Willingness Of Participants Research Articles

The features of optimal nonhormonal therapy of vegetative disorders among women with postmenopause

Objectives: to evaluate the clinical effectiveness of the Vitae-Melatonin in the complex treatment of vegetative disorders in postmenopausal women.Materials and methods. The 64 postmenopausal women who complained of vegetative disorders were included in our prospective study. Patients were divided into clinical groups. The first group consisted of 31 women who were prescribed a herbal preparation of Cimicifuga racemosa extract – 30 mg/day for 3 months. The second group included 33 patients who received in addition to the herbal medicine Vitae-Melatonin 3 mg/day every evening 2 hours before bedtime for 1 month. The clinical effectiveness of the therapy was assessed 1, 2 and 3 months after the start of treatment based on the dynamics of psychological disorders, somatic symptoms, vasomotor and sexual disorders, sleep problems and satisfaction with the therapy.Results. The use of herbal medicine containing Cimicifuga rhizome extract alone or in combination with Vitae-Melatonin in postmenopausal women significantly reduced the manifestations of vegetative disorders, including psychological and dyssomnia in a month from the start of therapy. After 3 months from the start of therapy, the advantage of combined therapy involving Vitae-Melatonin compared to the monotherapy of Cimicifuga rhizome was marked by a significant reduction of psychological disorders, somatic symptoms, vasomotor disorders and sleep problems (р = 0.003, р = 0.01, р = 0.02 and p = 0.015, respectively). Patient satisfaction with the combined therapy of vegetative disorders during the menopause compared to monophytotherapy was probably higher (risk ratio 1.63, 95% confidence interval 1.09–2.44, p = 0.018). There was no significant difference between the two research groups regarding side effects during and after the use of the drugs (p > 0.05).Conclusions. The use of Vitae-Melatonin at a dose of 3 mg/day in addition to phytotherapy in postmenopausal women had a clear clinical effect, which was a significant reduction of vegetative disorders, both compared to the initial indicators and in comparison with monophytotherapy. Results of the study showed the safety of melatonin, as well as the willingness of participants to continue using melatonin after 3 months of the treatment.

Digital prevention of depression for farmers? A qualitative study on participants' experiences regarding determinants of acceptance and satisfaction with a tailored guided internet intervention program

IntroductionFarmers, forest workers and gardeners have a higher risk of developing depression compared to other occupational populations. As part of the German pilot project “With us in balance”, the potential of six guided internet- and mobile-based interventions (IMIs) to prevent depression among their insurants is examined. The IMI program is tailored to various risk factors of depression, individual symptoms, and needs. Although IMIs have been shown to be effective in reducing depressive symptoms, there is little qualitative research about the acceptance of digital preventive IMIs. The aim of this qualitative study is to gain insights into participants' experiences with the guided IMIs by focusing on determinants for acceptance and satisfaction. MethodsSemi-structured interviews were conducted with 22/171 (13 %) intervention group (IG) participants of a randomized controlled trial. The interview guide was developed based on theoretical models of user acceptance (Unified Theory of Acceptance and Use of Technology) and patient satisfaction (evaluation model, discrepancy theory). The interviews were evaluated independently by two coders performing a deductive-inductive content analysis and attaining a substantial level of agreement (K = 0.73). ResultsThe qualitative analysis revealed 71 determinants for acceptance and satisfaction across ten dimensions: performance expectancy, organisation, e-coach, usability, training content and structure, training usage, training outcome, financing, social influence, and behavioural intention. The most frequently identified drivers for the IMI use include “location independence”, “positive relationship to the e-coach” (each n = 19, 86 %), “personal e-coach guidance”, “expertise of the e-coach”, “target group specific adaptation” (each n = 18, 82 %), “flexibility”, “high willingness for renewed participation” (each n = 17, 77 %), “fast and easy availability”, “training of health enhancing attitudes and behaviours” and “content with figurative expressions” (each n = 16, 73 %). DiscussionThe qualitative findings predominantly suggest the acceptance of and satisfaction with the IMI program for the prevention of depression in famers and related lines of work. Many identified positive drivers are related to the e-coach guidance, which emphasizes its importance in the preventive setting from the perspective of the participants. Nevertheless, some negative aspects have been identified which help to understand potential weaknesses of the IMI program. Participants indicated different needs in terms of IMI content and usage, which points towards the potential benefit of individualisation. The possibility of being able to use IMIs anonymously, flexibly and independently of location might be highly relevant for this specific target group.

