Sociodemographic Backgrounds Research Articles

“In every single way...we learn...to live”: Veterans’ Lived Experiences in the Whole Health Program

<h3>Research Objectives</h3> This qualitative project explored the impact of a values-based complementary and integrative health Veterans Health Administration (VHA) Whole Health program on patients' health and wellness. <h3>Design</h3> In-depth case reviews of participants' Whole Health program experiences were qualitatively analyzed and truncated to create succinct narratives reflecting each Veteran's lived experiences. <h3>Setting</h3> A Whole Health Service flagship at a large Veterans' Affairs Hospital in southeastern United States. <h3>Participants</h3> Nine participants from a larger study who engaged in Whole Health and represented diverse sociodemographic backgrounds and diverse Whole Health experiences were selected for in-depth case review. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> The main outcome is the participant narratives on their respective health experience before, during, and after Whole Health program. <h3>Results</h3> Participants were an average age of 65 years old; though the sub-sample was primarily male (n=6), participants' reflecting variation in race, marital status, and educational attainment were selectively sampled to maximize diverse representation. Participants' stories provide holistic and contextualized narratives that give a culturally sensitive and comprehensive perspective on their lived experience. Participants reported perceived impact on multidimensional aspects of health and wellness. Narratives also revealed improved ability to cope with pain, trauma, and grief, and created opportunity for establishing social network support and a sense of community. Some Veterans expressed mixed feelings regarding their personal program experience but indicated appreciation for the program as a viable option for integrated healthcare beyond the traditional VHA healthcare model. <h3>Conclusions</h3> Individual narratives explore the ways in which people integrate the complementary and integrative "Whole Health" program in their lives, promoting values-based wellness goals. The Whole Health approach to care promotes improvements in wellness, and opportunity to develop social network support and a sense of community. <h3>Author(s) Disclosures</h3> None to disclose.

Perceived Scarcity Across Sociodemographic Backgrounds Predicts Self-Reported Health

Abstract: Background: Perceived scarcity shows promise as an indicator of physical and mental health and a possible predictor of health disparities; however, a systematic investigation of how perceived scarcity is experienced across racial and ethnic, gender, and socioeconomic groups is imperative. Moreover, it is necessary to unpack the unique predictive power of each scarcity domain. Aims: First, differences in the experience of perceived scarcity by various sociodemographic groups in overall perceived scarcity and each of its three dimensions were explored using a cross-sectional sample. Next, using self-reported health outcome data collected from participants at a second time point, the direct and mediating role of perceived scarcity in the relationship between sociodemographic indicators and self-reported health was examined. Method: Participants included a racially and socioeconomically diverse online sample. One-way analyses of variance (ANOVAs) and t-tests were used to assess whether perceived scarcity, overall and by domain, varied by sociodemographic factors. PROCESS macro for SPSS v 3.5 was used to analyze the proposed direct effects and mediations. Results: Results indicate that sociodemographic differences do exist in perceived scarcity and in a variety of ways that may not be reflected when solely examining overall perceived scarcity. Dimensions of perceived scarcity were found to mediate the relationship between some sociodemographic factors and self-reported health. Limitations: Future research should address the limitations of the current study’s sample insofar as recruiting a wider sample of participants to include those experiencing the most extreme forms of scarcity. Conclusion: Findings support the importance of considering the unique experience of perceived scarcity by domain across sociodemographic groups when using it as a predictor or mediator of health.

Relationships of Local Food and Physical Activity Environments With Overweight in 5- to 17-Year-Old Malaysian Children.

Evidence on the associations between built environment and overweight in children outside developed countries is scarce. We examined associations between access to local food and physical activity environments and overweight in 5- to 17-year-old Malaysians in two states with differing overweight levels. Information on children was measured in the National Health and Morbidity Survey 2015 and combined with Geographic Information System-derived data on local food and physical activity environments. Access to the built environment was measured by presence and distance from child's residence. Complete data were available for 880 children. Access to local food outlets and parks was higher and associated with higher occurrence of overweight in children living in the state with higher overweight prevalence. When adjusted for sociodemographic factors, higher presence of and shorter distance to convenience stores and parks were associated with overweight. Both built environment and children's sociodemographic backgrounds should be considered when planning interventions to curb the overweight epidemic in Malaysia.

Creating a culture that supports food security and health equity at higher education institutions.

