Perceptions of Protection under Nondiscrimination Law

2020 ◽  
Vol 46 (1) ◽  
pp. 21-54
Author(s):  
Kristen Underhill
Keyword(s):  
Health Care Disparities ◽  
Perceived Barriers ◽  
Actual State ◽  
Medical Mistrust ◽  
Care Seeking ◽  
State Law ◽  
Federal Law ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Erroneous Beliefs

Nondiscrimination rules—statutes, regulations, and soft law protections—are critical for reducing health and health care disparities. Although scholarship has interrogated how nondiscrimination rules affect behavior by discriminators, comparatively little has considered how protections can affect choices made by members of protected groups. A number of states and some interpretations of federal law protect people from discrimination on the basis of sexual orientation. This Article seeks to identify relationships between actual state law, perceived state law, and experiences of discrimination and medical mistrust. This Article reports the results of a national cross-sectional survey of over 3,000 men using Grindr to meet male partners. Participants scored comparable to chance in knowledge about state nondiscrimination protections, with “optimistic errors” (erroneous beliefs that one was protected) significantly more common than pessimistic errors. Perceptions of protection were significantly correlated with lower medical mistrust and greater uptake of care, as well as lower perceived barriers to disclosure and care-seeking. Actual state law protections, however, were significant predictors of having had discussions with providers that depended on disclosure of sexual behavior or orientation. Building on these results, this Article considers pathways by which nondiscrimination law may exert welcome mat (and “unwelcome mat”) effects.

scholarly journals HEALTH CARE-SEEKING BEHAVIOUR OF COASTAL COMMUNITIES IN BANYUWANGI, INDONESIA: RESULTS OF A CROSS-SECTIONAL SURVEY

Jurnal NERS ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 66
Author(s):  
Susy Katikana Sebayang ◽  
Erni Astutik ◽  
Desak Made Sintha Kurnia Dewi ◽  
Ayik Mirayanti Mandagi ◽  
Septa Indra Puspikawati
Keyword(s):  
Health Care ◽  
Care Service ◽  
Health Care Service ◽  
Coastal Communities ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Seeking Behavior ◽  
Seeking Behavior

Introduction:  Improving health care-seeking behavior of the coastal communities is a pathway to improve their health. This analysis aims to explore the health care-seeking behavior of the coastal communities in Banyuwangi District to recommend the room for improvement for health promotion and health service improvement for these communities. Method: Data from a cross-sectional survey of metabolic syndrome and mental health conducted in coastal communities in Banyuwangi was used for analysis.  Randomly selected participants from a list of members of Family Welfare Development Group (Pembinaan Kesejahteraan Keluarga /PKK) were asked for an interview at corresponding village office in Ketapang, Bangsring, Bulu Agung, Grajagan and Kampung Mandar village.  Distribution of health care-seeking behaviors was analyzed individually and where possible were segregated by gender and age. Results: More than half of the coastal communities in Banyuwangi District went to health care service to seek health and 7 out of 10 turned to health care service to seek health for their family members.  Women more than men turned to health care service when they or their family members fell ill.  Private doctors rather than Puskesmas were more popular.  Private midwives were the most popular service for antenatal care (ANC) and delivery.  Although there was not a clear increase in health care service utilization over time, we found that contraceptive utilization increased with time. Conclusion: The utilization of health care service in Banyuwangi needs to be more promoted especially for men’s health.  

A Survey of the Characteristics and Administrator Perceptions of Family Councils in a Western Canadian Province

2020 ◽  
pp. 073346482096125
Author(s):  
Jennifer Baumbusch ◽  
Isabel Sloan Yip ◽  
Sharon Koehn ◽  
R. Colin Reid ◽  
Preet Gandhi
Keyword(s):  
Urban Areas ◽  
Perceived Barriers ◽  
Administrator Perceptions ◽  
Cross Sectional Survey ◽  
Canadian Province ◽  
Cross Sectional ◽  
Term Care ◽  
Privately Owned

Family Councils are independent, self-determining groups composed of family members (inclusive of friends) who have assembled with the main purpose of protecting and improving the quality of life of those living in long-term care (LTC) homes. This study aimed to describe the prevalence and characteristics of Family Councils in British Columbia, Canada. We conducted a cross-sectional survey with administrators of 259 homes and received 222 usable surveys. Of the 151 LTC homes that had Family Councils, it was most common for the homes to be larger (>50 residents), accredited, privately owned, and located in urban areas. Perceived barriers to Family Councils included lack of interest, tendency to focus on individual complaints, and the transitory nature of families. Perceived benefits of Family Councils included enhanced communication between staff and families, peer support, and collective advocacy. Recommendations focus on enhancing accessibility, information sharing, and meaningfulness of Family Councils to improve family engagement.

