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2.
J Prof Nurs ; 51: 64-73, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38614676

RESUMO

BACKGROUND: Nursing students are prone to sleep problems that affect their core self-evaluations. However, little attention has been paid to the specific roles of emotion regulation (including cognitive reappraisal and expressive suppression) and resilience in this process. OBJECTIVES: This study aimed to explore 1) the direct effect of sleep problems on core self-evaluations among nursing students; 2) the chain-mediating effect of cognitive reappraisal and resilience on the relationship between sleep problems and core self-evaluations; 3) the moderating effect of expressive suppression on the direct relationship between sleep problems and core self-evaluations; and 4) the moderating effect of expressive suppression on the indirect relationship between sleep problems affecting core self-evaluations through resilience. METHODS: A total of 345 nursing students completed a survey conducted between September and October 2022. Data was analyzed using descriptive analysis, Fisher exact test, Kruskal-Wallis H test, Spearman correlation analysis, and hierarchical regression analysis. Additionally, the SPSS PROCESS V4.0 plug-in was used to verify the moderated chain-mediating effect. RESULTS: Sleep problems directly affected core self-evaluations among nursing students. Cognitive reappraisal and resilience played a partial chain-mediating role in the relationship between sleep problems and core self-evaluations, with expressive suppression having a direct moderating effect. CONCLUSIONS: Opportunities exist for enhancing the core self-evaluations of nursing students by addressing their sleep problems, promoting cognitive reappraisal strategies, and increasing resilience. Additionally, encouraging expressive suppression can mitigate the negative impact of sleep problems on nursing students' core self-evaluations.


Assuntos
Bacharelado em Enfermagem , Regulação Emocional , Resiliência Psicológica , Transtornos do Sono-Vigília , Estudantes de Enfermagem , Humanos , Estudos Transversais , Autoavaliação Diagnóstica
3.
BMC Public Health ; 24(1): 1106, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38649835

RESUMO

BACKGROUND: Self-rated health (SRH) has been identified in many studies as a valid predictor of mortality and healthcare utilization. There is limited research on SRH and dietary intake. This study aimed to investigate the association between healthy eating index (HEI) and SRH in adults living in Tehran. METHODS: This cross-sectional study was carried out among 850 adult men and women aged 20-59 years who visited health centers in Tehran from 2021 to 2022. Dietary intake was assessed using a validated and reliable semiquantitative food frequency questionnaire with 168 food items, and SRH was assessed with one question: "In general, how do you rate your health?". We categorized SRH into excellent/very good, good, and fair/poor. In the descriptive statistics part, we used mean ± standard deviation or number (ratio) for quantitative and qualitative variables, respectively. The chi-squared test and one-way analysis of variance were used to calculate the percentage and mean for demographic characteristics across tertiles of SRH. An analysis of covariance was used to compare the means of energy, macronutrients, the HEI, and its component variables across the tertiles of SRH. RESULTS: The final sample included 795 participants (68.2% female; mean ± standard deviation age: 44.81 ± 10.62 years) whose 40% reported excellent/very good SRH, and 30% reported good and fair/poor SRH separately. There was no association between body mass index, physical activity, education, health status, smoking, and sleep duration with SRH. After adjustment, the total HEI score and its component scores did not differ across the tertiles of SRH status. However, participants with good SRH had a higher intake of total energy (mean difference (MD): 180.33 Kcal, P value < 0.001), total fat (MD: 8.15 gr, P value = 0.002), and total carbohydrates (MD: 20.18 gr, P value = 0.004) than those with fair/poor SRH. CONCLUSION: According to our findings, fair/poor SRH was associated with a lower consumption of total energy, total fat, and total carbohydrates in Iranian adults. Additional observational studies would be necessary to clarify these findings.


