Life Survey Research Articles

Wakanda forever! Consistency in correlates of black nationalist tendencies

Wakanda forever! Consistency in correlates of black nationalist tendencies

Abstract PO3-10-10: Are we adequately integrating patient reported outcomes in breast cancer clinical trials?

Abstract Background: Integrating patient reported outcomes (PROs) in cancer care enhances clinical outcomes and creates a paradigm shift in providing patient-centered care. Several studies performed in the past 15 years have demonstrated that systematic monitoring of patients using PROs through surveys improve patient-clinician communication, clinician awareness of symptoms, symptom management, patient satisfaction, quality of life, and overall survival. There has been uncertainty over the type of PRO system to implement in cancer care, how to evaluate PRO in clinical trials, and how to compare this to the clinician common terminology criteria for adverse events (CTCAE). The PRO concept was first introduced in 1975 with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life (QoL) survey. In May 2018, the National Cancer Institute established the PRO-CTCAE to be utilized for cancer patients to report and grade their treatment related adverse events, like that of clinician reported CTCAE. The goal of our study was to evaluate frequency of PRO incorporation in phase III breast cancer clinical trials. Methods: New England Journal of Medicine, Journal of Clinical Oncology, and Lancet were systematically searched to identify phase III breast cancer clinical trials published between January 2018 and June 2023. A total of 113 phase III studies were identified, 87 of which had reported protocols. Studies that did not demonstrate protocols on these search engines were not included in the review. Of these 87 clinical trials, 36 studies documented evaluation of PRO. These studies were segregated by year of publication. For each year, the number of total phase III breast cancer clinical trials that were published were compared to those that were published and evaluated PRO. A percentage was generated and allowed for a longitudinal trend to be analyzed over a 5-year period to assess if there was improved frequency of PRO integration into breast cancer clinical trials. Summary statistics were calculated using SAS 9.4. Results: 36 of 113 trials demonstrated PRO use and 26 utilized EORTC-QoL, 1 used PRO-CTCAE, and 9 used another measure of PRO assessment within their study protocol (such as FACT-B and PHQ-9. Additionally, in 2018, 33% of published breast cancer studies included PRO data. Since then, there have been fluctuations in breast cancer studies collecting PRO; 2019: 33%, 2020: 47%, 2021: 43%, 2022: 73%, and since the start of 2023: 9%. Conclusions: Our data suggests a trend towards improvement in frequency of PRO data collection in breast cancer clinical trials over the past 5 years, exemplified by the marked increase in 2022. There remains a need to incorporate PROs in clinical trials and routine care to improve patient experience and provide patient-centered care. Citation Format: Yadav Rina, Zhengyan Huang, Jessica Moss, Garima Gupta. Are we adequately integrating patient reported outcomes in breast cancer clinical trials? [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-10-10.

Abstract PO5-12-06: Minimization of treatment toxicity/side effects and their impact on quality of life (QoL) in patients (pts) with ER+/HER2- metastatic breast cancer (mBC)

