Showing papers by "Annsofie Adolfsson published in 2018"
TL;DR: County of residence and socio-economic factors were strongly associated with lower attendance in cervical screening, while being born in another country was of less importance.
Abstract: Background Cervical screening programs are highly protective for cervical cancer, but only for women attending screening procedure. Objective Identify socio-economic and demographic determinants for non-attendance in cervical screening. Methods Design: Population-based case-control study. Setting: Sweden. Population: Source population was all women eligible for screening. Based on complete screening records, two groups of women aged 30-60 were compared. The case group, non-attending women, (N = 314,302) had no smear registered for 6-8 years. The control group (N = 266,706) attended within 90 days of invitation. Main outcome measures: Risk of non-attendance by 9 groups of socioeconomic and demographic variables. Analysis: Unadjusted odds ratios (OR) and OR after adjustment for all variables in logistic regression models were calculated. Results Women with low disposable family income (adjOR 2.06; 95% confidence interval (CI) 2.01-2.11), with low education (adjOR 1.77; CI 1.73-1.81) and not cohabiting (adjOR 1.47; CI 1.45-1.50) were more likely to not attend cervical screening. Other important factors for non-attendance were being outside the labour force and receiving welfare benefits. Swedish counties are responsible for running screening programs; adjusted OR for non-participation in counties ranged from OR 4.21 (CI 4.06-4.35) to OR 0.54 (CI 0.52-0.57), compared to the reference county. Being born outside Sweden was a risk factor for non-attendance in the unadjusted analysis but this disappeared in certain large groups after adjustment for socioeconomic factors. Conclusion County of residence and socio-economic factors were strongly associated with lower attendance in cervical screening, while being born in another country was of less importance. This indicates considerable potential for improvement of cervical screening attendance in several areas if best practice of routines is adopted.
47 citations
TL;DR: It is worrying that nurses' need for further training was highest for effects and interaction of various types of medications, and further studies are needed to conclude if and how master's education improves patient outcome.
38 citations
TL;DR: To report results from and explore use of a multicentre, parallel‐group, unblinded, randomized controlled trial testing the effectiveness in terms of well‐being and diabetes management of a person‐centred, web‐based support programme for women with Type 1 diabetes, in pregnancy and postpartum.
Abstract: Aims To report results from and explore use of a multicentre, parallel-group, unblinded, randomized controlled trial testing the effectiveness in terms of well-being and diabetes management of a person-centred, web-based support programme for women with Type 1 diabetes, in pregnancy and postpartum. Methods Between 2011 and 2014, 174 pregnant women with Type 1 diabetes were randomly allocated (1:1) to web-based support and standard care (intervention group, n=83), or standard care (control group, n=91). The web-based support consisted of evidence-based information; a self-care diary for monitoring of daily activities; and peer support in a discussion forum. The primary outcomes (mean difference, measured at 6 months after childbirth) were well-being and diabetes management. Results No differences were found with regard to the primary outcome measure scores for general well-being [1.04 (95% CI -1.28 to 3.37); P=0.68] and self-efficacy of diabetes management [0.08 (95% CI -0.12 to 0.28); P= 0.75], after adjustment for baseline differences in the insulin administration method, nor with regard to the secondary outcome measures. Conclusions At 6 months after childbirth, the web-based support plus standard care was not superior to standard care in terms of general well-being or self-efficacy of diabetes management. This might be explained by the low number of participants who had a high activity level. Few simultaneously active participants in the web-based programme and stressors in motherhood and diabetes postpartum were the main barriers to its use. Further intervention studies that offer web-based support are needed, with lessons learned from the present study. (Clinicaltrials.gov identification number: NCT015665824).
20 citations
TL;DR: Adherence in terms of social interactions was negatively affected by limited active participation due to prolonged recruitment process and randomization effects, and recommendations to consider when designing and evaluating Web-based health interventions are given.
Abstract: Background: Numerous Web-based interventions have been implemented to promote health and health-related behaviors in persons with chronic conditions. Using randomized controlled trials to evaluate such interventions creates a range of challenges, which in turn can influence the study outcome. Applying a critical perspective when evaluating Web-based health interventions is important. Objective: The objective of this study was to critically analyze and discuss the challenges of conducting a Web-based health intervention as a randomized controlled trial. Method: The MODIAB-Web study was critically examined using an exploratory case study methodology and the framework for analysis offered through the Persuasive Systems Design model. Focus was on technology, study design, and Web-based support usage, with special focus on the forum for peer support. Descriptive statistics and qualitative content analysis were used. Results: The persuasive content and technological elements in the design of the randomized controlled trial included all four categories of the Persuasive Systems Design model, but not all design principles were implemented. The study duration was extended to a period of four and a half years. Of 81 active participants in the intervention group, a maximum of 36 women were simultaneously active. User adherence varied greatly with a median of 91 individual log-ins. The forum for peer support was used by 63 participants. Although only about one-third of the participants interacted in the forum, there was a fairly rich exchange of experiences and advice between them. Thus, adherence in terms of social interactions was negatively affected by limited active participation due to prolonged recruitment process and randomization effects. Lessons learned from this critical analysis are that technology and study design matter and might mutually influence each other. In Web-based interventions, the use of design theories enables utilization of the full potential of technology and promotes adherence. The randomization element in a randomized controlled trial design can become a barrier to achieving a critical mass of user interactions in Web-based interventions, especially when social support is included. For extended study periods, the technology used may need to be adapted in line with newly available technical options to avoid the risk of becoming outdated in the user realm, which in turn might jeopardize study validity in terms of randomized controlled trial designs. Conclusions: On the basis of lessons learned in this randomized controlled trial, we give recommendations to consider when designing and evaluating Web-based health interventions. [J Med Internet Res 2018;20(5):e160]
8 citations
TL;DR: A weak association was found between more unstable blood glucose levels and lower general well-being at two months postpartum, but no other associations with erratic glycaemia was found.
7 citations
TL;DR: The majority of Norwegian health care professionals participating in this study supported the national recommendation on ultrasound in pregnancy, and ultrasound users wanted to offer more ultrasound examinations during pregnancy, whereas non-users were generally content with the recommendation.
6 citations
07 May 2018
TL;DR: This research examines the impact of sexual violence in the Eastern part of the Congo on the lives of women and finds that women in the region are more likely to be victims of gender-based violence than the general population.
Abstract: Background: The impact of sexual violence in any community is extremely devastating and women in the Eastern part of the Congo are no exception. Sexual violence not only affects the health of women ...
1 citations
TL;DR: The attitudes to risk behavior among patients diagnosed with a Chlamydia infection at a Sexual Transmitted Infection (STI) clinic were described, with alcohol consumption emerged as a common denominator among the informants and as a contributor to risk.
Abstract: The aim of the study was to describe the attitudes to risk behavior among patients diagnosed with a Chlamydia infection at a Sexual Transmitted Infection (STI) clinic. Qualitative interviews face-to-face were conducted with twenty patients, aged 18 - 30 years, with confirmed Chlamydia infections were included. An interview guide was used and the participants described the behavior that had led to the infection. The material was analyzed using qualitative content analysis. Eighteen informants were included and the theme was risk. Recurrent among the informants was risk behavior in sexual relations when using alcohol, while risk behavior in life in general was almost non-existent. Of the 18 informants, sixteen had previously been tested for STIs, and ten had had an STI before. Alcohol consumption emerged as a common denominator among the informants and as a contributor to risk. In contrast, almost none of the informants exposed themselves to any unnecessary risks in life in general.