Return Envelope Research Articles

Methodological report of a cross-sectional survey of abortion-related knowledge, attitudes and practices amongst health professionals in Britain, strategies adopted and lessons learned: evidence from the SACHA Study

BackgroundMost surveys examining health professionals’ knowledge, attitudes and practices around abortion have used convenience samples and have targeted doctors. Our goal in the SACHA Study, drawing on evidence-based strategies to maximise response rates, was to achieve a representative sample of a wider range of health professionals, working in general practice, maternity services, pharmacies, sexual and reproductive health (SRH) clinics and specialist abortion services in Britain, to explore the knowledge, attitudes and experience of abortion care and views on future models of delivery.MethodsA cross-sectional questionnaire-based survey of midwives, doctors, nurses and pharmacists in England, Scotland and Wales was undertaken between November, 2021 and July, 2022. We used a stratified cluster sampling approach to select a random sample of sites and all eligible staff within those services were asked to respond to the survey. Evidence-based strategies to maximise completion rates were adopted, including postal delivery of the one-page questionnaire with personal letter of invitation and a stamped address envelope for return, inclusion of an unconditional voucher and follow-up.ResultsOverall, 147 of the 314 (46.8%) health service sites randomly selected took part in the survey. Reasons for non-participation included local Research and Development (R&D) Department non-response, lack of resources or insufficient time to support or approve the study, lack of interest in or perceived relevance of the topic and insufficient capacity to take part, exacerbated by work demands during the COVID epidemic. Of the 1370 questionnaires sent to eligible identified participants within these services, 771 were completed and returned (56.3%). At the service level the highest proportion of returns was from SRH clinics (81.0%) and the lowest from general practice (32.4%). In relation to profession, returns were highest amongst midwives (69.6%) and lowest amongst pharmacists (36.5%).ConclusionsObtaining information about health professional knowledge, attitudes and practices is key to guide service development and policy and to identify gaps in training and service provision in abortion. Despite our attempts to gain a representative sample of health professionals, the challenges we experienced limited the representativeness of the sample, despite the use of an evidence-based strategy.

The impact of reminders on representativeness and survey estimates among web-mode invited in the Danish National Health Survey.

Declining response proportions in health surveys may lead to increased non-response bias. Multiple reminders are often used to increase response proportions, and, thus, we aimed to determine if the use of reminders decreased the magnitude of non-response bias among web-mode invited in the Danish National Health Survey 2023. In the Danish National Health Survey 2023, a national random sample of 23467 individuals (aged ≥16 years) with residence in Denmark were invited by a secure electronic mail service. Invited individuals received up to five inquiries: (i) web invitation, (ii) web reminder, (iii) paper invitation including a questionnaire and a prepaid return envelope, (iv) paper reminder, and (v) paper reminder including a questionnaire and a prepaid return envelope. The cumulative response proportions after first-, second-, third-, fourth-, and fifth inquiries were 19.1%, 28.9%, 37.2%, 39.3%, and 42.0%, respectively. In general, third, fourth, and fifth mailing respondents were more often men, at younger ages, with non-Western backgrounds, and unmarried compared to first mailing respondents. Furthermore, third, fourth, and fifth mailing respondents were in general found to have less favorable health behavior than first mailing respondents, but also a lower prevalence of fair or poor self-rated health and long-standing health problems. In conlusion, reminders are an effective way to increase the response proportion. Furthermore, the use of reminders was found to decrease the magnitude of non-response bias; however, the decrease was small due to the low number of individuals responding after fourth and fifth inquiries.

S487 Modification of the Fecal Immunochemical Test (FIT) Return Envelope Process Improves Lab Acceptance Rate

S487 Modification of the Fecal Immunochemical Test (FIT) Return Envelope Process Improves Lab Acceptance Rate

Factors Associated With Mailed Fecal Immunochemical Test Completion in an Integrated Academic-Community Healthcare System.

