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An infinite number of fitness apps are available on various app stores. However, hardly any of them are fitted to the needs and requirements of care‐dependent people. This paper investigates the effectiveness of a customised fitness‐app prototype for increasing physical activity in home care service users. Home care service users from Austria and Italy were randomly assigned to two groups. In total, 216 participants were involved in the field trial, 104 received a tablet with the fitness app and an activity tracker (treatment group), 112 did not (control group). Regularity of physical activity, frequency of fitness exercises and walking behaviour were self‐reported by participants at baseline, after 4 months and after 8 months. In addition, the frequency of using the prototype was assessed based on the fitness app's logged usage data. We estimated multilevel mixed‐effects ordered logistic models to examine the effects of the intervention. After 4 months, the intervention increased the home care users' probability of agreeing strongly with being physically active on a regular basis by 28 percentage points (p < 0.001; 95% CI: 0.20, 0.36) and their probability of reporting to exercise more than once a week by 45 percentage points (p < 0.001; 95% CI: 0.32, 0.57). Walking behaviour was not affected on group‐level but improved for frequent users of the activity tracker. Frequent and regular users of the fitness app benefited most and effects persisted until the end of the 8 months controlled trial. Tailoring a fitness‐app prototype to the needs of care‐dependent people has the potential to support people with functional limitations to engage in a more active lifestyle. Future research is encouraged to seek further insights into how new technologies can support physical activities in people with long‐term care needs. [ABSTRACT FROM AUTHOR]

Increased rates of domestic violence (DV) have been associated with events such as public holidays, seasonal variations, disasters and economic crises. Sport is seen as gendered, exemplifying hegemonic masculinity and associated violence, with the link between sporting culture and violence against women well recognised. This paper reports on a systematic review of empirical research literature exploring the link between major sporting events and incidence of DV. We searched MEDLINE, CINAHL, PsycINFO, SPORTDiscus and Proquest Central databases from inception to December 2020 for quantitative studies examining major sports events and reports of DV using a pre–post comparison design. Study quality was assessed using the Kmet quality assessment tool. The review identified 1445 records following duplicate removal. Once screened and assessed for eligibility, 12 studies met the inclusion criteria. Results are presented qualitatively due to the heterogeneity across studies. Most studies originated in North America and the United Kingdom, used police records as their data source for measuring incidences of DV and few looked beyond the day of the sports event for recorded incidences of DV. Studies reviewed suggested that there is an association between certain major sports events and increased reporting of DV. However, studies' findings conflicted with regards to whether increases were associated with contact sports, the rivalry between competing teams, whether the events were emotionally salient and whether alcohol was a contributing factor. In conclusion, there is limited research globally. Heterogeneity and conflicting findings mean that more research is needed to understand the associations and inform community prevention/interventions to address DV. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the prevalence, severity, coping strategies and precipitating factors of food insecurity in university students in a large multi‐campus Australian university during the COVID‐19 lockdown in 2020, in context of providing information to inform institutional support. This was a cross‐sectional analysis which was part of a larger university‐led research project, the Thrive@Home study conducted at Monash University during the COVID‐19 pandemic. The main outcome measures included: Sociodemographic characteristics, PROMIS anxiety, PROMIS depression and the six‐item US Department of Agriculture Household Food Security Survey Module. All variables were reported according to the four levels of food security status (high (H), marginal (M), low (L) and very low (VL)). Chi‐squared tests were used to compare all categorical variables including demographic, mental health and food security status. A multivariable regression was conducted between food security status and mental health variables. Overall, n = 1315 students were included in the analysis. Of which, 5% were classified as having VL food security, 13% L, 14% M and 68% H. As food security worsened the likelihood of being unemployed looking for work, living alone and deteriorating physical health, diet quality and mental health increased. As food security status deteriorated the prevalence of needing to ask family or friends for food, shopping at multiple outlets for discounts, accessing emergency food relief, subsidised meals and financial assistance from organisations increased (p < 0.002). In regression models adjusting for covariates, depression (b (95%CI): VL = 7.2(4.1–10.3), L = 3.7(1.7–5.7), M = 2.0(0.1–3.8)) and anxiety (VL = 7.4(4.5–10.4), L = 3.5(1.5–5.4) and M = 2.0(0.3–3.8)) were positively associated with worsening food security. Food insecurity during COVID‐19 was associated with worsening mental health. This paper provides targets for future university‐led initiatives to promote student food security and supporting better access to physical and mental health services. [ABSTRACT FROM AUTHOR]

Chronic pain is common in older people. However, little is known about how pain is experienced in residents of retirement villages ('villages'), and how pain intensity and associations are experienced in relation to characteristics of residents and village living. We thus aimed to examine pain levels, prevalence and associated factors in village residents. The current paper is a cross‐sectional analysis of baseline data from the 'Older People in Retirement Villages' study in Auckland, New Zealand. Between July 2016 and August 2018, 578 village residents were interviewed face‐to‐face by gerontology nurse specialists, using interRAI Community Health Assessment (CHA) and customised survey. We used a validated pain scale and multivariable logistic regression analyses adjusted for pre‐specified confounders. Residents' median age was 82 years; 420 (73%) were female; 270 (47%) exhibited/reported daily pain, and in 11% this was severe. After controlling for confounders, daily pain was positively associated with self‐reported arthritis (OR = 3.88, 95% CI = 2.57–5.87), poor/fair self‐reported health (OR = 3.19, 95% CI = 1.29–7.93), having no health clinic on‐site (OR = 1.76, 95% CI = 1.10–2.83), and minimal fatigue (diminished energy but completes normal day‐to‐day activities) (OR = 1.77, 95% CI = 1.11–2.81). Similar associations were observed for levels of pain. We conclude that levels of pain and prevalence of daily pain are high in village residents. Self‐reported arthritis, self‐reported poor/fair health, no health clinic on‐site and minimal fatigue are all independently associated with a higher risk of daily pain and with levels of pain. This study suggests potential opportunities for villages to better provide on‐site support to decrease prevalence and severity of pain for their residents, and thus potentially increase wellbeing and quality‐of‐life, though as we cannot prove causality, more research is needed. [ABSTRACT FROM AUTHOR]

The Internet plays a significant role in health information searching, sharing and emotional support. However, scholars have devoted little attention to the complementary and substitute value of online health information from diseases, especially chronic diseases, health insurance, barriers to health resources and their interaction effects with income. This research uses data from the 2020 Health Information National Trends Survey (HINTS 2020), the latest HINTS survey that includes seeking online health information questions critical to this research. This paper proposes that the factors contributing to seeking online health information can be categorized into two modalities – complementary and substitutive. Concerning the complementary value, I argue that individuals with certain health conditions use online health information as a complementary health resource in addition to traditional health resources such as doctors to understand their health issues better. Online health information also functions as substitute information sources for individuals who have experienced more barriers to typical health information resources. [ABSTRACT FROM AUTHOR]

Patients who miss scheduled appointments reduce clinical productivity and delay access to care for other patients. Reminders have improved attendance for healthcare appointments previously, but it is not known if short message service (SMS) implementation reduces incidence of patients unable to attend (UTA) or who fail to attend (FTA) appointments in the public dental service. This paper studied the effectiveness of SMS reminders in increasing appointment attendance at outpatient public dental services in Queensland. Data were sourced from the adult service and the children and adolescent oral health service (CAOHS) at West Moreton Hospital and Health Service, a public dental service in Queensland. A total of 63,238 appointments pre‐implementation of SMS reminders and 55,028 appointments post‐implementation over a period of 2 years were analysed for rates of attendance, UTA and FTA. Characteristics of UTA and FTA appointments were analysed to identify factors that hindered improvement after implementation of reminders. For the CAOHS, the attendance rate decreased 4% (95% CI: 2%, 6%) following SMS implementation. The UTA rate also increased by 20% (95% CI: 15%, 25%). Following SMS implementation in the adult service, the attendance rate increased from 73.5 (95% CI: 72.6, 74.4) to 77.7 (95% CI: 76.6–78.8) per 100 appointments. The FTA rate post‐implementation was 1.08 (95% CI: 1.00, 1.16) times that from pre‐intervention, and the UTA rate decreased from 21.7 (95% CI: 21.2, 22.2) to 17.1 (95% CI: 16.6, 17.7) per 100 appointments. The SMS reminders had a mixed effect on the attendance, UTA and FTA rates for the CAOHS and adult services. Reminders reduced the rates of UTA for the CAOHS service and increased the rate of attendance for the adult service. There was an increase in the FTA rate for both services. [ABSTRACT FROM AUTHOR]

