Utilization Of Preventive Services Research Articles

Comparing Socio-Demographics and HIV Testing and Prevention Outcomes Between Low-Income HIV-Negative Heterosexually Active Black Women and Men with Health Insurance.

This study is to compare socio-demographic, HIV testing, and prevention factors experienced by insured low-income heterosexual Black women and men. We examined cross-sectionaldata from Black women and men (n = 5837) recruited in 23 U.S. cities for National HIV Behavioral Surveillance June-December 2019. We compared socio-demographic and behavioral factors between groups using log-linked Poisson regression models, producing adjusted prevalence ratios and 95% confidence intervals. Black women were less likely than Black men to have private insurance (aPR 0.61, 95% CI 0.50-0.74, p < 0.0001). Black women were more likely than Black men to have incomes at or below the poverty line (aPR 1.04, 95% CI 1.01-1.07, p = 0.02), be aware of PrEP (aPR 1.20, 95% CI 1.12-1.28, p < 0.0001), and have been recently tested for HIV (aPR 1.12, 95% CI 1.04, 1.20, p < 0.01). Despite insured status, many Black women and men experienced suboptimal access to and utilization of HIV testing and prevention services. Understanding how social conditions produce differential access to care may help inform HIV prevention interventions.

Utilization of Health Care Services and Accessibility Challenges among Adults Aged 50+ before and after Austerity Measures across 27 European Countries: Secular Trends in the SHARE Study from 2004/05 to 2019/20.

This study aimed to assess and compare the utilization of preventive and other health services and the cost or availability in different regions of Europe, before and during the economic crisis. The data used in the study were obtained from Wave 8 of the Survey of Health, Ageing and Retirement in Europe (2019/2020) and Wave 1 data (2004/5), with a sample size of 46,106 individuals aged ≥50 across 27 countries, adjusted to represent a population of N = 180,886,962. Composite scores were derived for preventive health services utilization (PHSU), health care services utilization (HCSU), and lack of accessibility/availability in health care services (LAAHCS). Southern countries had lower utilization of preventive services and higher utilization of other health services compared to northern countries, with a significant lack of convergence. Moreover, the utilization of preventive health services decreased, whereas the utilization of secondary care services increased during the austerity period. Southern European countries had a significantly higher prevalence of lack of accessibility. An increase in the frequency of lack of accessibility/availability in health care services was observed from 2004/5 to 2019/20. In conclusion, our findings suggest that health inequalities increase during crisis periods. Therefore, policy interventions could prioritize accessibility and expand health coverage and prevention services.

Equity and unmet need of non-communicable diseases services in Saudi Arabia using a National Household Survey (2019).

Saudi Arabia is implementing a comprehensive health system transformation in health services provision, governance, and financing. Given the high burden of non-communicable diseases (NCD), a key objective of the transformation is to integrate NCD prevention and treatment into primary care. The study objectives were to assess primary care service use for treatment of NCDs, to quantify existing inequities in preventive services utilization, and to identify regional and sociodemographic factors associated with these inequities. Using the 2019 Kingdom of Saudi Arabia World Health Survey, multivariable logistic regression models were conducted to identify predictors of utilization of primary care services for NCD prevention and treatment, unmet need among those with a diagnosis of diabetes, hypertension, or dyslipidemia, and unmet need in breast and cervical cancer screening. Among those with an NCD diagnosis, living in a high-income household was associated with a lower probability of having an unmet need compared to those in low-income households. Furthermore, rural residents were less likely to have an unmet need compared to urban residents (OR 0.58, p=0.029). Individuals without a perceived need for healthcare within the last 12 months had three times the probability of unmet need in comparison to those with such a perceived need (p<0.001). Women in all regions had a lower probability of ever having a mammogram compared to women in the central regions around Riyadh. Women with an education above a secondary level had five times the odds of undergoing cervical cancer screening and three times the likelihood of ever having a mammogram (P=0.012, p=0.02) than other women. Compared to women in low-income households, those in middle (OR 1.99, P=0.026), upper middle (OR 3.47, p<0.001), or high-income households (OR 2.59, p<0.001) had a higher probability of having had cervical cancer screening. Inequities in NCD treatment and prevention services' utilization in Saudi Arabia are strongly associated with region of living, population density, wealth, income, education and perceived need for health care. More research is needed to better understand the extent of unmet primary care needs for NCD and how to address the underlying contributing factors to access inequities.

