Trajetórias Relacionais e Reprodutivas Conducentes à Gravidez na Adolescência: a Realidade Nacional e Regional Portuguesa

Introduction: The current study aimed to describe the relational and reproductive trajectories leading to adolescent pregnancy in Portugal, and to explore whether there were differences in this process according to adolescents’ place of residence. Material and Methods: Data were collected between 2008 and 2013 in 42 public health services using a self-report questionnaire developed by the researchers. The sample consisted of a nationally representative group of pregnant adolescents (n = 459). Results: Regardless of having had one (59.91%) or multiple sexual partners (40.09%), the majority of adolescents became pregnant in a romantic relationship, using contraception at the time of the conception and knowing the contraceptive failure which led to pregnancy (39.22%). In some regions other trajectories were highly prevalent, reflecting options such as planning the pregnancy (Alentejo Region/ Azores Islands), not using contraception (Centro Region/Madeira Islands) or using it incorrectly, without identifying the contraceptive failure (Madeira Islands). On average, romantic relationships were longer than 19 months and adolescents’ partners were older than themselves (> 4 years) and no longer in school (75.16%); these results were particularly significant when the pregnancy was planned. Discussion: The knowledge gained in this study shows that prevention efforts must be targeted according to the adolescents’ needs in each region and should include high-risk male groups. Conclusion: Our results may enable more efficient health policies to prevent adolescent pregnancy in different country regions and support educators and health care providers on sexual education and family planning efforts. Keywords: Adolescent; Contraception; Sex Education; Pregnancy in Adolescence; Portugal.

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Screening mammography rates in women with diabetes.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.26_suppl.25 ◽

2014 ◽

Vol 32 (26_suppl) ◽

pp. 25-25

Author(s):

Christine Wei-Yin Tran ◽

Amy T. Wang ◽

Ryan Johnson ◽

Karthik Ghosh ◽

Nilay Shah

Keyword(s):

Breast Cancer ◽

Health Care Providers ◽

Screening Mammography ◽

Routine Screening ◽

Self Report ◽

Administrative Claims ◽

Care Providers ◽

Claims Database ◽

Increased Risk ◽

Nationally Representative

25 Background: Women with diabetes are at an increased risk of developing breast cancer, present with later stage disease, and experience higher breast cancer-specific mortality compared to nondiabetic women. Thus, it is imperative that diabetic women undergo routine screening mammography. Previous studies have shown conflicting results with smaller studies showing lower screening mammography rates among diabetics while a study using national self-report data showed that diabetic women were equally likely to be screened compared to nondiabetic women. Given the conflicting data and limitations of previous studies, we aimed to study receipt of mammography in diabetic women using a nationally representative administrative claims database. Methods: This was a retrospective study using a nationally representative administrative claims database from January 1, 2010, through December 31, 2012. We compared rates of receipt of mammography within a 2-year time frame in diabetic and nondiabetic women ages 40 to 64. We used Healthcare Effectiveness Data and Information Set (HEDIS) logic to define women with diabetes. We used CPT and ICD-9 codes to identify mammogram services received. We calculated odds ratios with 95% confidence intervals to compare mammogram rates among diabetics compared to nondiabetics. Results: 1,723,674 nondiabetic women and 133,973 diabetic women were identified. Among women ages 40 to 49, diabetic women had significantly decreased mammography rates compared to nondiabetic women (OR 0.84; 95% CI 0.83, 0.85). Rates were also lower in diabetic women ages 50 to 64 (OR 0.88; 95% CI 0.88, 0.91). Despite lower mammography rates among diabetics, diabetic women had 1.78 times more visits than nondiabetic women. Conclusions: Women with diabetes are less likely to undergo routine screening mammography than women without diabetes, despite having more encounters with health care providers. This study serves as a reminder to provide timely preventive health services to all patients regardless of medical comorbidities.

