The impact of current smoking, regular drinking, and physical inactivity on health care-seeking behavior in China

Background People with lifestyle behaviors, such as current smoking, regular drinking, and physical inactivity, may experience a lack of or delayed health care, leading to severe sickness and higher health care expenditures in the future. Hence, the current study aims to ascertain the effects of current smoking, regular drinking, and physical inactivity on health care-seeking behavior among adults who report physical discomfort in China. Methods The data used in this study were obtained from the China Family Panel Studies (CFPS). The final sample consisted of 44,362 individuals who participated in all five waves of data collection. Logistic regression models were used for the analysis. Results The results of fixed effects logistic regression showed that among those who reported physical discomfort, adults who currently smoked cigarettes were 0.65 times less likely to seek health care than those who formerly smoked. Compared to nondrinkers, adults who regularly drank alcohol had a decreased likelihood of seeking health care. Adults who never engaged in physical exercise had 24% lower odds of seeking health care than those who engaged in physical exercise. Conclusions Current smoking, regular drinking, and physical inactivity decreased the probability of seeking health care among adults who reported physical discomfort. Therefore, screening and brief advice programs should be delivered by primary-level care and should pay more attention to individuals who engage in lifestyle behaviors such as current smoking, regular drinking, and physical inactivity, thus avoiding missed opportunities to treat chronic conditions and detect new diseases early.

681Influenza vaccine effectiveness in young Japanese children over five seasons

Background Evidence is limited for influenza vaccine effectiveness (VE) against laboratory-confirmed influenza among young children. Using test-negative design (a modified case-control study) which minimizes confounding by health care-seeking behavior and misclassification of diseases, we aimed to monitor influenza VE among young children in Japan where all approved influenza vaccines are egg-propagated, inactivated formulations (IIV). Methods For seasons spanning 2013-14 to 2017-18 in Osaka and Fukuoka Prefectures, Japan, we employed prospective, active, and systematic recruitment of children aged <6 years who visited collaborating pediatric clinics within 7 days of influenza-like illness onset. Nasal aspirates were tested for influenza by real-time RT-PCR. Date of vaccination was confirmed by medical records or maternal and child health handbooks. Cases and controls were defined as being PCR-positive and -negative, respectively. Conditional logistic regression models were used to calculate adjusted VE ([1 - adjusted odds ratio] × 100%). Results We analyzed 4,614 subjects including 1,917 cases. VEs of IIV with 2 doses approximated 50%, ranging from 41% (95% confidence interval [CI]: 14 % to 60%) in 2016-17 season to 63% (95% CI: 45% to 76%) in 2017-18 season. Significant VEs were also shown for predominant circulating strains every season, irrespective of their antigenic match to vaccine strains (56% and 65% for A[H1N1]pdm, 37% and 50% for A[H3N2], and 60% for B[Yamagata]). Conclusions IIV provided modest and significant protection against laboratory-confirmed influenza in young Japanese children. Key messages Test-negative design is useful for monitoring influenza VE.

Health Care Seeking Behavior of Elderly People in Rural Part of Jimma Zone, South West Ethiopia

Background: Aging is the process of becoming older. Old age comprises age group of 60 year and above. Health care seeking behavior is any activity undertaken by individuals who perceive themselves to have a health problem or to be ill for the purpose of finding an appropriate therapy. Though health care seeking behavior of peoples have significant role for their health, limited number of studies were done so far in Ethiopia particularly among elderly peoples. To the best of our knowledge health seeking behavior of elderly people in Ethiopia haven’t been addressed well by previous researchers. Hence, the objective of this study was to measure health care seeking behavior and associated factors among elderly people in rural parts of Jimma zone, south west Ethiopia, 2020. Methods: Community based cross-sectional study was conducted among elderly peoples living in rural parts of Jimma Zone from March 10 to30, 2020. Multi stage sampling technique was used to select study participants. A total of 590 elderly peoples were included in the study. Data were collected using interviewer administered questionnaire. The data were entered into Epi data version 3.1 and exported to SPSS version 23 for analysis. Descriptive statistics were used to summarize the data. Bivariate and multivariate logistic regression analyses were used to identify factors associated with health seeking behavior. P – Value ≤ 0.05 was used to declare statistical significance.Result: The level of health care seeking behavior of elderly peoples in rural part of Jimma zone was 89.2%. Being female [AOR= 0.422(95%CI: 0.204–0.874)], good perception towards health facility[AOR= 20.676(95%CI: 5.077–84.205)], service option availability [AOR=8.597(95%CI: 1.998 – 36.989)], affordable price of modern health service [AOR=3.589(95%CI:1.631–7.900)], awareness about the cause of their sickness[AOR=6.060(95%CI:1.539–23.866)], and having good housing condition[AOR=5.017(95%CI=1.924–13.082) were predictors of health care seeking behavior. Conclusion: Health care seeking behavior of elderly people in rural part of Jimma zone was higher than what was reported in many other studies. Special attention is need from government and concerned stakeholders to take action on the identified factors of health care seeking behavior of elderly people.

