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Public Health Apr 2022The aim of the present analysis is to identify the reasons for accepting or rejecting the invitation to be screened by the Faecal Immunochemical Test as part of the free...
OBJECTIVES
The aim of the present analysis is to identify the reasons for accepting or rejecting the invitation to be screened by the Faecal Immunochemical Test as part of the free Danish screening programme for colorectal cancer (CRC).
STUDY DESIGN
A cross-sectional representative survey of 15,072 Danish citizens aged 50-80 years was collected in 2019 via a Web-based questionnaire administered by Statistics Denmark. Among the net sample of 6807 respondents (45%), 177 were excluded because of current treatment for colorectal disease.
METHODS
To determine the reasons for accepting or refusing the invitation to be screened for CRC, a latent class analysis was conducted, which allowed participants to provide several reasons for acceptance or rejection of screening.
RESULTS
The most important reason for participating in CRC screening was the active public programme. A further reason for participation was the perceived risk for CRC, mainly in combination with the public programme. The reasons for participation did not differ between individuals who had participated and those who intended to participate when offered. Among participants who declined screening, the most frequent reasons were that they forgot to participate or that they were concerned about the unpleasant test procedure. Among individuals who intended to decline screening, a perceived low risk for CRC was the most frequently cited reason.
CONCLUSIONS
Recommendation from a general practitioner (GP) was not given as a frequent reason for CRC screening participation which is discussed as a challenge to participation rates in population based screening program The main reasons reported for non-participation in CRC screening (i.e. forgot to participate or the unpleasant test procedure) might be addressed by a stronger endorsement from GPs.
Topics: Colorectal Neoplasms; Cross-Sectional Studies; Early Detection of Cancer; Humans; Mass Screening; Occult Blood
PubMed: 35248951
DOI: 10.1016/j.puhe.2022.01.010 -
BMC Medical Ethics Aug 2022The twenty-first century has witnessed an exponential increase in healthcare quality research. As such activities become more prevalent, physicians are increasingly...
BACKGROUND
The twenty-first century has witnessed an exponential increase in healthcare quality research. As such activities become more prevalent, physicians are increasingly needed to participate as subjects in research and quality improvement (QI) projects. This raises an important ethical question: how should physicians be remunerated for participating as research and/or QI subjects?
FINANCIAL VERSUS NON-MONETARY INCENTIVES FOR PARTICIPATION
Research suggests participation in research and QI is often driven by conditional altruism, the idea that although initial interest in enrolling in research is altruistic or prosocial, decisions to actually perform study tasks are cost-benefit driven. Thus, the three models commonly employed to appropriately compensate participants (in-kind compensation such as travel reimbursement, paying market rates for the subject's time, and paying market rates for the activity asked of the participant) are a poor fit when the participant is a clinician, largely due to the asymmetry between cost and benefit or value to the participant. Non-monetary alternatives such as protected time for participation, continuing education or maintenance of certification credit, or professional development materials, can provide viable avenues for reducing this asymmetry.
CONCLUSION
Research and QI are integral to the betterment of medicine and healthcare. To increase physician participation in these activities as the subject of study, new models are needed that clarify the physician's role in research and QI as a subject. Non-monetary approaches are recommended to successfully and ethically encourage research and QI participation, and thus incorporate these activities as a normal part of the ethical clinician's and successful learning healthcare system's world view.
Topics: Certification; Health Services Research; Humans; Physicians; Quality Improvement; Quality of Health Care
PubMed: 35964081
DOI: 10.1186/s12910-022-00817-5 -
Games For Health Journal Apr 2023Cognitive and physical activity are important for daily functioning. However, limited research exists on the motivators and barriers associated with older adults...
