Reduce Risk Behaviors Research Articles

Effects of a sexuality education programme on young people’s STI/HIV knowledge, attitudes and risk behaviour in Northeast Nigeria

Objective: The high prevalence of sexually transmitted infections (STIs) including human immunodeficiency virus (HIV) among Nigerian young people has been linked to poor knowledge, attitudes and risk behaviour. This study evaluated the effectiveness of a sexuality education programme (SEP) in improving adolescents’ STI/HIV knowledge and attitudes and reducing risk behaviour. Design: A quasi-experimental pre–post study was conducted. The experimental group ( n = 189) and comparison group ( n = 195) comprised senior secondary school students. Data were collected via a validated self-report questionnaire. A paired t-test, an independent t-test and a one-way between-group analysis of covariance (ANCOVA) were used to analyse the data. Setting: Three hundred eighty-four young people aged 15–20 years at low and high risk for STI/HIV infection participated in the SEP in a school setting in Northeast Nigeria. Results: There were significant post-intervention improvements in students’ knowledge, attitudes and practices in the experimental group ( p < .001). A t-test showed that after the SEP, the mean scores of STI/HIV knowledge (11.25 ± 3.39 vs 8.23 ± 3.60) and attitudes (29.63 ± 6.21 vs 35.38 ± 7.86) were significantly higher in the experimental group than that in the control group. Similarly, the mean risk behaviour score (6.83 ± 2.10 vs 5.64 ± 2.27) was higher in the experimental group than that in the control group post-intervention. Conclusion: The school-based SEP increases STI/HIV knowledge, improves positive attitudes and reduces STI/HIV risk behaviour among school young people in Nigeria.

Motivating Alzheimer’s Disease and Related Dementia Risk Reduction Behaviors in Older Adults: Motivational Cessation Message Development Findings

AbstractBackgroundSmoking, a modifiable risk factor for dementia, accounts for at least 14% of current Alzheimer’s disease cases. Older smokers are more likely to remain abstinent than younger adults when they use evidence‐based smoking treatment (EBST), thereby reducing their dementia risk. Unfortunately, older smokers are half as likely to try to quit than younger adults. Therefore, motivating older adults to quit using EBST is a vital public health priority.Method24 current smokers [M = 14.3 (SD = 9.5) cigarettes/day] with no dementia/MCI history, ages 50‐75 years, 83% White, 12.5% African American, 4% Mixed race, and 79% cisgender female completed a 2‐hour semi‐structured interview and survey via telephone that was analyzed using rapid content analysis.ResultThe most commonly reported health‐related concern was dementia/cognitive loss/loss of functioning, followed by cancer, heart attack/CVD, COPD/emphysema, pain/arthritis, falling, and death. Most participants believed they were at risk of their feared health‐consequence, and that quitting would help. Although all participants had seen previous advertisements for smoking cessation, the majority did not feel motivated to quit by these advertisements. Half of participants were unaware of any link between smoking and dementia, and only a quarter of participants remembered specifics about this link. The vast majority found a message about smoking raising dementia risk and quitting as a means to decrease that risk as motivating for cessation, with over half of participants stating this type of message would be more motivating than previous cessation advertisements. There were varied preferences for exact message content, but two broad categories arose: hope/change of quitting‐based messages and fear/risk of smoking‐based messages. Most participants were aware of smoking cessation pharmacotherapies from personal/relatives past use, but previous negative side effects, cessation failure, and cost were barriers to future use. Nevertheless, the majority of participants stated willingness to use some cessation pharmacotherapy. Many had not considered cessation counseling and were unaware how to access it; half were willing to use cessation counseling.ConclusionHopeful/change‐ and fear‐based messages around smoking and dementia risk could motivate cessation for older smokers. Although dementia is an important health consequence of smoking, older smokers are unaware of this modifiable risk factor.