Mailed fecal immunochemical test (FIT) outreach is an effective strategy to increase colorectal cancer (CRC) screening. The aim of this study was to determine the patient-level, clinic-level, and geographic-level factors associated with CRC screening completion in a mailed FIT outreach program. This retrospective cohort study was conducted in the integrated healthcare system of University of Washington Medicine and included patients aged 50-75 years, who were due for CRC screening, and had a primary care encounter in the past 3 years. Eligible patients received mailed outreach that included a letter with information about CRC screening, FIT kit, and a prepaid return envelope. CRC screening and factors associated with completion were obtained from electronic health records and the CRC screening program database. Of the 9,719 patients who received mailed outreach, 29.6% completed FIT mailed outreach. The median FIT return time was 27 days (interquartile range 14-54). On multivariate analysis, patients with a higher area deprivation index, insured through Medicaid, living without a partner, and whose last primary care visit was >12 months ago were less likely to complete a FIT compared with their counterparts. Over a 12-month period, overall CRC screening across the health system increased by 2 percentage points (68%-70%). Mailed FIT outreach in an integrated academic-community practice was feasible, with 32% of invited patients completing CRC screening by FIT or colonoscopy, on par with published literature. Patient and geographic-level factors were associated with CRC screening completion. These data will inform additional interventions aimed to increase CRC screening participation in this population.

Self-Screening for Cervical Cancer Offered through a Digital Platform in a Region of British Columbia with Lower Screening Rates.

Cervical cancer is highly preventable through vaccination, early detection, and treatment, yet is the fourth most common cancer globally. HPV testing is superior to cytology for the detection of cervical pre-cancer, and jurisdictions around the world are implementing HPV primary screening, which offers the opportunity for self-screening, an important self-care intervention. Digital health solutions are also increasingly important components of self-care. In this study, we assessed the acceptability and completion of self-screening for cervical cancer offered through a digital platform within a low screening uptake region of British Columbia. The primary objective of this study was to evaluate the acceptability of self-screening for cervical cancer offered through a digital platform as measured by return rates of self-screening kits. Patients due or overdue for cervix screening were invited to participate. Eligible participants registered online to receive a self-screening kit, which included a device for vaginal self-screening, instructions, and a return envelope, sent to their home. After self-screening using the vaginal device, HPV testing was conducted. HPV-negative participants were returned to routine screening, and HPV-positive participants were recommended for cytology or colposcopy. Attendance rates at follow-up were evaluated. Participants were invited to complete an acceptability survey. From April 2019 to December 2023, 283 participants were sent kits, with 207 kits returned for a completion rate of 73%. Of valid samples (n = 202), 15 were HPV positive, and 93% attended follow-up care. Most respondents found the CervixCheck website easy to use, informative, and secure and were satisfied with receiving their results online. CervixCheck had a high completion rate among participants who were sent a self-screening kit. High compliance with recommended follow-up and high acceptability of self-screening for cervical cancer was observed. Most participants indicated they would self-screen again in the future. Innovative approaches to cervical screening, including self-screening and the use of digital health interventions, are ways to enhance equity and improve uptake of cervical screening.

Montgomery Ward's Export Department: international orders and mail-order consumers in Latin America, 1890-1930

New primary source material documents the expansion of Montgomery Ward’s mail order through their export department to Latin American consumers from the end of the Spanish American War in 1898 to ca.1930, and the formative period of export advertising and mail order marketing for the first time. Chicago was the center of mail order and ready-made clothing; women’s ready-made suits provide a case study of merchandise. A Chicago clothier requested a U.S. State Department inquiry to study the viability of introducing American ready-made clothing in Latin America in 1899. This Government study provides significant details about ready-made clothing in Latin America previously unknown to scholars. U.S. mail order required international parcel post for growth, and a Ward employee championed its passage in 1919. New primary sources have been contextualized within the frameworks of business, advertising, postal, and dress history and political economy. Advances in export advertising led to growth, which has been traced using statistics from trade journals and an internal document about the history of the export department. The essay ends by examining the names and addresses of Latin American consumers from extant Montgomery Ward return envelopes that have been digitally mapped and interpreted. Latin American consumption theory will be examined apropos of consumers and the meaning of mail order goods.

The effect of mailed outreach on FIT completion among patients aged 45-50 in a safety net healthcare system.

Colorectal cancer screening is recommended starting at age 45, but there has been little research on strategies to promote screening in patients younger than 50. An outreach program quasi-randomly assigned patients aged 45-50 without recent fecal immunochemical test (FIT), colonoscopy or contraindications to screening to two intervention arms: electronic outreach with email and text (electronic outreach only)versus electronic outreach plus mailed outreach with FIT, an instructional letter and a prepaid return envelope (mailed + electronic outreach). In response to known disparities in screening uptake, all Black patients were assigned to receive mailed + electronic outreach. Among patients quasi-randomly assigned to an intervention (non-Black patients), the 180-day FIT completion rate was 18.8% in the electronic outreach only group (n = 1,318) and 25.0% in the mailed + electronic outreach group (n = 1,364) (difference 6.2% [95% CI 3.0, 9.4]). FIT completion was 16.6% among Black patients (n = 469), 8.4% (95% CI 4.1, 12.6) lower than among non-Black patients also assigned to mailed + electronic outreach. Among patients aged 45-50, mailed + electronic outreach had a greater effect on FIT completion than electronic outreach alone. Crossover between intervention groups likely lead to an underestimation of the effect of mailed outreach.

