Family Medicine and Community Health最新文献

{"title":"Validation of Hospital Anxiety and Depression Scale in an Indonesian population: a scale adaptation study.","authors":"Badai Bhatara Tiksnadi,&nbsp;Nurlita Triani,&nbsp;Faris Yuflih Fihaya,&nbsp;Iswandy Janetputra Turu' Allo,&nbsp;Shelly Iskandar,&nbsp;Diba Artsiyanti Ediyana Putri","doi":"10.1136/fmch-2022-001775","DOIUrl":"https://doi.org/10.1136/fmch-2022-001775","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to adapt the English-language Hospital Anxiety and Depression Scale (HADS) to the Indonesian language and evaluate the validity and reliability of the adapted version (ie, HADS-Indonesia).</p><p><strong>Design: </strong>A cross-sectional study was conducted between June and November 2018. First, a translation and back-translation process was conducted by a committee consisting of the researchers, a psychiatrist, a methodology consultant and two translators. Face and convergent validity and test-retest reliability evaluations were conducted. Next, structural validity and internal consistency analyses were performed. An intraclass correlation coefficient (ICC) test evaluated the scale's test-retest reliability. A Spearman's rank correlation coefficient was calculated to evaluate the correlation between HADS-Indonesia and Zung's Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) for convergent validity evidence. Next, a structural validity analysis using exploratory factor analysis (EFA) and an internal consistency evaluation based on Cronbach's alpha was conducted.</p><p><strong>Setting: </strong>This study was conducted in three villages in Jatinangor subdistrict, Sumedang Regency, West Java province, Indonesia; the villages were chosen based on their profiles.</p><p><strong>Participants: </strong>A total of 200 participants (male: n=91, 45.50% and female: n=109, 54.50%), with a mean age of 42.41 (14.25) years, were enrolled in this study using a convenience sampling method. The inclusion criteria were age ≥18 years old with basic Indonesian language literacy.</p><p><strong>Results: </strong>The overall HADS-Indonesia's ICC value was 0.98. There was a significant positive correlation between HADS-Indonesia's anxiety subscale and Zung's SAS (r_s=0.45, p=0.030) and between the depression subscale of HADS-Indonesia and Zung's SDS (r_s=0.58, p<0.001). The Kaiser-Meyer-Olkin statistics (KMO) (KMO=0.89) and Bartlett's test of sphericity (χ²(91, N=200)=1052.38, p<0.001)) indicated an adequate number of samples for EFA. All items' commonality was >0.40 and the average inter-item correlation was 0.36. EFA yielded a 2-factor solution explaining 50.80% (40.40%+10.40%) of the total variance. All items from the original HADS were retained, including its original subscales. The adapted HADS-Anxiety subscale consisted of seven items (alpha=0.85), and the HADS-Depression subscale consisted of seven items (alpha=0.80).</p><p><strong>Conclusions: </strong>HADS-Indonesia is a valid and reliable instrument for use in the general population of Indonesia. However, further studies are warranted to provide more sophisticated validity and reliability evidence.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d1/50/fmch-2022-001775.PMC10255233.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10003876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sense of community and mental health: a cross-sectional analysis from a household survey in Wisconsin.","authors":"Eunice Y Park,&nbsp;Thomas R Oliver,&nbsp;Paul E Peppard,&nbsp;Kristen C Malecki","doi":"10.1136/fmch-2022-001971","DOIUrl":"https://doi.org/10.1136/fmch-2022-001971","url":null,"abstract":"<p><strong>Background: </strong>In the USA, one in five adults live with a mental illness, and researchers have estimated that nearly half of the population will have a mental illness over the course of their lifetime. Research has shown significant associations between social relationships and mental health outcomes at the individual and population levels. This study aims to examine whether sense of community, a type of social capital, is associated with mental health.</p><p><strong>Methods: </strong>In a cross-sectional analysis, multiple logistic regression models were used to examine whether sense of community was associated with symptoms of depression, anxiety and stress reported over the last week. The analysis used data from the Survey of the Health of Wisconsin collected between 2014 and 2016. A total of 1647 observations are included in the analyses.</p><p><strong>Results: </strong>Compared with those who report a positive sense of community, those with a negative sense of community had a significantly higher odds of reporting depression, anxiety and stress symptoms. Socioeconomic status is negatively associated with depression and anxiety, but not with stress. Women were more likely to experience moderate, severe, or extremely severe anxiety and stress, compared with men.</p><p><strong>Conclusion: </strong>This study extends current understanding of health benefits of social capital and found that individuals' sense of community is associated with reduced symptoms of depression, anxiety and stress. Further research examining mechanisms to support improved sense of community and other types of social capital could benefit health equity research.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/63/fmch-2022-001971.PMC10314672.