-
JMIR Public Health and Surveillance Jun 2024Information on the public's preferences for current public health and social measures (PHSMs) and people's mental health under PHSMs is insufficient.
BACKGROUND
Information on the public's preferences for current public health and social measures (PHSMs) and people's mental health under PHSMs is insufficient.
OBJECTIVE
This study aimed to quantify the public's preferences for varied PHSMs and measure the level of pandemic fatigue in the COVID-19 normalization stage in China.
METHODS
A nationwide cross-sectional study with a discrete choice experiment and psychometric scales was conducted to assess public preferences for and attitudes toward PHSMs, using the quota sampling method. The COVID-19 Pandemic Fatigue Scale (CPFS) was used to screen fatigue levels among respondents. The multinomial logit model, latent class model, and Mann-Whitney test were used for statistical analysis. We also conducted subgroup analysis based on sex, age, monthly income, mental health status, and pandemic fatigue status.
RESULTS
A total of 689 respondents across China completed the survey. The discrete choice experiment revealed that respondents attached the greatest importance to the risk of COVID-19 infection within 3 months (45.53%), followed by loss of income within 3 months (30.69%). Vulnerable populations (low-income populations and elderly people) were more sensitive to the risk of infection, while younger respondents were more sensitive to income loss and preferred nonsuspension of social places and transportation. Migrants and those with pandemic fatigue had less acceptance of the mandatory booster vaccination and suspension of transportation. Additionally, a higher pandemic fatigue level was observed in female respondents, younger respondents, migrants, and relatively lower-income respondents (CPFS correlation with age: r=-0.274, P<.001; correlation with monthly income: r=-0.25, P<.001). Mandatory booster COVID-19 vaccination was also not preferred by respondents with a higher level of pandemic fatigue, while universal COVID-19 booster vaccination was preferred by respondents with a lower level of pandemic fatigue.
CONCLUSIONS
Pandemic fatigue is widely prevalent in respondents across China, and respondents desired the resumption of normal social life while being confronted with the fear of COVID-19 infection in the normalization stage of COVID-19 in China. During future pandemics, the mental burden and adherence of residents should be considered for the proper implementation of PHSMs.
Topics: Humans; COVID-19; China; Male; Female; Adult; Cross-Sectional Studies; Middle Aged; Public Health; Young Adult; Fatigue; Pandemics; Adolescent; Aged; Choice Behavior; Surveys and Questionnaires
PubMed: 38935420
DOI: 10.2196/45840 -
JAMA Network Open Jun 2024Adjuvant endocrine therapy (AET) use among women with early-stage, hormone receptor-positive breast cancer reduces the risk of cancer recurrence, but its adverse... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Adjuvant endocrine therapy (AET) use among women with early-stage, hormone receptor-positive breast cancer reduces the risk of cancer recurrence, but its adverse symptoms contribute to lower adherence.
OBJECTIVE
To test whether remote monitoring of symptoms and treatment adherence with or without tailored text messages improves outcomes among women with breast cancer who are prescribed AET.
DESIGN, SETTING, AND PARTICIPANTS
This nonblinded, randomized clinical trial (RCT) following intention-to-treat principles included English-speaking women with early-stage breast cancer prescribed AET at a large cancer center with 14 clinics across 3 states from November 15, 2018, to June 11, 2021. All participants had a mobile device with a data plan and an email address and were asked to use an electronic pillbox to monitor AET adherence and to complete surveys at enrollment and 1 year.
INTERVENTIONS
Participants were randomized into 3 groups: (1) an app group, in which participants received instructions for and access to the study adherence and symptom monitoring app for 6 months; (2) an app plus feedback group, in which participants received additional weekly text messages about managing symptoms, adherence, and communication; or (3) an enhanced usual care (EUC) group. App-reported missed doses, increases in symptoms, and occurrence of severe symptoms triggered follow-ups from the oncology team.
MAIN OUTCOMES AND MEASURES
The primary outcome was 1-year, electronic pillbox-captured AET adherence. Secondary outcomes included symptom management abstracted from the medical record, as well as patient-reported health care utilization, symptom burden, quality of life, physician communication, and self-efficacy for managing symptoms.
RESULTS
Among 304 female participants randomized (app group, 98; app plus feedback group, 102; EUC group, 104), the mean (SD) age was 58.6 (10.8) years (median, 60 years; range, 31-83 years), and 60 (19.7%) had an educational level of high school diploma or less. The study completion rate was 87.5% (266 participants). There were no statistically significant differences by treatment group in AET adherence (primary outcome): 76.6% for EUC, 73.4% for the app group (difference vs EUC, -3.3%; 95% CI, -11.4% to 4.9%; P = .43), and 70.9% for the app plus feedback group (difference vs EUC, -5.7%; 95% CI, -13.8% to 2.4%; P = .17). At the 1-year follow-up, app plus feedback participants had fewer total health care encounters (adjusted difference, -1.23; 95% CI, -2.03 to -0.43; P = .003), including high-cost encounters (adjusted difference, -0.40; 95% CI, -0.67 to -0.14; P = .003), and office visits (adjusted difference, -0.82; 95% CI, -1.54 to -0.09; P = .03) over the previous 6 months compared with EUC participants.
