Reasons For Non-participation Research Articles

A Scoping Review of Group Nutrition Education and Cooking Programs for People Affected by Cancer

BackgroundGroup nutrition education and cooking programs for people affected by cancer have the potential to address commonly reported unmet needs for dietary information, as well as provide opportunities for practical and social support. ObjectiveTo report the nutrition-related content, delivery methods, and outcomes measured in group nutrition education and cooking programs for people affected by cancer in the published literature, and describe how these programs were developed, implemented, and evaluated. MethodsA scoping review of academic literature is reported using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews guidelines. Key terms such as cancer, nutrition education, and cooking were searched across 4 databases (PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature, and Web of Science) on June 1, 2023, for records published over the past 10 years. Records were independently screened by 2 reviewers. Data extracted included program participants, components, nutrition-related content, delivery methods, outcomes measured, and information about how the program was developed, implemented, and evaluated. ResultsOf 2,254 records identified, 41 articles met eligibility criteria, reporting on 37 programs. Most programs were designed for adult cancer survivors (89%) and conducted after primary treatment (81%). Four programs invited caregivers to attend. Almost all programs (97%) included a nutrition education component, and more than half (59%) included cooking activities, with a predominant focus on recommendations and practical skills for healthy eating. Most programs were delivered byregistered dietitians and/or nutritionists (54%) and included group discussions (57%) and active involvement in cooking activities (57%) in program delivery. The participant outcomes that were measured covered dietary, psychosocial, clinical, and anthropometric domains. Many programs were developed with cancer survivors, dietitians or nutritionists, and researchers. No studies reported on sustainability of program implementation or overall costs. Programs were evaluated using data from surveys, focus groups, interviews, and field notes, with articles typically reporting on participation rates, reasons for nonparticipation, program acceptability, aspects of the nutrition-related programs valued by participants, and suggestions for improvement. ConclusionsFuture research should prioritize assessing the effectiveness of these programs for participants. Future development, implementation, and evaluation of these programs should include family members and friends and assess the sustainability of program delivery, including cost-effectiveness.

Reasons for Nonparticipation in the Special Supplemental Nutrition Program for Women, Infants, and Children

This cross-sectional study evaluates reasons reported for not participating in or withdrawing participation from the Special Supplemental Nutrition Program for Women, Infants, and Children from 2019 to March 2020.

International variation in ethics and contract approval processes for a low-risk observational study of mechanical ventilation discontinuation practices

ObjectivesTo describe international variation in ethics and contract processes, identify predictors of approval times, and reasons for nonparticipation in an international observational study of ventilation discontinuation practices. Study Design and SettingA nested cross-sectional survey of research personnel at 111 participating sites (representing 142 intensive care units [ICUs]) from six geographic regions (Canada, India, the United Kingdom, Europe, Australia/New Zealand, and the United States). ResultsWe analyzed responses from 80 sites (72.1% response rate). A single local or central approval was required at 34/80 (42.5%) and 23/80 (28.75%), respectively. Of those requiring central ethics approval, 20/23 (87.0%) sites required an additional approval. Sites with central vs. other ethics approval processes had significantly longer times to ethics approval (176 vs. 42 days; P < 0.0001). The median time to contract execution was 140 days (range: 11–1,215) with sites in India and the United States having the shortest and longest times to contract execution, respectively. We did not identify independent predictors of approval times. Of 190 sites that initially agreed to participate, 78 (41%) sites (89 ICUs) were ultimately unable to participate. ConclusionInternational ethics and contract approval times were lengthy and highly variable. Central ethics review processes significantly increased approval times.