scholarly journals Knowledge, attitude and practice towards tuberculosis in Gambia: a nation-wide cross-sectional survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Adedapo Olufemi Bashorun ◽  
Christopher Linda ◽  
Semeeh Omoleke ◽  
Lindsay Kendall ◽  
Simon D. Donkor ◽  
...  
Keyword(s):  
Care Seeking ◽  
Health Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Tb Control ◽  
Care Cascade ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice ◽  
Selection Of ◽  
Structured Questionnaire

Abstract Background Early diagnosis and treatment of tuberculosis (TB) are the mainstay of global and national TB control efforts. However, the gap between expected and reported cases persists for various reasons attributable to the TB services and care-seeking sides of the TB care cascade. Understanding individual and collective perspectives of knowledge, attitudes, beliefs and other social circumstances around TB can inform an evidence-based approach in engaging communities and enhance their participation in TB case detection and treatment. Methods The study was conducted during the Gambian survey of TB prevalence. This was a nationwide cross-sectional multistage cluster survey with 43,100 participants aged ≥15 years in 80 clusters. The study sample, a random selection of 10% of the survey population within each cluster responded to a semi-structured questionnaire administered by trained fieldworkers to assess the knowledge, attitudes and practice of the participants towards TB. Overall knowledge, attitude and practice scores were dichotomised using the computed mean scores and analysed using descriptive, univariable and multivariable logistic regression. Results All targeted participants (4309) were interviewed. Majority were females 2553 (59.2%), married 2614 (60.7%), had some form of education 2457 (57%), and were unemployed 2368 (55%). Although 3617 (83.9%) of the participants had heard about TB, only 2883 (66.9%) were considered to have good knowledge of TB. Overall 3320 (77%) had unfavourable attitudes towards TB, including 1896 (44%) who indicated a preference for staying away from persons with TB rather than helping them. However, 3607(83.7%) appeared to have the appropriate health-seeking behaviours with regard to TB as 4157 (96.5%) of them were willing to go to the health facility if they had symptoms suggestive of TB. Conclusions About 3 in 10 Gambians had poor knowledge on TB, and significant stigma towards TB and persons with TB persists. Interventions to improve TB knowledge and address stigma are required as part of efforts to reduce the burden of undiagnosed TB in the country.

scholarly journals Integrated care experiences and out-of-pocket expenditures: a cross-sectional survey of adults receiving treatment for HIV and hypertension in Malawi

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e032652
Author(s):  
Corrina Moucheraud ◽  
Matthew Hing ◽  
Juliet Seleman ◽  
Khumbo Phiri ◽  
Florence Chibwana ◽  
...  
Keyword(s):  
Integrated Care ◽  
Antihypertensive Medication ◽  
Cost Of Care ◽  
Hiv Care ◽  
Hiv Positive ◽  
Care Seeking ◽  
Cross Sectional Survey ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Medication Costs

ObjectivesAs HIV-positive individuals’ life expectancy extends, there is an urgent need to manage other chronic conditions during HIV care. We assessed the care-seeking experiences and costs of adults receiving treatment for both HIV and hypertension in Malawi.Design, setting and participantsA cross-sectional survey was conducted with HIV-positive adults with hypertension at a health facility in Lilongwe that offers free HIV care and free hypertension screening, with antihypertensives available for purchase (n=199). Questions included locations and costs of all medication refills and preferences for these refill locations. Respondents were classified as using ‘integrated care’ if they refilled HIV and antihypertensive medications simultaneously. Data were collected between June and December 2017.ResultsOnly half of respondents reported using the integrated care offered at the study site. Among individuals using different locations for antihypertensive medication refills, the most frequent locations were drug stores and public sector health facilities which were commonly selected due to greater convenience and lower medication costs. Although the number of antihypertensive medications was equivalent between the integrated and non-integrated care groups, the annual total cost of care differed substantially (approximately US$21 in integrated care vs US$90 for non-integrated care)—mainly attributable to differences in other visit costs for non-integrated care (transportation, lost wages, childcare). One-third of those in the non-integrated care group reported no expenditure for antihypertensive medication, and six people in each group reported no annual hypertension care-seeking costs at all.ConclusionsIndividuals using integrated care saw efficiencies because, although they were more likely to pay for antihypertensive medications, they did not incur additional costs. These results suggest that preferences and experiences must be better understood to design effective policies and programmes for integrated care among adults on antiretroviral therapy.

