Self-reported Health Information Research Articles

The mental health-related barriers and benefits to exercise in adults with and without chronic pain

BackgroundQualitative evidence points to the importance of both mental health-related barriers and benefits to exercise in chronic pain, yet this bidirectional relationship has not been established quantitatively. Methods89 adults with chronic pain (75 female, Age: M = 34.7, SD=13.2), and 89 demographically-matched individuals without chronic pain (73 female, Age: M = 32.0, SD=13.3) self-reported demographic and health information, mental health-related barriers and benefits to exercise, and leisure-time exercise activity. ResultsAdults with chronic pain had significantly higher scores on mental health-related barriers to exercise, and lower leisure-time exercise participation than adults without chronic pain. The groups did not differ on mental health-related benefits of exercise scores. Benefits scores positively predicted exercise, yet there was a significant negative interaction between pain and benefit scores, indicating a weaker positive relationship between benefits and exercise for adults with chronic pain than for those without chronic pain. Barrier scores significantly negatively predicted exercise engagement, but did not interact significantly with chronic pain. ConclusionMental health-related barriers and benefits to exercise are important considerations when prescribing exercise for adults with chronic pain. Adults with chronic pain may require individualised support to address mental health-related barriers to leisure-time exercise.

Sick at work and future sickness absence - a prospective study of two measures of sickness presence

Abstract Background Sickness presence (SP), or going to work despite being ill, is a common way of practicing sickness absence (SA). However, its consequences for long-term SA are poorly understood, and there is no consensus on how to measure SP. This study aims to examine the consequences of SP on long-term sickness absence (>14 days) using two different measures. Methods Data from a Danish public human service organization were analyzed, with approximately 2400 employees answering questionnaires in November 2019, yielding a response rate of 50%. Information on SA, work environment, self-reported health, SP episodes, and sociodemographic information were included in negative binomial regression models. The outcome variable was prospective episodes of SA (>14 days) taken from the SA register of the organization. Two different ways of measuring SP were used: a traditional measure of overall SP frequency and a measure of going to work with specific symptoms (fever, cold, headache, musculoskeletal pain). Results Participants who reported SP frequency of more than 10 times during the last 6 months had a two-fold risk of long-term SA (IRR: 2.19 (95%CI 1.09-4.58)) in the follow-up period. This risk remained significant even after adjusting for work environment factors, sociodemographic factors, self-rated health, and spells of sickness absence in the previous year. Going to work with fever (IR: 1.43) or cold (IR: 1.48) was also associated with long-term SA in the follow-up period. Conclusions SP may negatively impact employees’ health status and increase long-term sickness absence. Health professionals should be aware of the negative consequences of focusing solely on reducing short-term sickness absence especially if they inadvertently encourage employees to substitute sickness presence for sickness absence. Key messages • Going to work despite having ill health is common but may have adverse health consequences and lead to long-term sickness absence. • Focusing narrowly on reducing short-term sickness absence might be a bad idea for public health. Employees might feel encouraged to go ill to work which could increase future sick leave.

Predicting Alzheimer’s Disease with Interpretable Machine Learning

Introduction: This study aimed to develop novel machine learning models for predicting Alzheimer’s disease (AD) and identify key factors for targeted prevention. Methods: We included 1,219, 863, and 482 participants aged 60+ years with only sociodemographic, both sociodemographic and self-reported health, both the former two and blood biomarkers information from Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. Machine learning models were constructed for predicting the risk of AD for the above three populations. Model performance was evaluated by discrimination, calibration, and clinical usefulness. SHapley Additive exPlanation (SHAP) was applied to identify key predictors of optimal models. Results: The mean age was 73.49, 74.52, and 74.29 years for the three populations, respectively. Models with sociodemographic information and models with both sociodemographic and self-reported health information showed modest performance. For models with sociodemographic, self-reported health, and blood biomarker information, their overall performance improved substantially, specifically, logistic regression performed best, with an AUC value of 0.818. Blood biomarkers of ptau protein and plasma neurofilament light, age, blood tau protein, and education level were top five significant predictors. In addition, taurine, inosine, xanthine, marital status, and L.Glutamine also showed importance to AD prediction. Conclusion: Interpretable machine learning showed promise in screening high-risk AD individual and could further identify key predictors for targeted prevention.

Resting-state network functional connectivity before and after bariatric surgery.