Participation and Reasons for Non-participation in Sport and Recreational Activities Before and After the Outbreak of COVID-19: Analysis of Data From the 2016 and 2021 Poland National Sports Participation Survey

Abstract The ongoing study of factors that hinder physical activity (PA) supports the adaptation of intervention strategies to changing conditions and the creation of a more conducive environment for active lifestyles. The aim of the study was to analyze the barriers to Polish participation in sports and recreational activities (SRA) before and after the pandemic. Face-to-face interviews were conducted twice with a representative sample of Poles (in 2016 N=12183 household members, in 2021 N=8351). Descriptive statistical analysis was conducted using frequency and relative frequency (%). A Chi-square test of independence was used to analyze relationships between perceived barriers of non-participation in sports or physical recreation in 2016 and 2021 and the gender and age of respondents. In 2021, 38.8% (36.7% of women and 41.0% of men) declared participation in SRA (regularly or occasionally), with a 7.6 % point decrease in the number of those active compared to 2016. 20.6% of respondents participated in sports and recreation regularly in 2021. Compared to 2016, (21.7%) the difference was not statistically significant. Men declared regular participation more often than women (23.1% vs. 18.1% – 2021). Four main barriers were identified: (1) lack of free time – especially among 30 to 39-year-olds, 40 to 49-year-olds and men; (2) lack of interest, willingness or preference for passive leisure activities – especially among 15 to 19-year-olds; (3) having a medical condition and doctor’s contraindications – among 50 to 59-year-olds and 60 and older; and (4) age – especially among 60-year-olds. These barriers have not been overcome over time, and persisted or even gained in importance during the COVID-19 pandemic in addition to medical condition and doctor’s contraindications. We therefore turn our attention to eliminating these barriers, taking into account their importance in specific populations. It is essential to motivate people to overcome internal barriers through social support, health care, and government actions.

Supervised Home-Based Exercise Prehabilitation in Unfit Patients Scheduled for Pancreatic Surgery: Protocol for a Multicenter Feasibility Study.

Morbidity rates in pancreatic surgery are high, and frail patients with low aerobic capacity are especially at risk of complications and require prophylactic interventions. Previous studies of small patient cohorts receiving intra-abdominal surgery have shown that an exercise prehabilitation program increases aerobic capacity, leading to better treatment outcomes. In this study, we aim to assess the feasibility of a home-based exercise prehabilitation program in unfit patients scheduled for pancreatic surgery on a larger scale. In this multicenter study, adult patients scheduled for elective pancreatic surgery with a preoperative oxygen uptake (VO2) at the ventilatory anaerobic threshold ≤13 mL/kg/min or a VO2 at peak exercise ≤18 mL/kg/min will be recruited. A total of 30 patients will be included in the 4-week, home-based, partly supervised exercise prehabilitation program. The program comprises 25-minute high-intensity interval training on an advanced cycle ergometer 3 times a week. Training intensity will be based on steep ramp test performance (ie, a short-term maximal exercise test on a cycle ergometer), aiming to improve aerobic capacity. Twice a week, patients will perform functional task exercises to improve muscle function and functional mobility. A steep ramp test will be repeated weekly, and training intensity will be adjusted accordingly. Next to assessing the feasibility (participation rate, reasons for nonparticipation, adherence, dropout rate, reasons for dropout, adverse events, and patient and therapist appreciation) of this program, individual patients' responses to prehabilitation on aerobic capacity, functional mobility, body composition, quality of life, and immune system factors will be evaluated. Recruitment for this study began in January 2022 and is expected to be completed in the summer of 2023. Results of this study will provide important clinical and scientific knowledge on the feasibility of a partly supervised home-based exercise prehabilitation program in a vulnerable patient population. This might ease the path to implementing prehabilitation programs in unfit patients undergoing complex abdominal surgery, such as pancreatic surgery. ClinicalTrials.gov NCT05496777; https://classic.clinicaltrials.gov/ct2/show/NCT05496777. DERR1-10.2196/46526.

