Publications
Department of Medicine faculty members published more than 3,600 peer-reviewed articles in 2024.
2012
2012
BACKGROUND
Personal health records (PHR) may improve patients' health by providing access to and context for health information. Among patients receiving care at a safety-net HIV/AIDS clinic, we examined the hypothesis that a mental health (MH) or substance use (SU) condition represents a barrier to engagement with web-based health information, as measured by consent to participate in a trial that provided access to personal (PHR) or general (non-PHR) health information portals and by completion of baseline study surveys posted there.
METHODS
Participants were individually trained to access and navigate individualized online accounts and to complete study surveys. In response to need, during accrual months 4 to 12 we enhanced participant training to encourage survey completion with the help of staff. Using logistic regression models, we estimated odds ratios for study participation and for survey completion by combined MH/SU status, adjusted for levels of computer competency, on-study training, and demographics.
RESULTS
Among 2,871 clinic patients, 70% had MH/SU conditions, with depression (38%) and methamphetamine use (17%) most commonly documented. Middle-aged patients and those with a MH/SU condition were over-represented among study participants (N = 338). Survey completion was statistically independent of MH/SU status (OR, 1.85 [95% CI, 0.93-3.66]) but tended to be higher among those with MH/SU conditions. Completion rates were low among beginner computer users, regardless of training level (<50%), but adequate among advanced users (>70%).
CONCLUSIONS
Among patients attending a safety-net clinic, MH/SU conditions were not barriers to engagement with web-based health information. Instead, level of computer competency was useful for identifying individuals requiring substantial computer training in order to fully participate in the study. Intensive on-study training was insufficient to enable beginner computer users to complete study surveys.
View on PubMed2012
PURPOSE
Exposure to racial insults among youth in Jujuy, Argentina, was examined as a factor associated with smoking behavior.
METHODS
Youth sampled from eighth-grade classes in 27 randomly selected middle schools completed annual surveys in the ninth and tenth grades. Demographics, race/ethnicity (Indigenous/Amazonian, Indigenous/Andean, Indigenous unspecified group, Mixed European-Indigenous, European), cigarette smoking, and other attitudinal and behavioral factors were measured. Exposure to racial insults, measured in the ninth grade, was modeled to predict cigarette smoking in the previous 30 days (defined as current) in the tenth grade conditional on ninth grade smoking.
RESULTS
Of the 3,122 respondents, 35.5% reported exposure to racial insults and 33.8% were current smokers. Factors associated with racial insults were being male, indigenous language spoken at home, ever and current smoking, smoking in a ceremonial context, exposure to second-hand smoke at home, number of friends who smoke, having low expectations for the future, low identification with conforming role models, high identification with defiant role models, and depressive symptoms. Reported exposure to racial insults increased the risk of current smoking in the 10th grade among Indigenous Amazonian respondents (OR = 3.8; 95% CI 1.4-10.4) and among the Indigenous-unspecified group (OR = 1.8; 95% CI 1.1-2.8), but not among European or Indigenous Andean youth.
CONCLUSIONS
Exposure to racial insults is commonplace among youth in Jujuy. Evidence of a longitudinal effect of ninth-grade racial insults on tenth-grade smoking rates provides support for an association of racial insults with smoking behavior.
View on PubMed2012
2012
2012