Food insecurity on college campuses is a major public health problem and has been documented for the last decade. Sufficient food access is a crucial social determinant of health, thus campuses across the country have implemented various programmes, systems and policies to enhance access to food which have included food pantries, campus gardens, farmers' markets, meal share or voucher programmes, mobile food applications, campus food gleaning, food recovery efforts, meal deliveries and task force/working groups. However, little is understood about how to best address food insecurity and support students who are struggling with basic needs. The impact of food insecurity on students' academic and social success, in addition to their overall well-being, should be investigated and prioritised at each higher education institution. This is especially true for marginalised students, such as minority or first-generation students, who are at heightened risk for food insecurity. In order to create a culture of health equity, in which most at-risk students are provided resources and opportunities to achieve optimal well-being, higher education institutions must prioritise mitigating food insecurity on the college campus. Higher education institutions could benefit from adopting comprehensive and individualised approaches to promoting food security for marginalised students in order to facilitate equal opportunity for optimal scholastic achievement among students of all socio-demographic backgrounds.

Taking stock of incarcerated military veterans: a review of (and guide for) research

ABSTRACT The sociodemographic backgrounds of inmates are essential for understanding their prison experiences and the extent to which they cope with incarceration and recidivate upon release. The notion that military veterans might fare differently from other groups in the correctional system has existed for decades; yet scholars have only recently begun to focus on the effects that prior service has on metrics of prison adjustment and beyond. Increased emphasis on the prison experiences of military veterans necessitates a review of the studies published to date. In the current study, we take stock of the empirical research conducted on incarcerated veterans by systematically reviewing all articles published online between 2000 and 2022. Overall, we find little evidence to support the view that veteran status confers any specific benefits or vulnerabilities during incarceration or following release. However, given the limitations of the studies reviewed, we address several methodological concerns regarding the study of former service members and provide directions for future research.

An assessment of the impact of formal preparation activities on performance in the University Clinical Aptitude Test (UCAT): a national study

BackgroundPrevious studies have shown performance in the University Clinical Aptitude Test (UCAT) to be associated with measures of candidate socio-economic advantage such as parental occupation and type of school attended. It is possible that access to preparation support and materials may in part explain these associations. In this paper we determine whether use of formal preparation resources is associated with higher UCAT scores and whether differences in use of preparation resources exist between socio-demographic groups.MethodsAfter completing the 2017 UCAT UK school-leaver candidates (n = 14,332) were asked to answer a questionnaire regarding their use of official UCAT and commercial resources, school-based support, and time spent preparing. Multiple linear and logistic regression models were used to evaluate the associations between preparedness, demographic characteristics and UCAT performance.ResultsFive thousand, four hundred thirty-nine (38%) candidates responded to the questionnaire. Use of freely available UCAT official practice tests, paid commercial materials, attendance at school-based preparation courses and spending more time preparing were significantly associated with higher UCAT scores. Candidates who were from less deprived backgrounds and attending independent or grammar schools were significantly more likely to use paid commercial materials and spend longer preparing.ConclusionsReported use of preparation resources varies between candidates from different socio-demographic backgrounds and is associated independently with performance in the UCAT. Increasing the availability of freely available resources may mitigate some of these differences.

Sociodemographic characteristics and health-related quality of life of individuals undergoing antidepressant therapy

An important factor for averting depression and creating awareness about clinical treatment is patient preference. Therefore, investigating health-related quality of life associated with different antidepressants is necessary. A retrospective cohort study was performed using the 2018 Medical Expenditure Panel Survey. The MEPS is a nationally representative database of the civilian and noninstitutionalized population spanning different ages, both sexes, and a wide range of sociodemographic and economic backgrounds. Differences in clinical and sociodemographic characteristics among patients using different antidepressant classes were explored. The differences in Veterans RAND 12-Item Health Survey (VR-12) results among groups were examined. The VR-12 metric was used since it measures a patient’s overall perspective of their health. Approximately 34.6 million of the patients reported using at least one antidepressant during 2018. Most patients receiving tricyclic therapy reported substantially better mental HRQoL than patients receiving selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or combination therapy. Patients receiving atypical antidepressants reported substantially better mental HRQoL than those receiving other types of antidepressants. Most patients reported a substantial decline in HRQoL after SNRIs or combination therapy. This study found that HRQoL varied across antidepressant users. Thus, health care providers could benefit from taking into consideration quality of life when prescribing antidepressant agents. Moreover, further research is needed to explore other factors that could contribute to the quality of care for patients with depression.