Prehabilitation for frail patients undergoing total hip or knee replacement: protocol for the Joint PREP feasibility randomised controlled trial

BackgroundApproximately, 8% of community-based adults aged ≥ 50 years in England are frail. Frailty has been found to be associated with poorer outcomes after joint replacement. Targeting frailty preoperatively via exercise and protein supplementation has the potential to improve outcomes for people undergoing joint replacement. Prior to proceeding with a randomised controlled trial (RCT), a feasibility study is necessary to address key uncertainties and explore how to optimise trial design and delivery.MethodsThe Joint PRehabilitation with Exercise and Protein (Joint PREP) study is a feasibility study for a multicentre, two-arm, parallel group, pragmatic, RCT to evaluate the clinical and cost-effectiveness of prehabilitation for frail patients undergoing total hip or knee replacement. Sixty people who are ≥ 65 years of age, frail according to the self-reported Groningen Frailty Indicator, and scheduled to undergo total hip or knee replacement at 2–3 hospitals in England and Wales will be recruited and randomly allocated on a 1:1 ratio to the intervention or usual care group. The usual care group will receive the standard care at their hospital. The intervention group will be given a daily protein supplement and will be asked to follow a home-based, tailored daily exercise programme for 12 weeks before their operation, in addition to usual care. Participants will be supported through six follow-up calls from a physiotherapist during the 12-week intervention period. Study questionnaires will be administered at baseline and 12 weeks after randomisation. Embedded qualitative research with patients will explore their experiences of participating, reasons for nonparticipation, and/or reasons for withdrawal or treatment discontinuation. Primary feasibility outcomes will be eligibility and recruitment rates, adherence to the intervention, and acceptability of the trial and the intervention.DiscussionThis study will generate important data regarding the feasibility of a RCT to evaluate a prehabilitation intervention for frail patients undergoing total hip and knee replacement. A future phase-3 RCT will determine if preoperative exercise and protein supplementation improve the recovery of frail patients after primary joint replacement.Trial registrationISRCTN11121506, registered 29 September 2022.

"I Don't Want My Child to Be a Guinea Pig": Reasons for Non-Participation in a Parental Tobacco Cessation Trial in the Pediatric Emergency Department Setting.

(1) Background: Pediatric emergency department (PED) settings are opportune venues in which to recruit parental smokers into tobacco cessation interventions. However, the barriers associated with parents' participation in PED-based cessation trials are unknown. The objective was to explore parents' reasons for non-participation in a PED-based tobacco cessation trial. (2) Methods: We employed the framework method and conducted a qualitative data analysis of parental smokers who were eligible to participate in a PED-based tobacco cessation trial and did not choose to participate (n = 371). (3) Results: Two main themes emerged about reasons for non-participation: (a) Not interested in participating in a research study, and (b) concerns specific to the study. Parents had various reasons for not participating in the cessation trial including not being interested in quitting, parents' health and well-being, parents' beliefs about research, and time required for the study and follow-up visits. (4) Conclusion: General disinterest and specific study-related concerns were touted as reasons for non-participation in a PED-based tobacco cessation trial. Given the potential reductions in tobacco-related morbidity to both parents and children that tobacco control interventions can facilitate, future tobacco interventions should consider alterations in study design and recruitment strategies to encourage all eligible parental smokers to participate.

Baseline Features and Reasons for Nonparticipation in the Colonoscopy Versus Fecal Immunochemical Test in Reducing Mortality From Colorectal Cancer (CONFIRM) Study, a Colorectal Cancer Screening Trial

