Seeking Health Care Research Articles

Health behavior profiles and association with mental health status among US active-duty service members.

This study investigated the clustering of health behaviors among US active duty servicemembers (ADSM) into risk profiles and explored the association between these profiles with ADSM sociodemographic characteristics and mental health status. This study utilized secondary data from the 2018 Health Related Behaviors Survey (HRBS), a Department of Defense (DoD) self-administered online survey. Health behaviors included physical activity, screen use, sleep habits, tobacco/substance use, alcohol drinking, preventive health care seeking and condom use at last sex/having multiple sexual partners. Past-year mental health status was measured using the Kessler Screening Scale for Psychological Distress (K6). Latent class analysis (LCA) on health behaviors was used to cluster ADSMs into risk profiles. Multivariable logistic model was used to examine whether ADSM characteristics and mental health status were associated with ADSMs' risk profiles. The LCA identified a four-class model that clustered ADSMs into the following sub-groups: (1) Risk Inclined (14.4%), (2) High Screen Users (51.1%), (3) Poor Sleepers (23.9%) and (4) Risk Averse (10.6). Over a tenth (16.4%) of ADSMs were categorized as having serious psychological distress. Being male, younger, less educated, in the Army, Marine Corps or Navy were associated with higher odds of being Risk Inclined (AOR ranging from 1.26 to 2.42). Compared to the reference group of Risk Adverse ADSMs, those categorized as Risk Inclined (AOR: 8.30; 95% CI: 5.16-13.36), High Screen Users (AOR: 2.44; 95% CI: 1.56-3.82) and Poor Sleepers (AOR: 5.26; 95% CI: 3.38-8.19) had significantly higher odds of having serious psychological distress. Study findings suggest opportunities to tailor behavioral and health promotion interventions for each of the distinct risk profiles. For example, ADSM described as Risk Inclined may benefit from preventive mental health services. Solutions for ADSM described as Poor Sleepers may include education on sleep hygiene; instituting duty schedules; and shifting military cultural norms to promote sleep hygiene as a pathway to optimal performance and thus military readiness. ADSM with low-risk behavior profiles such as those described as Risk Averse may prove beneficial in the roll-out of interventions as they act as peer-educators or mentors.

Enhancing healthcare access and malaria management via mobile clinics and phone call services in Nuh district of Haryana, India.

Malaria remains a complex challenge in India due to its diverse epidemiology, multi-ethnic population, and multiplicity of malaria vectors. While progress has been made in reducing malaria nationally, persistent pockets hinder elimination efforts. These challenges include hidden reservoirs, inadequate healthcare, suboptimal surveillance, non-compliance, and subclinical infections. Shortage of grassroot level and primary care health staff, transportation issues and general inaccessibility and unavailability of healthcare services are additional challenges. Mobile healthcare vans have been tried and found useful in enhancing healthcare availability in several health conditions in different settings. Nuh district in Haryana, India is a malaria endemic region; it is indeed one of the districts included by India's NITI Aayog in the Aspirational Districts Programme, a government initiative that focuses on rapidly transforming and developing the most underdeveloped districts in country. With an aim to improve the healthcare seeking behavior of malaria-endemic community of selected villages of Nuh district, we carried out a study using interventions in two villages of the district, that had mobile malaria clinics and toll-free telephone services in enhancing healthcare access. We found that Sangel village had higher literacy rates (60.6%) as compared to 39.4% in Naushera. Similarly, the unemployment rate was higher for Naushera. It the mobile malaria clinic was deployed from December 2019 to July 2020 and a total of 269 phone calls were received from both the villages. A similar number of rapid tests and microscopy smears were examined and all were negative for malaria. The febrile patients were referred to the nearest healthcare facility. The study shows that the community is open to using these healthcare interventions. These initiatives of mobile malaria clinics and toll-free telephone services can bridge healthcare gaps, especially in malaria-endemic regions, aligning with India's malaria elimination and equitable healthcare access goals.

