Preference and willingness to pay for reproductive health services among adults in Urban-Rural transition settings of a developing country: evidence from a cross-sectional study in a rural district of Hanoi, Vietnam.

BACKGROUND: Since the introduction of fee-for-service models in public hospitals and the legalization of private health services in Vietnam in 1989, the price of reproductive health services has risen. These changes have exacerbated inequities in accessing reproductive health services. This study examines potential disparities in willingness to pay for reproductive health services among adults in a rural district of Hanoi. METHODS: A cross-sectional study was conducted at 9 communes in Thanh Oai district, a rural district of Hanoi, Vietnam, in July 2019. Face-to-face interviews were conducted using a structured questionnaire to collect self-reported data. The contingent valuation was used to examine willingness to pay for reproductive health services with a starting price of 2 million VND (~ US$86.2, July 2019 exchange rate), which is the average price of all RHS in public facilities in Vietnam. Multiple Logistic regression and Multiple Interval regression models were used to identify factors associated with willingness to pay and the amount that people were willing to pay for reproductive health services. RESULTS: Among 883 participants, this study found 59.1% of them willing to pay for reproductive health services at an average maximum amount of US$36.2, significantly less than the current average price of US$86.2. Occupation, number of sex partners, perception towards the necessity of reproductive health services, and prior use of reproductive health services were found to significantly influence willingness to pay for reproductive health services, while age, income level, gender, occupation, perception towards the necessity of reproductive health services and prior use of reproductive health services were reportedly correlated with the amount participants were willing to pay for reproductive health services. CONCLUSION: Lower willingness to pay for reproductive health services compared to the current prices (US$36.2 vs. US$86.2) is likely related to an overall low awareness of the necessity of reproductive health services, and future education campaigns should specifically target those from lower-income backgrounds. Financial subsidization should also be provided, especially for those from the low-income group, to ensure equitable access to reproductive health services. Given the heterogeneity of reproductive health services, further studies should examine the willingness to pay for each type of service independently.

Structural Equation Model for Social Support and Quality of Life Among Individuals With Mental Health Disorders During the COVID-19 Pandemic.

BACKGROUND: In light of the COVID-19 pandemic, the distribution of social support for mental health problems has likely become unequal. Family- and community-based social support has been recognized as a promising approach for mental disorders; however, limited global frameworks have been applied to developing countries such as Vietnam. OBJECTIVE: The aim of this study was to evaluate the quality of life and social support among patients with mental health disorders in Vietnam and to investigate the factors associated with quality of life among these patients. METHODS: A cross-sectional study was conducted on 222 psychiatric patients in Hanoi from 2020 to 2022. A structured questionnaire was developed based on four standardized scales: Mental Well-Being-5 scale, Multidimensional Scale of Perceived Social Support, EuroQoL-visual analog scale (EQ-VAS), and EuroQoL-5 dimensions-5 levels (EQ-5D-5L) scale. Tobit regression was used to identify factors associated with the EQ-5D-5L and EQ-VAS scores. Structural equation modeling was applied to verify the relationship between quality of life and social support. RESULTS: The results showed that perceived support from family scored the highest compared to support from friends and significant others. Patients with depression reported the lowest quality of life and perceived social support. Structural equation modeling showed a root mean square error of approximation of 0.055 (90% CI 0.006-0.090), comparative fit index of 0.954, Tucker-Lewis index of 0.892, and standardized root mean squared error of 0.036 (P<.001). The hypothetical model indicated statistically significant correlations between EQ-VAS score and social support (P=.004), EQ-5D-5L and mental well-being (P<.001), and social support and mental well-being (P<.001). Critical deterioration of quality of life and inconsistency in social support for patients with mental illness were also recorded. CONCLUSIONS: There is a need to enhance social support and service delivery in Vietnam, focusing on occupation and quality of life. The correlations between social support, quality of life, and mental health issues suggest the potential of a clinical-social integrated intervention model of care.

