Community Health Campaigns Research Articles

Perceptions of healthcare workers on men's sexual and reproductive health services utilization in Kwazulu-Natal.

Healthcare workers have crafted and implemented several health policies and programs to attract men, but men still struggle to access SRH services. This study explored healthcare workers' perceptions and views about the determinants of men's sexual and reproductive health service utilization. This qualitative study employed a purposive sampling technique to select healthcare workers in urology clinics and those managing men diagnosed with SRH conditions outside urology clinics. Data were analyzed thematically. HCWs highlighted men's lack of awareness due to inadequate community education and health campaigns, staff shortage, the unavailability of medicines and medical supplies, health system incapacity, personal factors, and cultural norms and beliefs as hindrances in using SRH services. Health policymakers and relevant stakeholders need to pay attention to the SRH needs of men. The ongoing awareness campaigns about the importance of SRH service utilization, including additional male nurses, can encourage men to engage more with such services.

The impact of text message reminders on cryotherapy uptake among women testing positive for HPV in western Kenya: a prospective cohort study

BackgroundMobile health (mHealth) has become an increasingly popular strategy to improve healthcare delivery and health outcomes. Communicating results and health education via text may facilitate program planning and promote better engagement in care for women undergoing human papillomavirus (HPV) screening. We sought to develop and evaluate an mHealth strategy with enhanced text messaging to improve follow-up throughout the cervical cancer screening cascade.MethodsWomen aged 25–65 participated in HPV testing in six community health campaigns (CHCs) in western Kenya as part of a single arm of a cluster-randomized trial. Women received their HPV results via text message, phone call, or home visit. Those who opted for text in the first four communities received “standard” texts. After completing the fourth CHC, we conducted two semi-structured focus group discussions with women to develop an “enhanced” text strategy, including modifying the content, number, and timing of texts, for the subsequent two communities. We compared the overall receipt of results and follow-up for treatment evaluation among women in standard and enhanced text groups.ResultsAmong 2368 women who were screened in the first four communities, 566 (23.9%) received results via text, 1170 (49.4%) via phone call, and 632 (26.7%) via home visit. In the communities where enhanced text notification was offered, 264 of the 935 screened women (28.2%) opted for text, 474 (51.2%) opted for phone call, and 192 (20.5%) for home visit. Among 555 women (16.8%) who tested HPV-positive, 257 (46.3%) accessed treatment, with no difference in treatment uptake between the standard text group (48/90, 53.3%) and the enhanced text group (22/41, 53.7%). More women in the enhanced text group had prior cervical cancer screening (25.8% vs. 18.4%; p < 0.05) and reported living with HIV (32.6% vs. 20.2%; p < 0.001) than those in the standard text group.ConclusionsModifying the content and number of texts as an enhanced text messaging strategy was not sufficient to increase follow-up in an HPV-based cervical cancer screening program in western Kenya. A one-size approach to mHealth delivery does not meet the needs of all women in this region. More comprehensive programs are needed to improve linkage to care to further reduce structural and logistical barriers to cervical cancer treatment.

Advanced HIV disease and its predictors among newly diagnosed PLHIV in the Gedeo zone, southern Ethiopia.