Factors Associated with Severe Malaria in Children Under Five Years of Age at Mbarara Regional Referral Hospital, Uganda

Malaria continues to be a major public health problem. In 2013, about 198 million cases of malaria were reported globally with a percentage of 82% in the WHO African Region, 12% in South-East Asia region and 5% in the Eastern Mediterranean region, leading to 584,000 deaths worldwide, with 90% of the deaths occurring in African region, 7% in the South-East Asia region and 2% in East Mediterranean regions. Uganda has the sixth highest number of annual deaths from malaria in Africa, as well as some of the highest reported malaria transmission rates in the world. Malaria was one of the leading causes of ill health and deaths, with approximately 16 million cases and over 10,500 deaths reported in 2013. It remains one of the most important diseases in Uganda in terms of morbidity and mortality. This study was aimed at determining the factors associated with severe malaria in children less than five years admitted to Mbarara Regional Referral Hospital. Of the 73 participants sampled, all participated in the study (100% response rate), with most of the children lying within age range of 2-3 years (38.4%), (n=28) the least number were in the age group of 0-1years and >3-4years of age that is 6.8 %. 57.5% of the patients with severe malaria were of male sex. Severe malaria was found to be more in second born children (43.8%). The highest number of patients with severe malaria had two siblings (39.7%), (n=29), with 53.4% (n=39) of the patients having onset of illness within two days from admission. Despite the effort put by the government on prevention of malaria there was a gap on utilization of mosquito nets and seeking health care within 24hours of onset of illness. Therefore, the health teams in the district and health workers in the hospital should sensitize people how to mosquito net as major preventive measure against malaria. Keywords: Malaria, Children, sub-Saharan Africa, Mosquito net, Health workers.

Investigating the Healthcare-seeking Behavior among Residents of Otuoke Community in Ogbia Local Government Area, Bayelsa State, Nigeria

Health is vital to human living. Poor health in rural areas is prevalent due to various issues impacting health status and service efficacy, with health service functionality measured by affordability and accessibility. Structured questionnaires and oral interviews were employed to investigate the healthcare-seeking behavior of residents of Otuoke community in Ogbia Local Government Area, Bayelsa State. The study established a low response of residents of Otuoke community to biomedical health care (12.8%). Cost (31.4%) was the main limiting factor to seeking health care by the residents. Other factors implicated in influencing healthcare-seeking behaviour include proximity, poor attitude of health care workers, poor medical services and long waiting time in assessing biomedical health care. Most of the respondents resorted to self-examination and self-medication to save cost and time, thereby utilizing the services of local chemists. Traditional healthcare practices still hold sway and gain more relevance based on the fact that it is easily accessible, acceptable and affordable to meet the rural dwellers' expectations compared to biomedical medicine. The study also identified perceived barriers to patronage of the Federal University Otuoke health facility by the students as mainly due to the unavailability of drugs and long waiting time to access medical care. Health education should be deployed to enlighten the residents on rational use of medications and access to treatment at healthcare facilities rather than self-examination and self-medication. University administration should develop strategies to enhance students’ accessibility to the university’s health care services and address the existing barriers.

Refreshed implementation strategy for respectful maternity care through policy dialog in Kenya

Background: Kenya’s Ministry of Health (MOH) has demonstrated its commitment to quality, respectful health care through the development of national RMNC/PCC policies embedded in existing RMNCAH policies. However, the MOH has identified a gap in the implementation of RMNC policies. Methods: MCGL conducted global and Kenya-specific literature reviews on topics including mistreatment, respectful newborn care, and best practices for RMNC interventions. In addition, qualitative data were obtained through three focused group discussions, and 15 key informant interviews (KIIs) at various levels. Results: Most studies have assessed manifestations, prevalence, and to, to a lesser extent, drivers of disrespect and abuse or mistreatment in facility childbirth. Respondents from the KIIs described cases of mistreatment including harassment, rudeness, denial of services, lack of privacy, and violence. In a 2017 qualitative study, participants described a lack of leadership, stewardship, and accountability toward existing RMNC policies, leading to a lack of implementation. The Kenya Free Maternity Policy recommended that despite this policy, women may still not attend health facilities for maternity care. Newborn experience has largely been excluded from the conversation of RMNC, which has an impact on women and providers with long-lasting effects on their mental health and future care seeking. KIIs were familiar with qualitative methods of measuring mistreatment through exit interviews. Conclusion: Counties are at different stages of advancing respectful care for mothers and newborns and integrating RMNC into existing primary healthcare systems. SA provides evidence regarding the development and implementation of effective RMNC policies and programs both globally and in Kenya.

