Sociodemographic Categories Research Articles

People‘s perceptions of Alzheimer‘s disease in Lithuania

Abstract Background The achievements in health sector resulted in longer lifespan which makes modern society to face aging problems. Alzheimer disease is one of the most obvious health problems becoming more prevalent in humanity's future. The aim of the study was to evaluate people's perceptions of Alzheimer disease in Lithuania. Methods The data were collected by self-administered questionnaire of 27 questions using online social media platform. 737 respondents gave the feedback in limited time of one-week period. Cronbach α of privity was found 0.62. The relative frequencies and prevalence ratios were compared in groups by different sociodemographic categories. Non-parametric tests were conducted to establish statistical significance which was set at p < 0.05. Confidence intervals were used for prevalence statistics. Results 56.1% of the respondents had insufficient awareness about Alzheimer's disease (95% CI: 52.2; 59.3%). The level of awareness depended on the education and person's occupation in health area. However, 47.1% of health professionals didn't have sufficient awareness. Respondents had problem recognizing Alzheimer's symptoms and risk factors. 51.7% believed that Alzheimer's disease is stigmatized in the society. More women and people with higher education agreed with this statement (p < 0.001). Alzheimer disease was ranked as third most intimidating disease. However just 37.9% knew it was fatal. 85% believed they could take care of the sick family member, but admitted the care should be done jointly by the family and the state (94.6%). Conclusions Awareness of Alzheimer disease is insufficient. People themselves have quite good perception of the disease, but think that there is stigma and little disdain in the society. Most of the respondents are ready to nurse their sick family members, however, they expect aid from the government. Nonetheless, respondents would prefer to be admitted to care institution if it would be their case. Key messages Age related diseases should become main problem to be solved in the future. One of them is Alzheimer’s disease, therefore the public health measurement should be taken now to prevent it. It is important to know people’s perception of the disease, before taking any preventive actions. It enables to see what areas need intervention and where can Public health measures help.

Does socio-demography affect preferences and concerns towards cashless payment? Evidence from the north-eastern region of India

Using primary data from respondents in Sikkim, in the north-eastern region of India, this study investigates the relationship between the sociodemographic characteristics of consumers and their preference for cashless payment instruments. The results show that debit/credit cards, online banking and payment apps are the preferred instruments for making cashless payments, irrespective of sociodemographic category, while the least preferred instrument is the e-wallet. Study subjects reported that being motivated to adopt cashless payment for a number of reasons, including convenience, financial incentives and promotional offers, reluctance to adopt cashless payment instruments was informed by security concerns, poor internet coverage, low acceptance levels among merchants, transaction costs and lack of technical know-how. The results also suggest that while people’s preferences towards cashless payment systems are significantly associated with gender, age, education, occupation and income, reluctance to adopt is significantly associated with occupation.

Consumer buying behaviour and purchase intention of organic food: a conceptual framework

PurposeThe paper aims to investigate existing research in factors impacting organic food purchase with special reference to eco-labels and identify the relative influence of various determinants.Design/methodology/approachA conceptual framework is proposed of organic food buying behaviour after analysing a sample of 154,072 consumers reported in 91 research studies from 2001–2020. The factors are categorised into four categories on the basis of relatedness. In addition, the factors were analysed based on time, region and national economic status.FindingsThe impact of consumer psychographics, socio-demographic and product-related factor categories were found to be more pronounced compared to supply-related factor category. The results show that among individual factors like health concern, environment concern, knowledge and awareness, eco-labels and price followed by trust in organic food are the most important factors in organic food purchase. The findings suggest that eco-labels increase trust in organic food by reducing information asymmetry in consumers. However, there were differences in perception and factors importance between high-income economies and emerging economies.Originality/valueThe study is unique, as it analyses secondary research based on criteria of high-income economies and emerging economies. The conceptual framework can also be incorporated further into different cognitive models like the theory of planned behaviour.

