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To investigate the individual and household-level factors influencing the willingness to pay for cataract surgery among patients aged 50 years and older in rural China: a cross-sectional study

Por: Ding · Y. · Chen · X. · Guan · H. · Du · K. · Zhang · Y. · Shi · Y.
Objectives

To investigate the factors influencing the willingness to pay (WTP) for cataract surgery among patients aged 50 years and older in rural China at both individual and household levels.

Design

A cross-sectional study.

Setting

The study was conducted in Gansu, China.

Participants

Patients aged ≥50 years who were diagnosed with cataracts indicated for surgery and lived rural in Gansu from October to December 2020 were included in the study.

Primary and secondary outcome measures

The main study outcome was the patients’ WTP for cataract surgery. The association of individual characteristics, knowledge about cataracts, health status and household characteristics with patients’ WTP was also evaluated based on the collected data using structured questionnaires.

Results

A total of 324 (85.94%) patients in the study reported that they were willing to pay for their cataract surgery. However, only 179 (47.48%) patients were willing to pay over ¥1000 to cover the cost of cataract surgery under the New Rural Cooperative Medical System (NRCMS). Patients aged 75 years and older were significantly less likely to pay for cataract surgery (p=0.037). Better visual status (p=0.032), self-reported severe poor visual status (p=0.001), higher annual household income (p=0.052) and a higher level of children’s education (p=0.076) were significantly more likely to pay for cataract surgery.

Conclusions

The WTP for cataract surgery in rural China is still insufficient. More than half of patients’ WTP for surgery do not cover the cost of cataract surgery after reimbursement by the NRCMS. Both individual and household characteristics contribute to the low WTP for cataract surgery.

Rationale for the shielding policy for clinically vulnerable people in the UK during the COVID-19 pandemic: a qualitative study

Por: Porter · A. · Akbari · A. · Carson-Stevens · A. · Dale · J. · Dixon · L. · Edwards · A. · Evans · B. · Griffiths · L. · John · A. · Jolles · S. · Kingston · M. R. · Lyons · R. · Morgan · J. · Sewell · B. · Whiffen · A. · Williams · V. A. · Snooks · H.
Introduction

Shielding aimed to protect those predicted to be at highest risk from COVID-19 and was uniquely implemented in the UK during the first year of the pandemic from March 2020. As the first stage in the EVITE Immunity evaluation (Effects of shielding for vulnerable people during COVID-19 pandemic on health outcomes, costs and immunity, including those with cancer:quasi-experimental evaluation), we generated a logic model to describe the programme theory underlying the shielding intervention.

Design and participants

We reviewed published documentation on shielding to develop an initial draft of the logic model. We then discussed this draft during interviews with 13 key stakeholders involved in putting shielding into effect in Wales and England. Interviews were recorded, transcribed and analysed thematically to inform a final draft of the logic model.

Results

The shielding intervention was a complex one, introduced at pace by multiple agencies working together. We identified three core components: agreement on clinical criteria; development of the list of people appropriate for shielding; and communication of shielding advice. In addition, there was a support programme, available as required to shielding people, including food parcels, financial support and social support. The predicted mechanism of change was that people would isolate themselves and so avoid infection, with the primary intended outcome being reduction in mortality in the shielding group. Unintended impacts included negative impact on mental and physical health and well-being. Details of the intervention varied slightly across the home nations of the UK and were subject to minor revisions during the time the intervention was in place.

Conclusions

Shielding was a largely untested strategy, aiming to mitigate risk by placing a responsibility on individuals to protect themselves. The model of its rationale, components and outcomes (intended and unintended) will inform evaluation of the impact of shielding and help us to understand its effect and limitations.

Investigation on the possibility of dynamic COVID-Zero strategy in China: a population-based transmission model analysis and economic evaluation

Por: Wang · X. · Pei · S. · Wang · L. · La · B. · Zhao · M. · Zhang · X. · Jia · Z.
Objective

To explore the feasible and cost-effective intervention strategies to achieve the goal of dynamic COVID-Zero in China.

Design

A Susceptible–Exposed–Infectious–Recovered model combined economic evaluation was used to generate the number of infections, the time for dynamic COVID-Zero and calculate cost-effectiveness under different intervention strategies. The model simulated the 1 year spread of COVID-19 in mainland China after 100 initial infections were imported.

Interventions

According to close contact tracing degree from 80% to 100%, close contact tracing time from 2 days to 1 day, isolation time from 14 days to 7 days, scope of nucleic acid testing (NAT) from 10% to 100% and NAT frequency from weekly to every day, 720 scenarios were simulated.

