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PURPOSE: Equity, Diversity, and Inclusion (EDI) initiatives within critical care research are limited by a lack of resources and inconsistent and rapidly changing language. The Canadian Critical Care Trials Group (CCCTG) is committed to modelling EDI for the critical care community through its programming, communications, protocols, and policies. The objective of developing the EDI glossary of sociodemographic determinants of health described here was to provide a resource for critical care professionals to support broader equity initiatives and to promote education and awareness about inclusive language. METHODS: Through literature review, we identified EDI-related sociodemographic determinants of health, defined as sociodemographic factors that are associated with disparities in health care and health outcomes, with a focus on critical care medicine. For each sociodemographic determinant of health, we identified umbrella terms (defined as domains) and subterms/constructs that are related to these domains. We designed the glossary collaboratively with the CCCTG EDI working group, patient and family partnerships committee, and executive committee, which included diverse knowledge users such as researchers, clinicians, and patient and family partners. RESULTS: We report on 12 sociodemographic determinants of health domains including age, sex, gender, sexuality, race and ethnicity, income, education, employment status, marital status, language, disability, and migration status. Each domain (e.g., sex) contains relevant subterms such as male, female, intersex. For each domain, we provide examples of disparities in health care and health outcomes with a focus on critical care medicine. CONCLUSIONS: This EDI glossary of sociodemographic determinants of health serves as a nonexhaustive resource that may be referenced by critical care researchers, research coordinators, clinicians, and patient and family partners. The glossary is an essential step to raising awareness about inclusive terminology and to fostering and advancing equity in critical care medicine.

RéSUMé: OBJECTIF: Les initiatives en matière d'équité, de diversité et d'inclusion (EDI) dans le cadre de la recherche en soins intensifs sont limitées à la fois par un manque de ressources et par un langage incohérent et évoluant rapidement. Le Groupe canadien de recherche en soins intensifs (CCCTG) s'est engagé à devenir un modèle en matière d'EDI pour la communauté des soins intensifs par le biais de ses programmes, de ses communications, de ses protocoles et de ses politiques. L'objectif de l'élaboration du glossaire pour les déterminants sociodémographiques de la santé respectant l'EDI décrit ici était de fournir une ressource aux professionnel·les des soins intensifs pour soutenir des initiatives d'équité plus larges et de promouvoir l'éducation et la sensibilisation au langage inclusif. MéTHODE: En procédant à l'examen de la littérature, nous avons identifié des déterminants sociodémographiques de la santé liés à l'EDI, définis comme des facteurs sociodémographiques associés à des disparités dans les soins de santé et les devenirs en santé, en mettant l'accent sur la médecine des soins intensifs. Pour chaque déterminant sociodémographique de la santé, nous avons identifié des termes génériques (définis comme des domaines) et des sous-termes/construits liés à ces domaines. Nous avons conçu le glossaire en collaboration avec le groupe de travail sur l'EDI du CCCTG, le comité des partenariats avec les patient·es et les familles et le comité exécutif, qui comprenait divers utilisateurs et utilisatrices des connaissances tels que des personnes impliquées dans la recherche ou en clinique ainsi que des partenaires issu·es de la patientèle et de leurs familles. RéSULTATS: Nous rendons compte de 12 domaines sociodémographiques pour les déterminants de la santé, notamment l'âge, le sexe, le genre, la sexualité, la race et l'origine ethnique, le revenu, l'éducation, la situation d'emploi, l'état matrimonial, la langue, le handicap et le statut migratoire. Chaque domaine (par exemple, le sexe) contient des sous-termes pertinents tels que masculin, féminin, intersexe. Pour chaque domaine, nous fournissons des exemples de disparités dans les soins de santé et les issues en matière de santé, en mettant l'accent sur la médecine des soins intensifs. CONCLUSION: Ce glossaire EDI des déterminants sociodémographiques de la santé sert de ressource non exhaustive qui peut être consultée par les équipes de recherche en soins intensifs, les coordonnateurs et coordonnatrices de recherche, les clinicien·nes et les patient·es ainsi que les familles. Ce glossaire est une étape essentielle pour sensibiliser à la terminologie inclusive et pour favoriser et faire progresser l'équité en médecine des soins intensifs.