Investigating Motivators for Managing Customers with Food Allergies in Ethnic Restaurants

Food allergic reactions frequently occur in ethnic restaurants. However, effective training materials specific to food allergies have not been readily available to employees. The objectives of the study were to investigate employee self-efficacy, perceived susceptibility, and commitment on the basis of individual and operational factors and what variables, among self-efficacy, perceived susceptibility, and commitment, are associated with the employee's intention to reduce risky behavior when handling food allergies in ethnic restaurants. A total of 256 employees who had or are currently working in ethnic restaurants and had direct contact with food or customers participated in this study through the Amazon Mechanical Turk Web site from October 2020 to April 2021. The statistical analysis results showed that employee self-efficacy, perceived susceptibility, and commitment vary on the basis of gender, food safety certification, training, and availability of menu items for customers with food allergies. In addition, employee self-efficacy, perceived susceptibility, and commitment are positively correlated with employee's risk reduction behavior for food allergies. The results of the study will provide practical guidelines for developing more multidimensional training programs specific to food allergies in ethnic restaurants.

Cost-effectiveness of hepatitis C virus test-and-treat and risk reduction strategies among men who have sex with men living with HIV in France.

Studies suggest that hepatitis C virus (HCV) micro-elimination is feasible among men who have sex with men (MSM) living with human immunodeficiency virus (HIV), through treatment-as-prevention and interventions aimed at reducing risk behaviours. However, their economic impact is poorly understood. The aim of this study was to assess the cost-effectiveness of HCV screening and risk reduction strategies in France. A compartmental deterministic mathematical model was developed to describe HCV disease transmission and progression among MSM living with HIV in France. We evaluated different combinations of HCV screening frequency (every 12, 6 or 3 months) and risk reduction strategies (targeting only high-risk or all MSM) from 2021 onwards. The model simulated the number of HCV infections, life-expectancy (LYs), quality-adjusted life-expectancy (QALYs), lifetime costs and incremental cost-effectiveness ratio (ICER) over a lifetime horizon (leading to an end of the simulation in 2065). All strategies increased QALYs, compared with current practices, that is yearly HCV screening, with no risk reduction. A behavioural intervention resulting in a 20% risk reduction in the high-risk group, together with yearly screening, was the least expensive strategy, and, therefore, cost-saving compared to current practices. The ICER per QALY gained for the strategy combining risk reduction for the high-risk group with 6-month HCV screening, compared to risk reduction with yearly screening, was €61,389. It also prevented 398 new HCV infections between 2021 and 2065, with a cost per infection averted of €37,790. All other strategies were dominated (more expensive and less effective than some other available alternative) or not cost-effective (ICER per QALY gained > €100,000). In the French context, current HCV screening practices without risk reduction among MSM living with HIV cannot be justified on economic grounds. Risk reduction interventions targeted to high-risk individuals-alongside screening either once or twice a year-could be cost-effective depending on the policymaker's willingness-to-pay.

Bank liquidity and capital shocks in unconventional times

This paper examines bank liquidity management following capital shocks under capital and liquidity regulation in a period of unconventional monetary policies. Studying European banks between 2010 and 2018, we find that bank liquidity is generally not affected by a negative capital shock. Capital shocks are nevertheless transmitted into liquidity positions through balance sheet adjustments. Addressing bank-level balance sheet policies, we find that the banks de-risk assets by replacing corporate loans with financial securities, especially if the shock takes place during periods of heightened central bank interventions. Moreover, asset-side-dominant risk-reducing behavior goes against regulatory intent and indicates that regulatory arbitrage considerations affect banks’ responses to shocks. Finally, we document heterogeneous responses by banks depending on their size, type, and country. These findings imply that compliance with regulation may lead to partial shortages in corporate lending, with banks prioritizing investment in government securities in event of a capital shock.

Efficacy of a Mobile App-Based Coaching Program for Addiction Prevention among Apprentices: A Cluster-Randomized Controlled Trial.

