In-person Survey Research Articles

Exploring factors associated with domestic violence among pregnant women in Pakistan and its implications for maternal and perinatal health

ABSTRACT Domestic violence during pregnancy is a critical health issue due to its significant implications for both maternal and fetal well-being. Women in South Asian countries are particularly at a higher risk of experiencing domestic violence. The objective of this study was to identify factors associated with domestic violence among pregnant women attending tertiary care antenatal services in Pakistan. The secondary aim was to evaluate the impact of domestic violence on maternal and perinatal outcomes. The study participants were 681 pregnant women registered for antenatal care and delivery at a tertiary care hospital in Islamabad, Pakistan. Data were collected through in-person surveys and medical chart reviews. Associations between domestic violence and study variables were examined by logistic regression analysis. Among the study participants, 31.4%experienced some form of domestic violence during pregnancy, with psychological abuse (16.4%) being the most prevalent followed by sexual abuse (9.5%) and physical violence (1.8%). Women whose husbands were unemployed were three times more likely to experience domestic violence (aOR; 3.3, 95%CI: 1.6, 7.0). Similarly, husband’s substance abuse was significantly associated with domestic violence during pregnancy (aOR: 120.8, 95%CI: 57.9, 252.2). Domestic violence was a significant predictor of adverse maternal outcomes, including anemia, preterm labor, and recurrent abdominal pain. Similarly, domestic violence was a significant predictor of NICU admission (aOR: 20.6, 95%CI: 12.6, 33.8) and low birthweight (aOR: 24.4, 95%CI: 10.2, 58.4). The study findings emphasize the urgent need for comprehensive interventions targeting domestic violence among women and preventing its cascading effects on pregnancies.

Osteoporosis: a problem still faulty addressed by the Romanian healthcare system. Results of a questionnaire survey of people aged 40 years and over.

We aimed to investigate the knowledge and awareness level of osteoporosis, its risk factors, the possible causes of underdiagnosis, as well as the preventive measures and lifestyle behavior of the Romanian population. A non-interventional, cross-sectional study was performed, consisting of an in-person survey, in 10 pharmacies located in both urban and rural settings in Romania. The survey was distributed to patients ≥40 years old. Of 189 respondents, 78.8% were women, the majority age group being 60-69 (31.7%) and 50-59 (30.7%) years old and coming from urban areas (69.3%). Although 75.1% of participants declared knowing about osteoporosis, having a moderate level of knowledge, and women being more aware of the pathology, 77.3% have never performed a DXA test. Moreover, participants already diagnosed with osteoporosis did not show a better disease knowledge than those without a diagnosis. Nearly half of the respondents did not know that a family history of the disease increases the risk of developing it and 60% of them thought that symptoms may develop before a fracture occurs. The preventive strategies tend to be disregarded and thus, underused. Moreover, 42.9% of participants reported being diagnosed with osteoporosis, do not undergo treatment, although they are aware of the existence of effective strategies. The dataset was used to build a participant compatibility network. The network's clustering revealed six relevant communities, which are not correlated with questionnaire results but reflect the patterns of feature associations. Preventive and therapeutic osteoporosis education programs are urgently needed in the Romanian population to decrease disability and high mortality risks and thus, to improve the quality of life.

Ease of Recycling in Glendale, Salt Lake City, Utah: Dissecting Recycling Efforts by Household Size, Age, Income and Gender

This study investigates the perceived ease of recycling in Glendale, Salt Lake City, Utah, USA, by household size, age, income, and gender. While existing research has broadly explored how sociodemographic factors impact recycling, there is a lack of comprehensive studies analyzing these factors within specific local contexts. This study aims to identify specific barriers and motivators across different demographics to enhance local recycling efforts using Glendale as a case study. Data were collected through an online survey of 111 respondents and analyzed using both quantitative and qualitative methods. The survey included questions about the demographic information, perceptions of recycling ease, and barriers to recycling. The analysis revealed that one-person households and young adults (18–35) face constraints such as limited space for recyclables, a lack of access to recycling bins in rental units, or high costs. Older adults (56 years or older) are highly committed but may face physical challenges. Higher-income households report higher participation due to better access and awareness, whereas lower-income households encounter significant barriers such as limited facility access and insufficient information. Gender differences indicate that women are slightly more proactive and committed to recycling compared to men. Recommendations include expanding recycling facilities, targeted educational campaigns, and economic incentives to encourage lower-income households, males, younger, and older adults. Addressing these demographic-specific barriers can improve recycling rates and contribute to more sustainable communities. Future studies should include in-person surveys as one of the limitations of this study is that an online survey format may introduce biases and the exclusion of residents without internet access.