The Colonoscopy Versus Fecal Immunochemical Test in Reducing Mortality From Colorectal Cancer (CONFIRM) randomized clinical trial sought to recruit 50 000 adults into a study comparing colorectal cancer (CRC) mortality outcomes after randomization to either an annual fecal immunochemical test (FIT) or colonoscopy. To (1) describe study participant characteristics and (2) examine who declined participation because of a preference for colonoscopy or stool testing (ie, fecal occult blood test [FOBT]/FIT) and assess that preference's association with geographic and temporal factors. This cross-sectional study within CONFIRM, which completed enrollment through 46 Department of Veterans Affairs medical centers between May 22, 2012, and December 1, 2017, with follow-up planned through 2028, comprised veterans aged 50 to 75 years with an average CRC risk and due for screening. Data were analyzed between March 7 and December 5, 2022. Case report forms were used to capture enrolled participant data and reasons for declining participation among otherwise eligible individuals. Descriptive statistics were used to characterize the cohort overall and by intervention. Among individuals declining participation, logistic regression was used to compare preference for FOBT/FIT or colonoscopy by recruitment region and year. A total of 50 126 participants were recruited (mean [SD] age, 59.1 [6.9] years; 46 618 [93.0%] male and 3508 [7.0%] female). The cohort was racially and ethnically diverse, with 748 (1.5%) identifying as Asian, 12 021 (24.0%) as Black, 415 (0.8%) as Native American or Alaska Native, 34 629 (69.1%) as White, and 1877 (3.7%) as other race, including multiracial; and 5734 (11.4%) as having Hispanic ethnicity. Of the 11 109 eligible individuals who declined participation (18.0%), 4824 (43.4%) declined due to a stated preference for a specific screening test, with FOBT/FIT being the most preferred method (2820 [58.5%]) vs colonoscopy (1958 [40.6%]; P < .001) or other screening tests (46 [1.0%] P < .001). Preference for FOBT/FIT was strongest in the West (963 of 1472 [65.4%]) and modest elsewhere, ranging from 199 of 371 (53.6%) in the Northeast to 884 of 1543 (57.3%) in the Midwest (P = .001). Adjusting for region, the preference for FOBT/FIT increased by 19% per recruitment year (odds ratio, 1.19; 95% CI, 1.14-1.25). In this cross-sectional analysis of veterans choosing nonenrollment in the CONFIRM study, those who declined participation more often preferred FOBT or FIT over colonoscopy. This preference increased over time and was strongest in the western US and may provide insight into trends in CRC screening preferences.

Hair Collection for Cortisol Among Youth Experiencing Homelessness.

Investigations of chronic physiological stress measured by hair cortisol are rapidly expanding among community samples of adolescents and adults. However, research examining physiological stress among youth experiencing homelessness is nascent despite the youth's increased risk for adverse exposures and subsequent impaired mental health. This article aimed to examine the feasibility of collecting hair for measuring cortisol among diverse youth experiencing homelessness and gain an understanding of variation in participation. Analysis of survey and hair participation data from three pilot studies among youth experiencing homelessness was conducted. Survey measures included sociodemographic characteristics (age, race and ethnicity, sex assigned at birth, and sexual orientation) and reasons for nonparticipation. Descriptive analysis examined participation rates in hair collection for cortisol measurement, including sociodemographic differences in participation. Participation in the hair sampling for cortisol was high for the combined sample (88.4%), with some variation across the three pilot studies. Insufficient hair for cutting was the most common reason for not participating; Black and multiracial youth, as well as male youth, had a higher prevalence of nonparticipation. The collection of hair for cortisol research among youth experiencing homelessness is feasible, and integration of physiological measures of stress into research with this vulnerable population should be considered, given their high risk for adversity and death by suicide and drug overdose. Methodological considerations and avenues for potential research are discussed.

Reasons for Nonparticipation in Outpatient Cardiac Rehabilitation Among Older Patients with Heart Failure: A Report of the Flagship Study.

Iritani, Naoki MSc; Adachi, Takuji PhD; Iwatsu, Kotaro PhD; Kamiya, Kuniyasu PhD; Kamisaka, Kenta PhD; Yamada, Sumio PhD; on behalf of the FLAGSHIP collaborators Author Information

A German Model Project for Workplace Health Promotion-Flow of Communication, Information, and Reasons for Non-Participation in the Offered Measures.

