Independent Predictors Of Willingness Research Articles

Perceived risk for falls and decision-making in riding raised ramps in mountain biking: a pilot study.

Mountain biking (MTB) is a challenging activity where riders face constant decisions on whether to attempt technical paths or features (e.g., wooden ramps and jumps) that pose risk for falls and injuries. Risk homeostasis theory posits that riders pursue an optimal non-zero level of risk that balances the rewards of attempting challenging features with the need to avoid unreasonable risk for injury. Little is known on how riders judge risk, and the level of risk that riders deem unacceptable. We conducted experiments with experienced MTB riders (n = 17) to examine how their willingness to ride raised wooden ramps depended on their perceived probability for falling (Pf) and their perceived probability for injury in the event of a fall (Pi) while riding the ramp. In one experiment, participants viewed ramps of varying widths and heights and described their willingness to ride each ramp, along with Pf and Pi. We found that Pf and Pi were independent predictors of willingness to attempt ramps. Moreover, the product Pf*Pi (the perceived risk for injury in attempting the ramp) was a stronger predictor than Pf or Pi alone. In a second experiment, participants viewed ramps of different widths, and reported the maximum (threshold) height where they would ride each ramp, along with Pf and Pi. We found that Pf*Pi at the threshold height, averaging 13%, did not vary with ramp width. We conclude that decisions on riding ramps are based on the product Pf*Pi. On average, riders refused to ride ramps when Pf*Pi exceeded 13%.

Willingness to Undergo Gastroscopy for Early Gastric Cancer Screening and Its Associated Factors During the COVID-19 Pandemic - A Nationwide Cross-Sectional Study in China.

This study aimed to investigate the willingness of Chinese adults aged 40 years and older to undergo gastroscopy for gastric cancer (GC) screening during the COVID-19 pandemic in 2020. The secondary purpose was to identify factors influencing willingness to undergo gastroscopy. A cross-sectional questionnaire survey was conducted in selected cities and counties from nine provinces in China using a multi-stage sampling approach. A multivariate logistic regression model was used to determine the independent predictors of willingness to undergo gastroscopy. This study included 1900 participants, and 1462 (76.95%) responded that they would undergo gastroscopy for GC screening. Participants of younger age, from the eastern region, living in an urban area, with higher educational levels, with Helicobacter pylori (H. pylori) infection, or with precancerous stomach lesions, were more willing to undergo gastroscopy. The top four reasons to reject gastroscopy were fear of pain or discomfort, worry about a possible devastating test result, no symptoms in self-feeling, and concern about the high expense. Of all those who would reject gastroscopy for GC screening, 36.76% (161/438) would be willing to accept painless gastroscopy, while 24.89% (109/438) would be willing to undergo gastroscopy screening if higher medical reimbursement rates were available. Participants considered that gastroscopy was a relatively fearful and unknown procedure, accompanied by high risks and benefits compared to all other life events. In general, 76.95% of participants over 40 years old were willing to undergo gastroscopy for GC screening in China during the COVID-19 pandemic. Participants' willingness to undergo GC screening increased due to medical resource constraints and increased interest in their health. Individuals with H. pylori infection are more likely to undergo gastroscopy, whereas old age individuals, those with lower educational levels, and those living in rural areas are more likely to reject gastroscopy.

Willingness to pay for social health insurance and its associated factors among public servants in Addis Ababa, Ethiopia: a cross-sectional study

