Barriers to Home Hemodialysis Across Saskatchewan, Canada: A Cross-Sectional Survey of In-Center Dialysis Patients

Background: Despite clinical and lifestyle advantages of home hemodialysis (HHD) compared with in-center hemodialysis (ICHD), it remains underutilized in our province. The aim of the study was to explore the patients’ perception and to identify the barriers to use of HHD in Saskatchewan, Canada. Objectives: The primary objective of the study was to evaluate and explore patient perceptions of HHD and to identify the obstacles for adoption of HHD in Saskatchewan. The secondary objective was to examine variations in the patients’ perceptions and barriers to HHD by center (main dialysis units vs satellite dialysis units). Design: This is a cross-sectional observational survey study. Setting: Two major centers (Regina and Saskatoon) and 5 associated satellite units attached to each center across the province of Saskatchewan. Patients: We approached all prevalent ICHD patients across Saskatchewan, 398 agreed to participate in the study. Measurements: Self-reported barriers to HHD were assessed using a questionnaire. Methods: A questionnaire was designed to determine the patients’ perceived barriers to HHD. Descriptive statistics was used to present the data. Chi-square and Mann-Whitney U test were used to compare the patients’ responses between main and satellite units Results: Satisfaction with current dialysis care (91%), increase in utility bills (65%), fear of catastrophic events at home (59%), medicalization of one’s home (54%), and knowledge deficits toward treatment modalities (54%) were the main barriers to HHD uptake. Compared with patients dialyzing in our main units, satellite patients chose not to pursue HHD more frequently because they had greater satisfaction with their current dialysis unit care (97% vs 87%, P < .001), felt more comfortable dialyzing under the supervision of medical staff (95% vs 86%, P < .007), could not afford additional utility costs (92% vs 45%, P < .001), were unaware of the risks and benefits of HHD (83% vs 33%, P < .001), had concerns over time commitments for training to HHD (69% vs 32%, P < .001), and had concern for family burnout (60.8% vs 40.6%, P < .001). Limitations: We used questionnaires to quantify known barriers, and this prevents inclusion of additional barriers that individual patients may consider important. Cross-sectional data can only be used as a snapshot. Only 398 patients agreed to participate, and the results cannot be generalized to 740 prevalent HD patients. We did not capture data on demographics (age, income, and literacy level), comorbidities, and dialysis vintage, which would have been helpful in interpretation of the results. Conclusions: Satisfaction with in-center care, lack of awareness and education, specifically in the satellite population, concerns with family burnout, expenses associated with utilities, and training time will need to be addressed to increase the uptake of HHD. Trial Registration: The study was not registered on a publicly accessible registry as it did not involve any health care intervention on human participants.

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Assessment of Knowledge and Practice of Fresh Dental Graduates, Dental Surgeons and Specialists of Multan about Different LA Techniques for Mandibular Teeth: A cross-sectional survey

10.53350/pjmhs211571745 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1745-1748

Author(s):

Zaid Bin Sohail ◽

Muhammad Salman Chishty ◽

M. Shairaz Sadiq ◽

Farhan Riaz ◽

Mehwish Munawar ◽

...

Keyword(s):

Nerve Block ◽

Dental Treatment ◽

Inferior Alveolar Nerve ◽

Mandibular Nerve ◽

Survey Study ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Dental Procedures ◽

