Low Attendance Rates Research Articles

A Randomized Controlled Feasibility Trial in Behavioral Weight Management for Underserved Postpartum African American Women: The RENEW Study

We aimed to test the feasibility of an in-person behavioral weight-loss intervention for underserved postpartum African American women with overweight or obesity in an urban hospital setting. Participants were randomized to an intervention of a culturally tailored adaptation of the Diabetes Prevention Program or usual care. The primary outcome was program satisfaction. Women who completed the intervention reported higher levels of satisfaction with the program, despite low attendance rates at group meetings. The intervention was not feasible because of these low rates of attendance and high rates of attrition after randomization. Offering the program electronically and off-site for convenience and more psychosocial support for postpartum women with obesity may improve feasibility.

Lower attendance rates in BreastScreen Norway among immigrants across all levels of socio-demographic factors: a population-based study

Several studies have shown that immigrants attend mammographic screening less frequently than non-immigrants. Studies have also shown that attendance is influenced by socio-demographic factors. We aimed to describe the relationship between socio-demographic factors and first attendance among immigrant and non-immigrant women invited to BreastScreen Norway. Our cohort consisted of 885,979 women invited to BreastScreen Norway for their first time between 1996 and 2015. We merged individual-level socio-demographic data to attendance data corresponding to women’s first invitation to the program. Using Poisson regression, we calculated rate ratios with 95% confidence intervals (95% CI) for attendance, stratified by region of origin. Covariates of interest included age, income, education level, employment status, marital status, citizenship and years since immigration, among others. Fifty-three percent of immigrants and 76% of non-immigrants attended mammographic screening after their first invitation; immigrants as a whole had lower attendance rates across all socio-demographic factors. However, the association between socio-demographic factors and attendance varied between immigrant groups. For all immigrants, no recorded education demonstrated the strongest association with non-attendance compared with ≤ 10 years recorded education (RRadj: 0.69, 95% CI: 0.67–0.71). Other factors associated with non-attendance were low income, living in Oslo, not being employed and being a recent immigrant. The association between socio-demographic factors and mammographic screening attendance differed between immigrant groups. Further studies and preventive health measures should take into account that considering immigrants as a homogeneous group may lead to less effective interventions.

Managing the 1920s' Chilean educational crisis: A historical view combined with machine learning.

In the first decades of the 20th century, political actors diagnosed the incubation of a crisis in the Chilean schooling process. Low rates of enrollment, literacy, and attendance, inefficiency in the use of resources, poverty, and a reduced number of schools were the main factors explaining the crisis. As a response, the Law on Compulsory Primary Education, considering mandatory for children between 6 and 14 years old to attend any school for at least four years, was passed in 1920. Using data from Censuses of the Republic of Chile from 1920 and 1930, reports of the Ministry of Justice, the Ministry of Education, and the Statistical Yearbooks between 1895 and 1930, we apply machine learning techniques (clustering and decision trees) to assess the impact of this law on the Chilean schooling process between 1920 and 1930. We conclude that the law had a positive impact on the schooling indicators in this period. Even though it did not overcome the differences between urban and rural zones, it brought about a general improvement of the schooling process and a more efficient use of resources and infrastructure in both big urban centers and small-urban and rural zones, thereby managing the so-called crisis of the Republic.

Hepatitis B in Moroccan-Dutch: a quantitative study into determinants of screening participation