BackgroundAs a means of establishing a sustained and fair health care financing system, Ethiopia has planned and ratified a legal framework to introduce a social health insurance program for employees of the formal sector to protect them against financial and health burdens. However, the implementation has been delayed due to the resistance of public servants to pay the proposed premium. The aim of this study was to estimate the magnitude of willingness to pay the proposed amount of premium set by the government for the social health insurance program and the factors associated with it among public servants in Addis Ababa, Ethiopia.MethodsAn institution-based cross-sectional study design was used to conduct the study. Multistage sampling was employed to select a total of 503 from 12 randomly selected public sectors. Data were collected using pretested, interviewer-administered structured questionnaires. A contingent valuation method with an iterative bidding game was used to elicit willingness to pay. Finally, logistic regression analysis was used to identify independent predictors of willingness to pay. Statistical significance was considered at P < 0.05 with adjusted odds ratios calculated at 95% CIs.ResultsOnly 35.4% were willing to pay the proposed premium (3% of their monthly salary). Those who had children from 6–18 years old (AOR = 3.252; 95% CI: 1.15, 9.22), had a history of unaffordable health service costs during the last 12 months (AOR = 9.631; 95% CI: 4.12, 22.52), and had prior information about the social health insurance program (AOR = 11.011, 95% CI. 3.735–32.462) were more likely to pay for the proposed social health insurance program compared to their counterparts.ConclusionThe willingness to pay the proposed amount premium for social health insurance among public servants in Addis Ababa was very low that implies the implementation will be challenging. Thus, the government of Ethiopia should consider reviewing the amount of premium contributions expected from employees before implementing the social health insurance scheme.

Willingness and Perceptions Regarding COVID-19 Vaccine Booster Dose in Pakistani Vaccinated Population: A Cross-Sectional Survey.

ObjectivesThis study was conducted to evaluate COVID-19 vaccine booster dose willingness and identify predictors and factors of willingness and hesitance in the vaccinated population of Pakistan.MethodsA cross-sectional web-based survey was undertaken between January and February 2022 to highlight the public perceptions regarding the COVID-19 booster dose and evaluate the willingness to get the additional dose. Demographic information and booster dose willingness were recorded through the questionnaire. Additionally, a 5-point Likert scale was employed to explore fears and beliefs regarding COVID-19 vaccinations. Univariate and multivariate regression was performed to identify booster dose willingness and hesitance factors.ResultsOf the 787 respondents, 69.6% were females, 75.3% fell in the 18–30 years age group, 53.5% were university students or had a Bachelor's degree. Overall, a 77.8% booster dose willingness was reported. Participants showed absence or low fear levels associated with a booster dose (47.3%). 60.1% agreed it was safe to receive an additional vaccine dose, with 44.1% agreeing that boosters are effective against coronavirus variants. Independent predictors of willingness included the absence of comorbidities, whereas not being willing to pay for the booster dose was a predictor of hesitance.ConclusionThis study showed a suboptimal willingness level of booster dose uptake among the vaccinated Pakistani population. Public health policymakers must undertake necessary awareness campaigns to strategize vaccination drives and dispel myths.

Postpartum women\u2019s views on human milk banking in a city in Southeast China: a cross-sectional survey

BackgroundDonor human milk is the best alternative for preterm infants when their mother’s own milk is insufficient or unavailable. The development of human milk banks in China started late, and in most of these banks, the amount of donor human milk is insufficient for clinical demand. Moreover, many mothers are reluctant to use donor human milk due to safety concerns. It is important to understand the potential supply and demand of donor human milk before establishing a new human milk bank. This study aimed to understand women’s acceptance of human milk banking in Wenzhou, southeastern China.MethodsA cross-sectional study was conducted in three community health centers in Wenzhou, southeast China, in December 2020. Data were collected from 305 postpartum women selected through convenience sampling. Sociodemographic, perinatal and breastfeeding characteristics, awareness and knowledge of human milk banking and willingness to donate human milk, and to accept donor human milk were assessed. Multivariable logistic regression analysis was used to explore independent predictors of willingness to donate human milk and to accept donor human milk.ResultsOnly 17% (52/305) of our participants had heard of human milk banking prior to this survey. The prevalence of willingness to donate human milk and use donor human milk in our study was 73.4% (224/305) and 44.6% (136/305), respectively. Employment (adjusted odds ratio [AOR] 2.30; 95% confidence interval [CI] 1.17, 4.50) and human milk banking knowledge (AOR 1.23; 95% CI 1.12, 1.35) were independent predictors of willingness to donate human milk. Monthly household income in the previous year (AOR 2.18; 95% CI 1.17, 4.06), awareness of human milk banking (AOR 2.41; 95% CI 1.24, 4.67) and knowledge of human milk banking (AOR 1.22; 95% CI 1.11, 1.35) were significantly associated with willingness to accept donor human milk.ConclusionsIn our study, awareness of human milk banks among women in the first year postpartum was low. More mothers were willing to donate human milk than to use donor human milk to feed their children. In our study, knowledge of human milk banking was a predictor of both willingness to donate human milk and willingness to use donor human milk. Programs with detailed information on human milk banking are needed to help mothers improve their knowledge and increase acceptance of human milk banking.