Dental Practitioners

Objective: To assess the knowledge about different mandibular nerve block techniques of fresh dental graduates, dental surgeons and specialists to attain mandibular nerve block for dental treatment in Multan. Design of the Study: It was a cross-sectional survey. Study Settings: This study was carried out at Department of Dentistry at Multan Medical & Dental College, Nishtar Institute of dentistry (Nishtar Medical University) and Bakhtawer Amin Dental College from August 2019 to August 2020. Material and Methods: The study involved 220 respondents. The questionnaire was administered to fresh dental graduates (house officers) and dental surgeons in 3 dental colleges of Multan, and was collected on the same day. House officers who did not return the forms were reminded personally and contacted on the phone thrice over the following week. Results of the Study: The frequency of respondants who could administer Gow-Gates without supervison was 20.9% (n=46). Participants from NID, Multan had the highest frequency (35.3%) with the lowest in BIMDC (16.6%)and MMDC(20.6%). The differences were non-significant (p=0.19). Significantly higher frequency of male respondants (10%, n=22) claimed they could administer Gow-Gates without supervison compared to female respondants (5.4%, n=12, p=0.012, Chi-Square). Training for Gow-Gates had been received by 12.7% (n=28) of the House Officers and dental surgeons. The Highest frequency of training was in NID, Multan (5.4%, n= 12, p= 0.016, chi-square). Conclusion: The majority of the dental practitioners of Multan used IANB as their primary LA technique and intraligamental injections as a supplemental LA technique in their clinics to attain mandibular molars anesthesia for general dental procedures like fillings, root canals and extractions. Keywords: Mandibular local anesthesia, Inferior alveolar nerve block, Gow-Gates technique

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Use of the Consumer-Based Meditation App Calm for Sleep Disturbances: Cross-Sectional Survey Study (Preprint)

10.2196/preprints.19508 ◽

2020 ◽

Author(s):

Jennifer Huberty ◽

Megan E Puzia ◽

Linda Larkey ◽

Michael R Irwin ◽

Ana-Maria Vranceanu

Keyword(s):

Sleep Disturbance ◽

Sleep Disturbances ◽

Mobile Apps ◽

Survey Study ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Common Time ◽

Usage Patterns ◽

Waking Up

BACKGROUND Over 30% of Americans report regular sleep disturbance, and consumers are increasingly seeking strategies to improve sleep. Self-guided mindfulness mobile apps may help individuals improve their sleep. Despite the recent proliferation of sleep content within commercially available mindfulness apps, there is little research on how consumers are using these apps for sleep. OBJECTIVE We conducted a cross-sectional survey among subscribers to Calm, a popular, consumer-based, mindfulness-based meditation app, and described and compared how good sleepers, poor sleepers, and those with self-reported insomnia use the app for sleep. METHODS Participants who were paying subscribers of Calm and had used a sleep component of Calm in the last 90 days were invited to complete an investigator-developed survey that included questions about sleep disturbance and the use of Calm for sleep. Based on self-reports of sleep disturbances and of insomnia diagnosis, participants were categorized as “good sleepers,” “poor sleepers,” or “those with insomnia diagnosis.” Chi-square tests compared reasons for downloading the app and usage patterns across participants with and without sleep disturbance. RESULTS There was a total of 9868 survey respondents. Approximately 10% of participants (1008/9868, 10.21%) were good sleepers, 78% were poor sleepers (7565/9868, 77.66%), and 11% reported a diagnosis of insomnia (1039/9868, 10.53%). The sample was mostly White (8185/9797, 83.55%), non-Hispanic (8929/9423, 94.76%), and female (8166/9578, 85.26%). The most common reasons for sleep disturbances were racing thoughts (7084/8604, 82.33%), followed by stress or anxiety (6307/8604, 73.30%). Poor sleepers and those with insomnia were more likely than good sleepers to have downloaded Calm to improve sleep (χ22=1548.8, P<.001), reduce depression or anxiety (χ22=15.5, P<.001), or improve overall health (χ22=57.6, P<.001). Respondents with insomnia used Calm most often (mean 5.417 days/week, SD 1.936), followed by poor sleepers (mean 5.043 days/week, SD 2.027; F2=21.544, P<.001). The most common time to use Calm was while lying down to sleep (7607/9686, 78.54%), and bedtime use was more common among poor sleepers and those with insomnia (χ22=382.7, P<.001). Compared to good and poor sleepers, those with insomnia were more likely to use Calm after waking up at night (χ22=410.3, P<.001). Most participants tried to use Calm on a regular basis (5031/8597, 58.52%), but regular nighttime use was most common among those with insomnia (646/977, 66.1%), followed by poor sleepers (4040/6930, 58.30%; χ22=109.3, P<.001). CONCLUSIONS Of the paying subscribers to Calm who have used one of the sleep components, approximately 90% have sleep difficulties, and 77% started using Calm primarily for sleep. These descriptive data point to areas of focus for continued refinement of app features and content, followed by prospective trials testing efficacy of consumer-based meditation mobile apps for improving sleep.