Cognitive and physical activity are important for daily functioning. However, limited research exists on the motivators and barriers associated with older adults participating and adhering to exergame studies that promote physical and cognitive activity. Our objective was to examine older adults' motivators and barriers to joining and completing a three-dimensional exergame study. Fourteen older adults who participated in the exergame study contributed to one of three focus group discussions. Inductive and deductive methods were used to analyze the qualitative data. Motivators for joining were generativity, peer referrals, self-improvement, and curiosity. Accomplishment, immersion, and exercise were motivators for retention. Participants also cited the structured schedule and adaptive difficulty features as motivators for retention. Barriers to participation included frustration due to lack of level advancement and fatigue/pain during gameplay. Some ( = 3) reported camera tracking issues as a barrier. Unanticipated gender-based trends arose when examining perceptions of the study team's role and motivators for retention. These findings will inform future research strategies for participant recruitment, enrollment, and retention, in addition to providing insights into the design of motivating, enjoyable, and sustainable exergames for older adults.
Topics: Humans; Aged; Exergaming; Exercise; Focus Groups
PubMed: 36706426
DOI: 10.1089/g4h.2022.0131 -
BMC Public Health Jan 2022Interventions that increase population physical activity are required to promote health and wellbeing. parkrun delivers community-based, 5 km events worldwide yet 43%...
Interventions that increase population physical activity are required to promote health and wellbeing. parkrun delivers community-based, 5 km events worldwide yet 43% who register never participate in a parkrun event. This research had two objectives; i) explore the demographics of people who register for parkrun in United Kingdom, Australia, Ireland, and don't initiate or maintain participation ii) understand the barriers to participating in parkrun amongst these people. Mandatory data at parkrun registration provided demographic characteristics of parkrun registrants. A bespoke online survey distributed across the three countries captured the reasons for not participating or only participating once. Of 680,255 parkrun registrants between 2017 and 19, 293,542 (43%) did not participate in any parkrun events and 147,148 (22%) only participated in one parkrun event. Females, 16-34 years and physically inactive were more likely to not participate or not return to parkrun. Inconvenient start time was the most frequently reported barrier to participating, with females more likely than males to report the psychological barrier of feeling too unfit to participate. Co-creating strategies with and for people living with a chronic disease, women, young adults, and physically inactive people, could increase physical activity participation within parkrun.
Topics: Australia; Exercise; Female; Health Promotion; Humans; Male; Surveys and Questionnaires; United Kingdom; Young Adult
PubMed: 35027014
DOI: 10.1186/s12889-022-12546-w -
Environmental Health and Preventive... 2022People's preventive behavior is crucial for reducing the infection and transmission of a novel coronavirus, especially in aging societies. Moreover, since behavioral...
The relationships between social participation before the COVID-19 pandemic and preventive and health-promoting behaviors during the pandemic: the JAGES 2019-2020 longitudinal study.
BACKGROUND
People's preventive behavior is crucial for reducing the infection and transmission of a novel coronavirus, especially in aging societies. Moreover, since behavioral restrictions may lead to high risks of secondary health impacts among older people, health-promoting behaviors, including proper nutrition intake and regular exercise, should also be encouraged. Although various studies have reported the positive association between social participation and health among older people, whether their social participation relates to preventive and health-promoting behaviors during the COVID-19 pandemic was uncertain. This study examined the relationships between social participation before the COVID-19 pandemic and preventive and health-promoting behaviors during the pandemic among older people in Japan.
METHODS
We obtained longitudinal data from the Japan Gerontological Evaluation Study (JAGES), which conducted baseline and follow-up surveys from November 2019 to January 2020 (pre-pandemic) and from November 2020 to February 2021 (during the pandemic) in ten municipalities. In total, 10,523 responses were analyzed. Preventive and health-promoting behaviors were measured by nine actions (e.g., wash/disinfect hands, wear masks, do exercise), and the total of these actions was divided into two (highly implemented ≥7 or not highly implemented <7). Social participation was assessed by nine activities (e.g., participating in volunteering, sports clubs, had paid work). Adjusted for covariates, we examined the relationships between each social participation and preventive and health-promoting behavior by the logistic regression analysis or the Poisson regression analysis.