Attitude and Information from Health Professionals Were Associated with Decision to Donate Organs among Arabic-Speaking Refugees: Exploring Opportunities for Intervention

Abstract This cross-sectional survey study conducted between May and August 2017 on Arabic-speaking refugees resettled in Australia examined factors associated with willingness to donate organs. Of the 239 respondents, those who expressed greater willingness to donate organs and tissues were more likely to: (a) be Christians; (b) have obtained information from healthcare professionals (HCPs); (c) have higher organ and tissue donation (OTD) knowledge; (d) have a positive attitude towards OTD; and (e) have high English language acculturation levels. Nevertheless, after controlling for English language usage and religion, having a positive attitude towards OTD and receiving information from HCPs emerged as independent predictors of willingness to donate, underscoring the importance of educational interventions by HCPs

Patient Knowledge, Beliefs and Barriers to Hepatitis B Care: Results of a Multicenter, Multiethnic Patient Survey.

A greater understanding of the determinants of health behavior among those with and at-risk of chronic hepatitis B virus (HBV) infection is needed for effective design and implementation of public health initiatives. To determine factors associated with (1) willingness to accept HBV antiviral treatment and (2) satisfaction with provider communication regarding HBV care in a diverse cohort of HBV-infected patients. Using a multifaceted model of health behavior, the Health Behavior Framework, we conducted a comprehensive assessment of knowledge, attitudes, beliefs, and barriers to HBV care. We enrolled 510 patients, with mean age 46years; 53.1% men; and 71.6% Asian or Hawaiian/Pacific Islander. Patients were knowledgeable about HBV infection, but one-fifth did not think that HBV was a treatable disease; over a quarter felt it was so common among family and friends that it did not concern them, and less than half of patients believed they were likely to have liver problems or transmit HBV to others during their lifetime. Perceived susceptibility to disease risk was the only independent predictor of willingness to accept HBV treatment (β = 0.23, p = 0.0005), and contrary to expectations, having a doctor that speaks the same language was predictive of lower patient satisfaction with provider communication about their HBV care (β = - 0.65, p < 0.0001). Patients with greater perceived susceptibility to the health consequences of HBV infection are more likely to accept treatment, and patient-provider language concordance impacts patient satisfaction with communication regarding HBV care in an unexpected direction.

Knowledge and attitudes of medical staff in Chinese psychiatric hospitals regarding COVID-19

On March 11, 2020, the World Health Organization (WHO) declared the novel coronavirus COVID-19 a pandemic. There are patients in psychiatric hospitals in China who have been infected with COVID-19, however, the knowledge and attitudes of psychiatric hospital staff towards infectious diseases and their willingness to work during the COVID-19 outbreak has not yet been investigated. This study was performed to assess the knowledge and attitudes of medical staff in two Chinese mental health centers during the COVID-19 outbreak. We included 141 psychiatrists and 170 psychiatric nurses in the study. We found that during the COVID-19 epidemic, 89.51% of the medical staff of the psychiatric hospitals studied had extensive knowledge of COVID-19, and 64.63% of them received the relevant training in hospitals. Furthermore, about 77.17% of participants expressed a willingness to care for psychiatric patients suffering from COVID-19 virus infection. Independent predictors of willingness to care for patients included advanced training and experience of caring for patients with COVID-19. In conclusion, this study suggests that increased attention should be paid to the knowledge and attitudes of medical staff at psychiatric hospitals during the COVID-19 outbreak.

Knowledge and attitudes of healthcare professionals and the impact on willingness to donate organs: a tertiary hospital survey.