Globally, HIV infection remains a leading cause of morbidity and mortality. Despite reducing new infections, the global response to advanced HIV disease (AHD) remains ineffective, leaving HIV epidemics a significant public health threat worldwide. In Ethiopia, evidence regarding AHD is scarce. Therefore, this study aimed to assess the prevalence and predictors of AHD among newly diagnosed people living with HIV (PLHIV) initiating antiretroviral therapy in the Gedeo zone, southern Ethiopia. A facility-based cross-sectional study was conducted from May 29, 2023, to February 06, 2024, at health facilities providing HIV care in the Gedeo zone, southern Ethiopia. A total of 427 PLHIV-initiating antiretroviral therapy (ART) were recruited for the study. The data were collected through face-to-face interviews and record reviews using KoboCollect version 2.4 and analyzed using R version 4.3.3. The Akaike information criterion (AIC) model selection was used to evaluate and choose the best-fitting model to describe the relationship between AHD and predictors. Finally, variables with a p-value less than 0.05 were considered independent predictors in the multivariable regression analysis. The study participants' mean (±SD) age was 31.3 (±8.7) years. The overall prevalence of AHD among newly diagnosed PLHIV-initiating ART was 34.4% (95% CI: 29.8%, 39.1%). Rural residence (AOR = 3.48, 95% CI: 2.24, 5.47), alcohol consumption (AOR = 2.48, 95% CI: 1.59, 3.90), and being identified through community-based index case testing (ICT) (AOR = 0.26, 95% CI: 0.13, 0.51) were found to be independent predictors of AHD. The prevalence of AHD among newly diagnosed individuals initiating ART was high. PLHIV who consume alcohol should receive detailed counseling on how it can negatively impact their progress with antiretroviral treatment. HIV testing should be enhanced in rural communities by strengthening community health campaigns. Furthermore, community-based index case testing should be strengthened for early identification of PLHIV.

Improving community health message reception through digital journalistic practices: Mixed-method evidence on health preventive behaviors and health podcast framing for emerging health issues

Health issues stemming from the public’s lack of access to scientific and health information prompted mounting concerns about public health responses. A growing amount of digital journalism scholarship has indicated the relevance of podcasts in health communication through reaching and engaging audiences in more significant preventive behaviors. Integrating digital journalistic practices in health podcasts as a practical and low-cost communication strategy can augment public adherence to addressing widespread health issues. However, the role of health podcasts in media framing in promoting preventive health behaviors is largely unknown. This study used a mixed-method approach (e.g., content analysis and quasi-experiments) to uncover the effectiveness of health podcasts’ framing practices (scientific vs. health frames). The content analysis results demonstrated that the health podcasts mainly used carrier and normal frames, while problem definitions and treatment were leading scientific frames. In a series of quasi-experiments comprising 640 respondents from the UAE and Pakistan, this research manipulated eight frames employed in health podcasts (i.e., two leading sub-frames for each scientific and health frame) to examine the causal mechanism that affects preventive health behaviors (hereafter PB). The findings established that the message-consistent effects of media frames manifesting scientific evidence and health orientation made audiences adopt PB. Theoretically, this research addresses the call for a more comprehensive “community digital journalistic practices model,” further delivering novel evidence on the health podcast framing approaches to offer more eloquent community health campaigns to raise public health issues.

Baseline assessment of oral health needs among underserved populations in the United States

Introduction: There are numerous inequities in access to oral healthcare in the United States (US). Lower utilization of oral healthcare services, a higher burden of dental diseases, and poorer dental outcomes are more prevalent among US immigrants compared to US-born populations. Study Sample: A sizable population of people in Iowa are immigrants. These immigrants are from democratic republic of congo (DRC), Eritrea, Burma, Bhutan, Burundi, Ethiopia, and Afghanistan. Iowa Refugee Assessment Report of 2018 shows that dental ailment is the second most prevalent condition among new entrant refugees. As a result, the Oral Health Programs targeted an oral health intervention at US immigrant populations. Objectives: This report aims to highlight significant findings from the baseline survey to further understand the needs for oral healthcare amongst immigrant and underserved populations in Iowa. This intervention utilized community peer educators to sensitize and mobilize immigrants to better access dental services. Training modules were developed for the volunteer peer educators and educational materials were translated into the native languages of the most populous refugees (French, Swahili, and Arabic). The Oral Health Program implemented a community health campaign, developing a questionnaire to capture demographic information, knowledge, awareness, barriers to uptake of dental check-ups/oral assessment,s and preferred sources of information. Preliminary findings indicated the need for increased awareness about oral health. Findings: There is a need to leverage existing social safety net programs to deliver oral health information and foster connections between dental service providers and their target populations. This study has shown the need for continued efforts towards increasing oral healthcare among underserved ethnic/minority and immigrant populations in Iowa. Future interventions need to focus on improving access and removing structural and social barriers to dental/oral care.