Use of fentanyl test strips by people who inject drugs: Baseline findings from the South Atlantic Fentanyl Test Strip Study (SAFTSS)

BackgroundResearch published during the early fentanyl period exposed a growing concern of unwitting fentanyl exposure and a general willingness to use fentanyl test strips (FTS). A paucity of FTS studies over the last several years has restricted our ability to understand FTS use in the late fentanyl era. The South Atlantic FTS Study (SAFTSS) was established to investigate contemporaneous changes in FTS use and drug use behavior among a rural cohort of PWID. MethodsBetween June 2021 and March 2022, a total of 541 PWID completed an in-person survey. Baseline survey questions included demographics, socioeconomic characteristics, and drugs used. FTS questions covered lifetime use, past 6-months, and past 30-day use and included reasons for using FTS, levels of access, and confidence testing illicit opioids and stimulants. Multivariable analyses examined significant baseline correlates of lifetime and 30-day FTS use. ResultsOverall, more than half (58%; N=315) used FTS in their lifetime. Among lifetime FTS users, almost half (47%) used FTS in the past 6 months and 30% in the past 30 days, with an average of 13 months from last FTS use and the baseline survey. The most common reason for not using FTS was “not having them with me when I use drugs.” Less frequent reasons were “I already know it's fentanyl” followed by “FTS take too much time to use.” Among past 30-day FTS users, 74% used FTS on heroin, 55% on methamphetamine, and 33% on fentanyl. Consumer confidence using FTS was higher with illicit opioids (66%) but lower for methamphetamine (43%). In both the lifetime and past 30-day models, PWID with FTS use were more likely than non-users to have witnessed an overdose in the past six months (lifetime aOR = 2.85, p<.001; 30-day aOR=2.57, p<.01). Virtually no differences in drug use behaviors were found when comparing past 30-days FTS use to no FTS use. Women (aOR=1.68, p<.05) and non-white PWID (aOR=2.43, p<.05) were more likely than men and white PWID to have used FTS. ConclusionsDeclines in FTS use are consistent with what syringe services programs have been signaling for years. Needs assessments to gauge interest in FTS before scaling up can help ensure funding better spent on naloxone and syringes is not allocated to idle FTS. Increased FTS among women and racial minorities presents opportunities for tailored interventions. Recognizing trauma associated with witnessing overdoses as a growing component of the opioid epidemic is a critical first step toward addressing the full spectrum of drug-related harm.

Evaluating the Use of Breast Self-Examination (BSE) for Recognizing Breast Cancer Awareness Among Jordanian Students and Workers in Medical Fields.

Globally, breast cancer (BC) is the most commonly detected neoplasm in women. Breast self-examination (BSE) is an effective screening technique that enables women to learn about the composition of their breasts and assist in the early identification of any potential breast abnormalities. This study aimed to assess the degree of BSE knowledge and attention among Jordanian females who are students or professionals in medical disciplines. Participants' knowledge about BSE and related issues was assessed using a self-administered questionnaire. The study invites participation from all females aged 18 and above, through both an online and in-person survey. The study extended invitations to female university students in Jordan across academic levels I, II, III, IV, V, and VI. A scoring system was employed, and the statistical analyses were performed using IBM SPSS Statistics (Version 20.0). The study had 946 female participants, with 98.41% of them being single. Low BSE practice was reported among 90.49% of the participants (n = 856) and this demonstrated a weak understanding of BC disease, including its possible risks, methods of detection, diagnosis, treatment, signs and symptoms, as well as knowledge about mammography and other related information. Only 27.27% (n = 258) of participants practice BSE once a month and on a regular basis. BC is considered the most prevalent malignant condition and the second largest cause of cancer-related deaths for women in Jordan. Screening strategies are essential for promptly identifying breast cancer and reducing the associated illness and death rates. It is recommended that women commence performing BSE starting at the age of 18. Furthermore, it is essential to incorporate a learning outcome in the cancer chapters that are directly relevant to the subject of BC and emphasize the significance of BSE for students pursuing a career in the medical area.