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OBJECTIVES: This study compared adults with type 2 diabetes (T2DM) and those without diabetes (ND) from East London in terms of sociodemographic characteristics, oral health behaviors, dietary practices, and alcohol and tobacco-related habits. MATERIALS AND METHODS: A total of 182 participants (n = 91 for each group) were recruited and requested to complete the validated questionnaire with 33 items. RESULTS: Results showed that the mean ± SD age was 61 ± 11.7 in the T2DM, while 51 ± 11.2 in the ND group. The mean ± SD age at T2DM diagnosis was 43 ± 10. There was a significant gender difference, with more males in the T2DM group (67.7%) and more females in the ND group (64.8%). Asian-British (38.4%) were significantly high in the T2DM group when compared to other ethnicities. 92.3% of T2DM participants were significantly more likely to use medications in comparison to the ND group (29.7%). The T2DM participants' personal statements on general health were fair (34%) and good (46.2%) when compared with the ND group (15.4% and 59.3%, respectively). The majority of T2DM and ND participants (98%) lacked dental insurance. In the T2DM group, 31.8% were receiving benefits, and 39.5% were retired, while 46% of the ND group were full-time employees. Tooth brushing twice a day was slightly less common in T2DM (68%) when compared to the ND group (78%). Nearly half of the participants in both groups failed to carry out interdental cleaning (T2DM = 52%; ND = 47%), and 38.5% of the T2DM group used mouthwash occasionally, while 30% of the ND group had it twice daily. There was a weak association between chewing paan and annual income in ND participants (r = .90, p = .49). There were significant differences in the presence of removable prostheses, juice, and sweetened juice consumptions between the two groups (p < .05). CONCLUSION: Within the confines of this study, being male, Asian British, retired due to disability, polypharmacy, and the presence of removable prostheses were all significant factors for T2DM.

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Objectives: Optimal adherence to antiretroviral therapy is required for viral load suppression. This study investigated the sociodemographic (age, sex, marital status, level of education, monthly income, settlement type, distance to the antiretroviral therapy-providing site, ethnicity) and health system (antiretroviral therapy-providing site) determinants of antiretroviral therapy adherence among human immunodeficiency virus-positive patients in the Volta Region, Ghana. Methods: A cross-section design was adopted, collecting data from 1729 human immunodeficiency virus patients and analysing them using STATA version 17 at level 0.05. Results: Antiretroviral therapy adherence was poor (51.2%). Being divorced (Adjusted odds ratio (AOR) = 0.65), widow (AOR = 0.58), cohabiting (AOR = 0.22), Ewe (AOR = 3.7), Ga/Dangbe (AOR = 2.27), living in a rural area (AOR = 1.54) and an urban area (AOR = 0.64), having a monthly income of GH₵1000 or less (AOR = 3.21), covering a distance of 51 km and above to the antiretroviral therapy centre (AOR = 1.79), receiving antiretroviral therapy from Ketu South Municipal Hospital (AOR = 0.09), Hohoe Municipal Hospital (AOR = 0.03), Ho Municipal Hospital (AOR = 0.02) and Ho Teaching Hospital (AOR = 0.09) were the determinants of antiretroviral therapy adherence. Conclusion: Antiretroviral therapy adherence was low. Interventions to improve antiretroviral therapy adherence should target these significant determinants.

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(1) The COVID-19 pandemic exacerbated health disparities, both between foreign and autochthonous populations. Italy was one of the European countries that was the most affected by the COVID-19 pandemic; however, only limited data are available on vaccine willingness. This study aims to assess the propensity of foreign and autochthonous populations residing in Italy to be vaccinated and the relative associated factors. (2) Data were collected and analysed from the two Italian surveillance systems, PASSI and PASSI d'Argento, in the period of August 2020-December 2021. The data include those of the Italian resident adult population over 18 years old. A multinomial logistic regression model, stratified by citizenship, was used to assess the associations of sociodemographic, health, and COVID-19 experience variables with vaccination attitudes. (3) This study encompassed 19,681 eligible subjects. Considering the willingness to be vaccinated, foreign residents were significantly less certain to get vaccinated (49.4% vs. 60.7% among Italians). Sociodemographic characteristics, economic difficulties, and trust in local health units emerged as factors that were significantly associated with vaccine acceptance. Having received the seasonal flu vaccine was identified as a predictor of COVID-19 vaccine acceptance among foreign and Italian residents. (4) This study underscores the significance of tailoring interventions to address vaccine hesitancy based on the diverse characteristics of foreign and Italian residents. This research offers practical insights for public health strategies, highlighting the importance of tailored educational campaigns, improved communication, and nuanced interventions to enhance vaccine acceptance and uptake within both populations.