Addictive behaviors such as tobacco/e-cigarette smoking, at-risk alcohol consumption, cannabis use or compulsive internet use are common among apprentices. ready4life is a mobile app-based preventive intervention program for apprentices that promotes life skills and reduces risky behavior. The present study tested the efficacy of ready4life for addiction prevention among apprentices in Switzerland within a controlled trial. Two-arm, cluster-randomized controlled trial including assessments at baseline and follow-up after 6 months. Participants of the intervention group received coaching by a conversational agent for 16 weeks. The main outcome measure was a composite score for addictive behaviors, which included (1) at-risk drinking, (2) tobacco/e-cigarette smoking, (3) cannabis use and (4) problematic internet use. A total of 2275 students from 159 vocational school classes in Switzerland, were invited for study participation. Of these, 1351 (59.4%) students with a mean age of 17.3 years and a male proportion of 56.6% provided informed consent to participate. The follow up assessment at month 6 was completed by 962 (71.2%) study participants. The results concerning the primary outcome showed a stronger decrease of addictive behaviors between baseline and follow up in the intervention group compared to the control group. In particular, significant effects were observed for at-risk drinking and problematic Internet use, while no significant effects were observed for tobacco/e-cigarette smoking and cannabis use. The majority of apprentices invited for program participation within vocational schools participated in the ready4life program for addiction prevention. The mobile app-based coaching was effective in reducing risk behaviors such as at-risk drinking and problematic Internet use in a group of adolescents who have an especially high risk of engaging in addictive activities.

Perinatal Cytomegalovirus Infection.

There have been recent advances in the field of congenital CMV infection (cCMV) related to antiviral treatment of pregnant women and infants, the implementation of newborn CMV screening programs, and the frequency and diagnosis of complications among infected children. In addition, postnatal CMV infection (pCMV) is increasingly recognized as a potential cause of long-term sequelae in addition to acute complications among preterm infants, raising important questions related to treatment, and prevention. High-dose valacyclovir appears to be safe and effective for the prevention of cCMV among women with first-trimester primary CMV infection. New studies reveal high rates of vestibular dysfunction and neuropsychiatric manifestations among children with cCMV. Some studies report associations between pCMV and long-term consequences, including neurodevelopmental delay and bronchopulmonary dysplasia, among very low birth weight infants, in addition to high risk of sepsis and death acutely, which has motivated efforts to eliminate the virus from breast milk by different methods. More long-term complications of cCMV are increasingly recognized among children previously thought to be asymptomatic. Although a preventive CMV vaccine may be achievable, strategies to reduce the burden of cCMV disease include maternal education about risk-reduction behaviors, antiviral treatment of pregnant women with primary infection, and newborn screening to allow timely, appropriate care. Similarly, although it remains unclear if pCMV causes long-term problems, there is growing interest in identifying and preventing disease from CMV infections among preterm infants.

LOW CARDIOVASCULAR RISK REDUCTION BEHAVIORS AMONG HYPERTENSIVES ATTENDING FOLLOW-UP CARE AT A TERTIARY-LEVEL HOSPITAL IN ADDIS ABABA, ETHIOPIA

Introduction: Cardiovascular disease (CVD) outcomes in hypertensives are substantially influenced by risk-reduction behaviors. Even though hypertensives in Ethiopia have a high prevalence of behavioral risks for negative CVD outcomes, little is known about risk-reduction behaviors in this population. Therefore, this study aimed to investigate the CVD risk reduction behaviors among adult hypertensives in Addis Ababa, Ethiopia. Method: A cross-sectional design was used. A sample of 384 hypertensives was selected using a systematic random sampling technique from the hypertension clinic registry. Epi data version 3.10 was used to clean the data, and SPSS version 25.0 was used for analysis. Descriptive statistic was used to determine participants’ CVD risk reduction behavioral status. Bivariate chi-square test and ordinal logistic regression analyses were run to identify variables associated with participants' ranked CVD risk reduction behavioral status at the p-value < .05 cutoff for statistical significance. Results: The mean (± standard deviation) age of participants was 53.61 (± 12.34) years, (range, 30-82 years), and 51.2% were males. The majority (56.5%) of them were at low CV risk reduction practices. Only 45.1% were at target BP control. The absence of comorbidities (p < .001), clinic visits every 3 months for hypertension (p = .041), normal body mass index (p = .008), hypertension duration of 5–9 years (p = .034), and young age adults (p = .041) were the characteristics significantly associated with the high CVD risk reduction practice. Conclusion: Hypertensives' adoption of CVD risk reduction behaviors was low, with a variety of unmanaged risk factors and a few cardioprotective behaviors. Healthcare providers may improve patients’ CV risk-reduction behavior through teaching lifestyle changes and more frequent clinic visits.