Self-esteem in the context of intimate partner violence: A concept analysis.

To explore the meaning of self-esteem in the context of intimate partner violence (IPV). IPV is a preventable public health issue. The dynamic of IPV diminishes women's self-esteem. Defining self-esteem will guide the development of IPV interventions in healthcare settings. Walker and Avant's eight-step approach was used. The search was conducted from Oxford Dictionary of English online, CINAHL, APA PsycInfo, PubMed, Women's Studies International, and Google Scholar. No limits on the year of publication were applied. Defining attributes of self-esteem are self-concept, self-affirmation, and self-respect. Antecedents of self-esteem are exposure to IPV and victim-blaming attitudes by healthcare professionals. Consequences include depression, substance abuse, and posttraumatic stress disorder. Empirical referents include self-worth, self-competence, self-blame, self-evaluation, self-confidence, and self-determination. Current literature is limited in its definition of self-esteem in the context of IPV. Women experiencing IPV with low self-esteem might not seek help for IPV from nurses. Nurses could develop culturally appropriate IPV screening tools that assess the changes in self-esteem among women from different sociodemographic and cultural backgrounds. The defining attributes could contribute to developing comprehensive IPV screening tools in healthcare settings.

Associations Between Genetic Risk for Adult Suicide Attempt and Suicidal Behaviors in Young Children in the US

Suicide rates have been increasing among youth in the US. While the heritability of suicide risk is well established, there is limited understanding of how genetic risk is associated with suicidal thoughts and behaviors in young children. To examine whether genetic susceptibility to suicide attempts (SAs) is associated with suicidal thoughts and behaviors in children. This case-control study examined data from the Adolescent Brain Cognitive Development (ABCD) study, a population-based longitudinal study of 11 878 US children enrolled at age 9 and 10 years from September 2016 to November 2018. Youth reports of suicidal ideation (SI) and SAs were obtained from the Kiddie Schedule for Affective Disorder and Schizophrenia at baseline and 2 subsequent years. After conservative quality control of genotype data, this analysis focused on 4344 unrelated individuals of European ancestry. Data analysis was conducted from November 2020 to February 2022. Children's lifetime experiences of SI and SAs were assessed each year from ages 9 to 10 years to ages 11 to 12 years. Polygenic risk scores (PRSs) for SAs were calculated for ABCD study participants based on the largest genome-wide association study of SA cases and controls of European ancestry (total sample n = 518 612). Of 4344 children of European ancestry (2045 [47.08%] female; mean [SD] age, 9.93 [0.62] years), significant associations were found between children's SA PRSs and their lifetime SAs with the most robust association in the follow-up year 2 (odds ratio, 1.43 [95% CI, 1.18-1.75]; corrected P = 1.85 × 10-3; Nagelkerke pseudo R2 = 1.51%). These associations remained significant after accounting for children's sociodemographic backgrounds, psychopathology symptoms, parental histories of suicide and mental health, and PRSs for major depression and attention-deficit/hyperactivity disorder (likelihood ratio test P &lt; .05). Children's depressive mood and aggressive behavior were the most significant partial mediators of SA genetic risk on SAs (mediation analysis P &lt; 1 × 10-16). Children's behavioral problems, such as attention problems, rule-breaking behavior, and social problems, also partially mediated the association of SA PRSs with SAs (mediation analysis false discover rate &lt; 0.05). This study's findings indicate that there may be genetic factors associated with SA risk across the life span and suggest behaviors and conditions through which the risk could be mediated in childhood. Further research is warranted to examine whether incorporating genetic data could improve the identification of children at risk for suicide.

P08-12 Equity review of the relationship between the physical environment and physical activity

BackgroundThe impact of the physical environment on physical activity is not equal for all citizens. According to the socioecological theory, moderators of the association can for example be income, education, age, ethnicity and gender. These moderating conditions are important for practice in order to plan and initiate the best solutions for different population groups.MethodsBased on a systematic review process 1464 studies were screened. After title, abstract and full text reading 41 studies remained and constitute the basis for this presentation.ResultsCitizens with different sociodemographic backgrounds are often geographically divided within cities. Looking at the overall characteristics of urban areas, studies show that citizens with lower incomes and shorter education often live in areas with higher population density and generally shorter distances to daily destinations. Conversely, citizens with higher incomes and longer education often have better access to trails, sidewalks and sports facilities. Several of the included studies find that access to facilities is inferior for low-income citizens, but other studies indicate that social and personal factors also play a role in the use of the areas. Adding to this, some evidence possits a lower adoption of for example new bike trails for citizens with shorter education. This leads many of the studies to recommend holistic efforts where improvements in the built environment are initiated simultaneously with other types of efforts that strengthen information, skills and motivation for physical activity. For example, combine cheaper or free access to sports facilities or gyms with marketing and beginners' courses. Another important finding from the equity review is a focus on safety from crime and traffic, which more often is a problem in low income areas, and at the same time a larger perceived barrier for women and elderly people.ConclusionThe interplay between sociodemographic characteristic and the physical environment is complex, but the review points to some important findings.

