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Pre-exposure prophylaxis (PrEP) use, anticipated PrEP stigma, and bisexual identity among a Black and Hispanic/Latino sexual and gender diverse sample. 黑人和西班牙裔/拉丁美洲裔性与性别多样性样本中暴露前预防疗法(PrEP)的使用情况、预期的 PrEP 耻辱感以及双性恋身份。
IF 2 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2023-07-01 Epub Date: 2022-04-25 DOI: 10.1080/08964289.2022.2048249
Ryan J Watson, Ethan Morgan, Jessica Sherman, Antonia E Caba, Christopher W Wheldon, Philip A Chan, Lisa A Eaton

Black and Hispanic/Latino sexual minority men and gender diverse (SMMGD) individuals are disproportionately impacted by the HIV epidemic. Uptake and adherence to pre-exposure prophylaxis (PrEP) is suboptimal among SMMGD Black and Hispanic/Latino individuals, but most research has approached this population as homogenous (e.g., a group operationalized as men who have sex with men). Bisexual men are less likely to disclose their sexual identity and report more mental health problems than their gay counterparts, but there is less attention to the impact of different sexual identities on PrEP use over time. We utilized data from three waves of a national longitudinal study (2020-2021) to characterize Black and Hispanic/Latino SMMGD participants' PrEP use including: 1) PrEP uptake during the study; 2) consistent PrEP use across the study; and 3) discontinuation of PrEP use since study baseline. We found bisexual men were significantly less likely than gay men to be consistent PrEP users and were more likely to discontinue PrEP use over the course of the study. Of the sample who reported PrEP use across surveys, 10% initiated PrEP during the study period, 0% of whom were bisexual. Additionally, bisexual participants reported statistically significantly higher anticipated PrEP stigma relative to gay participants. These findings have implications for HIV prevention interventions. Given the differences in PrEP experiences as a function of sexual identity, researchers and clinicians should consider the disruptive role of stigma (both biphobia and anticipated PrEP stigma) in PrEP care and adherence.

黑人和西班牙裔/拉美裔性少数男性和性别多元化(SMMGD)人群受到艾滋病毒疫情的影响尤为严重。在黑人和拉美裔性少数群体中,接触前预防疗法(PrEP)的接受率和坚持率都不尽如人意,但大多数研究都将这一人群视为同质群体(例如,以男男性行为者为操作群体)。与男同性恋相比,双性恋男性较少公开自己的性身份,并报告了更多的心理健康问题,但对不同性身份对长期使用 PrEP 的影响的关注较少。我们利用一项全国性纵向研究(2020-2021 年)的三波数据来描述黑人和西班牙裔/拉丁美洲裔 SMMGD 参与者使用 PrEP 的特点,包括1) 在研究期间使用 PrEP;2) 在整个研究期间持续使用 PrEP;3) 自研究基线以来停止使用 PrEP。我们发现,与男同性恋者相比,双性恋者持续使用 PrEP 的可能性要低得多,而且在研究过程中停止使用 PrEP 的可能性更大。在各次调查中报告使用 PrEP 的样本中,10% 在研究期间开始使用 PrEP,其中 0% 是双性恋。此外,与同性恋参与者相比,双性恋参与者报告的预期 PrEP 耻辱感明显更高。这些发现对艾滋病预防干预措施有一定的影响。鉴于 PrEP 体验因性身份而异,研究人员和临床医生应考虑污名化(包括双性恋恐惧症和预期 PrEP 污名化)在 PrEP 护理和坚持中的破坏性作用。
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引用次数: 0
Reasons for not Using HIV Pre-Exposure Prophylaxis (PrEP) among Gay and Bisexual Men in Australia: Mixed-Methods Analyses from a National, Online, Observational Study. 澳大利亚男同性恋和双性恋男性未使用HIV暴露前预防(PrEP)的原因:来自一项全国性、在线、观察性研究的混合方法分析。
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2023-07-01 Epub Date: 2022-02-17 DOI: 10.1080/08964289.2022.2033159
Steven P Philpot, Garrett Prestage, Martin Holt, Lisa Maher, Bridget Haire, Adam Bourne, Mohamed A Hammoud