Maternal Communication About Sexual Content and Ease of Access to Contraceptives.

Previous literature has emphasized the role of mothers in sexual health communication with their adolescents. However, the extant literature lacks exploration of the importance of parental communication in association to specific risk-reduction behaviors, such as access to contraceptives. Therefore, the purpose of the current study was to explore the roles of parental attachment, the mother-daughter relationship, and communication about sexual content during adolescence in relation to women's recalled access to contraceptives during their teen years. Cisgender female participants aged between 18 and 35 (N = 582) were retrospectively assessed on maternal and paternal attachment, the mother-daughter relationship, mother-daughter communication about sexual content, and their own access to contraceptives during their teen years. After controlling for socioeconomic status, participant race, and history of pregnancy, only maternal communication about sexual content significantly related to access to contraceptives and ease of access to contraceptives. These results demonstrated that specific communication about sexual content was associated with greater access and ease of access to contraceptives, whereas more general relationship factors and communication did not.

Change and Continuity in Preventive Practices Across the COVID-19 Pandemic Among Rural and Urban Latinx Immigrant Worker Families.

(1)The COVID-19 pandemic has put essential workers at high risk for contracting the disease. This study documents situational compliance with public health recommendations such as masking and social distancing among rural and urban Latinx families, with the goal of understanding change over time in COVID-19 risk reduction behaviors. (2)Respondents for 67 rural families and 44 urban families responded to repeated telephone surveys at three time points in the first year of the pandemic, providing data on use of masks and social distancing by themselves and family members while interacting with others at home, work, and in the community. Cumulative logistic regression models were employed to compare changes in risk behaviors between rural and urban groups over time. (3)While group descriptive results indicated behaviors that posed low risk at each time point, regression models revealed greater change between time points for rural than urban residents. Rural residents also had gendered patterns. (4)Patterns of change appear to reflect structural issues such as seasonal labor demand and gender roles more than pandemic fatigue or changing public health recommendations. The findings suggest that structural factors play a role in individuals complying with public health prevention measures for COVID-19.

Family forest owner perceptions of wildfire and invasive pest risk: The role of interpersonally-produced risks

Societal risks associated with natural hazards are largely determined by human decision-making and risk mitigation behaviors. While much is known about individual risk perception, there is a gap in understanding interpersonal risk production (IPR), defined as the decision to prepare for an environmental threat/hazard which influences the risk faced by others. This study considers IPR for two forest-based hazards: wildfires and invasive insects. We surveyed private landowners in Colorado and Massachusetts, two states with high incidence of wildfire, and invasive insects, respectively. Results suggest that the threat of both wildfire and invasive species hazards may be less relevant to private forest owners and thus not conducive to promoting present action. Land managers and policymakers can better leverage efficacy beliefs to encourage risk reduction behaviors if they can communicate the benefit of promoting cross-boundary cooperation and inter-personally produced risks when confronting forest hazards.

Social support in rural communities in Manabi province, Ecuador.

Social support has been found in many contexts, and in urban Ecuador, to be protective of health, particularly in the context of disaster. Fewer studies have explored the presence and impact of social support in rural Ecuador. This study engages a rural community in Ecuador to examine the general levels of social support, differences in social support based on different demographic groupings and relationships among social support and health outcomes and protective health behaviors. A cross-sectional design was used to survey 416 people in a rural Ecuadorian community that had recently experienced an earthquake. Spanish-language versions of the Multidimensional Scale of Perceived Social Support and the Interpersonal Support Evaluation List-12 were applied, as well as questions about demographics and risk reduction behaviors. Body mass index, blood pressure, and cholesterol and blood sugar levels were assessed. Analysis of variance assessed differences in social support among demographic groupings, risk reduction behaviors, and health outcomes. Levels of social support were moderate. Few statistically significant (ie p<0.05) differences in amount of social support received or in sources of social support were found. Men, people 80 years or older, divorced or widowed people, and people living in peripheral areas received less social support than women, people of all other ages, married/cohabitating people, and people living within the village, respectively. Effect sizes of these differences were small. No relationship between social support and health outcomes were found, and few were found for risk reduction factors. These findings indicate that social support may function differently in rural Ecuador than in urban contexts. Those promoting social support in rural communities may wish to focus on community-level, not individual-level, interventions. Limitations of applying an assessment of social support from urban Ecuadorian contexts to rural Ecuadorian contexts are discussed.

