs to COs in a collaborative and interdisciplinary context, which can be adapted to clinical practice by providers, experts, or stakeholders to support improvement in chronic care management.
{"title":"Primary Healthcare Providers' Activities in Linking Patients With Chronic Diseases to Community Organizations: A Scoping Review.","authors":"Nevena Grgurevic, Maud-Christine Chouinard, Édith Ellefsen, Émilie Hudon, Catherine Hudon","doi":"10.1177/21501319241257374","DOIUrl":"10.1177/21501319241257374","url":null,"abstract":"<p><strong>Context: </strong>Aging and increasing comorbidities in the population are leading to more complex care for patients and primary healthcare providers. Community organizations (COs) may play a role in the services offered to support patients with chronic diseases (PCDs) but there are currently no clear guidelines to support primary healthcare providers in linking patients to COs.</p><p><strong>Objectives: </strong>The aim of this study was to describe the role of primary healthcare providers regarding linking PCDs to COs by: (1) describing linking activities; and (2) identifying the main facilitators and barriers associated with these activities.</p><p><strong>Methods: </strong>This scoping review was based on the Arksey and O'Malley method, completed by Levac, Colquhoun, and O'Brien. Related keywords were used in 7 databases to search relevant studies. After the initial screening, 135 full texts were assessed for eligibility by 2 reviewers using inclusion/exclusion criteria. Empirical studies describing activities performed by primary healthcare providers in linking PCDs to COs or describing facilitators or barriers to linking activities were included. Studies describing activities linking to other services than COs or located in emergency departments were excluded.</p><p><strong>Results: </strong>In total, 28 studies were included. Information reported in the studies was classified into 8 main linking activities: capacity development, patient identification, assessment, information, planning, referral, follow-up, and collaboration. Facilitators and barriers to these activities were related to intrapersonal characteristics of providers and patients, professional practice, work environment, relationships, and external influences. Healthcare providers' involvement was often adapted according to their field of practice.</p><p><strong>Conclusion: </strong>This scoping review details the role of primary healthcare providers when linking PCDs to COs in a collaborative and interdisciplinary context, which can be adapted to clinical practice by providers, experts, or stakeholders to support improvement in chronic care management.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1177/21501319241266515
Soumitra S Bhuyan, Saurabh Kalra, Asos Mahmood, Akasha Rai, Kahuwa Bordoloi, Urmi Basu, Elizabeth O'Callaghan, Marilyn Gardner
Introduction: The global mental health crisis, compounded by the challenges of the COVID-19 pandemic, underscores the urgent need for accessible mental health care solutions. Telehealth services have emerged as a promising technology to address barriers to access mental health services. However, population-based studies examining telehealth utilization among individuals with depression are limited.
Methods: Using data from the National Cancer Institute's Health Information National Trends Survey (HINTS) of 2022 (n = 4502), we investigated telehealth utilization among individuals diagnosed with depression in the United States. We employed multivariable logistic regression analysis to assess the association, adjusting for demographics, health behaviors, health status, trust in the medical system, and access to transportation. We also studied the factors that motivated the use of telehealth among individuals diagnosed with depression.
Results: In the multivariable adjusted logistic regression models, individuals diagnosed with depression (AOR 2.59, 95% CI 1.96-3.42) were significantly more likely to use telehealth services relative to individuals with no depression diagnosis. Other factors associated with increased telehealth use included women (AOR 1.36, 95% CI 1.07-1.72), Hispanic ethnicity (AOR 1.78, 95% CI 1.28-2.48), being married or living with a partner (AOR 1.30, 95% CI 1.05-1.62), frequent healthcare visits (AOR 2.31, 95% CI 1.71-3.11), health insurance coverage (AOR 1.86, 95% CI 1.04-3.34), confidence in self-care (AOR 1.38, 95% CI 1.07-1.78), and lack of reliable transportation (AOR 1.57, 95% CI 1.01-2.42). Major motivation factors that influenced telehealth use among individuals with depression primarily included convenience, such as reduced travel times, as well as clinicians' recommendations.
Conclusion: Telehealth is a promising option for accessing mental health care, particularly for those with depression. Further research is needed to understand how well telehealth works and how it can be combined with traditional care, ensuring fair costs and keeping information safe.
