Non-medical Sources Research Articles

Social prescribers’ referral processes and decision-making about healthy eating and physical activity

Abstract Background Social Prescribing (SP) connects primary care patients with non-medical sources of support within the community. There are various SP models, with different referral routes. Many involve patients being referred to a link practitioner, who considers their needs and then “prescribes” or links them to appropriate local support services or resources, typically provided by the third sector. The present study aimed to explore the SP process and the decision-making of link practitioners, particularly around food and physical activity practices. Methods Sixteen semi-structured interviews were conducted with link practitioners working across Aberdeen City. A pragmatic Thematic Framework analysis was undertaken. Findings Participating link practitioners described their approach with clients as building rapport and trust while maintaining boundaries and managing expectations, and their community role as resource mapping and networking. Three broad categories of factors were considered during referral: 1) practicality (e.g., location, transport, cost, mobility, availability), 2) clients’ engagement (e.g., interest, motivation, readiness for change), and 3) link practitioners’ past experiences with services. Challenges identified included navigating waiting lists and service limitations, clients’ engagement and expectations, under-resourced services, navigating waiting lists with caseloads and the emotional burden of seeing people in very difficult situations. All link practitioners considered diet and exercise to fit within the remit of social prescribing but emphasised that clients should lead this discussion. Dietary support via social prescribing typically revolved around poverty rather than health. Discussion The study provides insight into the practical reality of making social prescribing decisions and has the potential to inform training and evaluation processes and support the development of health-focused social prescribing lifestyle interventions. Key messages • Social prescribing – a personalised approach, with clients supported to identify and achieve their health and wellbeing goals based on their strengths and resources available in the local community. • Social Prescribing - a promising platform for offering healthy eating interventions tailored to individual needs.

Women's perceptions and experiences with cannabis use in menopause: a qualitative study.

Since the legalization of recreational cannabis in 2018, the use of cannabis for medical reasons has increased in Canada. The aim of this study was to explore the experiences and perceptions of midlife women using cannabis for medical purposes coinciding with menopause symptom management. Semistructured, one-on-one interviews were conducted using a qualitative description method. This was the second phase of a mixed methods study, where interviewees were purposefully selected from a sample of women (ages 35 and over, located in Alberta) surveyed during the first phase of the study. Interviews were by phone or virtual meeting, audio-recorded, and transcribed verbatim. Qualitative content analysis was applied to analyze the data collected. Twelve interviews were conducted between December 2020 and April 2021. Menopause was perceived as a complex experience for women. Cannabis was described as a therapeutic agent, providing symptom relief through the menopause transition. Women reported similarities in their menopause and cannabis use experiences in the lack of information available, limited role of healthcare providers, feelings of stigmatization, and emphasis on self-education. Women self-managed their cannabis use, learning from their own experiences or the anecdotal sharing of others', accessed cannabis from a variety of medical and nonmedical sources, and relied on experimentation, and a range of supports were described. Midlife women pursued the use of cannabis medically to manage symptoms that overlap with menopause. Understanding how and why midlife women use cannabis medically can provide insight for future research and the development of educational resources to support women in menopause.

A transversal cross-sectional study of factors related to HPV vaccination status and cancer screening participation among French women aged 25–40

