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How healthy dietary patterns have an impact on overall and cause-specific mortality?

Por: Nguyen · N. T. H. · Duong · T. V.

Commentary on: Shan Z, Wang F, Li Y, Baden MY, Bhupathiraju SN, Wang DD, Sun Q, Rexrode KM, Rimm EB, Qi L, Tabung FK, Giovannucci EL, Willett WC, Manson JE, Qi Q, Hu FB. Healthy Eating Patterns and Risk of Total and Cause-Specific Mortality. JAMA Intern Med. 2023 Feb 1;183(2):142-153. doi: 10.1001/jamainternmed.2022.6117. Erratum in: JAMA Intern Med. 2023 Jun 1;183(6):627.

Implications for practice and research

  • Wholesome eating diets can be customised to align with person’s culinary traditions and tastes in accordance with the Dietary Guidelines for Americans to decrease the mortality risk.

  • Provide updated scientific evidences on the benefits of maintaining a healthy diet throughout the life course to take appropriate strategies and policies.

  • Context

    Healthy eating patterns play a prominent role in preserving public health. The association between dietary patterns with the mortality risk has been investigated in numerous countries.1 2

    SCALE-UP II: protocol for a pragmatic randomised trial examining population health management interventions to increase the uptake of at-home COVID-19 testing in community health centres

    Por: Del Fiol · G. · Orleans · B. · Kuzmenko · T. V. · Chipman · J. · Greene · T. · Martinez · A. · Wirth · J. · Meads · R. · Kaphingst · K. K. · Gibson · B. · Kawamoto · K. · King · A. J. · Siaperas · T. · Hughes · S. · Pruhs · A. · Pariera Dinkins · C. · Lam · C. Y. · Pierce · J. H. · Benson
    Introduction

    SCALE-UP II aims to investigate the effectiveness of population health management interventions using text messaging (TM), chatbots and patient navigation (PN) in increasing the uptake of at-home COVID-19 testing among patients in historically marginalised communities, specifically, those receiving care at community health centres (CHCs).

    Methods and analysis

    The trial is a multisite, randomised pragmatic clinical trial. Eligible patients are >18 years old with a primary care visit in the last 3 years at one of the participating CHCs. Demographic data will be obtained from CHC electronic health records. Patients will be randomised to one of two factorial designs based on smartphone ownership. Patients who self-report replying to a text message that they have a smartphone will be randomised in a 2x2x2 factorial fashion to receive (1) chatbot or TM; (2) PN (yes or no); and (3) repeated offers to interact with the interventions every 10 or 30 days. Participants who do not self-report as having a smartphone will be randomised in a 2x2 factorial fashion to receive (1) TM with or without PN; and (2) repeated offers every 10 or 30 days. The interventions will be sent in English or Spanish, with an option to request at-home COVID-19 test kits. The primary outcome is the proportion of participants using at-home COVID-19 tests during a 90-day follow-up. The study will evaluate the main effects and interactions among interventions, implementation outcomes and predictors and moderators of study outcomes. Statistical analyses will include logistic regression, stratified subgroup analyses and adjustment for stratification factors.

    Ethics and dissemination

    The protocol was approved by the University of Utah Institutional Review Board. On completion, study data will be made available in compliance with National Institutes of Health data sharing policies. Results will be disseminated through study partners and peer-reviewed publications.

    Trial registration number

    ClinicalTrials.gov: NCT05533918 and NCT05533359.

    Avoidance of healthcare service use and correlates among HIV-positive patients in Vietnam: a cross-sectional study

    Por: Nguyen · H. L. T. · Bui · T. M. · Dam · V. A. T. · Nguyen · T. T. · Nguyen · H. T. · Zeng · G. M. · Bradley · D. · Nguyen · Q. N. · Ngo · T. V. · Latkin · C. A. · Ho · R. C. · Ho · C. S.
    Objective

    The prevention of HIV/AIDS is not making sufficient progress. The slow reduction of HIV/AIDS infections needs to prioritise hesitancy towards service utilisation, including treatment duration, social support and social stigma. This study investigates HIV-positive patients’ avoidance of healthcare services and its correlates.

    Design

    A cross-sectional study.

    Setting

    The secondary data analysis used cross-sectional data from a randomised controlled intervention, examining the effectiveness of HIV-assisted smartphone applications in the treatment of HIV/AIDS patients in the Bach Mai and Ha Dong clinics in Hanoi.

    Methods

    Simple random sampling was used to identify 495 eligible patients. Two-tailed 2, Mann-Whitney, multivariate logistic and ordered logistic regression models were performed.

    Primary and secondary outcome measures

    The main study outcome was the patients’ healthcare avoidance and frequency of healthcare avoidance. The association of individual characteristics, social and behavioural determinants of HIV patients’ usage of health services was also determined based on the collected data using structured questionnaires.

    Results

    Nearly half of the participants avoid health service use (47.3%), while 30.7% rarely avoid health service use. Duration of antiretroviral therapy and initial CD4 cell count were negatively associated with avoidance of health services and frequency of health service avoidance. Similarly, those with the middle and highest income were more likely to avoid health services compared with those with the lowest income. People having health problems avoided health service use more frequently (OR 1.47, 95% CI 1.35 to 1.61).

    Conclusions

    Our study’s findings identify characteristics of significance in relation to health service avoidance and utilisation among HIV-positive patients. The results highlighted the need to improve satisfaction, adherence and utilisation of treatment. Moreover, identifying ways to address or incorporate those social determinants in new policy may also help the treatment of HIV/AIDS and strategically allocate funding in the changing financial and political climate of Vietnam.

    Trial registration number

    Thai Clinical Trials Registry TCTR20220928003.

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