Outcome measure

Cumulative number of infections (CI), social COVID-Zero duration (SCD), total cost (TC) and incremental cost-effectiveness ratio.

Results

205 of 720 scenarios could achieve the total COVID-Zero since the first case was reported. The fastest and most cost-effective strategy was Scenario 680, in which all close contacts were traced within 1 day, the isolation time was 14 days and 10% of the national population was randomly checked for NAT every day. In Scenario 680, the CI was 280 (100 initial infections) and the SCD was 13 days. The TC was ¥4126 hundred million and the cost of reducing one infection was ¥47 470. However, when the close contact tracing time was 2 days and the degree of close contact tracing was 80%–90%, the SCD would double to 24–101 days and the TCs increased by ¥16 505 to 37 134 hundred million compared with Scenario 680.

Conclusions

If all close contact was controlled within 1 day, the rapid social COVID-Zero can be achieved effectively and cost-effectively. Therefore, the future prevention and control of emerging respiratory infectious diseases can focus on enhancing the ability of close contact tracing.

Psychological impacts of COVID-19 on Vietnamese health workers over the prolonged restricted COVID-19 responses: a cross-sectional study

Por: Tran · B. · Nguyen · M. T. · Auquier · P. · Boyer · L. · Fond · G. · Vu · G. T. · Hoang · T. P. · Ho · P. T. · Nguyen · T. H. · Latkin · C. A. · Ho · C. S. · Ho · R. C. M. · Zhang · M. W. B.
Objective

We assessed the psychological impact posed by COVID-19 and its associated factors on the healthcare workforce nationwide during the peak of Vietnam’s fourth outbreak.

Design

A cross-sectional study.

Setting

Our study was conducted in 61 provinces of Vietnam.

Methods

A total of 2814 healthcare professionals in 61/63 provinces of Vietnam. An online questionnaire using Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale-4 (PSS-4) and Generalised Anxiety Disorder-7 (GAD-7) scales was distributed randomly to a subgroup of 503 respondents.

Primary and secondary outcome measures

To determine the impact of COVID-19 on the psychological of health workers, we conducted analyses to test a primary hypothesis related to participants based on three main scales including PHQ-9, PSS-4 and GAD-7 scales.

Results

Nearly half (49.7%) of healthcare workers experienced mild depression symptoms, 34.0% underwent moderate anxiety symptoms and 49.3% reported high-stress levels. Respondents who had a monthly income below 5 million VND (~US$212) and had more than 3 days of duty per week had a higher score on the anxiety scales. Compared with medical doctors, nurses/midwives had lower PHQ-9 (Coef=–2.53; 95% CI=–3.71 to –1.36) and GAD-7 scores (Coef=–2.36; 95% CI=–3.56 L to –1.16). Increased workload and work time was the harmful factor that increase the PHQ-9, GAD-7 or PSS-4 scores. More than half (53.9%) of respondents stated no demand for mental healthcare services.

Conclusions

Health workers who gained less financial rewards are reported to have higher levels of mental distress than others, implying the need for a raise in basic salary as well as compensation and encouragement schemes. To tackle hesitancy in seeking mental help, integrating online mental health therapy with e-health consultations via social media can be strategically implemented to augment service delivery, and simultaneously enhance the standard of mental health services.

Use of geofencing interventions in population health research: a scoping review

Por: Tobin · K. · Heidari · O. · Volpi · C. · Sodder · S. · Duncan · D.
Objectives

Technological advancements that use global positioning system (GPS), such as geofencing, provide the opportunity to examine place-based context in population health research. This review aimed to systematically identify, assess and synthesise the existing evidence on geofencing intervention design, acceptability, feasibility and/or impact.

Design

Scoping review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidance for reporting.

Data sources

PubMed, CINAHL, EMBASE, Web of Science, Cochrane and PsycINFO for articles in English published up to 31 December 2021.

Eligibility criteria

Articles were included if geofencing was used as a mechanism for intervention delivery. Exclusion criteria: (1) a component or combination of GPS, geographical information system or ecological momentary assessment was used without delivery of an intervention; (2) did not include a health or health-related outcome from the geofencing intervention; or (3) was not a peer-reviewed study.

Data extraction and synthesis

Several researchers independently reviewed all abstracts and full-text articles for final inclusion.

Results

A total of 2171 articles were found; after exclusions, nine studies were included in the review. The majority were published in 5 years preceding the search (89%). Geofences in most studies (n=5) were fixed and programmed in the mobile application carried by participants without their input. Mechanisms of geofencing interventions were classified as direct or indirect, with five studies (56%) using direct interventions. There were several different health outcomes (from smoking to problematic alcohol use) across the five studies that used a direct geofencing intervention.