CONCLUSIONS AND RELEVANCE
This RCT found that a remote monitoring app with alerts to the patient's care team and tailored text messages to patients did not improve AET adherence among women with early-stage breast cancer; however, it reduced overall and high-cost health care encounters and office visits without affecting quality of life.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT03592771.
Topics: Humans; Female; Breast Neoplasms; Middle Aged; Medication Adherence; Antineoplastic Agents, Hormonal; Mobile Applications; Aged; Text Messaging; Adult; Chemotherapy, Adjuvant
PubMed: 38935379
DOI: 10.1001/jamanetworkopen.2024.17873 -
Indian Journal of Public Health Oct 2023A major group of the population, especially antenatal checkup (ANC) mothers and their spouses, people admitted for surgery, and people attending STI clinics, are...
BACKGROUND
A major group of the population, especially antenatal checkup (ANC) mothers and their spouses, people admitted for surgery, and people attending STI clinics, are reluctant to pretest counseling.
OBJECTIVES
This study has been taken up to explore the barriers and possible solutions to improve the utilization of Facility based integrated counseling and testing center (F-ICTC) counseling services.
MATERIALS AND METHODS
Phase 1: In-depth interview and ranking with stakeholders from the F-ICTC center (n = 13) were conducted to identify the barriers to utilization of F-ICTC and solution for the same. Phase 2.
A
Delphi panel with experts (n = 17) was invited through mail to find out the potential solution to improve the utilization of F-ICTC counseling services.
RESULTS
Possible barriers from the stakeholders' perspectives were fear of the disease, violate the privacy, unacceptance, gender bias, fear of social stigma and discrimination, and neglect attached to the disease. At third round of Delphi experts had arrived at a consensus regarding of following possible potential solutions: 1. Those who refuse pretest counseling they should be asked to answer a set of questions(which are usually told during counseling), only those questions not answered correctly by them can be corrected, 2.conducive hospital environment, 3.zero discrimination policy, 4. group counseling for ANC mothers and patients in waiting area of the hospital,5. phone counseling for unwilling patients and relocation of testing center and health education camping.
CONCLUSION
Context-specific proactive evidence-based intervention will help in improving the proper utilization of the F-ICTC center.
Topics: Humans; Delphi Technique; Female; Counseling; Prenatal Care; Male; Pregnancy; Adult; India; Social Stigma; Interviews as Topic; Patient Acceptance of Health Care
PubMed: 38934833
DOI: 10.4103/ijph.ijph_1529_22 -
Indian Journal of Public Health Oct 2023The augmentation of precautionary behaviors through the application of health belief model (HBM) constructs could help in curbing the current pandemic.
BACKGROUND
The augmentation of precautionary behaviors through the application of health belief model (HBM) constructs could help in curbing the current pandemic.
OBJECTIVES
The objectives are to assess adherence to CAB and to evaluate its predictors using the constructs of HBM among COVID-19 vaccinees in Himachal Pradesh.
MATERIALS AND METHODS
A cross-sectional study using a telephone survey, with two-step stratified random sampling, was employed to acquire a sample of 441 respondents from Himachal Pradesh. Formal interviews were conducted using pretested, structured, self-administered questionnaires.
RESULTS
The mean age of respondents was 32.16 years (standard deviation = 12.77; range = 18-78 years). Maximum adherence was seen for wearing masks at 83% (95% confidence interval [CI]: 79.3%-86.3%), followed by maintenance of respiratory hygiene at 72.3% (95% CI 68%-78.4%). Nearly 42.2% (95% CI 37.6%-47.8%) conformed to social distancing norms. We observed minimum adherence for handwashing practices of 12.9% (95% CI 10%-16.3.0%). On bivariate analyses, except for perceived severity, all HBM constructs were significantly associated with CAB. However, after adjusting for gender, age, education, area of residence, and reduced income in multivariate analysis, perceived susceptibility, perceived barriers, and exposure to cues to action remained significant predictors of CAB.
CONCLUSIONS
The study highlights the empirical evidence of the application of HBM constructs to enhance behavioral adherence to COVID-19 precautionary measures.