An e-Mental Health Resource for COVID-19-Associated Stress Reduction: Mixed Methods Study of Reach, Usability, and User Perceptions.

BackgroundCOVID-19 and its public health response are having a profound effect on people’s mental health. To provide support during these times, Canada’s largest mental health and addiction teaching hospital (Centre for Addiction and Mental Health [CAMH]) launched the Mental Health and COVID-19 Pandemic website on March 18, 2020. This website was designed to be a nonstigmatizing psychoeducational resource for people experiencing mild to moderate distress due to COVID-19 and the public health response to the pandemic.ObjectiveThe aim of this study was to examine the reach, usability, and user perceptions of the CAMH Mental Health and COVID-19 Pandemic website.MethodsThis study used a mixed methods sequential explanatory design approach, which consisted of the following 2 distinct phases: (1) quantitative data collection and analysis and (2) qualitative semistructured interviews. In phase 1, we analyzed Google Analytics data to understand how many people visited the website and which were the most visited pages. We conducted a survey to identify users’ sociodemographic backgrounds, and assess the usability of the website using the System Usability Scale and users’ subjective stress levels using the Perceived Stress Scale (PSS-10). For phase 2, we conducted semistructured interviews to explore user experiences; user motivation, engagement, satisfaction, and perception of the stress reduction strategies; reflections of the website’s functionality, ease of use, navigation, and design; and recommendations for improvement.ResultsGoogle Analytics results showed 146,978 unique users from June 2020 to March 2021. Most users were from Canada (130,066, 88.5%). Between February 20, 2021, and June 4, 2021, 152 users completed the survey. Most users identified as white, female, and having at least a college degree. Based on the PSS-10 scores, most participants were experiencing moderate to high stress when they visited the website. Users rated the usability of the website as acceptable. Ten users completed in-depth interviews between May 2021 and June 2021. Positive feedback related to the content was that the website was a trustworthy source of mental health information with helpful evidence-based stress reduction strategies. Areas for improvement included the text heavy design of the website, wider dissemination/marketing, and greater accessibility of the website to meet the needs of diverse populations.ConclusionsAdding stress reduction resources to a website from a well-respected institution may be a practical method to increase awareness and access to evidence-based stress reduction resources during times of crisis, where there is severe disruption to usual health care contacts. Efforts to ensure that these resources are more widely accessed, especially by diverse populations, are needed.

Differences of people with visual disabilities in the perceived intensity of emotion inferred from speech of sighted people in online communication settings

Purpose As humans convey information about emotions by speech signals, emotion recognition via auditory information is often employed to assess one’s affective states. There are numerous ways of applying the knowledge of emotional vocal expressions to system designs that accommodate users’ needs adequately. Yet, little is known about how people with visual disabilities infer emotions from speech stimuli, especially via online platforms (e.g., Zoom). This study focussed on examining the degree to which they perceive emotions strongly or weakly, i.e., perceived intensity but also investigating the degree to which their sociodemographic backgrounds affect them perceiving different intensity levels of emotions when exposed to a set of emotional speech stimuli via Zoom. Materials and methods A convenience sample of 30 individuals with visual disabilities participated in zoom interviews. Participants were given a set of emotional speech stimuli and reported the intensity level of the perceived emotions on a rating scale from 1 (weak) to 8 (strong). Results When the participants were exposed to the emotional speech stimuli, calm, happy, fearful, sad, and neutral, they reported that neutral was the dominant emotion they perceived with the greatest intensity. Individual differences were also observed in the perceived intensity of emotions, associated with sociodemographic backgrounds, such as health, vision, job, and age. Conclusions The results of this study are anticipated to contribute to the fundamental knowledge that will be helpful for many stakeholders such as voice technology engineers, user experience designers, health professionals, and social workers providing support to people with visual disabilities. IMPLICATIONS FOR REHABILITATION Technologies equipped with alternative user interfaces (e.g., Siri, Alexa, and Google Voice Assistant) meeting the needs of people with visual disabilities can promote independent living and quality of life. Such technologies can also be equipped with systems that can recognize emotions via users’ voice, such that users can obtain services customized to fit their emotional needs or adequately address their emotional challenges (e.g., early detection of onset, provision of advice, and so on). The results of this study can be beneficial to health professionals (e.g., social workers) who work closely with clients who have visual disabilities (e.g., virtual telehealth sessions) as they could gain insights or learn how to recognize and understand the clients’ emotional struggle by hearing their voice, which is contributing to enhancement of emotional intelligence. Thus, they can provide better services to their clients, leading to building a strong bond and trust between health professionals and clients with visual disabilities even they meet virtually (e.g., Zoom).