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BACKGROUND: Studies find that delivery hospital explains a significant portion of the Black-White gap in severe maternal morbidity. No such studies have focused on the US Southeast, where racial disparities are widest, and few have examined the relative contribution of hospital, residential, and maternal factors. OBJECTIVE: This study aimed to estimate the portion of Georgia's Black-White gap in severe maternal morbidity during delivery through 42 days postpartum explained by hospital, residential, and maternal factors. STUDY DESIGN: Using linked Georgia hospital discharge, birth, and fetal death records for 2016 through 2020, we identified 413,124 deliveries to non-Hispanic White (229,357; 56%) or Black (183,767; 44%) individuals. We linked hospital data from the American Hospital Association and Center for Medicare and Medicaid Services, and area data from the Area Resource File and American Community Survey. We identified severe maternal morbidity indicator conditions during delivery or subsequent hospitalizations through 42 days postpartum. Using race-specific logistic models followed by a decomposition technique, we estimated the portion of the Black-White severe maternal morbidity gap explained by the following: (1) sociodemographic factors (age, education, marital status, and nativity), (2) medical conditions (diabetes mellitus, gestational diabetes, chronic hypertension, gestational hypertension or preeclampsia, and smoking), (3) obstetrical factors (singleton or multiple, and birth order); (4) access to care (no or third trimester care, and payer), (5) hospital factors that are time-varying (delivery volume, deliveries per full-time equivalent nurse, doctor communication, patient safety, and adverse event composite score) or measured time-invariant characteristics (ownership, profit status, religious affiliation, teaching status, and perinatal level), and (6) residential factors (county urban/rural classification, percent uninsured women of reproductive age, obstetrician-gynecologists per women of reproductive age, number of federally-qualified and community health centers, medically-underserved area [yes/no], and census tract neighborhood deprivation index). We estimated models with and without hospital fixed-effects, which account for unobserved time-invariant hospital characteristics such as within-hospital care processes or unmeasured hospital-specific factors. RESULTS: There was 1.8 times the rate of severe maternal morbidity per 100 discharges among non-Hispanic Black (3.15) than among White (1.73) individuals, with an explained proportion of 30.4% in models without and 49.8% in models with hospital fixed-effects. In the latter, hospital fixed-effects explained the largest portion of the Black-White severe maternal morbidity gap (15.1%) followed by access to care (14.9%) and sociodemographic factors (14.4%), with residential factors being protective for Black individuals (-7.5%). Smaller proportions were explained by medical (5.6%), obstetrical (4.0%), and time-varying hospital factors (3.2%). Within each category, the largest explanatory portion was payer type (13.3%) for access to care, marital status (10.3%) for sociodemographic, gestational hypertension (3.3%) for medical, birth order (3.6%) for obstetrical, and patient safety indicator (3.1%) for time-varying hospital factors. CONCLUSION: Models with hospital fixed-effects explain a greater proportion of Georgia's Black-White severe maternal morbidity gap than models without them, thereby supporting the point that differences in care processes or other unmeasured factors within the same hospital translate into racial differences in severe maternal morbidity during delivery through 42 days postpartum. Research is needed to discern and ameliorate sources of within-hospital differences in care. The substantial proportion of the gap attributable to racial differences in access to care and sociodemographic factors points to other needed policy interventions.

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BACKGROUND: Adolescents with autism spectrum disorder (ASD) are at an increased risk of overweight/obesity and adverse childhood experiences (ACEs). OBJECTIVE: This study examined whether ACEs increased the odds of overweight/obesity in adolescents with ASD. METHODS: This cross-sectional study used National Survey of Children's Health (NSCH) 2018-2019 data (N = 31,533 children ages 10-17 years, including n = 480 children with mild ASD and n = 423 children with moderate/severe ASD with normal or overweight/obese BMI). Parent-reported body mass index (BMI) was coded as overweight/obesity vs. normal weight. The independent variable was the count of nine ACEs. Binary logistic regression was conducted, controlling for social ecological factors. RESULTS: The odds of overweight/obesity in adolescents with ASD with 1-2 ACEs (OR 1.3, CI 1.1-1.4) and 3+ ACEs (OR 1.6, CI 1.3-2.0) were higher than those with 0 ACEs; odds increased with higher counts of ACEs. Household income level was the most significant sociodemographic influence on odds of obesity in adolescents with ASD (0-99 % Federal Poverty Level: OR 1.9, CI 1.6-2.3). Adolescents with moderate/severe ASD (OR 1.7, CI 1.2-2.5) and mild ASD (OR 1.6, CI 1.0-2.4) had higher odds of overweight/obesity after accounting for ACEs, race/ethnicity, sex, household income, and physical activity. CONCLUSION: Findings indicated ACEs are associated with ASD, which calls for integration of ACEs information within trauma-informed care practices for obesity prevention and intervention for adolescents with ASD. Persistent disparities of overweight/obesity exist by race/ethnicity, sex, and household income within this population, which indicates the need for tailoring trauma-informed approaches to the unique needs of this population.