Perinatal Mental Illness in the Middle East and North Africa Region—A Systematic Overview

Aims: Perinatal mental illness (PMI) is associated with a high risk of maternal and infant morbidity. Recently, several systematic reviews and primary studies have explored the prevalence and risk factors of PMI in the Middle East and North Africa (MENA) region. To our knowledge, there has been no critical analysis of the existing systematic reviews (SRs) on this topic in the MENA region. Our systematic overview primarily aimed to synthesize evidence from the published SRs on PMI in the MENA countries focusing on a) the prevalence of PMI and b) the risk factors associated with PMI. Methods: We conducted a systematic overview of the epidemiology of PMI in the Middle East and North Africa region by searching the PubMed, Embase, and PsycInfo databases for relevant publications between January 2008 and July 2019. In addition to searching the reference lists of the identified SRs for other relevant SRs and additional primary studies of relevance (those which primarily discussed the prevalence of PMI and/or risk and protective factors), between August and October 2019, we also searched Google Scholar for relevant studies. Results: After applying our inclusion and exclusion criteria, 15 systematic reviews (SRs) and 79 primary studies were included in our overview. Studies utilizing validated diagnostic tools report a PMI prevalence range from 5.6% in Morocco to 28% in Pakistan. On the other hand, studies utilizing screening tools to detect PMI report a prevalence range of 9.2% in Sudan to 85.6% in the United Arab Emirates. Wide variations were observed in studies reporting PMI risk factors. We regrouped the risk factors applying an evidence-based categorization scheme. Our study indicates that risk factors in the relational, psychological, and sociodemographic categories are the most studied in the region. Conversely, lifestyle-related risk factors were less studied. Conclusions: Our systematic overview identifies perinatal mental illness as an important public health issue in the region. Standardizing approaches for estimating, preventing, screening, and treating perinatal mental illness would be a step in the right direction for the region.

PROTEST MOODS OF THE REGION'S RESIDENTS AS A MANIFESTATION OF DESTRUCTIVE FORMS OF CIVIC ACTIVITY

The article analyzes the protest moods of residents of the Vologda region in the context of the development of civil activity of the population. The main trends of protest potential in various socio-demographic categories are considered, and the most significant factors affecting the formation of protest socio-political moods of the population of the region are determined. The research is based on the results of regular monitoring of public opinion conducted by the Center of the Russian Academy of Sciences in the Vologda region. It is concluded that in the period from 2008 to 2019 the protest potential of residents of the Vologda region remains at a relatively stable level. The highest indicators of potential protest activity are the categories of the population that negatively characterize the socio-economic and political situation in the country and region, are dissatisfied with their own financial situation, do not approve of the activities of government structures, and experience negative emotions. Particular attention is drawn to the significant share of potential participants in protest actions among those who demonstrate low indicators of civil participation. Protest moods do not contribute to the development of conventional activity of citizens, prevent the consolidation and solidarity of the population. In this context, the protest potential acts as a destructive form of civil activity of the population.

Depression and suicidal behavior in LGB and heterosexual populations in Serbia and their differences: Cross-sectional study.

BackgroundSexual identity is a significant risk factor for triggering symptoms of depression, as well as for suicide attempts in lesbian, gay and bisexual (LGB) population compared to the heterosexual population. To the best of our knowledge, data on the mental health of LGB persons in Serbia are lacking, and this is the first study to address this problem. The aim of the study was to examine the association between selected determinants and depression, and selected determinants and suicide attempts in LGB and heterosexual populations in the Republic of Serbia, as well as, their differences.MethodsWe conducted a cross-sectional study in 2015 of 264 heterosexual and LGB respondents using the "snowball sampling" method. We used linear regression analyses to investigate the relationship between socio-demographic variables and different sexual identity categories with PHQ-9 scores. We assessed associations between suicide attempts, and socio-demographic characteristics, sexual identity, depression, and suicidal thoughts using logistic regression.ResultsDepression symptoms were higher in female relative to male participants, in participants who were single, divorced or widowed in comparison to currently married, among people with a middle level of education compared to highly educated, and in respondents identified as bisexual or homosexual in comparison to heterosexual. Homosexual and bisexual participants reported suicidal attempts 27 [Odds Ratio (OR) = 27.31] and six times (OR = 6.40) more often than did heterosexual respondents, respectively. Suicide attempts were less frequently reported by single, divorced or widowed participants in comparison to married (OR = 0.25) and those with middle education (OR = 0.38) compared to highly educated.ConclusionsThe present study showed that LGB persons in Serbia have significantly more symptoms of depression and suicide attempts compared to heterosexuals. Public health interventions should focus on the early detection of depression and on overcoming prejudicial and discriminatory attitudes. Also, intervention should emphasize that homosexuality and bisexuality are normal, equal and morally acceptable expressions of human sexuality.