Qualitative acceptability testing of a paper-based care planner in patients with metastatic non-small cell lung cancer (mNSCLC).

259 Background: Patients with cancer and their caregivers often describe the fragmented, multi-modal and multi-provider cancer care experience as undertaking a difficult expedition without a map. Based on her experience in 2020 and using self and family management theories (doi: 10.1016/j.outlook.2008.10.004.), Daswani developed a pan-cancer patient planner, which helps patients and families prepare for appointments, track symptoms, and manage their care. It has been available since 2021 through hospitals, advocacy organizations and online retail channels. We adapted and customized the pan-cancer planner for patients with mNSCLC. We tested acceptability through a series of structured patient interviews, and a brief, in-person survey tool. Methods: A lung cancer survivor recruited members of the lung cancer community to participate in a 30-minute structured virtual interview. After reviewing the planner, interviewees were asked: 1) about their diagnosis and treatment experience and 2) to provide semi-structured feedback. We conducted interviews until thematic saturation was reached. We modified the planner based on interview results, distributed planners to patients and care-partners at a major lung cancer patient summit and immediately collected a brief survey to assess patient knowledge of their diagnosis and motivation for planner access. Results: The table shows high level thematic groups of interview responses. Interviewed patients concluded that the planner would have improved their experience because they would have: Stayed organized, facilitated note-taking during appointments, better tracked and managed symptoms &amp; meds, been more confident in decision-making and been able to journal, stay grounded and more mindful. Of 94 planners distributed at the summit, 49 patients knew their diagnosis, 31 knew their stage, 28 knew their cancer mutation status. Of the four domains of self-management, positive responses were: 1. Increase confidence 44 (47%) 2. Gain peace of mind 40 (43%) 3. Stay organized 58 (62%) 4. Manage meds &amp; symptoms 42 (45%). Conclusions: A paper based mNSCLC specific planner is acceptable to patients and they anticipate it would help with all four domains of self management (confidence, peace of mind, organization, med and symptom management) and enhance a difficult experience. We plan further usability testing as we did with the breast cancer planner (JCO Oncol Pract 19, 2023 (suppl 11; abstr 552)). Interviews of 8 (7 female, 1 male) patients (3 with English as a second language) were held in December 2023. Diagnosis Biomarker Testing Treatment Living with lung cancer Medical terms difficult to understand “Mutation” term caused anxiety Understanding options important Need for community Diagnosis often delayed Loss of agency Gratitude for care team Digital tools desired Cumulative trauma Additional languages Young adult survivorship desired

Impact of COVID-19 led transition of work culture and travel to work patterns on society and environment in Delhi

Globally, COVID-19 has led to changes in daily lifestyle and travel behavior. There was a shift from in-person physical jobs to work-from-home culture, even for those jobs that required in-person presence at the job location. However, this was not true for everyone, and a majority continued to travel to work. The limited capacity of public transport services and the fear of exposure to the virus restrained people from practicing their conventional mobility choices. We explore the impact of COVID-19 on the nature of jobs and related changes in work travel patterns by population groups for Delhi using in-person surveys conducted during 2021 in six localities of Delhi. We also estimated the short- and long-term impacts of altered behavior on expenditures and equivalent CO2 emissions.As per the analysis, lower income groups, having no vehicles, with lesser qualifications, and employed as daily wagers, had limited capacity to change to work-from-home during COVID-19. We observed an increased dependency on personal motorized vehicles, leading to increased expenditures and reduced affordability. Adopting work-from-home during COVID-19 helped reduce equivalent CO2 emissions per working member by 39%. However, as the work at the site resumes, the emissions are expected to increase. The study shows that COVID-19 led to short-term benefits, but in the long term, the externalities will likely increase. Working from home during the pandemic provides short-term benefits; the social benefits are not equally distributed, and the transport emissions shall increase in the long term.