Although approximately 31,000 Australian gay and bisexual men (GBM) are eligible for HIV pre-exposure prophylaxis (PrEP), only 18,500 people currently use it, indicating a need to investigate why GBM do not use it. This article uses data from a national, online, observational study. It adopts a mixed-methods analysis to responses to survey questions asking about reasons Australian GBM were not using PrEP in 2018, according to their level of HIV risk as delineated by the Australian PrEP prescribing guidelines at the time. Participants responded to check-box questions and had the option to respond to a qualitative free-text question. Results showed that just over one-fifth of men were at higher risk of HIV acquisition. Compared to lower-risk men, higher-risk men were more likely to indicate PrEP was too expensive and more likely to cite embarrassment asking for it. Reasons for not using PrEP included a lack of personal relevance, poor accessibility or knowledge, concerns about PrEP's inability to protect against STIs, potential side effects, and a preference for condoms. We conclude that health promotion more effectively targeting GBM who may benefit the most from PrEP may be valuable.

尽管大约31000名澳大利亚男同性恋和双性恋者有资格接受艾滋病毒暴露前预防(PrEP),但目前只有18500人使用它,这表明有必要调查为什么男同性恋和两性恋者不使用它。本文使用了一项全国性在线观察性研究的数据。根据当时澳大利亚PrEP处方指南规定的澳大利亚GBM的HIV风险水平,它采用混合方法分析对2018年澳大利亚GBM未使用PrEP的原因的调查问题的回答。参与者回答复选框问题,并可以选择回答定性自由文本问题。结果显示,刚刚超过五分之一的男性感染艾滋病毒的风险更高。与风险较低的男性相比,风险较高的男性更有可能表示PrEP太贵,也更有可能因为要求PrEP而感到尴尬。不使用PrEP的原因包括缺乏个人相关性、可及性或知识不足、担心PrEP无法预防性传播感染、潜在副作用以及偏爱避孕套。我们的结论是,更有效地针对可能从PrEP中受益最大的GBM进行健康促进可能是有价值的。
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引用次数: 1
Examining Changes in Sleep Duration Associated with the Onset of the COVID-19 Pandemic: Who is Sleeping and Who is Not? 研究 COVID-19 大流行开始时睡眠时间的变化:谁在睡觉,谁没有?
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2023-04-01 Epub Date: 2021-11-18 DOI: 10.1080/08964289.2021.2002800
Salma Batool-Anwar, Rebecca Robbins, Shahmir H Ali, Ariadna Capasso, Joshua Foreman, Abbey M Jones, Yesim Tozan, Ralph J DiClemente, Stuart F Quan

The COVID-19 pandemic has resulted in social isolation and reports of insomnia. However, reports of changes in sleep duration and associated factors are few. To determine the impact of COVID-19 on changes in sleep behavior, data were analyzed from an online survey of adults recruited via social media that included questions asking whether the respondent slept less or more after the onset of the pandemic as well as self-reported sociodemographic and occupational information; beliefs about COVID-19; and responses pertaining to loneliness, anxiety, and depression. There were 5,175 respondents; 53.9% had a change in sleep duration.17.1% slept less and 36.7% slept more. Sleeping more was related to greater education, being single/divorced/separated, unemployed or a student. Being retired, divorced/separated or a homemaker, and living in the Mountain or Central time zones were associated with less sleep. Beliefs that COVID-19 would result in personal adverse consequences was associated with both more and less sleep. However, the strongest associations for both more and less sleep were seen with depression, anxiety, and loneliness. In summary, changes in sleep duration since the start of the COVID-19 pandemic were highly prevalent among social media users and were associated with several sociodemographic factors and beliefs that COVID-19 would have adverse personal impacts. However, the strongest associations occurred with worse mental health suggesting that improvements may occur with better sleep.Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.2002800 .