Topics: Humans; COVID-19; India; Adult; Cross-Sectional Studies; Male; Female; Middle Aged; Health Belief Model; Adolescent; Young Adult; Aged; SARS-CoV-2; Health Behavior; Health Knowledge, Attitudes, Practice; Socioeconomic Factors; Hand Disinfection
PubMed: 38934832
DOI: 10.4103/ijph.ijph_1525_22 -
Indian Journal of Public Health Oct 2023To trigger quit intention and practice of preventive measures for COVID-19 among tobacco users; it is imperative for them to be well aware of the fact that they are at...
BACKGROUND
To trigger quit intention and practice of preventive measures for COVID-19 among tobacco users; it is imperative for them to be well aware of the fact that they are at higher risk of COVID-19 infection and should be at higher efficacy to practice preventive measures for the disease as compared to nonusers of tobacco.
OBJECTIVES
This community-based cross-sectional analytical study was conducted from April 2020 to May 2020 among 1203 adult participants to compare the threat and efficacy perception among users and nonusers of tobacco.
MATERIALS AND METHODS
Perception of threat was assessed using three questions on perceived threat and one question on perceived susceptibility; whereas perception of efficacy was assessed using four questions each on self-efficacy and response efficacy through telephonic interview.
RESULTS
There was no significant difference in the overall threat perception among users and nonusers of tobacco. However, state-wise analysis showed that tobacco users had higher perception of threat for SARS-CoV-2 infection in all the states except Telangana. The overall perception of efficacy among tobacco users was significantly higher as compared to nonusers of tobacco.
CONCLUSION
The study calls for active collaboration between tobacco control enthusiasts and the Government to promote awareness of a higher risk of COVID-19 disease among tobacco users. In essence, the study's implications extend beyond COVID-19 and can guide targeted efforts to promote awareness, behavior change, and collaboration in the context of other infectious diseases among tobacco users.
Topics: Humans; COVID-19; Cross-Sectional Studies; India; Male; Female; Adult; Middle Aged; Health Knowledge, Attitudes, Practice; SARS-CoV-2; Self Efficacy; Young Adult; Tobacco Use
PubMed: 38934829
DOI: 10.4103/ijph.ijph_1438_22 -
Indian Journal of Public Health Oct 2023Chronic headache greatly affects the quality of life and also constitutes a significant burden on the health system.
BACKGROUND
Chronic headache greatly affects the quality of life and also constitutes a significant burden on the health system.
OBJECTIVE
The objective of this study was to evaluate the feasibility of telephone-based follow-up in a cohort of headache patients in India.
MATERIALS AND METHODS
This was a longitudinal cohort study of patients with episodic headache with one physical visit in the neurology outpatient services in the last year. Two neurologists conducted the telephone follow up (TFU) of included patients 12 weeks apart. We evaluated the following: (1) objective characterization of headache, (2) coexistent depression and anxiety, (3) patient satisfaction, (4) treatment adherence, and (5) changes in medications.
RESULTS
A total of 214 out of 274 eligible patients were included in the cohort. The mean age was 31.74 ± 7.77 years (18-45), and 164 (77%) were females. Migraine without aura was the most common diagnosis in 159 (74%). The mean disease duration was 78.01 ± 70.15 months (8-360). Concurrent depression and anxiety were noted in 87 (40.6%) and 45 (21%) of the patients, respectively. There was a significant improvement in the headache frequency (23.82 vs. 1.06, P < 0.001), severity (7.21 vs. 2.62, P = 0.032), and Headache Impact 6-item score (58.12 vs. 38.01, P = 0.014) at baseline and second follow-up. The satisfaction level to TFU in the first and second interviews was 94.4% and 97.2%, respectively.
CONCLUSION
Telephone-based follow-up is a feasible alternative for repeat outpatient consultation of headache patients.
Topics: Humans; Female; Male; Adult; Telephone; Longitudinal Studies; India; Adolescent; Middle Aged; Patient Satisfaction; Feasibility Studies; Young Adult; Depression; Anxiety; Headache; Follow-Up Studies; Headache Disorders
PubMed: 38934827
DOI: 10.4103/ijph.ijph_1479_22 -
Indian Journal of Public Health Oct 2023Child sexual abuse occurs in a variety of settings and the POCSO Act, 2012 came into force with effect from November 14, 2012.
BACKGROUND
Child sexual abuse occurs in a variety of settings and the POCSO Act, 2012 came into force with effect from November 14, 2012.
OBJECTIVES
A community-based cross-sectional study to assess the knowledge regarding the POCSO Act among adults in the rural community of Chandigarh was carried out in full compliance with ethical standards provided by the institutional research and ethical committee.
MATERIALS AND METHODS
A nonprobability sampling technique was used to select 190 subjects from Sector 56, Palsora, Chandigarh.
RESULTS
This study found that 55.8% have an adequate level of knowledge and 44.2% have an inadequate level of knowledge.
CONCLUSIONS
The variables heard or seen by a victim of child abuse have only significant associations with the level of knowledge.
