More Like this

1. Gun Violence Exposure and Posttraumatic Symptoms Among Children and Youth

   https://doi.org/10.1002/jts.22466  

   Turner, Heather A. ; Mitchell, Kimberly J. ; Jones, Lisa M. ; Hamby, Sherry ; Wade, Jr., Roy ; Beseler, Cheryl L. ( December 2019 , Journal of Traumatic Stress)

   Although statistics on youth homicide and injury from gun violence are available, little research has focused on how gun violence overlaps with other victimizations or on the psychological impact of gun violence on children. Pilot survey data were collected on the experiences of 630 U.S. children (age range: 2–17 years) from Boston, Philadelphia, and rural areas of eastern Tennessee. Youth aged 10–17 years completed a self‐report survey on a wide range of gun violence exposures, and parents of younger children (aged 2–9 years) completed the survey as a proxy for that child. Direct gun violence exposure, witnessing gun violence, and hearing gunshots were all significantly associated with other forms of victimization,rs = .10–.38,p < .001. The findings suggest that youth who experience direct gun violence are often exposed to multiple violent contexts. For older youth (ages 10–17 years) polyvictimization was most strongly associated with posttraumatic symptoms, β = .35,p< .001, although witnessing gun violence still uniquely predicted a higher level of symptoms, β = .18,p< .01. For younger children (ages 2–9 years), hearing and witnessing gun violence were both related to posttraumatic symptoms, β = .15,p< .01 for both, even after controlling for polyvictimization. Mental health professionals and trauma‐informed services should be mindful that the traumatic impact of gun violence for children may not necessarily be attached to direct victimization experiences but may also result from simply seeing or hearing it in their neighborhoods.

    

   more » « less
2. Mental health during the COVID-19 pandemic: Impacts of disease, social isolation, and financial stressors

   https://doi.org/10.1371/journal.pone.0277562  

   Kraut, Robert E. ; Li, Han ; Zhu, Haiyi ( November 2022 , PLOS ONE)

   Nabi, Mohammad Hayatun (Ed.)

   Although research shows that the Covid-19 pandemic has led to declines in mental health, the existing research has not identified the pathways through which this decline happens.

   The current study identifies the distinct pathways through which COVID-induced stressors (i.e., social distancing, disease risk, and financial stressors) trigger mental distress and examines the causal impact of these stressors on mental distress.

   We combined evidence of objective pandemic-related stressors collected at the county level (e.g., lack of social contact, infection rates, and unemployment rates) with self-reported survey data from over 11.5 million adult respondents in the United States collected daily for eight months. We used mediation analysis to examine the extent to which the objective stressors influenced mental health by influencing individual respondents’ behavior and fears.

   County-level, day-to-day social distancing predicted significantly greater mental distress, both directly and indirectly through its effects on individual social contacts, worries about getting ill, and concerns about finances. Economic hardships were indirectly linked to increased mental distress by elevating people’s concerns about their household’s finances. Disease threats were both directly linked to mental distress and indirectly through its effects on individual worries about getting ill. Although one might expect that social distancing from people outside the home would have a greater influence on people who live alone, sub-analyses based on household composition do not support this expectation.

   This research provides evidence consistent with the thesis that the COVID-19 pandemic harmed the mental well-being of adults in the United States and identifies specific stressors associated with the pandemic that are responsible for increasing mental distress.

    

   more » « less
3. Gender, Soft Skills, and Patient Experience in Online Physician Reviews: A Large-Scale Text Analysis

   https://doi.org/10.2196/14455  

   Dunivin, Zackary ; Zadunayski, Lindsay ; Baskota, Ujjwal ; Siek, Katie ; Mankoff, Jennifer ( January 2020 , Journal of Medical Internet Research)

   Background Online physician reviews are an important source of information for prospective patients. In addition, they represent an untapped resource for studying the effects of gender on the doctor-patient relationship. Understanding gender differences in online reviews is important because it may impact the value of those reviews to patients. Documenting gender differences in patient experience may also help to improve the doctor-patient relationship. This is the first large-scale study of physician reviews to extensively investigate gender bias in online reviews or offer recommendations for improvements to online review systems to correct for gender bias and aid patients in selecting a physician. Objective This study examines 154,305 reviews from across the United States for all medical specialties. Our analysis includes a qualitative and quantitative examination of review content and physician rating with regard to doctor and reviewer gender. Methods A total of 154,305 reviews were sampled from Google Place reviews. Reviewer and doctor gender were inferred from names. Reviews were coded for overall patient experience (negative or positive) by collapsing a 5-star scale and coded for general categories (process, positive/negative soft skills), which were further subdivided into themes. Computational text processing methods were employed to apply this codebook to the entire data set, rendering it tractable to quantitative methods. Specifically, we estimated binary regression models to examine relationships between physician rating, patient experience themes, physician gender, and reviewer gender). Results Female reviewers wrote 60% more reviews than men. Male reviewers were more likely to give negative reviews (odds ratio [OR] 1.15, 95% CI 1.10-1.19; P<.001). Reviews of female physicians were considerably more negative than those of male physicians (OR 1.99, 95% CI 1.94-2.14; P<.001). Soft skills were more likely to be mentioned in the reviews written by female reviewers and about female physicians. Negative reviews of female doctors were more likely to mention candor (OR 1.61, 95% CI 1.42-1.82; P<.001) and amicability (OR 1.63, 95% CI 1.47-1.90; P<.001). Disrespect was associated with both female physicians (OR 1.42, 95% CI 1.35-1.51; P<.001) and female reviewers (OR 1.27, 95% CI 1.19-1.35; P<.001). Female patients were less likely to report disrespect from female doctors than expected from the base ORs (OR 1.19, 95% CI 1.04-1.32; P=.008), but this effect overrode only the effect for female reviewers. Conclusions This work reinforces findings in the extensive literature on gender differences and gender bias in patient-physician interaction. Its novel contribution lies in highlighting gender differences in online reviews. These reviews inform patients’ choice of doctor and thus affect both patients and physicians. The evidence of gender bias documented here suggests review sites may be improved by providing information about gender differences, controlling for gender when presenting composite ratings for physicians, and helping users write less biased reviews. 