COVID-19 大流行导致了社会隔离和失眠报告。然而,有关睡眠时间变化和相关因素的报道却很少。为了确定 COVID-19 对睡眠行为变化的影响,我们分析了通过社交媒体招募的成年人的在线调查数据,其中包括询问受访者在大流行开始后睡眠时间是否减少或增加的问题,以及自我报告的社会人口和职业信息;对 COVID-19 的看法;以及与孤独、焦虑和抑郁有关的回答。共有 5,175 名受访者;53.9% 的受访者睡眠时间有变化,17.1% 的受访者睡眠时间减少,36.7% 的受访者睡眠时间增加。睡眠时间增加与受教育程度较高、单身/离婚/分居、失业或学生有关。退休、离婚/分居或家庭主妇以及居住在山区或中部时区与睡眠减少有关。认为 COVID-19 会导致个人不良后果的信念与睡眠增加和减少都有关系。然而,抑郁、焦虑和孤独与睡眠增加和减少的关系最为密切。总之,自 COVID-19 大流行开始以来,睡眠时间的变化在社交媒体用户中非常普遍,并且与几个社会人口因素和认为 COVID-19 会对个人产生不利影响的观点有关。然而,与心理健康状况恶化的关系最为密切,这表明改善睡眠可能会改善心理健康状况。本文的补充数据可在 https://doi.org/10.1080/08964289.2021.2002800 上在线获取。
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引用次数: 0
Alcohol Use Severity among Hispanic Emerging Adults: Examining Intragroup Marginalization, Bicultural Self-Efficacy, and the Role of Gender within a Stress and Coping Framework. 西班牙裔新成人的酗酒严重程度:在压力和应对框架内考察群体内边缘化、双文化自我效能感以及性别的作用。
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2023-04-01 Epub Date: 2021-11-24 DOI: 10.1080/08964289.2021.2006130
Miguel Ángel Cano, Mario De La Rosa, Seth J Schwartz, Christopher P Salas-Wright, Brian T H Keum, Christina S Lee, Miguel Pinedo, Cory L Cobb, Craig A Field, Mariana Sanchez, Linda G Castillo, Priscilla Martinez, Elma I Lorenzo-Blanco, Brandy Piña-Watson, Marcel A de Dios

Most research on cultural stressors and alcohol has focused on intercultural stressors. Continuing to exclude intracultural stressors (e.g., intragroup marginalization) from alcohol research will yield a biased understanding of the experiences of Hispanics living in a bicultural society. As we amass more studies on intracultural stressors, research will be needed to identify mutable sociocultural factors that may mitigate the association between intracultural stressors and alcohol. To address these limitations, we examined the association between intragroup marginalization and alcohol use severity and the extent to which gender and bicultural self-efficacy may moderate this association. A convenience sample of 200 Hispanic emerging adults ages 18-25 (men = 101, women = 99) from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey. Data were analyzed using hierarchical multiple regression and moderation analyses. Higher intragroup marginalization was associated with higher alcohol use severity. Gender functioned as a moderator whereby intragroup marginalization was associated with higher alcohol use severity among men, but not women. Also, higher social groundedness functioned as a moderator that weakened the association between intragroup marginalization and alcohol use severity. Role repertoire did not function as a moderator. Our findings are significant because they enhance the reliability of the association between intragroup marginalization and alcohol use severity, and the moderating effect of gender in this respective association. This emerging line of research suggests that alcohol interventions targeting Hispanics may have a significant limitation by not accounting for intracultural stressors.