Healthcare professionals' advice on lifestyle behaviours is a key factor in improving a nation's health. Although allied health professionals have been well placed to provide such advice as part of patient care, little is known about the characteristics of allied health practitioners who discuss lifestyle topics with patients. This paper focused upon an overlooked avenue for lifestyle advice regarding an allied health profession – osteopathy. A workforce survey including questions about four lifestyle topics (including diet/nutrition, smoking/drugs/alcohol, physical activity/fitness, and stress management) was distributed to a nationally representative sample of Australian registered osteopaths in 2016. Separate multivariate logistic regression and Poisson regression models were developed to determine the most important predictors of the discussion of lifestyle factors. Amongst the 992 participating osteopaths, 89%, 49%, 38%, and 18% often discussed physical activity/fitness, stress management, diet/nutrition, and smoking/drugs/alcohol with their patients, respectively. Approximately 30% of participating osteopaths discussed at least three lifestyle topics with patients. Varied predictors were identified for discussing each lifestyle topic. Osteopaths who often discuss diet/nutrition in patient management plans were more likely to often discuss smoking/drugs/alcohol (OR = 14.13), physical activity/fitness (OR = 2.71), and/or stress management (OR = 1.69). In conclusion, lifestyle factors are often discussed with patients as part of osteopathy treatments in the Australian healthcare context. Osteopaths are well positioned to initiate discussions regarding patient lifestyles, and such discussions may be an effective contribution to health promotion. [ABSTRACT FROM AUTHOR]

There has been growing interest in exploring factors that influence the success or otherwise of welfare policies in democratic countries, such as the interrelationships between the proposed policy and the context it will be introduced into, such as the sociodemographic characteristics of the population and the population's previous experience with welfare policies. However, there has been little exploration of factors that could influence general population support for long-term care for older people. The aim of this study was to investigate the general population's attitudes for determinants of high-quality aged care and different mechanisms for funding and any impact of individual characteristics on these. A representative sample of the Australian general population aged 18 years and over (N = 10,315, 52% female, 22% aged 65 years and over) drawn via quota sampling participated in the survey online. Participants were asked to rate the importance of a list of 10 determinants of quality care and their support for four models of funding, both using a five-point Likert scale. We identified consistently high expectations for long-term care services across the general population, especially among older people, females, those with a family member in care, and those living in rural or regional areas. In terms of how governments practically fund a high-quality long-term care system, we also identified broad support among the general population for both payment of a co-contribution towards the cost of care by older people using services and increased government funding for the system. Over 40% of participants said they would be willing to pay additional tax to improve access and quality of aged care services. While often neglected by governments in the past who assumed voter apathy on the topic, by comparison, our findings indicate that there is currently a strong appetite among the general population for improvements to the quality of care provided and that they are willing to consider changes to the funding model. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, the well-being of older adults has been highlighted as a significant public health concern. In this study, we investigated the role of psychological resilience in mediating the relationship between positive self-perceptions of aging (SPA) and the subjective well-being (SWB) of community-dwelling older adults in Taiwan during the pandemic. We collected data through face-to-face interviews conducted from October 2021 to February 2022, involving 1,095 participants aged 50 years or above residing in a southern city in Taiwan. More than half of the study participants were female, aged 65 or older, and had less than a high school education. More than two thirds were married and/or living with partners. More than a third had two or more noncommunicable diseases. We calculated scores for SWB, positive SPA, and psychological resilience and examined correlations among the outcome and predictor variables. Our findings indicated that higher positive SPA was significantly associated with better SWB among community-dwelling older adults in Taiwan and that this association was mediated by psychological resilience. Specifically, after controlling for covariates, structural equation modeling (SEM) analysis revealed a significant main effect of positive SPA on SWB (b = 0.412, β = 0187, and p < 0.001), while bootstrap mediation analysis showed a statistically significant indirect mediating effect from positive SPA on SWB via psychological resilience (0.597, 95% bootstrap CIs = [0.445, 0.749], and p < 0.001). These findings highlight the potential importance of cultivating positive self-perceptions of aging and implementing resilience-centered interventions to promote well-being among Chinese older adults in the community. [ABSTRACT FROM AUTHOR]

Iran is a developing country with low levels of economic development and globalization and is ruled by a theocratic government. To address the lack of national research on well-being in Iran, this retrospective observational study aims to examine life satisfaction and its main determinants among Iranian adults. Using World Gallup Poll data collected between 2006 and 2017, we examined life satisfaction as a cognitive aspect of subjective well-being in relation to various factors. Our results show that income is the strongest predictor of life satisfaction, followed by standard of living, gender, social support, age, negative affect, and education. In developing countries such as Iran, which face significant economic, political, and social challenges, individuals prioritize the satisfaction of basic needs by emphasizing factors such as the socioeconomic status. In contrast, developed countries with established welfare systems may emphasize other values such as social connections and healthy lifestyle behaviors as key factors in life satisfaction. This study contributes to a deeper understanding of the determinants of life satisfaction in Iran and provides insights for future research and policy making. [ABSTRACT FROM AUTHOR]

Women's health is the foundation of society's health and it can be achieved only by addressing all aspects of their health. The aim of this systematic review and meta-analysis is to investigate the prevalence of social health of Iranian women and related factors. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used for reporting; the terms "social health," "women," "Iran," and related keywords were searched in PubMed, Web of Science, Scopus, PsychoInfo, ProQuest and local databases, SID, Magiran, Irandoc, Elmnet, and Noormags up to August 2022. The published English or Persian quantitative primary studies which were conducted in Iran and reported social health or its dimensions among Iranian women were included. The studies were assessed by quality assessment tool for observational cohort and cross-sectional studies developed by National Heart, Lung, and Blood Institute. From the 786 studies retrieved, 22 studies were finally included surveying different groups of women. Age, marital status, education, employment, socioeconomic status, social support, social participation, social trust, social security, communication skills, and self-esteem were the factors affecting women's social health. Five studies entered meta-analysis and mean score of social health was 98.54 (95% CI: 87.56–109.51) and it was the lowest among women who were the head of households. Since women's social health has been less considered in the society and research studies, further policies, legislations, and capacity building in mentioned fields are necessary. As social health is an important aspect of health, it is necessary for governments to address the known determinants of women's social health in order to plan and promote the health of women, family, and finally society. [ABSTRACT FROM AUTHOR]

Chinese government promoted a family physician contract service system in order to establish a tiered healthcare system in June 2016, but there was little evidence to assess the policy performance. This study aimed to examine the association of family physician contract services with the healthcare utilization of community residents in urban China. A cross-sectional face-to-face survey was conducted from July to September, 2019, in four advanced and exemplary cities for family physician contract services in China. A multistage cluster random sampling method was adopted to recruit residents aged 18 and above, and a total of 1508 participants were included in this study. The count model and logit regression were adopted to examine the associations between family physician contract service and healthcare utilization, and the potential bias was addressed using the propensity score matching (PSM) method. There was an increase in number of monthly primary care visits and annual referrals for contracted residents compared to noncontracted residents. Participants who had contracted with a family physician were more likely to choose a primary healthcare facility after illness than those who had not. However, no significant change was found in the number of annual hospital admissions between contracted and noncontracted residents. Family physician contract services may effectively strengthen the use of primary care facilities by community residents and promote the formation of a tiered healthcare system in China. [ABSTRACT FROM AUTHOR]

People with disabilities are susceptible to mental disorders, so it is very important to check and monitor their access to mental health services. There has been no study in this regard in Iran. This study aimed to measure the prevalence and socioeconomic inequality of subjective unmet needs for mental healthcare services (SUNMH) among individuals with disabilities and the various reasons behind them in the west of Iran. This descriptive-analytical and cross-sectional study was conducted on 613 people with disabilities over 18 years of age in Sanandaj city in 2023. Simple random sampling was used, and a questionnaire was applied to collect the data. The multivariate logistic regression was used to determine significant predictors of SUNMH. The concentration index (C) and concentration curve (CC) were calculated to measure inequality in the prevalence of SUNMH. Data were analyzed using STATA software version 16.0 (Stata Corp, College Station, TX, USA. About 47% of people had experienced SUNMH. Lack of financial ability with 45%, insufficient payment of basic health insurance for mental health services with 27%, and noncoverage of mental health services by basic health insurance with 25% were the three main reasons for SUNMH. According to the logistic regression model, unemployment (OR: 2.70, 95% CI: 1.31–5.53), not having supplementary insurance (OR: 2.03, 95% CI: 1.11–4.74), having another member with a disability in the household (OR: 3.33, 95% CI: 1.34–8.29), and poor economic status increased the odds of experiencing unmet need for mental health services by about 3, 2, 3, and 21 times, respectively (OR: 21.11, 95% CI: 13.72–48.11). The concentration index was −0.496, indicating a greater concentration of SUNMH in people with low socioeconomic status. Access to health services is not suitable among people with disabilities and a significant percentage of them suffer from SUNMH. Policy recommendations are proposed to address the primary obstacle of financial barriers to SUNMH and increase access to the necessary services, which include increasing the allocation of financial resources to specialized mental health services for individuals with disabilities and expanding disability-specific health insurance coverage with government financial support. [ABSTRACT FROM AUTHOR]