Behaviours and educational effect on the improvement of self-care among the diabetics

Globally diabetes causes a huge burden due its significant morbidity and mortality. In year 2019 almost 4.2 million people died from diabetic complications. Self-care is essential in management of diabetes since lifestyle modifications can successfully help in preventing diabetes associated complications. People with diabetes should engage in self-care practices to manage their condition. Diabetes education is essential to improve self-care for patients with the disease. The purpose of this research is to review the available information behaviours and educational effect on the improvement of self-care among the diabetics. A key element of diabetic management is sufficient knowledge of the disease as more education can develop a sense of empowerment and improve quality of life of patients. Patients with diabetes have demands that extend beyond just maintaining optimal glucose control and include preventing complications, limiting their impairment, and receiving rehabilitation. Healthy diet, exercise, blood sugar monitoring, adherence to medicine, strong problem-solving abilities, healthy coping mechanisms, and risk-reduction behaviours are the seven fundamental self-care behaviours in people with diabetes that predict positive results. Patient self-care is a cornerstone of diabetes care and is thought to increase patients' effectiveness in managing their condition by increasing awareness of the disease and enhancing prevention. It is evident from the available literature that diabetes education promotes self-care which has positive impact on health outcome and helps in managing the metabolic markers. Self-care among patients can only be encouraged through proper education at all healthcare levels.

An evaluation of value-based outcomes for women admitted to a dialectical behaviour therapy integrated practice unit: a follow-up study.

An earlier evaluation (Fox et al., ) highlighted reductions in risk behaviours and restrictive practices for women admitted to low secure dialectical behaviour therapy (DBT) unit. Since then, a value-based healthcare model has been adopted. To explore changes in health, social and psychological functioning, risk, quality of life, and in incidents of violence and restrictive practices, over the initial 12-month period of admission to a specialist DBT service. Data were extracted from electronic clinical records for 41 women with emotionally unstable personality disorder admitted to a specialist integrated practice unit (IPU) providing a comprehensive DBT programme. Secondary analysis was conducted on an anonymous dataset of routinely collected outcome measures at baseline admission, and 6 and 12 months post-admission. ANOVAs and pairwise post hoc comparisons, and non-parametric equivalents, were conducted to examine changes in outcomes. Findings showed statistically significant improvements in mental health scores on the ReQOL (p<.01), global, wellbeing, problems, functioning and risk scores on the COREOM (all p<.01), and severe disturbance, emotional wellbeing, socioeconomic status, risk and need scores on the HoNOS-Secure (all p<.05). Significant reductions in risk behaviours (p<.01) and restrictive practices (p<.01) were also apparent. The most substantiative improvements were largely demonstrated over a 12-month admission period. Admission to the DBT IPU yielded significant improvements on outcomes pertaining to quality of life, psychological distress, and risk. Importantly, these are outcomes that aligned with patients' perceptions of recovery.

Prevalence of injected drug use and access to OAT in prison: survey in 7 EU countries, 2014-2018