Abstract Introduction: Treatment toxicity and side effects may be underreported (Basu Roy. J Thorac Oncol 2018:13:1815-17) and can negatively impact QoL. As such toxicities can influence pts’ treatment decisions, we surveyed pts with ER+/HER2- mBC to better understand the impact and patient reporting accuracy of treatment toxicities/side effects. Methods: The EQUALS 3 (ESR1 QUAlity of Life Survey 3), 55-question survey was designed by the EQUALS Steering Committee, trialed by pt advocates, emailed to US subjects (Cure Media Group and authors’ contacts), and posted to private BC Facebook and Twitter groups for 2 wks in June 2023. Eligible pts had ER+/HER2- mBC and treatment changes due to disease progression. Pts received a $10 gift card at survey completion. Survey answers were descriptively summarized. Results: 213 pts completed the survey. Most were < 60 yrs of age (77%), White (44%) or Hispanic/Latino (48%), peri-/postmenopausal (54%), and college-educated (71%); had income >$50,000 (66%); lived in urban (51%)/rural areas (22%); and had therapy lines of 1st (8%), 2nd (36%), or 3rd+ (51%). Current mBC treatments were endocrine therapy (ET) ± targeted therapies (70%), antibody drug conjugate (8%), chemotherapy (11%), and other (10%). Most pts had a female oncologist (65%) who worked in an academic hospital (61%); 68% had >1 oncologist. Surveyed pts reported toxicity concerns for side effects ranging from serious to nuisance. Side effects most frequently reported as extremely/moderately concerning were respiratory symptoms (51%), blood clots in lungs (49%) or heart/brain (47%), cognitive dysfunction (47%), infections (46%), nausea/vomiting (44%), cardiac adverse effects (44%), diarrhea (42%), gait instability (41%), fatigue (39%), joint pain (39%), hair loss (33%), or sexual dysfunction (27%). Although 49% of pts felt comfortable speaking to their medical team (MT) about side effects, 62% reported having minimized side effects to their MT due to fears/concerns of being seen as a complainer (70%), dose reduction (66%), being taken off drug (65%), not accessing other drugs with similar toxicities (61%), reduced efficacy with lower dose (59%), or coming off trial (47%). Almost half (47%) did not report treatment side effects, mostly due to fear of being seen as a complainer (63%), being taken off drug (57%), reduced efficacy with lower dose (51%), dose reduction (50%), not accessing other drugs (50%), or coming off trial (41%). QoL was poor/very poor in 20% of pts and QoL was the most common (68%) important/very important factor for making a treatment decision based on risks. Most common side effects that negatively impacted QoL were sexual dysfunction (45%), joint pain (38%), vaginal atrophy/dryness (36%), fatigue (33%), bone pain (31%), and hair loss (26%). Toxicities/side effects also impacted pts’ anxiety (49%), career (46%), marriage (42%), finances (32%), housework (30%), and relationships (19%). Regret after taking a cancer medication due to side effects was reported by 46% of pts. Conclusion: In this survey of pts with ER+/HER2- mBC on ET predominantly, many treatment side effects caused concern, not necessarily related to their seriousness, and most pts had minimized or hid side effects at some point due to fear of negative perceptions from their MT, reduced treatment efficacy, or clinical trial changes. Although QoL was overall good for most, 20% had poor QoL (largely impacted by sexual dysfunction, joint pain, and vaginal issues). Regret about toxicities was also common and should be explored. Provider awareness of pts’ toxicity experience, fears, and impacts on daily lives opens the door for educational tools to improve MT communications for treatment decisions, informed consent, and more accurate toxicity reporting in clinical trials. Citation Format: Sarah Sammons, Jane Meisel, Kelly Shanahan, Timothy Pluard, Fumiko Chino, Dario Trapani, Dominic Carroll, Monica Kozlowski, Elizabeth Attias, Nicole Kuderer. Minimization of treatment toxicity/side effects and their impact on quality of life (QoL) in patients (pts) with ER+/HER2- metastatic breast cancer (mBC) [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-12-06.

Abstract PO3-12-05: Patient (pt)-provider communication challenges about side effects/toxicities from metastatic breast cancer (mBC) treatments