Bariatric surgery is an increasingly popular treatment for patients with severe obesity and related health issues (e.g., diabetes, cardiovascular disease). Studies have identified alterations in functional connectivity both in obesity and following surgical treatment for severe obesity. This study aimed to assess brain function via resting-state within-network connectivity in bariatric surgery patients with severe obesity. University hospital. Thirty-four bariatric surgery patients completed functional neuroimaging at baseline and postoperatively (goal, 12 weeks; actual, 16 weeks, on average). They also self-reported health information. Baseline resting-state functional connectivity (RSFC) was predicted by baseline age, body mass index (BMI), continuous positive airway pressure use, and reported history of rheumatoid arthritis and type 2 diabetes. Change in RSFC was assessed using the same predictors. This model was run with and without controlling for baseline RSFC. Higher baseline BMI predicted lower baseline RSFC in 3 networks. Lower baseline RSFC also was related to rheumatoid arthritis and type 2 diabetes. Difference between baseline and follow-up RSFC was strongly negatively associated with baseline RSFC. Controlling for baseline RSFC, type 2 diabetes negatively predicted RSFC difference. RSFC may reflect brain dysfunction in patients with obesity and related diseases. Thatless connectivity at baseline predicted greater positive change suggests that RSFC may be a biomarker of neurocognitive improvement following bariatric surgery. Diseases more prevalent in patients with obesity (e.g., rheumatoid arthritis and type 2 diabetes) along with elevated BMI negatively affect RSFC likely through inflammatory pathways.

Job loss negatively impacts the mental health of working Medicaid beneficiaries

PurposeFew have studied the relationship between employment and health in the Medicaid population. The purpose of this study is to estimate the impact of job loss on the mental health of working Medicaid beneficiaries.Design/methodology/approachThis study conducted a post hoc analysis of 1,538 adult Medicaid beneficiaries enrolled in a prospective cohort study. The authors matched participants who lost their job to participants who remained employed based on demographics, illness severity and social determinants of health. The authors estimated the effect of job loss on the odds of a diagnosis of depression and/or anxiety and self-reported mental health during a one-year follow-up period, stratified by prior history of depression and/or anxiety as documented in the Medicaid claims.FindingsAmong participants with no preexisting depression or anxiety, the incidence of depression or anxiety was 17% versus 7% (aOR = 2.85; 95% confidence interval (CI): 1.88 to 4.34) between those who lost versus kept their job, respectively, and the mean difference in self-reported mental health was −4.3 (95% CI: −6.02 to −2.58). Self-reported mental health was also poorer between those who lost versus kept their job among participants with preexisting depression and/or anxiety (x = −4.78 (95% CI: −8.90 to −0.66).Research limitations/implicationsLimitations of this study are as follows: we may not have matched on all factors that influence retaining a job; we do not distinguish between involuntary and voluntary job loss; generalizability is limited; and employment information is based on self-report.Practical implicationsOur society should invest more resources into supporting low-wage workers such as Medicaid beneficiaries.Social implicationsActive labor policies that connect people to jobs, help them retain their job and support skills training to secure a better quality job, could reduce health disparities in the Medicaid population.Originality/valueUse of both claims and self-reported mental health information to evaluate the impact of job loss on working Medicaid beneficiaries.

Adult experiences in Beckwith-Wiedemann syndrome.

Beckwith-Wiedemann syndrome (BWS) is an overgrowth and epigenetic disorder caused by changes on chromosome 11p15. The primary features requiring management in childhood include macroglossia, omphalocele, lateralized overgrowth, hyperinsulinism, and embryonal tumors. Management guidelines have not been developed for adults with BWS and there have been few studies to assess the clinical needs of these patients. Furthermore, there have been few studies on the psychosocial implications of BWS in children or adults. Here, we present a descriptive summary of data gathered from two separate adult BWS cohorts. The first, a patient-based survey cohort, includes self-reported health information and recollections about BWS experiences, while the second provides results of a medical record-based assessment from patients in an overgrowth registry. Results highlight the clinical features and medical issues affecting two large independent cohorts of adults with BWS while noting similarities. Open-ended questions asked of the survey cohort yielded themes to guide future qualitative studies. Finally, the study demonstrated the reliability of patient-reported data and the utility of international partnerships in this context.

A Health Survey-Based Prediction Equation for Incident CKD.

