Household Telephone Research Articles

Measuring changes in adult health and well-being during the COVID-19 pandemic and their relationship with adverse childhood experiences and current social assets: a cross-sectional survey

BackgroundAdverse childhood experiences (ACEs) can impact mental and physical health, leaving people with less resilience to health challenges across the life-course. This study examines whether individuals’ levels and changes in levels of mental health, physical health and sleep quality reported across the first year of the COVID-19 pandemic are associated with ACEs and moderated by social assets such as having trusted family and friends.MethodsA cross-sectional household telephone survey in England (a North West local authority) and Wales (nationally) using landline and mobile numbers stratified by health areas, deprivation quintile and age group and supplemented by an online survey. Data were collected from 4,673 English and Welsh residents aged ≥ 18 years during national COVID-19 restrictions (December 2020 to March 2021). Measures included nine types of ACE; self-reported mental health, physical health and sleep quality at time of survey (in pandemic) and one-year earlier (pre-pandemic); numbers of trusted family members and friends, knowledge of community help; and COVID-19 infection.ResultsACEs were strongly related to moving into poorer mental health, physical health, and sleep categories during the pandemic, with likelihoods more than doubling in those with ≥ 4 ACEs (vs. 0). ACEs were also associated with increased likelihood of moving out of poorer health and sleep categories although this was for a much smaller proportion of individuals. Individuals with more trusted family members were less likely to move into poorer health categories regardless of ACE counts.ConclusionsACEs are experienced by large proportions of populations and are associated with poorer health even in non-pandemic situations. However, they also appear associated with greater vulnerability to developing poorer health and well-being in pandemic situations. There is a minority of those with ACEs who may have benefited from the changes in lifestyles associated with pandemic restrictions. Connectedness especially with family, appears an important factor in maintaining health during pandemic restrictions.

Evaluation of residential demand response trials with smart heat pumps and batteries and their effect at the substation feeder

Residential demand response using low carbon technologies can potentially offer energy flexibility to the electricity network along with integration of renewable generation. This paper seeks to empirically evaluate the effectiveness of residential demand response trials on a low voltage feeder of a secondary substation in Barnsley (UK). The study used a sample of 14 well-insulated dwellings equipped with home batteries, heat pumps and solar photovoltaic systems coordinated using automated control. Statistical analysis was undertaken using time-series monitoring data obtained at the individual dwelling level, dwelling sample and at the feeder level of the local low voltage network. Resident experience of the trials was assessed through qualitative data obtained from household telephone surveys. Over three weeks of trials, daily demand response interventions of 2 h duration were applied to the sample of 14 dwellings. For evening peak times, the mean reduction in grid electricity import was found to be 1.3 kWh (67%) per dwelling for turn-down interventions which aimed to minimise import. For turn-up interventions between 1 and 3 pm, the mean increase in grid electricity import was found to be 5.8 kWh (645%) per dwelling. The effect of interventions was measured at the low voltage network level for two single-phase feeders, where penetration of trial homes was approximately one-third. A reduction in mean real power up to 21% was observed for turn-down interventions as well as an increase in real mean power up to 307% for turn-up interventions. In general, the trials had little effect on residents in terms of thermal comfort, hot water availability, noise disturbance or disruption to routines, and where such effects were noticed, they were broadly acceptable. The widespread implementation of residential demand response schemes will require increased roll-out of time-of-use tariffs, enhanced resident support and extensive monitoring of low voltage feeders in electricity substations.

Changes in Levels and Barriers of Physical Activity among Community-dwelling Older Adults during and after the Fifth Wave of COVID-19 Outbreak in Hong Kong: Repeated Random Telephone Surveys.