Abstract Introduction: Treatment decisions for ER+/HER2- mBC may be influenced by pt knowledge about treatment side effects, which is shaped by pt-provider communication. We conducted a survey of pts with ER+/HER2- mBC to better understand pt expectations and experiences of treatment toxicities, the extent they were discussed by the pts’ medical team (MT), and the sources/types of side effect information pts prefer. Methods: The 55-question, online ESR1 QUAlity of Life Survey 3 (EQUALS 3) survey was emailed to US pts from the Cure Media Group and authors’ contacts, and posted to private BC Facebook and Twitter pt groups for 2 weeks in June 2023. Eligible pts had ER+/HER2- mBC and reported changing treatments due to progression. Pts received a $10 gift card at survey completion. Survey answers were descriptively summarized. Results: 213 pts completed the survey; they were < 60 yrs of age (77%), White (44%) or Hispanic/Latino (48%), peri-/postmenopausal (54%), and urban-area residents (51%); and had college education (71%) and household income >$50K (66%). Most pts were on 2nd (36%) or 3rd+ (51%) therapy lines. Current mBC treatments were endocrine therapy ± targeted agent (70%), antibody-drug conjugate (8%), chemotherapy (11%), and others (10%). Most pts’ oncologists were female (65%), BC specialists (51%), and from an academic hospital (61%). Only half (49%) of surveyed pts felt extremely/very comfortable discussing side effects with their MT. Although 86% felt well informed about treatment toxicities, MTs did not proactively ask about pts’ greatest concerns on side effects for 15% of pts, nor about what side effects pts would find tolerable or intolerable for 25%. Oncologist/MT inquired about acceptability of side effects most often with treatment change (25%) or when brought up by the pt (20%), and at every single visit for only 19% of pts. Most pts felt extremely prepared for treatment toxicities (78%) and well prepared to manage them (86%), but 19% of pts still felt that their MT did not provide optimal guidance on managing potential side effects. Pt-centered conversations were most often missing: what rare but serious side effects to expect (44%), how to deal with potential side effects (39%), and what common side effects to expect (32%). Pts also reported that the likelihood of experiencing side effects (40%), what rare but serious side effects to expect (39%), and how to deal with potential side effects (28%) were not well presented. To facilitate treatment decisions, pts would like more time discussing treatment options (48%) or side effects (39%); additional written or visual resources on side effects (29%, 23%, respectively) or efficacy (39%, 8%); and the ability to ask questions and receive meaningful answers (39%), talk to other pts (20%), or listen to videos of their stories (11%). Pt testimonials (45%), toxicity descriptions/examples (42%), and toxicity management strategies (36%) were the most common additional forms of information that pts would like to have had on side effects. Conclusion: In this survey of pts with ER+/HER2- mBC, not all pts were comfortable discussing treatment toxicities with their MT, but MTs are mostly addressing side effects. However, there is still room for communication improvement and additional forms of toxicity information are needed for optimal decision-making. Despite generally feeling well prepared for toxicities, a significant proportion of pts report that the range and specifics of side effects and how to manage them were missing or not well presented in MT discussions. This survey highlights the need to improve both provider and pt education with the goal of effectively communicating toxicity specifics of mBC therapies, as well as the need for standardized pt education tools detailing risks and benefits of mBC therapies to assist pts in shared decision-making conversations. Citation Format: Sarah Sammons, Jane Meisel, Timothy Pluard, Kelly Shanahan, Fumiko Chino, Dario Trapani, Dominic Carroll, Monica Kozlowski, Elizabeth Attias, Nicole Kuderer. Patient (pt)-provider communication challenges about side effects/toxicities from metastatic breast cancer (mBC) treatments [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-12-05.

Rehabilitation Protocol for Children with Chest Tube for Pleural Effusion: A Quasi-Experimental Pre- and Post-test Study

Abstract Objective: The objective is to evaluate the effectiveness of a structured rehabilitation protocol on respiratory function and overall recovery in children with chest tubes for pleural effusion. Materials and Methods: A quasi-experimental pre-test and post-test design was employed. Thirty children aged 5–12 years with chest tubes for pleural effusion were enrolled. Participants were assessed before and after the intervention using pulmonary function tests (PFTs), physical activity levels and quality of life (QoL) surveys. The rehabilitation protocol included breathing exercises, physical therapy and educational sessions for patients and caregivers. Results: Significant improvements were observed in PFTs, physical activity levels and QoL scores post-intervention (P < 0.05). Conclusion: The structured rehabilitation protocol was effective in enhancing respiratory function and overall recovery in paediatric patients with chest tubes for pleural effusion.

Treatment Goals and Symptoms of Patients Presenting to a Center for Fibroid Care [ID 2683523