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Knowledge of healthy foods does not translate to healthy snack consumption among exercise science undergraduates

Nutrition and Health ◽

10.1177/0260106017704796 ◽

2017 ◽

Vol 23 (2) ◽

pp. 103-110 ◽

Cited By ~ 4

Author(s):

Laura H McArthur ◽

Antonette Valentino ◽

Donald Holbert

Keyword(s):

Food Choices ◽

Healthy Food ◽

Survey Study ◽

Similar Data ◽

Healthy Foods ◽

Exercise Science ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Snack Consumption

This cross-sectional survey study compared the on- and off-campus snack choices and related correlates of convenience samples of exercise science (ES) ( n = 165, M = 45%, F = 55%) and non-exercise science (NES) ( n =160, M = 43%, F = 57%) undergraduates. The hypothesis posed was that knowledge of healthy foods will not translate to healthier snack consumption by the ES students, and that the snack choices and related correlates of ES and NES students will be similar. Data were collected using self-administered questionnaires completed in classrooms (ES sample) and at high-traffic locations on-campus (NES sample). Chi-square and t-test analyses compared ES and NES students on snack correlates. Snacks consumed most often by the ES and NES students on-campus were health bars/squares ( n = 56 vs. n = 48) and savory snacks ( n = 55 vs. n = 71), and off-campus were savory snacks ( n = 60 vs. n = 71) and fruits ( n = 41 vs. n = 34). Over half of both samples believed their snack choices were a mix of unhealthy and healthy. Fruits were considered healthier snacks and chips less healthy by both samples, and fruits were the most often recommended snack. About 20% believed these choices would impact their health unfavorably, and about two thirds self-classified in the action stages for healthy snacking. Since knowledge about healthy food choices did not translate to healthy snack selection, these students would benefit from interventions that teach selection and preparation of healthy snacks on a restricted budget.

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Social Media Filter Use and Interest to Pursue Cosmetic Facial Plastic Procedures

The American Journal of Cosmetic Surgery ◽

10.1177/0748806820985751 ◽

2021 ◽

pp. 074880682098575

Author(s):

Rahul M. Varman ◽

Nicole Van Spronsen ◽

Mia Ivos ◽

Joshua Demke

Keyword(s):

Social Media ◽

Graduate Programs ◽

Survey Study ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Two Cities ◽

Facial Plastic ◽

History Of ◽

Specific Factors

Our aim was to explore the effect of social media face-altering programs on desire for subsequent facial plastic procedures. This was a cross-sectional survey study in two cities, incorporating participants ages 18 to 29 in undergraduate and graduate programs. Demographic and social media–specific factors were descriptively and quantitatively analyzed. Total respondents were n = 398. The use of face-enhancing Instagram filters was associated with subsequent desire to undergo facial plastic procedures (chi-square = 5.04, p < .05). History of prior psychiatric diagnosis was also independently associated with a desire to undergo facial plastic procedures (chi-square = 7.34, p < .05). The use of face-altering software on social media has a significant association with subsequent desire to undergo facial cosmetic procedures. Comorbid psychiatric disorders also independently have a significant effect on the desire to pursue such procedures. Continued studies and elucidation of these factors may benefit the facial plastic surgeon for appropriate counseling and management to optimize patient outcomes.