Association of Maternal Cervical Cancer Screening Adherence with Adolescent HPV Vaccination Among Adolescent-Mother Pairs.

Less than two-thirds of US adolescents are up-to-date with HPV vaccination. While mothers engaged in preventive care are more likely to seek preventive care for their children, current studies on associations between maternal cervical cancer screening (CCS) and adolescent HPV vaccination are needed. We assessed associations between maternal preventive service utilization and adolescent HPV vaccination using electronic health record data from a healthcare system in Washington State. We included adolescents (11-17 years) and their mothers with ≥ 1 primary care visit between 2018 and 2020. Outcomes were HPV vaccine initiation and completion. The primary exposure was maternal adherence to guideline-recommended CCS. Secondary exposures were maternal breast cancer screening adherence (for mothers ≥ 52 years) and ≥ 1 wellness visit ≤ 2 years. We used Generalized Estimating Equations to estimate prevalence ratios, and explore effect modification by adolescent sex, adolescent provider characteristics, and maternal language interpreter use. Of 4121 adolescents, 66% had a CCS-adherent mother, 82% initiated HPV vaccination, and 49% completed the series. CCS adherence was associated with higher initiation (adjusted prevalence ratio (APR):1.10, 95%CI:1.06-1.13) and completion (APR:1.16, 95%CI:1.08-1.23). Associations were stronger for male vs. female adolescents, adolescents who had a primary care provider in family practice vs. pediatrics, and adolescents who had the same primary care provider as their mother vs. not. Recent maternal wellness visit was also associated with higher initiation (APR:1.04, 95%CI:1.01-1.07) and completion (APR:1.12, 95%CI:1.05-1.20). Results suggest that delivering healthcare through a family-centered approach and engaging mothers in broad preventive care could increase adolescent HPV vaccination coverage.

Awareness and utilization of pre-exposure prophylaxis and HIV prevention services among transgender and non-binary adolescent and young adults.

Transgender and gender non-binary (TGNB) individuals are disproportionally affected by HIV and face high rates of discrimination and stigmatization, resulting in limited access to HIV prevention services. Pre-exposure prophylaxis (PrEP) is highly efficacious for reducing the risk of HIV transmission. However, little research is available regarding PrEP awareness and utilization among TGNB adolescents and young adults (AYA). TGNB AYA ages 15-24 years old were recruited between December 2021 and November 2022 for participation in a one-time, anonymous online survey study to assess PrEP awareness and perceptions, as well as barriers to its use. Participants were recruited from seven academic centers offering gender-affirming care to TGNB AYA across the United States. Of the 156 TGNB AYA individuals who completed the survey, most (67%) were aware of PrEP; however, few (7%) had been prescribed PrEP. Many (60%) had not spoken to a medical provider and, even if the medication was free and obtained confidentially, most participants did not plan to take PrEP due to low perceived HIV risk, lack of PrEP knowledge, and concern about interactions between their hormone therapy and PrEP. These findings underscore the need for broad PrEP educational efforts for both TGNB AYA and their providers to improve knowledge, identify potential PrEP candidates among TGNB AYA and improve access by addressing identified barriers.