Telehealth use and acceptability amongst a diverse oncology patient population.

104 Background: Existing research describes numerous barriers to care for patients with cancer, including time constraints, cost, and additional health conditions. We sought to assess telehealth access and experience amongst a diverse patient population at an academic medical center. Methods: We administered a 60-question, cross-sectional, in-person survey to adult patients with a diagnosis of solid tumor or hematological malignancy on active treatment at Columbia University Irving Medical Center (CUIMC) in New York, NY between January 2023 and February 2024. The survey assessed access to and attitudes, beliefs and experience with telehealth as part of routine care and clinical trials. Demographics including age, gender, race/ethnicity, marital status, income, insurance type and education were self-reported. Results: The survey was administered to 100 patients with cancer (breast cancer, n=25; gastrointestinal cancer, n=25; genitourinary cancer n=25; and hematologic malignancy, n=25); 37% were actively enrolled or previously enrolled on a clinical trial. The mean age was 61 years; 51% were female; 45% non-White, and 23% Hispanic. The majority (63%) reported traveling &gt;30 min to their treatment, with 48% reporting travel costs &gt;$20 per visit. Six percent reported difficulty receiving treatment due to cost, and 23% reported difficulty getting to visits due to other conditions or disabilities. The majority (87%) reported having access to a computer or electronic device; 99% of those had internet access and 81% were comfortable using the internet. Of those who had prior video visits (59%), almost all (97%) reported that video visits addressed their issues/questions well. About a quarter of the patients who had not had a video visit reported that they would prefer to have video visits about a cancer-related issue rather than going into the office. For those who preferred a video visit (n=18), top reasons included elimination of travel, convenience, and not feeling rushed. Top barriers among those who expressed hesitance (n=23) included lack of access to necessary technology, not knowing how to use the technology, concern about getting the same level of care, or preference for in-person communication. Similar to video visits, 52% participants reported that they had a scheduled telephone visit with their oncologist instead of going to the office; 98% reported that their issues were either somewhat or very well addressed. Conclusions: In this cross-sectional study amongst a racially, ethnically and socioeconomically diverse population, we found that most patients with cancer on active treatment had access to telehealth and were satisfied with telehealth visits. Those who had not utilized telehealth were interested given convenience and elimination of travel. We found minimal barriers to telehealth access in this diverse urban population. Telehealth may offer an adjunct to reduce financial and logistic barriers to cancer care.

Patient interest in clinical trials and remote technology among a diverse oncology patient population.

389 Background: Existing research describes a number of barriers limiting cancer clinical trial enrollment, including time constraints and financial burden, particularly among under-represented populations. In this study, we sought to assess the relationship between the use of remote technology in clinical trials and patient interest in trial participation amongst oncology patients at an urban academic medical center. Methods: We administered a 60-question, cross-sectional, in-person survey to adult patients with a solid tumor or hematological malignancy diagnosis on active treatment at Columbia University Irving Medical Center between 1/2023 and 2/2024. The survey assessed patient demographics, telehealth access, and interest in using telehealth as part of routine care and clinical trials. Demographics including age, gender, race/ethnicity, marital status, income, insurance type, education level, and cancer type were self-reported. Results: The survey was administered to 100 oncology patients. The mean age was 61 years; 51% were female; 45% non-White and 23% identified as Hispanic. The majority (87%) reported having access to a computer or electronic device; 99% of those having internet access and 81% being somewhat or very comfortable using the internet. Forty seven percent of patients had been offered a cancer clinical trial by their oncology provider, and 19% had participated or were currently participating in a clinical trial. Of the 53% of patients who had not been offered a clinical trial or did not know, 64% reported they would consider participating in a trial recommended by their oncologist. Among all respondents, 52% of patients reported it would make no difference in their decision to participate in a trial if they learned about the risks and benefits remotely (phone or video), 28% were somewhat more or much more likely to participate learning about the risks and benefits remotely, and 20% were somewhat less or much less likely to participate under these conditions. Seventy five percent of respondents would be willing to sign consent for a trial remotely. Sixty four percent of respondents were not willing to spend over an hour traveling to a trial site, citing time, cost, family, and work obligations as reasons for limiting travel. The majority of respondents (&gt;50%) indicated that they would be more likely to participate if the trial used remote technology to decrease the need to travel to a trial site. Conclusions: In this cross-sectional study amongst a diverse patient population, we found that the majority of oncology patients on active treatment have access to telehealth, express interest in clinical trials despite barriers to participation, and would be more likely to enroll in trials if remote communication reduced the amount of travel time for trial participation. Decreasing the logistical burden of cancer clinical trials may increase patient access and diversity in trial participation.