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Knowledge, Attitude and Awareness on Effect of Air Pollution on Children among Parents

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i47b33134 ◽

2021 ◽

pp. 347-354

Author(s):

B. Ashwin Krishna ◽

R. Gayatri Devi ◽

A. Jothi Priya

Keyword(s):

Air Pollution ◽

World Health Organisation ◽

World Health ◽

Survey Study ◽

P Value ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

The People ◽

Chi Square Test

Introduction: The World Health Organisation [WHO] recommended that breathing clean air reduces the risk of diseases such as Asthma and Lung cancer. Inhaling low quality of air causes several health problems such as headaches, nausea and tiredness. The main aim of this study is to create awareness among parents about the effect of air pollution on children. Materials and Methods: This is a cross sectional survey study. The standard questionnaire was prepared and distributed as Google forms to nearly 100-120 parents. The population was randomly selected. A self-administered structured questionnaire was prepared based on Knowledge attitude and awareness on effects of air pollution on children among parents. It was circulated to participants through an online platform (google forms). The statistics were done using SPSS software, chi square test was used to check the association and P value of 0.05% was said to be statistically significant. Results: 78.53% of the populations were aware that air pollution affects cognitive ability. 50.98% of the population responded that exposure of polluted air to pregnant female’s cause’s premature birth. 45.28% of females were aware that air pollution affects neutron development in the brain. As a result of this study most of the parents were aware about air pollution and its effects on their children. Conclusion: In this study females were slightly more aware about air pollution than males. If this awareness persists among all the people in the society many harmful effects such as air pollution and other related problems can be solved.

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Use of the Consumer-Based Meditation App Calm for Sleep Disturbances: Cross-Sectional Survey Study

JMIR Formative Research ◽

10.2196/19508 ◽

2020 ◽

Vol 4 (11) ◽

pp. e19508

Author(s):

Jennifer Huberty ◽

Megan E Puzia ◽

Linda Larkey ◽

Michael R Irwin ◽

Ana-Maria Vranceanu

Keyword(s):

Sleep Disturbance ◽

Sleep Disturbances ◽

Mobile Apps ◽

Survey Study ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Common Time ◽

Usage Patterns ◽

Waking Up

Background Over 30% of Americans report regular sleep disturbance, and consumers are increasingly seeking strategies to improve sleep. Self-guided mindfulness mobile apps may help individuals improve their sleep. Despite the recent proliferation of sleep content within commercially available mindfulness apps, there is little research on how consumers are using these apps for sleep. Objective We conducted a cross-sectional survey among subscribers to Calm, a popular, consumer-based, mindfulness-based meditation app, and described and compared how good sleepers, poor sleepers, and those with self-reported insomnia use the app for sleep. Methods Participants who were paying subscribers of Calm and had used a sleep component of Calm in the last 90 days were invited to complete an investigator-developed survey that included questions about sleep disturbance and the use of Calm for sleep. Based on self-reports of sleep disturbances and of insomnia diagnosis, participants were categorized as “good sleepers,” “poor sleepers,” or “those with insomnia diagnosis.” Chi-square tests compared reasons for downloading the app and usage patterns across participants with and without sleep disturbance. Results There was a total of 9868 survey respondents. Approximately 10% of participants (1008/9868, 10.21%) were good sleepers, 78% were poor sleepers (7565/9868, 77.66%), and 11% reported a diagnosis of insomnia (1039/9868, 10.53%). The sample was mostly White (8185/9797, 83.55%), non-Hispanic (8929/9423, 94.76%), and female (8166/9578, 85.26%). The most common reasons for sleep disturbances were racing thoughts (7084/8604, 82.33%), followed by stress or anxiety (6307/8604, 73.30%). Poor sleepers and those with insomnia were more likely than good sleepers to have downloaded Calm to improve sleep (χ22=1548.8, P<.001), reduce depression or anxiety (χ22=15.5, P<.001), or improve overall health (χ22=57.6, P<.001). Respondents with insomnia used Calm most often (mean 5.417 days/week, SD 1.936), followed by poor sleepers (mean 5.043 days/week, SD 2.027; F2=21.544, P<.001). The most common time to use Calm was while lying down to sleep (7607/9686, 78.54%), and bedtime use was more common among poor sleepers and those with insomnia (χ22=382.7, P<.001). Compared to good and poor sleepers, those with insomnia were more likely to use Calm after waking up at night (χ22=410.3, P<.001). Most participants tried to use Calm on a regular basis (5031/8597, 58.52%), but regular nighttime use was most common among those with insomnia (646/977, 66.1%), followed by poor sleepers (4040/6930, 58.30%; χ22=109.3, P<.001). Conclusions Of the paying subscribers to Calm who have used one of the sleep components, approximately 90% have sleep difficulties, and 77% started using Calm primarily for sleep. These descriptive data point to areas of focus for continued refinement of app features and content, followed by prospective trials testing efficacy of consumer-based meditation mobile apps for improving sleep.

