Risk factors for not completing health interventions and the potential impact on health inequalities between educational groups – a mixed method study from Denmark

ObjectivesPotentially modifiable risk factors account for approximately 23% of breast cancers, with obesity and alcohol being the two greatest. Breast screening and symptomatic clinical attendances provide opportunities (‘teachable moments’) to link health promotion and breast cancer-prevention advice within established clinical pathways. This study explored knowledge and attitudes towards alcohol as a risk factor for breast cancer, and potential challenges inherent in incorporating advice about alcohol health risks into breast clinics and screening appointments.DesignA mixed-method study including a survey on risk factors for breast cancer and understanding of alcohol content. Survey results were explored in a series of five focus groups with women and eight semi-structured interviews with health professionals.SettingWomen attending NHS Breast Screening Programme (NHSBSP) mammograms, symptomatic breast clinics and healthcare professionals in those settings.Participants205 women were recruited (102 NHSBSP attenders and 103 symptomatic breast clinic attenders) and 33 NHS Staff.ResultsAlcohol was identified as a breast cancer risk factor by 40/205 (19.5%) of attenders and 16/33 (48.5%) of staff. Overall 66.5% of attenders drank alcohol, and 56.6% could not estimate correctly the alcohol content of any of four commonly consumed alcoholic drinks. All women agreed that including a prevention-focussed intervention would not reduce the likelihood of their attendance at screening mammograms or breast clinics. Qualitative data highlighted concerns in both women and staff of how to talk about alcohol and risk factors for breast cancer in a non-stigmatising way, as well as ambivalence from specialist staff as to their role in health promotion.ConclusionsLevels of alcohol health literacy and numeracy were low. Adding prevention interventions to screening and/or symptomatic clinics appears acceptable to attendees, highlighting the potential for using these opportunities as ‘teachable moments’. However, there are substantial cultural and systemic challenges to overcome if this is to be implemented successfully.

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Towards cardiovascular disease prevention in Nigeria: A mixed method study of how adolescents and young adults in a university setting perceive cardiovascular disease and risk factors

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v12i1.2200 ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Nse A. Odunaiya ◽

Temilade B. Adesanya ◽

Emmanuel C. Okoye ◽

Oluwafemi O. Oguntibeju

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Young Adults ◽

Disease Prevention ◽

Mixed Method ◽

Cardiovascular Disease Prevention ◽

Adolescents And Young Adults ◽

Mixed Method Study ◽

University Setting

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Policy implications

Health inequalities ◽

10.1093/oso/9780198831419.003.0006 ◽

2019 ◽

pp. 163-182 ◽

Cited By ~ 1

Author(s):

Johan P. Mackenbach

Keyword(s):

Risk Factors ◽

Health Inequalities ◽

Population Level ◽

Policy Implications ◽

European Countries ◽

Evidence Based ◽

Inequalities In Health ◽

Quantitative Analyses ◽

Potential Impact ◽

Personal Reflections

Chapter 6 (‘Policy implications’) describes how several European countries have tried to reduce health inequalities. Even the well-resourced English strategy (1997–2010) has not reduced health inequalities at the population level, due to a combination of lack of evidence-based interventions and lack of scale of the efforts. Quantitative analyses of actually observed trends in European countries and of the potential impact of equalizing the distribution of risk factors show that reducing relative inequalities in health is almost impossible when overall health improves. It is therefore advisable to aim for reducing absolute inequalities in health, and to avoid overly ambitious quantitative targets. The book ends with a number of partly personal reflections on the sobering conclusions of 30 years of research, but also highlights some new inspirations for continued efforts to reduce health inequalities.

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A logistics sector’s perspective of factors and risks within the business environment that influence supply chains’ effectiveness: An explorative mixed method study

Journal of Transport and Supply Chain Management ◽

10.4102/jtscm.v9i1.177 ◽

2015 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Johanna A. Badenhorst-Weiss ◽

Beverley J. Waugh

Keyword(s):

Risk Factors ◽

Supply Chains ◽

Mixed Method ◽

Service Providers ◽

Business Environment ◽

Mixed Method Study ◽

Mixed Method Research ◽

Logistics Industry ◽

Operational Management ◽

Insight Into

Background: Supply chains in South Africa operate in a challenging business environment. This environment influences the efficiency and effectiveness of South African businesses and supply chains. These factors further influence the competitiveness of products produced in the country, the economic growth and development of South Africa.Objectives: The purpose of this study was two-fold: Firstly, to obtain insight into the main business environment risks and other factors, from a logistics perspective; and secondly, to demonstrate the use of methodology not often used in logistics research − the sequential mixed method.Method: The explorative study was conducted amongst logistics service providers and cargo owners in 2013 by means of a sequential mixed method study, consisting of a survey to determine the importance of risk factors in the business environment, followed by a qualitative study in the form of a focus group discussion to obtain richer data and insight into these risks and factors. The results of these two methods were integrated with industry literature.Results: It was found that increasing transportation costs, operational management of infrastructure and human resources-related problems pose the biggest challenges in the logistics industry. In addition, it was found that the mixed method research study has application possibilities in logistics research.Conclusion: The factors identified as particularly problematic for the logistics industry, namely ineffective operational management of infrastructure, the general conditions in the labour market and increasing costs (to some extent) are outside the control of individual organisations. However, organisations can control how they react and mitigate these risk factors. It is shown that these factors and risks can change overnight. The use of the explorative mixed method in obtaining qualitative and quantitative inputs and integrating it with existing literature proved to be a workable and usable methodology.

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