Conclusions

This scoping review found geofencing to be an emerging technology that is an acceptable and feasible intervention applied to several different populations and health outcomes. Future studies should specify the rationale for the locations that are geofenced and user input. Moreover, attention to mechanisms of actions will enable scientists to understand not only whether geofencing is an appropriate and effective intervention but why it works to achieve the outcomes observed.

Depression, anxiety and quality of life of Afghan women living in urban areas under the Taliban government: a cross-sectional study

Por: Neyazi · A. · Padhi · B. K. · Mohammadi · A. Q. · Ahmadi · M. · Erfan · A. · Bashiri · B. · Neyazi · M. · Ishaqzada · M. · Noormohammadi · M. · Griffiths · M. D.
Objectives

According to the World Health Organization, depression is a common mental health illness that is characterised by a persistent feeling of sadness and loss of interest. The present study examined the association of two mental health variables (ie, depression, anxiety) with quality of life (QoL) and the sociodemographic characteristics of Afghan women living in urban areas under the rule of Taliban government in Afghanistan.

Design

Cross-sectional study administered between 10 November 2021 to 25 December 2021 among women.

Setting

Across major provinces of Afghanistan (Herat, Mazar-e-Sharif, Kabul and Samangan).

Measurements

Data were collected using a pretested structured questionnaire. Data entry was carried out using Microsoft Excel 2016. And then exported to IBM SPSS V.26 for Microsoft Windows. Logistic regression models were used to examine the association of depression, anxiety with QoL and sociodemographic characteristics among women (N=438).

Results

The prevalence of depression symptoms was 80.4%, and the prevalence of mild to extremely severe anxiety was 81.0%. Depression symptoms among Afghan women were associated with being older, having more children, lower education level, other individuals’ bad behaviour, bad events experienced in the past month, and feeling physically ill. Multiple regression analysis indicated that low monthly household income (adjusted OR, AOR 2.260; 95% CI 1.179 to 4.331, p=0.014) poor physical domain of QoL (AOR 4.436; 95% CI 1.748 to 11.256, p=0.002) and poor psychological domain of QoL (AOR 23.499; 95% CI 7.737 to 71.369, p

Conclusion

The prevalence of depression was high among women living under the government of the Taliban in Afghanistan. Considering the high prevalence of depression, anxiety and their impact on QoL and the overall quality of healthcare services, international health organisations should implement programmes for regular screening of depression and anxiety, and there should be psychological counselling services available for vulnerable women living under the government of the Taliban.

What is the current state of research concerning self-efficacy in exercise behaviour? Protocol for two systematic evidence maps

Por: Bill · V. · Wilke · A. · Sonsmann · F. · Rocholl · M.
Introduction

Knowing about a risk factor is not sufficient to ensure corresponding behaviour as additional psychological factors play a role. Self-efficacy is one of the major factors. This also applies to physical activity and exercise behaviour, which is a major public health topic in both primary and secondary prevention. The amount of research on self-efficacy in exercise behaviour is high yet remains uncharted. This protocol presents the research design for two systematic evidence maps on self-efficacy in exercise behaviour in (1) primary prevention and (2) secondary prevention. These maps will thus provide a comprehensive overview over the current state in published empirical research as a starting point for future researchers.

Methods and analysis

The databases Medline (via PubMed) and PsycINFO (via EbscoHost) will be searched using the search terms ‘self-efficacy’ and any of the search terms ‘sport’ and ‘exercise’ in titles and abstracts. All empirical research studies which have measured self-efficacy in relation to exercise behaviour will be included. The primary prevention systematic evidence map will aggregate all studies on healthy humans and the secondary prevention systematic evidence map will include all studies on humans with a pre-existing condition. We will extract and present the data points authors, title, year, sample size (N), age groups, surveyed sport and method of measuring self-efficacy in both systematic evidence maps. Moreover, we will extract and present the target group in the systematic evidence map on primary prevention and the pre-existing condition in the systematic evidence map on secondary prevention. In addition to a data table, we will create freely accessible evidence maps in the form of graphs.

Ethics and dissemination

Since this is a protocol, an ethics approval is not required for the presented and planned work. The results of the two systematic evidence maps will be disseminated via publication in international peer-reviewed journals. In addition, data will be shared in detail via the Open Science Framework platform.

How capacity building of district health managers has been designed, delivered and evaluated in sub-Saharan Africa: a scoping review and best fit framework analysis

Por: Bosongo · S. · Belrhiti · Z. · Ekofo · J. · Kabanga · C. · Chenge · F. · Criel · B. · Marchal · B.
Objectives

We aimed to understand how capacity building programmes (CBPs) of district health managers (DHMs) have been designed, delivered and evaluated in sub-Saharan Africa. We focused on identifying the underlying assumptions behind leadership and management CBPs at the district level.