大多数关于文化压力源和酒精的研究都集中在跨文化压力源上。如果继续将文化内压力源(如群体内边缘化)排除在酒精研究之外,那么对于生活在双文化社会中的西班牙裔人的经历的理解就会产生偏差。当我们积累了更多关于文化内压力源的研究时,还需要进行研究以确定可缓解文化内压力源与酒精之间关联的可变社会文化因素。为了解决这些局限性,我们研究了群体内边缘化与酗酒严重程度之间的关联,以及性别和双文化自我效能在多大程度上可能缓和这种关联。来自亚利桑那州(n = 99)和佛罗里达州(n = 101)的 200 名 18-25 岁西班牙裔新兴成年人(男性 = 101,女性 = 99)完成了一项横截面调查。数据采用分层多元回归和调节分析法进行分析。组内边缘化程度越高,酗酒严重程度越高。性别是一个调节因子,即群体内边缘化与男性酗酒严重程度相关,但与女性无关。此外,较高的社会基础性也起到了调节作用,削弱了群体内边缘化与酗酒严重程度之间的联系。角色重现没有起到调节作用。我们的研究结果意义重大,因为它们增强了群体内边缘化与酗酒严重程度之间关联的可靠性,以及性别在这一关联中的调节作用。这项新的研究表明,针对西班牙裔的酒精干预措施可能会因为没有考虑到文化内压力因素而存在很大的局限性。
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引用次数: 0
Development and Psychometric Properties of the Sleep Parenting Scale for Infants. 婴儿睡眠养育量表的开发和心理测量特性。
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2023-04-01 Epub Date: 2021-11-18 DOI: 10.1080/08964289.2021.2002799
Brian K Lo, Melissa L McTernan, Jess Haines, Jennifer S Savage, Kari C Kugler, Sebastien Haneuse, Susan Redline, Elsie M Taveras, Kirsten K Davison

Although infants' sleep behaviors are shaped by their interactions with parents at bedtime, few tools exist to capture parents' sleep parenting practices. This study developed a Sleep Parenting Scale for Infants (SPS-I) and aimed to (1) explore and validate its factorial structure, (2) examine its measurement invariance across mothers and fathers, and (3) investigate its reliability and concurrent and convergent validity. SPS-I was developed via a combination of items modified from existing scales and the development of novel items. Participants included 188 mothers and 152 mother-father dyads resulting in 340 mothers and 152 fathers; about half were non-Hispanic white. Mothers and fathers completed a 14-item SPS-I for their 12-month-old infant. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to explore and validate SPS-I's underlying structure. Multigroup CFA was used to examine measurement invariance across mothers and fathers. Reliability was examined using Cronbach's alpha. Concurrent validity was assessed using linear regressions examining associations between SPS-I factors and parent-reported infants nighttime sleep duration. Convergent validity was assessed using paired-sample t-tests to test whether the SPS-I subscale scores were similar between mothers and fathers in the same household. EFA and CFA confirmed a 3-factor, 12-item model: sleep routines, sleep autonomy, and screen media in the sleep environment. SPS-I was invariant across mothers and fathers and was reliable. Concurrent and convergent validity were established. SPS-I has good psychometric properties, supporting its use for characterizing sleep routines, sleep autonomy, and screen media in the sleep environment by mothers and fathers.Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.2002799 .

虽然婴儿的睡眠行为是由他们在睡前与父母的互动所决定的,但很少有工具能记录父母的睡眠养育行为。本研究开发了婴儿睡眠养育量表(SPS-I),旨在:(1)探索并验证其因子结构;(2)检查其在母亲和父亲之间的测量不变性;(3)研究其可靠性、并发性和收敛性。SPS-I 是通过修改现有量表的项目和开发新项目相结合的方式编制的。参与者包括 188 位母亲和 152 位母亲-父亲二人组,共 340 位母亲和 152 位父亲;其中约一半为非西班牙裔白人。母亲和父亲为其 12 个月大的婴儿填写了 14 个项目的 SPS-I。探索性因子分析(EFA)和确证性因子分析(CFA)用于探索和验证 SPS-I 的基本结构。多组 CFA 用于检查母亲和父亲之间的测量不变性。使用 Cronbach's alpha 检验信度。通过线性回归检查 SPS-I 各因子与父母报告的婴儿夜间睡眠时间之间的关联,评估并发有效性。收敛效度采用配对抽样 t 检验来测试同一家庭中母亲和父亲的 SPS-I 分量表得分是否相似。EFA和CFA确认了一个3因素12项目模型:睡眠常规、睡眠自主性和睡眠环境中的屏幕媒体。SPS-I在不同父亲和母亲之间是不变的,并且是可靠的。同时有效性和收敛有效性均已确立。SPS-I 具有良好的心理测量特性,支持将其用于描述母亲和父亲的睡眠常规、睡眠自主性和睡眠环境中的屏幕媒体。本文的补充数据可在 https://doi.org/10.1080/08964289.2021.2002799 上在线获取。
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引用次数: 0
Mental Health and Alcohol Use during and before the Early Phases of the COVID-19 Pandemic. COVID-19 大流行初期及之前的心理健康和饮酒情况。
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2023-04-01 Epub Date: 2022-01-10 DOI: 10.1080/08964289.2021.2015278
Natalie Sumetsky, Jessica Frankeberger, Robert W S Coulter, Jessica G Burke, M Reuel Friedman, Christina Mair