Abstract Background People in prison report high rates of drug use and drug-related problems and people who use or inject drugs (PWUD) have higher rates of offending and an increased likelihood of spending part of their lives in prison. They represent a vulnerable population with high burden of diseases, socio-economic disadvantages and limited access to healthcare. In this study, we aimed to describe the lifetime prevalence (LTP) of heroin use, injected drug use and opioid agonist therapy (OAT) among people living in prison. Methods Individual data collection was carried out in seven European countries (Czech Republic, Latvia, Lithuania, Poland, Portugal, Slovenia, Spain) between 2014 and 2018 with a model European Questionnaire on Drug use among people in Prison. Risk factors analysis was carried out using multivariate logistic regression model. Results The analysis of EQDP data found that the LTP of heroin use was overall 22.4% (ranged from 7.3% in Poland to 27.5% in Spain). Female, recidivist offenders, individuals aged below 44 and with an history of mental health condition had a higher likelihood of being heroin user (p-value&amp;lt;0.05). The LTP of injected drug use was overall 20.6%(2176/10,587), while the prevalence of injected drug use in prison was 8.1%(745/9273) (with higher prevalence in countries that did not allow OAT initiation in prison: 17.5% in Latvia, 22.1% in Lithuania and 26.7% in Czech Republic). Among those who used heroin, 44.5%(772/1735) had access to OAT and among them 95.8(566/591) had access to OAT in prison. Conclusions Despite the heterogeneity of the results, there is a clear evidence that people in prison have a high prevalence of heroin and injected drug use. Prisons are an important point of access to OAT, and where treatment is available there is a reduction in risk behaviour. It is also important to implement tailored preventive interventions among vulnerable social groups at the community level. Key messages • People in prison in Europe have a high prevalence of heroin and injected drug use. Prisons can represent a point of access to integrated prison-community healthcare and social services for PWUD. • In order to plan adequate healthcare interventions, there is an urgent need to assess and monitor the prevalence of drug use also in other European countries.

Preventing HIV infection in pregnancy: a comprehensive ANC-based intervention in Western Uganda

Abstract Introduction Pregnant women in sub-Saharan Africa represent a high-risk group for HIV infection, but most endemic countries including Uganda do not engage specific HIV prevention measures in pregnancy. This longitudinal study aimed to assess outcomes of a comprehensive, ANC-embedded strategy to prevent seroconversions during pregnancy in Western Uganda. Methods HIV-negative ANC clients were administered an HIV risk assessment tool, followed by individual risk counselling. They received a fixed appointment for repeat HIV testing after three months. Those attending ANC without partners obtained formal partner invitation letters. At follow-up after three months, women not attending repeat testing were reminded via text message. Post-intervention risk behavior engagement was captured. We analyzed uptake of the intervention, HIV incidence rate, and associations with risk behavior. Results Of 1081 participants, 116 (10.7%) reported risk behavior engagement at first ANC visit, 148/1081 (13.7%) were accompanied by partners. The repeat test visit was attended by 848/1081 (78.5%) women, 42 (5.0%, p &amp;lt; 0.001) reported post-intervention risk behavior engagement, and 248 (29.4%, p &amp;lt; 0.001) were accompanied by partners. Seroconversion occurred in two women. In multivariable logistic regression, rural facility clients compared to urban ones (aOR 3.96; 95%CI 1.53-10.26), and women with positive or unknown partner HIV-status (aOR 2.86; 1.18-6.91) and partner alcohol abuse (aOR 2.68; 1.15-6.26) had increased odds for engagement in risk behavior despite the intervention. Conclusions After our intervention, risk behavior in pregnancy was reduced by half, and partner attendance had doubled compared to baseline. Our cohort showed a 0.76/100 women-years HIV incidence rate compared to 2.85 in pre-intervention data from the same setting. Clients from rural settings and women experiencing precarious partner situations require special attention to reduce risk behavior engagement during pregnancy. Key messages • HIV incidence in pregnancy in Western Uganda can be significantly reduced through a comprehensive, ANC-based counselling intervention. • Pregnant women from rural settings and those experiencing precarious partner situations require special attention regarding sexual risk behavior.

Effect of video- assisted teaching on knowledge regarding early detection and prevention of cervical cancer among women

