Sample records for national health interview

  1. National Health Interview Survey (NHIS)

    EPA Pesticide Factsheets

    The NHIS collects data on a broad range of health topics through personal household interviews. The results of NHIS provide data to track health status, health care access, and progress toward achieving national health objectives.

  2. Examining national trends in worker health with the National Health Interview Survey.

    PubMed

    Luckhaupt, Sara E; Sestito, John P

    2013-12-01

    To describe data from the National Health Interview Survey (NHIS), both the annual core survey and periodic occupational health supplements (OHSs), available for examining national trends in worker health. The NHIS is an annual in-person household survey with a cross-sectional multistage clustered sample design to produce nationally representative health data. The 2010 NHIS included an OHS. Prevalence rates of various health conditions and health behaviors among workers based on multiple years of NHIS core data are available. In addition, the 2010 NHIS-OHS data provide prevalence rates of selected health conditions, work organization factors, and occupational exposures among US workers by industry and occupation. The publicly available NHIS data can be used to identify areas of concern for various industries and for benchmarking data from specific worker groups against national averages.

  3. ADHD and Health Services Utilization in the National Health Interview Survey

    ERIC Educational Resources Information Center

    Cuffe, Steven P.; Moore, Charity G.; McKeown, Robert

    2009-01-01

    Objective: Describe the general health, comorbidities and health service use among U.S. children with ADHD. Method: The 2001 National Health Interview Survey (NHIS) contained the Strengths and Difficulties Questionnaire (SDQ; used to determine probable ADHD), data on medical problems, overall health, and health care utilization. Results: Asthma…

  4. Summary health statistics for U.S. children: National Health Interview Survey, 2001.

    PubMed

    Bloom, Barbara; Cohen, Robin A; Vickerie, Jackline L; Wondimu, Ethiopia A

    2003-11-01

    This report presents statistics from the 2001 National Health Interview Survey (NHIS) on selected health measures for children under 18 years of age, classified by sex, age, race, Hispanic origin, family structure, parent's education, family income, poverty status, health insurance coverage, residence, region, and health status. The topics covered are asthma, allergies, learning disability, Attention Deficit Hyperactivity Disorder (ADHD), prescription medication, respondent-assessed health status, school-loss days, usual place of health care, time since last contact with a health care professional, unmet dental need, time since last dental contact, and selected measures of health care access. The NHIS is a multistage probability sample survey conducted annually by interviewers of the U.S. Census Bureau for the Centers for Disease Control and Prevention, National Center for Health Statistics, and is representative of the civilian noninstitutionalized population of the United States. Data are collected during face-to-face interviews with adults present at the interview. Information about children is collected for one randomly selected child per family in face-to-face interviews with an adult proxy respondent familiar with the child's health. In 2001, most U.S. children under 18 years of age enjoyed excellent or very good health (84%). However, 10% had no health insurance coverage, and 5% had no usual place of health care. Thirteen percent of children had ever been diagnosed with asthma. Eight percent of children 3-17 years of age had a learning disability, and 6% of children had ADHD. Lastly, 11% of children in single-mother families had two or more visits to an emergency room in the past year compared with 6% of children in two-parent families.

  5. Summary health statistics for U.S. children: National Health Interview Survey, 1998.

    PubMed

    Blackwell, Debra L; Tonthat, Luong

    2002-10-01

    This report presents statistics from the 1998 National Health Interview Survey (NHIS) on selected health measures for children under 18 years of age, classified by sex, age, race/ethnicity, family structure, parent's education, family income, poverty status, health insurance coverage, place of residence, region, and current health status. The topics covered are asthma, allergies, learning disabilities, Attention Deficit Disorder, use of medication, respondent-assessed health status, school-loss days, usual place of medical care, time since last contact with a health care professional, selected health care risk factors, and time since last dental contact. The NHIS is a multistage probability sample survey conducted annually by interviewers of the U.S. Census Bureau for the National Center for Health Statistics, Centers for Disease Control and Prevention, and is representative of the civilian noninstitutionalized population of the United States. Data are collected during face-to-face interviews with adults present at the time of interview. Information about children is collected for one randomly selected child per family in face-to-face interviews with an adult proxy respondent familiar with the child's health. In 1998 most U.S. children under 18 years of age enjoyed excellent or very good health (84%). However, 12% of children had no health insurance coverage, and 6% of children had no usual place of medical care. Twelve percent of children had ever been diagnosed with asthma. An estimated 8% of children 3-17 years of age had a learning disability, and an estimated 6% of children had Attention Deficit Disorder (ADD). Lastly, 11% of children in single mother families had two or more visits to an emergency room in the past year compared with 6% of children in two-parent or single-father families.

  6. Summary Health Statistics for U.S. Children: National Health Interview Survey, 1999.

    ERIC Educational Resources Information Center

    Blackwell, Debra L.; Tonthat, Luong

    This report presents statistics from the 1999 National Health Interview Survey (NHIS) on selected health measures for children under 18 years of age, classified by sex, age, race/ethnicity, family structure, parent education, family income, poverty status, health insurance coverage, place of residence, region, and current health status. The NHIS…

  7. Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009. Data from the National Health Interview Survey. Vital and Health Statistics. Series 10, Number 249. DHHS Publication No. (PHS) 2011-1577

    ERIC Educational Resources Information Center

    Pleis, J. R.; Ward, B. W.; Lucas, J. W.

    2010-01-01

    Objectives: This report presents health statistics from the 2009 National Health Interview Survey (NHIS) for the civilian noninstitutionalized adult population, classified by sex, age, race and ethnicity, education, family income, poverty status, health insurance coverage, marital status, and place and region of residence. Estimates are presented…

  8. Dietary Screener Questionnaire in the National Health Interview Survey Cancer Control Supplement 2015

    Cancer.gov

    The National Health Interview Survey (NHIS) Cancer Control Supplement (CCS) is administered every five years and focuses on knowledge, attitudes, and practices in cancer-related health behaviors, screening, and risk assessment.

  9. Dietary Screener Questionnaire in the National Health Interview Survey Cancer Control Supplement 2010: Overview

    Cancer.gov

    The National Health Interview Survey (NHIS) Cancer Control Supplement (CCS) is administered every five years and focuses on knowledge, attitudes, and practices in cancer-related health behaviors, screening, and risk assessment.

  10. Tracking Psychosocial Health in Adults with Epilepsy—Estimates from the 2010 National Health Interview Survey

    PubMed Central

    Kobau, R; Cui, W; Kadima, N; Zack, MM; Sajatovic, M; Kaiboriboon, K; Jobst, B

    2015-01-01

    Objective This study provides population-based estimates of psychosocial health among U.S. adults with epilepsy from the 2010 National Health Interview Survey. Methods Multinomial logistic regression was used to estimate the prevalence of the following measures of psychosocial health among adults with and those without epilepsy: 1) the Kessler-6 scale of Serious Psychological Distress; 2) cognitive limitation; the extent of impairments associated with psychological problems; and work limitation; 3) Social participation; and 4) the Patient Reported Outcome Measurement Information System Global Health scale. Results Compared with adults without epilepsy, adults with epilepsy, especially those with active epilepsy, reported significantly worse psychological health, more cognitive impairment, difficulty in participating in some social activities, and reduced health-related quality of life (HRQOL). Conclusions These disparities in psychosocial health in U.S. adults with epilepsy serve as baseline national estimates of their HRQOL, consistent with Healthy People 2020 national objectives on HRQOL. PMID:25305435

  11. Health Outcomes among Hispanic Subgroups: Data from the National Health Interview Survey, 1992-95. Advance Data, Number 310.

    ERIC Educational Resources Information Center

    Hajat, Anjum; Lucas, Jacqueline B.; Kington, Raynard

    In this report, various health measures are compared across Hispanic subgroups in the United States. National Health Interview Survey (NHIS) data aggregated from 1992 through 1995 were analyzed. NHIS is one of the few national surveys that has a sample sufficiently large enough to allow such comparisons. Both age-adjusted and unadjusted estimates…

  12. Health Indicators for Older Sexual Minorities: National Health Interview Survey, 2013-2014.

    PubMed

    Dragon, Christina N; Laffan, Alison M; Erdem, Erkan; Cahill, Sean R; Kenefick, Daniel; Ye, Jiahui; Haffer, Samuel C

    2017-12-01

    Advances in lesbian, gay, and bisexual (sexual minority [SM]) acceptance and equality have been made in the past decade. However, certain SM subgroups continue to be disadvantaged due to lack of data and, thus, lack of knowledge about these populations. Data for older sexual minorities are especially lacking and will be increasingly important as more sexual minorities enter older age. This research explores results from a nationally representative health survey to elucidate some health indicators for older sexual minorities. Data from the 2013 and 2014 National Health Interview Surveys (NHIS) were pooled for increased sample size, and established research methods were followed as recommended by prior NHIS sexual orientation studies. We conducted descriptive analyses on the differences between SM and heterosexual groups, aged 65 years and older, for 12 health indicators. Four out of the 12 health indicators were significantly different for sexual minorities, and three out of those four indicated positive health outcomes or behaviors when compared with heterosexuals. Sexual minorities were more than three times as likely to receive HIV testing as heterosexual peers. Sexual minorities were more likely to receive an influenza vaccination, and much more likely to report excellent or very good health, than their heterosexual peers. Sexual minorities were more than twice as likely to report binge drinking, which is consistent with prior research for adult sexual minorities. This analysis is the first to examine national data on health indicators for sexual minorities, aged 65 years and older, using NHIS data. As more surveys begin to collect SMdata and more years of data are collected by NHIS, a clearer picture of the health of older adult sexual minorities should emerge.

  13. Orthopedic implant devices: prevalence and sociodemographic findings from the 1988 National Health Interview Survey.

    PubMed

    Moore, R M; Hamburger, S; Jeng, L L; Hamilton, P M

    1991-01-01

    National population-based estimates on the magnitude and distribution of orthopedic implant devices in the United States have not been available to date. The Food and Drug Administration's Center for Devices and Radiological Health (FDA/CDRH) collaborated with the Centers for Disease Control's National Center for Health Statistics (CDC/NCHS) in the design and conduct of a nationwide medical device implant survey to generate the first national population-based prevalence estimates of orthopedic implant devices. A Medical Device Implant Supplement to the 1988 National Health Interview Survey was administered in personal household interviews to a national sample of 47,485 households, which included 122,310 individuals. An estimated 6.5 million orthopedic implants were in use in the general US population in 1988, including 1.6 million artificial joints and 4.9 million fixation devices. As a group, orthopedic implants comprised nearly half of all medical device implants in use, 43.4%. The majority of artificial joint recipients were 65 years of age or older, white, and male. The majority of fixation device recipients were less than 45 years of age, white, and male. The limitations and strengths of these population-based estimates are discussed.

  14. Sexual orientation and health among U.S. adults: national health interview survey, 2013.

    PubMed

    Ward, Brian W; Dahlhamer, James M; Galinsky, Adena M; Joestl, Sarah S

    2014-07-15

    To provide national estimates for indicators of health-related behaviors, health status, health care service utilization, and health care access by sexual orientation using data from the 2013 National Health Interview Survey (NHIS). NHIS is an annual multipurpose health survey conducted continuously throughout the year. Analyses were based on data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Differences in health-related behaviors, health status, health care service utilization, and health care access by sexual orientation were examined for adults aged 18-64, and separately for men and women. Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay or lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ''something else,'' stated ''I don't know the answer,'' or refused to provide an answer. Significant differences were found in health-related behaviors, health status, health care service utilization, and health care access among U.S. adults aged 18-64 who identified as straight, gay or lesbian, or bisexual. NHIS sexual orientation data can be used to track progress toward meeting the Healthy People 2020 goals and objectives related to the health of lesbian, gay, and bisexual persons. In addition, the data can be used to examine a wide range of health disparities among adults identifying as straight, gay or lesbian, or bisexual. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  15. Prevalence and Correlates of ADHD Symptoms in the National Health Interview Survey

    ERIC Educational Resources Information Center

    Cuffe, Steven P.; Moore, Charity G.; McKeown, Robert E.

    2005-01-01

    Objective: Study the prevalence and correlates of ADHD symptoms in the National Health Interview Survey (NHIS). Methods: NHIS includes 10,367 children ages 4 to 17. Parents report lifetime diagnosis of ADHD and complete the Strengths and Difficulties Questionnaire (SDQ). Prevalences of clinically significant ADHD and comorbid symptoms by race and…

  16. Insomnia Associated with Valerian and Melatonin Usage in the 2002 National Health Interview Survey

    PubMed Central

    Bliwise, Donald L.; Ansari, Farzaneh Pour

    2007-01-01

    Study Objective: Many people use dietary supplements or herbal products to help them sleep. We analyzed the associations between melatonin use and insomnia and between valerian use and insomnia in a representative sample of the United States population. Design and Participants: The data reported upon here were collected in the 2002 Alternative Health/Complementary and Alternative Medicine (CAM) Supplement to the National Health Interview Survey. This was a survey of 31,044 personal interviews that constituted an age-representative and socioeconomically representative sample of the civilian noninstitutionalized population of the United States. Results: Of the survey sample, 5.9% used valerian and 5.2% used melatonin. Of those using valerian, 29.9% endorsed insomnia as 1 reason for CAM use, and, of melatonin users, 27.5% endorsed insomnia as 1 reason for CAM use. Relatively greater use occurred in individuals under age 60 years. The decision to use such substances was made in consultation with a health care provider less than half of the time. Conclusions: Large segments of the United States population used valerian or melatonin for insomnia within the year preceding the survey, and usage typically fell outside the purview of the health care system. Citation: Bliwise DL; Ansari FP. Insomnia associated with valerian and melatonin usage in the 2002 National Health Interview Survey. SLEEP 2007;30(7):881-884. PMID:17682659

  17. Health Indicators for Older Sexual Minorities: National Health Interview Survey, 2013–2014

    PubMed Central

    Laffan, Alison M.; Erdem, Erkan; Cahill, Sean R.; Kenefick, Daniel; Ye, Jiahui; Haffer, Samuel C.

    2017-01-01

    Abstract Purpose: Advances in lesbian, gay, and bisexual (sexual minority [SM]) acceptance and equality have been made in the past decade. However, certain SM subgroups continue to be disadvantaged due to lack of data and, thus, lack of knowledge about these populations. Data for older sexual minorities are especially lacking and will be increasingly important as more sexual minorities enter older age. This research explores results from a nationally representative health survey to elucidate some health indicators for older sexual minorities. Methods: Data from the 2013 and 2014 National Health Interview Surveys (NHIS) were pooled for increased sample size, and established research methods were followed as recommended by prior NHIS sexual orientation studies. We conducted descriptive analyses on the differences between SM and heterosexual groups, aged 65 years and older, for 12 health indicators. Results: Four out of the 12 health indicators were significantly different for sexual minorities, and three out of those four indicated positive health outcomes or behaviors when compared with heterosexuals. Sexual minorities were more than three times as likely to receive HIV testing as heterosexual peers. Sexual minorities were more likely to receive an influenza vaccination, and much more likely to report excellent or very good health, than their heterosexual peers. Sexual minorities were more than twice as likely to report binge drinking, which is consistent with prior research for adult sexual minorities. Conclusion: This analysis is the first to examine national data on health indicators for sexual minorities, aged 65 years and older, using NHIS data. As more surveys begin to collect SMdata and more years of data are collected by NHIS, a clearer picture of the health of older adult sexual minorities should emerge. PMID:29028455

  18. Gender disparities in health and healthcare: results from the Portuguese National Health Interview Survey.

    PubMed

    Perelman, Julian; Fernandes, Ana; Mateus, Céu

    2012-12-01

    Although women experience poorer health conditions during their lives, they live longer than men. The main explanations for this paradox suggest that women's excess of ill-health is limited to minor illnesses and their different attitudes toward health. The authors test these assumptions by investigating disparities between men and women in health and healthcare in Portugal. Data are used from the Portuguese National Health Interview Survey 2005/2006 (N = 33,662). Multivariate regressions showed that women were more likely to report worse self-rated health, more days with disability, higher prevalence of hypertension, chronic pain, cancer, anxiety and depression, and more medical consultations. Heart disease was significantly more prevalent among men, possibly explaining part of the paradox. Women's more frequent use of medical consultations may reflect their heightened awareness of health problems, which may protect them against early death. Gender differences in socioeconomic status explain part of the differences in health, but fail to provide a complete understanding.

  19. Improving the Usefulness and Use of Patient Survey Programs: National Health Service Interview Study

    PubMed Central

    Darzi, Ara; Gancarczyk, Sarah; Mayer, Erik

    2018-01-01

    Background A growing body of evidence suggests a concerning lag between collection of patient experience data and its application in service improvement. This study aims to identify what health care staff perceive to be the barriers and facilitators to using patient-reported feedback and showcase successful examples of doing so. Objective This study aimed to apply a systems perspective to suggest policy improvements that could support efforts to use data on the frontlines. Methods Qualitative interviews were conducted in eight National Health Service provider locations in the United Kingdom, which were selected based on National Inpatient Survey scores. Eighteen patient-experience leads were interviewed about using patient-reported feedback with relevant staff. Interviews were transcribed and underwent thematic analysis. Staff-identified barriers and facilitators to using patient experience feedback were obtained. Results The most frequently cited barriers to using patient reported feedback pertained to interpreting results, understanding survey methodology, presentation of data in both national Care Quality Commission and contractor reports, inability to link data to other sources, and organizational structure. In terms of a wish list for improved practice, staff desired more intuitive survey methodologies, the ability to link patient experience data to other sources, and more examples of best practice in patient experience improvement. Three organizations also provided examples of how they successfully used feedback to improve care. Conclusions Staff feedback provides a roadmap for policy makers to reconsider how data is collected and whether or not the national regulations on surveys and patient experience data are meeting the quality improvement needs of local organizations. PMID:29691207

  20. Injury episodes and circumstances: National Health Interview Survey, 1997-2007.

    PubMed

    Chen, Li Hui; Warner, Margaret; Fingerhut, Lois; Makuc, Diane

    2009-09-01

    The National Health Interview Survey (NHIS) provides estimates of nonfatal, medically attended injuries and poisonings occurring in the United States. The objectives of this report are to 1) document changes in the injury and poisoning section of NHIS from 1997 through 2007; 2) provide guidance on summarizing data across the 11-year study period; and 3) present detailed national estimates of nonfatal injury and poisoning episodes for the time period. NHIS samples the civilian, noninstitutionalized population of the United States living in households. NHIS data from the years 1997-2007 were used in this report. Some questions related to injury and poisoning episodes were modified in 2000 and 2004. During the period 1997-2004, many NHIS injury and poisoning questions were improved as a result of cognitive interviewing, data analysis, and feedback from interviewers and data users. Revisions to the NHIS injury and poisoning section pose some difficulties for trend analysis. However, some questions remained the same during the 11-year period, despite the questionnaire revisions. The injury and poisoning section has not been revised since 2004 and, where possible, analyses should be limited to 2004 and beyond. For analyses that require a longer time period, this report provides information on changes to questions and statistics that illustrate the effect of these changes on injury estimates. in 2007, the medically attended injury and poisoning episode rate among the U.S. civilian, noninstitutionalized population was 115.7 per 1,000 population. Despite differences in some questions during the period 1997-2007, NHIS data for these years show falls as the leading cause of injury and the home as the leading place that injury occurred.

  1. Health-Risk Behaviors among Our Nation's Youth: United States, 1992. Vital and Health Statistics. Series 10: Data from the National Health Interview Survey. No. 192.

    ERIC Educational Resources Information Center

    National Center for Health Statistics (DHHS/PHS), Hyattsville, MD.

    The 1992 National Health Interview Survey-Youth Risk Behavior Survey (NHIS-YRBS) studied 13,789 youth 12-21 years of age. This report presents the data according to sex, age, Hispanic origin, and race for youth of non-Hispanic origin. The 10 data tables cover: cigarette and other tobacco use, alcohol and other drug use, sexual experience, HIV/AIDS…

  2. Sexual orientation in the 2013 national health interview survey: a quality assessment.

    PubMed

    Dahlhamer, James M; Galinsky, Adena M; Joestl, Sarah S; Ward, Brian W

    2014-12-01

    Objective-This report presents a set of quality analyses of sexual orientation data collected in the 2013 National Health Interview Survey (NHIS). NHIS sexual orientation estimates are compared with those from the National Survey of Family Growth (NSFG) and the National Health and Nutrition Examination Survey (NHANES). Selected health outcomes by sexual orientation are compared between NHIS and NSFG. Assessments of item nonresponse, item response times, and responses to follow-up questions to the sexual orientation question are also presented. Methods-NHIS is a multipurpose health survey conducted continuously throughout the year by the Centers for Disease Control and Prevention's National Center for Health Statistics. Analyses in this report were based on NHIS data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Data from the 2006-2010 NSFG and 2009-2012 NHANES were used for the comparisons. Results-Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay/lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ''something else,'' stated ''I don't know the answer,'' or refused to answer. Responses to follow-up questions suggest that the sexual orientation question is producing little classification error. In addition, largely similar patterns of association between sexual orientation and health were observed for NHIS and NSFG. Analyses of item nonresponse rates revealed few data quality issues, although item response times suggest possible shortcutting of the question and comprehension problems for select respondents. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  3. Concurrent Medical Conditions and Health Care Use and Needs among Children with Learning and Behavioral Developmental Disabilities, National Health Interview Survey, 2006-2010

    ERIC Educational Resources Information Center

    Schieve, Laura A.; Gonzalez, Vanessa; Boulet, Sheree L.; Visser, Susanna N.; Rice, Catherine E.; Braun, Kim Van Naarden; Boyle, Coleen A.

    2012-01-01

    Studies document various associated health risks for children with developmental disabilities (DDs). Further study is needed by disability type. Using the 2006-2010 National Health Interview Surveys, we assessed the prevalence of numerous medical conditions (e.g. asthma, frequent diarrhea/colitis, seizures), health care use measures (e.g. seeing a…

  4. Comparison of NIS and NHIS/NIPRCS vaccination coverage estimates. National Immunization Survey. National Health Interview Survey/National Immunization Provider Record Check Study.

    PubMed

    Bartlett, D L; Ezzati-Rice, T M; Stokley, S; Zhao, Z

    2001-05-01

    The National Immunization Survey (NIS) and the National Health Interview Survey (NHIS) produce national coverage estimates for children aged 19 months to 35 months. The NIS is a cost-effective, random-digit-dialing telephone survey that produces national and state-level vaccination coverage estimates. The National Immunization Provider Record Check Study (NIPRCS) is conducted in conjunction with the annual NHIS, which is a face-to-face household survey. As the NIS is a telephone survey, potential coverage bias exists as the survey excludes children living in nontelephone households. To assess the validity of estimates of vaccine coverage from the NIS, we compared 1995 and 1996 NIS national estimates with results from the NHIS/NIPRCS for the same years. Both the NIS and the NHIS/NIPRCS produce similar results. The NHIS/NIPRCS supports the findings of the NIS.

  5. The 1994-1995 National Health Interview Survey on Disability (NHIS-D): A Bibliography of 20 Years of Research.

    PubMed

    Ward, Brian W; Ridolfo, Heather; Creamer, Lauren; Gray, Caroline

    The 1994-1995 National Health Interview Survey on Disability (NHIS-D) has been one of the most unique and important data sources for studying disability, impairment, and health in the United States. In celebration of the NHIS-D's twenty-year anniversary, we created an extensive bibliography (n=212) of research that has used these data.

  6. Prayer for Health and Primary Care: Results From the 2002 National Health Interview Survey

    PubMed Central

    Wilkinson, Joanne E.; Saper, Robert B.; Rosen, Amy K.; Welles, Seth L.; Culpepper, Larry

    2009-01-01

    Background and Objectives Prayer for health (PFH) is common; in 2002, 35% of US adults prayed for their health. We examined the relationship of PFH and primary care visits, with a special focus on African American women, using data from the 2002 National Health Interview Survey (NHIS). Methods We used chi-square analyses to compare the demographic (age group, gender, race, region, marital status, educational level, ethnicity) and health-related covariates (alcohol use, smoking status, and selected medical conditions) between individuals who did and did not pray for their health in the past year. Univariate associations between PFH and visit to primary care provider (PCP), with Mantel-Haenszel adjustment for confounding, were determined. Multivariate regression was used to determine independent factors associated with PFH and PCP visit, with SUDAAN to adjust for the clustered survey design. Results Subjects who prayed were more likely to be female, older than 58, Black, Southern, separated, divorced or widowed, and nondrinkers. Subjects who prayed were also more likely to have seen a PCP within the past year. Black women who prayed were also more likely to see a PCP. Conclusions These findings suggest that people who pray for their health do so in addition to, not instead of, seeking primary care. This finding is maintained but with a smaller effect size, in Black women. PMID:18830839

  7. For Medical Technologists: The Frontier of Clinical Pathology. Six Interviews Conducted at the National Institutes of Health.

    ERIC Educational Resources Information Center

    National Institutes of Health (DHEW), Bethesda, MD. Clinical Center.

    The responses of six medical technologists to an interviewer's questions give a view of the working life in the clinical pathology laboratory of the National Institutes of Health (NIH). The technologists cite the competence of co-workers, sophisticated equipment, opportunities to further their education, and the challenge of participation in…

  8. Predicting Impact of Childhood Disability on Families: Results from the 1995 National Health Interview Survey Disability Supplement

    ERIC Educational Resources Information Center

    Neely-Barnes, Susan; Marcenko, Maureen

    2004-01-01

    Predictors of impact on families with a child who has developmental disabilities were examined using results from the 1995 National Health Interview Study Disability Supplement (NHIS-D). From this sample, 505 children who met criteria for a developmental disability were selected. Predictors of impact on these families were investigated across and…

  9. Oral health care utilization by US rural residents, National Health Interview Survey 1999.

    PubMed

    Vargas, Clemencia M; Dye, Bruce A; Hayes, Kathy

    2003-01-01

    To compare the dental care utilization practices of rural and urban residents in the United States. Data on dental care utilization from the 1999 National Health Interview Survey for persons 2 years of age and older (n=42, 139) were analyzed by rural/urban status. Percentages and 95 percent confidence intervals were calculated to produce national estimates for having had a visit in the past year, the number of visits, reasons given for last dental visit and for not visiting a dentist, unmet dental needs, and private dental insurance. Rural residents were more likely to report that their last dental visit was because something was "bothering or hurting" (23.3% vs 17.6%) and that they had unmet dental needs (10.1% vs 7.5%). Urban residents were more likely to report having a dental visit in the past year (57.7% vs 66.5%) and having private dental insurance (32.7% vs 37.2%), compared to rural residents. There were no significant differences in most reasons given for not visiting the dentist between rural and urban respondents. Dental care utilization characteristics differ between rural and urban residents in the United States, with rural residents tending to underutilize dental care.

  10. The 1994–1995 National Health Interview Survey on Disability (NHIS-D): A Bibliography of 20 Years of Research

    PubMed Central

    Ward, Brian W.; Ridolfo, Heather; Creamer, Lauren; Gray, Caroline

    2015-01-01

    The 1994–1995 National Health Interview Survey on Disability (NHIS-D) has been one of the most unique and important data sources for studying disability, impairment, and health in the United States. In celebration of the NHIS-D’s twenty-year anniversary, we created an extensive bibliography (n=212) of research that has used these data. PMID:26640424

  11. Occupation and lung cancer mortality in a nationally representative U.S. Cohort: The National Health Interview Survey (NHIS).

    PubMed

    Lee, David J; Fleming, Lora E; Leblanc, William G; Arheart, Kristopher L; Chung-Bridges, Katherine; Christ, Sharon L; Caban, Alberto J; Pitman, Terry

    2006-08-01

    The objective of this study was to assess the risk of lung cancer mortality in a nationally representative sample of U.S. workers by occupation. National Death Index linkage identified 1812 lung cancer deaths among 143,863 workers who participated in the 1987, 1988, and 1990-1994 National Health Interview Surveys. Current and former smoking status was predictive of lung cancer mortality (hazard ratio [HR] = 15.1 and 3.8, respectively). Occupations with significantly higher risk for age- and smoking-adjusted lung cancer mortality included heating/air/refrigeration mechanics (HR = 3.0); not specified mechanics and repairers (HR = 2.8); financial records processing occupations (HR = 1.8); freight, stock, and materials handlers (HR = 1.5); and precision production occupations (HR = 1.4). Although tobacco use continues to be the single most important risk factor for lung cancer mortality, occupational exposure to lung carcinogens should be targeted as well to further reduce the burden of lung cancer.

  12. [Gender systems and/in the Spanish National Health Interview Survey].

    PubMed

    Ruiz Cantero, María Teresa; Papí Gálvez, Natalia; Carbrera Ruiz, Virginia; Ruiz Martínez, Ana; Alvarez-Dardet Díaz, Carlos

    2006-01-01

    To analyze the Spanish National Health Interview Survey (NHIS) from a gender perspective, with special emphasis on gender division of labor. We analyzed the 2003 Spanish NHIS from the perspective of the levels of gender observation, with gender understood as: a) the basis of social norms (responsibilities by sex, health risks, and problems related to masculine/feminine roles); b) the organizer of the social structure: gender division of labor, work overload, vertical/horizontal segregation, time spent in activities according to social times, access to resources), and c) a component of individual identity (conflicts due to multiple roles, body image dissatisfaction, self-esteem, self-perceived recognition of the work performed, assimilation of the sexual gender role, sex differences in health conditions). The Spanish NHIS is centered on the main provider, referred to in masculine grammatical form. Gender division of domestic labor is identified only by a general question. When using the concept of main activity for productive or reproductive work, the survey requires respondents to evaluate them and select only one, thus losing information and hampering analysis of the impact of an overload of work on health. Information on time used for reproductive work and leisure is not solicited. Assaults (intentional) and accidents (non-intentional) are combined in the same question, thus preventing research on gender-related violence. The Spanish NHIS includes the variable of sex, but its more descriptive than analytic focus limits gender analysis. The survey allows specific circumstances of employment-related inequalities between sexes to be measured, but does not completely allow other indicators of gender inequalities, such as the situation of housewives or work overload, to be measured.

  13. Movement and manual therapy for adults with arthritis: 2012 National Health Interview Survey.

    PubMed

    Pure, Elise; Terhorst, Lauren; Baker, Nancy

    2018-04-01

    The use of manual therapies (chiropractic manipulation, massage) and movement therapies (yoga, tai chi) by people with arthritis may relate to their personal characteristics, and the reported emotional and physical health outcomes may differ by type of therapy. To describe personal characteristics and predictors of manual and movement therapy use for people with arthritis, and to compare the use of manual versus movement therapy to improve physical and emotional health outcomes for people with arthritis. CAM respondents with arthritis were identified from the 2012 National Health Interview Survey (n = 8229). Data were analyzed to determine the overall percentages of CAM users, and to examine the associations between use/nonuse using multivariable linear regressions. White, well-educated, physically active females were more likely to use both types of therapy. Movement therapy users reported positive emotional health outcomes twice as much as manual therapy users and 10% more reported positive physical health outcomes. While both movement and manual therapies can have positive effects on people with arthritis, it appears that active therapies are more beneficial than passive therapies. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. The Prevalence of Short Sleep Duration by Industry and Occupation in the National Health Interview Survey

    PubMed Central

    Luckhaupt, Sara E.; Tak, SangWoo; Calvert, Geoffrey M.

    2010-01-01

    Study Objectives: To explore whether employment in industries likely to have non-standard work schedules (e.g., manufacturing and service) and occupations with long work-weeks (e.g., managerial/ professional, sales, and transportation) is associated with an increased risk of short sleep duration. Design: Cross-sectional epidemiologic survey. Setting: Household-based face-to-face survey of civilian, non-institutionalized US residents. Participants: Sample adults interviewed for the National Health Interview Survey in 1985 or 1990 (N = 74,734) or between 2004 and 2007 (N = 110,422). Most analyses focused on civilian employed workers interviewed between 2004 and 2007 (N = 66,099). Interventions: N/A Measurements and Results: The weighted prevalence of self-reported short sleep duration, defined as ≤6 h per day, among civilian employed workers from 2004-2007 was 29.9%. Among industry categories, the prevalence of short sleep duration was greatest for management of companies and enterprises (40.5%), followed by transportation/warehousing (37.1%) and manufacturing (34.8%). Occupational categories with the highest prevalence included production occupations in the transportation/warehousing industry, and installation, maintenance, and repair occupations in both the transportation/warehousing industry and the manufacturing industry. In the combined sample from 1985 and 1990, 24.2% of workers reported short sleep duration; the prevalence of short sleep duration was significantly lower during this earlier time period compared to 2004–2007 for 7 of 8 industrial sectors. Conclusions: Self-reported short sleep duration among US workers varies by industry and occupation, and has increased over the past two decades. These findings suggest the need for further exploration of the relationship between work and sleep, and development of targeted interventions for specific industry/occupation groups. Citation: Luckhaupt SE; Tak S; Calvert GM. The prevalence of short sleep duration

  15. Prevalence of Mindfulness Practices in the US Workforce: National Health Interview Survey.

    PubMed

    Kachan, Diana; Olano, Henry; Tannenbaum, Stacey L; Annane, Debra W; Mehta, Ashwin; Arheart, Kristopher L; Fleming, Lora E; Yang, Xuan; McClure, Laura A; Lee, David J

    2017-01-05

    Mindfulness-based practices can improve workers' health and reduce employers' costs by ameliorating the negative effect of stress on workers' health. We examined the prevalence of engagement in 4 mindfulness-based practices in the US workforce. We used 2002, 2007, and 2012 National Health Interview Survey (NHIS) data for adults (aged ≥18 y, n = 85,004) to examine 12-month engagement in meditation, yoga, tai chi, and qigong among different groups of workers. Reported yoga practice prevalence nearly doubled from 6.0% in 2002 to 11.0% in 2012 (P < .001); meditation rates increased from 8.0% in 2002 to 9.9% in 2007 (P < .001). In multivariable models, mindfulness practice was significantly lower among farm workers (odds ratio [OR] = 0.42; 95% confidence interval [CI], 0.21-0.83]) and blue-collar workers (OR = 0.63; 95% CI, 0.54-0.74) than among white-collar workers. Worker groups with low rates of engagement in mindfulness practices could most benefit from workplace mindfulness interventions. Improving institutional factors limiting access to mindfulness-based wellness programs and addressing existing beliefs about mindfulness practices among underrepresented worker groups could help eliminate barriers to these programs.

  16. Cell-phone use and self-reported hypertension: national health interview survey 2008.

    PubMed

    Suresh, Sivaranjani; Sabanayagam, Charumathi; Kalidindi, Sita; Shankar, Anoop

    2011-01-01

    Background. Cell-phone usage has increased dramatically over the last decade, along with a rising public concern over the health effects of using this device. The association between cell-phone usage and hypertension has not been examined before. Methods. We analysed data from 21,135 adults aged ≥18 years who participated in the 2008 National Health Interview Survey. Based on reported cell-phone use, participants were categorized as cell-phone nonusers, predominantly landline users, dual users of cell phone and landline, and predominantly cell-phone users. The main outcome of interest was self-reported physician-diagnosed hypertension (n = 6,793). Results. 43.5% of the participants were cell-phone nonusers, while 13.8% were predominantly cell-phone users. We found that cell-phone use was inversely associated with hypertension, independent of age, sex, race/ethnicity, smoking, alcohol consumption, education, body mass index (BMI), and physical activity. Compared to cell-phone nonusers, the multivariable odds ratio (95% confidence interval) of hypertension was 0.86 (0.75-0.98, P trend  =  .005) among predominantly cell-phone users. This inverse association between cell-phone use and hypertension was stronger in women, those aged <60 years, whites, and those with BMI <25 kg/m(2). Conclusion. We found that cell-phone usage was protectively associated with self-reported hypertension in a nationally representative sample of US adults.

  17. Cell-Phone Use and Self-Reported Hypertension: National Health Interview Survey 2008

    PubMed Central

    Suresh, Sivaranjani; Sabanayagam, Charumathi; Kalidindi, Sita; Shankar, Anoop

    2011-01-01

    Background. Cell-phone usage has increased dramatically over the last decade, along with a rising public concern over the health effects of using this device. The association between cell-phone usage and hypertension has not been examined before. Methods. We analysed data from 21,135 adults aged ≥18 years who participated in the 2008 National Health Interview Survey. Based on reported cell-phone use, participants were categorized as cell-phone nonusers, predominantly landline users, dual users of cell phone and landline, and predominantly cell-phone users. The main outcome of interest was self-reported physician-diagnosed hypertension (n = 6,793). Results. 43.5% of the participants were cell-phone nonusers, while 13.8% were predominantly cell-phone users. We found that cell-phone use was inversely associated with hypertension, independent of age, sex, race/ethnicity, smoking, alcohol consumption, education, body mass index (BMI), and physical activity. Compared to cell-phone nonusers, the multivariable odds ratio (95% confidence interval) of hypertension was 0.86 (0.75–0.98, P trend  =  .005) among predominantly cell-phone users. This inverse association between cell-phone use and hypertension was stronger in women, those aged <60 years, whites, and those with BMI <25 kg/m2. Conclusion. We found that cell-phone usage was protectively associated with self-reported hypertension in a nationally representative sample of US adults. PMID:21629867

  18. Parental Sexual Orientation and Children's Psychological Well-Being: 2013-2015 National Health Interview Survey.

    PubMed

    Calzo, Jerel P; Mays, Vickie M; Björkenstam, Charlotte; Björkenstam, Emma; Kosidou, Kyriaki; Cochran, Susan D

    2017-11-08

    Debate persists about whether parental sexual orientation affects children's well-being. This study utilized information from the 2013 to 2015 U.S., population-based National Health Interview Survey to examine associations between parental sexual orientation and children's well-being. Parents reported their children's (aged 4-17 years old, N = 21,103) emotional and mental health difficulties using the short form Strengths and Difficulties Questionnaire (SDQ). Children of bisexual parents had higher SDQ scores than children of heterosexual parents. Adjusting for parental psychological distress (a minority stress indicator) eliminated this difference. Children of lesbian and gay parents did not differ from children of heterosexual parents in emotional and mental health difficulties, yet, the results among children of bisexual parents warrant more research examining the impact of minority stress on families. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

  19. Choosing "Something Else" as a Sexual Identity: Evaluating Response Options on the National Health Interview Survey.

    PubMed

    Eliason, Michele J; Streed, Carl G

    2017-10-01

    Researchers struggle to find effective ways to measure sexual and gender identities to determine whether there are health differences among subsets of the LGBTQ+ population. This study examines responses on the National Health Interview Survey (NHIS) sexual identity questions among 277 LGBTQ+ healthcare providers. Eighteen percent indicated that their sexual identity was "something else" on the first question, and 57% of those also selected "something else" on the second question. Half of the genderqueer/gender variant participants and 100% of transgender-identified participants selected "something else" as their sexual identity. The NHIS question does not allow all respondents in LGBTQ+ populations to be categorized, thus we are potentially missing vital health disparity information about subsets of the LGBTQ+ population.

  20. Older adults' use of complementary and alternative medicine for mental health: findings from the 2002 National Health Interview Survey.

    PubMed

    Grzywacz, Joseph G; Suerken, Cynthia K; Quandt, Sara A; Bell, Ronny A; Lang, Wei; Arcury, Thomas A

    2006-06-01

    To compare complementary and alternative medicine (CAM) use among adults 65 and older with and without self-reported anxiety or depression, and to investigate the prevalence and predictors of CAM use for treatment by persons with anxiety or depression. Cross-sectional survey. Computer-assisted interviews conducted in participants' homes. Subjects included 5827 adults aged 65 and older who participated in the 2002 National Health Interview Survey including the Alternative Health Supplement. None. Overall use of CAM, use of four categories of CAM, and use of 20 CAM modalities. CAM use for treatment of any health condition, and CAM use to treat mental health. Eighty-one and seven tenths percent (81.7%) of older adults with self-reported anxiety or depression who used CAM in the past year, whereas 64.6% of older adults without these conditions used CAM. Differences in CAM use were driven by elevated use of spiritual practices, relaxation techniques, and use of nonvitamin, nonmineral natural products by patients with symptoms of mental conditions. Fewer than 20% of CAM users with self-reported anxiety or depression used CAM for their mental health. Few personal and health-related factors predicted CAM use for treatment among older adults with self-reported anxiety or depression. Older adults with self-reported anxiety or depression were more likely to use spiritual practices, relaxation techniques, and nonvitamin, nonmineral natural products than elders in good mental health. However, for the majority of older adults with self-reported anxiety or depression, CAM was used for purposes other than treating mental health.

  1. Development of the adult and child complementary medicine questionnaires fielded on the National Health Interview Survey

    PubMed Central

    2013-01-01

    The 2002, 2007, and 2012 complementary medicine questionnaires fielded on the National Health Interview Survey provide the most comprehensive data on complementary medicine available for the United States. They filled the void for large-scale, nationally representative, publicly available datasets on the out-of-pocket costs, prevalence, and reasons for use of complementary medicine in the U.S. Despite their wide use, this is the first article describing the multi-faceted and largely qualitative processes undertaken to develop the surveys. We hope this in-depth description enables policy makers and researchers to better judge the content validity and utility of the questionnaires and their resultant publications. PMID:24267412

  2. Development of the adult and child complementary medicine questionnaires fielded on the National Health Interview Survey.

    PubMed

    Stussman, Barbara J; Bethell, Christina D; Gray, Caroline; Nahin, Richard L

    2013-11-23

    The 2002, 2007, and 2012 complementary medicine questionnaires fielded on the National Health Interview Survey provide the most comprehensive data on complementary medicine available for the United States. They filled the void for large-scale, nationally representative, publicly available datasets on the out-of-pocket costs, prevalence, and reasons for use of complementary medicine in the U.S. Despite their wide use, this is the first article describing the multi-faceted and largely qualitative processes undertaken to develop the surveys. We hope this in-depth description enables policy makers and researchers to better judge the content validity and utility of the questionnaires and their resultant publications.

  3. Health Status of Older US Workers and Nonworkers, National Health Interview Survey, 1997-2011.

    PubMed

    Kachan, Diana; Fleming, Lora E; Christ, Sharon; Muennig, Peter; Prado, Guillermo; Tannenbaum, Stacey L; Yang, Xuan; Caban-Martinez, Alberto J; Lee, David J

    2015-09-24

    Many US workers are increasingly delaying retirement from work, which may be leading to an increase in chronic disease at the workplace. We examined the association of older adults' health status with their employment/occupation and other characteristics. National Health Interview Survey data from 1997 through 2011 were pooled for adults aged 65 or older (n = 83,338; mean age, 74.6 y). Multivariable logistic regression modeling was used to estimate the association of socioeconomic factors and health behaviors with 4 health status measures: 1) self-rated health (fair/poor vs good/very good/excellent); 2) multimorbidity (≤1 vs ≥2 chronic conditions); 3) multiple functional limitations (≤1 vs ≥2); and 4) Health and Activities Limitation Index (HALex) (below vs above 20th percentile). Analyses were stratified by sex and age (young-old vs old-old) where interactions with occupation were significant. Employed older adults had better health outcomes than unemployed older adults. Physically demanding occupations had the lowest risk of poor health outcomes, suggesting a stronger healthy worker effect: service workers were at lowest risk of multiple functional limitations (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.71-0.95); and blue-collar workers were at lowest risk of multimorbidity (OR, 0.84; 95% CI, 0.74-0.97) and multiple functional limitation (OR, 0.84; 95% CI, 0.72-0.98). Hispanics were more likely than non-Hispanic whites to report fair/poor health (OR, 1.62; 95% CI, 1.52-1.73) and lowest HALex quintile (OR, 1.21; 95% CI, 1.13-1.30); however, they were less likely to report multimorbidity (OR, 0.78; 95% CI, 0.73-0.83) or multiple functional limitations (OR, 0.82; 95% CI, 0.77-0.88). A strong association exists between employment and health status in older adults beyond what can be explained by socioeconomic factors (eg, education, income) or health behaviors (eg, smoking). Disability accommodations in the workplace could encourage employment

  4. Prevalence of Mindfulness Practices in the US Workforce: National Health Interview Survey

    PubMed Central

    Kachan, Diana; Olano, Henry; Tannenbaum, Stacey L.; Annane, Debra W.; Mehta, Ashwin; Arheart, Kristopher L.; Fleming, Lora E.; McClure, Laura A.; Lee, David J.

    2017-01-01

    Introduction Mindfulness-based practices can improve workers’ health and reduce employers’ costs by ameliorating the negative effect of stress on workers’ health. We examined the prevalence of engagement in 4 mindfulness-based practices in the US workforce. Methods We used 2002, 2007, and 2012 National Health Interview Survey (NHIS) data for adults (aged ≥18 y, n = 85,004) to examine 12-month engagement in meditation, yoga, tai chi, and qigong among different groups of workers. Results Reported yoga practice prevalence nearly doubled from 6.0% in 2002 to 11.0% in 2012 (P < .001); meditation rates increased from 8.0% in 2002 to 9.9% in 2007 (P < .001). In multivariable models, mindfulness practice was significantly lower among farm workers (odds ratio [OR] = 0.42; 95% confidence interval [CI], 0.21–0.83]) and blue-collar workers (OR = 0.63; 95% CI, 0.54–0.74) than among white-collar workers. Conclusion Worker groups with low rates of engagement in mindfulness practices could most benefit from workplace mindfulness interventions. Improving institutional factors limiting access to mindfulness-based wellness programs and addressing existing beliefs about mindfulness practices among underrepresented worker groups could help eliminate barriers to these programs. PMID:28055821

  5. Health-care access among adults with epilepsy: The U.S. National Health Interview Survey, 2010 and 2013✩

    PubMed Central

    Thurman, David J.; Kobau, Rosemarie; Luo, Yao-Hua; Helmers, Sandra L.; Zack, Matthew M.

    2017-01-01

    Introduction Community-based and other epidemiologic studies within the United States have identified substantial disparities in health care among adults with epilepsy. However, few data analyses addressing their health-care access are representative of the entire United States. This study aimed to examine national survey data about adults with epilepsy and to identify barriers to their health care. Materials and methods We analyzed data from U.S. adults in the 2010 and the 2013 National Health Interview Surveys, multistage probability samples with supplemental questions on epilepsy. We defined active epilepsy as a history of physician-diagnosed epilepsy either currently under treatment or accompanied by seizures during the preceding year. We employed SAS-callable SUDAAN software to obtain weighted estimates of population proportions and rate ratios (RRs) adjusted for sex, age, and race/ethnicity. Results Compared to adults reporting no history of epilepsy, adults reporting active epilepsy were significantly more likely to be insured under Medicaid (RR = 3.58) and less likely to have private health insurance (RR = 0.58). Adults with active epilepsy were also less likely to be employed (RR = 0.53) and much more likely to report being disabled (RR = 6.14). They experience greater barriers to health-care access including an inability to afford medication (RR = 2.40), mental health care (RR = 3.23), eyeglasses (RR = 2.36), or dental care (RR = 1.98) and are more likely to report transportation as a barrier to health care (RR = 5.28). Conclusions These reported substantial disparities in, and barriers to, access to health care for adults with active epilepsy are amenable to intervention. PMID:26627980

  6. In-depth interviews with state public health practitioners on the United States National Physical Activity Plan

    PubMed Central

    2013-01-01

    Background The United States National Physical Activity Plan (NPAP; 2010), the country’s first national plan for physical activity, provides strategies to increase population-level physical activity to complement the 2008 physical activity guidelines. This study examined state public health practitioner awareness, dissemination, use, challenges, and recommendations for the NPAP. Methods In 2011–2012, we interviewed 27 state practitioners from 25 states. Interviews were recorded and transcribed verbatim. Transcripts were coded using a standard protocol, verified and reconciled by an independent coder, and input into qualitative software to facilitate development of common themes. Results NPAP awareness was high among state practitioners; dissemination to local constituents varied. Development of state-level strategies and goals was the most frequently reported use of the NPAP. Some respondents noted the usefulness of the NPAP for coalitions and local practitioners. Challenges to the plan included implementation cost, complexity, and consistency with other policies. The most frequent recommendation made was to directly link examples of implementation activities to the plan. Conclusions These results provide early evidence of NPAP dissemination and use, along with challenges encountered and suggestions for future iterations. Public health is one of eight sectors in the NPAP. Further efforts are needed to understand uptake and use by other sectors, as well as to monitor long-term relevance, progress, and collaboration across sectors. PMID:23731829

  7. Use of Complementary Health Approaches Among Children Aged 4–17 Years in the United States: National Health Interview Survey, 2007–2012

    PubMed Central

    Black, Lindsey I.; Clarke, Tainya C.; Barnes, Patricia M.; Stussman, Barbara J.; Nahin, Richard L.

    2015-01-01

    Objective This report presents national estimates of the use of complementary health approaches among children aged 4–17 years in the United States. Selected modalities are compared for 2007 and 2012 to examine changes over time. Methods Data from the 2007 and 2012 National Health Interview Survey (NHIS) were analyzed for this report. The combined sample included 17,321 interviews with knowledgeable adults about children aged 4–17 years. Point estimates and estimates of their variances were calculated using SUDAAN software to account for the complex sampling design of NHIS. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. Results The use of complementary health approaches among children did not change significantly since 2007 (from 12.0% in 2007 to 11.6% in 2012). However, one approach, the use of traditional healers, showed a statistically significant decrease in use, from 1.1% in 2007 to 0.1% in 2012. No other significant decreases were identified. An increase in the use of yoga was observed during this period (from 2.3% in 2007 to 3.1% in 2012). Nonvitamin, nonmineral dietary supplements; chiropractic or osteopathic manipulation; and yoga, tai chi, or qi gong were the most commonly used complementary health approaches in both 2007 and 2012. Also consistent between 2007 and 2012 was that complementary health approaches were most frequently used for back or neck pain, head or chest cold, anxiety or stress, and other musculoskeletal conditions. PMID:25671583

  8. Health behaviors among people with epilepsy—Results from the 2010 National Health Interview Survey☆

    PubMed Central

    Cui, Wanjun; Zack, Matthew M.; Kobau, Rosemarie; Helmers, Sandra L.

    2015-01-01

    Objectives This study aimed to estimate and compare the prevalence of selected health behavior—alcohol use, cigarette smoking, physical activity, and sufficient sleep—between people with and without a history of epilepsy in a large, nationally representative sample in the United States. Methods We used data from the 2010 cross-sectional National Health Interview Survey (NHIS) to compare the prevalence of each health behavior for people with and without epilepsy while adjusting for sex, age, race/ethnicity, and family income. We also further categorized those with epilepsy into active epilepsy and inactive epilepsy and calculated their corresponding prevalences. Results The percentages of adults with a history of epilepsy (50.1%, 95% CI = 45.1%–55.2%) and with active epilepsy (44.4%, 95% CI = 37.6%–51.5%) who were current alcohol drinkers were significantly lower than that of those without epilepsy (65.1%, 95% CI = 64.2%–66.0%). About 21.8% (95% CI = 18.1%–25.9%) of adults with epilepsy and 19.3% (95% CI = 18.7%–19.9%) of adults without epilepsy were current smokers. Adults with active epilepsy were significantly less likely than adults without epilepsy to report following recommended physical activity guidelines for Americans (35.2%, 95% CI = 28.8%–42.1% vs. 46.3%, 95% CI = 45.4%–47.2%) and to report walking for at least ten minutes during the seven days prior to being surveyed (39.6%, 95% CI = 32.3%–47.4% vs. 50.8%, 95% CI = 49.9%–51.7%). The percentage of individuals with active epilepsy (49.8%, 95% CI = 42.0%–57.7%) who reported sleeping an average of 7 or 8 h a day was significantly lower than that of those without epilepsy (61.9%, 95% CI = 61.2%–62.7%). Conclusions Because adults with epilepsy are significantly less likely than adults without epilepsy to engage in recommended levels of physical activity and to get the encouraged amount of sleep for optimal health and well-being, promoting more safe physical activity and improved sleep

  9. A comparison of prevalence estimates for selected health indicators and chronic diseases or conditions from the Behavioral Risk Factor Surveillance System, the National Health Interview Survey, and the National Health and Nutrition Examination Survey, 2007-2008.

    PubMed

    Li, Chaoyang; Balluz, Lina S; Ford, Earl S; Okoro, Catherine A; Zhao, Guixiang; Pierannunzi, Carol

    2012-06-01

    To compare the prevalence estimates of selected health indicators and chronic diseases or conditions among three national health surveys in the United States. Data from adults aged 18 years or older who participated in the Behavioral Risk Factor Surveillance System (BRFSS) in 2007 and 2008 (n=807,524), the National Health Interview Survey (NHIS) in 2007 and 2008 (n=44,262), and the National Health and Nutrition Examination Survey (NHANES) during 2007 and 2008 (n=5871) were analyzed. The prevalence estimates of current smoking, obesity, hypertension, and no health insurance were similar across the three surveys, with absolute differences ranging from 0.7% to 3.9% (relative differences: 2.3% to 20.2%). The prevalence estimate of poor or fair health from BRFSS was similar to that from NHANES, but higher than that from NHIS. The prevalence estimates of diabetes, coronary heart disease, and stroke were similar across the three surveys, with absolute differences ranging from 0.0% to 0.8% (relative differences: 0.2% to 17.1%). While the BRFSS continues to provide invaluable health information at state and local level, it is reassuring to observe consistency in the prevalence estimates of key health indicators of similar caliber between BRFSS and other national surveys. Published by Elsevier Inc.

  10. Association between visual impairment and sleep duration: analysis of the 2009 National Health Interview Survey (NHIS).

    PubMed

    Ramos, Alberto R; Wallace, Douglas M; Williams, Natasha J; Spence, David Warren; Pandi-Perumal, Seithikurippu Ratnas; Zizi, Ferdinand; Jean-Louis, Girardin

    2014-10-01

    Visual impairment (VI) is associated with increased mortality and health factors such as depression and cardiovascular disease. Epidemiologic studies consistently show associations between sleep duration with adverse health outcomes, but these have not systematically considered the influence of VI. The aim of this study was to ascertain the independent association between VI and sleep duration using the National Health Interview Survey (NHIS) data. We also examined whether race/ethnicity influenced these associations independently of sociodemographic and medical characteristics. Our analysis was based on the 2009 NHIS, providing valid sleep and vision data for 29,815 participants. The NHIS is a cross-sectional household interview survey utilizing a multistage area probability design. Trained personnel from the US census bureau gathered data during face-to-face interview and obtained socio-demographic, self-reported habitual sleep duration and physician-diagnosed chronic conditions. The mean age of the sample was 48 years and 56% were female. Short sleep and long sleep durations were reported by 49% and 23% of the participants, respectively. Visual impairment was observed in 10%. Multivariate-adjusted logistic regression models showed significant associations between VI and short sleep (OR = 1.6, 95% CI = 1.5-1.9 and long sleep durations (OR = 1.6, 95% CI = 1.3-1.9). These associations persisted in multivariate models stratified by race-ethnic groups. Visual impairment was associated with both short and long sleep durations. Analysis of epidemiologic sleep data should consider visual impairment as an important factor likely to influence the amount of sleep experienced habitually.

  11. AIDS Knowledge and Attitudes, Provisional Data from the National Health Interview Survey: United States, August 1987. Advance Data from Vital and Health Statistics. No. 146.

    ERIC Educational Resources Information Center

    Dawson, Deborah A.; And Others

    This document presents provisional data for all Acquired Immune Deficiency Syndrome (AIDS) questionnaire items from the National Health Interview Survey (NHIS) for August 1987. It notes that the AIDS questionnaire was designed to provide baseline estimates of public knowledge and attitudes about AIDS transmission, the prevention of AIDS virus…

  12. Linking emotional distress to unhealthy sleep duration: analysis of the 2009 National Health Interview Survey.

    PubMed

    Seixas, Azizi A; Nunes, Joao V; Airhihenbuwa, Collins O; Williams, Natasha J; Pandi-Perumal, Seithikurippu Ratnas; James, Caryl C; Jean-Louis, Girardin

    2015-01-01

    The objective of the study was to examine the independent association of emotional distress with unhealthy sleep duration (defined as <7 or >8 hours). Data from the 2009 National Health Interview Survey (NHIS), a cross-sectional household survey, were analyzed to investigate the associations of emotional distress with unhealthy sleep durations, adjusting for sociodemographic factors, health risks, and chronic diseases through hierarchical multiple logistic regression analysis. A total of 27,731 participants (age range 18-85 years) from the NHIS 2009 dataset were interviewed. Unhealthy sleep duration is defined as sleep duration <7 or >8 hours, whereas healthy sleep is defined as sleep duration lasting for 7-8 hours. Emotional distress is based on the Kessler 6 Non-Specific Distress Battery, which assesses the frequency of feeling sad, nervous, restless, hopeless, worthless, and burdened, over a 30-day period. Of the sample, 51.7% were female; 83.1% were white and 16.9% were black. Eleven percent experienced emotional distress and 37.6% reported unhealthy sleep. Adjusted logistic regression analysis revealed that individuals with emotional distress had 55% greater odds of reporting unhealthy sleep (odds ratio [OR] =1.55, 95% confidence interval [CI] =1.42, 1.68, P<0.001). Emotional distress, an important proxy for poor psychological health, was a significant predictor of unhealthy sleep, independent of the influences of several factors including demographic (age, education, sex, race/ethnicity, and family income), health risks (alcohol consumption and smoking status), and chronic diseases/conditions (diabetes, obesity, hypertension, heart disease, cancer, and arthritis).

  13. Linking emotional distress to unhealthy sleep duration: analysis of the 2009 National Health Interview Survey

    PubMed Central

    Seixas, Azizi A; Nunes, Joao V; Airhihenbuwa, Collins O; Williams, Natasha J; Pandi-Perumal, Seithikurippu Ratnas; James, Caryl C; Jean-Louis, Girardin

    2015-01-01

    Objective The objective of the study was to examine the independent association of emotional distress with unhealthy sleep duration (defined as <7 or >8 hours). Methods Data from the 2009 National Health Interview Survey (NHIS), a cross-sectional household survey, were analyzed to investigate the associations of emotional distress with unhealthy sleep durations, adjusting for sociodemographic factors, health risks, and chronic diseases through hierarchical multiple logistic regression analysis. Participants A total of 27,731 participants (age range 18–85 years) from the NHIS 2009 dataset were interviewed. Measures Unhealthy sleep duration is defined as sleep duration <7 or >8 hours, whereas healthy sleep is defined as sleep duration lasting for 7–8 hours. Emotional distress is based on the Kessler 6 Non-Specific Distress Battery, which assesses the frequency of feeling sad, nervous, restless, hopeless, worthless, and burdened, over a 30-day period. Results Of the sample, 51.7% were female; 83.1% were white and 16.9% were black. Eleven percent experienced emotional distress and 37.6% reported unhealthy sleep. Adjusted logistic regression analysis revealed that individuals with emotional distress had 55% greater odds of reporting unhealthy sleep (odds ratio [OR] =1.55, 95% confidence interval [CI] =1.42, 1.68, P<0.001). Conclusion Emotional distress, an important proxy for poor psychological health, was a significant predictor of unhealthy sleep, independent of the influences of several factors including demographic (age, education, sex, race/ethnicity, and family income), health risks (alcohol consumption and smoking status), and chronic diseases/conditions (diabetes, obesity, hypertension, heart disease, cancer, and arthritis). PMID:26442563

  14. Assessing Measurement Error in Medicare Coverage From the National Health Interview Survey

    PubMed Central

    Gindi, Renee; Cohen, Robin A.

    2012-01-01

    Objectives Using linked administrative data, to validate Medicare coverage estimates among adults aged 65 or older from the National Health Interview Survey (NHIS), and to assess the impact of a recently added Medicare probe question on the validity of these estimates. Data sources Linked 2005 NHIS and Master Beneficiary Record and Payment History Update System files from the Social Security Administration (SSA). Study design We compared Medicare coverage reported on NHIS with “benchmark” benefit records from SSA. Principal findings With the addition of the probe question, more reports of coverage were captured, and the agreement between the NHIS-reported coverage and SSA records increased from 88% to 95%. Few additional overreports were observed. Conclusions Increased accuracy of the Medicare coverage status of NHIS participants was achieved with the Medicare probe question. Though some misclassification remains, data users interested in Medicare coverage as an outcome or correlate can use this survey measure with confidence. PMID:24800138

  15. National Health Interview Survey data on adult knowledge of AIDS in the United States.

    PubMed Central

    Hardy, A M

    1990-01-01

    Information collected with the 1989 National Health Interview Survey of AIDS Knowledge and Attitudes from a nationally representative sample of 40,609 adults was examined to determine how knowledge about AIDS varied within demographic subgroups of the population. Most adults (83 percent) had seen or heard public service announcements about AIDS in the month prior to interview, and 51 percent had read an AIDS brochure in the past. Sixty-seven percent of adults responded correctly to at least 10 of 14 general AIDS knowledge questions. Knowledge levels were higher among those who were more educated and those who had seen or heard public service announcements or had read brochures. White adults responded correctly to these questions more often than their black counterparts; non-Hispanics responded correctly more often than Hispanics (for statistical purposes, the population is divided twice, in the first instance racially and in the second, ethnically--white and black, Hispanic and non-Hispanic). Even with relatively high information levels, misperceptions about casual transmission persisted, with one-third of adults answering more than half of the questions about casual transmission incorrectly. The same population groups that had less general AIDS knowledge had more misperceptions about transmission. More than 80 percent of adults recognized that use of condoms and a monogamous relationship between two uninfected persons were effective means of preventing the spread of the AIDS virus. Seventy-four percent of adults had heard of the HIV antibody test.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2124363

  16. Insomnia, trouble sleeping, and complementary and alternative medicine: Analysis of the 2002 national health interview survey data.

    PubMed

    Pearson, Nancy J; Johnson, Laura Lee; Nahin, Richard L

    2006-09-18

    Insomnia and other disorders that result in trouble sleeping are common in the United States and are often associated with chronic health conditions. Some individuals with insomnia or trouble sleeping use complementary and alternative medicine (CAM) therapies to treat their condition, but the prevalence of such use and the most common types of CAM therapies selected are not known. Prevalence of insomnia or trouble sleeping and of CAM use for treating such conditions was examined using the 2002 National Health Interview Survey. Logistic regression was used to examine associations between insomnia or trouble sleeping, comorbid conditions, and use of CAM treatments. The 12-month prevalence rate of insomnia or trouble sleeping was 17.4%. There was a strong positive association between adults who reported having insomnia or trouble sleeping and adults who reported 4 of 5 common conditions: obesity (adjusted odds ratio [OR], 1.15; 99% confidence interval [CI], 1.01-1.31), hypertension (OR, 1.32; 99% CI, 1.16-1.51), congestive heart failure (OR, 2.24; 99% CI, 1.60-3.14), and anxiety or depression (OR, 5.64; 99% CI, 5.07-6.29). Of those with insomnia or trouble sleeping, 4.5% used some form of CAM therapy to treat their condition. According to the National Health Interview Survey analysis, over 1.6 million civilian, noninstitutionalized adult US citizens use CAM to treat insomnia or trouble sleeping. The details of this analysis will serve as a guide for future research on CAM therapies for sleep disorders.

  17. Asthma management practices in adults--findings from the German Health Update (GEDA) 2010 and the German National Health Interview and Examination Survey (DEGS1) 2008-2011.

    PubMed

    Steppuhn, Henriette; Langen, Ute; Mueters, Stephan; Dahm, Stefan; Knopf, Hildtraud; Keil, Thomas; Scheidt-Nave, Christa

    2016-01-01

    In Germany, population-wide data on adherence to national asthma management guidelines are lacking, and performance measures (PM) for quality assurance in asthma care are systematically monitored for patients with German national asthma disease management program (DMP) enrollment only. We used national health survey data to assess variation in asthma care PM with respect to patient characteristics and care context, including DMP enrollment. Among adults 18-79 years with self-reported physician-diagnosed asthma in the past 12 months identified from a recent German National Health Interview Survey (GEDA 2010: N = 1096) and the German National Health interview and Examination Survey 2008-2011 (DEGS1: N = 333), variation in asthma care PM was analyzed using logistic regression analysis. Overall, 38.4% (95% confidence interval: 32.5-44.6%) of adults with asthma were on current inhaled corticosteroid therapy. Regarding non-drug asthma management, low coverage was observed for inhaler technique monitoring (35.2%; 31.2-39.3%) and for provision of an asthma management plan (27.3%; 24.2-30.7%), particularly among those with low education. Specific PM were more complete among persons with than without asthma DMP enrollment (adjusted odds ratios ranging up to 10.19; 5.23-19.86), even if asthma patients were regularly followed in a different care context. Guideline adherence appears to be suboptimal, particularly with respect to PM related to patient counseling. Barriers to the translation of recommendations into practice need to be identified and continuous monitoring of asthma care PM at the population level needs to be established.

  18. Prevalence Rates of Work Organization Characteristics Among Workers in the U.S.: Data From the 2010 National Health Interview Survey

    PubMed Central

    Alterman, Toni; Luckhaupt, Sara E.; Dahlhamer, James M.; Ward, Brian W.; Calvert, Geoffrey M.

    2015-01-01

    Background Surveillance is needed to capture work organization characteristics and to identify their trends. Methods Data from the 2010 National Health Interview Survey (NHIS) were used to calculate prevalence rates for four work organization characteristics (long work hours, non-standard work arrangements, temporary positions, and alternative shifts) overall, and by demographic characteristics, and industry and occupation of current/recent employment. Results Data were available for 27,157 adults, of which 65% were current/recent workers. Among adults who worked in the past 12 months, 18.7% worked 48 hr or more per week, 7.2% worked 60 hr or more per week, 18.7% had non-standard work arrangements, 7.2% were in temporary positions, and 28.7% worked an alternative shift. Conclusions Prevalence rates of work organization characteristics are provided. These national estimates can be used to help occupational health professionals and employers to identify emerging occupational safety and health risks, allow researchers to examine associations with health, and use the data for benchmarking. PMID:22911666

  19. Prevalence of dermatitis in the working population, United States, 2010 National Health Interview Survey.

    PubMed

    Luckhaupt, Sara E; Dahlhamer, James M; Ward, Brian W; Sussell, Aaron L; Sweeney, Marie H; Sestito, John P; Calvert, Geoffrey M

    2013-06-01

    Prevalence patterns of dermatitis among workers offer clues about risk factors and targets for prevention, but population-based estimates of the burden of dermatitis among US workers are lacking. Data from an occupational health supplement to the 2010 National Health Interview Survey (NHIS-OHS) were used to estimate the prevalence of dermatitis overall and by demographic characteristics and industry and occupation (I&O) of current/recent employment. Data were available for 27,157 adults, including 17,524 current/recent workers. The overall prevalence rate of dermatitis among current/recent workers was 9.8% (range among I&O groups: 5.5-15.4%), representing approximately 15.2 million workers with dermatitis. The highest prevalence rates were among I&O groups related to health care. Overall, 5.6% of dermatitis cases among workers (9.2% among healthcare workers) were attributed to work by health professionals. Dermatitis affected over 15 million US workers in 2010, and its prevalence varied by demographic characteristics and industry and occupation of employment. The prevalence rate of work-related dermatitis based on the NHIS-OHS was approximately 100-fold higher than incidence rates based on the Bureau of Labor Statistics' Survey of Occupational Illness and Injury. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.

  20. Comparison of Health and Health Risk Factors Between Lesbian, Gay, and Bisexual Adults and Heterosexual Adults in the United States: Results From the National Health Interview Survey.

    PubMed

    Gonzales, Gilbert; Przedworski, Julia; Henning-Smith, Carrie

    2016-09-01

    Previous studies identified disparities in health and health risk factors among lesbian, gay, and bisexual (LGB) adults, but prior investigations have been confined to samples not representative of the US adult population or have been limited in size or geographic scope. For the first time in its long history, the 2013 and 2014 National Health Interview Survey included a question on sexual orientation, providing health information on sexual minorities from one of the nation's leading health surveys. To compare health and health risk factors between LGB adults and heterosexual adults in the United States. Data from the nationally representative 2013 and 2014 National Health Interview Survey were used to compare health outcomes among lesbian (n = 525), gay (n = 624), and bisexual (n = 515) adults who were 18 years or older and their heterosexual peers (n = 67 150) using logistic regression. Self-rated health, functional status, chronic conditions, psychological distress, alcohol consumption, and cigarette use. The study cohort comprised 68 814 participants. Their mean (SD) age was 46.8 (11.8) years, and 51.8% (38 063 of 68 814) were female. After controlling for sociodemographic characteristics, gay men were more likely to report severe psychological distress (odds ratio [OR], 2.82; 95% CI, 1.55-5.14), heavy drinking (OR, 1.97; 95% CI, 1.08-3.58), and moderate smoking (OR, 1.98; 95% CI, 1.39-2.81) than heterosexual men; bisexual men were more likely to report severe psychological distress (OR, 4.70; 95% CI, 1.77-12.52), heavy drinking (OR, 3.15; 95% CI, 1.22-8.16), and heavy smoking (OR, 2.10; 95% CI, 1.08-4.10) than heterosexual men; lesbian women were more likely to report moderate psychological distress (OR, 1.34; 95% CI, 1.02-1.76), poor or fair health (OR, 1.91; 95% CI, 1.24-2.95), multiple chronic conditions (OR, 1.58; 95% CI, 1.12-2.22), heavy drinking (OR, 2.63; 95% CI, 1.54-4.50), and heavy smoking (OR, 2.29; 95% CI, 1.36-3.88) than

  1. [Health behavior change: motivational interviewing].