Assessing Menstrual Cup Acceptability and Benefits in Uganda and Mozambique

Background: Managing menstrual hygiene is a challenge among girls and women especially in low-income countries due to traditional beliefs, lack of knowledge and information on best hygienic practices, and limited access to appropriate and affordable menstrual hygiene products. An alternative to using sanitary pads or tampons for menstrual hygiene management, is the menstrual cup. CouldYou? a US-based non-profit is addressing the challenges of Menstrual Health Management of rural women and girls in Africa with the CouldYou? Cup, a menstrual cup. There was an intervention through this initiative in selected provinces in Mozambique and Uganda where women and girls received the menstrual cup. This study therefore examines the acceptability and benefits of the CouldYou? Cup in these countries. Methods: The menstrual hygiene intervention in Uganda and Mozambique covered the period August 2021 to January 2022, on a sample size of one hundred and fourty-two (142) teenagers and adults who received CouldYou? Cups (menstrual cups.) One hundred and seven (107) were from Mozambique and thirty-five (35) from Uganda. The study selected participants from the Nampula province in Mozambique and Kyakitanga, Seguku, and Zana provinces in Uganda. The study categorized the respondents into teenagers and adults with overall average age being nineteen (19) years. Age ranged between twelve (12) and fourty-three (43) years. Community-based participatory research (CBPR) tools were used to record views and elicit rich responses from the girls. Quantitative surveys were conducted using KoboCollect. The qualitative data, on the other hand, was collected through FGDs and KIIs using interview guides and semi-structured interviews. Findings: The study has revealed that participants use multiple products to address their menstrual needs in Uganda and Mozambique. Since the women and girls started using the menstrual cup, the menstrual cup has become a sustainable and safer substitute for unhygienic menstrual products including old clothes / rags and toilet rolls. The menstrual cup has an average of 91.5% acceptability rate in Mozambique and Uganda measured by the willingness of participants to use the product. Acceptability was 100% in Uganda and 88.8% in Mozambique based on the willingness of participants to use the menstrual cup. Measuring acceptability by the product adoption rate gives a 95.8% acceptability across all countries and 98.6% when acceptability is measured by the “like” for the cup. On the average, each participant used the cup for four (4) months. 58.5% depended on only the menstrual cup and 36.6% used the menstrual with sanitary pads, and 0.7% used the menstrual cup with tampons to manage their monthly menstrual needs. In-depth interviews showed that participants who could afford sanitary pads, preferred to use the menstrual cup as a substitute to cut down their recurring monthly expenditure on menstrual products. Participants described economic and convenience as advantages of using the menstrual cup. Purchasing sanitary products was an economic burden to the study participants. Expenditure on menstrual products varied significantly across both countries. Results from a paired sample test across both countries showed a significant decrease in participants monthly expenditure on menstrual products by 76.5%. Average monthly expenditure had (at the point of data dissemination) decreased by 81.9% in Mozambique and by 23.5% in Uganda. Conclusion: Findings from this study reflect that the menstrual cup is accepted and used widely as a substitute for sanitary pads. The economic advantage of the menstrual cup outweighs all other benefits.

A Mindfulness-Based Intervention for University Students: A Feasibility Study

Background: Koru is a 4-week group mindfulness-based intervention that previously demonstrated psychological benefits in university students through its offering via a counseling center (Greeson, Juberg, Mayatan, James, & Rogers, 2014). Aim: This study examined the feasibility of Koru offered universally to students via collaborative outreach (i.e., student interest, attendance, adverse events, participant acceptability, and participant willingness to complete assessments). Method: Across five semesters, Koru was advertised via flyers, emails to student organizations and faculty and staff, and counseling center referrals at a southeastern public university with 29,000-students. Interested students were randomly assigned to Koru or a waitlist. In-person Koru groups took place in classrooms on campus. Assessments included practice logs, program evaluations, and pre- and post-intervention surveys measuring mindfulness and psychological symptoms. Results: Interest was sufficient to offer 2-3 groups per semester (171 students). Of those assigned to Koru, 44.4% completed 3-4 sessions and 34.9% did not attend any sessions. The adverse event rate was 2.9%. Evaluations were positive and all participants attending the last session completed them. The response rate was 29.0% for log completion and 17.9% for survey completion. Conclusion: Results support student interest in, and acceptability of Koru offered to all students on campus outside of a counseling center. Data collection was challenging.