BackgroundIn November 2016, the Dutch Health Council recommended hepatitis B (HBV) screening for first-generation immigrants from HBV endemic countries. However, these communities show relatively low attendance rates for screening programmes, and our knowledge on their participation behaviour is limited. We identified determinants associated with the intention to request an HBV screening test in first-generation Moroccan-Dutch immigrants. We also investigated the influence of non-refundable costs for HBV screening on their intention.MethodsOffline and online questionnaires were distributed among first- and second/third-generation Moroccan-Dutch immigrants using respondent-driven sampling. Random forest analyses were conducted to determine which determinants had the greatest impact on (1) the intention to request an HBV screening test on one’s own initiative, and (2) the intention to participate in non-refundable HBV screening at €70,-.ResultsOf the 379 Moroccan-Dutch respondents, 49.3% intended to request a test on their own initiative, and 44.1% were willing to attend non-refundable screening for €70,-. Clarity regarding infection status, not having symptoms, fatalism, perceived self-efficacy, and perceived risk of having HBV were the strongest predictors to request a test. Shame and stigma, fatalism, perceived burden of screening participation, and social influence of Islamic religious leaders had the greatest predictive value for not intending to participate in screening at €70,- non-refundable costs. Perceived severity and possible health benefit were facilitators for this intention measure. These predictions were satisfyingly accurate, as the random forest method retrieved area under the curve scores of 0.72 for intention to request a test and 0.67 for intention to participate in screening at €70,- non-refundable costs.ConclusionsBy the use of respondent-driven sampling, we succeeded in studying screening behaviour among a hard-to-reach minority population. Despite the limitations associated with correlated data and the sampling method, we recommend to (1) incorporate clarity regarding HBV status, (2) stress the risk of an asymptomatic infection, (3) emphasise mother-to-child transmission as the main transmission route, and (4) team up with Islamic religious leaders to help decrease elements of fatalism, shame, and stigma to enhance screening uptake of Moroccan immigrants in the Netherlands.

Connecting embedded and stand-alone peer mentoring models to enhance student engagement

This paper outlines the Trident Student Mentoring Program that runs in the College of Engineering at Victoria University, Melbourne, Australia. The program offers both embedded and stand-alone models of peer mentoring services to the same cohort of first-year students. It shows that by forming strong links between these two types of peer mentoring models, the inherent challenges of both, such as low attendance rates in stand-alone models and short periods of peer to peer time in embedded models, are mitigated.

Factors affecting the dose of methadone among patients receiving methadone maintenance therapy in Taiwan.

Methadone maintenance treatment (MMT) has been shown to be an effective therapeutic strategy for opioid users. This study aimed to investigate the predictive effect of clinically predominant sleep disturbance (CPSD) on the dose of methadone among opiate users receiving MMT during a follow-up period of 6 years in Taiwan. This retrospective study included 1,290 individuals with opioid dependence who visited our MMT clinic for the first time. Generalized estimating equations were used to analyze the effect of CPSD on the daily dose of methadone by controlling for the effects of demographic and MMT characteristics. A total of 469 (36.4%) participants were comorbid with CPSD. After controlling for the effects of demographic and MMT characteristics, the participants comorbid with CPSD had a higher dose of daily methadone than those without CPSD (estimate: 7.03, p < .001). Furthermore, younger age (estimate: -1.22, p < .001), older age at initial MMT (estimate: .44, p < .001), lower educational level (estimate: -.90, p = .003) and lower attendance rates (estimate: -.14, p = .033) are significantly related to higher doses of daily methadone. Our study provided a naturalistic observation of the cohort for long period, along with a large sample size which could reflect clinical practice in the real world. We reported that a higher daily dose of methadone was significantly associated with CPSD after controlling for the effects of other factors. CPSD should be routinely surveyed among heroin users receiving MMT. (Am J Addict 2018;27:225-230).

Mammographic screening attendance among immigrant and minority women: a systematic review and meta-analysis.

Background Groups of immigrant and minority women are more often diagnosed with advanced stage breast cancer than other women. Mammographic screening aims to reduce mortality from breast cancer through early detection in asymptomatic women. Purpose To compare mammographic screening attendance among immigrant and minority women to that of other women. Material and Methods A literature search of PubMed, Embase, Google Scholar, and Cochrane identified 1369 papers published between January 1995 and March 2016. In the review, we included 33 studies investigating mammographic screening attendance among immigrant and/or minority women. In a meta-analysis, we included 19 of the studies that compared attendance among immigrant and/or minority women with that among other women, using a random effects model. Results The review included studies from Europe, North America, and Oceania, with 42,666,093 observations of opportunities for mammographic screening. Attendance was generally lower among immigrant and minority women compared to other women (46.2% vs. 55.0%; odds ratio = 0.64, 95% confidence interval = 0.56-0.73; P < 0.05, I2 = 99.9%). Non-Western immigrants had lower attendance rates than other immigrants. Conclusion Immigrant and minority women had lower mammographic screening attendance than other women, which could potentially put them at increased risk for more advanced breast cancer. This review emphasizes the importance of continued efforts to engage with the preventative health needs of diverse populations in attempts to achieve equality in access to, and use of, care.

