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Tag: vulnerable populations

Dementia, Substance Misuse, and Social Determinants of Health: American Indian and Alaska Native Peoples’ Prevention, Service, and Care

Crouch MC, Cheromiah Salazar MBR, Harris SJ, Rosich RM. Dementia, Substance Misuse, and Social Determinants of Health: American Indian and Alaska Native Peoples’ Prevention, Service, and Care. Chronic Stress (Thousand Oaks). 2023 Jan 18;7:24705470221149479. doi: 10.1177/24705470221149479. PMID: 36699807; PMCID: PMC9869198.

A qualitative study was conducted to understand the cultural practices and beliefs among American Indian and Alaskan Native (AI/AN) Elders about Alzheimer’s disease and related dementia (ADRD). Interviews investigated the etiology, course, treatment, and cultural meanings of ADRD as well as the social determinants of health related to ADRD and role of substance use disorder. AI/AN tribal Elders are identified as individuals who are designated culture bearers, wisdom holders, and role models in their respective communities. Twelve AI/AN Elders (mean age=73) who speak English participated in semi-structured interviews. The sample was predominantly female (66.7%), Athabascan Tribal heritage (58.3%) and retired (66.7%). All participants had a family member with ADRD but did not themselves have an ADRD diagnosis. Qualitative analyses identified 6 themes of etiology, barriers to treatment, and social determinants: (1) postcolonial distress; (2) substance misuse; (3) distrust of Western medicine; (4) structural inequities; (5) walking in two worlds; and, (6) decolonizing and indigenizing medicine. Findings highlight potential causal factors in disease development and manifestation as viewed by AI/AN Elders. This study exemplified historical and ongoing discrimination and stress in Western medicine and the importance of adopting a holistic view to address cultural health disparities.


New mHealth Intervention Aims to Curb Smoking Among Black HIV Patients

Article Excerpt: Following a $1.3 million grant from the National Institute of Drug Abuse, Lorra Garey, a researcher from the University of Houston RESTORE Lab, plans to lead a research project to assess the impact of an mHealth application to mitigate smoking among Black people with HIV. HIV, a virus that attacks the body’s immune system, affects a large portion of the worldwide population. According to the World Health Organization, it has led to 40 million deaths globally. In addition, the US Department of Veterans Affairs noted that about 20 percent of US citizens with HIV are not aware that they have it, according to the press release.

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Article Source: mHealthIntelligence


Implementation and impact of a technology-based HIV risk-reduction intervention among Thai men who have sex with men using “Vialogues”: a randomized controlled trial

Anand T, Nitpolprasert C, Jantarapakde J, Meksena R, Phomthong S, Phoseeta P, Phanuphak P & Phanuphak N (2020) Implementation and impact of a technology-based HIV risk-reduction intervention among Thai men who have sex with men using “Vialogues”: a randomized controlled trial, AIDS Care, 32:3, 394-405, DOI: 10.1080/09540121.2019.1622638

A randomized controlled trial was conducted to evaluate the impact of a technology-based intervention on HIV risks and condom use behaviors among men who have sex with men (MSM) in Thailand. Seventy-six participants who were at least 18 years of age and reported unprotected sex in the last 6 months were recruited from the Thai Red Cross Anonymous Clinic. Participants were randomly assigned to control (N=39) and intervention arms (N=37). The intervention group received HIV/STI prevention education videos delivered online via and video sessions with a counselor monthly for 12 months. The control group received HIV counseling and testing alone for 12 months. Researchers compared attendance rates of recommended clinic visits and HIV testing, changes in HIV/AIDS knowledge, behavioral intentions, attitudes for engaging in safer sex, condom use self-efficacy, and risky behaviors at baseline, 6-month and 12-month follow-ups for both groups. Eighty-nine percent of participants in the intervention arm completed all monthly Vialogues sessions. At 12 months, participants in the intervention arm had significantly more clinic visits than those in the control arm (p=0.03). At 12 months, the intervention group also reported a significantly higher percentage of condom use for anal intercourse than the control group (p=0.003). Participants receiving the intervention also reported significantly reduced self-perceived HIV risk (p=0.001), popper use (p=0.002), and number of sexual partners (p=0.003), and increased condom use (p=0.006) from baseline to 6 months and 12 months. Results demonstrated that the Vialogues program was effective for improving safer sex behaviors and attitudes to lower HIV risk among Thai MSM.


Improving Behavioral Health Care For Older Americans: If Not Now, When?

Article Excerpt: Telemedicine and technological procedures have important roles in the care of older adults as this population and its demand for behavioral health care grow. Despite access limitations and some age-related health challenges such as vision or hearing problems, cognitive decline, and decreased motor skills that may make telemedicine difficult for some, older adults want to follow technological developments and can successfully adapt to telemedicine. Moreover, age-related challenges have not been shown to block older adults from successfully using telemedicine. Provider best practices have been developed and can include practice runs with specified platforms, collaborating with patient family/caregiver, using assisted technologies, and so forth. Providers can set up older adults with training and tools necessary for successful telemedicine adoption, and older adults demonstrated high stakeholder satisfaction with telemedicine.