Flavonoid Intake Varies by Racial/Ethnic Groups Within Sociodemographic Categories

Abstract Objectives Diets rich in flavonoids can reduce the risk of developing chronic diseases through their antioxidant and anti-inflammatory properties. While differences in flavonoid intake by race/ethnicity have been previously described, differences between race/ethnicity within categories sociodemographic characteristics have not been fully assessed. Therefore, the objective of this study was to estimate flavonoid intake and evaluate the disparities by race/ethnicity within categories of sociodemographic characteristics in US adults. Methods A total of 15,775 US adults aged 20 years and older in NHANES 2007–2014 were included in this cross-sectional study. Flavonoid intake was calculated by linking food consumption data from a 24-hour diet recall to a flavonoid database which has been expanded on by our research group using the USDA Databases for the Flavonoid (Release 3.3), and Isoflavone (Release 2.1) in addition to the USDA's Expanded Flavonoid Database for the Assessment of Dietary Intakes (Release 1.1). Mean (SE) flavonoid intakes by sociodemographic categories were compared with one-way ANOVA. Results Among US adults, mean (SE) total flavonoid intake was 227.6 (8.0) mg/day, and total flavonoid intake was highest in 40–59 year olds, non-Hispanic whites, those with a poverty-income ratio (PIR) ≥1.85, those with a college education or above, and those married or living with a partner. In most sociodemographic categories, Hispanics consistently had the lowest total flavonoid intakes compared to other races/ethnicities. Among Hispanic subgroups, total flavonoid intake was lowest in men, 20–39 years olds, PIR < 1.3, less than high school education, and single marital status (men only). Ethnic disparities in flavonoid intake were more pronounced between certain sociodemographic subcategories including men, 40–59 year olds, PIR < 1.3, less than high school education, and married marital status (men only). Conclusions These findings indicate that there are significant racial differences in flavonoid intake. Notably, Hispanics tended to have the lowest intake. Certain sociodemographic populations such as males, low income or low educated may be at an increased risk of flavonoid under-consumption. Funding Sources This research received no external funding.

A study of the family service expenditures and the socio-demographic characteristics via fixed marginals correspondence analysis

Our study focuses on two data set, the former provides the expenditures for several services for each family and the latter contains socio-demographic variables for the same statistical units. The main aim is to analyze, in a Correspondence Analysis context, the service expenditure of families based on the whole given data-set under two types of constraints: the global relative expenses for a given service and the global relative expenses for a given socio-demographic category. The purpose of measuring the relationship between expenditure on social services and the socio-demographic characteristics of families is conducted in an exploratory and predictive perspective. A new approach is then introduced which ensures compliance with the required constraints. Moreover, through a procedure, we have obtained a table of regression coefficients. This table shows interesting properties and it is easy to interpret. Finally, the performance of the results has been evaluated using computer-based resampling techniques.

Assisted reproductive technology use in the United States: a population assessment

To study social and demographic differentiation of assisted reproduction technology (ART) use at the population level in the United States. Population-based study. Not applicable. Women 15-49years old in the American Community Survey and National Vital Statistics Birth Certificate data from 2010-2017. Not applicable. Birth rate after ART by major sociodemographic categories and likelihood of having an ART birth. Net of education, age, period, and marital status, the incidence rates of ART births are lower for black women (0.57 times; 95% CI, 0.52-0.62) and Hispanic women (0.67 times; 95% CI, 0.57-0.62) relative to white women's rates; for Asian women, the incidence rates are 1.21 times that of white women's rates. Further, the incidence rates of ART births are higher for women with more than a 4-year degree (2.08 times; 95% CI, 1.90-2.27) relative to women with a 4-year degree, and are lower for women with less education. Women who are married have an incidence rate of ART that is 5.72 times (95% CI, 5.37-6.09) that of unmarried women. The incidence rates for 2013-2016 are statistically significantly higher than for 2010 by a factor of 1.16 (95% CI, 1.02-1.31), 1.16 (95% CI, 1.03-1.31), 1.27 (95% CI, 1.12-1.43), and 1.51 (95% CI, 1.43-1.82), respectively. The educational differences in ART exist across all age groups from 20 to 49, but are the largest among the 35-39 and 40-44 age groups. Large differences in the risk of an ART birth and the proportion of births and the total fertility rate due to ART exist across period, age, race, education, and marital status groups in the United States. Current measures of ART births may disguise an unmet need for ART.