It is unclear whether the impact of coronavirus disease 2019 (COVID-19) on physical activity (PA) among older adults would be long lasting, and there is a dearth of studies looking at the changes in barriers to performing PA among older adults before and after entering the "post-pandemic era". The study compared levels and barriers of PA among a random sample of community-dwelling older adults recruited during (February to April 2022) and after the fifth wave of the COVID-19 outbreak (May to July 2022) in Hong Kong. In addition, we investigated factors associated with low PA level among participants recruited at different time points. This study had two rounds of random telephone surveys. Participants were community-dwelling Chinese-speaking individuals aged 65 years or above and having a Hong Kong ID card. Household telephone numbers were randomly selected from the most updated telephone directories. Experienced interviewers carried out telephone interviews between 6pm and 10pm on weekdays and between 2pm and 9pm on Saturdays to avoid under-sampling of working individuals. We called 3900 and 3840 households in the first and second round, 640 and 625 households had an eligible older adult, and 395 and 370 completed the telephone survey. As compared to participants in the first round, fewer participants had low level of PA in the second round (28.6% versus 45.9%, P<.001). Participants in the second round had higher metabolic equivalent of tasks (MET)-minutes/week (median: 1707.5 versus 840, P<.001) and minutes of moderate-to-vigorous PA (MVPA) per week (median: 240 versus 105, P<.001) than those in the first round. After adjustment for significant background characteristics, participants who perceived a lack of physical capacity to do PA (adjusted odds ratio (AOR): 3.34 & 2.92, P=.001 & P=.002) and believed that PA would cause pain and discomfort (AOR: 2.04 & 2.82, P=.02 & P=.001) were more likely to have low level of PA in both rounds. Do not have time (AOR: 4.19, P=.01) and concern about COVID-19 infection during PA (AOR: 1.73, P=.02) were associated with low level of PA among participants in the first round, but not in the second round. Perceived a lack of space and facility to do PA at home (AOR: 2.03, P=.02) and cannot find people to do PA together (AOR: 1.80, P=.04) were associated with low PA level in the second round, but not in the first round. The level of PA increased significantly among older adults after Hong Kong entered the "post-pandemic era". Different factors influenced older adults' PA level during and after the fifth wave of the COVID-19 outbreak. Regular monitoring of the PA level and its associated factors should be conducted to guide health promotion and policy making.

The impact of COVID-19 on labour markets and living standards in Mauritius

AbstractUnderstanding the distributional impact of the COVID-19 crisis on the labour market and ultimately on the living standards of the population is key to designing adequate policy responses to shield individuals’ and families’ livelihoods. This article illustrates the impact of COVID-19 on the labour market as well as on living standards in the case of a small open economy: Mauritius. We present descriptive evidence based on a unique set of telephone household surveys, representative of the Mauritian population, conducted between May 2020 and March 2021. We find that women had a higher risk of losing their job and leaving the labour force, reversing a decade-long trend of increasing labour force participation. Low-skill workers in sectors that depend on global demand – and even more so if employed informally – together with women were more likely to be affected by the crisis. One in three households reported a loss in income since the start of the pandemic, and the probability of experiencing this shock increases with the number of household members who lost their job and who were employed informally. From a policy perspective, our findings underscore the negative distributional consequences of the pandemic and provide substantive evidence for the viability of a further proactive policy stance to shield the livelihoods of vulnerable households during the economic recovery phase.

Travel Behaviour and Barriers to Active Travel among Adults in Yaoundé, Cameroon

The literature on urban travel behaviour in Africa is sparse, limiting our understanding of how urban transport policies respond to human and planetary needs. We conducted a cross-sectional household telephone survey on 1334 participants, using a 24 h time-use diary, to investigate travel behaviour and barriers to active travel (walking and cycling) in Yaoundé, Cameroon. We found that two-thirds of all participants reported at least one trip; the median (IQR) numbers of trips per capita and per participant with trips were 2 (0–3) and 2 (2–3), respectively. The main trip modes were shared taxi (46%), walking (27%), private cars (11%), and motorcycle taxis (10%), with 25%, 56%, and 45% of all participants reporting the use of active, motorised, and public transport, respectively. The mean (IQR) trip duration was 48 (30–60) min; for participants who reported trips, the daily overall and active travel durations were 121 (60–150) and 28 (0–45) min, respectively. Women were less likely to travel, making fewer and shorter trips when they did. Participants in less wealthy households were more likely to travel. The primary barriers to both walking and cycling were the fear of road traffic injuries and the inconvenience of active travel modes. Therefore, local urban transport authorities need to improve the safety and convenience of active mobility and promote gender equity in transport. Restrictions to movements during the COVID-19 pandemic and the relatively small survey sample might have biased our results; thus, a representative travel survey could improve current estimates. More generally, high-quality research on travel behaviours and their correlates is needed in low-resource settings.

Population Attributable Fraction of Nonvaccination of Child and Adolescent Vaccines Attributed to Parental Vaccine Hesitancy, 2018-2019.