Detection of influencers in social networks: A Survey

&#x0D; Social media influencers have the power to influence others. Identifying influencers in online social networks is essential for various applications in many domains such as advertisement, community health campaigns, administrative science and politics. Detecting influencers on online social networks is achieved in accordance with specific criteria such as the number of subscribers, the number of interactions with them, the extent of people’s trust in them, etc. the present study encompasses differentmeasures such as application, techniques, dataset, factors, and dataset. Besides, a table summarising and illustrating the main ideas and approaches is given.&#x0D;

Heatwave and urinary hospital admissions in China: Disease burden and associated economic loss, 2014 to 2019

BackgroundMany studies have shown that heatwaves are associated with an increased prevalence of urinary diseases. However, few national studies have been undertaken in China, and none have considered the associated economic losses. Such information would be useful for health authorities and medical service providers to improve their policy-making and medical resource allocation decisions. ObjectivesTo explore the association between heatwaves and hospital admissions for urinary diseases and assess the related medical costs and indirect economic losses in China from 2014 to 2019. MethodsDaily meteorological and hospital admission data from 2014 to 2019 were collected from 23 study sites with different climatic characteristics in China. We assessed the heatwave–hospitalization associations and evaluated the location-specific attributable fractions (AFs) of urinary-related hospital admissions due to heatwaves by using a time-stratified case–crossover method with a distributed lag nonlinear model. We then pooled the AFs in a meta-analysis and estimated the national excess disease burden and associated economic losses. We also performed stratified analyses by sex, age, climate zone, and urinary disease subtype. ResultsA significant association between heatwaves and urinary-related hospital admissions was found with a relative risk of 1.090 (95 % confidence interval (CI): 1.050, 1.132). The pooled AF was 8.27 % (95%CI: 4.77 %, 11.63 %), indicating that heatwaves during the warm season (May to September) caused 248,364 urinary-related hospital admissions per year, with 2.42 (95%CI: 1.35, 3.45) billion CNY in economic losses, including 2.23 (95%CI: 1.29, 3.14) billion in direct losses and 0.19 (95%CI, 0.06, 0.31) billion in indirect losses, males, people aged 15–64 years, residents of temperate continental climate zones, and patients with urolithiasis were at higher risk. ConclusionTailored community health campaigns should be developed and implemented to reduce the adverse health effects and economic losses of heatwave-related urinary diseases, especially in the context of climate change.

Analysis of the image of stigma against covid-19 sufferers

The violent COVID-19 pandemic and mode of transmission have created fear in the community, potentially leading to social stigma. Social stigma or negative associations with individuals or groups with symptoms or with certain medical conditions. they are labelled Stereotype, discrimination, discrimination and/or identity harassment related to illness. Stigma actually causes disease to spread Society is spinning out of control. This study is a systematic review using online databases namely Scholar, ScienceDirect, and ProQuest. The keywords used were image Stigma, against, COVID-19.,sufferers. The selection process used the PRISMA protocol, resulting in 15 articles that met the inclusion criteria. When the COVID-19 pandemic emerged, stigma was based on a lack of public knowledge, supplemented by unsubstantiated information or uncontrolled fake news, leading to excessive public attention and fear, leading to misunderstandings and discriminatory treatment. Health workers bar COVID-19 survivors from leaving their homes, even refusing to bury bodies. Stigma not only affects the mentality of those who are discriminated against, but has the potential to create negative motivations in vulnerable communities by not adopting healthy behaviors or even concealing their illnesses, creating connections that identify barriers and contribute to increased COVID-19 mortality. Effective preventive measures can be taken to minimize stigma, provide education or awareness-raising in the form of community health campaigns and outreach, and screen false reports so the public can obtain information from reliable official sources. Factors contributing to the public's stigma against COVID-19 are the level of knowledge that affects individuals' perceptions and actions, as well as the spread of untrustworthy information. Stigma can take the form of discriminatory treatment, labelling and stereotyping. The impact of stigma on COVID-19 can create barriers to contact tracing, lead to case reporting and stress, and potentially lead to mental health issues. Prevention of COVID-19 can be achieved by providing education, health promotion, providing credible information and controlling false reporting, and providing psychological support counseling for those stigmatized by society.