Electronic Cigarette Use Among Young, Middle-aged, and Older Adults in the United States in 2017 and 2018

This study examines a trend in electronic cigarette use between 2017 and 2018 and stratifies results by sociodemographic categories.

Effects of anxiety and depression and early detection and management of emotional distress on length of stay in hospital in non-psychiatric inpatients in China: a hospital-based cohort study

BackgroundEmotional distress, including anxiety and depression, is associated with negative outcomes (such as poorer prognosis of physical diseases, longer hospital stays, and more readmissions) of patients in non-psychiatric settings. We investigated the effects of anxiety and depression, as well as the effects of early detection and management of emotional distress, in non-psychiatric inpatients on length of stay in hospital, with the aim of better informing the provision of medical care to meet the needs of non-psychiatric patients receiving general hospital care. MethodsThis real-world hospital-based cohort study included inpatients (aged ≥15 years) from 20 non-psychiatric departments in West China Hospital. The Huaxi emotional-distress index (HEI), a validated questionnaire for screening depression and anxiety in Chinese non-psychiatric clinical settings, was recommended for use in brief screening of non-psychiatric inpatients on their admission to hospital. Patients with depression or anxiety were provided with a graded psychological service, ranging from brief supportive care (for mild distress [HEI score 9–12]) to treatment by a psychiatrist or psychotherapist (for severe distress [HEI score ≥17]). Patients were grouped on the basis of whether brief screening and graded psychological service was provided (BS-GPS group) or not (non-BS-GPS group). Length of stay was compared between the groups and between patients with and without clinically significant anxiety or depression. FindingsFrom Jan 1, 2015, to Dec 31, 2018, 487 871 patients admitted to 20 non-psychiatric departments were included in the study, of whom 178 883 (36·7%) patients underwent brief screening on admission (BS-GPS group) and 308 988 (63·3%) patients were not screened (non-BS-GPS group). Across all departments, 9590 (5·4%) patients in the BS-GPS group (range 2·6–20·5% across departments) showed clinically significant anxiety or depression (ie, total HEI score ≥11). Mean length of stay differed significantly between patients with (12·7 days [SD 0·12]) and without (9·5 days [0·02], p<0·0001) clinically significant anxiety or depression, and between the BS-GPS group (9·6 days [0·02]) and the non-BS-GPS group (10·8 days [0·02], p<0·0001). These differences remained significant after controlling for sociodemographic factors and categories of physical diseases. InterpretationAnxiety and depression significantly prolonged the length of stay of non-psychiatric inpatients in general hospital. Early detection and management of emotional distress should be promoted and applied to better care for patients with non-psychiatric disorders and to conserve medical resources. Funding1.3.5 Project for Disciplines of Excellence of West China Hospital (Sichuan University), Science and Technology Benefit the People Project of Chengdu Municipal Government (grant numbers 2015-HM01-00011-SF and 2016-HM02-00095-SF), Science and Technology Support Program of Sichuan Provincial Government (grant number 2015SZ0058).

Training need analysis of the nurses working in the RDHS division Jaffna: development of a new method

Trainings for the nurses working in the Regional Directorate of Health Services, Jaffna wasn’t conducted based on their needs as existing system to assess the needs produced no output. The objective of the study was to develop a new tool to gather and analyse the training needs of the nurses.First stage of the project identified the strengths and weaknesses of the existing system in gathering and analysing the training needs. A new tool was developed by modifying Hennessey and Hicks training need analysis questionnaire and tested on nurses in the second stage. In the final stage, a training session was organised, based on the findings of the new tool, and effectiveness of this tool was assessed.Appraisal system and availability of funds were identified as the major strengths while inadequate training sessions and difficulty in analysing training needs were highlighted as weaknesses of the existing system.Response rate for testing the new tool was 71.8%. Training needs existed in all five superordinate categories and varied between socio demographic and service related categories of nurses.Nurses who were least experienced, belonged to grade 111 and working in critical units had highest need for training in all five superordinate categories.The new tool was found to be significantly more satisfactory (t =13.780, df =31, p&lt;0.001), and effective compared to the existing method.In conclusion introducing the new tool to the existing appraisal system could enable gathering and analysing the training needs of the nurses effectively.