Beyond race: Recruitment of diverse participants in clinical genomics research for rare disease.

Purpose: Despite recent attention to increasing diversity in clinical genomics research, researchers still struggle to recruit participants from varied sociodemographic backgrounds. We examined the experiences of parents from diverse backgrounds with enrolling their children in clinical genomics research on rare diseases. We explored the barriers and facilitators parents encountered and possible impacts of sociodemographic factors on their access to research. Methods: We utilized semi-structured interviews with parents of children participating in the Undiagnosed Diseases Network. Interview data were analyzed using comparative content analysis. Results: We interviewed 13 Hispanic, 11 non-Hispanic White, four Asian, and two biracial parents. Participants discussed different pathways to clinical genomics research for rare disease as well as how sociodemographic factors shaped families’ access. Themes focused on variation in: 1) reliance on providers to access research; 2) cultural norms around health communication; 3) the role of social capital in streamlining access; and 4) the importance of language-concordant research engagement. Conclusion: Our findings suggest that variables beyond race/ethnicity may influence access in clinical genomics research. Future efforts to diversify research participation should consider utilizing varied recruitment strategies to reach participants with diverse sociodemographic characteristics.

Going beyond "With a Partner" and "Intercourse": Does Anything Else Influence Sexual Satisfaction among Women? The Sexual Satisfaction Comprehensive Index.

The validated tools for measuring sexual satisfaction (SS) assess in fact other phenomena such as sexual functioning, assess SS within the context of a romantic heterosexual relationship and intercourse-type activity or were designed to be applied only in therapeutic or rehabilitation contexts. Consequently, they offer an incomplete understanding of SS, particularly among women. We thus developed an alternative measure of SS, the Sexual Satisfaction Comprehensive Index (SSCI), considering both the individual and with-a-partner dimensions, as well as the actual and desired experiences of satisfaction, along with other dimensions affecting SS, and explored its psychometric properties. A total of 1080 young to mid-aged women with different sociodemographic, relationship and sexual identity backgrounds voluntarily completed several measures of SS, including the SSCI. Results showed that the SSCI is a reliable measure for assessing SS. An exploratory and a confirmatory factor analysis confirmed the latent multidimensional structure of the SSCI, supporting its factorial validity. In addition, the SSCI showed appropriate convergent validity with other measures commonly used to assess SS. In sum, the SSCI was revealed to be a useful multidimensional index of SS for research and practice contexts which allows the practitioner or the researcher to make decisions on which dimension(s) are to be evaluated. This study focused on women’s SS, and future research with other gender, sexual and cultural identities is necessary to support its utility in multi-identity and multi-sexuality scenarios.

Trends in the Prevalence of Chronic Medication Use Among Children in Israel Between 2010 and 2019: Protocol for a Retrospective Cohort Study.

