51 research outputs found
Adjusting and censoring electronic monitoring device data. Implications for study outcomes
No full textElectronic monitoring device (EMD) data are widely used to measure adherence in HIV medication adherence research. EMD data represent an objective measure of adherence and arguably provide more valid data than other methods such as self-reported measures, pill counts, and drug level concentration. Moreover, EMD data are longitudinal, include many measurements, and yield a rich data set. This article illustrates potential pitfalls associated with this measurement technique, including lack of clarity associated with EMD data, and the extent to which adherence outcomes are affected by data management decisions. Recommendations are given regarding what information should be included in publications that report results based on EMD data so as to facilitate comparisons between studies
The health care relationship (HCR) trust scale: development and psychometric evaluation
No full textA sequential multi-method approach using focus groups, individual interviews, and quantitative instrument development procedures was used to develop and evaluate a scale to measure patient trust in health care providers (HCPs). The resulting 15-item Health Care Relationship (HCR) Trust Scale was tested for internal consistency, test-retest reliability, and construct validity. The Cronbach alphas were .92 (time 1) and .95 (time 2), respectively. Test-retest reliability was .59 (p < .01). The HCR Trust Scale did not correlate with the Marlowe-Crowne Social Desirability Scale (r = .20, p = .07) or the Rapid Estimate of Adult Literacy in Medicine scale (r = -.21, p = .13). Principal component factor analysis with varimax rotation revealed a three-factor solution that explained 69% of the estimated common variance in the HCR trust scale. Cronbach alphas for the 3 factors ranged from .81 to .89. Findings of this study support the use of the HCR Trust Scale for measuring trust in various HCPs by diverse patient populations. More work is needed to test the usefulness of the scale with a greater number of patients and in other chronic illness populations
Improving socioeconomic status may reduce the burden of malaria in sub Saharan Africa: A systematic review and meta-analysis
No full textBackgroundA clear understanding of the effects of housing structure, education, occupation, income, and wealth on malaria can help to better design socioeconomic interventions to control the disease. This literature review summarizes the relationship of housing structure, educational level, occupation, income, and wealth with the epidemiology of malaria in sub-Saharan Africa (SSA).MethodsA systematic review and meta-analysis was conducted following the preferred reporting items for systematic reviews and meta-analyses guidelines. The protocol for this study is registered in PROSPERO (ID=CRD42017056070), an international database of prospectively registered systematic reviews. On January 16, 2016, available literature was searched in PubMed, Embase, CINAHL, and Cochrane Library. All but case studies, which reported prevalence or incidence of Plasmodium infection stratified by socioeconomic status among individuals living in SSA, were included without any limits. Odds Ratio (OR) and Relative Risk (RR), together with 95% CI and p-values were used as effect measures. Heterogeneity was assessed using chi-square, Moran’s I2, and tau2 tests. Fixed (I22≥30%) or log-linear dose-response model was used to estimate the summary OR or RR.ResultsAfter removing duplicates and screening of titles, abstracts, and full text, 84 articles were found eligible for systematic review, and 75 of them were included in the meta-analyses. Fifty-seven studies were cross-sectional, 12 were prospective cohort, 10 were case-control, and five were randomized control trials. The odds of Plasmodium infection increased among individuals who were living in poor quality houses (OR 2.13, 95% CI 1.56–3.23, I2 = 27.7), were uneducated (OR 1.36, 95% CI 1.19–1.54, I2 = 72.4.0%), and were farmers by occupation (OR 1.48, 95% CI 1.11–1.85, I2 = 0.0%) [pPlasmodium infection also increased with a decrease in the income (OR 1.02, 95% CI 1.01–1.03, tau22 = 0.028) [pPlasmodium infection among individuals who were living in poor quality houses (RR 1.86, 95% CI 1.47–2.25, I2 = 0.0%), were uneducated (OR 1.27, 1.03–1.50, I2 = 0.0%), and were farmers (OR 1.36, 1.18–1.58) [pConclusionsLack of education, low income, low wealth, living in poorly constructed houses, and having an occupation in farming may increase risk of Plasmodium infection among people in SSA. Public policy measures that can reduce inequity in health coverage, as well as improve economic and educational opportunities for the poor, will help in reducing the burden of malaria in SSA.</div
Forest plot comparing the odds ratio of <i>Plasmodium</i> infection between individuals with primary education level versus those with secondary or more, and those with secondary versus tertiary or more education level Subtotal (summary) ORs estimated using random effect models when I<sup>2</sup> ≥30 and using fixed effect models when I<sup>2</sup><30.