Psychological impacts of COVID-19 on Vietnamese health workers over the prolonged restricted COVID-19 responses: a cross-sectional study.

OBJECTIVE: We assessed the psychological impact posed by COVID-19 and its associated factors on the healthcare workforce nationwide during the peak of Vietnam's fourth outbreak. DESIGN: A cross-sectional study. SETTING: Our study was conducted in 61 provinces of Vietnam. METHODS: A total of 2814 healthcare professionals in 61/63 provinces of Vietnam. An online questionnaire using Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale-4 (PSS-4) and Generalised Anxiety Disorder-7 (GAD-7) scales was distributed randomly to a subgroup of 503 respondents. PRIMARY AND SECONDARY OUTCOME MEASURES: To determine the impact of COVID-19 on the psychological of health workers, we conducted analyses to test a primary hypothesis related to participants based on three main scales including PHQ-9, PSS-4 and GAD-7 scales. RESULTS: Nearly half (49.7%) of healthcare workers experienced mild depression symptoms, 34.0% underwent moderate anxiety symptoms and 49.3% reported high-stress levels. Respondents who had a monthly income below 5 million VND (~US$212) and had more than 3 days of duty per week had a higher score on the anxiety scales. Compared with medical doctors, nurses/midwives had lower PHQ-9 (Coef=-2.53; 95% CI=-3.71 to -1.36) and GAD-7 scores (Coef=-2.36; 95% CI=-3.56 L to -1.16). Increased workload and work time was the harmful factor that increase the PHQ-9, GAD-7 or PSS-4 scores. More than half (53.9%) of respondents stated no demand for mental healthcare services. CONCLUSIONS: Health workers who gained less financial rewards are reported to have higher levels of mental distress than others, implying the need for a raise in basic salary as well as compensation and encouragement schemes. To tackle hesitancy in seeking mental help, integrating online mental health therapy with e-health consultations via social media can be strategically implemented to augment service delivery, and simultaneously enhance the standard of mental health services.

Functional near-infrared spectroscopy of medical students answering various item types.

Background: Traditionally, the effect of assessment item types including true/false questions (TFQs), multiple-choice questions (MCQs), short answer questions (SAQs), and case scenario questions (CSQs) is examined through psychometric qualities or student interviews. However, brain activity while answering such questions or items remains unknown. Functional near-infrared spectroscopy (fNIRS) can be used to safely measure cerebral cortex hemodynamic response during various tasks. Hence, this fNIRS study aimed to determine differences in frontotemporal cortex activity as medical students answered TFQs, MCQs, SAQs, and CSQs. Methods: In total, 24 medical students (13 males and 11 females) were recruited in this study during their mid-psychiatry posting. Oxy-hemoglobin and deoxy-hemoglobin levels in the frontal and temporal regions were measured with a 52-channel fNIRS system. Participants answered 9-18 trials under each of the four types of tasks that were based on their psychiatry curriculum during fNIRS measurements. The area under the oxy-hemoglobin curve (AUC) for each participant and each item type was derived. Repeated measures ANOVA with post-hoc Bonferroni-corrected pairwise comparisons were used to determine differences in oxy-hemoglobin AUC between TFQs, MCQs, SAQs, and CSQs. Results: Oxy-hemoglobin AUC was highest during the CSQs, followed by SAQs, MCQs, and TFQs in both the frontal and temporal regions. Statistically significant differences between different types of items were observed in oxy-hemoglobin AUC of the frontal region (p ≤ 0.001). Oxy-hemoglobin AUC in the frontal region was significantly higher during the CSQs than TFQ (p = 0.005) and during the SAQ than TFQ (p = 0.025). Although the percentage of correct responses was significantly lower in MCQ than in the other item types, there was no correlation between the percentage of correct response and oxy-hemoglobin AUC in both regions for all four item types (p > 0.05). Conclusion: CSQs and SAQs elicited greater hemodynamic response than MCQs and TFQs in the prefrontal cortex of medical students. This suggests that more cognitive skills may be required to answer CSQs and SAQs.