Evaluation of a Rural Organ Donation Campaign Designed to Improve Health Promotion among Young Adults

A health communication campaign to promote organ donation was conducted in partnership with Donate Life America at a rural university campus. Materials included posters, flyers, and postcards, along with personal contact. Participants included university students located at a rural university campus in a survey in a pre-post intervention during National Donate Life Month. Data from research about the campaign included the target audience who completed surveys prior to and after the campaign about attitude and intent towards donation. Likewise, after pre-post intervention of the campaign, reported rates for donor registration increased, and findings indicate that registration rates in this rural university campus are similar to baseline rates in other regions. Based on the population, additional health communication strategies should address disparate groups develop appropriately tailored interventions. Local community health campaigns may be effective in promoting donor registration and increasing communication and beneficial outcomes surrounding organ donation.

Public awareness of first aid treatment in acute burns

Background/Aim: Burn injury is a global public health concern. First aid in burns can reduce morbidity and mortality by stopping the burning process and reducing the size and ultimate depth of the burn injury. The aim of this study is to assess the knowledge about first aid for burns in an urban population in Malaysia. Methods: We conducted a cross-sectional study using questionnaires to assess the knowledge about first aid for acute burns in our single tertiary main national referral unit for burn injuries. A total of 100 respondents were interviewed. Respondents were voluntary outpatients in the surgical outpatient department. Results: Twenty-two percent of the respondents complied with World Health Organization (WHO) recommendations. Other methods used were toothpaste (5.6%), soy sauce (4.4%), traditional oils (3.3%), aloe vera gels (2.2%), and a variety of creams (3.3%). Twenty-five percent agreed that the best information in first aid is through a first aid course; 15% chose a phone application, 14% chose a website, and 12% chose a television advertisement. The recommended first aid treatment (running tap water for ≥ 20 minutes) has proven beneficial in reducing tissue temperature and severity of injury. Conclusion: In 2019, 91% of the Malaysia population had access to the internet, which offers fast and reliable information on first aid for acute burn injuries. The majority of our population still lacks knowledge about first aid treatment for acute burns. Implementation of education regarding burn first aid should target all populations in Malaysia through different community health campaigns, with collaboration between government and non-governmental agencies.

Socioeconomic Challenges of Adolescent Obesity

Obesity is the epidemic of the century, due to its prevalence, impact on national budgets, loss in a gross domestic product, productivity loss, and impact on mortality, morbidity and quality of life. National behaviour change campaigns have not yet shown acceptable long-term results, and there is a need for higher taxation on unhealthy food. Besides, adolescents are vulnerable and easily targeted by “ultra-funded” sophisticated marketing campaigns. Modest evidence on first and second-line treatments makes bariatric surgery the main treatment of choice. Bariatric surgery could be the standard of care provided to those adolescents who failed weight loss attempts for more than six months and present pre-specified high body mass index and obesity-related comorbidities. To confirm whether the findings extracted from the initial narrative search were still valid, an additional, more profound narrative search, including systematic literature review features, was performed, extracting information before the COVID-19 pandemic from three databases: PubMed from 2018 to 2019; Google Scholar from 2018 to 2019; and The Centre for Reviews and Dissemination from the University of York (from 2010 to 2019). Policymakers need to commit with community health campaigns to change societal behaviour on the real impact of obesity. There is a need for earmarked taxation on unhealthy food to prevent obesity publicly and provide enough funds to increase the provision and reimbursement of bariatric surgery. Bariatric surgery at early ages can reduce the progression of morbid obesity-related comorbidities. However, evaluations of morbidly obese adolescents are not performed in time, due to barriers, which avoid upcoming bariatric surgery procedures. Stakeholders should develop strategies to reduce attrition rate and improve patient retention through juvenile-oriented care. There are still ethical aspects pending since we do not fully know the long-term effects and complications. Given the low impact of public preventive campaigns targeting voluntary behavioural change in the long run, and the lax taxation and regulation on the food industry, decision makers should change their mind on bariatric surgery, from an indulgent waste of money to an effective fund-saver.