INTRODUCTION: Multidisciplinary fibroid centers represent a new model of fibroid care. We evaluated the goals and symptoms of patients presenting to our center. METHODS: This is a retrospective cohort study of patients presenting between June 2022 and June 2023. Patients were sent the Uterine Fibroid Symptom Quality of Life (UFS-QOL) survey and a goals questionnaire prior to first appointment. Patients who completed both were included. We obtained age, race, most recent hemoglobin level (Hgb), largest fibroid type on most recent imaging, composite symptom severity score (SS), and health-related QOL score (HRQL). This study met IRB exemption criteria. RESULTS: Of 581 patients, 326 (56%) completed both surveys. Mean age was 43.0 years (SD 8.0). Patients identified as Black (35.3%), White (24.8%), Asian (8.9%), and other/multiple race (7.7%). Most patients' largest fibroid was subserosal (37%), followed by intramural (28.7%), submucosal (5.9%), and combined type (28.3%). There was no difference in SS (P=.307) or HRQL (P=.504) between these groups. Most patients (60.7%) selected a top goal of symptom elimination, followed by treating anemia (21.2%) and becoming pregnant (18.1%). Almost a quarter (26.4%) reported difficulty conceiving, and they had higher SS (mean difference [MD] −6.1; 95% CI, −12.1, −0.6) and lower HRQL (MD 7.2; 95% CI, 0.4, 14.0). Patients with Hgb below 12 had higher SS (MD −8.6; 95% CI, −14.6, −2.7) and lower HRQL (MD 8.0; 95% CI, 1.1, 15.0). CONCLUSION: Most patients reported a primary goal of symptom elimination. Difficulty conceiving and low Hgb were associated with worse symptoms, yielding insight into treatment opportunities affecting QOL.

Prospective Monocentric Study About Quality of Life Survey After Embolization of Pelvic Varicose Veins in Women with Pelvic Veinous Disorders

Prospective Monocentric Study About Quality of Life Survey After Embolization of Pelvic Varicose Veins in Women with Pelvic Veinous Disorders

1624: Evaluating the impact of radiotherapy late effects against the NHS Cancer Quality of Life survey

1624: Evaluating the impact of radiotherapy late effects against the NHS Cancer Quality of Life survey

Family dysfunction, stressful life events, and mental health problems across development in the offspring of parents with an affective disorder.

Offspring of parents with affective disorders (OAD) are at risk of developing a wide range of mental disorders. Deficits in the rearing environment and high levels of stress are well-known risk factors for negative outcomes in OAD. Building on prior research, we aim to examine the longitudinal relationships between family dysfunction, stressful life events, and mental health in OAD and control offspring of parents with no affective disorder. In the present study, we hypothesized that high levels of family dysfunction would be associated with more internalizing and externalizing problems across time in OAD than in controls, and that family dysfunction would mediate the relationship between stressful life events in adolescence and poor mental health in adulthood, particularly in OAD. As part of the TRacking Adolescents' Lives Survey (TRAILS), 2230 participants (51% female, Mage = 11.1 years, SD = 0.6, at baseline) and their parents completed measures across six time points, spanning 15 years. Mental health, family dysfunction, and stressful life events were assessed with the Youth and Adult Self-Report, Family Assessment Device, and an in-house measure, respectively. Multi-group structured equation modeling revealed that family dysfunction was linked to internalizing and externalizing problems in OAD, but not controls, across time. Risk status did not moderate family dysfunction's mediation of the relationship between stressful life events and negative outcomes in adulthood. OAD show high sensitivity to dysfunction in the rearing environment across childhood and adolescence, which supports the use of family based interventions to prevent the development of mental disorders in high-risk youth.

Violence Victimization and Depressive Symptoms Among a Sub-Sample of Sexual and Gender Minority Adults in a Population-Based South African Study.

Sexual and gender minority (SGM) adults in South Africa face high levels of violence and poor mental health outcomes. Interventions to prevent these negative health implications are hampered by a lack of representative data among this population. This study aims to quantify the associations between three forms of violent victimization and depressive symptoms in a sub-sample of SGM drawn from a population-based cross-sectional study in Gauteng, South Africa. Data come from the sixth Quality of Life survey conducted in South Africa's Gauteng province. Brief screeners assessed childhood sexual abuse (CSA), past-year intimate partner violence (IPV), non-partner violence, and depressive symptoms. Three survey-weighted logistic regression analyses were fit to model associations between elevated depressive symptoms and CSA, past-year IPV, and past-year non-partner violence, controlling for socio-demographics (age, race, sex, area of residence, education, socioeconomic status, and recent employment). N = 1,328 SGM respondents were included. Over 40% (n = 537) reported depressive symptoms, while 17% (n = 222) reported CSA, 5% (n = 67) reported IPV, and 16% (n = 208) reported non-partner violence. CSA and non-partner violence were associated with significantly higher odds of reporting depressive symptoms (aOR: 1.51, 95% CI [1.03, 2.23]; aOR: 1.84, [1.24, 2.73], respectively). IPV was not associated with elevated depressive symptoms (aOR: 1.17, [0.64, 2.16]). In all models, employment in the past 7 days was associated with significantly lower odds of reporting depressive symptoms. Recent and childhood violence is a major burden that is associated with elevated symptoms of depression among SGM in urban South Africa. Community-tailored interventions and policy-related advocacy related to employment and violence prevention may alleviate depressive symptoms in SGM adults in Gauteng.