BackgroundIn 2020, uterine cervical cancer (UCC) was the 12th most common cancer among women in France and the 4th worldwide. French health authorities wanted to increase Human Papilloma Virus (HPV) vaccination and screening rates. There were still many barriers to these measures among young women, their families, and health professionals and teachers. Between 2014 and 2019, international studies found inconsistent effects of HPV vaccination on UCC screening. In 2022, a survey was conducted among women aged 25 to 40 in the Nord-Pas-de-Calais region to assess participation 1) in HPV vaccination and its barriers, 2) in UCC screening as a function of HPV vaccination status.MethodsData were collected using an anonymous online questionnaire distributed by QR code in 80 general practices randomly selected in the Nord-Pas-de-Calais region between January and June 2022. Results were analyzed bivariately using the Chi2 test, multivariately when numbers allowed, and in age subgroups (sensitivity analysis).Results407 complete questionnaires (for 602 participating women) were analyzed. In our sample, 41% of women aged 25 to 40 in the Nord-Pas-de-Calais region were vaccinated against HPV viruses in 2022. The risk factors for non-vaccination, after multivariable adjustment, were: the periods of eligibility for vaccination in the early days of French vaccination (2007–2012: odds ratio OR = 0.04 [95% CI, 0.02–0.09]; 2012–2017: OR = 0.5 [0.3–0.8]), information received from non-medical sources (OR = 0.3 [0.2–0.6]), and absence of information about vaccination (OR = 0.12 [0.05–0.27]). In our sample, 90% of women were screened for UCC. In bivariate analysis, women at risk of not being screened were those who were youngest, had been vaccinated against HPV, were not heterosexual, lived alone, had gynecological follow-up by their general practitioner, and did not have regular gynecological follow-up. Sensitivity analysis showed that the only risk factor significantly correlated with non-screening regardless of age group was lack of regular gynecological follow-up.ConclusionsParticipation in HPV vaccination and UCC screening is improved by medical education and gynecological follow-up. This multicenter study, limited by the relative youth of vaccination in France, should be repeated after 2037 to assess the possible effect of vaccination on screening.

A quality assessment of YouTube as an information resource for tonsillectomy

PurposeOnline resources are increasingly being utilised by patients to guide their clinical decision making, as an alternative or supplement to the traditional clinical-patient relationship. YouTube is an online repository of user and community generated videos, which is one of the most popular websites globally. We undertook a study to examine the quality of information presented in YouTube videos related to tonsillectomy. MethodsWe completed a systematic search of YouTube in May 2023 and identified 88 videos for inclusion in our study. Videos were published in the English language, focussing on tonsillectomy and tonsillectomy recovery, and were greater than 2 min in length. We recorded video quality metrics and two authors independently analysed the quality of information using three validated quality assessment tools described in the literature including the modified DISCERN, Global Quality Score, and the JAMA Benchmark Criteria. ResultsThe overall quality of the information was low with mean quality scores of Modified DISCERN (1.8 ± 1.3), GQS (2.6 ± 1.2), and JAMA Benchmark Criteria (1.6 ± 0.7). Information published by medical sources including medical professionals, healthcare organisations, and medical education channels scored significantly higher compared to non-medical sources across all quality measures and were of moderate overall quality and usefulness: Modified DISCERN (2.5 ± 1.1 vs 0.8 ± 0.9, z = −6.0, p < 0.001), GQS (3.2 ± 1.0 vs 1.7 ± 0.9, z = −5.7, p < 0.001), and JAMA (1.9 ± 0.8 vs 1.1 ± 0.3, z = −5.2, p < 0.001). Videos published during or after 2018 scored higher on Modified DISCERN (z = −3.2,p = 0.001) but not on GQS or JAMA. Video quality metrics such as total view count, likes, and comments, and channel subscriber count, did not correlate with higher video quality. However, amongst videos published by authoritative medical sources, total view count correlated positively with higher Modified DISCERN quality scores (p = 0.037). ConclusionThe overall quality and usefulness of YouTube videos on tonsillectomy is of low quality, but information published by authoritative medical sources score significantly higher. Clinicians should be mindful of increasing use of online information sources such as YouTube when counselling patients. Further research is needed in the medical community to create engaging, high-quality content to provide guidance for patients.

The Effects of Stigma: Older Persons and Medicinal Cannabis.