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Ultra-processed food (UPF) intake is associated with increased non-communicable disease risks. However, systematic reports on sociodemographic predictors of UPF intake are lacking. This review aimed to understand UPF consumption based on sociodemographic factors, using nationally representative cohorts. The systematic review was pre-registered (PROSPERO:CRD42022360199), following PRISMA guidelines. PubMed/MEDLINE searches ('ultra-processed/ultraprocessed' and 'ultra-processing/ultraprocessing') until 7 September 2022 retrieved 1131 results. Inclusion criteria included: observational, nationally representative adult samples, in English, in peer-reviewed journals, assessing the association between sociodemographics and individual-level UPF intake defined by the NOVA classification. Exclusion criteria included: not nationally representative, no assessment of sociodemographics and individual-level UPF intake defined by NOVA. Risk of bias was assessed using the Newcastle­Ottawa Scale (NOS). Fifty-five papers were included, spanning thirty-two countries. All thirteen sociodemographic variables identified were significantly associated with UPF intake in one or more studies. Significant differences in UPF intake were seen across age, race/ethnicity, rural/urbanisation, food insecurity, income and region, with up to 10­20% differences in UPF intake (% total energy). Higher UPF intakes were associated with younger age, urbanisation and being unmarried, single, separated or divorced. Education, income and socioeconomic status showed varying associations, depending on country. Multivariate analyses indicated that associations were independent of other sociodemographics. Household status and gender were generally not associated with UPF intake. NOS averaged 5·7/10. Several characteristics are independently associated with high UPF intake, indicating large sociodemographic variation in non-communicable disease risk. These findings highlight significant public health inequalities associated with UPF intake, and the urgent need for policy action to minimise social injustice-related health inequalities.

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Background: Most studies have focused on overweight/obesity and its secular trend, with insufficient studies on the factors influencing thinness and trends recently. To examine the trends of prevalence and sociodemographic determinants of thinness, overweight, and obesity among Chinese children and adolescents aged 7 to 18 years from 2010 to 2018. Methods: This study was based on cross-sectional data of 11,234 children and adolescents aged 7 to 18 years from the Chinese Family Panel Studies (CFPS) in 2010, 2014, and 2018, including anthropometric and sociodemographic characteristics variables. The nutritional status of each individual was determined according to China and WHO criteria. The demographic characteristics of different subgroups were tested by chi-square, and log-binomial regression was used to analyze the trend of prevalence and the relationship between sociodemographic characteristics and different nutritional statuses. Results: After adjusting for age, from 2010 to 2018, the overall prevalence of thinness decreased, and the prevalence of overweight increased in Chinese children and adolescents. The overall prevalence of obesity declined in boys and increased in girls, but in adolescents aged 16-18 years, it increased significantly. Log-binomial regression analysis showed that among all subjects, time (years), 16-18 years were negatively associated with thinness, while 13-15 years, walking to school, large family size, and paternal age at childbirth older than 30 years old were positively associated with thinness; 10-12/13-15/16-18 years, boarding at school, medium and large family sizes, and mother's education at junior middle school/junior high school and above were negatively associated with overweight/obesity, while time (years), boys were positively associated with overweight/obesity in the multivariate model by adjusting for the statistically significant factors (all p < 0.05). Conclusion: Chinese children and adolescents are facing a double burden of malnutrition. Future public health policies and interventions should prioritize high-risk groups specifically young age groups, boys, larger family sizes and so on.