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83 Electrocardiogram in Syncope: An old habit or clinically helpful?

Paediatrics & Child Health ◽

10.1093/pch/pxaa068.082 ◽

2020 ◽

Vol 25 (Supplement_2) ◽

pp. e34-e34

Author(s):

Anas Manouzi ◽

Quynh Doan ◽

Shubhayan Sanatani

Keyword(s):

High Risk ◽

Heart Defects ◽

Vasovagal Syncope ◽

Primary Objective ◽

Practice Pattern ◽

Survey Study ◽

Clinical Equipoise ◽

Emergency Physicians ◽

Cross Sectional Survey ◽

Cross Sectional

Abstract Background Syncope affects up to 50% of individuals by age 21 years and accounts for 1% of presentations to the emergency department (ED). Cardiac causes of syncope, including structural heart defects and rhythm disorders, cannot always be ruled out by an electrocardiogram (ECG) as this test lacks sensitivity and specificity. Conflicting recommendations for the role of ECG in evaluation of pediatric syncope underscore the clinical equipoise of how ECG findings influence physicians’ clinical decisions. Objectives The primary objective of this study is to determine how ECG findings affect ED physicians’ management of children presenting with vasovagal syncope. Our secondary objective is to document the practice pattern variation among ED physicians regarding their decision to obtain an ECG for the evaluation of vasovagal syncope in children. Design/Methods We conducted a prospective cross-sectional survey study using the REDCap platform. Our sample frame consisted of practicing emergency physicians enrolled in the Pediatric Emergency Research Canada (PERC) network. Outcome measures included frequency investigations, specialist consultation, and disposition stratified by type of syncope presentation (low/high risk). We also evaluated which specific ECG findings were likely to change physicians’ management and explored factors influencing the decision to perform or not perform the ECG. Results We obtained data from 105/225 (47%) potential respondents. In a clinical scenario presenting a vasovagal syncope, 52% of respondents would order an ECG. Forty-five percent changed their management if the ECG interpretation was anything other than “Normal ECG”. In a high-risk syncope scenario, an ECG was performed by 96% of respondents. Cardiology referral was requested by 93% of respondents, despite normal ECG findings. Borderline ECG findings led to significant practice variation in management, for both low and high-risk presentations scenarios. Overall, 66% of respondents stated that performing an ECG is not important to rule out a cardiac etiology in a typical vasovagal syncope presentation, but 64% stated that performing an ECG is important to reassure the patient. Conclusion There is substantial practice pattern variation among emergency physicians with regards to the frequency and motivations to order ECGs, and how ECG findings impact the management of pediatric syncope in the ED. Information provided by an ECG can lead to unnecessary change to clinical management, additional testing, and referrals to specialists for typical vasovagal syncope. This reinforces the importance of better knowledge translation surrounding evidence-based management of vasovagal syncope among ED physicians.

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The use of behaviour management techniques amongst paediatric dentists working in the Arabian region: a cross-sectional survey study

European Archives of Paediatric Dentistry ◽

10.1007/s40368-020-00560-8 ◽

2020 ◽

Author(s):

H. Nazzal ◽

O. I. El Shahawy ◽

S. Al-Jundi ◽

I. Hussein ◽

J. F. Tahmassebi

Keyword(s):