Adjustment for biased sampling using NHANES derived propensity weights

The Consent-to-Contact (C2C) registry at the University of California, Irvine collects data from community participants to aid in the recruitment to clinical research studies. Self-selection into the C2C likely leads to bias due in part to enrollees having more years of education relative to the US general population. Salazar et al. (2020) recently used the C2C to examine associations of race/ethnicity with participant willingness to be contacted about research studies. To address questions about generalizability of estimated associations we estimate propensity for self-selection into the convenience sample weights using data from the National Health and Nutrition Examination Survey (NHANES). We create a combined dataset of C2C and NHANES subjects and compare different approaches (logistic regression, covariate balancing propensity score, entropy balancing, and random forest) for estimating the probability of membership in C2C relative to NHANES. We propose methods to estimate the variance of parameter estimates that account for uncertainty that arises from estimating propensity weights. Simulation studies explore the impact of propensity weight estimation on uncertainty. We demonstrate the approach by repeating the analysis by Salazar et al. with the deduced propensity weights for the C2C subjects and contrast the results of the two analyses. This method can be implemented using our estweight package in R available on GitHub.

Willingness to volunteer in future HIV vaccine clinical trials: A literature review and evidence synthesis

Context: Developing an effective vaccine for HIV/AIDS is a global endeavor requiring the participation of willing volunteers. Aims: To evaluate the willingness of the global population to undergo vaccination and participate in clinical trials. Methods: Following PRISMA guidelines, relevant studies published from January 2005 to December 2019 that reported quantitative, qualitative, and mixed analyses in peer-reviewed research papers were sought in the major databases. The inclusion criteria were that the studies be related to the willingness of participants to undergo HIV vaccination and submit to subsequent clinical trials, that they are in English, conducted in any geographic location, and published during the target period. The exclusion criteria were grey literature and studies involving the stakeholders, medical students or medical fraternities, seropositive parents with seronegative offspring, the vaccine’s biochemical, immunological, or financial aspects, and participants below the age of 16. Systematic reviews, letters to the editor, and case studies were also excluded. Results: The selected databases initially yielded 334 articles, of which 27 remained after applying the inclusion and exclusion criteria. Demographic data, motivating factors, and the volunteers’ willingness levels were collected and analyzed. Conclusions: This review offers guidance for future research, including a standardized scale to predict the willingness of potential volunteer groups.

Peningkatan Literasi Keuangan melalui Perencanaan Dana Pendidikan Anak

This activity aims to provide knowledge, understanding, and skills to the community through training in planning for children's education funds as an effort to increase financial literacy. The method used is by training and practice. Evaluation of the training, among others, by looking at: (1) Participants' understanding of the material provided based on the results of the participants' pre-test and post-test evaluations; (2) the enthusiasm/response of participants in participating in the activities; (3) the ability of participants in practice; (4) Clarity of the speaker in delivering the material. The long-term target to be achieved in this activity is to make the community through PKK cadres able to manage family finances so that they can plan and prepare children's education funds in the future. Overall, the average score of participants before the socialization activities was carried out was 24.67 and increased to 71.67 after the training activities were carried out. An average increase of 47 points. The highest pre test score is 30 and the lowest score is 10, while for the post test session the highest score is 80 and the lowest score is 50. Based on these results, it can be concluded that this service activity is able to have a positive cognitive impact on knowledge about how to prepare children's education funds. . Meanwhile, in terms of affective awareness, willingness, and ability of participants in implementing family financial management so that they can plan and prepare funds for children's education in the future.

Multi-Level Barriers to Prison Mental Health and Physical Health Care for Individuals With Mental Illnesses.