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Vaccines against coronavirus disease 2019 (COVID-19) have been in use for over two years, but studies that reflect real-world vaccination coverage and demographic determinants are lacking. Using a multistage stratified random cluster sampling method, we planned to directly explore vaccination coverage and the demographic determinants of different doses of COVID-19 vaccines in Beijing, especially in older populations. All 348 community health service centers in 16 districts were involved. We performed multivariable logistic regression analyses to identify demographic determinants of different coverage rates via adjusted odds ratios (aORs) and 95% CIs. Of the 42,565 eligible participants, the total vaccination coverage rates for ≥1 dose, ≥2 doses, ≥3 doses, and 4 doses were 93.3%, 91.6%, 84.9%, and 13.0%, respectively, but decreased to 88.1%, 85.1%, 76.2%, and 3.8% in the older population. Among all participants, younger (aOR = 1.77, 95% CI: 1.60-1.95), male (aOR = 1.15, 95% CI: 1.06-1.23), and better-educated residents (high school and technical secondary school aOR = 1.58, 95% CI: 1.43-1.74; bachelor's degree aOR = 1.53, 95% CI: 1.37-1.70) were more likely to be fully vaccinated. People who lived in rural areas (aOR = 1.45, 95% CI: 1.31-1.60) and held the new rural cooperative health insurance (aOR = 1.37, 95% CI: 1.20-1.57) established a higher rate of full vaccination coverage. No history of chronic disease was positively associated with a higher coverage rate (aOR = 1.81, 95% CI: 1.66-1.97). Occupation also affected vaccination coverage. Demographic factors influencing the rate of vaccination with at least one or three doses were consistent with the results above. Results remained robust in a sensitivity analysis. Given the highly transmissible variants and declining antibody titers, accelerating the promotion of booster vaccination coverage, especially in high-risk groups such as the elderly, is a top priority. For all vaccine-preventable diseases, rapidly clarifying vaccine-hesitant populations, clearing barriers, and establishing a better immune barrier can effectively safeguard people's lives and property and coordinate economic development with epidemic prevention and control.

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Objectives: This study was conducted to assess poultry farmers' knowledge and practices regarding antibiotics, antimicrobial usage (AMU), and antimicrobial resistance (AMR), and to identify the sociodemographic factors of inappropriate use of antibiotics in commercial poultry farms in Bangladesh. Methods: A qualitative survey of 140 farmers in Bangladesh was conducted from March to May 2019. A logistic regression model was used to identify factors associated with the inappropriate use of antibiotics. Results: 47.1% of farmers were unable to explain antibiotics, 42.9% used antibiotics for preventive purposes, 4.3% used them as growth promoters, 25.7% used them as suggested by veterinarians, 42.9% used leftover antibiotics, 50% did not maintain antibiotics residual withdrawal period, and 98.6% did not know about AMR. In bivariable regression analysis, sex and primary occupation of poultry farmers, their knowledge about withdrawal periods for antibiotics, and no contact with veterinary surgeons (VS) were found to be significantly associated with the inappropriate use of antibiotics, while only 'no contact with VS' was identified in multivariable regression analysis. Conclusions: The findings suggest an urgent need to improve understanding of antibiotics and AMR. Adequate supervision by veterinarians would ensure adherence to appropriate AMU patterns, and would limit the misuse of antibiotics and associated AMR development in farms.

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OBJECTIVES: Activity diversity-an index of active lifestyles that captures variety (number) and evenness (consistency) in activity engagement-is known to support health in adulthood. However, less is known who has higher or lower activity diversity, information that helps identify individuals who may be at greater risk for poor health. This article examined sociodemographic characteristics and Big Five personality traits that may be associated with activity diversity. METHODS: We used 2 independent project samples (nsample1 = 2,699; nsample2 = 301). Sample 1 included U.S. national adults in a wide age range (25-84). Sample 2 included U.S. community-dwelling older adults (age = 65-89). Each study asked about different types of activity engagement using surveys. The activity diversity index was calculated in each sample, using Shannon's entropy method. RESULTS: In Sample 1, older adults, women, non-Hispanic White individuals, married/partnered individuals, and those with higher education and fewer functional limitations had higher activity diversity. Additionally, higher conscientiousness, higher extraversion, and lower neuroticism were each associated with higher activity diversity after controlling for sociodemographic factors. Extraversion and neuroticism remained significant in the younger group (age < 65) of Sample 1, but only extraversion was a significant factor associated with activity diversity in the older group (age ≥ 65). The results in the older group were generally replicated in Sample 2, such that higher extraversion in older adults was consistently associated with higher activity diversity independent of the strong correlates of sex, education, and functional limitations. DISCUSSION: Findings were discussed in terms of age-specific associations between sociodemographic and personality characteristics and activity diversity.