Positive Reinforcement ◽

Survey Study ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Chi Square ◽

Cross Sectional ◽

Behaviour Management ◽

Factors Affecting ◽

Dental Practitioners ◽

Management Techniques

Abstract Purpose The purposes of this study were to investigate paediatric dental practitioners’ training and confidence in using dental behaviour management techniques in the Arabian region and to assess the factors influencing the application of advanced behaviour management techniques. Methods: An online questionnaire was distributed to paediatric dental practitioners in the Arabian region. Data were analysed using descriptive statistics and Pearson Chi Square. Results A total of 113 responses were obtained. Of these, the majority were from Egypt (45%, n = 51). Just over half of the respondents were registered as specialists at the country where they were practicing paediatric dentistry (53%, n = 60). The use of behaviour management techniques varied amongst participants with tell-show-do (95%, n = 107) and positive reinforcement (89%, n = 101) being the most routinely used techniques. The majority of participants reported using voice control (83%) and parental separation (68%) techniques. Hand over mouth exercise (HOME) was only used by 24% (n = 27) of participants, whilst just over half of the participants, 53%, reported using protective stabilisation. A significant association was shown between country of practice, country of obtaining paediatric dental training, speciality status and the use of advanced behaviour management techniques, whilst confidence in using HOME and sedation were associated with work setting and country of practice, respectively. Conclusion The use of advanced behaviour management techniques was found to be high amongst respondents in the Arabian region. The lack of training in using these techniques, however, is of concern. Further assessment of the factors affecting the use of and confidence in applying advanced behaviour management techniques in the Arabian region is needed.

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Factors Associated with the Use of Different Treatment Modalities among Patients with Upper Airway Diseases in Taiwan: A Cross-Sectional Survey Study

Journal of Allergy ◽

10.1155/2013/720879 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Malcolm Koo ◽

Kai-Li Liang ◽

Hsin Tsao ◽

Ting-Ting Yen ◽

Rong-San Jiang ◽

...

Keyword(s):

Surgical Intervention ◽

Upper Airway ◽

Survey Study ◽

Treatment Modalities ◽

General Health Status ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Associated ◽

Topical Medications

Rhinitis is a common upper airway disease and can have great impact on patients' quality of life. Factors associated with the use of common treatment modalities among 279 Taiwanese rhinitis patients from the outpatient department of otolaryngology in a medical center were investigated using a cross-sectional survey study. Results from multiple logistic regression analysis, adjusted for etiologies of rhinitis, revealed that males were associated with surgical intervention (OR = 2.11, P=0.009). Lower educational level was associated with oral (OR = 2.31, P=0.024) and topical medications (OR = 2.50, P=0.005). Poor or fair general health status was associated with topical medications (OR = 4.47, P=0.001), whereas very good or excellent general health status was inversely associated with surgical intervention (OR = 0.32, P=0.002). Smoking was associated with the use of nasal irrigation (OR = 2.72, P=0.003). Worse disease-specific quality of life was associated with oral medications (OR = 2.46, P=0.010) and traditional Chinese medicine (OR = 5.43, P<0.001). In conclusion, the use of different treatment modalities for rhinitis was associated with different combinations of independent factors.

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Sports Bra Preferences by Age and Impact of Breast Size on Physical Activity among American Females

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312732 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12732

Author(s):

Katherine H. Rizzone ◽

Bianca Edison ◽

Nailah Coleman ◽

Cordelia Carter ◽

Ingrid Ichesco ◽

...

Keyword(s):

Physical Activity ◽

Sports Medicine ◽

Gender Disparity ◽

Survey Study ◽

Breast Size ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Young Females ◽

Important Barrier

For many females, sports bras are an essential piece of equipment for participation in sports and physical activity. Breast pain or discomfort from lack of support may be a contributing factor to the noted gender disparity in physical activity of females compared to males. Our objective was to evaluate sports bra usage and characterize sports bra preferences of an active female cohort. This multicenter cross-sectional survey study was conducted at five geographically distinct academic centers. Our measure was administered during outpatient sports medicine clinic visits to females aged 11–64 years old. Chi-square tests were used to compare characteristics across subgroups. Our analysis consisted of 438 respondents, with a mean age of 22 ± 12.2 years. More than a quarter (27.4%) reported lack of breast support prevented them from being active or exercising. Age (p = 0.03), breast size (p < 0.0001), and household income (p = 0.01) were significantly associated with greater frequency of physical activity being limited by lack of breast support. Lack of breast support may be an important barrier for young females of specific populations to meeting physical activity recommendations. Further research is needed to improve the understanding of this important piece of sporting equipment for women.

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