Background: Workplace health promotion (WHP) as a part of workplace health management (WHM) was strengthened in German legislature with the Prevention Act of 2015. However, smaller enterprises often do not offer WHM or WHP. Accordingly, a model-project for improving the uptake and implementation, particularly in micro-, small, and medium-sized enterprises (MSMEs) was carried out. The aim of the study was to determine reasons for non-participation in WHP offers and analyze communication issues, both from the employee’s and employer’s perspective. Methods: In total, 21 managers or persons responsible for WHP participated in the first online survey between March and April 2020, and 156 employees responded to the second online survey between June and October 2021. The importance of barriers and communication issues was investigated. Based on a principal component analysis on non-participation, differences regarding sociodemographic variables were analyzed. Results: Most employees knew about the offered measures and that the measures were cost free. There was no significant association between having communicated the offers to the employees and considering them suitable for their needs. Most of the managers or persons responsible for WHP rated the measures as sufficiently varied and allowed staff to take part during working-time. Reasons for non-participation from the managers’ point of view were travel time to the location of the offers, lack of time, and a missing fit between offers and employees’ needs. From the employees’ point of view, workload (including working time) was the main barrier to participation. Conclusions: For the practical implementation of model projects in MSMEs, special attention should be paid to ensuring opportunity to participate, which may be easier with in-house offers.

“Why don’t they participate?” Reasons for nonparticipation in adult learning and education from the viewpoint of self-determination theory

The study deals with the perceived reasons for nonparticipation in adult learning and education (ALE), drawing on existing research concerning the motivation for lifelong learning, adult attitudes towards education, and the study of dispositional barriers. The aim of the study is to determine the subjective reasons/motivation of adults not to participate in ALE and what factors influence their nonparticipation. For this purpose, we drew on self-determination theory (SDT). Based on that we have created the research tool “Motivation to Nonparticipation Scale” (MNP-S), which measures three factors: extrinsic motivation, intrinsic motivation, and amotivation. The empirical research was conducted with a representative sample of adults (N = 943, age: 19 to 81 years) who had not participated in ALE. Contrary to theoretical assumptions of SDT, amotivated adults do not predominate among nonparticipants, with the main subjective reasons for nonparticipation based on intrinsic or extrinsic motivations.

Factors influencing participation in preventive interventions for gastric cancer: the results from the GISTAR study.

Search-and-treat strategy for Helicobacter pylori and surveillance of patients with precancerous lesions are recommended to decrease the burden of gastric cancer in high-risk areas. We aimed to evaluate the acceptance of the target population to these strategies. We applied a search-and-treat strategy combined with biomarker screening (pepsinogens I and II, gastrin-17) for atrophic gastritis to healthy individuals aged 40-64 years within the GISTAR Pilot study. Different means of invitation were evaluated - direct telephone calls, letters of invitation via the general practitioners. Participants with altered biomarker results were invited to undergo upper gastrointestinal endoscopy. H.pylori positive individuals were offered eradication therapy. Data on the compliance to the treatment and reasons for noncompliance were collected via telephone. Altogether 3453 participants were enrolled. The attendance of women participants was 1.9 times higher although active invitation strategies were mainly targeting men. The yield for the telephone invitations was higher than for mail-delivered invitations (2.1 calls vs. 7.7 letters required to recruit one study subject). Out of 661 individuals reached with the invitation to undergo upper endoscopy, 520 (78.7%) attended the procedure. Out of 1185 study subjects eligible for eradication, 810 (68.4%) accepted it. Of those having received the medication, 765(94.4%) completed it. The reasons for nonparticipation were the overall misconception of the importance of screening, busy schedule and others. While only the minority of the target population participated in the gastric cancer prevention strategy, relatively high compliance was seen among the participants. The acceptance rate and the identified reasons for refusing to participate in our study indicate that there is a need to raise gastric cancer awareness and its existent preventive strategies within the general population for their successful implementation in the community.

Participation in a Heart Failure Clinical Trial: Perspectives and Opportunities From the VICTORIA Trial and VICTORIA Simultaneous Registry.