The Metamorphosis of Patient Priorities Throughout the Breast Reconstruction Process.

Breast reconstruction is a lengthy, multistage process guided by patients. It is vital to understand how their goals vary over time to achieve optimal outcomes. This study aimed to evaluate how breast reconstruction patients' priorities changed throughout the reconstructive process. Fifty women who underwent immediate breast reconstruction completed a quality of life survey at their preoperative appointment, 3, 6, and 12 months after surgery, and then again 10 years later. Scores on the survey's subsections corresponded to different patient priorities: survival, restitution, symmetry, and enhancement. The relationship between time and survey-measured patient priorities was analyzed with mixed-effects regression models and Tukey's HSD (honestly significant difference) tests were performed to make pairwise comparisons between time points. Survival scores decreased between 3 and 12 months after surgery (P < .001) before returning to baseline at long-term follow-up. Restitution scores were decreased only at 12 months postoperatively (T3 vs T0, T1, and T2, P < .001; T3 vs T4, P = .003). Symmetry scores increased from preoperatively to 6 months postoperatively (P < .001), and then fell back to baseline by month 12 (P < .001) and remained at that level at long-term follow-up. Enhancement scores increased from preoperatively to 12 months after surgery (P < .001), before returning to baseline at 10-year follow-up (T0 vs T4, P > .99; T3 vs T4, P < .001). Time had an overall significant effect on each subsection score (P < .001), but this relationship was restricted to certain time points. In the year following immediate breast reconstruction, patients' concern over their physical health decreases while they become increasingly focused on enhancing the appearance of their reconstructed breasts. However, by 10 years after surgery, patients' priorities were virtually unchanged from their preoperative desires.

Protocol on establishing a national disease registry-Swiss Pediatric Inflammatory Brain Disease Registry.

Pediatric-onset inflammatory brain diseases are a group of potentially life-threatening central nervous system disorders. Overall, pediatric-onset inflammatory brain diseases are rare and therefore difficult to study. Patient registries are well suited to study the natural history of (rare) diseases and have markedly advanced the knowledge on pediatric-onset inflammatory brain diseases in other countries. Following their example, we established a national pediatric-onset inflammatory brain disease registry in Switzerland (Swiss-Ped-IBrainD). The Registry aims to describe epidemiology, demographics, diagnostics, management, and treatment, since these areas remain understudied in Switzerland. Additionally, we want to promote research by fostering the knowledge exchange between study centers and setting up studies such as national quality of life surveys. We further aim to facilitate the access to national and international studies for patients with a pediatric-onset inflammatory brain disease living and/or treated in Switzerland. The Swiss-Ped-IBrainD is a multicentric, population-based, observational cohort study (IRB number: 2019-00377) collaborating with 11 neuropediatric centers in Switzerland. Patient screening, information and recruitment is mainly conducted by the local principal investigators. The data collection is organized centrally by the Executive Office of the registry. The collected data is purely observational. Medical records are the primary data source. All patients who have been diagnosed with a pediatric-onset inflammatory brain disease since 2005 are eligible. We aim to include all pediatric-onset inflammatory brain disease patients living and/or treated in Switzerland who meet the inclusion criteria. Considering existing literature and our single-center experience we anticipate 300-400 eligible patients. Currently, all 11 neuropediatric centers have been initiated and are recruiting. As of the first of May 2023, we have identified 275 eligible participants and obtained informed consent from 101 patients and/or families. None of the informed patients and/or families have refused participation.