Healthcare professionals (HCPs) working in critical care areas play an important role in the organ donation (OD) process. We studied HCPs' own willingness to be organ donors and its association with sociodemographic factors as well as their knowledge and attitudes about OD and transplantation. A cross-sectional survey of HCPs working in four critical care units in a major transplant centre in Malaysia was undertaken using a validated structured questionnaire. Responses were analysed using multivariable analysis with willingness to donate as the dependent variable. Of the 412 respondents (response rate 98.1%), the majority were nurses (60.4%), Malay (71.1%) and female (77.2%). Overall, 68.0% were willing to donate. The independent predictors of willingness to donate were profession (p < 0.001) and the Hindu religion (p = 0.001). Ethnicity (p = 0.003), religious belief (p < 0.001), knowledge (p = 0.016), belief in brain death (p = 0.018) and confidence in transplantation (p < 0.001) also independently correlated with willingness to donate, while attitudes to OD did not. Of those willing to donate, only 37.3% were carrying a donor card and only 63.1% had informed their family of their intention to donate. Although willingness to donate was higher in critical care HCPs than HCPs in general, significant knowledge gaps as well as certain beliefs and perceptions that could pose a barrier to OD were identified in this group. Measures to improve OD rates in Malaysia should include targeted educational programmes for HCPs working in critical care areas.

Blood Donation Practices of Tertiary Level Students in South Eastern Nigeria: Prevalence and Determinants

Introduction: Safe and adequate blood donation is critical in saving millions of lives annually. In many developing including Nigeria, there is paucity of blood donors.&#x0D; Aim: In this study, we assessed the blood donation practices of tertiary level students in Imo State, South East Nigeria as well as its prevalence and determinants.&#x0D; Methodology: Multistage sampling technique was used. Stage one involved the stratification of the institutions into universities and non-universities. In stage two, one university and one non -university was selected using simple random method. Stage three involved the selection of study participants from the student registry using systematic sampling method. Self-administered questionnaire was the study instrument. Data analysis was with Statistical Package for Social Sciences (IBM – SPSS) version 20.&#x0D; Results: Six hundred (600) undergraduates participated in the study. The mean age of the respondents was 21.3 ± 5.0 years. The one year prevalence of blood donation in this study was 13.8% and 63.1% of the non-donors were willing to donate. Respondents aged 15 – 29 years more willing to donate blood compared to those aged 30 – 44 years (OR = 3.03, p = 0.0003), those that were single were 4 times more willing to donate in comparison to those that were married/divorced (OR = 4.02, p &lt; 0.0001). Respondents that were of Catholic faith were also more willing to donate compared to those that were of Pentecostal/Orthodox denomination (OR = 2.72, p = &lt;0.0001). Class distribution and residence were not independent predictors of willingness to donate blood.&#x0D; Conclusion: From the findings in this study, it was obvious that the willingness to donate blood is far greater than the actual act of donating blood. There is need to continue to reach out to those willing to donate but do not know how to go about it.

Assessment of willingness to uptake male circumcision and associated factors among male students, south west Ethiopia

Background: Male circumcision has been shown to reduce the risk of transmission of HIV. As there was low level of circumcision and high prevalence of HIV/AIDS in Gambella, this study intends to identify predictors of willingness to uptake circumcision among indigenous male college students. Methods: A cross-sectional study was conducted among randomly selected 314 male college students who were selected using simple random sampling technique with self-administered questionnaire from March 27-30, 2014. The data were entered in to computer and analyzed using SPSS for windows version 16.0. Finally, logistic regressions analyses were used to identify independent predictors of willingness to uptake circumcision. To determine any association between the variables; we computed confidence interval of 95% at P. value &lt;0.05. Result: Three hundred fourteen [94%] of them completely filled and return the questionnaire; 99[31.6%] of them didn’t get circumcise and 130[41.4%] of male students believed that they could suffer rejection from their community if they would uptake circumcision. After multivariate logistic regression was employed, the result showed that; students who believed that they get rejected from society if circumcised were less likely to uptake circumcision 0.03 [AOR=.03, 95% CI: 0.01-0.12]. The other result showed that, as age of students increases by one year the odd of willingness to uptake circumcision also increases by 0.84 and the result was statistically significant [AOR=0.84, 95% CI: 0.71-0.99]. Perceived threat was also significantly associated and students who perceived HIV/AIDS as a high threat to them were about 1.28 times more likely willing to uptake circumcision [AOR=1.28, 95% CI: 1.10-1.53]. The other predictor variable was knowledge of students; per a unit increases in total score of knowledge the odds of willingness to uptake circumcision was increased by 1.5 folds [AOR=1.5, 95% CI: 1.13-2.08]. Conclusion: High perceived threat, knowledge, age and fear of rejection by society were the main predictors of willingness to uptake circumcision among male students. Therefore, designing communication strategies that directly address these factors should be implemented. Men who were willing to uptake circumcision should be provided access to high-quality male circumcision surgical services. It is also highly recommended providing accurate information that would increase the perceived threat of adolescents; reinforcement of messages regarding the importance of HIV risk-reduction strategies. Finally addressing these issues of adolescents at school or different institutional levels might be crucial and easier than shifting population-level norms around male circumcision in future strategies.

