Caregiver strain among non-Hispanic Black and Hispanic male caregivers with self-reported chronic health conditions.

OBJECTIVES: Caregiver strain often stems from unmet needs and is a risk factor for poor physical and psychological health. This study aims to identify factors associated with caregiver strain among middle-aged and older non-Hispanic Black and Hispanic male caregivers living with one or more chronic conditions. DESIGN: Data were analyzed from 418 male caregivers collected through Qualtrics Online Panels using an internet-delivered survey instrument (55.7% non-Hispanic Black, 44.3% Hispanic). Three ordinal regression models were fitted to assess factors associated with Caregiver Strain Scale tertiles: one for all men, one for non-Hispanic Black men only; and one for Hispanic men only. RESULTS: Similarities and differences were observed between the two groups in terms of factors associated with higher caregiver strain (i.e. lower disease self-management efficacy scores, providing ≥20 h of care per week). Uniquely for Non-Hispanic Black male caregivers, higher caregiver strain was associated with living with more children under the age of 18 (ß = 0.35, P = 0.011) and feeling more socially disconnected (ß = 0.41, P = 0.008). Uniquely for Hispanic male caregivers, higher caregiver strain levels were associated with experiencing lower pain levels (ß = -0.14, P = 0.040) and higher fatigue levels (ß = 0.23, P < 0.001). CONCLUSION: Findings from this study suggest that non-Hispanic Black and Hispanic men with chronic conditions have differing caregiving experiences. While bolstering social connectedness and caregiver support services may offset caregiver strain, tailored mental health and disease management programming are needed to meet the specific needs of non-Hispanic Black and Hispanic male caregivers.

Physician Trust in the News Media and Attitudes toward COVID-19.

CONTEXT: Previous research has established the importance of primary care physicians in communicating public health directives. The implicit assumption is that, because of their expertise, doctors provide accurate and up-to-date information to their patients independent of partisan affiliation or media trust. METHODS: The authors conducted an online survey of 625 primary care physicians and used the results to test (1) whether physician trust in media outlets is consistent with their political partisanship, and (2) whether trust in media outlets influences (a) personal concern that someone in their family will get sick, (b) perceptions about the seriousness of the pandemic as portrayed in the media, and (c) trust in federal government agencies and scientists. FINDINGS: Physicians are better positioned to critically evaluate health-related news, but they are subject to the same biases that influence public opinion. Physicians' partisan commitments influence media trust, and media trust influences concern that a family member will get sick, perceptions regarding the seriousness of the pandemic, and trust in federal government agencies and scientists. CONCLUSIONS: Physician trust in specific media outlets shapes their understanding of the pandemic, and-to the extent that they trust conservative media outlets-it may limit their effectiveness as health policy messengers.

Web-Based Health Information Seeking Among African American and Hispanic Men Living With Chronic Conditions: Cross-sectional Survey Study.

BACKGROUND: Previous research has identified disparities in seeking and using web-based health information to inform health-related behaviors. Relatively few studies however have examined the correlations between web-based health information seeking and use based on race, gender, age, and the presence of chronic health conditions. OBJECTIVE: In this study, we identify factors associated with seeking and using web-based health information among a uniquely vulnerable and intersectional population-middle-aged and older (40 years and older) African American and Hispanic men living with one or more chronic conditions. METHODS: Survey responses were collected from a purposive sample of African American and Hispanic men using Qualtrics web-based survey management software. To qualify for inclusion in the study, respondents had to identify as African American or Hispanic men, report having at least one chronic condition, and be aged 40 years and older. A series of binary logistic regression models was created using backward elimination. Statistical significance was determined at P<.05 for all analyses. RESULTS: Web-based health information seeking among African American and Hispanic men is a function of education, the presence of multiple chronic conditions, frustration with health care providers, internet use, and the perceived reliability of web-based health information. The use of web-based health information to inform interactions with health care providers was more common among African American and Hispanic men, who rated their health as relatively good, perceived barriers to care, used technology regularly, and took more daily medications. CONCLUSIONS: Understanding the factors that influence African American and Hispanic men seeking web-based health information may help improve the care and treatment of chronic conditions. African American and Hispanic men seek web-based health information as a substitute for routine care and to inform their discussions with health care providers.

Seeing is Believing? An Examination of Perceptions of Local Weather Conditions and Climate Change Among Residents in the U.S. Gulf Coast.