Topics: Humans; Cross-Sectional Studies; India; Health Knowledge, Attitudes, Practice; Female; Adult; Male; Child Abuse, Sexual; Child; Rural Population; Middle Aged; Young Adult
PubMed: 38934821
DOI: 10.4103/ijph.ijph_1637_22 -
Indian Journal of Public Health Oct 2023We measured COVID-19-related stigma and discrimination and its drivers using a concurrent mixed-methods design in Punjab. The simple random sampling was used to select...
We measured COVID-19-related stigma and discrimination and its drivers using a concurrent mixed-methods design in Punjab. The simple random sampling was used to select blocks, subcenters, and urban primary healthcenters from each of the four selected districts. The systematic random sampling was used to select households. A sample of 423 adults was interviewed using a structured questionnaire and 10 in-depth interviews were conducted using an interview guide. Binary logistic regression was performed to find the predictors. Stigma prevalence was mild 18%, moderate 45%, and severe 37%. Logistic regression indicated that stigma was lower in the rural compared to the urban population (P < 0.01). Hospitalized patients faced discrimination more often compared to those who were treated/quarantined at home. People feared police (71%), testing (69%), and contracting the infection (65%). Fear of screening, disclosure of status, and transmission of the virus were the drivers of stigma and discrimination. Co-occurrence of labeling, stereotyping, and cognitive separation was observed.
Topics: Humans; COVID-19; India; Social Stigma; Male; Female; Adult; SARS-CoV-2; Middle Aged; Stereotyping; Rural Population; Urban Population; Social Discrimination; Young Adult
PubMed: 38934816
DOI: 10.4103/ijph.ijph_1255_22 -
Indian Journal of Public Health Oct 2023The Saharia tribe of Madhya Pradesh has a very high tuberculosis (TB) burden. However, there is no report of adverse drug reaction (ADR) available in patients receiving... (Observational Study)
Observational Study
Adverse Drug Reaction Patterns of First-line Anti-tubercular Drugs among Saharia Tuberculosis Patients: An Observational Study in Particularly Vulnerable Tribal Group of Madhya Pradesh, India.
The Saharia tribe of Madhya Pradesh has a very high tuberculosis (TB) burden. However, there is no report of adverse drug reaction (ADR) available in patients receiving anti-TB chemotherapy in the community. Reporting and monitoring of ADRs among TB patients is still rare in marginalized communities. An observational prospective study was performed from November 2019 to June 2020 to assess the patterns of ADRs in 250 Saharia TB patients, who were prescribed Category-I daily DOTS (HRZE) by the physician. Both male and female participants equally experienced ADR during the treatment, but relatively more females (92.6%) than males (88.6%) reported ADR during Phase I. Out of 250 patients, 224 patients (89.6%) experienced one or more ADRs in Phase I. The central nervous system-related (75.6%) ADR was mostly reported followed by any gastrointestinal (74.4%), cardiovascular (49.2%) and any dermatological related (44.4%) ADRs. It is paramount to timely monitor and proactively manages ADRs pertaining to anti-TB drug treatment with minimal alteration in the treatment course.
Topics: Humans; India; Male; Female; Antitubercular Agents; Adult; Prospective Studies; Middle Aged; Tuberculosis; Drug-Related Side Effects and Adverse Reactions; Adolescent; Young Adult; Directly Observed Therapy; Aged
PubMed: 38934815
DOI: 10.4103/ijph.ijph_865_22 -
Indian Journal of Public Health Oct 2023The postnatal period is a critical phase indeed, in which, owing to the pandemic, an added apprehension being the safety and well-being of both, mother and child. This...
The postnatal period is a critical phase indeed, in which, owing to the pandemic, an added apprehension being the safety and well-being of both, mother and child. This study was mainly done to assess the attitude and practices regarding postnatal care during the Covid-19 pandemic among women availing services at Snehalaya hospital, Solur. It was a hospital based cross- sectional study done among post-natal mothers and data were collected using an interview schedule following sections such as- socio-demographic details, questions assessing the attitudes towards postnatal care during the pandemic followed by questions assessing the practices in the same period. It was found that of the total interviewed, nearly half mothers reported to have a fear of getting infected with Covid-19 and few reported to have a fear of deaths due to Covid-19. Fear of dying from Covid-19 was an evident finding seen more among the gainfully employed and those with bad obstetric history. The socioeconomic status did have a bearing on the perceptions towards the pandemic influence on the maternal and child health during the puerperal period.
Topics: Humans; COVID-19; Female; Fear; Cross-Sectional Studies; Adult; India; Postnatal Care; Hospitals, Maternity; SARS-CoV-2; Young Adult; Pregnancy; Socioeconomic Factors; Hospitals, Rural; Mothers; Health Knowledge, Attitudes, Practice
PubMed: 38934811
DOI: 10.4103/ijph.ijph_1522_22