Assuntos
Dieta Saudável , Nível de Saúde , Humanos , Irã (Geográfico) , Feminino , Masculino , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Dieta Saudável/estatística & dados numéricos , Adulto Jovem , Autoavaliação Diagnóstica , Autorrelato
4.
BMC Psychol ; 12(1): 175, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38532473

RESUMO

Humble leadership has gained attention in recent years due to its potential impact on employee performance. This study explores the association between humble leadership and follower innovative behavior by investigating the moderating role of core self-evaluation (CSE) and the mediating role of leader-member exchange (LMX). The study uses data from 328 followers and their immediate leaders to test a mediated moderation model. Results show that there is a favorable association between humble leadership and LMX and followers' innovative behavior, particularly pronounced for followers who possess lower levels of CSE. The findings suggest that humble leaders should focus their development efforts on followers with low CSE to achieve complementarity congruity and improved innovation. This research enhances the existing body of knowledge by emphasizing the significance of comprehending the functions of relational procedures and the psychological resources of followers in determining the effectiveness of humble leadership. These findings have practical implications for organizations seeking to enhance their leadership effectiveness and followers' innovative behavior.


Assuntos
Autoavaliação Diagnóstica , Liderança , Humanos
5.
BMC Psychol ; 12(1): 108, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429795

RESUMO

Humans are typically inept at evaluating their abilities and predispositions. People dismiss such a lack of metacognitive insight into their capacities while even enhancing (albeit illusorily) self-evaluation such that they should have more desirable traits than an average peer. This superiority illusion helps maintain a healthy mental state. However, the scope and range of its influence on broader human behavior, especially perceptual tasks, remain elusive. As belief shapes the way people perceive and recognize, the illusory self-superiority belief potentially regulates our perceptual and metacognitive performance. In this study, we used hierarchical Bayesian estimation and machine learning of signal detection theoretic measures to understand how the superiority illusion influences visual perception and metacognition for the Ponzo illusion. Our results demonstrated that the superiority illusion correlated with the Ponzo illusion magnitude and metacognitive performance. Next, we combined principal component analysis and cross-validated regularized regression (relaxed elastic net) to identify which superiority components contributed to the correlations. We revealed that the "extraversion" superiority dimension tapped into the Ponzo illusion magnitude and metacognitive ability. In contrast, the "honesty-humility" and "neuroticism" dimensions only predicted Ponzo illusion magnitude and metacognitive ability, respectively. These results suggest common and distinct influences of superiority features on perceptual sensitivity and metacognition. Our findings contribute to the accumulating body of evidence indicating that the leverage of superiority illusion is far-reaching, even to visual perception.


Assuntos
Metacognição , Ilusões Ópticas , Humanos , Ilusões Ópticas/fisiologia , Teorema de Bayes , Percepção Visual , Autoavaliação Diagnóstica
6.
Ned Tijdschr Geneeskd ; 1682024 02 07.
Artigo em Holandês | MEDLINE | ID: mdl-38349281

RESUMO

Social security disability assessors are required to objectively quantify disability with regards to potential ability to work. Difficulties arise when assessments need to be performed in the absence of objective medical data relying solely on self-report regarding subjective health complaints. In such cases, validity tests provide a useful tool during an assessment. This case report illustrates this through the outcomes of 3 disability assessments.


Assuntos
Avaliação da Deficiência , Previdência Social , Humanos , Autoavaliação Diagnóstica
7.
PLoS One ; 19(2): e0296383, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38330018

RESUMO

The widely observed positive bias on self-evaluation is mainly explained by the self-enhancement motivation which minimizes negative feedbacks and emphasizes positive ones. Recent agent based simulations suggest that a positive bias also emerges if the sensitivity to feedbacks decreases when the self-evaluation increases. This paper proposes a simple mathematical model in which these different biases are integrated. Moreover, it describes an experiment (N = 1509) confirming that the sensitivity to feedbacks tends to decrease when self-evaluation increases and that a directly related positive bias is detected.