A population-based screening study for cardiovascular diseases and diabetes in Danish postmenopausal women: acceptability and prevalence

BackgroundReducing women’s cardiovascular risk and the economic costs associated with cardiovascular diseases (CVD) and diabetes (DM) continues to be a challenge. Whether a multifaceted CVD screening programme is beneficial as a preventive strategy in women remains uncertain. The aim of this study was to investigate the prevalence of CVD and DM as well as the acceptability toward screening and preventive actions.MethodsAn observational study was performed among all women born in 1936, 1941, 1946 and 1951 living in Viborg Municipality, Denmark, from October 2011. In total, 1984 were invited to screening for abdominal aortic aneurysm (AAA), peripheral arterial disease (PAD), carotid plaque (CP), hypertension (HT), atrial fibrillation (AF), DM and dyslipidaemia. Participants with positive tests were offered prophylactic intervention including follow-up consultations in case of AAA, PAD and/or CP. Participants with AAA ≥ 50 mm were referred to specialists in vascular surgery. Women with AF or potential familial hypercholesterolaemia (FH) were referred to cardiology work-up.ResultsAmong those invited, 1474 (74.3%) attended screening, but the attendees’ share decreased with increasing age groups (p < 0.001). AAA was diagnosed in 10 (0.7%) women, PAD in 101 (6.9%) and CP in 602 (40.8%). The percentage of women with these conditions rose with increasing age group (p < 0.05). Unconfirmed potential HT was observed in 94 (6.4%), unknown AF in 6 (0.4%), DM in 14 (1%) and potential FH in 35 (2.4%). None of these findings differed across age groups. Among the 631 women diagnosed with AAA, PAD and/or CP, 182 (28.8%) were already in antiplatelet and 223 (35.3%) in lipid-lowering therapy prior to screening. Antiplatelet therapy was initiated in 215 (34.1%) and lipid-lowering therapy in 191 (30.3%) women. Initiation of antiplatelet and lipid-lowering therapy was further recommended to 134 (21.2%) and 141 (22.4%) women, respectively, who hesitated to follow the recommendation.ConclusionsThe study recorded an acceptable total attendance rate, even though a significantly lower attendance rate was observed in the eldest women. The identified hesitation towards prophylactic therapy may affect the rationale and effectiveness of CVD screening, and hesitation seems a critical issue that should be addressed in the design of future screening programmes.

Climate variability and the dichotomy in male–female school attendance: a case study of Zamfara State in semi‐arid Nigeria

This study examines the response of male and female school attendance to climate in Zamfara State, Nigeria from 1970 to 2006. Bivariate (Spearman) correlation, pairwise t‐test, standardised anomaly index and descriptive statistics were used to analyse climate, school enrolment and attendance data. Results showed that 71.52% of males and 28.48% of females attended school. The male pupil population was larger than the female pupil population at all schools, while the female dropout rate was greater than that of males at seven schools. Male attendance was highest at Township 1 Special Model Primary School, Gusau, and female attendance was highest at A Tunalim Primary School, Talata‐Mafara, while both were lowest at Wuya Model Primary School, Anka. Male school attendance and its total varied by school, from 30 to 3430 pupils, and the rate of attendance varied between 53.17 and 92.26%; female attendance varied between 4 and 1570 pupils. Both male and female pupils recorded low attendance and high dropout rates in drought years. The total annual dropout of male pupils at each school varied from 1 to 200, with a rate of between 36.26 and 81.53%, while annual female dropout varied from 1 to 100, with a rate of between 18.47 and 63.74%. The total dropout rate of the whole school population was 2.75% (1.62% male and 1.13% female); 58.79% of students who dropped out were male and 41.21% were female, accounting for 2.26% of the male and 3.97% of the female school population. Temperature showed no significant correlation with attendance. Rainfall had a more significant relationship with school attendance for male pupils than female pupils at P ≤ 0.05. The extent to which rainfall significantly determined school attendance varied from 14.82 to 25.91%. A pairwise t‐test showed a significant difference between male and female pupils' school attendance at all schools. This study concludes that climate affected male pupils more than female pupils.