ObjectivesPeople with mental illnesses are overrepresented in the U.S. prison population. It is well established that incarceration for this population poses physical and mental health risks including greater likelihood of victimization and suicide compared to the general prison population. Yet, research is less clear about how staff and services shape these prison experiences. The aim of this study was to examine how people with mental illnesses experience incarceration through interactions with correctional officers and treatment staff and their use of physical and mental health care services.MethodsThis project utilized a non-experimental design and qualitative research approach to address the research aims. Adults with mental illnesses who were formerly incarcerated were recruited from three different sites in the Midwest and East Coast. Participants completed an in-depth interview and brief survey on health histories. Data were analyzed using descriptive statistics and the framework method for qualitative analysis.ResultsParticipants (n = 43) identified challenges to utilizing health and mental health care including perceived access and quality of mental health, medical, or substance use treatments obtained during prison as well as participant's willingness to engage in services. Access to health care was marked by cumbersome procedures required for service use requests and inadequate staffing. Participants reported mixed experiences with medical and mental health staff ranging from experiencing kindness to feeling staff did not believe them. Participants perceived most correctional officers as exhibiting professionalism while some enacted stigma and created additional stressors.ConclusionInteractions with correctional staff and health care services have the potential to buffer the stressors and risks inherent in prisons for people with mental illnesses. Perceptions from participants suggest both individual- and systems-level opportunities for intervention to better support people with mental illnesses in prison.

Evaluating patient risk factors associated with low rates of breast cancer clinical trial accrual.

e18547 Background: In an ideal world, the populations studied in cancer clinical trials (CCT) would be representative of the patients seen in clinic. Unfortunately, significant disparities exist in trial enrollment. Patients who are white, male, insured, or of high socioeconomic status (SES) are overrepresented in NCI-sponsored CCT. Despite data indicating equal willingness for participation in CCT across all racial groups, lack of access, cultural barriers, and social determinants of health contribute to poor accrual rates among racial and ethnic minority patients. The Dan L. Duncan Comprehensive Cancer Center (DLDCCC) notably provides equal access to breast CCT at Smith Clinic (SC) within the Harris Health system and Baylor St. Luke’s Medical Center (BSLMC). The patient populations differ greatly at these two sites, with BSLMC serving > 95% insured, largely Caucasian patients, and SC serving 60% uninsured, mostly low SES patients, with > 80% racial and ethnic minorities. Despite equal access, patients at SC have a significantly higher CCT refusal rate. This retrospective cohort study aims to identify predictors of CCT refusal. Methods: We performed a retrospective review of a prospectively maintained database of new patients seen at DLDCCC dating from 5/2015 to 9/2021, which included 3043 patients screened for breast CCT. 366 patients were found to be eligible for CCT. Some patients were eligible for multiple CCT, so there were 431 total offers of CCT. We performed logistic regression to evaluate whether differences in age, clinic, race, trial type, and primary language may be underlying the observed differences in CCT enrollment rates. Results: In the BSLMC cohort, 61% (116/204) of eligible patients enrolled in a CCT, while in the SC cohort only 39% (74/227) of eligible patients elected to enroll in CCT. This difference was significant on univariate but not multivariate analysis. There were significant differences when comparing race and trial type in the overall patient set. On univariate analysis, SC patients, African American (AA) patients, Hispanic/Latino patients, and Spanish speaking patients were significantly more likely to decline CCT participation. However, on multivariate analysis, only the AA patient category was associated with enrollment refusal (odds ratio 0.261, 95% CI 0.116-0.563, p < 0.001). On both univariate and multivariate analyses, patients were significantly more likely to accept biobanking trials (multivariate: odds ratio 12.799, 95% CI 3.777-61.403, p < 0.001). Conclusions: Based on these findings, it is likely an oversimplification to assume that equal access will lead to a complete elimination of CCT disparities. Our AA patients were significantly less likely to agree to participate in clinical trials, challenging the commonly held view that lack of access is a major barrier. We are exploring interventions designed to improve our AA patient population’s views of trial enrollment.

Recruiting research participants for transport research: Reflections from studies on autonomous vehicles in the UK

Much research is dependent on the willingness of participants to give up their time – whether renumerated or not – and engage with the activities we have designed such as interviews, surveys, writing diaries, and taking photos. We talk about social research being dependent on ‘self-selection’, but we say less about what happens when the people with whom we wish to engage do not agree to do so; when we are unable to get the insights we need to answer our research questions or respond to our research aims. In this Viewpoint, we discuss three interconnected methodological themes: locating and accessing participants, participant self-selection and identification in the context of the research, and topical fatigue. We discuss these themes in relation to recent developments in transport and the rise of autonomous vehicles in particular.

