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Appetite Aug 2023Plant-forward diets offer a potential solution to many of the health and ecological crises that we find ourselves facing today. A key barrier to the adoption and...
Plant-forward diets offer a potential solution to many of the health and ecological crises that we find ourselves facing today. A key barrier to the adoption and maintenance of plant-forward diets is an anticipated lack of support from family members, friends and romantic partners. The present study examined how relational climate (i.e., the cohesion and flexibility of a partnership) contributes to the tension individuals anticipate in their relationship when a member reduces their animal-product consumption, and their own openness to reducing. Four hundred and ninety-six coupled individuals took part in an online survey. Analyses revealed that couples with more flexible leadership styles anticipated less tension should they or their partner adopt a plant-forward diet. However, dimensions of relational climate were largely unrelated to openness to plant-forward diets. Romantic couples who perceived themselves to be matched in terms of dietary habits were less open to reducing their animal-product consumption than unmatched couples. Politically left-leaning couples and females were more open to plant-forward diets. The meat attachments of male partners were reported as a particular barrier to dietary goals, as were practical concerns about meal coordination, finance, and health. Implications for promoting plant-forward dietary transitions are discussed.
Topics: Female; Animals; Humans; Diet; Friends; Marital Status
PubMed: 37244389
DOI: 10.1016/j.appet.2023.106617 -
Implementation Science Communications Aug 2023World Health Organization (WHO) HEARTS packages are increasingly used to control hypertension. However, their feasibility in persons living with HIV (PLHIV) is unknown.... (Review)
Review
Using the RE-AIM framework to evaluate the implementation and effectiveness of a WHO HEARTS-based intervention to integrate the management of hypertension into HIV care in Uganda: a process evaluation.
BACKGROUND
World Health Organization (WHO) HEARTS packages are increasingly used to control hypertension. However, their feasibility in persons living with HIV (PLHIV) is unknown. We studied the effectiveness and implementation of a WHO HEARTS intervention to integrate the management of hypertension into HIV care.
METHODS
This was a mixed methods study at Uganda's largest HIV clinic. Components of the adapted WHO HEARTS intervention were lifestyle counseling, free hypertension medications, hypertension treatment protocol, task shifting, and monitoring tools. We determined the effectiveness of the intervention among PLHIV by comparing hypertension and HIV outcomes at baseline and 21 months. The RE-AIM framework was used to evaluate the implementation outcomes of the intervention at 21 months. We conducted four focus group discussions with PLHIV (n = 42), in-depth interviews with PLHIV (n = 9), healthcare providers (n = 15), and Ministry of Health (MoH) policymakers (n = 2).
RESULTS
Reach: Among the 15,953 adult PLHIV in the clinic, of whom 3892 (24%) had been diagnosed with hypertension, 1133(29%) initiated integrated hypertension-HIV treatment compared to 39 (1%) at baseline. Among the enrolled patients, the mean age was 51.5 ± 9.7 years and 679 (62.6%) were female.
EFFECTIVENESS
Among the treated patients, hypertension control improved from 9 to 72% (p < 0.001), mean systolic blood pressure (BP) from 153.2 ± 21.4 to 129.2 ± 15.2 mmHg (p < 0.001), and mean diastolic BP from 98.5 ± 13.5 to 85.1 ± 9.7 mmHg (p < 0.001). Overall, 1087 (95.9%) of patients were retained by month 21. HIV viral suppression remained high, 99.3 to 99.5% (p = 0.694). Patients who received integrated hypertension-HIV care felt healthy and saved more money. Adoption: All 48 (100%) healthcare providers in the clinic were trained and adopted the intervention. Training healthcare providers on WHO HEARTS, task shifting, and synchronizing clinic appointments for hypertension and HIV promoted adoption.
IMPLEMENTATION
WHO HEARTS intervention was feasible and implemented with fidelity. Maintenance: Leveraging HIV program resources and adopting WHO HEARTS protocols into national guidelines will promote sustainability.
CONCLUSIONS
The WHO HEARTS intervention promoted the integration of hypertension management into HIV care in the real-world setting. It was acceptable, feasible, and effective in controlling hypertension and maintaining optimal viral suppression among PLHIV. Integrating this intervention into national guidelines will promote sustainability.
PubMed: 37626415
DOI: 10.1186/s43058-023-00488-2 -
Frontiers in Nutrition 2023Produce prescription programs represent a promising intervention strategy in the healthcare setting to address disparities in diet quality and diet-related chronic...
BACKGROUND
Produce prescription programs represent a promising intervention strategy in the healthcare setting to address disparities in diet quality and diet-related chronic disease. The objective of this study was to understand adoption and implementation factors related to these programs that are common across contexts and those that are context-specific.