   more » « less
4. Hydration in relation to water insecurity, heat index, and lactation status in two small‐scale populations in hot‐humid and hot‐arid environments

   https://doi.org/10.1002/ajhb.23447  

   Bethancourt, Hilary J. ; Swanson, Zane S. ; Nzunza, Rosemary ; Huanca, Tomas ; Conde, Esther ; Kenney, W. Larry ; Young, Sera L. ; Ndiema, Emmanuel ; Braun, David ; Pontzer, Herman ; et al ( June 2020 , American Journal of Human Biology)

   This study compared the prevalence of concentrated urine (urine specific gravity ≥1.021), an indicator of hypohydration, across Tsimane' hunter‐forager‐horticulturalists living in hot‐humid lowland Bolivia and Daasanach agropastoralists living in hot‐arid Northern Kenya. It tested the hypotheses that household water and food insecurity would be associated with higher odds of hypohydration.

   This study collected spot urine samples and corresponding weather data along with data on household water and food insecurity, demographics, and health characteristics among 266 Tsimane' households (N = 224 men, 235 women, 219 children) and 136 Daasanach households (N = 107 men, 120 women, 102 children).

   The prevalence of hypohydration among Tsimane' men (50.0%) and women (54.0%) was substantially higher (P < .001) than for Daasanach men (15.9%) and women (17.5%); the prevalence of hypohydration among Tsimane' (37.0%) and Daasanach (31.4%) children was not significantly different (P= .33). Multiple logistic regression models suggested positive but not statistically significant trends between household water insecurity and odds of hypohydration within populations, yet some significant joint effects of water and food insecurity were observed. Heat index (2°C) was associated with a 23% (95% confidence interval [CI]: 1.09‐1.40,P= .001), 34% (95% CI: 1.18‐1.53,P < .0005), and 23% (95% CI: 1.04‐1.44,P= .01) higher odds of hypohydration among Tsimane' men, women, and children, respectively, and a 48% (95% CI: 1.02‐2.15,P= .04) increase in the odds among Daasanach women. Lactation status was also associated with hypohydration among Tsimane' women (odds ratio = 3.35, 95% CI: 1.62‐6.95,P= .001).

   These results suggest that heat stress and reproductive status may have a greater impact on hydration status than water insecurity across diverse ecological contexts.

    

   more » « less
5. User-Centered Design of a Diabetes Self-Management Tool for Underserved Populations

   https://doi.org/10.1177/19322968231212220  

   Bonet-Olivencia, Samuel ; Carrillo-Leal, Jesus ; Rao, Arjun ; Sasangohar, Farzan ( November 2023 , Journal of Diabetes Science and Technology)

   User-centered design (UCD) or user experience design (UXD) methods have gained recent popularity for the design of mobile health (mHealth) interventions. However, there is a gap in application of these methods for diabetes self-management. This study aims to document the UCD process for a self-management mobile application aimed for patients with diabetes in underserved communities.

   A UCD mixed-methods approach including interviews with patients and providers, a review of literature, and a technology landscape analysis were used to define the app functional information requirements that informed the user experience/user interface design process. Usability studies with the app designers and developers, intended users, and a focus group of nurse educators and dieticians were used to test and improve the design.

   An mHealth app was developed with health-tracking features for stress, blood sugar, food, exercise, medications, weight, and blood pressure. We tackled a range of usability and user experience challenges, which encompassed addressing issues like low health literacy by employing a combination of user interface design principles, intuitive visualizations, customizable icons, seamless database integration, and automated data input features. Special attention was given to the design of educational content accounting for the intended users’ cultural background and literacy levels.

   User-centered design approach contributed to a better understanding of the intended users’ needs, limitations, mental models, and expectations, facilitating the design of a comprehensive mobile app for patients with diabetes in underserved communities that includes essential features for self-management while providing a strong educational component, addressing an important gap in the literature.

    

   more » « less