A biobehavioral intervention to enhance recovery following hematopoietic cell transplantation: Protocol for a feasibility and acceptability randomized control trial

BackgroundInsomnia, fatigue, and depression are among the most persistent and distressing concerns for hematologic cancer patients recovering from hematopoietic cell transplantation (HCT). This study will evaluate a novel behavioral intervention, Restoring Sleep and Energy after Transplant (ReSET), designed to alleviate insomnia, fatigue, and depression by improving rest-activity patterns. Evidence-based behavioral strategies to improve nighttime sleep and increase non-sedentary daytime activity will be combined to optimize 24-h rest-activity patterns. MethodsThe protocol herein evaluates the feasibility and acceptability of ReSET by conducting a pilot randomized controlled trial to compare the intervention with usual care. Adults undergoing HCT will be randomly assigned to ReSET or usual care. The ReSET arm will receive 3 face-to-face sessions and telephone coaching delivered in an individual format tailored to each patient. Patient-reported insomnia, fatigue, and depression will be the primary outcome measures. Actigraphy will be used to objectively quantify rest-activity patterns. Semi-structured interviews will evaluate participant satisfaction with ReSET. The goals are to determine: (1) participant satisfaction with and acceptability of the behavioral techniques; (2) facilitator fidelity and participant uptake of key intervention components; (3) ability to recruit, retain, and collect complete data from participants; (4) participant willingness to be randomized and acceptability of the control condition; and (5) validity and acceptability of the assessment strategy. ConclusionThe overarching goal is to optimize recovery following HCT with a brief, non-invasive intervention that can be implemented as a part of routine clinical care.

Evaluation of a Circadian Rhythm and Sleep-Focused Mobile Health Intervention for the Prevention of Accelerated Summer Weight Gain Among Elementary School-Age Children: Protocol for a Randomized Controlled Feasibility Study.

BackgroundThe i♥rhythm project is a mobile health adaptation of interpersonal and social rhythm therapy designed to promote healthy sleep and behavioral rhythms among 5-8-year olds during summer for the prevention of accelerated summer weight gain.ObjectiveThis pilot study will examine the feasibility, acceptability, and preliminary efficacy of the i♥rhythm intervention. This will ensure that the research protocol and procedures work as desired and are acceptable to families in preparation for the fully powered randomized controlled trial. The proposed study will examine the willingness of participants to participate in the intervention and determine whether modifications to the intervention, procedures, and measures are needed before conducting a fully powered study. We will assess our ability to (1) recruit, consent, and retain participants; (2) deliver the intervention; (3) implement the study and assessment procedures; (4) assess the reliability of the proposed measures; and (5) assess the acceptability of the intervention and assessment protocol.MethodsThis study will employ a single-blinded 2-group randomized control design (treatment and no-treatment control) with randomization occurring after baseline (Time 0) and 3 additional evaluation periods (postintervention [Time 1], and 9 months [Time 2] and 12 months after intervention [Time 3]). A sample of 40 parent-child dyads will be recruited.ResultsThis study was approved by the institutional review board of Baylor College of Medicine (H-47369). Recruitment began in March 2021. As of March 2022, data collection and recruitment are ongoing.ConclusionsThis study will address the role of sleep and circadian rhythms in the prevention of accelerated summer weight gain and assess the intervention’s effects on the long-term prevention of child obesity.Trial RegistrationClinicalTrials.gov NCT04445740; https://clinicaltrials.gov/ct2/show/NCT04445740.International Registered Report Identifier (IRRID)DERR1-10.2196/37002

Opportunities for Participation in Randomized Controlled Trials for Patients with Multiple Myeloma: Trial Access Depends on Restrictive Eligibility Criteria and Patient Expectations.