Prediction tools that incorporate self-reported health information could increase CKD awareness, identify modifiable lifestyle risk factors, and prevent disease. We developed and validated a survey-based prediction equation to identify individuals at risk for incident CKD (eGFR <60 ml/min per 1.73 m2), with and without a baseline eGFR. A cohort of adults with an eGFR ≥70 ml/min per 1.73 m2 from Ontario, Canada, who completed a comprehensive general population health survey between 2000 and 2015 were included (n=22,200). Prediction equations included demographics (age, sex), comorbidities, lifestyle factors, diet, and mood. Models with and without baseline eGFR were derived and externally validated in the UK Biobank (n=15,522). New-onset CKD (eGFR <60 ml/min per 1.73 m2) with ≤8 years of follow-up was the primary outcome. Among Ontario individuals (mean age, 55 years; 58% women; baseline eGFR, 95 (SD 15) ml/min per 1.73 m2), new-onset CKD occurred in 1981 (9%) during a median follow-up time of 4.2 years. The final models included lifestyle factors (smoking, alcohol, physical activity) and comorbid illnesses (diabetes, hypertension, cancer). The model was discriminating in individuals with and without a baseline eGFR measure (5-year c-statistic with baseline eGFR: 83.5, 95% confidence interval [CI], 82.2 to 84.9; without: 81.0, 95% CI, 79.8 to 82.4) and well calibrated. In external validation, the 5-year c-statistic was 78.1 (95% CI, 74.2 to 82.0) and 66.0 (95% CI, 61.6 to 70.4), with and without baseline eGFR, respectively, and maintained calibration. Self-reported lifestyle and health behavior information from health surveys may aid in predicting incident CKD. This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast.aspx?p=CJASN&e=2023_01_10_CJN05650522.mp3.

Oral health-related quality of life in 4–16-year-olds with and without juvenile idiopathic arthritis

BackgroundFew studies have investigated oral health-related quality of life (OHRQoL) in young individuals with juvenile idiopathic arthritis (JIA). Aims were to investigate whether OHRQoL differs between children and adolescents with JIA compared to controls without JIA, while adjusting for socio-demographic-, behavioral- and oral health-related covariates. Furthermore, to explore whether socio-behavioral and oral health-related covariates of OHRQoL vary according to group affiliation and finally, specifically for individuals with JIA, to investigate whether disease-specific features associate with OHRQoL. We hypothesized that participants with JIA have poorer OHRQoL compared to participants without JIA.MethodsIn this comparative cross-sectional study participants with JIA (n = 224) were matched to controls without JIA (n = 224). OHRQoL was assessed according to Early Childhood Oral Health Impact Scale (ECOHIS) (4–11-years-olds) and the child version of Oral Impacts on Daily Performances (Child-OIDP) (12–16-years-olds). JIA-specific characteristics were assessed by pediatric rheumatologists and socio-demographic, behavioral and self-reported oral health information collected by questionnaires. Index teeth were examined for caries by calibrated dentists. Multiple variable analyses were performed using logistic regression, reporting odds ratio (OR) and 95% confidence interval (CI). Two-way interactions were tested between group affiliation and the socio-behavioral- and oral health-related variables on the respective outcome variables.ResultsIn total, 96 participants with JIA and 98 controls were evaluated according to ECOHIS, corresponding numbers for Child-OIDP was 125 and 124. Group affiliation was not associated with impaired ECOHIS or Child-OIDP in adjusted analyses (OR = 1.95, 95% CI 0.94–4.04 and OR = 0.99, 95% CI 0.46–2.17, respectively). Female adolescents with JIA were more likely than males to report oral impacts according to Child-OIDP. Continued activity or flare was found to adversely affect Child-OIDP, also self-reported outcome measures in JIA associated with Child-OIDP.ConclusionsThis study did not provide consistent evidence to confirm the hypothesis that children and adolescents with JIA are more likely to have impaired OHRQoL compared to their peers without JIA. However, female adolescents with JIA were more likely than males to report impacts on OHRQoL. Furthermore, within the JIA group, adolescents with continued disease activity, flare or reporting pain, physical disability, had higher risk than their counterparts of impaired OHRQoL.