Randomized controlled trials (RCTs) often target enrollment of patients with demographics and outcomes less representative of the broader population of interest. To provide context for the VICTORIA trial (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction), we designed a registry of hospitalized patients with worsening heart failure to characterize their clinical profile, outcomes, and reasons for their nonparticipation in a RCT. Fifty-one RCT sites in Canada and the United States participated. Eligible patients included those with chronic heart failure, hospitalized for heart failure, and an ejection fraction <45%; no other exclusions were applied. Sites identified patients between 2017 and 2019 during the RCT enrollment period. RCT eligibility criteria were applied, and non-mutually exclusive reasons for nonenrollment were captured. Mortality at 1 year was estimated via the Meta-Analysis Global Group in Chronic Heart Failure risk score or as observed in the RCT. Overall, 2056 patients were enrolled in the registry; 61% (n=1256) were ineligible for the RCT, 37% (n=766) were eligible but not enrolled, and 2% (n=34) were also enrolled in the RCT. Registry participants had a median age of 70, 33% were women, and 63% were White. The median risk score predicted a 20.9% 1-year mortality, higher than in the RCT (predicted 14.7% and observed 11.5%). Major reasons for ineligibility in the RCT included the use of nitrates (23%), systolic blood pressure <100 mm Hg (12%), and substance use (11%) with other exclusion criteria <10%. For eligible patients, reasons for nonparticipation in the RCT included lack of interest in participating (28%), poor compliance (25%), inability to complete follow-up (23%), too sick (20%), unable to provide consent (17%), and distance from site (15%). Patients with worsening heart failure in routine clinical practice exhibit high-risk features, and approximately one-third were eligible for an RCT but excluded. The majority of these nonparticipating patients had modifiable reasons. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02861534.

Statutory skin cancer screening in Germany : Motivation and motives for participation versus nonparticipation

HintergrundIm Jahr 2008 wurde in Deutschland das gesetzliche Hautkrebsscreening (gHKS) für gesetzlich Versicherte ab 35 Jahren eingeführt. Primäres Ziel ist es, maligne Veränderungen der Haut frühzeitig zu diagnostizieren, die Mortalität zu reduzieren sowie die Morbidität und Lebensqualität zu verbessern. Obwohl das gHKS vor mehr als einer Dekade eingeführt wurde, wird dieses nur von einem Teil wahrgenommen.Ziel der ArbeitWelche Gründe bestehen für die geringe Teilnahmequote am gHKS in der berechtigten Normalbevölkerung?MethodikIn computergestützten Telefoninterviews mit einer repräsentativen Bevölkerungsstichprobe (N = 1015) gesetzlich Versicherter ab 18 Jahren wurden im Januar 2019 die Einstellung zum Thema Hautkrebs, die Rate der Inanspruchnahme des gHKS sowie die Gründe für die Nichtteilnahme erhoben. Ein Teil der Daten wurde mit vorausgehenden Erhebungen aus den Jahren 2011, 2013 und 2015 verglichen.ErgebnisseUnter den 1015 Teilnehmern wurde das Thema Hautkrebs von 40 % als besorgniserregend eingestuft. Zum gHKS waren 75,4 % der Befragten berechtigt. Von diesen hatten 52,6 % bisher noch nie am gHKS teilgenommen. Die Inanspruchnahme nahm im Alter jedoch zu. Ferner war die Nichtteilnehmerquote bei gehobenem Schulabschluss mit 45 % deutlich niedriger als bei niedrigem Schulabschluss mit 58 %. Der Anspruch auf das gHKS war 35 % der Nichtteilnehmer nicht bekannt. Als Grund für die Nichtteilnahme nannten 20 % Zeitmangel, 58 % sahen keine Notwendigkeit, weil sie sich gesund fühlen. Generell hielten aber 91 % aller 1015 Befragten Früherkennungsuntersuchungen für sinnvoll und hatten zu 66 % bereits an anderen Vorsorgeuntersuchungen teilgenommen.DiskussionDie mit etwa 50 % geringe Teilnehmerquote am gHKS sowie die abnehmende Besorgnis in der Bevölkerung um das Thema Hautkrebs legen nahe, dass eine weitere, auch risikogruppenorientierte Aufklärung der Bevölkerung über die Relevanz des Themas Hautkrebs notwendig ist.

