scholarly journals A cross-sectional survey of potential factors, motivations, and barriers influencing research participation and retention among people who use drugs in the rural USA

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Angela T. Hetrick ◽  
April M. Young ◽  
Miriam R. Elman ◽  
Sarann Bielavitz ◽  
Rhonda L. Alexander ◽  
...  
Keyword(s):  
Drug Use ◽  
Urban Areas ◽  
Research Participation ◽  
Community Outreach ◽  
Influential Factors ◽  
People Who Use Drugs ◽  
High Morbidity ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Financial Compensation

Abstract Background Despite high morbidity and mortality among people who use drugs (PWUD) in rural America, most research is conducted within urban areas. Our objective was to describe influencing factors, motivations, and barriers to research participation and retention among rural PWUD. Methods We recruited 255 eligible participants from community outreach and community-based, epidemiologic research cohorts from April to July 2019 to participate in a cross-sectional survey. Eligible participants reported opioid or injection drug use to get high within 30 days and resided in high-needs rural counties in Oregon, Kentucky, and Ohio. We aggregated response rankings to identify salient influences, motivations, and barriers. We estimated prevalence ratios to assess for gender, preferred drug use, and geographic differences using log-binomial models. Results Most participants were male (55%) and preferred methamphetamine (36%) over heroin (35%). Participants reported confidentiality, amount of financial compensation, and time required as primary influential factors for research participation. Primary motivations for participation include financial compensation, free HIV/HCV testing, and contribution to research. Changed or false participant contact information and transportation are principal barriers to retention. Respondents who prefer methamphetamines over heroin reported being influenced by the purpose and use of their information (PR = 1.12; 95% CI: 1.00, 1.26). Females and Oregonians (versus Appalachians) reported knowing and wanting to help the research team as participation motivation (PR = 1.57; 95% CI: 1.09, 2.26 and PR = 2.12; 95% CI: 1.51, 2.99). Conclusions Beyond financial compensation, researchers should emphasize confidentiality, offer testing and linkage with care, use several contact methods, aid transportation, and accommodate demographic differences to improve research participation and retention among rural PWUD.

scholarly journals A Descriptive Cross-Sectional Analysis Of Potential Factors, Motivations, And Barriers Influencing Research Participation And Retention Among People Who Use Drugs In The Rural United States

2021 ◽  
Author(s):  
Angela T Hetrick ◽  
April M. Young ◽  
Miriam R. Elman ◽  
Sarann Bielavtiz ◽  
Rhonda L. Alexander ◽  
...  
Keyword(s):  
Drug Use ◽  
Urban Areas ◽  
Research Participation ◽  
Community Outreach ◽  
Cross Sectional Study ◽  
Influential Factors ◽  
People Who Use Drugs ◽  
High Morbidity ◽  
Cross Sectional ◽  
Financial Compensation

Abstract Background: Despite high morbidity and mortality among people who use drugs (PWUD) in rural America, most research is conducted within urban areas. We describe influencing factors, motivations, and barriers to research participation and retention among rural PWUD. Methods: We recruited 255 eligible participants from community outreach and community-based, epidemiologic research cohorts from April-July 2019 to participate in a descriptive cross-sectional study. Eligible participants reported opioid or injection drug use to get high within 30 days and resided in high-needs rural counties in Oregon, Kentucky, and Ohio. We aggregated response rankings to identify salient influences, motivations, and barriers. We estimated prevalence ratios to assess for gender, preferred drug use, and geographic differences using log-binomial models.Results: Most participants were male (55%) and recently injected methamphetamine (61%) and/or heroin (57%). The primary influential factors for research participation are confidentiality, amount of financial compensation, and time required. Primary motivations for participation include financial compensation, free HIV/HCV testing, and linkage with resources. Changed or false participant contact information and transportation are principal barriers to retention. Respondents who prefer methamphetamines over heroin are more influenced by why their information is collected and how it is used (PR=1.12; 95%CI:1.00, 1.26). Knowing and wanting to help the research team are motivations for participation among Oregon participants (PR=2.12; 95%CI:1.51, 2.99) and females (PR=1.57; 95%CI:1.09, 2.26).Conclusions: Beyond financial compensation, researchers should emphasize confidentiality, offer testing and linkage with care, use several contact methods, aid transportation, and accommodate demographic differences to improve research participation and retention among rural PWUD.