Educational effects on ascertain dementia 8-item informant questionnaire to detect dementia in the Taiwanese population.

Researchers invited community-dwelling people whose age was above 50-year-old to attend the Memory Screening Project. AD8 was used to perform the informant interview with adult patients who were attending the Memory Screening Project in Taiwan. Individuals who scored ≥2 on the AD8 was suggested to accept referral for further cognitive performance evaluation tests, which included three validated dementia tests, i.e. the Mini-Mental Screening Examination (MMSE), the Cognitive Abilities Screening Instrument (CASI), and the Clinical Dementia Rating (CDR). Of the 102 participants who scored ≥2 on the AD8, only 25.5% attended the referral appointment. In participants who had achieved six or more years of education, AD8 scores were not significantly different between groups and could not differentiate between the non-dementia and patients with dementia in the receiver-operator characteristics curve analysis. In contrast, in those participants who had received less than six years of education, the AD8 scores significantly differentiated between non-dementia and patients with dementia (p = 0.03). There was a low rate of attendance at a specialist memory clinic following referral after the AD8 interview. Higher levels of education facilitated individuals to make a decision to accept the recommended referral appointment, while the AD8 showed a higher rate of differentiation between individuals who had received an education of less than six years.

Lower attendance rates in immigrant versus non-immigrant women in the Norwegian Breast Cancer Screening Programme.

The Norwegian Breast Cancer Screening Programme invites women aged 50-69 to biennial mammographic screening. Although 84% of invited women have attended at least once, attendance rates vary across the country. We investigated attendance rates among various immigrant groups compared with non-immigrants in the programme. There were 4,053,691 invitations sent to 885,979 women between 1996 and 2015. Using individual level population-based data from the Cancer Registry and Statistics Norway, we examined percent attendance and calculated incidence rate ratios, comparing immigrants with non-immigrants, using Poisson regression, following women's first invitation to the programme and for ever having attended. Immigrant women had lower attendance rates than the rest of the population, both following the first invitation (53.1% versus 76.1%) and for ever having attended (66.9% versus 86.4%). Differences in attendance rates between non-immigrant and immigrant women were less pronounced, but still present, when adjusted for sociodemographic factors. We also identified differences in attendance between immigrant groups. Attendance increased with duration of residency in Norway. A subgroup analysis of migrants' daughters showed that 70.0% attended following the first invitation, while 82.3% had ever attended. Immigrant women had lower breast cancer screening attendance rates. The rationale for immigrant women's non-attendance needs to be explored through further studies targeting women from various birth countries and regions.

Patterns in Participation: Factors Influencing Parent Attendance at Two, Centre-Based Early Childhood Interventions

Interventions training parents of at-risk children have received considerable empirical support but their effectiveness is undermined by low attendance rates. This research sought to clarify why parents, even with the best of intentions, fail to follow through to full participation in workshop programs; and to provide insight into ways to improve parental engagement. We examined participation in Parents as Partners, a school-based, early childhood intervention. Demographic and ongoing educational, social, emotional and behavioural data for 136 parent–child dyads were gathered from parents, teachers and children. Mitigation of a wide range of factors previously identified as barriers to attendance was also attempted. A post-intervention survey was conducted to examine parents’ insights into their attendance patterns. Overall, 91 parents attended and 44 failed to attend any workshops. Higher parent education and SEI, and better child language skills were good predictors of attendance (87%), but poor predictors of nonattendance (42%). Additionally, parent-child dyad profiles suggested that children of nonattending parents were more likely to benefit from workshop content than attenders’ children. Survey data suggested that attenders organised their schedules to facilitate follow-through but nonattenders were unable to do so. Family characteristics and practical reasons were central, interacting factors affecting attendance. Parental self-organisation appeared to moderate follow-through and to stem from lifestyle constraints related to lower SEI and parent education. This produced high nonattendance rates in parents of children who most needed support. It is urgent to discover to what extent innovative delivery platforms currently being explored (e.g., internet/social media) can improve parental engagement.