Reasons for Participation and Nonparticipation in Psychological Relapse Prevention for Anxiety and Depression: A Qualitative Study.

Anxiety and depressive disorders frequently recur, but participation in effective psychological interventions to prevent relapse is limited. The reasons for nonparticipation are largely unknown, hampering successful implementation. The aims of this study were: (1) to investigate reasons why patients with remitted anxiety or depressive disorders refuse cognitive-behavioral therapy relapse prevention interventions (RPIs), (2) to compare these reasons with reasons to participate, and (3) to gain insight into patients' preferences regarding relapse prevention. A qualitative study was conducted in which data were gathered from 52 semistructured interviews with patients who either refused or agreed to participate in psychological relapse prevention. The constant comparative method was used. The data showed that those who refused to participate (1) did have knowledge about relapse risks in general, (2) but did not relate this risk to themselves, and therefore, did not feel the need for relapse prevention, or (3) declined to participate for logistical reasons or reasons related to the content of the intervention. Preferences concerning the form and content of RPIs were very diverse. Psychoeducation on relapse should be provided to patients to help them relate recurrence risks to themselves. RPIs should also be individually tailored.

Reasons for Nonparticipation in a Sustained Hemodialysis Intradialytic Exercise Program

Patients with end-stage kidney disease requiring hemodialysis suffer frailty and poor physical function. Exercise can improve physical function; however, barriers exist to intradialytic exercise programs. The objective of this study was to explore patients' reasons for not exercising in an extant intradialytic exercise program. We conducted a retrospective analysis reporting the reasons for not exercising in an intradialytic exercise program in two hemodialysis centers over a 4-week period. We explored whether patient characteristics and the presence of an exercise professional were associated with missed exercise sessions. Seventy-five patients participating in the intradialytic exercise program completed 57% of prescribed intradialytic exercise sessions. The three most frequently reported reasons from patients not exercising were refusal (24%), followed by fatigue (19%) and symptoms (14%). Patients were more than twice as likely to exercise if a kinesiologist was present (odds ratio [OR]: 2.26, confidence interval [CI]: 1.5, 3.4 P=.03). They were less likely to exercise if they were women (OR: 0.66, CI: 0.45, 0.95 P=.002), had been on dialysis greater than 60months (OR: 0.55, CI: 0.37, 0.80 P<.002), or had more than two comorbid conditions (OR: 0.63, CI: 0.43, 0.90, P=.01). Patient adherence to intradialytic exercise programs is strongly associated with the presence of exercise professionals.

Qualitative Research in CKD: How to Appraise and Interpret the Evidence

Qualitative Research in CKD: How to Appraise and Interpret the Evidence

An Exploration of the Deterrents to Adult Basic Education Among Blue Collar Workers

This phenomenological study explored how blue collar workers employed in a north Mississippi manufacturing facility described their reasons for not participating in adult basic education (ABE) when nonparticipation would result in termination. The structure of the ABE classes was designed to reduce the costs and time constraints to participation. A group of 8 respondents constituted the sample from a population of 23 nonparticipating workers and maximal variation sampling was used to increase gender, race, and age diversity within the sample. Three major themes emerged as deterrents to participation: (a) Test of Adult Basic Education and ABE classes were not perceived as relevant, (b) fear of embarrassment, and (c) low self-efficacy (i.e., a self-perceived lack of capability to perform successfully). However, lack of relevancy and fear of embarrassment were found to be used as reasons for nonparticipation when low self-efficacy in learning new material, reading, and math problem solving were present.

Determinants for voluntary participation in staff screening during an methicillin-resistant Staphylococcus aureus (MRSA) outbreak on a neonatal ward

We investigated healthcare worker (HCW) behavior with regard to a voluntary methicillin-resistant Staphylococcus aureus (MRSA) staff screening during a MRSA outbreak in a neonatal ward. Avoiding MRSA transmission from HCWs to patients was the most important reason for participation. Inconvenient screening time was the most frequently cited reason for nonparticipation.