Cannabis has long been stigmatized as an illicit drug. Since legalization in Canada for both medical and recreational purposes, older adults' cannabis consumption has increased more than any other age group. Yet, it is unclear how the normalization of cannabis has impacted perceptions of stigma for older adults consuming cannabis medicinally. Qualitative description was used to elucidate the experiences of older Canadians aged 60+ related to stigma and their consumption of cannabis for medicinal purposes. Data collection involved semi-structured interviews. Data analysis examined how participants managed stigma related to cannabis use. Perceived stigma was evident in many participants' descriptions of their perceptions of cannabis in the past and present, and influenced how they accessed and consumed cannabis and their comfort in discussing its use with their healthcare providers. Participants employed several distinct strategies for managing stigma-concealing, re-framing, re-focusing, and proselytizing. Findings suggest that while medical cannabis consumption is becoming increasingly normalized among older adults, stigma related to cannabis persists and continues to shape older adults' experiences. A culture shift needs to occur among healthcare providers so that they are educated about cannabis and willing to discuss the possibilities of medicinal cannabis consumption with older adults. Otherwise, older adults may seek advice from recreational or other non-medical sources. Healthcare providers require education about the use of medical cannabis, so they can better advise older adults regarding its consumption for medicinal purposes.

Eco-Friendly and COVID-19 Friendly? Decreasing the Carbon Footprint of the Operating Room in the COVID-19 Era.

Surgery is one of the most energy-intensive branches of healthcare. Although the COVID-19 pandemic has reduced surgical volumes, infection control protocols have increased the ecological footprint of surgery owing to the extensive use of personal protective equipment, sanitation, testing and isolation resources. The burden of environmental diseases requiring surgical care, the international commitment towards environmental sustainability and the global efforts to return to the pre-pandemic surgical workflow call for action towards climate-friendly surgery. The authors have searched the peer-reviewed and gray literature for clinical studies, reports and guidelines related to the ecological footprint of surgical care and the available solutions and frameworks to reduce it. Numerous studies concede that surgery is associated with a high rate of energy utilization and waste generation that is comparable to major non-medical sources of pollution. Recommendations and research questions outlining environmentally sustainable models of surgical practices span from sanitation and air quality improvement systems to the allocation of non-recyclable consumables and energy-efficient surgical planning. The latter are particularly relevant to infection control protocols for COVID-19. Paving the way towards climate-friendly surgery is a worthy endeavor with a major potential to improve surgical practice and outcomes in the long term.

Bridging the gap between practice guidelines and clinical practice: Results from a consumer-oriented evaluation of sexual aids.

495 Background: Sexual health is often negatively impacted by cancer therapies. National Comprehensive Cancer Network (NCCN) survivorship guidelines for sexual health broadly recommend sexual aids, without detail about quality or availability. Using a consumer-oriented approach to identify and evaluate the “Internet of Things (IoT)”, our aim was to evaluate availability and quality of non-pharmacologic sexual aids to increase knowledge of sexual health resources. Methods: NCCN Survivorship 1.2022 guidelines were used to identify 13 non-pharmacologic categories of sexual aids related to recommendations about sexual health (e.g., vaginal dilator, vacuum erection device). For each of the item categories, an initial internet search evaluated the top 25 links for the “Best of.” Links were categorized by publication and author type, and candidate sexual health items were recorded. A separate search, using “best adult toy website” and “best sexual health website”, identified 3 mainstream consumer sites, 4 sexual health sites, and manufacturer websites selling candidate items. Websites were then used to record each item’s customer ratings on a 5-star scale. Before evaluating ratings, unavailable items were excluded. For dilators, dildos, and vibrators, items larger than estimated median penile dimensions (6.5” length, 4.6" circumference, 1.6” diameter) were also excluded due to likely being uncomfortable and non-therapeutic for most patients. Customer ratings search was conducted in May 2023. Potential therapeutic value was defined as a minimum of 50 ratings and a 4-star average. Descriptive statistics included prevalence, median and range. Results: The initial search for “best XXX” on 350 total hyperlinks yielded 874 potential items in the 13 categories from a diverse range of sources. 17.3% of links were connected to medical or health periodicals, but most (60.3%) were from magazines, newspapers, and blog posts. Content was rarely from NCCN (2.7%) or non-NCCCN (1.9%) medical sources. Content authors were mostly journalists, bloggers, or unknown author type (17.3%, 18.1%, 33.2% respectively). For the 874 candidate items, 537 met criteria for potential therapeutic value. Among the 537 items evaluated, 292 items met our customer-reported quality threshold, with a median of 631 reviews (range: 51-128,481) and a median rating of 4.4 stars (4.0-5.0). We identified useful items in each NCCN category with a median of 7 (1-107). Conclusions: Non-medical sources publish most sexual health items. Medical content rarely ranks highly on internet search. To address gaps between general recommendations and practical application, we identified many highly rated, potentially useful products in NCCN designated categories that may be valuable for patients as well as clinicians. We will publish the full list to lessen access and knowledge gaps and to stimulate further research.