Catholic Christians reject Protestants’ criticism and retaliate in their prayers

Christianity pledges the peaceful acceptance of attacks but elicited numerous intergroup conflicts. This contradiction may arise from basic group-processes, including the rejection of intergroup criticism. Catholic Christians (Experiment 1, N = 322, online; Experiment 2, N = 252 in-person survey during Church activities) responded to criticism of their faith that was either attributed to a fellow Catholic or a Protestant commenter. Criticism from a Protestant (vs. Catholic) source was rated to be less constructive, more threatening, and ascribed worse commenter characteristics. Outgroup criticism did not change support for the unity of Christians (ecumenism, Experiment 1) but increased the likelihood of praying for the commenter (Experiment 2). The content of outgroup-directed prayers was hostile. Effects emerged independent of reported fundamentalism and in a context highly conducive to inter-denomination debate. These findings demonstrate that religious group processes can evoke counter-normative defenses, thus spurring conflict. Understanding these processes may help mend divided societies.

Heterogeneous effects of Medicaid coverage on cardiovascular risk factors: secondary analysis of randomized controlled trial

ObjectivesTo investigate whether health insurance generated improvements in cardiovascular risk factors (blood pressure and hemoglobin A1c (HbA1c) levels) for identifiable subpopulations, and using machine learning to identify characteristics of people...

Abstract A108: Movement Over Virtual Reality (MOVR)-Latinx: Exploring the Acceptability and Feasibility of a Novel Virtual Reality Latin Dance Intervention among Latinos/as to Promote Physical Activity

Abstract Introduction: Physical inactivity is a significant public health concern contributing to numerous chronic diseases including cancer. Latina/o/x adults have higher rates of sedentary behavior compared to other racial/ethnic groups in the United States. Despite evidence supporting the efficacy and growing adoption of VR exercise programs, little is known about the role they play in the Latina/o/x community. The purpose of this study is to assess the acceptability and feasibility of a culturally tailored Latin dance inspired Virtual Reality (VR) intervention to promote physical activity and reduce cancer risk factors among Latina/o/x adults in Los Angeles. Methods: We used a community based participatory research approach to conduct two focus groups (n = 24) with diverse participants who self-identified as Latina/o/x and had not previously participated in a VR activity to explore acceptability and feasibility of a future culturally tailored VR study to promote physical activity in the Latina/o/x community. Participants were paired with culturally and language congruent student guides who provided 1:1 instruction and a 30-minute introductory session. The VR session was followed by in-person focus groups and baseline surveys that included demographic questions. Participants received a $100 gift card for their participation. Results: All participants were Spanish-speaking (n = 23, 95%) Latinos born outside the U.S. and the majority were Mexican (n = 9; 37.5%), the average age was 45 (range = 26 - 71), more than half had a high school education or higher (n = 13; 54.2%), and many were married or living with a partner (n = 15; 62.5%). Preliminary themes included: VR to promote intergenerational connections, the use or VR to overcome physical or environmental barriers, acceptability of VR as a therapeutic intervention, stress reduction via VR engagement, and the need for cultural tailoring to promote VR engagement. Conclusion: The majority of our sample of Latina/o/x participants reported VR as an acceptable means to engage in physical activity. Exploring ways to engage diverse racial and ethnic groups in research through community based participatory research and leveraging technology to build culturally informed interventions is an innovate approach to address cancer disparities. The information gained from this study will provide valuable insights into the acceptability and feasibility of a future randomized controlled trial. Citation Format: Desiree R. Acosta, Vanessa N Torres, Gael Perez, Jailene Cruz, Liana Gutierrez, Josyel Castellon, Paulina Monteon-Garcia, Yelba Castellon-Lopez. Movement Over Virtual Reality (MOVR)-Latinx: Exploring the Acceptability and Feasibility of a Novel Virtual Reality Latin Dance Intervention among Latinos/as to Promote Physical Activity [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A108.