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There is an urgent need for an in-depth and systematic assessment of a wide range of predictive factors related to populations most at risk for delaying and refusing COVID-19 vaccination as cases of the disease surge across the United States. Many studies have assessed a limited number of general sociodemographic and health-related factors related to low vaccination rates. Machine learning methods were used to assess the association of 151 social and health-related risk factors derived from the American Community Survey 2019 and the Centers for Disease Control and Prevention (CDC) BRFSS with the response variables of vaccination rates and unvaccinated counts in 1,555 ZIP Codes in California. The performance of various analytical models was evaluated according to their ability to regress between predictive variables and vaccination levels. Machine learning modeling identified the Gradient Boosting Regressor (GBR) as the predictive model with a higher percentage of the explained variance than the variance identified through linear and generalized regression models. A set of 20 variables explained 72.90% of the variability of unvaccinated counts among ZIP Codes in California. ZIP Codes were shown to be a more meaningful geo-local unit of analysis than county-level assessments. Modeling vaccination rates was not as effective as modeling unvaccinated counts. The public health utility of this model provides for the analysis of state and local conditions related to COVID-19 vaccination use and future public health problems and pandemics.

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Background: The objectives of the present study are to understand the longitudinal variability in COVID-19 reported cases at the county level and to associate the observed rates of infection with the adoption and lifting of stay-home orders.Materials and Methods: The study uses the trajectory of the pandemic in a county and controls for social and economic risk factors, physical environment, and health behaviors to elucidate the social determinants contributing to the observed rates of infection.Results and conclusion: Results indicated that counties with higher percentages of young individuals, racial and ethnic minorities and, higher population densities experienced greater difficulty suppressing transmission.Except for Education and the Gini Index, all factors were influential on the rate of COVID-19 spread before and after stay-home orders. However, after lifting the orders, six of the factors were not influential on the rate of spread; these included: African-Americans, Population Density, Single Parent Households, Average Daily PM2.5, HIV Prevalence Rate, and Home Ownership. It was concluded that different factors from the ones controlling the initial spread of COVID-19 are at play after stay-home orders are lifted.KEY MESSAGESObserved rates of COVID-19 infection at the County level in the U.S. are not directly associated with adoption and lifting of stay-home orders.Disadvantages in sociodemographic determinants negatively influence the rate of COVID-19 spread.Counties with more young individuals, racial and ethnic minorities, and higher population densities have greater difficulty suppressing transmission.

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INTRODUCTION: Stated preference studies are a valuable tool to elicit respondents' willingness to pay (WTP) for goods or services, especially in situations where no market valuation exists. Contingent valuation (CV) is a widely used approach among stated-preference techniques for eliciting WTP if prices do not exist or do not reflect actual costs, for example, when services are covered by insurance. This review aimed to provide an overview of relevant factors determining WTP for health services to support variable selection. METHODS: A comprehensive systematic literature search and review of CV studies assessing determinants of WTP for health services was conducted, including 11 electronic databases. Two of the authors made independent decisions on the eligibility of studies. We extracted all determinants used and related p values for the effect sizes (e.g. reported in regression models with WTP for a health service as outcome variable). Determinants were summarised in systematic evidence tables and structured by thematic domains. RESULTS: We identified 2082 publications, of which 202 full texts were checked for eligibility. We included 62 publications on 61 studies in the review. Across all studies, we identified 22 WTP determinants and other factors from 5 thematic domains: sociodemographic characteristics, perceived threat, perceived benefit, perceived barriers, and other information. CONCLUSION: Our review provides evidence on 22 relevant determinants of WTP for health services, which may be used for variable selection and as guidance for planning CV surveys. Endogeneity should be carefully considered before interpreting these determinants as causal factors and potential intervention targets.