Patient reported colonoscopy barriers: A cross sectional survey.

e23149 Background: As a leading cause of cancer-related death in the United States, colorectal cancer (CRC) screening is an acceptable cost-effective strategy to reducing mortality indices in the country. 10-yearly colonoscopy screening is the most effective with a mortality reduction of 73%. Despite this, CRC screening rates remain low. The purpose of this study was to describe barriers associated with colonoscopy screening in primary care settings. Methods: Postage pre-paid return envelopes and surveys were sent to all established patients aged > 50 from primary care practices (n = 4) in an employed physician group; the group also serves as a residency continuity clinic for a community teaching hospital. Variables included demographics and literature-reported barriers to colonoscopy screening. Whether or not a patient had a colonoscopy (including if > 10 years since a colonoscopy) was compared to patient reported barriers and demographics. Statistical significance was set at p < 0.05; strength of association was measured by Cramer’s V. Results: Average age of patients was 62 + 6 years; 61.4% were female; 35.3% were privately insured; and 10.3% were non-white. Older patients were slightly more likely to get screened, 63 + 6 years vs. 60 + 7 years (p = 0.006). Neither race, sex, insurance guarantor, education, marital status or income were associated with screening. Rate of colonoscopy screening in this series was 76.7% (n = 276/360), which was greater than rates reported by CDC for Ohio. In those screened, the rate of colonic or rectal polyps was remarkably noted to be up to 47.5% (131/276). The most important barriers to colonoscopy screening were knowledge of insurance coverage (p < 0.001; Cramer’s V = 0.216, p < 0.001); transportation to procedure (p = 0.001; Cramer’s V = 0.172, p = 0.001); someone to accompany patient (p = 0.002; Cramer’s V = 0.164, p = 0.002); and unaware of screening or lack of perceived health threat (p = 0.019; Cramer’s V = 0.150, p = 0.019). The remaining barriers were not associated with increased likelihood of colonoscopy: fear of finding cancer, belief in screening effectiveness, embarrassment or anxiety, or fear of invasive test. While bowel prep is often cited as a barrier to colonoscopy, this factor was not statistically significant. Likewise, physician-initiated discussion and time off from employment were not associated with screening. The most important colonoscopy barrier was patient knowledge regarding insurance for the procedure; overall, 29% of patients reported that they were unsure if colonoscopy was covered. Among those not screened, the rate rose to 47%. Conclusions: The most important colonoscopy barrier identified was patient knowledge regarding insurance for the procedure. While physician counseling for colonoscopy needs to include bowel prep and procedure risks, greater awareness of insurance coverage and social factors may facilitate physician understanding of colonoscopy screening hesitancy.

Pushing the envelope: the feasibility of using a mailed contrast sensitivity test to prioritise cataract waiting lists

BackgroundCataract waiting lists are growing globally. Pragmatic, cost-effective methods are required to prioritise the most urgent cases. Here we investigate the feasibility of using a third-party pen-and-paper contrast sensitivity, CS, test (SpotChecksTM), delivered by mail, and performed by patients at home unsupervised, to flag eyes requiring surgery.MethodsPen-and-paper CS tests were mailed to 233 people waiting for a cataract assessment, along with a prepaid return envelope (cross-sectional study). Response rates were tabulated (stratified by age, sex and socioeconomic status), and test scores analysed to see how well the home tests predicted which eyes were listed subsequently for surgery. A subset of patients (N = 39) also underwent in-person follow-up testing, to confirm the accuracy of the home data.ResultsForty-six percent of patients responded (216 eyes). No gross differences were observed between respondents and non-respondents, either in terms of age, sex, socioeconomic status, or geographic location (all P > 0.05). The home-test CS scores predicted which eyes were subsequently listed for surgery, with an AUROC {±CI95%} of 0.69 {0.61–0.76}. Predictive performance was further-improved when machine learning was used to combine CS scores with letter acuity, extracted from patients’ medical records (AUROC {±CI95%} = 0.77 {0.70–0.83}). Among 39 patients who underwent follow-up testing, home CS scores were correlated with various measures made in clinic: biometry signal-to-noise (P = 0.032), LogMAR acuity, Pelli-Robson CS and SpotChecks CS (all P < 0.001).ConclusionsMailing patients pen-and-paper CS tests may be a feasible, 'low-tech' way of prioritising patients on cataract waiting lists.