Risk Minimization Measures in Off-Label Drug Use: A Survey of Community Pharmacists in Malaysia

2020 ◽  
Vol 15 (3) ◽  
pp. 181-189
Author(s):  
Omotayo Fatokun
Keyword(s):  
Informed Consent ◽  
Drug Use ◽  
Perceived Risk ◽  
Adverse Drug Events ◽  
Community Pharmacists ◽  
Risk Minimization ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Off Label ◽  
Written Informed Consent

Background: While off-label drug use is common and sometimes necessary, it also presents considerable risks. Therefore, measures intended to prevent or reduce the potential exposure to off-label risks have been recommended. However, little is known about community pharmacists’ beliefs regarding these measures in Malaysia. Objectives: This study examined community pharmacists’ beliefs towards risk minimization measures in off-label drug use in Malaysia and assessed the relationship between perceived risk of off-label drug use and beliefs towards risk minimization measures. Methods: A cross-sectional survey was conducted among 154 pharmacists practicing in randomly selected community pharmacies in Kuala Lumpur and the State of Selangor, Malaysia. Results: The majority agreed or strongly agreed that adverse drug events from the off-label drug should be reported to the regulatory authority (90.9%) and the off-label drug should only be used when the benefit outweighs potential risks (88.3%). Less than half (48.1%) agreed or strongly agreed that written informed consent should be obtained before dispensing off-label drugs and a majority (63.7%) agreed or strongly agreed that the informed consent process will be burdensome to healthcare professionals. Beliefs towards risk minimization measures were significantly associated with perceived risk of off-label drug use regarding efficacy (p = 0. 033), safety (p = 0.001), adverse drug rection (p = 0.001) and medication errors (p = 0.002). Conclusion: The community pharmacists have positive beliefs towards most of the risk minimization measures. However, beliefs towards written informed consent requirements are not encouraging. Enhancing risk perception may help influence positive beliefs towards risk minimization measures.

scholarly journals Acute food insecurity and short-term coping strategies of urban and rural households of Bangladesh during the lockdown period of COVID-19 pandemic of 2020: report of a cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e043365
Author(s):  
Subhasish Das ◽  
Md. Golam Rasul ◽  
Md Shabab Hossain ◽  
Ar-Rafi Khan ◽  
Md Ashraful Alam ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Coping Strategies ◽  
Rural Areas ◽  
Urban Areas ◽  
Multinomial Logistic Regression ◽  
Rural Households ◽  
P Value ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Food Insecure Households

IntroductionWe conducted a cross-sectional survey to assess the extent and to identify the determinants of food insecurity and coping strategies in urban and rural households of Bangladesh during the month-long, COVID-19 lockdown period.SettingSelected urban and rural areas of Bangladesh.Participants106 urban and 106 rural households.Outcome variables and methodHousehold food insecurity status and the types of coping strategies were the outcome variables for the analyses. Multinomial logistic regression analyses were done to identify the determinants.ResultsWe found that around 90% of the households were suffering from different grades of food insecurity. Severe food insecurity was higher in urban (42%) than rural (15%) households. The rural households with mild/moderate food insecurity adopted either financial (27%) or both financial and food compromised (32%) coping strategies, but 61% of urban mild/moderate food insecure households applied both forms of coping strategies. Similarly, nearly 90% of severely food insecure households implemented both types of coping strategies. Living in poorest households was significantly associated (p value <0.05) with mild/moderate (regression coefficient, β: 15.13, 95% CI 14.43 to 15.82), and severe food insecurity (β: 16.28, 95% CI 15.58 to 16.97). The statistically significant (p <0.05) determinants of both food compromised and financial coping strategies were living in urban areas (β: 1.8, 95% CI 0.44 to 3.09), living in poorest (β: 2.7, 95% CI 1 to 4.45), poorer (β: 2.6, 95% CI 0.75 to 4.4) and even in the richer (β: 1.6, 95% CI 0.2 to 2.9) households and age of the respondent (β: 0.1, 95% CI 0.02 to 0.21).ConclusionBoth urban and rural households suffered from moderate to severe food insecurity during the month-long lockdown period in Bangladesh. But, poorest, poorer and even the richer households adopted different coping strategies that might result in long-term economic and nutritional consequences.