Simple SummaryOver the past decade, randomized controlled trials as an established instrument of evidence-based medicine have contributed fundamentally to the development and approval of new substances. However, it has been frequently shown that less than 5% of adult cancer patients enroll in clinical trials. Barriers to trial participation have been extensively studied, but the rate of trial participation has not changed substantially. In this retrospective analysis, we found that 53% of newly diagnosed multiple myeloma patients met the eligibility criteria, while only 38% of relapsed refractory patients were eligible. Moreover, our data show for the first time that eligible patients tend to become more reluctant to participate over the course of the disease, with 42% of newly diagnosed patients consenting, and only 7% of relapsed/refractory patients consenting. Thus, our results may assist with trial design improvements and address patient expectations and priorities in order to increase enrollment.Randomized controlled trials (RCT) are the driver of therapeutic innovations. However, it has been frequently shown that less than 5% of adult cancer patients enroll in clinical trials, although 70% of patients are considered as being willing to participate. Barriers to trial participation have been extensively studied. Although there is evidence that trial participation correlates with improved survival and reduced mortality, the rate of participation has not changed substantially. We provide retrospective data from a single-center analysis of 411 patients with multiple myeloma (MM) who were treated at the University Hospital Duesseldorf in Germany between January 2014 and December 2016. Each patient was analyzed for the real-world possibility of participating in a clinical study, based on the inclusion and exclusion (I/E) criteria and the recruiting period of open studies. The overall rate of study participation was 19%. A total of 53% of NDMM patients were eligible for first-line studies (GMMG-HD6, LenaMain). Of these, 80% consented to enrolment (42% of all). In contrast, only 38% of the RRMM population was eligible (GMMG-Relapse, Castor, Tourmaline, Admyre). Of these, only 22% (7% of all) consented. This was confirmed by virtual analysis, showing that only 29% of all RRMM patients would have been eligible for six internationally recruiting trials leading to later drug approval. The majority of cases were rendered ineligible by only one I/E criterion. The most common criteria were study-specific (prior therapies or refractory disease to a specific drug), kidney disease, and previous malignancy, followed by internal, neurologic, and infectious disease. In summary, this single-center analysis showed that I/E criteria permit study participation for most NNDM patients, with a dramatic decrease in the RRMM population. This is aggravated by the fact that the willingness for study participation also significantly declines in RRMM. Thus, addressing patient expectations and priorities seems to be the most promising approach to increasing patient enrollment in clinical trials.

Anti-TNF (adalimumab) injection for the treatment of adults with frozen shoulder during the pain predominant stage protocol for a multi-centre, randomised, double blind, parallel group, feasibility trial

Objectives: The Anti-Freaze-F trial will assess the feasibility of conducting a large randomised controlled trial to assess whether intra-articular injection of anti-TNF (adalimumab) can reduce pain and improve function in people with pain predominant early stage frozen shoulder. Methods and analysis: We are conducting a multi-centre, randomised feasibility study, with an embedded qualitative sub-study. We will recruit adults ≥18 years with a new episode of shoulder pain attributable to early stage frozen shoulder, recruited from at least five UK NHS musculoskeletal and related physiotherapy services. Participants (n=84) will be randomised (centralised computer generated 1:1 allocation) to receive either: 1) intra-articular injection of anti-TNF (adalimumab 160mg) or 2) placebo injection (saline [0.9% sodium chloride]), both under ultrasound guidance. A second injection of the allocated treatment (adalimumab 80mg) or equivalent volume of placebo will be administered 2-3 weeks later. All participants will receive a physiotherapy advice leaflet providing education and advice about frozen shoulder and pain management. The primary feasibility objectives are: 1) the ability to screen and identify potential participants with pain predominant early stage frozen shoulder; 2) willingness of eligible participants to consent and be randomised to intervention; 3) practicalities of delivering the intervention, including time to first injection and number of participants receiving second injection; 4) standard deviation of the Shoulder Pain and Disability Index (SPADI) score and attrition rate at 3 months from baseline in order to estimate the sample size for a definitive trial. We will also assess follow up rates and viability of patient-reported outcome measures and range of shoulder motion for a definitive trial. Research Ethics Committee approval (REC 21/NE/0214). Trial registration number: ISRCTN 27075727; EudraCT number: 2021-003509-23; ClinicalTrials.gov NCT05299242.

Caregiver Knowledge of and Attitudes Toward the Levonorgestrel-Containing Intrauterine Device for the Treatment of Heavy Menstrual Bleeding in Adolescents and Young Adults.

We evaluated caretaker knowledge of and attitudes toward the levonorgestrel-containing intrauterine device (L-IUD) as a treatment option for adolescents and young adults with heavy menstrual bleeding. A survey assessed demographic characteristics, menstrual history, perception of the L-IUD, and knowledge of the indications, risks, and benefits of the L-IUD. Participant recruitment occurred in the offices of a pediatric gynecologist, pediatric hematologist, and adolescent medicine physician in a hospital-based practice in New York. English-speaking caretakers of patients with a chief concern of heavy menstrual bleeding (<21 years old) were invited to participate. Electronic and paper surveys were administered prior to seeing the physician. The primary outcome was participant willingness to allow their daughter to use the L-IUD for heavy menstrual bleeding. Additional outcomes were explored by calculating a mean knowledge score and conducting a descriptive analysis of the perception questions. Forty surveys were included. Seventy percent of participants said they would allow their daughter to use birth control pills for heavy menstrual bleeding, whereas only 10% said the same of the L-IUD. The mean knowledge score was 73.3% (±15.7). Sixty-five percent of participants expressed the need for additional information on the L-IUD. Caretaker acceptance of the L-IUD as treatment for their daughter with heavy menstrual bleeding is limited. Although baseline knowledge was high, many indicated needing additional information. Because heavy menstrual bleeding can negatively impact quality of life, potential caretaker bias must be addressed to ensure full access to this highly effective treatment option.