RESULTS
Older people who participated in social activities pre-pandemic showed a tendency to implement preventive and health-promoting behaviors during the pandemic. Especially, participations in "sports" and "Kayoi-no-ba" were positively related to "do exercise." Only "had paid work" was negatively related to highly implemented preventive and health-promoting behaviors.
CONCLUSIONS
There were the positive relationships between social participation and preventive and health-promoting behavior. This study also indicated that older people who did not participate in social activities or had paid work before the COVID-19 pandemic may have higher risks of infection and secondary health impacts. Taking into account such old people's lifestyles as well as their workplace conditions, promoting appropriate behaviors need to be considered.
Topics: Humans; Aged; Pandemics; COVID-19; Social Participation; Longitudinal Studies; Japan; Surveys and Questionnaires
PubMed: 36351630
DOI: 10.1265/ehpm.22-00154 -
Frontiers in Psychology 2022Changes in the external market environment put forward objective requirements for the formulation of organizational strategic plans, making it difficult for the... (Review)
Review
Changes in the external market environment put forward objective requirements for the formulation of organizational strategic plans, making it difficult for the organization's leaders to make the right and effective decisions quickly on their own. As a result, participative leadership, which encourages and supports employees to participate in the decision-making process of organizations, has received increasing attention in both theory and practice. We searched the literature related to participative leadership in databases such as Web of Science, EBSCO, ProQuest, and China National Knowledge Infrastructure (CNKI). Based on this, we clarify the concept of participative leadership, propose a definition of participative leadership, summarize measurement scales for this type of leadership, and compare participative leadership with other leadership styles (empowering leadership and directive leadership). We also present a research framework for participative leadership that demonstrates its antecedents; the mechanisms for its development based on social exchange theory, conservation of resources theory, social cognitive theory; social information processing theory, and implicit leadership theory; and outcomes. Finally, we identify five potential research areas: Connotation, antecedents, outcomes, mediators and moderators, and study of participative leadership in China.
PubMed: 35719563
DOI: 10.3389/fpsyg.2022.924357 -
Archives of Physical Medicine and... Sep 2019To investigate the influence of traditional culture on health, disability, and health care services among American Indian and Alaska Native (AI/AN) children and youth...
OBJECTIVE
To investigate the influence of traditional culture on health, disability, and health care services among American Indian and Alaska Native (AI/AN) children and youth with disabilities.
DESIGN
Exploratory descriptive qualitative analysis.
SETTING
Tertiary children's hospital.
PARTICIPANTS
A purposively sampled group (N=17) of AI/AN youth (n=4) with disability lasting at least 6 months age 8-24 years old and parents (n=13) of AI/AN children with disability lasting at least 6 months age 6 months to 17 years old.
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
Participant responses to semistructured interview questions regarding health beliefs, daily activities, participation in cultural activities, and experiences receiving or having their child receive health care and rehabilitation services.
RESULTS
Three themes were identified: (1) participation in cultural activities is important for health as an AI/AN person; (2) experiences participating in cultural activities with functional differences; and (3) lack of recognition of the culturally related functional needs of AI/AN children with disabilities by rehabilitation providers. Children participated in cultural activities primarily through attendance at community-wide events. Barriers to participation in cultural activities included environmental barriers and adaptive mobility devices ill-suited to rough terrain. Participants perceived addressing functional needs related to culture, and cultural activities was not an expected part of rehabilitation services.
CONCLUSIONS
AI/AN children with disabilities experience barriers to participation in cultural activities, making it hard for them to achieve their definition of ideal health. Rehabilitation services have not identified or addressed these unmet culturally related functional needs.