The early phases of the coronavirus 19 disease (COVID-19) pandemic were associated with changes in psychological well-being and alcohol use. However, it is unclear whether these changes are artifacts of psychological well-being and alcohol use prior to the pandemic across different sociodemographic groups. We received surveys from 247 adult residents of Allegheny County, Pennsylvania (United States), with an oversampling of sexual- and gender-minority individuals. Responses included measures of psychological well-being, substance use, and sociodemographic characteristics. Unadjusted mean depression scores, anxiety scores, and number of drinking days increased for all age and income groups during COVID-19, while average number of drinks per drinking day and days intoxicated differentially increased or decreased by age and income groups. Using Bayesian seemingly unrelated regression, we assessed depression and anxiety symptoms and alcohol use during the early stages of the pandemic and one month before COVID-19 was first identified in Allegheny County concurrently. Those in the youngest (18-24) group drank on more days during (but not before) the pandemic than those in the 25-44 age group. Compared to cisgender women, gender-minority adults had higher depression scores during the early stages of the pandemic. Employed adults had lower anxiety scores during (but not before) the pandemic than adults who were unemployed. Those with past-year annual incomes above $80,000 had fewer drinks on average drinking occasions than those in the $40,000 or below group before (but not during) the pandemic. Patterns of psychological distress and alcohol use associated with the COVID-19 pandemic differ by subgroup compared to patterns prior to the pandemic. Interventions addressing worsening mental health outcomes and shifting alcohol use patterns must be sensitive to the needs of vulnerable groups, such as younger adults and those experiencing poverty or unemployment.

冠状病毒19型疾病(COVID-19)大流行的早期阶段与心理健康和饮酒的变化有关。然而,目前还不清楚这些变化是否是不同社会人口群体在大流行之前心理健康和饮酒情况的伪影。我们收到了宾夕法尼亚州阿勒格尼县(美国)247 名成年居民的调查问卷,其中包括性少数群体和性别少数群体的超额抽样。回答内容包括对心理健康、药物使用和社会人口特征的测量。在 COVID-19 期间,所有年龄组和收入组的未调整平均抑郁分数、焦虑分数和饮酒天数都有所增加,而平均每天饮酒天数和醉酒天数则因年龄组和收入组的不同而有所增减。利用贝叶斯似乎无关回归法,我们对大流行初期和阿勒格尼县首次发现 COVID-19 前一个月的抑郁和焦虑症状以及饮酒情况进行了评估。与 25-44 岁年龄组的人相比,最年轻(18-24 岁)年龄组的人在大流行期间(而不是之前)饮酒的天数更多。在大流行病的早期阶段,与顺性别女性相比,性别少数群体成年人的抑郁得分更高。与失业的成年人相比,就业的成年人在大流行期间(而非之前)的焦虑得分较低。在疫情发生前(而非疫情发生期间),上一年年收入高于 80,000 美元的人平均饮酒次数少于年收入在 40,000 美元或以下的人。与大流行之前的模式相比,COVID-19 大流行期间各亚组的心理困扰和饮酒模式有所不同。针对心理健康恶化和饮酒模式改变的干预措施必须对弱势群体的需求保持敏感,如年轻成年人和经历贫困或失业的人群。
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引用次数: 0
Psychosocial Predictors of Intention to Vaccinate Against the Coronavirus (COVID-19). 冠状病毒(COVID-19)疫苗接种意向的社会心理预测因素
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2023-04-01 DOI: 10.1080/08964289.2021.1990006
Ho Phi Huynh, Ágnes Zsila, Lisset Martinez-Berman