Preventive service utilization among adults with cystic fibrosis covered by private insurance is comparable to the general population

BackgroundAs the life expectancy of the cystic fibrosis (CF) population is lengthening with modulator therapies, diligent age-appropriate screening and preventive care are increasingly vital for long-term health and wellbeing. MethodsWe performed a retrospective analysis comparing rates of receiving age- and sex-appropriate preventive services by commercially insured adult people with CF (PwCF) and adults without CF from the general population (GP) via the Truven Health MarketScan database (2012–2018). ResultsWe captured 25,369 adults with CF and 488,534 adults from the GP in the United States. Comparing these groups, we found that 43% versus 39% received an annual preventive visit, 28% versus 28% were screened for chlamydia, 38% versus 37% received pap smears every 3 years (21–29-year-old females), 33% versus 31% received pap smears every 5 years (30–64-year-old females), 55% versus 44% received mammograms, 23% versus 21% received colonoscopies, and 21% versus 20% received dyslipidemia screening (all screening rates expressed per 100 person-years). In age-stratified analysis, 18–27-year-old PwCF had a lower rate of annual preventive visits compared to adults in the same age group of the GP (27% versus 42%). ConclusionsWe discovered a comparable-to-superior rate of preventive service utilization in adults with CF relative to the GP, except in young adulthood from 18–27 years. Our findings establish the importance of meeting the primary care needs of adults with CF and call for development of strategies to improve preventive service delivery to young adults.

Race and ethnicity are inadequate predictors of ambulatory visit length and utilization of preventive services

Health disparities can be experienced by any disadvantaged group who has limited access to healthcare or decreased quality of care. Quality of care can be measured by physician-patient communication measures such as length of visit, health outcomes, patient satisfaction, or by the services one receives such as screening or health education. This study aims to determine the relationship between length of physician-patient encounter, number of preventive services, ethnicity, and race.This study utilizes data from the National Ambulatory Medical Care Survey (NAMCS) from 2007 to 2016. Visits with a single diagnosis were selected. Visits with the five most frequent diagnoses were selected by International Classification of Diseases, Ninth or Tenth Revision (ICD-9/ICD-10) classification. The primary outcome is time spent with a physician in minutes and the number of preventive services provided represented by the Preventive Service Index (PSI).Of 255,916 visits, non-white individuals made up 16.2% (95% Confidence Interval 15.9–16.4) while Latinos represented 13.4% (95%CI 13.2-13.6) of individuals. Multivariate analysis revealed minimal differences in visit length in race and ethnic groups regardless of diagnosis. Greater PSI was associated with individuals less than 43 years old (Odds Ratio (OR) 2.0, 95% CI 1.8–2.3, p =< 0.0001), those who reside in metropolitan statistical areas (MSAs) (OR 1.2, 95% CI 1.1-1.4, p = 0.006), non-white individuals (OR 1.2, 95% CI 1.1–1.3, p = 0.004), and those with private insurance (OR 1.3, 95% CI 1.1–1.4, p =< 0.0001).Race and ethnicity do not predict length of time with a physician regardless of diagnosis. Age, race, location within a metropolitan area, and insurance are significant but minimal predictors of receiving preventive services in the rank-order leading five most frequent diagnoses. This large, population-based study highlights improvements in the distribution of healthcare services from previous studies.

A national sample of developmentally disabled adolescents with obesity and their utilization of preventive dental care services.

Previous literature indicates that adolescents with developmental disabilities and obesity may have more oral health complications than healthy adolescents. However, dental care utilization among adolescents with developmental disabilities (DDs) and obesity is unclear. We investigated the differences in the utilization of preventive dental services between this high-risk group of adolescents and those with no DDs or obesity. Parent-reported data of adolescents 10-17 years (n = 68,942) from the 2016 to 2019 National Survey of Children's Health was used. In addition to descriptive and bivariate statistics, we ran three multiple logistic regression models guided by Andersen's Behavioral Model of Health Services Use, predicting the use of dental cleanings, fluoride treatments, and dental sealants. Among adolescents with DDs and obesity, dental cleanings, fluoride treatments, and dental sealant utilization prevalence were 76%, 48%, and 21%, respectively. In comparison, adolescents with no DDs or obesity had a prevalence of 83%, 50%, and 19%, respectively. Multiple logistic regression analysis showed that adolescents with DDs and obesity did not significantly differ in their receipt of dental cleanings (p = .07), fluoride treatments (p = .55), and dental sealants (p = .23) compared to those with neither DDs nor obesity. Adolescents with DDs but no obesity were 22% and 30% more likely to receive fluoride treatments (p < .0001) and dental sealants (p < .0001), respectively. Fewer than half of adolescents with DDs and obesity utilized fluoride treatments, and less than one quarter utilized dental sealants but used all three preventive services at the same rate as those with no DDs or obesity. This study identified no differences in preventive dental care services utilization in adolescents with developmental disabilities (DDs) and obesity compared to those without DDs and obesity. However, the utilization of preventive dental services in this population is influenced by the federal poverty level and family background.

