A national survey of U.S. caregivers’ perceptions of integrative health for their children

Little is known about the role of living circumstances to the perception of subjective well-being (SWB) and health of adults with intellectual disability (ID). The aim of the present study was to examine whether living circumstances impact differently on the perception of health and SWB and whether potential differences persist after accounting for other variables (e.g. level of support needs and reporting method). Secondary data analysis was undertaken of a large national survey of adults with an ID in England, aged 16years and over. Participants were identified as living with family (N=1528) or living out of home (N=874). The results of t-test and chi-square revealed that levels of health and SWB were perceived as being higher for people living with family than those living in out-of-home settings. Multiple linear regression analyses fitted to explore factors associated with these reported differences revealed that, when controlling for other variables, living with family was highly associated with reports of better SWB. Multiple logistic regression revealed that whilst the health status of people living with families were perceived as better, this was only true when their support needs were low. Poorest health outcomes were found for people with highest support needs who lived with family. On the whole, the health and well-being of adults living with family were perceived more positively than those living out of home. However, potential health disparities exist for those with high support needs who live with family. Further longitudinal research is needed to explore causes and potential solution to these inequalities.

Worldwide trends in health risks, lifestyle behaviors, health perceptions, and health-seeking patterns suggest alarming disparities among individuals from low- and middle-income countries; particularly for older individuals (≥ 60 years). This study aims to compare health risks, perceptions, lifestyle behaviors, and health-seeking patterns between younger (< 60 years) and older (≥ 60 years) Filipinos from rural communities in the Philippines; and assess relationships between demographic, health risks and perceptions, and lifestyle behaviors to bolster health promotion efforts. A comparative cross-sectional study was employed with 863 younger and 427 older Filipinos. Results show that older participants were more likely to be single/widowed and had ≤ high school education. Older participants had higher rates of hypertension, dyslipidemia, diabetes, and depression but were more likely to report higher quality of life, ≥ 150 minutes of physical activity per week, ≥ 5 servings of fruits and vegetable per day, more difficulty falling asleep, report seeing a physician regularly, going to the community health center when sick, and attend stress management classes compared to their younger counterparts (all p’s < .001). There were no differences in rates of obesity, self-medication, and use of integrative health. Older age was associated with higher risks, improved health perceptions, healthier lifestyle behaviors, and better health-seeking patterns. Our data suggest that health risks are higher in older individuals but risky lifestyle behaviors were higher in younger individuals and suggest the need to design separate health promotion interventions that target the unique needs of older and younger Filipinos from rural communities.

To examine the association between non-alcoholic fatty liver disease (NAFLD) and general health perception. This cross sectional and prospective follow-up study was performed on a cohort of a sub-sample of the first Israeli national health and nutrition examination survey, with no secondary liver disease or history of alcohol abuse. On the first survey, in 2003-2004, 349 participants were included. In 2009-2010 participants from the baseline survey were invited to participate in a follow-up survey. On both baseline and follow-up surveys the data collected included: self-reported general health perception, physical activity habits, frequency of physician's visits, fatigue impact scale and abdominal ultrasound. Fatty liver was diagnosed by abdominal ultrasonography using standardized criteria and the ratio between the median brightness level of the liver and the right kidney was calculated to determine the Hepato-Renal Index. Out of 349 eligible participants in the first survey, 213 volunteers participated in the follow-up cohort and were included in the current analysis, NAFLD was diagnosed in 70/213 (32.9%). The prevalence of "very good" self-reported health perception was lower among participants diagnosed with NAFLD compared to those without NAFLD. However, adjustment for BMI attenuated the association (OR = 0.73, 95%CI: 0.36-1.50, P = 0.392). Similar results were observed for the hepato-renal index; it was inversely associated with "very good" health perception but adjustment for BMI attenuated the association. In a full model of multivariate analysis, that included all potential predictors for health perception, NAFLD was not associated with the self-reported general health perception (OR = 0.86, 95%CI: 0.40-1.86, P = 0.704). The odds for "very good" self-reported general health perception (compared to "else") increased among men (OR = 2.42, 95%CI: 1.26-4.66, P = 0.008) and those with higher performance of leisure time physical activity (OR = 1.01, 95%CI: 1.00-1.01, P < 0.001, per every minute/week) and decreased with increasing level of BMI (OR = 0.91, 95%CI: 0.84-0.99, P = 0.028, per every kg/m(2)) and older age (OR = 0.96, 95%CI: 0.93-0.99, P = 0.033, per one year). Current smoking was not associated with health perception (OR = 1.31, 95%CI: 0.54-3.16, P = 0.552). Newly diagnosed (naive) and previously diagnosed (at the first survey, not naive) NAFLD patients did not differ in their self-health perception. The presence of NAFLD at the first survey as compared to normal liver did not predict health perception deterioration at the 7 years follow-up. In terms of health-services utilization, subjects diagnosed with NAFLD had a similar number of physician's visits (general physicians and specialty consultants) as in the normal liver group. Parameters in the fatigue impact scale were equivalent between the NAFLD and the normal liver groups. Fatty liver without clinically significant liver disease does not have independent impact on self-health perception.

