McKay M.T.,Center for Public Health
Substance Use and Misuse | Year: 2015
Family factors have been widely implicated in the development of adolescent drinking behaviors. These include parental attachment and parental rules concerning drinking behaviors. Moreover, throughout adolescence attachment to parents gives way to attachment to peers, and parental rules about alcohol use become less strict. The present study examined the relationship between parental and peer attachment, parental rules on drinking and alcohol use in a large sample (n = 1,724) of adolescents in the United Kingdom. Controlling for school grade (proxy for age), sex and the non-independence of respondents (clustering at school level) results showed that scores on a parental rules on drinking questionnaire were a significant statistical predictor when comparing moderate drinkers and abstainers, as well as moderate drinkers and problematic drinkers. Scores on both attachment scales were also significant, but only in the comparison between moderate and problematic drinkers, with lower attachment to parents and higher attachment to peers associated with problematic drinking. © 2015 Informa Healthcare USA, Inc.
Christensen A.I.,University of Southern Denmark |
Ekholm O.,University of Southern Denmark |
Kristensen P.L.,Region of Southern Denmark |
Larsen F.B.,Center for Public Health |
And 3 more authors.
European Journal of Public Health | Year: 2015
Background: Reminders are routinely applied in surveys to increase response rates and reduce the possibility of bias. This study examines the effect of multiple reminders on the response rate, non-response bias, prevalence estimates and exposure-outcome relations in a national self-administered health survey. Data derive from the Danish National Health Survey 2010, in which 298 550 individuals (16 years of age or older) were invited to participate in a cross-sectional survey using a mixed-mode approach (paper and web questionnaires). At least two reminders were sent to non-respondents, and 177 639 individuals completed the questionnaire (59.5%). Response patterns were compared between four groups of individuals (first mailing respondents, second mailing respondents, third mailing respondents and non-respondents). Results: Multiple reminders led to an increase in response rate from 36.7 to 59.5%; however, the inclusion of second and third mailing respondents did not change the overall characteristics of respondents compared with non-respondents. Furthermore, only small changes in prevalence estimates and exposure-outcome relationships were observed when including second and third mailing respondents compared with only first mailing respondents. Conclusions: Multiple reminders were an effective way to increase the response rate in a national Danish health survey. However, when differences do exist between respondents and non-respondents, the results suggest that second and third mailings are unlikely to eliminate these differences. Overall, multiple reminders seemed to have only minor effect on response patterns and study conclusions in the present study. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Christensen A.I.,University of Southern Denmark |
Ekholm O.,University of Southern Denmark |
Glumer C.,Research Center for Prevention and Health |
Andreasen A.H.,Research Center for Prevention and Health |
And 3 more authors.
Scandinavian Journal of Public Health | Year: 2012
Aims: In 2010 the five Danish regions and the National Institute of Public Health at the University of Southern Denmark conducted a national representative health survey among the adult population in Denmark. This paper describes the study design and the sample and study population as well as the content of the questionnaire. Methods: The survey was based on five regional stratified random samples and one national random sample. The samples were mutually exclusive. A total of 298,550 individuals (16 years or older) were invited to participate. Information was collected using a mixed mode approach (paper and web questionnaires). A questionnaire with a minimum of 52 core questions was used in all six subsamples. Calibrated weights were computed in order to take account of the complex survey design and reduce non-response bias. Results: In all, 177,639 individuals completed the questionnaire (59.5%). The response rate varied from 52.3% in the Capital Region of Denmark sample to 65.5% in the North Denmark Region sample. The response rate was particularly low among young men, unmarried people and among individuals with a different ethnic background than Danish. Conclusions: The survey was a result of extensive national cooperation across sectors, which makes it unique in its field of application, e.g. health surveillance, planning and prioritizing public health initiatives and research. However, the low response rate in some subgroups of the study population can pose problems in generalizing data, and efforts to increase the response rate will be important in the forthcoming surveys. © 2012 the Nordic Societies of Public Health.
Anderson L.,Cancer Epidemiology and Health Services Research Group |
O'Rorke M.,Cancer Epidemiology and Health Services Research Group |
Jamison J.,Antrim Area Hospital |
Wilson R.,Antrim Area Hospital |
Gavin A.,Center for Public Health
Journal of Medical Virology | Year: 2013
There is substantial international variation in human papillomavirus (HPV) prevalence; this study details the first report from Northern Ireland and additionally provides a systematic review and meta-analysis pooling the prevalence of high-risk (HR-HPV) subtypes among women with normal cytology in the UK and Ireland. Between February and December 2009, routine liquid based cytology (LBC) samples were collected for HPV detection (Roche Cobas® 4800 [PCR]) among unselected women attending for cervical cytology testing. Four electronic databases, including MEDLINE, were then searched from their inception till April 2011. A random effects meta-analysis was used to calculate a pooled HR-HPV prevalence and associated 95% confidence intervals (CI). 5,712 women, mean age 39 years (±SD 11.9 years; range 20-64 years), were included in the analysis, of which 5,068 (88.7%), 417 (7.3%) and 72 (1.3%) had normal, low, and high-grade cytological findings, respectively. Crude HR-HPV prevalence was 13.2% (95% CI, 12.7-13.7) among women with normal cytology and increased with cytological grade. In meta-analysis the pooled HR-HPV prevalence among those with normal cytology was 0.12 (95% CIs, 0.10-0.14; 21 studies) with the highest prevalence in younger women. HPV 16 and HPV 18 specific estimates were 0.03 (95% CI, 0.02-0.05) and 0.01 (95% CI, 0.01-0.02), respectively. The findings of this Northern Ireland study and meta-analysis verify the prevalent nature of HPV infection among younger women. Reporting of the type-specific prevalence of HPV infection is relevant for evaluating the impact of future HPV immunization initiatives, particularly against HR-HPV types other than HPV 16 and 18. J. Med. Virol. 85:295-308, 2013. © 2012 Wiley Periodicals, Inc. Copyright © 2012 Wiley Periodicals, Inc.