Acceptance of Social Media Recruitment for Clinical Studies Among Patients With Hepatitis B: Mixed Methods Study.

Social media platforms are increasingly used to recruit patients for clinical studies. Yet, patients' attitudes regarding social media recruitment are underexplored. This mixed methods study aims to assess predictors of the acceptance of social media recruitment among patients with hepatitis B, a patient population that is considered particularly vulnerable in this context. Using a mixed methods approach, the hypotheses for our survey were developed based on a qualitative interview study with 6 patients with hepatitis B and 30 multidisciplinary experts. Thematic analysis was applied to qualitative interview analysis. For the cross-sectional survey, we additionally recruited 195 patients with hepatitis B from 3 clinical centers in Germany. Adult patients capable of judgment with a hepatitis B diagnosis who understood German and visited 1 of the 3 study centers during the data collection period were eligible to participate. Data analysis was conducted using SPSS (version 28; IBM Corp), including descriptive statistics and regression analysis. On the basis of the qualitative interview analysis, we hypothesized that 6 factors were associated with acceptance of social media recruitment: using social media in the context of hepatitis B (hypothesis 1), digital literacy (hypothesis 2), interest in clinical studies (hypothesis 3), trust in nonmedical (hypothesis 4a) and medical (hypothesis 4b) information sources, perceiving the hepatitis B diagnosis as a secret (hypothesis 5a), attitudes toward data privacy in the social media context (hypothesis 5b), and perceived stigma (hypothesis 6). Regression analysis revealed that the higher the social media use for hepatitis B (hypothesis 1), the higher the interest in clinical studies (hypothesis 3), the more trust in nonmedical information sources (hypothesis 4a), and the less secrecy around a hepatitis B diagnosis (hypothesis 5a), the higher the acceptance of social media as a recruitment tool for clinical hepatitis B studies. This mixed methods study provides the first quantitative insights into social media acceptance for clinical study recruitment among patients with hepatitis B. The study was limited to patients with hepatitis B in Germany but sets out to be a reference point for future studies assessing the attitudes toward and acceptance of social media recruitment for clinical studies. Such empirical inquiries can facilitate the work of researchers designing clinical studies as well as ethics review boards in balancing the risks and benefits of social media recruitment in a context-specific manner.

Dispensary personnel's views and experiences regarding oncologic cannabis and the counsel they offer adults withcancer.

A minority of oncologists feel qualified to advise adults with cancer on issues pertaining to medicinal cannabis. Adults with cancer frequently access medicinal cannabis information from non-medical sources such as cannabis dispensaries. We explored dispensary personnel's views and experiences regarding oncologic cannabis and the counsel they extend individuals with cancer. Snowball sampling in this qualitative study facilitated recruitment across 13 states (N = 26). Semi-structured phone interviews ceased with thematic saturation. A multi-stage thematic analysis combined inductive and deductive codes. Of the 26 dispensary personnel interviewed, 54% identified as female and 19% as non-white. Median age was 40 years. A consensus emerged among participants concerning the botanical's efficacy for cancer-related symptoms; less so regarding its antineoplastic potential. Principles for serving those with cancer included provision of client-centered, symptom-based, and trial-and-error approaches. Non-inhalation modes of administration were generally recommended. No consensus was reached as to whether delta-9-tetrahydrocannabinal (THC)- or cannabidiol-predominant products were preferable in this population. Challenges in oncologic advising included successfully identifying individuals with cancer at the dispensary counter, financial toxicity, the special treatment required for the THC-naïve, and operating in the absence of standardized guidelines. These informed assertions suggest that members of the oncologic community should grapple with the extent to which they feel comfortable with both the nature and degree of counsel adults with cancer receive through dispensaries.

Patient motivators to use opioids for acute pain after emergency care.