DOES AN ANTENATAL EDUCATIONAL PROGRAM IMPROVE MATERNAL OUTCOMES AMONG OBESE PREGNANT WOMEN IN THE KURDISTAN REGION OF IRAQ

Background&#x0D; Maternal obesity is associated with health risks for mother and new-born. Obesity during pregnancy has increased dramatically in Iraqi Kurdistan.&#x0D; Objectives &#x0D; The aim for this study is to assess the influence of an educational program on the maternal pregnancy outcomes of obese women attending primary health centres in a large city in the Kurdistan region of Iraq.&#x0D; Methods&#x0D; A quasi –experiment was undertaken. 292 pregnant women who attended one of three health centres for their antenatal care prior to 20 weeks gestation were recruited to the study. 99 women were recruited were of normal weight with a BMI of 20-25Kg/m2, (baseline group), 96 women had a BMI ≥ 30 and were randomised to receive normal care (control group) and 97 obese women were allocated to received normal antenatal care and invited to participate in an antenatal education programme (intervention group). Maternal outcomes measured were gestational weight gain during pregnancy, pregnancy induced hypertension, Gestational Diabetes Mellitus and duration of pregnancy.&#x0D; Results&#x0D; Obese women were older and were more likely to have had more pregnancies than normal weight women. Regarding maternal outcomes there was no statistically significant difference among the three groups regarding pregnancy induced hypertension, and Gestational age at onset of labour. In relation to gestational diabetes mellitus findings indicated that the prevalence of gestational diabetes mellitus was reduced among those obese women who received the educational programme compared to the control and baseline groups. In addition all obese women (intervention and control groups) had a statistically significant lower weight gain in pregnancy compared to baseline group. &#x0D; Conclusions&#x0D; The antenatal education programme made a small difference to maternal outcomes. The prevalence of gestational diabetes was reduced in women who accessed the programme suggesting that gestational diabetescould be decreased by educating women during pregnancy regarding healthy diet and exercise.One factor which may have affected the results of this study was the low attendance rate among women who were randomised to receive the education programme. A higher rate of attendance at education classes may have improved outcomes in others areas.

Study on the Inverted Class Improved by Students’ Micro Learning Resource

In the era of network information highly developed, the traditional classroom teaching model has been greatly challenged. The low rate of class attendance has become a common phenomenon. In the teaching of college optional courses, teachers try to use micro learning resource to change traditional teaching model. They organize the student group to work together to record micro learning resource and apply to the inverted classroom. Teachers get the experience from the teaching practice and continue to improve the quality of teaching.

Clinical, behavioural and social indicators for poor glycaemic control around the time of transfer to adult care: a longitudinal study of 126 young people with diabetes.

To describe and compare changes in glycaemic control in young people with Type 1 diabetes over time between the last 2 years in paediatric care and the first 2 years in adult care and to identify risk factors for poor glycaemic control. Our retrospective cohort study followed participants aged 14-22 years from 2 years before to 2 years after transfer from paediatric to adult care. Changes in glycaemic control were calculated using repeated measurements. We adjusted for gender, age at diabetes onset, age at transfer, duration of diabetes at transfer, gap (amount of time) between last paediatric and first adult visit, comorbidity, learning disability and/or mental health conditions and family structure. We examined associations between acute hospital admissions, low visit attendance rate, loss to follow-up and baseline HbA1c level. Among 126 participants, the mean HbA1c level was 80 mmol/mol (9.4%) pre-transfer but decreased by an average of 3 mmol/mol (0.3%) each year post-transfer (P = 0.005). Young people with a learning disability and/or a mental health condition had worse glycaemic control (P = 0.041) and the mean HbA1c of those with divorced parents was 14 mmol/mol (1.2%) higher (P = 0.014). Almost one-third of participants were admitted to the hospital for acute diabetes care. Low visit attendance rate, high baseline HbA1c level, learning disability and/or mental health conditions and divorced parents predicted acute hospital admissions. Glycaemic control improved significantly after transfer to adult care, but the mean HbA1c level remained high. Future interventions should focus on young people with divorced parents, those with a learning disability and/or mental health condition and those who do not attend clinical visits to improve HbA1c levels and thereby reduce hospitalization rates.