Audiologists' perspective on the treatment of ear-related ear, nose, and throat conditions in rural Victoria.

To understand the experience of audiologists in managing and treating ear-related ear, nose and throat conditions in rural areas, and to identify the compounding factors that influence patient outcomes and potential targets for intervention. A focus group was conducted using a qualitative descriptive approach. Responses were audio-recorded, transcribed and thematically analysed. The focus group was conducted in the rural town of Mildura in the state of Victoria, Australia. A sample of 19 audiologists from Victoria participated, of which 14 were rurally based and 5 were metropolitan-based. The length of participants' professional experience ranged from 1 to 43years. Long wait lists, and a lack of locally based ear, nose and throat surgeons were identified as barriers to the treatment of ear-related ear, nose and throat conditions. Open communication between health services and efficient care for time-sensitive conditions were seen as outcomes of good practice. Hand hygiene, nose-blowing, reducing tobacco smoke exposure and promoting the use of noise protective equipment were the 4 community health campaigns mentioned to support ear care for those residing in rural areas. Additional themes of ear conditions, treatment, management and primary health care were identified. Improving referral pathways for the treatment of ear-related ear, nose and throat conditions, and providing education about ear, nose and throat assessment and treatment in primary health care settings could increase appropriate referrals, improve patient outcomes and reduce wait periods for treatment.

Community-Based HIV Testing for Urban Youth in Western Kenya.

Youth aged 15-24years comprise 48% of new HIV infections and 15% of persons living with HIV in Kisumu County, Kenya. We assessed factors associated with HIV infection among youth participating in the Community Health Initiative (CHI) implemented in an urban informal settlement in 2018. Predictors of HIV infection were assessed by multivariable logistic regression. CHI engaged 4,441 youth through community health campaigns and home-based HIV testing. HIV prevalence was 3.5% overall and 7.1% among young women aged 20-24. There were 24 youth newly identified as HIV-positive out of 157 total HIV-positive youth. HIV-positive status was positively associated with being female (aOR = 2.46; 95% CI 1.57, 3.84) and aged 20-24 (aOR = 2.40; 95% CI 1.52, 3.79), and inversely associated with secondary school education or higher (aOR = 0.27; 95% CI 0.16, 0.44). Our findings highlight the need for HIV prevention programs specially tailored for youth to further reduce new HIV infections in this priority population.

Knowledge, Attitudes and Practices of the Population in an Urban District Facing COVID-19 in Kisangani, DRC

Objective: To determine the levels of knowledge, attitudes and practices towards Covid-19 among residents of the Plateau Boyoma neighborhood.&#x0D; Methods: A questionnaire was designed and a cross- sectional survey was carried out among 214 households in the Plateau Boyoma district between September 27 and October 27, 2020. Participants were questioned on knowledge, attitudes and practices towards the COVID-19. The data was analyzed by SPSS.&#x0D; Results: The majority of respondents were males aged 39 to 45 years. Most of the participants had higher education (68.7%). The main sources of information on COVID-19 were radio and television. The majority of respondents had a positive attitude towards complying with government infection control measures, 43.9% said they frequently wash their hands with soap and water, cover their mouth and their skin, respectively nose when coughing or sneezing. However, household concern about COVID-19 is very great. In this study, the surveys had a high level of knowledge about COVID-19 and adapted attitudes towards this disease. However, community health campaigns are necessary to have optimistic attitudes and practice appropriate intervention measures without misconceptions.