Assuntos
Autoavaliação Diagnóstica , Autoavaliação (Psicologia) , Viés , Motivação
8.
Hum Resour Health ; 22(1): 14, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38336699

RESUMO

BACKGROUND: This study investigated the mediating and moderating impact of core self-evaluations in the path from emotional labor to burnout. Our hypothesized associations are based on Hobfoll (Rev Gen Psychol 6:307-24, 2002) conservation of resources theory. METHOD: Three hundred nurses from four hospitals in Abadan, Iran, were invited to participate in our study. Of the 300, 255 completed all sections and questions in our survey for an 85% response rate. The posited direct and indirect effects were evaluated with structural equation modeling and the interaction effects were evaluated with hierarchical moderated regression and simple regression slope plots. RESULT: Deep acting has indirect effects on burnout through core self-evaluations. Though unrelated to surface acting, core self-evaluations moderate its impact: under low core self-evaluations, surface acting is strongly related to emotional exhaustion and inversely related to personal accomplishment, whereas, under high core self-evaluations, surface acting is unrelated to these burnout dimensions. CONCLUSION: Our findings reveal the dual functions of CSE as a psychological resource and buffer to offset the interpersonal demands of patient care. Limitations, directions for future research, and practical implications are discussed.


Assuntos
Esgotamento Profissional , Enfermeiras e Enfermeiros , Humanos , Autoavaliação Diagnóstica , Irã (Geográfico) , Esgotamento Profissional/psicologia , Esgotamento Psicológico , Inquéritos e Questionários
9.
J Affect Disord ; 350: 148-154, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38228274

RESUMO

BACKGROUND: Temporal self-appraisal (TSA) is the trajectory of self-appraisal over time, including how a person views their past and future selves in relation to their present self. In this study, we examined the TSA of individuals with and without a history of suicide-related thoughts and behaviors (STBs). METHODS: Using Amazon Mechanical Turk for recruitment, we studied 397 participants on validated measures of TSA, STBs, and mood. RESULTS: The non-STB group (n = 291) had a TSA trajectory similar to that previously found for nonclinical populations, with perceived self-improvement over time. In contrast, the TSA of the STB group (n = 106) had two distinct qualities: their TSA profiles were more negative at all time points (past, present, and future) than the non-STB group, and they displayed similar anticipated present-to-future growth as the non-STB group but perceived minimal past-to-present change. These differences persisted when controlling for depression, anxiety, and stress, suggesting a distinct STB-related TSA profile independent of comorbid affective states. LIMITATIONS: This study is limited by the use of self-report measures and cross-sectional design. CONCLUSIONS: By investigating TSA, this study provides insights into the unique aspects of self-appraisal associated with having a history of STBs and emphasizes the need for therapeutic interventions that foster self-continuity and positive self-appraisal across time. Future research should focus on clarifying the mechanisms underlying this distinct self-appraisal pattern in the STB group and the effects of interventions that enhance temporal self-appraisal.


Assuntos
Autoavaliação Diagnóstica , Ideação Suicida , Humanos , Estudos Transversais , Transtornos de Ansiedade , Ansiedade
10.
BMC Psychol ; 12(1): 15, 2024 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-38178241

RESUMO

Advancement in learning grammar and using it practically is one of the challenges of English as foreign learners (EFL) learners. Its progression may be expedited or slowed down by a variety of causes. Among the crucial factors, the possible effects of self-evaluation, teacher support, and L2 grit were still untouched which is the target of the current research. In so doing, 86 EFL students at the intermediate level were divided into two groups (i.e., experimental group and control group). The students in the control group (CG) are exposed to normal education, whereas learners in experimental group (EG) get extra instruction to practice self-evaluation and L2 Grit. Moreover, the emphasis on the teacher's position as a facilitator and supporter was more prominent in the EG. Based on data screening which was completed via one-way ANCOVA, learners in EG were more successful in grammar assessment due to the treatment. Further research avenues and educational implications were elaborated upon.