Cultural adaptation of cognitive stimulation therapy (CST) for Chinese people with dementia: multicentre pilot study.

Ageing of the Chinese population will drive a continued surge in dementia prevalence. Empirically tested non-pharmacological interventions developed in western cultures may be implemented in Chinese. Cognitive Stimulation Therapy (CST) that originated in the UK has proven benefits on cognition and quality of life in people with dementia. We investigated the feasibility and cultural appropriateness of CST in Hong Kong Chinese (CST-HK). Mixed methods research was conducted following the formative method for adapting psychotherapy. A culturally adapted CST-HK, developed involving multidisciplinary stakeholders, was tested in a pilot multicentre study in people with mild dementia (n = 30) receiving community or residential care. Changes in cognition and quality of life were measured. Opinions from family caregivers and group facilitators (n = 25) were collected through focus groups and in-depth interviews for understanding the appropriateness of CST-HK. Feasibility was explored. After receiving CST-HK, 54% of participants achieved outcome of no cognitive deterioration, and 23% showed clinically meaningful improvement. Family caregivers and group facilitators expressed good acceptance of CST, with a low attrition (13%) and high attendance rate of CST-HK sessions (92%). Key cultural issues identified are (i) less active opinion sharing in group discussions due to conservatism/cautiousness and (ii) preference of practical activities with reward/recognition over pure discussion due to pragmatism. The CST-HK is feasible and culturally appropriate in Hong Kong Chinese. Further amendments can be made to ensure language use and enjoyment, with potential implications on effectiveness. We have provided a systematically developed, culturally adapted protocol for larger-scale implementation and research in Chinese populations. Copyright © 2017 John Wiley & Sons, Ltd.

Impact of Students’ Class Attendance on Recalling Previously Acquired Information

Background: In recent years, availability of class material including typed lectures, the professor’s Power Point slides, sound recordings, and even videos made a group of students feel that it is unnecessary to attend the classes. These students usually read and memorize typed lectures within two or three days prior to the exams and usually pass the tests even with low attendance rate. Thus, the question is how effective is this learning system and how long the one-night memorized lessons may last. Methods: A group of medical students (62 out of 106 students), with their class attendance and educational achievements in the Medical Mycology and Parasitology course being recorded since two years ago, was selected and their knowledge about this course was tested by multiple choice questions (MCQ) designed based on the previous lectures. Results: Although the mean re-exam score of the students at the end of the externship was lower than the corresponding final score, a significant association was found between the scores of the students in these two exams (r=0.48, P=0.01). Moreover, a significant negative association was predicted between the number of absences and re-exam scores (r=-0.26, P=0.037). Conclusion: As our findings show, the phenomenon of recalling the acquired lessons is preserved for a long period of time and it is associated with the students’ attendance. Many factors including generation effect (by taking notes) and cued-recall (via slide picture) might play a significant role in the better recalling of the learned information in students with good class attendance. Keywords: STUDENT, MEMORY, LONG-TERM, RECALL, ABSENTEEISM, LEARNING

FREKUENSI KUNJUNGAN POSYANDU DAN RIWAYAT KENAIKAN BERAT BADAN SEBAGAI FAKTOR RISIKO KEJADIAN STUNTING PADA ANAK USIA 3 – 5 TAHUN