Topics: Adolescent; Adult; Alaska Natives; Child; Child, Preschool; Culturally Competent Care; Disabled Persons; Environment; Female; Health Knowledge, Attitudes, Practice; Humans; Indians, North American; Infant; Interviews as Topic; Male; Middle Aged; Parents; Qualitative Research; Self-Help Devices; Social Participation; Young Adult
PubMed: 30578776
DOI: 10.1016/j.apmr.2018.11.016 -
JAMA Network Open Aug 2022Many randomized clinical trials (RCTs) led by high-income countries (HICs) now enroll patients from lower middle-income countries (LMICs) and upper middle-income...
IMPORTANCE
Many randomized clinical trials (RCTs) led by high-income countries (HICs) now enroll patients from lower middle-income countries (LMICs) and upper middle-income countries (UMICs). Although enrolling diverse populations promotes research collaborations, there are issues regarding which countries participate in RCTs and how this participation may contribute to global research.
OBJECTIVE
To describe which UMICs and LMICs participate in RCTs led by HICs.
DESIGN, SETTING, AND PARTICIPANTS
A cross-sectional study of all oncology RCTs published globally during January 1, 2014, to December 31, 2017, was conducted. The study cohort was restricted to RCTs led by HICs that enrolled participants from LMICs and UMICs. Study analyses were conducted in November 1, 2021, to May 31, 2022.
MAIN OUTCOMES AND MEASURES
A bibliometric approach (Web of Science 2007-2017) was used to explore whether RCT participation was proportional to other measures of cancer research activity. Participation in RCTs (ie, percentage of RCTs in the cohort in which each LMIC and UMIC participated) was compared with country-level cancer research bibliometric output (ie, percentage of total cancer research bibliometric output from the same group of countries that came from a specific LMIC and UMIC).
RESULTS
Among the 636 HIC-led RCTs, 186 trials (29%) enrolled patients in LMICs (n = 84 trials involving 11 LMICs) and/or UMICs (n = 181 trials involving 26 UMICs). The most common participating LMICs were India (42 [50%]), Ukraine (39 [46%]), Philippines (23 [27%]), and Egypt (12 [14%]). The most common participating UMICs were Russia (115 [64%]), Brazil (94 [52%]), Romania (62 [34%]), China (56 [31%]), Mexico (56 [31%]), and South Africa (54 [30%]). Several LMICs are overrepresented in the cohort of RCTs based on proportional cancer research bibliometric output: Ukraine (46% of RCTs but 2% of cancer research bibliometric output), Philippines (27% RCTs, 1% output), and Georgia (8% RCTs, 0.2% output). Overrepresented UMICs include Russia (64% RCTs, 2% output), Romania (34% RCTs, 2% output), Mexico (31% RCTs, 2% output), and South Africa (30% RCTs, 1% output).
CONCLUSIONS AND RELEVANCE
In this cross-sectional study, a substantial proportion of RCTs led by HICs enrolled patients in LMICs and UMICs. The LMICs and UMICs that participated in these trials did not match overall cancer bibliometric output as a surrogate for research ecosystem maturity. Reasons for this apparent discordance and how these data may inform future capacity-strengthening activities require further study.
Topics: Clinical Trials as Topic; Developed Countries; Developing Countries; Humans; Income; India; Research Report
PubMed: 35980637
DOI: 10.1001/jamanetworkopen.2022.27252 -
Health Expectations : An International... Aug 2022Long-term follow-up is necessary to understand the impact of perinatal interventions. Exploring parents' motives and experiences in consenting to their children taking...
BACKGROUND
Long-term follow-up is necessary to understand the impact of perinatal interventions. Exploring parents' motives and experiences in consenting to their children taking part in longitudinal studies and understanding what outcomes are important to families may enhance participation and mitigate the loss to follow-up. As existing evidence is largely based on investigators' perspectives using Western samples, the present pilot study explored parents' perspectives in a multicultural New Zealand context.
METHODS
Data were generated using semi-structured interviews with parents whose children had participated in a longitudinal study after neonatal recruitment. Parents' experiences of being part of the study were analysed thematically using an inductive approach.