The level of sense of coherence among Swedish nursing staff.

To explore the level of sense of coherence among Swedish nursing staff. An explorative quantitative study design was adopted using a short form for measuring sense of coherence. Data were collected in January 2018 from nurses working in full-time positions at two hospitals in Western Sweden. A total of 93 nurses completed the 13 item questionnaire measuring sense of coherence. Descriptive statistics were applied to obtain means and standard deviations. Spearman's rank correlation was used to describe strength of association between sense of coherence and socio-demographic categories. Between-group differences were defined using the nonparametric tests of Mann Whitney U test and Kruskal-Wallis test. The internal consistency of the SOC-13 was low. An inter-item-correlation test indicated that two items decreased the internal consistency of the scale. The level of the three dimensions of sense of coherence varied; manageability was weakest and decreased the total sense of coherence. The meaningfulness dimension was as strongest. On a national level, nurses reported weaker sense of coherence (SOC) than the general population, but stronger in an international comparison of nurses. They found their work difficult to manage, but meaningful. On a national level, the nurses reported weaker SOC than the general population, but stronger in an international comparison of nurses. Findings from this study will have an impact on how nurses can manage work related stress in terms of sense of coherence. There will also be an impact on nurses' well-being, which in a long run benefits patients.

College alcohol beliefs: Measurement invariance, mean differences, and correlations with alcohol use outcomes across sociodemographic groups.

Undergraduate students who believe that alcohol plays a central role in college life are prone to drink more frequently, in larger quantity, and experience more drinking problems. The College Life Alcohol Salience Scale (CLASS) measures individuals' college-related alcohol beliefs but has been used predominantly in Euro American and freshman student samples. Emerging research suggests mean differences in college alcohol beliefs by gender and years in college, and measurement nonequivalence across nations. It remains unclear whether the CLASS functions the same way across segments of the U.S. college population, whether students across sociodemographic groups differ in their college alcohol beliefs, and the extent to which these beliefs predict their drinking-related outcomes. This study included 1,148 undergraduates student (Mage = 19.95; 65.0% women; 44.9%, 19.9%, 10.3%, and 16.7% Euro, Asian, African, and Latinx Americans, respectively). Most students lived on campus (69.9%) and were not affiliated with the Greek system (65.7%). Multigroup confirmatory factor analyses supported scalar invariance of the CLASS scores across gender, years in college, and campus residence. Scale data achieved metric invariance and partial scalar invariance for ethnicity and Greek membership status. Associations between college alcohol beliefs and alcohol consumption, and drinking problems, were equivalent across sociodemographic categories, but differences in latent mean scores were found across gender, ethnicity, and Greek affiliations. Clinical utility of the CLASS and implications for considering college alcohol beliefs as a risk factor for hazardous alcohol use are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Prevalence and correlates of diagnosed and undiagnosed hypertension in the indigenous Kuna population of Panam\xe1

BackgroundTo determine the prevalence of hypertension and investigate sociodemographic correlates in an indigenous Kuna community living on the San Blas islands of Panama.MethodsData was collected from adults using a paper-based survey using a cross sectional study design. Blood pressure was measured, and hypertension defined at two cut-points: 130/80 mmHg and 140/90 mmHg. Individuals with undiagnosed hypertension had a blood pressure measurement that indicated hypertension, however, the individual had not been told by a doctor they had hypertension. Whereas individuals with diagnosed hypertension had been told by a healthcare provider that they had hypertension. Univariate tests compared diagnosed and undiagnosed hypertension by sociodemographic categories and logistic regression models tested individual correlates adjusting for all sociodemographic factors.ResultsTwo hundred and eleven adult indigenous Kuna participated in the study. Overall prevalence of hypertension was 6.2% (95%CI:3.32–10.30) as defined by 140/90 mmHg, and 16.6% (95%CI:11.83–22.31) as defined by 130/80 mmHg. Hypertension was significantly higher in men (31.6, 95% CI:19.90–45.24, compared to 11.0, 95% CI:6.56–17.09). Individuals with low income were 3 times more likely to be hypertensive (OR = 3.13, 95% CI:1.02–9.60) and 3.5 times more likely to have undiagnosed hypertension (OR = 3.42, 95% CI:1.01–11.52); while those with moderate income were 6 times more likely to be hypertensive (OR = 7.37, 95% CI:1.76–30.90) compared to those who were poor.ConclusionThe prevalence of diagnosed and undiagnosed hypertension is higher in men and those with higher income. Investigating these factors remains vitally important in helping improve the health of the Kuna through targeted interventions to address chronic disease.