Assuntos
Autoavaliação Diagnóstica , Pessoal de Educação , Humanos , Estudantes , Internacionalidade , Aprendizagem
11.
BMC Public Health ; 24(1): 280, 2024 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-38263032

RESUMO

BACKGROUND: The overall level of negative affect (NeA) has been linked to impaired health. However, whether the diurnal timing of NeA matters and whether the NeA-health relationship is mediated by sleep quality remain unclear. METHODS: Using a longitudinal dataset (2006, 2009 and 2014 waves) consisting of 1959 participants, we examined the within-person impact of both bedtime NeA and non-bedtime NeA measured by Day Reconstruction Method (DRM) on subjective health measured by Visual Analogue Scale (VAS), and the mediating effect of sleep quality on the NeA-health relationships by fixed effect models. RESULTS: Bedtime NeA predicted poorer health, while non-bedtime NeA was unrelated to health. The deleterious impact of bedtime NeA reduced and became non-significant after sleep quality was controlled for. Bedtime NeA also significantly predicted impaired sleep quality. CONCLUSIONS: Bedtime NeA is a stronger predictor of poorer health than non-bedtime NeA, and the deleterious influence of bedtime NeA on health seems to operate through poor sleep quality. Therefore, interventions to reduce bedtime NeA could potentially improve subsequent sleep quality, thereby protecting people to some extent from impaired health status.


Assuntos
Autoavaliação Diagnóstica , Qualidade do Sono , Humanos , China , Nível de Saúde , Medição da Dor
12.
Eval Rev ; 48(2): 221-250, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37153985

RESUMO

Program evaluations often investigate complex or multi-dimensional constructs, such as individual opinions or attitudes, by means of ratings. A different interpretation of the same question may affect cross-country comparability, leading to the Differential Item Functioning problem. Anchoring vignettes were introduced in the literature as a way to adjust self-evaluations from this interpersonal incomparability. In this paper, we first introduce a new nonparametric solution to analyse anchoring vignette data, recoding a variable based on a rating scale to a new corrected-variable that guarantees comparability in any cross-country analysis. Then, we exploit the flexibility of a mixture model introduced to account for uncertainty in the response process (the CUP model) to test if the proposed solution is effectively able to remove this reported heterogeneity. This solution is easy to construct and has important advantages compared with the original nonparametric solution adopted with anchoring vignette data. The novel indicator is applied to investigate self-reported depression in an old population. Data that will be analysed come from the second wave of the Survey of Health, Ageing and Retirement in Europe, collected in 2006/2007. Results highlight the need of correcting for reported heterogeneity comparing individual self-evaluations. Once interpersonal incomparability resulting from the different uses of response scales is removed from the self-assessments, some estimates are reversed in magnitude and signs with respect to the analysis of the collected data.


Assuntos
Autoavaliação Diagnóstica , Autoavaliação (Psicologia) , Humanos , Depressão , Inquéritos e Questionários , Autorrelato
13.
Child Dev ; 95(1): 24-33, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37434380

RESUMO

This study examines the development of children's self-assessment of their prosociality in normative social comparisons with an average peer, who was either a concrete individual, or an abstract one, at a school of average socioeconomic level in south Israel (N = 148, Age 6-12 years, 51% females; June 2021). Results show that older children exhibited the better-than-average (BTA) effect by perceiving themselves as more generous than their average peer. Conversely, younger children exhibited a worse-than-average effect, in that they assumed that their peers would act more generously than themselves ( η p 2 = .23 ). Only the older children (aged 8 years onward) were significantly affected by the concreteness of the target of comparison by exhibiting the BTA effect only when the average peer was abstract (not concrete).


Assuntos
Autoavaliação Diagnóstica , Autoavaliação (Psicologia) , Criança , Feminino , Humanos , Adolescente , Masculino , Grupo Associado , Instituições Acadêmicas , Israel
14.
Copenhagen; World Health Organization. Regional Office for Europe; 2024. (WHO/EURO:2024-9215-48987-72997).
em Inglês | WHO IRIS | ID: who-376139

RESUMO

This self-evaluation tool is intended to be used by national immunization technical advisory groups (NITAGs) to conduct self-evaluations. It can also be used by NITAG partners to assist NITAGs in conducting the evaluation through semi-structured interviews. The tool addresses a NITAG’s functionality, the quality of work processes and outputs and its integration into the policy process. Annexes provide further instructions for completing the evaluation and a template of an improvement plan.