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9748960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influenza presentations and use of neuraminidase inhibitors by Australian general practice registrars: a cross-sectional analysis from the ReCEnT study.","authors":"Chris Moller, Mieke van Driel, Andrew Davey, Amanda Tapley, Elizabeth G Holliday, Alison Fielding, Joshua Davis, Jean Ball, Anna Ralston, Alexandria Turner, Katie Mulquiney, Neil Spike, Kristen Fitzgerald, Parker Magin","doi":"10.1136/fmch-2022-002107","DOIUrl":"10.1136/fmch-2022-002107","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to establish prevalence and associations of (1) influenza and influenza-like illness (IILI) presentations to Australian general practice (GP) registrars (trainees) and (2) the use of neuraminidase inhibitors (NAIs) by GP registrars for new presentations of IILI, for the 10 years leading up to the COVID-19 pandemic in Australia (2010-2019).</p><p><strong>Design: </strong>This was a cross-sectional analysis of the Registrar Clinical Encounters in Training ongoing inception cohort study of the in-consultation experience and clinical behaviours of GP registrars. Data are collected by individual registrars three times (from 60 consecutive consultations each time) at 6 monthly intervals. Data include diagnoses/problems managed and medicines prescribed, along with multiple other variables. Univariate and multivariable logistic regression was used to establish associations of registrars seeing patients with IILI and of prescribing NAIs for IILI.</p><p><strong>Setting: </strong>Teaching practices within the Australian general practitioner specialist vocational training programme. Practices were located in five of the six Australian states (plus one territory).</p><p><strong>Participants: </strong>GP registrars in each of their three compulsory 6-month GP training terms.</p><p><strong>Results: </strong>From 2010 to 2019, 0.2% of diagnoses/problems seen by registrars were IILI. 15.4% of new IILI presentations were prescribed an NAI. IILI diagnoses were less likely in younger (0-14) and older (65+) age groups, and more likely in an area of higher socioeconomic advantage. There was considerable variation in NAI prescribing between regions. There was no significant association of prescribing NAIs with age or Aboriginal and/or Torres Strait Islander patients.</p><p><strong>Conclusions: </strong>IILI presentations were more likely among working-age adults and not among those groups at higher risk. Similarly, high-risk patient groups who would benefit most were not more likely to receive NAIs. The epidemiology and management of IILI has been distorted by the COVID-19 pandemic, but the burden of influenza in vulnerable populations must not be overlooked. Appropriately targeted antiviral therapy with NAIs influences outcomes for vulnerable patients. General practitioners manage the majority of IILI in Australia, and understanding GP IILI presentation and NAI prescribing patterns is a key first step to enabling sound and rational prescribing decisions for better patient outcomes.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/4c/fmch-2022-002107.PMC10277129.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9668163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of the New Early Warning Score (NEWS) in combination with the neutrophil-lymphocyte ratio for the prediction of prognosis in older patients with pneumonia.","authors":"Eiichi Kakehi,&nbsp;Ryo Uehira,&nbsp;Nobuaki Ohara,&nbsp;Yukinobu Akamatsu,&nbsp;Taeko Osaka,&nbsp;Shigehisa Sakurai,&nbsp;Akane Hirotani,&nbsp;Takafumi Nozaki,&nbsp;Keisuke Shoji,&nbsp;Seiji Adachi,&nbsp;Kazuhiko Kotani","doi":"10.1136/fmch-2023-002239","DOIUrl":"https://doi.org/10.1136/fmch-2023-002239","url":null,"abstract":"<p><strong>Objective: </strong>Predictors of prognosis are necessary for use in routine clinical practice for older patients with pneumonia, given the ageing of the population. Recently, the National Early Warning Score (NEWS), a comprehensive predictor of severity that consists solely of physiological indicators, has been proposed to predict the prognosis of pneumonia. The neutrophil/lymphocyte ratio (NLR) is a simple index of inflammation that may also be predictive of pneumonia. In the present study, we aimed to determine whether NEWS or a combination of NEWS and NLR predicts mortality in older patients with pneumonia.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>A general hospital in Japan.</p><p><strong>Participants: </strong>We collected data from patients aged ≥65 years with pneumonia who were admitted between 2018 and 2020 (n=282; age=85.3 (7.9)). Data regarding vital signs, demographics and the length of hospital stay, in addition to the NEWS and NLR, were extracted from the participants' electronic medical records.</p><p><strong>Intervention: </strong>The utility of the combination of NEWS and NLR was assessed using NEWS×NLR and NEWS+NLR.