Electronic 1 year follow up after ablation

Abstract Background Several studies have shown that phone calls are an effective but resource intensive Follow-up (FU) method to collect patient reported data (PROM) after discharge from hospital. Regarding patient preference for FU, who has been ablated for atrial fibrillation (AF), most of the AF patients favoured a questionnaire with a stamped return envelope. In 2019 the National registry for ablation and electrophysiology in Norway (AblaNor) was established. All patients who have been in an EP lab receive an electronic FU questionnaire (ePROM) 1 year after the date of ablation. In Norway, it has been developed a technical solution which allows data submitted from the patient to be registered in the Health Network,"ePROM engine". Little is known about the functionality and response rate of electronic solutions. Purpose The aim of our study was to investigate an electronic FU approach in general and in different patient subgroups from AblaNor. Method We used data from the National register of ablation and electrophysiologi in Norway, Ablanor. The data are FU questionnaire who all patients received 1 year after ablation. All questionares are the same, independent diagnosis group. The patients received the FU questionnaires electronically via Helse Norge.no. The data is based on registrations from 2020-21. Results The data shows that amongst the 7169 selected procedures in 2020 and 2021, 5235 completed the ePROM form . There is a difference in response rates for both age and sex alone. Younger women have a higher response rate than men of same age, whereas in older age groups,men have higher response rates than women . Patients who have been ablated for AF have a higher respons rate than other procedures. Patients who have only undergone an electrophysiological examination (EP) have the lowest response rate. Conclusion Mandatory follow-up 1 year after completion of the procedure takes place in electronic form and contains simple registration of PROMS. The response rate among patients is 78% over the two years. This indicates an extremely high level of digital competence and motivation among patients to provide feedback for completed treatment. This shows that there is a discrepancy for FU regarding patient who has been ablated for atrial fibrillation (AF) . Abbreviations RFA: Radiofrequency Ablation; FU: Follow-up; AF: Atrial fibrillation; PROM: Patient reported outcome Measurement

The Medium-Term Outcomes of Patients With Suspected Scaphoid Fractures: A Single-Centre Retrospective Cohort Study.

Background The medium-termoutcomesof patients (six to 14 months post-injury) with non-specific wrist injuries managed as suspected scaphoid fractures are not clear from the current literature. These patients' wrists are immobilized in casts or splints, and some receive physiotherapy. They receive serial imaging and follow-up appointments as needed. Aims This study aims to describe the medium-term outcomes of patients with non-specific wrist injuries managed as suspected scaphoid fractures. Methods This is a single-centre retrospective cohort study. Patients with suspected scaphoid fractures were identified from a consecutive database and were included.Patients diagnosed with a definitive scaphoid fracture at any point in time were excluded. Patients with any pre-existing wrist pathology were also excluded. In total 113 patients were posted the Patient-Rated-Wrist-Evaluation (PRWE) questionnaire at six to 14 months post-injury with a self-addressed return envelope. Demographic and PRWE data were collated and described. Results Twenty-two patients (19% of totalpatients) returned a completed questionnaire. The median PRWE score was 32 out of 100 indicating mild pain and disability. 45.5% of patients were in this category. A minority of patients (9%)continued to suffer severe or very severe pain and disability. Patients with PRWE scores <40, representing pain and disability that is mild or less, reported very low difficulty completing work and recreational activities. Patients tended not to have pain at rest and experienced the most difficulty lifting heavy objects. Conclusion Most patients with non-specific wrist injuries managed as suspected scaphoid fractures experience some pain and disability in the medium term. For most this is minimal or mild, however some patients experience significant pain and disability. This study adds to existing evidence that this is the case. The reasons why these patients suffer are unclear. This study highlights the need to refine clinical practice to improve the outcomes of these patients.

Use of Home-Based Self-Collected Dried Blood Spots to Test for Syphilis, Human Immunodeficiency Virus, Hepatitis C and B Virus Infections and Measuring Creatinine Concentration.

