Healthcare Topics Research Articles

Does a text messaging intervention improve knowledge, attitudes and practice regarding iodine deficiency and iodized salt consumption?

To determine the effectiveness of implementation of a prevention programme via mobile phone text messaging in enhancing knowledge, attitudes and practice concerning iodine deficiency and iodized salt consumption. In a randomized controlled trial, participants were subjected to a brief tele-educational support regarding iodine deficiency and the importance of iodized salt consumption. The intervention group received daily text messages via mobile phone for 6 weeks. Knowledge, attitude and practice scores, urinary iodine concentration and salt iodine content were assessed at baseline and 8 weeks after the intervention. Participants were recruited from health-care centres in Tehran, the capital city of Iran. For the present study 205 females aged ≥18 years were randomly assigned to the intervention (n 95) and control (n 110) groups. A significant difference was found in median knowledge scores between the intervention and control groups at follow-up (P = 0.004). There was also a significant difference in median attitude scores between the intervention and control groups (P = 0.02). The intervention group did not differ significantly in median practice score, urinary iodine concentration and salt iodine content from the control group. Text messaging interventions are effective in improving individuals' knowledge and attitudes regarding preventive health-care topics.

DTB Select: 7 | July 2012

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DTB Select: 6 | June 2012

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How occupational health care professionals experience evidence‐based guidelines in Finland: a qualitative study

Evidence-based guidelines are currently the most relevant source of information in practice. The adherence to and use of guidelines is often influenced by attitudes towards the guidelines themselves, which have not been sufficiently explored in occupational health. This study examines the attitude of Finnish occupational nurses' and doctors' attitudes towards evidence-based guidelines. Ten occupational doctors and eight occupational nurses were interviewed in Southern Finland on their attitudes towards evidence-based guidelines in 2009. The nurses were not very familiar with the concept of evidence-based medicine. Rather, they used recommendations developed in their workplace or by their employer. The evidence base of these recommendations was not clear. The doctors considered the evidence-based guidelines reliable and practical, but did not always act according to them. Participants felt that they did not have time to check guidelines during their working hours. Participants wished for clearer, shorter guidelines on occupational health care topics, which would help in their practical daily work and clarify roles in teamwork. Based on these positive attitudes, the use of guidelines may be more common than it seems. The viewpoints of all occupational health professional groups should be taken into account in guideline development, particularly on the availability and usability of the guidelines.

DTB Select: 5 | May 2012

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Getting physicians to open the survey: little evidence that an envelope teaser increases response rates

BackgroundPhysician surveys are an important tool to assess attitudes, beliefs and self-reported behaviors of this policy relevant group. In order for a physician to respond to a mailed survey, they must first open the envelope. While there is some evidence that package elements can impact physician response rates, the impact of an envelope teaser is unknown. Here we assess this by testing the impact of adding a brightly colored "$25 incentive" sticker to the outside of an envelope on response rates and nonresponse bias in a survey of physicians.MethodsIn the second mailing of a survey assessing physicians' moral beliefs and views on controversial health care topics, initial nonrespondents were randomly assigned to receive a survey in an envelope with a colored "$25 incentive" sticker (teaser group) or an envelope without a sticker (control group). Response rates were compared between the teaser and control groups overall and by age, gender, region of the United States, specialty and years in practice. Nonresponse bias was assessed by comparing the demographic composition of the respondents to the nonrespondents in the experimental and control condition.ResultsNo significant differences in response rates were observed between the experimental and control conditions overall (p = 0.38) or after stratifying by age, gender, region, or practice type. Within the teaser condition, there was some variation in response rate by years since graduation. There was no independent effect of the teaser on response when simultaneously controlling for demographic characteristics (OR = 0.875, p = 0.4112).ConclusionsNeither response rates nor nonresponse bias were impacted by the use of an envelope teaser in a survey of physicians in the United States.

DTB Select: 4 | April 2012

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DTB Select: 3 | March 2012

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DTB Select: 2 | February 2012

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Application of social network analysis to health care sectors.

ObjectivesThis study aimed to examine the feasibility of social network analysis as a valuable research tool for indicating a change in research topics in health care and medicine.MethodsPapers used in the analysis were collected from the PubMed database at the National Library of Medicine. After limiting the search to papers affiliated with the National Institutes of Health, 27,125 papers were selected for the analysis. From these papers, the top 100 non-duplicate and most studied Medical Subject Heading terms were extracted. NetMiner V.3 was used for analysis. Weighted degree centrality was applied to the analysis to compare the trends in the change of research topics. Changes in the core keywords were observed for the entire group and in three-year intervals.ResultsThe core keyword with the highest centrality value was "Risk Factor," followed by "Molecular Sequence Data," "Neoplasms," "Signal Transduction," "Brain," and "Amino Acid Sequence." Core keywords varied between time intervals, changing from "Molecular Sequence Data" to "Risk Factors" over time. "Risk Factors" was added as a new keyword and its social network was expanded. The slope of the keywords also varied over time: "Molecular Sequence Data," with a high centrality value, had a decreasing slope at certain intervals, whereas "SNP," with a low centrality value, had an increasing slope at certain intervals.ConclusionsThe social network analysis method is useful for tracking changes in research topics over time. Further research should be conducted to confirm the usefulness of this method in health care and medicine.

DTB Select: 1 | January 2012

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DTB Select: 11 | December 2011

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DTB Select: 10 | November 2011

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DTB Select: 9 | October 2011

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DTB Select: 8 | September 2011

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DTB Select: 7 | August 2011

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Risk factors and interventions with statistically significant tiny effects

Large studies may identify postulated risk factors and interventions with very small effect sizes. We aimed to assess empirically a large number of statistically significant relative risks (RRs) of tiny magnitude and their interpretation by investigators. RRs in the range between 0.95 and 1.05 were identified in abstracts of articles of cohort studies; articles published in NEJM, JAMA or Lancet; and Cochrane reviews. For each eligible tiny effect and the respective study, we recorded information on study design, participants, risk factor/intervention, outcome, effect estimates, P-values and interpretation by study investigators. We also calculated the probability that each effect lies outside specific intervals around the null (RR interval 0.97-1.03, 0.95-1.05, 0.90-1.10). We evaluated 51 eligible tiny effects (median sample size 112 786 for risk factors and 36 021 for interventions). Most (37/51) appeared in articles published in 2006-10. The effects pertained to nutrition (n = 19), genetic and other biomarkers (n = 8), correlates of health care (n = 8) and diverse other topics (n = 16) of clinical or public health importance and mostly referred to major clinical outcomes. A total of 15 of the 51 effects were >80% likely to lie outside the RR interval 0.97-1.03, but only 8 were >40% likely to lie outside the RR interval 0.95-1.05 and none was >1.7% likely to lie outside the RR interval 0.90-1.10. The authors discussed at least one concern for 23 effects (small magnitude n = 19, residual confounding n = 11, selection bias n = 1). No concerns were expressed for 28 effects. Statistically significant tiny effects for risk factors and interventions of clinical or public health importance become more common in the literature. Cautious interpretation is warranted, since most of these effects could be eliminated with even minimal biases and their importance is uncertain.

A Five-Step Guide for Moving from Observational Studies to Interventional Research for Women Veterans

A Five-Step Guide for Moving from Observational Studies to Interventional Research for Women Veterans

DTB Select: 6 | July 2011

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Practising medicine in China: an unsolved dilemma.

Practising medicine in China: an unsolved dilemma.