A Comparison of Methods to Adjust Risk Models for Measurement Error in Dietary Exposure

ObjectivesTo compare approaches to adjust for measurement error when exploring the relationship between the sodium-to-potassium ratio and hypertension and blood pressure.MethodsUsing National Health and Nutrition Examination Survey (NHANES) data from 2005–2010, Zhang et al. (2013) examined relationships between the sodium-to-potassium ratio (Na:K) and hypertension and blood pressure. They used the Iowa State University (ISU) Method to account for measurement error assuming the dietary intakes assessed with up to two 24-hour recalls (24 HR) per person were unbiased for long-term (usual) intake. We replicated their analytic dataset (n = 10,467 adults ³20 y). Systolic and diastolic blood pressure values were calculated as the mean of three readings; a binary variable for hypertension status was derived from blood pressure values and self-reported health information. Logistic (hypertension) and linear (blood pressure) models were adjusted for age, sex, and race/ethnicity. The primary exposure variable, Na:K, was obtained from calibration models that adjusted for random variation in the 24 HR. The National Cancer Institute (NCI) Method used regression calibration from a joint model - fit with two methods, maximum likelihood and Markov Chain Monte Carlo (MCMC) - for sodium and potassium. A third model used the ISU Method to univariately model each component. All calibration models adjusted for the same covariates as the regression models plus nuisance effects. Standard errors for estimates and differences (e.g., MCMC - ISU) were computed using Balanced Repeated Replication to account for NHANES’ survey design.ResultsBoth NCI implementations gave nearly equivalent results that sometimes differed from the ISU results. A one-unit increase in Na:K was associated with a mean systolic blood pressure increase of 2.82 mmHg, se .57 (ISU) vs. 3.87 mmHg, se .87 (MCMC) (t-test pdiff = 0.005), and a mean diastolic blood pressure increase of 0.80 mmHg, se .43 (ISU) vs. 0.61, se .68 (MCMC) (pdiff = 0.495). A one-unit increase in Na:K was associated with an increase of 0.41, se .11 (ISU) vs. 0.63, se .18 (MCMC) (pdiff = 0.008) in the log odds of hypertension.ConclusionsThe choice of modeling approaches for 24 HRs may affect estimated error-corrected relationships between health outcomes and dietary intake.Funding SourcesVanier Canada Graduate Scholarship.

Obesity and Eligibility for Obesity Treatments Among Adults With Disabilities in the U.S.

Obesity has been associated with disability; yet, the proportion who meet clinical criteria for obesity treatment among adults with disabilities remains poorly defined. Characterization of obesity and treatment eligibility by disability type may prioritize high-need groups. This study assessed the prevalence of obesity and eligibility for antiobesity pharmacotherapy and/or bariatric surgery in adults with disability. This cross-sectional weighted analysis of the 2019 National Health Interview Survey, including self-reported health and sociodemographic information, was conducted in 2021. Burden of obesity defined by BMI and odds of meeting consensus criteria for antiobesity pharmacotherapy and/or surgery were calculated by functional disability type: vision, hearing, cognition, communication, mobility, and self-care. From 29,170 community-dwelling adult respondents (59.1% response), the overall prevalence of disability was 10%. The prevalence of obesity among adults with a disability was 40.1% vs 30.5% for U.S. adults overall (p&lt;0.0001). An estimated 17.1% with disability met the criteria for both bariatric surgery and antiobesity pharmacotherapy; another 39.8% were eligible for pharmacotherapy alone (vs 7.9% and 33.2%, respectively, for adults overall; p&lt;0.0001). In fully adjusted models, disability was associated with greater ORs for mild obesity (OR=1.2; 95% CI=1.1, 1.4), moderate‒severe obesity (OR=2.1; 95% CI=1.8, 2.3), and criteria for bariatric surgery (OR=2.4; 95% CI=2.1, 2.7) and pharmacotherapy (OR=1.3; 95% CI=1.2, 1.4). Mobility, self-care, and cognition disabilities were associated with eligibility for bariatric surgery and antiobesity pharmacotherapy. Individuals with disabilities have higher odds of obesity and eligibility for antiobesity treatments. Comorbidities should be considered, accommodations should be provided, and insurance coverage should be expanded to ensure access to antiobesity treatments for adults with disabilities.