Treatment Nonadherence among Multimorbid Chronic Disease Patients: Evidence from 3515 Subjects in Indonesia.

Background and Objectives: Multimorbid patients require intensive treatment for their diseases. However, little research has been given to their treatment adherence as part of its management. This study aims to determine the prevalence and characteristics of chronic disease multimorbidity in Indonesia, alongside its treatment nonadherence. Materials and Methods: We conducted a cross-sectional study using the fifth Indonesian Family Life Survey database among adult subjects aged ≥ 15 years with multimorbidity. Our descriptive and multivariate analyses include sex, age, formal education, ethnicity, geographic residence, demographic residence, household size, insurance ownership, annual income, current self-perceived health status, missing active days, smoking behavior, and body mass index. Results: We identified 3515 multimorbid patients, constituting 30.8% prevalence across chronic disease patients. Hypertension was found to be a prevalent component of multimorbidity (61.2%), followed by digestive diseases (44.5%) and arthritis (30.3%). We identified that 36.4% of the subjects were nonadherent to their chronic disease treatment. Characteristics associated with nonadherence were found to be a good self-perception of health (aOR 1.79, 95% CI 1.54-2.08), active smoking behavior (aOR 1.51, 95% CI 1.14-1.99), no smoking behavior (aOR 1.44, 95% CI 1.08-1.90), missing seven active/productive days or less in the past month due to poor health (aOR 1.36, 95% CI 1.10-1.68), no insurance ownership (aOR 1.20, 95% CI 1.04-1.39), age of 15-65 years (aOR 1.25, 95% CI 1.01-1.55), income below IDR 40 million (aOR 1.23, 95% CI 1.04-1.46), and household size of 2-6 people (aOR 1.17, 95% CI 1.01-1.36). Conclusions: While the prevalence of multimorbidity in Indonesia is generally similar to that observed in previous studies, we have identified patient characteristics related to nonadherence. We suggest that patient's nonadherence was primarily dictated by their self-perception of health and treatment complexity. With the longstanding issue of nonadherence, this study indicated the need to consider creating patient-tailored treatment programs in clinical practice to improve adherence by considering individual patients' characteristics.

Electronic Version of the Family Quality of Life Survey (eFQOLS): Reliability and Validity for Families of Individuals With Disabilities and Chronic Health Conditions

This study tested the psychometric properties of an electronic Family Quality of Life Survey (eFQOLS) when used with families of individuals with disabilities and/or chronic health conditions. Data gathered from 272 family caregivers using the eFQOLS were subjected to reliability analysis, correlation analysis, and confirmatory factor analysis to test the internal consistency of the scales, as well as criterion and construct validity of the internal structure of the scale. Testing factor structures of the item-level domain models indicated that initiative and stability had low factor loadings in many domains. As a result, these items were deleted from the subscales. The subscale-level FQOL factor structure demonstrated a good fit after two adjustments. The internal consistency of the 27-item total FQOL scale was excellent (α = .93), while that of the subscales ranged from moderate to strong (α = .69 to .90). The eFQOLS had a moderate degree of construct validity, good criterion validity, and reliability when used with diverse families across the lifespan. Additional research is needed to continue refining the survey with a more heterogenous sample.

Construct validity of the 12-item Short Form Health Survey (SF-12) version 2 and the impact of lifestyle modifications on the health-related quality of life among Indian adults with prediabetes: results from the D-CLIP trial.