Assuntos
Autoavaliação Diagnóstica , Políticas , Vacinas
15.
Scand Cardiovasc J ; 58(1): 2295782, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38130125

RESUMO

Background. Poor maternal self-rated health in healthy women is associated with adverse neonatal outcomes, but knowledge about self-rated health in pregnant women with congenital heart disease (CHD) is sparse. This study, therefore, investigated self-rated health before, during, and after pregnancy in women with CHD and factors associated with poor self-rated health. Methods. The Swedish national registers for CHD and pregnancy were merged and searched for primiparous women with data on self-rated health; 600 primiparous women with CHD and 3062 women in matched controls. Analysis was performed using descriptive statistics, chi-square test and logistic regression. Results. Women with CHD equally often rated their health as poor as the controls before (15.5% vs. 15.8%, p = .88), during (29.8% vs. 26.8% p = .13), and after pregnancy (18.8% vs. 17.6% p = .46). None of the factors related to heart disease were associated with poor self-rated health. Instead, factors associated with poor self-rated health during pregnancy in women with CHD were ≤12 years of education (OR 1.7, 95%CI 1.2-2.4) and self-reported history of psychiatric illness (OR 12.6, 95%CI 1.4-3.4). After pregnancy, solely self-reported history of psychiatric illness (OR 5.2, 95%CI 1.1-3.0) was associated with poor self-rated health. Conclusion. Women with CHD reported poor self-rated health comparable to controls before, during, and after pregnancy, and factors related to heart disease were not associated with poor self-rated health. Knowledge about self-rated health may guide professionals in reproductive counselling for women with CHD. Further research is required on how pregnancy affects self-rated health for the group in a long-term perspective.


Assuntos
Autoavaliação Diagnóstica , Nível de Saúde , Cardiopatias Congênitas , Feminino , Humanos , Recém-Nascido , Gravidez , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/epidemiologia
16.
PLoS One ; 18(12): e0295704, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38150447

RESUMO

BACKGROUND: Despite reporting poorer self-rated mental health (SRMH) than boys, girls exhibit greater resilience and academic achievement, and less risk taking or death by suicide. Might this apparent paradox be an artefact arising from girls' and boys' different interpretations of the meaning of SRMH? We examined whether the indicator, SRMH, had a different meaning for girls and boys. METHODS: In 2021-2, we circulated social media invitations for youth age 13-18 to complete an online survey about their mental health, and which of 26 individual and social circumstances shaped that rating. All data were submitted anonymously with no link to IP addresses. After comparing weightings for each characteristic, factor analyses identified domains for the whole group and for girls and boys. RESULTS: Poor SRMH was reported by 47% of 506 girls and 27.8% of 216 boys. In general, circumstances considered important to this rating were similar for all, although boys focussed more on sense of identity, self-confidence, physical well-being, exercise, foods eaten and screen time, while girls paid more attention to having a boyfriend or girlfriend, comparisons with peers, and school performance. With factor analysis and common to boys and girls, domains of resilience, behavior/community, family, relationships with peers and future vision emerged. Girls' poorer SRMH did not arise from a more expansive interpretation of mental health. Instead, it may reflect perceived or real disadvantages in individual or social circumstances. Alternatively, girls' known greater resilience may propel lower SRMH which they use intuitively to motivate future achievement and avoid the complacency of thinking that 'all is well'. CONCLUSIONS: The relative similarity of attributes considered before rating one's mental health suggests validity of this subjective measure among girls and boys.