Physical Well-being in Early Childhood Teachers: Correlates of Work-related Musculoskeletal Issues and Fitness among these “Educational Athletes”

ABSTRACT Early care and education (ECE) teachers are constantly moving throughout their day with varying physical demands akin to those of athletes. Teachers are continuously bending, stooping, and squatting to lift and carry children as well as sitting on the floor or in child-sized furniture—all activities that require substantial fitness. This said, many ECE teachers have health issues including obesity, diminished aerobic capacity, and perceived stress, which can adversely influence their physical well-being and place them at risk for work-related musculoskeletal issues. This study of ECE teachers, which is part of a larger study of overall teacher wellness, involved direct, on-site measures of ECE teachers’ cardiorespiratory capacity and in-classroom ergonomic assessment of activities. These measures were then triangulated with self-reported health information to better understand the current status of various aspects of teachers’ physical well-being and correlational analysis was then used to identify potential risk and/or protective factors. Research Findings: ECE teachers are constantly moving throughout their day with varying physical demands and stressors that, combined with unfavorable working conditions, contribute to developing musculoskeletal pain and poor cardiorespiratory fitness. Practice or Policy: Many of the physical wellness issues identified in this study can be mitigated through modest changes that could be incorporated into teachers’ daily work behaviors and activities, such as education and programs to enhance the physical wellness of these “educational athletes” and better-prepare them for the “sport of teaching.”

Aetiology and risk factors of bacterial gastroenteritis among febrile outpatients at the Dschang District Hospital, West Region of Cameroon: a cross-sectional study

ObjectivesTo investigate the bacterial aetiologies and associated risk factors of gastroenteritis among typhoid suspected cases.DesignCross-sectional study.SettingThis study was conducted at Dschang District Hospital of the Menoua Division, West Region of...

Feasibility of implementing a same-day electronic screening tool for clinical assessment to measure patient-reported outcomes for eliciting actionable information on adherence to HIV medication and related factors in a busy Canadian urban HIV clinic.

An optimal adherence to antiretroviral therapy (ART) is fundamental for suppression of HIV viral load and favourable treatment outcomes. Patient-reported outcomes (PROs) are effective tools for improving patient-provider communication and focusing providers' awareness on current health problems. The objectives of this analysis were (1) to determine the feasibility of implementing an electronic screening tool to measure PROs in a Canadian HIV clinic to obtain information on ART adherence and related factors and (2) to determine the factors related to sub-optimal adherence. This implementation research with a convenience sample of 600 people living with HIV (PLWH) was conducted in a busy, academic, urban HIV clinic in Toronto, Canada. PLWH were approached to participate in PRO assessments just prior to their in-clinic appointments, including health-related domains such as mental health, housing, nutrition, financial stress and medication adherence, and responses were summarized on a single sheet available for providers to review. Feasibility of implementing PROs was assessed by quantifying response rate, completion rate, time taken and participation rate. Medication adherence was elicited by self-report of the percentage of prescribed HIV medications taken in the last month. Unadjusted and adjusted odds ratios were estimated from logistic regression models to identify factors associated with adherence of <95%. Of the 748 PLWH invited to participate, 692 (participation rate: 92.5%) completed the PRO assessments as standard of care in clinic. Of these, 600 consented to the use of their PRO results for research and were included in this analysis. The average response rate to the ART-related questions was 96.8% and mean completion rate was 95.5%. The median time taken to complete the assessment was 12.0 (IQR = 8.4-17.3)min, adjusted 8.7 (IQR = 7.2-10.8)min. 445 (74.9%) of participants were male, and 153 (26.2%) reported dissatisfaction with ART. 105 (19.7%) of the PLWH reported ART adherence of <95%. Multivariable logistic regression identified the following risk factors for sub-optimal adherence: dissatisfaction with ART (OR = 2.30, 95% CI 1.38-3.83), not having a family doctor or not visiting a family doctor in last year (OR = 1.69, 95% CI 1.02-2.79). Collecting self-reported health information from PLWH through PROs in a busy urban clinic was feasible and can provide relevant information to healthcare providers on issues related to adherence. This has a potential to help in individualizing ambulatory care.

Association between community-based self-reported COVID-19 symptoms and social deprivation explored using symptom tracker apps: a repeated cross-sectional study in Northern Ireland

ObjectivesThe aim of the study was to investigate the spatial and temporal relationships between the prevalence of COVID-19 symptoms in the community-level and area-level social deprivation.DesignSpatial mapping, generalised linear models,...