Patients are stakeholders in their own pain management. Factors motivating individuals to seek or use opioids therapeutically for treatment of acute pain are not well characterized but could be targeted to reduce incident iatrogenic opioid use disorder (OUD). Emergency departments (EDs) commonly encounter patients in acute pain for whom decisions regarding opioid therapy are required. Decision-making is necessarily challenged in episodic, unscheduled care settings given time pressure, limited information, and lack of pre-existing patient provider relationship. Patients may decline to take prescribed opioids or conversely seek opioids from other providers or non-medical sources. Using a framework analysis approach, we qualitatively analyzed transcripts from 29 patients after discharge from an ED visit for acute pain at a large, urban, academic hospital in the midwestern United States to describe motivating factors influencing patient decisions regarding opioid use for acute pain. A semi-structured interview guide framed participant discussion in either a focus group or interview transcribed and analyzed with conventional content analysis. Four major themes emerged from our analysis including a) pain management literacy, b) control preferences, c) risk tolerance, and d) cues to action. Our findings suggest targets for future intervention development and a framework to guide the engagement of patients as stakeholders in their own acute pain management.

Can youtube be trusted as a source of quality and reliable information on COVID-19 vaccination in Italy?

On March 2022, six different search queries were used to retrieve COVID-19 vaccination-related videos, resulting in the identification of 329 videos, and their characteristics were described. Two validated instruments, namely HoNCode and DISCERN, were used to assess the reliability and quality of the videos' content. Of the total number of videos, 72.0% were from non-medical or generalist channels. The most represented category was internet media (32.5%) while the less frequent was educational medical channel (7.0%). Videos from medical channels had higher reliability (p=0.002) and quality (p<0.001) than not medical channels, despite receiving fewer visualizations (p=0.004), likes (p=0.018) and comments (p<0.001). Media and news agencies sources consistently delivered lower quality content. These findings suggest that public health professionals and institutions should consider investing in social media representation to fill the gap with non-medical sources in terms of popularity, to provide reliable and interesting videos, and ultimately deliver health education to the general public.

Maxillary Frenulum and "Lip Tie": What Parents Understand.

To determine the proportion of parents that have some knowledge of abnormal maxillary frenulum, or "lip tie,"and their sources of this information. Cross-sectional study. Otolaryngology clinic. Consecutive parents of children ≤12 years of age presenting at a pediatric otolaryngology clinic were surveyed to discover their understanding of "lip tie" in children. The survey included questions on the effects of "lip tie,"where they learned about "lip tie,"whether they thought their child had "lip tie,"whether they had a child undergo "lip tie" division, and how concerned they would be if they thought their child had "lip tie."Information on participant demographics and social media was collected. Overall, 59.8% (193) of the 323 parents surveyed had heard of "lip tie"; of those, 17.1% (33) had a child that had undergone "lip tie" surgery. Most parents (91.2%, 176) thought "lip tie" caused breastfeeding problems. Roughly one-quarter of parents (51 of 197 responses) rated their concern about "lip tie" as >8 of 10 on a Likert scale (mean, 5.7). The reported sources of "lip tie" information included lactation consultants (36.8%, 71), nurses (22.8%, 44), and pediatricians (31.6%, 61) as well as nonmedical sources, such as social media, family, and friends (68.4%, 132). Overall, 87% (282) of the 323 participants reported daily use of social media. Although many parents are concerned about "lip tie,"much of their information on this condition comes from nonmedical sources. Social media would be a valuable platform to provide accurate information on "lip tie."

Aversion to Mesh Use in Pelvic Floor Surgery in a Latina Population at the U.S.-Mexico Border.