Home-based self-collected dried blood spot (DBS) sampling could simplify sexual health and preexposure prophylaxis care and reduce sexually transmitted infections (STIs) clinic visits for men who have sex with men (MSM). We compared the performance of DBS to venipuncture collected blood samples to test four STIs and creatinine concentration. We invited MSM clients of the Amsterdam STI clinic to participate. Routinely collected peripheral blood was tested for syphilis treponemal antibody, HIV (HIV Ag/Ab), HCV (antibodies), HBV (HBsAg) and creatinine concentration. Participants received a home kit for DBS sampling, a return envelope and a questionnaire to evaluate the acceptability, feasibility and usability of DBS, measured on 5-point Likert scales, 1 representing complete disagreement and 5 complete agreement. We assessed sensitivity and specificity of DBS versus peripheral blood-based testing. In 2020 to 2021, we included 410 participants; 211 (51.5%) returned a completed DBS card, 117 (28.5%) returned a partially filled card and 82 (20.0%) did not return a card. The sensitivity for syphilis was 90.8% and the specificity 84.3%. For both HIV Ag/Ab and HBsAg, the sensitivity and specificity were 100.0%. The sensitivity for HCV antibody was 80.0%, and the specificity was 99.2%. The DBS creatinine concentration was a mean of 5.3 μmol/L higher than in venipuncture obtained plasma. Participants' median willingness to take a future DBS was 4 (interquartile range, 3-5). Dried blood spot may be an acceptable method among MSM for STI testing and creatinine follow-up during preexposure prophylaxis use. However, collecting enough blood on DBS cards was a challenge, and sensitivities for syphilis and HCV serology were too low.

P162 The Biosimilar Switch: IBD nurse's experience in Our Lady of Lourdes Hospital

Abstract Background A biological medication contains an active substance that is produced from a biological source such as living cells, hormones or enzymes. The active substance in a biological medicine is what makes the medicine work. Biological medicines are also called biologics. A biosimilar medicine is a biological medicine that is developed to be highly similar to an existing biologic but they are not identical and so cannot be considered to be generics. Biosimilars were introduced in Ireland in 2014. In 2018, Our Lady of Lourdes Hospital commenced a procurement programme to decide which Infliximab biosimilar to switch our patients to. This process would allow for a huge cost-saving to the hospital budget and also allowed for the allocation of a whole-time clinical nurse specialist to add the IBD nursing team. The infliximab biological switch was then carried out starting in October 2019. All patients received a letter explaining the switch and a booklet to explain the meaning of biosimilars. The patients were then either phoned or spoken to in person by either the IBD nurse or a GI pharmacist, and any questions or concerns addressed. Methods A patient satisfaction survey was sent to each patient 6 months after the switch. Each questionnaire was sent with a prepaid return envelope. The questionnaire consisted of 7 questions with tick box answers. 1. Gender? 2. Age? 3. Did you receive a letter and information booklet in the post prior to the day of your infusion switch. 4. Did you get the opportunity to talk to someone on the phone prior to your infusion? 5. Did you get the opportunity to speak to a nurse or pharmacist on the day of your infusion? If so who? 6. Were you given a named person to contact if you had any issues after our first infusion? 7. Were you happy with the overall experience of the infliximab biosimilar switch? Results 86 patients were switched from the originator to the biosimilar Flixabi. 22 responses were received. 1. 11 male; 11 female 2. Age 16-19 - 2; 20-29 - 1; 30-39 - 4; 40-49 - 4; 50-59 - 9; 70-79 - 1; preferred not to answer - 1. 3. 20 received the letter and booklet; 2 did not. 4. 15 spoke to someone on the phone; 6 did not and 1 could not remember. 5. 22 - spoke to a nurse; 0 - pharmacist. 6. 20 - yes; 2 - no. 7. 21 - yes; 1 - unsure. Conclusion Of the 86 patients who were switched 22 responded to the questionnaire. 21 patients were happy with their overall experience with how the switch was conducted.