Is self-sampling to test for high-risk papillomavirus an acceptable option among women who have been treated for high-grade cervical intraepithelial neoplasia?

ObjectiveSelf-sampling to test for high risk human papilloma virus (HPV) is becoming an increasingly important component of cervical cancer screening. The aim of this observational study is to examine how women treated for high-grade cervical intraepithelial neoplasia (CIN) view HPV self-sampling.MethodsInvited to participate in the present study were patients who had undergone treatment of high-grade CIN (grade 2 or higher) and were followed-up at 6-months at the Karolinska University Hospital, Stockholm. The participants were instructed as to how to perform HPV self-sampling. Thereafter, the participants completed a questionnaire about HPV self-sampling and other cervical cancer screening methods, as well as about self-perceived risk of cervical cancer without regular gynecologic follow-up and about specific knowledge regarding HPV, CIN and cervical cancer.ResultsAltogether 479 women enrolled in this study. The participation rate was 96.6%. Nearly 75% of the participants stated they would consider performing the HPV self-sampling prior to their next gynecologic follow-up. Confidence in HPV self-sampling was a significant independent predictor of willingness to perform HPV self-sampling. However, confidence in HPV self-sampling was significantly lower than confidence in Papanicolaou smears and in HPV testing with samples collected by health professionals. Higher specific knowledge about HPV, CIN and cervical cancer was also a significant independent predictor of willingness to perform HPV self-sampling, as was having travelled longer distance to attend gynecologic follow-up. Participants with lower income and without completed university education expressed significantly higher confidence in HPV self-sampling and lower confidence in Papanicolaou smears than the other women.ConclusionsTo the best of our knowledge, this is the first study to examine the views of women treated for high-grade CIN vis-à-vis HPV self-sampling. The latter is an acceptable option for the vast majority of this cohort of women.

Deterrents to Organ Donation: A Multivariate Analysis of 766 Survey Respondents

Although successful on many fronts, solid organ transplantation fails patients who die on waitlists. Too few organ donors beget this failure. Dispelling misperceptions associated with donation and transplantation would expectedly increase donation and decrease waitlist mortality; recipients would also receive transplants earlier in their disease process, leading to better post-transplantation outcomes. Survey responses to 7 questions pertaining to organ donation and transplantation were analyzed to determine their association with willingness to donate. Subgroup analyses according to race, residence status (rural vs nonrural), and education level were performed. There were 766 respondents; 84.6% were willing to be a donor, 76.2% were female, 79.7% were Caucasian, and 16.5% were African-American. Having concerns about getting inadequate medical care if registered as a donor was the strongest independent predictor of willingness to donate overall (odds ratio 0.21; 95% CI 0.13 to 0.36) and in each subgroup; African Americans were more likely than Caucasians to have this concern (20.2% vs 9.5%; p< 0.001). Race (odds ratio 0.41; 95% CI 0.22 to 0.75 for African Americans) and age were also predictive overall, but less so. Willingness to donate a family member's organs depended on whether a discussion about donation had hypothetically occurred: 61.0% would donate if there had been no discussion; 95.2% would donate if the family member had said "yes" to donation; and 11.0% would donate if the family member had said "no" (p < 0.001). If there was no prior discussion, having concerns about getting less-aggressive medical care predicted willingness to donate a family member's organs (odds ratio 0.40; 95% CI 0.25 to 0.65). The strongest deterrent of willingness to donate one's own or a family member's organs is a misperception that should be correctable. Race and age are less predictive. Efforts to dispel misperceptions and increase donation remain desperately needed to improve waitlist mortality and post-transplantation outcomes.