BackgroundPrescription of psychostimulants has significantly increased in most countries worldwide for both preschool and school-aged children. Understanding the trends of chronic medication use among children in different age groups and from different sociodemographic backgrounds is essential. It is essential to distinguish between selected therapy areas to help decision-makers evaluate not only the relevant expected medication costs but also the specific services related to these areas.ObjectiveThis study will analyze differences in trends regarding medications considered psychobehavioral treatments and medications considered nonpsychobehavioral treatments and will identify risk factors and predictors for chronic medication use among children.MethodsThis is a retrospective study. Data will be extracted from the Clalit Health Services data warehouse. For each year between 2010 and 2019, there are approximately 1,500,000 children aged 0-18 years. All medication classes will be identified using the Anatomical Therapeutic Chemical code. A time-trend analysis will be performed to investigate if there is a significant difference between the trends of children’s psychobehavioral and nonpsychobehavioral medication prescriptions. A logistic regression combined with machine learning models will be developed to identify variables that may increase the risk for specific chronic medication types and identify children likely to get such treatment.ResultsThe project was funded in 2019. Data analysis is currently underway, and the results are expected to be submitted for publication in 2022. Understanding trends regarding medications considered psychobehavioral treatments and medications considered nonpsychobehavioral treatments will support the identification of risk factors and predictors for chronic medication use among children.ConclusionsAnalyzing the response of the patient (and their parents or caregivers) population over time will hopefully help improve policies for prescriptions and follow-up of chronic treatments in children.International Registered Report Identifier (IRRID)DERR1-10.2196/36756

Targeted Primary and Secondary Preventive Strategies for Depression among Malaysian Pharmacy Students.

The global depression burden has remained a challenge throughout the pre- and post-pandemic era. The pandemic effect has led to the spiraling of mental disorders among young people who will be the next generation of leaders. This study aims to identify university students’ sociodemographic, psychosocial and academic backgrounds and performance associated with depression symptoms for the development of primary and secondary preventive strategies for mental health. A cross-sectional study was conducted using an online questionnaire distributed to 19 institutions in Malaysia offering a Bachelor of Pharmacy degree program. The self-rated Depression Anxiety Stress Scale (DASS-42) was used to assess depression symptoms. Pearson’s chi-square test and Fisher’s exact test were used to assess the investigated variables with depression symptoms. Independent T-test and one-way ANOVA were used to compare means of depression score across variables. Binary logistic regression was employed to examine the relationship between the investigated variables and depression symptoms. A total of 610 pharmacy students participated, of which 47% (n = 289/610) were having depression symptoms. Students who smoke nicotine and those who have separated parents, family history of mental illness, and poor academic performance were associated with depression symptoms (p < 0.05). Differences in geographical areas, race and religion also showed significant associations with depression symptoms. Parental marital status, poor academic performance, history of mental illness and comorbidities were statistically predicting depression symptoms (p < 0.05). Primary preventive strategies allowing students to harness healthy coping skills for stress, nicotine-free campaigns and a holistic curriculum are warranted. Secondary measures on mindfulness and compassion skills activities to benefit students who experienced early life crises are highly recommended. Enforcing these targeted strategies in collaboration with health and social sectors should be the primary agenda of universities to ensure their uptake.

A framework for identifying perceived Quality of Life indicators for the elderly in the neighbourhood context: a case study of Kolkata, India

Review of existing research reveals sporadic explorations of the vast concept of perceived Quality of Life (QoL) of elderly. Assessment of QoL of elderly in South Asian countries have been so far based on measurement models developed on western ideologies. The distinctively dissimilar perspectives and philosophies of the elderly living in South Asian countries seeks for development of QoL models from their perspective. The importance of the neighbourhood environment in the lives of the elderly and the preference of the elderly to age-in-place, also necessitates research on improving the QoL of the elderly in the context of their residential environment. This paper, exploring the perspectives of a group of Indian elderly, describes the stages of identification of a set of factors (components) and a broad set of domains (latent constructs which these factors cater to), influencing perceived QoL of Indian elderly to promote ageing-in-place. The methodology combines qualitative and quantitative research techniques, which includes literature review, followed by focus group discussions and close-ended interviews with Indian elderly from varied socio-demographic backgrounds. The present study, using Principal Component Analysis, identifies seven broad domains and 37 QoL factors influencing perceived QoL of Indian and elderly, which can be further validated on a larger sample for the development of a QoL index. The structure of domains and factors, identified for the Indian elderly varies considerably from that identified from literature. The study concludes with an exploration of the prioritisation of the identified domains among different socio-demographic groups.

Perceptions of workplace climate and diversity, equity, and inclusion within health services and policy research.