Health education is one of the most effective and efficient ways to achieve the goal of universal health coverage and the sustainable development goals. The equity of access to health services (especially services from community healthcare centers) for internal migrants is an important issue of global concern. However, due to the registration system, long-term residence plan, education level, and other determinants, it is more difficult for internal migrants to enjoy equitable health education compared with local residents. At present, there is no research on signing up with family doctors mainly from community healthcare centers among internal migrants and their impact on access to health education services. In this nationwide cross-sectional study, we used the migrant population dynamic monitoring survey (MDMS) in 2018 to assess the disparities in signing up with a family doctor and its association with health education among internal migrants in China. Among the 151,892 participants, a total of 11.26% migrants had signed up with a family doctor and 81.37% internal migrants had received health education. There was a significant association between signing up with a family doctor and health education in the univariate model (aOR = 1.113; 95% CI: 1.095, 1.132) and the multivariate model (aOR = 1.107, 95% CI: 1.089, 1.126). Meanwhile, age (aORinteraction = 0.996, 95% CI: 0.994, 0.997), migration time (aORinteraction = 0.927, 95% CI: 0.907, 0.948), and migration range (aORinteraction = 0.994, 95% CI: 0.992, 0.997) also had an impact on the relationship between signing up with family doctors and health education. Due to the health education inequalities among internal migrants in China, we need to improve health education access and utilization of internal migrants. As signed up with family doctors was significantly associated with health education among migrants in China, we recommended that the government and healthcare facilities promote health education through family doctors. The number and professional ability of family doctors should also be improved especially in areas with weak healthcare service resources in the future. [ABSTRACT FROM AUTHOR]

Background. As part of the efforts being made to achieve universal health coverage, Ethiopia plans to introduce a social health insurance scheme for the formal sector. Although the contribution will be collected as 3% of an employee's gross salary from both the employee and employer, there is a concern that the premium may not be affordable for the majority of civil servants and that there could be limited interest in joining the scheme. As a result, the purpose of this study was to assess public servants' awareness, willingness to join, and affordability of social health insurance in Arba Minch, south Ethiopia. Methods and Materials. A cross-sectional study design was used with 713 randomly chosen public employees from Arba Minch town from January 1 to 30, 2019. The survey participants were selected based on a multistage stratified random sampling method. Descriptive statistics were used to summarize awareness and affordability of the scheme, and both bivariate and multivariable logistic regressions were used to examine factors driving the outcome variables. Variables that had a p value of less than 0.25 in bivariate analysis were changed to multivariate analysis, and a p value of less than 0.05 was cutoff point for multivariate analysis. The odds ratio and 95% CI were used to report the findings. Result. In this study, 692 people voluntarily participated, which corresponds to a response rate of 97%. As the results revealed, 347 (50.1%) respondents had never heard of SHI before, 607 (87.7%) were able to afford the 3% of gross salary per month as a scheme premium, and 254 (36.7%) were willing to join the scheme. Working sector, regularly listening for health information through mass media, and social network participation were significantly associated with awareness of the SHI scheme. Also, educational status, family size, and net income were found to be significant factors associated with the affordability of the SHI scheme. On the other hand, awareness of SHI, family size, regularly listening for health information, and participation in social networks were significantly associated with willingness to join SHI during multivariate analysis. Conclusion. Half of the participants were unaware of social health insurance, suggesting that the program is not well known. Although only one-third of respondents were willing to join and pay for the program, the majority were able to afford the proposed contribution of 3% of gross wages per month. [ABSTRACT FROM AUTHOR]

Family caregivers' sense of security benefits older adults who receive home care. Advance care planning (ACP) is reported to affect family caregivers' experience positively, but it might differ depending on family caregivers' kin relationships with the older adults. This study aimed to investigate whether ACP for older adults in home care settings is associated with family caregivers' sense of security and whether such an association depends on the family caregivers' status as spouses or adult children. Clarifying this association may offer practical support for implementing ACP while maintaining family caregivers' sense of security. This study was part of a prospective cohort study in Japan. The participants were older adults who used home-visit nursing services, their family caregivers, and the nurses who cared for them, recruited through the professional associations of home care nurses across Japan. Family caregivers answered a sense of security questionnaire, and the nurses were asked whether ACP was conducted. Data were collected three times from nurses and twice from family caregivers over a three-month period from August 2019 to June 2020. Multivariate logistic regression analyses were performed to examine the association between ACP implementation and positive changes in the sense of security scores after three months. Data from 169 cases were analyzed; 28.1% of the family caregivers were men and 55.6% were spouses. ACP was performed in 53.8% of the cases. The multivariate analysis showed an interactive effect between ACP implementation and family caregivers' kin relationships. For spouses, ACP was significantly associated with a positive change in their sense of security. For adult children, such an association was not found. Thus, ACP might have a positive effect on caregiving spouses' sense of security. Adult child caregivers, who often have multiple responsibilities and have difficulties facing their parents' physical decline, may need support in addition to ACP. [ABSTRACT FROM AUTHOR]

Carer-employees (CEs) are unpaid carers who are simultaneously working in paid employment. Workplace stress often compounds with caregiving stress to cause negative health effects for CEs. This analysis investigates cross-sectional data of the 2018 Canadian General Social Survey (GSS) to determine whether CEs who experienced work interferences (WIs), including taking time off work, turning down a job offer or promotion, and taking a less demanding job, were associated with poor mental health due to caregiving responsibilities. Carer-friendly work policies (CFWPs) and social support would lower the mental health impact of CEs and moderate the association between WIs and mental health. Of the 23,025 respondents, 4,291 were CEs. A series of multivariate logistic regressions were conducted on various mental health symptoms (e.g., feeling tired, experiencing appetite loss, and having trouble sleeping). Most WIs were positively associated with mental health symptoms. CFWPs, such as flexible scheduling, the option to work part-time, being able to take a leave of absence or an extended leave, and feeling that CFWPs can be taken without negative impacts on one's career, were negatively associated with at least one mental health symptom caused by the caregiving responsibilities. The option to telework was found to be nonsignificant. Generally, social support was associated with an increased chance of mental health symptoms, apart from help from the community. CEs who worked in workplaces that promoted CFWPs without negative impacts on their careers were less likely to feel anxious when turning down a job offer or promotion. Our study highlights the importance of CFWPs for CEs' mental health. As the number of CEs increases over time, the need for effective and wide-ranging CFWPs becomes more important. [ABSTRACT FROM AUTHOR]

Objectives. The study aims to determine the social care need among overweight and obese older adults by identifying the number of social care support receipts from different sources. Methods. A sample of 5640 participants (aged 50 years and over) taken from the English Longitudinal Study of Ageing Wave 8 dataset. Multivariate logistic regression analysis was performed to explore the relationship between the study variables. Results. The statistical analyses demonstrated that overweight and obese older adults are the recipients of increasing amounts of informal social care. Moderate and morbidly obese participants are the recipients of increasing amounts of formal care compared to their normal-weight counterparts, with morbid obesity being a strong predictor for receipt of formal care. Conclusions. The present study's findings demonstrate that for older adults aged 50 years presence of morbid obesity is a strongest predictor for receipt of formal care, and their well-being is not associated with formal or informal care receipt. The findings on how wider lifestyle factors influence the number of social care receipts, from different sources, may help policymakers and healthcare providers to allocate limited resources for adult social care services and promote healthy ageing rather than just focusing on weight loss alone. [ABSTRACT FROM AUTHOR]