Recorded Diagnoses of Depression During Delivery Hospitalizations in the United States, 2000-2015.

To describe national, state-specific, and sociodemographic trends in diagnoses of depressive disorders recorded during delivery hospitalizations. Data were analyzed from the National Inpatient Sample (2000-2015) and 31 publicly available State Inpatient Databases (2000-2015) of the Healthcare Cost and Utilization Project. Delivery hospitalizations were identified by using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnostic and procedure codes for obstetric delivery. Depressive disorders were identified from ICD-9-CM diagnoses codes classified as depressive disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (291.89, 292.84, 293.83, 296.2-296.26, 296.3-296.36, 300.4, and 311). Prevalence rates and average annual rate change were calculated nationally and across 28 states with at least 3 years of data and age, payer source, and race or ethnicity. The U.S. rate of depressive disorders recorded during delivery hospitalizations increased from 4.1 diagnoses per 1,000 hospitalizations in 2000 to 28.7 in 2015. Rates significantly increased in 27 of the 28 states. Recent (2014-2015) rates were lowest in Hawaii and Nevada (less than 14/1,000) and highest in Vermont, Minnesota, Oregon, and Wisconsin (greater than 49/1,000). Rates in 2015 were highest among those aged 35 years or older, public insurance recipients, and non-Hispanic white women (greater than 31/1,000). The highest annual rate increases were in Vermont and Maine (3.8/1,000 or greater). Non-Hispanic white women, those 35 years of age or older, and public insurance recipients showed the highest annual rate increases during 2000-2015 (1.7/1,000 or greater). During 2000-2015, rates of depressive disorders recorded during delivery hospitalizations increased nationally, in 27 states with available data, and across all sociodemographic categories.

Sociodemographic and Psychosocial Factors Associated with Diet Quality Among Native American Adults: Baseline Data from the OPREVENT2 Study (P04-007-19)

ObjectivesTo identify sociodemographic and psychosocial factors associated with diet quality among Native American adults. MethodsCross-sectional data from the baseline assessment of a cluster-randomized obesity prevention trial (OPREVENT2) of 580 Native American adults from six tribal communities in the Midwest and Southwest. The Healthy Eating Index (HEI-2015) was used to define diet quality, calculated from a semi-quantitative food frequency questionnaire (modified Block FFQ). Sociodemographic (age, sex, education, food assistance) and psychosocial factors (nutrition knowledge, self-efficacy, health eating intentions) were assessed via questionnaires administered by trained data collectors. One-way ANOVA, linear regression models, and two-tailed t-tests assessed compared mean total HEI scores among sociodemographic categories. Bivariate linear regression models assessed the relation between psychosocial factors and diet quality. ResultsOverall diet quality was low, with a mean HEI-2015 score of 49 (SD + 8), which is 10 points lower than in the general U.S. population. The HEI scores of smokers were an average of 3 points lower than those of non-smokers (P < 0.001), and females had better diet quality (2.2 points higher) than males (P < 0.01). Those receiving commodity food assistance had mean total HEI scores 2.7 points lower than those who did not receive commodities (P < 0.005), and no other source of food assistance was associated with HEI. Self-efficacy (b = 0.66; P < 0.001) and healthy eating intentions (b = 0.72; P < 0.001) were positively associated with mean HEI. ConclusionsWhile nutrition knowledge has been a key focus of many dietary interventions, it does not appear to be associated with better diet quality among Native Americans. This finding suggests that it is necessary to focus interventions on factors other than nutrition knowledge that may impact food choice. Because higher self-efficacy and healthy eating intentions were associated with better diet quality, a social-cognitive approach to dietary interventions may be more effective in Native American populations. Funding SourcesOPREVENT2 is funded by a grant from the National Heart, Lung, and Blood Institute.