scholarly journals Assessing Factors Associated with TB Awareness in Nepal: A National and Subnational Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5124
Author(s):  
Yoko Iwaki ◽  
Santosh Kumar Rauniyar ◽  
Shuhei Nomura ◽  
Michael C. Huang
Keyword(s):  
Socioeconomic Factors ◽  
Influential Factors ◽  
Regional Level ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Information And Communication ◽  
High Level

Tuberculosis (TB) has still remained a serious global health threat in low- and middle-income countries in recent years. As of 2021, Nepal is one of the high TB burden countries, with an increasing prevalence of cases. This study evaluates factors associated with TB awareness in Nepal. This study uses data from the Nepal Demographic and Health Survey, a cross-sectional survey carried out from June 2016 to January 2017. Multilevel logistic regression is performed to examine the association of demographic and socioeconomic factors with TB awareness. Our findings show a high level of TB awareness in all seven provinces of Nepal. Province 5 has the highest level of awareness (98.1%) among all provinces, followed by provinces 3 and 4, while province 6 has the lowest awareness level (93.2%) compared to others. Socioeconomic factors such as wealth, education and owning a mobile phone are significantly associated with TB awareness. Socioeconomic determinants are influential factors associated with TB awareness in Nepal. The wide variation in the proportion of awareness at a regional level emphasizes the importance of formulating tailored strategies to increase TB awareness. For instance, the use of mobile phones could be an effective strategy to promote TB awareness at a regional level. This study provides valuable evidence to support further research on the contribution of information and communication technology (ICT) usage to improving TB awareness in Nepal.

scholarly journals Career Intentions and Dropout Causes Among Medical Students in Kazakhstan

Medicina ◽  
2013 ◽  
Vol 49 (6) ◽  
pp. 45
Author(s):  
Kamila Faizullina ◽  
Galina Kausova ◽  
Zhanna Kalmataeva ◽  
Ardak Nurbakyt ◽  
Saule Buzdaeva
Keyword(s):  
Medical Students ◽  
Human Resources ◽  
Rural Areas ◽  
Urban Areas ◽  
Human Resources For Health ◽  
Medical Schools ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Unequal Distribution ◽  
Survey Tool

Background and Objective. The number of new entrants to higher medical schools of Kazakhstan increased by 1.6 times from 2007 to 2012. However, it is not known how it will affect the shortage of human resources for health. Additionally, human resources for health in rural areas of Kazakhstan are 4 times scarcer than in urban areas. The aim of the present study was to investigate the intentions of students toward their professional future and readiness to work in rural areas, as well as to determine the causes for dropping out from medical schools. Material and Methods. A cross-sectional survey was conducted in 2 medical universities in Almaty during the academic year 2011–2012. The study sample included medical students and interns. In total, 2388 students participated in the survey. The survey tool was an anonymous questionnaire. Results. The students of the first years of studies compared with those of later years of studies were more optimistic about the profession and had more intentions to work in the medical field. Only 8% of the students reported a wish to work in rural localities. On the other hand, 4% of the students did not plan to pursue the profession. On the average, every third medical student dropped out on his/her own request. Conclusions. Associations between intentions to work according to the profession and the year of studies, faculty, and residence area before enrolling in a medical school were documented. The majority of the students who came from rural areas preferred to stay and look for work in a city, which might contribute to an unequal distribution of physicians across the country.