Older people prefer to remain living in their own home for as long as possible; however, many require support to do so through health and other care services provided in the home. This study aimed to explore the trends in usage of a home-based care service by older people in metropolitan Melbourne and factors associated with unplanned hospitalisations. This longitudinal study analysed episodes of home-based care for people aged ≥65 years between 2006 and 2015. An episode of care was defined as the period of time during which the home care services were provided to the client. Care episodes culminated in a planned discharge from the service or an unplanned hospitalisation. Descriptive statistics and multivariable logistic regression were utilised to investigate the characteristics associated with unplanned hospitalisations. Utilisation of home-based care services over the 10-year period showed an increasing rate of use by people aged ≥85 years and a reduced usage rate by females aged 70–84 years and males 75–79 years old. Of 170,001 episodes of care, 43,608 (25.7%) resulted in an unplanned hospitalisation. Home-based care delivered to people aged ≥85 years showed an increasing rate of episodes ending in an unplanned transfer to the hospital. Between 2006 and 2015, individuals aged 85–89 years displayed a rate increase of 18.7% in episodes ending in an unplanned hospitalisation; for those aged ≥90 years, the rate rise was 43.6%. Factors associated with an unplanned hospitalisation included advancing age, male gender, living alone, cognitive dysfunction, and the complexity of medical issues. Health policy has focussed on providing services to enable older people to remain in their own home. The increasing rate of unplanned hospitalisations for community-dwellers aged ≥85 years suggests more support is required to enable ageing in place. [ABSTRACT FROM AUTHOR]

Background. Community-based health insurance (CBHI) is one of the strategies among others to be used for the achievement of universal health coverage (UHC) through providing financial protection to the citizens of a country. The schemes have been seen as effective in reducing out-of-pocket (OOP) payments and improving access to the healthcare services. This study tried to assess health-related quality of life between members and nonmembers of the scheme in rural southwest Ethiopia. Study Method. A community-based comparative cross-sectional study was conducted between the insured and uninsured populations. A standardized WHOQOL-BREF questionnaire was used. Cross-tab and frequency table analysis were done to tabulate for monovariable and bivariable analysis. Multiple linear regressions were employed to determine associations by adjusting for potential confounders. The association decision was made after fitted assumptions and adjustments done by modeling. Results. About six hundred thirty-four (634) households completed the survey with a response rate of 97.2%. More than 90% of the participants were illiterate and elementary education completed and farmers. Most uninsured family members claimed that they had difficulty affording annual payments 72.5%, P < 0.001. Willingness to pay was higher for insured members of households (72.2%), P < 0.001. Being insured had experienced a higher quality of life than uninsured, β (95% CI), 4.15 (2.52, 5.77), and P < 0.001. Marital status other than married had lower quality of life experiences than married alone, β (95% CI), −6.83 (−9.75, −3.92), and P < 0.001. Male respondents were experiencing lower quality than females, β (95% CI), −2.49 (−4.25, −0.72), and P = 0.006. Family number of the household and quality of life had positive linear relations, β (95% CI), 0.87 (0.43, 1.31), P < 0.001. Conclusions and Recommendations. Being insured had positive implications for quality of life. Inhabitants have to be encouraged to the scheme membership. [ABSTRACT FROM AUTHOR]

Participation by patients with chronic diseases under primary health care requires more attention to achieve effective disease management and better health outcomes. In 2016, China proposed accelerating the establishment of a system of family doctors (FDs) and strengthening doctor-patient communication to better meet residents' health service needs. This study aimed to describe perceived participation in primary health care among patients with chronic diseases in northeastern China and explore the impact of FD contract services and patient's trust on patients' perceived participation. A cross-sectional survey of 847 patients with chronic diseases in 16 primary healthcare institutions was conducted in Jilin Province, China. Among all participants, 453 patients reported signing up for FD contract services (62.93%). The perceived participation of patients with chronic diseases was at a low level (mean = 6.71 and SD = 3.35). After controlling for sociodemographic variables and health-related variables, FD contract services directly and indirectly influenced patients' perceived participation. The patient's trust was a mediator in the relationship between FD contract services and perceived participation. This study confirmed the valuation of family doctor contract services and provided a theoretical basis for the formulation of primary health service policies. Health organizations should continue to enhance the capacity of primary health services and attract more chronic disease patients to contract with FD teams, thereby enhancing doctor-patient trust and increasing patient's participation in primary health care. [ABSTRACT FROM AUTHOR]

In the United States, about half of pregnancies are unintended, and most women of reproductive age are at risk of unintended pregnancy. Research has explored predictors of contraceptive use and unintended pregnancy, but there is a lack of research regarding access to preferred contraceptive method(s) and the complex pathways from sociodemographic factors to these family planning outcomes. This study applied Levesque et al.'s (2013) healthcare access framework to investigate pathways from sociodemographic factors and indicators of access to family planning outcomes using secondary data. Data were collected at four time points via an online survey between November 2012 and June 2014. Participants were US women of reproductive age who were seeking to avoid pregnancy (N = 1036; Mage = 27.91, SD = 5.39; 6.9% Black, 13.6% Hispanic, 70.2% white, 9.4% other race/ethnicity). We conducted mediational path analysis, and results indicated that contraceptive knowledge (β = 0.116, p = 0.004), insurance coverage (β = 0.423, p < 0.001), and relational provider engagement (β = 0.265, p = 0.011) were significant predictors of access to preferred contraceptive method. Access to preferred contraceptive method directly predicted use of more effective contraception (β = 0.260, p < 0.001) and indirectly predicted decreased likelihood of experiencing unintended pregnancy via contraceptive method(s) effectiveness (β = −0.014, 95% confidence interval: −0.041, −0.005). This study identifies pathways to and through access to preferred contraceptive methods that may be important in determining family planning outcomes such as contraceptive use and unintended pregnancy. This information can be used to improve access to contraception, ultimately increasing reproductive autonomy by helping family planning outcomes align with patients' needs and priorities. [ABSTRACT FROM AUTHOR]

Enhancing the voluntary supportive actions of older adults towards other community‐dwelling citizens is an important measure for a healthy community. Volunteering action in adulthood is related to the volunteering actions of older adults' parents, which they remember from their youth. In this study, the association between parents' former voluntary supportive actions and the current voluntary supportive actions of older adults is explored. Questionnaires were distributed to community‐dwelling citizens aged 65 years and above, in Tokamachi city, Niigata Prefecture, Japan (response rate: 81.7%). Participants self‐reported their current voluntary supportive actions and reported on their parents' former voluntary actions during their youth. The results indicated that the current voluntary supportive actions of the study participants were related to the former voluntary actions of their parents (OR: 2.28, 95% CI: 1.62–3.20). Moreover, the participants were more likely to extend support in contexts which are more closely related to one's private life, only when their parents provided support in those private contexts. The study provides implications for the importance of considering life experiences when facilitating voluntary supportive actions and renders information on how unique strategies should to be implemented to involve individuals who are unfamiliar with volunteering actions. [ABSTRACT FROM AUTHOR]

Federally certified opioid treatment programs (OTPs) provide psychosocial counselling in addition to medications for opioid use disorder (MOUDs) using a patient‐centered approach in providing substance use disorder treatment. This study explored factors associated with patients' adherence to counselling while receiving MOUD at an OTP. A retrospective cohort design using data on adult patients (n = 1151, 61% females, 39% males) admitted to an OTP from July 1, 2014, to June 30, 2016, was employed. The data were for single episodes of care up to 52 weeks. Survival analysis (cox proportional hazards regression) assessed the relationship of personal characteristics, socio‐economic status, payment for services, type of substance use, comprehensive care and social support with counselling for up to a year. Results indicated that age, having services paid for by public means, was associated with counselling adherence. Primary heroin use patients had a higher risk of counselling adherence failure than patients who primarily used non‐medicinal prescription substances. Treatment agencies may benefit from funding and using evidence‐based practices for primary heroin use patients and young adults to better engage and retain these populations in treatment. [ABSTRACT FROM AUTHOR]

Disasters affect the well‐being of individuals, families and communities. Health and social care providers are essential in response and recovery efforts and are among the most vulnerable to negative physical and mental health impacts of a disaster. Few evidence‐based interventions are available to address the psychological needs of providers. The aim of this study was to examine the psychological distress of health and social care providers before and after participating in the brief group intervention, Resilience and Coping for the Healthcare Community (RCHC) and its expanded version, RCHC+. We conducted a pragmatic non‐randomised cluster trial with 762 health and social care providers in south Texas and Puerto Rico post‐Hurricanes Harvey and Maria. Participants completed surveys assessing post‐traumatic stress (PTSD), anxiety, burnout and secondary traumatic stress (STS) prior to intervention delivery and at two time points post‐intervention. We calculated the frequency of symptom cut‐off scores at baseline, then estimated multilevel ordinal models to examine changes in symptoms across time. Prior to participation in the RCHC (approximately 12 months after the hurricanes), providers reported high levels of PTSD, anxiety and STS symptoms. After participation, providers in both intervention conditions reported a significant reduction in PTSD symptoms from baseline that was sustained over both time points. The likelihood of a reduction in symptoms of anxiety and STS from baseline was sustained at both time points for participants in the RCHC+ condition. These findings indicate that both the RCHC and RCHC+ interventions may reduce psychological distress for health and social care providers and could be an important part of advance planning to support provider's mental health during and after a disaster. Further examination of the RCHC in other disaster contexts could provide additional insight into the responsiveness of the intervention to reducing psychological distress symptoms. [ABSTRACT FROM AUTHOR]