</p><p><strong>Main outcome measures: </strong>Their predictive ability for 30-day mortality as the primary outcome was assessed using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>According to the NEWS classification, 80 (28.3%), 64 (22.7%) and 138 (48.9%) of the participants were at low, medium and high risk of mortality, respectively. The 30-day mortality for the entire cohort was 9.2% (n=26), and the mortality rate increased with the NEWS classification: low, 1.3%; medium, 7.8%; and high, 14.5%. The NLRs were 6.0 (4.2-9.8), 6.8 (4.8-10.4) and 14.6 (9.4-22.2), respectively (p<0.001). The areas under the ROC curves for 30-day mortality were 0.73 for the NEWS score, 0.84 for NEWS×NLR and 0.83 for NEWS+NLR, indicating that the combinations represent superior predictors of mortality to the NEWS alone. NEWS×NLR and NEWS+NLR tended to have better sensitivity, accuracy, positive predictive value and negative predictive value than NEWS alone (p=0.06).</p><p><strong>Conclusions: </strong>A combination of the NEWS and NLR (NEWS×NLR or NEWS+NLR) may be superior to the NEWS alone for the prediction of 30-day mortality in older patients with pneumonia. However, further validation of these combinations for use in the prediction of prognosis is required.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/8c/fmch-2023-002239.PMC10314686.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9758125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biopsy of Canada's family physician shortage.","authors":"Kaiyang Li,&nbsp;Anna Frumkin,&nbsp;Wei Guang Bi,&nbsp;Jamie Magrill,&nbsp;Christie Newton","doi":"10.1136/fmch-2023-002236","DOIUrl":"https://doi.org/10.1136/fmch-2023-002236","url":null,"abstract":"<p><p>Family physicians provide comprehensive care for the community and are an integral part of the healthcare system. Canada is experiencing a shortage of family physicians, driven in part by overbearing expectations of family physicians, limited support and resources, antiquated physician compensation, and high clinic operating costs. An additional factor contributing to this scarcity is the shortage of medical school and family medicine residency spots, which have not kept pace with population demand. We analysed and compared data on provincial populations and numbers of physicians, residency spots and medical school seats across Canada. Family physician shortages are the highest in the territories (>55%), Quebec (21.5%) and British Columbia (17.7%). Among the provinces, Ontario, Manitoba, Saskatchewan and British Columbia have the fewest family physicians per 100 000 persons in the population. Among the provinces that offer medical education, British Columbia and Ontario have the fewest medical school seats per population, while Quebec has the most. British Columbia has the smallest medical class size and the least number of family medicine residency spots as a function of population, and one of the highest percentages of provincial residents without family doctors. Paradoxically, Quebec has a relatively large medical class size and a high number of family medicine residency spots as a function of population, but also one of the highest percentages of provincial residents without family doctors. Possible strategies to improve the current shortage include encouraging Canadian medical students and international medical graduates to consider family medicine, and reducing administrative burdens for current physicians. Other steps include creating a national data framework, understanding physician needs to guide effective policy changes, increasing seats in medical schools and family residency programmes, providing financial incentives and facilitating entry into family medicine for international medical graduates.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/fa/fmch-2023-002236.PMC10186392.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9483872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Answering calls for rigorous health equity research: a cross-sectional study leveraging electronic health records for data disaggregation in Latinos.","authors":"John Heintzman, Dang Dinh, Jennifer A Lucas, Elena Byhoff, Danielle M Crookes, Ayana April-Sanders, Jorge Kaufmann, Dave Boston, Audree Hsu, Sophia Giebultowicz, Miguel Marino","doi":"10.1136/fmch-2022-001972","DOIUrl":"10.1136/fmch-2022-001972","url":null,"abstract":"<p><strong>Introduction: </strong>Country of birth/nativity information may be crucial to understanding health equity in Latino populations and is routinely called for in health services literature assessing cardiovascular disease and risk, but is not thought to co-occur with longitudinal, objective health information such as that found in electronic health records (EHRs).</p><p><strong>Methods: </strong>We used a multistate network of community health centres to describe the extent to which country of birth is recorded in EHRs in Latinos, and to describe demographic features and cardiovascular risk profiles by country of birth. We compared geographical/demographic/clinical characteristics, from 2012 to 2020 (9 years of data), of 914 495 Latinos recorded as US-born, non-US-born and without a country of birth recorded. We also described the state in which these data were collected.</p><p><strong>Results: </strong>Country of birth was collected for 127 138 Latinos in 782 clinics in 22 states. Compared with those with a country of birth recorded, Latinos without this record were more often uninsured and less often preferred Spanish. While covariate adjusted prevalence of heart disease and risk factors were similar between the three groups, when results were disaggregated to five specific Latin countries (Mexico, Guatemala, Dominican Republic, Cuba, El Salvador), significant variation was observed, especially in diabetes, hypertension and hyperlipidaemia.