    PubMed

    Pócs, Dávid; Hamvai, Csaba; Kelemen, Oguz

    2017-08-01

    Public health data show that early mortality in Hungary could be prevented by smoking cessation, reduced alcohol consumption, regular exercise, healthy diet and increased adherence. Doctor-patient encounters often highlight these aspects of health behavior. There is evidence that health behavior change is driven by internal motivation rather than external influence. This finding has led to the concept of motivational interview, which is a person-centered, goal-oriented approach to counselling. The doctor asks targeted questions to elicit the patient's motivations, strengths, internal resources, and to focus the interview around these. The quality and quantity of the patient's change talk is related to better outcomes. In addition, the interview allows the patient to express ambivalent feelings and doubts about the change. The doctor should use various communication strategies to resolve this ambivalence. Furthermore, establishing a good doctor-patient relationship is the cornerstone of the motivational interview. An optimal relationship can evoke change talk and reduce the patient's resistance, which can also result in a better outcome. The goal of the motivational interview is to focus on the 'why' to change health behavior rather than the 'how', and to utilize internal motivation instead of persuasion. This is the reason why motivational interview has become a widely-accepted evidence based approach. Orv Hetil. 2017; 158(34): 1331-1337.

  2. Using motivational interviewing: through evidence-based health coaching.

    PubMed

    Huffman, Melinda

    2014-10-01

    To enhance compliance and achieve better outcomes, providers must actively engage their patients and caregivers in different ways than in the past. One strategy that has gained national attention is motivational interviewing through evidence-based health coaching. A closer look at this exciting new clinical skill reveals what it is, how it works, why it is so successful, and why our traditional patient approach has fallen short.

  3. Mortality experience of the 1986-2000 National Health Interview Survey Linked Mortality Files participants.

    PubMed

    Ingram, Deborah D; Lochner, Kimberly A; Cox, Christine S

    2008-10-01

    The National Center for Health Statistics (NCHS) has produced the 1986-2000 National Health Interview Survey (NHIS) Linked Mortality Files by linking eligible adults in the 1986-2000 NHIS cohorts through probabilistic record linkage to the National Death Index to obtain mortality follow-up through December 31, 2002. The resulting files contain more than 120,000 deaths and an average of 9 years of survival time. To assess how well mortality was ascertained in the linked mortality files, NCHS has conducted a comparison of the mortality experience of the 1986-2000 NHIS cohorts with that of the U.S. population. This report presents the results of this comparative mortality assessment. Methods The survival of each annual NHIS cohort was compared with that of the U.S. population during the same period. Cumulative survival probabilities for each annual NHIS cohort were derived using the Kaplan-Meier product limit method, and corresponding cumulative survival probabilities were computed for the U.S. population using information from annual U.S. life tables. The survival probabilities were calculated at various lengths of follow-up for each age-race-sex group of each NHIS cohort and for the U.S. population. Results As expected, mortality tended to be underestimated in the NHIS cohorts because the sample includes only civilian, noninstitutionalized persons, but this underestimation generally was not statistically significant. Statistically significant differences increased with length of follow-up, occurred more often for white females than for the other race-sex groups, and occurred more often in the oldest age groups. In general, the survival experience of the age-race-sex groups of each NHIS cohort corresponds quite closely to that of the U.S. population, providing support that the ascertainment of mortality through the probabilistic record linkage accurately reflects the mortality experience of the NHIS cohorts.

  4. Activity-Limiting Musculoskeletal Conditions in US Veterans Compared to Non-Veterans: Results from the 2013 National Health Interview Survey

    PubMed Central

    Hinojosa, Ramon

    2016-01-01

    Past military service is associated with health outcomes, both positive and negative. In this study we use the 2013 National Health Interview Survey to examine the constellation of conditions referred to as musculoskeletal disorders (MSDs) for Veterans and non-veterans with health conditions that limit their daily activities. Multivariate logistic regression analysis reveal that Veterans are more likely to report MSDs like neck and back problems, fracture bone and joint problems as an activity limiting problem compared to non-veterans. The relationship between age and reports of activity limiting MSDs is moderated by Veteran status. Veterans in this sample report more activity limiting MSDs at younger ages compared to non-veterans and fewer MSDs at older ages. This research contributes to our understanding of potentially limiting health conditions at earlier ages for Veterans. PMID:28005905

  5. Workplace Harassment and Morbidity Among US Adults: Results from the National Health Interview Survey.

    PubMed

    Khubchandani, Jagdish; Price, James H

    2015-06-01

    Most research on workplace harassment originates from European countries.Prevalence of workplace harassment and associated morbidity has not been well studied in the United States. The purpose of this study was to assess in a sample of US workers the prevalence of workplace harassment and the psychological and physical health consequences of workplace harassment. The 2010 National Health Interview Survey data were analyzed in 2014 for this study. We computed the prevalence of workplace harassment, assessed the demographic and background characteristics of victims of harassment, and tested the association between harassment and selected health risk factors by using logistic regression analysis. Statistical significance was established as p < 0.01. A total of 17,524 adults were included in our study (51.5% females and 74.9% Whites). A little <1 in 10 (8.1%) reported being harassed in the workplace in the past 12 months. The odds of harassment were significantly higher for females (OR 1.47, p < 0.001),multiracial individuals (OR 2.30, p < 0.001), and divorced or separated individuals (OR 1.88, p < 0.001). Victims of harassment were significantly more likely to: be obese, sleep less, and smoke more. In addition, harassment was associated with psychosocial distress, pain disorders, work loss, bed days, and worsening health of employees in the past 12 months. Analysis was stratified by gender and distinct health risk patterns for men and women victims were observed. Workplace harassment in the US is associated with significant health risk factors and morbidity. Workplace policies and protocols can play a significant role in reducing harassment and the associated negative health outcomes.

  6. Health Coaching: An Update on the National Consortium for Credentialing of Health & Wellness Coaches

    PubMed Central

    2015-01-01

    In September 2014, Global Advances in Health and Medicine editor Michele Mittelman, RN, MPH, interviewed four of the leaders in health and wellness coaching about trends in coaching and the progress of the National Consortium for Credentialing of Health & Wellness Coaches. Following are the transcripts of those interviews. Additionally, videos of the interviews are available at www.gahmj.com. PMID:25694854

  7. Food security among young adults with disabilities in the United States: Findings from the National Health Interview Survey.

    PubMed

    Brucker, Debra L

    2016-04-01

    Prior research has suggested that young adults with disabilities face economic, health and social disadvantage. Food security, an area of disadvantage that can influence overall health, has not been fully explored for this population. To examine levels of food security between young adults with and without disabilities, controlling for individual characteristics. Logistic regression analysis of a nationally representative sample of young adults (age 18-25) (n = 32,795) with and without disabilities, using pooled data form the 2011-2013 National Health Interview Survey. Young adults with disabilities have significantly higher odds (OR: 2.58, p < 0.001) of living in a household that is food insecure than young adults without disabilities, even when controlling for individual characteristics. Odds of living in a household that is food insecure are particularly high (OR: 5.35, p < 0.001) among young adults with high levels of psychological distress, controlling for other factors. Young adults with disabilities have increased odds of living in a household that is food insecure. This study has important policy and community program implications. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Hearing difficulty attributable to employment by industry and occupation: an analysis of the National Health Interview Survey--United States, 1997 to 2003.

    PubMed

    Tak, SangWoo; Calvert, Geoffrey M

    2008-01-01

    To estimate the national burden of hearing difficulty among workers in US industries and occupations. Data on 130,102 employed National Health Interview Survey respondents between the ages of 18 to 65 years who were interviewed between 1997 and 2003 were analyzed to estimate the population prevalence, adjusted prevalence ratios, and fractions of hearing difficulty attributable to employment. The estimated population prevalence of hearing difficulty was 11.4% (24% attributable to employment). The adjusted prevalence ratios of hearing difficulty were highest for railroads, mining, and primary metal manufacturing industry. Occupations with increased risk of hearing difficulty were mechanics/repairers, machine operators, and transportation equipment operators. Hearing difficulty was differentially distributed across various industries. In industries with high rates, employers and workers should take preventive action to reduce the risk of occupational hearing loss.

  9. Morbidity ranking of U.S. workers employed in 206 occupations: the National Health Interview Survey (NHIS) 1986-1994.

    PubMed

    Lee, David J; Fleming, Lora E; Gómez-Marín, Orlando; LeBlanc, William G; Arheart, Kristopher L; Caban, Alberto J; Christ, Sharon L; Chung-Bridges, Katherine; Pitman, Terry

    2006-02-01

    The objective of this study was to rank U.S. occupations by worker morbidity. From 1986 through 1994, morbidity information was collected on over 410,000 U.S. workers who participated in the National Health Interview Survey, an annual household survey representative of the U.S. civilian noninstitutionalized population. A multivariate adjusted logistic regression morbidity summary score was created for each worker group based on seven indicators: days of restricted activity, bedrest, and missed work in the previous 2 weeks; doctor visits and hospitalizations in the previous 12 months; reported health conditions; and health status. Worker groups reporting the greatest morbidity included social workers, inspectors, postal clerks, psychologists, and grinding machine operators; worker groups reporting the least morbidity included dentists, pilots, physicians, pharmacists, and dietitians. These findings aid in the identification of worker groups that require increased attention for morbidity research and prevention.

  10. The prevalence of selected potentially hazardous workplace exposures in the US: findings from the 2010 National Health Interview Survey.

    PubMed

    Calvert, Geoffrey M; Luckhaupt, Sara E; Sussell, Aaron; Dahlhamer, James M; Ward, Brian W

    2013-06-01

    Assess the national prevalence of current workplace exposure to potential skin hazards, secondhand smoke (SHS), and outdoor work among various industry and occupation groups. Also, assess the national prevalence of chronic workplace exposure to vapors, gas, dust, and fumes (VGDF) among these groups. Data were obtained from the 2010 National Health Interview Survey (NHIS). NHIS is a multistage probability sample survey of the civilian non-institutionalized population of the US. Prevalence rates and their variances were calculated using SUDAAN to account for the complex NHIS sample design. The data for 2010 were available for 17,524 adults who worked in the 12 months that preceded interview. The highest prevalence rates of hazardous workplace exposures were typically in agriculture, mining, and construction. The prevalence rate of frequent handling of or skin contact with chemicals, and of non-smokers frequently exposed to SHS at work was highest in mining and construction. Outdoor work was most common in agriculture (85%), construction (73%), and mining (65%). Finally, frequent occupational exposure to VGDF was most common among mining (67%), agriculture (53%), and construction workers (51%). We identified industries and occupations with the highest prevalence of potentially hazardous workplace exposures, and provided targets for investigation and intervention activities. Copyright © 2012 Wiley Periodicals, Inc.

  11. The Prevalence of Selected Potentially Hazardous Workplace Exposures in the US: Findings From the 2010 National Health Interview Survey

    PubMed Central

    Calvert, Geoffrey M.; Luckhaupt, Sara E.; Sussell, Aaron; Dahlhamer, James M.; Ward, Brian W.

    2015-01-01

    Objective Assess the national prevalence of current workplace exposure to potential skin hazards, secondhand smoke (SHS), and outdoor work among various industry and occupation groups. Also, assess the national prevalence of chronic workplace exposure to vapors, gas, dust, and fumes (VGDF) among these groups. Methods Data were obtained from the 2010 National Health Interview Survey (NHIS). NHIS is a multistage probability sample survey of the civilian non-institutionalized population of the US. Prevalence rates and their variances were calculated using SUDAAN to account for the complex NHIS sample design. Results The data for 2010 were available for 17,524 adults who worked in the 12 months that preceded interview. The highest prevalence rates of hazardous workplace exposures were typically in agriculture, mining, and construction. The prevalence rate of frequent handling of or skin contact with chemicals, and of non-smokers frequently exposed to SHS at work was highest in mining and construction. Outdoor work was most common in agriculture (85%), construction (73%), and mining (65%). Finally, frequent occupational exposure to VGDF was most common among mining (67%), agriculture (53%), and construction workers (51%). Conclusion We identified industries and occupations with the highest prevalence of potentially hazardous workplace exposures, and provided targets for investigation and intervention activities. PMID:22821700

  12. Linkage of the National Health Interview Survey to air quality data.

    PubMed

    Parker, Jennifer D; Kravets, Nataliya; Woodruff, Tracey J

    2008-02-01

    This report describes the linkage between the National Health Interview Survey (NHIS) and air monitoring data from the U.S. Environmental Protection Agency (EPA). There have been few linkages of these data sources, partly because of restrictions on releasing geographic detail from NHIS on public-use files in order to protect participant confidentiality. Pollution exposures for NHIS respondents were calculated by averaging the annual average exposure estimates from EPA air monitors both within 5, 10, 15, and 20 miles of the respondent's block-group location (which is available on restricted NHIS data files) and by county of residence. The 1987-2005 linked data files--referred to as NHIS-EPAAnnualAir--were used to describe the percentage of NHIS respondents linked and the median exposures by linkage method, survey year, and pollutant. Using the 2005 NHIS-EPAAnnualAir data file, the percentage linked and median exposure were described by respondent characteristics, linkage method, and pollutant. Many decisions were made to define pollution exposures for NHIS respondents, including monitor selection, location assignment for NHIS respondents, and geographic linkage criteria. Geographic linkage criteria for assigning area-level exposure estimates affected the percentage and composition of respondents included in the resulting linked sample. Median exposure estimates, however, were similar among geographic linkage methods. NHIS-EPAAnnualAir data files for 1985 through 2005 are currently available to users in the NCHS Research Data Center.

  13. Interrelationships of added sugars intake, socioeconomic status, and race/ethnicity in adults in the United States: National Health Interview Survey, 2005.

    PubMed

    Thompson, Frances E; McNeel, Timothy S; Dowling, Emily C; Midthune, Douglas; Morrissette, Meredith; Zeruto, Christopher A

    2009-08-01

    The consumption of added sugars (eg, white sugar, brown sugar, and high-fructose corn syrup) displaces nutrient-dense foods in the diet. The intake of added sugars in the United States is excessive. Little is known about the predictors of added sugar intake. To examine the independent relationships of socioeconomic status and race/ethnicity with added sugar intake, and to evaluate the consistency of relationships using a short instrument to those from a different survey using more precise dietary assessment. Cross-sectional, nationally representative, interviewer-administered survey. Adults (aged > or = 18 years) participating in the 2005 US National Health Interview Survey Cancer Control Supplement responding to four added sugars questions (n=28,948). The intake of added sugars was estimated using validated scoring algorithms. Multivariate analysis incorporating sample weights and design effects was conducted. Least squares means and confidence intervals, and significance tests using Wald F statistics are presented. Analyses were stratified by sex and controlled for potential confounders. The intake of added sugars was higher among men than women and inversely related to age, educational status, and family income. Asian Americans had the lowest intake and Hispanics the next lowest intake. Among men, African Americans had the highest intake, although whites and American Indians/Alaskan Natives also had high intakes. Among women, African Americans and American Indians/Alaskan Natives had the highest intakes. Intake of added sugars was inversely related to educational attainment in whites, African Americans, Hispanic men, and American Indians/Alaskan Native men, but was unrelated in Asian Americans. These findings were generally consistent with relationships in National Health and Nutrition Examination Survey 2003-2004 (using one or two 24-hour dietary recalls). Race/ethnicity, family income, and educational status are independently associated with intake of added

  14. Cost-related Nonadherence to Medication Treatment Plans: Native Hawaiian and Pacific Islander National Health Interview Survey, 2014.

    PubMed

    McElfish, Pearl A; Long, Christopher R; Payakachat, Nalin; Felix, Holly; Bursac, Zoran; Rowland, Brett; Hudson, Jonell S; Narcisse, Marie-Rachelle

    2018-04-01

    Adherence to medication treatment plans is important for chronic disease (CD) management. Cost-related nonadherence (CRN) puts patients at risk for complications. Native Hawaiians and Pacific Islanders (NHPI) suffer from high rates of CD and socioeconomic disparities that could increase CRN behaviors. Examine factors related to CRN to medication treatment plans within an understudied population. Using 2014 NHPI-National Health Interview Survey data, we examined CRN among a nationally representative sample of NHPI adults. Bonferroni-adjusted Wald test and multivariable logistic regression were performed to examine associations among financial burden-related factors, CD status, and CRN. Across CD status, NHPI engaged in CRN behaviors had, on an average, increased levels of perceived financial stress, financial insecurity with health care, and food insecurity compared with adults in the total NHPI population. Regression analysis indicated perceived financial stress [adjusted odds ratio (AOR)=1.16; 95% confidence intervals (CI), 1.10-1.22], financial insecurity with health care (AOR=1.96; 95% CI, 1.32-2.90), and food insecurity (AOR=1.30; 95% CI, 1.06-1.61) all increase the odds of CRN among those with CD. We also found significant associations between perceived financial stress (AOR=1.15; 95% CI, 1.09-1.20), financial insecurity with health care (AOR=1.59; 95% CI, 1.19-2.12), and food insecurity (AOR=1.31; 95% CI, 1.04-1.65) and request for lower cost medication. This study demonstrated health-related and non-health-related financial burdens can influence CRN behaviors. It is important for health care providers to collect and use data about the social determinants of health to better inform their conversations about medication adherence and prevent CRN.

  15. The health care provider's role and patient compliance to health promotion advice from the user's perspective: analysis of the 2006 National Health Interview Survey data.

    PubMed

    Ndetan, Harrison; Evans, Marion Willard; Bae, Sejong; Felini, Martha; Rupert, Ronald; Singh, Karan P

    2010-01-01

    The recommendations of health care providers have been shown to be a predictor of future healthy behaviors. However, patient adherence to these recommendations may differ based upon the type of health care professional providing the information. This study explored patient compliance in the United States over a 12-month period and contracted the patient response to recommendations given by chiropractors versus medical doctors. Multiple logistic regression models were used for analyses of data from the Sample Adult Core component of the 2006 National Health Interview Survey (n = 24 275). Analyses were performed separately for recommendation and compliance of weight loss, increase exercise, and diet change by health profession subtype (chiropractor and medical doctor). About 30.5% of the respondents reported receiving advice from their provider. Among these, 88.0% indicated they complied with the advice they received. Patients who were advised were more likely to comply (odds ratio [OR] [95% CI], 10.41[9.34-11.24]). Adjusting for seeing a physical therapist, age, and body mass index, chiropractors were less likely to advice patients compared to medical doctors (OR [95% CI], 0.38 [0.30-0.50]). In general, there was a 21% increased odds that patients who received and complied with health promotion advice from their health care provider would report an improved health status (OR [95% CI], 1.21 [1.10-1.33]) compared with those who did not comply or were not advised. Chiropractors in the United States give health promotion recommendation to their patients but are less likely to do so than general medical doctors. Patients tend to comply with health providers' recommendations and those who do report better health. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  16. Place of Birth and Sleep Duration: Analysis of the National Health Interview Survey (NHIS).

    PubMed

    Newsome, Valerie; Seixas, Azizi; Iwelunmor, Juliet; Zizi, Ferdinand; Kothare, Sanjeev; Jean-Louis, Girardin

    2017-07-07

    While sleep disturbance has been related to a number of negative health outcomes, few studies have examined the relationship between place of birth and sleep duration among individuals living in the US. Data for 416,152 adult participants in the 2000-2013 National Health Interview Survey (NHIS), who provided self-reported hours of sleep and place of birth were examined. Associations were explored between healthy sleep (7-8 h), referenced to unhealthy sleep (<7 or >8 h), and place of birth using multivariate logistic regression analysis. The mean age of the sample was 47.4 ± 0.03 years; 56% were female. Of the respondents, 61.5% reported experiencing healthy sleep, 81.5% reported being born in the US and 18.5% were foreign-born adults. Descriptive statistics revealed that Indian Subcontinent-born respondents (71.7%) were more likely to report healthy sleep compared to US-born respondents (OR = 1.53, 95% CI = 1.37-1.71, p < 0.001), whereas African-born respondents (43.5%) were least likely to report healthy sleep (OR = 0.78, 95% CI = 0.70-0.87, p < 0.001). These findings suggest that place of birth should be considered in the assessment of risk factors for unhealthy sleep.

  17. Eczema Is Associated with Childhood Speech Disorder: A Retrospective Analysis from the National Survey of Children's Health and the National Health Interview Survey.

    PubMed

    Strom, Mark A; Silverberg, Jonathan I

    2016-01-01

    To determine if eczema is associated with an increased risk of a speech disorder. We analyzed data on 354,416 children and adolescents from 19 US population-based cohorts: the 2003-2004 and 2007-2008 National Survey of Children's Health and 1997-2013 National Health Interview Survey, each prospective, questionnaire-based cohorts. In multivariate survey logistic regression models adjusting for sociodemographics and comorbid allergic disease, eczema was significantly associated with higher odds of speech disorder in 12 of 19 cohorts (P < .05). The pooled prevalence of speech disorder in children with eczema was 4.7% (95% CI 4.5%-5.0%) compared with 2.2% (95% CI 2.2%-2.3%) in children without eczema. In pooled multivariate analysis, eczema was associated with increased odds of speech disorder (aOR [95% CI] 1.81 [1.57-2.05], P < .001). In a single study assessing eczema severity, mild (1.36 [1.02-1.81], P = .03) and severe eczema (3.56 [1.70-7.48], P < .001) were associated with higher odds of speech disorder. History of eczema was associated with moderate (2.35 [1.34-4.10], P = .003) and severe (2.28 [1.11-4.72], P = .03) speech disorder. Finally, significant interactions were found, such that children with both eczema and attention deficit disorder with or without hyperactivity or sleep disturbance had vastly increased risk of speech disorders than either by itself. Pediatric eczema may be associated with increased risk of speech disorder. Further, prospective studies are needed to characterize the exact nature of this association. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Are Workplace Psychosocial Factors Associated With Work-Related Injury in the US Workforce?: National Health Interview Survey, 2010.

    PubMed

    Farnacio, Yvonne; Pratt, Michael E; Marshall, Elizabeth G; Graber, Judith M

    2017-10-01

    Psychosocial hazards in the workplace may adversely impact occupational and general health, including injury risk. Among 16,417 adult workers in the 2010 National Health Interview Survey Occupational Health Supplement, weighted prevalence estimates were calculated for work-related injuries (WRI) and any injuries. The association between injury and psychosocial occupational hazards (job insecurity, work-family imbalance, hostile work environment) was assessed adjusting for sociodemographic and occupational factors. WRI prevalence was 0.65% (n = 99); any injury prevalence was 2.46% (n = 427). In multivariable models job insecurity, work-family imbalance, and hostile work environment were each positively associated with WRI prevalence (odds ratio [OR]: 1.60, 95% CI: 0.97-2.65; OR: 1.69, 95% CI 0.96-2.89; and 2.01, 95% CI 0.94-4.33, respectively). Stressful working conditions may contribute to injuries. There is need for ongoing surveillance of occupational psychosocial risk factors and further study of their relationship with injury.

  19. Mental and Physical Health-Related Quality of Life among US Cancer Survivors: Population Estimates from the 2010 National Health Interview Survey

    PubMed Central

    Weaver, Kathryn E.; Forsythe, Laura P.; Reeve, Bryce B.; Alfano, Catherine M.; Rodriguez, Juan L.; Sabatino, Susan A.; Hawkins, Nikki A.; Rowland, Julia H.

    2012-01-01

    Background Despite extensive data on health-related quality of life (HRQOL) among cancer survivors, we do not yet have an estimate of the percent of survivors with poor mental and physical HRQOL compared to population norms. HRQOL population means for adult-onset cancer survivors of all ages and across the survivorship trajectory also have not been published. Methods Survivors (n=1,822) and adults with no cancer history (n=24,804) were identified from the 2010 National Health Interview Survey. The PROMIS® Global Health Scale was used to assess HRQOL. Poor HRQOL was defined as one standard deviation or more below the PROMIS population norm. Results Poor physical and mental HRQOL were reported by 24.5% and 10.1% of survivors, respectively, compared to 10.2% and 5.9% of adults without cancer (both p<.0001). This represents a population of approximately 3.3 million and 1.4 million US survivors with poor physical and mental HRQOL. Adjusted mean mental and physical HRQOL scores were similar for breast, prostate, and melanoma survivors compared to adults without cancer. Survivors of cervical, colorectal, hematologic, short-survival, and other cancers had worse physical HRQOL; cervical and short-survival cancer survivors reported worse mental HRQOL. Conclusion These data elucidate the burden of cancer diagnosis and treatment among US survivors and can be used to monitor the impact of national efforts to improve survivorship care and outcomes. Impact We present novel data on the number of US survivors with poor HRQOL. Interventions for high-risk groups that can be easily implemented are needed to improve survivor health at a population level. PMID:23112268

  20. Estimating Disability Prevalence Among Adults by Body Mass Index: 2003–2009 National Health Interview Survey

    PubMed Central

    Courtney-Long, Elizabeth; Campbell, Vincent A.; Wethington, Holly R.

    2012-01-01

    Introduction Obesity is associated with adverse health outcomes in people with and without disabilities; however, little is known about disability prevalence among people who are obese. The purpose of this study was to determine the prevalence and type of disability among obese adults in the United States. Methods We analyzed pooled data from sample adult modules of the 2003–2009 National Health Interview Survey (NHIS) to obtain national prevalence estimates of disability, disability type, and obesity by using 30 questions that screened for activity limitations, vision and hearing impairment, and cognitive, movement, and emotional difficulties. We stratified disability prevalence by category of body mass index (BMI, measured as kg/m2): underweight, less than 18.5; normal weight, 18.5 to 24.9; overweight, 25.0 to 29.9; and obese, 30.0 or higher. Results Among the 25.3% of adult men and 24.6% of women in our pooled sample who were obese, 35.2% and 46.9%, respectively, reported a disability. In contrast, 26.7% of men and 26.8% women of normal weight reported a disability. Disability was much higher among obese women than among obese men (46.9% vs 35.2%, P < .001). Movement difficulties were the most common disabilities among obese men and women, affecting 25.3% of men and 37.9% of women. Conclusion This research contributes to the literature on obesity by including disability as a demographic in characterizing people by body mass index. Because of the high prevalence of disability among those who are obese, public health programs should consider the needs of those with disabilities when designing obesity prevention and treatment programs. PMID:23270667

  1. A Summary of Expenditures and Sources of Payment for Personal Health Services from the National Medical Care Expenditure Survey: Data Preview 24. National Health Care Expenditure Study.

    ERIC Educational Resources Information Center

    Kasper, Judith A.; And Others

    The National Center for Health Services Research and Health Care Technology Assessment conducted a study to examine how Americans use health care services and to determine national patterns of health expenditures and insurance coverage. Data were obtained from the National Medical Care Expenditure Survey interviews conducted with 14,000 randomly…

  2. Exposure to Alcoholism in the Family: United States, 1988. Advance Data from Vital and Health Statistics of the National Center for Health Statistics. Number 205.

    ERIC Educational Resources Information Center

    Schoenborn, Charlotte A.

    This report is based on data from the 1988 National Health Interview Survey on Alcohol (NHIS-Alcohol), part of the ongoing National Health Interview Survey conducted by the National Center for Health Statistics. Interviews for the NHIS are conducted in person by staff of the United States Bureau of the Census. Information is collected on each…

  3. Association Between Vestibular Vertigo and Motor Vehicle Accidents: Data From the 2016 National Health Interview Survey.

    PubMed

    Wei, Eric X; Agrawal, Yuri

    2018-05-18

    Recent evidence has shown that individuals with vestibular impairment have higher rates of self-reported driving difficulty compared with individuals without vestibular impairment. However, it is unknown whether individuals with vestibular impairment are more likely to be involved in motor vehicle accidents. We used data from the 2016 National Health Interview Survey of U.S. adults to evaluate whether individuals with vestibular vertigo are more likely to experience motor vehicle accidents relative to individuals without vestibular vertigo. In multivariate analysis, vestibular vertigo was associated with an over threefold increased odds of motor vehicle accidents (odds ratio, 3.5; 95% confidence interval, 1.7-7.3). This study supports an assciation between vestibular dysfunction and driving impairment, and provides a relative risk of motor vehicle accidents associated with vestibular vertigo that clinicians may utilize in counseling patients on the potential safety hazards of driving.

  4. Reported Child Health Status, Hispanic Ethnicity, and Language of Interview: United States, 2011-2012.

    PubMed

    Pastor, Patricia N; Reuben, Cynthia A; Duran, Catherine R

    2015-09-10

    This report has three objectives: a) to describe the reported health status of four subgroups of school-age children: Hispanic children with a Spanish interview (Hispanic–Spanish interview), Hispanic children with an English interview (Hispanic–English interview), non-Hispanic black children, and non-Hispanic white children; b) to describe selected characteristics of children in the four subgroups; and c) to consider whether the characteristics of children account for subgroup variations in reported health status. Data from the 2011–2012 National Survey of Children’s Health were used to describe the health status of children aged 5–17 years using three categories: a) poor or fair, b) good, and c) very good or excellent health. The reported health status of children in the four subgroups was examined using multinomial logistic regression, controlling for the effects of demographic and socioeconomic characteristics and a measure of acculturation. Compared with children in the other subgroups, Hispanic–Spanish interview children were more likely to have reports of poor or fair health (10.6% compared with 1.8%–4.4%) and good health (39.7% compared with 7.7%– 14.4%). Controlling for demographic and socioeconomic characteristics and a measure of acculturation eliminated the subgroup differences in poor or fair health, but not good health. Even after adjustment for confounders, Hispanic–Spanish interview children more often were reported to have good health rather than very good or excellent health compared with children in the other subgroups. Worse reported health status of Hispanic–Spanish interview children, compared with children in other subgroups, could not be explained completely by the confounders in the analysis. Additional research is needed to determine whether the worse reported health status of Hispanic children with Spanish interviews reflects the actual health conditions of these children or difficulties in translating the health status

  5. Eczema Is Associated with Childhood Speech Disorder: A Retrospective Analysis from the National Survey of Children’s Health and the National Health Interview Survey

    PubMed Central

    Strom, Mark A.; Silverberg, Jonathan I.

    2016-01-01

    Objective To determine if eczema is associated with an increased risk of a speech disorder. Study design We analyzed data on 354 416 children and adolescents from 19 US population-based cohorts: the 2003–2004 and 2007–2008 National Survey of Children’s Health and 1997–2013 National Health Interview Survey, each prospective, questionnaire-based cohorts. Results In multivariate survey logistic regression models adjusting for sociodemographics and comorbid allergic disease, eczema was significantly associated with higher odds of speech disorder in 12 of 19 cohorts (P < .05). The pooled prevalence of speech disorder in children with eczema was 4.7% (95% CI 4.5%–5.0%) compared with 2.2% (95% CI 2.2%–2.3%) in children without eczema. In pooled multivariate analysis, eczema was associated with increased odds of speech disorder (aOR [95% CI] 1.81 [1.57–2.05], P < .001). In a single study assessing eczema severity, mild (1.36 [1.02–1.81], P = .03) and severe eczema (3.56 [1.70–7.48], P < .001) were associated with higher odds of speech disorder. History of eczema was associated with moderate (2.35 [1.34–4.10], P = .003) and severe (2.28 [1.11–4.72], P = .03) speech disorder. Finally, significant interactions were found, such that children with both eczema and attention deficit disorder with or without hyperactivity or sleep disturbance had vastly increased risk of speech disorders than either by itself. Conclusions Pediatric eczema may be associated with increased risk of speech disorder. Further, prospective studies are needed to characterize the exact nature of this association. PMID:26520915

  6. Prevalence and predictors of children's dietary supplement use: the 2007 National Health Interview Survey1234

    PubMed Central

    Dwyer, Johanna; Nahin, Richard L; Rogers, Gail T; Barnes, Patricia M; Jacques, Paul M; Sempos, Christopher T; Bailey, Regan

    2013-01-01

    Background: Little is known about the characteristics of US children who are dietary supplement users. Objective: We described the prevalence and predictors of and reasons for giving children dietary supplements. Design: The study included children <18 y of age who participated in the Complementary and Alternative Medicine supplement of the National Health Interview Survey of 2007 whose proxies provided complete information on child dietary supplement use. Results: A total of 37% of subjects used dietary supplements, 31% of subjects used multivitamin mineral (MVM) products exclusively, 4% of subjects used single vitamins or minerals solely or in combination with MVMs, and 2% of subjects used nonvitamin, nonmineral products either solely or in combination with other supplements. Users were more likely than nonusers to be Asian, white, or non-Hispanic; belong to families with higher parental education and income levels; reside in areas other than the South; be in good, very good, or excellent health; have private health insurance; and have a usual place at which they received conventional medical care. Children (3%) with the most disease burden and health care were more likely to use supplements than were healthier children. Supplements were given for the prevention or treatment of many illnesses and conditions. Neither the caregiver's reasons nor specific supplements used were consistently associated with particular conditions. Conclusions: The 37% of US children who used any type of dietary supplements differed from nonusers in family socioeconomic status and many other health-related characteristics. Users were given supplements to prevent or treat many illnesses and conditions for which there is only limited evidence of their efficacy. PMID:23576049

  7. Relationship Between Health Service Use and Health Information Technology Use Among Older Adults: Analysis of the US National Health Interview Survey

    PubMed Central

    2011-01-01

    Background Older adults are the most frequent and heaviest users of health services in the United States; however, previous research on older adults’ use of health information technology (HIT) has not examined the possible association of HIT use among older adults with their use of health services. Objective This study examined the relationship between US older adults’ use of health services and their use of the Internet for health-related activities, controlling for socioeconomic characteristics and aging-related limitations in sensory and cognitive function. It also examined gender differences in the pattern of association between the types of health services used and HIT use. Methods The data for this study were drawn from the 2009 US National Health Interview Survey (NHIS), which was the first nationally representative household survey to collect data on HIT (Internet) use. First, the rates of lifetime and 12-month HIT use among sample adults (n = 27,731) by age group (18-29 to 85 and over) were analyzed. Second, bivariate analysis of sociodemographic characteristics, health status, and health service use by HIT use status among those aged 65 or older (n = 5294) was conducted. Finally, multivariate binary logistic regression analysis was used to test the study hypotheses with 12-month HIT use as the dependent variable and 12-month health service uses among the age group 65 or older as possible correlates. Results The rates of HIT use were significantly lower among the age groups 65 or older compared with the younger age groups, although the age group 55 to 64 was not different from those younger. The rates of HIT use decreased from 32.2% in the age group 65 to 74 to 14.5% in the age group 75 to 84 and 4.9% in the 85 and older age group. For both genders, having seen or talked to a general practitioner increased the odds of HIT use. However, having seen or talked to a medical specialist, eye doctor, or physical therapist/occupational therapist (PT/OT) were

  8. Relationship between health service use and health information technology use among older adults: analysis of the US National Health Interview Survey.

    PubMed

    Choi, Namkee

    2011-04-20

    Older adults are the most frequent and heaviest users of health services in the United States; however, previous research on older adults' use of health information technology (HIT) has not examined the possible association of HIT use among older adults with their use of health services. This study examined the relationship between US older adults' use of health services and their use of the Internet for health-related activities, controlling for socioeconomic characteristics and aging-related limitations in sensory and cognitive function. It also examined gender differences in the pattern of association between the types of health services used and HIT use. The data for this study were drawn from the 2009 US National Health Interview Survey (NHIS), which was the first nationally representative household survey to collect data on HIT (Internet) use. First, the rates of lifetime and 12-month HIT use among sample adults (n = 27,731) by age group (18-29 to 85 and over) were analyzed. Second, bivariate analysis of sociodemographic characteristics, health status, and health service use by HIT use status among those aged 65 or older (n = 5294) was conducted. Finally, multivariate binary logistic regression analysis was used to test the study hypotheses with 12-month HIT use as the dependent variable and 12-month health service uses among the age group 65 or older as possible correlates. The rates of HIT use were significantly lower among the age groups 65 or older compared with the younger age groups, although the age group 55 to 64 was not different from those younger. The rates of HIT use decreased from 32.2% in the age group 65 to 74 to 14.5% in the age group 75 to 84 and 4.9% in the 85 and older age group. For both genders, having seen or talked to a general practitioner increased the odds of HIT use. However, having seen or talked to a medical specialist, eye doctor, or physical therapist/occupational therapist (PT/OT) were significantly associated with HIT use only

  9. National Health and Nutrition Examination Survey: National Youth Fitness Survey Estimation Procedures, 2012.

    PubMed

    Johnson, Clifford L; Dohrmann, Sylvia M; Kerckove, Van de; Diallo, Mamadou S; Clark, Jason; Mohadjer, Leyla K; Burt, Vicki L

    2014-11-01

    The National Health and Nutrition Examination Survey's (NHANES) National Youth Fitness Survey (NNYFS) was conducted in 2012 by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS). NNYFS collected data on physical activity and fitness levels to evaluate the health and fitness of children aged 3-15 in the United States. The survey comprised three levels of data collection: a household screening interview (or screener), an in-home personal interview, and a physical examination. The screener's primary objective was to determine whether any children in the household were eligible for the interview and examination. Eligibility was determined by preset selection probabilities for desired sex-age subdomains. After selection, the in-home personal interview collected demographic, health, physical activity, and nutrition information about the child as well as information about the household. The examination included physical measurements and fitness tests. This report provides background on the NNYFS program and summarizes the survey's sample design specifications. The report presents NNYFS estimation procedures, including the methods used to calculate survey weights for the full sample as well as a combined NHANES/NNYFS sample for 2012 (accessible only through the NCHS Research Data Center). The report also describes appropriate variance estimation methods. Documentation of the sample selection methods, survey content, data collection procedures, and methods to assess nonsampling errors are reported elsewhere. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  10. Standardized morbidity ratios of four chronic health conditions among World Trade Center responders: Comparison to the National Health Interview Survey.

    PubMed

    Kim, Hyun; Kriebel, David; Liu, Bian; Baron, Sherrry; Mongin, Steven; Baidwan, Navneet K; Moline, Jacqueline M

    2018-05-01

    We conducted external comparisons for the prevalence of asthma, hypertension, diabetes, and cancer among World Trade Center (WTC) general responders using the National Health Interview Survey (NHIS) as the reference, along with internal comparisons for the incidence of asthma. Standardized Morbidity Ratios (SMRs) were calculated for the prevalence of the health conditions, and risk ratios (RRs) for asthma incidence. Relative to the NHIS, asthma prevalence was in excess in responders over the study years (age-adjusted SMRs = 1.3-2.8). Hypertension prevalence began to exceed expected from 2006 while diabetes was lower than expected. An upward trend towards excess cancer prevalence was observed. Internal comparisons showed elevated asthma incidence among protective service and utility workers compared to construction workers; while those who arrived at the WTC site in the morning of 9/11 had a lower asthma risk than those who arrived in the afternoon. The use of NHIS data as a reference population demonstrates and reconfirms several important patterns of excess risk in WTC responders. External comparisons are an alternative for disaster cohorts without an established comparison group. © 2018 Wiley Periodicals, Inc.

  11. Comparing cancer screening estimates: Behavioral Risk Factor Surveillance System and National Health Interview Survey.

    PubMed

    Sauer, Ann Goding; Liu, Benmei; Siegel, Rebecca L; Jemal, Ahmedin; Fedewa, Stacey A

    2018-01-01

    Cancer screening prevalence from the Behavioral Risk Factor Surveillance System (BRFSS), designed to provide state-level estimates, and the National Health Interview Survey (NHIS), designed to provide national estimates, are used to measure progress in cancer control. A detailed description of the extent to which recent cancer screening estimates vary by key demographic characteristics has not been previously described. We examined national prevalence estimates for recommended breast, cervical, and colorectal cancer screening using data from the 2012 and 2014 BRFSS and the 2010 and 2013 NHIS. Treating the NHIS estimates as the reference, direct differences (DD) were calculated by subtracting NHIS estimates from BRFSS estimates. Relative differences were computed by dividing the DD by the NHIS estimates. Two-sample t-tests (2-tails), were performed to test for statistically significant differences. BRFSS screening estimates were higher than those from NHIS for breast (78.4% versus 72.5%; DD=5.9%, p<0.0001); colorectal (65.5% versus 57.6%; DD=7.9%, p<0.0001); and cervical (83.4% versus 81.8%; DD=1.6%, p<0.0001) cancers. DDs were generally higher in racial/ethnic minorities than whites, in the least educated than most educated persons, and in uninsured than insured persons. For example, the colorectal cancer screening DD for whites was 7.3% compared to ≥8.9% for blacks and Hispanics. Despite higher prevalence estimates in BRFSS compared to NHIS, each survey has a unique and important role in providing information to track cancer screening utilization among various populations. Awareness of these differences and their potential causes is important when comparing the surveys and determining the best application for each data source. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. The prevalence of short sleep duration by industry and occupation in the National Health Interview Survey.

    PubMed

    Luckhaupt, Sara E; Tak, SangWoo; Calvert, Geoffrey M

    2010-02-01

    To explore whether employment in industries likely to have non-standard work schedules (e.g., manufacturing and service) and occupations with long work-weeks (e.g., managerial/professional, sales, and transportation) is associated with an increased risk of short sleep duration. Cross-sectional epidemiologic survey. Household-based face-to-face survey of civilian, non-institutionalized US residents. Sample adults interviewed for the National Health Interview Survey in 1985 or 1990 (N = 74,734) or between 2004 and 2007 (N = 110,422). Most analyses focused on civilian employed workers interviewed between 2004 and 2007 (N = 66,099). N/A. The weighted prevalence of self-reported short sleep duration, defined as < or = 6 h per day, among civilian employed workers from 2004-2007 was 29.9%. Among industry categories, the prevalence of short sleep duration was greatest for management of companies and enterprises (40.5%), followed by transportation/warehousing (37.1%) and manufacturing (34.8%). Occupational categories with the highest prevalence included production occupations in the transportation/warehousing industry, and installation, maintenance, and repair occupations in both the transportation/warehousing industry and the manufacturing industry. In the combined sample from 1985 and 1990, 24.2% of workers reported short sleep duration; the prevalence of short sleep duration was significantly lower during this earlier time period compared to 2004-2007 for 7 of 8 industrial sectors. Self-reported short sleep duration among US workers varies by industry and occupation, and has increased over the past two decades. These findings suggest the need for further exploration of the relationship between work and sleep, and development of targeted interventions for specific industry/occupation groups.

  13. Arthritis Impact on U.S. Life Quality: Morbidity and Mortality Effects from National Health Interview Survey Data 1986-1988 And 1994 Using Qwbx1 Estimates of Well-Being

    ERIC Educational Resources Information Center

    Anderson, John P.; Kaplan, Robert M.; Ake, Christopher F.

    2004-01-01

    Objective: To estimate the impact of arthritis using a general health index and National Health Interview Survey (NHIS) data. Methods: Morbidity data came from NHIS Public Use data, from the years 19861988 and 1994. The data are 423 400 cases, representing 975 421 153 person-years. Quality of Well-being Scale (QWB) morbidity scores were imputed…

  14. The incidence of hypertension and its risk factors in the German adult population: results from the German National Health Interview and Examination Survey 1998 and the German Health Interview and Examination Survey for Adults 2008-2011.

    PubMed

    Diederichs, Claudia; Neuhauser, Hannelore

    2017-02-01

    To analyze incident hypertension and its risk factors based on 11.9 years follow-up of a recent National Examination Survey cohort in Germany. Out of 7124 participants of the German National Health Interview and Examination Survey 1998 (GNHIES98), 640 had died at follow-up 2008-2011 and 3045 were reexamined as part of the German Health Interview and Examination Survey for Adults 2008-2011 (DEGS1). Baseline and follow-up included standardized blood pressure (BP) measurements. Hypertension was defined as BP of at least 140/90 mmHg or intake of antihypertensive medication in participants with known hypertension. Out of 2231 GNHIES98-DEGS1 participants aged 18-79 years without hypertension in 1998, 26.2% developed hypertension within a mean of 11.9 (range 10.0-14.1) years (men 29.0%, women 23.4%). In univariate analysis, hypertension incidence was positively associated with age, BMI, initial BP levels, pulse pressure, and alcohol consumption. Comorbidities such as diabetes and hyperlipidemia increased the chance to develop hypertension. In the multivariate model, initial SBP and DBP levels had the strongest influence on the development of future hypertension (7% increase in men and 5% in women per mmHg SBP). The percentage of aware, treated, and controlled hypertensive patients were 75.8, 62.1, and 50.3% in men and 83.8, 73.3, and 59.0% in women. The high 11.9-year incidence in all age groups points to the lifelong potential for prevention of hypertension.

  15. Use of protective eyewear in U.S. adults: results from the 2002 national health interview survey.

    PubMed

    Forrest, Kimberly Y Z; Cali, Joseph M; Cavill, Wilma J

    2008-01-01

    Many eye injuries occur because of not using protective eyewear. This study analyzed the 2002 National Health Interview Survey data to examine the rate of using protective eyewear during activities that could cause eye injuries outside the workplace and the correlates of not using protective eyewear among U.S. adults. The rate of participation in activities that could cause eye injuries and the rate of protective eyewear use during these activities were estimated using sample weights to yield national estimates. A total of 30,894 individuals in the survey provided valid data for the current analysis, which revealed that 29.3% of the U.S. adults reported engaging in activities that could cause an eye injury and 32.1% of those used eye protection while doing such activities. Males were more likely to use eye protection than females (34.7% vs. 25.2%). The age group of 18-24 years was least likely to use eye protection (15.3%). Other factors associated with not using protective eyewear included being black or other races, non-retired individuals, and those from low-income families (all p-values < 0.05). Use of protective eyewear during activities that could cause eye injuries was relatively low in the US adult population. Certain groups were at a higher risk for not using eye protection, including females, young adults aged 18-24 years, black or other races, and individuals with a low socioeconomic status. To promote eye safety, health education programs should target these high-risk groups.

  16. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES).

    PubMed

    Kweon, Sanghui; Kim, Yuna; Jang, Myoung-jin; Kim, Yoonjung; Kim, Kirang; Choi, Sunhye; Chun, Chaemin; Khang, Young-Ho; Oh, Kyungwon

    2014-02-01

    The Korea National Health and Nutrition Examination Survey (KNHANES) is a national surveillance system that has been assessing the health and nutritional status of Koreans since 1998. Based on the National Health Promotion Act, the surveys have been conducted by the Korea Centers for Disease Control and Prevention (KCDC). This nationally representative cross-sectional survey includes approximately 10 000 individuals each year as a survey sample and collects information on socioeconomic status, health-related behaviours, quality of life, healthcare utilization, anthropometric measures, biochemical and clinical profiles for non-communicable diseases and dietary intakes with three component surveys: health interview, health examination and nutrition survey. The health interview and health examination are conducted by trained staff members, including physicians, medical technicians and health interviewers, at a mobile examination centre, and dieticians' visits to the homes of the study participants are followed up. KNHANES provides statistics for health-related policies in Korea, which also serve as the research infrastructure for studies on risk factors and diseases by supporting over 500 publications. KCDC has also supported researchers in Korea by providing annual workshops for data users. KCDC has published the Korea Health Statistics each year, and microdata are publicly available through the KNHANES website (http://knhanes.cdc.go.kr).

  17. Patterns of Health Information Technology Use according to Sexual Orientation among US Adults Aged 50 and Older: Findings from a National Representative Sample-National Health Interview Survey 2013-2014.

    PubMed

    Lee, Ji Hyun; Giovenco, Danielle; Operario, Don

    2017-08-01

    Health disparities among sexual minority adults ages 50 and older have been documented. Factors such as lifetime discrimination and internalized stigma may deter sexual minority individuals from seeking health services. Several studies suggest that health information technology may facilitate health education and outreach to populations whose health behaviors are affected by stigma such as older sexual minority people. This study examined the role of sexual minority identity as a factor that is associated with health information technology use. Data from the 2013-2014 National Health Interview Survey (NHIS) were analyzed. Multivariate logistic regressions were used to compare the odds of using technology as a resource for health information between sexual minority versus heterosexual US adults aged 50 and older. Adjusting for sociodemographic variables and health variables, sexual minority participants had increased odds of using computers to look up health information on the Internet (OR = 2.01, 95% CI 1.53-2.64), using computers to fill a prescription (OR = 1.97, 95% CI 1.36-2.85), and using computers to communicate with health-care provider by e-mail (OR = 2.13, 95% CI 1.55-2.92), compared with heterosexuals. Findings reveal greater use of health information technology among older sexual minority adults when compared to their heterosexual counterparts. While sensitive, competent providers and culturally appropriate prevention services are essential to meeting the needs of aging sexual minority populations, health information technology use may be an innovative means of reducing disparities in information access as structural changes are implemented.

  18. Acute and chronic disability among U.S. farmers and pesticide applicators: the National Health Interview Survey (NHIS).

    PubMed

    Gómez-Marín, O; Fleming, L E; Lee, D J; LeBlanc, W; Zheng, D; Ma, F; Jané, D; Pitman, T; Caban, A

    2004-11-01

    The National Health Interview Survey (NHIS) is a multipurpose household survey of the U.S. civilian non-institutionalized population conducted annually since 1957. From 1986 to 1994, over 450,000 U.S. workers, age 18 years and older, participated in a probability sampling of the entire non-institutionalized U.S. population; variables collected included a range of measures of acute and chronic disability. The objective of the present study was to assess predictors of health status, and acute and chronic disability for farmers and pesticide applicators (pesticide-exposed workers) compared to all other U.S. workers using the 1986-1994 NHIS. After adjustment for sample weights and design effects using SUDAAN, several measures of acute and chronic disability and health status were modeled with multiple logistic regression. Farmers (n = 9576) were significantly older compared to all other U.S. workers (n = 453,219) and pesticide applicators (n = 180). Farmers and pesticide applicators had a higher proportion of males, whites, and Hispanics and were less educated. After adjusting for age, gender, race-ethnicity, and education, compared to all other workers, farmers were significantly less likely to report acute and chronic disability and health conditions, while pesticide applicators were more likely to report chronic disability, health conditions, and poor health. Given the cross-sectional nature of the data and the significant job demands of farming, both leading to a relative healthy worker effect, the present results indicate that at any point in time, farmers report less acute and chronic disability, compared to other U.S. workers, whereas pesticide applicators report similar or poorer health.

  19. Life years lost and lifetime health care expenditures associated with diabetes in the U.S., National Health Interview Survey, 1997-2000.

    PubMed

    Leung, Man-Yee Mallory; Pollack, Lisa M; Colditz, Graham A; Chang, Su-Hsin

    2015-03-01

    This study analyzed the lifetime health care expenditures and life years lost associated with diabetes in the U.S. Data from the National Health Interview Survey (NHIS), the Medical Expenditure Panel Survey from 1997 to 2000, and the NHIS Linked Mortality Public-use Files with a mortality follow-up to 2006 were used to estimate age-, race-, sex-, and BMI-specific risk of diabetes, mortality, and annual health care expenditures for both patients with diabetes and those without diabetes. A Markov model populated by the risk and cost estimates was used to compute life years and total lifetime health care expenditures by age, race, sex, and BMI classifications for patients with diabetes and without diabetes. Predicted life expectancy for patients with diabetes and without diabetes demonstrated an inverted U shape across most BMI classifications, with highest life expectancy being for the overweight. Lifetime health care expenditures were higher for whites than blacks and for females than males. Using U.S. adults aged 50 years as an example, we found that diabetic white females with a BMI >40 kg/m(2) had 17.9 remaining life years and lifetime health expenditures of $185,609, whereas diabetic white females with normal weight had 22.2 remaining life years and lifetime health expenditures of $183,704. Our results show that diabetes is associated with large decreases in life expectancy and large increases in lifetime health care expenditures. In addition to decreasing life expectancy by 3.3 to 18.7 years, diabetes increased lifetime health care expenditures by $8,946 to $159,380 depending on age-race-sex-BMI classification groups. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  20. [Social differences and indicators of perceived health, chronic diseases, disability and life style in the 1994. ISTAT national health interview survey].

    PubMed

    Vannoni, F; Burgio, A; Quattrociocchi, L; Costa, G; Faggiano, F

    1999-01-01

    In this paper social differences in health, analysed by different dimensions (perceived health, chronic diseases, functional deficits and disability) and social differences in lifestyle, in particular smoking habit and use of health services for the prevention of some female tumours, are described. The study is based on the data collected in the National Interview Survey on Health Status and Use of Health Care Services, conducted by ISTAT in the 1994. The analysis has been performed separately for males and females, computing Prevalence Rate Ratios (PRR) standardized by age. Educational level and social class, based on Schizzerotto's classification, have been used as determinants of differences in health and lifestyle. Unfavourable perception of health status and most of chronic diseases, referred as diagnosed by a doctor, show an increasing prevalence with decreasing educational level. Less striking differences are observed in the occurrence of injuries and in the restriction of daily life activities caused by diseases. A lower educational level corresponds to a regular increase in the proportion of disabled subjects. Females show higher differences than males in overweight and underweight prevalences in favour of more educated. Smoking habit shows an inverse correlation with education in males and a direct correlation in females, while attempts to quit smoking are more common among more educated individuals. Among women, the tendency to use screening tests for the prevention of some tumours is directly proportional to the educational level. Similar findings were obtained using the social class, with small bourgeoisie and working class showing similar excess risks, compared to bourgeoisie. This study found significant social inequalities in health status and in lifestyle in Italian population in 1994. The discussion argues that in absence of preventive interventions on disadvantaged groups of the population an increase of social differences in health is

  1. Association between workplace psychosocial factors and mental health in Black, Hispanic, and White women: Cross-sectional findings from the National Health Interview Survey.

    PubMed

    Mutambudzi, Miriam

    2017-01-01

    Research evaluating the relation of workplace psychosocial factors to mental health among U.S. women of different racial/ethnic backgrounds is limited. This study investigated the relationship between work-related psychosocial factors and mental health among non-Hispanic Black, Hispanic, and non-Hispanic White women using data from the 2010 National Health Interview Survey. Independent variables of interest included job insecurity, workplace harassment, and work-family conflict (WFC). Multiple Poisson regression models were used to examine the associations between the outcome and independent variables. The prevalence of unfavorable mental health was highest among non-Hispanic Black women (36%) compared to Hispanic (34%) and non-Hispanic White (30%) women. A higher proportion of non-Hispanic Black women reported WFC compared to Hispanics and non-Hispanic Whites (χ 2 = 15.50, p < .01), while more Hispanics reported job insecurity (χ 2 = 116.81, p < .01). Prevalence of workplace harassment did not differ significantly by race/ethnicity. Odds of unfavorable mental health were significantly higher for women reporting psychosocial work factors. Unexpectedly, a greater association between psychosocial work factors and unfavorable mental health was observed among non-Hispanic White women compared to non-White women; however, caution should be taken in interpreting these cross-sectional results. Future studies should investigate temporal associations and additional psychosocial variables that were not available for use in the current study.

  2. 75 FR 69681 - Proposed Collection; Comment Request; California Health Interview Survey Cancer Control Module...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ... State. The CHIS sample is designed to provide statistically reliable estimates statewide, for California... activity, obesity, and human papillomavirus. Additionally, CHIS is designed to be comparable to the National Health Interview Survey (NHIS) data in order to conduct comparative analyses. CHIS provides...

  3. Walking for Transportation and Leisure Among U.S. Adults--National Health Interview Survey 2010.

    PubMed

    Paul, Prabasaj; Carlson, Susan A; Carroll, Dianna D; Berrigan, David; Fulton, Janet E

    2015-06-16

    Walking, the most commonly reported physical activity among U.S. adults, is undertaken in various domains, including transportation and leisure. This study examined prevalence, bout length, and mean amount of walking in the last week for transportation and leisure, by selected characteristics. Self-reported data from the 2010 National Health Interview Survey (N = 24,017) were analyzed. Prevalence of transportation walking was 29.4% (95% CI: 28.6%-30.3%) and of leisure walking was 50.0% (95% CI: 49.1%-51.0%). Prevalence of transportation walking was higher among men; prevalence of leisure walking was higher among women. Most (52.4%) transportation walking bouts were 10 to 15 minutes; leisure walking bouts were distributed more evenly (28.0%, 10-15 minutes; 17.1%, 41-60 minutes). Mean time spent in transportation walking was higher among men, decreased with increasing BMI, and varied by race/ethnicity and region of residence. Mean time spent leisure walking increased with increasing age and with decreasing BMI. Demographic correlates and patterns of walking differ by domain. Interventions focusing on either leisure or transportation walking should consider correlates for the specific walking domain. Assessing prevalence, bout length, and mean time of walking for transportation and leisure separately allows for more comprehensive surveillance of walking.

  4. Innovation in qualitative interviews: "Sharing Circles" in a First Nations community.

    PubMed

    Rothe, J P; Ozegovic, D; Carroll, L J

    2009-10-01

    There is growing recognition that different research approaches are necessary to understand the complex interaction between individual and social processes that contribute to risk-taking and injuries. Therefore, qualitative studies have an important role in injury prevention research. This article describes qualitative research in general and outlines some of the ways qualitative research can add to our understanding of injury. It also describes the role, format and methods of interviews (person-to-person and focus groups) commonly performed in qualitative studies, and proposes a novel approach to interviewing that has special relevance and value in injury research with indigenous populations. This methodology adapts focus group methods to be consistent with the goals and procedures of the traditional First Nations communities' Sharing Circles. This adaptation provides a culturally appropriate and sensitive method of developing a deep and broad understanding of indigenous participants' verbal descriptions of their feelings, their experiences and their modes of reasoning. After detailing of this adaptation of the Sharing Circle as a vibrant and vital interview and analysis method, the use of Sharing Circle interview methodology will be illustrated in a study investigating how an Alberta First Nations community experiences and deals with disproportionate levels of injuries arising from impaired driving, outlining important findings uncovered using this novel interviewing method. These findings have been informative to First Nations communities themselves, have informed policy makers provincially and nationally, and have instigated culturally appropriate intervention techniques for Canadian First Nations communities.

  5. Life Years Lost and Lifetime Health Care Expenditures Associated With Diabetes in the U.S., National Health Interview Survey, 1997–2000

    PubMed Central

    Leung, Man-Yee Mallory; Pollack, Lisa M.; Colditz, Graham A.

    2015-01-01

    OBJECTIVE This study analyzed the lifetime health care expenditures and life years lost associated with diabetes in the U.S. RESEARCH DESIGN AND METHODS Data from the National Health Interview Survey (NHIS), the Medical Expenditure Panel Survey from 1997 to 2000, and the NHIS Linked Mortality Public-use Files with a mortality follow-up to 2006 were used to estimate age-, race-, sex-, and BMI-specific risk of diabetes, mortality, and annual health care expenditures for both patients with diabetes and those without diabetes. A Markov model populated by the risk and cost estimates was used to compute life years and total lifetime health care expenditures by age, race, sex, and BMI classifications for patients with diabetes and without diabetes. RESULTS Predicted life expectancy for patients with diabetes and without diabetes demonstrated an inverted U shape across most BMI classifications, with highest life expectancy being for the overweight. Lifetime health care expenditures were higher for whites than blacks and for females than males. Using U.S. adults aged 50 years as an example, we found that diabetic white females with a BMI >40 kg/m2 had 17.9 remaining life years and lifetime health expenditures of $185,609, whereas diabetic white females with normal weight had 22.2 remaining life years and lifetime health expenditures of $183,704. CONCLUSIONS Our results show that diabetes is associated with large decreases in life expectancy and large increases in lifetime health care expenditures. In addition to decreasing life expectancy by 3.3 to 18.7 years, diabetes increased lifetime health care expenditures by $8,946 to $159,380 depending on age-race-sex-BMI classification groups. PMID:25552420

  6. Social Determinants of Health, Cost-related Nonadherence, and Cost-reducing Behaviors Among Adults With Diabetes: Findings From the National Health Interview Survey.

    PubMed

    Patel, Minal R; Piette, John D; Resnicow, Kenneth; Kowalski-Dobson, Theresa; Heisler, Michele

    2016-08-01

    Cost-related nonadherence (CRN) is prevalent among individuals with diabetes and can have significant negative health consequences. We examined health-related and non-health-related pressures and the use of cost-reducing strategies among the US adult population with and without diabetes that may impact CRN. Data from the 2013 wave of National Health Interview Survey (n=34,557) were used to identify the independent impact of perceived financial stress, financial insecurity with health care, food insecurity, and cost-reducing strategies on CRN. Overall, 11% (n=4158) of adults reported diabetes; 14% with diabetes reported CRN, compared with 7% without diabetes. Greater perceived financial stress [prevalence ratio (PR)=1.07; 95% confidence interval (CI), 1.05-1.09], financial insecurity with health care (PR=1.6; 95% CI, 1.5-1.67), and food insecurity (PR=1.30; 95% CI, 1.2-1.4) were all associated with a greater likelihood of CRN. Asking the doctor for a lower cost medication was associated with a lower likelihood of CRN (PR=0.2; 95% CI, 0.2-0.3), and 27% with CRN reported this. Other cost-reducing behavioral strategies (using alternative therapies, buying prescriptions overseas) were associated with a greater likelihood of CRN. Half of the adults with diabetes perceived financial stress, and one fifth reported financial insecurity with health care and food insecurity. Talking to a health care provider about low-cost options may be protective against CRN in some situations. Improving screening and communication to identify CRN and increase transparency of low-cost options patients are pursuing may help safeguard from the health consequences of cutting back on treatment.

  7. The Health of Children--1970: Selected Data From the National Center for Health Statistics.

    ERIC Educational Resources Information Center

    National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.

    In this booklet, charts and graphs present data from four divisions of the National Center for Health Statistics. The divisions represented are those concerned with vital statistics (births, deaths, fetal deaths, marriages and divorces); health interview statistics (information on health and demographic factors related to illness); health…

  8. Use of complementary and alternative medicine during pregnancy and the postpartum period: an analysis of the National Health Interview Survey.

    PubMed

    Birdee, Gurjeet S; Kemper, Kathi J; Rothman, Russell; Gardiner, Paula

    2014-10-01

    Complementary and alternative medicine (CAM) is commonly used among women, but few national data exist regarding CAM use during pregnancy or the postnatal period. Data from the 2007 National Health Interview Survey were analyzed for women ages between the ages of 18 and 49 years who were pregnant or had children less than 1 year old. CAM use was identified based on standard definitions of CAM from the National Institutes of Health's National Center for Complementary and Alternative Medicine. CAM use among women who were pregnant or with a child less than 1 year was compared with the other similarly aged female responders. CAM use was examined among these women stratified by sociodemographics, health conditions, and conventional medicine use through bivariable and multivariable logistic regression models. Among pregnant and postpartum women from the ages of 19 to 49 years in the United States, 37% of pregnant women and 28% of postpartum women reported using CAM in the last 12 months compared with 40% of nonpregnant/non-postpartum women. Mind-body practices were the most common CAM modality reported, with one out of four women reporting use. Biological therapies, excluding vitamins and minerals, during the postpartum period were used by only 8% of women. Using multivariable regression modeling, we report no significant difference in CAM use among pregnant compared with non-pregnant women (adjusted odds ratio [AOR], 0.88; [95% confidence interval 0.65-1.20]), but lower CAM use among postpartum women compared with non-pregnant women (AOR 0.67; [0.52-0.88]), while adjusting for sociodemographics. CAM use among pregnancy similar to women who are not pregnant, while postpartum CAM use decreases. Further evaluation of CAM therapies among pregnant and postpartum women is necessary to determine the costs and benefits of integrative CAM therapies in conventional care.

  9. Awareness of cancer susceptibility genetic testing: the 2000, 2005, and 2010 National Health Interview Surveys.

    PubMed

    Mai, Phuong L; Vadaparampil, Susan Thomas; Breen, Nancy; McNeel, Timothy S; Wideroff, Louise; Graubard, Barry I

    2014-05-01

    Genetic testing for several cancer susceptibility syndromes is clinically available; however, existing data suggest limited population awareness of such tests. To examine awareness regarding cancer genetic testing in the U.S. population aged ≥25 years in the 2000, 2005, and 2010 National Health Interview Surveys. The weighted percentages of respondents aware of cancer genetic tests, and percent changes from 2000-2005 and 2005-2010, overall and by demographic, family history, and healthcare factors were calculated. Interactions were used to evaluate the patterns of change in awareness between 2005 and 2010 among subgroups within each factor. To evaluate associations with awareness in 2005 and 2010, percentages were adjusted for covariates using multiple logistic regression. The analysis was performed in 2012. Awareness decreased from 44.4% to 41.5% (p<0.001) between 2000 and 2005, and increased to 47.0% (p<0.001) in 2010. Awareness increased between 2005 and 2010 in most subgroups, particularly among individuals in the South (pinteraction=0.03) or with a usual place of care (pinteraction=0.01). In 2005 and 2010, awareness was positively associated with personal or family cancer history and high perceived cancer risk, and inversely associated with racial/ethnic minorities, age 25-39 or ≥60 years, male gender, lower education and income levels, public or no health insurance, and no provider contact in 12 months. Despite improvement from 2005 to 2010, ≤50% of the U.S. adult population was aware of cancer genetic testing in 2010. Notably, disparities persist for racial/ethnic minorities and individuals with limited health care access or income. Published by Elsevier Inc.

  10. Walking for Transportation or Leisure Among U.S. Women and Men - National Health Interview Survey, 2005-2015.

    PubMed

    Ussery, Emily N; Carlson, Susan A; Whitfield, Geoffrey P; Watson, Kathleen B; Berrigan, David; Fulton, Janet E

    2017-06-30

    Physical activity confers considerable health benefits, but only half of U.S. adults report participating in levels of aerobic physical activity consistent with guidelines (1,2). Step It Up! The Surgeon General's Call to Action to Promote Walking and Walkable Communities identified walking as an important public health strategy to increase physical activity levels (3). A previous report showed that the self-reported prevalence of walking for transportation or leisure increased by 6 percentage points from 2005 to 2010 (4), but it is unknown whether this increase has been sustained. CDC analyzed National Health Interview Survey (NHIS) data from 2005 (26,551 respondents), 2010 (23,313), and 2015 (28,877) to evaluate trends in the age-adjusted prevalence of self-reported walking among adults aged ≥18 years. The prevalence of walking increased steadily among women, from 57.3% in 2005, to 62.5% in 2010, and to 65.1% in 2015 (significant linear trend). Among men, a significant linear increase in reported walking was observed, from 54.3% in 2005, to 61.8% in 2010, and to 62.8% in 2015, although the increase stalled between 2010 and 2015 (significant linear and quadratic trends). Community design policies and practices that encourage pedestrian activity and programs tailored to the needs of specific population subgroups remain important strategies for promoting walking (3).

  11. Changes among US Cancer Survivors: Comparing Demographic, Diagnostic, and Health Care Findings from the 1992 and 2010 National Health Interview Surveys.

    PubMed

    Buchanan, Natasha D; King, Jessica B; Rodriguez, Juan L; White, Arica; Trivers, Katrina F; Forsythe, Laura P; Kent, Erin E; Rowland, Julia H; Sabatino, Susan A

    2013-01-01

    Background. Differences in healthcare and cancer treatment for cancer survivors in the United States (US) have not been routinely examined in nationally representative samples or studied before and after important Institute of Medicine (IOM) recommendations calling for higher quality care provision and attention to comprehensive cancer care for cancer survivors. Methods. To assess differences between survivor characteristics in 1992 and 2010, we conducted descriptive analyses of 1992 and 2010 National Health Interview Survey (NHIS) data. Our study sample consisted of 1018 self-reported cancer survivors from the 1992 NHIS and 1718 self-reported cancer survivors from the 2010 NHIS who completed the Cancer Control (CCS) and Cancer Epidemiology (CES) Supplements. Results. The prevalence of reported survivors increased from 1992 to 2010 (4.2% versus 6.3%). From 1992 to 2010, there was an increase in long-term cancer survivors and a drop in multiple malignancies, and surgery remained the most widely used treatment. Significantly fewer survivors (<10 years after diagnosis) were denied insurance coverage. Survivors continue to report low participation in counseling or support groups. Conclusions. As the prevalence of cancer survivors continues to grow, monitoring differences in survivor characteristics can be useful in evaluating the effects of policy recommendations and the quality of clinical care.

  12. Psychological Distress and Hypertension: Results from the National Health Interview Survey for 2004–2013

    PubMed Central

    Ojike, Nwakile; Sowers, James R.; Seixas, Azizi; Ravenell, Joseph; Rodriguez-Figueroa, G.; Awadallah, M.; Zizi, F.; Jean-Louis, Girardin; Ogedegbe, Olugbenga; McFarlane, Samy I.

    2016-01-01

    Background/Aims Psychological conditions are increasingly linked with cardiovascular disorders. We aimed to examine the association between psychological distress and hypertension. Methods We used data from the National Health Interview Survey for 2004-2013. Hypertension was self-reported and the 6-item Kessler Psychological Distress Scale was used to assess psychological distress (a score ≥13 indicated distress). We used a logistic regression model to test the assumption that hypertension was associated with psychological distress. Results Among the study participants completing the survey (n = 288,784), 51% were female; the overall mean age (±SEM) was 35.3 ± 0.02 years and the mean body mass index was 27.5 ± 0.01. In the entire sample, the prevalence of psychological distress was 3.2%. The adjusted odds of reporting hypertension in psychologically distressed individuals was 1.53 (95% CI = 1.31-1.80, p = 0.01). Conclusion The findings suggest that psychological distress is associated with higher odds of hypertension after adjusting for other risk factors for high blood pressure. Further studies are needed to confirm these findings and to elucidate the mechanisms by which stress increases hypertension risk. PMID:27275156

  13. Mental health professionals' perspectives of telemental health with remote and rural First Nations communities.

    PubMed

    Gibson, Kerri; O'Donnell, Susan; Coulson, Heather; Kakepetum-Schultz, Tina

    2011-01-01

    We conducted an online survey and interviews amongst mental health workers in Canada who reported experience in working with rural and remote First Nations (although not necessarily telemental health). Sixty-three respondents (of the 164) to the online survey reported experience in working with clients in remote and rural First Nations. Only 16 of the online survey respondents with remote and rural First Nations experience reported having received training in videoconferencing use. When asked how frequently they used videoconferencing with clients, 51% reported never using it, 19% used it once every few months and 10% reported using it a few times a month. Approximately 50% of participants reported finding it useful. Approximately 38% found the technology easy or very easy to use, and 15% found it very difficult. Individual in-depth interviews were also conducted with professionals who had First Nations telemental health experience specifically (n = 5). A quantitative data analysis was used to explore their perceptions of usefulness and ease of use of telemental health, as well as the relationships among these constructs. Advantages, disadvantages and challenges in using the technology were identified from the qualitative data. Promising ways forward include incorporating traditional practices and the Seven Teachings into telemental health services.