Understanding the role of vaccine hesitancy in undervaccination or nonvaccination of childhood vaccines is important for increasing vaccine confidence and uptake. We used data from April to June interviews in the 2018 and 2019 National Immunization Survey-Flu (n= 78,725, United States), a nationally representative cross-sectional household cellular telephone survey. We determined the adjusted population attributable fraction (PAF) for each recommended childhood vaccine to assess the contribution of vaccine hesitancy to the observed nonvaccination level. Hesitancy is defined as being somewhat or very hesitant toward childhood vaccines. Furthermore, we assessed the PAF of nonvaccination for influenza according to sociodemographic characteristics, Department of Health and Human Services region, and state. The proportion of nonvaccination attributed to parental vaccine hesitancy was lowest for hepatitis B birth dose vaccine (6.5%) and highest for ≥3-dose diphtheria and tetanus toxoids and acellular pertussis vaccine (31.3%). The PAF of influenza nonvaccination was highest for non-Hispanic Black populations (15.4%), households with high educational (17.7%) and income (16.5%) levels, and urban areas (16.1%). Among states, PAF ranged from 25.4% (New Hampshire) to 7.5% (Louisiana). Implementing strategies to increase vaccination confidence and uptake are important, particularly during the coronavirus disease 2019 pandemic.

Citizen perceptions of fracking-related earthquakes: Exploring the roles of institutional failures and resource loss in Oklahoma, United States

Drawing from hazard and disaster literature, this article advances Freudenburg’s concept of recreancy and Hobfoll’s Conservation of Resources theory in response to calls for more theory development in research on hydraulic fracturing. Respectively, these theoretical frames refer to stress associated with trust in institutional failure to safeguard the wellbeing of society, as well as resource loss, threat of loss, or investment of resources without return or gain. We contribute to the expanding body of knowledge in energy and social science research by investigating risk perceptions of induced seismicity (earthquakes) associated with hydraulic fracturing processes. Using structural equation modeling, we analyze data from a 2018 household telephone survey in two regions of Oklahoma (N = 600). Findings indicate that perceptions of recreancy (β = 0.38), opinion of fracking risks (β = 0.31), and number of earthquakes (β = 0.11) directly affect perceptions of earthquake risk, while political views, economic resource loss and views of fracking benefits are indirectly related to perceptions of earthquake risk.

Suicidal Ideation and Predictors of Psychological Distress during the COVID-19 Pandemic in Eswatini: A Population-Based Household Telephone Survey.

The unpredictability of the COVID-19 pandemic can induce psychological distress in individuals. We investigated perceived stressors, prevalence of psychological distress and suicidal ideation, and predictors of psychological distress among adults during the COVID-19 pandemic in Eswatini. This study was a cross-sectional, population-based household telephone survey of 993 conveniently sampled adults (18+ years) from all the four administrative regions of Eswatini. Data were collected between 9 June and 18 July 2020 during the first wave of the COVID-19 pandemic, when the country was under a partial lockdown. COVID-19-related psychological distress was assessed using the Kessler 6-item Psychological Distress Scale (K6). We performed weighted modified Poisson regression analyses to identify significant predictors of moderate/severe psychological distress (K6 scores: ≥5). The weighted prevalences of moderate (K6 scores: 5–12) and severe psychological distress (K6 scores: ≥13) were 41.7% and 5.4%, respectively. Participants reported several perceived COVID-19-related stressors, including worries and fears of the contagion-specific death, serious need for food and money, and concerns about loss of income or business. The weighted prevalence of suicidal ideation was 1.5%. Statistically significant predictors of increased risk for moderate/severe psychological distress included living in the Hhohho and Manzini regions; feeling not well informed about COVID-19; feeling lonely; having received COVID-19 food or financial relief from the government; feeling burdened by the lockdown; being married; and being youth (18–24 years). The results call for the government to urgently augment the provision of mental health services during the pandemic. Mental health practitioners and programs may use several stressors and risk factors identified in this study to inform interventions and government policies aimed at reducing psychological distress induced by the pandemic.