</p><p><strong>Conclusions: </strong>In a multistate network, thousands of non-US-born, US-born and patients without a country of birth recorded had differing demographic characteristics, but clinical variation was not observed until data was disaggregated into specific country of origin. State policies that enhance the safety of immigrant populations may enhance the collection of health equity related data. Rigorous and effective health equity research using Latino country of birth information paired with longitudinal healthcare information found in EHRs might have significant potential for aiding clinical and public health practice, but it depends on increased, widespread and accurate availability of this information, co-occurring with other robust demographic and clinical data nativity.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/08/fmch-2022-001972.PMC10186452.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9483875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal health information is essential for universal health coverage.","authors":"Danielle Muscat,&nbsp;Rachael Hinton,&nbsp;Don Nutbeam,&nbsp;Erin Kenney,&nbsp;Shyama Kuruvilla,&nbsp;Zsuzsanna Jakab","doi":"10.1136/fmch-2022-002090","DOIUrl":"https://doi.org/10.1136/fmch-2022-002090","url":null,"abstract":"<p><p>Universal access to health information is a human right and essential to achieving universal health coverage and the other health-related targets of the sustainable development goals. The COVID-19 pandemic has further highlighted the importance of trustworthy sources of health information that are accessible to all people, easily understood and acted on. WHO has developed <i>Your life, your health: Tips and information for health and wellbeing</i>, as a new digital resource for the general public which makes trustworthy health information understandable, accessible and actionable. It provides basic information on important topics, skills and rights related to health and well-being. For those who want to learn more, in-depth information can be accessed through links to WHO videos, infographics and fact sheets. Towards ensuring access to universal health information, this resource was developed using a structured method to: (1) synthesise evidence-based guidance, prioritising public-oriented content, including related rights and skills; (2) develop messages and graphics to be accessible, understandable and actionable for all people based on health literacy principles; (3) engage with experts and other stakeholders to refine messages and message delivery; (4) build a digital resource and test content to obtain feedback from a range of potential users and (5) adapt and co-develop the resource based on feedback and new evidence going forward. As with all WHO global information resources, <i>Your life, your health</i> can be adapted to different contexts. We invite feedback on how the resource can be used, refined and further co-developed to meet people's health information needs.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/61/fmch-2022-002090.PMC10231010.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10195227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated model of primary and mental healthcare for the refugee population served by an academic medical centre.","authors":"Katharine E Daniel,&nbsp;Sarah R Blackstone,&nbsp;Joseph S Tan,&nbsp;Richard L Merkel,&nbsp;Fern R Hauck,&nbsp;Claudia W Allen","doi":"10.1136/fmch-2022-002038","DOIUrl":"https://doi.org/10.1136/fmch-2022-002038","url":null,"abstract":"Refugees are at increased risk for developing mental health concerns due to high rates of trauma exposure and postmigration stressors. Moreover, barriers to accessing mental health services result in ongoing suffering within this population. Integrated care—which combines primary healthcare and mental healthcare into one cohesive, collaborative setting—may improve refugees’ access to comprehensive physical and mental health services to ultimately better support this uniquely vulnerable population. Although integrated care models can increase access to care by colocating multidisciplinary services, establishing an effective integrated care model brings unique logistic (eg, managing office space, delineating roles between multiple providers, establishing open communication practices between specialty roles) and financial (eg, coordinating across department-specific billing procedures) challenges. We therefore describe the model of integrated primary and mental healthcare used in the International Family Medicine Clinic at the University of Virginia, which includes family medicine providers, behavioural health specialists and psychiatrists. Further, based on our 20-year history of providing these integrated services to refugees within an academic medical centre, we offer potential solutions for addressing common challenges (eg, granting specialty providers necessary privileges to access visit notes entered by other specialty providers, creating a culture where communication between providers is the norm, establishing a standard that all providers ought to be CC’ed on most visit notes). We hope that our model and the lessons we have learned along the way can help other institutions that are interested in developing similar integrated care systems to support refugees’ mental and physical health.","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/73/fmch-2022-002038.PMC10083854.