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Introduction: Governments and public health authorities across many jurisdictions implemented social (physical) distancing measures to contain the spread of the 2019 novel coronavirus disease (COVID-19). Adherence to these measures is variable and likely influenced by various factors. This study aimed to 1) identify the individual sociodemographic, COVID-19 and social distancing related, and psychological determinants of social distancing adherence, and 2) explore regional differences in social distancing adherence in the United States (U.S.) and English-speaking Canada based on each region's discrepant response to social distancing restrictions. Methods: A web-based repeated cross-sectional survey was conducted in 4,942 English-speaking participants from the four most populous U.S. states, specifically New York, California, Texas, and Florida, and Canada (www.covid19-database.com). The study was conducted at two timepoints, from May 1 to 5, 2020 (n = 1,019, Canadian participants only) and from July 6 to 10, 2020 (n = 3,923). Separate univariate models were computed for individual sociodemographic, COVID-19 and social distancing related, and psychological determinants of social distancing adherence. To determine the total variance explained, a univariate analysis including all of the determinants was performed. Regional differences in social distancing were compared between the four U.S. states and Canada, and between the U.S. as a whole and Canada. Results: Adherence to social distancing was higher in May (mean = 4.4/5.0±0.7) compared to July (mean = 4.3/5.0±0.7) [t (4940) = 6.96, p < 0.001], likely a reflection of relaxing restrictions. There were no regional differences in adherence. Sociodemographic, COVID-19 and social distancing related, and psychological determinants explained 10, 36, and 23% of the variance of social distancing adherence, respectively. Higher perceived seriousness of COVID-19 [ß (SE) = 0.39 (0.01), p < 0.001, partial η2 = 0.22], lower risk propensity [ß (SE) = -0.15 (0.01), p < 0.001, partial η2 = 0.06], germ aversion [ß (SE) = 0.12 (0.01), p < 0.001, partial η2 = 0.03], age [ß (SE) = 0.01 (0.00), p < 0.001, partial η2 = 0.02], and greater social support [ß (SE) = 0.03 (0.00), p < 0.001, partial η2 = 0.02] had the largest effects on social distancing adherence. Conclusion: Public service initiatives to emphasize the serious consequences of infection and targeted interventions toward certain sociodemographic groups, such as younger adults and vulnerable individuals in greater need of social support, may help enhance the public's adherence to social distancing measures during subsequent waves of COVID-19 and future pandemics.

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Between 2016 and 2019, a catch-up human papillomavirus (HPV) vaccination took place in Norway for women born between 1991 and 1996. The aim of this study was to identify sociodemographic determinants of complete vaccination (3 doses) and partial vaccination (1-2 doses). A random sample of 10,000 women who were offered catch-up HPV vaccination were invited. We assessed the association between sociodemographic characteristics and vaccination completion using univariable and multivariable multinomial logistic regression.Of 4,967 respondents, 3,464 (63%) received complete vaccination and 298 (7%) received partial vaccination. 30% did not receive any vaccination and functioned as reference group. Compared with having Norwegian caregivers, having a caregiver from non-western countries decreased the odds of partial and complete vaccination (aOR = 0.57; 95%CI = 0.35-0.95 and aOR = 0.57; 95%CI = 0.44-0.74). Having a caregiver from other western countries decreased the odds of complete vaccination (aOR = 0.72; 95%CI = 0.52-0.98). Residing in Norway for 10 years or longer significantly increased the odds of complete vaccination (aOR = 2.65; 95%CI = 1.58-4.43). Being in a relationship significantly increased the odds of partial vaccination compared with being single (aOR = 1.50; 95%CI = 1.02-2.21). Being married (aOR = 0.66; 95%CI = 0.50-0.86) and having children (aOR = 0.53; 95%CI = 0.42-0.68) decreased the odds of complete vaccination. Having university education increased the odds of both partial and complete vaccination (aOR = 2.19; 95%CI = 1.47-3.25 and aOR = 4.11; 95%CI = 3.33-5.06).Having a caregiver born outside of Norway, having children and being married decreased the odds of receiving complete HPV vaccination. This highlights the need to target communication around HPV vaccination toward different ethnic communities and include more specific messaging that having children and being married does not necessarily prevent HPV infections.

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Objetivo principal: el objetivo de esta investigación es describir los hábitos de consumo alimentario y determinar qué variables sociodemográficas, dentro del colectivo de los estudiantes jóvenes universitarios, están implicadas en la elección de los alimentos. Metodología: se aplicó un cuestionario ad hoc, anónimo y auto-administrado a 599 estudiantes de la Universidad de Alicante, matriculados en el curso académico 2018/2019. Resultados principales: los resultados muestran que los jóvenes universitarios concentran sus ingestas en la comida (90,2%) y la cena (82%). Se evidenció, además, que los alimentos incluidos en la dieta mediterránea se consumen dos o tres veces por semana en esta población, pero en porcentajes diferentes. Los datos confirman que los educados en un estilo democrático consumen, en un 59%, alimentos enriquecidos con vitaminas y minerales por encima de otros estilos educativos familiares. De los estudiantes que afirmaban consumir alimentos precocinados un 51,9% pertenecen a un estilo educativo democrático, un 32,3% al permisivo, un 14,6% al autoritario y un 1,2% al negligente, lo que confirma la influencia de la cultura educativa familiar en los hábitos de alimentación de este grupo etario para esta variable. Conclusión principal: se concluye que las pautas definitorias de la dieta mediterránea han perdido protagonismo en este grupo poblacional, al comparar sus resultados con los de otros momentos históricos. Además, los resultados obtenidos muestran que los estilos de crianza no influyen de forma determinante en la elección de la alimentación en la etapa universitaria, a excepción del consumo alimentos precocinados.(AU)