Disaster experience, social capitals, and behavioral health

On April 20, 2010, the Deepwater Horizon oil rig exploded, and oil spilled from the breached well-head for months, leading to an unprecedented environmental disaster with implications for behavioral health. Disasters are thought to affect behavioral health, and social capital is thought to ameliorate behavioral health impacts after disasters, though empirical evidence is mixed. One possible explanation for the discrepancy in findings relates to the activation of social capital in different contexts. In a disaster context, certain types of social capital may be more beneficial than others, and these relationships could differ between those directly affected by the disaster and those who are unaffected. The goal of this study is to assess the relationships between different forms of social capital (community engagement, trust, and social support) on different behavioral health indicators (depression, anxiety, and alcohol misuse) using data from the first wave of the Survey of Trauma, Resilience, and Opportunity among Neighborhoods in the Gulf (STRONG), a probabilistic household telephone survey fielded 6 years after the onset of the Deepwater Horizon oil spill (DHOS). We employ a structural equation modeling approach where multiple social capital and behavioral health variables can be included and their pathways tested in the same model, comparing the results between those who reported experiencing disruptions related to the DHOS and those who did not. Among those who experienced the DHOS, social support was negatively associated with both depression (β = − 0.085; p = 0.011) and anxiety (β = − 0.097; p = 0.003), and among those who did not experience the DHOS, social support was positively associated with alcohol misuse (β = 0.067; p = 0.035). When controlling for the other social capital variables, social support was the only form of social capital with a significant relationship to behavioral health, and these relationships differ based on whether or not a person experienced the disaster. This suggests that social capital does not have a uniformly ameliorative relationship with behavioral health in the aftermath of disasters.

Prevalence of, and factors associated with health supplement use in Dubai, United Arab Emirates: a population-based cross-sectional study

BackgroundHealth supplement (HS) products that are available in the Emirate of Dubai (United Arab Emirates; UAE) contain chemicals that may adversely affect human health. This study aimed to investigate the prevalence of, and factors associated with HS consumption, knowledge, related adverse events, and reporting practices of adverse events amongst the general population in Dubai, UAE.MethodsA cross-sectional household telephone survey using a computer-assisted questionnaire was conducted amongst a random representative sample (n = 1203) of the Dubai population that assessed HS use and knowledge. Dependent variables were supplement use and reports of adverse events while independent variables included socio-demographic factors, knowledge, attitudes, and practice. Logistic regression analysis was performed to identify factors independently associated with HS use.ResultsAmong the 1203 participants in this study, 455 (37.8%) reported ever using HS. Amongst ever-users, reasons for use were to improve health (66.1%), for bodybuilding (9.9%), disease prevention (6.8%), and weight management (5.3%). The majority of users purchased their HS from pharmacies (88.4%) or were prescribed HS (46.6%). Vitamins were the most commonly used HS (87.9%) followed by minerals (10.5%) and sports nutrition products (10.5%). Only 2.9% of users experienced an adverse event associated with HS use which all resolved when the HS was discontinued. Only three of those affected reported the incident. Multivariate logistic regression analysis revealed that HS use was independently associated with female gender (adjusted odds ratio [AOR]; 3.26, 95% confidence interval [CI]: 2.26–4.70), higher income (AOR 2.41, 95% CI: 1.20–4.83), being a past-smoker (AOR 2.39, 95% CI: 1.27–4.48), having an allergy (AOR 1.75, 95% CI: 1.14–2.66), more frequent doctor visits (AOR 1.86, 95% CI: 1.02–3.39), taking prescribed medications (AOR 1.47, 95% CI: 1.04–2.06), and knowledge about HS (AOR 3.91, 95% CI: 2.26–6.76).ConclusionsOur study provides the first population-based estimates of HS use and HS-related adverse events in the Gulf region. Adverse events associated with HS are infrequent and this may be due to the well-developed regulatory framework in Dubai and the high level of knowledge amongst consumers who mainly consume vitamins and minerals on the advice of pharmacists or healthcare professionals.

Community food environment moderates association between health care provider advice to lose weight and eating behaviors.

Patients who receive weight loss advice from a health care provider (HCP) are more likely to eat healthy. The food environment affects eating behaviors. This study explored how the community food environment may moderate the relationship between HCP advice to lose weight and eating behaviors. Data were obtained from a household telephone survey in 4 New Jersey cities from two cross-sectional panels (2009–10 and 2014). Analyses were limited to 1427 overweight and obese participants. Self-reports assessed frequency of consumption of fruits, vegetables, sugar sweetened beverages, and fast food. Community food data were purchased from InfoUSA and Nielsen and classified according to previously established protocol. Stratified gamma regression analysis determined the differences in the association between receiving weight loss advice and eating behaviors stratified by community food environment. Stratified analyses revealed that receiving advice to lose weight from a HCP was associated with lower reported consumption of total sugar-sweetened beverages, soda, and sweetened fruit drinks when participants lived near a small grocery store, or far from a supermarket, limited service restaurant, or convenience store. There were no associations between receiving weight loss advice and sugar sweetened beverage consumption when participants lived near supermarkets, limited service restaurants, or convenience stores. There were no associations with fruit, vegetable, salad or fast-food consumption, regardless of the community food environment. Food environment may play a critical role in moderating the association between HCP advice and eating behaviors. Interventions that enhance the community food environment may help convert HCP advice into improved eating behaviors.