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Medicine use of elderly Chinese and Vietnamese immigrants and attitudes to home medicines review

Australian Journal of Primary Health ◽

10.1071/py10099 ◽

2012 ◽

Vol 18 (1) ◽

pp. 50 ◽

Cited By ~ 8

Author(s):

Lesley White ◽

Christiane Klinner

Keyword(s):

Focus Groups ◽

General Practitioners ◽

Health Care Providers ◽

Service Use ◽

Unmet Need ◽

Care Providers ◽

Public Health Services ◽

Elderly Chinese ◽

Chinese Group ◽

Home Medicines Review

There is a paucity of research into the perceptions of elderly Australian ethnic minorities towards public health services related to quality use of medicines. Among the six fastest growing ethnic groups in Australia, the Mandarin-speaking Chinese and Vietnamese constitute the largest elderly populations with poor English skills. This paper investigates the relationships of elderly Chinese and Vietnamese migrants with medicines, general practitioners and pharmacists, and how these relationships influence their awareness and attitudes of the home medicines review (HMR) program. Two semi-structured focus groups were held with a total of 17 HMR-eligible patients who have never received a HMR, one with Chinese and one with Vietnamese respondents, each in the respective community language. Confusion about medications and an intention to have a HMR were pronounced among all participants although none of them had heard of the program before participating in the focus groups. Respondents reported difficulties locating a pharmacist who spoke their native language, which contributed to an increased unmet need for medicine information. The Chinese group additionally complained about a lack of support from their general practitioners in relation to their medicine concerns and was adamant that they would prefer to have a HMR without the involvement of their general practitioner. Our results indicate a distinct HMR need but not use among elderly Chinese and Vietnamese eligible patients with poor English skills. Home medicines review service use and perceived medication problems are likely to improve with an increasing availability of bilingual and culturally sensitive health care providers.

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Abstract 002: Patient Provider Communication and Patient-centered Outcomes Among Patients With Atherosclerotic Cardiovascular Disease in United States: Medical Expenditure Panel Survey 2010-2013

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.002 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Victor Okunrintemi ◽

Erica Spatz ◽

Joseph Salami ◽

Haider Warraich ◽

Salim Virani ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Medical Expenditure Panel Survey ◽

Medical Expenditure ◽

Atherosclerotic Cardiovascular Disease ◽

Care Providers ◽

Patient Centered ◽

Patient Reported ◽

Centered Care ◽

Nationally Representative

Background: With recent enactment of Accountable Care Act, consumer reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey (CAHPS) in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative adult US population with established atherosclerotic cardiovascular disease (ASCVD). Methods: The study population consisted of a nationally representative sample of 8223 individuals (age ≥ 18 years) representing 21.6 million with established ASCVD (self-reported or ICD-9 diagnosis) reporting a usual source of care in the 2010-2013 pooled Medical Expenditure Panel Survey (MEPS) cohort. Participants responded to questions from CAHPS that assess satisfaction with PPC (four-point response scale: never, sometimes, usually, always ) :(1) “How often providers show respect for what you had to say” (2) “How often health care providers listened carefully to you” (3) “How often health care providers explained things so you understood” (4) “How often health providers spent enough time with you” We developed a weighted PPC composite score, categorized as 1 ( never / sometimes ), 2 ( usually ), and 3 ( always ). Outcomes of interest were 1) patient reported outcomes (PRO): SF-12 physical/mental health status, 2) quality of care measures: statin and ASA use, 3) health-care resource utilization (HRU): Emergency room visits & hospital stays, 4) total annual and out of pocket healthcare expenditures (HCE). Results: As shown in the table, those with ASCVD reporting ineffective (never/sometimes) vs. effective PCC (always) were over 2-fold more likely to report poor PRO, 34% & 22% less likely to report statin and ASA use respectively, had a significantly greater HRU (OR≥ 2 ER visit: 1.40 [95% CI:1.09-1.80], OR≥ 2 hospitalization: 1.35 [95% CI:1.02-1.77], as well as an estimated $1,294 ($121-2468) higher annual HCE. Conclusion: This study reveals a strong relationship between patient-physician communication among those with established ASCVD with patient-reported outcomes, utilization of evidence based therapies, healthcare resource utilization and expenditures.

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Extended Breastfeeding in Poland: Knowledge of Health Care Providers and Attitudes on Breastfeeding Beyond Infancy

Journal of Human Lactation ◽

10.1177/0890334418819448 ◽

2018 ◽

Vol 35 (2) ◽

pp. 371-380 ◽

Cited By ~ 1

Author(s):

Barbara Baranowska ◽

Marta Malinowska ◽

Ewelina Stanaszek ◽

Dorota Sys ◽

Grażyna Bączek ◽

...