导言:全球心理健康危机,再加上 COVID-19 大流行所带来的挑战,凸显了人们对无障碍心理保健解决方案的迫切需求。远程保健服务已成为一种很有前景的技术,可以解决获得心理健康服务的障碍。然而,针对抑郁症患者使用远程医疗服务的人群研究却十分有限:利用美国国家癌症研究所 2022 年健康信息全国趋势调查(HINTS)的数据(n = 4502),我们调查了美国被诊断为抑郁症患者的远程医疗使用情况。我们采用了多变量逻辑回归分析来评估这种关联,并对人口统计学、健康行为、健康状况、对医疗系统的信任度以及交通便利性进行了调整。我们还研究了促使抑郁症患者使用远程医疗的因素:在多变量调整逻辑回归模型中,与未诊断出抑郁症的患者相比,诊断出抑郁症的患者(AOR 2.59,95% CI 1.96-3.42)使用远程保健服务的可能性明显更高。与远程保健使用率增加相关的其他因素包括女性(AOR 1.36,95% CI 1.07-1.72)、西班牙裔(AOR 1.78,95% CI 1.28-2.48)、已婚或与伴侣同居(AOR 1.30,95% CI 1.05-1.62)、经常就医(AOR 1.36,95% CI 1.07-1.72)、与远程保健使用率增加相关的其他因素包括62)、频繁就医(AOR 2.31,95% CI 1.71-3.11)、医疗保险覆盖率(AOR 1.86,95% CI 1.04-3.34)、对自我护理的信心(AOR 1.38,95% CI 1.07-1.78)以及缺乏可靠的交通工具(AOR 1.57,95% CI 1.01-2.42)。影响抑郁症患者使用远程医疗的主要动机因素包括方便(如减少旅行时间)和临床医生的建议:结论:远程医疗是获得心理健康护理的一个很有前景的选择,尤其是对抑郁症患者而言。要了解远程保健的效果如何,以及如何将其与传统保健相结合,确保公平的成本和信息安全,还需要进一步的研究。
{"title":"Motivation and Use of Telehealth Among People with Depression in the United States.","authors":"Soumitra S Bhuyan, Saurabh Kalra, Asos Mahmood, Akasha Rai, Kahuwa Bordoloi, Urmi Basu, Elizabeth O'Callaghan, Marilyn Gardner","doi":"10.1177/21501319241266515","DOIUrl":"https://doi.org/10.1177/21501319241266515","url":null,"abstract":"<p><strong>Introduction: </strong>The global mental health crisis, compounded by the challenges of the COVID-19 pandemic, underscores the urgent need for accessible mental health care solutions. Telehealth services have emerged as a promising technology to address barriers to access mental health services. However, population-based studies examining telehealth utilization among individuals with depression are limited.</p><p><strong>Methods: </strong>Using data from the National Cancer Institute's Health Information National Trends Survey (HINTS) of 2022 (n = 4502), we investigated telehealth utilization among individuals diagnosed with depression in the United States. We employed multivariable logistic regression analysis to assess the association, adjusting for demographics, health behaviors, health status, trust in the medical system, and access to transportation. We also studied the factors that motivated the use of telehealth among individuals diagnosed with depression.</p><p><strong>Results: </strong>In the multivariable adjusted logistic regression models, individuals diagnosed with depression (AOR 2.59, 95% CI 1.96-3.42) were significantly more likely to use telehealth services relative to individuals with no depression diagnosis. Other factors associated with increased telehealth use included women (AOR 1.36, 95% CI 1.07-1.72), Hispanic ethnicity (AOR 1.78, 95% CI 1.28-2.48), being married or living with a partner (AOR 1.30, 95% CI 1.05-1.62), frequent healthcare visits (AOR 2.31, 95% CI 1.71-3.11), health insurance coverage (AOR 1.86, 95% CI 1.04-3.34), confidence in self-care (AOR 1.38, 95% CI 1.07-1.78), and lack of reliable transportation (AOR 1.57, 95% CI 1.01-2.42). Major motivation factors that influenced telehealth use among individuals with depression primarily included convenience, such as reduced travel times, as well as clinicians' recommendations.</p><p><strong>Conclusion: </strong>Telehealth is a promising option for accessing mental health care, particularly for those with depression. Further research is needed to understand how well telehealth works and how it can be combined with traditional care, ensuring fair costs and keeping information safe.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1177/21501319241295914
Christopher W Wheldon, Cristian L Flores, Imani Wilson-Shabazz, Caseem C Luck, Katie Singley, Sarah B Bass
Introduction: Populations at risk for HIV infection-including gay, bisexual, and other men who have sex with men (GBM) and transgender/gender diverse people (TGD)-are at disproportionate risk for anal cancer. Most anal cancers are caused by human papillomavirus (HPV) and are preventable with HPV vaccination and screening. Engaging at-risk populations who are already receiving HIV preventive care (eg, pre-exposure prophylaxis [PrEP]) may be an effective implementation strategy. The purpose of this study was to (1) identify the information, motivation, and behavioral skills that influence decisions about anal cancer prevention and to (2) describe the healthcare utilization patterns among PrEP users that impact their engagement in anal cancer prevention.