This study aimed to validate the factor structure of the 12-item Short-Form (SF-12) health-related quality of life (HRQOL) survey for Indian adults and assess the impact of lifestyle modification on the SF-12 of Indian adults with prediabetes. To validate the context-specific construct of the SF-12, two-factor confirmatory factor analysis (CFA) was performed using data from 1285 adults residing in Chennai, India, who screened for the Diabetes Community Lifestyle Improvement Program (D-CLIP). D-CLIP was a randomized controlled trial of 578 participants with prediabetes (283 treatment, 293 control), focusing on the effect of lifestyle modifications on the prevention of diabetes. Physical and mental component scores (PCS and MCS) were computed by using CFA standardized factor loadings. Multiple linear regression was subsequently conducted to estimate the effect of lifestyle modification on post-study changes of PCS and MCS among D-CLIP participants. Cronbach's alpha and CFA fit indices demonstrated acceptable reliability and model fit of the SF-12 for Indian adults. The intervention group showed greater mean change in PCS after study participation compared to the controls (1.63 ± 0.82, p = 0.046); no significant difference was observed for MCS between two groups (1.00 ± 0.85, p = 0.242). The study confirmed that the SF-12 is suitable for assessing the physical and mental health dimensions of HRQOL for Indian adults. Our findings suggest that the benefits of diabetes prevention lifestyle modification strategies may primarily enhance the physical well-being of adults with prediabetes. Further studies validating the SF-12 in a broader Asian Indian population are needed. Clinicaltrials.gov, NCT01283308.

Minimal clinically important differences in health-related quality of life after treatment with direct-acting antivirals for chronic hepatitis C: ANRS CO22 HEPATHER cohort (PROQOL-HCV).

Patient Reported Outcomes Quality of Life survey for HCV (PROQOL-HCV) is a specific tool developed to assess health-related quality of life (HRQoL) in patients with chronic hepatitis C receiving direct-acting antivirals (DAA). Thresholds for clinically meaningful changes in PROQOL-HCV scores should be documented to improve the tool's use in clinical practice. This study aimed to estimate the minimal clinically important differences (MCIDs) in PROQOL-HCV scores before and after HCV cure by DAA among participants in the prospective cohort ANRS-CO22 HEPATHER. Data from 460 chronic HCV patients were collected at DAA initiation (baseline) and 24weeks after treatment end. MCIDs were estimated for the six HRQoL dimensions (Physical Health (PH), Emotional Health (EH), Future Uncertainty (FU), Intimate Relationships (IR), Social Health (SH), and Cognitive Functioning (CF)) using two approaches: anchor-based and score distribution-based. Each MCID was estimated for improvement/deterioration both globally and separately for patients with a baseline PRQoL-HCV score ≤ 50 (group1) and patients with a baseline PRQoL-HCV score > 50 (group2). The pooled MCIDs for improvement/deterioration globally, in group1, and in group2, respectively, were as follows: 8.8/-7.6, 9.7/-9.5, and 6.0/-6.9 for PH; 7.1/-4.6, 7.7/-9.6, and 6.6/-6.7 for EH; 6.7/-6.7, 8.2/-8.2, and 6.0/-6.0 for FU; 7.0/-7.0, 5.4/-5.4, and 6.2/-6.2 for IR; 7.7/-7.7, 8.6/-8.6, and 6.5/-6.5 for SH; 7.3/-5.6, 9.1/-8.0, and 6.5/-6.3 for CF. The overall MCID for the PROQOL-HCV scores ranged from 6.7 to 8.8 for improvement and from -7.7 to -4.6 for deterioration. The effect of DAA on PROQOL-HCV scores seemed particularly beneficial for patients with lower baseline scores. This subgroup could be motivated to take DAA if they are informed of the benefits for their HRQoL.

What determines participation in sport for older adults in England: A multilevel analysis of Active Lives data.

Physical inactivity within an ageing population is an ongoing public health concern for policymakers. Engagement in sport forms a foundation of policy designed to encourage physical activity participation and improve health and wellbeing. This study aimed to (i) understand the extent to which older adults participate in sport and the (ii) correlates that predict this involvement within an English population sample of older adults. A further aim was (iii) to examine the extent in which sports participation may vary due to the opportunity provided across Active Partnerships in England. To address this, a multi-level analysis framed through COM-B was conducted of the 2021 English Active Lives dataset (i.e., during the COVID-19 pandemic). The Active Lives survey provides population-level insight into sport, exercise, and physical activity participation across England. It samples upwards of n = 180,000 participants beyond the age of 16 years and asks questions on factors that influence participation. Our findings drawn from a sample of n = 68,808 older adults (i.e., >60-years of age) indicate that when accounting for variation across regions sports participation was significantly predicted by age (β = -.246, p = .040) and multiple deprivation (β = .706, p = .030). Further, our analysis suggests sports participation across regions is associated with changes in the perceptions of opportunity to participate (β = -28.70, p = .001). As the UK transitions from the COVID-19 pandemic, findings have implications for the promotion of sports participation for older adults, in that local, regional, and national stakeholders must do more to change perceptions of social and physical opportunity within an ageing population. This may be achieved through adaptations to the recreational sporting landscape, raising awareness, and supportive policy changes on a national level.