Mapping Studies of Alcohol Use Among People Living with HIV/AIDS During 1990-2019 (GAPRESEARCH).

Alcohol drinking has long been reported to be common in people living with HIV/AIDS, having biological and behavioral impacts on the transmission, progression, and prevention of HIV/AIDS. A total of 7059 eligible articles and reviews published in English from 1990 to 2019 were extracted from the WOS. Results show an increase in publication volume, while citations peak for papers published in 2006. Content analysis reveals a wide-ranging coverage of topics, with the most popular being effects of alcohol consumption on ART adherence and outcomes, alcohol-related sexual behaviors, TB co-infection, and psycho-socio-cultural considerations in examining and designing measures targeting alcohol use and interventions to reduce alcohol dependence in PLWHA. This calls for more active engagement of governments in research and in designing and implementing interventions, as well as collaborations and knowledge transfer from high-income countries to developing counterparts, to effectively address alcohol use-related issues in PLWHA, moving toward the HIV/AIDS eradication target.

A reverse pattern in work motivation among Vietnamese health care workers during the prolonged COVID-19 outbreak of 2021: Determinants and implications.

Background: The workload burden of the COVID-19 pandemic on health systems requires not only financial support but also long-term and contextualized policies. We assessed the work motivation and its determinants among health workers at Vietnamese hospitals and facilities during the prolonged COVID-19 outbreaks in 2021. Methods: A cross-sectional study was conducted among 2814 health care professionals across all three regions of Vietnam from October to November 2021. An online questionnaire, including the Work Motivation Scale, distributed by the snowball method to a subgroup of 939 respondents, investigated changes in working characteristics due to COVID-19, work motivation, and occupational intention. Results: Only 37.2% of respondents committed to their current job and about 40% reported a decrease in their job satisfaction. The Work Motivation Scale scored the lowest in "financial motivation" and the highest in "perception of work value". Participants who were in the north region, of younger age, unmarried, and who had a low level of adaptability to external work pressure, shorter experience, and less job satisfaction tended to be less motivated and committed to their current job. Conclusions: Intrinsic motivation has increased in importance during the pandemic. Therefore, policymakers should develop interventions that raise intrinsic, psychological motivation instead of only focusing on salary raises. Issues about intrinsic motivations of health care workers such as low adaptability to stress and professionalism in routine work should be prioritized during the pandemic preparedness and control.

Scholarly literature in HIV-related lesbian, gay, bisexual, and transgender studies: A bibliometric analysis.

Introduction: Lesbian, gay, bisexual, and transgendered (LGBT) people are marginalized and understudied. Analyzing research activity worldwide is vital to better understand their needs in confronting the HIV epidemic. This study aimed to evaluate the global literature to identify the research collaboration, content, and tendency in HIV-related issues among the LGBT populations. Methods: Peer-reviewed original articles and reviews were achieved from the Web of Science Core Collection database. Country's collaborations and co-occurrence of most frequent terms were illustrated by VOSviewer software. The Latent Dirichlet Allocation (LDA) and the linear regression model were utilized to uncover the hidden topics and examine the research trend. Results: From 1990 to 2019, a total of 13,096 publications were found. Stigma, sexual risk behaviors and HIV testing were the major topics in the LGBT research during the study period. Among 15 topics, topics about HIV/Sexually transmitted infections (STIs) prevalence, Outcomes of HIV/AIDS care and treatment, and Opportunistic infections in HIV-positive LGBT people showed decreasing attention over years, while other topics had a slight to moderate increase. Discussion: Our study underlined the exponential growth of publications on the LGBT population in HIV research, and suggested the importance of performing regional collaborations in improving research capacity. Moreover, further research should focus on examining the manner to increase the coverage of HIV testing and treatment, as well as implement HIV-interventions with low cost and easy to scale-up.