Keyword(s):

Health Care Providers ◽

Health Professionals ◽

Further Education ◽

Self Report ◽

Care Providers ◽

Online Questionnaire ◽

Cross Sectional ◽

Convenience Sample ◽

Level Of Knowledge ◽

The Relationship

Background: Extended breastfeeding is rare in Poland, and lack of acceptance and understanding is often evident in public opinion. The ability to provide reliable information about breastfeeding beyond infancy depends on health professionals’ levels of knowledge and attitudes. They are considered by most parents in Poland to be authorities in the field of child nutrition. Research aims: To determine (1) the level of knowledge and the attitudes of Polish health professionals towards extended breastfeeding; (2) the relationship between personal breastfeeding experience and attitudes towards extended breastfeeding; and (3) the relationship between knowledge about breastfeeding beyond twelve months and attitudes towards breastfeeding beyond infancy. Methods: A one-group prospective, cross-sectional, self-report style survey was used. The convenience sample ( N = 495) comprised gynaecologists, neonatologists and midwives. Data were collected via an online questionnaire and the results were analyzed with the use of descriptive statistics, a chi-square independence test, Fisher’s exact test, post-hoc testing, and two-part tables using SPSS. Results: Most of the respondents (76.7%; n = 384) had a low level of knowledge about the benefits of breastfeeding beyond twelve months and even emphasized that this nutritional choice could have negative impacts. There was a positive correlation ( F = 105.847; p = < .01) between levels of knowledge and respondents’ attitudes towards breastfeeding beyond infancy. Attitudes were also influenced by the length of time respondents had breastfed. Conclusion: Healthcare providers have an insufficient level of knowledge about extended breastfeeding and need further education in this area.

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The Effect of the E-Patuh Application on HIV/Aids Patients’ Adherence in Consuming Antiretroviral

Jurnal Keperawatan Padjadjaran ◽

10.24198/jkp.v7i1.809 ◽

2019 ◽

Vol 7 (1) ◽

Author(s):

Alfian Alfian ◽

Kusman Ibrahim ◽

Imas Rafiyah

Keyword(s):

Health Care ◽

Medication Adherence ◽

Health Care Providers ◽

Antiretroviral Treatment ◽

Intervention Group ◽

Self Report ◽

Care Providers ◽

Aids Patients ◽

Antiretroviral Adherence ◽

Hiv Aids

Medication adherence is behavior that refers to client obeys in following a medication, and makes lifestyle changes in accordance of recommendations from health care providers. Antiretroviral adherence is paramount for HIV/AIDS patients. The effects were often a problem in antiretroviral treatment and toxicity and often be the reason for replacing or stopping antiretroviral treatment. This study aimed to determine the “E-Patuh” Applications effect on antiretroviral adherence in patients Of HIV/AIDS In West Java. The research design was a quasi-experimental with nonequivalent control group design. The location of this research was in RSUD Kota Bandung and in RSUD Kota Banjar. The respondents was selected without randomization and used purposive sampling technique. Respondents in this study were 30 respondents. Data were obtained using self-report questionnaires. The intervention group was monitored a 30-day android-based E-Patuh application and monitored on an E-Patuh website and then measured adherence value with self-report. Data were analyzed using SPSS 22 with chi-square test. The results showed a significant difference between adherence value before and after application of E-Patuh in the intervention group with (p <0.05) with obtained p value = 0,006. The results of this study prove a positive effect on the using of E-Patuh applications against ARV medication adherence in the intervention group with the support system of the E-Patuh application. The used of E-Patuh is helpful in improving ARV adherence in HIV/AIDS patients. The features contained in E-Patuh were directly reminiscent of the timing of taking medication for PWLH. E-Patuh should be consideration for PLHIV and health care providers in hospitals to improve ARV adherence to reduce mortality rates in people living with HIV.

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Reported Problems and Adherence in Using Asthma Medications Among Adolescents and Their Caregivers

Annals of Pharmacotherapy ◽

10.1177/1060028018766603 ◽

2018 ◽

Vol 52 (9) ◽

pp. 855-861 ◽

Cited By ~ 5

Author(s):

Betsy Sleath ◽

Daniel Gratie ◽

Delesha Carpenter ◽

Scott A. Davis ◽

Charles Lee ◽

...