  14. Vestibular vertigo and comorbid cognitive and psychiatric impairment: the 2008 National Health Interview Survey.

    PubMed

    Bigelow, Robin T; Semenov, Yevgeniy R; du Lac, Sascha; Hoffman, Howard J; Agrawal, Yuri

    2016-04-01

    Patients with vestibular disease have been observed to have concomitant cognitive and psychiatric dysfunction. We evaluated the association between vestibular vertigo, cognitive impairment and psychiatric conditions in a nationally representative sample of US adults. We performed a cross-sectional analysis using the 2008 National Health Interview Survey (NHIS), which included a Balance and Dizziness Supplement, and questions about cognitive function and psychiatric comorbidity. We evaluated the association between vestibular vertigo, cognitive impairment (memory loss, difficulty concentrating, confusion) and psychiatric diagnoses (depression, anxiety and panic disorder). We observed an 8.4% 1-year prevalence of vestibular vertigo among US adults. In adjusted analyses, individuals with vestibular vertigo had an eightfold increased odds of 'serious difficulty concentrating or remembering' (OR 8.3, 95% CI 4.8 to 14.6) and a fourfold increased odds of activity limitation due to difficulty remembering or confusion (OR 3.9, 95% CI 3.1 to 5.0) relative to the rest of the US adults. Individuals with vestibular vertigo also had a threefold increased odds of depression (OR 3.4, 95% CI 2.9 to 3.9), anxiety (OR 3.2, 95% CI 2.8 to 3.6) and panic disorder (OR 3.4, 95% CI 2.9 to 4.0). Our findings indicate that vestibular impairment is associated with increased risk of cognitive and psychiatric comorbidity. The vestibular system is anatomically connected with widespread regions of the cerebral cortex, hippocampus and amygdala. Loss of vestibular inputs may lead to impairment of these cognitive and affective circuits. Further longitudinal research is required to determine if these associations are causal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Prevalence and etiologies of adult communication disabilities in the United States: Results from the 2012 National Health Interview Survey.

    PubMed

    Morris, Megan A; Meier, Sarah K; Griffin, Joan M; Branda, Megan E; Phelan, Sean M

    2016-01-01

    Communication disabilities, including speech, language and voice disabilities, can significantly impact a person's quality of life, employment and health status. Despite this, little is known about the prevalence and etiology of communication disabilities in the general adult population. To assess the prevalence and etiology of communication disabilities in a nationally representative adult sample. We conducted a cross-sectional study and analyzed the responses of non-institutionalized adults to the Sample Adult Core questionnaire within the 2012 National Health Interview Survey. We used respondents' self-report of having a speech, language or voice disability within the past year and receiving a diagnosis for one of these communication disabilities, as well as the etiology of their communication disability. We additionally examined the responses by subgroups, including sex, age, race and ethnicity, and geographical area. In 2012 approximately 10% of the US adult population reported a communication disability, while only 2% of adults reported receiving a diagnosis. The rates of speech, language and voice disabilities and diagnoses varied across gender, race/ethnicity and geographic groups. The most common response for the etiology of a communication disability was "something else." Improved understanding of population prevalence and etiologies of communication disabilities will assist in appropriately directing rehabilitation and medical services; potentially reducing the burden of communication disabilities. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. 76 FR 2398 - Submission for OMB Review; Comment Request; California Health Interview Survey Cancer Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-13

    ... designed to provide statistically reliable estimates statewide, for California counties, and for California... papillomavirus. Additionally, CHIS is designed to be comparable to the National Health Interview Survey (NHIS) data in order to conduct comparative analyses. CHIS provides enhanced estimates for cancer risk factors...

  17. Walking for Transportation and Leisure Among U.S. Adults—National Health Interview Survey 2010

    PubMed Central

    Paul, Prabasaj; Carlson, Susan A.; Carroll, Dianna D.; Berrigan, David; Fulton, Janet E.

    2015-01-01

    Background Walking, the most commonly reported physical activity among U.S. adults, is undertaken in various domains, including transportation and leisure. Methods This study examined prevalence, bout length, and mean amount of walking in the last week for transportation and leisure, by selected characteristics. Self-reported data from the 2010 National Health Interview Survey (N = 24,017) were analyzed. Results Prevalence of transportation walking was 29.4% (95% CI: 28.6%–30.3%) and of leisure walking was 50.0% (95% CI: 49.1%–51.0%). Prevalence of transportation walking was higher among men; prevalence of leisure walking was higher among women. Most (52.4%) transportation walking bouts were 10 to 15 minutes; leisure walking bouts were distributed more evenly (28.0%, 10–15 minutes; 17.1%, 41–60 minutes). Mean time spent in transportation walking was higher among men, decreased with increasing BMI, and varied by race/ethnicity and region of residence. Mean time spent leisure walking increased with increasing age and with decreasing BMI. Conclusion Demographic correlates and patterns of walking differ by domain. Interventions focusing on either leisure or transportation walking should consider correlates for the specific walking domain. Assessing prevalence, bout length, and mean time of walking for transportation and leisure separately allows for more comprehensive surveillance of walking. PMID:25133651

  18. How many schools adopt interviews during the student admission process across the health professions in the United States of America?

    PubMed Central

    2016-01-01

    Health profession schools use interviews during the admissions process to identify certain non-cognitive skills that are needed for success in diverse, inter-professional settings. This study aimed to assess the use of interviews during the student admissions process across health disciplines at schools in the United States of America in 2014. The type and frequency of non-cognitive skills assessed were also evaluated. Descriptive methods were used to analyze a sample of interview rubrics collected as part of a national survey on admissions in the health professions, which surveyed 228 schools of medicine, dentistry, pharmacy, nursing, and public health. Of the 228 schools, 130 used interviews. The most desirable non-cognitive skills from 34 schools were identified as follows: communication skills (30), motivation (22), readiness for the profession (17), service (12), and problem-solving (12). Ten schools reported using the multiple mini-interview format, which may indicate potential for expanding this practice. Disparities in the use of interviewing across health professions should be verified to help schools adopt interviews during student admissions processes. PMID:26924541

  19. How many schools adopt interviews during the student admission process across the health professions in the United States of America?

    PubMed

    Glazer, Greer; Startsman, Laura F; Bankston, Karen; Michaels, Julia; Danek, Jennifer C; Fair, Malika

    2016-01-01

    Health profession schools use interviews during the admissions process to identify certain non-cognitive skills that are needed for success in diverse, inter-professional settings. This study aimed to assess the use of interviews during the student admissions process across health disciplines at schools in the United States of America in 2014. The type and frequency of non-cognitive skills assessed were also evaluated. Descriptive methods were used to analyze a sample of interview rubrics collected as part of a national survey on admissions in the health professions, which surveyed 228 schools of medicine, dentistry, pharmacy, nursing, and public health. Of the 228 schools, 130 used interviews. The most desirable non-cognitive skills from 34 schools were identified as follows: communication skills (30), motivation (22), readiness for the profession (17), service (12), and problem-solving (12). Ten schools reported using the multiple mini-interview format, which may indicate potential for expanding this practice. Disparities in the use of interviewing across health professions should be verified to help schools adopt interviews during student admissions processes.

  20. Primary healthcare nurses' experiences with motivational interviewing in health promotion practice.

    PubMed

    Brobeck, Elisabeth; Bergh, Håkan; Odencrants, Sigrid; Hildingh, Cathrine

    2011-12-01

    The aim of the study was to describe primary healthcare nurses' experiences with motivational interviewing as a method for health promotion practice. A person's lifestyle has a major effect on his or her health. Motivational interviewing is one way of working with lifestyle changes in health promotion practice. The basic plan of motivational interviewing is to help people understand their lifestyle problems and make positive lifestyle changes. Motivational interviewing has been proven to be more effective than conventional methods in increasing patient motivation. This study has a descriptive design and uses a qualitative method. Twenty nurses who worked in primary health care and actively used motivational interviewing in their work were interviewed. Qualitative content analysis was used to process the data. The primary healthcare nurses' experiences with motivational interviewing as a method of health promotion practice demonstrate that motivational interviewing is a demanding, enriching and useful method that promotes awareness and guidance in the care relationship. The results also show that motivational interviewing is a valuable tool for primary healthcare nurses' health promotion practice. This study shows that motivational interviewing places several different demands on nurses who use this method. Those who work with motivational interviewing must make an effort to incorporate this new method to avoid falling back into the former practice of simply giving advice. Maintaining an open mind while implementing motivational interviewing in real healthcare settings is crucial for nurses to increase this method's effectiveness. The nurses in the study had a positive experience with motivational interviewing, which can contribute to the increased use, adaption and development of motivational interviewing among primary healthcare professionals. Increased motivational interviewing knowledge and skills would also contribute to promotion of health lifestyle practices

  1. German health interview and examination survey for adults (DEGS) - design, objectives and implementation of the first data collection wave

    PubMed Central

    2012-01-01

    Background The German Health Interview and Examination Survey for Adults (DEGS) is part of the recently established national health monitoring conducted by the Robert Koch Institute. DEGS combines a nationally representative periodic health survey and a longitudinal study based on follow-up of survey participants. Funding is provided by the German Ministry of Health and supplemented for specific research topics from other sources. Methods/design The first DEGS wave of data collection (DEGS1) extended from November 2008 to December 2011. Overall, 8152 men and women participated. Of these, 3959 persons already participated in the German National Health Interview and Examination Survey 1998 (GNHIES98) at which time they were 18–79 years of age. Another 4193 persons 18–79 years of age were recruited for DEGS1 in 2008–2011 based on two-stage stratified random sampling from local population registries. Health data and context variables were collected using standardized computer assisted personal interviews, self-administered questionnaires, and standardized measurements and tests. In order to keep survey results representative for the population aged 18–79 years, results will be weighted by survey-specific weighting factors considering sampling and drop-out probabilities as well as deviations between the design-weighted net sample and German population statistics 2010. Discussion DEGS aims to establish a nationally representative data base on health of adults in Germany. This health data platform will be used for continuous health reporting and health care research. The results will help to support health policy planning and evaluation. Repeated cross-sectional surveys will permit analyses of time trends in morbidity, functional capacity levels, disability, and health risks and resources. Follow-up of study participants will provide the opportunity to study trajectories of health and disability. A special focus lies on chronic diseases including asthma

  2. The Prevalence and Characteristics of Fibromyalgia in the 2012 National Health Interview Survey.

    PubMed

    Walitt, Brian; Nahin, Richard L; Katz, Robert S; Bergman, Martin J; Wolfe, Frederick

    2015-01-01

    Most knowledge of fibromyalgia comes from the clinical setting, where healthcare-seeking behavior and selection issues influence study results. The characteristics of fibromyalgia in the general population have not been studied in detail. We developed and tested surrogate study specific criteria for fibromyalgia in rheumatology practices using variables from the US National Health Interview Survey (NHIS) and the modification (for surveys) of the 2010 American College of Rheumatology (ACR) preliminary fibromyalgia criteria. The surrogate criteria were applied to the 2012 NHIS and identified persons who satisfied criteria from symptom data. The NHIS weighted sample of 8446 persons represents 225.7 million US adults. Fibromyalgia was identified in 1.75% (95% CI 1.42, 2.07), or 3.94 million persons. However, 73% of identified cases self-reported a physician's diagnosis other than fibromyalgia. Identified cases had high levels of self-reported pain, non-pain symptoms, comorbidity, psychological distress, medical costs, Social Security and work disability. Caseness was associated with gender, education, ethnicity, citizenship and unhealthy behaviors. Demographics, behaviors, and comorbidity were predictive of case status. Examination of the surrogate polysymptomatic distress scale (PSD) of the 2010 ACR criteria found fibromyalgia symptoms extending through the full length of the scale. Persons identified with criteria-based fibromyalgia have severe symptoms, but most (73%) have not received a clinical diagnosis of fibromyalgia. The association of fibromyalgia-like symptoms over the full length of the PSD scale with physiological as well as mental stressors suggests PSD may be a universal response variable rather than one restricted to fibromyalgia.

  3. The Prevalence and Characteristics of Fibromyalgia in the 2012 National Health Interview Survey

    PubMed Central

    Walitt, Brian; Nahin, Richard L.; Katz, Robert S.; Bergman, Martin J.; Wolfe, Frederick

    2015-01-01

    Background Most knowledge of fibromyalgia comes from the clinical setting, where healthcare-seeking behavior and selection issues influence study results. The characteristics of fibromyalgia in the general population have not been studied in detail. Methods We developed and tested surrogate study specific criteria for fibromyalgia in rheumatology practices using variables from the US National Health Interview Survey (NHIS) and the modification (for surveys) of the 2010 American College of Rheumatology (ACR) preliminary fibromyalgia criteria. The surrogate criteria were applied to the 2012 NHIS and identified persons who satisfied criteria from symptom data. The NHIS weighted sample of 8446 persons represents 225.7 million US adults. Results Fibromyalgia was identified in 1.75% (95% CI 1.42, 2.07), or 3.94 million persons. However, 73% of identified cases self-reported a physician’s diagnosis other than fibromyalgia. Identified cases had high levels of self-reported pain, non-pain symptoms, comorbidity, psychological distress, medical costs, Social Security and work disability. Caseness was associated with gender, education, ethnicity, citizenship and unhealthy behaviors. Demographics, behaviors, and comorbidity were predictive of case status. Examination of the surrogate polysymptomatic distress scale (PSD) of the 2010 ACR criteria found fibromyalgia symptoms extending through the full length of the scale. Conclusions Persons identified with criteria-based fibromyalgia have severe symptoms, but most (73%) have not received a clinical diagnosis of fibromyalgia. The association of fibromyalgia-like symptoms over the full length of the PSD scale with physiological as well as mental stressors suggests PSD may be a universal response variable rather than one restricted to fibromyalgia. PMID:26379048

  4. Language of Interview, Self-Rated Health, and the Other Latino Health Puzzle

    PubMed Central

    Morenoff, Jeffrey D.; Williams, David R.; House, James S.

    2011-01-01

    Objectives. We investigated whether the conventional Spanish translation of the self-rated health survey question helps explain why Latinos' self-rated health is worse than Whites' despite more objective health measures showing them to be as healthy as or healthier than are Whites. Methods. We analyzed the relationship between language of interview and self-rated health in the Chicago Community Adult Health Study (2001–2003) and the 2003 Behavioral Risk Factor Surveillance System. Results. Being interviewed in Spanish was associated with significantly higher odds of rating health as fair or poor in both data sets. Moreover, adjusting for language of interview substantially reduced the gap between Whites and Latinos. Spanish-language interviewees were more likely to rate their health as fair (regular in Spanish) than as any other choice, and this preference was strongest when compared with categories representing better health (good, very good, and excellent). Conclusions. Our findings suggest that translation of the English word “fair” to regular induces Spanish-language respondents to report poorer health than they would in English. Self-rated health should be interpreted with caution, especially in racial/ethnic comparisons, and research should explore alternative translations. PMID:21164101

  5. The National Health Educator Job Analysis 2010: Process and Outcomes

    ERIC Educational Resources Information Center

    Doyle, Eva I.; Caro, Carla M.; Lysoby, Linda; Auld, M. Elaine; Smith, Becky J.; Muenzen, Patricia M.

    2012-01-01

    The National Health Educator Job Analysis 2010 was conducted to update the competencies model for entry- and advanced-level health educators. Qualitative and quantitative methods were used. Structured interviews, focus groups, and a modified Delphi technique were implemented to engage 59 health educators from diverse work settings and experience…

  6. Prevalence of Smoking and Obesity Among U.S. Cancer Survivors: Estimates From the National Health Interview Survey, 2008-2012.

    PubMed

    Shoemaker, Meredith L; White, Mary C; Hawkins, Nikki A; Hayes, Nikki S

    2016-07-01

    To describe smoking and obesity prevalence among male and female cancer survivors in the United States.
. Cross-sectional survey.
. Household interviews.
. 9,753 survey respondents who reported ever having a malignancy, excluding nonmelanoma skin cancers. 
. Data from the National Health Interview Survey (2008-2012) were used to calculate weighted smoking status prevalence estimates. Cross-tabulations of smoking and weight status were produced, along with Wald chi-square tests and linear contrasts.
. Cancer history, smoking status, obesity status, gender, age, and age at diagnosis.
. Seventeen percent of cancer survivors reported current smoking. Female survivors had higher rates of current smoking than males, particularly in the youngest age category. Male survivors who currently smoked had lower obesity prevalence rates than males who previously smoked or never smoked. Among female survivors, 31% were obese and no significant differences were seen in obesity prevalence by smoking status for all ages combined. 
. The findings highlight the variation in smoking status and weight by age and gender. Smoking interventions may need to be targeted to address barriers specific to subgroups of cancer survivors.
. Nurses can be instrumental in ensuring that survivors receive comprehensive approaches to address both weight and tobacco use to avoid trading one risk for another.

  7. Impact of Time to Maternal Interview on Interview Responses in the National Birth Defects Prevention Study

    PubMed Central

    Tinker, Sarah C.; Gibbs, Cassandra; Strickland, Matthew J.; Devine, Owen J.; Crider, Krista S.; Werler, Martha M.; Anderka, Marlene T.; Reefhuis, Jennita

    2013-01-01

    Prenatal exposures often are assessed using retrospective interviews. Time from exposure to interview may influence data accuracy. We investigated the association of time to interview (TTI) with aspects of interview responses in the National Birth Defects Prevention Study, a population-based case-control study of birth defects in 10 US states. Mothers completed a computer-assisted telephone interview 1.5–24 months after their estimated date of delivery. Proxy metrics for interview quality were whether certain exposures were reported, whether the start month of reported medication use or illness was reported, or whether responses were missing. Interaction by case status was assessed. Interviews were completed with 30,542 mothers (22,366 cases and 8,176 controls) who gave birth between 1997 and 2007. Mothers of cases were interviewed later than were mothers of controls (11.7 months vs. 9.5 months, respectively). In adjusted analyses, having a TTI that was greater than 6 months was associated with only a few aspects of interview responses (e.g., start month of pseudoephedrine use). Interaction by case-control status was observed for some exposures; mothers of controls had a greater reduction in interview quality with increased TTI in these instances (e.g., report of morning sickness, start month of acetaminophen use and ibuprofen use). The results suggest that TTI might impact interview responses; however, the impact may be minimal and specific to the type of exposure. PMID:23645625

  8. Impact of time to maternal interview on interview responses in the National Birth Defects Prevention Study.

    PubMed

    Tinker, Sarah C; Gibbs, Cassandra; Strickland, Matthew J; Devine, Owen J; Crider, Krista S; Werler, Martha M; Anderka, Marlene T; Reefhuis, Jennita

    2013-06-01

    Prenatal exposures often are assessed using retrospective interviews. Time from exposure to interview may influence data accuracy. We investigated the association of time to interview (TTI) with aspects of interview responses in the National Birth Defects Prevention Study, a population-based case-control study of birth defects in 10 US states. Mothers completed a computer-assisted telephone interview 1.5-24 months after their estimated date of delivery. Proxy metrics for interview quality were whether certain exposures were reported, whether the start month of reported medication use or illness was reported, or whether responses were missing. Interaction by case status was assessed. Interviews were completed with 30,542 mothers (22,366 cases and 8,176 controls) who gave birth between 1997 and 2007. Mothers of cases were interviewed later than were mothers of controls (11.7 months vs. 9.5 months, respectively). In adjusted analyses, having a TTI that was greater than 6 months was associated with only a few aspects of interview responses (e.g., start month of pseudoephedrine use). Interaction by case-control status was observed for some exposures; mothers of controls had a greater reduction in interview quality with increased TTI in these instances (e.g., report of morning sickness, start month of acetaminophen use and ibuprofen use). The results suggest that TTI might impact interview responses; however, the impact may be minimal and specific to the type of exposure.

  9. Measuring the Prevalence of Diagnosed Chronic Obstructive Pulmonary Disease in the United States Using Data From the 2012-2014 National Health Interview Survey

    PubMed Central

    Nugent, Colleen N.; Blumberg, Stephen J.; Vahratian, Anjel

    2017-01-01

    Objectives: This study, measuring the prevalence of chronic obstructive pulmonary disease (COPD), examined (1) whether a single survey question asking explicitly about diagnosed COPD is sufficient to identify US adults with COPD and (2) how this measure compares with estimating COPD prevalence using survey questions on diagnosed emphysema and/or chronic bronchitis and all 3 survey questions together. Methods: We used data from the 2012-2014 National Health Interview Survey to examine different measures of prevalence among 7211 US adults who reported a diagnosed respiratory condition (ie, emphysema, chronic bronchitis, and/or COPD). Results: We estimated a significantly higher prevalence of COPD by using a measure accounting for all 3 diagnoses (6.1%; 95% CI, 5.9%-6.3%) than by using a measure of COPD diagnosis only (3.0%; 95% CI, 2.8%-3.1%) or a measure of emphysema and/or chronic bronchitis diagnoses (4.7%; 95% CI, 4.6%-4.9%). This pattern was significant among all subgroups examined except for non-Hispanic Asian adults. The percentage difference between measures of COPD was larger among certain subgroups (adults aged 18-39, Hispanic adults, and never smokers); additional analyses showed that this difference resulted from a large proportion of adults in these subgroups reporting a diagnosis of chronic bronchitis only. Conclusions: With the use of self- or patient-reported health survey data such as the National Health Interview Survey, it is recommended that a measure asking respondents only about COPD diagnosis is not adequate for estimating the prevalence of COPD. Instead, a measure accounting for diagnoses of emphysema, chronic bronchitis, and/or COPD may be a better measure. Additional analyses should explore the reliability and validation of survey questions related to COPD, with special attention toward questions on chronic bronchitis. PMID:28135423

  10. Food Insecurity Among Young Adults With Intellectual and Developmental Disabilities in the United States: Evidence From the National Health Interview Survey.

    PubMed

    Brucker, Debra L; Nord, Derek

    2016-11-01

    People with intellectual or developmental disabilities (IDD) face higher levels of poverty than others, which can lead to concerns regarding areas of well-being, such as food security. Young adults with IDD who are, in many cases, transitioning from the system of educational, health care, and income supports of their youth into the adult world may be particularly vulnerable. Using pooled data from the 2011-2014 National Health Interview Survey, we find that young adults with IDD have significantly higher levels of food insecurity than young adults without disabilities, even when controlling for poverty. Young adults with IDD who are living in low-income households are not significantly more likely to participate in the Supplemental Nutrition Assistance Program (SNAP) than young adults without disabilities who are also living in low-income households. Although our results suggest that SNAP is effectively reaching many young adults with IDD in need of nutrition assistance, further research is needed to determine the specific effects of food insecurity and SNAP participation on overall economic and health outcomes for this population.

  11. An Insider's Perspective on the National Spelling Bee: An Interview with James Maguire

    ERIC Educational Resources Information Center

    Henkin, Roxanne; Harmon, Janis; Pate, Elizabeth; Moorman, Honor

    2008-01-01

    In this article, the coeditors of "Voices from the Middle" present an interview with James Maguire, author of "The American Bee: The National Spelling Bee and the Culture of Word Nerds." During the interview, Maguire talked about his experiences with the National Spelling Bee to provide some insight to middle-level teachers and students. Maguire…

  12. Postdeployment behavioral health screening: face-to-face versus virtual behavioral health interviews.

    PubMed

    Sipos, Maurice L; Foran, Heather M; Crane, Maria L; Wood, Michael D; Wright, Kathleen M

    2012-05-01

    Virtual behavioral health (VBH) services are used frequently to address the high demand for behavioral health (BH) services in the military. Few studies have investigated the relationship between the use of VBH services and BH outcomes or preferences for the use of VBH technologies. In this article, we evaluated BH interviews conducted via video teleconferencing (VTC) or face-to-face in terms of BH symptoms, satisfaction rates, stigma, barriers to care, and preferences for future use of BH care. Soldiers (n = 307) from the headquarters element of an operational unit were surveyed 4 months following a 12-month deployment to Iraq. There were no significant differences in satisfaction rates based on interview modality, but significantly more soldiers preferred face-to-face interviews over VTC interviews in the future. Soldiers who preferred face-to-face interviews also reported higher levels of anxiety and depression symptoms than those who preferred VTC interviews. No significant age differences were found in terms of interview modality satisfaction or preference. Soldiers with greater deployment experience were more likely to report that they would not like using VTC if seeking BH care in the future than soldiers with less deployment experience. These findings highlight the importance of promoting choice in type of BH interview modality.

  13. Prevalence and Work-Relatedness of Carpal Tunnel Syndrome in the Working Population, United States, 2010 National Health Interview Survey

    PubMed Central

    Luckhaupt, Sara E.; Dahlhamer, James M.; Ward, Brian W.; Sweeney, Marie H.; Sestito, John P.; Calvert, Geoffrey M.

    2015-01-01

    Background Patterns of prevalence and work-relatedness of carpal tunnel syndrome (CTS) among workers offer clues about risk factors and targets for prevention. Methods Data from an occupational health supplement to the 2010 National Health Interview Survey were used to estimate the prevalence of self-reported clinician-diagnosed CTS overall and by demographic characteristics. The proportion of these cases self-reported to have been attributed to work by clinicians was also examined overall and by demographic characteristics. In addition, the distribution of industry and occupation (I&O) categories to which work-related cases of CTS were attributed was compared to the distribution of I&O categories of employment among current/recent workers. Results Data were available for 27,157 adults, including 17,524 current/recent workers. The overall lifetime prevalence of clinician-diagnosed CTS among current/recent workers was 6.7%. The 12-month prevalence was 3.1%, representing approximately 4.8 million workers with current CTS; 67.1% of these cases were attributed to work by clinicians, with overrepresentation of certain I&O categories. Conclusions CTS affected almost 5 million U.S. workers in 2010, with prevalence varying by demographic characteristics and I&O. PMID:22495886

  14. Workplace mistreatment and sickness absenteeism from work: results from the 2010 National Health Interview survey.

    PubMed

    Asfaw, Abay G; Chang, Chia C; Ray, Tapas K

    2014-02-01

    This study examined the association between workplace mistreatment and occurrence, duration, and costs of sickness absenteeism. We used the 2010 National Health Interview Survey and considered 13,807 employed adult respondents. We used a zero-inflated negative binomial (zinb) model to examine the association between exposure to workplace mistreatment and the occurrence and number of workdays missed due to illness/injury in the preceding 12 months. In 2010, 7.6% of US workers employed at the time of the survey reported having been mistreated at their workplace. Both occurrence and duration of sickness absence were higher for mistreated than for non-mistreated workers. The zinb results showed that being mistreated was associated with a 42% increase in the number of missed workdays, controlling for covariates. The marginal effect analysis showed that lost workdays differed by 2.45 days between mistreated and non-mistreated workers. This implies that workplace mistreatment was associated with $4.1 billion, or 5.5%, of sickness absenteeism costs in 2010. Workplace mistreatment is associated with sickness absence in the United States. While a causal relationship could not be established due to the cross-sectional design of the study, this study reveals the economic importance of developing workplace mistreatment prevention strategies. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  15. CASPer, an online pre-interview screen for personal/professional characteristics: prediction of national licensure scores.

    PubMed

    Dore, Kelly L; Reiter, Harold I; Kreuger, Sharyn; Norman, Geoffrey R

    2017-05-01

    Typically, only a minority of applicants to health professional training are invited to interview. However, pre-interview measures of cognitive skills predict for national licensure scores (Gauer et al. in Med Educ Online 21 2016) and subsequently licensure scores predict for performance in practice (Tamblyn et al. in JAMA 288(23): 3019-3026, 2002; Tamblyn et al. in JAMA 298(9):993-1001, 2007). Assessment of personal and professional characteristics, with the same psychometric rigour of measures of cognitive abilities, are needed upstream in the selection to health profession training programs. To fill that need, Computer-based Assessment for Sampling Personal characteristics (CASPer)-an on-line, video-based screening test-was created. In this paper, we examine the correlation between CASPer and Canadian national licensure examination outcomes in 109 doctors who took CASPer at the time of selection to medical school. Specifically, CASPer scores were correlated against performance on cognitive and 'non-cognitive' subsections of both the Medical Council of Canada Qualifying Examination (MCCQE) Parts I (end of medical school) and Part II (18 months into specialty training). Unlike most national licensure exams, MCCQE has specific subcomponents examining personal/professional qualities, providing a unique opportunity for comparison. The results demonstrated moderate predictive validity of CASPer to national licensure outcomes of personal/professional characteristics three to six years after admission to medical school. These types of disattenuated correlations (r = 0.3-0.5) are not otherwise predicted by traditional screening measures. These data support the ability of a computer-based strategy to screen applicants in a feasible, reliable test, which has now demonstrated predictive validity, lending evidence of its validation for medical school applicant selection.

  16. Comparison of Health Information Technology Use Between American Adults With and Without Chronic Health Conditions: Findings From The National Health Interview Survey 2012

    PubMed Central

    Lauche, Romy; Sibbritt, David; Olaniran, Bolanle; Cook, Ronald; Adams, Jon

    2017-01-01

    Background Health information technology (HIT) is utilized by people with different chronic conditions such as diabetes and hypertension. However, there has been no comparison of HIT use between persons without a chronic condition, with one chronic condition, and multiple (≥2) chronic conditions (MCCs). Objective The aim of the study was to assess the difference in HIT use between persons without a chronic condition, with one chronic condition, and with MCCs, to describe the characteristics of HIT use among those with chronic conditions and to identify the predictors of HIT use of the persons with one chronic condition and MCCs. Methods A secondary data analysis was conducted in spring 2017 using the National Health Interview Survey (NHIS) 2012 Family Core and Sample Adult Core datasets that yielded 34,525 respondents aged 18 years and older. Measures included overall HIT use (ie, any use of the following five HIT on the Internet: seeking health information, ordering prescription, making appointment, emailing health provider, and using health chat groups), as well as sociodemographic and health-related characteristics. Sociodemographic and health characteristics were compared between HIT users and nonusers among those who reported having at least one chronic condition using chi-square tests. Independent predictors of HIT use were identified using multiple logistic regression analyses for those with one chronic condition, with MCCs, and without a chronic condition. Analyses were weighted and performed at significance level of .005. Results In 2012, adults with one health chronic condition (raw count 4147/8551, weighted percentage 48.54%) was significantly higher than among those with MCCs (3816/9637, 39.55%) and those with none of chronic condition (7254/16,337, 44.40%, P<.001). Seeking health information was the most prevalent HIT use. Chi-square tests revealed that among adults with chronic conditions, those who used HIT were significantly different from their

  17. Design and operation of the national home health aide survey: 2007-2008.

    PubMed

    Bercovitz, Anita; Moss, Abigail J; Sengupta, Manisha; Harris-Kojetin, Lauren D; Squillace, Marie R; Emily, Rosenoff; Branden, Laura

    2010-03-01

    This report provides an overview of the National Home Health Aide Survey (NHHAS), the first national probability survey of home health aides. NHHAS was designed to provide national estimates of home health aides who provided assistance in activities of daily living (ADLs) and were directly employed by agencies that provide home health and/or hospice care. This report discusses the need for and objectives of the survey, the design process, the survey methods, and data availability. METHODS NHHAS, a multistage probability sample survey, was conducted as a supplement to the 2007 National Home and Hospice Care Survey (NHHCS). Agencies providing home health and/or hospice care were sampled, and then aides employed by these agencies were sampled and interviewed by telephone. Survey topics included recruitment, training, job history, family life, client relations, work-related injuries, and demographics. NHHAS was virtually identical to the 2004 National Nursing Assistant Survey of certified nursing assistants employed in sampled nursing homes with minor changes to account for differences in workplace environment and responsibilities. RESULTS From September 2007 to April 2008, interviews were completed with 3,416 aides. A public-use data file that contains the interview responses, sampling weights, and design variables is available. The NHHAS overall response rate weighted by the inverse of the probability of selection was 41 percent. This rate is the product of the weighted first-stage agency response rate of 57 percent (i.e., weighted response rate of 59 percent for agency participation in NHHCS times the weighted response rate of 97 percent for agencies participating in NHHCS that also participated in NHHAS) and the weighted second-stage aide response rate of 72 percent to NHHAS.

  18. Understanding Spanish-Language Response in a National Health Communication Survey: Implications for Health Communication Research.

    PubMed

    Ramírez, A Susana; Willis, Gordon; Rutten, Lila Finney

    2017-05-01

    Spanish-speaking Latinos account for 13% of the U.S. population yet are chronically under-represented in national surveys; additionally, the response quality suffers from low literacy rates and translation challenges. These are the same issues that health communicators face when understanding how best to communicate important health information to Latinos. The Health Information National Trends Survey (HINTS) offers a unique opportunity to understand the health communication landscape and information needs of the U.S. We describe the challenges in recruiting Spanish-speaking HINTS respondents and strategies used to improve rates and quality of responses among Spanish-speaking Latinos. Cognitive interviewing techniques helped to better understand how Spanish-speaking Latinos were interpreting the survey questions, and the extent to which these interpretations matched English-speaking respondents' interpretations. Some Spanish-speaking respondents had difficulty with the questions because of a lack of access to health care. Additionally, Spanish-speaking respondents had a particularly hard time answering questions that were presented in a grid format. We describe the cognitive interview process, and consider the impact of format changes on Spanish-speaking people's responses and response quality. We discuss challenges that remain in understanding health information needs of non-English-speakers.

  19. Computer-assisted self interviewing in sexual health clinics.

    PubMed

    Fairley, Christopher K; Sze, Jun Kit; Vodstrcil, Lenka A; Chen, Marcus Y

    2010-11-01

    This review describes the published information on what constitutes the elements of a core sexual history and the use of computer-assisted self interviewing (CASI) within sexually transmitted disease clinics. We searched OVID Medline from 1990 to February 2010 using the terms "computer assisted interviewing" and "sex," and to identify published articles on a core sexual history, we used the term "core sexual history." Since 1990, 3 published articles used a combination of expert consensus, formal clinician surveys, and the Delphi technique to decide on what questions form a core sexual health history. Sexual health histories from 4 countries mostly ask about the sex of the partners, the number of partners (although the time period varies), the types of sex (oral, anal, and vaginal) and condom use, pregnancy intent, and contraceptive methods. Five published studies in the United States, Australia, and the United Kingdom compared CASI with in person interviews in sexually transmitted disease clinics. In general, CASI identified higher risk behavior more commonly than clinician interviews, although there were substantial differences between studies. CASI was found to be highly acceptable and individuals felt it allowed more honest reporting. Currently, there are insufficient data to determine whether CASI results in differences in sexually transmitted infection testing, diagnosis, or treatment or if CASI improves the quality of sexual health care or its efficiency. The potential public health advantages of the widespread use of CASI are discussed.

  20. Access to care and use of the Internet to search for health information: results from the US National Health Interview Survey.

    PubMed

    Amante, Daniel J; Hogan, Timothy P; Pagoto, Sherry L; English, Thomas M; Lapane, Kate L

    2015-04-29

    The insurance mandate of the Affordable Care Act has increased the number of people with health coverage in the United States. There is speculation that this increase in the number of insured could make accessing health care services more difficult. Those who are unable to access care in a timely manner may use the Internet to search for information needed to answer their health questions. The aim was to determine whether difficulty accessing health care services for reasons unrelated to insurance coverage is associated with increased use of the Internet to obtain health information. Survey data from 32,139 adults in the 2011 National Health Interview Study (NHIS) were used in this study. The exposure for this analysis was reporting difficulty accessing health care services or delaying getting care for a reason unrelated to insurance status. To define this exposure, we examined 8 questions that asked whether different access problems occurred during the previous 12 months. The outcome for this analysis, health information technology (HIT) use, was captured by examining 2 questions that asked survey respondents if they used an online health chat room or searched the Internet to obtain health information in the previous 12 months. Several multinomial logistic regressions estimating the odds of using HIT for each reported access difficulty were conducted to accomplish the study objective. Of a survey population of 32,139 adults, more than 15.90% (n=5109) reported experiencing at least one access to care barrier, whereas 3.63% (1168/32,139) reported using online health chat rooms and 43.55% (13,997/32,139) reported searching the Internet for health information. Adults who reported difficulty accessing health care services for reasons unrelated to their health insurance coverage had greater odds of using the Internet to obtain health information. Those who reported delaying getting care because they could not get an appointment soon enough (OR 2.2, 95% CI 1.9-2.5), were

  1. Race, Ethnicity, and Self-Reported Hypertension: Analysis of Data From the National Health Interview Survey, 1997–2005

    PubMed Central

    2009-01-01

    Objective. I estimated the association between race and self-reported hypertension among Hispanics and non-Hispanics and determined whether this association was stronger among non-Hispanics. Methods. With data from the 1997–2005 National Health Interview Survey, I used logistic regression to estimate the strength of the association between race/ethnicity and self-reported hypertension among US adults. Results. The overall prevalence of self-reported hypertension was 24.5%, with lower prevalence among Hispanics (16.7%) than among non-Hispanics (25.2%; P < .01). Blacks, regardless of ethnicity, had the highest prevalence. Compared with non-Hispanic Whites, non-Hispanic Blacks had 48% (odds ratio [OR] = 1.48; 95% confidence interval [CI] = 1.41, 1.55) greater odds of reporting hypertension; Hispanic Whites had 23% (OR = 0.81; 95% CI = 0.76, 0.88) lower odds. There was no difference in the strength of the association between race and self-reported hypertension observed among non-Hispanics (OR for Blacks = 1.47) and among Hispanics (OR for Blacks = 1.20; for interaction, P = 0.43). Conclusions. The previously reported hypertension advantage of Hispanics holds for Hispanic Whites only. As Hispanics continue their rapid growth in the United States, race may have important implications on their disease burden, because most US health disparities are driven by race and its socially patterned experiences. PMID:19059869

  2. Predictors of Internet use for health information among male and female Internet users: Findings from the 2009 Taiwan National Health Interview Survey.

    PubMed

    Koo, Malcolm; Lu, Ming-Chi; Lin, Shih-Chun

    2016-10-01

    The Internet is an increasingly important source of health information for the general population. Both preventive health behavior and Internet use are known to be different between men and women. However, few studies have compared predictors of Internet use for health information between the sexes. To investigate the prevalence and predictors of Internet use for health information among male and female adult Internet users using data from a population-based survey in Taiwan. Respondents between the ages of 20-65 years were identified from the dataset of the 2009 Taiwan National Health Interview Survey. The outcome variable of the study, the utilization of the Internet for health information, was ascertained by asking whether the respondent had ever used the Internet to search for health information or obtain health services. Univariate and multivariate logistic regression analyses were conducted separately for men and women to evaluate factors associated with the use of Internet for health information. Of the 2741 adults aged 20-65 years who had ever used the Internet, 1766 (64.4%) of them had used it for health information or services. Multivariate logistic regression analyses showed that a higher educational level (adjusted odds ratio [AOR]=3.60, P<0.001), living alone (AOR=1.77, P=0.019), had exercised in the past two weeks (AOR=2.41, P<0.001), residing in city or urban district (AOR=1.28, P=0.049), with a perceived health status of extremely good, very good, or good (AOR=1.34, P=0.022), and had used Western medicine services in the past month (AOR=1.51, P=0.005) were significantly associated with health information use in male Internet users. On the other hand, age between 20-44.9 years (AOR=1.87, P<0.001), a higher educational level (AOR=3.57, P<0.001), being married (AOR=1.68, P=0.001), had exercised in the past two weeks (AOR=1.56, P<0.001), and had a mean monthly personal income of NT$ 20,000 and above were significant factors in female Internet users

  3. National Health and Nutrition Examination Survey: national youth fitness survey plan, operations, and analysis, 2012.

    PubMed

    Borrud, Lori; Chiappa, Michele M; Burt, Vicki L; Gahche, Jaime; Zipf, George; Johnson, Clifford L; Dohrmann, Sylvia M

    2014-04-01

    In October 2008, the federal government issued its first-ever Physical Activity Guidelines for Americans to provide science-based guidance on the types and amounts of physical activity that provide substantial health benefits for Americans (1). Guidelines for children and adolescents recommend 60 minutes or more of aerobic, muscle-strengthening, or bone-strengthening physical activity daily (1). While the number of children in the United States who meet the recommendations in the Physical Activity Guidelines is unknown, the percentage that is physically active in the United States may be declining. No recent national data exist on the fitness levels of children and adolescents. The National Health and Nutrition Examination Survey's (NHANES) National Youth Fitness Survey (NNYFS) was conducted in 2012 and collected data on physical activity and fitness levels for U.S. children and adolescents aged 3-15 years. The objective of NNYFS was to provide national-level estimates of the physical activity and fitness levels of children, based on interview and physical examination data. Results from the survey are intended to contribute to the development of policies and programs to improve youth fitness nationally. The data also may be used in the development of national reference standards for measures of fitness and physical activity. Methods The NNYFS survey design used the design for NHANES, which is a multistage probability sample of the civilian noninstitutionalized resident population of the United States. NNYFS consisted of a household interview and a physical activity and fitness examination in a mobile examination center. A total of 1,640 children and adolescents aged 3-15 were interviewed, and 1,576 were examined. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  4. [Methodological design of the National Health and Nutrition Survey 2016].

    PubMed

    Romero-Martínez, Martín; Shamah-Levy, Teresa; Cuevas-Nasu, Lucía; Gómez-Humarán, Ignacio Méndez; Gaona-Pineda, Elsa Berenice; Gómez-Acosta, Luz María; Rivera-Dommarco, Juan Ángel; Hernández-Ávila, Mauricio

    2017-01-01

    Describe the design methodology of the halfway health and nutrition national survey (Ensanut-MC) 2016. The Ensanut-MC is a national probabilistic survey whose objective population are the inhabitants of private households in Mexico. The sample size was determined to make inferences on the urban and rural areas in four regions. Describes main design elements: target population, topics of study, sampling procedure, measurement procedure and logistics organization. A final sample of 9 479 completed household interviews, and a sample of 16 591 individual interviews. The response rate for households was 77.9%, and the response rate for individuals was 91.9%. The Ensanut-MC probabilistic design allows valid statistical inferences about interest parameters for Mexico´s public health and nutrition, specifically on overweight, obesity and diabetes mellitus. Updated information also supports the monitoring, updating and formulation of new policies and priority programs.

  5. Comparison of Health Information Technology Use Between American Adults With and Without Chronic Health Conditions: Findings From The National Health Interview Survey 2012.

    PubMed

    Zhang, Yan; Lauche, Romy; Sibbritt, David; Olaniran, Bolanle; Cook, Ronald; Adams, Jon

    2017-10-05

    Health information technology (HIT) is utilized by people with different chronic conditions such as diabetes and hypertension. However, there has been no comparison of HIT use between persons without a chronic condition, with one chronic condition, and multiple (≥2) chronic conditions (MCCs). The aim of the study was to assess the difference in HIT use between persons without a chronic condition, with one chronic condition, and with MCCs, to describe the characteristics of HIT use among those with chronic conditions and to identify the predictors of HIT use of the persons with one chronic condition and MCCs. A secondary data analysis was conducted in spring 2017 using the National Health Interview Survey (NHIS) 2012 Family Core and Sample Adult Core datasets that yielded 34,525 respondents aged 18 years and older. Measures included overall HIT use (ie, any use of the following five HIT on the Internet: seeking health information, ordering prescription, making appointment, emailing health provider, and using health chat groups), as well as sociodemographic and health-related characteristics. Sociodemographic and health characteristics were compared between HIT users and nonusers among those who reported having at least one chronic condition using chi-square tests. Independent predictors of HIT use were identified using multiple logistic regression analyses for those with one chronic condition, with MCCs, and without a chronic condition. Analyses were weighted and performed at significance level of .005. In 2012, adults with one health chronic condition (raw count 4147/8551, weighted percentage 48.54%) was significantly higher than among those with MCCs (3816/9637, 39.55%) and those with none of chronic condition (7254/16,337, 44.40%, P<.001). Seeking health information was the most prevalent HIT use. Chi-square tests revealed that among adults with chronic conditions, those who used HIT were significantly different from their counterpart peers who did not use HIT

  6. Prevalence of Smoking and Obesity Among U.S. Cancer Survivors: Estimates From the National Health Interview Survey, 2008–2012

    PubMed Central

    Shoemaker, Meredith L.; White, Mary C.; Hawkins, Nikki A.; Hayes, Nikki S.

    2017-01-01

    Purpose/Objectives To describe smoking and obesity prevalence among male and female cancer survivors in the United States. Design Cross-sectional survey. Setting Household interviews. Sample 9,753 survey respondents who reported ever having a malignancy, excluding nonmelanoma skin cancers. Methods Data from the National Health Interview Survey (2008–2012) were used to calculate weighted smoking status prevalence estimates. Cross-tabulations of smoking and weight status were produced, along with Wald chi-square tests and linear contrasts. Main Research Variables Cancer history, smoking status, obesity status, gender, age, and age at diagnosis. Findings Seventeen percent of cancer survivors reported current smoking. Female survivors had higher rates of current smoking than males, particularly in the youngest age category. Male survivors who currently smoked had lower obesity prevalence rates than males who previously smoked or never smoked. Among female survivors, 31% were obese and no significant differences were seen in obesity prevalence by smoking status for all ages combined. Conclusions The findings highlight the variation in smoking status and weight by age and gender. Smoking interventions may need to be targeted to address barriers specific to subgroups of cancer survivors. Implications for Nursing Nurses can be instrumental in ensuring that survivors receive comprehensive approaches to address both weight and tobacco use to avoid trading one risk for another. PMID:27314186

  7. Use of Low-dose Aspirin as Secondary Prevention of Atherosclerotic Cardiovascular Disease Among US Adults (From the National Health Interview Survey, 2012)

    PubMed Central

    Fang, Jing; George, Mary G.; Gindi, Renee M.; Hong, Yuling; Yang, Quanhe; Ayala, Carma; Ward, Brian W.; Loustalot, Fleetwood

    2015-01-01

    Current guidelines recommend that adults with atherosclerotic cardiovascular disease take low-dose aspirin or other antiplatelet medications as secondary prevention of recurrent cardiovascular events. Yet, no national level assessment of low-dose aspirin use for secondary prevention of cardiovascular disease has been reported among a community-based population. Using data from the 2012 National Health Interview Survey, we assessed low-dose aspirin use among those with atherosclerotic cardiovascular disease. We estimated the prevalence ratios of low-dose aspirin use, adjusting for sociodemographic status, health insurance, and cardiovascular risk factors. Among those with atherosclerotic cardiovascular disease (n=3,068), 76% had been instructed to take aspirin, and 88% of those were following this advice. Of those not advised, 11% took aspirin on this own. Overall, 70% were taking aspirin (including those who followed their health care provider's advice and those who were not advised but took aspirin on their own). Logistic regression models showed that women, non-Hispanic blacks and Hispanics, those aged 40–64 years, with a high school education or with some college, or with fewer cardiovascular disease risk factors were less likely to take aspirin than men, non-Hispanic whites, those aged ≥65 years, with a college education or higher, or with all four selected cardiovascular disease risk factors, respectively. Additional analyses conducted among those with coronary heart disease only (n=2,007) showed similar patterns. In conclusion, use of low-dose aspirin for secondary prevention was 70%, with high reported adherence to health care providers' advice to take low-dose aspirin (88%), and significant variability within subgroups. PMID:25670639

  8. Understanding Spanish-language Response in a National Health Communication Survey: Implications for Health Communication Research

    PubMed Central

    Ramírez, A Susana; Willis, Gordon; Rutten, Lila Finney

    2017-01-01

    Spanish-speaking Latinos account for 13% of the US population yet are chronically under-represented in national surveys; additionally, response quality suffers from low literacy rates and translation challenges. These are the same issues that health communicators face when understanding how best to communicate important health information to Latinos. The Health Information National Trends Survey (HINTS) offers a unique opportunity to understand the health communication landscape and information needs of the U.S. population. We describe the challenges in recruiting Spanish-speaking HINTS respondents and strategies used to improve rates and quality of responses among Spanish-speaking Latinos. Cognitive interviewing techniques helped to better understand how Spanish-speaking Latinos were interpreting the survey questions, and the extent to which these interpretations matched English-speaking respondents’ interpretations. Some Spanish-speaking respondents had difficulty with the questions because of a lack of access to health care. Additionally, Spanish-speaking respondents had a particularly hard time answering questions that were presented in a grid format. We describe the cognitive interview process, and consider the impact of format changes on Spanish-speaking people’s responses and response quality. We discuss challenges that remain in understanding health information needs of non-English-speakers. PMID:28414618

  9. SECOND NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES II)

    EPA Science Inventory

    The second National Health and Nutrition Examination Survey, NHANES II, is a nationwide probability sample of 27,801 persons from 6 months 74 years of age. From this sample, 25,286 people were interviewed and 20,322 people were examined, resulting in an overall response rate of 7...

  10. Barriers and facilitators to establishing a national public health observatory.

    PubMed

    Pooransingh, Shalini; Misir, Akenath; Ramdath, Dan; Ramsewak, Samuel; Jaglal, Susan; Cameron, Cathy; Goel, Vivek

    2015-11-01

    To determine what stakeholders perceive as barriers and facilitators to creating a national public health observatory (PHO) in Trinidad and Tobago. A descriptive study was conducted based on 15 key informant interviews carried out from April to September 2013. The key informants worked within the health care sector in Trinidad and Tobago. Using a semi-structured interview guide, information was collected on knowledge, attitudes, and beliefs about creating a PHO; barriers and facilitators to creating and sustaining a PHO; legal considerations; and human resource and information technology requirements. Common themes of the responses were identified. The majority of participants supported the development of a national PHO, recognized its value in informing their work, and indicated that a national PHO could 1) provide information to support evidence-informed decision-making for health policy and strategic planning; 2) facilitate data management by establishing data policies, procedures, and standards; 3) increase the use of data by synthesizing and disseminating information; and 4) provide data for benchmarking. However, a number of barriers were identified, including 1) the perception that data collection is not valued; 2) untimely availability of data; 3) limited data synthesis, dissemination, and utilization to inform decision-making; and 4) challenges related to the allocation of human resources and existing information technology. Key informants support the development of a national PHO in Trinidad and Tobago. The findings align well within the components of the conceptual framework for establishing national health observatories. A stepwise approach to establishing a national PHO in Trinidad and Tobago, beginning with structural components and followed by functional components, is recommended. A national PHO in Trinidad and Tobago could serve as a model for other countries in the Caribbean.

  11. Utilization of medical and health-related services among school-age children and adolescents with special health care needs (1994 National Health Interview Survey on Disability [NHIS-D] Baseline Data).

    PubMed

    Weller, Wendy E; Minkovitz, Cynthia S; Anderson, Gerard F

    2003-09-01

    To determine how sociodemographic factors and type of insurance influence use of medical and health-related services by children with special health care needs (CSHCN), after controlling for need. A cross-sectional analysis of 1994 National Health Interview Disability Survey was conducted. Children between 5 and 17 years were identified as chronically ill according to the Questionnaire for Identifying Children with Chronic Conditions (n = 3061). Independent variables included child and family characteristics categorized as predisposing, enabling, and need. Dependent variables included use of 4 medical or 7 health-related services. Most children (88.7%) had seen a physician; 23.9% had an emergency department visit, 11.4% had a mental health outpatient visit, and 6.4% were hospitalized. Health-related service use ranged from <5.0% (transportation and social work) to 65.1% (medical care coordination); 20% to 30% of children used the remaining services (therapeutic, assistive devices, nonmedical care coordination, housing modifications). In fully adjusted logistic models, children with public insurance were significantly more likely than privately insured children to use 2 of the 4 medical services and 5 of the 7 health-related services. Non-Hispanic black children and children from less educated families were significantly less likely to use many of the services examined. In 1994, factors in addition to need influenced medical and health-related service use by CSHCN. Differences in the scope of benefits covered by public insurance compared with private insurance may influence utilization of medical and especially health-related services. Attention is needed to ensure that CSHCN who are racial/ethnic minorities or are from less educated families have access to needed services. Future studies should determine whether these patterns have changed over time.

  12. Net Differences in Interview Data on Chronic Conditions and Information Derived from Medical Records. Vital and Health Statistics, Series 2, No. 57.

    ERIC Educational Resources Information Center

    Madow, William G.

    The California study, based on data from a national survey, compared accuracy and completeness of information on 7,182 chronic health conditions of persons, 17 years of age or older, given in household interviews with diagnostic information given by group medical plan physicians. Overreporting referred to conditions reported in the interview which…

  13. An Exploration of Changes in the Measurement of Mammography in the National Health Interview Survey.

    PubMed

    Gonzales, Felisa A; Willis, Gordon B; Breen, Nancy; Yan, Ting; Cronin, Kathy A; Taplin, Stephen H; Yu, Mandi

    2017-11-01

    Background: Using the National Health Interview Survey (NHIS), we examined the effect of question wording on estimates of past-year mammography among racially/ethnically diverse women ages 40-49 and 50-74 without a history of breast cancer. Methods: Data from one-part ("Have you had a mammogram during the past 12 months?") and two-part ("Have you ever had a mammogram"; "When did you have your most recent mammogram?") mammography history questions administered in the 2008, 2011, and 2013 NHIS were analyzed. χ 2 tests provided estimates of changes in mammography when question wording was either the same (two-part question) or differed (two-part question followed by one-part question) in the two survey years compared. Crosstabulations and regression models assessed the type, extent, and correlates of inconsistent responses to the two questions in 2013. Results: Reports of past-year mammography were slightly higher in years when the one-part question was asked than when the two-part question was asked. Nearly 10% of women provided inconsistent responses to the two questions asked in 2013. Black women ages 50 to 74 [adjusted OR (aOR), 1.50; 95% confidence interval (CI), 1.16-1.93] and women ages 40-49 in poor health (aOR, 2.22; 95% CI, 1.09-4.52) had higher odds of inconsistent responses; women without a usual source of care had lower odds (40-49: aOR, 0.42; 95% CI, 0.21-0.85; 50-74: aOR, 0.42; 95% CI, 0.24-0.74). Conclusions: Self-reports of mammography are sensitive to question wording. Researchers should use equivalent questions that have been designed to minimize response biases such as telescoping and social desirability. Impact: Trend analyses relying on differently worded questions may be misleading and conceal disparities. Cancer Epidemiol Biomarkers Prev; 26(11); 1611-8. ©2017 AACR . ©2017 American Association for Cancer Research.

  14. Concordance between current job and usual job in occupational and industry groupings: assessment of the 2010 national health interview survey.

    PubMed

    Luckhaupt, Sara E; Cohen, Martha A; Calvert, Geoffrey M

    2013-09-01

    To determine whether current job is a reasonable surrogate for usual job. Data from the 2010 National Health Interview Survey were utilized to determine concordance between current and usual jobs for workers employed within the past year. Concordance was quantitated by kappa values for both simple and detailed industry and occupational groups. Good agreement is considered to be present when kappa values exceed 60. Overall kappa values ± standard errors were 74.5 ± 0.5 for simple industry, 72.4 ± 0.5 for detailed industry, 76.3 ± 0.4 for simple occupation, 73.7 ± 0.5 for detailed occupation, and 80.4 ± 0.6 for very broad occupational class. Sixty-five of 73 detailed industry groups and 78 of 81 detailed occupation groups evaluated had good agreement between current and usual jobs. Current job can often serve as a reliable surrogate for usual job in epidemiologic studies.

  15. Mental Health Chaplains: Practitioners' Perspectives on Their Value, Purpose and Function in the UK National Health Service

    ERIC Educational Resources Information Center

    Gubi, Peter Madsen; Smart, Harry

    2016-01-01

    There is limited research into the value, purpose and function of Mental Health (MH) Chaplains. Yet, they are employed within National Health Service Trusts in the UK. Eight MH Chaplains were interviewed to explore how they see their value, purpose and function. The data were analysed using interpretative phenomenological analysis. The data reveal…

  16. Mental distress and health care use among survivors of adolescent and young adult cancer: A cross-sectional analysis of the National Health Interview Survey.

    PubMed

    Kaul, Sapna; Avila, Jaqueline C; Mutambudzi, Miriam; Russell, Heidi; Kirchhoff, Anne C; Schwartz, Cindy L

    2017-03-01

    The current study was conducted to examine the prevalence and correlates of mental distress among survivors of adolescent and young adult (AYA) cancer and a comparison group. A total of 875 AYA cancer survivors who were diagnosed between the ages of 15 and 39 years and who were at least 5 years from their initial diagnosis were identified from the 2013 and 2014 National Health Interview Surveys. A comparison group was created. The Kessler nonspecific mental/psychological distress scale was used to examine none/low, moderate, and severe distress. The issues of whether individuals talked to mental health professionals within the previous year and if they could afford mental health care also were examined. Variables (ie, demographics, behavioral [eg, smoking status], comorbidity, and mental health visits) associated with distress among the 2 groups were identified using multinomial logistic regressions. Survivors reported mental distress more often than the comparison group (moderate: 23.2% vs 16.9%; and severe: 8.4% vs 3.0% [P<.001]). Survivors cited not being able to afford mental health care more often (6.4% vs 2.3%; P = .002). Moreover, 74.7% and 52.2% of survivors, respectively, with moderate and severe distress had not talked to a mental health professional. Contrary to the comparison group, survivors who were current smokers reported severe distress more often compared with nonsmokers (relative risk, 3.59; 95% confidence interval, 1.46-8.84 [P = .01]). Having public and no insurance versus private insurance and report of sleep-related trouble within the previous week were found to be associated with greater distress among survivors. AYA cancer survivors are more likely to demonstrate mental distress than individuals without cancer. Nevertheless, few survivors may be receiving professional mental health services. Survivors need greater access to mental health screening and counseling to address the current gaps in care delivery. Cancer 2017;123:869-78.

  17. Health Services Use and Costs for Americans with Intellectual and Developmental Disabilities: A National Analysis

    ERIC Educational Resources Information Center

    Fujiura, Glenn T.; Li, Henan; Magaña, Sandy

    2018-01-01

    Health services and associated costs for adults with intellectual and developmental disabilities (IDD) were nationally profiled and the predictors of high expense users statistically modeled. Using linked data from the National Health Interview Survey and Medical Expenditure Panel Survey for the years 2002 through 2011, the study found a mixed…

  18. Native Americans in the Health Professions: Two Interviews.

    ERIC Educational Resources Information Center

    Westberg, Jane

    1999-01-01

    Interviews with Dr. Joseph Bell, president of the American Association of Indian Physicians (AAIP), and Wabanang Kuczek, physician assistant, discuss health-care services needed by Native people, AAIP efforts to recruit Indian students into medicine, links to traditional healing, key health issues facing Indian people, and career opportunities as…

  19. The political ecology of health: perceptions of environment, economy, health and well-being among 'Namgis First Nation.

    PubMed

    Richmond, C; Elliott, S J; Matthews, R; Elliott, B

    2005-12-01

    Informed by Mayer's (Progr. Hum. Geogr 20 (1996) 441) political ecology of disease framework, this paper investigates First Nation's perceptions of the links between environment, economy and health and well-being. A case study of 'Namgis First Nation (Alert Bay, British Columbia, Canada) is used to explore the risks and benefits of salmon aquaculture for British Columbia's First Nations. Analysis of interview data (n = 23) indicates strong links between reduced access to environmental resources, marginal participation in the economy, and declining community health and well being. Results suggest that aquaculture development has further decreased the community's access to environmental resources, thereby restricting those economic, social, and cultural activities that determine good health and well-being for this community.

  20. Motivational interviewing in the health care setting

    USDA-ARS?s Scientific Manuscript database

    Alcohol use disorders are related to many negative health, emotional, societal, and economic consequences. These disorders are often difficult to treat because individuals suffering from them tend to be ambivalent about and resistant to change. Motivational interviewing (MI) provides healthcare prov...

  1. Impact of HPV testing, HPV vaccine development, and changing screening frequency on national Pap test volume: projections from the National Health Interview Survey (NHIS).

    PubMed

    Eltoum, Isam A; Roberson, Janie

    2007-02-25

    The frequently cited number of 50 million annual Papanicolaou cervical screening (Pap) tests performed in the US was based on the National Health Interview Survey (NHIS) of the 1980s. Since then, monumental changes have occurred. More change will soon follow when primary human papilloma virus (HPV) testing and/or HPV vaccine delivery are fully accepted and implemented. The objectives of this study were 1) to estimate the total annual Pap tests performed in the US based on recent NHIS surveys, and 2) to estimate the potential change in the total annual Pap volume produced by changing demographics, reduced screening frequency, HPV testing, and the HPV vaccine. In the NHIS 2000 and NHIS 2005, women were asked to report the frequency of their Pap tests for the 6 years prior to the interview and to report whether they had abnormal findings. The authors analyzed the survey respondents answers to these questions by using SAS Survey Procedures (SAS Institute, NC). The results were stratified by age, and the total national volume was then extrapolated from a similarly stratified 2000 US census. The projected increase of total Pap tests for the next 25 years was determined by using the projected census data. Potential reductions of Pap tests performed secondarily to HPV testing of women >30 years old and of HPV vaccination were also determined. Based on NHIS 2000 and NHIS 2005, 66 million (95% CI, 65-68) and 65 million (95% CI, 64-67) Pap tests were performed in the US, respectively. Had HPV testing been performed in women older than 30 years who had both negative HPV and negative 3-year Pap tests, then 30% (95% CI, 29-32%) of Pap tests would not have been performed. If both HPV testing and vaccination are performed, the total number of Pap tests performed annually is predicted to be reduced by 43% (95% CI, 35-38%). Therefore, despite an expected increase in the population of women eligible for Pap tests, the total number will likely decrease substantially in the future

  2. Positive Health Psychology: An Interview with Shelley Taylor.

    ERIC Educational Resources Information Center

    Rich, Grant Jewell

    2000-01-01

    Presents an interview with Shelley Taylor, a professor of Psychology at the University of California in Los Angles (California). Addresses topics such as how she became interested in psychology, the importance of health psychology in the curriculum, the ideal training for students in health psychology, and her work with "positive illusions." (CMK)

  3. Students' perspectives on promoting healthful food choices from campus vending machines: a qualitative interview study.

    PubMed

    Ali, Habiba I; Jarrar, Amjad H; Abo-El-Enen, Mostafa; Al Shamsi, Mariam; Al Ashqar, Huda

    2015-05-28

    Increasing the healthfulness of campus food environments is an important step in promoting healthful food choices among college students. This study explored university students' suggestions on promoting healthful food choices from campus vending machines. It also examined factors influencing students' food choices from vending machines. Peer-led semi-structured individual interviews were conducted with 43 undergraduate students (33 females and 10 males) recruited from students enrolled in an introductory nutrition course in a large national university in the United Arab Emirates. Interviews were audiotaped, transcribed, and coded to generate themes using N-Vivo software. Accessibility, peer influence, and busy schedules were the main factors influencing students' food choices from campus vending machines. Participants expressed the need to improve the nutritional quality of the food items sold in the campus vending machines. Recommendations for students' nutrition educational activities included placing nutrition tips on or beside the vending machines and using active learning methods, such as competitions on nutrition knowledge. The results of this study have useful applications in improving the campus food environment and nutrition education opportunities at the university to assist students in making healthful food choices.

  4. Effect of unaffordable medical need on distress level of family member: analyses of 1997-2013 United States National Health Interview Surveys.

    PubMed

    Chih, Hui Jun; Liang, Wenbin

    2017-09-02

    Reduced funding to public health care systems during economic downturns is a common phenomenon around the world. The effect of health care cost on family members of the patients has not been established. This paper aims to explore the relationship between affordability of health care and vulnerability of family members to distress levels. Data of a total of 262,843 participants were obtained from 17 waves (1997-2013) of the United States National Health Interview Survey. Multinomial logistic regression was used to investigate psychological distress level as a result of having family members who experienced unmet medical needs due to cost. Among participants without family members who experienced unmet needs for medical care due to cost, risks of having 'moderate' (score of 5-12) or 'serious' (score of 13 or above) level of psychological distress were 1.0% and 11.5%, respectively. Risks of having 'moderate' or 'serious' level of psychological distress were 3.1% and 23.4%, respectively among participants with family members who experienced unmet needs. The adjusted relative risk ratio of 'moderate' and 'serious', as compared to 'normal' level of psychological distress, were 1.58 (95% confidence interval: 1.47-1.69) and 2.09 (95% confidence interval: 1.78-2.45) if one's family members experienced unmet medical needs. Unmet medical needs due to cost increases risk of distress levels experienced by family members. Careful planning and adequate funding to public health care system could be implemented to prevent any unnecessary detrimental effect on mental health among family members of the unwell and any further increment of the prevalence of mental illnesses. This recommendation aligns with the World Health Organization Mental Health Action Plan 2013-2020.

  5. The effect of cigarette price increase on the cigarette consumption in Taiwan: evidence from the National Health Interview Surveys on cigarette consumption.

    PubMed

    Lee, Jie-Min; Hwang, Tsorng-Chyi; Ye, Chun-Yuan; Chen, Sheng-Hong

    2004-12-14

    This study uses cigarette price elasticity to evaluate the effect of a new excise tax increase on cigarette consumption and to investigate responses from various types of smokers. Our sample consisted of current smokers between 17 and 69 years old interviewed during an annual face-to-face survey conducted by Taiwan National Health Research Institutes between 2000 to 2003. We used Ordinary Least Squares (OLS) procedure to estimate double logarithmic function of cigarette demand and cigarette price elasticity. In 2002, after Taiwan had enacted the new tax scheme, cigarette price elasticity in Taiwan was found to be -0.5274. The new tax scheme brought about an average annual 13.27 packs/person (10.5%) reduction in cigarette consumption. Using the cigarette price elasticity estimate from -0.309 in 2003, we calculated that if the Health and Welfare Tax were increased by another NT 3 dollars per pack and cigarette producers shifted this increase to the consumers, cigarette consumption would be reduced by 2.47 packs/person (2.2%). The value of the estimated cigarette price elasticity is smaller than one, meaning that the tax will not only reduce cigarette consumption but it will also generate additional tax revenues. Male smokers who had no income or who smoked light cigarettes were found to be more responsive to changes in cigarette price. An additional tax added to the cost of cigarettes would bring about a reduction in cigarette consumption and increased tax revenues. It would also help reduce incidents smoking-related illnesses. The additional tax revenues generated by the tax increase could be used to offset the current financial deficiency of Taiwan's National Health Insurance program and provide better public services.

  6. Americans Needing Home Care, United States. Data from the National Health Survey.

    ERIC Educational Resources Information Center

    Feller, Barbara A.

    1986-01-01

    This report presents information from the Home Care Supplement to the National Health Interview Survey (NHIS) on the types of help needed by adults with chronic health problems who live outside of institutions. Home care items discussed include: (1) assistance in basic physical activities; (2) assistance in home management activities; (3) adults…

  7. [Physical activity: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

    PubMed

    Krug, S; Jordan, S; Mensink, G B M; Müters, S; Finger, J; Lampert, T

    2013-05-01

    Regular physical activity can have a positive effect on health at any age. Today's lifestyles, however, can often be characterised as sedentary. Therefore, the promotion of physical activity and sports has become an integral part of public health measures. The representative data of adults aged 18 to 79 years in Germany obtained from the "German Health Interview and Examination Survey for Adults" (DEGS1) provide an overview of self-estimated current physical activity behaviour. The results show that one third of the adult population claims to pay close attention to reaching a sufficient level of physical activity and one fourth participates in sports for at least 2 h/week on a regular basis. Thus, the percentage of adults regularly engaged in sports has increased compared to the previous "German National Health Interview and Examination Survey 1998". Still, four out of five adults do not achieve at least 2.5 h/week of moderate-intensity physical activity as recommended by the World Health Organisation. Consequently, future individual-level and population-level interventions should focus on target group-specific measures while continuing to promote regular physical activity in all segments of the population. An English full-text version of this article is available at SpringerLink as supplemental.

  8. Telephone health services in the field of rare diseases: a qualitative interview study examining the needs of patients, relatives, and health care professionals in Germany.

    PubMed

    Babac, Ana; Frank, Martin; Pauer, Frédéric; Litzkendorf, Svenja; Rosenfeldt, Daniel; Lührs, Verena; Biehl, Lisa; Hartz, Tobias; Storf, Holger; Schauer, Franziska; Wagner, Thomas O F; Graf von der Schulenburg, J-Matthias

    2018-02-09

    Rare diseases are, by definition, very serious and chronic diseases with a high negative impact on quality of life. Approximately 350 million people worldwide live with rare diseases. The resulting high disease burden triggers health information search, but helpful, high-quality, and up-to-date information is often hard to find. Therefore, the improvement of health information provision has been integrated in many national plans for rare diseases, discussing the telephone as one access option. In this context, this study examines the need for a telephone service offering information for people affected by rare diseases, their relatives, and physicians. In total, 107 individuals participated in a qualitative interview study conducted in Germany. Sixty-eight individuals suffering from a rare disease or related to somebody with rare diseases and 39 health care professionals took part. Individual interviews were conducted using a standardized semi-structured questionnaire. Interviews were analysed using the qualitative content analysis, triangulating patients, relatives, and health care professionals. The fulfilment of qualitative data processing standards has been controlled for. Out of 68 patients and relatives and 39 physicians, 52 and 18, respectively, advocated for the establishment of a rare diseases telephone service. Interviewees expected a helpline to include expert staffing, personal contact, good availability, low technical barriers, medical and psychosocial topics of counselling, guidance in reducing information chaos, and referrals. Health care professionals highlighted the importance of medical topics of counselling-in particular, differential diagnostics-and referrals. Therefore, the need for a national rare diseases helpline was confirmed in this study. Due to limited financial resources, existing offers should be adapted in a stepwise procedure in accordance with the identified attributes.