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9283076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition risk varies according to social network type: data from the Canadian Longitudinal Study on Aging.","authors":"Christine Marie Mills,&nbsp;Heather H Keller,&nbsp;Vincent Gerard DePaul,&nbsp;Catherine Donnelly","doi":"10.1136/fmch-2022-002112","DOIUrl":"https://doi.org/10.1136/fmch-2022-002112","url":null,"abstract":"<p><strong>Objective: </strong>There were two primary objectives, namely: (1) to determine the social network types that Canadian adults aged 45 and older belong to and (2) to discover if social network type is associated with nutrition risk scores and the prevalence of high nutrition risk.</p><p><strong>Design: </strong>A retrospective cross-sectional study.</p><p><strong>Setting: </strong>Data from the Canadian Longitudinal Study on Aging (CLSA).</p><p><strong>Participants: </strong>17 051 Canadians aged 45 years and older with data from baseline and first follow-up of the CLSA.</p><p><strong>Results: </strong>CLSA participants could be classified into one of seven different social network types that varied from restricted to diverse. We found a statistically significant association between social network type and nutrition risk scores and percentage of individuals at high nutrition risk at both time points. Individuals with restricted social networks had lower nutrition risk scores and are more likely to be at nutrition risk, whereas individuals with diverse social networks had higher nutrition risk scores and are less likely to be at nutrition risk.</p><p><strong>Conclusions: </strong>Social network type was associated with nutrition risk in this representative sample of Canadian middle-aged and older adults. Providing adults with opportunities to deepen and diversify their social networks may decrease the prevalence of nutrition risk. Individuals with more restricted networks should be proactively screened for nutrition risk.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/75/fmch-2022-002112.PMC9950914.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9371335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Segmentation analysis of the unvaccinated US adult population 2 years into the COVID-19 pandemic, 1 December 2021 to 7 February 2022.","authors":"Israel Agaku,&nbsp;Caleb Adeoye,&nbsp;Naa Adjeley Anamor Krow,&nbsp;Theodore Long","doi":"10.1136/fmch-2022-001769","DOIUrl":"https://doi.org/10.1136/fmch-2022-001769","url":null,"abstract":"<p><strong>Objective: </strong>We performed a segmentation analysis of the unvaccinated adult US population to identify sociodemographic and psychographic characteristics of those who were vaccine accepting, vaccine unsure and vaccine averse.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Nationally representative, web-based survey.</p><p><strong>Participants: </strong>211 303 participants aged ≥18 years were asked in the Household Pulse Survey conducted during 1 December 2021 to 7 February 2022, whether they had ever received a COVID-19 vaccine. Those answering 'No' were asked their receptivity to the vaccine and their responses were categorised as vaccine averse, unsure and accepting. Adjusted prevalence ratios (APR) were calculated in separate multivariable Poisson regression models to evaluate the correlation of the three vaccine dispositions.</p><p><strong>Results: </strong>Overall, 15.2% of US adults were unvaccinated during 1 December 2021 to 7 February 2022, ranging from 5.8% in District of Columbia to 29.0% in Wyoming. Of the entire unvaccinated population nationwide, 51.0% were vaccine averse, 35.0% vaccine unsure and 14.0% vaccine accepting. The likelihood of vaccine aversion was higher among those self-employed (APR=1.11, 95% CI 1.02 to 1.22) or working in a private company (APR=1.09, 95% CI 1.01 to 1.17) than those unemployed; living in a detached, single-family house than in a multiunit apartment (APR=1.15, 95% CI 1.04 to 1.26); and insured by Veterans Affairs/Tricare than uninsured (APR=1.22, 95% CI 1.01 to 1.47). Reasons for having not yet received a vaccine differed among those vaccine accepting, unsure and averse. The percentage reporting logistical or access-related barriers to getting a vaccine (eg, difficulty getting a vaccine, or perceived cost of the vaccine) was relatively higher than those vaccine accepting. Those vaccine unsure reported the highest prevalence of barriers related to perceived safety/effectiveness, including wanting to 'wait and see' if the vaccines were safe (45.2%) and uncertainty whether the vaccines would be effective in protecting them from COVID-19 (29.6%). Those vaccine averse reported the highest prevalence for barriers pertaining to lack of trust in the government or in the vaccines (50.1% and 57.5% respectively), the perception that COVID-19 was not that big of a threat (32.2%) and the perception that they did not need a vaccine (42.3%).</p><p><strong>Conclusions: </strong>The unvaccinated segment of the population is not a monolith, and a substantial segment may still get vaccinated if constraining factors are adequately addressed.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/32/42/fmch-2022-001769.PMC9943697.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10832162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}