Community pharmacist encounters with patients displaying suicide warning signs: a cross-sectional survey

BackgroundMental health is a prominent public health issue exacerbated by the coronavirus disease 2019 pandemic. Community pharmacists are positioned to contribute. ObjectivesThis study aimed to describe Iowa community pharmacists’ encounters, confidence, behaviors, and training needs related to patients with suicide warning signs and explore relationships between demographics and previous training with encounter frequency, confidence, and behaviors. MethodsA cross-sectional survey was mailed to a sample of community pharmacists in Iowa. Three contacts were made between May and June 2022 including a prenotification letter, survey with a paid return envelope, and reminder postcard, each with a QR code for optional online completion. The survey included demographics, suicide warning sign encounter types, confidence, suicide prevention behaviors, and suicide prevention training history and needs. Analysis of variance and t tests compared differences between demographics and previous training with encounter frequency, confidence, and behaviors. ResultsThe response rate was 18.3% with 161 survey completions. Pharmacists reported encounters with patients who appeared distressed (96.3%), made concerning statements related to suicide (23.8%), and disclosed suicidal thoughts (8.8%). A minority of pharmacists had asked patients about suicide (21.1%) or referred them to crisis resources in the past year (17.4%). A third had previous suicide prevention training (37.9%), which was associated with higher levels of confidence (P < 0.001) and intervention behaviors (P < 0.05). Respondents expressed interest in training, particularly on intervention and referral. ConclusionsThis sample of community pharmacists encountered patients with suicide warning signs. Providing more pharmacists with training and support in understanding local mental health resources and referrals may increase their confidence and engagement in suicide prevention.

Risk-stratified faecal immunochemical testing (FIT) for urgent colonoscopy in Lynch syndrome during the COVID-19 pandemic.

Lynch syndrome is a hereditary cancer disease resulting in an increased risk of colorectal cancer. Herein, findings are reported from an emergency clinical service implemented during the COVID-19 pandemic utilizing faecal immunochemical testing ('FIT') in Lynch syndrome patients to prioritize colonoscopy while endoscopy services were limited. An emergency service protocol was designed to improve colonoscopic surveillance access throughout the COVID-19 pandemic in England for people with Lynch syndrome when services were extremely restricted (1 March 2020 to 31 March 2021) and promoted by the English National Health Service. Requests for faecal immunochemical testing from participating centres were sent to the National Health Service Bowel Cancer Screening South of England Hub and a faecal immunochemical testing kit, faecal immunochemical testing instructions, paper-based survey, and pre-paid return envelope were sent to patients. Reports with faecal haemoglobin results were returned electronically for clinical action. Risk stratification for colonoscopy was as follows: faecal haemoglobin less than 10 µg of haemoglobin/g of faeces (µg/g)-scheduled within 6-12 weeks; and faecal haemoglobin greater than or equal to 10 µg/g-triaged via an urgent suspected cancer clinical pathway. Primary outcomes of interest included the identification of highest-risk Lynch syndrome patients and determining the impact of faecal immunochemical testing in risk-stratified colonoscopic surveillance. Fifteen centres participated from June 2020 to March 2021. Uptake was 68.8 per cent amongst 558 patients invited. For 339 eligible participants analysed, 279 (82.3 per cent) had faecal haemoglobin less than 10 µg/g and 60 (17.7 per cent) had faecal haemoglobin greater than or equal to 10 µg/g. In the latter group, the diagnostic accuracy of faecal immunochemical testing was 65.9 per cent and escalation to colonoscopy was facilitated (median 49 versus 122 days, χ2 = 0.0003, P < 0.001). Faecal immunochemical testing demonstrated clinical value for Lynch syndrome patients requiring colorectal cancer surveillance during the pandemic in this descriptive report of an emergency COVID-19 response service. Further longitudinal investigation on faecal immunochemical testing efficacy in Lynch syndrome is warranted and will be examined under the 'FIT for Lynch' study (ISRCTN15740250).

Actively encouraging online responses to a mixed-mode mail and web survey: a case of nudging anglers in Ontario, Canada

ABSTRACT Little effort has focused on encouraging less costly, online responses within mixed-mode surveys. From an Ontario angler survey, this gap is addressed by applying a nudge (i.e., mail push to web) or control (i.e., providing a print questionnaire and return envelope) for the final mail contact. The nudge increased the share of online responses from the final contact by over 40% while only slightly decreasing (1.3%) the response rate. The nudge most heavily affected senior anglers (65–70 years old) who experienced a 58% increase in online responses but an 11% decrease to the response rate from the final contact. The increased response rate for the control came at a cost of about $25 and $4 (CAD 2021) per additional response for overall and senior anglers, respectively. Thus, the cost-effectiveness of the nudge depends on the population being targeted.