  9. Evaluation of a mock interview session on residency interview skills.

    PubMed

    Buckley, Kelsey; Karr, Samantha; Nisly, Sarah A; Kelley, Kristi

    2018-04-01

    To evaluate the impact of student pharmacist participation in a mock interview session on confidence level and preparation regarding residency interview skills. The study setting was a mock interview session, held in conjunction with student programming at the American College of Clinical Pharmacy (ACCP) Annual Meeting. Prior to the mock interview session, final year student pharmacists seeking residency program placement were asked to complete a pre-session survey assessing confidence level for residency interviews. Each student pharmacist participated in up to three mock interviews. A post-session survey evaluating confidence level was then administered to consenting participants. Following the American Society for Health-System Pharmacists (ASHP) Pharmacy Resident Matching Program (RMP), a post-match electronic survey was sent to study participants to determine their perception of the influence of the mock interview session on achieving successful interactions during residency interviews. A total of 59 student pharmacists participated in the mock interview session and completed the pre-session survey. Participants completing the post-session survey (88%, n = 52) unanimously reported an enhanced confidence in interviewing skills following the session. Thirty responders reported a program match rate of 83%. Approximately 97% (n = 29) of the respondents agreed or strongly agreed that the questions asked during the mock interview session were reflective of questions asked during residency interviews. Lessons learned from this mock interview session can be applied to PGY1 residency mock interview sessions held locally, regionally, and nationally. Students participating in the ACCP Mock Interview Session recognized the importance of the interview component in obtaining a postgraduate year 1 (PGY1) pharmacy residency. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. [Changes in the prevalence of statin use in Germany - findings from national health interview and examination surveys 1997-1999 and 2008-2011].

    PubMed

    Knopf, Hildtraud C; Busch, Markus A; Du, Yong; Truthmann, Julia; Schienkiewitz, Anja; Scheidt-Nave, Christa

    2017-05-01

    Evidence-based guideline recommendations on lipid lowering drug treatment, in particular statin treatment, play an essential role in the management of dyslipidemias and in the prevention of cardiovascular disease events. In Germany, statutory health insurance data provide information on time trends in the prescription of lipid lowering drugs. However, population-based data regarding changes in user prevalence according to socio-demographic and health-related characteristics are lacking. Based on data from national health interview and examination surveys for adults in Germany 1997-1999 (GNHIES98) and 2008-2010 (DEGS1), the present analysis aims to close this information gap with a particular focus on the use of statins. The study population consisted of 7,099 participants (GNHIES98) and 7,091 participants (DEGS1) aged 18 to 79 years at the time of the respective surveys. Primary data on medication use within 7 days prior to the survey were collected using standardized medication interviews and brown-bag drug review. Unique product identifiers on original drug containers were scanned and coded according to the latest version of the Anatomical Therapeutic Chemical (ATC) classification system. Medical history was obtained in computer-assisted personal interviews. A history of stroke or coronary heart disease (CHD) was assessed among persons aged 40 to 79 years only, and previous stroke or CHD were defined as cardiovascular disease. Obesity was defined as a body mass index (BMI) of ≥ 30kg/m 2 ) based on calculation from standardized measures of body weight and height. Information on socio-demographic variables and type of health insurance was collected using standardized self-administered questionnaires. In cross-sectional descriptive analyses we calculated the prevalence of statin use (ATC codes: C10AA, C10BA, C10BX) by survey as well as the changes between surveys stratified according to relevant preexisting diseases and other co-variables. The association between

  11. The National Map Customer Requirements: Findings from Interviews and Surveys

    USGS Publications Warehouse

    Sugarbaker, Larry; Coray, Kevin E.; Poore, Barbara

    2009-01-01

    The purpose of this study was to receive customer feedback and to understand data and information requirements for The National Map. This report provides results and findings from interviews and surveys and will guide policy and operations decisions about data and information requirements leading to the development of a 5-year strategic plan for the National Geospatial Program. These findings are based on feedback from approximately 2,200 customers between February and August 2008. The U.S. Geological Survey (USGS) conducted more than 160 interviews with 200 individuals. The American Society for Photogrammetry and Remote Sensing (ASPRS) and the International Map Trade Association (IMTA) surveyed their memberships and received feedback from over 400 members. The Environmental Systems Research Institute (ESRI) received feedback from over 1,600 of its U.S.-based software users through an online survey sent to customers attending the ESRI International User Conference in the summer of 2008. The results of these surveys were shared with the USGS and have been included in this report.

  12. Design and operation of the National Survey of Children with Special Health Care Needs, 2009-2010.

    PubMed

    Bramlett, Matthew D; Blumberg, Stephen J; Ormson, A Elizabeth; George, Jacquelyn M; Williams, Kim L; Frasier, Alicia M; Skalland, Benjamin J; Santos, Kathleen B; Vsetecka, Danielle M; Morrison, Heather M; Pedlow, Steven; Wang, Fang

    2014-11-01

    This report presents the development, plan, and operation of the 2009-2010 National Survey of Children with Special Health Care Needs, a module of the State and Local Area Integrated Telephone Survey. The survey is conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. This survey was designed to produce national and state-specific prevalence estimates of children with special health care needs (CSHCN), to describe the types of services that they need and use, and to assess aspects of the system of care for CSHCN. A random-digit-dial sample of households with children under age 18 years was constructed for each of the 50 states and the District of Columbia. The sampling frame consisted of landline phone numbers and cellular(cell) phone numbers of households that reported a cell-phone-only or cell-phone-mainly status. Children in identified households were screened for special health care needs. If CSHCN were identified in the household, a detailed interview was conducted for one randomly selected child with special health care needs. Respondents were parents or guardians who knew about the children's health and health care. A total of 196,159 household screening interviews were completed from July 2009 through March 2011, resulting in 40,242 completed special-needs interviews, including 2,991 from cell-phone interviews. The weighted overall response rate was 43.7% for the landline sample, 15.2% for the cell-phone sample, and 25.5% overall. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  13. Prevalence of Multiple Chronic Conditions Among US Adults: Estimates From the National Health Interview Survey, 2010

    PubMed Central

    Schiller, Jeannine S.

    2013-01-01

    Preventing and ameliorating chronic conditions has long been a priority in the United States; however, the increasing recognition that people often have multiple chronic conditions (MCC) has added a layer of complexity with which to contend. The objective of this study was to present the prevalence of MCC and the most common MCC dyads/triads by selected demographic characteristics. We used respondent-reported data from the 2010 National Health Interview Survey (NHIS) to study the US adult civilian noninstitutionalized population aged 18 years or older (n = 27,157). We categorized adults as having 0 to 1, 2 to 3, or 4 or more of the following chronic conditions: hypertension, coronary heart disease, stroke, diabetes, cancer, arthritis, hepatitis, weak or failing kidneys, chronic obstructive pulmonary disease, or current asthma. We then generated descriptive estimates and tested for significant differences. Twenty-six percent of adults have MCC; the prevalence of MCC has increased from 21.8% in 2001 to 26.0% in 2010. The prevalence of MCC significantly increased with age, was significantly higher among women than men and among non-Hispanic white and non-Hispanic black adults than Hispanic adults. The most common dyad identified was arthritis and hypertension, and the combination of arthritis, hypertension, and diabetes was the most common triad. The findings of this study contribute information to the field of MCC research. The NHIS can be used to identify population subgroups most likely to have MCC and potentially lead to clinical guidelines for people with more common MCC combinations. PMID:23618545

  14. The effect of cigarette price increase on the cigarette consumption in Taiwan: evidence from the National Health Interview Surveys on cigarette consumption

    PubMed Central

    Lee, Jie-Min; Hwang, Tsorng-Chyi; Ye, Chun-Yuan; Chen, Sheng-Hong

    2004-01-01

    Background This study uses cigarette price elasticity to evaluate the effect of a new excise tax increase on cigarette consumption and to investigate responses from various types of smokers. Methods Our sample consisted of current smokers between 17 and 69 years old interviewed during an annual face-to-face survey conducted by Taiwan National Health Research Institutes between 2000 to 2003. We used Ordinary Least Squares (OLS) procedure to estimate double logarithmic function of cigarette demand and cigarette price elasticity. Results In 2002, after Taiwan had enacted the new tax scheme, cigarette price elasticity in Taiwan was found to be -0.5274. The new tax scheme brought about an average annual 13.27 packs/person (10.5%) reduction in cigarette consumption. Using the cigarette price elasticity estimate from -0.309 in 2003, we calculated that if the Health and Welfare Tax were increased by another NT$ 3 per pack and cigarette producers shifted this increase to the consumers, cigarette consumption would be reduced by 2.47 packs/person (2.2%). The value of the estimated cigarette price elasticity is smaller than one, meaning that the tax will not only reduce cigarette consumption but it will also generate additional tax revenues. Male smokers who had no income or who smoked light cigarettes were found to be more responsive to changes in cigarette price. Conclusions An additional tax added to the cost of cigarettes would bring about a reduction in cigarette consumption and increased tax revenues. It would also help reduce incidents smoking-related illnesses. The additional tax revenues generated by the tax increase could be used to offset the current financial deficiency of Taiwan's National Health Insurance program and provide better public services. PMID:15598345

  15. Implementing Health Impact Assessment at National Level: An Experience in Iran.

    PubMed

    Damari, Behzad; Vosoogh-Moghaddam, Abbas; Riazi-Isfahani, Sahand

    2018-02-01

    According to the general health policies issued in 2014, Health Impact Assessment (HIA) or Health Annex should be implemented in Iran. The present study provided a model for executing HIA in the Iranian context as a developing country. This is a system design study with the qualitative approach. The data on the system components were gathered via reviews of the literature, in-depth interviews and focused group discussions (FGDs) with experts. The information were contently analyzed in order to draft the model and a consensus was reached on by the steering committee. Fifteen in-depth interviews and six FGD meeting were conducted. The equity-based approach in assessing the health impacts of policies, programs and projects were chosen as the most practical tool. Experts believe that for the next five years, HIA should be used just for the "national projects" so that the ministries and national agencies could be empowered. Components of the model including structure, procedures, and standards, management style, mission and resources were prepared. The national regulations and protocols were sent to the SCHFS Secretariat for final revision and the council approval. The hasty implementation of HIA will face serious resistances as the health-oriented attitude and behavior in both government and non-governmental sectors will gradually form. Also, the overlapping of the contents of HIA with other tools such as Environmental, Cultural and Social Impact Assessments, currently used by other sectors, causes difficulties in implementing the HIA by the Ministry of Health and Medical Education.

  16. [The National Board of Health's information pamphlet to pregnant women causes insecurity].

    PubMed

    Jensen, Puk; Brodersen, John

    2010-06-07

    Since 2004, all pregnant women in Denmark have been offered prenatal screening. The aim of this study was to investigate how the Danish National Board of Health's information pamphlet adressed to pregnant women was perceived by young female readers. Five women aged 23-26 years were interviewed. At the time of the interview, none of the women were pregnant or had previously been pregnant. The five individual interviews were carried out using a semi-structured interview guide. They were recorded, transcribed and analysed using Steinar Kvale's theory of meaning condensation. After reading the pamphlet, the informants became worried, anxious or frightened about the risk of giving birth to a seriously ill or handicapped child. They all wanted a risk estimation in order to be reassured that they were going to have a healthy child. The existence of a screening programme was perceived as an indication of risk. In its present form, the information pamphlet of the Danish National Board of Health suggests a yes rather than a no regarding participation in prenatal screening. This is reprehensible, partly because the aim of the pamphlet was to strengthen the self-determination of pregnant women, and partly because the benefits of participation in the screening programme do not clearly outweigh the corresponding drawbacks for the individual pregnant woman.

  17. Adults with an epilepsy history fare significantly worse on positive mental and physical health than adults with other common chronic conditions-Estimates from the 2010 National Health Interview Survey and Patient Reported Outcome Measurement System (PROMIS) Global Health Scale.

    PubMed

    Kobau, Rosemarie; Cui, Wanjun; Zack, Matthew M

    2017-07-01

    Healthy People 2020, a national health promotion initiative, calls for increasing the proportion of U.S. adults who self-report good or better health. The Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health Scale (GHS) was identified as a reliable and valid set of items of self-reported physical and mental health to monitor these two domains across the decade. The purpose of this study was to examine the percentage of adults with an epilepsy history who met the Healthy People 2020 target for self-reported good or better health and to compare these percentages to adults with history of other common chronic conditions. Using the 2010 National Health Interview Survey, we compared and estimated the age-standardized prevalence of reporting good or better physical and mental health among adults with five selected chronic conditions including epilepsy, diabetes, heart disease, cancer, and hypertension. We examined response patterns for physical and mental health scale among adults with these five conditions. The percentages of adults with epilepsy who reported good or better physical health (52%) or mental health (54%) were significantly below the Healthy People 2020 target estimate of 80% for both outcomes. Significantly smaller percentages of adults with an epilepsy history reported good or better physical health than adults with heart disease, cancer, or hypertension. Significantly smaller percentages of adults with an epilepsy history reported good or better mental health than adults with all other four conditions. Health and social service providers can implement and enhance existing evidence-based clinical interventions and public health programs and strategies shown to improve outcomes in epilepsy. These estimates can be used to assess improvements in the Healthy People 2020 Health-Related Quality of Life and Well-Being Objective throughout the decade. Published by Elsevier Inc.

  18. The Community Child Health Network Life Stress Interview: a brief chronic stress measure for community health research.

    PubMed

    Tanner Stapleton, Lynlee R; Dunkel Schetter, Christine; Dooley, Larissa N; Guardino, Christine M; Huynh, Jan; Paek, Cynthia; Clark-Kauffman, Elizabeth; Schafer, Peter; Woolard, Richard; Lanzi, Robin Gaines

    2016-07-01

    Chronic stress is implicated in many theories as a contributor to a wide range of physical and mental health problems. The current study describes the development of a chronic stress measure that was based on the UCLA Life Stress Interview (LSI) and adapted in collaboration with community partners for use in a large community health study of low-income, ethnically diverse parents of infants in the USA (Community Child Health Network [CCHN]). We describe the instrument, its purpose and adaptations, implementation, and results of a reliability study in a subsample of the larger study cohort. Interviews with 272 mothers were included in the present study. Chronic stress was assessed using the CCHN LSI, an instrument designed for administration by trained community interviewers to assess four domains of chronic stress, each rated by interviewers. Significant correlations ranging from small to moderate in size between chronic stress scores on this measure, other measures of stress, biomarkers of allostatic load, and mental health provide initial evidence of construct and concurrent validity. Reliability data for interviewer ratings are also provided. This relatively brief interview (15 minutes) is available for use and may be a valuable tool for researchers seeking to measure chronic stress reliably and validly in future studies with time constraints.

  19. 76 FR 60531 - National Institute of Justice Interview Room Recording Systems and License Plate Readers Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-29

    ... Justice Interview Room Recording Systems and License Plate Readers Workshop AGENCY: National Institute of Justice. ACTION: Notice of the Interview Room Recording Systems and License Plate Readers Workshops.... The focus of the workshops is the development of NIJ performance standards for Interview Room...

  20. The DeMarco factor: interview with a health policy advocate.

    PubMed

    Jernigan, David H

    2010-05-01

    An interview with Vincent DeMarco, President of the Maryland Citizen's Health Initiative, reviews the history and strategies used to win victories for public health on gun policy and tobacco taxes and to seek passage of higher alcohol taxes in the state of Maryland. DeMarco emphasizes the need to build broad coalitions, to engage policy makers at election time and not just or primarily during legislative sessions, and to take advantage of the power of the news media as a microphone for reaching millions of possible supporters. The interview concludes with recommendations for public health training and practitioners in order to become successful policy advocates in a rapidly changing media and political landscape.

  1. HIV policy implementation in two health and demographic surveillance sites in Uganda: findings from a national policy review, health facility surveys and key informant interviews.

    PubMed

    McRobie, Ellen; Wringe, Alison; Nakiyingi-Miiro, Jessica; Kiweewa, Francis; Lutalo, Tom; Nakigozi, Gertrude; Todd, Jim; Eaton, Jeffrey William; Zaba, Basia; Church, Kathryn

    2017-04-05

    Successful HIV testing, care and treatment policy implementation is essential for realising the reductions in morbidity and mortality those policies are designed to target. While adoption of new HIV policies is rapid, less is known about the facility-level implementation of new policies and the factors influencing this. We assessed implementation of national policies about HIV testing, treatment and retention at health facilities serving two health and demographic surveillance sites (HDSS) (10 in Kyamulibwa, 14 in Rakai). Ugandan Ministry of Health HIV policy documents were reviewed in 2013, and pre-determined indicators were extracted relating to the content and nature of guidance on HIV service provision. Facility-level policy implementation was assessed via a structured questionnaire administered to in-charge staff from each health facility. Implementation of policies was classified as wide (≥75% facilities), partial (26-74% facilities) or minimal (≤25% facilities). Semi-structured interviews were conducted with key informants (policy-makers, implementers, researchers) to identify factors influencing implementation; data were analysed using the Framework Method of thematic analysis. Most policies were widely implemented in both HDSS (free testing, free antiretroviral treatment (ART), WHO first-line regimen as standard, Option B+). Both had notable implementation gaps for policies relating to retention on treatment (availability of nutritional supplements, support groups or isoniazid preventive therapy). Rakai implemented more policies relating to provision of antiretroviral treatment than Kyamulibwa and performed better on quality of care indicators, such as frequency of stock-outs. Factors facilitating implementation were donor investment and support, strong scientific evidence, low policy complexity, phased implementation and effective planning. Limited human resources, infrastructure and health management information systems were perceived as major

  2. Neighborhood Social Cohesion and Sleep Outcomes in the Native Hawaiian and Pacific Islander National Health Interview Survey.

    PubMed

    Young, Marielle C; Gerber, Monica W; Ash, Tayla; Horan, Christine M; Taveras, Elsie M

    2018-05-16

    Native Hawaiians and Pacific Islanders (NHPIs) have the lowest attainment of healthy sleep duration among all racial and ethnic groups in the United States. We examined associations of neighborhood social cohesion with sleep duration and quality. Cross-sectional analysis of 2,464 adults in the NHPI National Health Interview Survey (2014). Neighborhood social cohesion was categorized as a continuous and categorical variable into low (<12), medium (12-14) and high (>15) according to tertiles of the distribution of responses. We used multinomial logistic regression to examine the adjusted odds ratio of short and long sleep duration relative to intermediate sleep duration. We used binary logistic regression for dichotomous sleep quality outcomes. Sleep outcomes were modeled as categorical variables. 40% of the cohort reported short (<7 hours) sleep duration and only 4% reported long (>9 hours) duration. Mean (SE, range) social cohesion score was 12.4 units (0.11, 4-16) and 23% reported low social cohesion. In multivariable models, each 1 SD decrease in neighborhood social cohesion score was associated with higher odds of short sleep duration (OR: 1.14, 95% CI: 1.02, 1.29). Additionally, low social cohesion was associated with increased odds of short sleep duration (OR: 1.53, 95% CI: 1.10, 2.13). No associations between neighborhood social cohesion and having trouble falling or staying asleep and feeling well rested were found. Low neighborhood social cohesion is associated with short sleep duration in NHPIs.

  3. Trends in death rates among U.S. adults with and without diabetes between 1997 and 2006: findings from the National Health Interview Survey.

    PubMed

    Gregg, Edward W; Cheng, Yiling J; Saydah, Sharon; Cowie, Catherine; Garfield, Sanford; Geiss, Linda; Barker, Lawrence

    2012-06-01

    To determine whether all-cause and cardiovascular disease (CVD) death rates declined between 1997 and 2006, a period of continued advances in treatment approaches and risk factor control, among U.S. adults with and without diabetes. We compared 3-year death rates of four consecutive nationally representative samples (1997-1998, 1999-2000, 2001-2002, and 2003-2004) of U.S. adults aged 18 years and older using data from the National Health Interview Surveys linked to National Death Index. Among diabetic adults, the CVD death rate declined by 40% (95% CI 23-54) and all-cause mortality declined by 23% (10-35) between the earliest and latest samples. There was no difference in the rates of decline in mortality between diabetic men and women. The excess CVD mortality rate associated with diabetes (i.e., compared with nondiabetic adults) decreased by 60% (from 5.8 to 2.3 CVD deaths per 1,000) while the excess all-cause mortality rate declined by 44% (from 10.8 to 6.1 deaths per 1,000). Death rates among both U.S. men and women with diabetes declined substantially between 1997 and 2006, reducing the absolute difference between adults with and without diabetes. These encouraging findings, however, suggest that diabetes prevalence is likely to rise in the future if diabetes incidence is not curtailed.

  4. National health spending trends in 1996. National Health Accounts Team.

    PubMed

    Levit, K R; Lazenby, H C; Braden, B R

    1998-01-01

    The National Health Accounts, produced annually by the Health Care Financing Administration's Office of the Actuary, present estimates for 1960-1996 of nationwide spending for health care and the sources funding that care. This year's estimates set two records: Spending topped $1 trillion for the first time, and expenditure growth slowed to the lowest rate seen in thirty-seven years of measuring health care spending--4.4 percent. The combination of decelerating health spending and a growing economy has kept national health spending as a share of the nation's gross domestic product unchanged for the fourth consecutive year.

  5. Correlates of generalized anxiety disorder: independent of co-morbidity with depression: findings from the first Israeli National Health Interview Survey (2003-2004).

    PubMed

    Muhsen, Khitam; Lipsitz, Joshua; Garty-Sandalon, Noga; Gross, Raz; Green, Manfred S

    2008-11-01

    Generalized anxiety disorder (GAD) is a prevalent psychiatric disorder with chronic symptoms and is commonly comorbid with depression. To identify correlates of GAD among adults and to describe treatment patterns and functional limitations among individuals with this disorder. Data for 2,082 subjects aged >or=21 years from the first Israeli national health interview survey (INHIS-1) (2003-2004) were analyzed. Information on GAD was collected using the short form of the Composite International Diagnostic Interview. Data were also obtained on socio-demographic, physical health characteristics, history of life threatening events, treatment seeking behaviors, use of medication and functional impairment. The prevalence of GAD was highest among people aged 40-59 years, in those with asthma, hypertension and in those with osteoporosis. Regular exercise was associated with reduced prevalence for GAD (adjusted OR 0.46, 95% CI 0.22-0.95). The exclusion of individuals with major depression from analysis strengthened the association with age (adjusted OR 5.7, 95% CI 1.7, 19.7), weakened the association between GAD and osteoporosis (adjusted OR 3.4, 95% CI 1.2, 9.8), asthma (adjusted OR 3.4, 95% CI 1.2, 9.5) and regular exercise (adjusted OR 0.47 95% CI 0.2, 1.14). In this sub-sample, hypertension was no longer associated with GAD, and a significant association was found between GAD and past experience of life threatening events (adjusted OR 2.3, 95% CI 1.1-4.9). Psychiatric and psychological consultations were low among people with GAD (11.5% and 26.4% for those without and with comorbid depression, respectively), concurrent with a high degree of functional limitation. Middle age, history of traumatic life events, and certain chronic medical diseases (e.g., asthma and osteoporosis) are important risk factors for GAD. They could be used to help identify and treat people with GAD.

  6. The "Something Else" of Sexual Orientation: Measuring Sexual Identities of Older Lesbian and Bisexual Women Using National Health Interview Survey Questions.

    PubMed

    Eliason, Michele J; Radix, Asa; McElroy, Jane A; Garbers, Samantha; Haynes, Suzanne G

    2016-07-07

    Terminology related to sexuality and gender is constantly evolving, and multiple factors are at play when individuals answer questions on surveys. We examined patterns of responding to the National Health Interview Survey (NHIS) sexual identity questions in a multisite health intervention study for lesbian and bisexual women aged 40 to 84 years. Of 376 participants, 80% (n = 301) chose "lesbian or gay," 13% (n = 49) selected "bisexual," 7% (n = 25) indicated "something else," and 1 participant chose "don't know the answer." In response to the follow-up question for women who said "something else" or "don't know," most (n = 17) indicated that they were "not straight, but identify with another label." One participant chose "transgender, transsexual, or gender variant," five chose "You do not use labels to identify yourself," and three chose "you mean something else." Lesbian, bisexual, and "something else" groups were compared across demographic and health-related measures. Women who reported their sexual identity as "something else" were younger, more likely to have a disability, more likely to be in a relationship with a male partner, and had lower mental health quality of life than women who reported their sexual identity as lesbian or bisexual. Respondents who answer "something else" pose challenges to analysis and interpretation of data, but should not be discarded from samples. Instead, they may represent a subset of the community that views sexuality and gender as fluid and dynamic concepts, not to be defined by a single label. Further study of the various subsets of "something else" is warranted, along with reconsideration of the NHIS question options. Copyright © 2016 Jacobs Institute of Women's Health. All rights reserved.

  7. Breast and cervical cancer screening among Hispanic subgroups in the USA: estimates from the National Health Interview Survey 2008, 2010, and 2013.

    PubMed

    Shoemaker, Meredith L; White, Mary C

    2016-03-01

    This study examined patterns in mammography and Pap test use across and within subpopulations of Hispanic women. Based on data from the National Health Interview Survey (2008, 2010, and 2013), we estimated the proportion of Hispanic women reporting testing for breast and cervical cancer for specific subgroups. We examined test use by demographic characteristics using Chi-square tests. Overall, the proportion of women aged 50-74 years who reported a mammogram within the past 2 years did not differ significantly across Hispanic subgroups. Among publically and uninsured women, however, proportions of mammography utilization varied significantly across Hispanic subgroups. The proportion of women aged 21-65 years who received a Pap test within the past 3 years differed significantly across Hispanic subgroups. Among subgroups of Hispanic women, patterns in mammography and Pap test use vary by insurance status, length of US residency, and type of screening. Certain subgroups of Hispanic women may benefit from culturally tailored efforts to promote breast and cervical cancer screening.

  8. The association between demographic and behavioral characteristics and sunburn among U.S. adults - National Health Interview Survey, 2010.

    PubMed

    Holman, Dawn M; Berkowitz, Zahava; Guy, Gery P; Hartman, Anne M; Perna, Frank M

    2014-06-01

    To examine the association between demographic and behavioral characteristics and sunburn among U.S. adults. We used 2010 National Health Interview Survey data (N=24,970) to conduct multivariable logistic regressions examining associations with having 1 or more sunburns in the past year and having 4 or more sunburns in the past year. Overall, 37.1% of adults experienced sunburn in the past year. The adjusted prevalence of sunburn was particularly common among adults aged 18-29years (52.0%), those who repeatedly burn or freckle after 2weeks in the sun (45.9%), whites (44.3%), indoor tanners (44.1%), those with a family history of melanoma (43.9%), and those who are US-born (39.5%). Physical activity, alcohol consumption, and overweight/obesity were positively associated with sunburn (all P<0.001); sun protection behaviors were not significantly associated with sunburn (P=0.35). Among those who were sunburned in the past year, 12.1% experienced 4 or more sunburns. Sunburn is common, particularly among younger adults, those with a more sun-sensitive skin type, whites, those with a family history of melanoma, the highly physically active, and indoor tanners. Efforts are needed to facilitate sun-safety during outdoor recreation, improve the consistency of sun protection practices, and prevent sunburn, particularly among these subgroups. Published by Elsevier Inc.

  9. [The semi-structured interview: at the border of public health and anthropology].

    PubMed

    Imbert, Geneviève

    2010-09-01

    The interview is the tool for data collection the most used in the context of research conducted in health sciences, human sciences and social sciences. After completing some generalities about the different types of interviews, the focus is on semi-structured interview during its various stages including the processing and data analysis, this from the return of a lived experience of research in work on the border of the field of public health and that of anthropology. If this approach and contextualized the semistructured interview may a priori appear specific, the reader interested in the development of qualitative research in a humanistic perspective and the implementation of multidisciplinary strategies to ascertain its universal character.

  10. Health equity in the New Zealand health care system: a national survey.

    PubMed

    Sheridan, Nicolette F; Kenealy, Timothy W; Connolly, Martin J; Mahony, Faith; Barber, P Alan; Boyd, Mary Anne; Carswell, Peter; Clinton, Janet; Devlin, Gerard; Doughty, Robert; Dyall, Lorna; Kerse, Ngaire; Kolbe, John; Lawrenson, Ross; Moffitt, Allan

    2011-10-20

    In all countries people experience different social circumstances that result in avoidable differences in health. In New Zealand, Māori, Pacific peoples, and those with lower socioeconomic status experience higher levels of chronic illness, which is the leading cause of mortality, morbidity and inequitable health outcomes. Whilst the health system can enable a fairer distribution of good health, limited national data is available to measure health equity. Therefore, we sought to find out whether health services in New Zealand were equitable by measuring the level of development of components of chronic care management systems across district health boards. Variation in provision by geography, condition or ethnicity can be interpreted as inequitable. A national survey of district health boards (DHBs) was undertaken on macro approaches to chronic condition management with detail on cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke and diabetes. Additional data from expert informant interviews on program reach and the cultural needs of Māori and Pacific peoples was sought. Survey data were analyzed on dimensions of health equity relevant to strategic planning and program delivery. Results are presented as descriptive statistics and free text. Interviews were transcribed and NVivo 8 software supported a general inductive approach to identify common themes. Survey responses were received from the majority of DHBs (15/21), some PHOs (21/84) and 31 expert informants. Measuring, monitoring and targeting equity is not systematically undertaken. The Health Equity Assessment Tool is used in strategic planning but not in decisions about implementing or monitoring disease programs. Variable implementation of evidence-based practices in disease management and multiple funding streams made program implementation difficult. Equity for Māori is embedded in policy, this is not so for other ethnic groups or by geography. Populations

  11. National Health Information Center

    MedlinePlus

    ... About ODPHP National Health Information Center National Health Information Center The National Health Information Center (NHIC) is ... of interest View the NHO calendar . Federal Health Information Centers and Clearinghouses Federal Health Information Centers and ...

  12. Prevalence and comorbidity of diabetes mellitus among non-institutionalized older adults in Germany - results of the national telephone health interview survey ‘German Health Update (GEDA)’ 2009

    PubMed Central

    2013-01-01

    Background Despite the major public health impact of diabetes, recent population-based data regarding its prevalence and comorbidity are sparse. Methods The prevalence and comorbidity of diabetes mellitus were analyzed in a nationally representative sample (N = 9133) of the non-institutionalized German adult population aged 50 years and older. Information on physician-diagnosed diabetes and 20 other chronic health conditions was collected as part of the national telephone health interview survey ‘German Health Update (GEDA)’ 2009. Overall, 51.2% of contacted persons participated. Among persons with diabetes, diabetes severity was defined according to the type and number of diabetes-concordant conditions: no diabetes-concordant condition (grade 1); hypertension and/or hyperlipidemia only (grade 2); one comorbidity likely to represent diabetes-related micro- or macrovascular end-organ damage (grade 3); several such comorbidities (grade 4). Determinants of diabetes severity were analyzed by multivariable ordinal regression. Results The 12-month prevalence of diabetes was 13.6% with no significant difference between men and women. Persons with diabetes had a significantly higher prevalence and average number of diabetes-concordant as well as diabetes-discordant comorbidities than persons without diabetes. Among persons with diabetes, 10.2%, 46.8%, 35.6% and 7.4% were classified as having severity grade 1–4, respectively. Determinants of diabetes severity included age (cumulative odds ratio 1.05, 95% confidence interval 1.03-1.07, per year) and number of discordant comorbidities (1.40, 1.25-1.55). With respect to specific discordant comorbidities, diabetes severity was correlated to depression (2.15, 1.29-3.56), respiratory disease (2.75, 1.72-4.41), musculoskeletal disease (1.53, 1.06-2.21), and severe hearing impairment (3.00, 1.21-7.41). Conclusions Diabetes is highly prevalent in the non-institutionalized German adult population 50 years and older. Diabetes

  13. National health care reform and the 103rd Congress: the activities and influence of public health advocates.

    PubMed Central

    Schauffler, H; Wilkerson, J

    1997-01-01

    OBJECTIVES: This study examined the activities and influence of public health interest groups and coalitions on the national health care reform debates in the 103rd Congress. METHODS: Congressional staff and representatives of public health interest groups, coalitions, and government health agencies were interviewed. Content analysis of eight leading national health care reform bills was performed. RESULTS: The public health community coalesced around public health in health care reform; nearly all the major interest groups and government health agencies joined two or more public health or prevention coalitions, and half joined three or more. The most effective influence on health care reform legislation was early, sustained personal contact with Congress members and their staffs, accompanied by succinct written materials summarizing key points. Media campaigns and grassroots mobilization were less effective. Seven of the eight leading health care reform bills included one or more of the priorities supported by public health advocates. CONCLUSIONS: The public health community played an important role in increasing awareness and support for public health programs in the health care reform bills of the 103rd Congress. PMID:9240098

  14. Self-Reported Cognitive Impairment Across Racial/Ethnic Groups in the United States, National Health Interview Survey, 1997-2015.

    PubMed

    Luo, Huabin; Yu, Gary; Wu, Bei

    2018-01-11

    The primary objectives of this study were 1) to examine trends of self-reported cognitive impairment among 5 major racial/ethnic groups during 1997-2015 in the United States and 2) to examine differences in the trends across these groups. Data were from the National Health Interview Survey (NHIS). The sample consisted of 155,682 people aged 60 or older. Respondents were asked to report whether any family member was "limited in any way because of difficulty remembering or because of experiencing periods of confusion." Race/ethnicity categories were non-Hispanic white, non-Hispanic black, Native American, Hispanic, and Asian. We applied hierarchical age-period-cohort cross-classified random-effects models for the trend analysis. All analyses accounted for the complex survey design of NHIS. The overall rate of self-reported cognitive impairment increased from 5.7% in 1997 to 6.7% in 2015 (P for trend <.001). Among non-Hispanic white respondents, the rate increased from 5.2% in 1997 to 6.1% in 2015 (slope = 0.14, P for trend <.001). We observed no significant trend in rate of cognitive impairment in other groups. After we controlled for covariates, we found that Asian (B = 0.31), non-Hispanic black (B = 0.37), Hispanic (B = 0.25), and Native American (B = 0.87) respondents were more likely than non-Hispanic white respondents to report cognitive impairment (P <.001 for all). We found an increased rate of self-reported cognitive impairment in older adults of 5 major racial/ethnic groups from 1997 through 2015 in the United States. However, the rate of self-reported cognitive impairment was low, which may suggest underreporting. There is a need to further promote awareness of the disease among individuals, family members, and health care providers.

  15. Validity of EQ-5D in general population of Taiwan: results of the 2009 National Health Interview and Drug Abuse Survey of Taiwan.

    PubMed

    Yu, Sheng-Tsung; Chang, Hsing-Yi; Yao, Kai-Ping; Lin, Yu-Hsuan; Hurng, Baai-Shyun

    2015-10-01

    The aim of this study was to examine the validity of the EuroQOL five dimensions questionnaire (EQ-5D) using a nationally representative data from the National Health Interview Survey (NHIS) through comparison with short-form 36 (SF-36). Data for this study came from the 2009 NHIS in Taiwan. The study sample was the 4007 participants aged 20-64 years who completed the survey. We used SUDAAN 10.0 (SAS-Callable) to carry out weighed estimation and statistical inference. The EQ index was estimated using norm values from a Taiwanese study as well as from Japan and the United Kingdom (UK). The SF-36 score was standardized using American norm values. In terms of concurrent validity, the EQ-5D met the five hypotheses. The results did not fulfill hypothesis that women would have lower visual analogue scale (EQ-VAS) scores. In terms of discriminant validity, the EQ-5D fulfilled two hypotheses. Our results approached but did not fulfill hypothesis that there would be a weak association between the physical and psychological dimensions of the EQ-5D and the mental component summary score of the SF-36. Results were comparable regardless of whether the Japanese or UK norm value sets were used. We were able to fulfill many, not all of our validity hypotheses regardless of whether the established Japanese or UK norm value sets or the Taiwanese norm values were used. The EQ-5D is an effective and simple instrument for assessing health-related quality of life of general population in Taiwan.

  16. Physical and mental health status of survivors of multiple cancer diagnoses: findings from the National Health Interview Survey.

    PubMed

    Andrykowski, Michael A

    2012-07-15

    Little research has identified the physical and mental health status of survivors of multiple primary cancer diagnoses. By using data from the population-based 2009 National Health Information Survey, 154 survivors of multiple primary cancer diagnoses, 1427 survivors of a single cancer diagnosis, and 25,004 individuals without a history of cancer diagnosis were identified. The multiple cancer group was compared with the single cancer and no cancer groups with regard to physical and mental health status using analysis of covariance and binary logistic regression. Relative to the no cancer group, the multiple cancer group reported significantly poorer mental health status, greater lifetime, recent, and current prevalence of a variety of medical conditions and comorbidities, and more health-related disability. Although observed group differences between the multiple cancer and single cancer groups were less pronounced than those between the multiple cancer and no cancer groups, a consistent pattern was also evident; the multiple cancer group reported significantly poorer status relative to the single cancer group across a range of mental and physical health and illness-related disability indices. Diagnosis of 2 or more primary cancers (excluding nonmelanoma skin cancers) is associated with increased risk for poorer physical and mental health status over and above that associated with diagnosis of a single primary cancer. Survivors of multiple and single primary cancer diagnoses should be considered as distinct subgroups, and increased attention should be devoted to the unique status and needs of survivors of multiple primary cancer diagnoses. Copyright © 2011 American Cancer Society.

  17. Characteristics Associated with Consumption of Sports and Energy Drinks among US Adults: National Health Interview Survey, 2010

    PubMed Central

    Park, Sohyun; Onufrak, Stephen; Blanck, Heidi M.; Sherry, Bettylou

    2015-01-01

    Sales of sports and energy drinks have increased dramatically, but there is limited information on regular consumers of sports and energy drinks. Characteristics associated with sports and energy drink intake were examined among a sample representing the civilian noninstitutionalized US adult population. The 2010 National Health Interview Survey data for 25,492 adults (18 years of age or older; 48% males) were used. Nationwide, 31.3% of adults were sports and energy drink consumers during the past 7 days, with 21.5% consuming sports and energy drinks one or more times per week and 11.5% consuming sports and energy drinks three or more times per week. Based on multivariable logistic regression, younger adults, males, non-Hispanic blacks and Hispanics, not-married individuals, adults with higher family income, those who lived in the South or West, adults who engaged in leisure-time physical activity, current smokers, and individuals whose satisfaction with their social activities/relationships was excellent had significantly higher odds for drinking sports and energy drinks one or more times per week. In this model, the factor most strongly associated with weekly sports and energy drink consumption was age (odds ratio [OR]=10.70 for 18- to 24-year-olds, OR=6.40 for 25- to 39-year-olds, OR=3.17 for 40- to 59-year-olds vs 60 years or older). Lower odds for consuming sports and energy drinks one or more times per week were associated with other/multiracial (OR=0.80 vs non-Hispanic white) and obesity (OR=0.87 vs underweight/normal weight). Separate modeling of the association between other beverage intake and sports and energy drink intake showed that higher intake of regular soda, sweetened coffee/tea drinks, fruit drinks, milk, 100% fruit juice, and alcohol were significantly associated with greater odds for drinking sports and energy drinks one or more times per week. These findings can help medical care providers and public health officials identify adults most in

  18. Group Motivational Interviewing in Schools: Development of a Health Promotion Intervention

    ERIC Educational Resources Information Center

    Hawkins, Jemma L.; Bravo, Paulina; Gobat, Nina; Rollnick, Stephen; Jerzembek, Gabrielle; Whitehead, Sarah; Chanon, Sue; Kelson, Mark; Adams, Orla; Murphy, Simon

    2016-01-01

    Objective: In the light of the shortcomings of curriculum-based health promotion in secondary schools, group motivational interviewing provides a potential alternative approach. This two-phase study set out to establish the key components, feasibility and acceptability of a group motivational interviewing intervention, focused on alcohol…

  19. National health and nutrition examination survey: plan and operations, 1999-2010.

    PubMed

    Zipf, George; Chiappa, Michele; Porter, Kathryn S; Ostchega, Yechiam; Lewis, Brenda G; Dostal, Jennifer

    2013-08-01

    Background-Starting in 1999, the National Health and Nutrition Examination Survey (NHANES) became a continuous, ongoing annual survey of the noninstitutionalized civilian resident population of the United States. A continuous survey allowed content to change to meet emerging needs. Objective-This report describes how NHANES for 1999-2010 was designed and implemented. NHANES is a national survey designed to provide national estimates on various health-related topics. Methods-The survey used in-person face-to-face interviews and physical examinations for data collection. Approximately 5,000 people per year participated in NHANES. The 5,000 people surveyed each year are representative of the entire U.S. population. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  20. Factors That Influence Enrolment and Retention in Ghana’ National Health Insurance Scheme

    PubMed Central

    Millicent Kotoh, Agnes; Aryeetey, Genevieve Cecilia; der Geest, Sjaak Van

    2018-01-01

    Background: The government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2004 with the goal of achieving universal coverage within 5 years. Evidence, however, shows that expanding NHIS coverage and especially retaining members have remained a challenge. A multilevel perspective was employed as a conceptual framework and methodological tool to examine why enrolment and retention in the NHIS remains low. Methods: A household survey was conducted after 20 months educational and promotional activities aimed at improving enrolment and retention rates in 15 communities in the Central and Eastern Regions (ERs) of Ghana. Observation, indepth interviews and informal conversations were used to collect qualitative data. Forty key informants (community members, health providers and district health insurance schemes’ [DHISs] staff) purposely selected from two casestudy communities in the Central Region (CR) were interviewed. Several community members, health providers and DHISs’ staff were also engaged in informal conversations in the other five communities in the region. Also, four staff of the Ministry of Health (MoH), Ghana Health Service (GHS) and National Health Insurance Authority (NHIA) were engaged in in-depth interviews. Descriptive statistics was used to analyse quantitative data. Qualitative data was analysed using thematic content analysis. Results: The results show that factors that influence enrolment and retention in the NHIS are multi-dimensional and cut across all stakeholders. People enrolled and renewed their membership because of NHIS’ benefits and health providers’ positive behaviour. Barriers to enrolment and retention included: poverty, traditional risk-sharing arrangements influence people to enrol or renew their membership only when they need healthcare, dissatisfaction about health providers’ behaviour and service delivery challenges. Conclusion: Given the multi-dimensional nature of barriers to enrolment and retention

  1. Characteristics of national and statewide health care-associated infection surveillance programs: A qualitative study.

    PubMed

    Russo, Philip L; Havers, Sally M; Cheng, Allen C; Richards, Michael; Graves, Nicholas; Hall, Lisa

    2016-12-01

    There are many well-established national health care-associated infection surveillance programs (HAISPs). Although validation studies have described data quality, there is little research describing important characteristics of large HAISPs. The aim of this study was to broaden our understanding and identify key characteristics of large HAISPs. Semi-structured interviews were conducted with purposively selected leaders from national and state-based HAISPs. Interview data were analyzed following an interpretive description process. Seven semi-structured interviews were conducted over a 6-month period during 2014-2015. Analysis of the data generated 5 distinct characteristics of large HAISPs: (1) triggers: surveillance was initiated by government or a cooperative of like-minded people, (2) purpose: a clear purpose is needed and determines other surveillance mechanisms, (3) data measures: consistency is more important than accuracy, (4) processes: a balance exists between the volume of data collected and resources, and (5) implementation and maintenance: a central coordinating body is crucial for uniformity and support. National HAISPs are complex and affect a broad range of stakeholders. Although the overall goal of health care-associated infection surveillance is to reduce the incidence of health care-associated infection, there are many crucial factors to be considered in attaining this goal. The findings from this study will assist the development of new HAISPs and could be used as an adjunct to evaluate existing programs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Cultural elements underlying the community health representative - client relationship on Navajo Nation.

    PubMed

    Gampa, Vikas; Smith, Casey; Muskett, Olivia; King, Caroline; Sehn, Hannah; Malone, Jamy; Curley, Cameron; Brown, Chris; Begay, Mae-Gilene; Shin, Sonya; Nelson, Adrianne Katrina

    2017-01-09

    Navajo Nation Community Health Representatives (CHR) are trained community health workers (CHWs) who provide crucial services for patients and families. The success of the CHRs' interventions depends on the interactions between the CHRs and their clients. This research investigates the culturally specific factors that build and sustain the CHR-client interaction. In-depth interviews were conducted with 16 CHRs on Navajo Nation. Interviews were transcribed and coded according to relevant themes. Code summaries were organized into a narrative using grounded theory techniques. The analysis revealed four findings critical to the development of a CHR-client relationship. Trust is essential to this relationship and provides a basis for providing quality services to the client. The ability to build and maintain trust is defined by tradition and culture. CHRs must be respectful of the diverse traditional and social practices. Lastly, the passing of clients brings together the CHR, the client's family, and the community. Understanding the cultural elements of the CHR-client relationship will inform the work of community partners, clinical providers, and other indigenous communities working to strengthen CHR programs and obtain positive health outcomes among marginalized communities.

  3. National health expenditures, 1990

    PubMed Central

    Levit, Katharine R.; Lazenby, Helen C.; Cowan, Cathy A.; Letsch, Suzanne W.

    1991-01-01

    During 1990, health expenditures as a share of gross national product rose to 12.2 percent, up from 11.6 percent in 1989. This dramatic increase is the second largest increase in the past three decades. The national health expenditure estimates presented in this article document rapidly rising health care costs and provide a context for understanding the health care financing crisis facing the Nation today. The 1990 national health expenditures incorporate the most recently available data. They differ from historical estimates presented in the preceding article. The length of time and complicated process of producing projections required use of 1989 national health expenditures—data available prior to the completion of the 1990 estimates presented here. PMID:10114934

  4. Cigarette smoking trends among U.S. working adult by industry and occupation: findings from the 2004-2012 National Health Interview Survey.

    PubMed

    Syamlal, Girija; Mazurek, Jacek M; Hendricks, Scott A; Jamal, Ahmed

    2015-05-01

    To examine trends in age-adjusted cigarette smoking prevalence among working adults by industry and occupation during 2004-2012, and to project those prevalences and compare them to the 2020 Healthy People objective (TU-1) to reduce cigarette smoking prevalence to ≤12%. We analyzed the 2004-2012 National Health Interview Survey (NHIS) data. Respondents were aged ≥18 years working in the week prior to the interview. Temporal changes in cigarette smoking prevalence were assessed using logistic regression. We used the regression model to extrapolate to the period 2013-2020. Overall, an estimated 19.0% of working adults smoked cigarettes: 22.4% in 2004 to 18.1% in 2012. The largest declines were among workers in the education services (6.5%) industry and in the life, physical, and social science (9.7%) occupations. The smallest declines were among workers in the real estate and rental and leasing (0.9%) industry and the legal (0.4%) occupations. The 2020 projected smoking prevalences in 15 of 21 industry groups and 13 of the 23 occupation groups were greater than the 2020 Healthy People goal. During 2004-2012, smoking prevalence declined in the majority of industry and occupation groups. The decline rate varied by industry and occupation groups. Projections suggest that certain groups may not reach the 2020 Healthy People goal. Consequently, smoking cessation, prevention, and intervention efforts may need to be revised and strengthened, particularly in specific occupational groups. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco [2014]. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  5. Systematic review of Latin American national oral health surveys in adults.

    PubMed

    Duran, Doris; Monsalves, Maria Jose; Aubert, Josefina; Zarate, Victor; Espinoza, Iris

    2018-04-27

    Oral diseases represent a main public health problem worldwide. There is scarce information about oral health indicators in adults in middle-income countries in Latin America and Africa. To identify and describe national health surveys with national representative samples that included oral health assessment for adults in Latin America. A systematic review was conducted in scientific and regional bibliographic databases (PubMed, SciELO, Wos and Embase); this was complemented with searchings in grey literature (Google Scholar, Open Grey and government health organization websites), from August 2016 to May 2017 (from 2000 to date). Studies conducted, supervised or funded by Ministries of Health or National Health Institutes were included. Data extracted included country, year, methods, interview and dental examination. Two researchers independently performed search and data extraction. Results were discussed as a group. Only 5 countries in Latin America have developed national health surveys evaluating the dental status in adults, with overall national representative samples during 2000-2015: Brazil, Colombia, Panama, Chile and Uruguay. Main differences were observed in the type of dental indicators selected, measure of dental services access and the professional who performed the dental examination. While some dental surveys were specifically designed as oral health surveys (Brazil, Colombia, Panama and Uruguay) and the examination was performed by dentists, other surveys represent a module within a general health survey (Chile) and the examination was performed by nurses. There are a small number of Latin American countries that report research about dental status with national representation samples. Most of these studies have been conducted as national oral health surveys, and fieldwork was carried out by dentists. The development of oral health research in this part of the world should be promoted as these surveys provide relevant information to monitor oral

  6. Health equity in the New Zealand health care system: a national survey

    PubMed Central

    2011-01-01

    Introduction In all countries people experience different social circumstances that result in avoidable differences in health. In New Zealand, Māori, Pacific peoples, and those with lower socioeconomic status experience higher levels of chronic illness, which is the leading cause of mortality, morbidity and inequitable health outcomes. Whilst the health system can enable a fairer distribution of good health, limited national data is available to measure health equity. Therefore, we sought to find out whether health services in New Zealand were equitable by measuring the level of development of components of chronic care management systems across district health boards. Variation in provision by geography, condition or ethnicity can be interpreted as inequitable. Methods A national survey of district health boards (DHBs) was undertaken on macro approaches to chronic condition management with detail on cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke and diabetes. Additional data from expert informant interviews on program reach and the cultural needs of Māori and Pacific peoples was sought. Survey data were analyzed on dimensions of health equity relevant to strategic planning and program delivery. Results are presented as descriptive statistics and free text. Interviews were transcribed and NVivo 8 software supported a general inductive approach to identify common themes. Results Survey responses were received from the majority of DHBs (15/21), some PHOs (21/84) and 31 expert informants. Measuring, monitoring and targeting equity is not systematically undertaken. The Health Equity Assessment Tool is used in strategic planning but not in decisions about implementing or monitoring disease programs. Variable implementation of evidence-based practices in disease management and multiple funding streams made program implementation difficult. Equity for Māori is embedded in policy, this is not so for other ethnic groups or

  7. The National Network of Libraries of Medicine's outreach to the public health workforce: 2001–2006

    PubMed Central

    Cogdill, Keith W.; Ruffin, Angela B.; Stavri, P. Zoë

    2007-01-01

    Objective: The paper provides an overview of the National Network of Libraries of Medicine's (NN/ LM's) outreach to the public health workforce from 2001 to 2006. Description: NN/LM conducts outreach through the activities of the Regional Medical Library (RML) staff and RML-sponsored projects led by NN/LM members. Between 2001 and 2006, RML staff provided training on information resources and information management for public health personnel at national, state, and local levels. The RMLs also contributed significantly to the Partners in Information Access for the Public Health Workforce collaboration. Methods: Data were extracted from telephone interviews with directors of thirty-seven NN/LM-sponsored outreach projects directed at the public health sector. A review of project reports informed the interviews, which were transcribed and subsequently coded for emergent themes using qualitative analysis software. Results: Analysis of interview data led to the identification of four major themes: training, collaboration, evaluation of outcomes, and challenges. Sixteen subthemes represented specific lessons learned from NN/LM members' outreach to the public health sector. Conclusions: NN/LM conducted extensive information-oriented outreach to the public health workforce during the 2001-to-2006 contract period. Lessons learned from this experience, most notably the value of collaboration and the need for flexibility, continue to influence outreach efforts in the current contract period. PMID:17641766

  8. Relationships, Expertise, Incentives, and Governance: Supporting Care Home Residents' Access to Health Care. An Interview Study From England

    PubMed Central

    Goodman, Claire; Davies, Sue L.; Gordon, Adam L.; Meyer, Julienne; Dening, Tom; Gladman, John R.F.; Iliffe, Steve; Zubair, Maria; Bowman, Clive; Victor, Christina; Martin, Finbarr C.

    2015-01-01

    Objectives To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. Methods Qualitative, semistructured interviews with a purposive sample of people with direct experience of commissioning, providing, and regulating health care provision in care homes and care home residents. Data from interviews were augmented by a secondary analysis of previous interviews with care home residents on their personal experience of and priorities for access to health care. Analysis was framed by the assumptions of realist evaluation and drew on the constant comparative method to identify key themes about what is required to achieve quality health care provision to care homes and resident health. Results Participants identified 3 overlapping approaches to the provision of NHS that they believed supported access to health care for older people in care homes: (1) Investment in relational working that fostered continuity and shared learning between visiting NHS staff and care home staff, (2) the provision of age-appropriate clinical services, and (3) governance arrangements that used contractual and financial incentives to specify a minimum service that care homes should receive. Conclusion The 3 approaches, and how they were typified as working, provide a rich picture of the stakeholder perspectives and the underlying assumptions about how service delivery models should work with care homes. The findings inform how evidence on effective working in care homes will be interrogated to identify how different approaches, or specifically key elements of those approaches, achieve different health-related outcomes in different situations for residents and associated health and social care organizations. PMID:25687930

  9. Relationships, expertise, incentives, and governance: supporting care home residents' access to health care. An interview study from England.

    PubMed

    Goodman, Claire; Davies, Sue L; Gordon, Adam L; Meyer, Julienne; Dening, Tom; Gladman, John R F; Iliffe, Steve; Zubair, Maria; Bowman, Clive; Victor, Christina; Martin, Finbarr C

    2015-05-01

    To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. Qualitative, semistructured interviews with a purposive sample of people with direct experience of commissioning, providing, and regulating health care provision in care homes and care home residents. Data from interviews were augmented by a secondary analysis of previous interviews with care home residents on their personal experience of and priorities for access to health care. Analysis was framed by the assumptions of realist evaluation and drew on the constant comparative method to identify key themes about what is required to achieve quality health care provision to care homes and resident health. Participants identified 3 overlapping approaches to the provision of NHS that they believed supported access to health care for older people in care homes: (1) Investment in relational working that fostered continuity and shared learning between visiting NHS staff and care home staff, (2) the provision of age-appropriate clinical services, and (3) governance arrangements that used contractual and financial incentives to specify a minimum service that care homes should receive. The 3 approaches, and how they were typified as working, provide a rich picture of the stakeholder perspectives and the underlying assumptions about how service delivery models should work with care homes. The findings inform how evidence on effective working in care homes will be interrogated to identify how different approaches, or specifically key elements of those approaches, achieve different health-related outcomes in different situations for residents and associated health and social care organizations. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All

  10. National Geographic Education. An Interview with Gilbert M. Grosvenor, President and Chairman of the Board, National Geographic Society.

    ERIC Educational Resources Information Center

    Jumper, Sidney R.

    1991-01-01

    Presents an interview with Gilbert Grosvenor, president and chairman of the board of the National Geographic Society. Examines student and public ignorance about geography. Describes the Society's Geography Education Project, Geographic Alliance Project, and Education Foundation. Includes Grosvenor's call for greater emphasis on geography in…

  11. [National Health and Nutrition Survey 2012: design and coverage].

    PubMed

    Romero-Martínez, Martín; Shamah-Levy, Teresa; Franco-Núñez, Aurora; Villalpando, Salvador; Cuevas-Nasu, Lucía; Gutiérrez, Juan Pablo; Rivera-Dommarco, Juan Ángel

    2013-01-01

    To describe the design and population coverage of the National Health and Nutrition Survey 2012 (NHNS 2012). The design of the NHNS 2012 is reported, as a probabilistic population based survey with a multi-stage and stratified sampling, as well as the sample inferential properties, the logistical procedures, and the obtained coverage. Household response rate for the NHNS 2012 was 87%, completing data from 50,528 households, where 96 031 individual interviews selected by age and 14,104 of ambulatory health services users were also obtained. The probabilistic design of the NHNS 2012 as well as its coverage allowed to generate inferences about health and nutrition conditions, health programs coverage, and access to health services. Because of their complex designs, all estimations from the NHNS 2012 must use the survey design: weights, primary sampling units, and stratus variables.

  12. Sleep Disturbances in Adults With Arthritis: Prevalence, Mediators, and Subgroups at Greatest Risk. Data From the 2007 National Health Interview Survey

    PubMed Central

    LOUIE, GRANT H.; TEKTONIDOU, MARIA G.; CABAN-MARTINEZ, ALBERTO J.; WARD, MICHAEL M.

    2012-01-01

    Objective To examine the prevalence of sleep disturbances in adults with arthritis in a nationally representative sample, mediators of sleep difficulties, and subgroups of individuals with arthritis at greatest risk. Methods Using data on US adults ages ≥18 years participating in the 2007 National Health Interview Survey, we computed the prevalence of 3 measures of sleep disturbance (insomnia, excessive daytime sleepiness, and sleep duration <6 hours) among persons with arthritis. We used logistic regression analysis to examine if the association of arthritis and sleep disturbances was independent of sociodemographic characteristics and comorbidities, and to identify potential mediators. We used classification trees to identify subgroups at higher risk. Results The adjusted prevalence of insomnia was higher among adults with arthritis than those without arthritis (23.1% versus 16.4%; P < 0.0001), but was similar to those with other chronic diseases. Adults with arthritis were more likely than those without arthritis to report insomnia (unadjusted odds ratio 2.92, 95% confidence interval 2.68 –3.17), but adjustment for sociodemographic characteristics and comorbidities attenuated this association. Joint pain and limitation due to pain mediated the association between arthritis and insomnia. Among adults with arthritis, those with depression and anxiety were at highest risk for sleep disturbance. Results for excessive daytime sleepiness and sleep duration <6 hours were similar. Conclusion Sleep disturbance affects up to 10.2 million US adults with arthritis, and is mediated by joint pain and limitation due to pain. Among individuals with arthritis, those with depression and anxiety are at greatest risk. PMID:20890980

  13. National health expenditures, 1989

    PubMed Central

    Lazenby, Helen C.; Letsch, Suzanne W.

    1990-01-01

    Spending for health care in the United States grew to $604.1 billion in 1989, an increase of 11.1 percent from the 1988 level. Growth in national health expenditures has been edging upward since 1986, when the annual growth in the health care bill was 7.7 percent. Health care spending continues to command a larger and larger proportion of the resources of the Nation: In 1989, 11.6 percent of the Nation's output, as measured by the gross national product, was consumed by health care, up from 11.2 percent in 1988. PMID:10113559

  14. The Nation's Memory: The United States National Archives and Records Administration. An Interview with Don W. Wilson, Archivist of the United States, National Archives and Records Administration.

    ERIC Educational Resources Information Center

    Brodhead, Michael J.; Zink, Steven D.

    1993-01-01

    Discusses the National Archives and Records Administration (NARA) through an interview with the Archivist of the United States, Don Wilson. Topics addressed include archival independence and congressional relations; national information policy; expansion plans; machine-readable archival records; preservation activities; and relations with other…

  15. Explaining the Immigrant Health Advantage: Self-selection and Protection in Health-Related Factors Among Five Major National-Origin Immigrant Groups in the United States.

    PubMed

    Riosmena, Fernando; Kuhn, Randall; Jochem, Warren C

    2017-02-01

    Despite being newcomers, immigrants often exhibit better health relative to native-born populations in industrialized societies. We extend prior efforts to identify whether self-selection and/or protection explain this advantage. We examine migrant height and smoking levels just prior to immigration to test for self-selection; and we analyze smoking behavior since immigration, controlling for self-selection, to assess protection. We study individuals aged 20-49 from five major national origins: India, China, the Philippines, Mexico, and the Dominican Republic. To assess self-selection, we compare migrants, interviewed in the National Health and Interview Surveys (NHIS), with nonmigrant peers in sending nations, interviewed in the World Health Surveys. To test for protection, we contrast migrants' changes in smoking since immigration with two counterfactuals: (1) rates that immigrants would have exhibited had they adopted the behavior of U.S.-born non-Hispanic whites in the NHIS (full "assimilation"); and (2) rates that migrants would have had if they had adopted the rates of nonmigrants in sending countries (no-migration scenario). We find statistically significant and substantial self-selection, particularly among men from both higher-skilled (Indians and Filipinos in height, Chinese in smoking) and lower-skilled (Mexican) undocumented pools. We also find significant and substantial protection in smoking among immigrant groups with stronger relative social capital (Mexicans and Dominicans).

  16. Explaining the Immigrant Health Advantage: Self-selection and Protection in Health-Related Factors Among Five Major National-Origin Immigrant Groups in the United States

    PubMed Central

    Riosmena, Fernando; Kuhn, Randall; Jochem, Warren C.

    2017-01-01

    Despite being newcomers, immigrants often exhibit better health relative to native-born populations in industrialized societies. We extend prior efforts to identify whether self-selection and/or protection explain this advantage. We examine migrant height and smoking levels just prior to immigration to test for self-selection; and we analyze smoking behavior since immigration, controlling for self-selection, to assess protection. We study individuals aged 20–49 from five major national origins: India, China, the Philippines, Mexico, and the Dominican Republic. To assess self-selection, we compare migrants, interviewed in the National Health and Interview Surveys (NHIS), with nonmigrant peers in sending nations, interviewed in the World Health Surveys. To test for protection, we contrast migrants’ changes in smoking since immigration with two counterfactuals: (1) rates that immigrants would have exhibited had they adopted the behavior of U.S.-born non-Hispanic whites in the NHIS (full —assimilation ); and (2) rates that migrants would have had if they had adopted the rates of nonmigrants in sending countries (no-migration scenario). We find statistically significant and substantial self-selection, particularly among men from both higher-skilled (Indians and Filipinos in height, Chinese in smoking) and lower-skilled (Mexican) undocumented pools. We also find significant and substantial protection in smoking among immigrant groups with stronger relative social capital (Mexicans and Dominicans). PMID:28092071

  17. Characteristics associated with consumption of sports and energy drinks among US adults: National Health Interview Survey, 2010.

    PubMed

    Park, Sohyun; Onufrak, Stephen; Blanck, Heidi M; Sherry, Bettylou

    2013-01-01

    Sales of sports and energy drinks have increased dramatically, but there is limited information on regular consumers of sports and energy drinks. Characteristics associated with sports and energy drink intake were examined among a sample representing the civilian noninstitutionalized US adult population. The 2010 National Health Interview Survey data for 25,492 adults (18 years of age or older; 48% males) were used. Nationwide, 31.3% of adults were sports and energy drink consumers during the past 7 days, with 21.5% consuming sports and energy drinks one or more times per week and 11.5% consuming sports and energy drinks three or more times per week. Based on multivariable logistic regression, younger adults, males, non-Hispanic blacks and Hispanics, not-married individuals, adults with higher family income, those who lived in the South or West, adults who engaged in leisure-time physical activity, current smokers, and individuals whose satisfaction with their social activities/relationships was excellent had significantly higher odds for drinking sports and energy drinks one or more times per week. In this model, the factor most strongly associated with weekly sports and energy drink consumption was age (odds ratio [OR]=10.70 for 18- to 24-year-olds, OR=6.40 for 25- to 39-year-olds, OR=3.17 for 40- to 59-year-olds vs 60 years or older). Lower odds for consuming sports and energy drinks one or more times per week were associated with other/multiracial (OR=0.80 vs non-Hispanic white) and obesity (OR=0.87 vs underweight/normal weight). Separate modeling of the association between other beverage intake and sports and energy drink intake showed that higher intake of regular soda, sweetened coffee/tea drinks, fruit drinks, milk, 100% fruit juice, and alcohol were significantly associated with greater odds for drinking sports and energy drinks one or more times per week. These findings can help medical care providers and public health officials identify adults most in

  18. Clinicians' Perspectives on Motivational Interviewing-Based Brief Interventions in College Health

    ERIC Educational Resources Information Center

    Rash, Elizabeth M.

    2008-01-01

    Brief interventions based on motivational interviewing (MI) are emerging as effective strategies for behavior change in college students. However, implementation of MI-based brief interventions may be challenging in the college health environment, and their practicality is controversial. The author explored college health clinicians' perspectives…

  19. Factors That Influence Enrolment and Retention in Ghana' National Health Insurance Scheme.

    PubMed

    Kotoh, Agnes Millicent; Aryeetey, Genevieve Cecilia; Van der Geest, Sjaak

    2017-10-17

    The government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2004 with the goal of achieving universal coverage within 5 years. Evidence, however, shows that expanding NHIS coverage and especially retaining members have remained a challenge. A multilevel perspective was employed as a conceptual framework and methodological tool to examine why enrolment and retention in the NHIS remains low. A household survey was conducted after 20 months educational and promotional activities aimed at improving enrolment and retention rates in 15 communities in the Central and Eastern Regions (ERs) of Ghana. Observation, indepth interviews and informal conversations were used to collect qualitative data. Forty key informants (community members, health providers and district health insurance schemes' [DHISs] staff) purposely selected from two casestudy communities in the Central Region (CR) were interviewed. Several community members, health providers and DHISs' staff were also engaged in informal conversations in the other five communities in the region. Also, four staff of the Ministry of Health (MoH), Ghana Health Service (GHS) and National Health Insurance Authority (NHIA) were engaged in in-depth interviews. Descriptive statistics was used to analyse quantitative data. Qualitative data was analysed using thematic content analysis. The results show that factors that influence enrolment and retention in the NHIS are multi-dimensional and cut across all stakeholders. People enrolled and renewed their membership because of NHIS' benefits and health providers' positive behaviour. Barriers to enrolment and retention included: poverty, traditional risk-sharing arrangements influence people to enrol or renew their membership only when they need healthcare, dissatisfaction about health providers' behaviour and service delivery challenges. Given the multi-dimensional nature of barriers to enrolment and retention, we suggest that the NHIA should engage DHISs, health

  20. Sexual Orientation and Health Information Technology Use: A Nationally Representative Study of U.S. Adults.

    PubMed

    Dahlhamer, James M; Galinsky, Adena M; Joestl, Sarah S; Ward, Brian W

    2017-04-01

    The purpose of this study was to compare the prevalence and odds of participation in online health-related activities among lesbian, gay, and bisexual adults and straight adults aged 18-64. Primary data collected in the 2013 and 2014 National Health Interview Survey, a nationally representative household health survey, were used to examine associations between sexual orientation and four measures of health information technology (HIT) use. Data were collected through face-to-face interviews (some telephone follow-up) with 54,878 adults aged 18-64. Compared with straight men, both gay and bisexual men had higher odds of using computers to schedule appointments with healthcare providers, and using email to communicate with healthcare providers. Gay men also had significantly higher odds of seeking health information or participating in a health-related chat group on the Internet, and using computers to fill a prescription. No significant associations were observed between sexual orientation and HIT use among women in the multivariate analysis. Gay and bisexual men make greater use of HIT than their straight counterparts. Additional research is needed to determine the causal factors behind these group differences in the use of online healthcare, as well as the health implications for each group.

  1. Three-Quarters of Persons in the US Population Reporting a Clinical Diagnosis of Fibromyalgia Do Not Satisfy Fibromyalgia Criteria: The 2012 National Health Interview Survey.

    PubMed

    Walitt, Brian; Katz, Robert S; Bergman, Martin J; Wolfe, Frederick

    2016-01-01

    Although fibromyalgia criteria have been in effect for decades, little is known about how the fibromyalgia diagnosis is applied and understood by clinicians and patients. We used the National Health Interview Survey (NHIS) to determine the prevalence of self-reported clinician diagnosed fibromyalgia and then compared demographics, symptoms, disability and medical utilization measures of persons with a clinical diagnosis of fibromyalgia that did not meet diagnostic criteria (false-positive or prior [F/P] fibromyalgia) to persons with and without criteria-positive fibromyalgia. The National Health Interview Survey (NHIS) collected information about both clinical diagnosis and symptoms of fibromyalgia that was appropriately weighted to represent 225,726,257 US adults. Surrogate NHIS diagnostic criteria for fibromyalgia were developed based on the level of polysymptomatic distress (PSD) as characterized in the 2011 modified American College of Rheumatology criteria (ACR) for fibromyalgia. Persons with F/P fibromyalgia were compared with persons who do not have fibromyalgia and those meeting surrogate NHIS fibromyalgia criteria. Of the 1.78% of persons reporting a clinical diagnosis, 73.5% did not meet NHIS fibromyalgia criteria. The prevalence of F/P fibromyalgia is 1.3%. F/P fibromyalgia is associated with a mild degree of polysymptomatic distress (NHIS PSD score 6.2) and characterized by frequent but not widespread pain and insomnia. Measures of work disability and medical utilization in F/P fibromyalgia were equal to that seen with NHIS criteria positive fibromyalgia and were 6-7x greater in F/P fibromyalgia than in non-fibromyalgia persons. F/P fibromyalgia was best predicted by being female (Odds Ratio [OR] 8.81), married (OR 3.27), and white (OR 1.96). In contrast, being a white, married woman was only modestly predictive of NHIS (criteria positive) fibromyalgia (OR 2.1). The majority of clinically diagnosed fibromyalgia cases in the US do not reach levels of

  2. Three-Quarters of Persons in the US Population Reporting a Clinical Diagnosis of Fibromyalgia Do Not Satisfy Fibromyalgia Criteria: The 2012 National Health Interview Survey

    PubMed Central

    Walitt, Brian; Katz, Robert S.; Bergman, Martin J.; Wolfe, Frederick

    2016-01-01

    Objectives Although fibromyalgia criteria have been in effect for decades, little is known about how the fibromyalgia diagnosis is applied and understood by clinicians and patients. We used the National Health Interview Survey (NHIS) to determine the prevalence of self-reported clinician diagnosed fibromyalgia and then compared demographics, symptoms, disability and medical utilization measures of persons with a clinical diagnosis of fibromyalgia that did not meet diagnostic criteria (false-positive or prior [F/P] fibromyalgia) to persons with and without criteria-positive fibromyalgia. Methods The National Health Interview Survey (NHIS) collected information about both clinical diagnosis and symptoms of fibromyalgia that was appropriately weighted to represent 225,726,257 US adults. Surrogate NHIS diagnostic criteria for fibromyalgia were developed based on the level of polysymptomatic distress (PSD) as characterized in the 2011 modified American College of Rheumatology criteria (ACR) for fibromyalgia. Persons with F/P fibromyalgia were compared with persons who do not have fibromyalgia and those meeting surrogate NHIS fibromyalgia criteria. Results Of the 1.78% of persons reporting a clinical diagnosis, 73.5% did not meet NHIS fibromyalgia criteria. The prevalence of F/P fibromyalgia is 1.3%. F/P fibromyalgia is associated with a mild degree of polysymptomatic distress (NHIS PSD score 6.2) and characterized by frequent but not widespread pain and insomnia. Measures of work disability and medical utilization in F/P fibromyalgia were equal to that seen with NHIS criteria positive fibromyalgia and were 6-7x greater in F/P fibromyalgia than in non-fibromyalgia persons. F/P fibromyalgia was best predicted by being female (Odds Ratio [OR] 8.81), married (OR 3.27), and white (OR 1.96). In contrast, being a white, married woman was only modestly predictive of NHIS (criteria positive) fibromyalgia (OR 2.1). Conclusions The majority of clinically diagnosed fibromyalgia

  3. Focus group interview: an underutilized research technique for improving theory and practice in health education.

    PubMed

    Basch, C E

    1987-01-01

    The purpose of this article is to increase awareness about and stimulate interest in using focus group interviews, a qualitative research technique, to advance the state-of-the-art of education and learning about health. After a brief discussion of small group process in health education, features of focus group interviews are presented, and a theoretical framework for planning a focus group study is summarized. Then, literature describing traditional and health-related applications of focus group interviews is reviewed and a synthesis of methodological limitations and advantages of this technique is presented. Implications are discussed regarding: need for more inductive qualitative research in health education; utility of focus group interviews for research and for formative and summative evaluation of health education programs; applicability of marketing research to understanding and influencing consumer behavior, despite notable distinctions between educational initiatives and marketing; and need for professional preparation faculty to consider increasing emphasis on qualitative research methods.