Limited studies have examined patient aversion to mesh use in pelvic surgery, especially in Latinas. This study aimed to assess aversion to pelvic surgery with mesh for urinary incontinence and pelvic organ prolapse in a sample of Latinas on the U.S.-Mexico border. This was a cross-sectional study of self-identified Latinas with symptoms of pelvic floor disorders, recruited at their initial consultation visit at a single, academic urogynecology clinic. Participants completed a validated survey to assess perceptions of mesh use in pelvic surgery. Participants also completed questionnaires assessing the presence and severity of pelvic floor symptoms and level of acculturation. The primary outcome was aversion to mesh surgery, as indicated by a response of "yes" or "maybe" to the question "Based on what you already know, would you avoid surgery using mesh?" Descriptive analysis, univariate relative risk, and linear regression analysis were completed to identify characteristics associated with mesh avoidance. Significance was assessed and considered at P values <0.05. Ninety-six women were included. Only 6.3% had prior pelvic floor surgery using mesh. Sixty-six percent indicated that they would be likely to avoid pelvic surgery that uses mesh. Only 9.4% indicated that they obtained information regarding mesh directly from medical professionals. Levels of concern regarding the use of mesh varied widely (29.2% not worried, 19.1% somewhat worried, 16.9% very worried). Higher percentages of "more acculturated" participants indicated a desire to avoid mesh surgery (58.7% vs 27.3%, P < 0.05). In this Latina population, a majority of patients indicated an aversion to using mesh in pelvic surgery. Few patients obtained information regarding mesh directly from medical professionals, relying instead on nonmedical sources.

Conocimiento de síntomas y factores de riesgo de enfermedad cerebrovascular en convivientes de personas en riesgo

Introducción: a pesar de los avances en el manejo del ACV, incluyendo la opción de trombólisis, pocos pacientes consultan de manera oportuna. Entre los motivos de ello se encuentran el desconocimiento de los síntomas de instauración y de las posibilidades terapéuticas disponibles.&#x0D; Objetivos: evaluar el grado de conocimiento acerca del ACV entre los convivientes de personas en riesgo de un evento cerebrovascular.&#x0D; Materiales y Métodos: estudio poblacional, descriptivo y transversal realizado en la ciudad de Manizales, entre convivientes o cuidadores de personas mayores de 60 años, hipertensos y/o diabéticos, entrevistados en sus hogares. Se diligenció un formulario con preguntas acerca del conocimiento espontáneo de síntomas y factores de riesgo (FR), conducta a adoptar frente a un ACV y AIT y si conocían la existencia de un medicamento trombolítico.&#x0D; Resultados: se entrevistaron 218 convivientes con edades entre 17 y 89 años (X 50,9 ± 15 años). El 68,8% de la muestra eran mujeres, 46,3% eran hijos, 23,4% cónyuges y 13,7% convivientes ajenos a la familia. Un 70,7% no conocía ningún síntoma de alarma y 45,4% ningún FR de ACV. La HTA fue el FR más citado, seguido de dislipidemia y tabaquismo, mientras que la DM fue el menos recordado. El 82,1% mencionó haber obtenido información acerca del ACV de fuentes no médicas. Solo 1,4% (n=3) de los encuestados conocía la existencia de un medicamento trombolítico.&#x0D; Conclusión: esta investigación identificó fallas significativas en el grado de conocimiento que tienen las personas acerca de la enfermedad cerebrovascular, no desde la condición de pacientes sino de convivientes de sujetos en riesgo de un evento cerebrovascular, dado que ellos son los llamados a reconocer rápidamente síntomas y actuar diligentemente. Se reitera la urgente necesidad de educar a los pacientes, sus cuidadores y al público en general, empleando diversos recursos de información tanto por profesionales de la salud como por mensajes en medios de comunicación que permitan hacer una efectiva prevención primaria y secundaria del ACV.

Knowledge and information sources towards Helicobacter pylori in Jordan.