Abstract 14764: Underuse of Preventive Care Among Female Sudden Death Victims

Background: Sudden death accounts for approximately 10% of deaths among working age adults. The rate of sudden death among females is one third lower than males, although the burden of chronic medical conditions are similar in victims of both sexes. The reasons for this difference are unclear and may be important in addressing preventive screening underutilization, as preventive screenings have been shown to reduce morbidity and mortality. Research Questions: Does utilization of preventive services differ among sudden death victims and living controls? Do these differences vary by sex? Aims: We aim to describe receipt of preventive screenings and influenza vaccination in sudden death victims and to compare these rates to those of a living control population. Methods: Clinical records from 267 out-of-hospital sudden death victims aged 18-64 in Wake County, North Carolina from 2013-2015 and 1112 demographically matched living controls from the same county and time were compared. Victims were identified by screening Emergency Medical Service records and adjudicated to exclude expected deaths from chronic disease, trauma, suicide, and overdose. Records were systematically reviewed for evidence of influenza vaccination and receipt of colon, cervical, and breast cancer screenings within the past five years, according to USPSTF criteria. Percentage of individuals who received each preventive screening were compared using means difference tests. Binomial regression was performed to investigate the effect of insurance status on preventive care receipt Results: Rates of colonoscopy and influenza vaccination were similar between cases and controls among both sexes. Female victims had low utilization of preventive services and were less likely to have received Pap smears (24.1% vs 50.9%; p&lt;0.001) and mammography (44.0% vs 65.2%; p&lt;0.001) compared to controls. While these differences can be partially explained by insurance status, with both private and public insurance being protective, screening differences remained significant. Conclusion: Significant differences in preventive screenings are present among female sudden death victims and may represent an important behavioral pattern to identify and intervene upon in these vulnerable patients.

Utilisation of cardiovascular preventive services in a rheumatoid arthritis population-based cohort

ObjectivesThe objective is to examine utilisation of cardiovascular preventive services in patients with rheumatoid arthritis (RA), compared with a non-RA population, and to examine cardiovascular disease (CVD) screening rates among...

Exploring health service utilization among elderly populations in Hungary: A comparison of rural and urban settings in the context of Unhealthy Ageing

Abstract Background The demographic transition presents a significant challenge for health systems due to increasing healthcare needs of ageing population, particularly in Central and Eastern European (CEE) countries. In first step, we aimed to describe the health status and use of health services among elderly living in the most deprived region in Hungary, and to compare the use of health services (including preventive and healthcare services) among older adults living in urban and rural areas. Methods A complex health survey was carried out on randomly selected sample of individuals aged 65 years and older (n = 443) in Northeast Hungary in 2022. Demographic, socioeconomic characteristics and use of health services were analysed by type of residence. Results Generally, 15.3% of elderlies rated their health as poor/very poor (14.9% in rural and 15.7% in urban areas), and 57.8% (63.5% and 52.6%) reported limitation in daily activities. Elderlies living in rural area in comparison with that living in urban area reported lower frequency of visiting a dentist (21% vs. 32.9%; p = 0.006), and specialists (53.4% vs. 63.8%; p = 0.028), having fecal occult blood testing (8.8% vs. 21.7%; p &amp;lt; 0.001), colorectal cancer screening (12.1% vs. 20.9%; p = 0.014), and mammography (16% vs. 26.6%; p = 0.035), and reported higher frequency of blood pressure measurement (90.9% vs. 84.4%; p = 0.042). After adjustment for demographic, socioeconomic and health related factors, urban residence showed positive association with having fecal occult blood testing (OR = 2.72, 95% CI: 1.42-5.22), and negative association with blood pressure (OR = 0.44, 95% CI: 0.23-0.86) and blood glucose measurements (OR = 0.55, 95% CI: 0.33-0.92). Conclusions Our findings suggest the impact of residence on health (especially preventive) service utilization among older adults in Hungary. Further comprehensive studies are needed to describe the health needs of older people to implement policies to promote healthy ageing in CEE countries.