Video education about genetic privacy and patient perspectives about sharing prenatal genetic data: a randomized trial

Laboratories offering cell-free DNA often reserve the right to share prenatal genetic data for research or even commercial purposes, and obtain this permission on the patient consent form. Although it is known that nonpregnant patients are often reluctant to share their genetic data for research, pregnant patients' knowledge of, and opinions about, genetic data privacy are unknown. We investigated whether pregnant patients who had already undergone cell-free DNA screening were aware that genetic data derived from cell-free DNA may be shared for research. Furthermore, we examined whether pregnant patients exposed to video education about the Genetic Information Nondiscrimination Act-a federal law that mandates workplace and health insurance protections against genetic discrimination-were more willing to share cell-free DNA-related genetic data for research than pregnant patients who were unexposed. In this randomized controlled trial (ClinicalTrials.gov Identifier: NCT04420858), English-speaking patients with singleton pregnancies who underwent cell-free DNA and subsequently presented at 17 0/7 to 23 6/7 weeks of gestation for a detailed anatomy scan were randomized 1:1 to a control or intervention group. Both groups viewed an infographic about cell-free DNA. In addition, the intervention group viewed an educational video about the Genetic Information Nondiscrimination Act. The primary outcomes were knowledge about, and willingness to share, prenatal genetic data from cell-free DNA by commercial laboratories for nonclinical purposes, such as research. The secondary outcomes included knowledge about existing genetic privacy laws, knowledge about the potential for reidentification of anonymized genetic data, and acceptability of various use and sharing scenarios for prenatal genetic data. Eighty-one participants per group were required for 80% power to detect an increase in willingness to share data from 60% to 80% (α=0.05). A total of 747 pregnant patients were screened, and 213 patients were deemed eligible and approached for potential study participation. Of these patients, 163 (76.5%) consented and were randomized; one participant discontinued the intervention, and two participants were excluded from analysis after the intervention when it was discovered that they did not fulfill all eligibility criteria. Overall, 160 (75.1%) of those approached were included in the final analysis. Most patients in the control group (72 [90.0%]) and intervention (76 [97.4%]) group were either unsure about or incorrectly thought that cell-free DNA companies could not share prenatal genetic data for research. Participants in the intervention group were more likely to incorrectly believe that their prenatal genetic data would not be shared for nonclinical purposes than participants in the control group (28.8% in the control group vs 46.2% in the intervention; P=.03). However, video education did not increase participant willingness to share genetic data in multiple scenarios. Non-White participants were less willing than White participants to allow sharing of genetic data specifically for academic research (P<.001). Most participants were unaware that their prenatal genetic data may be used for nonclinical purposes. Pregnant patients who were educated about the Genetic Information Nondiscrimination Act were not more willing to share genetic data than those who did not receive this education. Surprisingly, video education about the Genetic Information Nondiscrimination Act led patients to falsely believe that their data would not be shared for research, and participants who identified as racial minorities were less willing to share genetic data. New strategies are needed to improve pregnant patients' understanding of genetic privacy.

Are Farmers Willing to Pay for Centralized Mode Provision of Rural Domestic Sewage Treatment? A Large-Scale Assessment in North China