Assuntos
Artefatos , Saúde Mental , Masculino , Feminino , Adolescente , Humanos , Autoimagem , Logro , Autoavaliação Diagnóstica , Fatores Sexuais
17.
PeerJ ; 11: e15871, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37927795

RESUMO

Background: To explore the direct effect of core self-evaluation and the indirect effects of positive and negative coping styles on school adaptation of high school students after their return to school during the COVID-19 pandemic. Methods: The Core Self-Evaluation Scale, Simple Coping Style Scale, and School Adaptation Questionnaire were used for the psychometric analysis of 500 high school students (229 males and 271 females) one month after their return to school. The bootstrap method was applied for mediation analysis. Results: A positive correlation was noted between core self-evaluation and school adaptation (r = 0.56), and the predictive effect was significant (ß = 0.43). Core self-evaluation positively predicted positive coping styles, which positively predicted school adaptation, while core self-evaluation negatively predicted negative coping styles, which negatively predicted school adaptation. Positive and negative coping styles played a significant mediating role between core self-evaluation and school adaptation. The mediating effect included the indirect effects generated by two pathways: core self-evaluation → positive coping style → school adaptation (95% CI [0.08-0.19]) and core self-evaluation → negative coping style → school adaptation (95% CI [0.03-0.11]). Conclusion: There is a positive association between the core self-evaluation and school adaptation of high school students after their return to school during the COVID-19 pandemic. It may directly or indirectly affect the school adaptation of high school students after their return to school through positive or negative coping styles. After returning to school, educators should guide students to view themselves positively, cultivate healthy core self-evaluation, and enable them to have good school adaptation.


Assuntos
COVID-19 , Masculino , Feminino , Humanos , COVID-19/epidemiologia , Pandemias , Autoavaliação Diagnóstica , Retorno à Escola , Adaptação Psicológica , Estudantes
18.
BMC Psychol ; 11(1): 391, 2023 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-37957764

RESUMO

BACKGROUND: As social networking sites (SNSs) with diverse functions gradually become an important social place for modern people, openness, as a personality trait that represents the willingness to consider diverse things, will be more likely to affect people's cognitive and emotional experience (e.g., social anxiety) in social interactions. This study examined the relationship between openness and social anxiety and the underlying psychological mechanism in the internet age based on the cognitive-behavioral model of social anxiety. METHODS: This cross­sectional survey study conducted a questionnaire survey of 522 college students from two provinces in China (191 male; age range 18-25; M = 20.76, SD = 1.34). RESULTS: The results showed that openness is negatively related to social anxiety. Self-evaluation and passive SNS use independently mediate the relationship between openness and social anxiety, respectively. Moreover, openness is associated with social anxiety both through the chain mediating roles of active SNS use and self-evaluation and through the chain mediating roles of passive SNS use and self-evaluation. CONCLUSIONS: Openness is negatively associated with social anxiety, and the different ways of SNS use and self-evaluation are the underlying mechanisms. These results provide insights into the clinical treatment of social anxiety and how to benefit from online interactions.


Assuntos
Autoavaliação Diagnóstica , Rede Social , Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Estudos Transversais , Medo , Ansiedade
19.
Transl Psychiatry ; 13(1): 344, 2023 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-37951951

RESUMO

The brain's default mode network has a central role in the processing of information concerning oneself. Dysfunction in this self-referential processing represents a key component of multiple mental health conditions, particularly social anxiety disorder (SAD). This case-control study aimed to clarify alterations to network dynamics present during self-appraisal in SAD participants. A total of 38 adolescents and young adults with SAD and 72 healthy control participants underwent a self-referential processing fMRI task. The task involved two primary conditions of interest: direct self-appraisal (thinking about oneself) and reflected self-appraisal (thinking about how others might think about oneself). Dynamic causal modeling and parametric empirical Bayes were then used to explore differences in the effective connectivity of the default mode network between groups. We observed connectivity differences between SAD and healthy control participants in the reflected self-appraisal but not the direct self-appraisal condition. Specifically, SAD participants exhibited greater excitatory connectivity from the posterior cingulate cortex (PCC) to medial prefrontal cortex (MPFC) and greater inhibitory connectivity from the inferior parietal lobule (IPL) to MPFC. In contrast, SAD participants exhibited reduced intrinsic connectivity in the absence of task modulation. This was illustrated by reduced excitatory connectivity from the PCC to MPFC and reduced inhibitory connectivity from the IPL to MPFC. As such, participants with SAD showed changes to afferent connections to the MPFC which occurred during both reflected self-appraisal as well as intrinsically. The presence of connectivity differences in reflected and not direct self-appraisal is consistent with the characteristic fear of negative social evaluation that is experienced by people with SAD.