Abstract T P213: An Interactive Video Improves the Understanding of a Hypothetical Adaptive Acute Stroke Trial

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Brendan McEvoy ◽  
Jason Tehranisa ◽  
William J Meurer
Keyword(s):  
Acute Stroke ◽  
Interactive Video ◽  
Research Participation ◽  
Consent Process ◽  
Trial Participation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Absolute Increase ◽  
Video Group ◽  
Stroke Trial

BACKGROUND AND PURPOSE: The communication of adaptive clinical trials can be more difficult due to the increased complexity of the design itself, especially in an emergent, time-sensitive setting such as with acute stroke patients. We hypothesized that introducing brief, comprehension questions into a video explaining a hypothetical acute stroke trial would improve the understanding of the trial allocation procedure and increase patient participation. METHODS: We conducted a cross-sectional survey of adult patients presenting to the emergency department. After obtaining verbal consent, patients were randomized to one of four groups: They watched a video with either an RAR or a standard hypothetical acute stroke trial, with or without the addition of interactive comprehension questions. These questions addressed research procedures relevant to the consent process and operation of the trial. Subjects were asked whether they would consent to the trial and if they could identify the method of randomization and allocation used. RESULTS: A total of 720 patients were enrolled. A significantly higher proportion of individuals in the RAR interactive video group (85.9%) correctly identified the trial allocation method assigned versus the RAR uninterrupted video group (60.4%), absolute increase: 25.5% (95% confidence interval, 17-33%). Additionally, there was significantly higher trial participation in the RAR interactive video group (table). CONCLUSIONS: Integrating structured comprehension questions into the consent process of a hypothetical acute stroke trial increased understanding of the RAR trial design and further attracted more research participation. Improving the communication of the trial procedures within a simulated situation that mimics the rapid discussion regarding an emergency research trial is beneficial and should be incorporated into future acute stroke trials

Perceived neighborhood food access is associated with consumption of animal-flesh food, fruits and vegetables among mothers and young children in peri-urban Cambodia

2021 ◽  
pp. 1-29
Author(s):  
Minh-Cam Duong ◽  
Hung Nguyen-Viet ◽  
Delia Grace ◽  
Chhay Ty ◽  
Huy Sokchea ◽  
...  
Keyword(s):  
Food Consumption ◽  
Urban Areas ◽  
Food Access ◽  
Fruits And Vegetables ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Phnom Penh ◽  
Consumption Frequency ◽  
Future Work

Abstract Objective: To examine whether mothers’ perceived neighborhood food access is associated with their own and their young children’s consumption of animal-flesh food, fruits and vegetables in peri-urban areas of Cambodia. Design: A cross-sectional survey measured food consumption frequency and perceived neighborhood food access, the latter including six dimensions of food availability, affordability, convenience, quality, safety and desirability. Multivariate logistic regression was used to assess the association between food access and food consumption. Setting: Peri-urban districts of Phnom Penh and Siem Reap, Cambodia Participants: 198 mothers of children between 6 to 24 months old. Results: Over 25% of the mothers and 40% of the children had low consumption (< once a day) of either animal-flesh food or fruits and vegetables. Compared with perceived high food access, perceived low food access was associated with an adjusted 5.6-fold and 4.3-fold greater odds of low animal-flesh food consumption among mothers (95% CI 2.54, 12.46) and children (95% CI 2.20, 8.60) respectively. Similarly, relative to perceived high access, perceived low food access was associated with 7.6-times and 5.1-times higher adjusted odds of low fruits and vegetables consumption among mothers (95% CI 3.22, 18.02) and children (95% CI 2.69, 9.83) respectively. Conclusions: Mothers’ perceived neighborhood food access was an important predictor of their own and their young children’s nutrient-rich food consumption in peri-urban Cambodia. Future work is needed to confirm our findings in other urban settings and examine the role of neighborhood food environment on the consumption of both nutrient-rich and nutrient-poor food.