What role do objective weather conditions play in coastal residents' perceptions of local climate shifts and how do these perceptions affect attitudes toward climate change? While scholars have increasingly investigated the role of weather and climate conditions on climate-related attitudes and behaviors, they typically assume that residents accurately perceive shifts in local climate patterns. We directly test this assumption using the largest and most comprehensive survey of Gulf Coast residents conducted to date supplemented with monthly temperature data from the U.S. Historical Climatology Network and extreme weather events data from National Climatic Data Center. We find objective conditions have limited explanatory power in determining perceptions of local climate patterns. Only the 15- and 19-year hurricane trends and decadal summer temperature trend have some effects on perceptions of these weather conditions, while the decadal trend of total number of extreme weather events and 15- and 19-year winter temperature trends are correlated with belief in climate change. Partisan affiliation, in contrast, plays a powerful role affecting individual perceptions of changing patterns of air temperatures, flooding, droughts, and hurricanes, as well as belief in the existence of climate change and concern for future consequences. At least when it comes to changing local conditions, "seeing is not believing." Political orientations rather than local conditions drive perceptions of local weather conditions and these perceptions-rather than objectively measured weather conditions-influence climate-related attitudes.

Primary care physicians' strategies for addressing COVID-19 vaccine hesitancy.

OBJECTIVE: To explore the strategies that primary care physicians use to address patient COVID-19 vaccine hesitancy. METHOD: We administered an online survey to 625 primary care physicians from May 14 to May 25, 2021, to assess the messages that primary care physicians use to encourage hesitant patients to get vaccinated against COVID-19.589 physicians from the total pool of 625 provided open-ended responses. We conducted thematic content analysis on the responses based on previous research and themes identified within the data. SETTING: The survey was administered online using the survey research firm Dynata. RESULTS: Eleven primary themes emerged from our analysis, which included, physicians addressing specific concerns about vaccine safety (including costs versus benefits), physicians helping patients understand what it means to remain unvaccinated, or whether physicians try to connect emotionally through the use of guilt, or personal experience, whether physicians use derisive language to communicate with unvaccinated patients. In addition, a small number of physicians indicated they would not attempt to persuade someone who is vaccine hesitant. CONCLUSIONS: Our study shows that while some of the physicians used different strategies to address vaccine hesitancy, some of the physicians used harsh language or did not make any effort to reduce COVID-19 related vaccine hesitancy among their patients. Focused advocacy and training are needed to increase physician engagement in vaccine-related dialogues with their patients. Such efforts will ensure that critical opportunities for patient education and awareness-building are not missed and ensure high levels of vaccination uptake.

The Changing Nature of Telehealth Use by Primary Care Physicians in the United States.

INTRODUCTION: Prior to the COVID-19 pandemic, telehealth utilization was growing slowly and steadily, although differentially across medical specialties in the United States. The pandemic dramatically expanded physician use of telehealth, but our understanding of how much telehealth use has changed in primary care in the United States, the correlates of physician telehealth uptake, and the frequency with which primary care physicians intend to use telehealth after the pandemic are unknown. This paper is designed to assess these important questions. METHODS: Using data from an original national survey of 625 primary care physicians conducted from May 14 to May 25, 2021, we investigate the frequency of physician telehealth use before and during the pandemic and intended use after the pandemic. We also assess the correlates of changes in telehealth use by physicians, comparing telehealth use before the pandemic to use during and after the pandemic. RESULTS: The proportion of primary care physicians using telehealth often, jumped from 5.3% (95% CI 3.5, 7.0) before the pandemic to 46.2% (95% CI 42.3, 50.2) during the pandemic. More importantly, over 70% of physicians intended to use telehealth at least occasionally after the pandemic compared to just 18.7% before, with younger physicians, physicians without telehealth training in medical school, and Asian physicians most likely to increase their telehealth use long-term. DISCUSSION: The COVID-19 pandemic has spurred expansion in telehealth use by primary care physicians that will continue to shape care delivery well beyond the pandemic. Policy change could be needed to facilitate this growth of telehealth long-term.

Imperfect messengers? An analysis of vaccine confidence among primary care physicians.