Assuntos
Fobia Social , Adulto Jovem , Adolescente , Humanos , Fobia Social/diagnóstico por imagem , Autoavaliação Diagnóstica , Estudos de Casos e Controles , Teorema de Bayes , Imageamento por Ressonância Magnética , Giro do Cíngulo , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico
20.
JAMA ; 330(20): 1971-1981, 2023 11 28.
Artigo em Inglês | MEDLINE | ID: mdl-38015219

RESUMO

Importance: Optimal strategies for increasing cervical cancer screening may differ by patient screening history and health care setting. Mailing human papillomavirus (HPV) self-sampling kits to individuals who are overdue for screening increases adherence; however, offering self-sampling kits to screening-adherent individuals has not been evaluated in the US. Objective: To evaluate the effectiveness of direct-mail and opt-in approaches for offering HPV self-sampling kits to individuals by cervical cancer screening history (screening-adherent and currently due, overdue, or unknown). Design, Setting, and Participants: Randomized clinical trial conducted in Kaiser Permanente Washington, a US integrated health care delivery system. Individuals aged 30 to 64 years with female sex, a primary care clinician, and no hysterectomy were identified through electronic health records (EHRs) and enrolled between November 20, 2020, and January 28, 2022, with follow-up through July 29, 2022. Interventions: Individuals stratified as due (eg, at the time of randomization, these individuals have been previously screened and are due for their next screening in ≤3 months) were randomized to receive usual care (patient reminders and clinician EHR alerts [n = 3671]), education (usual care plus educational materials about screening [n = 3960]), direct mail (usual care plus educational materials and a mailed self-sampling kit [n = 1482]), or to opt in (usual care plus educational materials and the option to request a kit [n = 3956]). Individuals who were overdue for screening were randomized to receive usual care (n = 5488), education (n = 1408), or direct mail (n = 1415). Individuals with unknown history for screening were randomized to receive usual care (n = 2983), education (n = 3486), or to opt in (n = 3506). Main Outcomes and Measures: The primary outcome was screening completion within 6 months. Primary analyses compared direct-mail or opt-in participants with individuals randomized to the education group. Results: The intention-to-treat analyses included 31 355 randomized individuals (mean [SD] age, 45.9 [10.4] years). Among those who were due for screening, compared with receiving education alone (1885 [47.6%]), screening completion was 14.1% (95% CI, 11.2%-16.9%) higher in the direct-mail group (914 [61.7%]) and 3.5% (95% CI, 1.2%-5.7%) higher in the opt-in group (2020 [51.1%]). Among individuals who were overdue, screening completion was 16.9% (95% CI, 13.8%-20.0%) higher in the direct-mail group (505 [35.7%]) compared with education alone (264 [18.8%]). Among those with unknown history, screening was 2.2% (95% CI, 0.5%-3.9%) higher in the opt-in group (634 [18.1%]) compared with education alone (555 [15.9%]). Conclusions and Relevance: Within a US health care system, direct-mail self-sampling increased cervical cancer screening by more than 14% in individuals who were due or overdue for cervical cancer screening. The opt-in approach minimally increased screening. To increase screening adherence, systems implementing HPV self-sampling should prioritize direct-mail outreach for individuals who are due or overdue for screening. For individuals with unknown screening history, testing alternative outreach approaches and additional efforts to document screening history are warranted. Trial Registration: ClinicalTrials.gov Identifier: NCT04679675.


Assuntos
Detecção Precoce de Câncer , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Pessoa de Meia-Idade , Detecção Precoce de Câncer/métodos , Escolaridade , Papillomavirus Humano/isolamento & purificação , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/etiologia , Autoavaliação Diagnóstica , Estados Unidos/epidemiologia , Adulto , Serviços Postais
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