Factors associated with utilization of preventive dental services among elderly patients at a university dental hospital, Thailand

IntroductionPreventive dentistry refers to dental practices that help to preserve good oral health throughout an individual's lifetime. However, studies on the utilization of preventive dental services among older patients are limited. This study aimed to explore factors associated with the utilization of preventive dental services among elderly patients attending a university dental hospital in Thailand. Material and methodsThis retrospective cohort study was conducted between February 15 and March 30, 2023. We comprised secondary data from patients over 60 years of age who visited the Faculty of Dentistry between January 1, 2019, and December 31, 2020. This data was retrieved from the dental hospital resource system. Descriptive statistics, Pearson's Chi-Square test, and multivariable logistic regression were performed to analyze the data. ResultsThere were 367 participants in this study. Most participants were women (59.0 %) and younger than 70 years old (55.6 %). Bivariate analyses indicated that patients with adequate dental health insurance (p = 0.016) and those receiving regular dental care (p = 0.021) had higher utilization of preventive dental services. Multivariable logistic regression confirmed statistically significant associations between high utilization of preventive dental services and adequate dental health insurance (p = 0.020) and regular dental visits (p = 0.020). ConclusionThe findings of this study indicate that elderly patients without adequate dental insurance and those who did not visit the dentists regularly are less likely to utilize preventive dental services. To bolster preventive care utilization, policymakers should prioritize and promote regular dental visits and enhance dental insurance benefits for older people.

The impact of COVID-19 on patients diagnosed with melanoma, breast, and colorectal cancer

BackgroundThe COVID-19 pandemic impacted healthcare resource allocation and utilization of preventative medical services. It is unknown if there is resultant stage migration of melanoma, breast, and colorectal cancer when comparing extended time periods before and after the pandemic onset. MethodsA retrospective cohort study of melanoma, breast, and colorectal cancer patients was completed. Clinical and pathological staging was compared utilizing 12 and 22-month timeframes before and after the pandemic outbreak. ResultsBetween the 22-month pre- and post-COVID-19 groups, breast cancer clinical stage T2 significantly increased, and pathological stage 2 decreased. Colorectal cancer clinical stage T1 decreased, stage T4 increased, and stage 0 decreased in the 22-month groups. In the 12-month groups, melanoma clinical stage T1 increased, and colorectal cancer clinical stage N2 increased. ConclusionsEvaluating extended timeframes beyond the immediate pre- and post-COVID-19 period revealed significant increases in clinical staging of breast and colorectal cancer, suggesting advanced disease is becoming more evident as time progresses.

Prevalence and determinants of community members utilizing preventive services offered by family physicians in Riyadh, Saudi Arabia.

Early detection and prevention of diseases can reduce morbidity, mortality, and economic burden. There is need to assess the utilization of preventive services for common chronic diseases, cancers, and vaccinations. This study aimed to estimate the prevalence and sequence of utilization of preventive services for common chronic diseases, cancers, and vaccinations in addition to exploring community perspectives on these services. This study was a cross-sectional survey, which was conducted at primary healthcare centers in Prince Sultan Military Medical City covering Riyadh region from October 2022 to January 2023. The study used a self-administered questionnaire to collect data from attendees aged 18 years and older, focusing on the utilization of eight preventive services (blood glucose testing, blood pressure measurement, cholesterol testing, screening for breast cancer, screening for cervical cancer, screening for colorectal cancer, screening for prostate cancer, and flu and pneumococcal vaccines). Descriptive statistics of the study were reported in frequencies and percentages. Chi-square test was used to assess association between outcome variables. Participants were mostly married and had a higher educational degree. However, a considerable number is not accessing primary healthcare services regularly. The results showed that the rate of utilizing preventive services was as follows: blood pressure screening (91%), blood glucose testing (72%), cholesterol testing (65.8%), vaccination utilization (39.5%), breast cancer screening (8%), prostate cancer screening (4.6%), colon cancer screening (4.2%), and least utilized was cervical cancer screening with frequency of (3%). The results underscore the importance of increasing awareness and accessibility of primary healthcare services to promote better health outcomes in the region.