Impact of using wearable devices on psychological Distress: Analysis of the health information national Trends survey

3: Gender specific psychosocial correlates of pubertal timing in a national sample of Swiss adolescents

Marital status and quality of relationships: The impact on health perception

Little is known whether parent's indoor environment quality (IEQ)-related symptoms or health perceptions influence the risk of self- or parent-reported symptoms in their children. We assessed (i) the association of parents' IEQ-related symptoms with IEQ-related symptoms in their children at school and (ii) whether parental IEQ-related health worry increases the risk for children's symptoms. We used two Finnish studies: a national, population-based survey of indoor air and related health problems (n=611 parents) and a subset of survey for all primary school pupils (grade 3-6) and their parents in Helsinki, which also included school IEQ-related symptoms reported by children (n=1617 parent-child dyads). In the school survey, parent's own symptoms increased strongly their reporting of their children's symptoms at school (aOR 4.0, 95% CI 2.7-6.0 for parents experiencing a lot of symptoms) and also symptoms reported by the child itself (aOR 2.2, 95% CI 1.5-3.1). Similar, but slightly weaker associations were seen with parental IEQ-related health worries. Results remained unchanged when adjusted for the IEQ of school buildings or parental and children's allergic diseases. Similar associations were seen in the national survey between parent's symptoms at work and child's symptoms at school. The results suggest that parents' health perceptions may increase the reporting of children's IEQ-related symptoms even more than is typically seen for many indoor air contaminants.

Patient-reported experience measures (PREMs) are useful for assessing health care quality and safety and patients' perceptions of health care. We aimed to assess the relationship between PREMS [e.g., measures of patient-centered care (PCC)] and health care quality metrics. We conducted a national survey via mail. Survey data were supplemented with US Department of Veteran Affairs (VA) administrative data. Veteran (n = 5512) VA health care users participated in the study. PCC measures included: patient activation; shared decision-making(SDM); empathy and holistic care; chronic illness care; perceptions of participation, respect for choices, and support; and overall health care experience. Health care quality measures included: preventive care screening receipt; chronic condition management (diabetes, hypertension); and health care utilization (hospitalizations, emergency room (ER) visits). Analyses included: bivariate comparisons of PCC measures by health care quality measures; and multivariate linear regression to identify variables associated with attaining multiple positive health care quality indicators (when controlling for potential confounders). PREMs assessing factors relating to patient-provider communication (e.g., empathic provider care, shared decision-making) are mainly related to clinical indicators representing good chronic condition management, while those relating more broadly to health care in general (e.g., patient activation, chronic illness care) are mainly related to measures of appropriate health care use (e.g., preventive care screening receipt; potentially avoidable hospitalizations; unscheduled care, such as ER visits). When controlling for potential confounders, higher perceptions of the decision-making effectiveness component of SDM (β = 0.004, p = 0.03) and empathy and holistic care (β = 0.01, p = 0.02) showed a weak but positive relationship with attaining a greater number of positive health care quality indicators, while a weak but negative relationship emerged for perceptions of participation, respect for choices, and support (β = -0.003, p = 0.03) and overall VA experiences (β = -0.10, p = 0.04). PREMs that measure PCC offer rich data about health care quality while engaging patients, and considering patient experiences and preferences, in performance assessment. PREMs may be used to supplement existing performance metrics.