Objective: the objective of this research is to describe food consumption habits and determine which sociodemographic variables, within the group of young university students, are involved in the choice of food. Methods: an ad hoc, Anonymous and self-administered questionnaire was applied to 599 students from the University of Alicante, enrolled in the 2018/2019 academic year. Results: the results show that university students concentrate their intakes at lunch (90.2%) and dinner (82%). It was also shown that the foods included in the Mediterranean diet are consumed two or three times a week in this population, but in different percentages. The data confirm that those educated in a democratic style consume, in 59%, foods enriched with vitamins and minerals above other family educational styles. Of the students who claimed to consume precooked foods, 51.9% belong to a democratic educational style, 32.3% to permissive, 14.6% to authoritarian and 1.2% to negligent, which confirms the influence of family educational culture in the eating habits of this ade group for this variable. Conclusions: it is concluded that the defining guidelines of the Mediterranean diet have lost prominence in this population group, when comparing their results with those od other historical moments. In addition, it is confirmed that the defining guidelines of the Mediterranean diet have been losing prominence along the years.(AU)

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OBJECTIVE: How best to provide an increasingly diverse population with health information has become a major concern for health policy makers in Europe and beyond. Our study aims to investigate factors explaining variation in people's health information seeking behaviour. Our findings can be used to identify target groups for policy interventions that aim to provide health information efficiently. METHODS: Cross-sectional, paper-based, multilingual survey of a random sample of enrolees of two statutory health insurers in Hamburg, Germany. Data were collected from September to December 2017. Multivariable logistic regression was used to examine sociodemographic and health-related individual characteristics and their associations with participants' choice of ten sources of health information. FINDINGS: Participants' choice of information sources differed significantly across the following sociodemographic and health-related characteristics: age, gender, immigration status, education, employment status, marital status and general state of health. Immigrants and individuals with low educational attainment were most likely to use emergency departments as sources of health information. CONCLUSION: Policy interventions aiming to manage the use of health information sources should focus on immigrants and individuals with low educational attainment. Providing multilingual, low-threshold counselling and information services could be an efficient way to reduce short-term costs of health information seeking behaviour to health insurers or other payers of care while improving patient empowerment.

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The access of people with disabilities to digital solutions promotes their inclusion and participation in many aspects of life. Computer games based on hearing or haptic devices have been gaining popularity among persons with visual impairment (VI), and players tend to display improved spatial and abstract reasoning skills, as well as better social interaction and self-confidence, after playing these games. However, a recent survey suggested that excessive gaming could represent a public health concern as a harmful form of behavior in young people associated with risk factors of negative psychosomatic and physical complaints. Young persons with VI are regular users of various technologies, but little is still known about their media patterns. This study aimed to determine the characteristics of the variables associated with gaming for adolescents with VI. The participants were 490 students, aged 13-24 years, from special schools for students with VI. Data was collected using a self-administered questionnaire. The current survey indicated a tendency towards excessive gaming in a significant proportion of young persons with VI. Sociodemographic variables are important in predicting gaming prevalence or screen time, but further research focused on establishing possible mediators (such as parental attitudes towards media) are necessary for identifying problematic gaming behaviors among students with VI.

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BACKGROUND: Raised blood pressure, also known as hypertension (HPT), has been a distressing health concern among Malaysians. An upward trend is found on the prevalence of newly-diagnosed HPT, contributing to the high number of overall hypertensive patients in Malaysia. To understand the cause and reduce the economic burden caused by HPT, current research aims to examine the dependency among sociodemographic and behavioural determinants of newly-diagnosed HPT among Malaysians. METHODS: The current study uses secondary data from the Fifth National Health and Morbidity Survey (NHMS V) 2015, a population based cross-sectional study. This study uses the Bayesian Network (BN) modelling to design and build a 'causal' model and identify potential determinants and their respective conditional probability on the prevalence of newly-diagnosed HPT among Malaysians. RESULTS: This study shows that Malaysians with newly-diagnosed HPT are directly affected by the age and body mass index (BMI). Additionally, household income, sex, marital status, ethnicity, strata, education levels, occupation, fruit intake, vegetable intake, smoking status, physical activity and plain water intake indirectly affect the incidence of the newly-diagnosed HPT. CONCLUSION: These results may be helpful in implementing appropriate policies to prevent and monitor the increasing prevalence of newly-diagnosed HPT among adults in Malaysia.