BACKGROUND: Growing narratives emphasize using primary care physicians as leaders in efforts to promote COVID-19 vaccination among the vaccine hesitant. Critically however, little is known about vaccine confidence among primary care physicians themselves. The objective of this study was to assess both physician confidence that in general, vaccines are safe, effective, and important, as well as physician confidence in each COVID-19 vaccine in the United States. METHODS: We rely on data from a national survey of primary care physicians conducted from May 14-May 25, 2021. We assess the influence of demographic, social, and political factors on physician beliefs that in general, vaccines are safe, effective, and important, as well as physician confidence in the safety of the Moderna, Pfizer, and Johnson & Johnson COVID-19 vaccines. RESULTS: 10.1% of primary care physicians do not agree that, in general, vaccines are safe, 9.3% do not agree they are effective, and 8.3% do not agree they are important. While 68.7% of physicians were 'very confident' in the safety of the Moderna vaccine and 72.7% were 'very confident' in the safety of the Pfizer vaccine, only 32.1% of physicians were 'very confident' in the safety of the Johnson & Johnson COVID-19 vaccine. CONCLUSION: A troubling proportion of primary care physicians lack high levels of vaccine confidence. These physicians may not be well positioned to actively promote COVID-19 vaccination even as political and media narratives push physicians to lead this effort. Interventions aimed at improving vaccine confidence among some physicians may be needed so that all physicians can fulfill needed roles as trusted vaccine communicators.

Contextualizing the Chronic Care Model among Non-Hispanic Black and Hispanic Men with Chronic Conditions.

Middle-aged and older men of color with chronic conditions have low utilization of preventive health services. In the context of the Chronic Care Model (CCM), the objective of this study was to identify perceptions about being informed, activated patients and having productive interactions in healthcare settings among non-Hispanic Black and Hispanic middle-aged and older men with chronic health conditions in the United States. Using an internet-based survey deployed nationally using a Qualtrics panel, data were collected from a sample of non-Hispanic Black and Hispanic men aged 40 years and older with one or more self-reported chronic conditions (n = 2028). Chi-square tests and one-way ANOVAs were used to describe this national sample by race/ethnicity and age group (40-64 years and ≥65 years). Results suggest that most health-related factors differed more on age than by race/ethnicity. Younger age groups reported less preventive care, greater barriers to self-care, mental health issues, and risky behavior. Findings from this study provide insight into the health status and healthcare utilization of racial/ethnic men with one or more chronic conditions. Results may help inform prevention and treatment interventions for middle-aged and older men of color.

Understanding the effects of past flood events and perceived and estimated flood risks on individuals' voluntary flood insurance purchase behavior.

Over the past several decades, the economic damage from flooding in the coastal areas has greatly increased due to rapid coastal development coupled with possible climate change impacts. One effective way to mitigate excessive economic losses from flooding is to purchase flood insurance. Only a minority of coastal residents however have taken this preventive measure. Using original survey data for all coastal counties of the United States Gulf Coast merged with contextual data, this study examines the effects of external influences and perceptions of flood-related risks on individuals' voluntary behaviors to purchase flood insurance. It is found that the estimated flood hazard conveyed through the U.S. Federal Emergency Management Agency's (FEMA's) flood maps, the intensities and consequences of past storms and flooding events, and perceived flood-related risks significantly affect individual's voluntary purchase of flood insurance. This behavior is also influenced by home ownership, trust in local government, education, and income. These findings have several important policy implications. First, FEMA's flood maps have been effective in conveying local flood risks to coastal residents, and correspondingly influencing their decisions to voluntarily seek flood insurance in the U.S. Gulf Coast. Flood maps therefore should be updated frequently to reflect timely and accurate information about flood hazards. Second, policy makers should design strategies to increase homeowners' trust in the local government, to better communicate flood risks with residents, to address the affordability issue for the low-income, and better inform less educated homeowners through various educational programs. Future studies should examine the voluntary flood insurance behavior across countries that are vulnerable to flooding.

Race, racial resentment, attentiveness to the news media, and public opinion toward the Jena Six.

Objective. We outline the role of race, racial resentment, and attentiveness to news in structuring public opinion toward the prosecution of the Jena Six, the name given to six African-American high school students who beat a white student, five of whom were subsequently charged with attempted second-degree murder.Method. We rely on a telephone survey of 428 registered voters collected in the aftermath of the protests in Jena, Louisiana.Results. Public reactions were heavily filtered by race and associated with measures of racial resentment. African Americans followed news about the protests more closely, believed race was the most important consideration in the decision to prosecute, and believed the decision to prosecute was the wrong decision. Racially conservative white respondents were less likely to believe race was the most important consideration in the decision to prosecute and were more likely to believe that the decision to prosecute was the right decision. Consistent with theories of agenda setting and framing, attentiveness to the news influenced perceptions regarding the importance of race in the decision to prosecute but not whether the decision was the right decision.Conclusions. At least within the context of the Deep South, race and racial attitudes continue to be an important predictor of public reactions to racially charged events. Attentiveness to the news influenced the lens through which events were interpreted, but not perceptions of whether the outcome was the right decision.