Abstract C059: Disparities in psychological distress among colorectal cancer survivors: Impact on emergency room usage and overall mortality

Abstract Introduction: Cancer survivorship often entails considerable psychological distress. Colorectal cancer (CRC) presents distinct stressors including the use of colostomy and multimodality treatments resulting in side effects for many patients. These factors increases the likelihood of social isolation, body image issues, intimacy problems, and marital strain which affect mental health of CRC survivors. However, information about the prevalence of psychological distress in this population and its association with clinical outcomes are lacking. We examined the prevalence of psychological distress and its association with emergency room usage (ER) and all-cause mortality among CRC survivors. Methods: We utilized data from the 2000-2018 National Health Interview Survey (NHIS) and the NHIS linked mortality files. The NHIS is an annual cross-sectional, nationally representative, in-person survey of the civilian, noninstitutionalized population in the United States. The main exposure was psychological distress, assessed with the six-item Kessler Psychological Distress Scale (K6) and classified as (no/low, moderate, severe). The outcomes were ER usage during the past 12 months and all-cause mortality. Multivariable logistic and Cox proportional hazards models were used to examine the associations between psychological distress, and ER usage and all-cause mortality, respectively. The models were adjusted for age, gender, survey year, race/ethnicity, marital status, education, smoking, geographic region, visit to mental professionals, general health status, comorbidities, and time since cancer diagnosis. Results: A total of 3198 CRC survivors were included in the study, of whom 4.1% and 19.6% reported severe and moderate psychological distress, respectively. In the 12 months preceding the survey, 29.8% of CRC survivors had ER usage and 41.5% deaths occurred with a median follow-up of 84 months. In the adjusted model, compared to CRC survivors with low/no psychological distress, those with severe (aOR=1.86; 95% CI, 1.11–3.10) or moderate (aOR=1.60; 95% CI, 1.22–2.11) psychological distress had high odds of reporting ER use. Similarly, after adjusting for covariates, CRC survivors with severe (aHR =1.32; 95% CI, 1.30–1.34) or moderate (aHR =1.02; 95% CI, 1.01–1.02) psychological distress had higher risk of all-cause mortality compared with survivors experiencing low/no psychological distress. Conclusion: CRC survivors with severe or moderate psychological distress have higher ER usage and all-cause mortality. This finding emphasizes the significance of timely identifying and addressing psychological distress to improve quality of life and clinical outcomes of patients diagnosed with CRC. Integrating mental health support into routine cancer care may reduce distress levels, potentially leading to fewer ER usage and lower mortality rates among CRC survivors. Citation Format: Mrudula Nair, Pranali Patel, Chaitali S Dagli, Nada Al-Antary, Oluwole A Babatunde, Nosayaba Osazuwa-Peters, Eric Adjei Boakye. Disparities in psychological distress among colorectal cancer survivors: Impact on emergency room usage and overall mortality [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C059.

Social Network Density Mediates the Association Between Problematic Social Media Use and Depressive Symptoms

Previous studies have indicated that problematic social media use (PSMU) is positively related to depressive symptoms. However, the potential mechanisms underlying this relationship are not well understood. For example, prior research found that depressive symptoms are related to one’s social network structure, such as network size and density. Therefore, we examined whether one’s social network size and density mediate the relationship between PSMU and depressive symptoms. We conducted an in-person survey to collect measures of PSMU, social network size and density, and depressive symptoms. Our analysis showed that there was a positive relationship between PSMU and depressive symptoms, which was mediated by social network density but not size. Specifically, the greater one’s PSMU, the less dense their social network, and the greater their depressive symptoms. Our research suggests that PSMU may affect how individuals maintain their social connections with others, which may affect mental health. Implications were discussed.