Patient Willingness to Have Tests to Guide Antibiotic Use for Respiratory Tract Infections: From the WWAMI Region Practice and Research Network (WPRN).

The majority of consultations for acute respiratory tract infections (RTIs) lead to prescriptions for antibiotics, which have limited clinical benefit. We explored patients' willingness to have blood tests as part of the diagnostic work-up for RTIs, and patient knowledge about antibiotics. Patients at 6 family medicine clinics were surveyed. Regression modeling was used to determine independent predictors of willingness to have venous and point-of-care (POC) blood tests, and knowledge of the value of antibiotics for RTIs. Data were collected from 737 respondents (response rate 83.8%), of whom 65.7% were women, 60.1% were white, and 25.1% were current smokers; patients' mean age was 46.9 years. Sex (female), race (white), and a preference to avoid antibiotics were independent predictors of greater level of antibiotic knowledge. A total of 63.1% were willing to have a venous draw and 79% a POC blood test, to help guide antibiotic decision-making. Non-American Indian/Alaskan Native race, current smoking, and greater knowledge of antibiotics were independent predictors of willingness to have a POC test. A large majority of patients seemed willing to have POC tests to facilitate antibiotic prescribing decisions for RTIs. Poor knowledge about antibiotics suggests better education regarding antibiotic use might influence patient attitudes towards use of antibiotics for RTIs.

Community Willingness to Participate in a Dengue Study in Aceh Province, Indonesia.

BackgroundDengue virus infection is the most rapidly spreading vector-borne disease in the world. Essential research on dengue virus transmission and its prevention requires community participation. Therefore, it is crucial to understand the factors that are associated with the willingness of communities in high prevalence areas to participate in dengue research. The aim of this study was to explore factors associated with the willingness of healthy community members in Aceh province, Indonesia, to participate in dengue research that would require phlebotomy.Methodology/Principal FindingsA community-based cross-sectional study was carried out in nine regencies and municipalities of Aceh from November 2014 to March 2015. Interviews using a set of validated questionnaires were conducted to collect data on demography, history of dengue infection, socioeconomic status, and knowledge, attitude and practice regarding dengue fever. Two-step logistic regression and Spearman’s rank correlation (rs) analysis were used to assess the influence of independent variables on dependent variables. Among 535 participants, less than 20% had a good willingness to participate in the dengue study. The factors associated with good willingness to participate were being female, working as a civil servant, private employee or entrepreneur, having a high socioeconomic status and good knowledge, attitude and practice regarding dengue. Good knowledge and attitude regarding dengue were positive independent predictors of willingness to participate (OR: 2.30 [95% CI: 1.36–3.90] and 3.73 [95% CI: 2.24–6.21], respectively).Conclusion/SignificanceThe willingness to participate in dengue research is very low among community members in Aceh, and the two most important associated factors are knowledge and attitude regarding dengue. To increase participation rate, efforts to improve the knowledge and attitude of community members regarding dengue fever and dengue-related research is required before such studies are launched.

Awareness of and Willingness to Use Oral Pre-Exposure Prophylaxis for HIV Prevention among HIV-Serodiscordant Heterosexual Couples: A Cross-Sectional Survey in Xinjiang, China