To describe the perception of professional climate in health services and policy research (HSPR) and efforts to advance diversity, equity, and inclusion (DEI) in the HSPR workforce and workplaces. We administered the HSPR Workplace Culture Survey online to health services and policy researchers. Our survey examined participants' sociodemographic, educational, and professional backgrounds, their perception on DEI in HSPR, experience with DEI initiatives, feeling of inclusion, and direct and witnessed experiences of discrimination at their institutions/organizations. We calculated sample proportions of responses by gender identity, sexual orientation, race/ethnicity, and disability status and compared them with Fisher's exact test. We administered the survey online from July 28 to September 4, 2020. HSPR professionals and trainees aged 18 and older were eligible to participate. Analyses used complete cases only (n=906; 70.6% completion rate). 53.4% of the participants did not believe that the current workforce reflects the diversity of communities impacted by HSPR. Although most participants have witnessed various DEI initiatives at their institutions/organizations, nearly 40% characterized these initiatives as "tokenistic." Larger proportions of participants who identified as female, LGBQI+, underrepresented racial/ethnic groups, and those with a disability held this perception than their male, heterosexual, White, and non-disabled counterparts. Current DEI initiatives focused on "planning" activities (e.g., convening task forces) rather than "implementation" activities (e.g., establishing mentoring or network programs). 43.7% of the participants felt supported on their career development, while female, Black, Hispanic/Latino, LGBQI+ participants and those with a disability experienced discrimination at their workplace. Despite an increasing commitment to increasing the diversity of the HSPR workforce and improving equity and inclusion in the HSPR workplace, our results suggest that there is more work to be done to achieve such goals.

Community-Based Workforce for COVID-19 Contact Tracing and Prevention Activities in New York City, July-December 2020.

High rates of hospitalization and death disproportionately affected Black, Latino, and Asian residents of New York City at the beginning of the COVID-19 pandemic. To suppress COVID-19 transmission, New York City implemented a workforce of community engagement specialists (CESs) to conduct home-based contact tracing when telephone numbers were lacking or telephone-based efforts were unsuccessful and to disseminate COVID-19 information and sanitary supplies. We describe the recruitment, training, and deployment of a multilingual CES workforce with diverse sociodemographic backgrounds during July-December 2020 in New York City. We developed standard operating procedures for infection control and safety measures, procured supplies and means of transportation, and developed protocols and algorithms to efficiently distribute workload. From July through December 2020, 519 CESs were trained to conduct in-person contact tracing and activities in community settings, including homes, schools, and businesses, where they disseminated educational materials, face masks, hand sanitizer, and home-based specimen collection kits. During the study period, 94 704 records of people with COVID-19 and 61 246 contacts not reached by telephone-based contact tracers were referred to CESs. CESs attempted home visits or telephone calls with 84 230 people with COVID-19 and 49 303 contacts, reaching approximately 55 592 (66%) and 35 005 (71%), respectively. Other CES activities included monitoring recently arrived travelers under quarantine, eliciting contacts at point-of-care testing sites, and advising schools on school-based COVID-19 mitigation strategies. This diverse CES workforce allowed for safe, in-person implementation of contact tracing and other prevention services for individuals and communities impacted by COVID-19. This approach prioritized equitable delivery of community-based support services and resources.

Influence of cochlear implants on hearing-related quality of life: results from Chinese children with cochlear implants entering mainstream education

ObjectivesThis study aimed to 1) assess the hearing-related Quality of Life (QoL) of children with cochlear implants (CIs) in China and 2) investigate the impact of CI in children and of the socio-demographic backgrounds of their guardians on the hearing-related QoL of children with CIs in the Chinese mainstream education system. MethodsThis study used the Mandarin Children with Cochlear Implants: Parental Perspectives questionnaire (MPP), which assessed the communication capability, auditory perception, self-independence, level of happiness with family, social interaction, academic performance, outcome assessment for CI, and level of family support in children with CIs. Both univariate and multiple linear regression analyses were performed to identify the relationship of CI in children and the socio-demographic backgrounds of their guardians with hearing-related QoL in children with CI. ResultA total of 124 responses were collected, and they indicated satisfaction and improvement across all aspects of the MPP Questionnaire. Statistical analysis revealed that an earlier age of cochlear implantation (≤3 years old) could improve the communication capabilities, self-independence, social interaction performance, and academic performance of children with CIs. In addition, children with CI from the urban regions demonstrated better social interaction performance than that by those from the rural regions of China. ConclusionCIs can improve hearing-related QoL in children with pre-lingual or congenital hearing loss entering the mainstream education system in China. This study showed that early age of cochlear implantation was critical for successful long-term auditory development and academic achievement in children with CIs in China. Therefore, healthcare professionals and educators in China should advocate for CI for children with severe congenital or pre-lingual hearing loss.