The Effect of Medicaid Eligibility on Utilization of Services and Access to Care among Health Center Patients: A Regression Discontinuity Design

The United States’ Affordable Care Act (ACA) aims to improve access to and quality of care for low-income patients. To do so, it expands Medicaid eligibility from individuals under 100% of the federal poverty level (FPL) to include those under 138% of the FPL. Based on the 2014 Health Center Patient Survey (a nationally representative survey sponsored by the Health Resources and Services Administration (HRSA) (n = 4,380)), this study examined the effects of the Medicaid eligibility on having a usual source of care and the utilization of preventive services among health center patients. A regression discontinuity approach was used to identify the causative impact of Medicaid enrollment on low-income and nonelderly health center patients. Our findings suggest that Medicaid enrollment led to a substantial increase in the probability of both undergoing a routine checkup and having had a fecal occult blood test within the past year. These results indicate that changes to Medicaid policy have the potential to affect vulnerable populations. The evidence we provide supports the importance of maintaining the ACA due to its expanded Medicaid funding.

Psychometric Validation of the Patient Anal Cancer Knowledge Scale (PACKS) in a Cohort of Black and Hispanic/Latino Sexual and Gender Diverse Young Adults.

Lack of anal cancer information in priority populations is a major barrier to the uptake and utilization of prevention services. A validated measure of anal cancer knowledge is needed to inform patient education and shared clinical decision-making for anal cancer prevention. The purpose of this study was to validate the Patient Anal Cancer Knowledge Scale (PACKS) in a sample of GBM, namely Black and Hispanic gay, bisexual, and other men who have sex with men (GBM) and gender expansive young adults (aged 18-30 years) living in the USA (N=188). Anal cancer knowledge was hypothesized as a 3-factor scale representing (1) risk and primary prevention (9 items), (2) symptoms (5 items), and (3) screening (3 items). Confirmatory factor analysis, internal consistency, and criterion validity were assessed. The 3-factor model demonstrated adequate fit (RMSEA=0.02; CFI=0.99). All items loaded on their respective factors (p<0.01). Scale scores indicated low to moderate anal cancer knowledge and acceptable reliability: factor 1 (M=3.5; SD=2.3; range: 0-9; α=.71), factor 2 (M=2.9; SD=1.9; range: 0-5; α=.85), and factor 3 (M=2.0; SD=1.2; range: 0-3; α=.79). History of HPV vaccination (51.3%) was positively correlated with factors 1 and 2. The PACKS demonstrated good construct validity related to knowledge of anal cancer risk, prevention, symptoms, and screening. Limited anal cancer knowledge among Black and Hispanic GBM is a potential barrier to the uptake and utilization of prevention recommendations.

Disparities in utilization of preventive health services among Asian young adults in the United States

Despite the favorable health impacts of preventive services use, young adults remain at a higher risk of not using these services compared with older adults. This study seeks to identify barriers to receiving recommended preventive services among Asian young adults compared to other racial/ethnic young adults.Using 2016–2018 National Health Interview Survey data, this study examined barriers to recommended preventive services among non-Hispanic (NH) Asian young adults aged 18–39 years compared with other racial/ethnic groups in the United States (Total = 25,430; NH Asians = 6.3%). General prevention included fasting blood sugar, cholesterol, blood pressure, and Human Immunodeficiency Virus checkups. We documented information on vaccinations for influenza, pneumonia, tetanus, hepatitis A/B, and female-specific preventive care measures.NH Asian young adults reported blood pressure checkups less often than NH Whites (72.88% vs. 79.92%, p < 0.001). NH Asian young adults were also less likely to report HIV testing than all other racial/ethnic groups (p < 0.001). After controlling for covariates, NH Whites (odds ratio [OR] = 2.00, 95% confidence interval [CI] = 1.60, 2.50), NH Blacks (OR = 1.55, 95% CI = 1.18, 2.02), and other races (OR = 2.40, 95% CI = 1.60, 3.58) were more likely to receive any preventive services than NH Asians. Among those receiving any preventive services, there were no differences between NH Asians and all other racial/ethnic groups in whether they reported receiving relatively more preventive services.Our findings demonstrate that the rates of certain recommended preventive services use were lower among NH Asian young adults. Targeted public health strategies are needed to increase the use of preventive healthcare for racial/ethnic minority young adults.