Antimicrobial resistance related knowledge, attitude and practice of general practitioners, patients and farmers: A cross-sectional study in Uzbekistan

ObjectivesThe objective was to identify antimicrobial resistance related knowledge, attitudes and practice gaps of general practitioners, patients and farmers. MethodsCross-sectional, mixed-mode (in-person and distance) survey conducted out among the key antimicrobial prescribers and consumers in Uzbekistan, from March to October 2020. We calculated knowledge and attitude scores and applied multivariable adaptive linear regression. ResultsData were collected from 718 adults (236 - GPs, 251 - patients and 231 - farmers) aged 18 years and older. 66.5 % (n = 157) of general practitioners didn't base their antimicrobials prescription on guidelines. A third were not familiar with the delayed antibiotic prescriptions strategy. Most general practitioners prescribe antibiotics on patients' request; one third if patients have fever, almost 60 % (n = 142) if patients have cough with sputum.Majority of patients believed that antibiotics can cure influenza and cold. Every third farmer thought that antibiotics is an antiviral and every fifth a tool to increase productivity. Almost two third of them used antibiotics to protect livestock/poultry/fish from disease.For all three groups, the strongest predictor for the right attitude was the knowledge level. ConclusionsAll three groups had knowledge gaps in the form of misconception and problem underestimation which manifests itself as a wrong practice. Interventions are needed at the national, institutional and individual levels, in particular in the trainings of general practitioners and farmers.

Knowledge of dementia and Alzheimer's disease among healthcare professionals in Peru.

Primary care physicians and other healthcare providers report feeling unprepared to treat persons with dementia (PWD), especially in developing countries OBJECTIVE: We aimed to assess the knowledge of dementia and Alzheimer's disease (AD) among health professionals in both primary and tertiary care in Peru. We conducted an in-person and virtual survey of healthcare professionals trained in Peru throughout the year 2020. The survey was developed based on a previously published one and reviewed by an expert panel. We compared groups using a Chi-squared test. A Bonferroni corrected p-value of 0.008 was used for statistical significance. Out of 804 surveys, we excluded 56 due to incomplete data. A total of 41.6% of respondents were doctors and 21.8%, nurses. One fifth of participants did not recognize AD as a cause of dementia and over half considered "senile dementia" a valid clinical entity. Scores were higher among those with postgraduate training, multiple patients with dementia, or those who had practiced for over 10 years. There is a low level of knowledge of dementia and AD among health professionals in Peru, which worsens outside of Lima. Pernicious ideas, such as senile dementia, are still significantly present among respondents.

Proxy Responses in Research on COVID-19 Among People With Intellectual and Developmental Disabilities.

Researchers and advocates have long called for improved research methods that better include people with intellectual and developmental disabilities (IDD), but challenges to doing so persist. Proxy responses are frequently used to circumvent some of these challenges, but may not fully capture the perspectives of people with IDD. The COVID-19 pandemic highlighted the possibility of consequences due to a lack of research about health outcomes for people with IDD, with documented disproportionate impact but little understanding about specific experiences for people with IDD. Using exploratory graph analysis (EGA) we explored the use of proxy responses on the COVID-19 Supplement of the National Core Indicators In-Person Survey. Findings suggest significant differences in response patterns between people who answered independently, via proxy, and with a mix of response types beyond what would be expected due to demographic differences in participants.

Transitioning an In-Person Survey of Older Adults to Multi-Mode Data Collection.