Design

Scoping review.

Data sources

We searched five electronic databases (MEDLINE, Health Systems Evidence, Wiley Online Library, Cochrane Library and Google Scholar) on 6 April 2021 and 13 October 2022. We also searched for grey literature and used citation tracking.

Eligibility criteria

We included all primary studies (1) reporting leadership or management capacity building of DHMs, (2) in sub-Saharan Africa, (3) written in English or French and (4) published between 1 January 1987 and 13 October 2022.

Data extraction and synthesis

Three independent reviewers extracted data from included articles. We used the best fit framework synthesis approach to identify an a priori framework that guided data coding, analysis and synthesis. We also conducted an inductive analysis of data that could not be coded against the a priori framework.

Results

We identified 2523 papers and ultimately included 44 papers after screening and assessment for eligibility. Key findings included (1) a scarcity of explicit theories underlying CBPs, (2) a diversity of learning approaches with increasing use of the action learning approach, (3) a diversity of content with a focus on management rather than leadership functions and (4) a diversity of evaluation methods with limited use of theory-driven designs to evaluate leadership and management capacity building interventions.

Conclusion

This review highlights the need for explicit and well-articulated programme theories for leadership and management development interventions and the need for strengthening their evaluation using theory-driven designs that fit the complexity of health systems.

Understanding the valuation of paediatric health-related quality of life: a qualitative study protocol

Introduction

There is evidence from previous studies that adults value paediatric health-related quality of life (HRQoL) and adult HRQoL differently. Less is known about how adolescents value paediatric HRQoL and whether their valuation and decision-making processes differ from those of adults. Discrete choice experiments (DCEs) are widely used to develop value sets for measures of HRQoL, but there is still much to understand about whether and how the methods choices in the implementation of DCE valuation tasks, such as format, presentation and perspective, affect the decision-making process of participants. This paper describes the protocol for a qualitative study that aims to explore the decision-making process of adults and adolescents when completing DCE valuation tasks. The study will also explore the impact of methodological choices in the design of DCE studies (including decisions about format and presentation) on participants’ thinking process.

Methods and analysis

An interview protocol has been developed using DCE valuation tasks. Interviews will be conducted online via Zoom with both an adolescent and adult sample. In the interview, the participant will be asked to go through some DCE valuation tasks while ‘thinking aloud’. After completion of the survey, participants will then be asked some predetermined questions in relation to various aspects of the DCE tasks. Interviews will be recorded and transcribed and analysed using a thematic analysis approach.

Ethics and dissemination

Ethics approval for this study has been received for the adult sample (UTS ETH20-9632) as well as the youth sample (UTS ETH22-6970) from the University of Technology Sydney Human Research Ethics Committee. Results from this study will inform the methods to be used in development of value sets for use in the health technology assessment of paediatric interventions and treatments. Findings from this study will also be disseminated through national/international conferences and peer-reviewed journals.

Qualitative exploration of the impact of COVID-19 on the food environment of urban informal settlements of Dhaka, Bangladesh

Por: Hasan · A. M. R. · Smith · G. · Selim · M. A. · Khatun · F. · Mahmood · S. S. · Reidpath · D. D. · Rasheed · S.
Objective

Our study explored the impact of the COVID-19 pandemic on the food environment from the perspective of the urban poor and food vendors.

Design

This was a qualitative study conducted during September 2020 and February 2021.

Setting

The study was carried out in two purposively selected informal settlements of Dhaka City, Bangladesh.

Participants

We conducted 21 in-depth interviews with residents of informal settlements and 10 key informant interviews with food vendors and food aid workers.

Result

The availability of staple foods was not disrupted during the pandemic but some perishables foods became more expensive due to supply chain disruptions and increased transportation costs. Limited market hours affected market access and mobility restrictions adversely affected local vendors. Cart vendors selling perishables incurred business losses they could ill afford. Demand for food reduced as employment disruption lead to reduced purchasing power and, therefore, reduction of quantity, quality and desirability of foods purchased. Respondents reported skipping meals and going hungry. The aid received was considered inadequate to meet needs.

Conclusion

The food environment of the urban poor was disrupted from both supply and demand sides and the organisational response (both government and non-government) was severely inadequate. The social safety net needs to be extended and redesigned to ensure food security and health for the urban working poor in the future.