scholarly journals Knowledge and Awareness of Cervical Cancer among HIV-Infected Women in Ethiopia

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Netsanet Shiferaw ◽  
Mohamad I. Brooks ◽  
Graciela Salvador-Davila ◽  
Shumet Lonsako ◽  
Konjit Kassahun ◽  
...  
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Cervical Cancer Prevention ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Seeking Behavior ◽  
Seeking Behavior ◽  
Health Care Seeking Behavior

Introduction. Cervical cancer is one of the leading causes of cancer death among Ethiopian women. Low awareness of cervical cancer, in combination with low health care seeking behavior, is a key challenge for cervical cancer prevention. This study assessed the knowledge of cervical cancer among HIV-infected women in Ethiopia. Methods. A facility-based cross-sectional survey was conducted from August to September 2012 among HIV-infected women between 21 and 49 years of age. Basic descriptive statistics were performed using SPSS. Results. A total of 432 HIV-infected women participated in this study. About 71% of participants had ever heard of cervical cancer. Among women who had ever heard of cervical cancer, 49% did not know the cause while 74% were able to identify at least one risk factor for cervical cancer. Only 33% of women were able to correctly address when women should seek care and 33% identified at least one treatment option for cervical cancer. Conclusion. This study revealed that knowledge about cervical cancer was generally low, in particular for health care seeking behavior and treatment of cervical cancer. Health awareness programs should be strengthened at both community and health facility levels with emphasis highlighting the causes, risk factors, care seeking behaviors, and treatment options for cervical cancer.

Advice and Care for Headaches: Who Seeks it, Who Gives it?

Cephalalgia ◽  
2004 ◽  
Vol 24 (9) ◽  
pp. 740-752 ◽  
Author(s):  
E Thomas ◽  
HF Boardman ◽  
H Ogden ◽  
DS Millson ◽  
PR Croft
Keyword(s):  
Population Survey ◽  
Female Gender ◽  
Population Based ◽  
Linkage Study ◽  
Self Report ◽  
Care Seeking ◽  
Sources Of Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Increased Risk

Using data from a cross-sectional survey and a prospective record linkage study the aims of this study were to: (i) determine sources of advice and care for headaches in a population survey of adults, and (ii) investigate prospectively the influences of headaches on general practice consultation in a 12-month follow-up of the responders to the population survey. A population based cross-sectional survey was mailed to 4885 adults (aged ≥ 18 years) with an adjusted response rate of 56% ( n = 2662). The main outcome measures of interest were (i) self-report advice and care-seeking in the survey (ii) consultation with general practitioner for headache and for other conditions in 12-month period subsequent to the survey. Reporting a recent GP consultation for headache was associated with younger age (mean: 46 vs 48 years), female gender (68% vs 60%), and greater headache severity as measured by frequency, pain, and associated disability. The commonest sources of advice and care in the past were GPs (27%), opticians (21%), and pharmacists (8%). Consultations for headache were not common in the 12-months following the survey ( n = 144); however, those reporting a recent headache were almost 4 times more likely to consult subsequently with a headache than those not (relative risk; 95% CI: 3.7; 1.9, 7.0). Recent reporting of headache was also associated with an increased risk of consulting for mental disorders (1.7; 1.2, 2.6), diseases of the digestive (1.6; 1.1, 2.3) and respiratory system (1.4; 1.1, 1.8), and a decreased risk of consulting for circulatory diseases (0.8; 0.7, 1.0). Only a minority of headache sufferers consult their GP, regardless of severity, with opticians and pharmacists being other important sources of information. Headache appears to have an additional impact upon GP workload through increased rates of consultations for nonheadache conditions amongst headache sufferers. The interesting findings regarding rates of consultation for digestive and circulatory conditions amongst headache sufferers may be linked to the use of headache medication.

scholarly journals Nationwide survey on attitudes and perceived barriers toward provision of pharmaceutical care among final year undergraduate pharmacy students in the United Arab Emirates

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246934
Author(s):  
Ali M. Tawfiq ◽  
Muaed Jamal Alomar ◽  
Nageeb Hassan ◽  
Subish Palaian
Keyword(s):  
Pharmaceutical Care ◽  
United Arab Emirates ◽  
Nationwide Survey ◽  
Perceived Barriers ◽  
Pharmacy Students ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Positive Attitudes ◽  
Patient Health ◽  
Students Attitudes