MP10-11 SEASONAL AND COVID PANDEMIC-RELATED VARIATIONS IN PATIENTS′ SELF-REPORTED ADHERENCE TO NUTRITION RECOMMENDATIONS FOR STONE PREVENTION SUGGEST TEMPORAL INCREASES IN STONE RECURRENCE RISK

You have accessJournal of UrologyCME1 Apr 2023MP10-11 SEASONAL AND COVID PANDEMIC-RELATED VARIATIONS IN PATIENTS′ SELF-REPORTED ADHERENCE TO NUTRITION RECOMMENDATIONS FOR STONE PREVENTION SUGGEST TEMPORAL INCREASES IN STONE RECURRENCE RISK Riley J Medenwald and Kristina L Penniston Riley J MedenwaldRiley J Medenwald More articles by this author and Kristina L PennistonKristina L Penniston More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003225.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Nutrition therapy for stone prevention is indicated if risks are diet-related. Dietary recommendations (DRs) include higher fluid intake, lower salt intake, lower dietary acid load, and normal calcium (neither excessive nor insufficient). Adherence is challenging to assess and optimally includes multiple measures including patient-reported outcomes. We assessed adherence to individualized targeted DRs issued in our multidisciplinary stone prevention clinic. METHODS: From 1/2020-1/2021 we invited patients to complete a questionnaire 1 month after their appointment. They were to estimate the number of days within the last week they followed specific DRs prescribed them and number of days they followed all DRs. Questionnaires were sent by mail with postage-paid return envelopes. This was a quality improvement project; patients were offered to respond anonymously. RESULTS: Respondents (n=132) represented 29% of patients who were sent questionnaires and were 50% female (61±13 y). Of those providing clinical details, 77% were recurrent stone formers; 46% were on stone medication(s). There were no adherence differences for men vs. women, recurrent vs. one-time stone formers, nor for those on stone-related medications vs. not. Overall, adherence to eating more F/V was lower (4.7 vs. 5.5 d/week for all other DRs, p<0.004). We separated responses by receipt: summer/fall (April to mid-November) and winter/spring (mid-November to April), and by pre- vs. post-COVID (before/after March 2020). F/V intake was significantly lower during winter/spring than summer/fall (4.4 vs. 5.5 d/week, p=0.009). Related to the COVID pandemic, patients reported lower adherence to all DRs after the pandemic start (5.0 vs. 5.9 d/week, P=0.009 for difference from before). CONCLUSIONS: Overall, adherence to eating more F/V was significantly lower than for other DRs and was lower yet during winter/spring. The COVID pandemic did not affect F/V intake specifically but did reduce adherence to all DRs. F/V are important in stone prevention because they provide HCO3 precursors that increase urine citrate and pH. F/V also provide other stone inhibitors, including phytate (which in urine inhibits calcium stone formation) and prebiotics, some of which enhance oxalate-degrading gut bacteria. Moreover, F/V intake can account for up to 30% of urine output and thus may help meet fluid recommendations. Barriers to F/V intake, which may include seasonal variations in cost and availability, should be addressed. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e118 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Riley J Medenwald More articles by this author Kristina L Penniston More articles by this author Expand All Advertisement PDF downloadLoading ...

Patient satisfaction levels for complete dentures (F/F) delivered by undergraduate dental students

One important aspect of acceptance of full denture treatment is that of patient’s perceived outcome. A teaching environment is the best place for future clinicians to understand this aspect of treatment. The aim of this study was to assess the satisfaction levels of patients who received complete dentures delivered by undergraduate dental students at the University of Otago. Participants’ attitude toward dentures was measured via a 16-item questionnaire based on Patient’s Denture Assessment (PDA) questionnaire. It comprises of items that assessed factors related to dentures and was quantified on a four-point scale. A total of 60 edentulous patients wearing maxillary and mandibular dentures were recruited then contacted using a list of patients whose treatment were carried out and completed in the undergraduate clinic from 2010-2018 and were sent an explanatory letter, an informed consent form, and a self-administered questionnaire in a return envelope to the University of Otago Faculty of Dentistry. Bivariate analysis was then carried out on the responses. 55% of the invited participants responded to the survey. The mean extent of PDA impacts was 0.15 (range 0.0-0.71). There were no significant differences in the experience of the prevalence and extent of PDA impacts by gender and age. 81.8% reported their denture to be very important to them and 91% found it “very easy” or “easy” to eat and swallow. 88% enjoyed their meals “well” or “very well”. Bivariate analysis showed those aged 70 years old or younger were less likely to report issues with the denture, while there was no statically significant difference between genders. Overall, the participants expressed satisfaction with the treatment received at the faculty over the sub-groups of function, speech/aesthetics, upper denture, lower denture, and considered the denture to be of high importance.