Obstetric service demand is the main health need of the Vietnamese population in Guangxi, China: A cross-sectional study.

China has become an emerging destination for international migration, especially in some Association of South East Asian Nations countries, but the situation of migrants seeking medical care in China remains unclear. A retrospective cross-sectional study was conducted in a hospital in Chongzuo, which provides medical services for foreigners, to investigate the situation of Vietnamese people seeking health care in Guangxi, China. Vietnamese patients who visited the hospital between 2018 and 2020 were included in the study. Demographic characteristics, clinical characteristics, characteristics of payment for medical costs, and characteristics of hospitalization were compared between outpatients and inpatients. In total, 778 Vietnamese outpatients and 173 inpatients were included in this study. The percentages of female outpatients and inpatients were 93.44% and 88.44% (χ2 = 5.133, P = .023), respectively. Approximately 30% of outpatients and 47% of inpatients visited the hospital due to obstetric needs. The proportions of outpatients with basic medical insurance for urban residents, basic medical insurance for urban employees, and new cooperative medical schemes were 28.02%, 3.21%, and 2.31%, respectively. In comparison, the proportion of inpatients with the above 3 types of medical insurance was 16.76%, 1.73%, and 2.31%, respectively. The proportion of different payments for medical costs between outpatients and inpatients were significantly different (χ2 = 24.404, P < .01). Middle-aged Vietnamese females in Guangxi, China, may have much greater healthcare needs. Their main medical demand is for obstetric services. Measurements should be taken to improve the health services targeting Vietnamese female, but the legitimacy of Vietnamese in Guangxi is a major prerequisite for them to access more and better healthcare services.

Identifying delays in healthcare seeking and provision: The Three Delays-in-Healthcare and mortality among infants and children aged 1–59 months

Delays in illness recognition, healthcare seeking, and in the provision of appropriate clinical care are common in resource-limited settings. Our objective was to determine the frequency of delays in the “Three Delays-in-Healthcare”, and factors associated with delays, among deceased infants and children in seven countries with high childhood mortality. We conducted a retrospective, descriptive study using data from verbal autopsies and medical records for infants and children aged 1–59 months who died between December 2016 and February 2022 in six sites in sub-Saharan Africa and one in South Asia (Bangladesh) and were enrolled in Child Health and Mortality Prevention Surveillance (CHAMPS). Delays in 1) illness recognition in the home/decision to seek care, 2) transportation to healthcare facilities, and 3) the receipt of clinical care in healthcare facilities were categorized according to the “Three Delays-in-Healthcare”. Comparisons in factors associated with delays were made using Chi-square testing. Information was available for 1,326 deaths among infants and under 5 children. The majority had at least one identified delay (n = 854, 64%). Waiting &gt;72 hours after illness recognition to seek health care (n = 422, 32%) was the most common delay. Challenges in obtaining transportation occurred infrequently when seeking care (n = 51, 4%). In healthcare facilities, prescribed medications were sometimes unavailable (n = 102, 8%). Deceased children aged 12–59 months experienced more delay than infants aged 1–11 months (68% vs. 61%, P = 0.018). Delays in seeking clinical care were common among deceased infants and children. Additional study to assess the frequency of delays in seeking clinical care and its provision among children who survive is warranted.