How does political orientation influence one’s environmental attitude and behaviour? Debate over country park conservation in Hong Kong

In light of the increasing political involvement of people in environmental policies, it is important to understand the influences of political orientation on environmental attitudes and environmental behaviours regarding local environmental policies and issues. This study investigated the differences in the levels of environmental attitude (EA) and environmentally responsible behaviour (ERB) among individuals of different political orientations, including rarely studied pro-centrists and people with no political orientation, through the case of country park development in Hong Kong. A household telephone survey was carried out, and 481 successful samples were collected. SPSS 24.0 was used for the statistical analysis of the collected data. The results of the current study showed that individuals with no political orientation and a pro-centrism stance represent up to 60% of the population in Hong Kong. Liberals reported the highest levels of EA and ERB, followed by the intermediate groups of pro-centrists and individuals with no political orientation. Conservatives were found to be least concerned about the environment and least involved in ERB. Thus, a gradual decrease in EA and ERB from liberals to conservatives was observed. A discrepancy between the levels of EA and ERB among all the participants was found. Reasons for such differences were suggested based on local societal atmosphere and attitudes towards ERBs that oppose the government.

Heat-health warnings in regional Australia: examining public perceptions and responses

ABSTRACTHeatwaves are an increasing environmental hazard and an important public health issue in Australia. Heat-health warnings are being adopted widely to promote protective behaviours, but there has been limited evaluation of public responses. This study used a household telephone survey to examine public attitudes and responses to heat-health warnings in regional areas in two Australian states, South Australia and Victoria. The results indicate a high level of recall of heat-health warnings and awareness about managing extreme heat. Respondents viewed heat-health warnings positively, but the effects on behaviour change were variable. Our findings suggest that the warnings may be reinforcing existing protective behaviours more than promoting change. Perceptions of heat risks were higher among women than men, but lower in older age groups. Evidence of this nature is important to identify ways to improve heat-health warnings and more effectively address the public health risks.

Pilot surveys to improve monitoring of marine recreational fisheries in Hawaiʻi

Marine recreational fishing from shore and from private boats in Hawaiʻi is monitored via the Hawaiʻi Marine Recreational Fishing Survey (HMRFS), using an access point intercept survey to collect catch rate information, and the Coastal Household Telephone Survey (CHTS) to collect fishing effort data. In response to a recent HMRFS review, roving surveys of shoreline fishing effort and catch rate, an aerial fishing effort survey, and a mail survey of fishing effort were tested simultaneously on one of the main Hawaiian Islands (Oʻahu) and compared with the current HMRFS approach for producing shoreline fishing estimates. The pilot roving surveys were stratified by region (rural vs urban), shift (three 4-h periods during the day), and day type (weekday vs weekend). A pilot access point survey of private boat fishing was also conducted on Oʻahu, using an alternate sampling design created by NOAA Fisheries’ Marine Recreational Information Program (MRIP). Three overlapping 6-h time blocks and site clusters with unequal inclusion probabilities were used to cover daytime fishing. Group catch was recorded for an entire vessel rather than individual catch, which is the current standard for MRIP intercept surveys. Although catch estimates from the pilot private boat survey were comparable to the current HMRFS catch estimates, the catch estimates from the pilot roving survey were lower than the HMRFS estimates. HMRFS uses effort data from the CHTS, which includes both day and night fishing in all areas, to estimate total catch, whereas effort data from the roving shoreline survey covered only daytime fishing from publicly accessible areas. We therefore suggest that a roving survey conducted during the day should have complementary surveys to include night fishing and fishing in remote and private/restricted areas. Results from these pilot studies will be used to improve the current surveys of marine recreational fishing activities in Hawaiʻi.