Video-based Parkinson’s disease assessments in a nationwide cohort of Fox Insight participants

IntroductionParkinson’s disease (PD) research is hampered by slow, inefficient recruitment and burdensome in-person assessments that may be challenging to conduct in a world affected by COVID-19. Fox Insight is an ongoing prospective clinical research study that enables individuals to participate in clinical research from their own homes by completing online questionnaires. To date, over 45,000 participants with and without PD have enrolled. We sought to validate self-reported PD diagnosis in the Fox Insight cohort, assess the validity of other self-reported health information, and evaluate the willingness of participants to participate in video-based research studies. MethodsIndividuals with and without self-reported PD enrolled in Fox Insight were invited to participate in this virtual research study. Participants completed online questionnaires and two virtual visits, during which we conducted standard cognitive and motor assessments. A movement disorder expert determined the most likely diagnosis, which was compared to self-reported diagnosis. ResultsA total of 203 participants from 40 U.S. states, 159 with remote clinician-determined PD and 44 without, completed the study (59% male, mean (SD) age 65.7 (9.8)). Level of agreement between self-reported PD diagnosis in Fox Insight and clinician-determined diagnosis was very good ((kappa = 0.85, 95% CI 0.76–0.94). Overall, 97.9% of participants were satisfied with the study, 98.5% were willing to participate in a future observational study with virtual visits, and 76.1% were willing to participate in an interventional trial with virtual visits. ConclusionAmong the Fox Insight cohort, self-reported diagnosis is accurate and interest in virtual research studies is high.

Random survival forests using linked data to measure illness burden among individuals before or after a cancer diagnosis: Development and internal validation of the SEER-CAHPS illness burden index

PurposeTo develop and internally validate an illness burden index among Medicare beneficiaries before or after a cancer diagnosis. MethodsData source: SEER-CAHPS, linking Surveillance, Epidemiology, and End Results (SEER) cancer registry, Medicare enrollment and claims, and Medicare Consumer Assessment of Healthcare Providers and Systems (Medicare CAHPS) survey data providing self-reported sociodemographic, health, and functional status information. To generate a score for everyone in the dataset, we tabulated 4 groups within each annual subsample (2007–2013): 1) Medicare Advantage (MA) beneficiaries or 2) Medicare fee-for-service (FFS) beneficiaries, surveyed before cancer diagnosis; 3) MA beneficiaries or 4) Medicare FFS beneficiaries surveyed after diagnosis. Random survival forests (RSFs) predicted 12-month all-cause mortality and drew predictor variables (mean per subsample = 44) from 8 domains: sociodemographic, cancer-specific, health status, chronic conditions, healthcare utilization, activity limitations, proxy, and location-based factors. Roughly two-thirds of the sample was held out for algorithm training. Error rates based on the validation (“out-of-bag,” OOB) samples reflected the correctly classified percentage. Illness burden scores represented predicted cumulative mortality hazard. ResultsThe sample included 116,735 Medicare beneficiaries with cancer, of whom 73 % were surveyed after their cancer diagnosis; overall mean mortality rate in the 12 months after survey response was 6%. SEER-CAHPS Illness Burden Index (SCIBI) scores were positively skewed (median range: 0.29 [MA, pre-diagnosis] to 2.85 [FFS, post-diagnosis]; mean range: 2.08 [MA, pre-diagnosis] to 4.88 [MA, post-diagnosis]). The highest decile of the distribution had a 51 % mortality rate (range: 29–71 %); the bottom decile had a 1% mortality rate (range: 0–2 %). The error rate was 20 % overall (range: 9% [among FFS enrollees surveyed after diagnosis] to 36 % [MA enrollees surveyed before diagnosis]). ConclusionsThis new morbidity measure for Medicare beneficiaries with cancer may be useful to future SEER-CAHPS users who wish to adjust for comorbidity.

Prevalence of Adenomyosis Among Symptomatic Young Adults in Association with Patient-Reported Outcomes: A Pilot Study