Social isolation is associated with adverse health outcomes in the general older adult population, but little is known about indicators of social isolation in family caregiver populations. This cross‐sectional study examined the prevalence of social isolation in the 2015 National Survey of Caregiving. Using the Convoy Model of social relations, a life‐course social support framework, we also examined associations between social isolation and caregiver self‐reported health. Using multiple ordinal logistic regression models, we examined social isolation – operationalised with a five‐item summative measure and, alternatively, with each social isolation item – as a predictor of self‐reported general health status. On the dichotomised summative measure, 24.74% (n = 2,175) were more isolated. Younger caregivers were more isolated (M = 56.77 years, SE = 0.76) compared with those who were not (M = 60.86 years, SE = 0.41). Self‐reported general health was as follows: 4.93% poor; 15.67% fair; 25.62% good; 34.81% very good and 18.97% excellent. Less social isolation was associated with higher odds of better self‐reported health (Adjusted odds ratio [AOR] = 1.19; CI = 1.05–1.35). Of the individual social isolation indicators, only a lack of community participation was associated with higher odds of worse self‐reported health (AOR = 1.57; CI = 1.25–1.97). Social isolation and particularly community participation were associated with caregiver health status. It may be necessary for healthcare providers to consider these factors in caregiver health assessments. Future research is recommended to understand the consequences of various social isolation indicators in diverse samples including younger caregivers. [ABSTRACT FROM AUTHOR]

Migration‐related stress is detrimental to children's mental health, yet little is known about the potential mechanisms behind this association. This study examines the mediating role of inflow city identity in the association between migration‐related stress and depression and the moderating role of social participation amongst Chinese migrant children. A sample of 484 migrant children aged 8–17 years is randomly recruited through a cross‐sectional survey in Kunming, China. Inflow city identity partially mediates the association between migration‐related stress and migrant children's depression. Moreover, social participation moderates the above relationship. The direct and indirect effects are significant for migrant children with low social participation but insignificant for migrant children with high social participation. This study deepens the theoretical understanding of the underlying mechanism between migration stress and psychological distress and provides practical implications for preventing mental disorders in Chinese migrant children. [ABSTRACT FROM AUTHOR]

Although continuous treatment leads to better patient outcomes, evidence regarding the effect of the continuity of care (COC) on preventable hospitalisation and medical expenses in Korea for patients with dyslipidaemia is insufficient. We evaluated the effect of COC on preventable hospitalisation and medical expenses for patients with dyslipidaemia. This study used National Health Insurance Sampling cohort data (2008–2015). We measured COC with the Bice–Boxerman index based on the outpatient visits of patients diagnosed with dyslipidaemia for the first time. Preventable hospitalisation included admission for cardiovascular disease (CVD) and all costs for outpatient visits. We evaluated the association of COC with preventable hospitalisation and medical expenses using a generalised estimating equation model. Patients (N = 53,372) with newly diagnosed dyslipidaemia participated. Compared to non‐hospitalised patients, hospitalised patients had higher fragmentation scores for CVD, met more healthcare providers, had higher total outpatient visits and had a lower proportion of primary healthcare providers served. A higher fragmentation score was associated with an increased risk of hospitalisation (rate ratio [RR]: 1.873, 95% confidence interval [CI]: 1.520–2.309) and healthcare expenditure (RR: 1.381, 95% CI: 1.322–1.442). The magnitude of the effect of COC on hospitalisation differed according to patients' drug intake and residence location. Fragmentation of care was associated with preventable hospitalisation and increased healthcare costs, especially for patients taking medications/living in rural areas. It is necessary to promote a more effective COC. [ABSTRACT FROM AUTHOR]

The plethora of pathways leading to health problems of later life has made the causal assessment of widowhood on the health of older adults difficult. This research aimed to assess the short‐term impact of widowhood on the objective health of older adults and to the moderating role of community‐based care (CBC) in improving the health outcomes of older adults. In this study, the activities of daily living (ADLs) and number of hospitalisations of older adults were measured, and PSM‐DID models were conducted. Widowhood had a significant negative impact on the objective health of older adults. Widowed adults had higher ADL scores (B = 0.569, 95 percent CI: 0.295 to 0.844) and more hospitalisations (B = 2.551, 95 percent CI: 1.189 to 3.914) than nonwidowed adults. Meanwhile, CBC in urban areas can significantly reduce ADL scores (B = −0.154, SE = 0.082) and the number of hospitalisations (B = −1.402, SE = 0.348) in older adults, whereas CBC in rural areas can only significantly reduce ADL scores (B = −0.197, SE = 0.087). Taken together, there is an urgent need to focus on the health of widowed and older adults and to provide CBC in both urban and rural areas equally. [ABSTRACT FROM AUTHOR]

This retrospective cohort study aimed to identify heterogeneous cognition, depression, and life satisfaction trajectory groups, and to examine the independent contributions of watching television and reading to these trajectories among middle‐aged and older adults. A sample was taken from the Taiwan Longitudinal Study on Aging (TLSA) with measures of cognition, depression, life satisfaction, watching television, and reading during 12 years of follow‐up (N = 4440). Group‐based trajectory models and multinomial logistic regressions were used. The findings showed that the cohort was separated into three global cognition groups of low‐cognition (n = 376), declining‐cognition (n = 805), and maintained‐cognition (n = 2718); three episodic memory groups of high‐declining (n = 540), middle‐stable (n = 2066), and improving groups (n = 1293); three depression groups of low‐to‐low (n = 2571), median‐to‐high (n = 960), and high‐to‐high groups (n = 368); and three life satisfaction groups of low‐ (n = 1133), middle‐ (n = 977), and high‐level groups (n = 1789). Also, the findings demonstrated that after adjusting for covariates, those who did not watch television or read at the baseline had independently significantly increased odds of having lower global cognitive function, higher depression, and lower life satisfaction over time versus those who watched television or read almost every day. Based on the findings obtained, group‐based trajectories of cognition, depression, and life satisfaction scores identified distinct subgroups among TLSA participants. Moreover, the findings suggest that healthcare providers need to develop more targeted population interventions to ensure successful aging. Healthcare providers can encourage older adults, particularly new retirees, to participate in leisure activities (i.e., watching television and reading) to reduce prevalence rates of cognitive impairment and depression. [ABSTRACT FROM AUTHOR]

Carers of people living with a disability, mental health problems, alcohol or drug dependency, chronic condition, terminal illness or who are frail due to age may experience negative caregiving impacts. Although carers' social isolation has been reported in many qualitative studies, it has largely been neglected in quantitative studies. Using data collected in the Carers NSW 2020 National Carer Survey, this large‐scale quantitative study aimed to identify the extent of Australian carers' social connectedness and what factors may be related to their social well‐being. The validated Friendship Scale was used to measure social connectedness of 5585 carers. More than half (56.2%) of these carers were socially isolated. Analysis found that a longer duration of caring, more time spent weekly caring, living with the care recipient, caring for a greater number of people, receiving no help from others, higher reported psychological distress and reporting perceived needs were all associated with greater social isolation. Identifying as female or nonbinary/gender diverse, identifying with a culturally and linguistically diverse background, and caring as a parent, former partner or young carer were also related to poorer social connectedness. Health and social services need to consider the needs of carers, identify carers who are socially isolated and provide resources to promote social connectedness. Greater attention in practice and research to focus on carers' social connectedness to address this crucial caregiving experience is required. [ABSTRACT FROM AUTHOR]

Social isolation is a well‐established determinant of late‐life well‐being, and it may be particularly relevant for older adults in Puerto Rico following Hurricane María. The abbreviated Lubben Social Network Scale (LSNS‐6) is a widely used measure of social isolation, but it has not been validated with Spanish‐speaking older adults. The objectives of this study were to (1) assess the psychometric properties of a Spanish‐language LSNS‐6 and (2) examine its association with self‐rated health (SRH) and psychological sense of community (PSOC). Data came from face‐to‐face survey interviews with a nonprobability sample of 154 community‐dwelling older adults in Puerto Rico 2 years after Hurricane María. We assessed the LSNS‐6's internal consistency reliability and convergent validity. We then conducted structural equational modelling consisting of (1) a measurement model using confirmatory factor analysis to test the factor structure of the LSNS‐6 and (2) a structural model using path analysis to examine the direct effect of social isolation on SRH and to test the role of PSOC as a mediator in this relationship. The LSNS‐6 demonstrated acceptable internal consistency reliability (α = 0.74) and convergent validity, r(151) = −0.33, p < 0.001. A correlated two‐factor model (Family and Friends) provided the best fit (comparative fit index = 0.986, Tucker–Lewis index = 0.975, root mean square error of approximation = 0.082, standardised root mean squared residual = 0.033). Path model results show the Friends factor was negatively associated with SRH (β = −0.31, p = 0.045), whilst the Family factor was nonsignificant. The Friends factor had a statistically significant indirect effect on SRH through PSOC (β = 0.08, 95% CI [0.01, 0.29]). Our findings provide insight into the effect of social isolation on health amongst older adults in Puerto Rico and highlight the potential role of PSOC for assessment and intervention with older adults in post‐disaster settings. [ABSTRACT FROM AUTHOR]