Intentions to use a novel Zika vaccine: the effects of misbeliefs about the MMR vaccine and perceptions about Zika.

BackgroundPeople’s intentions to use vaccines are influenced by their beliefs about both the specific vaccine and the disease it prevents. In the absence of firm beliefs about Zika virus (ZIKV), individuals may base their intentions to vaccinate against it on beliefs about other vaccines, and specifically the misbelief that MMR causes autism.MethodsA survey of 3337 Americans, using a random-digit-dialing sample of landline telephone households and cell-phones.ResultsIntentions to use a Zika vaccine were influenced by beliefs about Zika, science in general, and MMR. Intentions were positively influenced by perceived severity of and vulnerability to Zika, as well as belief in science’s efficacy. However, intentions were negatively influenced by the belief that MMR causes autism in children.ConclusionThe misbelief about MMR and autism may reduce people’s intentions to use a new Zika vaccine. However, perceptions of severity of and vulnerability to Zika may increase intentions. Implications for science educators and public health officials are discussed.

Parental perspectives on hand, foot, and mouth disease among children in Hong Kong: a longitudinal study.

Hand, foot, and mouth disease (HFMD), usually a self-limiting illness for young children, could cause a significant burden for parents because it can take up to 1-2 weeks for a sick child to recover. We conducted a two-wave longitudinal study over one summer peak season (May-July 2014) of HFMD to examine parents' HFMD-related risk perceptions and protective responses. In total, 618 parents with at least one child aged ⩽12 years, recruited using randomly-dialled household telephone calls completed the baseline survey interview, 452 of whom subsequently completed the follow-up survey. Around two-thirds of participants perceived the chance of their child being infected by HFMD was 'zero/very small/small' but the likelihood of being hospitalized once infected was 'somewhat likely/likely/very likely'. At follow-up, 82% reported washing child's hands frequently (Hygiene), 16% would keep their child away from school if HFMD cases were identified in school (Distancing) and 23% were 'very likely/certainly' to take the child for HFMD vaccination if available (Vaccination). Anticipated regret was consistently the strongest predictor for Hygiene (OR 3.34), and intention of Distancing (OR 2.58) and Vaccination (OR 3.16). Interventions focusing on anticipated regret may be effective to promote protective behaviour against HFMD among parents for their children.

Mitigating Litigating: An Examination of Psychosocial Impacts of Compensation Processes Associated with the 2010 BP Deepwater Horizon Oil Spill.

During the past four decades, a number of social science scholars have conceptualized technological disasters as a social problem. More specifically, research in this arena has identified individual and collective stress as a secondary trauma of processes intended to provide compensation and economic relief from disasters in general and, more specifically, technological disasters. Based on data from a 2013 household telephone survey of 1,216 residents of coastal Alabama, this article examines the relationship between psychosocial stress and compensation processes related to the 2010 BP Deepwater Horizon oil spill. We examine involvement with claims, settlement, and litigation activities; vulnerability and exposure to the spill; ties to resources; resource loss and gain; perceptions of risk and recreancy; and intrusive stress and avoidance behaviors as measured by the impact of event scale. Regression analysis reveals that the strongest contributors to intrusive stress were being part of the compensation process, resource loss, concerns about air quality, and income. Although being involved with compensation processes was a significant predictor of avoidance behaviors, the strongest contributors to avoidance behaviors were resource loss, air quality concern, income, being male, minority status, and community attachment. Beliefs that the compensation process was as distressing as the oil spill also significantly contributed to intrusive stress and avoidance behaviors. This research represents a step toward filling a gap in empirical evidence regarding the extent to which protracted compensation processes exacerbate adverse psychosocial impacts of disasters and hinder community recovery.

Understanding public support for recycling policy: To unveil the political side of influence and implications

Policy support from the public is gaining importance for successful implementation of environmental policy. Yet the underlying factors of policy support for environmental policy have not been comprehensively examined. While considerable number of studies offered explanation of the phenomenon from the perspective of environmental psychology and social psychology, the growing attention to political factors has not been adequately addressed. In light of this, the present study systematically identified political factors and integrated them with psychological attributes to build a conceptual model for investigating level of policy support for recycling policy. A random household telephone survey was conducted in Hong Kong. 504 valid responses were collected for model testing. The results suggested that although psychological attributes, attitude and perceived benefits, are significant in predicting recycling policy support, political factors are stronger predictors, which perceived policy effectiveness, policy fairness, policy preference, and participatory process demonstrated a significant effect on the level of policy support. In addition, the explanatory power of the conceptual model remarkably increased after political factors were added to the model. The model enables us to compare effects of different sources on the level of policy support, in turn, advances our understanding of the phenomenon. In addition to shaping positive attitude towards recycling and enhancing perceived benefits of recycling practices among the public, policy-makers should put more efforts in formulating a fair, responsive recycling policy that demonstrates capability of policy goal attainment. Public involvement during policy formulation stage is also highly encouraged for mobilizing greater public support.