METHODS
In this qualitative case comparison study, we conducted qualitative interviews with eight clinic staff from five primary care "safety net" clinics, identified by a partnering non-profit organization that operated the programs, in April-July 2021.
RESULTS
Across clinics, the ability to provide a tangible benefit to patients was a key factor in adoption. Flexibility in integrating into clinic workflows was a facilitator of implementation. Fit with usual operations varied across clinics. Common challenges were the need for changes to the workflow and extra staff time. Clinic staff were skeptical about the sustainability of both the benefits to patients and the ability to continue the program at their clinics.
DISCUSSION
This study adds to a growing body of knowledge on the adoption and implementation of produce prescription programs. Future research will further this understanding, providing the evidence necessary to guide adopting clinics and to make informed policy decisions to best promote the growth and financial sustainability of these programs.
PubMed: 37964933
DOI: 10.3389/fnut.2023.1221785 -
Annals of Behavioral Medicine : a... Aug 2023We address four questions about interventions to promote physical activity in cancer survivors: (a) How often is both the adoption and maintenance of behavior change...
BACKGROUND/PURPOSE
We address four questions about interventions to promote physical activity in cancer survivors: (a) How often is both the adoption and maintenance of behavior change tested in trials? (b) How often do interventions generate adoption-plus-maintenance of behavior change? (c) Are intervention strategies specifically geared at promoting maintenance of behavior change deployed in trials? and (d) Which intervention strategies distinguish trials that promote both the adoption and maintenance of physical activity from trials that promote adoption-only or generate no behavioral changes?
METHODS
Computerized literature searches identified 206 reports of randomized trials that measured physical activity in the wake of the intervention.
RESULTS
Only 51 reports (24%) measured both behavioral adoption (postintervention) and behavioral maintenance (≥3 months follow-up). The 51 reports included 58 tests of interventions; 22% of tests observed both adoption and maintenance of physical activity, 26% reported adoption-only, and 52% found no change in behavior. Change techniques designed to promote behavioral maintenance were used much less frequently than adoption techniques or adoption and maintenance techniques. Interventions that aimed to improve quality of life, used supervised exercise sessions, were undertaken in community centers, and deployed fewer behavior change techniques were associated with adoption-plus-maintenance of physical activity in cancer survivors.
CONCLUSIONS
The present findings offer new insights into the adoption and maintenance of physical activity and highlight the need to routinely assess these forms of behavior change in future trials. More extensive testing of intervention strategies specifically geared at maintenance of behavior change is warranted.
Topics: Humans; Cancer Survivors; Quality of Life; Exercise; Health Behavior; Neoplasms
PubMed: 37078961
DOI: 10.1093/abm/kaad002 -
Revue Medicale de Liege Jan 2024In recent years, the number of drug shortages has risen alarmingly both in Belgium and internationally. Between 2010 and 2020, the number of reported shortages is almost...
In recent years, the number of drug shortages has risen alarmingly both in Belgium and internationally. Between 2010 and 2020, the number of reported shortages is almost 27 times higher, according to the French Agency for the Safety of Medicines and Health Products. A recent survey conducted by the European Association of Hospital Pharmacists showed that 95 % of hospital pharmacists consider drug shortages to be a major problem. The drug classes most affected include anti-infectives, analgesics and anaesthetics. The sudden and unpredictable occurrence of drug shortages has a negative impact on the daily lives of healthcare professionals and patients. Doctors are sometimes forced to prescribe alternative treatments that are considered less effective or even less well tolerated. These alternatives make it more difficult for patients to adhere to their treatment and generate an additional risk of medication errors. There are several possible solutions to minimize these shortages: relocating production sites to Europe, imposing penalties on offending companies, adopting a common European policy for managing shortages of medicines of major therapeutic interest,... As a corollary to these proposals, legal texts have been adopted to regulate and guarantee the supply of medicines in Belgium.
Topics: Humans; Belgium; Europe; Surveys and Questionnaires; Pharmacists; Drug Industry
PubMed: 38223966
DOI: No ID Found -
American Journal of Health Promotion :... Sep 2023Genetic wellness programs (GWPs) are a highly innovative workforce wellness product. Recently marketed to U.S. employers by at least 16 vendors, GWPs take advantage of...
PURPOSE
Genetic wellness programs (GWPs) are a highly innovative workforce wellness product. Recently marketed to U.S. employers by at least 16 vendors, GWPs take advantage of low-cost DNA sequencing to detect genetic risk factors for an increasing array of diseases. The purpose of this research is to understand perceptions, concerns, and barriers related to GWPs, among employees from Black, White, and Asian backgrounds and different income levels.