The first three rounds of the National Social Life, Health, and Aging Project (NSHAP) were in-person. Preparing for Round Four (R4), NSHAP began developing ways to collect complex questionnaire and biomeasure data remotely. R4 was scheduled to begin in 2020, but due to the coronavirus pandemic, NSHAP delayed R4 data collection and instead conducted a study on respondents' experiences during the pandemic, as well as pretests to strengthen NSHAP's remote data collection capability. This paper describes the methodology, results, and lessons learned from these efforts which were undertaken as a bridge between NSHAP's all in-person past and multimode future. The Covid-19 Study was a multimode survey of NSHAP respondents to assess the impact of the pandemic. The multimode approach allowed evaluation of the feasibility of using different modes of data collection with older adults. NSHAP adapted its in-person questionnaire for phone and web administration and conducted pretests of the full phone questionnaire and sections of the web questionnaire. The project developed and tested a "BioBox," a kit containing all the supplies and instructions for respondents to self-collect biomeasures remotely. The BioBox was tested through an in-lab and in-home pilot, followed by two larger-scale pretests. The Covid-19 Study and pretests achieved NSHAP respondent participation in remote questionnaire and biomeasure collection, despite being accustomed to fully in-person data collection. Our findings and experiences will inform the collection of NSHAP data in future rounds and could inform other panel studies of older adults considering multimode data collection.

Clinical health outcomes of Ebola virus disease survivors eight years post recovery: a cross-sectional study in Sierra Leone.

The West African Ebola virus disease (EVD) epidemic that occurred between 2013-2016 resulted in >28,000 confirmed cases and >11,000 fatalities. Thousands of survivors necessitate an understanding of the long-term health effects and future medical needs of these patients. A cross-sectional study of 595 EVD survivors from Sierra Leone and 403 close contacts (n=998). An in-person survey conducted between November 2021 and March 2022 included demographics, clinical health symptomology assessment of each organ system and a reproductive health assessment including sexual dysfunction question sets. The frequency of each disorder was examined and the association of each disorder with EVD survival was assessed. Of 12 number of symptom types, five were reported by >50% of EVD survivors (Ocular, Neurological, Constitutional, Genitourinary, Dermatological), and all but one were reported by >40% of EVD survivors. Symptom types associated with EVD survival included ENT symptoms (AOR: 8.75, 95% CI: 5.63 - 13.60, p < 0.001), ocular symptoms (AOR: 7.18, 95% CI: 5.02 - 10.25, p < 0.001), dermatological symptoms (AOR: 4.16, 95% CI: 3.06 - 5.65, p < 0.001) and cardiovascular symptoms (AOR: 2.96, 95% CI: 2.12 - 4.13, p < 0.001). The West Africa EVD epidemic resulted in a high prevalence of persistent health issues among disease survivors. Continued support for survivor services in West Africa is crucial, and future outbreak response planning should include dedicated funding to ensure adequate care for survivors, both during the acute phase of infection and throughout the post recovery period.

Impact of a monitoring and evaluation training in 3 PEPFAR-supported countries

BackgroundThe second phase of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) transitioned from scaling up HIV prevention and treatment to promoting sustainability and capacity building for programs monitoring performance and evaluating key program indicators. We assessed the success of a monitoring and evaluation (M&E) curriculum designed to build capacity in three PEPFAR-supported countries. MethodsWe customized M&E trainings based on country-specific epidemic control priorities in Ethiopia, Guatemala, and Cameroon. The M&E curriculum included five modules and three evaluation activities to assess impact: (i) in-person pre-post confidence assessment surveys (CAS), (ii) in-person pre-post knowledge tests (PPKT), and (iii) electronic 6–12 months post-training translating knowledge into practice (TKP) surveys. Pre- and post-training results were compared within and across countries and triangulation with the qualitative data evaluated overall success. ResultsAmong 188 participants attending M&E trainings, 154 (82 %) responded to CAS and 165 (88 %) participants from Ethiopia and Cameroon completed PPKT. Overall CAS scores between pre- and post-test improved [Score mean difference:1.5–1.9]. PPKT indicated statistically significant knowledge gained. One out of five TKP respondents provided direct application examples from the M&E training. ConclusionWhile feedback was predominantly positive overall, revisions were recommended for three of the five modules. Developing a customizable and adaptable M&E curriculum may sustain countries’ ability to monitor their progress towards epidemic control.