Methods: Using purposive sampling in the United States, we ensured diverse representation among PrEP users aged 18 to 45 across gender and ethnoracial identities. Recruitment sources included primary healthcare clinics, social media, and community venues. Semi-structured interviews were recorded, transcribed, and coded using structural, pattern, and theoretical approaches.
Results: Participants (N = 36) were mostly cisgender gay ethnoracial minority men. We identified 29 unique codes that were nested within 3 categories: individual decision-making, healthcare utilization patterns, and healthcare system influences. Participants commonly lacked essential information about HPV and anal cancer, often holding misconceptions about risks and prevention. Motivation for anal cancer prevention was driven by healthcare interactions and perceived risks, while fragmented healthcare and reliance on telemedicine were potential barriers. Many participants used telehealth services to access PrEP, described it as convenience, cost-effective, and liked the lack of provider interaction. Some participants used telehealth for PrEP and did not have a primary care provider. The importance of access to LGBTQ+-affirmative healthcare services was highlighted.
Conclusions: Integrating patient education and prevention services into ongoing PrEP management can enhance the reach and equity of anal cancer prevention. Our model underscores critical areas of misinformation, necessary systems-level changes, and unmet needs.
{"title":"Needs and Opportunities for Anal Cancer Prevention in Patients Engaged With PrEP Care: Development of Conceptual Model.","authors":"Christopher W Wheldon, Cristian L Flores, Imani Wilson-Shabazz, Caseem C Luck, Katie Singley, Sarah B Bass","doi":"10.1177/21501319241295914","DOIUrl":"10.1177/21501319241295914","url":null,"abstract":"<p><strong>Introduction: </strong>Populations at risk for HIV infection-including gay, bisexual, and other men who have sex with men (GBM) and transgender/gender diverse people (TGD)-are at disproportionate risk for anal cancer. Most anal cancers are caused by human papillomavirus (HPV) and are preventable with HPV vaccination and screening. Engaging at-risk populations who are already receiving HIV preventive care (eg, pre-exposure prophylaxis [PrEP]) may be an effective implementation strategy. The purpose of this study was to (1) identify the information, motivation, and behavioral skills that influence decisions about anal cancer prevention and to (2) describe the healthcare utilization patterns among PrEP users that impact their engagement in anal cancer prevention.</p><p><strong>Methods: </strong>Using purposive sampling in the United States, we ensured diverse representation among PrEP users aged 18 to 45 across gender and ethnoracial identities. Recruitment sources included primary healthcare clinics, social media, and community venues. Semi-structured interviews were recorded, transcribed, and coded using structural, pattern, and theoretical approaches.</p><p><strong>Results: </strong>Participants (N = 36) were mostly cisgender gay ethnoracial minority men. We identified 29 unique codes that were nested within 3 categories: individual decision-making, healthcare utilization patterns, and healthcare system influences. Participants commonly lacked essential information about HPV and anal cancer, often holding misconceptions about risks and prevention. Motivation for anal cancer prevention was driven by healthcare interactions and perceived risks, while fragmented healthcare and reliance on telemedicine were potential barriers. Many participants used telehealth services to access PrEP, described it as convenience, cost-effective, and liked the lack of provider interaction. Some participants used telehealth for PrEP and did not have a primary care provider. The importance of access to LGBTQ+-affirmative healthcare services was highlighted.</p><p><strong>Conclusions: </strong>Integrating patient education and prevention services into ongoing PrEP management can enhance the reach and equity of anal cancer prevention. Our model underscores critical areas of misinformation, necessary systems-level changes, and unmet needs.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1177/21501319241291466
Prawira Oka, Aminath Shiwaza Moosa, Chirk Jenn Ng
Background: Globally, most patients with hypertension have suboptimal blood pressure (BP) control. Multiple barriers prevent primary care physicians (PCPs) from effectively caring for these patients. This study aimed to explore the challenges faced by PCPs in providing optimal care for patients with hypertension, with a specific focus on identifying new barriers.
Methods: This qualitative study involved 17 PCPs across 5 primary care clinics in Singapore. A trained researcher conducted individual in-depth interviews using a topic guide. Purposive sampling was employed to ensure adequate representation of seniority until data saturation was achieved. The audio-recorded interviews were transcribed verbatim and independently checked. The data were managed using NVivo and thematic analysis was conducted.
Results: New barriers were divided into patient, physician, drug, and systemrelated factors. Patient factors included a preference for natural health remedies and the inconvenience of blood tests. Meanwhile, physicians faced challenges diagnosing and treating patients with various BP phenotypes and BP variability. The initiation of dual therapy was a drugrelated barrier. Finally, system factors included the suboptimal layout of the electronic medical records (EMR) that impeded effective hypertension management.