Nearly half of California adults, including one out of every three young adults, have either prediabetes — a precursor to type 2 diabetes — or undiagnosed diabetes, according to a UCLA study. The research provides the first analysis and breakdown of California prediabetes rates by county, age and ethnicity, and offers alarming insights into the future of the nation’s diabetes epidemic. Conducted by the UCLA Center for Health Policy Research and commissioned by the California Center for Public Health Advocacy, the study analyzed hemoglobin A1c and fasting plasma glucose findings from the National Health and Nutrition Examination Survey together with California Health Interview Survey data from over 40,000 respondents. The study estimates that some 13 million adults in California, or 46 percent, have prediabetes or undiagnosed diabetes, while another 2.5 million adults, or 9 percent, have already been diagnosed with diabetes. Combined, the two groups represent 15.5 million people — 55 percent of the state’s population. Because diabetes is more common among older adults, the study’s finding that 33 percent of young adults aged 18 to 39 have prediabetes is of particular concern. “This is the clearest indication to date that the diabetes epidemic is out of control and getting worse,” said Dr. Harold Goldstein, executive director of the health advocacy center. “With limited availability of healthy food in low-income communities, a preponderance of soda and junk food marketing, and urban neighborhoods lacking safe places to play, we have created a world where diabetes is the natural consequence. If there is any hope to keep health insurance costs from skyrocketing, health care providers from being overwhelmed and millions of Californians from suffering needlessly from amputations, blindness and kidney failure, the state of California must launch a major campaign to turn around the epidemic of type 2 diabetes.” The study estimates prediabetes rates by county, finding major disparities across the state, particularly among those aged 18 to 39. For those young adults, prediabetes rates ranged from lows of 26 percent in Lake County and 28 percent in San Francisco County to a high of 40 percent in rural Kings County and Imperial County. Racial and ethnic disparities are extremely pronounced. There are statistically higher prediabetes rates among young adult Pacific Islanders (43 percent), African Americans (38 percent), American Indians (38 percent), multiracial Californians (37 percent), Latinos (36 percent) and Asian Americans (31 percent) than among white young adults (29 percent), pointing to the need to focus additional prevention efforts in those communities. No demographic or region appeared to be free of the diabetes and prediabetes epidemics, as outlined in the policy brief. Complicating matters is the fact that many people do not get tested for prediabetes because the test often is not covered by insurance, particularly for those under the age of 45. And although there are effective interventions to help people control their weight and adopt a healthier lifestyle, these programs are often not be covered by insurers. “There are significant barriers not only to people knowing their status, but getting effective help,” said Dr. Susan Babey, lead author of the study and co-director of the UCLA Center for Health Policy Research’s Chronic Disease Program. “A simple blood test for diabetes should be covered by all insurers, as should the resources and programs that can make a real difference in stopping the progression of this terrible disease.” Prediabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diabetes diagnosis. Up to 30 percent of people with prediabetes will develop type 2 diabetes within five years, and as many as 70 percent of them will develop the disease in their lifetime. Diabetes is associated with dramatically increased risk of amputation, nerve damage, blindness, kidney disease, heart disease, hospitalization and premature death. Diabetes is one of America’s fastest-growing diseases and one of the most costly. Nationally, diabetes rates have tripled over the past 30 years. In California, the rate has increased by 35 percent since 2001. Nationally, annual medical spending for people with diabetes is almost twice that for people without diabetes. A person who is diagnosed with diabetes by age 40 will have lifetime medical spending that is $124,600 more than someone who is not. Three-quarters of that care is paid through Medicare and Medi-Cal, including $254 million in annual hospital costs that are paid by Medi-Cal alone. To avoid the progression from prediabetes to diabetes, the study’s authors recommend greater participation in the National Diabetes Prevention Program, as well as policy and other changes to increase screening and prevention and encourage healthy, active lifestyles. “For most people, type 2 diabetes is entirely preventable,” Dr. Goldstein said. “If Medi-Cal covered diabetes prevention programs and every health provider screened for prediabetes, we could prevent a large proportion of cases. In exchange for a proactive investment today, we can save billions of dollars in health care costs over the next five years and beyond, and save thousands of lives.”