This study aims to explore the associations between personality traits and depressive symptoms among Chinese adults and analyse the gender and age differences in the associations. A national representative sample of 28,628 adults aged 18 and above were selected from the 2018 China Family Panel Studies (CFPS) data. The short version of the Big Five Inventory (CBF‐PI‐15) and the Center for Epidemiologic Studies Depression (CES‐D 8) were used to measure personality traits and depressive symptoms respectively. Binary logistic regression models were employed to analyse the associations between personality traits and depressive symptoms in the whole participants, different age groups and genders respectively. After adjustment, higher levels of conscientiousness, extraversion and agreeableness were related to lower level of depressive symptoms, while higher levels of openness and neuroticism were related to higher level of depressive symptoms (p < 0.05). A significant interaction between gender and conscientiousness on depressive symptoms was found (interaction p = 0.005), and the association between conscientiousness and depressive symptoms was stronger in males than females (p < 0.001). Significant interactions between age and conscientiousness (interaction p = 0.007), agreeableness (interaction p = 0.001) on depressive symptoms were found respectively. Moreover, the associations of conscientiousness and agreeableness with depressive symptoms were strongest among old group, followed by middle‐aged group, and then young group (p < 0.05). In conclusion, conscientiousness, extraversion and agreeableness had negative associations with depressive symptoms, while openness and neuroticism had positive associations with depressive symptoms. The negative association between conscientiousness and depressive symptoms was stronger among males than females, and the negative associations of conscientiousness and agreeableness with depressive symptoms were strongest among old group, followed by middle‐aged group, and then young group. [ABSTRACT FROM AUTHOR]

Extensive studies have explored the factors affecting caregiving stress, but how oral health of care recipients (CRs) associates with caregiving stress and the mechanism behind it are not well‐known. Guided by Stress Process Theory, this study addressed such research gaps. Caregiver services dataset came from the 13th National Survey of Older Americans Act Participants in the United States (N = 1289). Caregiving stress included physical, emotional, and financial stress. The oral health of CRs was self‐rated by a single item. The functional ability of CRs was assessed by activities of daily living (ADLs) and instrumental activities of daily living (IADLs). PROCESS 3.4 for SPSS 26.0 was used to conduct the mediation analyses. Results from the study showed that caregivers reported slightly high levels of physical (M = 3.06, SD = 1.33, Range = 1–5), emotional (M = 3.43, SD = 1.28, Range = 1–5), and financial (M = 2.83, SD = 1.43, Range = 1–5) stress. The results from hierarchical linear regression revealed that poor oral health of CRs was significantly associated with higher levels of physical (B = 0.11, p < 0.001), emotional (B = 0.09, p < 0.01), and financial (B = 0.12, p < 0.001) stress, respectively. The functional ability of CRs mediated such relationships between the oral health of CRs and the caregiving stress of their family caregivers. Findings from this study enrich our theoretical and practical understanding of caregiving stress in aged care and offer programs and policy implications of oral and physical healthcare for community‐dwelling older adults. [ABSTRACT FROM AUTHOR]

Many studies have disentangled the perceived benefits of vegetation on subjective well‐being (SWB). Yet, scant attention has been paid to the joint effect of vegetation and building density on SWB. This study explores the relationship between streetscape vegetation (SV), building density and SWB in Beijing, China. Our analysis relies on rich measures of street view data to assess SV exposure at the neighbourhood level. Notably, we distinguish between trees (SV‐tree) and grasses (SV‐grass) when evaluating SV metrics. The results suggest that streetscape trees and grasses are positively associated with SWB, though estimated effects are dependent upon tree and grass density exposures. We also find that the effects of streetscape trees and grass are moderated by building density in the neighbourhood. Additional decomposition analysis provides the insight that the well‐being implications of street vegetation and building density are varied significantly by individual sociodemographic characteristics such as sex, age and income. The findings of this study suggest the importance of considering density in SV planning and land use policies to enhance people's quality of life. [ABSTRACT FROM AUTHOR]

This study investigated the factors associated with clinical symptoms and level of functioning at baseline and after 4 months of navigation, in youth with mental health and/or addiction concerns involved with a family navigation service. Participants in this pre‐post study were caregivers who accessed a mental health and addictions navigation service between March 2018 and July 2019 on behalf of their youth aged 13–26 who had mental health and/or addiction concerns. Evaluations were conducted at baseline and at 4 months after entering navigation. The dependent variable, youth mental health symptoms and functioning, was assessed by caregivers using the Symptoms and Functioning Severity Scale. The sample included 345 caregivers of youth (youth: mean age 18 years, 57% male). At intake, using multiple linear regression, caregiver strain (β = 0.481, p < 0.001), youth completion of ADLs (β = −0.156, p = 0.002) and youth motivation (β = −0.110, p = 0.021) contributed significantly to variance in symptoms and functioning (R2 = 0.373, p < 0.001). Using ANOVA to compare complete pre/post data (n = 115), there was a significant main effect of time on the youth symptoms and functioning score (F[1, 107] = 9.278, p = 0.003). Furthermore, the interaction of time, youth completion of ADLs (low vs. high at baseline) and youth motivation (low vs. high at baseline) was significant (F[1, 107] = 4.699, p = 0.032). Youth with low motivation and low completion of ADLs at baseline experienced the largest improvements in symptoms and functioning after 4 months of navigation. These findings suggest that this group of youth should be a primary target in mental health and addiction navigation. [ABSTRACT FROM AUTHOR]

The present study investigates the effects of group appraisal and acculturation orientations on burnout of social workers working with immigrants. The study is based on the Threat‐Benefit and the Acculturation Theories. The proposed theoretical model was tested in a sample of social workers working with immigrants from the Former Soviet Union (FSU) in Israel (n = 313). Amongst the study participants, 254 were Israeli born, and 59 were immigrants from the FSU. The results demonstrated that social workers' acculturation orientations mediate the connection between the appraisal of the immigrant group and the social workers' burnout when working with immigrants from this group. Specifically, appraisal of immigrants as beneficial for the receiving society was associated with a stronger orientation towards preserving the immigrant culture (β = 0.22). On the other hand, appraisal of immigrants as threatening the receiving society was associated with a weaker orientation towards preserving the immigrant culture (β = −0.21) and with a stronger orientation towards acquiring the majority culture by immigrants (β = 0.12). A stronger acculturation orientation related to preserving the immigrant culture was associated with a lower level of burnout (β = −0.13) and a higher sense of personal accomplishments of social workers working with immigrants (β = 0.20). Immigrant social workers, compared to their native colleagues, reported a higher level of personal accomplishment (M[SD]IM = 5.08[1.24] vs. M[SD]IS = 4.21[1.39]) but also a higher level of burnout working with immigrant clients (M[SD]IM = 1.88[0.83] vs. M[SD]IS = 1.60[0.63]). The main conclusion following the present study relates to the importance of developing a positive appraisal of immigrants and accepting the immigrant culture for successful work with immigrants. [ABSTRACT FROM AUTHOR]

The transition to parenthood represents a moment of change and adaptation in which the dyadic marital relationship becomes a triadic relationship. Facilitating a positive transition requires a thorough understanding of the explanatory model of the relationship between parental–infant bonding, dyadic adjustment and quality of life (QoL) from an integrative perspective of the family unit. The aim of this work was to analyse the relationships between parent–infant bonding, dyadic adjustment and QoL from an intra‐partner perspective, 6–12 months after the birth of a child. A cross‐sectional observational study was performed in a convenience sample of 222 couples 6–12 months postpartum, enrolled from October 2013 to March 2016. The mean age of the mothers was 34.07 years (SD = 3.67), and for the fathers, it was 35.75 years (SD = 4.02). Mothers perceived better QoL and greater mother–infant bonding compared to fathers. The perception of an adequate dyadic adjustment, together with positive parent–infant bonding, had positively influenced the individual QoL of both members of the couple 6–12 months after birth. From an intra‐partner perspective, the positive transition was influenced by the relationship between parent–infant bonding, dyadic adjustment and QoL. Positive parent–infant bonding in mothers and fathers, as well as promotion of the quality of the relationships between couples, can help promote a better QoL. Positive health results can be achieved in terms of individual and family well‐being by designing healthcare interventions that encourage the presence and participation of the family unit. [ABSTRACT FROM AUTHOR]