HEALTH SEEKING BEHAVIOUR TOWARDS HYPERTENSION AMONG ADULT TRADERS IN AHIA OHURU MARKET, ABA ABIA STATE

The study examined health seeking behavior towards hypertension among adult traders in Ahia Ohuru Market Aba, Abia State. The state was randomly selected while the market was purposively chosen because it was one of the largest. Thereafter, 342 adult traders were selected by balloting. Information on adults’socio-demographic and health seeking behavior were gathered using questionnaire. Digital automatic blood pressure monitor was used to measure their blood pressures. Frequencies and percentages were used to analyze data collected while association was tested using chi square. Result showed that 35.3% and 14.9% visited private and government health facilities, respectively while 4.1% sought traditional health practitioners and 2.3% faith healers. On self-medication with herbal drugs, 22.5% and 28.1% did that most times when they were ill and for illness they considered severe. For pharmaceutical drugs, 46.5% and 14.2% self-medicated with them when sick and did that for mild illnesses most times, respectively Blood pressure readings revealed that 39.4% had normal, 30.8% were pre-hypertensive and 18.9% and 10.9% had stages I and II hypertension, respectively. Association between adults’ health seeking behavior and blood pressure was positive and significant with visit to private health facility, self -medication with herbal, pharmaceutical drugs and faith healers with X2 and p-values of 12.56; 0.057, 23.67; 0.036, 27.56; 0.027 and 17.34; 0.043, respectively. In conclusion, seeking health care in questionable places or self- medication plus other factors may adversely affect onset and progression of hypertension.

Individual Patient Factors Associated with the Use of Physical or Digital Primary Care in Sweden.

Introduction: Little is known about factors that influence patients' choice to use physical or digital primary care. This study aimed to compare self-rated health, internet habits, and what patients deem important when choosing health care between users of physical and digital primary health care. Methods: We recruited 2,716 adults visiting one of six physical or four digital primary health care providers in Stockholm, Sweden, October 2020 to May 2021. Participants answered a questionnaire with questions about sociodemography, self-rated health, internet habits, and what they considered important when seeking care. We used logistic regression and estimated odds ratios (ORs) for choosing digital care. Results: Digital users considered themselves healthier and used the internet more, compared with physical users (p < 0.001). Competence of health care staff was the most important factor when seeking care to both physical and digital users (90% and 78%, respectively). Patients considering it important to avoid leaving home were more likely to seek digital care (OR 29.55, 95% confidence interval [CI] 12.65-69.06), while patients valuing continuity were more likely to seek physical care (OR 0.25, 95% CI 0.19-0.32). These factors were significant also when adjusting for self-rated health and sociodemographic characteristics. Conclusion: What patients considered important when seeking health care was associated with what type of care they sought. Patient preferences should be considered when planning health care to optimize resource allocation.

Substance Use Among People Seeking Health Care Services in Primary Health Care Settings in Coastal Karnataka

Background: Patients with substance use disorders are common in general medical practice and are a major risk factor for several non-communicable diseases. Appropriate screening is a vital step for providing brief interventions which can provide a good opportunity to tackle this crisis and in achieving target 3.5 of the sustainable development goal which includes strengthening the prevention and treatment of substance abuse. Objectives: To study the magnitude of substance use and factors associated with it among people seeking health care services at primary care settings. Methods: The cross-sectional study recruited people seeking services at primary care settings to screen for substance users (SU) and determine the associated factors. The data was collected using a pretested semi-structured questionnaire including socio-demographic characteristics, health status and the Alcohol, Smoking and Substance Involvement Screening Test tool. Results: The study showed that 43.4% of the participants were SU. The current use of smokeless tobacco was higher compared to tobacco smoking (21.3% and 4.7%). The multivariate logistic regression showed that advancing age (AOR: 2.61 and 95% CI of 1.01–6.79), male gender (AOR: 705 and 95% CI of 4.25–11.70), primary and middle school (AOR: 3.24 and 95% CI of 1.52–6.92) literacy status, unemployed (AOR: 0.49 and 95% CI of 0.25–0.95), religion and other backward caste (AOR: 2.42 and 95% CI of 1.37–4.30) were significant correlates of SU. Conclusion: Substance use was reported by two-fifths of the participants seeking services at primary care centres in our study and stresses the need for incorporating brief interventions to prevent higher degrees of dependence and its complications.