The COVID-19 pandemic has wreaked havoc across the world. Public health efforts to combat the disease and return life to normalcy largely rests upon COVID-19 vaccination distribution and uptake. Thus, it is critical to examine factors that predict people's intentions to vaccinate. This study explored predictors of intention to vaccinate against COVID-19 among demographic and personal factors, health behaviors and beliefs, COVID-19-specific beliefs, and trust in physicians, using a sample of U.S. adults. We employed bivariate correlations and hierarchical regression to analyze the data. We found that the strongest predictors are political orientation, trust in physicians, subjective norms, and prior flu shot uptake. These associations suggest that individuals who held more liberal political views, expressed higher levels of trust in their primary care provider, perceived stronger social pressure to vaccinate against COVID-19, and received a flu shot during the previous flu season, had a stronger intention to vaccinate against COVID-19. Based on our results, we suggest that public health efforts to increase vaccination uptake for COVID-19 vaccines focus on addressing political orientation (conservatism), involve primary care providers, emphasize vaccination as the norm (and not the exception), and use information about previous flu vaccinations to target vaccination campaigns.

新冠肺炎疫情在全球范围内造成严重破坏。抗击该疾病和恢复正常生活的公共卫生工作在很大程度上取决于COVID-19疫苗的分发和吸收。因此,检查预测人们接种疫苗意图的因素是至关重要的。本研究以美国成年人为样本,探讨了人口统计学和个人因素、健康行为和信念、COVID-19特定信念以及对医生的信任等因素对COVID-19疫苗接种意向的预测因素。我们采用双变量相关和层次回归分析数据。我们发现最强的预测因子是政治倾向、对医生的信任、主观规范和先前的流感疫苗接种。这些关联表明,持有更自由的政治观点、对初级保健提供者表达更高程度的信任、认为接种COVID-19疫苗的社会压力更大、并在上一个流感季节接种过流感疫苗的个人,接种COVID-19疫苗的意愿更强。根据我们的研究结果,我们建议,提高COVID-19疫苗接种率的公共卫生工作应侧重于解决政治倾向(保守主义),让初级保健提供者参与进来,强调疫苗接种是常态(而不是例外),并利用以前接种流感疫苗的信息来开展有针对性的疫苗接种活动。
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引用次数: 7
An Adaptation, Extension and Pre-Testing of an Interactive Decision Aid for Men Diagnosed with Localized Prostate Cancer in Iceland: A Mixed-Method Study. 冰岛男性诊断为局限性前列腺癌的交互式决策辅助的适应、扩展和预测试:一项混合方法研究。
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2023-04-01 DOI: 10.1080/08964289.2021.2000926
Valgerdur Kristin Eiriksdottir, Thordis Jonsdottir, Heiddis B Valdimarsdottir, Kathryn L Taylor, Marc D Schwartz, Rafn Hilmarsson, Eirikur Orri Gudmundsson, Jon Orn Fridriksson, Birna Baldursdottir

In this study an interactive decision aid (DA) for men diagnosed with localized prostate cancer was adapted, extended and pre-tested. The DA's prototype was based on a literature review and other empirically tested DAs. Semi-structured interviews with 12 men (age 65-80) diagnosed with localized prostate cancer were conducted to get feedback on content, usability, and the DA's layout. The interviews were analyzed using thematic analysis and themes were identified using deductive and inductive coding. Participants found the accessibility of the information and the explicit values clarification tool helpful. Four themes were identified: (1) usability and design, (2) content and knowledge, (3) deciding factors of decision-making, and (4) social support. Participants valued receiving extensive and realistic information on surgery/radiation therapy side effects and getting unbiased presentations of treatment options. Following the thematic analysis, the DA was revised and tested in a survey among 11 newly diagnosed prostate cancer patients (age 60-74). The participants valued the DA and found it helpful when making a treatment decision, and all reported that they would recommend it to others making a prostate cancer treatment decision. The DA is currently being tested in a randomized clinical trial (RCT). This is the first DA developed for prostate cancer patients in Iceland and if the results of the RCT show that it is more effective than standard care in assisting newly diagnosed patients with their treatment decision, the DA can be easily translated and adapted to cultures similar to Iceland such as the Nordic countries.