Neighborhood Racial Diversity, Socioeconomic Status, and Perceptions of HIV-Related Discrimination and Internalized HIV Stigma Among Women Living with HIV in the United States.

Relationships that traverse sociodemographic categories may improve community attitudes toward marginalized groups and potentially protect members of those groups from stigma and discrimination. The present study evaluated whether internalized HIV stigma and perceived HIV-related discrimination in health care settings differ based on individual- and neighborhood-level characteristics of women living with HIV (WLHIV). We also sought to extend previous conceptual and empirical work to explore whether perceived HIV-related discrimination mediated the association between neighborhood racial diversity and internalized HIV stigma. A total of 1256 WLHIV in the Women's Interagency HIV Study (WIHS) attending 10 sites in metropolitan areas across the United States completed measures of internalized HIV stigma and perceived HIV-related discrimination in health care settings. Participants also provided residential information that was geocoded into Federal Information Processing Standard (FIPS) codes and linked with census-tract level indicators. In cross-sectional analyses, greater neighborhood racial diversity was associated with less internalized HIV stigma and less perceived HIV-related discrimination regardless of individual race. Neighborhood median income was positively associated with internalized HIV stigma and perceived discrimination, while individual income was negatively associated with perceptions of stigma and discrimination. In an exploratory mediation analysis, neighborhood racial diversity had a significant indirect effect on internalized HIV stigma through perceived HIV-related discrimination. An indirect effect between neighborhood income and internalized stigma was not supported. These findings suggest that greater neighborhood racial diversity may lessen HIV stigma processes at the individual level and that HIV stigma-reduction interventions may be most needed in communities that lack racial diversity.

Assessing electronic personal health information use: An update on progress toward healthy people 2020 objectives

ObjectiveTo assess progress toward Healthy People 2020 health information technology objectives using nationally representative data. MethodsWe used data from six administrations (2003–2017) of the Health Information National Trends Survey (HINTS) to examine trends in the proportion of Americans who manage electronic Personal Health Information (ePHI) and email their healthcare providers. Two targets were evaluated: (1) a goal to exceed 15.7% of the general population for accessing ePHI (10% improvement), and (2) a goal to exceed 15% for communicating with health providers (10% improvement). Analyses included bivariate and multivariable logistic regression models, including assessing predicted marginal for key sociodemographic variables to explain observed digital divides in health information technology use over time. ResultsSelf-reported management of ePHI online significantly increased between 2008 and 2017 from 14.2% to 70.9% (p < 0.001; HP2020 target = 15.7% by 2020). Use of email to connect with healthcare providers also significantly increased, from 7.0% in 2003 to 41.1% in 2017 (p < 0.001; HP2020 target = 15.0% by 2020). Multivariable regression revealed significant differences by sex, age, race/ethnicity (ePHI only), education, income, and geography over time. ConclusionsTargets set forth in HP2020 were exceeded for these health information technology objectives. Though an increase in adoption of these tools was seen across all sociodemographic categories, disparities persist and have even widened for certain groups. As efforts move forward to set targets for HP2030, the persistence of the digital divide amongst these groups should be considered.

Prison law and human rights in post-communist Romania: Staff attitudes toward change

Previous research has documented the crucial role that the perceptions and attitudes of prison staff play in everyday prison practice and the treatment of prisoners. The current study follows this contention in order to investigate how prison staff in Romania perceive the outcomes of the recently adopted prison law advocating the principle of humanization and the protection of prisoners’ rights. Specifically, drawing from Jacobs’ (1980) early study on the impact of the prisoners’ rights movement, the effects of the prison law on: (1) prisoners; (2) prison practice and management; and (3) prison staff are investigated from the perspective of a sample of approximately 300 staff members. Whether these perceptions vary across specific socio-demographic groups, occupational categories and groups defined by their level of job satisfaction, punitive attitudes and commitment to custodial role is also examined. We conclude by arguing that, although time is needed to thoroughly assess the prison law’s effects, surveying prison staff’s opinions and perceptions about its outcomes is nevertheless legitimate, because how staff members feel, experience and perceive these outcomes and whether the balance inclines toward the positive aspects or toward the negative ones are crucial for the success or, on the contrary, the failure of an ongoing implementation of those reforms.