What Patients Want in a Transgender Center: Building a Patient-Centered Program

Abstract: Gender affirmation is standard medical care, and community input is an essential component of patient-centered care. This study shares how our organization assessed patients' perceptions of health care organizations that provide gender-affirming care. Building on qualitative interview data, we distributed an online survey via a lesbian-gaybisexual-transgender-queer research firm. The survey was completed by 314 transgender individuals residing in 37 U.S. states and territories. Most respondents (69%) reported negative experiences seeking health care. Patients would travel long distances for competent providers and were more willing to seek care from an institution actively working to change a formerly negative reputation. Patients described high-quality organizations as prioritizing staff training (95.5%), having inclusive policies (93.3%), and hiring expert staff (86.0%). Programs should ensure cultural competency training for all staff. They should recruit and retain providers skilled in transgender medicine, especially trans-identified providers. Patient experience and reputation in the community influence where patients seek care.

Reproductive healthcare seeking behaviour of women of the reproductive age group in an urban resettlement area of district Gautam Buddh Nagar in Uttar Pradesh, India.

Reproductive tract infections (RTIs) and gynaecological morbidities constitute a significant proportion of morbidities in women of the reproductive age group. To find out the proportion of reproductive age group women in an urban resettlement colony having the symptoms of gynaecological morbidities and RTI/sexually transmitted infection (STI) and to explore the healthcare seeking behaviour of the women during such ailments. A community-based cross-sectional study was conducted from January to June 2023 among 317 females aged 15 to 49 years in an urban resettlement area of Gautam Buddh Nagar district in Uttar Pradesh. Statistical analysis used included descriptive statistics and Chi-square test. SPSS 23 was used for data analysis. There was a prevalence of 65.3% of at least one self-reported symptom suggestive of RTI/STI or gynaecological morbidity among the respondents. Among the symptomatic respondents, 54.1% were found to seek treatment. Among the reasons given for not seeking treatment in any health facility, the majority (83.1%) responded 'lack of awareness that the problem needed medical treatment' and 'stigma related with the problem' to be the main reasons. The reproductive healthcare seeking behaviour was found to be inadequate, with only 54.1% of symptomatic respondents seeking treatment. Enhanced health awareness sessions can be planned in the short term, and skilled communicators within or outside of the health system in the long term may be deployed to disseminate information in the community regarding sexual and gynaecological morbidities in reproductive age group women and their timely intervention.

Comparing Social Isolation in Older Adults With and Without Physical Health Challenges During COVID-19: Church and Church Friends Matter.

Older adults were disproportionately affected by COVID-19. The purpose of this study was to explore experiences of sudden-onset social isolation and factors that influenced it among social isolation in two groups of older adults. A qualitative thematic study with a survey component was conducted comparing 18 older adults in two groups: 12 reporting physical health challenges and 6 reporting no physical health challenges. Three qualitative themes describe experiences of (a) avoiding risk to personal health as the reason to postpone healthcare, (b) grieving church and church friends as a lost social connection, and (c) compound stress due to converging factors related to personal health, public health, racial justice movement and critical national events. Those with physical health challenges were less able to postpone seeking healthcare, suffered from compound stress, and were more likely to feel isolated when unable to participate in church activities. Religious, faith, or spiritual supports may be important buffers against social isolation during public health emergencies, especially for older adults with physical health challenges and when there is concurrent social unrest.