Stunting is a chronic nutrition problem that requires precise intervention. Risk factors of stunting are need to be assessed to find the solution, such as attendance rate in integrated health post (posyandu) and weight gain. This was a case control study done in children aged 3-5 years old in Sidoarum village, Godean, Sleman, Yogyakarta. Sampling was done by simple random sampling technique with total 43 respondents in each group. Stunting is categorized based on the value of the z-score of height for age less than -2 SD. Primary data was obtained by interview, while attendance rate in integrated health post and weight gain were obtained through secondary data that is growth monitoring card (KMS) and monthly reports of integrated health post. Statistic test used for bivariate analysis was Chi-square and Multiple Logistic Regression for multivariate analysis. Result of bivariate analysis found that attendance rate in integrated health post and weight gain are related to stunting. Result showed that a low rate of attendance in integrated health post is the most dominant factor for the incidence of stunting in children aged 3-5 years (OR = 3.1, CI 95%= 1,268-7,623). This study concluded that children who are less active to come to integrated health post have 3.1 times higher risk of stunting compared to children who are actively come to integrated health postKeywords: attendance rate in integrated health post, children, stunting, weight gain

Patterns of attendance to health checks in a municipality setting: the Danish 'Check Your Health Preventive Program'.

We aimed to investigate the determinants of attendance to a preventive health check program and to explore the homogeneity of the attenders.4853 eligible persons living in the municipality of Randers, Denmark, from 2012 to 2013, aged 30–49 years, received an invitation to attend the ‘Check Your Health Preventive Program’. Data was obtained from the Danish National Registers. Socio-demographic factors, use of preventive services, morbidity were examined as determinants of attendance by Poisson regression analyses. A chi-squared automatic interaction detection decision tree analysis was used to identify mutually exclusive groups.In total, 55% of the invited population attended (49% men). Attenders were more likely to be: of higher age; immigrants; cohabiting; have: higher socio-economic status; higher use of preventive services and lower morbidity. Decision tree analysis revealed six groups, with the most important variable being income: 1) low income, low education (A = attendance rate: 38%; P = population size: 11%); 2) low income, education higher than 10 years, living alone (A: 41%; P: 5%); 3) low income, education higher than 10 years, cohabiting (A: 56%; P: 16%); 4) middle income (A: 60%; P: 34%); 5) high income, living alone (A: 56%; P: 4%); 6) high income, cohabiting (A: 69%; P: 30%).More than half of a general population voluntarily attended a general health check, despite a resource intensive offer. People with low resources had lower attendance rates. This study adds a detailed description of mutually exclusive groups of attenders, for use in future planning and implementation of preventive actions.

Kundalini yoga as mutual recovery: a feasibility study including children in care and their carers

Purpose The purpose of this paper is to test whether incorporating a 20-week Kundalini yoga programme into a residential home for children improves well-being outcomes. Design/methodology/approach This is a mixed methods feasibility study. Feasibility was assessed through recruitment and retention rates as well as participants’ self-report perceptions on social inclusion, mental health and well-being and through semi-structured interviews on the benefits of the study. Mutual recovery entailed that children in care (CIC), youth practitioners and management participated together in the Kundalini yoga sessions. Findings The study initially enrolled 100 per cent of CIC and 97 per cent (29/30) of eligible staff. Attendance was low with an average rate of four sessions per participant (SD=3.7, range 0-13). All the participants reported that the study was personally meaningful and experienced both individual (e.g. feeling more relaxed) and social benefits (e.g. feeling more open and positive). Pre- and post-yoga questionnaires did not show any significant effects. Low attendance was associated with the challenges faced by the children’s workforce (e.g. high levels of stress, low status, profile and pay) and insufficient consultation and early involvement of stakeholders on the study implementation process. Research limitations/implications Because of the chosen research approach (i.e. feasibility study) and low attendance rate, the research results may lack generalisability. Therefore, further research with larger samples including a control or comparison group to pilot similar research questions is mandatory. Practical implications This study has generated a number of valuable guiding principles and recommendations that might underpin the development of any future intervention for CIC and staff working in children’s homes. Social implications The concept of togetherness and mutuality within residential spaces is discussed in the paper. Originality/value The effects of Kundalini yoga have not been reported before in any peer-review publications. This paper fulfils an identified need (i.e. poor outcomes among CIC and residential staff) and shows how movement and creative practices can support the concept of mutual recovery.