Cancer is the second most common disease in India responsible for maximum mortality with about 0.3 million deaths per year. This is owing to the poor availability of prevention, diagnosis and treatment of the disease. Almost 9 out of 10 deaths occur from cervical cancer in less developed countries. Cancer of the cervix is largely preventable. The risk can be minimized by promotion of sexual risk reduction behavior and genital hygiene. Further prevention can be achieved by screening, using Visual Inspection with Acidic Acid (VIA) or Pap smear test, which can detect precancerous lesions early so as to prevent progress towards invasive cancer by timely treatment. A pre-experimental, One-group pre-test post-test design was undertaken for the study. 300 women were selected as the sample, Non- probability convenient sampling technique was utilized to select the sample from the population. After assessing knowledge video assisted teaching was implemented. After intervention on 7th day the post-test knowledge was assessed. Chi-square was used to measure the association of background variables of patients. ‘t’ test was used to assess the effectiveness of structured interventional programme of the patients. In the comparison between mean pretest and posttest knowledge score it is clear that during the pretest the knowledge score was poor (40%), fair ( 10%), good ( 40%) and excellent ( 10%), and after the administration of video assisted teaching, posttest was done and there was an improvement in the knowledge score of the female by poor (0%), fair (16.7%), good (23.3%) and excellent was( 60%), so there was a great difference in the knowledge score between the pre-test and posttest. The mean pretest knowledge score was 13.67 ± 7.66, while the posttest knowledge score was 23.80 ± 5.53 and the computed t value was found to be 19.105, The difference was found to be statistically significant. There will be significant association between the pretest knowledge score and selected demographic variables at the level of P≤ 0.05. is accepted as there is significant association between pretest knowledge score and selected demographic variables like religion, marital status, Age of women at marriage, no. of times they have conceived, methods of contraception’s, educational status, occupation, kinds of addiction, recurrent infections, history of cancer in family, previous information regarding cancer, history of pap test. The study recommended the utilization of video assisted teaching programme by community health nurses, nurse researchers, nurse administrators, nurse educators and health care professionals to improve knowledge of early detection of cervical cancer.

Travel despite the COVID-19 pandemic: Implications for tourism recovery.

The COVID-19 pandemic has devastated the global tourism industry. This study explores why some Chinese residents travel during the pandemic. A mixed-methods research design was adopted, guided by the health belief model and relevant literature. Through 21 interviews with Chinese tourists who took an overnight leisure trip in May 2020, and a national survey among Chinese residents, this study explored factors influencing Chinese residents’ travel-related decisions and behaviors during the pandemic. Results outline the influences of health beliefs, government trust, past travel experience, and psychological capital on tourists’ risk-reduction behaviors. Theoretical and practical implications are provided regarding tourism recovery during pandemics.

COVID-19 vaccination and mask wearing behaviors in the United States, August 2020 - June 2021

ABSTRACT Background During the rollout of COVID-19 vaccination, many states relaxed mask wearing requirements for those who were vaccinated. The aim of this study was to look at the association between vaccination status and mask wearing behaviors. Methods Seven waves of surveys (n=6721) were conducted between August 2020 and June 2021. Participants were asked about initiation of COVID-19 vaccination and mask wearing behavior when going to work/school or a grocery store. Odds ratios (ORs) and 95% confidence intervals (CIs) from logistic regression were used to estimate associations between vaccination status and mask wearing at work/school and at the grocery store. Results Between April and June 2021, mask wearing at work or school declined among both those vaccinated (74% to 49%) and unvaccinated (46% to 35%). There was a similar decline for mask wearing at grocery stores. The odds of wearing a mask among the vaccinated were 2.35 times higher at work/school (95% CI: 1.82, 3.04) and 1.65 times at a grocery store (95% CI: 1.29, 2.11). Conclusion This study showed that mask wearing decreased after mask guidelines were relaxed, with consistently lower mask wearing among the unvaccinated, indicating a reluctance among the unvaccinated to adopt COVID-19 risk reduction behaviors.

Associations of a Multilevel School Health Program and Health Outcomes Among Lesbian, Gay, and Bisexual Youth.

Lesbian, gay, and bisexual (LGB) adolescents are often at higher risk than their heterosexual peers for adverse sexual health, violence, mental health, and substance use outcomes. Schools are a vital resource for enhancing protective behaviors and reducing risk behaviors. Sixteen school districts selected schools to implement a sexual health program (exposed) or usual programming (unexposed). We analyzed LGB student health outcomes using 2015 and 2017 Youth Risk Behavior Surveys. Analyses compared LGB student health outcomes by exposure status across time points using a multilevel approach. Program exposure was associated with decreased odds of ever having sex, ever testing for HIV, and using effective hormonal birth control, and an increased odds of condom use. There were no significant findings among secondary violence, mental health, and substance use outcomes. This evaluation highlights the potential for schools to reduce sexual risk behaviors among LGB youth, and opportunities to improve access to health services.