In 2017, the Jordanian Ministry of Health reported that gastric cancer was one of Jordan's most diagnosed cancers. Gastric cancer is often linked to Helicobacter pylori, one of the foremost risk factors. Despite the high prevalence of H. pylori in Jordan, no information is available regarding the general population's awareness of the harmful effects of this pathogen. The study aims to assess the knowledge and the impact of the source of knowledge on H. pylori among the general population in Jordan. A cross-sectional study involving 933 participants was conducted between May and July of 2021. After meeting the inclusion criteria and consenting to participate in this study, participants completed the questionnaire. An interview-based questionnaire covered the following sections: sociodemographic data and knowledge related to H. pylori infection. 63% of the participants had a high level of education, 70.5% got their information about H. pylori infection from non-medical sources, and 68.7% had a low level of knowledge. Working in the medical field, attaining information from medical resources, and having a history of self-reported or family member of H. pylori infection showed a significant association with a high level of knowledge. The Mann-Whitney U test showed that the mean ranks of all knowledge items in the medical source group significantly exceed those of the non-medical source group (p-values < 0.05). In Jordan, the awareness of H. pylori was unsatisfying, like in other countries. Nevertheless, misconceptions in knowledge about H. pylori were identified and further awareness must be spread and advocated. Close observation of the non-medical sources of information is essential for delivering sufficient amount of knowledge to the general population.

Maternal Health Information Disparities Amid Covid-19: Comparing Urban and Rural Expectant Mothers in Ghana

The Covid-19 pandemic disrupted mothers’ access to credible and reliable health information from their healthcare providers. However, the impact of the pandemic on maternal health information access among rural and urban mothers has not been studied, especially in the Global South. Guided by the channel complementarity theory, we examined the sources of maternal health information rural and urban Ghanaian mothers used during the pandemic. Specifically, we analyzed the role access to technology plays in determining the quantity and quality of maternal health information expectant mothers had during the pandemic. Through purposive and snowball sampling techniques, we recruited and conducted in-depth interviews with 15 mothers, eight from rural communities and seven from urban communities in Ghana. We thematically analyzed the data and found that rural and urban mothers used medical and non-medical sources to obtain maternal health information. While medical sources remained the most credible information source even amid the pandemic, the mothers equally appreciated the immense benefits of other sources, particularly the internet. Our findings also suggest that the motivations for using maternal health information sources complementarily were not limited to the mothers’ functional needs, level of interest, and source characteristics but also covered the mothers’ location, resources, and health information literacy levels.

Multi-Source Data Interpretation For Field Scale Precision Management In Healthcare Industry

Precision management is a critical component of healthcare, where access to accurate and timely data is essential for effective decision-making. In the healthcare industry, precision management involves the use of multiple data sources to understand patient needs and improve health outcomes. Multi-source data interpretation, specifically at the field scale, is becoming increasingly popular as a means to obtain a comprehensive view of patient care. Field scale precision management in healthcare involves the integration of data from various sources, including electronic health records, patient-generated data, and social determinants of health. Through the use of advanced analytics and machine learning algorithms, this data can be processed and interpreted to identify patterns, trends, and insights that can help healthcare providers make more informed decisions. The application of multi-source data interpretation in healthcare is particularly important because it allows for a more holistic view of patient health, taking into account factors beyond traditional medical metrics. For example, social determinants of health, such as access to healthy food and safe housing, can have a significant impact on patient health outcomes, and these factors can be identified through the analysis of non-medical data sources. Overall, the use of multi-source data interpretation for field scale precision management in healthcare has the potential to significantly improve patient outcomes by providing healthcare providers with a more complete understanding of patient needs and circumstances. With advances in technology and analytics, healthcare providers can better harness the power of data to optimize patient care and improve health outcomes at scale.

Disability and Opioids Among Pregnant Women

This study using data from the 2015 to 2018 National Survey on Drug Use and Health examined prescription opioid use and misuse among pregnant women with sensory, cognitive, or daily activities–related disabilities. Pregnant women with any type of disability had higher adjusted odds of using (AOR, 1.71; 95% confidence interval [CI], 1.27–2.29) and misusing (AOR, 2.00; 95% CI, 1.22–3.28) opioids within the past year. Pain relief (59.5%) was the greatest motive for last opioid misuse. Approximately, 45% of women acquired opioids from friends/relatives and 25% obtained opioids from other non-medical sources. Pregnant women with disabilities are at increased risk for prescription opioid use and misuse.

Attitudes towards COVID‑19 vaccination in patients with cancer: A cross‑sectional study of 12 oncology centers.