MORBIDITY PROFILE AND RISK FACTORS AMONG UNDER-FIVES AND HEALTH CARE SEEKING BEHAVIOURS OFTHEIR PARENTS

The present study investigated the morbidity profile and its risk factors amongunder-fivesand the health care seeking behavioursof their parents in a selectedPanchayat,Ernakulam.Theobjectivesofthestudyweretoassessthemorbidityprofileand its risk factors among under-fives and health care seeking behaviours of parentsand to find the association between morbidity and selected demographic variables andselectedriskfactors.Across-sectionalcommunity-baseddescriptivesurveydesignwasemployed.Thesamplewereselectedusingconveniencesamplingtechnique.Thetoolsweremorbidityprofileassessmentchecklist,riskfactorassessmentchecklistandhealthcare seeking behaviour checklist tool. The findings showed that 81% children hadmorbidityand19%hadnomorbidity.Themost commonmorbidconditionswerecoldand running nose (76%),followed by cough (73%),fever (64%) and hand foot andmouth disease(8%).With regard to a risk factors leading to morbidity, 27% were notgiven exclusive breast feeding, 25% did not start complimentary feeding at the end ofsix months, 14% did not wash their hands before feeding the children, 28% had nofamily history of respiratory tract infection, 20% had no proper ventilation at home,34% had no proper waste disposal, 67% were exposed to passive smoking, 52% ofchildrenweregoingtoAnganwadiand4%hadcongenitaldisorders.Presentstudyalsoshowsthat52%ofmothersreliedonallopathicsectorandequalpercentage(12%)usedAyurvedaandprevious medicationand14%madeuseofhomeremedyduringdiseaseconditions of their children. The findings also showed that there was no associationbetweenmorbidityandselecteddemographicvariables.Thefindingsshowedtherewasassociation between morbidity and using boiled water for drinking (p = 0.038), familyhistoryofrespiratory infections(p=0.05),child goingto day-care/Anganwadi.

Examining the Type, Quality, and Content of Web-Based Information for People With Chronic Pain Interested in Spinal Cord Stimulation: Social Listening Study.

The increased availability of web-based medical information has encouraged patients with chronic pain to seek health care information from multiple sources, such as consultation with health care providers combined with web-based information. The type and quality of information that is available on the web is very heterogeneous, in terms of content, reliability, and trustworthiness. To date, no studies have evaluated what information is available about neuromodulation on the web for patients with chronic pain. This study aims to explore the type, quality, and content of web-based information regarding spinal cord stimulation (SCS) for chronic pain that is freely available and targeted at health care consumers. The social listening tool Awario was used to search Facebook (Meta Platforms, Inc), Twitter (Twitter, Inc), YouTube (Google LLC), Instagram (Meta Platforms, Inc), blogs, and the web for suitable hits with "pain" and "neuromodulation" as keywords. Quality appraisal of the extracted information was performed using the DISCERN instrument. A thematic analysis through inductive coding was conducted. The initial search identified 2174 entries, of which 630 (28.98%) entries were eventually withheld, which could be categorized as web pages, including news and blogs (114/630, 18.1%); Reddit (Reddit, Inc) posts (32/630, 5.1%); Vimeo (Vimeo, Inc) hits (38/630, 6%); or YouTube (Google LLC) hits (446/630, 70.8%). Most posts originated in the United States (519/630, 82.4%). Regarding the content of information, 66.2% (383/579) of the entries discussed (fully discussed or partially discussed) how SCS works. In total, 55.6% (322/579) of the entries did not elaborate on the fact that there may be >1 potential treatment choice and 47.7% (276/579) did not discuss the influence of SCS on the overall quality of life. The inductive coding revealed 4 main themes. The first theme of pain and the burden of pain (1274/8886, 14.34% coding references) explained about pain, pain management, individual impact of pain, and patient experiences. The second theme included neuromodulation as a treatment approach (3258/8886, 36.66% coding references), incorporating the background on neuromodulation, patient-centered care, SCS therapy, and risks. Third, several device-related aspects (1722/8886, 19.38% coding references) were presented. As a final theme, patient benefits and testimonials of treatment with SCS (2632/8886, 29.62% coding references) were revealed with subthemes regarding patient benefits, eligibility, and testimonials and expectations. Health care consumers have access to web-based information about SCS, where details about the surgical procedures, the type of material, working mechanisms, risks, patient expectations, testimonials, and the potential benefits of this therapy are discussed. The reliability, trustworthiness, and correctness of web-based sources should be carefully considered before automatically relying on the content.