To estimate the effectiveness of using standardized health vignettes to adjust self-reported health taking into account household and community variables to correct for systematic bias. The national health survey "Evaluación del Desempeño 2002" (Mexican component of the World Health Survey) was used. This survey analyzed subject's health perception based on their responses to hypothetical questions referring to third parties in the vignettes within eight domains. Variations in responses were attributed to socio-demographic, socioeconomic, community, differences of the subjects. To assess those variations, an index for each domain was constructed and used as a variable in a series of linear regression models to estimate the relation between health perceptions, self-reported health, socioeconomic and socio-demographic characteristics. The health perception index derived from the vignettes showed a positive, logarithmic correlation with household expenditure for each health domain, after controlling for socio-demographic, health and community characteristics. No relationship was found between the health status described in the vignettes and self-reported health status. In no case was the explanatory power above 10%. The low explanatory power of the models, and the lack of correlation between self reported health status and the health perception index, suggest that the variability in the vignettes responses cannot be explained by differences in self-reported health status or socioeconomic and socio-demographic characteristics. These results from Mexico suggest that vignette-based methods to correct for systematic variability in perception of own health status are of limited efficacy and reinforce the importance of collecting objective measures of health status in health surveys.

To describe the reported oral health behaviours and perceptions of Indigenous Australians living in Darwin, Northern Territory and to compare those with estimates for Darwin and Australia derived from the National Survey of Adult Oral Health (NSAOH). A total of 181 Indigenous Australians aged 22 years and over living in Darwin, participating in screening for a wider randomised clinical trial, were included. Information on socio-demographic characteristics, oral health status including oral health behaviours and perceptions was collected using a questionnaire. Differences between the Darwin study (DS) participants and Australians in NSAOH were made based on non-overlapping 95% confidence intervals. Almost 72% of DS participants had last seen a dentist over a year earlier, compared to 47% and 39% of NSAOH Darwin and Australian participants, respectively. A higher proportion of DS participants usually visited a dentist because of a problem than NSAOH Darwin and NSAOH Australian participants. A higher proportion of DS participants had avoided or delayed a dental visit because of cost than NSAOH participants. Over three times as many DS participants rated their oral health as fair/poor compared to NSAOH participants. A higher proportion of DS participants had perceived gum disease and one or more symptoms of gum disease than NSAOH participants. A higher proportion of DS participants experienced toothache, felt uncomfortable about appearance of their mouth and avoided eating because of oral problems than NSAOH participants. A higher proportion of Indigenous Australians living in Darwin presented with non-optimal oral health behaviours and perceptions compared with both the Darwin and Australian general populations.

This study examines the relationship of self-identified disability and oral health perception in a veteran population. The National Survey of Veterans, 2010, database was used to conduct a cross-sectional study of 8,303 participants. Questionnaires were mailed to the veterans, and the questions were developed to assess sociodemographic information, health perception, and health status, among other areas of interest. The Andersen Behavioral Model was used as the framework for the study. The outcome of interest was perceived oral health, and the main variable of interest was self-identified disability. The data were analyzed for descriptive, and bivariate analyses, and logistic regression. There were 1,904 participants (21.2 percent) with self-identified disability. There were 2,505 participants (41.0 percent) who indicated negative oral health perception. In logistic regression, individuals with self-identified disability had an unadjusted odds ratio of 1.63 (95 percent CI: 1.44, 1.85) and an adjusted odds ratio of 1.69 (95 percent CI: 1.44, 1.99) for negative oral health perception as compared with participants who did not self-identify disability. Oral health perception in a veteran population is affected by predisposing and enabling factors among which is self-identified disability.

BackgroundThe last decades have seen significant developments in the economic, political, technological and social landscape as well as in the nature of work that has been re-shaped under these impacts....