Conclusion: A multi-pronged approach is required to address the significant barriers to providing optimal hypertension care. Patients should be empowered through education and minimizing the inconvenience of medication titrations. Additionally, physicians should be better equipped to diagnose and treat patients with more challenging BP phenotypes. Finally, improved access to combination pills and an optimized EMR would contribute to improved care for patients with hypertension.
{"title":"Exploring the Challenges Faced by Primary Care Physicians in Providing Optimal Care for Patients With Hypertension: A Qualitative Study.","authors":"Prawira Oka, Aminath Shiwaza Moosa, Chirk Jenn Ng","doi":"10.1177/21501319241291466","DOIUrl":"10.1177/21501319241291466","url":null,"abstract":"<p><strong>Background: </strong>Globally, most patients with hypertension have suboptimal blood pressure (BP) control. Multiple barriers prevent primary care physicians (PCPs) from effectively caring for these patients. This study aimed to explore the challenges faced by PCPs in providing optimal care for patients with hypertension, with a specific focus on identifying new barriers.</p><p><strong>Methods: </strong>This qualitative study involved 17 PCPs across 5 primary care clinics in Singapore. A trained researcher conducted individual in-depth interviews using a topic guide. Purposive sampling was employed to ensure adequate representation of seniority until data saturation was achieved. The audio-recorded interviews were transcribed verbatim and independently checked. The data were managed using NVivo and thematic analysis was conducted.</p><p><strong>Results: </strong>New barriers were divided into patient, physician, drug, and systemrelated factors. Patient factors included a preference for natural health remedies and the inconvenience of blood tests. Meanwhile, physicians faced challenges diagnosing and treating patients with various BP phenotypes and BP variability. The initiation of dual therapy was a drugrelated barrier. Finally, system factors included the suboptimal layout of the electronic medical records (EMR) that impeded effective hypertension management.</p><p><strong>Conclusion: </strong>A multi-pronged approach is required to address the significant barriers to providing optimal hypertension care. Patients should be empowered through education and minimizing the inconvenience of medication titrations. Additionally, physicians should be better equipped to diagnose and treat patients with more challenging BP phenotypes. Finally, improved access to combination pills and an optimized EMR would contribute to improved care for patients with hypertension.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1177/21501319241287454
Komang Matalia Gandari, Luh Seri Ani, I Made Adi Wirawan
Nurses play an important role in travel medicine. However, information about the role of nurses in travel medicine is still limited. This systematic literature review is aimed to exploring the role of nurses in travel medicine to improve service performance in travelers. This study was systematically compiled this review based on a literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. The inclusion criteria are articles about travel health nursing, complete original articles, articles written in English and non-review articles. The quality of the studies was also assessed based on the Newcastle Ottawa Scale for observational studies. About 5 out of 257 articles were selected from 3 electronic databases, namely PubMed, Ebsco Host, and Scopus. Analysis of the 5 articles found that the role of travel health caregivers differs from country to country. The primary role of nurses in travel health in the U.S. is to conduct are-travel counseling. Nurses in the Netherlands have the authority to prescribe medicines needed for tourists. In Iris nurses play a role in providing support to the mental health of individual tourists, while in Spain, nurses play a role in emergency care for tourists. Nurses play an important role in the health of travel, including health services for travelers before and during the trip. The results of this review add to the understanding of the role of nurses in travel medicine that contributes to improving nurse performance and tourist welfare.
{"title":"Exploring the Role of Nurses in Travel Medicine to Improve Service Performance in Travelers: A Systematic Review.","authors":"Komang Matalia Gandari, Luh Seri Ani, I Made Adi Wirawan","doi":"10.1177/21501319241287454","DOIUrl":"10.1177/21501319241287454","url":null,"abstract":"<p><p>Nurses play an important role in travel medicine. However, information about the role of nurses in travel medicine is still limited. This systematic literature review is aimed to exploring the role of nurses in travel medicine to improve service performance in travelers. This study was systematically compiled this review based on a literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. The inclusion criteria are articles about travel health nursing, complete original articles, articles written in English and non-review articles. The quality of the studies was also assessed based on the Newcastle Ottawa Scale for observational studies. About 5 out of 257 articles were selected from 3 electronic databases, namely PubMed, Ebsco Host, and Scopus. Analysis of the 5 articles found that the role of travel health caregivers differs from country to country. The primary role of nurses in travel health in the U.S. is to conduct are-travel counseling. Nurses in the Netherlands have the authority to prescribe medicines needed for tourists. In Iris nurses play a role in providing support to the mental health of individual tourists, while in Spain, nurses play a role in emergency care for tourists. Nurses play an important role in the health of travel, including health services for travelers before and during the trip. The results of this review add to the understanding of the role of nurses in travel medicine that contributes to improving nurse performance and tourist welfare.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}