APPROACH
Qualitative study with 3 focus groups (FGs).
SETTING
Employees of large high-technology companies (deemed likely early GWP adopters).
RESPONDENTS
21 individuals recruited online through
METHOD
FG guide developed via literature review and landscape analysis, and pre-tested. FGs led by a trained moderator and audio-recorded. Transcripts content analyzed for key themes.
RESULTS
Nearly all respondents saw potential benefits to GWP participation for themselves or their families. However, there were profound differences in perceptions of risks to GWP participation between Black and White/Asian respondents. These differences surfaced in three broad areas: privacy and discrimination risks; family impact risks; and feelings about the employer. Willingness to participate in a GWP also varied between Black employee respondents and White and Asian employee respondents (including low-income White employees). Only 27% of Black employees would participate in GWP, compared to 90% of the other employees.
CONCLUSION
Most employees appear likely to support employer adoption of GWPs. However, Black employees report significant concerns regarding participation. Addressing these concerns through program design would benefit all employees, and could increase trust and uptake of GWPs.
Topics: Humans; Race Factors; Workplace; Health Promotion; Focus Groups; Qualitative Research
PubMed: 37439004
DOI: 10.1177/08901171231184360 -
Heliyon Nov 2023Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to pneumonia and acute...
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to pneumonia and acute respiratory distress syndrome. The COVID-19 pandemic had a major impact on the stock of blood banks worldwide. This study aims to assess the prevalence of COVID-19 in a population of whole blood donors and analyze the possible association between blood group and susceptibility to the disease and the impact of adopting preventive measures against SARS-CoV-2 infection. : This retrospective study included all whole blood donors from a Portuguese hospital between July and September 2021. A self-assessment questionnaire was used to collect data on COVID-19 infection, vaccination, and preventive measures. Statistical analysis was performed using Chi-square and Mann-Whitney U tests. : The prevalence of COVID-19 in the donor population was 11.96% (n = 97), with only 2 cases of serious illness requiring hospitalization. No association was found between blood group and disease susceptibility. Older men were less likely to adopt preventive measures. The vaccination rate was high, with 84.26% of donors having received at least one dose of the vaccine. Seven donors declined COVID-19 vaccination. Preventive measures did not differ based on COVID-19 infection status or vaccination. : Although there was a higher frequency of COVID-19 in group A donors, the blood group was not associated with susceptibility to infection. The donor population consisted of young individuals without comorbidities, showing a COVID-19 prevalence like the general population and few severe cases. The high vaccination rate and adoption of preventive measures likely contributed to these findings.
PubMed: 38027845
DOI: 10.1016/j.heliyon.2023.e20570 -
European Radiology Jan 2024To map the clinical use of CE-marked artificial intelligence (AI)-based software in radiology departments in the Netherlands (n = 69) between 2020 and 2022.
OBJECTIVES
To map the clinical use of CE-marked artificial intelligence (AI)-based software in radiology departments in the Netherlands (n = 69) between 2020 and 2022.
MATERIALS AND METHODS
Our AI network (one radiologist or AI representative per Dutch hospital organization) received a questionnaire each spring from 2020 to 2022 about AI product usage, financing, and obstacles to adoption. Products that were not listed on www.AIforRadiology.com by July 2022 were excluded from the analysis.
RESULTS
The number of respondents was 43 in 2020, 36 in 2021, and 33 in 2022. The number of departments using AI has been growing steadily (2020: 14, 2021: 19, 2022: 23). The diversity (2020: 7, 2021: 18, 2022: 34) and the number of total implementations (2020: 19, 2021: 38, 2022: 68) has rapidly increased. Seven implementations were discontinued in 2022. Four hospital organizations said to use an AI platform or marketplace for the deployment of AI solutions. AI is mostly used to support chest CT (17), neuro CT (17), and musculoskeletal radiograph (12) analysis. The budget for AI was reserved in 13 of the responding centers in both 2021 and 2022. The most important obstacles to the adoption of AI remained costs and IT integration. Of the respondents, 28% stated that the implemented AI products realized health improvement and 32% assumed both health improvement and cost savings.
CONCLUSION
The adoption of AI products in radiology departments in the Netherlands is showing common signs of a developing market. The major obstacles to reaching widespread adoption are a lack of financial resources and IT integration difficulties.
CLINICAL RELEVANCE STATEMENT
The clinical impact of AI starts with its adoption in daily clinical practice. Increased transparency around AI products being adopted, implementation obstacles, and impact may inspire increased collaboration and improved decision-making around the implementation and financing of AI products.