在这项研究中,交互式决策辅助(DA)的男性诊断为局限性前列腺癌改编,扩展和预测试。DA的原型是基于文献综述和其他经验检验的DA。对12名确诊为局限性前列腺癌的男性(65-80岁)进行了半结构化访谈,以获得对内容、可用性和DA布局的反馈。访谈采用主题分析法进行分析,主题采用演绎编码和归纳编码进行识别。参与者发现信息的可及性和明确的价值观澄清工具很有帮助。确定了四个主题:(1)可用性和设计,(2)内容和知识,(3)决策的决定因素,(4)社会支持。参与者重视获得关于手术/放射治疗副作用的广泛和现实的信息,并获得公正的治疗方案介绍。在主题分析之后,对11名新诊断的前列腺癌患者(60-74岁)进行了调查,并对DA进行了修订和检验。参与者重视DA,并发现它在做出治疗决定时很有帮助,并且所有人都报告说他们会向其他做出前列腺癌治疗决定的人推荐DA。DA目前正在一项随机临床试验(RCT)中进行测试。这是冰岛第一个为前列腺癌患者开发的DA,如果随机对照试验的结果表明它在帮助新诊断的患者做出治疗决定方面比标准治疗更有效,那么DA可以很容易地翻译并适应与冰岛相似的文化,如北欧国家。
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引用次数: 0
Provider Perspectives on Barriers to Routine HIV Testing of Adolescent and Young Adult Patients in Emergency Department Settings. 提供者对急诊科青少年和青年患者常规HIV检测障碍的看法。
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2023-04-01 Epub Date: 2021-12-29 DOI: 10.1080/08964289.2021.2020207
Mobolaji Ibitoye, Alex S Bennett, Mona Bugaghis, Lauren S Chernick, Don C Des Jarlais, Ian David Aronson

HIV testing rates among US youth aged 13-24 years are sub-optimal, with high rates of missed testing opportunities in emergency departments (EDs). We assessed barriers to routine HIV testing of youth in urban ED settings from the perspective of healthcare providers. Ten physicians and nurses were recruited from the pediatric and adult EDs at a high-volume hospital in New York City, USA to complete in-depth interviews to provide their perspectives on barriers to routine HIV testing of youth ages 13 to 24 in EDs. Interviews were conducted using a semi-structured interview guide with questions and probes. All interviews were conducted via Zoom due to the COVID-19 pandemic and were audio-recorded and transcribed verbatim. Transcripts were coded independently by two researchers using an inductive thematic analysis approach. Participants often offered HIV testing to youth in the ED based on their perceptions of patients' HIV risk, with pediatric providers sometimes discouraging adolescents they perceived to be at low HIV risk from testing. Participants cited other priorities, logistics of blood-based testing, and discomfort discussing HIV as other reasons for not offering HIV testing to all youth in the ED. Efforts are needed to encourage providers to offer HIV testing to all youth regardless of perceived risk, as the ED often serves as youths' only point of contact with the healthcare system. Emphasis on this and the importance of early detection, along with institutional change, clear guidance, and support for the testing process may help increase youth testing and avoid missed HIV diagnosis opportunities.