Practice, confidence and continuity of breast self-examination among women in Thailand during COVID-19 pandemic: a cross-sectional study

Por: Taneepanichskul · S. · Chuemchit · M. · Wongsasuluk · P. · Sirichokchatchawan · W. · Hounnaklang · N. · Zongram · O. · Sematong · S. · Viwattanakulvanid · P. · Herman · B.
Objective

Breast self-examination (BSE) is the most feasible screening tool compared with clinical breast examination and mammography. It is crucial to address the associated factors of practising BSE to develop a targeted BSE promotion programme and improve the BSE quality in Thai women, particularly during the COVID-19 pandemic.

Design and setting

We conducted a cross-sectional study in Thailand’s north and northeast region from March 2020 to November 2022.

Participants

This study involved 405 women aged 30–70 years old.

Variables and outcomes

Demographic information, health status and BSE were collected using a modified questionnaire based on the Champion Health Belief Model. The outcomes were ever-practising BSE, BSE practice within the last 6 months, continuity of BSE and confidence in doing BSE. Logistic regression and decision tree analysis identified the associated factors.

Results

75.55% of participants ever performed BSE. Around 74.18% did BSE within the last 6 months. Diploma graduates (adjusted OR (aOR) 25.48, 95% CI 2.04 to 318.07), 21–40 reproductive years (aOR 4.29, 95% CI 1.22 to 15.08), ever pregnant (aOR 3.31, 95% CI 1.05 to 10.49), not drinking alcohol (aOR 2.1, 95% CI 1.04 to 4.55), not receiving hormone replacement (aOR 5.51, 95% CI 2.04 to 14.89), higher knowledge (aOR 1.29, 95% CI 1.09 to 1.52), attitude (aOR 1.15, 95% CI 1.05 to 1.26) and practice/cues of action towards BSE were associated with ever-practising BSE. Frequent high-fat diet, high awareness of breast cancer, lower knowledge of BSE and lower attitude toward BSE were associated with not practising BSE within 6 months and BSE discontinuation. Only high knowledge of BSE was associated with absolute confidence in BSE (p

Conclusion

Despite having a higher percentage than other studies in different countries prior to the pandemic, it is still crucial to improve knowledge of BSE to encourage BSE practice, confidence and continuity of BSE in Thai women. Moreover, the BSE campaign should target women with prolonged exposure to oestrogen and sedentary lifestyle.

Feasibility of a peer-supported, WhatsApp-assisted, lifestyle modification intervention for weight reduction among adults in an urban slum of Karachi, Pakistan: a mixed-methods, single-group, pretest-post-test, quasi-experimental study

Por: Naz · S. · Haider · K. A. · Jaffar · A. · Khan · U. · Azam · I. · Siddiqui · A. R. · Iqbal · R.
Objectives

This pilot study assessed whether a peer-supported, WhatsApp-assisted lifestyle modification intervention for weight reduction is feasible to execute a definitive trial.

Design

A mixed-methods, single group, pretest and post-test, quasi-experimental study.

Setting

Azam Basti, an urban slum in Karachi, Pakistan.

Participants

Fifty participants (males and females aged 20–60) with a body mass index of >23 kg/m2, along with their nominated peers from the same family.

Intervention

Using motivational interviewing techniques, a trained nutritionist delivered the lifestyle modification intervention to the participants and peers for 3 days after the baseline assessment and then once monthly for 1 year. The intervention was delivered in groups using WhatsApp voice calls. The education sessions mainly focused on dietary modifications, physical activity advice and peer-support assignments to achieve a 5% wt loss from the participant’s initial body weight.

Outcomes

The feasibility measures included screening, recruitment, retention and monthly interview response rates. At 1 year, in-depth interviews (IDIs) with participants and peers were conducted to explore the facilitators, barriers, acceptability and experiences of the intervention. Changes in weight, calorie intake/day and calorie expenditure/day were also assessed.

Results

The recruitment and retention rates were 32% (n=50/156) and 78% (n=39/50), respectively, while the response rate for monthly interviews ranged between 66% (n=33) and 94% (n=47). The mean weight loss at 1 year was 2.2 kg, and the reduction in mean calorie intake was 386 kcal/day. There were no changes in the mean calorie expenditure. During the IDIs, participants and peers reported intervention via WhatsApp and peer support as convenient, flexible and supportive.

Conclusions

The quantitative and qualitative findings of the current pilot study support the scale-up of this work with minor modifications to the screening method as well as close monitoring and motivational interviewing to improve adherence in terms of physical activity.

Trial registration number

NCT05928338.

Prevalence and risk factors of work-related musculoskeletal disorders among cashiers in small-scale businesses: a cross-sectional study in Ethiopia

Por: Hailu Tesfaye · A. · Desye · B. · Engdaw · G. T.
Objective

This study aimed to investigate the prevalence and factors associated with work-related musculoskeletal disorders among cashiers in small-scale businesses in Northwestern Ethiopia.