Costs of integrating hypertension care into HIV care in rural East African clinics.

Sub-Saharan Africa faces twin epidemics of HIV and noncommunicable diseases including hypertension. Integrating hypertension care into chronic HIV care is a global priority, but cost estimates are lacking. In the SEARCH Study, we performed population-level HIV/hypertension testing, and offered integrated streamlined chronic care. Here, we estimate costs for integrated hypertension/HIV care for HIV-positive individuals, and costs for hypertension care for HIV-negative individuals in the same clinics. Microcosting analysis of healthcare expenditures within Ugandan HIV clinics. SEARCH (NCT: 01864603) conducted community health campaigns for diagnosis and linkage to care for both HIV and hypertension. HIV-positive patients received hypertension/HIV care jointly including blood pressure monitoring and medications; HIV-negative patients received hypertension care at the same clinics. Within 10 Ugandan study communities during 2015-2016, we estimated incremental annual per-patient hypertension care costs using micro-costing techniques, time-and-motion personnel studies, and administrative/clinical records review. Overall, 70 HIV-positive and 2355 HIV-negative participants received hypertension care. For HIV-positive participants, average incremental cost of hypertension care was $6.29 per person per year, a 2.1% marginal increase over prior estimates for HIV care alone. For HIV-negative participants, hypertension care cost $11.39 per person per year, a 3.8% marginal increase over HIV care costs. Key costs for HIV-positive patients included hypertension medications ($6.19 per patient per year; 98% of total) and laboratory testing ($0.10 per patient per year; 2%). Key costs for HIV-negative patients included medications ($5.09 per patient per year; 45%) and clinic staff salaries ($3.66 per patient per year; 32%). For only 2-4% estimated additional costs, hypertension care was added to HIV care, and also expanded to all HIV-negative patients in prototypic Ugandan clinics, demonstrating substantial synergy. Our results should encourage accelerated scale-up of hypertension care into existing clinics.

Community-based HIV testing services in an urban setting in western Kenya: a programme implementation study

Some countries are struggling to reach the UNAIDS target of 90% of all individuals with HIV knowing their HIV status, especially among men and youth. To identify individuals who are unaware of their HIV-positive status and achieve testing saturation, we implemented a hybrid HIV testing approach in an urban informal settlement in western Kenya. In this study, we aimed to describe the uptake of HIV testing and linkage to care and treatment during this programme. The Community Health Initiative involved community mapping, household census, multidisease community health campaigns, and home-based tracking in the informal settlement of Obunga in Kisumu, Kenya. 52 multidisease community health campaigns were held throughout the programme coverage area, at which HIV testing by certified testing service counsellors was one of the health services available. Individuals aged 15 years or older who were not previously identified as HIV-positive, children younger than 15 years who reported being sexually active or for whom testing was requested by a parent or guardian, and individuals who tested HIV-negative within the past 3 months but who reported a recent risk were all eligible for testing. Health and counselling services were tailored for men and youth to encourage their participation. Individuals identified during the census who did not attend a community health campaign were tracked using global positioning system data and offered home-based HIV testing services. We calculated the previously unidentified fraction, defined as the number of individuals who were newly identified as HIV-positive as a proportion of all individuals previously identified and newly identified as HIV-positive. Between Jan 11 and Aug 29, 2018, the Community Health Initiative programme reached 23 584 individuals, of whom 11 526 (48·9%) were men and boys and 5635 (23·9%) were aged 15-24 years. Of 12 769 individuals who were eligible for HIV testing, 12 407 (97·2%) accepted testing, including 3917 (31·6%) first-time testers. 101 individuals were newly identified as HIV-positive out of 1248 total individuals who were HIV-positive, representing an 8·1% previously unidentified fraction. The previously unidentified fraction was highest among men (9·8%) and among people aged 15-24 years (15·3%). Community-based hybrid HIV testing was successfully implemented in an urban setting. Innovative approaches that make HIV testing more accessible and acceptable, particularly to men and young people, are crucial for achieving testing and treatment saturation. Focusing on identifying individuals who are unaware of their HIV-positive status in combination with monitoring the previously unidentified fraction has the potential to achieve the UNAIDS Fast Track commitment to end AIDS by 2030. US President's Emergency Plan for AIDS Relief through the US Centers for Disease Control and Prevention.

Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda

IntroductionInterventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV...

Comparison of the costs of HPV testing through community health campaigns versus home-based testing in rural Western Kenya: a microcosting study

ObjectivesTo estimate the cost of human papillomavirus (HPV)-based screening through community health campaigns (CHCs) and home-based testing.SettingCHCs and home-based testing in six communities in rural Western Kenya.ParticipantsCHCs and home-based screening...

Systems-level barriers to treatment in a cervical cancer prevention program in Kenya: Several observational studies.

ObjectiveTo identify health systems-level barriers to treatment for women who screened positive for high-risk human papillomavirus (hrHPV) in a cervical cancer prevention program in Kenya.MethodsIn a trial of implementation strategies for hrHPV-based cervical cancer screening in western Kenya in 2018–2019, women underwent hrHPV testing offered through community health campaigns, and women who tested positive were referred to government health facilities for cryotherapy. The current analysis draws on treatment data from this trial, as well as two observational studies that were conducted: 1) periodic assessments of the treatment sites to ascertain availability of resources for treatment and 2) surveys with treatment providers to elicit their views on barriers to care. Bivariate analyses were performed for the site assessment data, and the provider survey data were analyzed descriptively.ResultsSeventeen site assessments were performed across three treatment sites. All three sites reported instances of supply stockouts, two sites reported treatment delays due to lack of supplies, and two sites reported treatment delays due to provider factors. Of the 16 providers surveyed, ten (67%) perceived lack of knowledge of HPV and cervical cancer as the main barrier in women’s decision to get treated, and seven (47%) perceived financial barriers for transportation and childcare as the main barrier to accessing treatment. Eight (50%) endorsed that providing treatment free of cost was the greatest facilitator of treatment.ConclusionPatient education and financial support to reach treatment are potential areas for intervention to increase rates of hrHPV+ women presenting for treatment. It is also essential to eliminate barriers that prevent treatment of women who present, including ensuring adequate supplies and staff for treatment.

Changing lifestyle for dementia risk reduction: Inductive content analysis of a national UK survey.

To explore what motivates individuals to change their behaviour to reduce their risk of dementia. We conducted secondary qualitative analysis of a UK-based online survey on motivation to change lifestyle and health behaviour for dementia risk reduction. Participants were recruited through social media, the Join Dementia Research network and the National Institute for Health Research Portfolio. Free-text comments from people aged ≥50 years were analysed by two researchers independently using inductive content analysis. Inter-rater agreement was measured through Cohen's Kappa coefficient. Of the 3,948 participants completing the survey, 653 provided free text comments that were included in the analysis (Mean age = 64.1; SD = 8.3 years). The majority of the sample were women (n = 459; 70.3%), Caucasian (n = 625; 95.7%) and married/in partnership (n = 459; 70.3%). Three overarching themes were identified: (1) motivators to changing lifestyle; (2) barriers for lifestyle change; and, (3) quality of the information received. The inter-rater reliability of the coding was high (k = 0.7). Having a family history of dementia or feeling like they had a healthy lifestyle already were motivating factors for behaviour change. Having competing health priorities other than dementia and caring for someone acted as de-motivators as they reduced the time available to dedicate to one's own health. Evidence-based information around dementia prevention was a motivator, but commonly the information was not trusted. Aligned with the World Health Organisation (WHO) mandate on dementia prevention, community health campaigns targeting population awareness around behaviour change and dementia risk factor reduction are urgently needed. To be successful, such campaigns will need to be accompanied by individual approaches that can overcome age-related barriers and individual differences in motivation levels, personal barriers and trust in the information received.