P700 Perceptions towards established and emerging dietary therapies for Crohn’s disease management among the adult patients: results from a questionnaire survey

Abstract Background Exclusive enteral nutrition (EEN) and partial enteral nutrition (PEN), replacing at least 50% of the energy intake with formula, remain the only evidence-based dietary therapies in the management of Crohn’s disease (CD). Nonetheless, emerging solid food-based dietary therapies are being researched to offer equally effective, but more palatable alternatives. We assessed the perceptions of adults with CD towards EEN, 50% PEN, and novel dietary therapies within a cross-sectional questionnaire survey. Methods The 26-question anonymous survey with a pre-paid return envelope was mailed to 300 adult patients with CD treated with biologics under the care of the NHS Greater Glasgow &amp; Clyde. A reminder was resent three months later. Responses to open-ended questions regarding concerns about 50% PEN use were analysed independently by two researchers using thematic analysis. Results One-hundred and sixty patients (85/160, 53% female) completed and returned the survey (response rate: 53%). Forty-two percent (67/158) had already followed some form of an exclusion diet, with low spice (32/158, 20%) and low fibre (24/158, 15%) diets being the most popular. Although only a quarter of patients believed that EEN or PEN could help with their CD (42/157, 27%), the majority believed that diet could help (84/157, 54%), with another 13% (21/157) reporting already using diet for CD management. Although only around half of the patients were willing to try EEN (80/157, 51%), the majority were willing to try PEN instead (124/157, 79%) (EEN vs. PEN chi-square: P&amp;lt;.001). Most patients preferred to follow an exclusion diet meal plan to prepare at home (65/154, 42%) compared to EEN or PEN (53/153, 34%). Similarly, most patients preferred to follow a meal plan to prepare at home (76/151, 50%) rather than a meal plan with pre-made meals delivered (59/151, 39%). When asked about preferences related to PEN use, most patients reported that they would prefer to follow a flexible meal plan, allowing them to choose meals to replace to fit their lifestyle (92/153, 60%). The most commonly reported concerns about PEN identified within the thematic analysis were taste/palatability (25%, 34/136), satiety/hunger (22%, 30/136), taste fatigue (14%, 19/136), and impact on social life (14%, 19/136). Conclusion Most adult patients would prefer to follow an exclusion diet meal plan rather than EEN or 50% PEN. However, the majority would try 50% PEN which allows for more flexibility and may be easier to comply with than EEN.

Resting 12‑lead ECG tests performed by patients at home amid the COVID-19 pandemic — Results from the first 1000 patients

BackgroundThere were surges in the demand for telehealth and home care in the COVID-19 pandemic. A new home ECG testing model was developed and used in the real-world clinical practice. MethodsSince June 2020, QT Medical, Inc. (Diamond Bard, California) has been providing home ECG testing service by mail. Upon receiving the order from a clinician, an ECG testing kit was sent to the patient by mail. The kit included an ECG recorder, a prepositioned electrode strip of proper size for the patient (determined by the ordering clinician), printed instructions for performing the test, and a return envelope. We reviewed and analyzed the de-identified administrative dataset of the first 1000 ECG tests ordered by 37 medical practices. ResultsOf the 1000 patients served by this mail delivery home ECG testing service, 77.3% were female and 22.7% were male. Their ages ranged from 1 year old to 96 years old, mean 49.5 ± 13.4 years (median 52). 92.9% patients completed their tests with clinical quality ECGs uploaded to their ordering clinician's online accounts. Of those who did not complete the tests, the main reason was they “no longer needed the test”. Failure to complete the test due to technical issues was 1.4%. Only one patient had to repeat the test due to inadequate ECG quality as judged by the ordering physician. The median turnaround time, from the kit being mailed out to the recorder being returned, was 10 days. Overall, 2.2% of the ECG devices were lost in shipping or unreturned by patients. ConclusionOf the first 1000 patients who had their ECG tests at homes, it was found that this home ECG testing platform and care model could be reliably used by patients with no training to acquire clinical grade ECG. The current study proved that medical standard, resting 12‑lead ECG can be performed by the majority of patients at home.