BACKGROUND: There are many concerns nowadays about many issues in adolescent health behavior. This study was conducted to assess the prevalence of dietary habits, physical activity and sedentary behaviors among Egyptian adolescents and to assess how they perceive their physical and emotional health. METHODS: The study was cross sectional and was conducted from December 2014 to July 2015 in Menoufia governorate in Egypt. Number of adolescents participating in the study was 329. Their BMI percentile was calculated using a percentile online calculator. A questionnaire about health behaviors of the students and their perception of health was distributed. RESULTS: The prevalence of overweight and obesity among students was 18.8% and 10% respectively. Bad dietary and sedentary behaviors were common among them. Poor perception of health and negative feelings were also common. CONCLUSIONS: national surveys and health promotion programs are urgently needed to focus on health behaviors of the Egyptian adolescent children.

Self-rated health reflects a person's integrated perception of health, including its biological, psychological, and social dimensions. It is a predictor of morbidity and mortality. To assess the current status of self-rated health and associated factors in the Kingdom of Saudi Arabia, we analyzed data from the Saudi Health Interview Survey. We conducted a large national survey of adults aged 15 years or older. A total of 10,735 participants completed a standardized health questionnaire. Respondents rated their health with a five-point scale. Data on socio-demographic characteristics, chronic diseases, health-related habits and behaviors, and anthropometric measurements were collected. Associated factors of self-rated health were analyzed using a backward elimination multivariate logistic regression model. More than 77% of respondents rated their health as excellent/very good. Female sex [odds ratio (OR) 1.52, 95% confidence interval (CI) 1.24-1.88], decades of age (OR 1.35, 95% CI 1.25-1.46), diagnosed diabetes mellitus (OR 1.54, 95 CI 1.22-1.93), diagnosed hypercholesterolemia (OR 1.37, 95% CI 1.06-1.79), diagnosed hypertension (OR 1.55, 95% CI 1.22-1.96), number of other diagnosed chronic diseases (OR 1.69, 95% CI 1.41-2.03), limited vigorous activity (OR 3.59, 95% CI 2.84-4.53), need for special equipment (OR 2.62, 95% CI 1.96-3.51), and more than 3 h of daily television/computer screen time (OR 1.59, 95% CI 1.11-2.29) were positively associated with poor/fair health. Smoking, obesity, and physical inactivity were not associated with self-reported health. We found that preventable risk factors are not associated with Saudis' self-rated health. This optimistic perception of health poses a challenge for preventive interventions in the Kingdom and calls for campaigns to educate the public about the harm of unhealthy behaviors.

Background: Among the 20% of US adults who use mind-body (MB) medicine, half also use other types of complementary and alternative medicine (CAM). Our prior work showed that CAM use is associated with better selfreported health. However, little is known about the association between the use of MB therapies and perceptions of health. Method: Objective: To determine the association between the use of mind-body therapies and self-rated health. Design: We analyzed cross-sectional data from the 2007 US National Health Interview Survey (n=23,393). We partitioned the CAM-user respondents into 3 mutually exclusive groups: 1. MB-only, 2. Both MB and Non-MB-CAM (MB-Plus), and 3. Non-MB-CAM only. We used multivariable logistic regression to model the likelihoods of respondents’ reporting ‘Excellent’ health and reporting ‘Better’ health than the prior year. We controlled for socio-demographic, clinical and behavioral confounders and evaluated the models. Results: 8% of U.S. adults used MB-Only, 18% used non-MB-CAM, and 10% used both. Compared to users of Non-MBCAM, users of MB-Only (adjusted-OR=1.13,95%CI=[0.96,1.33]) and MB-Plus (adjusted-OR=1.09,95%CI=[0.94,1.26]) were not significantly more likely to report ‘Excellent health’. However, compared to users of Non-MB-CAM, users of MBPlus were more likely (adjusted-OR=1.48,95%CI=[1.28,1.71]) to report ‘Better’ health over the prior year while users of MB alone were not. Conclusion: Respondents who used MB in addition to other CAM therapies were significantly more likely to report improvement in self-rated health over the prior year. Large prospective trials are needed to establish whether MB therapies, used as an adjunctive treatment with other CAM, will lead to improvement in health.