  4. The Great Unknown: Daniel Handler Interviews National Book Award-Winner Judy Blundell

    ERIC Educational Resources Information Center

    Handler, Daniel

    2009-01-01

    This article presents an interview with National Book Award-winner Judy Blundell. For nearly 20 years, Blundell has toiled in anonymity, turning out more than 100 mysteries, romances, and media tie-ins under various pen names, such as Jude Watson. But in mid-November, the writer-for-hire was suddenly shoved into the spotlight. That's when "What I…

  5. Improving health care proxy documentation using a web-based interview through a patient portal

    PubMed Central

    Crotty, Bradley H; Kowaloff, Hollis B; Safran, Charles; Slack, Warner V

    2016-01-01

    Objective Health care proxy (HCP) documentation is suboptimal. To improve rates of proxy selection and documentation, we sought to develop and evaluate a web-based interview to guide patients in their selection, and to capture their choices in their electronic health record (EHR). Methods We developed and implemented a HCP interview within the patient portal of a large academic health system. We analyzed the experience, together with demographic and clinical factors, of the first 200 patients who used the portal to complete the interview. We invited users to comment about their experience and analyzed their comments using established qualitative methods. Results From January 20, 2015 to March 13, 2015, 139 of the 200 patients who completed the interview submitted their HCP information for their clinician to review in the EHR. These patients had a median age of 57 years (Inter Quartile Range (IQR) 45–67) and most were healthy. The 99 patients who did not previously have HCP information in their EHR were more likely to complete and then submit their information than the 101 patients who previously had a proxy in their health record (odds ratio 2.4, P = .005). Qualitative analysis identified several ways in which the portal-based interview reminded, encouraged, and facilitated patients to complete their HCP. Conclusions Patients found our online interview convenient and helpful in facilitating selection and documentation of an HCP. Our study demonstrates that a web-based interview to collect and share a patient’s HCP information is both feasible and useful. PMID:26568608

  6. Perspectives of frontline health workers on Ghana's National Health Insurance Scheme before and after community engagement interventions.

    PubMed

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F

    2016-05-28

    Barely a decade after introduction of Ghana's National Health Insurance Scheme (NHIS), significant successes have been recorded in universal access to basic healthcare services. However, sustainability of the scheme is increasingly threatened by concerns on quality of health service delivery in NHIS-accredited health facilities coupled with stakeholders' discontentment with the operational and administrative challenges confronting the NHIS. The study sought to ascertain whether or not Systematic Community Engagement (SCE) interventions have a significant effect on frontline health workers' perspectives on the NHIS and its impact on quality health service delivery. The study is a randomized cluster trial involving clinical and non-clinical frontline health workers (n = 234) interviewed at baseline and follow-up in the Greater Accra and Western regions of Ghana. Individual respondents were chosen from within each intervention and control groupings. Difference-in-difference estimations and propensity score matching were performed to determine impact of SCE on staff perceptions of the NHIS. The main outcome measure of interest was staff perception of the NHIS based on eight (8) factor-analyzed quality service parameters. Staff interviewed in intervention facilities appeared to perceive the NHIS more positively in terms of its impact on "availability and quality of drugs (p < 0.05)" and "workload on health staff/infrastructure" than those interviewed in control facilities (p < 0.1). Delayed reimbursement of service providers remained a key concern to over 70 % of respondents in control and intervention health facilities. Community engagement in quality service assessment is a potential useful strategy towards empowering communities while promoting frontline health workers' interest, goodwill and active participation in Ghana's NHIS.

  7. Social class, race/ethnicity and all-cause mortality in the US: longitudinal results from the 1986-1994 National Health Interview Survey.

    PubMed

    Muntaner, Carles; Hadden, Wilbur C; Kravets, Nataliya

    2004-01-01

    Occupational social class has become a leading indicator of social inequalities in health. In the US, economic sectors are distinct with respect to wages, benefits, job security, promotion ladders and working conditions. The growing economic sector of self-employed workers is characterized by lower wages and benefits, and greater job insecurity. Little attention has been given to the association between economic sector measures of social class and all-cause mortality, and there have been no studies of mortality among the self-employed. To determine risk of death associated with economic sector social class, this study entails a longitudinal analysis of the National Health Interview Survey (NHIS), an annual household survey representative of the US population for the period 1986-1994 (n = 377,129). The sample includes 201,566 men and 175,563 women, aged 24-65 years of age, in the civilian labor force. Non- professionals are at higher risk of death than professionals across all sectors and self-employed professionals are at higher risk of death than professionals employed in government and production. Additional social class differences are accounted for by age, race, gender and marital status. Results are also partially explained by income. After controlling for income, Black professionals did not show a lower risk of death than Black non-professionals and self-employed Hispanic professionals had a higher risk of death than Hispanic professionals employed in the private sector. Given the growth of self-employment in the US, the noted increased risk of death among self-employed professionals merits further investigation and monitoring.

  8. Use of complementary and alternative medical therapies among racial and ethnic minority adults: results from the 2002 National Health Interview Survey.

    PubMed Central

    Graham, Robert E.; Ahn, Andrew C.; Davis, Roger B.; O'Connor, Bonnie B.; Eisenberg, David M.; Phillips, Russell S.

    2005-01-01

    PURPOSE: Complementary and alternative medicine (CAM) use among ethnic minority populations is poorly understood. We sought to examine CAM use in Hispanics, non-Hispanic blacks and non-Hispanic whites. METHODS: We analyzed data from the Alternative Health Supplement to the 2002 National Health Interview Survey (NHIS), including information on 19 different CAM therapies used in the past 12 months. RESULTS: An estimated 34% of Hispanic, non-Hispanic black and non-Hispanic white adults in the United States used at least one CAM therapy (excluding prayer) during the prior 12 months (2002). CAM use was highest for non-Hispanic whites (36%), followed by Hispanics (27%) and non-Hispanic blacks (26%). Non-Hispanic whites were more likely to use herbal medicine, relaxation techniques and chiropractic more frequently than Hispanics and non-Hispanic blacks. After controlling for other sociodemographic factors, Hispanic and non-Hispanic black races/ethnicities were associated with less CAM use, with adjusted odds ratios (95% confidence intervals) of 0.78 (0.70, 0.87) and 0.71 (0.65, 0.78), respectively. Hispanics cited using CAM because conventional medical treatments were too expensive more frequently than non-Hispanic blacks or whites. Hispanics had the highest provider nondisclosure rates (68.5%), followed by non-Hispanic blacks (65.1%) and non-Hispanic whites (58.1%). CONCLUSIONS: Excluding prayer, Hispanics and non-Hispanic blacks used CAM less frequently than non-Hispanic whites and were less likely to disclose their use to their healthcare provider. Further research is needed to improve our understanding of the disparities in CAM use. PMID:15868773

  9. Differences in short and long sleep durations between blacks and whites attributed to emotional distress: analysis of the National Health Interview Survey in the United States.

    PubMed

    Seixas, Azizi A; Auguste, Emmanuella; Butler, Mark; James, Caryl; Newsome, Valerie; Auguste, Evan; da Silva Fonseca, Vilma Aparecida; Schneeberger, Andres; Zizi, Ferdinand; Jean-Louis, Girardin

    2017-02-01

    The current study examined the role of emotional distress in explaining racial/ethnic differences in unhealthy sleep duration. Data from the 2004-2013 National Health Interview Survey were analyzed using SPSS 20. Data were collected through personal household interviews in the United States. Of the total 261,686 participants (age≥18 years), 17.0% were black, 83.0% were white, and the mean age was 48 years (SE=0.04). To ascertain total sleep duration, participants were asked, "How many hours of sleep do you get on average in a 24-hour period?" Sleep duration was coded as short sleep (<7hours), average sleep (7-8hours), or long sleep (>8hours). Emotional distress-feeling sad, nervous, restless, hopeless, worthless, and burdened over a 30-day period-was measured using Kessler-6, a 6-item screening scale. Of the participants reporting significant emotional distress (4.0% black, 3.5% white), χ 2 analyses revealed that a higher percentage of blacks, compared with whites, reported unhealthy sleep durations. Relative to Whites, Blacks had increased prevalence of short sleep (prevalence ratio=1.32, P<.001) or long sleep (odds ratio =1.189, P<.001). The interaction between race/ethnicity and emotional distress was significantly associated with short (prevalence ratio=0.99, P<.001) and long sleep (odds ratio=0.98, P<.001) durations. Individuals of the black race/ethnicity or those reporting greater levels of emotional distress are more likely to report short or long sleep duration. Emotional distress might partially explain racial/ethnic differences in unhealthy sleep duration between blacks and whites. Copyright © 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

  10. FastStats: Women's Health

    MedlinePlus

    ... Statistics Tables for U.S. Adults: National Health Interview Survey, 2016, Table A-11c [PDF – 133 KB] Alcohol ... on data from the 2016 National Health Interview Survey, data table for figure 9.2 [PDF – 1. ...

  11. Prioritizing Surgical Care on National Health Agendas: A Qualitative Case Study of Papua New Guinea, Uganda, and Sierra Leone

    PubMed Central

    Dare, Anna J.; Lee, Katherine C.; Bleicher, Josh; Elobu, Alex E.; Kamara, Thaim B.; Liko, Osborne; Luboga, Samuel; Danlop, Akule; Kune, Gabriel; Hagander, Lars; Leather, Andrew J. M.; Yamey, Gavin

    2016-01-01

    Background Little is known about the social and political factors that influence priority setting for different health services in low- and middle-income countries (LMICs), yet these factors are integral to understanding how national health agendas are established. We investigated factors that facilitate or prevent surgical care from being prioritized in LMICs. Methods and Findings We undertook country case studies in Papua New Guinea, Uganda, and Sierra Leone, using a qualitative process-tracing method. We conducted 74 semi-structured interviews with stakeholders involved in health agenda setting and surgical care in these countries. Interviews were triangulated with published academic literature, country reports, national health plans, and policies. Data were analyzed using a conceptual framework based on four components (actor power, ideas, political contexts, issue characteristics) to assess national factors influencing priority for surgery. Political priority for surgical care in the three countries varies. Priority was highest in Papua New Guinea, where surgical care is firmly embedded within national health plans and receives significant domestic and international resources, and much lower in Uganda and Sierra Leone. Factors influencing whether surgical care was prioritized were the degree of sustained and effective domestic advocacy by the local surgical community, the national political and economic environment in which health policy setting occurs, and the influence of international actors, particularly donors, on national agenda setting. The results from Papua New Guinea show that a strong surgical community can generate priority from the ground up, even where other factors are unfavorable. Conclusions National health agenda setting is a complex social and political process. To embed surgical care within national health policy, sustained advocacy efforts, effective framing of the problem and solutions, and country-specific data are required. Political

  12. Private dental visits per dentist in Spain from 1987 to 1997. An analysis from the Spanish national Health Interview Surveys.

    PubMed

    Bravo, Manuel

    2002-10-01

    In view of the sharp increase in the number of dentists in Spain, the aim of the present study was to analyse changes in the private dentist workload in Spain over the period 1987-97. Data were taken from censuses of the population and of dental practitioners, and from the Spanish National Health Interview Surveys. The percentage of people that had visited the dentist in the 3 months prior to the survey was calculated, and of these, the percentage whose last visit was private. The total number of visits made by those people was taken as the estimate of total private visits in Spain during 3 months. Total private activity in 1 year was derived by multiplying this estimate by four. Annual private activity was then divided by the number of dentists. From 1987 to 1997, the Spanish population grew 2.5% (from 38.7 to 39.7 million) and the number of dentists increased by 136.1% (from 6373 to 15,044). The total annual number of private dental visits (+/-SE) was 35.7 +/- 1.0 million in 1987, and 48.9 +/- 2.0 million in 1997 - a 36.8% increase. Thus, the mean number of private dental visits per dentist decreased 42.0% (from 5610 +/- 152 to 3251 +/- 133). A significant reduction in private dental visits per dentist is taking place in Spain.

  13. The association between demographic and behavioral characteristics and sunburn among U.S. adults — National Health Interview Survey, 2010⋆

    PubMed Central

    Holman, Dawn M.; Berkowitz, Zahava; Guy, Gery P.; Hartman, Anne M.; Perna, Frank M.

    2015-01-01

    Objective To examine the association between demographic and behavioral characteristics and sunburn among U.S. adults. Method We used 2010 National Health Interview Survey data (N = 24,970) to conduct multivariable logistic regressions examining associations with having 1 or more sunburns in the past year and having 4 or more sunburns in the past year. Results Overall, 37.1% of adults experienced sunburn in the past year. The adjusted prevalence of sunburn was particularly common among adults aged 18–29 years (52.0%), those who repeatedly burn or freckle after 2 weeks in the sun (45.9%), whites (44.3%), indoor tanners (44.1%), those with a family history of melanoma (43.9%), and those who are US-born (39.5%). Physical activity, alcohol consumption, and overweight/obesity were positively associated with sunburn (all P < 0.001); sun protection behaviors were not significantly associated with sunburn (P = 0.35). Among those who were sunburned in the past year, 12.1% experienced 4 or more sunburns. Conclusion Sunburn is common, particularly among younger adults, those with a more sun-sensitive skin type, whites, those with a family history of melanoma, the highly physically active, and indoor tanners. Efforts are needed to facilitate sun-safety during outdoor recreation, improve the consistency of sun protection practices, and prevent sunburn, particularly among these subgroups. PMID:24589442

  14. Improving health care proxy documentation using a web-based interview through a patient portal.

    PubMed

    Bajracharya, Adarsha S; Crotty, Bradley H; Kowaloff, Hollis B; Safran, Charles; Slack, Warner V

    2016-05-01

    Health care proxy (HCP) documentation is suboptimal. To improve rates of proxy selection and documentation, we sought to develop and evaluate a web-based interview to guide patients in their selection, and to capture their choices in their electronic health record (EHR). We developed and implemented a HCP interview within the patient portal of a large academic health system. We analyzed the experience, together with demographic and clinical factors, of the first 200 patients who used the portal to complete the interview. We invited users to comment about their experience and analyzed their comments using established qualitative methods. From January 20, 2015 to March 13, 2015, 139 of the 200 patients who completed the interview submitted their HCP information for their clinician to review in the EHR. These patients had a median age of 57 years (Inter Quartile Range (IQR) 45-67) and most were healthy. The 99 patients who did not previously have HCP information in their EHR were more likely to complete and then submit their information than the 101 patients who previously had a proxy in their health record (odds ratio 2.4, P = .005). Qualitative analysis identified several ways in which the portal-based interview reminded, encouraged, and facilitated patients to complete their HCP. Patients found our online interview convenient and helpful in facilitating selection and documentation of an HCP. Our study demonstrates that a web-based interview to collect and share a patient's HCP information is both feasible and useful. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. National health expenditures, 1983

    PubMed Central

    Gibson, Robert M.; Levit, Katharine R.; Lazenby, Helen; Waldo, Daniel R.

    1984-01-01

    Although growing more slowly than in recent years, spending for health continued to account for an increasing share of the Nation's gross national product. In 1983, spending for health amounted to 10.8 percent of the gross national product, or $1,459 per person. Public programs financed 40 percent of all personal health care spending. Medicare and Medicaid expended $91 billion in benefits, 29 percent of all spending for personal health. New estimates of spending in calendar year 1983, along with revised measures of the benefits paid by private health insurers, are presented here. PMID:10310949

  16. Immigrant Health Inequalities in the United States: Use of Eight Major National Data Systems

    PubMed Central

    Kogan, Michael D.

    2013-01-01

    Eight major federal data systems, including the National Vital Statistics System (NVSS), National Health Interview Survey (NHIS), National Survey of Children's Health, National Longitudinal Mortality Study, and American Community Survey, were used to examine health differentials between immigrants and the US-born across the life course. Survival and logistic regression, prevalence, and age-adjusted death rates were used to examine differentials. Although these data systems vary considerably in their coverage of health and behavioral characteristics, ethnic-immigrant groups, and time periods, they all serve as important research databases for understanding the health of US immigrants. The NVSS and NHIS, the two most important data systems, include a wide range of health variables and many racial/ethnic and immigrant groups. Immigrants live 3.4 years longer than the US-born, with a life expectancy ranging from 83.0 years for Asian/Pacific Islander immigrants to 69.2 years for US-born blacks. Overall, immigrants have better infant, child, and adult health and lower disability and mortality rates than the US-born, with immigrant health patterns varying across racial/ethnic groups. Immigrant children and adults, however, fare substantially worse than the US-born in health insurance coverage and access to preventive health services. Suggestions and new directions are offered for improvements in health monitoring and for strengthening and developing databases for immigrant health assessment in the USA. PMID:24288488

  17. National Health Expenditures, 1979

    PubMed Central

    Gibson, Robert M

    1980-01-01

    Outlays for health care in the nation reached $212.2 billion in calendar year 1979—12.5 percent higher than in 1978, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $943 per person in the United States and was equal to 9.0 percent of the Gross National Product. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. PMID:10309255

  18. Motivations for contributing to health-related articles on Wikipedia: an interview study.

    PubMed

    Farič, Nuša; Potts, Henry W W

    2014-12-03

    Wikipedia is one of the most accessed sources of health information online. The current English-language Wikipedia contains more than 28,000 articles pertaining to health. The aim was to characterize individuals' motivations for contributing to health content on the English-language Wikipedia. A set of health-related articles were randomly selected and recent contributors invited to complete an online questionnaire and follow-up interview (by Skype, by email, or face-to-face). Interviews were transcribed and analyzed using thematic analysis and a realist grounded theory approach. A total of 32 Wikipedians (31 men) completed the questionnaire and 17 were interviewed. Those completing the questionnaire had a mean age of 39 (range 12-59) years; 16 had a postgraduate qualification, 10 had or were currently studying for an undergraduate qualification, 3 had no more than secondary education, and 3 were still in secondary education. In all, 15 were currently working in a health-related field (primarily clinicians). The median period for which they have been an active editing Wikipedia was 3-5 years. Of this group, 12 were in the United States, 6 were in the United Kingdom, 4 were in Canada, and the remainder from another 8 countries. Two-thirds spoke more than 1 language and 90% (29/32) were also active contributors in domains other than health. Wikipedians in this study were identified as health professionals, professionals with specific health interests, students, and individuals with health problems. Based on the interviews, their motivations for editing health-related content were summarized in 5 strongly interrelated categories: education (learning about subjects by editing articles), help (wanting to improve and maintain Wikipedia), responsibility (responsibility, often a professional responsibility, to provide good quality health information to readers), fulfillment (editing Wikipedia as a fun, relaxing, engaging, and rewarding activity), and positive attitude to

  19. Motivations for Contributing to Health-Related Articles on Wikipedia: An Interview Study

    PubMed Central

    2014-01-01

    Background Wikipedia is one of the most accessed sources of health information online. The current English-language Wikipedia contains more than 28,000 articles pertaining to health. Objective The aim was to characterize individuals’ motivations for contributing to health content on the English-language Wikipedia. Methods A set of health-related articles were randomly selected and recent contributors invited to complete an online questionnaire and follow-up interview (by Skype, by email, or face-to-face). Interviews were transcribed and analyzed using thematic analysis and a realist grounded theory approach. Results A total of 32 Wikipedians (31 men) completed the questionnaire and 17 were interviewed. Those completing the questionnaire had a mean age of 39 (range 12-59) years; 16 had a postgraduate qualification, 10 had or were currently studying for an undergraduate qualification, 3 had no more than secondary education, and 3 were still in secondary education. In all, 15 were currently working in a health-related field (primarily clinicians). The median period for which they have been an active editing Wikipedia was 3-5 years. Of this group, 12 were in the United States, 6 were in the United Kingdom, 4 were in Canada, and the remainder from another 8 countries. Two-thirds spoke more than 1 language and 90% (29/32) were also active contributors in domains other than health. Wikipedians in this study were identified as health professionals, professionals with specific health interests, students, and individuals with health problems. Based on the interviews, their motivations for editing health-related content were summarized in 5 strongly interrelated categories: education (learning about subjects by editing articles), help (wanting to improve and maintain Wikipedia), responsibility (responsibility, often a professional responsibility, to provide good quality health information to readers), fulfillment (editing Wikipedia as a fun, relaxing, engaging, and

  20. Association of birthplace and self-reported hypertension by racial/ethnic groups among US adults--National Health Interview Survey, 2006-2010.

    PubMed

    Fang, Jing; Ayala, Carma; Loustalot, Fleetwood

    2012-12-01

    Over the past few decades, the proportion of US adults who were foreign-born has been increasing, as has the overall prevalence of hypertension. Here, we compared the prevalence of self-reported hypertension among native-born adults with that among foreign-born adults, classified by racial/ethnic group. Using 2006-2010 data from the National Health Interview Survey (NHIS), we compared the age-adjusted prevalence of hypertension among native-born adults to foreign-born adults, specified by continent of birthplace and race/ethnicity. Results are expressed as unadjusted odds ratios (ORs) and three sets of adjusted odds ratios (AORs) adjusted for selected sociodemographic, behavioral and health-related characteristics. All results accounted for NHIS sampling design variables. The analytic sample was 124,260 with 16.3% foreign-born adults. Among the foreign-born adults, 56% were from Central or South America, 22% from Asia, 13% from Europe, and 4% from Africa. Overall and after adjustment, hypertension prevalence was significantly higher among US-born adults than among foreign-born adults (AOR: 1.28, 95% CI: 1.21-1.36). By race/ethnicity, hypertension prevalence was higher among US-born non-Hispanic blacks than either foreign-born non-Hispanic blacks (AOR: 1.24, 95%CI: 1.02-1.50) or all Africa-born immigrants of any race/ethnicity [AOR: 1.45, 95% confidence interval (CI): 1.07-1.97]. Among foreign-born adults, duration of US residence was positively associated with the likelihood of hypertension. Hypertension prevalence was higher among US-born adults than among foreign-born adults and higher among US-born non-Hispanic blacks than in any other group. Among foreign-born adults, hypertension risk increased with the number of years they had lived in the United States.

  1. The experiences of mentors on a career development and mentoring programme for female mental health nurses in the UK National Health Service.

    PubMed

    Woolnough, Helen M; Davidson, Marilyn J; Fielden, Sandra L

    2006-08-01

    This paper presents the experiences of executive and non-executive UK National Health Service (NHS) Trust directors and senior managers as mentors in a career development and mentoring programme for a cohort of 27 female mental health nurses from six NHS mental health trusts. Baseline interview data was collated from 27 mentors prior to the programme. Twenty-four mentors participated in semi-structured telephone interviews investigating their experiences of being a mentor at the end of the programme. The interview transcripts were analysed using thematic content analysis. Experience as a mentor impacted on mentors in a variety of ways and the common themes which emerged from the data included: increased understanding of the mentoring role, increased awareness of career barriers for female mental health nurses, improved ground-level insight in relation to nursing staff and the patients they care for, improved professional reputation, increased networks, new insights into organizational issues, personal enjoyment and fulfilment and desire to implement organizational change. All mentors interviewed stated that they would consider becoming a mentor again. The mentoring relationship was an invaluable learning experience for mentors and results from this study suggested that trained mentors have an important role to play as change agents in the NHS.

  2. Nonresponse in the National Survey of Children's Health, 2007.

    PubMed

    Skalland, Benjamin J; Blumberg, Stephen J

    2012-06-01

    For random-digit-dial telephone surveys, the increasing difficulty in contacting eligible households and obtaining their cooperation raises concerns about the potential for nonresponse bias. This report presents an analysis of nonresponse bias in the 2007 National Survey of Children's Health, a module of the State and Local Area Integrated Telephone Survey conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. An attempt was made to measure bias in six key survey estimates using four different approaches: comparison of response rates for subgroups, use of sampling frame data, study of variation within the existing survey, and comparison of survey estimates with similar estimates from another source. Even when nonresponse-adjusted survey weights were used, the interviewed population was more likely to live in areas associated with higher levels of home ownership, lower home values, and greater proportions of non-Hispanic white persons when compared with the nonresponding population. Bias was found (although none greater than 3%) in national estimates of the proportion of children in excellent or very good health, those with consistent health insurance coverage, and those with a medical home. However, the level and direction of the bias depended on the approach used to measure it. There was no evidence of significant bias in the proportion of children with preventive medical care visits, those with families who ate daily meals together, or those living in safe neighborhoods.

  3. The privatization of environmental health services: a national survey of practices and perspectives in local health departments.

    PubMed

    Keane, Christopher; Marx, John; Ricci, Edmund

    2002-01-01

    This article presents nationally representative data on environmental health (EH) services privatized by local public health departments, enforcement and assurance mechanisms for privatized services, and administrators' views about EH services that should not be privatized. A national sample of 380 local public health departments, stratified by jurisdiction size, was drawn from a universe of 2,488 departments. Telephone interviews were conducted with 347 administrators of departments. Results were weighted to be nationally representative. Approximately one-quarter of departments had privatized at least one EH service, almost always to for-profit organizations. The two most common reasons given for privatizing EH services were cost savings or increased efficiency and lack of capacity or expertise to carry out the service. The most rigorous, although infrequent, technique of enforcement and assurance of EH standards when services were privatized was double-testing of samples. Departments more commonly relied on state licensing and certification of contractors. When asked what services should not be privatized, 27% of respondents cited EH services. Many respondents argued against privatizing environmental services that have inherent regulatory functions. They expressed concern that privatization would fragment the public health infrastructure by impairing communication, diminishing control over performance, or weakening health departments' capacity to respond to environmental and other health crises. These findings raise serious concerns about the privatization of EH.

  4. The Characteristics and Motivations of Online Health Information Seekers: Cross-Sectional Survey and Qualitative Interview Study

    PubMed Central

    Inglis, Nadia; Ronnie, Jennifer; Large, Shirley

    2011-01-01

    Background Most households in the United Kingdom have Internet access, and health-related Internet use is increasing. The National Health Service (NHS) Direct website is the major UK provider of online health information. Objective Our objective was to identify the characteristics and motivations of online health information seekers accessing the NHS Direct website, and to examine the benefits and challenges of the health Internet. Methods We undertook an online questionnaire survey, offered to users of the NHS Direct website. A subsample of survey respondents participated in in-depth, semistructured, qualitative interviews by telephone or instant messaging/email. Questionnaire results were analyzed using chi-square statistics. Thematic coding with constant comparison was used for interview transcript analysis. Results In total 792 respondents completed some or all of the survey: 71.2% (534/750 with data available) were aged under 45 years, 67.4% (511/758) were female, and 37.7% (286/759) had university-level qualifications. They sought information for themselves (545/781, 69.8%), someone else (172/781, 22.0%), or both (64/781, 8.2%). Women were more likely than men to seek help for someone else or both themselves and someone else (168/509 vs 61/242, χ2 2 = 6.35, P = .04). Prior consultation with a health professional was reported by 44.9% (346/770), although this was less common in younger age groups (<36 years) (χ2 1 = 24.22, P < .001). Participants aged 16 to 75 years (n = 26, 20 female, 6 male) were recruited for interview by telephone (n = 23) and instant messaging/email (n = 3). Four major interview themes were identified: motivations for seeking help online; benefits of seeking help in this way and some of the challenges faced; strategies employed in navigating online health information provision and determining what information to use and to trust; and specific comments regarding the NHS Direct website service. Within the motivation category, four

  5. Racial and ethnic disparities associated with knowledge of symptoms of heart attack and use of 911: National Health Interview Survey, 2001.

    PubMed

    McGruder, Henraya E; Greenlund, Kurt J; Malarcher, Ann M; Antoine, Theresa L; Croft, Janet B; Zheng, Zhi-Jie

    2008-01-01

    Heart attacks are more prevalent among Hispanics and Blacks than among Whites. Bystanders must be able to recognize heart attack symptoms and activate the emergency response system in order to receive time-dependent therapies that increase survival. This study estimated racial/ethnic disparities in awareness of heart attack symptoms in a sample of the US population. We evaluated data from 33,059 adult participants in the 2001 National Health Interview Survey. Respondents indicated their awareness of five heart attack symptoms and the need to call 911 in the presence of such symptoms. Hispanics and Blacks were less likely to recognize each heart attack symptom than were Whites (P<.05). Hispanics (25.6%), people aged 18-24 years (33.6%), men (39.1%), and those with less than a high school education (31.3%) were less likely to recognize all five heart attack symptoms and report that they would call 911 than were Whites (45.8%), Blacks (36.1%), respondents aged 45-64 years (47.7%) and >65 years (43.9%), and those with a high school education (41.0%) or more (45.6%). In multivariate logistic regression analyses, Blacks (OR .73, 95% CI .66-.80) and Hispanics (OR .49, 95% CI .45-.54) were less likely than were Whites to recognize all five heart attack symptoms and the need to call 911 if someone had these symptoms. One Healthy People 2010 goal is to eliminate health disparities. Racial/ethnic disparities exist in knowledge of heart attack symptoms and the need to call 911. Special educational efforts should focus on Black and Hispanic populations and highlight the importance of symptoms and time-dependent therapies.

  6. More than 40% of those not taking antiseizure medication with recent seizures reported that epilepsy or its treatment interfered with their recent activities, 2010 and 2013 US National Health Interview Surveys.

    PubMed

    Kobau, Rosemarie; Cui, Wanjun; Zack, Matthew M

    2016-09-01

    From the combined 2010 and 2013 National Health Interview Surveys, we estimated US national age-standardized prevalence of adults with active epilepsy who reported that a nervous system/sensory organ condition caused a limitation (e.g., walking; memory; or physical, mental, or emotional problems) and, separately, that epilepsy interfered with their activities (e.g., working, schooling, or socializing) during the 30days preceding the survey. Sixty-one percent of adults who took antiseizure medication and had recent seizures and 51% of those who took medication and had no seizures reported having limitations caused by a nervous system/sensory organ condition. Sixty-two percent of adults who took antiseizure medication and had recent seizures and 20% of those who took medication and had no seizures reported that epilepsy or its treatment interfered with their recent activities. Forty-one percent of those who did not take medication and had recent seizures also reported that epilepsy interfered with their activities. To reduce activity limitations in people with epilepsy, health and social service providers can ensure that adequate policies and practices that promote access to high quality care and social participation are in effect in organizations and communities. Published by Elsevier Inc.

  7. Low Back Pain Prevalence and Related Workplace Psychosocial Risk Factors: A Study Using Data From the 2010 National Health Interview Survey.

    PubMed

    Yang, Haiou; Haldeman, Scott; Lu, Ming-Lun; Baker, Dean

    2016-09-01

    The objectives of this study were to estimate prevalence of low back pain, to investigate associations between low back pain and a set of emerging workplace risk factors, and to identify worker groups with an increased vulnerability for low back pain in the United States. The data used for this cross-sectional study came from the 2010 National Health Interview Survey, which was designed to collect data on health conditions and related risk factors from the US civilian population. The variance estimation method was used to compute weighted data for prevalence of low back pain. Multivariable logistic regression analyses stratified by sex and age were performed to determine the odds ratios (ORs) and the 95% confidence interval (CI) for low back pain. The examined work-related psychosocial risk factors included work-family imbalance, exposure to a hostile work environment, and job insecurity. Work hours, occupation, and other work organizational factors (nonstandard work arrangements and alternative shifts) were also examined. The prevalence of self-reported low back pain in the previous 3 months among workers in the United States was 25.7% in 2010. Female or older workers were at increased risk of experiencing low back pain. We found significant associations between low back pain and a set of psychosocial factors, including work-family imbalance (OR 1.27, CI 1.15-1.41), exposure to hostile work (OR 1.39, CI 1.25-1.55), and job insecurity (OR 1.44, CI 1.24-1.67), while controlling for demographic characteristics and other health-related factors. Older workers who had nonstandard work arrangements were more likely to report low back pain. Women who worked 41 to 45 hours per week and younger workers who worked >60 hours per week had an increased risk for low back pain. Workers from several occupation groups, including male health care practitioners, female and younger health care support workers, and female farming, fishing, and forestry workers, had an increased risk of

  8. Psychiatric comorbidity in autism spectrum disorder: Correspondence between mental health clinician report and structured parent interview.

    PubMed

    Stadnick, Nicole; Chlebowski, Colby; Baker-Ericzén, Mary; Dyson, Margaret; Garland, Ann; Brookman-Frazee, Lauren

    2017-10-01

    Publicly funded mental health services are critical in caring for children with autism spectrum disorder. Accurate identification of psychiatric comorbidity is necessary for effective mental health treatment. Little is known about psychiatric diagnosis for this population in routine mental health care. This study (1) examined correspondence between psychiatric diagnoses reported by mental health clinicians and those derived from a structured diagnostic interview and (2) identified predictors of agreement between clinician-reported and diagnostic interview-derived diagnoses in a sample of 197 children aged 4-14 years with autism spectrum disorder receiving mental health services. Data were drawn from a randomized effectiveness trial conducted in publicly funded mental health services. Non-autism spectrum disorder diagnoses were assessed using an adapted version of the Mini-International Neuropsychiatric Interview, parent version. Cohen's kappa was calculated to examine agreement between Mini-International Neuropsychiatric Interview, parent version and clinician-reported diagnoses of comorbid conditions. Children met criteria for an average of 2.83 (standard deviation = 1.92) Mini-International Neuropsychiatric Interview, parent version diagnoses. Agreement was poor across all diagnostic categories (κ values: 0.06-0.18). Logistic regression identified child gender and clinical characteristics as significant predictors of agreement for specific diagnoses. Results underscore the need for training mental health clinicians in targeted assessment of specific psychiatric disorders and prioritizing treatment development and testing for specific diagnoses to improve care for children with autism spectrum disorder served in publicly funded mental health settings.

  9. National Surveys of Population Health: Big Data Analytics for Mobile Health Monitors.

    PubMed

    Schatz, Bruce R

    2015-12-01

    At the core of the healthcare crisis is fundamental lack of actionable data. Such data could stratify individuals within populations to predict which persons have which outcomes. If baselines existed for all variations of all conditions, then managing health could be improved by matching the measuring of individuals to their cohort in the population. The scale required for complete baselines involves effective National Surveys of Population Health (NSPH). Traditionally, these have been focused upon acute medicine, measuring people to contain the spread of epidemics. In recent decades, the focus has moved to chronic conditions as well, which require smaller measures over longer times. NSPH have long utilized quality of life questionnaires. Mobile Health Monitors, where computing technologies eliminate manual administration, provide richer data sets for health measurement. Older technologies of telephone interviews will be replaced by newer technologies of smartphone sensors to provide deeper individual measures at more frequent timings across larger-sized populations. Such continuous data can provide personal health records, supporting treatment guidelines specialized for population cohorts. Evidence-based medicine will become feasible by leveraging hundreds of millions of persons carrying mobile devices interacting with Internet-scale services for Big Data Analytics.

  10. Combat Experience and Mental Health in the Israel National Health Survey.

    PubMed

    Lubin, Gadi; Barash, Igor; Levinson, Daphna

    2016-01-01

    To compare the mental health status of those who participated in combat related activities during their service with that of soldiers whose army service did not include combat related activities Method: A representative sample extracted from the National Population Register of non-institutionalized residents aged 21 or older of Israel was used in this crosssectional survey. Data on mental health disorders, sociodemographic background and army service were collected using face-to-face computer-assisted interviews. Combat experience per se was not associated with lifetime diagnosis of PTSD. Former combat soldiers had significantly lower lifetime prevalence and 12 months prevalence of any mood or anxiety disorders including PTSD. This work is in line with previous literature showing that combat exposure, as such, has limited contribution to lifetime PTSD in some groups of veterans. The inverse relationship between combat exposure and PTSD might be explained by the selection of potential combatants among all recruits and by the heightened preparedness to military life stressors.

  11. The Effects of Respondents' Consent to Be Recorded on Interview Length and Data Quality in a National Panel Study

    ERIC Educational Resources Information Center

    McGonagle, Katherine A.; Brown, Charles; Schoeni, Robert F.

    2015-01-01

    Recording interviews is a key feature of quality control protocols for most survey organizations. We examine the effects on interview length and data quality of a new protocol adopted by a national panel study. The protocol recorded a randomly chosen one-third of all interviews digitally, although all respondents were asked for permission to…

  12. Transitioning to a national health system in Cyprus: a stakeholder analysis of pharmaceutical policy reform.

    PubMed

    Wouters, Olivier J; Kanavos, Panos G

    2015-09-01

    To review the pharmaceutical sector in Cyprus in terms of the availability and affordability of medicines and to explore pharmaceutical policy options for the national health system finance reform expected to be introduced in 2016. We conducted semi-structured interviews in April 2014 with senior representatives from seven key national organizations involved in pharmaceutical care. The captured data were coded and analysed using the predetermined themes of pricing, reimbursement, prescribing, dispensing and cost sharing. We also examined secondary data provided by the Cypriot Ministry of Health; these data included the prices and volumes of prescription medicines in 2013. We identified several key issues, including high medicine prices, underuse of generic medicines and high out-of-pocket drug spending. Most stakeholders recommended that the national government review existing pricing policies to ensure medicines within the forthcoming national health system are affordable and available, introduce a national reimbursement system and incentivize the prescribing and dispensing of generic medicines. There were disagreements over how to (i) allocate responsibilities to governmental agencies in the national health system, (ii) reconcile differences in opinion between stakeholders and (iii) raise awareness among patients, physicians and pharmacists about the benefits of greater generic drug use. In Cyprus, if the national health system is going to provide universal health coverage in a sustainable fashion, then the national government must address the current issues in the pharmaceutical sector. Importantly, the country will need to increase the market share of generic medicines to contain drug spending.

  13. Out-of-Pocket Expenditures on Complementary Health Approaches Associated with Painful Health Conditions in a Nationally Representative Adult Sample

    PubMed Central

    Nahin, Richard L.; Stussman, Barbara J.; Herman, Patricia M.

    2015-01-01

    National surveys suggest that millions of adults in the United States use complementary health approaches such as acupuncture, chiropractic manipulation, and herbal medicines to manage painful conditions such as arthritis, back pain and fibromyalgia. Yet, national and per person out-of-pocket (OOP) costs attributable to this condition-specific use are unknown. In the 2007 National Health Interview Survey, use of complementary health approaches, reasons for this use, and associated OOP costs were captured in a nationally representative sample of 5,467 adults. Ordinary least square regression models that controlled for co-morbid conditions were used to estimate aggregate and per person OOP costs associated with 14 painful health conditions. Individuals using complementary approaches spent a total of $14.9 billion (S.E. $0.9 billion) OOP on these approaches to manage these painful conditions. Total OOP expenditures seen in those using complementary approaches for their back pain ($8.7 billion, S.E. $0.8 billion) far outstripped that of any other condition, with the majority of these costs ($4.7 billion, S.E. $0.4 billion) resulting from visits to complementary providers. Annual condition-specific per-person OOP costs varied from a low of $568 (SE $144) for regular headaches, to a high of $895 (SE $163) for fibromyalgia. PMID:26320946

  14. Factors associated with Taiwanese lesbians' breast health-care behavior and intentions: Qualitative interview findings.

    PubMed

    Wang, Ya-Ching; Griffiths, Jane; Grande, Gunn

    2017-09-01

    This article presents the qualitative findings of a mixed-methods study that explored factors influencing lesbians' breast health-care behavior and intentions. A total of 37 semi-structured face-to-face interviews were conducted among women who self-identified as lesbians or women who partnered with the same gender who were aged 20 years or above in four areas of Taiwan (North, Central, South, and East Taiwan) between August 2012 and October 2012. Interviews were audio recorded with participants' consent. The interviews were analyzed using constant comparative analysis with Nvivo audio-coding support. Four themes were identified to be strongly associated with the lesbians' breast health-care behavior and their intentions, namely, gender identity, gender role expression, partners' support, and concerns about health-care providers' reactions. Important barriers to the women's breast health-care behavior and intentions were masculine identity ("T-identity" in Taiwan), masculine appearance, concerns about health-care providers' lack of knowledge of multiple gender diversity, and their attitudes toward lesbians. Conversely, their partners' support was a factor facilitating the women's breast health-care behavior and intentions, particularly for the T-identity lesbians. These findings suggest the significance of and need for culturally competent care and are important for improving Taiwanese lesbians' breast health.

  15. US Trends in Quality-Adjusted Life Expectancy From 1987 to 2008: Combining National Surveys to More Broadly Track the Health of the Nation

    PubMed Central

    Cutler, David M.; Rosen, Allison B.

    2013-01-01

    Objectives. We used data from multiple national health surveys to systematically track the health of the US adult population. Methods. We estimated trends in quality-adjusted life expectancy (QALE) from 1987 to 2008 by using national mortality data combined with data on symptoms and impairments from the National Medical Expenditure Survey (1987), National Health Interview Survey (1987, 1994–1995, 1996), Medical Expenditure Panel Survey (1992, 1996, 2000–2008), National Nursing Home Survey (1985, 1995, and 1999), and Medicare Current Beneficiary Survey (1992, 1994–2008). We decomposed QALE into changes in life expectancy, impairments, symptoms, and smoking and body mass index. Results. Years of QALE increased overall and for all demographic groups—men, women, Whites, and Blacks—despite being slowed by increases in obesity and a rising prevalence of some symptoms and impairments. Overall QALE gains were large: 2.4 years at age 25 years and 1.7 years at age 65 years. Conclusions. Understanding and consistently tracking the drivers of QALE change is central to informed policymaking. Harmonizing data from multiple national surveys is an important step in building this infrastructure. PMID:24028235

  16. Implementation of a National Workplace Wellness Program for Health Workers in Botswana

    PubMed Central

    Ledikwe, Jenny H.; Semo, Bazghina-werq; Sebego, Miram; Mpho, Maureen; Mothibedi, Heather; Mawandia, Shreshth; O’Malley, Gabrielle

    2017-01-01

    The Botswana workplace wellness program (WWP) for health care workers (HCWs) was initiated in 2007. WWP implementation was assessed using a sequential, explanatory, mixed methods design including a national implementation assessment (27 health districts) and in-depth interviews (n = 38). Level of implementation varied across districts with health screening, therapeutic recreation, and health promotion implemented more frequently than occupational health activities and psychosocial services. Facilitators to WWP implementation included establishment of a dedicated, diverse WWP committee; provision of administrative support, and integration of activities into organizational culture. Barriers included competing priorities related to delivery of health services to clients, limited technical ability to deliver occupation health activities and psychosocial support, receipt of health services from colleagues, and limited appreciation for personal wellness by some HCWs. Ensuring the well-being of HCWs is critical in reaching international health goals. PMID:28742763

  17. The Effects of Respondents’ Consent to be Recorded on Interview Length and Data Quality in a National Panel Study

    PubMed Central

    McGonagle, Katherine A.; Brown, Charles; Schoeni, Robert F.

    2014-01-01

    Recording interviews is a key feature of quality control protocols for most survey organizations. We examine the effects on interview length and data quality of a new protocol adopted by a national panel study. The protocol recorded a randomly chosen one-third of all interviews digitally, although all respondents were asked for permission to record their interview, and interviewers were blind to whether or not interviews were recorded. We find that the recording software slowed the interview slightly. Interviewer knowledge that the interview may be recorded improved data quality, but this knowledge also increased the length of the interview. Interviewers with higher education and performance ratings were less reactive to the new recording protocol. Survey managers may face a trade-off between higher data quality and longer interviews when determining recording protocols. PMID:26550000

  18. Usual Alcohol Consumption and Risks for Nonfatal Fall Injuries in the United States: Results From the 2004-2013 National Health Interview Survey.

    PubMed

    Chen, Chiung M; Yoon, Young-Hee

    2017-07-29

    Acute alcohol consumption is known to be a risk factor for fall injuries. The study sought to determine whether usual alcohol consumption increases the risk for nonfatal fall injuries. Data from 289,187 sample adults in the 2004-2013 U.S. National Health Interview Surveys were analyzed. Of these, 3,368 (∼1%) reported a total of 3,579 fall-injury episodes requiring medical consultation in the past 3 months. Latent class analysis based on four contextual indicators identified four ecological subtypes of fall injury within two age groups (18-49 and 50+). Five drinking patterns (i.e., lifetime abstainer, former drinker, low-risk drinker, increased-risk drinker, and highest-risk drinker) were categorized according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) low-risk drinking guidelines. Controlling for potential confounders, negative binomial regression estimated the adjusted rates of any type and subtypes of fall injury, by gender, for each drinking pattern relative to lifetime abstainer. Compared with lifetime abstainers, the adjusted rate of any fall injury for adults ages 18-49 was significantly higher among highest-risk drinkers (men: incidence rate ratio [IRR] = 2.59, 95% confidence interval [CI] [1.60, 4.20]; women: IRR = 1.90, 95% CI [1.24, 2.91]) and increased-risk drinkers (men: IRR = 1.94, 95% CI [1.25, 3.00]; women: IRR = 1.51, 95% CI [1.11, 2.07]). Furthermore, highest-risk drinkers had higher adjusted rates of either leisure- or sports-related fall injuries than lifetime abstainers. Alcohol consumption exceeding NIAAA's low-risk drinking guidelines is associated with elevated rates of nonfatal fall injuries. Findings underscore the importance of adhering to these recommendations.

  19. The matron's role in acute National Health Service trusts.

    PubMed

    Gould, Dinah

    2008-10-01

    The aim of this study was to describe how matrons in an acute National Health Service trust perceive and undertake their role since its reconfiguration in 2005 and to investigate their needs for continuing professional development. Matrons returned to acute National Health Service trusts in 2002 to provide a senior, authoritative nursing presence throughout clinical areas. Their function is to promote high standards of clinical care and leadership; ensure that administrative and support services are in place to deliver high standards of care; and provide a visible, accessible and authoritative presence in ward settings. Data were obtained by interview. A qualitative approach using a semi-structured interview schedule was used to obtain data from 22 matrons and the data were subjected to thematic analysis. There were differences in the way that matrons performed their role. They promoted clinical leadership effectively and maintained a high clinical profile. Attempts to promote high standards of cleanliness and infection control were less effective because of the shortcomings of the domestic service. Overall the matron role is proving effective. However, matrons' ability to promote adequate levels of environmental cleanliness and control infection is a cause for concern. IMPLICATIONS FOR NURSING MANAGERS: The study findings suggest that where an existing service is performing poorly, expecting another occupational group to oversee it will not contribute to improvement unless resources can be improved. WHAT THIS PAPER ADDS TO CURRENT KNOWLEDGE: This study has provided an in-depth evaluation of the matron role at a local level. It is to date the most comprehensive study of its kind.

  20. Mental health nursing students' experiences of stress during training: a thematic analysis of qualitative interviews.

    PubMed

    Galvin, J; Suominen, E; Morgan, C; O'Connell, E-J; Smith, A P

    2015-12-01

    What is known on the subject? Stress can impact students on mental health nurse training. This can have implications at the individual level (e.g. their own mental health) and at the level of the organization (e.g. sickness absence and attrition). What this paper adds to existing knowledge? We interviewed 12 mental health nursing students regarding the stress they experienced during training. Participants described how the academic demands can at times be unbearable during clinical placements. There were also issues with 'being a student' on some placements, with participants describing negative attitudes towards them from staff. The younger participants reported feeling overwhelmed on their initial placements and described some of the main challenges of mental health work for them. Raising concerns about the quality of care on wards was also described as particularly challenging for the students. What are the implications for practice? This paper can be useful to help training providers support mental health nursing students. Recommendations include reducing academic demands during clinical placements and extending and promoting existing support services beyond normal 9 am-5 pm working hours, even if these services are limited. Younger students could be better supported by being allocated to the more well-resourced placements in the early stages of their training. Raising awareness among staff of the tasks students can and cannot perform can help improve staff/student relations. Finally, students should be educated about the issues around raising concerns on placements to help the government's drive for a more open and transparent National Health Service (NHS). Previous studies investigating stress in nursing students focus on general nursing students or adopt quantitative measures. A qualitative study focusing specifically on mental health nursing students is required. One-to-one interviews were carried out with mental health nursing students (n = 12). Data were

  1. Selection of essential medicines for South Africa - an analysis of in-depth interviews with national essential medicines list committee members.

    PubMed

    Perumal-Pillay, Velisha Ann; Suleman, Fatima

    2017-01-07

    The South African (SA) public health system has employed an Essential Medicines List (EML) with Standard Treatment Guidelines (STGs) in the public sector since 1996. To date no studies have reported on the process of selection of essential medicines for SA EMLs and how this may have changed over time. This study reports on the decision making process for the selection of essential medicines for SA EMLs, over the years, as described by various members of the National Essential Medicines List Committee (NEMLC) and their task teams. Qualitative in-depth interviews, guided by an interview questionnaire, were conducted with 11 members of the SA NEMLC and their task teams (both past and present members) during the period January - April 2015. Interviews were recorded and transcribed verbatim. Transcripts were then coded by the first author and verified by the second author before being reconciled and input into NVIVO, a qualitative software, to facilitate analysis of the data. The interviews conducted suggest that the NEMLC process of medicine selection has been refined over the years. This together with the EML review process is now essentially predominantly an evidence based process where quality, safety and efficacy of a medicine is considered first followed by cost considerations which includes pharmacoeconomic evaluations, and pricing of medicines. This is the first study in SA to report on how decisions are taken to include or exclude medicines on SA national EMLs and provides insight into the SA EML medicine selection, review and monitoring processes over time. The results show that the NEMLC has undergone tremendous transformation over the years. Whilst the membership of the committee largely remains unchanged, the committee has developed its policies and processes over the years. However there is still a need to strengthen the monitoring and evaluation aspects of the SA EML policy process.

  2. Development of the National Health Information Systems in Botswana: Pitfalls, prospects and lessons.

    PubMed

    Seitio-Kgokgwe, Onalenna; Gauld, Robin D C; Hill, Philip C; Barnett, Pauline

    2015-01-01

    Studies evaluating development of health information systems in developing countries are limited. Most of the available studies are based on pilot projects or cross-sectional studies. We took a longitudinal approach to analysing the development of Botswana's health information systems. We aimed to: (i) trace the development of the national health information systems in Botswana (ii) identify pitfalls during development and prospects that could be maximized to strengthen the system; and (iii) draw lessons for Botswana and other countries working on establishing or improving their health information systems. This article is based on data collected through document analysis and key informant interviews with policy makers, senior managers and staff of the Ministry of Health and senior officers from various stakeholder organizations. Lack of central coordination, weak leadership, weak policy and regulatory frameworks, and inadequate resources limited development of the national health information systems in Botswana. Lack of attention to issues of organizational structure is one of the major pitfalls. The ongoing reorganization of the Ministry of Health provides opportunity to reposition the health information system function. The current efforts including development of the health information management policy and plan could enhance the health information management system.

  3. About one-half of adults with active epilepsy and seizures have annual family incomes under $25,000: The 2010 and 2013 US National Health Interview Surveys.

    PubMed

    Us Centers For Disease Control And Prevention Epilepsy Program

    2016-05-01

    People with active epilepsy are those who reported being told that they have epilepsy or a seizure disorder and either take antiseizure medication or have had a seizure during the past 12months. We used combined 2010 and 2013 National Health Interview Survey (NHIS) data on US adults with active epilepsy to examine whether taking medications and seizure frequency differed by sex, age, race/ethnicity, and reported or imputed annual family income. Of adults with active epilepsy, 45.5% reported taking medication and having at least one seizure, 41.3% reported taking medication and having no seizures, and 13.2% reported not taking any medication and having at least one seizure. About one-half of adults with active epilepsy and seizures have annual family incomes of less than $25,000. Promoting self-management supports and improved access to specialty care may reduce the burden of uncontrolled seizures in adults with epilepsy. Published by Elsevier Inc.

  4. Wise, Holistic Thinking: An Interview with Jean Sunde Peterson

    ERIC Educational Resources Information Center

    Henshon, Suzanna E.

    2012-01-01

    This article presents an interview with Jean Sunde Peterson, professor and director of school-counselor preparation in the Department of Educational Studies at Purdue University. She is a licensed mental health counselor and a national certified counselor, planning to return to clinical work with gifted children and adolescents and their families…

  5. Multisite Study of New Autism Diagnostic Interview-Revised (ADI-R) Algorithms for Toddlers and Young Preschoolers

    ERIC Educational Resources Information Center

    Kim, So Hyun; Thurm, Audrey; Shumway, Stacy; Lord, Catherine

    2013-01-01

    Using two independent datasets provided by National Institute of Health funded consortia, the Collaborative Programs for Excellence in Autism and Studies to Advance Autism Research and Treatment (n = 641) and the National Institute of Mental Health (n = 167), diagnostic validity and factor structure of the new Autism Diagnostic Interview (ADI-R)…

  6. A faculty-led mock residency interview exercise for fourth-year doctor of pharmacy students.

    PubMed

    Koenigsfeld, Carrie F; Wall, Geoffrey C; Miesner, Andrew R; Schmidt, Ginelle; Haack, Sally L; Eastman, Darla K; Grady, Sarah; Fornoff, Anisa

    2012-02-01

    To determine whether a faculty-led mock-interview activity enhanced pharmacy student preparation for the residency interview process and increased match rates. Twenty-eight doctor of pharmacy students volunteered for a 40-minute mock-interview session with 2-person faculty teams. A standard roster of 12 interview questions was derived from published literature and the faculty members' experience. Feedback on the student's interview performance was provided verbally during the session. Following the interview, students were given a 2-part survey instrument. The first part of the survey was administered immediately following the mock-interview session and the second part was administered after the standard date for residency program results (known as "Match Day"). Participant match rates were compared to American Society of Health-System Pharmacists (ASHP) national rates. 82.5% (23 of 27) of students in the mock-interview group matched a postgraduate year 1 (PGY1) program. Compared to national rates (61.9%), more students in our surveyed mock-interview group matched a PGY1 residency (P = .015; odds ratio [OR] 3.546, 95% CI 1.161-12.116). Higher match rates were seen in the students completing the mock residency interview compared to ASHP national rates. In general, students completing the mock interview found the process helpful and felt better prepared for their residency interviews.

  7. UNDERSTANDING HOW HEALTHY WORKPLACES ARE CREATED: IMPLICATIONS FOR DEVELOPING A NATIONAL HEALTH SERVICE HEALTHY WORKPLACE PROGRAM.

    PubMed

    Wyatt, Katrina M; Brand, Sarah; Ashby-Pepper, Julie; Abraham, Jane; Fleming, Lora E

    2015-01-01

    The workplace is an important setting for promoting health and well-being. We sought to understand how successful workplace health and well-being programs were developed and implemented to inform the development of a program for a National Health Service (NHS) hospital. Case studies of successful healthy workplace programs with 34 semi-structured employee interviews informed 12 interviews with NHS staff. Interviews were thematically analyzed using Nvivo. Themes were fed back to participants for further clarification and validation. Healthy workplace programs were characterized by senior management endorsement; collective sense of ownership; presence of visible "quick wins"; and a sense that participation was easy and fun, not mandated. Programs evolved organically, allowing trust to be built and activities to be developed with employees. Interviews with NHS staff suggested a lack of belief in the possibility of change in their workplace due to time and workload pressures, and a sense of an "us and them" relationship with management, as well as environmental barriers. A consistent pattern of how the conditions for a healthy workplace can be created, which map onto the results from the NHS ward staff, suggest that without creating an enabling environment for health-promoting behaviors, workplace programs will have poor uptake and retention.

  8. Mary Wakefield: Health Resources and Services Administrator. Interview.

    PubMed

    Wakefield, Mary

    2014-06-01

    Dr. Mary Wakefield is the administrator of the Health Resources and Services Administration. She came from the University of North Dakota, where she directed the Center for Rural Health. She has served as director of the Center for Health Policy, Research and Ethics at George Mason University and has worked with the World Health Organization's Global Programme on AIDS in Geneva, Switzerland. She is a fellow in the American Academy of Nursing and was elected to the Institute of Medicine of the National Academies. A native of North Dakota, Wakefield holds a doctoral degree in nursing from the University of Texas.

  9. Teaching health science students foundation motivational interviewing skills: use of motivational interviewing treatment integrity and self-reflection to approach transformative learning.

    PubMed

    M, Schoo A; S, Lawn; E, Rudnik; C, Litt J

    2015-12-21

    Many undergraduate and graduate-entry health science curricula have incorporated training in motivational interviewing (MI). However, to effectively teach skills that will remain with students after they graduate is challenging. The aims of this study were to find out self-assessed MI skills of health students and whether reflecting on the results can promote transformative learning. Thirty-six Australian occupational therapy and physiotherapy students were taught the principles of MI, asked to conduct a motivational interview, transcribe it, self-rate it using the Motivational Interviewing Treatment Integrity (MITI) tool and reflect on the experience. Student MI skills were measured using the reported MITI subscores. Student assignments and a focus group discussion were analysed to explore the student experience using the MITI tool and self-reflection to improve their understanding of MI principles. Students found MI challenging, although identified the MITI tool as useful for promoting self-reflection and to isolate MI skills. Students self-assessed their MI skills as competent and higher than scores expected from beginners. The results inform educational programs on how MI skills can be developed for health professional students and can result in transformative learning. Students may over-state their MI skills and strategies to reduce this, including peer review, are discussed. Structured self-reflection, using tools such as the MITI can promote awareness of MI skills and compliment didactic teaching methods.

  10. Factors that impact access to ongoing health care for First Nation children with a chronic condition.

    PubMed

    Coombes, Julieann; Hunter, Kate; Mackean, Tamara; Holland, Andrew J A; Sullivan, Elizabeth; Ivers, Rebecca

    2018-06-14

    Access to multidisciplinary health care services for First Nation children with a chronic condition is critical for the child's health and well-being, but disparities and inequality in health care systems have been almost impossible to eradicate for First Nation people globally. The objective of this review is to identify the factors that impact access and ongoing care for First Nation children globally with a chronic condition. An extensive systematic search was conducted of nine electronic databases to identify primary studies that explored factors affecting access to ongoing services for First Nation children with a chronic disease or injury. Due to the heterogeneity of included studies the Mixed Method Appraisal Tool (MMAT) was used to assess study quality. A total of six studies from Australia, New Zealand and Canada were identified and included in this review. Four studies applied qualitative approaches using in-depth semi structured interviews, focus groups and community fora. Two of the six studies used quantitative approaches. Facilitators included the utilisation of First Nation liaison workers or First Nation Health workers. Key barriers that emerged included lack of culturally appropriate health care, distance, language and cultural barriers, racism, the lack of incorporation of First Nation workers in services, financial difficulties and transport issues. There are few studies that have identified positive factors that facilitate access to health care for First Nation children. There is an urgent need to develop programs and processes to facilitate access to appropriate health care that are inclusive of the cultural needs of First Nation children.

  11. National health expenditures, 1985

    PubMed Central

    Waldo, Daniel R.; Levit, Katharine R.; Lazenby, Helen

    1986-01-01

    Slower price inflation in 1985 translated into slower growth of national health expenditures, but underlying growth in the use of goods and services continued along historic trends. Coupled with somewhat sluggish growth of the gross national product, this adherence to trends pushed the share of our Nation's output accounted for by health spending to 10.7 percent. Some aspects of health spending changed: Falling use of hospital services was offset by rising hospital profits and increased use of other health care services. Other aspects remained the same: Both the public sector and the private sector continued efforts to contain costs, efforts that have affected and will continue to affect not only the providers of care but the users of care as well. PMID:10311775

  12. Transitioning to a national health system in Cyprus: a stakeholder analysis of pharmaceutical policy reform

    PubMed Central

    Kanavos, Panos G

    2015-01-01

    Abstract Objective To review the pharmaceutical sector in Cyprus in terms of the availability and affordability of medicines and to explore pharmaceutical policy options for the national health system finance reform expected to be introduced in 2016. Methods We conducted semi-structured interviews in April 2014 with senior representatives from seven key national organizations involved in pharmaceutical care. The captured data were coded and analysed using the predetermined themes of pricing, reimbursement, prescribing, dispensing and cost sharing. We also examined secondary data provided by the Cypriot Ministry of Health; these data included the prices and volumes of prescription medicines in 2013. Findings We identified several key issues, including high medicine prices, underuse of generic medicines and high out-of-pocket drug spending. Most stakeholders recommended that the national government review existing pricing policies to ensure medicines within the forthcoming national health system are affordable and available, introduce a national reimbursement system and incentivize the prescribing and dispensing of generic medicines. There were disagreements over how to (i) allocate responsibilities to governmental agencies in the national health system, (ii) reconcile differences in opinion between stakeholders and (iii) raise awareness among patients, physicians and pharmacists about the benefits of greater generic drug use. Conclusion In Cyprus, if the national health system is going to provide universal health coverage in a sustainable fashion, then the national government must address the current issues in the pharmaceutical sector. Importantly, the country will need to increase the market share of generic medicines to contain drug spending. PMID:26478624

  13. Trends in Sexual Orientation Missing Data Over a Decade of the California Health Interview Survey

    PubMed Central

    Viana, Joseph; Grant, David; Cochran, Susan D.; Lee, Annie C.; Ponce, Ninez A.

    2015-01-01

    Objectives. We explored changes in sexual orientation question item completion in a large statewide health survey. Methods. We used 2003 to 2011 California Health Interview Survey data to investigate sexual orientation item nonresponse and sexual minority self-identification trends in a cross-sectional sample representing the noninstitutionalized California household population aged 18 to 70 years (n = 182 812 adults). Results. Asians, Hispanics, limited-English-proficient respondents, and those interviewed in non-English languages showed the greatest declines in sexual orientation item nonresponse. Asian women, regardless of English-proficiency status, had the highest odds of item nonresponse. Spanish interviews produced more nonresponse than English interviews and Asian-language interviews produced less nonresponse when we controlled for demographic factors and survey cycle. Sexual minority self-identification increased in concert with the item nonresponse decline. Conclusions. Sexual orientation nonresponse declines and the increase in sexual minority identification suggest greater acceptability of sexual orientation assessment in surveys. Item nonresponse rate convergence among races/ethnicities, language proficiency groups, and interview languages shows that sexual orientation can be measured in surveys of diverse populations. PMID:25790399

  14. Indicator-based systems of performance management in the National Health Service: a comparison of the perceptions of local- and national-level managers.

    PubMed

    Jones, G T

    2000-02-01

    Historically, the UK Government has policed the use of National Health Service (NHS) resources through the centralization of control. With the majority of resource-draining decisions being taken by clinicians, however, professional financial accountability is becoming more important within the NHS management structure. Variations in clinical performance can be monitored through the use of performance indicators, although these are not without their problems. The use of league tables of such indicators in the national press is now infamous and there is much anecdotal evidence about the intraorganizational conflict arising from the use of such tables. A questionnaire survey and interview study of clinical directors, clinical service directors and business managers in several Scottish NHS Trusts was undertaken to ascertain the perceptions of local-level managers on the issue of performance indicators. Interviews were also carried out with a number of personnel in the Scottish Office Department of Economics and Information, the Division of Health Gain and the Finance Directorate. This paper explores the differences between the perceptions of the managers at these two levels of the NHS with regards to issues of performance measurement, intraorganizational conflict and corporate vision.

  15. 37 CFR 1.133 - Interviews.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Interviews. 1.133 Section 1... COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES National Processing Provisions Interviews § 1.133 Interviews. (a)(1) Interviews with examiners concerning applications and other matters pending before the...

  16. How Well Do Americans Know Geography? "National Geographic" Editor Discusses Meaning for Schools (Interview).

    ERIC Educational Resources Information Center

    Koerner, Thomas

    1987-01-01

    Gilbert Grosvenor, editor of "National Geographic," is interviewed about the importance of geography for Americans. He claims our lack of geographic knowledge impedes our ability to act and compete in the world market as a world power and points out that geographic ignorance extends to people employed at high levels of government. (MD)

  17. Cross-national replication of the gender identity interview for children.

    PubMed

    Wallien, Madeleine S C; Quilty, Lena C; Steensma, Thomas D; Singh, Devita; Lambert, Susan L; Leroux, Annie; Owen-Anderson, Allison; Kibblewhite, Sarah J; Bradley, Susan J; Cohen-Kettenis, Peggy T; Zucker, Kenneth J

    2009-11-01

    We administered the Gender Identity Interview for Children, a 12-item child-informant measure, to children referred clinically for gender identity problems in Toronto, Ontario, Canada (N = 329) and Amsterdam, The Netherlands (N = 228) and 173 control children. Confirmatory factor analysis identified a Cognitive Gender Confusion factor (4 items) and an Affective Gender Confusion factor (8 items). Patients from both clinics had a significantly higher deviant total score than the controls, and the Dutch patients had a significantly higher deviant score than the Toronto patients. In this cross-national study, we are the first to report on the validity of this measure to discriminate children with gender identity disorder from controls outside of North America.

  18. The Design and Implementation of the 2016 National Survey of Children's Health.

    PubMed

    Ghandour, Reem M; Jones, Jessica R; Lebrun-Harris, Lydie A; Minnaert, Jessica; Blumberg, Stephen J; Fields, Jason; Bethell, Christina; Kogan, Michael D

    2018-05-09

    Introduction Since 2001, the Health Resources and Services Administration's Maternal and Child Health Bureau (HRSA MCHB) has funded and directed the National Survey of Children's Health (NSCH) and the National Survey of Children with Special Health Care Needs (NS-CSHCN), unique sources of national and state-level data on child health and health care. Between 2012 and 2015, HRSA MCHB redesigned the surveys, combining content into a single survey, and shifting from a periodic interviewer-assisted telephone survey to an annual self-administered web/paper-based survey utilizing an address-based sampling frame. Methods The U.S. Census Bureau fielded the redesigned NSCH using a random sample of addresses drawn from the Census Master Address File, supplemented with a unique administrative flag to identify households most likely to include children. Data were collected June 2016-February 2017 using a multi-mode design, encouraging web-based responses while allowing for paper mail-in responses. A parent/caregiver knowledgeable about the child's health completed an age-appropriate questionnaire. Experiments on incentives, branding, and contact strategies were conducted. Results Data were released in September 2017. The final sample size was 50,212 children; the overall weighted response rate was 40.7%. Comparison of 2016 estimates to those from previous survey iterations are not appropriate due to sampling and mode changes. Discussion The NSCH remains an invaluable data source for key measures of child health and attendant health care system, family, and community factors. The redesigned survey extended the utility of this resource while seeking a balance between previous strengths and innovations now possible.

  19. Improving completion rates for client intake forms through Audio Computer-Assisted Self-Interview (ACASI): results from a pilot study with the Avon Breast Health Outreach Program.

    PubMed

    Hallum-Montes, Rachel; Senter, Lindsay; D'Souza, Rohan; Gates-Ferris, Kathryn; Hurlbert, Marc; Anastario, Michael

    2014-01-01

    This study compares rates of completion of client intake forms (CIFs) collected via three interview modes: audio computer-assisted self-interview (ACASI), face-to-face interview (FFI), and self-administered paper-based interview (SAPI). A total of 303 clients served through the Avon Breast Health Outreach Program (BHOP) were sampled from three U.S. sites. Clients were randomly assigned to complete a standard CIF via one of the three interview modes. Logistic regression analyses demonstrated that clients were significantly more likely to complete the entire CIF via ACASI than either FFI or SAPI. The greatest observed differences were between ACASI and SAPI; clients were almost six times more likely to complete the CIF via ACASI as opposed to SAPI (AOR = 5.8, p < .001). We recommend that where feasible, ACASI be utilized as an effective means of collecting client-level data in healthcare settings. Adoption of ACASI in health centers may translate into higher completion rates of intake forms by clients, as well as reduced burden on clinic staff to enter data and review intake forms for completion. © 2013 National Association for Healthcare Quality.