scholarly journals Study of Working Experience in Remote Rural Areas after Medical Graduation

2015 ◽  
Vol 12 (2) ◽  
pp. 121-125
Author(s):  
KR Thapa ◽  
BK Shrestha ◽  
MD Bhattarai
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Sampling Method ◽  
Postgraduate Training ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Remote Areas ◽  
Convenience Sampling ◽  
A Priority

Background Posting of doctors in remote rural areas has always been a priority for Government; however data are scarce in the country about experience of doctors of working in remote areas after medical graduation.Objective A questionnaire survey of doctors was planned to analyze their experience of working after graduation in remote rural areas in various parts of the country.Method The cross-sectional survey was done by convenience sampling method. A one-page questionnaire with one partially closed-end and five open-end type questions was distributed to the doctors who had worked in remote rural areas after graduation under various governments’ postings.Result Two-third of participants had their home in urban areas and 89.8% had stayed for 1 to 5 years. About half of the participants had difficulty in getting the posting in the remote areas of their choice. Most participants indicated provision of opportunities for Residential (postgraduate) Training as their reasons of going to remote areas as well as their suggestions to encourage young graduates to go there. Similarly most also suggested appropriate career, salary and incentives to encourage doctors to go to work in remote areas. About 85% of participants pointed out the major problem faced while posted in remote areas as difficulty in handling varied situations with no guidance or seniors available around.Conclusion The notable points indicated by the participants are centered on the opportunity for Residential Training and difficulties faced without such training. Residential Training is a priority to be considered while planning the health policy for optimum health care of people.Kathmandu University Medical Journal Vol.12(2) 2014: 121-125

scholarly journals Improved ascertainment of modes of HIV transmission in Ukraine indicates importance of drug injecting and homosexual risk

2020 ◽  
Author(s):  
Kostyantyn Dumchev ◽  
Marina Kornilova ◽  
Roksolana Kulchynska ◽  
Marianna Azarskova ◽  
Charles Vitek
Keyword(s):  
Drug Use ◽  
Survey Data ◽  
Hiv Transmission ◽  
Significant Degree ◽  
Injecting Drug Use ◽  
Behavioral Risk ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mode Of Transmission ◽  
Homosexual Transmission

Abstract Background It is important to understand how HIV infection is transmitted in the population in order to guide prevention activities and properly allocate limited resources. In Ukraine and other countries where injecting drug use and homosexuality are stigmatized, the information about mode of transmission in case registration systems is often biased. Methods We conducted a cross-sectional survey in a random sample of patients registered at HIV clinics in seven regions of Ukraine in 2013-2015. The survey assessed behavioral risk factors and serological markers of viral hepatitis B and C. We analyzed the discrepancies between the registered mode of transmission and the survey data, and evaluated trends over three years. Results Of 2,285 participants, 1,032 (45.2%) were females. The proportion of new HIV cases likely caused by injecting drug use based on the survey data was 59.7% compared to 33.2% in official reporting, and proportion of cases likely acquired through homosexual transmission was 3.8% compared to 2.8%. We found a significant decrease from 63.2% to 57.5% in the proportion of injecting drug use-related cases and a steep increase from 2.5 to 5.2% in homosexual transmission over three years. Conclusions The study confirmed the significant degree of misclassification of HIV mode of transmission among registered cases. The role of injecting drug use in HIV transmission is gradually decreasing, but remains high. The proportion of cases related to homosexual transmission is relatively modest, but is rapidly increasing, especially in younger men. Improvements in ascertaining the risk factor information are essential to monitor the epidemic and to guide programmatic response.

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