Depressive symptoms are associated with immunological failure among HIV-positive patients in Vietnam.

As the lives of people living with HIV (PLWH) become increasingly normalized, more focus is being given to the associated comorbidities of HIV, including those related to mental health such as depression. This study aims to evaluate the correlation between depressive symptoms and HIV outcomes in Vietnam through the measurement of CD4 cell count. A mixed design was utilized, in which both a longitudinal assessment of CD4 cell counts and a cross-sectional survey of depressive symptoms were conducted on 481 patients in the Bach Mai and Ha Dong HIV clinics (Hanoi, Vietnam). CD4 cell count data was extracted from the medical records of participants, and depressive symptoms were screened using the Patient Health Questionnaire (PHQ-9). The results illustrate that the presence of moderately severe to severe depressive symptoms is associated with lower CD4 cell counts, indicating poorer HIV outcomes resulting from comorbid depression. This correlation was especially noticeable in the PHQ-9 items for psychomotor agitation/retardation (p < 0.05) and suicidal ideation (p < 0.05). Future policy and treatment options for HIV in Vietnam should consider the presence of comorbid mental health conditions in order to provide more suitable and effective treatment in the goal of providing a higher quality of life for PLWH.

Social Media Addiction among Vietnam Youths: Patterns and Correlated Factors.

BACKGROUND: Prior research has investigated how the excessive use of social media has an impact on one's functioning. Youths are among the most vulnerable subjects to the impacts of social media overuse, especially in Vietnam (a developing country). However, very little evidence has been provided on social media addiction. This work aims to determine the prevalence of social media addiction amongst Vietnamese individuals and the factors associated with social media addiction. METHOD: An online cross-sectional study was conducted from June to July 2020 in Vietnam. Participants completed the structured questionnaire, which comprised four main components: (1) social characteristics; (2) The Bergen Social Media Addiction Scale; (3) stress associated with neglect and negative reactions by online peers and fear of missing out (FOMO); and (4) status of social media platform usage. RESULTS: Some demographic factors, such as gender, the locality of accommodation, and relationship status affected the overall scores. The results also indicated Facebook, Zalo, and Youtube to be the most popular social media platforms among Vietnamese youths. Individuals who used social media for gaming also had higher BSMAS scores. FOMO and stress associated with neglect by online peers had a high correlation with social media addiction. CONCLUSIONS: This study is one of the first studies to examine social media addiction and its associated factors in Vietnam. Interventions for social media addiction need to be developed in different fields: clinical research, policy, and education.

Determinants of mental health among youths and adolescents in the digital era: Roles of cyber and traditional bullying, violence, loneliness, and environment factors.

Introduction: Although the pathogenesis of depressive disorders is not fully elucidated, untreated adolescent depression can lead to serious sequelae such as impaired academic performance and social functioning, substance use disorders, poor self-esteem, and increased risk for suicidal ideation and attempts. Literature on adolescent mental health in Vietnam is limited, despite increased international awareness of this critical issue. This study aimed to investigate the prevalence and associations of depressive symptoms in Vietnamese adolescents. Methods: A cross-sectional, self-administered survey was conducted in five provinces of Vietnam among adolescents aged 14 to 24 years. In addition to collecting participants' demographics, a structured questionnaire was developed to examine depressive symptoms, suicidal ideation, loneliness, and cyberbullying victimization. Depressive symptoms and loneliness were assessed via the PHQ-9 and UCLA Loneliness Scale, respectively. Two-tailed Chi-squared, Mann-Whitney, and Kruskal-Wallis tests were performed to examine associations between variables. Multivariate Logistic regression models were conducted to examine the associations between prior-defined variables and positive depressive symptoms. Results: Among 1,600 respondents, 31.8% of participants reported having mild-moderate or severe depressive symptoms. Participants within the moderate-severe depressive symptom group had significantly lower community cohesion scores than those of participants in normal and mild depressive symptom groups (p < 0.05). Youths living alone were more likely to have moderate-severe depressive symptoms (OR 2.16; 95% CI: 1.09-4.25). Cyberbullying had significant associations with depressive severity (OR 1.93; 95% CI 1.38-2.70). Conclusion: The findings of this study characterize various risk and protective factors for depression in Vietnamese youths and adolescents. The results highlight the importance of raising awareness and increasing access to educational resources for depression and other mental health illnesses. With the rising prevalence of depression, parents, teachers, and community leaders play a vital role in addressing mental health problems in adolescents.