  20. Towards National eHealth Implementation--a comparative study on WHO/ITU National eHealth Strategy Toolkit in Iran.

    PubMed

    Riazi, Hossein; Jafarpour, Maryam; Bitaraf, Ehsan

    2014-01-01

    Experiences has shown that utilization of ICT in health sector requires national commitment and planned efforts to make the best use of existing capacity. Establishing the main directions as well as planning the detailed steps needed are key to achieving longer-term goals such as health sector efficiency, reform or more fundamental transformation. Collaboration between the health and ICT sectors, both public and private, is central to this effort. As the major United Nations agencies for health and telecommunications respectively, the World Health Organization (WHO) and the International Telecommunication Union (ITU) have recognized the importance of collaboration for eHealth in their global resolutions, which encourage countries to develop national eHealth strategies; the National eHealth Strategy Toolkit is the proof of these recommendations. In this study a mapping of eHealth components in WHO/ITU National eHealth Strategy Toolkit and our national eHealth vision is presented.

  1. National Health Expenditures, 1982

    PubMed Central

    Gibson, Robert M.; Waldo, Daniel R.; Levit, Katharine R.

    1983-01-01

    Rapid growth in the share of the nation's gross national product devoted to health expenditure has heightened concern over the survival of government entitlement programs and has led to debate of the desirability of current methods of financing health care. In this article, the authors present the data at the heart of the issue, quantifying spending for various types of health care in 1982 and discussing the sources of funds for that spending. PMID:10310273

  2. Lessons from Early Medicaid Expansions Under Health Reform: Interviews with Medicaid Officials

    PubMed Central

    Sommers, Benjamin D; Arntson, Emily; Kenney, Genevieve M; Epstein, Arnold M

    2013-01-01

    Background The Affordable Care Act (ACA) dramatically expands Medicaid in 2014 in participating states. Meanwhile, six states have already expanded Medicaid since 2010 to some or all of the low-income adults targeted under health reform. We undertook an in-depth exploration of these six “early-expander” states—California, Connecticut, the District of Columbia, Minnesota, New Jersey, and Washington—through interviews with high-ranking Medicaid officials. Methods We conducted semi-structured interviews with 11 high-ranking Medicaid officials in six states and analyzed the interviews using qualitative methods. Interviews explored enrollment outreach, stakeholder involvement, impact on beneficiaries, utilization and costs, implementation challenges, and potential lessons for 2014. Two investigators independently analyzed interview transcripts and iteratively refined the codebook until reaching consensus. Results We identified several themes. First, these expansions built upon pre-existing state-funded insurance programs for the poor. Second, predictions about costs and enrollment were challenging, indicating the uncertainty in projections for 2014. Other themes included greater than anticipated need for behavioral health services in the expansion population, administrative challenges of expansions, and persistent barriers to enrollment and access after expanding eligibility—though officials overall felt the expansions increased access for beneficiaries. Finally, political context—support or opposition from stakeholders and voters—plays a critical role in shaping the success of Medicaid expansions. Conclusions Early Medicaid expansions under the ACA offer important lessons to federal and state policymakers as the 2014 expansions approach. While the context of each state’s expansion is unique, key shared experiences were significant implementation challenges and opportunities for expanding access to needed services. PMID:24834369

  3. Adult vaccination coverage levels among users of complementary/alternative medicine - results from the 2002 National Health Interview Survey (NHIS).

    PubMed

    Stokley, Shannon; Cullen, Karen A; Kennedy, Allison; Bardenheier, Barbara H

    2008-02-22

    While many Complementary/Alternative Medicine (CAM) practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged > or = 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage. Data from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever), and > or = 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics. Overall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value < 0.001) and pneumococcal (40% vs 33%; p-value < 0.001) vaccines but were not significantly different for hepatitis B (60% vs 56%; p-value = 0.36). Among non-priority adults, recent CAM users had significantly higher unadjusted and adjusted vaccination coverage levels compared to non-CAM users for all three vaccines (p-values < 0.001). Vaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue

  4. International health electives: thematic results of student and professional interviews.

    PubMed

    Petrosoniak, Andrew; McCarthy, Anne; Varpio, Lara

    2010-07-01

    The purpose of this study was to explore the complexities (including harms and benefits) of international health electives (IHEs) involving medical trainees. This exploration contributes to the ongoing debate about the goals and implications of IHEs for medical trainees. This qualitative study used anonymous, one-to-one, semi-structured interviews. All participants had previous international health experiences. Between September 2007 and March 2008, we interviewed a convenience sample of health care professionals (n=10) and medical trainees (n=10). Using a modified grounded theory methodology, we carried out cycles of data analysis in conjunction with data collection in an iterative and constant comparison process. The study's thematic structure was finalised when theme saturation was achieved. Participants described IHEs in both negative and positive terms. IHEs were described as unsustained short-term contributions that lacked clear educational objectives and failed to address local community needs. Ethical dilemmas were described as IHE challenges. Participants reflected that many IHEs included aspects of medical tourism and the majority of participants described the IHE in negative terms. However, a few participants acknowledged the benefits of the IHE. Specifically, it was seen as an introduction to a career in global health and as a potential foundation for more sustainable projects with positive host community impacts. Finally, despite similar understandings among participants, self-awareness of medical tourism was low. International health electives may include potential harms and benefits for both the trainee and the host community. Educational institutions should encourage and support structured IHEs for trainee participation. We recommend that faculties of medicine and global health educators establish pre-departure training courses for trainees and that IHE opportunities have sufficient structures in place to mitigate the negative effects of medical

  5. National Health Expenditures, 1978

    PubMed Central

    Gibson, Robert M.

    1979-01-01

    Outlays for health care in the Nation reached $192.4 billion in calendar year 1978--13 percent higher than in 1977, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $863 per person in the United States and was equal to 9.1 percent of the GNP. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. Revised estimates are presented extending back to 1965. PMID:10309049

  6. 78 FR 55751 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute...: National Institutes of Health, Neuroscience Building, Conference Room D, 6001 Executive Boulevard...: National Institutes of Health, Neuroscience Building, Conference Room D, 6001 Executive Boulevard...

  7. Fathers and their children's health: a telephone interview study.

    PubMed

    Hallberg, A-C; Kristiansson, R; Beckman, A; Petersson, K; Råstam, L; Håkansson, A

    2007-07-01

    To study fathers' perception of, and involvement in, their children's health. Telephone interviews according to a structured guide. County of Skåne, Sweden. Answers regarding care and upbringing of child, child's health and ill health, and role of father. 237 fathers of small children. Fathers seem to be involved in their children to a large extent, both in caring and playing activities with their children. Most of them (82%) think that the child's health is good, and half of them (55%) have, at some time, contacted a doctor. The fathers mention security, love and commitment as important factors for being a good father, and almost all (97%) think that they are good fathers. Yet, only slightly more than half of them (54%) state that they have sufficient time for the child. Today, fathers are subject to quite different expectations to participate actively in their children's everyday life than was the case for previous generations. Therefore, more studies of fathers' involvement in their children are needed, as well as a new approach within the health care system to fathers' participation.

  8. Medical Home Disparities for Latino Children by Parental Language of Interview

    PubMed Central

    DeCamp, Lisa Ross; Choi, Hwajung; Davis, Matthew M.

    2015-01-01

    Examination of Latino children in aggregate ignores important subgroup differences due to the parents’ English language ability. Previous reports of the pediatric medical home have not stratified Latino children by parental language differences to compare the two groups directly. We analyzed the 2007 National Survey of Children’s Health to determine medical home prevalence among Latino children, stratified by language of parental interview. Most Latino children with a Spanish-language parental interview had a usual source of care, but only one-quarter had a medical home. Striking medical home disparities persisted for Latino children with a Spanish-language interview, even after adjustment for potential confounders. Lack of a medical home was associated with disparities in the quality of care, more so than access disparities. Addressing health care disparities for Latino children requires particular attention to the unique needs of Latino children with parents who may experience language barriers during health care encounters. PMID:22080700

  9. 76 FR 71047 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on...., Chief, Extramural Project Review Branch EPRB, NIAAA, National Institutes of Health, 5365 Fishers Lane... Awards., National Institutes of Health, HHS) Dated: November 8, 2011. Jennifer S. Spaeth, Director...

  10. 78 FR 24427 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; 60-Day..., the National Human Genome Research Institute (NHGRI), National Institutes of Health (NIH), will... Genome Research Institute (NHGRI), National Institutes of Health (NIH). Need and Use of Information...

  11. Methodological Aspects of Focus Groups in Health Research: Results of Qualitative Interviews With Focus Group Moderators.

    PubMed

    Tausch, Anja P; Menold, Natalja

    2016-01-01

    Although focus groups are commonly used in health research to explore the perspectives of patients or health care professionals, few studies consider methodological aspects in this specific context. For this reason, we interviewed nine researchers who had conducted focus groups in the context of a project devoted to the development of an electronic personal health record. We performed qualitative content analysis on the interview data relating to recruitment, communication between the focus group participants, and appraisal of the focus group method. The interview data revealed aspects of the focus group method that are particularly relevant for health research and that should be considered in that context. They include, for example, the preferability of face-to-face recruitment, the necessity to allow participants in patient groups sufficient time to introduce themselves, and the use of methods such as participant-generated cards and prioritization.

  12. Building the national health information infrastructure for personal health, health care services, public health, and research

    PubMed Central

    Detmer, Don E

    2003-01-01

    Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII) offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries). The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security) framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin PMID:12525262

  13. National Suicide Prevention Lifeline: Enhancing Mental Health Care for Suicidal Individuals and Other People in Crisis

    ERIC Educational Resources Information Center

    Gould, Madelyn S.; Munfakh, Jimmie L. H.; Kleinman, Marjorie; Lake, Alison M.

    2012-01-01

    Linking at-risk callers to ongoing mental health care is a key goal of crisis hotline interventions that has not often been addressed in evaluations of hotlines' effectiveness. We conducted telephone interviews with 376 suicidal and 278 nonsuicidal crisis callers to the National Suicide Prevention Lifeline (Lifeline) to assess rates of mental…

  14. 8 CFR 245.6 - Interview.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Interview. 245.6 Section 245.6 Aliens and... ADMITTED FOR PERMANENT RESIDENCE § 245.6 Interview. Each applicant for adjustment of status under this part shall be interviewed by an immigration officer. This interview may be waived in the case of a child...

  15. 8 CFR 1245.6 - Interview.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Interview. 1245.6 Section 1245.6 Aliens and... OF STATUS TO THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 1245.6 Interview. Each applicant for adjustment of status under this part shall be interviewed by an immigration officer. This interview may be...

  16. Correlates of osteoporosis among Jewish and Arab women aged 45-74 in Israel: national women's health interview survey.

    PubMed

    Nitzan-Kaluski, Dorit; Chinich, Ayelet; Ifrah, Anneke; Merom, Dafna; Green, Manfred S

    2003-01-01

    To determine the prevalence and correlates of osteoporosis among middle-aged and elderly Jewish and Arab women in Israel. A cross-sectional study on a random sample of Israeli women, carried out through telephone interviews. Questions included physician-diagnosed osteoporosis, demographic and lifestyle variables, medical conditions, and present and past use of estrogen-containing medications. Body mass index (BMI) was calculated from reported height and weight. A national population-based survey conducted from March through August 1998. A national random sample of 888 women aged 45-74. The overall prevalence of self-reported osteoporosis was estimated at 13.7%. The rates increased abruptly from about 5.8% at ages 45-59 to 19.6% at ages 60-64, and reached 27.7% at ages 70-74. Between ages 45-59, the rates were higher among Arab women, whereas in the older group they were higher among Jewish women. There was a marked increase following menopause. After adjustment for potential confounders, at ages 45-59, osteoporosis was positively associated with menopause and BMI, whereas at ages 60-74, it was positively associated with age and family history of osteoporosis, and negatively associated with BMI. The prevalence of physician-diagnosed osteoporosis in Israel among women aged 45-74 is estimated to be 13.7%, which is similar to that for the United States. The association of osteoporosis with risk factors is age-dependent, and in particular, age-BMI interaction on osteoporosis requires further investigation.

  17. A Nonresponse Bias Analysis of the Health Information National Trends Survey (HINTS).

    PubMed

    Maitland, Aaron; Lin, Amy; Cantor, David; Jones, Mike; Moser, Richard P; Hesse, Bradford W; Davis, Terisa; Blake, Kelly D

    2017-07-01

    We conducted a nonresponse bias analysis of the Health Information National Trends Survey (HINTS) 4, Cycles 1 and 3, collected in 2011 and 2013, respectively, using three analysis methods: comparison of response rates for subgroups, comparison of estimates with weighting adjustments and external benchmarks, and level-of-effort analysis. Areas with higher concentrations of low socioeconomic status, higher concentrations of young households, and higher concentrations of minority and Hispanic populations had lower response rates. Estimates of health information seeking behavior were higher in HINTS compared to the National Health Interview Survey (NHIS). The HINTS estimate of doctors always explaining things in a way that the patient understands was not significantly different from the same estimate from the Medical Expenditure Panel Survey (MEPS); however, the HINTS estimate of health professionals always spending enough time with the patient was significantly lower than the same estimate from MEPS. A level-of-effort analysis found that those who respond later in the survey field period were less likely to have looked for information about health in the past 12 months, but found only small differences between early and late respondents for the majority of estimates examined. There is some evidence that estimates from HINTS could be biased toward finding higher levels of health information seeking.

  18. 76 FR 40383 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Government-Owned Inventions; Availability for Licensing AGENCY: Public Health Service, National Institutes of Health, HHS. ACTION: Notice... the indicated licensing contact at the Office of Technology Transfer, National Institutes of Health...

  19. Is Some Provider Advice on Smoking Cessation Better Than No Advice? An Instrumental Variable Analysis of the 2001 National Health Interview Survey

    PubMed Central

    Bao, Yuhua; Duan, Naihua; Fox, Sarah A

    2006-01-01

    Research Objective To estimate the effect of provider advice in routine clinical contacts on patient smoking cessation outcome. Data Source The Sample Adult File from the 2001 National Health Interview Survey. We focus on adult patients who were either current smokers or quit during the last 12 months and had some contact with the health care providers or facilities they most often went to for acute or preventive care. Study Design We estimate a joint model of self-reported smoking cessation and ever receiving advice to quit during medical visits in the past 12 months. Because providers are more likely to advise heavier smokers and/or patients already diagnosed with smoking-related conditions, we use provider advice for diet/nutrition and for physical activity reported by the same patient as instrumental variables for smoking cessation advice to mitigate the selection bias. We conduct additional analyses to examine the robustness of our estimate against the various scenarios by which the exclusion restriction of the instrumental variables may fail. Principal Findings Provider advice doubles the chances of success in (self-reported) smoking cessation by their patients. The probability of quitting by the end of the 12-month reference period increased from 6.9 to 14.7 percent, an effect that is of both statistical (p<.001) and clinical significance. Conclusions Provider advice delivered in routine practice settings has a substantial effect on the success rate of smoking cessation among smoking patients. Providing advice consistently to all smoking patients, compared with routine care, is more effective than doubling the federal excise tax and, in the longer run, likely to outperform some of the other tobacco control policies such as banning smoking in private workplaces. PMID:17116112

  20. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

    National Consortium on Health Science and Technology Education, Okemos, MI.

    This document presents the National Health Care Skill Standards, which were developed by the National Consortium on Health Science and Technology and West Ed Regional Research Laboratory, in partnership with educators and health care employers. The document begins with an overview of the purpose and benefits of skill standards. Presented next are…

  1. National health expenditures, 1991

    PubMed Central

    Letsch, Suzanne W.; Lazenby, Helen C.; Levit, Katharine R.; Cowan, Cathy A.

    1992-01-01

    Spending for health care rose to $751.8 billion in 1991, an increase of 11.4 percent from the 1990 level. National health expenditures as a share of gross domestic product increased to 13.2 percent, up from 12.2 percent in 1990. The health care sector exhibited strong growth, despite slow growth in the overall economy. This combination resulted in the largest increase in the share of the Nation's output consumed by health care in the past three decades. In this article, the authors present estimates of health spending in the United States for 1991. The authors also examine reasons for the unusually large growth in Medicaid expenditures and highlight recent trends in the hospital sector. PMID:10127445

  2. A Feasibility Trial of Mental Health First Aid First Nations: Acceptability, Cultural Adaptation, and Preliminary Outcomes.

    PubMed

    Crooks, Claire V; Lapp, Andrea; Auger, Monique; van der Woerd, Kim; Snowshoe, Angela; Rogers, Billie Jo; Tsuruda, Samantha; Caron, Cassidy

    2018-03-25

    The Mental Health First Aid First Nations course was adapted from Mental Health First Aid Basic to create a community-based, culturally safe and relevant approach to promoting mental health literacy in First Nations contexts. Over 2.5 days, the course aims to build community capacity by teaching individuals to recognize and respond to mental health crises. This feasibility trial utilized mixed methods to evaluate the acceptability, cultural adaptation, and preliminary effectiveness of MHFAFN. Our approach was grounded in community-based participatory research principles, emphasizing relationship-driven procedures to collecting data and choice for how participants shared their voices. Data included participant interviews (n = 89), and surveys (n = 91) from 10 groups in four provinces. Surveys contained open-ended questions, retrospective pre-post ratings, and a scenario. We utilized data from nine facilitator interviews and 24 facilitator implementation surveys. The different lines of evidence converged to highlight strong acceptability, mixed reactions to the cultural adaptation, and gains in participants' knowledge, mental health first aid skill application, awareness, and self-efficacy, and reductions in stigma beliefs. Beyond promoting individual gains, the course served as a community-wide prevention approach by situating mental health in a colonial context and highlighting local resources and cultural strengths for promoting mental well-being. © 2018 The Authors American Journal of Community Psychology published by Wiley Periodicals, Inc. on behalf of Society for Community Research and Action.

  3. National Health Care Skill Standards.

    ERIC Educational Resources Information Center

    Far West Lab. for Educational Research and Development, San Francisco, CA.

    This booklet contains draft national health care skill standards that were proposed during the National Health Care Skill Standards Project on the basis of input from more than 1,000 representatives of key constituencies of the health care field. The project objectives and structure are summarized in the introduction. Part 1 examines the need for…

  4. [Health-related quality of life of children and adolescents in Germany. Norm data from the German Health Interview and Examination Survey (KiGGS)].

    PubMed

    Ravens-Sieberer, U; Ellert, U; Erhart, M

    2007-01-01

    This study investigates the health-related quality of life of children and adolescents in Germany, using the internationally employed KINDL-R questionnaire for measuring the health-related quality of life of children and adolescents. In the National Health Interview and Examination Survey for Children and Adolescents (KiGGS) the parents of 14,836 children and adolescents aged 3-17 years completed the KINDL-R, as well as 6,813 children and adolescents (11-17 years old). The reliability (Cronbach's alpha = 0.85) and validity of the measurements using the KINDL-R were confirmed. The differences in health-related quality of life of children and adolescents from different social backgrounds and with different health statuses, which were to be expected on theoretical grounds, were demonstrated by the KINDL-R scores (size of effect "d" up to 1.52). The means and percentiles were calculated for the total sample as well as stratified by age group, sex, geographical region (East/West), migratory status and socio-economic status. The results of this study can be used as representative, normative data for the population of children and adolescents in Germany in general, as well as stratified for sociodemographic and socio-economic subpopulations, in order to interpret test scores on health-related quality of life (KINDL-R).

  5. Impact of Cardiovascular Health on Hearing: Interview with Ray Hull

    ERIC Educational Resources Information Center

    Montgomery, Judy K.

    2006-01-01

    Do you belong to a sports club or gym? Do you like to work out, play tennis, swim, or run regularly? If so, you are also improving your hearing health. I did not learn this from a sports column; I learned it from interviewing Ray Hull. Dr. Raymond H. Hull, PhD, is a professor of communication sciences and disorders, audiology, and director of the…

  6. What Does the Public Know about Preventing Cancer? Results from the Health Information National Trends Survey (HINTS)

    ERIC Educational Resources Information Center

    Hawkins, Nikki A.; Berkowitz, Zahava; Peipins, Lucy A.

    2010-01-01

    This study provides information about the public's familiarity with cancer prevention strategies and examines the association between this familiarity and actual prevention behavior. Data from interviews with 5,589 adults included in the 2003 Health Information National Trends Survey (HINTS) were analyzed. Most respondents were able to cite one or…

  7. Correction to: CASPer, an online pre-interview screen for personal/professional characteristics: prediction of national licensure scores.

    PubMed

    Dore, Kelly L; Reiter, Harold I; Kreuger, Sharyn; Norman, Geoffrey R

    2017-12-01

    In re-examining the paper "CASPer, an online pre-interview screen for personal/professional characteristics: prediction of national licensure scores" published in AHSE (22(2), 327-336), we recognized two errors of interpretation.

  8. Has Adolescent Suicidality Decreased in the United States? Data from Two National Samples of Adolescents Interviewed in 1995 and 2005

    ERIC Educational Resources Information Center

    Wolitzky-Taylor, Kate B.; Ruggiero, Kenneth J.; McCart, Michael R.; Smith, Daniel W.; Hanson, Rochelle F.; Resnick, Heidi S.; de Arellano, Michael A.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2010-01-01

    We compared the prevalence and correlates of adolescent suicidal ideation and attempts in two nationally representative probability samples of adolescents interviewed in 1995 (National Survey of Adolescents; N = 4,023) and 2005 (National Survey of Adolescents-Replication; N = 3,614). Participants in both samples completed a telephone survey that…

  9. 76 FR 16798 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center for Scientific Review.... Place: National Institutes of Health, 6701 Rockledge Drive, Bethesda, MD 20892 (Telephone Conference..., National Institutes of Health, 6701 Rockledge Drive, Room 4136, MSC 7850, Bethesda, MD 20892, (301) 435...

  10. 75 FR 6044 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... individual intramural programs and projects conducted by the National Institute of Environmental Health...

  11. Policy mapping for establishing a national emergency health policy for Nigeria

    PubMed Central

    Aliyu, Zakari Y

    2002-01-01

    Background The number of potential life years lost due to accidents and injuries though poorly studied has resulted in tremendous economic and social loss to Nigeria. Numerous socio-cultural, economic and political factors including the current epidemic of ethnic and religious conflicts act in concert in predisposing to and enabling the ongoing catastrophe of accident and injuries in Nigeria. Methods Using the "policymaker", Microsoft-Windows® based software, the information generated on accidents and injuries and emergency health care in Nigeria from literature review, content analysis of relevant documents, expert interviewing and consensus opinion, a model National Emergency Health Policy was designed and analyzed. A major point of analysis for the policy is the current political feasibility of the policy including its opportunities and obstacles in the country. Results A model National Emergency Health Policy with policy goals, objectives, programs and evaluation benchmarks was generated. Critical analyses of potential policy problems, associated multiple players, diverging interests and implementation guidelines were developed. Conclusions "Political health modeling" a term proposed here would be invaluable to policy makers and scholars in developing countries in assessing the political feasibility of policy managing. Political modeling applied to the development of a NEHP in Nigeria would empower policy makers and the policy making process and would ensure a sustainable emergency health policy in Nigeria. PMID:12181080

  12. National health expenditures, 1988

    PubMed Central

    1990-01-01

    Every year, analysts in the Health Care Financing Administration present figures on what our Nation spends for health. As the result of a comprehensive re-examination of the definitions, concepts, methods, and data sources used to prepare those figures, this year's report contains new estimates of national health expenditures for calendar years 1960 through 1988. Significant changes have been made to estimates of spending for professional services and to estimates of what consumers pay out of pocket for health care. In the first article, trends in use of and expenditure for various types of goods and services are discussed, as well as trends in the sources of funds used to finance health care. In a companion article, the benchmark process is described in more detail, as are the data sources and methods used to prepare annual estimates of health expenditures. PMID:10113395

  13. 76 FR 53685 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Submission for OMB Review... data collection projects, the Center for Scientific Review (CSR), National Institutes of Health (NIH... for public comment. The National Institutes of Health may not conduct or sponsor and the respondent is...

  14. Interview: Health technology assessment in Asia: an emerging trend.

    PubMed

    Yang, Bong-min

    2012-05-01

    Bong-min Yang, PhD (in economics), is Professor and former Dean of the School of Public Health at the Seoul National University, South Korea. Professor Yang has led research and written many papers in health economics and healthcare systems in Korea and Asia. His recent research and publications focus on the field of economic evaluation and outcomes research. He played a key role in the introduction of a formal health technology assessment system within Korean healthcare. He is currently serving as Executive Director, Institute of Health and Environment, Seoul National University. In addition to his research and publications, Professor Yang is Associate Editor for Journal of Comparative Effectiveness Research, is co-editor-in-chief for Value in Health Regional Issues, and is currently chair of the Management Advisory Board of Value in Health and a member of the editorial board of the Journal of Medical Economics. He has been a policy consultant to China, Japan, Indonesia, Hong Kong, Malaysia, Taiwan, Thailand and India. He has also worked as a short-term consultant at the WHO, ADB, UNDP and the World Bank. For the Korean government, he served as Chairperson of the Health Insurance Reform Committee, and Chairperson of the Drug Pricing and Reimbursement Committee. He is currently serving as Chair of the International Society of Pharmacoeconomics and Outcomes Research-Asia Consortium, and a member of the Board of Directors of the International Society of Pharmacoeconomics and Outcomes Research.

  15. Teaching motivational interviewing to first-year medical students to improve counseling skills in health behavior change.

    PubMed

    Poirier, Maria K; Clark, Matthew M; Cerhan, Jane H; Pruthi, Sandhya; Geda, Yonas E; Dale, Lowell C

    2004-03-01

    To examine the effectiveness of motivational interviewing training on improving medical students' knowledge of and confidence in their ability to counsel patients regarding health behavior change. In the spring of 2002, 42 first-year medical students participated in a counseling course on health behavior change. Three small groups focused on learning and practicing motivational interviewing techniques using brief lectures, interactive class activities, student role-plays, and simulated patients. Students completed an identical precourse and postcourse questionnaire that measured their confidence and knowledge regarding counseling skills in health behavior change. The medical students reported improved confidence in their understanding of motivational interviewing after participation in the course (very confident, 77%) compared with before the course (very confident, 2%). Each of the 8 confidence items were compared before and after the course using a signed rank test. All comparisons indicated a significant improvement (P < .001) in confidence. Regarding knowledge-based questions, students showed significant improvement; 31% of students answered all the questions correctly before the course, and 56% answered all the questions correctly after the course (P = .004). These results show that teaching motivational interviewing techniques to first-year medical students can enhance student confidence in and knowledge of providing counseling to patients regarding health behavior change.

  16. Assessing the quality of care in a new nation: South Sudan's first national health facility assessment.

    PubMed

    Berendes, Sima; Lako, Richard L; Whitson, Donald; Gould, Simon; Valadez, Joseph J

    2014-10-01

    We adapted a rapid quality of care monitoring method to a fragile state with two aims: to assess the delivery of child health services in South Sudan at the time of independence and to strengthen local capacity to perform regular rapid health facility assessments. Using a two-stage lot quality assurance sampling (LQAS) design, we conducted a national cross-sectional survey among 156 randomly selected health facilities in 10 states. In each of these facilities, we obtained information on a range of access, input, process and performance indicators during structured interviews and observations. Quality of care was poor with all states failing to achieve the 80% target for 14 of 19 indicators. For example, only 12% of facilities were classified as acceptable for their adequate utilisation by the population for sick-child consultations, 16% for staffing, 3% for having infection control supplies available and 0% for having all child care guidelines. Health worker performance was categorised as acceptable in only 6% of cases related to sick-child assessments, 38% related to medical treatment for the given diagnosis and 33% related to patient counselling on how to administer the prescribed drugs. Best performance was recorded for availability of in-service training and supervision, for seven and ten states, respectively. Despite ongoing instability, the Ministry of Health developed capacity to use LQAS for measuring quality of care nationally and state-by-state, which will support efficient and equitable resource allocation. Overall, our data revealed a desperate need for improving the quality of care in all states. © 2014 John Wiley & Sons Ltd.

  17. Oral Health-Related Quality of Life in the Elderly in Israel--Results from the National Health and Nutrition Survey of the Elderly 2005-2006.

    PubMed

    Zusman, Shlomo Paul; Kushnir, Daniel; Natapov, Lena; Goldsmith, Rebecca; Dichtiar, Rita

    2016-01-01

    To assess the oral health-related quality of life of the Israeli elderly. Data were collected from a subsample of those interviewed for the cross-sectional Mabat Zahav National Health and Nutrition Survey of the Elderly, carried out in 2005 and 2006 by the Ministry of Health in Israel. In-person interviews were conducted in the interviewees' homes using a structured questionnaire which included 7 questions on subjective dental health status and the 14 questions of the Oral Health Impact Profile 14 (OHIP-14). Statistical significance of continuous variables was assessed with the Student t-test; categorical variables with normal distribution were analysed using the chi-square test and those with non-normal distribution with the Wilcoxon Mann-Whitney two-sample test. 828 Jews and 159 Arabs from the total survey population of 1852 elderly (1536 Jews and 316 Arabs) completed the OHIP-14 questionnaire. An impact of oral health on the quality of life was reported by 16.6% of the respondents, 19.2% of females and 13.9% of males (p<0.05). There were statistically significant differences in impact prevalence by gender, place of birth and economic status. No such differences were found by age group, population group or education. Significant statistical correlation was found between subjective assessment of general and dental health and OHIP impact prevalence, with poorer assessment correlated with increased prevalence of impact. The quality of life of 17% of Israeli elderly is affected by oral health. The OHIP-14 findings emphasise the importance of including basic dental treatment (treatment of dental pain and infections) in the range of services covered by the National Health Insurance Law.

  18. 32 CFR 637.21 - Recording interviews and interrogations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 4 2011-07-01 2011-07-01 false Recording interviews and interrogations. 637.21 Section 637.21 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... interviews and interrogations. The recording of interviews and interrogations by military police personnel is...

  19. 32 CFR 637.21 - Recording interviews and interrogations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Recording interviews and interrogations. 637.21 Section 637.21 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... interviews and interrogations. The recording of interviews and interrogations by military police personnel is...

  20. 32 CFR 637.21 - Recording interviews and interrogations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 4 2013-07-01 2013-07-01 false Recording interviews and interrogations. 637.21 Section 637.21 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... interviews and interrogations. The recording of interviews and interrogations by military police personnel is...

  1. 32 CFR 637.21 - Recording interviews and interrogations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Recording interviews and interrogations. 637.21 Section 637.21 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... interviews and interrogations. The recording of interviews and interrogations by military police personnel is...

  2. 32 CFR 637.21 - Recording interviews and interrogations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Recording interviews and interrogations. 637.21 Section 637.21 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... interviews and interrogations. The recording of interviews and interrogations by military police personnel is...

  3. Innovation within a national health care system.

    PubMed

    Young, Antony

    2017-05-01

    Tony is a practicing frontline National Health Service surgeon and director of medical innovation at Anglia Ruskin University and has founded 4 medical-technology start-ups. He has also cofounded the £500 million Anglia Ruskin MedTech Campus, which will become one of the world's largest health innovation spaces. In 2014, he was appointed as national clinical director for innovation at National Health Service England and in February 2016 became the first national clinical lead for innovation. In this role, he provides clinical leadership and support in delivering improved health outcomes in England, drives the uptake of proven innovations across the National Health Service, promotes economic growth through innovation, and helps make the National Health Service the go-to place on the planet for medical innovation. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Multiple mini interview (MMI) for general practice training selection in Australia: interviewers' motivation.

    PubMed

    Burgess, Annette; Roberts, Chris; Sureshkumar, Premala; Mossman, Karyn

    2018-01-25

    Multiple Mini Interviews (MMIs) are being used by a growing number of postgraduate training programs and medical schools as their interview process for selection entry. The Australian General Practice and Training (AGPT) used a National Assessment Centre (NAC) approach to selection into General Practice (GP) Training, which include MMIs. Interviewing is a resource intensive process, and implementation of the MMI requires a large number of interviewers, with a number of candidates being interviewed simultaneously. In 2015, 308 interviewers participated in the MMI process - a decrease from 340 interviewers in 2014, and 310 in 2013. At the same time, the number of applicants has steadily increased, with 1930 applications received in 2013; 2254 in 2014; and 2360 in 2015. This has raised concerns regarding the increasing recruitment needs, and the need to retain interviewers for subsequent years of MMIs. In order to investigate interviewers' reasons for participating in MMIs, we utilised self-determination theory (SDT) to consider interviewers' motivation to take part in MMIs at national selection centres. In 2015, 308 interviewers were recruited from 17 Regional Training Providers (RTPs) to participate in the MMI process at one of 15 NACs. For this study, a convenience sample of NAC sites was used. Forty interviewers were interviewed (n = 40; 40/308 = 13%) from five NACs. Framework analysis was used to code and categorise data into themes. Interviewers' motivation to take part as interviewers were largely related to their sense of duty, their desire to contribute their expertise to the process, and their desire to have input into selection of GP Registrars; a sense of duty to their profession; and an opportunity to meet with colleagues and future trainees. Interviewers also highlighted factors hindering motivation, which sometimes included the large number of candidates seen in one day. Interviewers' motivation for contributing to the MMIs was largely related

  5. 8 CFR 245a.19 - Interviews.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 8 Aliens and Nationality 1 2014-01-01 2014-01-01 false Interviews. 245a.19 Section 245a.19 Aliens... AND NATIONALITY ACT Legal Immigration Family Equity (LIFE) Act Legalization Provisions § 245a.19 Interviews. (a) All aliens filing applications for adjustment of status with the Service under this section...

  6. 8 CFR 245a.19 - Interviews.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Interviews. 245a.19 Section 245a.19 Aliens... AND NATIONALITY ACT Legal Immigration Family Equity (LIFE) Act Legalization Provisions § 245a.19 Interviews. (a) All aliens filing applications for adjustment of status with the Service under this section...

  7. 8 CFR 245a.19 - Interviews.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Interviews. 245a.19 Section 245a.19 Aliens... IMMIGRATION AND NATIONALITY ACT Legal Immigration Family Equity (LIFE) Act Legalization Provisions § 245a.19 Interviews. (a) All aliens filing applications for adjustment of status with the Service under this section...

  8. 8 CFR 245a.19 - Interviews.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Interviews. 245a.19 Section 245a.19 Aliens... AND NATIONALITY ACT Legal Immigration Family Equity (LIFE) Act Legalization Provisions § 245a.19 Interviews. (a) All aliens filing applications for adjustment of status with the Service under this section...

  9. Health financing in Malawi: Evidence from National Health Accounts

    PubMed Central

    2010-01-01

    Background National health accounts provide useful information to understand the functioning of a health financing system. This article attempts to present a profile of the health system financing in Malawi using data from NHA. It specifically attempts to document the health financing situation in the country and proposes recommendations relevant for developing a comprehensive health financing policy and strategic plan. Methods Data from three rounds of national health accounts covering the Financial Years 1998/1999 to 2005/2006 was used to describe the flow of funds and their uses in the health system. Analysis was performed in line with the various NHA entities and health system financing functions. Results The total health expenditure per capita increased from US$ 12 in 1998/1999 to US$25 in 2005/2006. In 2005/2006 public, external and private contributions to the total health expenditure were 21.6%, 60.7% and 18.2% respectively. The country had not met the Abuja of allocating at least 15% of national budget on health. The percentage of total health expenditure from households' direct out-of-pocket payments decreased from 26% in 1998/99 to 12.1% in 2005/2006. Conclusion There is a need to increase government contribution to the total health expenditure to at least the levels of the Abuja Declaration of 15% of the national budget. In addition, the country urgently needs to develop and implement a prepaid health financing system within a comprehensive health financing policy and strategy with a view to assuring universal access to essential health services for all citizens. PMID:21062503

  10. Healthcare financing in Syria: satisfaction with the current system and the role of national health insurance--a qualitative study of householders' views.

    PubMed

    Mershed, Mania; Busse, Reinhard; van Ginneken, Ewout

    2012-01-01

    This study aims to identify the satisfaction with the current public health system and health benefit schemes, examine willingness to participate in national health insurance and review expectations and preferences of national health insurance. To this end, qualitative semi-structured interviews were carried out with 19 Syrian householders. Our results show that a need for health reform exists and that Syrian people are willing to support a national health insurance scheme if some key issues are properly addressed. Funding of the scheme is a major concern and should take into account the ability to pay and help the poor. In addition, waiting times should be shortened and sufficient coverage guaranteed. On the whole, the people would support a national health insurance with national pooling and purchasing under a public set-up, but important concerns of such a system regarding corruption and inefficiency were voiced too. Installing a quasi non-governmental organisation as manager of the insurance system under the stewardship of the Ministry of Health could provide a compromise acceptable to the people. Copyright © 2012 John Wiley & Sons, Ltd.

  11. Community Action for Health in India's National Rural Health Mission: One policy, many paths.

    PubMed

    Gaitonde, Rakhal; San Sebastian, Miguel; Muraleedharan, V R; Hurtig, Anna-Karin

    2017-09-01

    Community participation as a strategy for health system strengthening and accountability is an almost ubiquitous policy prescription. In 2005, with the election of a new Government in India, the National Rural Health Mission was launched. This was aimed at 'architectural correction' of the health care system, and enshrined 'communitization' as one of its pillars. The mission also provided unique policy spaces and opportunity structures that enabled civil society groups to attempt to bring on to the policy agenda as well as implement a more collective action and social justice based approach to community based accountability. Despite receiving a lot of support and funding from the central ministry in the pilot phase, the subsequent roll out of the process, led in the post-pilot phase by the individual state governments, showed very varied outcomes. This paper using both documentary and interview based data is the first study to document the roll out of this ambitious process. Looking critically at what varied and why, the paper attempts to derive lessons for future implementation of such contested concepts. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. [Health education as a transversal proposal: an analysis of the national curriculum guidelines and certain teaching conceptions].

    PubMed

    Marinho, Julio Cesar Bresolin; da Silva, João Alberto; Ferreira, Maira

    2015-01-01

    Starting from the assumption that transversality is conceived as a proposal for change in education, the article outlines certain inferences on the subject. The analysis is founded on the transversal subject of "health" in the national curriculum guidelines (PCN), on semi-structured interviews and on reports resulting from conversations with teachers. It reveals that, in Brazil, the notion of transversality gained importance during the 1990s, when the PCN were established, which listed "transversal themes." In the view of the teachers interviewed, health education appears as something apart, on the margins of the curriculum. The authors believe that this is the case owing to the consolidation of the subject fields at school and the curricular structure in teacher training courses.

  13. The politics of methodology in 'post-medical geography': mental health research and the interview.

    PubMed

    Parr, H

    1998-12-01

    This paper argues that emerging 'post-medical geographies' require attention to the methodological in order to fully appreciate how different geographical knowledges are produced and contextualized within the politics of research relationships. 'Geographies of mental health and illness' are focused upon in order to argue that the 'peopling' of health research should also be accompanied by debate about what sorts of methodologies we employ in accessing these minds/bodies and voices. The research interview is a primary focus here. A critique of psychoanalytic approaches to geographical research argues that such 'models' of interpretation and management can mean that participants or research 'subjects' can be framed in almost diagnostic categories of behaviour. Empirical examples of mental health research in Nottingham are used to argue that more flexible approaches which pay attention to perceived dualisms (such as 'sanity' and 'insanity'), negotiation, embodiment, socio-spatial contexts and content within the interview situation may aid in understanding the politics which encompass geographical health research.

  14. The Spanish Diagnostic Interview Schedule. Reliability and comparison with clinical diagnoses.

    PubMed

    Burnam, M A; Karno, M; Hough, R L; Escobar, J I; Forsythe, A B

    1983-11-01

    The National Institute of Mental Health Diagnostic Interview Schedule (DIS) was translated into Spanish. The reliability of the Spanish instrument, its equivalence to the English version, and its agreement with clinical diagnoses were examined in a study of 90 bilingual (English-and Spanish-speaking) and 61 monolingual (Spanish-speaking only) patients from a community mental health center. The study design involved two independent DIS administrations and one independent clinical evaluation of each subject.

  15. Impact of asylum interviews on the mental health of traumatized asylum seekers

    PubMed Central

    Schock, Katrin; Rosner, Rita; Knaevelsrud, Christine

    2015-01-01

    Background Asylum interviews within the asylum procedure are associated with psychological stress for traumatized asylum seekers. This study investigates the impact of asylum interviews on the mental health in a sample of 40 traumatized asylum seekers. The comparison group consisted of refugees (N=10) that had not been invited to an asylum interview. Additionally, the moderating effects of trial-related variables such as perceived justice of the trial, stress of giving testimony, and stress of waiting for the asylum interview were examined. Method Participants were assessed on average 10 days before (t1) and 16 days after (t2) the asylum interview. Chi-square tests for dichotomous and categorical variables were used to compare the descriptive statistics of the two groups. To investigate symptom changes from t1 to t2, paired t-tests were calculated. The magnitude of effects was measured by Cohen's effect size d within groups. Hierarchical regression analyses were conducted for demographic and trial variables predicting posttraumatic intrusions, avoidance, and hyperarousal. Results Data showed a significant increase in posttraumatic intrusions and a significant decrease in posttraumatic avoidance and hyperarousal symptoms from t1 to t2. No significant symptom changes in the posttraumatic stress disorder subscales were found in the comparison group. The results of hierarchical regression analyses revealed perceived justice of the interview to predict the increase of intrusions and the number of experienced traumata and testimony stress to predict posttraumatic avoidance. Conclusions The present findings underline the stressful impact of asylum interviews on traumatized refugees. They indicate that the asylum interview might decrease posttraumatic avoidance and trigger posttraumatic intrusions, thus highlight the importance of ensuring that the already vulnerable group of traumatized refugees needs to be treated with empathy during their asylum interview. PMID:26333540

  16. 78 FR 24760 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Prospective Grant of Start... Prevention in Humans AGENCY: National Institutes of Health, HHS. ACTION: Notice. SUMMARY: This is notice, in accordance with 35 U.S.C. 209(c)(1) and 37 CFR 404.7(a)(1)(i), that the National Institutes of Health...

  17. 8 CFR 245a.19 - Interviews.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Interviews. 245a.19 Section 245a.19 Aliens... Interviews. (a) All aliens filing applications for adjustment of status with the Service under this section must be personally interviewed, except that the adjudicative interview may be waived for a child under...

  18. Trends in Obesity Prevalence in Adults With a History of Cancer: Results From the US National Health Interview Survey, 1997 to 2014

    PubMed Central

    Shi, Zaixing; Sardo Molmenti, Christine L.; Rundle, Andrew; Tsai, Wei Yann

    2016-01-01

    Purpose Obesity after a diagnosis of specific cancers has been associated with worse prognosis. We examined the trend in obesity prevalence among cancer survivors in the United States in the past two decades and compared trends with those of adults without a history of cancer. Patients and Methods This was a population-based nationally representative sample of 538,969 noninstitutionalized US adults 18 to 85 years old with and without a history of cancer who participated in annual cross-sectional National Health Interview Surveys from 1997 to 2014. Obesity was defined as body mass index ≥ 30 kg/m2 for non-Asians and body mass index ≥ 27.5 kg/m2 for Asians. Results Among 32,447 cancer survivors identified, the most common cancer diagnoses were breast (n = 6,948), prostate (n = 3,984), and colorectal (n = 2,546). From 1997 to 2014, the prevalence of obesity increased from 22.4% to 31.7% in cancer survivors and from 20.9% to 29.5% in adults without a history of cancer (P for trend < .001, both groups). Over this period, the estimated rate of annual increase in obesity prevalence was higher in women and men with a history of cancer compared with those without a history of cancer (all P for interaction < .001). The estimated rate of annual increase in obesity prevalence was 3.1% in female and 3.7% in male colorectal cancer survivors, 3.0% in breast cancer survivors, and 2.1% in prostate cancer survivors (all P < .001). In subgroup analyses, populations with the highest rates of increasing obesity burden were colorectal cancer survivors, breast cancer survivors, and non-Hispanic blacks. Conclusion From 1997 to 2014, obesity increased more rapidly among adult cancer survivors compared with the general population. Colorectal and breast cancer survivors and non-Hispanic blacks were identified as being at the highest risk for obesity. PMID:27458295

  19. Trends in Obesity Prevalence in Adults With a History of Cancer: Results From the US National Health Interview Survey, 1997 to 2014.

    PubMed

    Greenlee, Heather; Shi, Zaixing; Sardo Molmenti, Christine L; Rundle, Andrew; Tsai, Wei Yann

    2016-09-10

    Obesity after a diagnosis of specific cancers has been associated with worse prognosis. We examined the trend in obesity prevalence among cancer survivors in the United States in the past two decades and compared trends with those of adults without a history of cancer. This was a population-based nationally representative sample of 538,969 noninstitutionalized US adults 18 to 85 years old with and without a history of cancer who participated in annual cross-sectional National Health Interview Surveys from 1997 to 2014. Obesity was defined as body mass index ≥ 30 kg/m(2) for non-Asians and body mass index ≥ 27.5 kg/m(2) for Asians. Among 32,447 cancer survivors identified, the most common cancer diagnoses were breast (n = 6,948), prostate (n = 3,984), and colorectal (n = 2,546). From 1997 to 2014, the prevalence of obesity increased from 22.4% to 31.7% in cancer survivors and from 20.9% to 29.5% in adults without a history of cancer (P for trend < .001, both groups). Over this period, the estimated rate of annual increase in obesity prevalence was higher in women and men with a history of cancer compared with those without a history of cancer (all P for interaction < .001). The estimated rate of annual increase in obesity prevalence was 3.1% in female and 3.7% in male colorectal cancer survivors, 3.0% in breast cancer survivors, and 2.1% in prostate cancer survivors (all P < .001). In subgroup analyses, populations with the highest rates of increasing obesity burden were colorectal cancer survivors, breast cancer survivors, and non-Hispanic blacks. From 1997 to 2014, obesity increased more rapidly among adult cancer survivors compared with the general population. Colorectal and breast cancer survivors and non-Hispanic blacks were identified as being at the highest risk for obesity. © 2016 by American Society of Clinical Oncology.

  20. A Randomized Trial of Motivational Interviewing

    PubMed Central

    Catley, Delwyn; Goggin, Kathy; Harris, Kari Jo; Richter, Kimber P.; Williams, Karen; Patten, Christi; Resnicow, Ken; Ellerbeck, Edward F.; Bradley-Ewing, Andrea; Lee, Hyoung S.; Moreno, Jose L.; Grobe, James E.

    2015-01-01

    Introduction Despite limitations in evidence, the current Clinical Practice Guideline advocates Motivational Interviewing for smokers not ready to quit. This study evaluated the efficacy of Motivational Interviewing (MI) for inducing cessation-related behaviors among smokers with low motivation to quit. Design Randomized clinical trial. Setting/participants Two-hundred fifty-five daily smokers reporting low desire to quit smoking were recruited from an urban community during 2010–2011 and randomly assigned to Motivational Interviewing, health education, or brief advice using a 2:2:1 allocation. Data were analyzed from 2012 to 2014. Intervention Four sessions of Motivational Interviewing utilized a patient-centered communication style that explored patients’ own reasons for change. Four sessions of health education provided education related to smoking cessation while excluding elements characteristic of Motivational Interviewing. A single session of brief advice consisted of brief, personalized advice to quit. Main outcomes measures Self-reported quit attempts, smoking abstinence (biochemically verified), use of cessation pharmacotherapies, motivation, and confidence to quit were assessed at baseline and 3- and 6-month follow-ups. Results Unexpectedly, no significant differences emerged between groups in the proportion who made a quit attempt by 6-month follow-up (Motivational Interviewing, 52.0%; health education, 60.8%; brief advice, 45.1%; p=0.157). Health education had significantly higher biochemically verified abstinence rates at 6 months (7.8%) than brief advice (0.0%) (8% difference, 95% CI=3%, 13%, p=0.003), with the Motivational Interviewing group falling in between (2.9% abstinent, 3% risk difference, 95% CI=0%, 6%, p=0.079). Both Motivational Interviewing and health education groups showed greater increases in cessation medication use, motivation, and confidence to quit relative to brief advice (all p<0.05), and health education showed greater

  1. Human papillomavirus vaccine uptake among 18- to 26-year-old women in the United States: National Health Interview Survey, 2010.

    PubMed

    Laz, Tabassum H; Rahman, Mahbubur; Berenson, Abbey B

    2013-04-01

    Human papillomavirus (HPV) vaccine uptake among young adult women has been reported to be very low. The authors conducted this study to provide an update on HPV vaccine uptake among 18- to 26-year-old women. The authors used the National Health Interview Survey 2010 data to estimate HPV vaccine coverage and their correlates. Overall, 22.7% of women initiated (≥1 dose) and 12.7% completed the vaccine (≥3 doses). Thus, about 56% of women who initiated the vaccine completed it. Multivariate logistic regression analyses showed that younger age, unmarried status, Papanicolaou test, influenza vaccine, lifetime vaccines, and HPV vaccine awareness were positively associated with receiving ≥1 and ≥3 doses. In addition, uninsured women were less likely to receive ≥1 dose (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.28-0.84), and blacks (OR, 0.48; 95% CI, 0.23-0.99) and women with a family income <100% of the federal poverty level (OR, 0.40; 95% CI, 0.21-0.73) were less likely to receive ≥3 doses. Furthermore, based on vaccine initiators, blacks were less likely than whites to complete the vaccine (OR, 0.29; 95% CI, 0.16-0.55). Two thirds of unvaccinated women were not interested in future vaccination. Among those who were interested, >76.4% preferred to receive it free or at a lower cost, whereas 20% would pay the full cost of the vaccine. One in 8 women completed the 3-dose HPV vaccine. Educational and vaccine financing programs are needed to improve the uptake among low-income minority women who are at increased risk for cervical cancer. Copyright © 2012 American Cancer Society.

  2. Low Back Pain Prevalence and Related Workplace Psychosocial Risk Factors: A Study Using Data From the 2010 National Health Interview Survey

    PubMed Central

    Yang, Haiou; Haldeman, Scott; Lu, Ming-Lun; Baker, Dean

    2017-01-01

    Objectives The objectives of this study were to estimate prevalence of low back pain, to investigate associations between low back pain and a set of emerging workplace risk factors and to identify worker groups with an increased vulnerability for low back pain in the US. Methods The data used for this study came from the 2010 National Health Interview Survey (NHIS), which was designed to collect data on health conditions and related risk factors obtained from the US civilian population. The variance estimation method was used to compute weighted data for prevalence of low back pain. Multivariable logistic regression analyses stratified by sex and age were performed to determine the odds ratios (ORs) and the 95% Confidence Interval (CI) for low back pain. The examined work-related psychosocial risk factors included work-family imbalance, exposure to a hostile work environment and job insecurity. Work hours, occupation and other work organizational factors (non-standard work arrangements and alternative shifts) were also examined. Results The prevalence rate of self-reported low back pain in previous three months among workers in the U.S. was 25.7% in 2010. Female or older workers were at increased risk of experiencing low back pain. We found significant associations between low back pain and a set of psychosocial factors, including work-family imbalance (OR 1.27, CI 1.15–1.41), exposure to hostile work (OR 1.39, CI 1.25–1.55), and job insecurity (OR 1.44, CI 1.24–1.67), while controlling for demographic characteristics and other health related factors. Older workers who had non-standard work arrangements were more likely to report low back pain. Females who worked 41–45 hours per week and younger workers who worked over 60 hours per week had an increased risk for low back pain. Workers from several occupation groups, including, male healthcare practitioners, female and younger healthcare support workers, and female farming, fishing and forestry workers had

  3. 78 FR 42967 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and Blood Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee... Resources Research, National Institutes of Health, HHS) Dated: July 12, 2013. Michelle Trout, Program...

  4. Ethnographic interviews to elicit patients' reactions to an intelligent interactive telephone health behavior advisor system.

    PubMed

    Kaplan, B; Farzanfar, R; Friedman, R H

    1999-01-01

    Information technology is being used to collect data directly from patients and to provide educational information to them. Concern over patient reactions to this use of information technology is especially important in light of the debate over whether computers dehumanize patients. This study reports reactions that patient users expressed in ethnographic interviews about using a computer-based telecommunications system. The interviews were conducted as part of a larger evaluation of Telephone-Linked Care (TLC)-HealthCall, an intelligent interactive telephone advisor, that advised individuals about how to improve their health through changes in diet or exercise. Interview findings suggest that people formed personal relationships with the TLC system. These relationships ranged from feeling guilty about their diet or exercise behavior to feeling love for the voice. The findings raise system design and user interface issues as well as research and ethical questions.

  5. Changing dentate status of adults, use of dental health services, and achievement of national dental health goals in Denmark by the year 2000.

    PubMed

    Petersen, Poul Erik; Kjøller, Mette; Christensen, Lisa Bøge; Krustrup, Ulla

    2004-01-01

    This study analyzes the current profile of dentate status and use of dental health services among adults in Denmark at the turn of the millennium, assesses the impact on dentate status of sociodemographic factors and use of dental health services in adulthood and in childhood, and highlights the changes over time in dental health conditions among adults. Finally, the intention of the study was to evaluate the Danish dental health care system's level of achievement of the official goals for the year 2000 as formulated by the World Health Organization and the National Board of Health. The subjects of this study included a national representative sample of 16,690 Danish citizens aged 16 years and older (response rate=74.2%). A subsample (n=3,818) took part in a survey of dental care habits in childhood and prevalence of removable dentures; 66 percent of persons selected responded. Personal interviews were used to collect information on dentate status, use of dental health services and living conditions; data on dental care habits in childhood and prevalence of removable dentures were collected by self-administered questionnaires. In all, 8 percent of interviewed persons were edentulous, while 80 percent had 20 or more natural teeth. At age 65-74 years, 27 percent were edentulous and 40 percent had 20 teeth or more; 58 percent wore removable dentures. Dentate status and prevalence of dentures were highly related to educational background and income, particularly for older age groups. Among persons interviewed, 80 percent paid regular dental visits and visits were most frequent among persons of high education and income. At age 35-44 years 95 percent had participated in regular dental care in childhood compared to 49 percent of 65-74-year-olds. Multivariate analyses revealed that sociobehavioral factors had significant effects on dentate status. Compared to similar studies carried out in 1987 and 1994, the present survey indicates a positive trend of improved dentate

  6. 75 FR 71134 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U....398, Cancer Research Manpower; 93.399, Cancer Control, National Institutes of Health, HHS) Dated...

  7. The challenge of comprehensively mapping children's health in a nation-wide health survey: design of the German KiGGS-Study.

    PubMed

    Kurth, Bärbel-Maria; Kamtsiuris, Panagiotis; Hölling, Heike; Schlaud, Martin; Dölle, Rüdiger; Ellert, Ute; Kahl, Heidrun; Knopf, Hiltraud; Lange, Michael; Mensink, Gert Bm; Neuhauser, Hannelore; Rosario, Angelika Schaffrath; Scheidt-Nave, Christa; Schenk, Liane; Schlack, Robert; Stolzenberg, Heribert; Thamm, Michael; Thierfelder, Wulf; Wolf, Ute

    2008-06-04

    From May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Aim of this first nationwide interview and examination survey was to collect comprehensive data on the health status of children and adolescents aged 0 to 17 years. Participants were enrolled in two steps: first, 167 study locations (sample points) were chosen; second, subjects were randomly selected from the official registers of local residents. The survey involved questionnaires filled in by parents and parallel questionnaires for children aged 11 years and older, physical examinations and tests, and a computer assisted personal interview performed by study physicians. A wide range of blood and urine testing was carried out at central laboratories. A total of 17 641 children and adolescents were surveyed - 8985 boys and 8656 girls. The proportion of sample neutral drop-outs was 5.3%. The response rate was 66.6%. The response rate showed little variation between age groups and sexes, but marked variation between resident aliens and Germans, between inhabitants of cities with a population of 100 000 or more and sample points with fewer inhabitants, as well as between the old West German states and the former East German states. By analysing the short non-responder questionnaires it was proven that the collected data give comprehensive and nationally representative evidence on the health status of children and adolescents aged 0 to 17 years.

  8. Health Information National Trends Survey in American Sign Language (HINTS-ASL): Protocol for the Cultural Adaptation and Linguistic Validation of a National Survey.

    PubMed

    Kushalnagar, Poorna; Harris, Raychelle; Paludneviciene, Raylene; Hoglind, TraciAnn

    2017-09-13

    The Health Information National Trends Survey (HINTS) collects nationally representative data about the American's public use of health-related information. This survey is available in English and Spanish, but not in American Sign Language (ASL). Thus, the exclusion of ASL users from these national health information survey studies has led to a significant gap in knowledge of Internet usage for health information access in this underserved and understudied population. The objectives of this study are (1) to culturally adapt and linguistically translate the HINTS items to ASL (HINTS-ASL); and (2) to gather information about deaf people's health information seeking behaviors across technology-mediated platforms. We modified the standard procedures developed at the US National Center for Health Statistics Cognitive Survey Laboratory to culturally adapt and translate HINTS items to ASL. Cognitive interviews were conducted to assess clarity and delivery of these HINTS-ASL items. Final ASL video items were uploaded to a protected online survey website. The HINTS-ASL online survey has been administered to over 1350 deaf adults (ages 18 to 90 and up) who use ASL. Data collection is ongoing and includes deaf adult signers across the United States. Some items from HINTS item bank required cultural adaptation for use with deaf people who use accessible services or technology. A separate item bank for deaf-related experiences was created, reflecting deaf-specific technology such as sharing health-related ASL videos through social network sites and using video remote interpreting services in health settings. After data collection is complete, we will conduct a series of analyses on deaf people's health information seeking behaviors across technology-mediated platforms. HINTS-ASL is an accessible health information national trends survey, which includes a culturally appropriate set of items that are relevant to the experiences of deaf people who use ASL. The final HINTS

  9. Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98).

    PubMed

    Finger, Jonas D; Tylleskär, Thorkild; Lampert, Thomas; Mensink, Gert B M

    2012-12-15

    We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined. The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables. After adjusting for age and region, a higher education level was associated with more leisure-time activity - with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1.6 (1.2-2.1), respectively

  10. April Spotlight: National Minority Health Month

    Cancer.gov

    Each April, we recognize National Minority Health Month and National Minority Cancer Awareness Week. Dr. Peter Ogunbiyi shares how CRCHD’s work is related to the 2017 theme: Bridging Health Equity Across Communities.

  11. Ghana's National Health insurance scheme and maternal and child health: a mixed methods study.

    PubMed

    Singh, Kavita; Osei-Akoto, Isaac; Otchere, Frank; Sodzi-Tettey, Sodzi; Barrington, Clare; Huang, Carolyn; Fordham, Corinne; Speizer, Ilene

    2015-03-17

    Ghana is attracting global attention for efforts to provide health insurance to all citizens through the National Health Insurance Scheme (NHIS). With the program's strong emphasis on maternal and child health, an expectation of the program is that members will have increased use of relevant services. This paper uses qualitative and quantitative data from a baseline assessment for the Maternal and Newborn errals Evaluation from the Northern and Central Regions to describe women's experiences with the NHIS and to study associations between insurance and skilled facility delivery, antenatal care and early care-seeking for sick children. The assessment included a quantitative household survey (n = 1267 women), a quantitative community leader survey (n = 62), qualitative birth narratives with mothers (n = 20) and fathers (n = 18), key informant interviews with health care workers (n = 5) and focus groups (n = 3) with community leaders and stakeholders. The key independent variables for the quantitative analyses were health insurance coverage during the past three years (categorized as all three years, 1-2 years or no coverage) and health insurance during the exact time of pregnancy. Quantitative findings indicate that insurance coverage during the past three years and insurance during pregnancy were associated with greater use of facility delivery but not ANC. Respondents with insurance were also significantly more likely to indicate that an illness need not be severe for them to take a sick child for care. The NHIS does appear to enable pregnant women to access services and allow caregivers to seek care early for sick children, but both the quantitative and qualitative assessments also indicated that the poor and least educated were less likely to have insurance than their wealthier and more educated counterparts. Findings from the qualitative interviews uncovered specific challenges women faced regarding registration for the NHIS and other

  12. A Novel Scenario-Based Interview Tool to Evaluate Nontechnical Skills and Competencies in Global Health Delivery.

    PubMed

    Wroe, Emily B; McBain, Ryan K; Michaelis, Annie; Dunbar, Elizabeth L; Hirschhorn, Lisa R; Cancedda, Corrado

    2017-08-01

    Despite rapid growth in the number of physicians and academic institutions entering the field of global health, there are few tools that inform global health curricula and assess physician readiness for this field. To address this gap, we describe the development and pilot testing of a new tool to assess nontechnical competencies and values in global health. Competencies assessed include systems-based practice, interpersonal and cross-cultural communication, professionalism and self-care, patient care, mentoring, teaching, management, and personal motivation and experience. The Global Health Delivery Competency Assessment Tool presents 15 case vignettes and open-ended questions related to situations a global health practitioner might encounter, and grades the quality of responses on a 6-point ordinal scale. We interviewed 17 of 18 possible global health residents (94%), matched with 17 residents not training in global health, for a total of 34 interviews. A second reviewer independently scored recordings of 13 interviews for reliability. Pilot testing indicated a high degree of discriminant validity, as measured by the instrument's ability to distinguish between residents who were and were not enrolled in a global health program ( P  < .001). It also demonstrated acceptable consistency, as assessed by interrater reliability (κ = 0.53), with a range of item-level agreement from 84%-96%. The tool has potential applicability to a variety of academic and programmatic activities, including evaluation of candidates for global health positions and evaluating the success of training programs in equipping practitioners for entry into this field.

  13. Threat to Knowledge: Research and the Future of Archeology in the National Parks. An Interview with Scholar Archeologist Bill Lipe.

    ERIC Educational Resources Information Center

    Lipe, Bill

    2001-01-01

    Interview examines the competing interests of U.S. national parks, which preserve Native American archaeological sites as the basis of cultural and historical interpretation to the public, and archaeologists, whose research excavations may destroy sites. National Park Service projects that encompass both stewardship and interpretation are…

  14. Australia's national men's health policy: masculinity matters.

    PubMed

    Saunders, Margo; Peerson, Anita

    2009-08-01

    The development of Australia's first national men's health policy provides an important opportunity for informed discussions of health and gender. It is therefore a concern that the stated policy appears to deliberately exclude hegemonic masculinity and other masculinities, despite evidence of their major influence on men's health-related values, beliefs, perspectives, attitudes, motivations and behaviour. We provide an evidence-based critique of the proposed approach to a national men's health policy which raises important questions about whether the new policy can achieve its aims if it fails to acknowledge 'masculinity' as a key factor in Australian men's health. The national men's health policy should be a means to encourage gender analysis in health. This will require recognition of the influence of hegemonic masculinity, and other masculinities, on men's health. Recognising the influence of 'masculinity' on men's health is not about 'blaming' men for 'behaving badly', but is crucial to the development of a robust, meaningful and comprehensive national men's health policy.

  15. Ethnographic interviews to elicit patients' reactions to an intelligent interactive telephone health behavior advisor system.

    PubMed Central

    Kaplan, B.; Farzanfar, R.; Friedman, R. H.

    1999-01-01

    Information technology is being used to collect data directly from patients and to provide educational information to them. Concern over patient reactions to this use of information technology is especially important in light of the debate over whether computers dehumanize patients. This study reports reactions that patient users expressed in ethnographic interviews about using a computer-based telecommunications system. The interviews were conducted as part of a larger evaluation of Telephone-Linked Care (TLC)-HealthCall, an intelligent interactive telephone advisor, that advised individuals about how to improve their health through changes in diet or exercise. Interview findings suggest that people formed personal relationships with the TLC system. These relationships ranged from feeling guilty about their diet or exercise behavior to feeling love for the voice. The findings raise system design and user interface issues as well as research and ethical questions. PMID:10566420

  16. [Health and indigenous peoples in Brazil: reflections based on the First National Survey of Indigenous People's Health and Nutrition].

    PubMed

    Carlos, E A Coimbra

    2014-04-01

    The current configuration of indigenous peoples' health in Brazil results from a complex historical trajectory, responsible for major delays for this population segment in the countrywide social advances seen in recent decades, particularly in the fields of health, education, housing, and sanitation. The main focus of this contribution is to review synthetically a selection of the main results of the First National Survey of Indigenous People's Health and Nutrition, conducted in the period 2008-2009, which visited 113 villages across the Brazil and interviewed 6,692 women and 6,128 children. Among the results, emphasis is given to the observed poor sanitation conditions in villages, high prevalence of chronic malnutrition, anemia, diarrhea, and acute respiratory infections in children, and the emergence of non-communicable chronic diseases in women. The scenario depicted by this survey requires urgent critical review of indigenous health policy in order to better meet the health needs of Brazil's indigenous population.

  17. Prevalence and trends of leisure-time physical activity by occupation and industry in U.S. workers: the National Health Interview Survey 2004-2014.

    PubMed

    Gu, Ja K; Charles, Luenda E; Ma, Claudia C; Andrew, Michael E; Fekedulegn, Desta; Hartley, Tara A; Violanti, John M; Burchfiel, Cecil M

    2016-10-01

    Studies describing prevalence and trends of physical activity among workers in the United States are scarce. We aimed to estimate prevalence and trends of "sufficient" leisure-time physical activity (LTPA) during the 2004-2014 time period among U.S. workers. Data were collected for U.S. workers in the National Health Interview Survey. LTPA was categorized as sufficiently active (moderate intensity, ≥150 minutes per week), insufficiently active (10-149 minutes per week), and inactive (<10 minutes per week). Prevalence of LTPA was adjusted for age using 2010 U.S. working population as a standardized age distribution. Prevalence trends of "sufficient" LTPA significantly increased from 2004 to 2014 (45.6% to 54.8%; P < .001). Among industry groups, the highest prevalence of "sufficient" LTPA was observed among workers in Professional/Scientific/Technical Services (62.1%). The largest increases were observed among workers in Public Administration (51.3%-63.4%). Among occupational groups, "sufficient" LTPA prevalence was lowest in farming/fishing/forestry (30.8%) and highest in life/physical/social science (66.4%). Prevalence of LTPA significantly increased from 2004 to 2014 in most occupational and industry groups. Among U.S. workers, trends of "sufficient" LTPA significantly increased between 2004 and 2014. Overall, a larger proportion of white-collar compared to blue-collar workers were engaged in "sufficient" LTPA. Published by Elsevier Inc.

  18. Stakeholders' views of recurrent sore throat, tonsillitis and their management: a qualitative interview study for the NAtional Trial of Tonsillectomy IN Adults (NATTINA Part 1).

    PubMed

    McSweeney, L A; Rousseau, N S; Wilson, J A; Wilkes, S; Haighton, C A

    2017-04-01

    To determine the impact of recurrent sore throats and tonsillitis in adults and stakeholder views of treatment pathways. Qualitative semistructured interview design reporting novel data from a feasibility study for a UK national trial of tonsillectomy in adults. Nine study sites linked to ear, nose and throat departments in National Health Service hospitals located across the United Kingdom. Fifteen patients, 11 general practitioners and 22 ear, nose and throat staff consented to in-depth interviews, which were analysed using a framework analysis approach. Views of stakeholder groups. Recurrent sore throats were reported to severely impact patients' family, work and social life. Ear, nose and throat staff stated that patients faced increasing barriers to secondary care service access. General practitioners were under pressure to reduce 'limited clinical value' surgical procedures. The findings from this study suggest that there is a disconnect between the attitudes of the stakeholders and the reality of recurrent sore throat, tonsillectomy procedures and service provision. More evidence for the role of tonsillectomy is needed from randomised controlled trials to determine whether it should continue to be ranked as a procedure of limited clinical effectiveness. © 2016 John Wiley & Sons Ltd.

  19. 75 FR 25259 - National Health Care Workforce Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... GOVERNMENT ACCOUNTABILITY OFFICE National Health Care Workforce Commission AGENCY: Government... members to the National Health Care Workforce Commission, with appointments to be made not later [email protected] . Mail: GAO Health Care, Attention: National Health Care Workforce Commission Nominations, 441...

  20. Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study.

    PubMed

    Bristowe, Katherine; Hodson, Matthew; Wee, Bee; Almack, Kathryn; Johnson, Katherine; Daveson, Barbara A; Koffman, Jonathan; McEnhill, Linda; Harding, Richard

    2018-01-01

    Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples. Semi-structured in-depth qualitative interviews analysed using thematic analysis. In total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer ( n = 21), non-cancer ( n = 16) and both a cancer and a non-cancer conditions ( n = 3). In total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals' preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness. Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people.

  1. From diagnosis to health: a cross-cultural interview study with immigrants from Somalia.

    PubMed

    Wallin, Anne-Marie; Ahlström, Gerd

    2010-06-01

    Being diagnosed as having a chronic disease gives rise to emotions. Beliefs about health are culturally constructed and affect people's decisions regarding treatment. No studies have been reported that focus on the health beliefs of immigrants of Somalian origin with diabetes and how these people experiences the diagnosis. Therefore the aim of the present study was to investigate how immigrants from Somalia living in Sweden experienced receiving the diagnosis and describe their beliefs about health. The sample consisted of 19 adults with diabetes born in Somalia and now living in Sweden who were interviewed with the aid of an interpreter. The interviews were subjected to qualitative content analysis. From the analysis of what the participants said about their experiences of the diagnosis there emerged three themes: 'Existential brooding', 'Avoiding the diagnosis' and 'Accepting what is fated'. Three themes also emerged from the analysis of what they said about beliefs about health: 'Health as absence of disease', 'Health as general well-being' and 'Fated by a higher power'. A major finding was that women when they communicated their experiences regarding the diagnosis and health beliefs made more use of supernatural beliefs than men did. The participants, irrespective of gender, did not immediately respond with shock or other strong emotion when they received the diagnosis. The study provides health-care staff with knowledge concerning a minority group's experiences of being diagnosed as having diabetes and their beliefs about health. The findings indicate that men and women differ in how they experiences the diagnosis and how they described their health beliefs. The quality improvement of health education and nursing for patients with diabetes calls for consideration of the variation of beliefs related to cultural background and gender.