No full textWeights estimated using inverse variance method. I2, a measure of heterogeneity.</p
Adapting and testing an evidence-based antiretroviral medication adherence intervention in China
No full textSession presented on: Thursday, July 25, 2013:
Purpose: To test the effectiveness of a culturally adapted evidence-based home nursing intervention to improve adherence to antiretroviral medications among people living with HIV/AIDS (PLWH/A) in Hunan, China.
Methods: In a randomized, controlled trial, 114 subjects were assigned to receive a culturally adapted intervention consisting of monthly visits and interim phone calls plus standard care or standard care alone. The intervention previously demonstrated efficacy in a randomized clinical trial conducted in the United States. All subjects were residents of Hunan, China, living with HIV/AIDS and self-reporting less than 90% adherence to prescribed medications. Measures included a 7-day visual analogue medication adherence scale, a social support rating scale, the Chinese version of the Center for Epidemiological Studies Depression scale Chinese, and an HIV/AIDS stigma scale. Data were collected in structured face-to-face interviews at baseline, 6 months, and 12 months at the time of a regularly scheduled clinical visit. Information regarding ARV regimen, treatment duration, time of diagnosis, CD4 count and HIV-RNA was extracted from the medical record.
Results: Subjects were 72% male (N=82); 52% (N=59) married; and only 28% (N=32) stably employed. Thirty-one percent (N=35) reported past or current drug abuse. The great majority (98%) had a CD4 count at baseline that was less than 350 cells/mm3. At 6 months and 12 months, a greater proportion of subjects in the intervention group self-reported adherence greater than 90% compared to the control group. The difference over time is significant (Extended Mantel-Haenszel Test: 8.8, p=.003).
Conclusions: In spite of significant cultural differences, evidence-based interventions can be implemented effectively in new settings and with new populations
Forest plot comparing the odds ratio of <i>Plasmodium</i> infection between individuals without formal education or illiterate with those who had primary and secondary or more education level.
No full textSubtotal (summary) ORs estimated using random effect model. Weights estimated using inverse variance method. I2, a measure of heterogeneity.</p
Forest plot showing the relationship of windows, floor, ceiling and eaves nature of a house with the epidemiology of malaria in sub-Saharan Africa.
No full textValues show the odds ratio of Plasmodium infection (95% CI). Subtotal (summary) ORs estimated using random effect models when I2 ≥30 and using fixed effect models when I2 2, a measure of heterogeneity.</p
Deaths Due to Screenable Cancers Among People Living With HIV Infection, Florida, 2000–2014
No full textINTRODUCTION: Because of antiretroviral therapy, people living with HIV infection are surviving longer and are at higher risk for chronic diseases. This study's objective was to assess the magnitude of deaths due to cancers for which there are screening recommendations for people living with HIV in Florida. METHODS: Florida Department of Health Enhanced HIV/AIDS Reporting System data were matched with Department of Health Vital Records and the National Death Index to identify deaths and their causes through 2014. The sex-specific and cause-specific mortality rates and indirect standardized mortality ratios (SMRs, using U.S. mortality rates as a standard) were calculated during 2016 for people reported with HIV infection 2000-2014.RESULTS: Despite the competing risk of HIV mortality, among the 25,678 females, there was a higher risk of cervical (SMR=6.32, 95% CI=4.63, 8.44), colorectal (SMR=2.05, 95% CI=1.44, 2.83), liver (SMR=8.96, 95% CI=5.39, 14.03), and lung (SMR=5.82, 95% CI=4.80, 6.96) cancer mortality and lower risk of breast cancer mortality (SMR=0.57, 95% CI=0.42, 0.76). Among 63,493 males, there was a higher risk of liver (SMR=5.50, 95% CI=4.47, 6.70) and lung (4.63, 95% CI=4.11, 5.19) cancer mortality. Among males, the lung cancer SMR significantly declined 2000-2014 (p<0.05), but was still high in 2012-2014 (SMR=3.59, 95% CI=2.87, 4.43). CONCLUSIONS: These results indicate the importance of primary and secondary cancer prevention during primary care for people living with HIV infection.</p
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