Keyword(s):

Health Care Providers ◽

Self Efficacy ◽

Persistent Asthma ◽

Outcome Expectations ◽

Self Report ◽

Care Providers ◽

Medical Visit ◽

Efficacy Outcome ◽

Controller Medications ◽

The Relationship

Background: Many factors affect youth adherence to asthma medications. Better understanding of the relationship between problems reported by youth in using asthma medications, self-efficacy, outcome expectations, and adherence is needed. Objective: The study examined the relationship between youth and caregiver problems in using asthma medications, asthma management self-efficacy, outcome expectations, and youth- and caregiver-reported adherence to asthma controller medications. Methods: Adolescents with persistent asthma and their caregivers were recruited at 4 pediatric practices. Youth were interviewed after their medical visit while caregivers completed a questionnaire. Multivariable linear regression was used to analyze the data. Results: Of 359 participating youth, 319 were on controller medications. Youth reported 60% average adherence, whereas caregivers reported 69%. Youth who reported difficulty using their inhaler correctly and youth who reported difficulty remembering to take their medications were significantly less likely to be adherent. Caregivers who reported that it was hard to remember when to give the asthma medications were significantly less likely to report their child being adherent. Both youth and caregivers with higher outcome expectations were significantly more likely to self-report being adherent. Conclusions: Pharmacists and other health care providers should consider asking youth and caregivers about problems in using asthma medications, self-efficacy in managing asthma, and outcome expectations for following treatment regimens, so that they can help youth overcome difficulties they might have in managing their asthma.

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Sex Education on TikTok: A Content Analysis of Themes

Health Promotion Practice ◽

10.1177/15248399211031536 ◽

2021 ◽

pp. 152483992110315

Author(s):

Leah R. Fowler ◽

Lauren Schoen ◽

Hadley Stevens Smith ◽

Stephanie R. Morain

Keyword(s):

Health Care ◽

Content Analysis ◽

Sexual Health ◽

Sex Education ◽

Health Care Providers ◽

Gender Diversity ◽

Sexual Pleasure ◽

Sexual Practices ◽

Future Research ◽

Care Providers

Leading medical and public health societies endorse comprehensive sex education, but only 20 states and Washington, D.C., currently require information about contraception when sex education is taught, and even fewer require the inclusion of topics such as gender diversity or consent. At the same time, social media use, especially the video-sharing app TikTok, is increasing among teens. TikTok, therefore, offers a novel opportunity to make up for shortcomings in sex education and convey sexual health information to adolescents. To describe the availability and content of sexual education on TikTok, we conducted a content analysis of themes for 100 sex education–focused videos. We found that female anatomy was the most frequently addressed topic. Sexual pleasure was the second most common theme, within which discussions of the female orgasm and arousal constituted the most common subtheme. Other common themes include contraception and sexual health. These sought-after topics may be incongruent with those presented in standard school- or home-based sex education or interactions with health care providers, and this disconnect suggests opportunities for health care providers and educators to initiate conversations or offer resources on these themes as part of routine interaction. We conclude with recommendations for future research to consider the factual accuracy of sex education on TikTok and determine how exposure to this content affects adolescents’ understanding of the risks and benefits of intercourse, sexual practices, age- and gender-based sexual norms, and other health behaviors.

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Transgender Intimate Partner Violence and Help-Seeking Patterns

Journal of Interpersonal Violence ◽

10.1177/0886260519880171 ◽

2019 ◽

pp. 088626051988017 ◽

Cited By ~ 1

Author(s):

Victoria Kurdyla ◽

Adam M. Messinger ◽

Milka Ramirez

Keyword(s):

Intimate Partner Violence ◽

Health Care Providers ◽

Sexual Minority ◽

Partner Violence ◽

Help Seeking ◽

The United States ◽

Intimate Partner ◽

Self Report ◽

Care Providers ◽

Convenience Sample

Intimate partner violence (IPV) against transgender individuals is highly prevalent and impactful, and thus research is needed to examine the extent to which survivors are able to reach needed assistance and safety. To our knowledge, no U.S.-based quantitative studies have explored transgender utilization patterns and perceptions regarding a broad range of help-giving resources (HGRs). The present article fills this gap in the literature by exploring help-seeking attitudes and behaviors of a convenience sample of 92 transgender adults and 325 cisgender sexual minority adults in the United States. Results from an online questionnaire indicate that, among the subsample experiencing IPV ( n = 187), help-seeking rates were significantly higher among transgender survivors (84.1%) than cisgender sexual minority survivors (67.1%). In addition, transgender survivors most commonly sought help from friends (76.7%), followed by mental health care providers (39.5%) and family (30.2%), whereas formal HGRs such as police, IPV telephone hotlines, and survivor shelters had low utilization rates. Among all transgender participants, IPV survivors were significantly less likely than nonsurvivors to perceive family, medical doctors, and survivor hotlines as helpful HGRs for other survivors in general. Finally, transgender survivors were significantly less likely than nonsurvivors to self-report a willingness to disclose any future IPV to family. Although replication with larger, probability samples is needed, these findings suggest that friends often represent the primary line of defense for transgender survivors seeking help, and thus bystander intervention trainings and education should be adapted to address not just cisgender but also transgender IPV. Furthermore, because most formal HGR types appear to be underutilized and perceived more negatively by transgender survivors, renewed efforts are needed to tailor services, service advertising, and provider trainings to the needs of transgender communities. Directions for future research are reviewed.