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Article Source: Health Affairs


Meet Grandma’s New Robot Pal

Article Excerpt: New York State is giving hundreds of “companion robots” to seniors at risk of social isolation, The Verge reports. Named ElliQ, the lamp-esque robots — from Israeli AI firm Intuition Robotics — are designed to make small talk, crack jokes and more. ElliQ’s “face” pivots toward whomever it’s speaking with, lending the bots a disarming, Pixar-like quality. A companion touchscreen can display pictures and other data (like weather reports) and handle video calls. Why it matters: Researchers have linked social isolation to all sorts of negative health outcomes: Loneliness is associated with a 50% higher risk of dementia, 32% increased risk of stroke and 29% greater risk of heart disease, and “significantly increases a person’s risk of premature death from all causes,” per the Centers for Disease Control and Prevention.

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Article Source: Axios


A New Study Finds that A Smoking Cessation App Can Reach a Diverse Group of Users

Article Excerpt: A new study published in the open access journal JMIR Public Health and Surveillance shows that a digital cessation app to quit smoking can draw a diverse audience, including at-risk and underrepresented groups. According to the Centers for Disease Control and Prevention, tobacco use continues to be the leading preventable cause of death, disease, and disability in the United States. For years, the state of Washington has been investing in helping residents quit tobacco. In 2015, the state broadened its offering to include free access to the 2Morrow Health tobacco cessation smartphone app. Washington State public health prioritizes the needs and well-being of all residents and assures that underserved and at-risk populations are reached. This digital solution allowed the state to cast a wider net to reach more and different tobacco users.

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Article Source: Newswise


Towards digital health equity – A qualitative study of the challenges experienced by vulnerable groups in using digital health services in the COVID-19 era

Kaihlanen AM, Virtanen L, Buchert U, Safarov N, Valkonen P, Hietapakka L, Horhammer I, Kujala S, Kouvonen A, Heponiemi T. (2022). Towards digital health equity – A qualitative study of the challenges experienced by vulnerable groups in using digital health services in the COVID-19 era. BMC Health Serv Res 22, 188.

This study examined the challenges experienced by vulnerable groups in using digital health services during the COVID-19 pandemic. Researchers conducted semi-structured qualitative interviews between October 2020 and May 2021 in Finland. The 74 participants included older adults, people with migrant status, patients using mental health services, people who are high users of health services, and unemployed people. The barriers of digital health services were interpreted through digital determinants of health based on the Digital Health Equity Framework. The study found that most participants identify insufficient digital and/or language skills as challenges. Participants also indicated a lack of support and training, poor health, and lack of strong e-identification or suitable devices prevented access to digital health. Additionally, digital health was perceived to be not applicable for every case or capable of replacing in-person services. Fear, lack of trust regarding digital platforms, and security concerns were also identified. Participants perceived digital communication with a health care provider to be less personal and more prone to misunderstandings compared to in-person contact. Participants found digital health options were not always available or they were unaware of existing digital services. Based on these findings, the researchers concluded that digital health is not equally accessible to all persons and major issues must be addressed to reduce the accessibility gap.


Doctors, Companies Push to Keep Looser, Pandemic-Era Rules for Prescribing Opioid Addiction Treatment via Telemedicine

Article Excerpt: It got a lot easier for patients with opioid addiction to get their medication remotely during the pandemic — and now addiction doctors and telehealth companies are pushing Congress to make those flexibilities permanent. Before Covid-19, patients had to see a doctor in person for prescriptions to help them with their addictions, like buprenorphine. Now, at least temporarily, they can get them via telehealth appointments. Experts say loosening the rules helped eliminate longstanding barriers to addiction care, like a lack of transportation or a shortage of clinicians who prescribe medically assisted treatment, especially in rural communities. But the changes are temporary, tied to the state of “emergency” associated with the pandemic — and proponents want them made permanent.

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Article Source: STAT News


FDA Grants Breakthrough Therapy Designation to Device to Treat AML-Induced Depression

Article Excerpt: The FDA has granted a breakthrough device designation to BNT200, a digital therapeutic designed to treat anxiety and depressive symptoms in adults with acute myeloid leukemia (AML) currently hospitalized for a regimen of high-intensity induction chemotherapy, according to a press release by Blue Note Therapeutics. BNT200 is a software that is designed to treat the unique psychological stressors that create anxiety and depressive symptoms in adult patients with AML undergoing high-intensity induction chemotherapy. It is an on-demand digital therapeutic, with content synchronized with high-intensity chemotherapy treatment.

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Article Source: Targeted Oncology