Assessment of Urban Health Extension Package Utilization and Healthcare Seeking Behavior among Model and Non-Model Households in Addis Ababa, Ethiopia

BACKGROUND: Ethiopia has been implementing the Urban Health Extension Program (UHEP) at the community level since 2009. The program was a pro-poor and cost-effective approach that aimed to enhance utilization of urban health extension program packages and empower community healthcare-seeking behavior. This study was conducted to compare the utilization and healthcare-seeking behaviors of urban health extension program packages and the healthcare-seeking behaviors of model and non-model households. METHODS: A community-based comparative cross-sectional study was conducted among 594 female household heads (297 models and 297 non-models) using a structured face-to-face interview. A bivariate and multivariable logistic regression analysis was employed to identify associated factors. A p-value less than 0.05 and an adjusted odds ratio (AOR) with a 95% confidence interval were carried out to identify significant factors. RESULTS: Urban health extension program package utilization was 78% among model households and 64.2% among non-model female households. A total of 75.5% model and 65.2% non-model female household heads had appropriate healthcare-seeking behavior. Moreover, having information about UHEPs (AOR = 2.35, 95% CI = 1.08-3.42), frequency of home visits by UHEWs (AOR = 2.12, 95% CI = 1.01-3.13), knowledge about UHEPs (AOR = 3.14, 95% CI = 2.43-4.47), and household graduation status (AOR = 3.052, 95% CI = 2.024-5.13) were significantly associated with urban health extension program package utilization and healthcare-seeking behaviors. CONCLUSION: In terms of utilization, the overall urban health extension package favors model female household heads over non-model female household heads. As a result, raising awareness, having frequent home visits, and focusing more on disease prevention and control packages will boost the adoption of urban health extension packages.

Assessment of Various Factors Contributing to Unfavourable Oral Health Care Seeking Behaviour: A Cross-Sectional Study.

Access to effective oral health care is crucial for a good quality of life. Unfortunately, many individuals face barriers in accessing the necessary oral health care services. By examining various factors, we can gain a better understanding of the challenges faced by the population and work towards improving oral health care outcomes. This study aims to assess the various factors contributing to unfavorable oral healthcare-seeking behavior in Chennai city. A cross-sectional study was conducted in Chennai city involving six hundred and twenty-four individuals from the general population from 12 wards by lottery method. The data collection process involved interviews using a pre-designed questionnaire, through which demographic information was gathered. The Penchansky and Thomas model was employed to assess barriers in service utilization. All completed questionnaires were included in the data analysis, which was performed using SPSS version 20. In the present study, among the various dimensions of access suggested by Penchansky and Thomas, the major reason for unfavorable oral healthcare-seeking behavior was accommodation (54.8%), followed by affordability (20.2%), accessibility (5.6%), acceptability (4.4%), and availability (1.1%). The other reasons that contributed were sociocultural factors (26.4%), lack of awareness (20.8%), and psychosocial factors (11.8%). The present study highlights lack of time as the major factor contributing to unfavourable oral healthcare-seeking behaviour in an urban population. This finding contrasts with previous studies that have focussed on the lack of awareness about dental diseases and the high cost of dental treatment in rural areas.

Rheumatoid Arthritis Care Experiences of Black People Living in Canada: A Qualitative Study to Inform Health Service Improvements.

To understand experiences related to rheumatoid arthritis (RA) care and propose service-level strategies to reduce and mitigate inequities for Black people living in Canada. Purposive and respondent driven sampling was used to recruit participants for qualitative interviews to explore population factors relevant to RA care and challenges and facilitators for access to health care services, medications, and enacting preferred treatment plans. Thematic analysis was conducted using the Braun and Clarke method with inductive and deductive coding and critical race theory guiding analysis. Six women and two men with RA, and two women health care professionals, expressed how their racial identity contributed to their understanding of RA, preferences for treatment, and outcome goals. Health care access was influenced by financial limitations and racism, by exclusion, and discrimination, and also by cultural norms in seeking health care and awareness about RA within the Black community. Participants experienced health system fragmentation and were not connected to ancillary supports. Treatment decision-making was influenced by the legacy of oppression and medical experimentation on Black people and the predominance of biomedical approaches emphasized by health care providers. Holistic and cultural approaches, provided in safe, trauma-informed care environments, with flexibility in service models, are desired. Partnerships between arthritis care services and Black community organizations are proposed to promote community awareness and knowledge about arthritis and provide support mechanisms for patients within their community. Our study highlights unique considerations based on race and ethnicity and provides suggestions for arthritis care to mitigate inequities for Black people living with arthritis.