Design

A multicentre cross-sectional study was conducted from July to September 2022. The data were collected using a validated and standardised Nordic Musculoskeletal Questionnaire. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14. A multivariable logistic regression analysis was used to ascertain the significance of associations at p

Setting

The study was conducted in small-scale businesses in the North Gondar Zone.

Participants

A total of 618 cashiers participated in this study.

Outcome measures

The primary outcome of the study is the prevalence of work-related musculoskeletal disorders, which was measured using the Nordic Musculoskeletal Questionnaire.

Results

The response rate was 97.5% (N=618). The majority (373; 60.4%) of the study participants were female. The mean (±SD) age of the participants was 30 (±8.3) years. The prevalence of work-related musculoskeletal disorders during the last 12 months was found to be 75.4% (n=466) (95% CI 71.8%, 78.8%). Marital status (married) (AOR=2.12; 95% CI 1.26, 3.56), lack of physical exercise (AOR=2.07; 95% CI 1.32, 3.23), alcohol consumption (AOR=3.55; 95% CI 2.18, 5.78) and awkward work posture (AOR=2.40; 95% CI 1.43, 4.0) were significant factors associated with work-related musculoskeletal disorders among sampled cashiers.

Conclusion

This study concluded that the overall prevalence of work-related musculoskeletal disorders was high among cashiers in small-scale businesses. Being married, a lack of physical exercise, alcohol consumption and awkward work posture were significant factors of work-related musculoskeletal disorders. To reduce work-related musculoskeletal disorders, it is recommended taking part in physical activity, avoiding alcohol consumption and avoiding awkward work posture.

Determinants of gastric cancer screening attendance in Southeastern China: a cross-sectional study

Por: Huang · Z. · Hu · Z. · Wong · L. P. · Lin · Y.
Objectives

This study aimed to identify the determinants of gastric cancer screening attendance among individuals aged 40 years in a region with high gastric cancer in China.

Design

An anonymous, cross-sectional survey was conducted between October 2021 and March 2022.

Setting

A self-administered online survey was conducted in Fujian Province in Southeastern China.

Participants

People aged 40 years living in five selected cities in Fujian Province with no history of cancer.

Main outcome measures

Gastric cancer screening attendance was measured with the question ‘Have you ever been screened for gastric cancer in the past’.

Results

In total, 2547 complete responses were obtained. The mean age of respondents was 47.72±7.20 years, and 59.8% were men. A total of 42.6% of participants reported that they had undergone gastric cancer screening. The result of multivariable logistic regression analysis showed that participants with a first-degree relative affected with gastric cancer (OR=2.02, 95% CI: 1.58 to 2.59) and high perceived susceptibility of gastric cancer (OR=2.03, 95% CI: 1.58 to 2.59) were the strongest facilitators for screening attendance. Other factors positively associated with screening attendance were age 51–60 years (OR=1.69, 95% CI: 1.31 to 2.18), living in urban regions (OR=1.27, 95% CI: 1.05 to 1.55), friends/neighbours/colleagues with gastric cancer (OR=1.30, 95% CI: 1.07 to 1.58), history of chronic gastric disease (OR=1.90, 95% CI: 1.57 to 2.30), perceived high cost (OR=1.28, 95% CI: 1.01 to 1.61) and physician recommendation (OR=1.71, 95% CI: 1.36 to 2.16). On the other hand, factors negatively associated with screening attendance included perceived barriers, namely screening is only necessary when symptoms present (OR=0.71, 95% CI: 0.58 to 0.87) and perceived appointment for gastroscopy screening is difficult and time-consuming (OR=0.75, 95% CI: 0.60 to 0.94). No significant association was found between knowledge level and participation in screening.

Conclusion

This study highlights important individual-level factors and barriers to gastric cancer screening. Strategies targeting under-screened populations and eliminating patient-perceived barriers to gastric cancer screening are essential.

Comprehensive assessment of resources for prevention and control of chronic and non-communicable diseases in China: a cross-sectional study

Por: Yi · Z. · Xu · T. · Yang · J. · Yu · S. · Zhou · M. · Li · H. · Guo · J. · Qian · J. · Dong · W.
Objective

This study aims to comprehensively evaluate the resources for prevention and control of chronic and non-communicable diseases (NCDs) in China to provide a reference basis for optimising the resource allocation for prevention and control of NCDs.