Study Objective To estimate the prevalence of adenomyosis among young adult patients with dysmenorrhea and/or heavy menstrual bleeding based on transvaginal ultrasounds (TVUS) and to assess various patient-reported outcome measures. Design Prospective cohort study. This abstract is an interim analysis of a larger ongoing study. Setting Outpatient minimally invasive gynecologic l surgery (MIGS) clinic. Patients or Participants Patients ages of 18 to 27 presenting with dysmenorrhea and/or heavy menstrual bleeding (n=15). Interventions TVUS to evaluate menstrual complaints and study questionnaires including self-reported health and demographic information, as well as validated patient-reported outcome measures (PROMs) from the Menstrual Bleeding Questionnaire (MBQ), Endometriosis Health Profile-30, and the EQ-5D-3L to evaluate menstrual symptoms, health status, and impact on quality of life. Measurements and Main Results Data from 15 patients have been analyzed thus far. TVUS reports were assessed for markers associated with adenomyosis and based on the presence of these markers, were given a TVUS diagnosis of adenomyosis. The prevalence of TVUS-diagnosed adenomyosis among the sample was 33.3%. The most common ultrasound markers were a heterogenous myometrium (60.0%) and asymmetrical thickening (26.7%). Patients with TVUS-diagnoses of adenomyosis had higher EHP-30 pain scores (59.1±28.3 vs. 42.1±20.2; p=0.249), EHP-30 emotional well-being scores (43.8±30.9 vs. 26.7±17.4; p=0.205), and higher EHP-30 composite scores, which includes impact on quality of life (53.1±29.8 vs. 36.9±20.2; p=0.258) than patients without TVUS-diagnoses of adenomyosis. Patients with TVUS-diagnoses of adenomyosis had similar MBQ scores as patients without the TVUS diagnoses (18±9.8 vs. 23.1±10.7; p=0.938). Conclusion Findings of this pilot study support a higher prevalence of adenomyosis among young adults than has been reported in previous literature. Patients with TVUS-diagnosed adenomyosis trended towards worse dysmenorrhea, physical and mental health statuses and overall quality of life. Current research gaps in adenomyosis among this age group necessitate further research, especially as we learn more about true prevalence rates.

Frailty and Nutrition Risk Screening in Home-Delivered Meal Clients

Community service providers, such as Meals on Wheels (MOW) programs, help older adults remain in their homes despite advanced care needs. The purpose of this study was to determine if a frailty index (FI) could be calculated from self-reported health, function, and nutrition information already collected by MOW providers to provide additional information for care planning and risk stratification. Data from 258 MOW clients at one provider were used to calculate the FI from 40 possible health and age-related variables collected during routine health assessments. The average FI was 0.29 ± 0.13(SD), range 0.05–0.68. Frailty was categorized as non-frail, vulnerable, frail, and most frail; nutrition risk increased incrementally with these categories; however, they appear to assess risk from differing angles and etiologies. The addition of the FI can provide a more holistic picture of MOW client health than nutrition risk alone and the FI can be calculated from routinely-collected data.

Relationships of health information orientation and cancer history on preferences for consent and control over biospecimens in a biobank: A race-stratified analysis.

In this study, we investigated how patients' self-reported health information efficacy, relationship with health providers, and cancer history are associated with their preferences for informed consent and need for control over biobank biospecimens. We recruited 358 women aged 40 and older (56% African American; 44% European American) and analyzed the data using multivariable regression models. Results show that African American participants' health information efficacy was significantly and negatively associated with their need for control over biospecimens and preference for a study-specific model. European American participants' dependency on doctors was a significant and negative predictor of their preference for a study-specific model. Several significant interaction effects, which varied across races, were found with regard to health information efficacy, personal cancer history, need for control, and preference for a study-specific model. The study findings suggest it is important to consider health information efficacy, relationship with providers, and need for control when developing large diverse biobanks.

Example A: Using online respondent-driven sampling among men who have sex with men in Vietnam

Abstract Men who have sex with men (MSM) represent a key population at enhanced risk of sexually transmitted infections including HIV. HIV incidence rates are increasing amongst MSM in Vietnam. The last prevalence rates estimates range between 4% and 12% in major cities (2014). High rates of syphilis, chlamydia and gonorrhoea have also been reported, including drug resistant gonorrhoea. MSM face a strong cultural stigma, especially predominant in rural areas, which make them hard-to-reach in relation to preventive activities. In this context, respondent-driven sampling (RDS) becomes an efficient solution for sampling as well as for testing health promotive interventions. The high Internet penetration rate makes web-based RDS to enable sampling as well as testing risk reduction interventions, an appealing alternative to reduce costs, increase data reliability and to facilitate project management of complex study designs. In this talk, we will present and discuss the implementation of a nation-wide webRDS study of MSM in Vietnam aiming to collect self-reported sexual health and risk behaviour information. Using the same web-RDS system, we combine RDS with a double-blinded randomised controlled trial to implement an online intervention based on the participants own responses to encourage self-reflection. The system allows us to follow up respondents for several months after the initial intervention to check the consequences of the intervention on individual behaviour over time.