The Effect of an Educational Intervention Based on an Integrated Social Cognition Model on Waste Recycling at the Source Among Housewives in Lahijan City: A Quasi-Experimental Study

Background: Recycling is proposed as an economic model for saving raw material and energy costs, pollution reduction, reducing waste, resource depletion, and situation improvement in a range of environmental pollution issues. Objectives: The present study aimed to investigate the effect of educational interventions based on an integrated social cognition model (ISCM) on waste recycling at the source among housewives in Lahijan City, Iran. Methods: In this quasi-experimental study, a total of 144 women who sought health care services in Lahijan were selected using a multistage random sampling method. The participants were then evenly divided into intervention and control groups, with each group consisting of 72 women. The study was conducted between 2021 and 2022. Data collection tools included demographic information questionnaires, awareness questions, and ISCM constructs about waste recycling at the source. The total mean scores for the content validity ratio (CVR; 0.84) and content validity index (CVI; 0.83), Cronbach's alpha coefficient (0.85), and internal consistency (0.84) were measured to evaluate the validity and reliability of the questionnaire. Educational content based on ISCM constructs was prepared and carried out in the intervention group in six 60-90-minute sessions virtually via mobile phone using WhatsApp messenger over 6 consecutive weeks. The data were collected before and 1 month after the educational intervention and analyzed using descriptive statistics, Chi-square, independent t-test, paired t-test, and analysis of covariance (ANCOVA) using SPSS version 25. Results: The mean age of the participants was 38.9 ± 12.1 years. Before the study, the 2 groups had no statistically significant difference regarding all demographic variables, awareness, and ISCM constructs (P &gt; 0.05). The 2 groups showed a statistically significant difference in the mean scores of awareness, attitude, subjective norms, perceived behavioral control, self-efficacy, behavioral intention, and action and coping planning after the intervention (P &lt; 0.001). The mean ± SD of the behavior score increased from 17.25 ± 4.96 before the intervention to 25.78 ± 4.95 after the intervention (P &lt; 0.001). Conclusions: The design and implementation of educational interventions based on ISCM have the potential to enhance housewives' performance in waste management and recycling while also increasing their awareness levels.

Healthcare seeking behavior and delays in case of Drug-Resistant Tuberculosis patients in Bangladesh: Findings from a cross-sectional survey.

The emergence of Drug-Resistant Tuberculosis (DR-TB) has become a major threat globally and Bangladesh is no exception. Delays in healthcare seeking, proper diagnosis and initiation of treatment cause continuous transmission of the resistant tubercule bacilli through the communities. This study aimed to assess the different health care-seeking behaviors and delays among DR-TB patients in Bangladesh. A prospective cross-sectional study was conducted from November to December 2018, among 92 culture positive and registered DR-TB patients in four selected hospitals in Bangladesh. Data were collected through face-to-face interviews with survey questionnaire as well as record reviews. Among the 92 study participants, the median patient delay was 7 (IQR 3, 15) days, the median diagnostic delay was 88 (IQR 36.5, 210), the median treatment delay was 7 (IQR 4,12) days, and the median total delay among DR-TB patients was 108.5 (IQR 57.5, 238) days. 81.32% sought initial care from informal healthcare providers. The majority (68.48%) of the informal healthcare providers were drug sellers while 60.87% of patients sought care from more than four healthcare points before being diagnosed with DR-TB. The initial care seeking from multiple providers was associated with diagnostic and total delays. In Bangladesh, DR-TB cases usually seek care from multiple providers, particularly from informal providers, and among them, alarmingly higher healthcare-seeking related delays were noted. Immediate measures should be taken both at the health system levels and, in the community, to curb transmission and reduce the burden of the disease.