Accessibility of health services outside metropolitan centres in Australia is sub‐optimal. Recognising the barriers and enablers of healthcare access in rural, remote and regional settings is necessary to improving health service access in these disadvantaged populations. Accordingly, this study aimed to examine the determinants of healthcare use in rural, remote and regional South Australia. Cross‐sectional survey data were collected from adults living outside metropolitan Adelaide in South Australia between April 2017 and March 2018. Using a multi‐modal recruitment campaign, eligible adults were invited to complete the 44‐item consumer utilisation, expectations and experiences of healthcare instrument. Independent predictors of health service utilisation (dependent variable) were determined using negative binomial regression. The questionnaire was completed by 3926 predominantly female (52.5%) adults aged ≥50 years (56.7%), residing in regional South Australia (84.5%). Fifteen independent variables were significantly associated with health service utilisation using univariate analyses. Using negative binomial regression analysis, two predisposing factors (sex, remoteness), three enabling factors (income, health literacy, employment), two need factors (health rating, multimorbidity) and two personal health practices (alcohol, diet) were independently and significantly associated with healthcare use. Female sex (OR = 1.436, p < 0.001), good/excellent health rating (OR = 0.589, p < 0.001) and high multimorbidity (OR = 1.408, p < 0.001) were the strongest predictors of health service use. These findings will help inform the development of targeted health promotion and service engagement strategies for regional populations, which in addition to addressing workforce shortages, may help address inequity in health outcomes, particularly for groups engaging with regional healthcare services infrequently. [ABSTRACT FROM AUTHOR]

Social intervention with children with disabilities and their families should be understood through the principles of family‐centred practice. In Spain, early intervention is understood as interventions aimed at children from 0 to 6 years old and their families. Professionals carry out the reception, assessment and intervention. This study aims to analyse the relationship between mental and physical health, caregivers' levels of anxiety and depression and the child's development during the fostering and assessment phase. The sample is made up of 135 families using child development centres in the Balearic Islands. Four questionnaires were completed: Health‐Related Quality of Life SF‐12, Anxiety and Depression Scale, Child Behaviour Checklist (CBCL 1½–5) and socio‐demographic questionnaire. The results show that parents of children with disabilities have higher levels of mental health impairment than physical health impairment. They also score higher on anxiety than on depression. It is worth noting that professional discipline is a variable to be taken into account in relation to parents' perception of their child's developmental improvement. In addition, the association between the developmental subscales, where the more the child is affected, the more the parents' mental health is affected. The same pattern occurs with caregivers' levels of anxiety and depression. In short, we propose a reflection on the application of family‐centred practices during interventions, understanding the lack of professional training as a predictor of the quality of early intervention. [ABSTRACT FROM AUTHOR]

Females and males frequently report substantial differences in social capital indicators and may use healthcare distinctly. Nevertheless, the potential effect of sex on the relation between social capital and healthcare use remains unclear. This study aims to quantify the association between different indicators of individuals' social capital and healthcare use, according to sex. Data were retrieved from the Sixth Wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), which was conducted in 2015, and included 68,188 participants from 18 countries. Adjusted odds ratios (AOR) and 95% confidence intervals (95%CI) were computed using logistic regression. Overall, males and females with smaller social networks, those who live alone or with any other relatives besides their partners, and those whose first close confidant was a family member or a neighbour reported fewer contacts with medical doctors or nurses, as well as with dentists or dental hygienists. Amongst females, participation in educational or training courses (AOR = 1.67, 95%CI:1.40–2.00; p for interaction = 0.035) and sport, social or any other club (AOR = 1.79, 95%CI:1.58–2.02; p for interaction = 0.043) was associated with a more frequent contact with dentists or dental hygienists. Females who participated in volunteer or charity work (AOR = 0.76, 95%CI:0.64–0.91; p for interaction = 0.042) and political or community‐related organisations (AOR = 0.72, 95%CI:0.52–1.00; p for interaction = 0.030) were less likely to report the use of polypharmacy. This outcome was more frequently observed amongst females who referred feelings of severe loneliness (AOR = 1.44, 95%CI:1.22–1.68; p for interaction < 0.001). Social capital is associated with healthcare use distinctively amongst males and females. Increasing opportunities for social participation may improve healthcare use, particularly amongst females. [ABSTRACT FROM AUTHOR]

This study investigated how physicians, nurses, and social workers in community health care services make judgements about possible child maltreatment in ambiguous situations. We examined the influences of social biases (i.e., perceptions linking ethnicity, gender, and family socioeconomic status to child maltreatment) and belonging to distinctive occupational groups (i.e., physicians, nurses, and social workers) on professionals' assessment of suspected child maltreatment, intention to consult with others, and reporting. We used an experimental survey design including vignettes presenting a child's history inspired by real‐life clinical cases. Data were collected from 397 health care professionals—170 physicians, 179 nurses, and 48 social workers—employed at community health care clinics in northern Israel. Findings show that the child's gender and family socioeconomic status had significant effects on assessment of possible child maltreatment. Also, professionals' occupational group had significant effects on assessment of child maltreatment and intention to pursue consultation. Another key finding was the significant effects of judgements about child maltreatment assessment, consultation, and reporting on one another. The study reinforces efforts to improve health care professionals' management of suspected child maltreatment that include the development of clinical decision support systems that use routinely collected electronic medical record data. [ABSTRACT FROM AUTHOR]

Policy guidance promotes supporting people to live in their own homes for as long as possible with support from homecare services. People living with dementia who need such support can experience a range of physical and cognitive difficulties, which can increase the risks associated with homecare for this group. We aimed to examine risk and safety issues for people with dementia and their homecare workers and risk mitigation practices adopted by homecare workers to address identified risks. We searched MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, ASSIA and Cochrane Central Register of Controlled Trials databases 5 March 2021. Included studies focussed on homecare for people with dementia and had a risk or safety feature reported. Risk of bias was assessed with the Joanna Briggs Institute Critical Appraisal tools. Two authors assessed articles for potential eligibility and quality. A narrative synthesis combines the findings. The search identified 2259 records; 27 articles, relating to 21 studies, met the eligibility criteria. The review identified first‐order risks that homecare workers in the studies sought to address. Two types of risk mitigation actions were reported: harmful interventions and beneficial interventions. Actions adopted to reduce risks produced intended benefits but also unintended consequences, creating second‐order risks to both clients with dementia and homecare workers, placing them at greater risk. Risk mitigation interventions should be person‐centred, the responsibility of all relevant professions, and planned to minimise the creation of unintended risks. [ABSTRACT FROM AUTHOR]

Hepatitis B testing is the gateway for prevention and care. However, previous studies document low hepatitis B testing uptake in sub‐Saharan Africa. This study investigated knowledge, stigma endorsement and knowing someone with hepatitis B as correlates of hepatitis B testing behaviours among people in the Greater Accra and Northern regions of Ghana. A cross‐sectional survey was completed by 971 participants (Greater Accra = 503, and Northern region = 468) between October 2018 and January 2019. Approximately 54% of the participants reported having been tested for hepatitis B. The logistic regression analyses showed that having greater hepatitis B knowledge was positively associated with hepatitis B testing (OR = 1.22, 95% CI: 1.14–1.30). Higher hepatitis B stigma endorsement was negatively related to hepatitis B testing (OR = 0.97, 95% CI: 0.96–0.99). Also, participants who knew someone (i.e. parent, sibling and/or friend) with hepatitis B were more likely to have tested compared to those who did not know someone with hepatitis B (OR = 7.15, 95% CI: 5.04–10.14). This study demonstrates that knowing someone with hepatitis B increases the likelihood of testing, highlighting the need to create safe and non‐judgmental contexts for people with hepatitis B (PWHB) to disclose if they want to. Also, given that greater hepatitis B knowledge increases testing and hepatitis B stigma endorsement impedes testing, interventions that increase knowledge and reduce stigma should be incorporated in efforts to promote testing in Ghana. [ABSTRACT FROM AUTHOR]