Methods

China Chronic Disease and Risk Factor Surveillance sites and National Demonstration Areas for Integrated Chronic and Non-communicable Disease Prevention and Control (NCDDA) were selected as investigation objects. In December 2021, the district (or county) resource allocation for NCD prevention and control was investigated through the NCDDA management information system. According to the index system of NCD prevention and control, 31 indicators of 6 dimensions were collected, and the weighted technique for order preference by similarity to an ideal solution, weighted rank-sum ratio and fuzzy comprehensive evaluation methods were used for comprehensive evaluation of resources for prevention and control of NCDs.

Results

The 653 districts (or counties) in this study cover 22.96% of China’s districts (or counties). The top three weights were full-time staff for NCD prevention and control (0.1066), the amount of funds for NCD prevention and control (0.0967), and the coverage rate of districts (or counties) establishing chronic obstructive pulmonary disease surveillance information system (0.0886). The comprehensive evaluation results for the resources for prevention and control of NCDs by the three methods were basically the same. The results of fuzzy comprehensive evaluation showed that the resource allocation in urban areas (0.9268) was better than that in rural areas (0.3257), the one in eastern region (0.9016) was better than that in central (0.3844) and western regions (0.3868), and the one in NCDDA (0.9625) was better than that in non-NCDDA (0.2901).

Conclusion

The resources in China for NCD prevention and control differ among different regions, which should be taken into account in future policymaking and resource allocation.

Effectiveness of humanitarian health interventions: a systematic review of literature published between 2013 and 2021

Objectives

To provide a thorough mapping of the current quality and depth of evidence examining the effectiveness of health interventions in humanitarian settings in low and middle-income countries published in peer-reviewed journals since 2013.

Methods

We searched MEDLINE, Embase and Global Health for English language peer-reviewed literature published from May 2013 through April 2021 to analyse the strength of evidence on health interventions’ effectiveness in humanitarian settings in low and middle-income countries across nine thematic areas. Quality was assessed using standardised criteria and critical appraisal tools based on study design.

Results

A total of 269 publications were included in this review. The volume of publications increased since the first Elrha Humanitarian Health Evidence Review in 2013, but non-communicable diseases and water, sanitation and hygiene remain the areas with the most limited evidence base on intervention effectiveness in addition to injury and rehabilitation. Economic evaluations continued to constitute a small proportion (5%) of studies. Half of studies had unclear risk of bias, while 28% had low, 11% moderate and 11% high risk of bias. Despite increased diversity in studied interventions, variations across and within topics do not necessarily reflect the health issues of greatest concern or barriers to quality service delivery in humanitarian settings.

Conclusions

Despite an increasing evidence base, the challenge of implementing high-quality and well-reported humanitarian health research persists as a critical concern. Improvements in reporting and intervention description are needed as are study designs that allow for attribution, standard indicators and longer term follow-up and outcome measures. There is a clear need to prioritise expansion of cross-cutting topics, namely health service delivery, health systems and cost-effectiveness.

PROSPERO registration number

CRD42021254408.

Our health, our research. Identifying public health research priorities among children and youth in a multiethnic population: protocol for a community-based participatory health research priority survey

Por: Irgens · E. L. · Berglen · G. · Christoffersen · T. · Henninen · A. P. · Hermansen · R. · Karlsen · M. R. E. · Kokkvoll · A. S. · Liabo · K. · Mollersen · S. · Rugland · G. · Stock · M. H. · Zachariassen · T. O. · Kjaer · M.
Introduction

Emphasis on public involvement (PI) in health research has increased in the last 20 years. However, there is limited literature on PI in planning and conducting population-based health research. This study aims to identify child and adolescent health research priorities among children and stakeholder groups in Northern Norway by inviting PI groups to collaborate with researchers to develop and conduct a research priority survey.

Methods and analysis

This is a community-based participatory research project. The methods for research prioritisation are informed by those developed by the James Lind Alliance. In addition, the survey design and engagement plans are developed in extensive collaboration with child and youth stakeholder groups. Nine PI groups have met three times to develop an anonymous child and youth health research priority survey, as well as strategies for recruitment and dissemination of results. All 5th–10th grade pupils in the Finnmark region will be invited to participate in the survey, as well as caretakers and adults working for and with children and youth. The survey results will be analysed in collaboration with the PI groups, and research priorities checked with existing research literature.

Ethics and dissemination

The study is registered and approved by the Data Protection Authorities at the Finnmark Hospital Trust and the Expert Committee for Sami Health Research. Descriptions of methods applied and the survey results will be published in popular and scientific publications.

