Shamly Austin

Acupuncture Use in the United States: Who, Where, Why, and at What Price?

Despite the increase in acupuncture uses and greater than ever before interest of funding agencies to fund biomedical research in acupuncture, little is known about the profile of acupuncture users. We examined who these individuals are, where they reside, why they use acupuncture, and what price they pay. The increased use and high costs associated with each acupuncture visit poses questions to health care insurers regarding its coverage. Profiling will help conventional providers identify the segment of the population who are more likely to use acupuncture and educate them on the possible risks and benefits of using it with conventional medicine.

Health Care Providers’ Recommendations for Physical Activity and Adherence to Physical Activity Guidelines Among Adults With Arthritis

Introduction Physical activity is beneficial for reducing pain and improving health-related quality of life among people with arthritis. However, physical inactivity is prevalent among people with arthritis. Health care providers’ recommendations act as a catalyst for changes in health behavior. However, information about the effectiveness of such recommendations is limited in the arthritis literature. We examined the association between providers’ recommendations for physical activity and adherence to physical activity guidelines for adults with arthritis and whether adults’ age influenced this association. Methods We used combined data of adult respondents aged 45 years or older with provider-diagnosed arthritis (N = 10,892) from the 2011 Behavioral Risk Factor Surveillance System to conduct a retrospective, cross-sectional study. We used a multivariable logistic regression model to examine the association between health care providers’ recommendations and adherence to physical activity guidelines among adults with arthritis. Results Adults with arthritis who received health care providers’ recommendations for physical activity were more likely (odds ratio, 1.22; 95% confidence interval, 1.12–1.32) to adhere to physical activity guidelines than those who did not, after controlling for relevant covariates. Adults’ age did not influence the association between providers’ recommendations and adherence to physical activity (odds ratio, 1.00; 95% confidence interval, 0.99–1.00), after controlling for covariates. Conclusion Health care providers’ recommendations are associated with adherence to physical activity guidelines among adults with arthritis. Providers should recommend physical activity to adults with arthritis.

Disparities in Use of Gynecologic Oncologists for Women with Ovarian Cancer in the United States

OBJECTIVE To examine disparities in utilization of gynecologic oncologists (GOs) across race and other sociodemographic factors for women with ovarian cancer. DATA SOURCES Obtained SEER-Medicare linked dataset for 4,233 non-Hispanic White, non-Hispanic African American, Hispanic of any race, and Non-Hispanic Asian women aged ≥ 66 years old diagnosed with ovarian cancer during 2000-2002 from 17 SEER registries. Physician specialty was identified by linking data to the AMA master file using Unique Physician Identification Numbers. STUDY DESIGN Retrospective claims data analysis for 1999-2006. Logistic regression models were used to analyze the association between GO utilization and race/ethnicity in the initial, continuing, and final phases of care. PRINCIPAL FINDINGS GO use decreased from the initial to final phase of care (51.4-28.8 percent). No racial/ethnic differences were found overall and by phase of cancer care. Women >70 years old and those with unstaged disease were less likely to receive GO care compared to their counterparts. GO use was lower in some SEER registries compared to the Atlanta registry. CONCLUSIONS GO use for the initial ovarian cancer treatment or for longer term care was low but not different across racial/ethnic groups. Future research should identify factors that affect GO utilization and understand why use of these specialists remains low.

Breast cancer screening interventions in selected counties across US regions

ObjectivesTo determine the types of, and the populations targeted by interventions implemented to increase breast cancer screening rates in counties with large African American populations across different US regions.MethodsA brief questionnaire was administered by e-mail to county representatives from 33 states from October 2008 through March 2009. Responses were obtained from 33% of 203 targeted counties.ResultsMost counties (>80%) reported interventions for African American women and for women with low income. Women were exposed to different kinds of interventions depending on where they lived. Most counties in the Northeast (93%), Southwest (82%), and Midwest (100%) implemented interventions that provided free or low cost mammograms. Counties in the Southeast (83%) were more likely to report education interventions. Counties from the Southwest reported using a variety of interventions to encourage breast cancer screening.ConclusionIn this selected group of counties, different types of interventions were used to increase breast cancer screening in minority and disadvantaged women. Interventions implemented were similar to those shown in the literature to be effective in increasing screening rates in specific populations. Future research should examine the use of screening interventions in a larger sample of US counties.

Individuals With Disabilities Who Have Diabetes: Do We Have Targeted Interventions?

According to 2010 data from the Centers for Disease Control and Prevention (CDC), diabetes is the seventh leading cause of death in the United States. It is assumed that various diabetes interventions are available to help individuals manage this chronic disease, but that is not the case. The literature is scant regarding interventions focused on people with disabilities who have diabetes. The purpose of this article is to review interventions specifically focused on people with disabilities who have diabetes and to discuss the effect of these interventions on this population.