Evaluation of farmers’ willingness to participate (WTPP) and willingness to pay (WTP) for the centralized mode provision (CMP) of rural domestic sewage treatment (RDST) is imperative to improve the rural environment as well as to alleviate government financial pressures. This study adopted the contingent valuation method as well as face-to-face interview questionnaires to assess rural residents’ provision mode preferences, WTPP, and WTP for the CMP of RDST in China. Based on 761 samples collected from Shandong, Jilin, and Gansu provinces of China, we applied econometric models to estimate farmers’ WTPP and WTP for the CMP of RDST and explore the potential influencing factors, respectively. Results show that 1) 81.87% of the farmers would be willing to contribute to CMP of RDST; 2) farmers’ perceptions of the necessity of RDST, pollution of rural domestic sewage, and government propaganda significantly and positively affect their WTP; and 3) the expected WTP for CMP of RDST with the total respondents and the respondents with positive WTPP were estimated to be 7.59 USD/year and 10.10 USD/year (for a total of 20 years), accounting for 16.28 and 21.65% of construction costs, respectively. Based on these outcomes, it could be further estimated that the aggregate value was between 179.05 million USD/year and 238.26 million USD/year which implied that the farmers’ WTP may be a potentially non-negligible funding source for the CMP of RDST. The enhancement of environmental awareness of farmers and strengthening of propaganda should be the next priority of the Chinese government. Priority should also be assigned to villages closer to towns when the government formulates relevant strategies and policies. The results of this study provide references for policy formulation related to broadening the funding sources in RDST and exploring farmer payment mechanisms and implications for other developing countries.

A two-stage benefit optimization and multi-participant benefit-sharing strategy for hybrid renewable energy systems in rural areas under carbon trading

Hybrid renewable energy systems (HRESs) are a promising tool for reducing emissions in rural areas. Suitable transaction mechanisms and impartial benefit-sharing strategies are the basis for sustainable HRESs. An HRES that focuses on biomass energy comprising three participants, is proposed and a two-stage benefit optimization and sharing model that is based on a reward-punishment-tiered carbon trading (CT) policy is established in this study. To ensure that maximum benefits are gained from HRESs, impartial benefit-sharing strategies such as minimum cost-retaining savings, Nash negotiation, and an improved Shapley value are selected. The results of the first stage show that the benefits of an alliance between the three participants increased by $22621.08 and $11497.49, respectively, under CT. The results of the second stage show that a suitable benefit-sharing strategy can be selected according to the needs of different cooperation models, with the contribution of all participants fully reflected under the improved Shapley value method. The use of a two-stage optimization model improved the willingness of participants to cooperate, based on the premise of maximum benefits. Additionally, new ideas for promoting the development of rural energy can further be provided.

Willingness of Nursing Home Residents and Students to Participate in an Intergenerational Program: Effects of Traits and Pressing Developmental Tasks

ABSTRACT In the present study, we examined whether pressing developmental tasks, that is identity formation and generativity, and personality traits predict nursing home residents’ and students’ willingness to take part in an intergenerational encounter program. A total of 406 students and 114 nursing home residents reported on personality traits, age-relevant developmental tasks, and their willingness to participate in the program. Analyses verified that higher levels of openness were positively associated with participation willingness in both age groups. In addition, lower self-concept clarity among students and higher concern for generativity among older adults predicted their willingness for program participation. Findings are discussed with respect to their relevance for the planning of similar intervention programs in future.

Qualitative study of willingness and demand for participation in decision-making regarding anticoagulation therapy in patient undergoing heart valve replacement

BackgroundPromoting patient participation in decision-making aims to maintain the partnership between doctors and patients, reflect the patients’ goals, values, and preferences, and achieve patient-centered care. Realizing patient-centered care, shared collaboration between doctors and patients, and the decision-making process that considers the patients’ priorities and goals are the keys to high-quality health care. Therefore, it is indispensable to analyze the patients’ willingness to participate in the decision-making process and related participation needs regarding anticoagulation treatment for patients undergoing valve replacement.PurposeTo analyze the patients’ willingness to participate in the decision-making process and the participation needs of patients undergoing mechanical cardiac valve replacement in the process of anticoagulation therapy to provide a basis for promoting patients' participation in decision-making.MethodsUsing phenomenological research methods, data were collected through semistructured interviews. Patients were interviewed after mechanical valve replacement from June to August 2021 in a Grade A hospital in Nanjing. Data were analyzed according to the Colaizzi phenomenology method.ResultsThree major themes were identified from the data: strong willingness to participate but low actual participation, supportive needs, and family members’ participation.ConclusionsThis study guided interventions to encourage patients who underwent heart valve replacement to participate in the decision-making process. From the patient's perspective, obtaining support in the decision-making process and caregiver enthusiasm is important. This study prompted thoughts about the use of auxiliary tools and provided a reliable basis for constructing decision-making auxiliary programs to guide clinical practice.