Health Care–Seeking Behavior in a Scheduled Tribe Community in India: A Mixed-Methods Research Using the Framework of Andersen’s Behavioral Model

India’s scheduled tribe population very often bears the brunt of inequity in accessing health care. The mixed-method research assessed the health care–seeking behavior (HSB) of a tribal community residing in the eastern fringes of Kolkata metropolis. An adult, preferably the head, in 209 households was interviewed followed by qualitative interviews with relevant stakeholders. Conceptual framework of Andersen’s behavioral model helped in identifying the potential predisposing, enabling, and need factors that influenced HSB. A total of 25.4% respondents reportedly sought informal care during last illness episode. Multivariable hierarchical-regression model (Nagelkerke R2 = 0.381) showed that respondents’ education level (adjusted odds ratio [AOR]; 95% confidence interval [CI]: 2.52 [1.22-5.21]), household size (AOR [95% CI]: 3.14 [1.41-6.95]), nonenrollment to health insurance (AOR [95% CI]: 2.47 [1.08-5.59]), decision making by household head (AOR [95% CI]: 2.40 [1.23-4.71]), distance from the nearest urban primary health center (AOR [95% CI]: 3.18 [1.44-7.03]), and poor perception to illness severity [AOR [95% CI]: 2.24 [1.07-4.72]) were significantly associated to inappropriate HSB. Predominant health system barriers that emerged from qualitative interviews were irregular logistics, unfavorable outpatient timing, absence of female doctors, and nonretention of doctors at local urban primary health center. Community level barriers were poor awareness, self-medication practices, poor health insurance coverage, and poor public transportation. Recognition of these determinants may help in developing health promotion interventions tailored to their needs.

HEALTH LITERACY AND HEALTH CARE SEEKING BEHAVIOR OF THE ELDERLY IN HUE CITY

Objectives: To assess the health literacy and identify the relationship between the health literacy and health care seeking behavior among the older persons in Hue city. Methods: A cross-sectional study was conducted in Hue city. 400 older persons were interviewed directly using a structured questionnaire. Health literacy was assessed by HLS- Asian- Q. Multivariate logistic regression model was used to identify the relationship between health literacy and health care seeking behavior. Results: 20.0% of the respondents got inadequate health literacy. The proportion of the elderly who achieved health literacy in health care, health prevention and health promotion were 25.7%, 10.0% and 28.0%, respectively. The percentage of the elderly who have sought health care services and health promotion services were 76.7% and 68,0%, respectively. There was a relationship between health literacy and treatment seeking behaviour (OR= 3.71; 95% CI: 1.25-11.01) and health prevention service seeking behaviour among participants (OR=3.30; 95% CI:1.16-9.40). Conclusions: Health literacy of the elderly was still low in Hue city. There is influence of health literacy on health care seeking behavior among them. Enhancing health literacy for the older persons should be a necessary solution to improve their health status. Keywords: Health literacy, health seeking behavior, older persons, Hue city.

Health Care–Seeking Behavior of Children With Acute Respiratory Infections Symptoms: Analysis of the 2012 and 2017 Indonesia Demographic and Health Surveys

Our study examined factors associated with the utilization of health services in children younger than 5 years with acute respiratory infections (ARIs) symptoms in Indonesia. Data were derived from the 2012 and 2017 Indonesia Demographic and Health Survey. Information from 1408 children younger than 5 years showing ARI symptoms in the past 2 weeks before the survey was analyzed using logistic regression analyses. Around 25% of children younger than 5 years with ARI symptoms did not receive medical care. The odds of receiving care increased in mothers from rich households. The odds reduced in children aged 2 or more years; children of mothers not assisted by trained delivery attendants; mothers attending none or <4 antenatal visits; mothers delivering at home, and mothers reporting that permission to visit health services was a problem. Efforts to improve care-seeking behavior are required. Health promotion strategies and interventions to improve access to reach community not regularly exposed to health services are important.

Health care seeking behavior for common childhood morbidities in Ethiopia: The effects of maternal behavior and access to key health services

The authors have withdrawn this preprint due to author disagreement.