Pharmaceutical care (PC) practice is still limited in the United Arab Emirates. It is crucial to understand pharmacy students’ attitudes and their perceived barriers towards PC provision, to evaluate the effectiveness of theoretical and practical curricula in creating positive attitudes toward PC. This study aims to assess attitudes of final year undergraduate pharmacy students in the United Arab Emirates (UAE), and the barriers perceived by them to practice PC. A cross-sectional survey-based study was conducted in February and March, 2020, involving colleges in UAE offering undergraduate pharmacy programs and having students in their final year. Participants filled a questionnaire covering attitudes’ items, based on the Pharmaceutical Care Attitudes Survey (PCAS), and several perceived barriers. A stratified sample of 193 students participated from six universities, 85% were females, 92.2% and 64.8% completed or engaged in community and hospital pharmacy training respectively, at the time of the study. Attitudes’ items receiving the highest agreement were PC will improve patient health (95.3%), all pharmacists should perform PC (93.3%) and PC would benefit pharmacists (92.7%). However, 44.6% agreed PC is not worth the additional workload. Females showed higher attitudes’ total scores, median (IQR): 55 (51–58) and 52 (49–55.5) for females and males respectively, P = 0.032. Having incomplete courses was also associated with lower scores, median (IQR): 55 (51–58) and 52 (48.5–55.5) for “No” and “Yes” respectively, P = 0.048. Poor image of the pharmacist’s role and lack of private counseling area or inappropriate pharmacy layout were the most perceived barriers, with around 78% agreement. In conclusion, final year undergraduate pharmacy students in the UAE have positive attitudes towards pharmaceutical care. The current curricula may be satisfactory in fostering positive attitudes among students. Poor image of the pharmacist’s role and lack of counseling area or inappropriate pharmacy layout were the main barriers identified, among other barriers.

scholarly journals Self-Reported Diabetes Or Hypertension Diagnoses And Antenatal Care Among Child-Bearing Women In Rural Bangladesh: A Cross-Sectional Study

2021 ◽  
Author(s):  
Allyson P. Bear ◽  
Wendy L. Bennett ◽  
Joanne Katz ◽  
Kyu Han Lee ◽  
Atique Iqbal Chowdhury ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Reference Group ◽  
Wealth Quintile ◽  
Diabetes Diagnosis ◽  
Care Seeking ◽  
National Guidelines ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Rural Bangladesh

Abstract Background: Health care systems in limited resource settings may not meet the needs of pregnant women where the burden of diabetes and hypertension is rapidly increasing. We described screening and diagnosis of diabetes or hypertension among recently pregnant women in rural Bangladesh and the antenatal care received.Methods: We asked recently pregnant women about ever having been screened for or diagnosed with hypertension or diabetes and their antenatal care-seeking experiences in a cross-sectional survey in the Baliakandi, Bangladesh. We used chi-squared tests and logistic regression to test the associations between self-reported coverage of hypertension and diabetes screening, diagnoses, and elements of antenatal care by age, wealth, educational attainment, and gravidity. Results: Among 4,692 respondents, 97% reported having been screened and 10% of screened women reported a diagnosis of hypertension. Women 30–39 years of age (aOR 3.02, 95% CI 2.00, 4.56) or in the top wealth quintile (aOR 1.70, 95% CI 1.18, 2.44) were more likely to be diagnosed with hypertension compared to reference groups. Any hypertension diagnosis was associated with reporting four or more antenatal care contacts (44% vs. 35%, p < 0.01), blood pressure measurements (85% vs. 79%, p < 0.01), and urine (71% vs. 61%, p < 0.01) tests conducted during antenatal care visits.For diabetes, 46% of respondents reported having been screened and 3% of screened women reported a diagnosis. Women 30–39 years of age were more likely to be diagnosed with diabetes (aOR 8.19, 95% CI 1.74, 38.48) compared to the reference group. Any diabetes diagnosis was associate with reporting four or more antenatal care contacts (48% vs. 36%, p = 0.04) and having blood testing during pregnancy (83% vs. 66%, p < 0.01). However, the frequency and quality of antenatal care was below the national guidelines among all groups.Conclusion: Focused efforts to ensure that women receive the recommended number of antenatal care contacts, coupled with improved compliance with antenatal care guidelines (including universal screening for diabetes at 24–28 weeks of pregnancy), would improve awareness of hypertension and diabetes among women in Bangladesh.

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