  2. 78 FR 35837 - National Institute on Minority Health and Health Disparities Research Endowments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health 42 CFR Part 52i [Docket Number NIH-2007-0931] RIN 0925-AA61 National Institute on Minority Health and Health Disparities Research Endowments AGENCY: National Institutes of Health, Department of Health and Human Services. ACTION: Notice of...

  3. 78 FR 64228 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Health Sciences Special Emphasis Panel Assessment of Toxic and Carcinogenic Effects from Exposure to...

  4. NATIONAL HEALTH PROVIDER INVENTORY

    EPA Science Inventory

    The National Health Provider Inventory provides data on services, location, staff, capacity, and other characteristics of selected health care providers in the United States. Information is collected via mail questionnaire with telephone follow up to all providers (100% census) o...

  5. 76 FR 55930 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center For Scientific Review..., National Institutes of Health, 6701 Rockledge Drive, Room 6194, MSC 7804, Bethesda, MD 20892, 301-996-6208... of Health, 6701 Rockledge Drive, Bethesda, MD 20892, (Virtual Meeting). Contact Person: Joseph Thomas...

  6. General Practitioners' Perspective on eHealth and Lifestyle Change: Qualitative Interview Study.

    PubMed

    Brandt, Carl Joakim; Søgaard, Gabrielle Isidora; Clemensen, Jane; Sndergaard, Jens; Nielsen, Jesper Bo

    2018-04-17

    Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior for their patients and themselves. A total of 10 (5 female and 5 male) GPs were recruited by purposive sampling, aged 38 to 69 years (mean 51 years), of which 4 had an urban uptake of patients and 6 a rural uptake. All of them worked in the region of Southern Denmark where GPs typically work alone or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices to help patients challenged with lifestyle issues and themselves. We also interviewed how they treated lifestyle-challenged patients in general and how they imagined eHealth could be used in the future. All GPs had smartphones or tablets, and everyone communicated on a daily basis with patients about disease and medicine via their electronic health record and the internet. We identified 3 themes concerning the use of eHealth: (1) how eHealth is used for patients; (2) general practitioners' own experience with improving lifestyle and eHealth support; and (3) relevant coaching techniques for transformation into eHealth. GPs used eHealth frequently for themselves but only infrequently for their patients. GPs are familiar with behavioral change techniques and are ready to use them in eHealth if they are used to

  7. Hearing levels in US adults aged 20-69 Years: National Health and Nutrition Examination Survey 1999-2002

    NASA Astrophysics Data System (ADS)

    Murphy, William J.; Themann, Christa L.; Franks, John R.

    2005-04-01

    The National Health and Nutrition Examination Survey (NHANES) is a nationally representative, population-based survey designed to assess the health and nutritional status of the civilian, non-institutionalized US population. Data were collected through a personal interview regarding health history and through physical examination. Earlier NHANES surveys were conducted on a periodic basis; however, in 1999, NHANES began collecting data on a continuing, annual basis. During NHANES I, which ran from 1971-1975, audiometric testing was conducted on adults aged 25-74 years. No subsequent testing of adults was conducted in the NHANES program until 1999, when NHANES began audiometric testing of adults aged 20-69 years. This report examines the hearing levels for adults in the United States and compares them with the hearing data from NHANES I. Hearing levels are grouped by age and are grouped by ethnicity and gender.

  8. Length of Residence in the United States is Associated With a Higher Prevalence of Cardiometabolic Risk Factors in Immigrants: A Contemporary Analysis of the National Health Interview Survey.

    PubMed

    Commodore-Mensah, Yvonne; Ukonu, Nwakaego; Obisesan, Olawunmi; Aboagye, Jonathan Kumi; Agyemang, Charles; Reilly, Carolyn M; Dunbar, Sandra B; Okosun, Ike S

    2016-11-04

    Cardiometabolic risk (CMR) factors including hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia are high among United States ethnic minorities, and the immigrant population continues to burgeon. Hypothesizing that acculturation (length of residence) would be associated with a higher prevalence of CMR factors, the authors analyzed data on 54, 984 US immigrants in the 2010-2014 National Health Interview Surveys. The main predictor was length of residence. The outcomes were hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia. The authors used multivariable logistic regression to examine the association between length of US residence and these CMR factors.The mean (SE) age of the patients was 43 (0.12) years and half were women. Participants residing in the United States for ≥10 years were more likely to have health insurance than those with <10 years of residence (70% versus 54%, P<0.001). After adjusting for region of birth, poverty income ratio, age, and sex, immigrants residing in the United States for ≥10 years were more likely to be overweight/obese (odds ratio [OR], 1.19; 95% CI, 1.10-1.29), diabetic (OR, 1.43; 95% CI, 1.17-1.73), and hypertensive (OR, 1.18; 95% CI, 1.05-1.32) than those residing in the United States for <10 years. In an ethnically diverse sample of US immigrants, acculturation was associated with CMR factors. Culturally tailored public health strategies should be developed in US immigrant populations to reduce CMR. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  9. Revolutionizing gender: Mariela Castro MS, director, National Sex Education Center, Cuba. Interview by Gail Reed.

    PubMed

    Castro, Mariela

    2012-04-01

    Medicine, social conditions, culture and politics are inextricably bound as determinants of health and wellbeing. In Cuba, perhaps this is nowhere more evident than in the arduous struggle to consider non-discriminatory analysis of gender-sensitive components as fundamental to population health, medical practice and research; national policy; and above all, public consciousness. Among the standard-bearers of this cause is Mariela Castro, psychologist and educator with a master's degree in sexuality, who directs the National Sex Education Center (CENESEX), its journal Sexologia y Sociedad, and the National Commission for Comprehensive Attention to Transsexual People. The Center's work is at the vortex of national polemics on sexuality, approaches to sex education and health, and respect for the human rights of people of differing sexual orientations and gender identities. The daughter of President Raúl Castro and the late Vilma Espín--who, as founder and leader of the Federation of Cuban Women, pioneered the defense of both women and homosexuals--Mariela Castro nevertheless speaks with her own voice in national as well as international debates. MEDICC Review talked with her about the range of issues that link gender to WHO's broad definition of health as the highest level of physical and mental wellbeing.

  10. National health inequality monitoring: current challenges and opportunities.

    PubMed

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne; Boerma, Ties

    National health inequality monitoring needs considerably more investment to realize equity-oriented health improvements in countries, including advancement towards the Sustainable Development Goals. Following an overview of national health inequality monitoring and the associated resource requirements, we highlight challenges that countries may encounter when setting up, expanding or strengthening national health inequality monitoring systems, and discuss opportunities and key initiatives that aim to address these challenges. We provide specific proposals on what is needed to ensure that national health inequality monitoring systems are harnessed to guide the reduction of health inequalities.

  11. Development of Interviewer Response Rate Standards for National Surveys

    ERIC Educational Resources Information Center

    Erdman, Chandra; Adams, Tamara; O'Hare, Barbara C.

    2016-01-01

    Realistic response rate expectations are important for successfully allocating and managing data collection efforts under limited resources. Interviewer performance is often evaluated against response rate standards, and face-to-face interviewer performance can vary due to, in part, the socioeconomic characteristics of the neighborhoods in which…

  12. 37 CFR 1.133 - Interviews.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Interviews. 1.133 Section 1.133 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES National Processing Provisions Interviews § 1.133...

  13. 37 CFR 1.133 - Interviews.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Interviews. 1.133 Section 1.133 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES National Processing Provisions Interviews § 1.133...

  14. 14 CFR 1213.105 - Interviews.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Interviews. 1213.105 Section 1213.105 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION RELEASE OF INFORMATION TO NEWS AND INFORMATION MEDIA § 1213.105 Interviews. (a) Only spokespersons designated by the Assistant Administrator for...

  15. 14 CFR 1213.105 - Interviews.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Interviews. 1213.105 Section 1213.105 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION RELEASE OF INFORMATION TO NEWS AND INFORMATION MEDIA § 1213.105 Interviews. (a) Only spokespersons designated by the Assistant Administrator for...

  16. Does Attending Worship Mitigate Racial/Ethnic Discrimination in Influencing Health Behaviors? Results from an Analysis of the California Health Interview Survey

    ERIC Educational Resources Information Center

    Caldwell, Julia T.; Takahashi, Lois M.

    2014-01-01

    Existing research suggests that religious institutions play a significant role in improving the health of communities, particularly those coping with racial and ethnic discrimination. Using the California Health Interview Survey, this article examines the relationship of self-reported experiences of racial/ethnic discrimination, worship…

  17. Meaning of Health: The Perspectives of Aboriginal Adults and Youth in a Northern Manitoba First Nations Community.

    PubMed

    Isaak, Corinne A; Marchessault, Gail

    2008-01-01

    To explore perspectives on the meaning of health to Aboriginal adults and youth living in a northern Manitoba First Nations community. Six focus groups with 29 youth and individual interviews with 10 adults were audio-recorded, transcribed verbatim and thematically analyzed. Adults and older youth used aspects of health depicted in the Medicine Wheel to describe being healthy, but younger youth were not as specific. Both generations spoke about the importance of positive adult role models (emotional health), incorporation of traditional First Nations practices into everyday life (spiritual health), changes in diet and activity (physical health) and the significance of making good choices (mental health). Participants incorporated aspects of current and traditional lifestyles into their discussion of health. Use of the Medicine Wheel to conceptualize health holistically on the part of both adults and older youth suggest that it may be an effective way to frame health promotion strategies for younger youth. Because it is in harmony with cultural values, such an approach may influence other members of this community to adopt healthful lifestyle practices. Copyright © 2008 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  18. [The Unified National Health System and the third sector: Characterization of non-hospital facilities providing basic health care services in Belo Horizonte, Minas Gerais, Brazil].

    PubMed

    Canabrava, Claudia Marques; Andrade, Eli Iôla Gurgel; Janones, Fúlvio Alves; Alves, Thiago Andrade; Cherchiglia, Mariangela Leal

    2007-01-01

    In Brazil, nonprofit or charitable organizations are the oldest and most traditional and institutionalized form of relationship between the third sector and the state. Despite the historical importance of charitable hospital care, little research has been done on the participation of the nonprofit sector in basic health care in the country. This article identifies and describes non-hospital nonprofit facilities providing systematically organized basic health care in Belo Horizonte, Minas Gerais, Brazil, in 2004. The research focused on the facilities registered with the National Council on Social Work, using computer-assisted telephone and semi-structured interviews. Identification and description of these organizations showed that the charitable segment of the third sector conducts organized and systematic basic health care services but is not recognized by the Unified National Health System as a potential partner, even though it receives referrals from basic government services. The study showed spatial and temporal overlapping of government and third-sector services in the same target population.

  19. Innovating for Transformation in First Nations Health Using Community-Based Participatory Research.

    PubMed

    Kyoon-Achan, Grace; Lavoie, Josée; Avery Kinew, Kathi; Phillips-Beck, Wanda; Ibrahim, Naser; Sinclair, Stephanie; Katz, Alan

    2018-06-01

    Community-based participatory research (CBPR) provides the opportunity to engage communities for sustainable change. We share a journey to transformation in our work with eight Manitoba First Nations seeking to improve the health of their communities and discuss lessons learned. The study used community-based participatory research approach for the conceptualization of the study, data collection, analysis, and knowledge translation. It was accomplished through a variety of methods, including qualitative interviews, administrative health data analyses, surveys, and case studies. Research relationships built on strong ethics and protocols to enhance mutual commitment to support community-driven transformation. Collaborative and respectful relationships are platforms for defining and strengthening community health care priorities. We further discuss how partnerships were forged to own and sustain innovations. This article contributes a blueprint for respectful CBPR. The outcome is a community-owned, widely recognized process that is sustainable while fulfilling researcher and funding obligations.

  20. Quality of reproductive health services at commune health stations in Viet Nam: implications for national reproductive health care strategy.

    PubMed

    Ngo, Anh D; Hill, Peter S

    2011-05-01

    This paper presents a qualitative study conducted in 2009 of provider and patient perceptions of primary level reproductive health services provided by commune health stations (CHSs), and the implications for Viet Nam's 2011-2020 National Strategy for Reproductive Health Care. In the three provinces of Thai Nguyen, Thua Thien Hue, and Vinh Long, we interviewed the heads of CHSs, held focus group discussions with midwives and women patients, and observed facilities. Half the 30 CHSs visited were in poor physical condition; the rest were newly renovated. However, the model of service delivery was largely unchanged from ten years before. Many appeared to fall short in meeting patient expectations in terms of modern medical equipment and technology, range of drug supplies, and levels of staff expertise. As a result, many women were turning to private doctors and public hospitals, at least in urban areas, or seeking medication from pharmacies. To make CHS clinics sustainable, promotion of access to reproductive health services should be undertaken concurrently with quality improvement. A responsive payment scheme must also be developed to generate revenues. Efforts should be made to reduce the unnecessary use of more costly services from private clinics and higher level public facilities. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  1. Repeated Interviews with Children Who Are the Alleged Victims of Sexual Abuse

    ERIC Educational Resources Information Center

    Katz, Carmit; Hershkowitz, Irit

    2013-01-01

    Objective: The present study was designed to test the effects of repeated retrievals in the course of forensic investigations with children who are the alleged victims of sexual abuse. Method: Using the National Institute of Child Health and Human Development protocol, 56 children participated in a first free-recall interview that was followed by…

  2. April Spotlight: National Minority Health Month

    Cancer.gov

    Each April, we recognize National Minority Health Month (NMHM) because of its direct relevance to us at the National Cancer Institute’s Center to Reduce Cancer Health Disparities (NCI CRCHD). This year’s NMHM theme, Partnering for Health Equity, brings attention to the need for individuals, institutions, and communities to work together to address social determinants of health, including those related to access to educational, economic, and job opportunities and the quality of education and job training.

  3. [Development of a Conceptual Framework for the Assessment of Chronic Care in the Spanish National Health System].

    PubMed

    Espallargues, Mireia; Serra-Sutton, Vicky; Solans-Domènech, Maite; Torrente, Elena; Moharra, Montse; Benítez, Dolors; Robles, Noemí; Domíngo, Laia; Escarrabill Sanglas, Joan

    2016-07-07

    The aim was to develop a conceptual framework for the assessment of new healthcare initiatives on chronic diseases within the Spanish National Health System. A comprehensive literature review between 2002 and 2013, including systematic reviews, meta-analysis, and reports with evaluation frameworks and/or assessment of initiatives was carried out; integrated care initiatives established in Catalonia were studied and described; and semistructured interviews with key stakeholders were performed. The scope and conceptual framework were defined by using the brainstorming approach.Of 910 abstracts identified, a total of 116 studies were included. They referred to several conceptual frameworks and/or assessment indicators at a national and international level. An overall of 24 established chronic care initiatives were identified (9 integrated care initiatives); 10 in-depth interviews were carried out. The proposed conceptual framework envisages: 1)the target population according to complexity levels; 2)an evaluation approach of the structure, processes, and outcomes considering the health status achieved, the recovery process and the maintenance of health; and 3)the dimensions or attributes to be assessed. The proposed conceptual framework will be helpful has been useful to develop indicators and implement them with a community-based and result-oriented approach and a territorial or population-based perspective within the Spanish Health System. This will be essential to know which are the most effective strategies, what are the key elements that determine greater success and what are the groups of patients who can most benefit.

  4. Comparison of the multiple mini-interview with the traditional interview for U.S. emergency medicine residency applicants: a single-institution experience.

    PubMed

    Soares, William E; Sohoni, Aparajita; Hern, Herbert G; Wills, Charlotte P; Alter, Harrison J; Simon, Barry C

    2015-01-01

    The multiple mini-interview (MMI) is a validated interview technique used primarily to evaluate medical school applicants. No study has compared MMIs with traditional interviews (TIs) in the evaluation of U.S. emergency medicine residency (EMR) applicants. During the 2011-2012 interview season, a four-station MMI was incorporated into the interview process for EMR applicants at Alameda Health System-Highland Hospital (AHS). A postinterview anonymous questionnaire was offered to all applicants after they submitted their rank lists but prior to release of National Residency Matching Program results. Respondents rated their perceptions of the MMI and TI on a five-point Likert scale. McNemar chi-square test was used to explore differences in respondents' perceptions of interview styles. One hundred ten interviewees completed the survey (73%). Overall, applicants found the TI more enjoyable than the MMI process (98 [89%] compared with 48 [44%], McNemar chi-square=28.66, P<.01) and preferred the TI process to the MMI (66 [60%] compared with 9 [10%], McNemar chi-square=40.81, P<.01). Sixteen applicants (14%) indicated that the use of the MMI would negatively affect their ranking of the program. In contrast to prior studies, U.S. EMR applicants to AHS preferred the TI to the MMI. Further investigation into the use of the MMI for selecting U.S. EMR applicants is warranted.

  5. Health information exchange: national and international approaches.

    PubMed

    Vest, Joshua R

    2012-01-01

    Health information exchange (HIE), the process of electronically moving patient-level information between different organizations, is viewed as a solution to the fragmentation of data in health care. This review provides a description of the current state of HIE in seven nations, as well was three international HIE efforts, with a particular focus on the relation of exchange efforts to national health care systems, common challenges, and the implications of cross-border information sharing. National and international efforts highlighted in English language informatics journals, professional associations, and government reports are described. Fully functioning HIE is not yet a common phenomenon worldwide. However, multiple nations see the potential benefits of HIE and that has led to national and international efforts of varying scope, scale, and purview. National efforts continue to work to overcome the challenges of interoperability, record linking, insufficient infrastructures, governance, and interorganizational relationships, but have created architectural strategies, oversight agencies, and incentives to foster exchange. The three international HIE efforts reviewed represent very different approaches to the same problem of ensuring the availability of health information across borders. The potential of HIE to address many cost and quality issues will ensure HIE remains on many national agendas. In many instances, health care executives and leaders have opportunities to work within national programs to help shape local exchange governance and decide technology partners. Furthermore, HIE raises policy questions concerning the role of centralized planning, national identifiers, standards, and types of information exchanged, each of which are vital issues to individual health organizations and worthy of their attention.

  6. Training and calibration of interviewers for oral health literacy using the BREALD-30 in epidemiological studies.

    PubMed

    Vilella, Karina Duarte; Assunção, Luciana Reichert da Silva; Junkes, Mônica Carmem; Menezes, José Vitor Nogara Borges de; Fraiz, Fabian Calixto; Ferreira, Fernanda de Morais

    2016-08-22

    The objective of this study was to describe an interviewer training and calibration method to evaluate oral health literacy using the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) in epidemiological studies. An experienced researcher (gold standard) conducted all training sessions. The interviewer training and calibration sessions included three different phases: theoretical training, practical training, and calibration. In the calibration phase, six interviewers (dentists) independently assessed 15 videos of individuals who had different levels of oral health literacy. Accuracy and reproducibility were evaluated using the kappa coefficient and the intraclass correlation coefficient (ICC). The percentage of agreement for each word in the instrument was also calculated. After training, the kappa values were higher than 0.911 and 0.893 for intra- and inter-rater agreement, respectively. When the results were analyzed separately for the different levels of literacy, the lowest agreement rate was found when evaluating the videos of individuals with low literacy (K = 0.871), but still within the range considered to be near-perfect agreement. The ICC values were higher than 0.990 and 0.975 for intra- and inter-rater agreement, respectively. The lowest percentage of agreement was 86.6% for the word "hipoplasia" (hypoplasia). This interviewer training and calibration method proved to be feasible and effective. Therefore, it can be used as a methodological tool in studies assessing oral health literacy using the BREALD-30.

  7. Wealth and the nation's health.

    PubMed

    Blackburn, C

    1993-07-01

    Social and economic prosperity to a great extent depend on a healthy population; similarly good health depends on adequate income, writes Clare Blackburn. The government strategy for health promotion outlined most recently in The health of the nation, fails to acknowledge this. Nevertheless health visitors and school nurses cannot ignore the links between health and wealth.

  8. A novel performance monitoring framework for health research systems: experiences of the National Institute for Health Research in England

    PubMed Central

    2011-01-01

    Background The National Institute for Health Research (NIHR) was established in 2006 with the aim of creating an applied health research system embedded within the English National Health Service (NHS). NIHR sought to implement an approach for monitoring its performance that effectively linked early indicators of performance with longer-term research impacts. We attempted to develop and apply a conceptual framework for defining appropriate key performance indicators for NIHR. Method Following a review of relevant literature, a conceptual framework for defining performance indicators for NIHR was developed, based on a hybridisation of the logic model and balanced scorecard approaches. This framework was validated through interviews with key NIHR stakeholders and a pilot in one division of NIHR, before being refined and applied more widely. Indicators were then selected and aggregated to create a basket of indicators aligned to NIHR's strategic goals, which could be reported to NIHR's leadership team on a quarterly basis via an oversight dashboard. Results Senior health research system managers and practitioners endorsed the conceptual framework developed and reported satisfaction with the breadth and balance of indicators selected for reporting. Conclusions The use of the hybrid conceptual framework provides a pragmatic approach to defining performance indicators that are aligned to the strategic aims of a health research system. The particular strength of this framework is its capacity to provide an empirical link, over time, between upstream activities of a health research system and its long-term strategic objectives. PMID:21435265

  9. Women's health nursing in the context of the National Health Information Infrastructure.

    PubMed

    Jenkins, Melinda L; Hewitt, Caroline; Bakken, Suzanne

    2006-01-01

    Nurses must be prepared to participate in the evolving National Health Information Infrastructure and the changes that will consequently occur in health care practice and documentation. Informatics technologies will be used to develop electronic health records with integrated decision support features that will likely lead to enhanced health care quality and safety. This paper provides a summary of the National Health Information Infrastructure and highlights electronic health records and decision support systems within the context of evidence-based practice. Activities at the Columbia University School of Nursing designed to prepare nurses with the necessary informatics competencies to practice in a National Health Information Infrastructure-enabled health care system are described. Data are presented from electronic (personal digital assistant) encounter logs used in our Women's Health Nurse Practitioner program to support evidence-based advanced practice nursing care. Implications for nursing practice, education, and research in the evolving National Health Information Infrastructure are discussed.

  10. National Health Insurance and Health Education: Strategies for Change.

    ERIC Educational Resources Information Center

    Dwore, Richard B.

    1980-01-01

    The concept of National Health Insurance (NHI) as one of several strategies for resolving health problems in the U.S. is discussed. NHI goals include comprehensive health care, quality health care, efficient delivery systems, phased-in benefits, and consumer representation. (JD)

  11. NATIONAL FRAMEWORK FOR THE SUSTAINABILITY OF HEALTH KNOWLEDGE TRANSLATION INITIATIVES IN UGANDA.

    PubMed

    Basaza, Robert; Kinegyere, Alison; Mutatina, Boniface; Sewankambo, Nelson

    2018-01-01

    The aim of this study was to provide evidence about the design and implementation of policies for advancing the sustainability of knowledge translation (KT) initiatives and policies in Uganda's health system. We searched for and reviewed evidence about KT sustainability issues in Uganda, the impacts of options, barriers to implementing these options, and implementation strategies to address such barriers. In instances where the systematic reviews provided limited evidence, these were supplemented with relevant primary studies. Documents such as the government reports and unpublished literature were also included in the search. Key informant interviews and a policy dialogue were conducted, and an expert working group guided the study. The KT sustainability issues identified were: the absence of a specific unit within the health sector to coordinate and synthesize research; health worker not familiar with KT activities and not often used. Furthermore, Uganda lacks a mechanism to sustain its current national health frameworks or platforms, and does not have a system to ensure the sustained coordination of existing national health KT platforms. The policy options proposed include: (i) the identification of a KT champion; (ii) the establishment of an operational KT framework; (iii) KT capacity building for researchers and research users, as well as policy and decision makers. The sustainability of KT will be influenced by the prevailing context and concerns within healthcare both in Uganda and internationally. Furthermore, the availability of resources for KT advocacy, communication, and program design will impact on the sustainability of Uganda's KT activities.

  12. Comparing oral health care utilization estimates in the United States across three nationally representative surveys.

    PubMed

    Macek, Mark D; Manski, Richard J; Vargas, Clemencia M; Moeller, John F

    2002-04-01

    To compare estimates of dental visits among adults using three national surveys. Cross-sectional data from the National Health Interview Survey (NHIS), National Health and Nutrition Examination Survey (NHANES), and National Health Expenditure surveys (NMCES, NMES, MEPS). This secondary data analysis assessed whether overall estimates and stratum-specific trends are different across surveys. Dental visit data are age standardized via the direct method to the 1990 population of the United States. Point estimates, standard errors, and test statistics are generated using SUDAAN. Sociodemographic, stratum-specific trends are generally consistent across surveys; however, overall estimates differ (NHANES III [364-day estimate] versus 1993 NHIS: -17.5 percent difference, Z = 7.27, p value < 0.001; NHANES III [365-day estimate] vs. 1993 NHIS: 5.4 percent difference, Z = -2.50, p value = 0.006; MEPS vs. 1993 NHIS: -29.8 percent difference, Z = 16.71, p value < 0.001). MEPS is the least susceptible to intrusion, telescoping, and social desirability. Possible explanations for discrepancies include different reference periods, lead-in statements, question format, and social desirability of responses. Choice of survey should depend on the hypothesis. If trends are necessary, choice of survey should not matter however, if health status or expenditure associations are necessary, then surveys that contain these variables should be used, and if accurate overall estimates are necessary, then MEPS should be used. A validation study should be conducted to establish "true" utilization estimates.

  13. An Interview with Noam Chomsky

    ERIC Educational Resources Information Center

    Jack, Gavin

    2006-01-01

    This article presents a transcript of an interview that the author conducted with Noam Chomsky. In this interview, Chomsky talks about language acquisition and his theory of Universal Grammar. He then explains how the USA best exemplifies the individualist national culture. He also cites the challenges researchers should address in intercultural…

  14. Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98)

    PubMed Central

    2012-01-01

    Background We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined. Methods The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables. Results After adjusting for age and region, a higher education level was associated with more leisure-time activity – with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1

  15. CGH observes National Women’s Health Week

    Cancer.gov

    This week, the U.S. Department of Health and Human Services is observing the 17th annual National Women’s Health Week. The goal of the National Women's Health Week is to empower women to make their health a priority. In celebration, the NCI Center for Global Health held a seminar on the Knowledge Summaries for Comprehensive Breast Cancer Control: Pathways for Advanced Cancer Planning.

  16. National Institute on Minority Health and Health Disparities

    MedlinePlus

    ... both baby and mom. More Minorities and Mental Health: Moving Beyond the Stigma Mental illness is one ... Review Board for Multi-Site Research Resources Public Health 2016 AHRQ National Healthcare Quality and Disparities Report ...

  17. What are the physical and psychological health effects of suicide bereavement on family members? Protocol for an observational and interview mixed-methods study in Ireland

    PubMed Central

    Larkin, Celine; Corcoran, Paul; Matvienko-Sikar, Karen; Arensman, Ella

    2017-01-01

    Introduction Research indicates that experiencing the suicide of a relative can have a significant impact on family members' emotional health. However, research incorporating the impact of suicide bereavement on family members' physical health is sparse. This paper details the protocol for a mixed-methods study of suicide-bereaved family members. The study will primarily examine the physical and mental health needs of those bereaved by suicide. A secondary objective of the study is to describe the support service needs of family members bereaved by suicide. Methods and analysis A mixed-methods approach, using semistructured interviews and self-report questionnaires, will be used. Interviews will be conducted with a group of 15–20 relatives who experienced suicide bereavement. This protocol will follow the COREQ checklist criteria for the reporting of qualitative research interviews. Thematic analysis will be used to examine experiences and impact of bereavement on psychological and physical health. Self-report quantitative data on well-being will be analysed using descriptive statistics. Ethics and dissemination Ethical approval to conduct this study has been granted from the Clinical Research Ethics Committee of the Cork Teaching Hospitals. Pseudonyms will be given to participants to protect anonymity. It will be explained to participants that participation in the study is voluntary and they have to right to withdraw at any time. The findings of this research will be disseminated to regional, national and international audiences through publication in peer-reviewed international journals and presentations at scientific conferences. This research also forms part of a PhD thesis. PMID:28363930

  18. Collecting reliable information about violence against women safely in household interviews: experience from a large-scale national survey in South Asia.

    PubMed

    Andersson, Neil; Cockcroft, Anne; Ansari, Noor; Omer, Khalid; Chaudhry, Ubaid Ullah; Khan, Amir; Pearson, Luwei

    2009-04-01

    This article describes the first national survey of violence against women in Pakistan from 2001 to 2004 covering 23,430 women. The survey took account of methodological and ethical recommendations, ensuring privacy of interviews through one person interviewing the mother-in-law while another interviewed the eligible woman privately. The training module for interviewers focused on empathy with respondents, notably increasing disclosure rates. Only 3% of women declined to participate, and 1% were not permitted to participate. Among women who disclosed physical violence, only one third had previously told anyone. Surveys of violence against women in Pakistan not using methods to minimize underreporting could seriously underestimate prevalence.

  19. 75 FR 26871 - National Women's Health Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-12

    ... Part III The President Proclamation 8516--National Women's Health Week, 2010 Proclamation 8517... National Women's Health Week, 2010 By the President of the United States of America A Proclamation In recent decades, our Nation has made extraordinary progress in promoting women's health issues. However...

  20. Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study

    PubMed Central

    Bristowe, Katherine; Hodson, Matthew; Wee, Bee; Almack, Kathryn; Johnson, Katherine; Daveson, Barbara A; Koffman, Jonathan; McEnhill, Linda; Harding, Richard

    2017-01-01

    Background: Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. Aim: To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples. Design: Semi-structured in-depth qualitative interviews analysed using thematic analysis. Setting/participants: In total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer (n = 21), non-cancer (n = 16) and both a cancer and a non-cancer conditions (n = 3). Results: In total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals’ preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness. Conclusion: Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access

  1. 76 FR 44597 - National Institutes of Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and Blood Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee... Health, HHS) Dated: July 20, 2011. Anna P. Snouffer, Deputy Director, Office of Federal Advisory...

  2. How participants report their health status: cognitive interviews of self-rated health across race/ethnicity, gender, age, and educational attainment.

    PubMed

    Garbarski, Dana; Dykema, Jennifer; Croes, Kenneth D; Edwards, Dorothy F

    2017-10-04

    Self-rated health (SRH) is widely used to measure subjective health. Yet it is unclear what underlies health ratings, with implications for understanding the validity of SRH overall and across sociodemographic characteristics. We analyze participants' explanations of how they formulated their SRH answer in addition to which health factors they considered and examine group differences in these processes. Cognitive interviews were conducted with 64 participants in a convenience quota sample crossing dimensions of race/ethnicity (white, Latino, black, American Indian), gender, age, and education. Participants rated their health then described their thoughts when answering SRH. We coded participants' answers in an inductive, iterative, and systematic process from interview transcripts, developing analytic categories (i.e., themes) and subdimensions within. We examined whether the presence of each dimension of an analytic category varied across sociodemographic groups. Our qualitative analysis led to the identification and classification of various subdimensions of the following analytic categories: types of health factors mentioned, valence of health factors, temporality of health factors, conditional health statements, and descriptions and definitions of health. We found differences across groups in some types of health factors mentioned-corresponding, conflicting, or novel with respect to prior research. Furthermore, we also documented various processes through which respondents integrate seemingly disparate health factors to formulate an answer through valence and conditional health statements. Finally, we found some evidence of sociodemographic group differences with respect to types of health factors mentioned, valence of health factors, and conditional health statements, highlighting avenues for future research. This study provides a description of how participants rate their general health status and highlights potential differences in these processes across

  3. Prevalence and trends of leisure-time physical activity by occupation and industry in U.S. workers: the National Health Interview Survey 2004–2014

    PubMed Central

    Gu, Ja K.; Charles, Luenda E.; Ma, Claudia C.; Andrew, Michael E.; Fekedulegn, Desta; Hartley, Tara A.; Violanti, John M.; Burchfiel, Cecil M.

    2016-01-01

    Purpose Studies describing prevalence and trends of physical activity among workers in the United States are scarce. We aimed to estimate prevalence and trends of “sufficient” leisure-time physical activity (LTPA) during the 2004–2014 time period among U.S. workers. Methods Data were collected for U.S. workers in the National Health Interview Survey. LTPA was categorized as sufficiently active (moderate intensity, ≥150 minutes per week), insufficiently active (10–149 minutes per week), and inactive (<10 minutes per week). Prevalence of LTPA was adjusted for age using 2010 U.S. working population as a standardized age distribution. Results Prevalence trends of “sufficient” LTPA significantly increased from 2004 to 2014 (45.6% to 54.8%; P < .001). Among industry groups, the highest prevalence of “sufficient” LTPA was observed among workers in Professional/Scientific/Technical Services (62.1%). The largest increases were observed among workers in Public Administration (51.3%–63.4%). Among occupational groups, “sufficient” LTPA prevalence was lowest in farming/fishing/forestry (30.8%) and highest in life/physical/social science (66.4%). Prevalence of LTPA significantly increased from 2004 to 2014 in most occupational and industry groups. Conclusions Among U.S. workers, trends of “sufficient” LTPA significantly increased between 2004 and 2014. Overall, a larger proportion of white-collar compared to blue-collar workers were engaged in “sufficient” LTPA. PMID:27659584

  4. Diagnosed Attention Deficit Hyperactivity Disorder and Learning Disability: United States, 2004-2006. Data from the National Health Interview Survey. Vital and Health Statistics. Series 10, Number 237

    ERIC Educational Resources Information Center

    Pastor, Patricia N.; Reuben, Cynthia A.

    2008-01-01

    Objectives: This report presents national estimates of the prevalence of diagnosed attention deficit hyperactivity disorder (ADHD) and learning disability (LD) in U.S. children 6-17 years of age and describes the prevalence of these conditions for children with selected characteristics. The use of educational and health care services and the…

  5. Scientific disputes that spill over into Research Ethics: interview with Maria Cecília de Souza Minayo.

    PubMed

    Minayo, Maria Cecília de Souza

    2015-09-01

    This is an interview with Maria Cecília de Souza Minayo, by university lecturers Iara Coelho Zito Guerriero and Maria Lúcia Magalhães Bosi. It reflects the heat of the current debates surrounding implementation of a specific protocol for evaluation of research in the Human and Social Sciences (HSS), vis-à-vis the current rules set by the National Health Council, which have a clearly biomedical bias. The interview covers the difficulties of introducing appropriate and fair rules for judgment of HSS projects, in the face of a hegemonic understanding of the very concept of science by biologists and medical doctors, who tend not to recognize other approaches unless those approaches adopt their frames of reference. In this case, the National Health Council becomes the arena of this polemic, leading researchers in the human and social sciences to ask themselves whether the health sector has the competency to create rules for other areas of knowledge.

  6. Challenges in converting an interviewer-administered food probe database to self-administration in the National Cancer Institute Automated Self-administered 24-Hour Recall (ASA24).

    PubMed

    Zimmerman, Thea Palmer; Hull, Stephen G; McNutt, Suzanne; Mittl, Beth; Islam, Noemi; Guenther, Patricia M; Thompson, Frances E; Potischman, Nancy A; Subar, Amy F

    2009-12-01

    The National Cancer Institute (NCI) is developing an automated, self-administered 24-hour dietary recall (ASA24) application to collect and code dietary intake data. The goal of the ASA24 development is to create a web-based dietary interview based on the US Department of Agriculture (USDA) Automated Multiple Pass Method (AMPM) instrument currently used in the National Health and Nutrition Examination Survey (NHANES). The ASA24 food list, detail probes, and portion probes were drawn from the AMPM instrument; portion-size pictures from Baylor College of Medicine's Food Intake Recording Software System (FIRSSt) were added; and the food code/portion code assignments were linked to the USDA Food and Nutrient Database for Dietary Studies (FNDDS). The requirements that the interview be self-administered and fully auto-coded presented several challenges as the AMPM probes and responses were linked with the FNDDS food codes and portion pictures. This linking was accomplished through a "food pathway," or the sequence of steps that leads from a respondent's initial food selection, through the AMPM probes and portion pictures, to the point at which a food code and gram weight portion size are assigned. The ASA24 interview database that accomplishes this contains more than 1,100 food probes and more than 2 million food pathways and will include about 10,000 pictures of individual foods depicting up to 8 portion sizes per food. The ASA24 will make the administration of multiple days of recalls in large-scale studies economical and feasible.

  7. Health and safety needs in early care and education programs: what do directors, child health records, and national standards tell us?

    PubMed

    Alkon, Abbey; To, Kim; Mackie, Joanna F; Wolff, Mimi; Bernzweig, Jane

    2010-01-01

    To identify the overlapping and unique health and safety needs and concerns identified by early care and education (ECE) directors, health records, and observed compliance with national health and safety (NHS) standards. Cross-sectional study. 127 ECE programs from 5 California counties participated in the study, including 118 directors and 2,498 children's health records. Qualitative data were collected using standardized ECE directors' interviews to identify their health and safety concerns; and objective, quantitative data were collected using child health record reviews to assess regular health care, immunizations, health insurance, special health care needs, and screening tests and an observation Checklist of 66 key NHS standards collected by research assistants. The overlapping health and safety needs and concerns identified by the directors and through observations were hygiene and handwashing, sanitation and disinfection, supervision, and the safety of indoor and outdoor equipment. Some of the health and safety needs identified by only one assessment method were health and safety staff training, medical plans for children with special health care needs and follow-up on positive screening tests. Comprehensive, multimethod assessments are useful to identify health and safety needs and develop public health nursing interventions for ECE programs.

  8. National Minority Health Month Spotlight: Career Development

    Cancer.gov

    April is National Minority Health Month and in support of the 2016 theme, Accelerating Health Equity for the Nation, the NCI Center to Reduce Cancer Health Disparities (CRCHD) is highlighting how diversity training and career development opportunities are contributing to efforts to reduce the unequal burden of cancer in our society.

  9. Relations among obesity, family socioeconomic status, oral health behaviors, and dental caries in adolescents: the 2010-2012 Korea National Health and nutrition examination survey.

    PubMed

    Kim, Jin Ah; Choi, Hayon Michelle; Seo, Yunhee; Kang, Dae Ryong

    2018-06-22

    The purpose of this study was to examine the relationships among obesity, family socioeconomic status, oral health behaviors, and dental caries and to identify possible differences in factors related with dental caries according to gender among a representative sample of Korean adolescents. Data were obtained from the Korean National Health and Nutrition Examination Survey, which was conducted between 2010 and 2012. This nationally representative cross-sectional survey included approximately 10,000 individuals, including adolescents, each year as a survey sample, and collected information on socioeconomic status, health-related behaviors, quality of life, healthcare utilization, anthropometric measures, biochemical and clinical profiles for non-communicable diseases, and dietary intake via three component surveys (health interview, health examination, and nutrition survey). The health interview and health examination were conducted by trained staff members. A total of 1646 adolescents of ages 13 to 18 years old were included in this study; there were 879 males and 767 females. Data were analyzed by t-test, X 2 -test, and univariate and multivariate logistic regression analyses using SAS 9.4 and 'R' statistical software for Windows to account for the complex sampling design. In males, significant associations between family income and dental caries on permanent teeth were noted after adjusting for confounding variables; the odds ratios and 95% confidence intervals thereof were 0.43(0.24-0.76), 0.41(0.24-0.70), and 0.28(0.16-0.49) for low-middle, middle-high, and high family income, respectively. Smoking experience showed a significant association with dental caries on permanent teeth in females. Oral health behaviors, such as tooth brushing frequency, were associated with dental caries in only male adolescents. There was no association between obesity and dental caries on permanent teeth in either male or female adolescents. The present study demonstrated that

  10. Health/Service Providers' Perspectives on Barriers to Healthy Weight Gain and Physical Activity in Pregnant, Urban First Nations Women.

    PubMed

    Darroch, Francine E; Giles, Audrey R

    2016-01-01

    The purpose of this article is to examine health/service providers' perspectives of barriers to healthy weight gain and physical activity for urban, pregnant First Nations women in Ottawa, Canada. Through the use of semi-structured interviews, we explored 15 health/service providers' perspectives on the complex barriers their clients face. By using a postcolonial feminist lens and a social determinants of health framework, we identified three social determinants of health that the health/service providers believed to have the greatest influence on their clients' weight gain and physical activity during pregnancy: poverty, education, and colonialism. Our findings are then contextualized within existing Statistics Canada and the Ottawa Neighbourhood Study data. We found that health/service providers are in a position to challenge colonial relations of power. We conclude by urging health/service providers, researchers, and policymakers alike to take into consideration the ways in which these social determinants of health and their often synergistic effects affect urban First Nations women during pregnancy. © The Author(s) 2015.

  11. DataView: National Health Expenditures, 1998

    PubMed Central

    Cowan, Cathy A.; Lazenby, Helen C.; Martin, Anne B.; McDonnell, Patricia A.; Sensenig, Arthur L.; Stiller, Jean M.; Whittle, Lekha S.; Kotova, Kimberly A.; Zezza, Mark A.; Donham, Carolyn S.; Long, Anna M.; Stewart, Madie W.

    1999-01-01

    In 1998, national health care expenditures reached $1.1 trillion, an increase of 5.6 percent from the previous year. This marked the fifth consecutive year of spending growth under 6 percent. Underlying the stability of the overall growth, major changes began taking place within the Nation's health care system. Public payers felt the initial effects of the Balanced Budget Act of 1997 (BBA), and private payers experienced increased health care costs and increased premium growth. PMID:11481774

  12. 75 FR 33983 - Establishing the National Prevention, Health Promotion, and Public Health Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-16

    ... 13544 of June 10, 2010 Establishing the National Prevention, Health Promotion, and Public Health Council... of Health and Human Services, the National Prevention, Health Promotion, and Public Health Council... Health and Human Services; (4) the Secretary of Transportation; (5) the Secretary of Education; (6) the...

  13. The USGS National Wildlife Health Center: Advancing wildlife and ecosystem health

    USGS Publications Warehouse

    Moede Rogall, Gail; Sleeman, Jonathan M.

    2017-01-11

    In 1975, the Federal government responded to the need for establishing national expertise in wildlife health by creating the National Wildlife Health Center (NWHC), a facility within the Department of the Interior; the NWHC is the only national center dedicated to wildlife disease detection, control, and prevention. Its mission is to provide national leadership to safeguard wildlife and ecosystem health through active partnerships and exceptional science. Comparisons are often made between the NWHC, which strives to protect the health of our Nation’s wildlife, and the Centers for Disease Control and Prevention (CDC), which strive to protect public health. The NWHC, a science center of the U.S. Geological Survey (USGS) with specialized laboratories, works to safeguard the Nation’s wildlife from diseases by studying the causes and drivers of these threats, and by developing strategies to prevent and manage them. In addition to the main campus, located in Madison, Wisconsin, the NWHC also operates the Honolulu Field Station that addresses wildlife health issues in Hawaii and the Pacific Region.

  14. Preconditions needed for establishing a trusting relationship during health counselling - an interview study.

    PubMed

    Eriksson, Irene; Nilsson, Kerstin

    2008-09-01

    To examine the preconditions needed by district nurses to build a trusting relationship during health counselling of patients with hypertension. Trust has been found to be an important aspect of the patient-nurse relationship. Little research has focused on how trust is formed in patient-nurse relationships or the conditions the development process requires when working with health counselling; in particular not in relation to hypertension. Qualitative study. Qualitative data were collected through open-ended interviews with all (10) district nurses from three primary health care districts of western Sweden. All interviewees work with the health counselling of patients with hypertension. A latent content analysis was performed with thematic coding of the content of the interviews. The first theme that emerged from the analysis, the nurses' competence, describes the nurses' consciousness of their method of expression, both oral and non-verbal, as well as their pedagogical competence and their ability to be reliable in their profession. The second theme, the patient meeting, describes the continuity in the patient meeting and creating respectful communication. The results show an awareness of preconditions influencing building a trusting relationship. When creating a trusting relationship the communication and pedagogical competences of district nurses have considerable importance. Despite this awareness they state that it is easy to fall into a routinised way of working. The implications of this study might be used as support and guidance for district nurses when developing their competence in health counselling in relations to patients with hypertension. This knowledge is also important when planning for nurse-led clinics for this patient group.

  15. Postdeployment military mental health training: cross-national evaluations.

    PubMed

    Foran, Heather M; Garber, Bryan G; Zamorski, Mark A; Wray, Mariane; Mulligan, Kathleen; Greenberg, Neil; Castro, Carl Andrew; Adler, Amy B

    2013-05-01

    Deployments increase risk for adjustment problems in service members. To mitigate this increased risk, mental health training programs have been developed and implemented in several nations. As part of a coordinated effort, three nations adapted a U.S. mental health training program that had been validated by a series of group randomized trials demonstrating improvement in postdeployment adjustment. Implementation of evidence-based programs in a new context is challenging: How much of the original program needs to remain intact in order to retain its utility? User satisfaction rates can provide essential data to assess how well a program is accepted. This article summarizes service member ratings of postdeployment mental health training and compares ratings from service members across four nations. The participating nations (Canada, New Zealand, United Kingdom, and the United States) administered mental health training to active duty military personnel in their respective nations. Following the training, military personnel completed an evaluation of the training. Overall, across the four nations, more than 70% of military personnel agreed or strongly agreed that they were satisfied with the mental health training. Although some differences in evaluations were observed across nations, components of training that were most important to overall satisfaction with the training were strikingly similar across nations. Fundamentally, it appears feasible that despite cultural and organizational differences, a mental health training program developed in one nation can be successfully adapted for use in other nations. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  16. Nurses' performance on primary care in the National Health Service in England.

    PubMed

    Toso, Beatriz Rosana Gonçalves de Oliveira; Filippon, Jonathan; Giovanella, Ligia

    2016-01-01

    To analyze the expansion of nursing roles in primary care in the English National Health Service and the implications for professional practice. qualitative research in case study format, held in London, England, in six primary care units. Data were obtained through interviews with nine nurses. After the thematic data analysis, two units emerged: the nurses' performance characteristics and effects of the expansion of nursing roles. expansion of nurses' roles: consultation, diagnosis and drug therapy, case management and monitoring of chronic conditions. Repercussions: for the user, there was improved access, communication and comprehensive care, increased duration of consultations, resulting in greater adherence; for nurses, there was the expansion of professional skills, knowledge and professional recognition; to the health care system, it resulted in cost savings. benefits in expanding nursing roles, were visible, contributing to primary care quality.

  17. Insights into Chronic Functional Movement Disorders: The Value of Qualitative Psychiatric Interviews.

    PubMed

    Epstein, Steven A; Maurer, Carine W; LaFaver, Kathrin; Ameli, Rezvan; Sinclair, Stephen; Hallett, Mark

    Patients with functional movement disorders (FMDs) are commonly seen by neurologists and psychosomatic medicine psychiatrists. Research literature provides scant information about the subjective experiences of individuals with this often chronic problem. To enhance our understanding of psychologic aspects of FMDs by conducting qualitative interviews of research subjects. In total, 36 patients with FMDs were recruited from the Human Motor Control clinic at the National Institutes of Health. Each subject participated in a qualitative psychiatric interview and a structured diagnostic psychiatric interview. Of our 36 subjects, 28 had current or lifetime psychiatric disorders in addition to conversion disorder and 22 had current disorders. Qualitative interviews provided rich information on patients' understanding of their illnesses and impaired cognitive processing of emotions. Our study supports the addition of open-ended qualitative interviews to delineate emotional dynamics and conceptual frameworks among such patients. Exploratory interviews generate enhanced understanding of such complex patients, above and beyond that gained by assessing DSM diagnostic comorbidities. Copyright © 2016 The Academy of Psychosomatic Medicine. All rights reserved.

  18. Mothers' perceptions of their health choices, related duties and responsibilities: A qualitative interview study.

    PubMed

    Kangasniemi, Mari; Blomberg, Katja; Korhonen, Anne

    2015-11-01

    to describe mothers' perceptions of their health choices, related duties and responsibilities. descriptive exploratory study with qualitative research method. interviews conducted after the clients' regular health visits to one publicly provided maternity clinic in a southern city in Finland. 13 mothers aged between 21 and 40-years-old, who were pregnant or had given birth in the past four weeks. Six of participants were pregnant or had delivered for first time and it was the second to fourth pregnancy for the remainder. one-to-one semi-structured interviews using the inductive content analysis method. women reported increased responsibility for their health choices for themselves and their baby during pregnancy. However, their duties and responsibilities were seldom discussed at maternity clinics. The duty to reconsider their health choices was described as a predictor of commitment to their pregnancy and motherhood, but they recognised that it required sufficient knowledge to realise this. In addition, the mothers said their health choices changed from private to one of public interest during this period. health choices are connected to maternal duties and responsibilities, but they can sometimes lack clarity during this new phase of life. In future, more research should be conducted to study maternal duties and responsibilities in different contexts. findings highlight the skills of nurses and midwives at maternity clinics to discuss and support mothers' moral pondering during pregnancy. Although health choices in general are well recognised as a part of maternal counselling, these findings suggest a moral perspective should be incorporated into the advice that is provided. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Forest health monitoring: 2007 national technical report

    Treesearch

    Barbara L. Conkling

    2011-01-01

    The Forest Health Monitoring Program produces an annual technical report that has two main objectives. The first objective is to present information about forest health from a national perspective. The second objective is to present examples of useful techniques for analyzing forest health data new to the annual national reports and new applications of techniques...

  20. Forest health monitoring: 2009 national technical report

    Treesearch

    Kevin M. Potter; Barbara L. Conkling

    2012-01-01

    The annual national technical report of the Forest Health Monitoring Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation...

  1. Canada deserves a national health system.

    PubMed

    Noseworthy, T W

    1997-01-01

    A defining--some would say peculiar--feature about Canada and Canadians is the strong position that we give social programs within our national identity. FORUM presents an essay by Dr. Thomas Noseworthy based on an address to the annual meeting of the Association of Canadian Medical Colleges in April 1996. In it, Dr. Noseworthy calls for a national health system. He sees the federal government retaining an important role in preserving medicare and, in fact, strengthening its powers in maintaining national consistency and standards. Dr. Noseworthy's views are contrary to the governmental decentralization and devolution of powers occurring across the country. In a "point/counterpoint" exchange on this issue, we have invited commentaries from three experts. Raisa Deber leads off by noting that while a national health system may be desirable, constitutional provisions would be an obstacle. Governments, says Deber, have an inherent conflict of interest between their responsibility for maintaining the health care system and their desire to shift costs. Michael Rachlis reminds us that medicare fulfills important economic as well as social objectives. It helps to support Canada's business competitiveness among other nations. The problem, say Rachlis, is that public financing of health care does not ensure an efficient delivery system. Michael Walker offers some reality orientation. He observes that Canada's health care system is based upon ten public insurance schemes with widely different attributes. While he supports a minimum standard of health care across the country, citizens should be able to purchase private medical insurance and have access to a parallel private health care delivery system. Ultimately, this debate is about who should control social programs: the provinces or the federal government? We'll let you, the readers, decide.

  2. National action for European public health research.

    PubMed

    McCarthy, Mark; Zeegers Paget, Dineke; Barnhoorn, Floris

    2013-11-01

    Research and innovation are the basis for improving health and health services. The European Union (EU) supports research through multi-annual programmes. Public Health Innovation and Research in Europe (PHIRE) investigated how European countries cooperate for action in public health research. In PHIRE, following stakeholder workshops and consultations, a national report on public health research was created for 24 of 30 European countries. The report template asked five questions, on national links to European public health research and on national research through the Structural Funds and Ministry of Health. The national reports were assessed with framework analysis, and the country actions were classified strong/partial/weak or none. There were responses to the five questions sufficient for this analysis for between 14 and 20 countries Six countries had public health research aligned with the EU, while three (large) countries were reported not aligned. Only two countries expressed strong engagement in developing public health research within Horizon 2020: most Ministries of Health had no position and only had contact with EU health research through other ministries. Only two countries reported use of the 2007-13 Structural Funds for public health research. While seven Ministries of Health led research from their own funds, or linked with Ministries of Science in six, the Ministries of Health of seven countries were reported not to be involved in public health research. Ministries of Health and stakeholders are poorly engaged in developing public health research, with the Horizon 2020 research programme, or the Structural Funds. The European Commission should give more attention to coordination of public health research with member states if it is to give best value to European citizens.

  3. Social Determinants of Health in the United States: Addressing Major Health Inequality Trends for the Nation, 1935-2016

    PubMed Central

    Singh, Gopal K.; Daus, Gem P.; Allender, Michelle; Ramey, Christine T.; Martin, Elijah K.; Perry, Chrisp; Reyes, Andrew A. De Los; Vedamuthu, Ivy P.

    2017-01-01

    Objectives: This study describes key population health concepts and examines major empirical trends in US health and healthcare inequalities from 1935 to 2016 according to important social determinants such as race/ethnicity, education, income, poverty, area deprivation, unemployment, housing, rural-urban residence, and geographic location. Methods: Long-term trend data from the National Vital Statistics System, National Health Interview Survey, National Survey of Children’s Health, American Community Survey, and Behavioral Risk Factor Surveillance System were used to examine racial/ethnic, socioeconomic, rural-urban, and geographic inequalities in health and health care. Life tables, age-adjusted rates, prevalence, and risk ratios were used to examine health differentials, which were tested for statistical significance at the 0.05 level. Results: Life expectancy of Americans increased from 69.7 years in 1950 to 78.8 years in 2015. However, despite the overall improvement, substantial gender and racial/ethnic disparities remained. In 2015, life expectancy was highest for Asian/Pacific Islanders (87.7 years) and lowest for African-Americans (75.7 years). Life expectancy was lower in rural areas and varied from 74.5 years for men in rural areas to 82.4 years for women in large metro areas, with rural-urban disparities increasing during the 1990-2014 time period. Infant mortality rates declined dramatically during the past eight decades. However, racial disparities widened over time; in 2015, black infants had 2.3 times higher mortality than white infants (11.4 vs. 4.9 per 1,000 live births). Infant and child mortality was markedly higher in rural areas and poor communities. Black infants and children in poor, rural communities had nearly three times higher mortality rate compared to those in affluent, rural areas. Racial/ethnic, socioeconomic, and geographic disparities were particularly marked in mortality and/or morbidity from cardiovascular disease, cancer

  4. Design of the national health security preparedness index.

    PubMed

    Uzun Jacobson, Evin; Inglesby, Tom; Khan, Ali S; Rajotte, James C; Burhans, Robert L; Slemp, Catherine C; Links, Jonathan M

    2014-01-01

    The importance of health security in the United States has been highlighted by recent emergencies such as the H1N1 influenza pandemic, Superstorm Sandy, and the Boston Marathon bombing. The nation's health security remains a high priority today, with federal, state, territorial, tribal, and local governments, as well as nongovernment organizations and the private sector, engaging in activities that prevent, protect, mitigate, respond to, and recover from health threats. The Association of State and Territorial Health Officials (ASTHO), through a cooperative agreement with the Centers for Disease Control and Prevention (CDC) Office of Public Health Preparedness and Response (OPHPR), led an effort to create an annual measure of health security preparedness at the national level. The collaborative released the National Health Security Preparedness Index (NHSPI(™)) in December 2013 and provided composite results for the 50 states and for the nation as a whole. The Index results represent current levels of health security preparedness in a consistent format and provide actionable information to drive decision making for continuous improvement of the nation's health security. The overall 2013 National Index result was 7.2 on the reported base-10 scale, with areas of greater strength in the domains of health surveillance, incident and information management, and countermeasure management. The strength of the Index relies on the interdependencies of the many elements in health security preparedness, making the sum greater than its parts. Moving forward, additional health security-related disciplines and measures will be included alongside continued validation efforts.

  5. Rural trustees brave the health care funding crisis. Interview by Matthew D. Pavelich.

    PubMed

    Ramstead, O

    1992-01-01

    Ole Ramstead, FCA, this issue's interview subject, is board chair at Parkland Regional Care Centre in Melfort, Saskatchewan. He is also a chartered accountant and income tax specialist. Mr. Ramstead discusses potential changes in Canadian health care directions--such as the amalgamation of hospital governing boards and administrations--and their special impact on rural facilities.

  6. National Health Expenditures, 19801

    PubMed Central

    Gibson, Robert M.; Waldo, Daniel R.

    1981-01-01

    The United States spent an estimated $247 billion for health care in 1980 (Figure 1), an amount equal to 9.4 percent of the Gross National Product (GNP). Highlights of the figures that underlie this estimate include the following: Health care expenditures in 1980 accelerated at a time when the economy as a whole exhibited sluggish growth. The 9.4 percent share of the GNP was a dramatic increase from the 8.9 percent share in 1979.Health care expenditures amounted to $1,067 per person in 1980 (Table 1). Of that amount, $450, or 42.2 percent, came from public funds.Expenditures for health care included $64.9 billion in premiums to private health insurance, $70.9 billion in Federal payments, and $33.3 billion in State and local government funds (Table 2).Hospital care accounted for 40.3 percent of total health care spending in 1980 (Table 3). These expenditures increased 16.2 percent between 1979 and 1980, to a level of $99.6 billion.Spending for the services of physicians increased 14.5 percent to $46.6 billion, 18.9 percent of all health care spending.All third parties combined—private health insurers, governments, philanthropists, and industry—financed 67.6 percent of the $217.9 billion spent for personal health care in 1980 (Table 4), ranging from 90.9 percent of hospital care services to 62.7 percent of physicians' services and 38.5 percent of the remainder (Table 5).Direct payments by consumers reached $70.6 billion in 1980 (Table 6). This accounted for 32.4 percent of all personal health care expenses.Outlays for health care benefits by the Medicare and Medicaid programs totaled $60.6 billion, including $35.8 billion for hospital care. The two programs combined to pay for 27.8 percent of all personal health care in the nation (Table 7). PMID:10309470

  7. Forest health monitoring: 2008 national technical report

    Treesearch

    Kevin M. Potter; Barbara L. Conkling

    2012-01-01

    The Forest Health Monitoring (FHM) Program’s annual national technical report has three objectives: (1) to present forest health status and trends from a national or a multi-State regional perspective using a variety of sources, (2) to introduce new techniques for analyzing forest health data, and (3) to report results of recently completed evaluation monitoring...

  8. The Politico-Economic Challenges of Ghana's National Health Insurance Scheme Implementation.

    PubMed

    Fusheini, Adam

    2016-04-27

    National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs) as a vehicle to universal health coverage (UHC) and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS) as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI) legislation (ACT 650) in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two) and Northern (two) Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under the NHIS requires political stewardship. Political

  9. [The Brazilian National Health Conference: challenges for the country].

    PubMed

    Gadelha, Paulo

    2015-10-01

    This article was published in the context of the upcoming 15th Brazilian National Health Conference and addresses the country's health challenges based on the history of previous conferences. The authors analyze the evolution of health as a public policy agenda, highlighting the role of such institutions as the Brazilian Center for Health Studies (CEBES), the Brazilian Association of Collective Health (Abrasco), and the National Health Council in advocating and establishing the Brazilian Unified National Health System (SUS). The article also focuses on expectations concerning the 15th National Health Conference within a political and economic scenario that raises questions and challenges both for the future of health policy, exemplified by SUS, and the current capacity to mobilize stakeholders.

  10. Study protocol: cross-national comparative case study of recovery-focused mental health care planning and coordination (COCAPP).

    PubMed

    Simpson, Alan; Hannigan, Ben; Coffey, Michael; Jones, Aled; Barlow, Sally; Cohen, Rachel; Všetečková, Jitka; Faulkner, Alison; Haddad, Mark

    2015-07-03

    The collaborative care planning study (COCAPP) is a cross-national comparative study of care planning and coordination in community mental healthcare settings. The context and delivery of mental health care is diverging between the countries of England and Wales whilst retaining points of common interest, hence providing a rich geographical comparison for research. Across England the key vehicle for the provision of recovery-focused, personalised, collaborative mental health care is the care programme approach (CPA). The CPA is a form of case management introduced in England in 1991, then revised in 2008. In Wales the CPA was introduced in 2003 but has now been superseded by The Mental Health (Care Co-ordination and Care and Treatment Planning) (CTP) Regulations (Mental Health Measure), a new statutory framework. In both countries, the CPA/CTP requires providers to: comprehensively assess health/social care needs and risks; develop a written care plan (which may incorporate risk assessments, crisis and contingency plans, advanced directives, relapse prevention plans, etc.) in collaboration with the service user and carer(s); allocate a care coordinator; and regularly review care. The overarching aim of this study is to identify and describe the factors that ensure CPA/CTP care planning and coordination is personalised, recovery-focused and conducted collaboratively. COCAPP will employ a concurrent transformative mixed methods approach with embedded case studies. Phase 1 (Macro-level) will consider the national context through a meta-narrative mapping (MNM) review of national policies and the relevant research literature. Phase 2 (Meso-level and Micro-level) will include in-depth micro-level case studies of everyday 'frontline' practice and experience with detailed qualitative data from interviews and reviews of individual care plans. This will be nested within larger meso-level survey datasets, senior-level interviews and policy reviews in order to provide

  11. [Current evidence on the motivational interview in the approach to health care problems in primary care].

    PubMed

    Bóveda Fontán, Julia; Pérula de Torres, Luis Ángel; Campiñez Navarro, Manuel; Bosch Fontcuberta, Josep M; Barragán Brun, Nieves; Prados Castillejo, Jose Antonio

    2013-11-01

    The motivational interview has been widely used as a clinical method to promote behavioural changes in patients, helping them to resolve their ambivalence to obtain their own motivations. In the present article, a review is made of the main meta-analyses and systematic and narrative reviews on the efficacy of the motivational interview in the primary health care environment. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  12. Nursing and the national policy of education for health care professionals for the Brazilian national Health System.

    PubMed

    Haddad, Ana Estela

    2011-12-01

    The objective of the present article is to identify the aspects and characteristic of creating and implementing the national policy for the administration of health education, over the last six years, with particular emphasis on the central role of nursing undergraduate studied and the profession as a field of knowledge that structures the management of care and the working process in health. The advancements and the current challenges that are posed to implement the National Health System and the role of connecting health care and education administrators and establishing an interfederal network to assure the success of the ongoing initiatives.

  13. Social Determinants of Health in the United States: Addressing Major Health Inequality Trends for the Nation, 1935-2016.

    PubMed

    Singh, Gopal K; Daus, Gem P; Allender, Michelle; Ramey, Christine T; Martin, Elijah K; Perry, Chrisp; Reyes, Andrew A De Los; Vedamuthu, Ivy P

    2017-01-01

    This study describes key population health concepts and examines major empirical trends in US health and healthcare inequalities from 1935 to 2016 according to important social determinants such as race/ethnicity, education, income, poverty, area deprivation, unemployment, housing, rural-urban residence, and geographic location. Long-term trend data from the National Vital Statistics System, National Health Interview Survey, National Survey of Children's Health, American Community Survey, and Behavioral Risk Factor Surveillance System were used to examine racial/ethnic, socioeconomic, rural-urban, and geographic inequalities in health and health care. Life tables, age-adjusted rates, prevalence, and risk ratios were used to examine health differentials, which were tested for statistical significance at the 0.05 level. Life expectancy of Americans increased from 69.7 years in 1950 to 78.8 years in 2015. However, despite the overall improvement, substantial gender and racial/ethnic disparities remained. In 2015, life expectancy was highest for Asian/Pacific Islanders (87.7 years) and lowest for African-Americans (75.7 years). Life expectancy was lower in rural areas and varied from 74.5 years for men in rural areas to 82.4 years for women in large metro areas, with rural-urban disparities increasing during the 1990-2014 time period. Infant mortality rates declined dramatically during the past eight decades. However, racial disparities widened over time; in 2015, black infants had 2.3 times higher mortality than white infants (11.4 vs. 4.9 per 1,000 live births). Infant and child mortality was markedly higher in rural areas and poor communities. Black infants and children in poor, rural communities had nearly three times higher mortality rate compared to those in affluent, rural areas. Racial/ethnic, socioeconomic, and geographic disparities were particularly marked in mortality and/or morbidity from cardiovascular disease, cancer, diabetes, COPD, HIV/AIDS, homicide

  14. Self-reported health as a cultural health determinant in Arab and Jewish Israelis MABAT--National Health and Nutrition Survey 1999-2001.

    PubMed

    Baron-Epel, Orna; Kaplan, Giora; Haviv-Messika, Amalia; Tarabeia, Jalal; Green, Manfred S; Kaluski, Dorit Nitzan

    2005-09-01

    Subjective health (SH) status serves as a measure of health in many studies of health-related issues as it is a good predictor of mortality, morbidity, and use of health services. The measure is used in many population groups. However, the degree to which it measures the same condition in different ethnic groups is not clear. Within Israel's first National Health and Nutrition Survey (MABAT) conducted during 1999-2001, face-to-face interviews were held with 3222 Israeli interviewees, 2379 Jews and 843 Arabs, aged between 25-64 years. Respondents reported their SH, co-morbidity, and other socioeconomic characteristics. Arabs reported higher levels of SH than Jews. In logistic regression analysis, co-morbidity was a much stronger correlate of poorer SH in the Arab than in the Jewish population. The association between socioeconomic variables depended on ethnic group and sex. The findings indicate that SH in Jews and Arabs does not necessarily have the same meaning in relation to objective measures of health, and caution should be exercised in the use of this measure in different population groups with different cultures. Arabs tend to evaluate health better than Jews even though life expectancy is lower and morbidity and mortality are higher in the former population group. Yet diagnosis of a disease increases the frequency of reporting lower SH, more in Arabs than in Jews.

  15. The rudiments of an Internet-based health plan for consumers: an interview with John Danaher, MD, MBA. Interview by Richard L. Reece.

    PubMed

    Danaher, J

    2000-01-01

    Richard L. Reece, MD, interviewed John Danaher, MD, MBA, on August 16, 2000, to discuss how his new company is preparing for the perfect storm--the looming convergence of demanding consumers, defined contributions, and Internet-based health plans. He describes how his firm is putting financial and clinical tools in the hands of consumers and physicians, so consumers can be more enlightened in their health care choices. Danaher says, "We're not about buying goods and services online. We are transforming the way consumers buy health care and seek insurance. We're trying to be a 401 k where people get on, knowing their risk profile and return horizons. We aim to motivate consumers to be proactive in making health care choices. How do we make consumers responsible and motivated enough to take control of managing their health care costs? How well we articulate this call to consumer action will be the key to our success."

  16. 75 FR 48853 - National Health Center Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-11

    ... Part IV The President Proclamation 8545--National Health Center Week, 2010 #0; #0; #0..., 2010 National Health Center Week, 2010 By the President of the United States of America A Proclamation America's community health centers are a vital component of our health care system, providing underserved...

  17. 77 FR 47765 - National Health Center Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-09

    ... Health Center Week, 2012 By the President of the United States of America A Proclamation For nearly half a century, health centers have helped make primary care services available and affordable for... lives. During National Health Center Week, we recognize the professionals who power our Nation's health...

  18. What are the physical and psychological health effects of suicide bereavement on family members? Protocol for an observational and interview mixed-methods study in Ireland.

    PubMed

    Spillane, Ailbhe; Larkin, Celine; Corcoran, Paul; Matvienko-Sikar, Karen; Arensman, Ella

    2017-03-30

    Research indicates that experiencing the suicide of a relative can have a significant impact on family members' emotional health. However, research incorporating the impact of suicide bereavement on family members' physical health is sparse. This paper details the protocol for a mixed-methods study of suicide-bereaved family members. The study will primarily examine the physical and mental health needs of those bereaved by suicide. A secondary objective of the study is to describe the support service needs of family members bereaved by suicide. A mixed-methods approach, using semistructured interviews and self-report questionnaires, will be used. Interviews will be conducted with a group of 15-20 relatives who experienced suicide bereavement. This protocol will follow the COREQ checklist criteria for the reporting of qualitative research interviews. Thematic analysis will be used to examine experiences and impact of bereavement on psychological and physical health. Self-report quantitative data on well-being will be analysed using descriptive statistics. Ethical approval to conduct this study has been granted from the Clinical Research Ethics Committee of the Cork Teaching Hospitals. Pseudonyms will be given to participants to protect anonymity. It will be explained to participants that participation in the study is voluntary and they have to right to withdraw at any time. The findings of this research will be disseminated to regional, national and international audiences through publication in peer-reviewed international journals and presentations at scientific conferences. This research also forms part of a PhD thesis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Conversations on telemental health: listening to remote and rural First Nations communities.