Social network and HIV/AIDS: A bibliometric analysis of global literature.

Social networks (SN) shape HIV risk behaviors and transmission. This study was performed to quantify research development, patterns, and trends in the use of SN in the field of HIV/AIDS, and used Global publications extracted from the Web of Science Core Collection database. Networks of countries, research disciplines, and most frequently used terms were visualized. The Latent Dirichlet Allocation method was used for topic modeling. A linear regression model was utilized to identify the trend of research development. During the period 1991-2019, in a total of 5,698 publications, topics with the highest volume of publications consisted of (1) mental disorders (16.1%); (2) HIV/sexually transmitted infections prevalence in key populations (9.9%); and (3) HIV-related stigma (9.3%). Discrepancies in the geographical distribution of publications were also observed. This study highlighted (1) the rapid growth of publications on a wide range of topics regarding SN in the field of HIV/AIDS, and (2) the importance of SN in HIV prevention, treatment, and care. The findings of this study suggest the need for interventions using SN and the improvement of research capacity via regional collaborations to reduce the HIV burden in low- and middle-income countries.

Global mapping of epidemic risk assessment toolkits: A scoping review for COVID-19 and future epidemics preparedness implications.

Preparedness and responses to infectious disease epidemics and pandemics require the understanding of communities' and multisectoral systems' characteristics with regards to diseases transmission and population's vulnerabilities. This study aimed to summarize measurement profiles of existing risk assessment toolkits to inform COVID-19 control at global and national levels. An online search in different databases and online sources was performed to identify all epidemic risk and vulnerability assessment instruments. Medline/PubMed, Web of Science databases, and websites of public health organizations were used for the searching process. Of 14 toolkits, levels of setting were mostly at the global or nation level. Components such as Governance and Legislation, Financing, Health Service Provision, and Human Resources are key domains in almost all toolkits. Some important issues for disease detection and surveillance, such as laboratory or capacity of the community for disease control, were not adequately addressed in several toolkits. Limited studies were found that validated the toolkits. Only five toolkits were used in COVID-19 studies. This study provides a summary of risk assessment toolkits to inform epidemic responses. We call for global and national efforts in developing more contextualized and responsive epidemic risk assessment scales incorporating specific-disease and -country factors to inform operational decisions making and strengthen countries' capacities in epidemic responses.

Practices, Perceived Benefits, and Barriers Among Medical Students and Health Care Professionals Regarding the Adoption of eHealth in Clinical Settings: Cross-sectional Survey Study.

BACKGROUND: eHealth is increasingly becoming an indispensable part of health practice and policy-making strategies. However, the use of eHealth tools in clinical practice and the perceptions of eHealth among medical students and health care professionals in Vietnam are not well understood. OBJECTIVE: This study aims to investigate perceptions and practices regarding eHealth and their associated factors among medical students and health care professionals. METHODS: A web-based cross-sectional study was conducted on 523 medical students and health care professionals. Information about the practices for, perceived barriers to, and benefits of eHealth application in clinical practices was collected. Multivariate Tobit and logistic regression models were used to determine factors associated with perceptions and practices. RESULTS: In total, 61.6% (322/523) of participants used eHealth tools in clinical practices, with moderate levels of eHealth literacy. The score for the perceived benefits of eHealth tools was low. The most common barrier for eHealth utilization was human resources for IT (240/523, 45.9%), followed by security and risk control capacity (226/523, 43.2%) and no training in eHealth application (223/523, 42.6%). Age, eHealth literacy, and the use of the internet for updating medical knowledge were positively associated with using eHealth tools in clinical practices. CONCLUSIONS: eHealth tools were moderately used in clinical practices, and the benefits of eHealth were underestimated among health care professionals and medical students in Vietnam. Renovating the current medical education curriculum to integrate eHealth principles should be required to equip health care professionals and medical students with essential skills for rapid digital transformation.