美国13-24岁青年的艾滋病毒检测率 年是次优的,急诊科错过检测机会的比率很高。我们从医疗保健提供者的角度评估了城市ED环境中青年常规HIV检测的障碍。从美国纽约市一家大容量医院的儿科和成人急诊室招募了10名医生和护士,他们完成了深入的访谈,以提供他们对13至24岁急诊室青少年常规HIV检测障碍的看法。访谈使用半结构化访谈指南进行,其中包括问题和调查。由于新冠肺炎大流行,所有采访都是通过Zoom进行的,并进行了录音和逐字转录。两名研究人员使用归纳主题分析方法对转录本进行了独立编码。参与者经常根据他们对患者艾滋病毒风险的看法,向急诊室的年轻人提供艾滋病毒检测,儿科服务提供者有时会劝阻他们认为艾滋病毒风险较低的青少年进行检测。与会者列举了其他优先事项、血液检测的后勤保障以及讨论艾滋病毒时的不适,作为不向ED的所有青年提供艾滋病毒检测的其他原因。需要努力鼓励提供者向所有青年提供艾滋病病毒检测,无论其感知到的风险如何,因为ED通常是青年与医疗系统的唯一联系点。强调这一点和早期检测的重要性,以及体制改革、明确的指导和对检测过程的支持,可能有助于增加青年检测,避免错过艾滋病毒诊断机会。
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引用次数: 4
The Association between Sibship Composition and Child Eating Behaviors. 兄弟姐妹构成与儿童饮食行为的关系。
IF 2.3 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2023-04-01 DOI: 10.1080/08964289.2021.1997892
Rana H Mosli, Hebah A Kutbi

Development of eating habits and patterns during childhood can have life-long effects on weight and health status. Family structure, functioning, and interactions during mealtimes may influence the development of eating behaviors among children. The objective of this study was to examine the association between sibship composition and child eating behaviors among preschoolers in Saudi Arabia. One hundred and fifteen mothers were recruited through various preschools around the city of Jeddah, Saudi Arabia. A previously validated Arabic version of the Children's Eating Behavior Questionnaire (CEBQ) was completed over the telephone along with questions assessing sibship composition and demographic characteristics. Spearman correlations and adjusted linear regression models were examined to assess the association between sibship composition and child eating behaviors. Adjusting for covariates, number of older siblings was positively associated with emotional over eating, food responsiveness, and the desire to drink. Number of older sisters was positively associated with the desire to drink but negatively associated with food fussiness. Having a greater number of older (rather than younger) siblings may be associated with food-approach eating behaviors. Having a greater number of older sisters may be associated with less food fussiness. Focusing on older siblings in encouraging healthy eating habits and appropriate food choices may be beneficial in promoting adaptive eating behaviors and prevention of excessive energy intake and weight gain. Future longitudinal and mixed-methods research studies with larger sample sizes are needed in order to better understand the underlying mechanisms for the associations between sibship composition and child eating behaviors.

儿童时期饮食习惯和模式的发展对体重和健康状况有终生的影响。家庭结构、功能和进餐时的互动可能会影响儿童饮食行为的发展。本研究的目的是研究沙特阿拉伯学龄前儿童的兄弟姐妹组成和儿童饮食行为之间的关系。在沙特阿拉伯吉达市的各个幼儿园招募了115名母亲。儿童饮食行为问卷(CEBQ)的阿拉伯语版本是通过电话完成的,同时还有评估兄弟姐妹组成和人口特征的问题。我们检验了Spearman相关性和调整后的线性回归模型,以评估兄弟姐妹构成与儿童饮食行为之间的关系。调整协变量后,年长兄弟姐妹的数量与情绪性暴饮暴食、食物反应和饮酒欲望呈正相关。姐姐的数量与喝酒的欲望呈正相关,但与食物的挑剔呈负相关。有更多的哥哥姐姐(而不是弟弟妹妹)可能与食物相关的饮食行为有关。姐姐越多,对食物的挑剔就越少。以年长的兄弟姐妹为重点,鼓励健康的饮食习惯和适当的食物选择,可能有利于促进适应性饮食行为和预防过度的能量摄入和体重增加。为了更好地理解兄弟姐妹组成和儿童饮食行为之间联系的潜在机制,未来需要更大样本量的纵向和混合方法研究。
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引用次数: 1
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Behavioral Medicine
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