KEY POINTS
• The adoption of artificial intelligence products for radiology has steadily increased since 2020 to at least a third of the centers using AI in clinical practice in the Netherlands in 2022. • The main areas in which artificial intelligence products are used are lung nodule detection on CT, aided stroke diagnosis, and bone age prediction. • The majority of respondents experienced added value (decreased costs and/or improved outcomes) from using artificial intelligence-based software; however, major obstacles to adoption remain the costs and IT-related difficulties.
Topics: Humans; Artificial Intelligence; Netherlands; Radiology; Radiography; Radiologists
PubMed: 37515632
DOI: 10.1007/s00330-023-09991-5 -
JMIR MHealth and UHealth Nov 2023Many adults use e-cigarettes to help them quit cigarette smoking. However, the impact of self-selected use of e-cigarettes on cigarette smoking cessation, particularly... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Many adults use e-cigarettes to help them quit cigarette smoking. However, the impact of self-selected use of e-cigarettes on cigarette smoking cessation, particularly when concurrently receiving app-based behavioral interventions, remains unexplored.
OBJECTIVE
This study used data from a randomized trial of 2 smartphone apps to compare 12-month cigarette smoking cessation rates between participants who used e-cigarettes on their own (ie, adopters: n=465) versus those who did not (ie, nonadopters: n=1097).
METHODS
The study population included all participants who did not use e-cigarettes at baseline. "Adopters" were those who self-reported the use of e-cigarettes at either 3- or 6-month follow-ups. "Nonadopters" were those who self-reported no use of e-cigarettes at either follow-up time point. The primary cessation outcome was self-reported, complete-case, 30-day point prevalence abstinence from cigarette smoking at 12 months. Secondary outcomes were missing-as-smoking and multiple imputation analyses of the primary outcome, prolonged abstinence, and cessation of all nicotine and tobacco products at 12 months. In logistic regression models, we first examined the potential interaction between e-cigarette use and treatment arm (iCanQuit vs QuitGuide) on the primary cessation outcome. Subsequently, we compared 12-month cigarette smoking cessation rates between adopters and nonadopters separately for each app.
RESULTS
There was suggestive evidence for an interaction between e-cigarette use and treatment arm on cessation (P=.05). In the iCanQuit arm, 12-month cigarette smoking cessation rates were significantly lower among e-cigarette adopters compared with nonadopters (41/193, 21.2% vs 184/527, 34.9%; P=.003; odds ratio 0.55, 95% CI 0.37-0.81). In contrast, in the QuitGuide arm, 12-month cigarette smoking cessation rates did not differ between adopters and nonadopters (46/246, 18.7% vs 104/522, 19.9%; P=.64; odds ratio 0.91, 95% CI 0.62-1.35).
CONCLUSIONS
The use of e-cigarettes while concurrently receiving an app-based smoking cessation intervention was associated with either a lower or an unimproved likelihood of quitting cigarette smoking compared to no use. Future behavioral treatments for cigarette smoking cessation should consider including information on the potential consequences of e-cigarette use.
TRIAL REGISTRATION
ClinicalTrials.gov NCT02724462; https://clinicaltrials.gov/study/NCT02724462.
Topics: Adult; Humans; Electronic Nicotine Delivery Systems; Smoking Cessation; Behavior Therapy; Logistic Models; Tobacco Products
PubMed: 37943594
DOI: 10.2196/48896 -
PloS One 2023Smart homes represent the complement of various automation technologies that together make up a network of devices facilitating the daily tasks of residents. These...
Smart homes represent the complement of various automation technologies that together make up a network of devices facilitating the daily tasks of residents. These technologies are being studied for their application from different sectors, including the projection of their use to improve energy consumption planning and health care management. However, technology adoption depends on social awareness within the scope of cognitive advantages and innovations compared to perceived risk because although there are multiple benefits, potential users express fears related to the loss of autonomy and security. This study carries out a systematic literature review based on PRISMA in order to analyze research trends and literary evolution in the technological adoption of smart homes, considering the main theories and variables applied by the community. In proposing a research agenda in accordance with the identified gaps and the growing and emerging themes of the object of study, it is worth highlighting the growing interest in the subject, both for the present and its development in the future. Until now, adoption factors have been attributed more to the technological acceptance model and the diffusion of innovation theory, adopting components of the Theory of Planned Behavior; therefore, in several cases, the attributes of different theories are merged to adapt to the needs of each researcher, promoting the creation of empirical and extended models.
Topics: Humans; Technology; Automation; Research Personnel
PubMed: 37862296
DOI: 10.1371/journal.pone.0292558