Patients with cancer are a high-priority population for COVID-19 vaccination, as per guideline recommendations. The present cross-sectional study was performed to assess the perception of patients with cancer from Romania regarding COVID-19 vaccines. The study included 932 patients with solid and hematologic malignancies. This was a multicenter study including 12 oncology centers located in Western and Northwestern Romania. Between December 2021 and January 2022, patients with cancer completed an individual paper questionnaire regarding acceptance of the SARS-CoV-2 vaccination, type of vaccine, side effects and source of information. During the first year of the vaccination campaign in Romania, 58.05% (541/932) of the investigated patients received COVID-19 vaccines. The vaccination rate was highest in the 61-70 year age group (61.22%). The most frequently used vaccine was Pfizer-BioNTech (72%). There was a statistically significant association between the rate of vaccination and the area of residence and level of education (P<0.001), with rural residence and a lower level of education being predictive factors for COVID-19 vaccination hesitancy. Patients living in rural areas used non-medical sources (e.g. mass media, social platforms) as their main source of information (53.40%, 204/382), whereas patients living in urban areas (64.90%, 357/550) used predominantly medical sources (e.g. recommendations from oncologists and general practitioners). The main source of information among non-vaccinated patients was mass media (e.g. television, radio); 72.38% vs. 29.67% among vaccinated patients. For the latter, the primary source of information was the recommendations made by oncologists (59.70%) and general practitioners (56.76%). The most commonly reported side effect was injection site pain (20-33% for the first dose and 5-27% for the second dose). In conclusion, the present study confirmed that patients with cancer may be reluctant to receive a COVID-19 vaccine, mainly due to the fear of its potential side effects. Although there is scientific evidence to support the efficacy and safety of vaccines, the primary source of information for patients may affect vaccine uptake, thus affecting the efforts to stop the pandemic. Furthermore, the present study revealed that non-vaccinated patients preferred mass media as their main source of information, whereas vaccinated patients relied on the recommendations made by oncologists or general practitioners.

S2112 Receptive Anal Intercourse in IBD Patients: Impact on Treatment of Anorectal Disease

Introduction: Receptive anal intercourse (RAI) is a common practice both among men and women. For patients with medically refractory ulcerative colitis (UC) or UC with dysplasia who practice RAI,, it has been cited anecdotally as a reason not to pursue IPAA surgery. There remains a lack of formal studies investigating the true extent of and impact of RAI on IBD patients who have anorectal disease. Case Description/Methods: A 40-year-old man with a 15-year history of pancolonic UC presented with worsening abdominal pain and hematochezia. Flexible sigmoidoscopy revealed Mayo 3 inflammation. Stool infectious studies were negative and he was started on 40 mg of prednisone tapered over 8 weeks. Due to a history of treatment failure with infliximab, vedolizumab was started as an outpatient. He had clinical response but his symptoms worsened when prednisone was decreased below 20 mg. Despite 2 consultative visits with colorectal surgery, he refused an elective total colectomy with IPAA. He presented a year later with a UC flare despite being on continuous prednisone. After a week of intravenous steroids, inpatient flexible sigmoidoscopy still showed Mayo 3 inflammation. Urgent colectomy with IPAA was recommended. Despite being known to our health system for over one year, he admitted to regularly practicing RAI for the first time and state that was the reason he declined IPAA surgery. Biopsies from his flexible sigmoidoscopy revealed CMV infection, and he has treated with valacyclovir. His symptoms eventually remitted and he was successfully weaned off prednisone. He continues to be on maintenance vedolizumab. Discussion: Our case presents several major challenges in caring for IBD patients who practice RAI. Due to the social stigma associated with it, some patients may be reluctant to discuss with their providers how RAI impacts their overall health. In some instances, the patients instead rely on non-medical sources of information. There is lack of consensus in the surgical literature and anecdotally on whether RAI is permissible after IPAA surgery. Conceivably, a hand-sewn anastomosis may be the technique of choice compared to stapled anastomosis to allow for continued RAI practice after IPAA surgery. Additional considerations and discussion may be needed when deciding the pouch length. Overall, IBD patients who practice RAI represent an under-studied population with likely specialized medical and surgical needs.