ObjectivesWe aimed to investigate the awareness of and willingness to use oral pre-exposure prophylaxis (PrEP) for HIV prevention among HIV-negative partners in HIV-serodiscordant heterosexual couples in Xinjiang, China and determine factors that predict willingness to use oral PrEP.MethodsBetween November 2009 and December 2010, a cross-sectional survey was carried out among 351 HIV-negative partners in HIV-serodiscordant heterosexual couples from three cities in Xinjiang, China. Participants completed a self-administered questionnaire to assess their awareness of and willingness to use oral PrEP. Additionally, blood samples were collected to test for HIV infection. Univariate and multivariate logistic regression analyses were performed to identify predictors of willingness to use oral PrEP.ResultsOnly 10 participants (2.8%) reported having heard of PrEP, and only two reported ever using PrEP. However, 297 (84.6%) reported that they were willing to use oral PrEP if it was proven to be both safe and effective. Results of multivariate analysis revealed the following independent predictors of willingness to use oral PrEP: monthly household income (adjusted odds ratio = 2.78, <1000 RMB vs. ≥1000 RMB, 95% confidence interval: 1.36–5.69), perceived likelihood of contracting HIV from HIV-positive partner (adjusted odds ratio = 2.63, likely vs. unlikely, 95% confidence interval: 1.12–6.19), and worrying about being discriminated against by others due to oral PrEP use (adjusted odds ratio = 9.43, No vs. Yes, 95% confidence interval: 3.78–23.50).ConclusionsOur results showed HIV-negative partners in HIV-serodiscordant heterosexual couples in China had low awareness of oral PrEP but high willingness to use oral PrEP for HIV prevention. Cost of oral PrEP should be taken into consideration in future PrEP prevention strategy. In addition, efforts should be made to reduce stigma attached to oral PrEP use, which may increase its acceptability among potential users.

Abstract B18: Race and trust as predictors of willingness to recommend HPV vaccination

Abstract Racial disparities in cervical cancer incidence and mortality persist, with incidence rates highest among Latinas and mortality rates highest among Black women compared to other racial/ethnic groups. Routine vaccination against high-risk human papilloma virus (HPV) types that are causally associated with cervical cancer is recommended for females aged 11–12, with use by females as young as 9 years. Studies indicate a broad range in rates of vaccine acceptability among parents and caregivers but little attention has been paid to sociocultural factors that influence acceptability across racial groups. One such factor that may play a central role in vaccine acceptability is healthcare-related trust, a variable that often differs across racial groups and is typically lower in communities of color compared to whites. Therefore, the goal of the current study was to examine the association between race, healthcare-related trust, and willingness to recommend the HPV vaccine to younger female relatives in a diverse urban sample of adult women. Participants were 2147 women age 27 and older (mean age=49 years) recruited through a quota sampling strategy in Queens, NY as part of a larger intervention study. All participants completed street intercept interviews that asked about basic sociodemographic and healthcare information, one's prior awareness of the HPV vaccine, and whether one would recommend the vaccine to a daughter or other family members. Participants were also asked the extent to which they trusted doctors and hospitals. Approximately 60% of the sample self-identified as African American or Latino and the remainder as White or Asian. Seventy-six percent reported that they had heard of the HPV vaccine previously. Multivariable logistic regression that included only sociodemographic and healthcare variables revealed that, compared to Latinas, Black (OR=.522, 95% CI: .400 − .683, p&amp;lt;.0001), Asian (OR=.644, 95% CI: .476 − .873, p&amp;lt;.005), and White women (OR=.521, 95% CI: .394 − .687, p&amp;lt;.0001) were less likely to be willing to recommend HPV vaccination, in addition to those with no awareness of the HPV vaccine before the interview (OR=.656, 95% CI: .528 − .815, p&amp;lt;.0001). Women of higher education levels (OR=1.233, 95% CI: 1.018 − 1.492, p&amp;lt;.03) and those adherent to pap test guidelines (OR=.594, 95% CI: .472 − .746, p&amp;lt;.0001) were more likely to be willing to recommend. The next set of analyses examined the effect of trust on willingness to recommend the vaccine across racial groups, in addition to the other sociodemographic and healthcare variables. Trust emerged as a significant independent predictor of willingness to recommend for Latinas (OR=1.312, 95% CI: 1.037 − 1.660, p&amp;lt;.02), Black (OR=1.838, 95% CI: 1.462 − 2.310, p&amp;lt;.003), and Asian (OR=1.651, 95% CI: 1.192 − 2.287, p&amp;lt;.003) women but not for White women (OR=1.257, 95% CI: .979 − 1.612, p&amp;lt;.07). Results suggest that Latina and Black women who report low trust in providers and healthcare settings are an important focus for interventions related to increasing knowledge and uptake of HPV vaccination. Future work may also further explore other factors in addition to trust that account for greater willingness to recommend vaccination among Latinas and investigate their relevance, strength, and mutability in other racial groups. Citation Information: Cancer Prev Res 2011;4(10 Suppl):B18.