Older Adults' Awareness of Deprescribing: A Population-Based Survey.

ObjectivesTo determine older adults’ awareness of the concept of medication‐induced harm and their familiarity with the term “deprescribing.” Secondary objectives were to ascertain determinants of self‐initiated deprescribing conversations and to identify how older adults seek information on medication harms.DesignCross‐sectional population‐based household telephone survey using random‐digit dialling.SettingCanada.ParticipantsCommunity‐dwelling adults aged 65 and older (N = 2,665; n = 898 men, n = 1,767 women, mean age 74.9 ± 7.2, range 65–100).MeasurementsInformation was gathered on age; sex; awareness of the term “deprescribing”; knowledge and information‐seeking behaviors related to medication harms; and previous initiation of a deprescribing conversation with a healthcare professional. Three targeted classes of potentially inappropriate prescriptions were asked about: sedative‐hypnotics, glyburide, and proton pump inhibitors. Descriptive statistics and regression analyses were used to quantify associations.ResultsTwo‐thirds (65.2%, 95% confidence interval (CI) = 63.4–67.0%) of participants were familiar with the concept of medication‐induced harms. Only 6.9% (95% CI = 5.9–7.8%) recognized the term deprescribing; 48% (95% CI = 46–50%) had researched medication‐related harms. Older adults most commonly sought information from the Internet (35.5%, 95% CI = 33.4–37.6%), and from health care professionals (32.2%, 95% CI = 30.1–34.3%). Patient‐initiated deprescribing conversations were associated with awareness of medication harms (odds ratio (OR) = 1.74, 95% CI = 1.46–2.07), familiarity with the term deprescribing (OR = 1.55, 95% CI = 1.13–2.12), and information‐seeking behaviors (OR = 4.57, 95% CI = 3.84–5.45), independent of age and sex.ConclusionHealthcare providers can facilitate patient‐initiated deprescribing conversations by providing information on medication harms and using the term “deprescribing.”

Low-carbon homes, thermal comfort and household practices: Uplifting the energy-efficiency discourse

Abstract: Reducing carbon emissions within the residential sector plays an important role in meeting carbon reduction targets. Low-carbon homes or homes with very high-energy efficiency ratings aim to decrease residential carbon emissions by reducing overall energy demand and increasing reliance on low-carbon energy sources. Numerous assessment and rating tools are available to motivate investment in low-carbon homes. However, the demand for low-carbon products and homes has been lower than anticipated. This study explored householders’ notions of home comfort and energy efficiency, as well as construction specialists’ perceptions about the market for low-carbon products and homes to investigate how such a market could be enhanced. The study collected data though four phases. Phase 1 and 2 explored householders’ views through focus groups (n=107) and a household telephone survey (n=866). Phase 3 explored construction specialists’ views through an online specialist survey (n=492) and phase 4 included an online experimental study (n=2008) to test message frames promoting low-carbon homes to potential home buyers. Overall, telephone survey participants expressed high levels of interest in energy efficient homes and homes with lower running costs. Phase 1 and 2 data also showed that the notion of home energy efficiency constructed by householders is heavily based on technological aspects, such as energy efficient appliances and/or renewable energy sources, which are closely related to the economic (i.e. saving energy costs) or environmental (i.e. reducing carbon emissions) benefits of energy efficiency. However, the same data indicated that energy efficient features such as airflow and ventilation, appropriate indoor temperatures and natural light are closely related to householders’ notion of home comfort, suggesting that the market for energy efficient homes could be enhanced by making the link between energy efficiency and home comfort more evident. This concept was tested through a message framing survey, which confirmed that messages embedded with the notion of energy efficiency in the context of home comfort were more effective in increasing the perceived benefits of low-carbon homes than standard messages that simply listed energy features. Implications of these findings for enhancing the uptake of low-carbon homes are discussed.