Youth in special education have complex needs that are supported across multiple systems. Our research investigates the use of adult income assistance, as one structure that supports youth as they transition to adulthood. We created a cohort of youth (5–22 years old) using linked administrative data from British Columbia government ministries from 1996 to 2018. Youth were grouped by their special education funding (most to least; Level 1, Level 2, Level 3, Unfunded, and no special education). We investigated (1) youth characteristics and service use patterns, (2) which youth used income supports after the child‐to‐adult transition (19–22 years old), and what youth characteristics and service use patterns were associated with use, and (3) how much income support they used (CAD$). Of 174,527 youth, 254 (0.1%) were Level 1, 6020 (3.4%) were Level 2, 4409 (2.5%) were Level 3, 21,232 (12.2%) were Unfunded, and 142,612 (81.7%) were not in special education. Youth assigned higher funding levels, compared to lower levels, generally had increased service use, and in the transition to adult services were more likely to use income supports, and received more income support. An important exception was youth with serious behavioural/mental health special education funding (Level 3), who had increased service use for their level of funding, but received less income support due to a reliance on Temporary versus Disability Assistance. Youth that received an accredited diploma were less likely to use income supports. Factors related to the use of income supports are further described. This study highlights differences in access to income support when youth transition to adult services and considerations around equitable access to support. [ABSTRACT FROM AUTHOR]

We aimed to assess the association between change in social participation and long‐term improved cognitive function among older adults. Data were obtained from 9648 participants aged ≥60 years in the 2011, 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey, a national prospective cohort study. Cox regression models were used to calculate adjusted risk ratios (aRRs). Social participation was increased in 20.5% of the participants, decreased in 37.8% of the participants and stable in 41.7% of the participants from the 2011 wave to the 2014–2018 waves. The improved cognitive function rate was 17.9% at follow‐up. Compared to individuals with decreased social participation from the 2011 wave to the 2014–2018 waves, individuals with unchanged total social participation were 59% (aRR = 1.59, 95% CI: 1.35–1.87) more likely to have improved cognitive function in the 2014–2018 waves, and individuals with increased social participation were 61% (aRR = 1.61, 95% CI: 1.43–1.82) more likely to have improved cognitive function, regardless of the baseline social participation status. As for the three forms of social participation, compared with the participants with decreased social participation, those with increased participation in organised social activities, increased participation in group leisure‐time activities, unchanged informal social interactions and increased informal social interactions were 24% (aRR = 1.24, 95% CI: 1.02–1.51), 49% (aRR = 1.49, 95% CI: 1.21–1.84), 55% (aRR = 1.55, 95% CI: 1.37–1.76) and 57% (aRR = 1.57, 95% CI: 1.34–1.84) more likely to have improved cognitive function (all p < 0.05) respectively. The results were stable in the sensitivity analysis. Our findings highlight the importance of promoting social participation from a multidimensional perspective (duration, frequency and forms) to improve cognitive function among older adults, for policy makers and healthcare workers in the community. [ABSTRACT FROM AUTHOR]

The Child Dental Benefits Schedule (CDBS) is an ongoing scheme administered through the Australian Government providing eligible children funding for clinical dental treatment. This study aimed to investigate the access of dental services across children's early childhood and examine whether the CDBS has improved access to dental care. The longitudinal study of Australian children is an ongoing cross‐sequential cohort study with a representative sample of Australian children recruited in 2004. Birth (0–1 year) and kindergarten (4–5 years) cohorts were recruited through Medicare enrolment information at baseline and were representative of the Australian child population. Population‐weighted longitudinal mixed effects Poisson models with individual identifiers as a random effect were used to assess the effect of Medicare dental schedules on reported dental attendance. Prior to the implementation of the CDBS for both cohorts, the birth cohort reported the lowest attendance rate at age 4–5. The introduction of the CDBS increased the rate of dental attendance for the low household income group by 8% (95% CI: 1%, 15%) after adjusting for confounders. The model provides evidence that dental attendance increased with age and the Indigenous population have 31% (95% CI: 4%, 55%) lower attendance rate after adjustment. The increase in reported access to dental services and favourable visiting patterns in low‐income households during the operation of the CDBS provides some evidence that the schedule's primary aims to improve access to care in the child population are being met. Access to healthcare is multifaceted and the underutilisation of the schedule in the population warrants review of the schedule performance using other patient‐centred indicators. [ABSTRACT FROM AUTHOR]

This study examines if parental neglect is significantly associated with adolescent cyberbullying perpetration, and whether this relationship is mediated by smartphone addiction. In addition, the moderation of self‐regulation in the direct and indirect effects of parental neglect on cyberbullying perpetration among adolescents is determined. A random sample of 728 Chinese adolescents from Grade 10 to 12 in senior high schools respond to anonymous questionnaires regarding parental neglect, smartphone addiction, self‐regulation and cyberbullying perpetration. The data are then analysed using macro PROCESS. Results reveal that adolescents who are neglected by parents are more likely to engage in cyberbullying perpetration. Smartphone addiction significantly partially mediates the above relationship. Moreover, self‐regulation not only moderates the relationship of cyberbullying perpetration with parental neglect but also its association with smartphone addiction among adolescents. This study contributes to a better understanding of how parental neglect increases the risk of adolescent cyberbullying perpetration, which may be reduced through tailored interventions. [ABSTRACT FROM AUTHOR]

In Ontario, new home care clients are screened with the interRAI Contact Assessment and only those expected to require longer‐term services receive the comprehensive RAI‐Home Care assessment. Although Ontario adopted this two‐step approach in 2010, it is unknown whether the assessment guidelines were implemented as intended. To evaluate implementation fidelity, the purpose of this study is to compare expected to actual client profiles and care co‐ordinator practice patterns. We linked interRAI CA and RAI‐HC assessments and home care referrals and services data for a retrospective cohort of adult home care clients admitted in FY 2016/17. All assessments were done by trained health professionals as part of routine practice. Descriptive analyses were used to evaluate congruency between recommended and actual practice. Adjusted cause‐specific hazards and logistic approaches were used to examine time to RAI‐HC assessment and being a high‐priority client. Of 225,989 unique home care clients admitted to the publicly funded home care program, about three‐quarters of clients were assessed with the interRAI CA only (27.9% completed the Preliminary Screener only and 46.6% completed both the Preliminary Screener and Clinical Evaluation). There was substantial agreement between the skip logic and completion of the Clinical Evaluation section (Cohen's kappa = 0.67 [95% CI: 0.66–0.67]). One‐quarter of clients were assessed with both the interRAI CA and RAI‐HC. As expected, RAI‐HC assessed clients were older, reported more health needs, and often received home care services for >6 months. Clients in higher Assessment Urgency Algorithm (AUA) levels were significantly more likely to receive a RAI‐HC assessment and be assigned to a higher home care priority level; however, 28.3% of clients in the highest AUA level did not receive a RAI‐HC assessment. We conclude that the use of the interRAI CA and RAI‐HC balances the investment of time and resources with the information and tools to deliver high‐quality, holistic, and client‐centred care. The interRAI CA guides the care co‐ordinator to screen every client for a broad range of possible needs and tailor further assessment to each client's unique needs. We recommend integrating the AUA into provincial assessment guidelines as well as developing a new quality indicator focused on measuring access to the home care system. [ABSTRACT FROM AUTHOR]

Care‐giving burden and internalised stigma are prevalent among family caregivers of people diagnosed with schizophrenia. Internalised stigma has been regarded as a source of care‐giving burden. But it remains unclear if high levels of internalised stigma directly contribute to an increased risk of care‐giving burden or if the effects could be buffered by psychological factors. This cross‐sectional study was to investigate the relationship between internalised stigma and care‐giving burden, and to determine the mediating effects of coping styles and social support. Data were collected from 344 Chinese family caregivers of adults diagnosed with schizophrenia in a psychiatric outpatient department of a tertiary hospital in Changsha, Hunan between April and August 2018. A self‐reported questionnaire was used to collect data anonymously. Instruments included the Simplified Coping Style Questionnaire, the Multidimensional Scale of Perceived Social Support, the Internalized Stigma of Mental Illness Scale and the Caregiver Burden Inventory. Data analysis was conducted using descriptive statistics, the Spearman correlation and regression analysis to estimate direct and indirect effects using bootstrap analysis. Results showed that internalised stigma, social support and passive coping were significant correlates of care‐giving burden; social support partially mediated the relationship between internalised stigma and care‐giving burden; active coping did not show impacts on internalised stigma and care‐giving burden. This study provided social workers and healthcare providers with a better understanding of the development of care‐giving burden. Comprehensive interventions should be designed to provide supportive resources and reduce the possibilities of internalisation of stigma and passive coping, to alleviate care‐giving burden. [ABSTRACT FROM AUTHOR]