Assessment of knowledge, attitudes and practices towards COVID-19 among rural adolescents in Thakurgaon district, Bangladesh: an interview-based study

Por: Hossain · M. S. · Banik · R. · Hosen · I. · Islam · M. Z. · Kundu · L. R.
Objectives

To evaluate the understanding, opinions and actions concerning COVID-19, referred to as knowledge, attitudes and practices (KAP), among rural adolescents in Bangladesh. Additionally, the study aimed to identify the determinants that may influence adolescents’ KAP.

Design

An interview-based cross-sectional study.

Setting

The study area was the Thakurgaon district, which was located in the northwestern region of Bangladesh.

Participants

A total of 266 rural adolescents were selected using a non-probability (convenience sampling) technique.

Main outcome measures

Sociodemographic characteristics, source of information, COVID-19-related KAP, and their associated factors.

Results

The majority of the respondents were females and reported that mass media (eg, television channels and papers) was the main source of information to learn about COVID-19. The mean score for knowledge was 7.15±3, whereas the scores were 10.5±2.8, and 8.78±2.66 for attitude and practice, respectively. Among the adolescents, only 11% had adequate knowledge, a positive attitude (27%) and good practices (31%). The predictive factors related to adolescents' knowledge and attitude were their religion, educational level and family income. Adolescents who were from the Islamic religion and who had secondary education were more knowledgeable and encompassed more positive attitudes. Besides, poor KAP towards COVID-19 was significantly higher among the participants with the lowest family income (less than 10 000 BDT). Moreover, their knowledge was significantly associated with their attitudes and practices.

Conclusion

The study found that adolescents in rural areas lacked sufficient knowledge of COVID-19 and engaged in unsatisfactory preventative behaviour. Therefore, the development of effective health education programmes that incorporate consideration of KAP-modifying factors is needed. In addition, the result would be helpful for other similar types of pandemics.

Mapping the literature on decision regret in patients with non-communicable diseases (NCDs): a scoping review protocol

Por: Brera · A. S. · Arrigoni · C. · Magon · A. · Conte · G. · Belloni · S. · Bonavina · L. · Caruso · R. · Pasek · M.
Introduction

Decision regret refers to feelings of remorse or dissatisfaction with a decision made regarding the treatment. Mapping the meaningful aspects of decision regret in patients with non-communicable diseases (NCDs) is necessary to provide a comprehensive understanding of the phenomenon and inform the development of effective interventions to address it. For this reason, this protocol aimed to describe the methodological aspects of a scoping review focused on mapping all the meaningful aspects of decision regret in patients with NCDs and provide a conceptual and comprehensive framework of the phenomenon.

Methods and analysis

The study described in this protocol will be performed following the Joanna Briggs Institute (JBI) methodology for scoping reviews. The anticipated starting time is July/August 2023 and the anticipated end of the review is June 2024. This scoping review will include quantitative, qualitative, primary and secondary literature, as well as grey literature on decision regret in patients with NCDs. The systematic search will be performed by consulting PubMed, Embase, Scopus, CINAHL, the Cochrane Library and Google Scholar. English-language articles from any context will be eligible for inclusion. Two independent reviewers will take part in an iterative process of evaluating literature, choosing papers and extracting data. Disagreements among reviewers will be solved through consensus meetings. Results will be presented in relation to the review question by employing tables, figures and narrative summaries.

Ethics and dissemination

This scoping review did not require ethical approval since it involves a literature review and does not include new data collection from human participants. The results of the review will provide a summary of the available literature on decision regret experienced by patients with NCDs, which is crucial for developing preventive educational interventions in situations where multiple therapeutic options are available.

Public health measures on COVID-19 in North Korea: a quantitative analysis of media programmes in 2020-2022

Por: Kim · T. · Kim · J. · Jeon · J. · Moon · J. S.
Objectives

Details regarding the management of COVID-19 in North Korea are unknown. The aim of this paper was to analyse media programmes in North Korea in order to understand public health measures and policies concerning COVID-19.

Setting

State-run news agency in North Korea.

Primary and secondary outcome measures

The classification of television programmes on COVID-19 broadcast in a state-run news agency, from January 2020 to May 2022, and public health measures introduced in the programmes.

Results

A total of 2671 programmes concerning COVID-19 were included in the study. These programmes provided detailed clinical guidelines to laypeople without medical expertise, including instructions for the usage of medication and preventive measures. An association between the media concern regarding COVID-19 and trade volume, as a proxy of border closure according to the concern of the authorities, provided hints to understand the priorities and aims of the authorities.

Conclusions

The research outcomes provided significant insights into the effort to understand an impaired healthcare system and prevalent drug abuse behaviours in North Korea. Findings from further studies on the recently collected data might suggest additional implications on the North Korean policies on COVID-19.

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