Cross-Cultural Dimensions of Meaning in the Evaluation of Events in World History?

The universality versus culture specificity of quantitative evaluations (negative-positive) of 40 events in world history was addressed using World History Survey data collected from 5,800 university students in 30 countries/societies. Multidimensional scaling using generalized procrustean analysis indicated poor fit of data from the 30 countries to an overall mean configuration, indicating lack of universal agreement as to the associational meaning of events in world history. Hierarchical cluster analysis identified one Western and two non-Western country clusters for which adequate multidimensional fit was obtained after item deletions. A two-dimensional solution for the three country clusters was identified, where the primary dimension was historical calamities versus progress and a weak second dimension was modernity versus resistance to modernity. Factor analysis further reduced the item inventory to identify a single concept with structural equivalence across cultures, Historical Calamities, which included man-made and natural, intentional and unintentional, predominantly violent but also nonviolent calamities. Less robust factors were tentatively named as Historical Progress and Historical Resistance to Oppression. Historical Calamities and Historical Progress were at the individual level both significant and independent predictors of willingness to fight for one’s country in a hierarchical linear model that also identified significant country-level variation in these relationships. Consensus around calamity but disagreement as to what constitutes historical progress is discussed in relation to the political culture of nations and lay perceptions of history as catastrophe.

Public opinion of a stroke clinical trial using exception from informed consent

BackgroundAcute stroke is a leading cause of morbidity and mortality. Clinical trials in stroke are challenging because victims often do not have the capacity to provide informed consent, excluding those patients most likely to benefit from the research.AimWe evaluated patient willingness to participate in a hypothetical acute stroke trial using an exception from informed consent.MethodsConsecutive patients presenting to four emergency departments (EDs) underwent structured interviews regarding a hypothetical stroke trial using an exception from informed consent.ResultsOf 461 (72% of eligible) participants, 55% (95% CI, 50%–59%) were willing to be enrolled in the hypothetical study without giving informed consent. After multivariable analysis, independent predictors of willingness to enroll included Catholic religion (OR 1.57, 95% CI 1.17–2.10) and belief that current therapy offers a >50% chance of full recovery (OR 1.29, 95% CI 1.05–1.57). There was no difference between the proportion willing to enroll in a cardiac arrest study vs. a stroke study (55% vs. 55%, p = 0.83)ConclusionsFifty-five percent of ED patients would be willing to be enrolled in a stroke trial using exception from informed consent.

Implantable cardioverter-defibrillator deactivation at the end of life: A physician survey

Among older adults, implantable cardioverter-defibrillator (ICD) use is increasing. ICD shocks can occur at end of life (EOL) and cause substantial distress, warranting consideration of ICD deactivation discussions. This nationwide physician survey sought to (1) determine if physicians discuss ICD deactivation at the EOL, (2) identify predictors of those discussions, and (3) ascertain physicians' knowledge/attitudes about ICD use. We surveyed 4,876 physicians stratified by specialty (cardiologists, electrophysiologists, general internists, and geriatricians). The mailed survey presented 5 vignettes (eg, end-stage chronic obstructive pulmonary disease, advanced dementia) wherein ICD deactivation might be considered and 17 Likert-scaled items. Five hundred fifty-eight (12%) physicians returned surveys. Respondents were largely men (77%) and white (69%). Most physicians (56%-83%) said they would initiate deactivation discussions in all 5 vignettes, whereas significantly more (82%-94%) would discuss advance directives and do not resuscitate status. In logistic regression analyses, a history of prior deactivation discussions was an independent predictor of willingness to discuss deactivation (adjusted OR range, 2.8-8.8) in 4 of the 5 vignettes. General internists and geriatricians were less likely than electrophysiologists to agree that ICD shocks are painful and to distinguish between the ICD's pacing and defibrillator functions. Finally, most physicians believed that informed consent for ICD implantation should include information about deactivation (77%) and endorsed the need for expert guidance in this area (58%). Most physicians would discuss ICD deactivation at EOL. The strongest predictor of this was a history of prior discussions. Knowledge about ICDs varies by specialty, and most expressed a desire for more expert guidance about ICD management at EOL.