Testing a single item screener to support family doctors in identifying patients with limited health literacy: convergent validity of the SILS and the HLS-EU-Q16

BackgroundLow health literacy (HL) is associated with reduced disease self-management skills, worse health outcomes, an increased number of hospitalizations, more frequent use of the emergency room and less utilization of preventive services. To support patients with low HL it is crucial to identify affected patients. HL is a multidimensional construct, which covers different skills and abilities to make informed health decisions. Validated brief screening tools to assess health-literacy-related skills or abilities in primary care settings are currently not available in German. This study aimed to validate a single item screener developed in the US for the German primary care setting.MethodsOur study used cross-sectional data from a survey among mainly chronically ill patients (n = 346) conducted in family practices in the state of North Rhine-Westphalia. We explored the convergent validity between a single item literacy screener (SILS) and the HLS-EU-Q16. The SILS measures functional HL by asking patients about their need for help when reading information materials. The HLS-EU-Q16 is a multidimensional HL measure frequently used for research purposes in Germany. Associations between the two instruments were examined using Spearman’s correlations and regression analyses. The diagnostic performance of the SILS relative to the HLS-EU-Q16 was assessed using receiver operator curves (ROC).ResultsThe SILS had a statistically significant correlation with the HLS-EU-Q16 (Spearman ρ: 0.35) and explained 26% of its total variance. Stratified analyses of the convergent validity between both instruments by age, sex, migration background, education level and chronic disease status showed moderate statistically significant correlations in all subgroups (range: 0.223 to 0.428). With an area under the curve of 0.66, the receiver operator curve indicated a satisfactory diagnostic performance of the SILS relative to the HLS-EU-Q16.ConclusionsThe SILS provided an acceptable initial assessment of HL limitations among a heterogeneous population of mainly chronically ill patients in a primary care setting. With only one item, the SILS can be a short and effective tool for routine use in primary care and specialized care settings. Future research should test the SILS in other populations and pilot applications of the SILS in routine care.

Provider Perceptions of Attitudes toward People who Inject Drugs and Treatment Services among Community Members, Service Providers, and Law Enforcement Officials

Objective: People who inject drugs (PWIDs) often face stigma, leading to barriers in accessing healthcare and may contribute to negative health outcomes. The objective of this study was to understand and describe the manifestations of stigma toward PWIDs and their impact on the utilization of essential prevention services. Methods: We interviewed 44 persons knowledgeable about PWIDs’ healthcare needs. Interviews explored perceptions of the community, healthcare service providers, law enforcement attitudes toward PWIDs, and treatment services. Results: Respondents believed that the community generally has stigmatizing attitudes towards PWIDs; treatment program personnel and healthcare providers have less stigmatized attitudes but could benefit from more education and training on drug use and addiction. Conclusions: Education and training on stigma and its negative impact on the lives of PWIDs for K-12 students and for healthcare professionals (eg, treatment options, harm reduction strategies) might mitigate stigma toward PWIDs and improve access to services and outcomes.

Assessing Awareness and Utilization of Preventive Services, Complications, and Risk Factors Among Diabetic Patients in Jeddah, Saudi Arabia

Assessing Awareness and Utilization of Preventive Services, Complications, and Risk Factors Among Diabetic Patients in Jeddah, Saudi Arabia