    PubMed

    Gibson, Kerri L; Coulson, Heather; Miles, Roseanne; Kakekakekung, Christal; Daniels, Elizabeth; O'Donnell, Susan

    2011-01-01

    Telemental health involves technologies such as videoconferencing to deliver mental health services and education, and to connect individuals and communities for healing and health. In remote and rural First Nations communities there are often challenges to obtaining mental healthcare in the community and to working with external mental health workers. Telemental health is a service approach and tool that can address some of these challenges and potentially support First Nations communities in their goal of improving mental health and wellbeing. Community members' perspectives on the usefulness and appropriateness of telemental health can greatly influence the level of engagement with the service. It appears that no research or literature exists on First Nations community members' perspectives on telemental health, or even on community perspectives on the broader area of technologies for mental health services. Therefore, this article explores the perspectives on telemental health of community members living in two rural and remote First Nations communities in Ontario, Canada. METHODS; This study was part of the VideoCom project, a collaborative research project exploring how remote and rural First Nations communities are using ICTs. This current exploration was conducted with the support of Keewaytinook Okimakanak (KO), our partner in Northwestern Ontario. With the full collaboration of the communities' leadership, a team involving KO staff and VideoCom researchers visited the two communities in the spring of 2010. Using a participatory research design, we interviewed 59 community members, asking about their experiences with and thoughts on using technologies and their attitudes toward telemental health, specifically. A thematic analysis of this qualitative data and a descriptive quantitative analysis of the information revealed the diversity of attitudes among community members. Finally, based on a discussion with the community telehealth staff, a 'ways forward

  20. Attitudes and perceptions of health professionals towards management of hypothyroidism in general practice: a qualitative interview study

    PubMed Central

    Dew, Rosie; King, Kathryn; Okosieme, Onyebuchi E; Pearce, Simon H; Donovan, Gemma; Taylor, Peter N; Hickey, Janis; Dayan, Colin M; Leese, Graham; Razvi, Salman; Wilkes, Scott

    2018-01-01

    Objective To explore the attitudes and perceptions of health professionals towards management of hypothyroidism that contributes to the suboptimal treatment of hypothyroidism in general practice. Design A qualitative interview study using semistructured interviews. Participants Sixteen participants were interviewed between March and August 2016 comprising nine general practitioners (GPs), four pharmacists, two practice nurses and one nurse practitioner. Setting General practice and community pharmacies in the counties of Northumberland, Tyne and Wear, Stockton-on-Tees and North Cumbria, North of England, UK. Method A grounded-theory approach was used to generate themes from interviews, which were underpinned by the theory of planned behaviour to give explanation to the data. Results Although health professionals felt that hypothyroidism was easy to manage, GPs and nurses generally revealed inadequate knowledge of medication interactions and levothyroxine pharmacokinetics. Pharmacists felt limited in the advice that they provide to patients due to lack of access to patient records. Most GPs and nurses followed local guidelines, and relied on blood tests over clinical symptoms to adjust levothyroxine dose. The information exchanged between professional and patient was usually restricted by time and often centred on symptoms rather than patient education. Health professionals felt that incorrect levothyroxine adherence was the main reason behind suboptimal treatment, although other factors such as comorbidity and concomitant medication were mentioned. Enablers perceived by health professionals to improve the management of hypothyroidism included continuity of care, blood test reminders, system alerts for interfering medications and prescription renewal, and accessible blood tests and levothyroxine prescriptions for patients. Conclusion There is a significant health professional behavioural component to the management of hypothyroidism. Addressing the differences in

  1. The Kenyan national response to internationally agreed sexual and reproductive health and rights goals: a case study of three policies.

    PubMed

    Oronje, Rose N

    2013-11-01

    While priorities for, and decision-making processes on, sexual and reproductive health and rights have been determined and led mainly at the international level, conflicting power dynamics and responses at the national level in some countries have continued to pose challenges for operationalising international agreements. This paper demonstrates how these conflicts have played out in Kenya through an analysis of three policy-making processes, which led to the Adolescent Reproductive Health and Development Policy (2003), the Sexual Offences Act (2006), and the National Reproductive Health Policy (2007). The paper is based on data from a broader study on the drivers and inhibitors of sexual and reproductive health policy reform in Kenya, using a qualitative, case study design. Information was gathered through 54 semi-structured, in-depth interviews with governmental and civil society policy actors and an extensive review of policy documents and media reports. The paper shows that the transformative human rights framing of access to sexual and reproductive health, supported by both a strong global women's rights movement and progressive governmental and inter-governmental actors to defeat opposition to sexual and reproductive health and rights at the international level, has not been as influential or successful at the national level in Kenya, and has made comprehensive national reforms difficult to achieve. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  2. National Health Expenditures, 1996

    PubMed Central

    Levit, Katharine R.; Lazenby, Helen C.; Braden, Bradley R.; Cowan, Cathy A.; Sensenig, Arthur L.; McDonnell, Patricia A.; Stiller, Jean M.; Won, Darleen K.; Martin, Anne B.; Sivarajan, Lekha; Donham, Carolyn S.; Long, Anna M.; Stewart, Madie W.

    1997-01-01

    The national health expenditures (NHE) series presented in this report for 1960-96 provides a view of the economic history of health care in the United States through spending for health care services and the sources financing that care. In 1996 NHE topped $1 trillion. At the same time, spending grew at the slowest rate, 4.4 percent, ever recorded in the current series. For the first time, this article presents estimates of Medicare managed care payments by type of service, as well as nursing home and home health spending in hospital-based facilities. PMID:10179997

  3. [Connection between the knowledge of the recommendations of the National Nutrition and Health Program and patterns of eating behaviour and physical activity].

    PubMed

    Escalon, H; Beck, F; Bossard, C

    2013-02-01

    Nutrition education is one of the main lines of the French nutrition policy that has been undertaken for several years. The underlying hypothesis of this approach is that knowledge improvement is one of the ways likely to contribute to health-enhancing diet and physical activity. The objective of this paper, based on the 2008 Health and nutrition Barometer, is to examine the associations observed between knowledge and behavior with regard to diet and physical activity. The 2008 Health and nutrition Barometer is a nationally representative telephone survey conducted on 4714 individuals aged 12-75 years. For six recommendations of the National Nutrition and Health Program (Programme national nutrition santé [PNNS]), multiple logistic models were used to identify associations between knowledge of these recommendations and behavior, among adults aged 18-75 years. For food consumed on the day before the interview, odds ratios were adjusted for sex, age, education level, agglomeration size and region. As bivariate analysis showed that income level was significant for recommended consumption of fish, this variable was introduced among adjustment variables. Similarly, the variable occupation was introduced for physical activity. A positive association between knowledge of recommendations and nutritional behavior on the day before interview was observed for fruit and vegetables (OR=1.7), dairy products (OR=1.6), and starchy food (OR=1.6). The same was observed for consumption of fish during the 15 days before the interview (OR=5.0) and for physical activity during a usual week (OR=1.5) but not for the "meat, seafood and eggs" food group. Eating habits and physical activity are positively associated with knowledge of nutritional recommendations, mainly acquired via nutritional information and educational actions. Nevertheless, the important differences observed for certain dietary groups between knowledge of recommendations and dietary intake emphasizes the need to further

  4. Equally inequitable? A cross-national comparative study of racial health inequalities in the United States and Canada.

    PubMed

    Ramraj, Chantel; Shahidi, Faraz Vahid; Darity, William; Kawachi, Ichiro; Zuberi, Daniyal; Siddiqi, Arjumand

    2016-07-01

    Prior research suggests that racial inequalities in health vary in magnitude across societies. This paper uses the largest nationally representative samples available to compare racial inequalities in health in the United States and Canada. Data were obtained from ten waves of the National Health Interview Survey (n = 162,271,885) and the Canadian Community Health Survey (n = 19,906,131) from 2000 to 2010. We estimated crude and adjusted odds ratios, and risk differences across racial groups for a range of health outcomes in each country. Patterns of racial health inequalities differed across the United States and Canada. After adjusting for covariates, black-white and Hispanic-white inequalities were relatively larger in the United States, while aboriginal-white inequalities were larger in Canada. In both countries, socioeconomic factors did not explain inequalities across racial groups to the same extent. In conclusion, while racial inequalities in health exist in both the United States and Canada, the magnitudes of these inequalities as well as the racial groups affected by them, differ considerably across the two countries. This suggests that the relationship between race and health varies as a function of the societal context in which it operates. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Daily sleep, weekly working hours, and risk of work-related injury: US National Health Interview Survey (2004-2008).

    PubMed

    Lombardi, David A; Folkard, Simon; Willetts, Joanna L; Smith, Gordon S

    2010-07-01

    The impact on health and safety of the combination of chronic sleep deficits and extended working hours has received worldwide attention. Using the National Health Interview Survey (NHIS), an in-person household survey using a multistage, stratified, clustered sample design representing the US civilian, non-institutionalized population, the authors estimated the effect of total daily self-reported sleep time and weekly working hours on the risk of a work-related injury. During the survey period 2004-2008, 177,576 persons (ages 18-74) sampled within households reported that they worked at a paid job the previous week and reported their total weekly work hours. A randomly selected adult in each household (n = 75,718) was asked to report his/her usual (average) total daily sleep hours the prior week; complete responses were obtained for 74,415 (98.3%) workers. Weighted annualized work-related injury rates were then estimated across a priori defined categories of both average total daily sleep hours and weekly working hours. To account for the complex sampling design, weighted multiple logistic regression was used to independently estimate the risk of a work-related injury for categories of usual daily sleep duration and weekly working hours, controlling for important covariates and potential confounders of age, sex, race/ethnicity, education, type of pay, industry, occupation (proxy for job risk), body mass index, and the interaction between sleep duration and work hours. Based on the inclusion criteria, there were an estimated 129,950,376 workers annually at risk and 3,634,446 work-related medically treated injury episodes (overall injury rate 2.80/100 workers). Unadjusted annualized injury rates/100 workers across weekly work hours were 2.03 (< or =20 h), 3.01 (20-30 h), 2.45 (31-40 h), 3.45 (40-50 h), 3.71 (50-60 h), and 4.34 (>60 h). With regards to self-reported daily sleep time, the estimated annualized injury rates/100 workers were 7.89 (<5 h sleep), 5.21 (5

  6. Cognitive Interviews of Vietnamese Americans on Healthy Eating and Physical Activity Health Educational Materials.

    PubMed

    Nguyen, Bang H; Nguyen, Chi P; McPhee, Stephen J; Stewart, Susan L; Bui-Tong, Ngoc; Nguyen, Tung T

    2015-01-01

    The purpose of this study was to better understand if a health educational presentation using culturally adapted materials was understandable and culturally appropriate, and that the content was retained, in an older Vietnamese American population. This study used cognitive interviewing. A convenient sampling was used to recruit eight participants by staff of a community-based organization from its client base. This is the first study to document that family eating style poses a challenge for estimating food intake among Vietnamese Americans. Participants who ate in a family eating style were not able to recall or estimate the number of servings of protein and vegetables. Some older Vietnamese Americans used food for healing and self-adjusted portion sizes from dietary recommendations. Cognitive interviewing is a useful method to improve comprehension, retention, and cultural appropriateness of health educational materials. Further nutrition research concerning intake measurement in ethnic groups that practice a family eating style is warranted.

  7. Cross-national diffusion of mental health policy

    PubMed Central

    Shen, Gordon C

    2014-01-01

    Background: Following the tenets of world polity and innovation diffusion theories, I focus on the coercive and mimetic forces that influence the diffusion of mental health policy across nations. International organizations’ mandates influence government behavior. Dependency on external resources, namely foreign aid, also affects governments’ formulation of national policy. And finally, mounting adoption in a region alters the risk, benefits, and information associated with a given policy. Methods: I use post-war, discrete time data spanning 1950 to 2011 and describing 193 nations’ mental health systems to test these diffusion mechanisms. Results: I find that the adoption of mental health policy is highly clustered temporally and spatially. Results provide support that membership in the World Health Organization (WHO), interdependence with neighbors and peers in regional blocs, national income status, and migrant sub-population are responsible for isomorphism. Aid, however, is an insufficient determinant of mental health policy adoption. Conclusion: This study examines the extent to which mental, neurological, and substance use disorder are addressed in national and international contexts through the lens of policy diffusion theory. It also adds to policy dialogues about non-communicable diseases as nascent items on the global health agenda. PMID:25337601

  8. Mechanisms of motivational interviewing in health promotion: a Bayesian mediation analysis

    PubMed Central

    2012-01-01

    Background Counselor behaviors that mediate the efficacy of motivational interviewing (MI) are not well understood, especially when applied to health behavior promotion. We hypothesized that client change talk mediates the relationship between counselor variables and subsequent client behavior change. Methods Purposeful sampling identified individuals from a prospective randomized worksite trial using an MI intervention to promote firefighters’ healthy diet and regular exercise that increased dietary intake of fruits and vegetables (n = 21) or did not increase intake of fruits and vegetables (n = 22). MI interactions were coded using the Motivational Interviewing Skill Code (MISC 2.1) to categorize counselor and firefighter verbal utterances. Both Bayesian and frequentist mediation analyses were used to investigate whether client change talk mediated the relationship between counselor skills and behavior change. Results Counselors’ global spirit, empathy, and direction and MI-consistent behavioral counts (e.g., reflections, open questions, affirmations, emphasize control) significantly correlated with firefighters’ total client change talk utterances (rs = 0.42, 0.40, 0.30, and 0.61, respectively), which correlated significantly with their fruit and vegetable intake increase (r = 0.33). Both Bayesian and frequentist mediation analyses demonstrated that findings were consistent with hypotheses, such that total client change talk mediated the relationship between counselor’s skills—MI-consistent behaviors [Bayesian mediated effect: αβ = .06 (.03), 95% CI = .02, .12] and MI spirit [Bayesian mediated effect: αβ = .06 (.03), 95% CI = .01, .13]—and increased fruit and vegetable consumption. Conclusion Motivational interviewing is a resource- and time-intensive intervention, and is currently being applied in many arenas. Previous research has identified the importance of counselor behaviors and client change talk in the

  9. Forest health monitoring: 2004 national technical report

    Treesearch

    John W. Coulston; Mark J. Ambrose; Kurt H. Riitters; Barbara L. Conkling

    2005-01-01

    The Forest Health Monitoring (FHM) Program’s annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. Results presented in the report pertain to the Santiago Declaration’s Criterion 1— Conservation of Biological Diversity and Criterion 3—Maintenance of Forest Ecosystem Health and...

  10. National Health Expenditures, 1993

    PubMed Central

    Levit, Katharine R.; Sensenig, Arthur L.; Cowan, Cathy A.; Lazenby, Helen C.; McDonnell, Patricia A.; Won, Darleen K.; Sivarajan, Lekha; Stiller, Jean M.; Donham, Carolyn S.; Stewart, Madie S.

    1994-01-01

    This article presents data on health care spending for the United States, covering expenditures for various types of medical services and products and their sources of funding from 1960 to 1993. Although these statistics show a slowing in the growth of health care expenditures over the past few years, spending continues to increase faster than the overall economy. The share of the Nation's health care bill funded by the Federal Government through the Medicaid and Medicare programs steadily increased from 1991 to 1993. This significant change in the share of health expenditures funded by the public sector has caused Federal health expenditures as a share of all Federal spending to increase dramatically. PMID:10140156

  11. Using the cognitive interviewing process to improve survey design by allied health: A qualitative study.

    PubMed

    Howlett, Owen; McKinstry, Carol; Lannin, Natasha A

    2018-04-01

    Allied health professionals frequently use surveys to collect data for clinical practice and service improvement projects. Careful development and piloting of purpose-designed surveys is important to ensure intended measuring (that respondents correctly interpret survey items when responding). Cognitive interviewing is a specific technique that can improve the design of self-administered surveys. The aim of this study was to describe the use of the cognitive interviewing process to improve survey design, which involved a purpose-designed, online survey evaluating staff use of functional electrical stimulation. A qualitative study involving one round of cognitive interviewing with three occupational therapists and three physiotherapists. The cognitive interviewing process identified 11 issues with the draft survey, which could potentially influence the validity and quality of responses. The raised issues included difficulties with: processing the question to be able to respond, determining a response to the question, retrieving relevant information from memory and comprehending the written question. Twelve survey amendments were made following the cognitive interviewing process, comprising four additions, seven revisions and one correction. The cognitive interviewing process applied during the development of a purpose-designed survey enabled the identification of potential problems and informed revisions to the survey prior to its use. © 2017 Occupational Therapy Australia.

  12. National Health Expenditures, 19811

    PubMed Central

    Gibson, Robert M.; Waldo, Daniel R.

    1982-01-01

    The United States spent an estimated $287 billion for health care in 1981 (Figure 1), an amount equal to 9.8 percent of the Gross National Product (GNP). Highlights of the figures that underly this estimate include the following: Health care expenditures continued to grow at a rapid rate in 1981, at a time when the economy as a whole exhibited sluggish growth. The 9.8 percent share of the GNP was a dramatic increase from the 8.9 percent share seen just two years earlier.Health care expenditures amounted to $1,225 per person in 1981 (Table 1). Of that amount, $524, or 42.7 percent, came from public funds.Hospital care accounted for 41.2 percent of total health care spending in 1981 (Table 2). These expenditures increased 17.5 percent from 1980, to a level of $118 billion.Spending for the services of physicians increased 16.9 percent to $55 billion—19.1 percent of all health care spending.Public sources provided 42.7 percent of the money spent on health in 1981, including Federal payments of $84 billion and $39 billion in State and local government funds (Table 3).All third parties combined—private health insurers, governments, private charities, and Industry—financed 67.9 percent of the $255 billion in personal health care in 1981 (Table 4), covering 89.2 percent of hospital care services, 62.1 percent of physicians' services, and 41.3 percent of the remainder (Table 5).Direct patient payments for health care reached $82 billion in 1981, accounting for 32.1 percent of all personal health care expenses (Table 6). Consumers and their employers paid another $73 billion in premiums to private health insurers, $67 billion of which was returned in the form of benefits.Outlays for health care benefits by the Medicare and Medicaid programs totaled $73 billion, including $42 billion for hospital care. The two programs combined paid for 28.6 percent of all personal health care in the nation (Table 7). PMID:10309718

  13. [The use of interviews in participative intervention and research: the GAM tool as a collective interview].

    PubMed

    Sade, Christian; de Barros, Leticia Maria Renault; Melo, Jorge José Maciel; Passos, Eduardo

    2013-10-01

    This paper seeks to assess a way of conducting interviews in line with the ideology of Brazilian Psychiatric Reform. In the methodology of participative intervention and research in mental health, the interview is less a data collection than a data harvesting procedure. It is designed to apply the principles of psychosocial care, autonomy as the basis for treatment, the predominance of the users and of their social networks and civic participation. Inspired by the Explicitation Interview technique, the contention is that the handling of the interview presupposes an open attitude able to promote and embrace different viewpoints. This attitude makes the interview a collective experience of sharing and belonging, allowing participants to reposition themselves subjectively in treatment with the emergence of groupality. As an example of using the interview as a methodological tool in mental health research, we examine research into adaptation of the tool of Autonomous Medication Management (GAM). It is an interventionist approach guided by principles that foster autonomy and the protagonist status of users of psychotropic medication, their quality of life, their rights and recognition of the multiple significances of medication, understood here as a collective interview technique.

  14. Changes in physical functioning among men and women aged 50-79 years in Germany: an analysis of National Health Interview and Examination Surveys, 1997-1999 and 2008-2011.

    PubMed

    Buttery, A K; Du, Y; Busch, M A; Fuchs, J; Gaertner, B; Knopf, H; Scheidt-Nave, C

    2016-12-01

    This study examines changes in physical functioning among adults aged 50-79 years in Germany based on data from two German National Health Interview and Examination Surveys conducted in 1997-1999 (GNHIES98) and 2008-2011 (DEGS1). Using cross-sectional data from the two surveys (GNHIES98, n = 2884 and DEGS1, n = 3732), we examined changes in self-reported physical functioning scores (Short Form-36 physical functioning subscale (SF-36 PF)) by sex and age groups (50-64 and 65-79 years). Covariables included educational level, living alone, nine chronic diseases, polypharmacy (≥5 prescribed medicines), body mass index, sports activity, smoking and alcohol consumption. Multimorbidity was defined as ≥2 chronic diseases. Multivariable models were fitted to examine consistency of changes in physical functioning among certain subgroups and to assess changes in mean SF-36 PF scores, adjusting for changes in covariables between surveys. Mean physical functioning increased among adults aged 50-79 years between surveys in unadjusted analyses, but this change was not as marked among men aged 65-79 years who experienced rising obesity (20.6 to 31.5%, p = 0.004) and diabetes (13.0 to 20.0%, p = 0.014). Prevalence of multimorbidity and polypharmacy use increased among men and women aged 65-79 years. In sex and age specific multivariable analyses, changes in physical functioning over time were consistent across subgroups. Gains in physical functioning were explained by improved education, lower body mass index and improved health-related behaviours (smoking, alcohol consumption, sports activity) in women, but less so among men. Physical functioning improved in Germany among adults aged 50-79 years. Improvements in the population 65-79 years were less evident among men than women, despite increases in multimorbidity prevalence among both sexes. Changes in health behaviours over time differed between sexes and help explain variations in physical functioning

  15. Online health information search and evaluation: observations and semi-structured interviews with college students and maternal health experts.

    PubMed

    Kim, Hyojin; Park, Sun-Young; Bozeman, Ingrid

    2011-09-01

    While the Internet is a popular source of health information, health seekers' inadequate skills to locate and discern quality information pose a potential threat to their healthcare decision-making. We aimed to examine health information search and appraisal behaviours among young, heavy users of the Internet. In study 1, we observed and interviewed 11 college students about their search strategies and evaluation of websites. In study 2, three health experts evaluated two websites selected as the best information sources in study 1. Familiarity with health websites and confidence in search strategies were major factors affecting search and evaluation behaviours. Website quality was mostly judged by aesthetics and peripheral cues of source credibility and message credibility. In contrast to users' favourable website evaluation, the experts judged the websites to be inappropriate and untrustworthy. Our results highlight a critical need to provide young health seekers with resources and training that are specifically geared toward health information search and appraisal. The role of health seekers' knowledge and involvement with the health issue in search effort and success warrants future research. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  16. Toward a national health risk management approach in Australia.

    PubMed

    O'Donnell, Carol

    2002-01-01

    There has been increasing international consensus about the importance of competition for achieving national growth and community well-being. The Australian government accordingly has introduced policies to promote such competition. Major legislative review and many public inquiries have assisted implementation of national competition policy and the development of national goals and standards related to international agreements to promote health and sustainable development. Since the 1980s, Australia has had legislation that requires the identification and control of health risks arising at work. The management structures necessary for coordinated delivery of national programs designed for effective identification and control of health risks arising in communities to achieve national health and development goals are still being developed, however. Major difficulties related to this development are discussed. National health development programs should be approached primarily through establishment of regional partnerships between bodies responsible for managing community health, local government, and employment placement, in consultation with other relevant organizations and the community. Related research and evaluation programs are required.

  17. Disability, Health Insurance Coverage, and Utilization of Acute Health Services in the United States. Disability Statistics Report 4.

    ERIC Educational Resources Information Center

    LaPlante, Mitchell P.

    This report uses data from the 1989 National Health Interview Survey to estimate health insurance coverage of children and nonelderly adults with disabilities and their utilization of physician and hospital care as a function of health insurance status. In part 1, national statistics on disability and insurance status are provided for different…

  18. 14 CFR § 1213.105 - Interviews.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Interviews. § 1213.105 Section § 1213.105 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION RELEASE OF INFORMATION TO NEWS AND INFORMATION MEDIA § 1213.105 Interviews. (a) Only spokespersons designated by the Assistant Administrator for...

  19. The utilization of research evidence in Health Workforce Policies: the perspectives of Portuguese and Brazilian National Policy-Makers.

    PubMed

    Craveiro, Isabel; Hortale, Virginia; Oliveira, Ana Paula Cavalcante de; Dal Poz, Mario; Portela, Gustavo; Dussault, Gilles

    2018-03-01

    The production of knowledge on Human Resources for Health (HRH) issues has increased exponentially since 2000 but integration of the research in the policy-making process is often lagging. We looked at how research on HRH contributes or not to inform policy decisions and interventions affecting the health workforce in Portugal and Brazil. We designed a comparative case study of semi-structured interviews with present and past national decision-makers, policy advisors and researchers. Issues explored included the existence of a national HRH policy and the use, or non-use, of research evidence by policy makers and reasons to do so. Interviews were audio recorded, transcribed, anonymized and analysed thematically. Policy-makers in Brazil recognize a greater use of evidence in the process of defining HRH policy when compared to Portugal's. But the existence of formal instruments to support policy development is not sufficient to ensure that policies are informed by evidence. In both countries the importance of the use of evidence in the formulation of policies was recognized by policy-makers. However, the influence of other factors, such as political pressures from various lobby groups and from the media and the policy short timeframe which requires rapid responses, is predominant.

  20. Developing the national community health assistant strategy in Zambia: a policy analysis

    PubMed Central

    2013-01-01

    Background In 2010, the Ministry of Health in Zambia developed the National Community Health Assistant strategy, aiming to integrate community health workers (CHWs) into national health plans by creating a new group of workers, called community health assistants (CHAs). The aim of the paper is to analyse the CHA policy development process and the factors that influenced its evolution and content. A policy analysis approach was used to analyse the policy reform process. Methodology Data were gathered through review of documents, participant observation and key informant interviews with CHA strategic team members in Lusaka district, and senior officials at the district level in Kapiri Mposhi district where some CHAs have been deployed. Results The strategy was developed in order to address the human resources for health shortage and the challenges facing the community-based health workforce in Zambia. However, some actors within the strategic team were more influential than others in informing the policy agenda, determining the process, and shaping the content. These actors negotiated with professional/statutory bodies and health unions on the need to develop the new cadre which resulted in compromises that enabled the policy process to move forward. International agencies also indirectly influenced the course as well as the content of the strategy. Some actors classified the process as both insufficiently consultative and rushed. Due to limited consultation, it was suggested that the policy content did not adequately address key policy content issues such as management of staff attrition, general professional development, and progression matters. Analysis of the process also showed that the strategy might create a new group of workers whose mandate is unclear to the existing group of health workers. Conclusions This paper highlights the complex nature of policy-making processes for integrating CHWs into the health system. It reiterates the need for recognising the

  1. Developing the national community health assistant strategy in Zambia: a policy analysis.

    PubMed

    Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

    2013-07-20

    In 2010, the Ministry of Health in Zambia developed the National Community Health Assistant strategy, aiming to integrate community health workers (CHWs) into national health plans by creating a new group of workers, called community health assistants (CHAs). The aim of the paper is to analyse the CHA policy development process and the factors that influenced its evolution and content. A policy analysis approach was used to analyse the policy reform process. Data were gathered through review of documents, participant observation and key informant interviews with CHA strategic team members in Lusaka district, and senior officials at the district level in Kapiri Mposhi district where some CHAs have been deployed. The strategy was developed in order to address the human resources for health shortage and the challenges facing the community-based health workforce in Zambia. However, some actors within the strategic team were more influential than others in informing the policy agenda, determining the process, and shaping the content. These actors negotiated with professional/statutory bodies and health unions on the need to develop the new cadre which resulted in compromises that enabled the policy process to move forward. International agencies also indirectly influenced the course as well as the content of the strategy. Some actors classified the process as both insufficiently consultative and rushed. Due to limited consultation, it was suggested that the policy content did not adequately address key policy content issues such as management of staff attrition, general professional development, and progression matters. Analysis of the process also showed that the strategy might create a new group of workers whose mandate is unclear to the existing group of health workers. This paper highlights the complex nature of policy-making processes for integrating CHWs into the health system. It reiterates the need for recognising the fact that actors' power or position in the

  2. 'I felt a little bubbly in my tummy': eliciting pre-schoolers' accounts of their health visit using a computer-assisted interview method.

    PubMed

    Bokström, P; Fängström, K; Calam, R; Lucas, S; Sarkadi, A

    2016-01-01

    In the health care services, children's rights to participate in all matters that concern them are considered important. However, in practice this can be challenging with young children. In My Shoes (IMS) is a computer-assisted interview tool developed to help children talk about their experiences. The aim of the study was to evaluate the IMS' ability to elicit pre-schoolers' subjective experiences and accurate accounts of a routine health visit as well as the children's engagement in the interview process. Interviews were conducted with 23 children aged 4-5 years, 2-4 weeks after their health visit. The interviews were transcribed verbatim and analysed using a method inspired by Content Analysis to evaluate IMS's ability to elicit accounts about subjective experiences. Accurate accounts were assessed by comparing the transcribed interviews with the filmed visits at the child health centre. The children's engagement was defined by the completion and length of the interviews, and the children's interaction with the software. All children gave accounts about their subjective experiences, such as their emotional state during the visit, available toys or rewards they received. All children related to the correct event, they all named at least one person who was present and 87% correctly named at least one examination procedure. The majority of children (91%) completed the interview, which lasted 17-39 min (M = 24), and 96% interacted with the IMS software. IMS was feasible to help children describe their health care experiences, in both detail and depth. The children interacted with the software and maintained their interest for an extended period of time. © 2015 John Wiley & Sons Ltd.

  3. Benefits and problems of electronic information exchange as perceived by health care professionals: an interview study

    PubMed Central

    2011-01-01

    Background Various countries are currently implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs, their overall adoption remains low and meets resistance from health care providers. This study aims to increase our understanding of health care providers' attitude towards the n-EPR, by investigating their perceptions of the benefits and problems of electronic information exchange in health care and the n-EPR in particular. Methods The study was conducted in three Dutch health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, interviews were conducted with 17 stakeholders working in these organisations. Relevant themes were deduced by means of thematic qualitative analysis. Results Health care providers perceived electronic information exchange to promote the efficiency and quality of care. The problems they perceived in electronic information exchange mainly concerned the confidentiality and safety of information exchange and the reliability and quality of patient data. Many problems perceived by health care providers did not specifically apply to the n-EPR, but to electronic information exchange in general. Conclusions The implementation of the Dutch n-EPR has mainly followed a top-down approach, thereby neglecting the fact that the perceptions and preferences of its users (health care providers) need to be addressed in order to achieve successful implementation. The results of this study provide valuable suggestions about how to promote health care providers' willingness to adopt electronic information exchange, which can be useful for other countries currently implementing an n-EPR. Apart from providing information about the benefits and usefulness of electronic information exchange, efforts should be focused on minimising the problems as perceived by health care providers. The safety and

  4. Benefits and problems of electronic information exchange as perceived by health care professionals: an interview study.

    PubMed

    Zwaanswijk, Marieke; Verheij, Robert A; Wiesman, Floris J; Friele, Roland D

    2011-10-07

    Various countries are currently implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs, their overall adoption remains low and meets resistance from health care providers. This study aims to increase our understanding of health care providers' attitude towards the n-EPR, by investigating their perceptions of the benefits and problems of electronic information exchange in health care and the n-EPR in particular. The study was conducted in three Dutch health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, interviews were conducted with 17 stakeholders working in these organisations. Relevant themes were deduced by means of thematic qualitative analysis. Health care providers perceived electronic information exchange to promote the efficiency and quality of care. The problems they perceived in electronic information exchange mainly concerned the confidentiality and safety of information exchange and the reliability and quality of patient data. Many problems perceived by health care providers did not specifically apply to the n-EPR, but to electronic information exchange in general. The implementation of the Dutch n-EPR has mainly followed a top-down approach, thereby neglecting the fact that the perceptions and preferences of its users (health care providers) need to be addressed in order to achieve successful implementation. The results of this study provide valuable suggestions about how to promote health care providers' willingness to adopt electronic information exchange, which can be useful for other countries currently implementing an n-EPR. Apart from providing information about the benefits and usefulness of electronic information exchange, efforts should be focused on minimising the problems as perceived by health care providers. The safety and confidentiality of electronic information exchange

  5. NATIONAL ORAL HEALTH SURVEILLANCE SYSTEM (NOHSS)

    EPA Science Inventory

    National Oral Health Surveillance System (NOHSS) is a collaborative effort between CDC's Division of Oral Health and The Association of State and Territorial Dental Directors (ASTDD). NOHSS is designed to help public health programs monitor the burden of oral disease, use of the ...

  6. Do surgeon interviewers have human factor-related issues during the long day UK National Trauma and Orthopaedic specialty recruitment process?

    PubMed

    Scrimgeour, D S G; Higgins, J; Bucknall, V; Arnett, R; Featherstone, C R; Cleland, J; Lee, A J; Brennan, P A

    2018-03-05

    The role that human factors (HF) play in contributing to medical error is increasingly being recognised by healthcare professionals. Surprisingly, much less is known about the possible effects of HF including boredom, fatigue and organisational influences, on performance outside of the clinical environment such as examining or assessing candidates in other high stakes situations. The authors used a validated 38 response questionnaire based around the HF analysis and classification system (HFACS) to assess factors including stress and pressure, care and support and working within the rules for surgeon interviewers at the UK national trainee selection process in Trauma and Orthopaedic surgery. 121 completed questionnaires were analysed (86% response rate). No statistically significant differences were found between interviewer experience, grade or role at the interview and the mean scores obtained for all four factor items. Overall interviewers had a positive experience during national selection with mean factor scores ranging from 3.80 to 3.98 (out of a maximum satisfaction score of 5). Careful planning by organisations and recognising the importance of the human element are essential to ensure assessors are looked after properly during high stakes assessment processes. Our data suggests that a positive experience for examiners is likely to benefit candidate performance and contribute to a fair and reliable recruitment process. The relationship between examiner experience and candidate performance merits further investigation. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  7. Kenneth W. Kizer on a national quality strategy. Interview by Lori Blades and Patricia A. Cholewka.

    PubMed

    Kizer, K W

    2000-01-01

    Kenneth W. Kizer, MD MPH, is president and chief executive officer (CEO) of the National Forum for Health Care Quality Measurement and Reporting (National Quality Forum [NQF]), a not-for-profit membership organization created to develop and implement a national strategy for measuring and reporting healthcare quality. Dr. Kizer previously served as Under Secretary for Health in the U.S. Department of Veterans Affairs (VA) and is widely credited as being the chief architect of and driving force behind the greatest transformation of VA healthcare since its creation in 1946. NQF is a public-private partnership designed to involve all segments of the nation's healthcare system. The organization was proposed as part of the findings of the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry (1998). Since the release of those findings, leaders from consumer, purchaser, provider, health plan, and health services research organizations, as well as from government, have met to define the mission, structure, and financing of NQF, and staff support has been provided by the United Hospital Fund of New York. NQF is primarily a membership dues- and grant-financed organization and has received significant public and private funding from foundation and corporate grants, including a $2.5-million founding grant from the Robert-Wood Johnson Foundation and a $1-million founding grant from the California Healthcare Foundation. NQF also received initial financial support from The Commonwealth Fund and United Hospital Fund.

  8. [Methodological design for the National Survey Violence Against Women in Mexico].

    PubMed

    Olaiz, Gustavo; Franco, Aurora; Palma, Oswaldo; Echarri, Carlos; Valdez, Rosario; Herrera, Cristina

    2006-01-01

    To describe the methodology, the research designs used, the estimation and sample selection, variable definitions, collection instruments, and operative design and analytical procedures for the National Survey Violence Against Women in Mexico. A complex (two-step) cross-sectional study was designed and the qualitative design was carried out using in-depth interviews and participant observation in health care units. We obtained for the quantitative study a total of 26 240 interviews in women users of health services and 2 636 questionnaires for health workers; the survey is representative of the 32 Mexican states. For the qualitative study 26 in-depth interviews were conducted with female users and 60 interviews with health workers in the States of Quintana Roo, Coahuila and the Federal District.

  9. National Health Insurance by Regulation: Mandated Employee Benefits,

    DTIC Science & Technology

    1980-04-01

    A0AO95 050 RANW CORP SANTA MONICA CA F/0 S/I1 NATIONAL HEALTH INSURANCE BY REKULATION: MANDATED EMPLOYEE NE-TC(U) APR 80 C E PI4ELPS LICLASSIFIED...31 ! 9 : I NATIONAL HEALTH INSURANCE BY REGULATION: MANDATED EMPLOYEE BENEFITS 1 I. INTRODUCTION Social issues have often been solved...offer a variety of insurance packages to employees , iThis paper was presented at the Conference on "National Health Insurance: Ihat Now, What Later, What

  10. Clinical Differences Among Patients Treated for Mental Health Problems in General Medical and Specialty Mental Health Settings in the National Comorbidity Survey Replication (NCS-R)

    PubMed Central

    Uebelacker, Lisa A.; Wang, Philip S.; Berglund, Patricia; Kessler, Ronald C.

    2009-01-01

    Objective General medical (GM) treatments for mental health disorders are less likely to be adequate than specialty mental health (SMH) treatments. We explored whether differences in clinical characteristics of patients treated in each sector (GM-only or SMH-only) or in both sectors (GM + SMH) may help to explain this finding. Method We analyzed data from the National Comorbidity Survey Replication (NCS-R), a nationally representative household survey of 5692 English-speaking adult household residents that was carried out in 2001–03. The NCS-R used a fully-structured diagnostic interview to assess DSM-IV disorders, including mood, anxiety, impulse-control, and substance use disorders. We classified disorders in terms of a three-category severity gradient (serious, moderate, mild) based on information about clinically significant distress and role impairment. We collected self-report data on chronic physical conditions, socio-demographics, and type of treatment received for emotional and substance use problems in the 12 months before the interview. Results Patients who received GM+SMH treatment had more severe mental disorders and a higher prevalence of mood and anxiety disorders than patients who received treatment in only one of the two sectors. Patients seen in the GM-only and GM+SMH had more chronic physical conditions than patients seen in SMH-only. Conclusions Patient characteristics may partially explain the lower intensity and adequacy of GM treatment. PMID:16950373

  11. Health care providers' perceived barriers to and need for the implementation of a national integrated health care standard on childhood obesity in the Netherlands - a mixed methods approach.

    PubMed

    Schalkwijk, Annemarie A H; Nijpels, Giel; Bot, Sandra D M; Elders, Petra J M

    2016-03-08

    In 2010, a national integrated health care standard for (childhood) obesity was published and disseminated in the Netherlands. The aim of this study is to gain insight into the needs of health care providers and the barriers they face in terms of implementing this integrated health care standard. A mixed-methods approach was applied using focus groups, semi-structured, face-to-face interviews and an e-mail-based internet survey. The study's participants included: general practitioners (GPs) (focus groups); health care providers in different professions (face-to-face interviews) and health care providers, including GPs; youth health care workers; pediatricians; dieticians; psychologists and physiotherapists (survey). First, the transcripts from the focus groups were analyzed thematically. The themes identified in this process were then used to analyze the interviews. The results of the analysis of the qualitative data were used to construct the statements used in the e-mail-based internet survey. Responses to items were measured on a 5-point Likert scale and were categorized into three outcomes: 'agree' or 'important' (response categories 1 and 2), 'disagree' or 'not important'. Twenty-seven of the GPs that were invited (51 %) participated in four focus groups. Seven of the nine health care professionals that were invited (78 %) participated in the interviews and 222 questionnaires (17 %) were returned and included in the analysis. The following key barriers were identified with regard to the implementation of the integrated health care standard: reluctance to raise the subject; perceived lack of motivation and knowledge on the part of the parents; previous negative experiences with lifestyle programs; financial constraints and the lack of a structured multidisciplinary approach. The main needs identified were: increased knowledge and awareness on the part of both health care providers and parents/children; a social map of effective intervention; structural

  12. Assessing health information technology in a national health care system--an example from Taiwan.

    PubMed

    Chi, Chunhuei; Lee, Jwo-Leun; Schoon, Rebecca

    2012-01-01

    The purpose of this article is to investigate one core research question: How can health information technology (HIT) be assessed in a national health care system context? We examine this question by taking a systematic approach within a national care system, in which the purpose of HIT is to contribute to a common national health care system's goal. to promote population health in an efficient way. Based on this approach we first develop a framework and our criteria of assessment, and then using Taiwan as a case study, demonstrate how one can apply this framework to assess a national system's HIT. The five criteria we developed are how well does the HIT (1) provide accessible and accurate public health and health care information to the population; (2) collect and provide population health and health care data for government and researchers to analyze population health and processes and outcomes of health care services, (3) provide accessible and timely information that helps to improve provision of cost-effective health care at an institutional level and promotes system-wide efficiency; (4) minimize transaction and administrative costs of the health care system; and (5) establish channels for population participation in governance while also protecting individual privacy. The results indicate that Taiwan has high levels of achievement in two criteria while falling short in the other three. Major lessons we learned from this study are that HIT exists to serve a health care system, and the national health care system context dictates how one assesses its HIT. There is a large body of literature published on the implementation of HIT and its impact on the quality and cost of health care delivery. The vast majority of the literature, however, is focused on a micro institutional level such as a hospital or a bit higher up, on an HMO or health insurance firm. Few have gone further to evaluate the implementation of HIT and its impact on a national health care system

  13. Forest health monitoring: 2002 national technical report

    Treesearch

    John W. Coulston; Mark J. Ambrose; Kurt H. Riitters; Barbara L. Conkling

    2005-01-01

    The Forest Health Monitoring (FHM) Program’s annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. This annual report focuses on “Criterion 3—Maintenance of Forest Ecosystem Health and Vitality” from the “Criteria and Indicators of Sustainable Forestry of the Santiago Declaration”...

  14. Service user engagement: A co-created interview schedule exploring mental health recovery in young adults.

    PubMed

    McCauley, Claire-Odile; McKenna, Hugh; Keeney, Sinead; McLaughlin, Derek

    2017-10-01

    The aim of this study was to co-create of an interview schedule exploring mental health recovery in collaboration with young adult service users. Service user involvement in research has been increasingly recognized as providing a vital authentic insight into mental health recovery. Engagement and collaboration with service users have facilitated the exploration of inaccessible or under-investigated aspects of the lived experience of mental health recovery, not only directing the trajectory of research, but making it relevant to their own contextual experience. A qualitative content analysis framework was employed in the co-creation of a semi-structured interview schedule through an engagement process with service users. Two separate engagement groups took place at the premises of the service user organizations, between January - February 2014. Miles and Huberman's analysis framework was chosen for this phase as it enabled the visual presentation of factors, concepts or variables and the established relationship between them. The lived experience of mental ill health in young adulthood and how this was understood by others was a particularly relevant theme for participants. Further themes were identified between the impact of painful experiences at this developmental life stage leading to a deeper understanding of others through finding meaning in their own mental health recovery journey. Our findings identified that suffering painful experiences is an integral aspect in the process of mental health recovery. This understanding has particular relevance to mental health nursing practice, ensuring the care delivered is cognizant of the suffering or painful experiences that young adults are encountering. © 2017 John Wiley & Sons Ltd.

  15. Generating Health Estimates by Zip Code: A Semiparametric Small Area Estimation Approach Using the California Health Interview Survey.

    PubMed

    Wang, Yueyan; Ponce, Ninez A; Wang, Pan; Opsomer, Jean D; Yu, Hongjian

    2015-12-01

    We propose a method to meet challenges in generating health estimates for granular geographic areas in which the survey sample size is extremely small. Our generalized linear mixed model predicts health outcomes using both individual-level and neighborhood-level predictors. The model's feature of nonparametric smoothing function on neighborhood-level variables better captures the association between neighborhood environment and the outcome. Using 2011 to 2012 data from the California Health Interview Survey, we demonstrate an empirical application of this method to estimate the fraction of residents without health insurance for Zip Code Tabulation Areas (ZCTAs). Our method generated stable estimates of uninsurance for 1519 of 1765 ZCTAs (86%) in California. For some areas with great socioeconomic diversity across adjacent neighborhoods, such as Los Angeles County, the modeled uninsured estimates revealed much heterogeneity among geographically adjacent ZCTAs. The proposed method can increase the value of health surveys by providing modeled estimates for health data at a granular geographic level. It can account for variations in health outcomes at the neighborhood level as a result of both socioeconomic characteristics and geographic locations.

  16. The National Mental Health Registry (NMHR).

    PubMed

    Aziz, A A; Salina, A A; Abdul Kadir, A B; Badiah, Y; Cheah, Y C; Nor Hayati, A; Ruzanna, Z Z; Sharifah Suziah, S M; Chee, K Y

    2008-09-01

    The National Mental Health Registry (NMHR) collects information about patients with mental disorder in Malaysia. This information allows us to estimate the incidence of selected mental disorders, and to evaluate risk factors and treatment in the country. The National Mental Health Registry (NMHR) presented its first report in 2004, a year after its establishment. The report focused on schizophrenia as a pioneer project for the National Mental Health Registry. The development of the registry has progressed with data collected from government-based facilities, the academia and the private sector. The 2003-2005 report was recently published and distributed. Since then the registry has progressed to include suicides and other mental illnesses such as depression. The NMHR Report 2003-2005 provides detailed information about the profile of persons with Schizophrenia who presented for the first time to various psychiatry and mental health providers throughout Malaysia. More detailed description regarding pharmacotherapy is reported and few cross tabulations done in an effort to provide better understanding and more clinically meaningful reports.

  17. The United Nations and One Health: the International Health Regulations (2005) and global health security.

    PubMed

    Nuttall, I; Miyagishima, K; Roth, C; de La Rocque, S

    2014-08-01

    The One Health approach encompasses multiple themes and can be understood from many different perspectives. This paper expresses the viewpoint of those in charge of responding to public health events of international concern and, in particular, to outbreaks of zoonotic disease. Several international organisations are involved in responding to such outbreaks, including the United Nations (UN) and its technical agencies; principally, the Food and Agriculture Organization of the UN (FAO) and the World Health Organization (WHO); UN funds and programmes, such as the United Nations Development Programme, the World Food Programme, the United Nations Environment Programme, the United Nations Children's Fund; the UN-linked multilateral banking system (the World Bank and regional development banks); and partner organisations, such as the World Organisation for Animal Health (OIE). All of these organisations have benefited from the experiences gained during zoonotic disease outbreaks over the last decade, developing common approaches and mechanisms to foster good governance, promote policies that cut across different sectors, target investment more effectively and strengthen global and national capacities for dealing with emerging crises. Coordination among the various UN agencies and creating partnerships with related organisations have helped to improve disease surveillance in all countries, enabling more efficient detection of disease outbreaks and a faster response, greater transparency and stakeholder engagement and improved public health. The need to build more robust national public human and animal health systems, which are based on good governance and comply with the International Health Regulations (2005) and the international standards set by the OIE, prompted FAO, WHO and the OIE to join forces with the World Bank, to provide practical tools to help countries manage their zoonotic disease risks and develop adequate resources to prevent and control disease

  18. Environmental public health tracking of childhood asthma using California health interview survey, traffic, and outdoor air pollution data.

    PubMed

    Wilhelm, Michelle; Meng, Ying-Ying; Rull, Rudolph P; English, Paul; Balmes, John; Ritz, Beate

    2008-09-01

    Despite extensive evidence that air pollution affects childhood asthma, state-level and national-level tracking of asthma outcomes in relation to air pollution is limited. Our goals were to evaluate the feasibility of linking the 2001 California Health Interview Survey (CHIS), air monitoring, and traffic data; estimate associations between traffic density (TD) or outdoor air pollutant concentrations and childhood asthma morbidity; and evaluate the usefulness of such databases, linkages, and analyses to Environmental Public Health Tracking (EPHT). We estimated TD within 500 feet of residential cross-streets of respondents and annual average pollutant concentrations based on monitoring station measurements. We used logistic regression to examine associations with reported asthma symptoms and emergency department (ED) visits/hospitalizations. Assignment of TD and air pollution exposures for cross-streets was successful for 82% of children with asthma in Los Angeles and San Diego, California, Counties. Children with asthma living in high ozone areas and areas with high concentrations of particulate matter < 10 microm in aerodynamic diameter experienced symptoms more frequently, and those living close to heavy traffic reported more ED visits/hospitalizations. The advantages of the CHIS for asthma EPHT include a large and representative sample, biennial data collection, and ascertainment of important socio-demographic and residential address information. Disadvantages are its cross-sectional design, reliance on parental reports of diagnoses and symptoms, and lack of information on some potential confounders. Despite limitations, the CHIS provides a useful framework for examining air pollution and childhood asthma morbidity in support of EPHT, especially because later surveys address some noted gaps. We plan to employ CHIS 2003 and 2005 data and novel exposure assessment methods to re-examine the questions raised here.

  19. The role of topic, interviewee and question in predicting rich interview data in the field of health research.

    PubMed

    Ogden, Jane; Cornwell, Danielle

    2010-11-01

    Although texts recommend the generation of rich data from interviews, no empirical evidence base exists for achieving this. This study aimed to operationalise richness and to assess which components of the interview (for example, topic, interviewee, question) were predictive. A total of 400 interview questions and their corresponding responses were selected from 10 qualitative studies in the area of health identified from university colleagues and the UK Data Archive database. The analysis used the text analysis program, Linguistic Inquiry and Word Count, and additional rating scales. Richness was operationalised along five dimensions. 'Length of response' was predicted by a personal, less specific or positive topic, not being a layperson, later questions, open or double questions; 'personal richness' was predicted by being a healthy participant and questions about the past and future; 'analytical responses' were predicted by a personal or less specific topic, not being a layperson, later questions, questions relating to insight and causation; 'action responses' were predicted by a less specific topic, not being a layperson, being healthy, later and open questions. The model for 'descriptive richness' was not significant. Overall, open questions, located later on and framed in the present or past tense, tended to be most predictive of richness. This could inform improvements in interview technique. © 2010 The Authors. Sociology of Health & Illness © 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  20. Forest health monitoring: 2006 national technical report

    Treesearch

    Mark J. Ambrose; Barbara L. Conkling

    2009-01-01

    The Forest Health Monitoring Program’s annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. The report is organized according to the Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests of the...

  1. Forest health monitoring: 2005 national technical report

    Treesearch

    Mark J. Ambrose; Barbara L. Conkling

    2007-01-01

    The Forest Health Monitoring program's annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. The report is organized according to the Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests of the Santiago Declaration. The results...

  2. Losing a loved one to homicide: prevalence and mental health correlates in a national sample of young adults.

    PubMed

    Zinzow, Heidi M; Rheingold, Alyssa A; Hawkins, Alesia O; Saunders, Benjamin E; Kilpatrick, Dean G

    2009-02-01

    The present study examined the prevalence, demographic distribution, and mental health correlates of losing a loved one to homicide. A national sample of 1,753 young adults completed structured telephone interviews measuring violence exposure, mental health diagnoses, and loss of a family member or close friend to a drunk driving accident (vehicular homicide) or murder (criminal homicide). The prevalence of homicide survivorship was 15%. African Americans were more highly represented among criminal homicide survivors. Logistic regression analyses found that homicide survivors were at risk for past year posttraumatic stress disorder (OR = 1.88), major depressive episode (OR = 1.64), and drug abuse/dependence (OR = 1.77). These findings highlight the significant mental health needs of homicide survivors.

  3. Losing a Loved One to Homicide: Prevalence and Mental Health Correlates in a National Sample of Young Adults

    PubMed Central

    Zinzow, Heidi; Rheingold, Alyssa A.; Hawkins, Alesia; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2010-01-01

    The present study examined the prevalence, demographic distribution, and mental health correlates of losing a loved one to homicide. A national sample of 1753 young adults completed structured telephone interviews measuring violence exposure, mental health diagnoses, and loss of a family member or close friend to a drunk driving accident (vehicular homicide) or murder (criminal homicide). The prevalence of homicide survivorship was 15.2%. African Americans were more highly represented among criminal homicide survivors. Logistic regression analyses found that homicide survivors were at risk for past year posttraumatic stress disorder (OR = 1.88), major depressive episode (OR = 1.64), and drug abuse/dependence (OR = 1.77). These findings highlight the significant mental health needs of homicide survivors. PMID:19230006

  4. Public Health Systems Research: Setting a National Agenda

    PubMed Central

    Lenaway, Dennis; Halverson, Paul; Sotnikov, Sergey; Tilson, Hugh; Corso, Liza; Millington, Wayne

    2006-01-01

    The Institute of Medicine has recommended that policy decisions about improvement of national public health systems be guided by sound scientific evidence. However, to date there is no national research agenda to help guide public health systems. The Centers for Disease Control and Prevention was called upon to lead a collaborative consensus-based process to define key research questions and establish a framework to create opportunities to better coordinate, leverage, and identify public health resources, which are increasingly scarce. The public health systems research agenda that emerged from this process has 14 overarching priority research themes. This national agenda should stimulate and guide research to meet the urgent need to improve the nation’s public health systems. PMID:16449601

  5. The Politico-Economic Challenges of Ghana’s National Health Insurance Scheme Implementation

    PubMed Central

    Fusheini, Adam

    2016-01-01

    Background: National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs) as a vehicle to universal health coverage (UHC) and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS) as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI) legislation (ACT 650) in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Methods: Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two) and Northern (two) Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Results: Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. Conclusion: The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under the NHIS

  6. Selected preconception health indicators and birth weight disparities in a national study.

    PubMed

    Strutz, Kelly L; Richardson, Liana J; Hussey, Jon M

    2014-01-01

    This analysis explored the effect of timing, sequencing, and change in preconception health across adolescence and young adulthood on racial/ethnic disparities in birth weight in a diverse national cohort of young adult women. Data came from Waves I (1994-1995), III (2001-2002), and IV (2007-2008) of the National Longitudinal Study of Adolescent Health. Eligibility was restricted to all singleton live births to female non-Hispanic White, non-Hispanic Black, Mexican-origin Latina, or Asian/Pacific Islander participants (n = 3,014) occurring between the Wave III (ages 18-26 years) and IV (ages 24-32 years) interviews. Birth weight was categorized into low (<2,500 g), normal (2,500-4,000 g), and macrosomic (>4,000 g). Preconception health indicators were cigarette smoking, heavy alcohol consumption, overweight or obesity, and inadequate physical activity, measured in adolescence (Wave I, ages 11-19 years) and early adulthood (Wave III) and combined into four-category variables to capture the timing and sequencing of exposure. Measures of preconception health did not explain the Black-White disparity in low birth weight, which increased after adjustment for confounders (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.33-3.53) and effect modification by overweight/obesity (OR, 3.58; 95% CI, 1.65-7.78). A positive association between adult-onset overweight/obesity and macrosomia was modified by race (OR, 3.83; 95% CI, 1.02-14.36 for Black women). This longitudinal analysis provides new evidence on preconception health and racial/ethnic disparities in birth weight. Specifically, it indicates that interventions focused on prevention of overweight/obesity and maintenance of healthy weight during the transition to adulthood, especially among Black females, may be warranted. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  7. National Institutes of Health eliminates funding for national architecture linking primary care research.

    PubMed

    Peterson, Kevin A

    2007-01-01

    With the ending of the National Electronic Clinical Trial and Research Network (NECTAR) pilot programs and the abridgement of Clinical Research Associate initiative, the National Institutes of Health Roadmap presents a strategic shift for practice-based research networks from direct funding of a harmonized national infrastructure of cooperating research networks to a model of local engagement of primary care clinics performing practice-based research under the aegis of regional academic health centers through Clinical and Translational Science Awards. Although this may present important opportunities for partnering between community practices and large health centers, for primary care researchers, the promise of a transformational change that brings a unified national primary care community into the clinical research enterprise seems likely to remain unfulfilled.

  8. Health Care Disparities and Language Use at Home among Latino, Asian American, and American Indian Adolescents: Findings from the California Health Interview Survey

    ERIC Educational Resources Information Center

    Hahm, Hyeouk Chris; Lahiff, Maureen; Barreto, Rose M.; Shin, Sunny; Chen, Wan-Yi

    2008-01-01

    Using the 2001 California Health Interview Survey, this study compared health status, medical insurance, and having a usual source of care for 2,230 ethnic minority adolescents based on language use at home: Group 1, English only; Group 2, both English and another language; and Group 3, exclusively another language. Adjusting for demographic…

  9. Motivational interviewing interactions and the primary health care challenges presented by smokers with low motivation to stop smoking: a conversation analysis.

    PubMed

    Codern-Bové, Núria; Pujol-Ribera, Enriqueta; Pla, Margarida; González-Bonilla, Javier; Granollers, Silvia; Ballvé, José L; Fanlo, Gemma; Cabezas, Carmen

    2014-11-26

    Research indicates that one third of smokers have low motivation to stop smoking. The purpose of the study was to use Conversational Analysis to enhance understanding of the process in Motivational Interviewing sessions carried out by primary care doctors and nurses to motivate their patients to quit smoking. The present study is a substudy of the Systematic Intervention on Smoking Habits in Primary Health Care Project (Spanish acronym: ISTAPS). Motivational interviewing sessions with a subset of nine participants (two interview sessions were conducted with two of the nine) in the ISTAPS study who were current smokers and scored fewer than 5 points on the Richmond test that measures motivation to quit smoking were videotaped and transcribed. A total of 11 interviews conducted by five primary health care professionals in Barcelona, Spain, were analysed. Qualitative Content Analysis was used to develop an analytical guide for coding transcriptions. Conversation Analysis allowed detailed study of the exchange of words during the interaction. Motivational Interviewing sessions had three phases: assessment, reflection on readiness to change, and summary. The interaction was constructed during an office visit, where interactional dilemmas arise and can be resolved in various ways. Some actions by professionals (use of reiterations, declarations, open-ended questions) helped to construct a framework of shared relationship; others inhibited this relationship (focusing on risks of smoking, clinging to the protocol, and prematurely emphasizing change). Some professionals tended to resolve interactional dilemmas (e.g., resistance) through a confrontational or directive style. Interactions that did not follow Motivational Interviewing principles predominated in seven of the interviews analysed. Conversational analysis showed that the complexity of the intervention increases when a health professional encounters individuals with low motivation for change, and interactional

  10. Why some countries have national health insurance, others have national health services, and the U.S. has neither.

    PubMed

    Navarro, V

    1989-01-01

    This article presents a discussion of why some capitalist developed countries have national health insurance schemes, others have national health services, and the U.S. has neither. The first section provides a critical analysis of some of the major answers given to these questions by authors belonging to the schools of thought defined as 'public choice', 'power group pluralism' and 'post-industrial convergence'. The second section puts forward an alternative explanation rooted in an historical analysis of the correlation of class forces in each country. The different forms of funding and organization of health services, structured according to the corporate model or to the liberal-welfare market capitalism model, have appeared historically in societies with different correlations of class forces. In all these societies the major social force behind the establishment of a national health program has been the labor movement (and its political instruments--the socialist parties) in its pursuit of the welfare state. In the final section the developments in the health sector after World War II are explained. It is postulated that the growth of public expenditures in the health sector and the growth of universalism and coverage of health benefits that have occurred during this period are related to the strength of the labor movement in these countries.

  11. Vitalum study design: RCT evaluating the efficacy of tailored print communication and telephone motivational interviewing on multiple health behaviors

    PubMed Central

    van Keulen, Hilde M; Mesters, Ilse; Brug, Johannes; Ausems, Marlein; Campbell, Marci; Resnicow, Ken; Zwietering, Paul J; van Breukelen, Gerard; van Mechelen, Willem; Severens, Johan L; de Vries, Hein

    2008-01-01

    Background A large proportion of adults fail to meet public health guidelines for physical activity as well as fruit, vegetable and fat intake. Interventions are needed to improve these health behaviors. Both computer tailoring and motivational interviewing have shown themselves to be promising techniques for health behavior change. The Vitalum project aims to compare the efficacy of these techniques in improving the health behaviors of adults aged 45–70. This paper describes the design of the Vitalum study. Methods/Design Dutch general medical practices (N = 23) were recruited via a registration network or by personal invitation. The participants were then enrolled through these general practices using an invitational letter. They (n = 2,881) received a written baseline questionnaire to assess health behaviors, and potential psychosocial and socio-demographic behavioral determinants. A power analysis indicated that 1,600 participants who were failing to meet the guidelines for physical activity and either fruit or vegetable consumption were needed. Eligible participants were stratified based on hypertension status and randomized into one of four intervention groups: tailored print communication, telephone motivational interviewing, combined, and control. The first two groups either received four letters or took part in four interviews, whereas the combined group received two letters and took part in two interviews in turns at 5, 13, 30 and 43 weeks after returning the baseline questionnaire. Each letter and interview focused on physical activity or nutrition behavior. The participants also took part in a telephone survey 25 weeks after baseline to gather new information for tailoring. There were two follow-up questionnaires, at 47 and 73 weeks after baseline, to measure short- and long-term effects. The control group received a tailored letter after the last posttest. The process, efficacy and cost-effectiveness of the interventions will be examined by means of

  12. Resistance to group clinical supervision: A semistructured interview study of non-participating mental health nursing staff members.

    PubMed

    Buus, Niels; Delgado, Cynthia; Traynor, Michael; Gonge, Henrik

    2018-04-01

    This present study is a report of an interview study exploring personal views on participating in group clinical supervision among mental health nursing staff members who do not participate in supervision. There is a paucity of empirical research on resistance to supervision, which has traditionally been theorized as a supervisee's maladaptive coping with anxiety in the supervision process. The aim of the present study was to examine resistance to group clinical supervision by interviewing nurses who did not participate in supervision. In 2015, we conducted semistructured interviews with 24 Danish mental health nursing staff members who had been observed not to participate in supervision in two periods of 3 months. Interviews were audio-recorded and subjected to discourse analysis. We constructed two discursive positions taken by the informants: (i) 'forced non-participation', where an informant was in favour of supervision, but presented practical reasons for not participating; and (ii) 'deliberate rejection', where an informant intentionally chose to not to participate in supervision. Furthermore, we described two typical themes drawn upon by informants in their positioning: 'difficulties related to participating in supervision' and 'limited need for and benefits from supervision'. The findings indicated that group clinical supervision extended a space for group discussion that generated or accentuated anxiety because of already-existing conflicts and a fundamental lack of trust between group members. Many informants perceived group clinical supervision as an unacceptable intrusion, which could indicate a need for developing more acceptable types of post-registration clinical education and reflective practice for this group. © 2017 Australian College of Mental Health Nurses Inc.

  13. 'Questerviews': using questionnaires in qualitative interviews as a method of integrating qualitative and quantitative health services research.

    PubMed

    Adamson, Joy; Gooberman-Hill, Rachael; Woolhead, Gillian; Donovan, Jenny

    2004-07-01

    Multi-method approaches are increasingly advocated in health services research (HSR). This paper examines the use of standardised self-completion questionnaires and questions, during in-depth interviews, a technique termed 'questerviews'. 'Questerview' techniques were used in four empirical studies of health perceptions conducted by the authors. The studies included both standardised self-completion questions or questionnaires and in-depth interviews. Respondents were tape-recorded while they completed the standardised questionnaires and were encouraged to discuss their definitions of terms and responses to items in-depth. In all studies, 'questerviews' were fully transcribed and data analysis involved the scrutinising of transcripts to identify emergent themes. Responses to the standardised items led to rich sources of qualitative data. They proved to be useful triggers as respondents discussed their understanding and definitions of terms, often explaining their responses with stories from their own experiences. The items triggered detailed exploration of the complex factors that comprise health, illness and healthcare seeking, and gave considerable insight into the ways in which people respond to standardised questions. Apparently simple questions and response categories conceal considerable complexity. Inclusion of standardised survey questions in qualitative interviews can provide an easy and fruitful method to explore research issues and provide triggers to difficult or contested topics. Well designed and validated questionnaires produce data of immense value to HSR, and this value could be further enhanced by their use within a qualitative interview. We suggest that the technique of 'questerviews' is a tangible and pragmatic way of doing this.

  14. Cell Phone and Face-to-Face Interview Responses in Population-Based Surveys: How Do They Compare?

    ERIC Educational Resources Information Center

    Mahfoud, Ziyad; Ghandour, Lilian; Ghandour, Blanche; Mokdad, Ali H.; Sibai, Abla M.

    2015-01-01

    Findings on the reliability and cost-effectiveness of the use of cellular phones vis-à-vis face-to-face interviews in investigating health behaviors and conditions are presented for a national epidemiological sample from Lebanon. Using self-reported responses on identical questions, percentage agreement, ? statistics, and McNemar's test were used…

  15. An evaluation of National Health Service England's Care Maker Programme: A mixed-methods analysis.

    PubMed

    Zubairu, Kate; Christiansen, Angela; Kirkcaldy, Andrew; Kirton, Jennifer A; Kelly, Carol A; Simpson, Paul; Gillespie, Andrea; Brown, Jeremy M

    2017-12-01

    To investigate the impact and sustainability of the Care Maker programme across England from the perspective of those involved in its delivery. The Care Maker programme was launched in England in 2013. It aims to support the "Compassion in Practice" strategy, with particular emphasis on the 6Cs of care, compassion, competence, communication, courage and commitment. Care Makers were recruited in an ambassadorial role. The intention was to inspire individuals throughout the National Health Service in England to bridge national policy with those delivering care. A mixed methods design was chosen, but this article focuses on two of the four distinct empirical data collection phases undertaken as part of this evaluation: a questionnaire with Care Makers; and two case studies of separate National Health Service trust sites. Data were collected for this evaluation in 2015. An online questionnaire was distributed to the total population of Care Makers across the National Health Service in England. It included a combination of open and closed questions. The case studies involved semistructured telephone interviews with a range of professionals engaged with the Care Maker programme across the trust sites. Care Makers reported that participation in the programme had offered opportunities in terms of improving the quality-of-care provision in the workplace as well as contributing towards their own professional development. The Care Maker programme has supported and helped underpin the nursing, midwifery and care strategy "Compassion in Practice". This model of using volunteers to embed strategy and policy could potentially be used in other areas of clinical practice and indeed in other countries. © 2017 John Wiley & Sons Ltd.

  16. Forest health monitoring: 2003 national technical report

    Treesearch

    John W. Coulston; Mark J. Ambrose; Kurt H. Riitters; Barbara L. Conkling; William D. Smith

    2005-01-01

    The Forest Health Monitoring Program’s annual national reports present results from forest health data analyses focusing on a national perspective. The Criteria and Indicators for the Conservation and Sustainable Management of Temperate and Boreal Forests are used as a reporting framework. This report has five main sections. The first contains introductory material....

  17. Racial and Ethnic Differences in Dietary Intake, Physical Activity, and Body Mass Index (BMI) Among Cancer Survivors: 2005 and 2010 National Health Interview Surveys (NHIS).

    PubMed

    Byrd, Doratha A; Agurs-Collins, Tanya; Berrigan, David; Lee, Richard; Thompson, Frances E

    2017-12-01

    This paper reports racial/ethnic differences in mean dietary and alcohol intake, physical activity, and body mass index (BMI) among cancer survivors and examines adherence to the American Cancer Society and the US Dietary Guidelines for Americans. Data are from the cross-sectional 2005 and 2010 National Health Interview Surveys (NHIS). The total sample of cancer survivors (N = 3367) included non-Hispanic Whites (NHW; N = 2698), non-Hispanic Blacks (NHBs; N = 379), and Hispanics (N = 290). We compared mean reported dietary intake, moderate/vigorous physical activity, and BMI among racial/ethnic groups. Predicted marginals and multivariate logistic regression analysis were used to compare prevalence of non-adherence with recommendations among groups. Among the three racial/ethnic groups, Hispanics had the highest mean intake of vegetables, fiber, and calcium (p = 0.0003; p < 0.0001; p = 0.001). In the logistic regression model adjusting for sociodemographic covariates, smoking and BMI, Hispanics had lower non-adherence to fiber guidelines (OR = 0.38; CI = 0.24-0.58) than NHWs. NHBs had significantly higher non-adherence to vegetable guidelines (OR = 1.63; CI = 1.07-2.47). NHBs and Hispanics had lower non-adherence with alcohol guidelines than NHWs (OR = 0.35 and 0.38; CI = 0.18-0.69 and 0.19-0.76, respectively). NHBs and Hispanics were more likely to be overweight/obese (OR = 1.66 and 1.57; CI = 1.24-2.23 and CI = 1.11-2.21, respectively). There are racial/ethnic differences in certain health behaviors of cancer survivors. However, non-adherence to guidelines is high in all three racial/ethnic groups. Achieving the recommended guidelines for diet, physical activity, and a healthy BMI is a concern for all cancer survivors, indicating the need for intervention among this growing group of at-risk individuals.

  18. Collecting Practice-level Data in a Changing Physician Office-based Ambulatory Care Environment: A Pilot Study Examining the Physician induction interview Component of the National Ambulatory Medical Care Survey.

    PubMed

    Halley, Meghan C; Rendle, Katharine A; Gugerty, Brian; Lau, Denys T; Luft, Harold S; Gillespie, Katherine A

    2017-11-01

    Objective This report examines ways to improve National Ambulatory Medical Care Survey (NAMCS) data on practice and physician characteristics in multispecialty group practices. Methods From February to April 2013, the National Center for Health Statistics (NCHS) conducted a pilot study to observe the collection of the NAMCS physician interview information component in a large multispecialty group practice. Nine physicians were randomly sampled using standard NAMCS recruitment procedures; eight were eligible and agreed to participate. Using standard protocols, three field representatives conducted NAMCS physician induction interviews (PIIs) while trained ethnographers observed and audio recorded the interviews. Transcripts and field notes were analyzed to identify recurrent issues in the data collection process. Results The majority of the NAMCS items appeared to have been easily answered by the physician respondents. Among the items that appeared to be difficult to answer, three themes emerged: (a) physician respondents demonstrated an inconsistent understanding of "location" in responding to questions; (b) lack of familiarity with administrative matters made certain questions difficult for physicians to answer; and (c) certain primary care‑oriented questions were not relevant to specialty care providers. Conclusions Some PII survey questions were challenging for physicians in a multispecialty practice setting. Improving the design and administration of NAMCS data collection is part of NCHS' continuous quality improvement process. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  19. State institutions and social identity: National representation in soldiers' and civilians' interview talk concerning military service.

    PubMed

    Gibson, Stephen; Condor, Susan

    2009-06-01

    Theory and research deriving from social identity or self-categorization perspectives often starts out with the presumption that social actors necessarily view societal objects such as nations or states as human categories. However, recent work suggests that this may be only one of a number of forms that societal representation may take. For example, nations may be understood variously as peoples, places, or institutions. This paper presents findings from a qualitative interview study conducted in England, in which soldiers and civilians talked about nationhood in relation to military service. Analysis indicated that, in this context, speakers were often inclined to use the terms 'Britain', 'nation', and 'country' as references to a political institution as opposed to a category of people. In addition, there were systematic differences between the ways in which the two samples construed their nation in institutional terms. The civilians were inclined to treat military service as a matter of obedience to the dictates of the Government of the day. In contrast, the soldiers were more inclined to frame military service as a matter of loyalty to state as symbolically instantiated in the body of the sovereign. Implications for work adopting a social identity perspective are discussed.

  20. The National Adolescent Student Health Survey: Survey Replication Booklet.

    ERIC Educational Resources Information Center

    American School Health Association, Kent, OH.

    The National Adolescent Student Health Survey (NASHS), initiated in 1985, is conducted to examine the health-related knowledge, practices, and attitudes of the nation's youth in the following health areas: AIDS; Nutrition; Consumer Health; Sexually Transmitted Disease; Drug and Alcohol Use; Suicide; Injury Prevention; and Violence. Findings…