Examining the well-being of military spouses in the context of the COVID-19 pandemic using the Quality of Life survey

LAY SUMMARY The Quality of Life (QOL) survey of military spouses is a critical mechanism to inform the Canadian Armed Forces in efforts to support military families. Conducted during the COVID-19 pandemic, the 2022 survey examined spouses’ mental health and identified the challenges faced during this time, on top of the usual demands of military life. Consistent with results from past QOL surveys, the top issues that challenge civilian military spouses were relocation, primary health care, and spousal employment. Civilian military spouses who expressed concerns related to health, social connection, and employment also reported lower levels of well-being. Offering programs that can help address these concerns is important to support the well-being of military spouses.

Young adults’ work-family life courses and mental health trajectories from adolescence to young adulthood: a TRAILS study

PurposeWork-family life courses have been associated with mental health at various time points in life but little is known about how mental health develops during these work-family life courses. The aim of this study was to examine mental health trajectories from adolescence to young adulthood in women and men with different work-family life courses.MethodsData from 992 young adults participating in the 18-year follow-up TRacking Adolescents’ Individual Lives Survey (TRAILS) were used. Work-family life courses from ages 18 to 28 years were previously constructed using sequence analysis. For each work-family life course, trajectories of internalising and externalising problems from ages 11 to 29 years were estimated using a multi-group random intercept growth model. Differences in mental health trajectories were examined across work-family life courses.ResultsFor women, trajectories of internalising and externalising problems in young adulthood differed significantly between work-family life courses (p = 0.037 and p < 0.001, respectively). Women in the inactive work-family life course reported the highest scores of internalising and externalising problems during the entire young adulthood but the differences in mental health scores became most pronounced at age 29. Trajectories of internalising and externalising problems of men did not significantly differ between the work-family life courses.ConclusionMental health trajectories differed between women depending on their work-family life course. In men, differences between work-family life courses were less pronounced. Future studies should examine which work-family events and transitions captured in work-family life courses are associated with subsequent mental health problems during longer follow-up.

Proximity to public green spaces and depressive symptoms among South African residents: a population-based study

BackgroundExposure to green spaces has been suggested to improve mental health and may reduce the risk of depression. However, there is generally limited evidence on the association between green spaces and depression originating from low-and middle-income countries and Africa in particular. Here, we investigate the association between proximity to public green spaces and depressive symptoms among residents of Gauteng Province, South Africa.MethodsWe used data from the 2017/2018 Gauteng quality of life survey. We included all individuals aged 18 years or older residing in the nine municipalities of Gauteng Province that completed the survey (n = 24,341). Depressive symptoms were assessed using the Patient Health Questionnaire-2. Proximity to public green spaces was defined as self-reported walking time (either less or greater than 15 min) from individuals’ homes to the nearest public green space. To assess the association between access to public green spaces and depressive symptoms, we used mixed-effects models, adjusted for age, sex, population group (African, Indian/Asian, Coloured (mixed race), and White), educational attainment, and municipality. We additionally performed stratified analyses by age, sex, educational attainment, and population group to evaluate whether associations differed within subgroups. Associations are expressed as prevalence ratios (PR) and their 95% confidence intervals (95% CI).ResultsWe observed a 6% (PR = 0.94, 95%CI = 0.92–0.96) prevalence reduction in depressive symptoms for individuals who reported that the nearest public green space was less than 15 min from their homes as compared to those who reported > 15 min. After stratification, this inverse association was stronger among females, individuals aged 35–59 years,those with higher levels of educational attainment, and Coloured individuals as compared to their counterparts.ConclusionOur findings suggest that public green spaces close to residential homes may be associated with a reduction in the occurrence of depressive symptoms among urban populations in resource-constrained settings like South Africa.