Mental wellbeing among urban young adults in a developing country: A Latent Profile Analysis.

Introduction: This study aimed to explore the mental wellbeing profiles and their related factors among urban young adults in Vietnam. Methods: A cross-sectional study was conducted in Hanoi, which is the capital of Vietnam. There were 356 Vietnamese who completed the Mental Health Inventory-5 (MHI-5) questionnaire. The Latent Profile Analysis (LPA) was used to identify the subgroups of mental wellbeing through five items of the MHI-5 scale as the continuous variable. Multinomial logistic regression was used to determine factors related to subgroups. Results: Three classes represented three levels of MHI-5 score, which included "Poor mental health," "Fair mental health," and "Good mental health," were, respectively, 14.3, 46.6, and 39.0%. Compared to a low household economy, participants with an average household economy had 2.11 and 4.79 times higher odds of being in a good mental health class relative to fair and poor mental health classes. Respondents with more than two acute symptoms had 3.85 times higher odds of being in a good mental health class relative to a poor mental health class, as compared to those without acute symptoms. Regarding the measurement of the Perceived Social Support Scale (MSPSS), people having support from their family had 1.80 and 2.23 times higher odds of being in classes of fair and good mental health relative to the poor mental health class; and participants having friend support also had 1.87 times higher odds of being in a good mental health class compared with the fair mental health class, as the MSPSS score increased by 1 unit. People with Rosenberg's self-esteem scale increased by 1 score, those who had 1.17, 1.26, and 1.47 times higher odds of being in a good compared to fair mental health class, fair compared to poor mental health class, and good compared to poor mental health class, respectively. Conclusion: Our findings were given to promote a new classification method for mental health screening among the general population. The current findings could be used as evidence to develop policies and plans that focus on encouraging early screening for mental health problems among the general young population in the future.

Parent-Child Relationship Quality and Internet Use in a Developing Country: Adolescents' Perspectives.

Objective: The goal of the study was to explore the relationship between parent-children relationships related to using the internet among kids and potentially associated factors. Materials and Methods: A sample of 1.216 Vietnamese students between the ages of 12 and 18 agreed to participate in the cross-sectional online survey. Data collected included socioeconomic characteristics and internet use status of participants, their perceived changes in relationship and communication between parents and children since using the internet, and parental control toward the child's internet use. An Ordered Logistic Regression was carried out to determine factors associated with parent-children relationship since using the internet. Results: The characteristics of the relationship between children and their parents since using the Internet were divided into three levels: deterioration (7.0%), stability (78.2%), and improvement (14.8%). The topics that children most often communicate with their parents include learning, housework, and future directions. Two-way interactive activities, such as supporting parents to use the Internet, have a positive impact on the parent-child relationship. Stubborn parental control, such as establishing rules about contact or allowing Internet access and setting up global positioning system (GPS) to track negatively affecting parent-child relationships. Conclusion: Findings indicated that changes in the quality of the parent-child relationship were self-assessed by participants regard to kids' internet use, especially in the COVID-19 epidemic context. Educational campaigns and programs to raise awareness of parents as to the dangers and negative influences that their children may encounter online, psychology of children's behaviors and effects of different responding strategies are recommended.

Corrigendum: Interdisciplinary Assessment of Hygiene Practices in Multiple Locations: Implications for COVID-19 Pandemic Preparedness in Vietnam.

[This corrects the article DOI: 10.3389/fpubh.2020.589183.].