Association between self-reported length of time in the USA and blood lead levels: National Health and Nutrition Examination Survey 2013-2016.

OBJECTIVES: The aim of this study is to determine the association between length of time in the USA with blood lead (BPb). DESIGN: Population-based cross-sectional study using data from the 2013-2016 National Health and Nutrition Examination Survey. SETTING: USA. PARTICIPANTS: 5933 men and women (≥15 years); subgroups of men only (n=2867), women only (n=3064) and women of childbearing age (15-45 years) (n=1580). PRIMARY AND SECONDARY OUTCOMES: The primary outcome was BPb concentration. The main exposure variable was self-reported number of years spent in the USA, categorised as: born in the USA; 0-4 years; 5-9 years; 10-19 years and ≥20 years. We used linear regression models adjusted for race/ethnicity, education, blood cotinine, age, sex (as appropriate) and accounted for complex survey design. RESULTS: Women of childbearing age who have lived 0-4 years in the USA have, on average, a 54% (95% CI 36% to 75%) higher BPb compared with women born in the USA. Corresponding results for all women, men and the entire population were 49% (95% CI 34% to 66%), 49% (95% CI 28% to 75%) and 49% (95% CI 33% to 66%), respectively. Similar, statistically significant, results were observed for other time periods (5-9 years, 10-19 years and ≥20 years); the magnitude of the association decreased with increasing time in the USA. CONCLUSIONS: This study provides additional evidence that newcomers to the USA may be a population at higher risk of elevated BPb.

Self-reported healthcare provider utilization across United States Midwestern households.

Understanding the relationships between health care provider usage and demographics of patients is necessary for the development of educational materials, outreach information, and programs targeting individuals who may benefit from services. This analysis identified relationships between health care provider usage and individual's demographics. A sample of Midwestern U.S. respondents (n = 1265) was obtained through the use of an online survey distributed February 12-26, 2016 and was targeted to be representative of the population of the Midwestern states sampled in terms of sex, age, income, and state of residence. Specific factors identified as significant in contributing to provider usage (in the past five years) differed across the eleven provider types studied. In the most commonly used practitioners (the general or primary physician), relationships between provider usage and age, income, health insurance coverage status, and having children in the household were identified. Furthermore, significant (and positive) correlations were identified between the usage of various practitioners; reporting the use of one type of practitioner studied was correlated positively with reporting the use of another type of health care provider studied in this analysis. This analysis provides insight into the relationships between health care provider usage and demographics of individuals, which can aid in the development of educational materials, outreach programs, and policy development.

Social desirability bias in reporting of holiday season healthfulness.

Respondents participating in survey or interview based research often tend to give answers that put themselves in a favorable light, displaying social desirability bias (SDB). Understanding the susceptibility of individuals to underreport their perceived unhealthy holiday behaviors or over report holiday behaviors they perceive as healthy has important implications for health promotion and health policy surrounding the holiday season. This study examines SDB specific to the reporting of holiday food consumption and health-related behaviors. An online survey of 620 U.S. consumers was utilized to collect data in which SDB was accounted for via indirect questioning. The online survey was conducted by Purdue University from November 17-19, 2014. Up to 64% of respondents displayed SDB for the eight holiday health statements studied. Respondents over the age of 45 and without children more frequently displayed social desirability bias. Respondents who displayed SDB with respect to acceptable health related holiday food consumption behaviors may be more susceptible to social pressures surrounding other consumption decision making. Understanding SDB in health and behavior reporting, in particular for the traditionally challenging, in terms of health outcomes, holiday season is critical for health practitioners as they seek to promote healthy behaviors.

Cultural Beliefs Underlying Medication Adherence in People of Chinese Descent in the United States.

This article examines the meanings, practices, and cultural beliefs underlying medication adherence in people of Chinese descent living in the United States. The narratives were analyzed using interpretive phenomenology, resulting in the following themes that influenced the communication and behaviors around medication adherence of the participants: (a) cultural concepts of yin yang balance and "qi," (b) understandings of Western and Chinese medicine's efficacy profiles, (c) importance of family and social support, and (d) level of acculturation. This article discusses the influence of these themes on medication adherence and proposes that health communication campaigns, interventions, and doctor-patient communication about increasing medication adherence with people of Chinese descent should engage these understandings.

Deconstructing the portrayals of HIV/AIDS among campaign planners targeting tribal populations in Koraput, India: a culture-centered interrogation.

This article deconstructs the portrayal of HIV/AIDS in the tribal dominated district of Koraput, India, among program planners, service delivery personnel, nongovernmental organizations (NGOs), etc. who plan, implement, and evaluate HIV/AIDS interventions targeting tribal communities in the region. Drawing upon postcolonial and subaltern studies approaches, we critically examine the ideological assumptions that circulate in the dominant discursive spaces among campaign planners and implementers who target HIV/AIDS among the tribal population in Koraput, India. Based on our critical examination, we suggest guidelines for engaging with program planners and implementers through health communication pedagogy informed by the culture-centered approach.