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Residential transience among US adolescents: association with depression and mental health treatment

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796018000823 ◽

2019 ◽

Vol 28 (6) ◽

pp. 682-691 ◽

Cited By ~ 1

Author(s):

C. Glasheen ◽

V. Forman-Hoffman ◽

S. Hedden ◽

T. Ridenour ◽

J. Wang ◽

...

Keyword(s):

Mental Health ◽

Health Care Providers ◽

Mental Health Treatment ◽

Representative Sample ◽

Care Providers ◽

Health Treatment ◽

The Past ◽

Significant Difference ◽

Nationally Representative ◽

To Receive

AbstractAimsResidential instability, including transience (i.e. unusually frequent mobility), is associated with higher risk for emotional and behavioural problems in children and young adults. However, most studies have not compared the effect of recent v. more distal moves on mental health or on mental health treatment. This study examined associations between recent (past year) and distal (past 2–4 years) residential transience and past year major depressive episode (MDE) and mental health treatment in a nationally representative sample of US adolescents aged 12–17.MethodsData are from the 2010–2014 National Surveys on Drug Use and Health (n = ~107 300 adolescents). T-tests were used to examine the prevalence of MDE by number of moves in the past 5 years among a nationally representative sample of adolescents. Additionally, multivariable logistic regression models were used to evaluate the adjusted association between recent (⩾2 moves in the past year) and distal (⩾4 moves in the past 5 years, but no recent transience) and (1) past year MDE and (2) past year mental health treatment among adolescents with MDE.ResultsMDE prevalence increased linearly with number of moves in the past 5 years (p < 0.001). The adjusted odds of MDE were greater among youths with distal transience (adjusted odds ratio (AOR) = 1.25, 95% confidence interval (CI) = 1.09–1.44) and among those with proximal transience (AOR = 1.31, 95% CI = 1.17–1.46), compared with those without transience in the past 5 years. The MDE prevalence did not differ between those with distal and proximal transience (p = 0.163). In youths with past year MDE, the prevalence of past year mental health treatment was greater among those with proximal transience compared with those without transience (AOR = 1.40, 95% CI = 1.15–1.70), but there was no significant difference in treatment among those with distal v. no transience.ConclusionsDistal and recent transience are associated with past year MDE among adolescents. Adolescents with MDE who had recent transience were more likely to receive past year mental health treatment compared with those without transience. However, those with only distal transience were not more likely to receive treatment. Parents, school officials and health care providers should be aware that residential mobility in the past 5 years may indicate increased odds of depression among adolescents even among adolescents whose housing stability has improved in the past year.

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Literacy, Numeracy, and Health Information Seeking Among Middle-Aged and Older Adults in the United States

Journal of Aging and Health ◽

10.1177/0898264318800918 ◽

2018 ◽

Vol 32 (1-2) ◽

pp. 33-41 ◽

Cited By ~ 5

Author(s):

Takashi Yamashita ◽

Anthony R. Bardo ◽

Darren Liu ◽

Phyllis A. Cummins

Keyword(s):

United States ◽

Older Adults ◽

Health Literacy ◽

Health Information ◽

Health Care Providers ◽

Information Seeking ◽

The United States ◽

Health Information Seeking ◽

Care Providers ◽

Nationally Representative

Objectives: Health literacy is often viewed as an essential skill set for successfully seeking health information to make health-related decisions. However, this general understanding has yet to be established with the use of nationally representative data. The objective of this study was to provide the first nationally representative empirical evidence that links health information seeking behaviors with health literacy among middle-age to older adults in the United States. Methods: Data were obtained from the 2012/2014 Program for the International Assessment of Adult Literacy (PIAAC). Our analytic sample is representative of adults age 45 to 74 years ( N = 2,989). Results: Distinct components of health literacy (i.e., literacy and numeracy) were uniquely associated with the use of different health information sources (e.g., health professionals, the Internet, television). Discussion: Findings should be useful for government agencies and health care providers interested in targeting health communications, as well as researchers who focus on health disparities.

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