RESULTS
Parents (n = 16) were generally happy with the outcomes measured. Additionally, parents were interested in lifelong goals such as the impact of parental diabetes. We identified three themes: (1) Facilitators: Research participation was aided by motives and parent and research characteristics such as wishing to help others and straightforward recruitment; (2) Barriers: A hesitancy to participate was due to technical and clinical research aspects, participation burden and cultural barriers, such as complex wording, time commitment and nonindigenous research and (3) Benefits: Children and parents experienced advantages such as the opportunity for education.
CONCLUSIONS
Parents reported positive experiences and described the unexpected benefit of increasing families' health knowledge through participation. Improvements for current follow-up studies were identified. Different ethnicities reported different experiences and perspectives, which warrants ongoing research, particularly with indigenous research participants.
PATIENT OR PUBLIC CONTRIBUTION
No active partnership with parents of patients took place.
Topics: Child; Follow-Up Studies; Humans; Infant, Newborn; Longitudinal Studies; Parents; Pilot Projects; Qualitative Research
PubMed: 35393722
DOI: 10.1111/hex.13473 -
BMC Women's Health Jun 2022The World Health Organisation's efforts to eliminate cervical cancer by 2030 with a target of 70% screening coverage using a high-performance test demand that women...
BACKGROUND
The World Health Organisation's efforts to eliminate cervical cancer by 2030 with a target of 70% screening coverage using a high-performance test demand that women increase participation in screening. Factors that impact uptake of screening must therefore be identified and bottlenecks addressed, especially in lower- and middle-income countries where cervical cancer incidence remains high. This study investigated Muslim women, participation in, intention to engage in and self-efficacy about cervical cancer screening.
METHODS
An analytical cross-sectional study was conducted among Muslim women aged 18 years and above in the Cape Coast Metropolis of Ghana using an interviewer-administered questionnaire. Data were analysed using appropriate descriptive statistics, Chi-square test, point biserial correlation and binary logistic regression analysis.
RESULTS
The mean age of participants was approximately 31 years (M = 30.9, SD = 10.4). Out of the 431 women, 21 (4.9%) had ever participated in cervical cancer screening. Participants demonstrated very low knowledge about cervical cancer and screening, with a mean knowledge score of 3.68 out of 15. Knowledge about cervical cancer was associated with increased odds of participating in cervical cancer screening (aOR = 1.32, 95%CI 1.11, 1.56). Concerns about similarity with health provider in terms of gender and faith was associated with decreased odds of cervical cancer screening self-efficacy (aOR = 0.81, 95% CI 0.67). Islamic modesty (aOR = 0.88, 95%CI 0.81, 0.96) was associated with decreased self-efficacy about seeking cervical cancer screening, whereas attitude (aOR = 1.32, 95%CI 1.14, 1.53) was significantly associated with increased self-efficacy about seeking cervical cancer screening. Again, Islamic modesty (aOR = 0.88, 95%CI 0.80, 0.97) was associated with decreased intention to participate in screening, whereas attitude (aOR = 1.42, 95%CI 1.20, 1.68) was associated with increased intention to participate in screening.
CONCLUSIONS
There are gaps in knowledge of cervical cancer among Muslim women in this study as less than 5% had participated in screening. A positive attitude was found to influence intention to screen and actual participation in screening programmes. Islamic modesty and commitment to the Islamic faith decreased intention and self-efficacy regarding screening. Therefore, comprehensive and appropriate socio-cultural and religion-specific interventions aimed at addressing the barriers to screening are important in improving uptake among Muslim women.
Topics: Adult; Cross-Sectional Studies; Early Detection of Cancer; Female; Ghana; Health Knowledge, Attitudes, Practice; Humans; Intention; Islam; Mass Screening; Self Efficacy; Uterine Cervical Neoplasms
PubMed: 35698121
DOI: 10.1186/s12905-022-01803-0