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Biomedical subjects

Ping-Hsin Chen

Publications and source records attributed to Ping-Hsin Chen.

5 recordsLinked to original sources

Breast and cervical cancer screening in obese minority women.

PURPOSE: Studies using survey data from mostly white women showed that obese women are less likely than nonobese women to undergo breast and cervical cancer screening. It is unclear if these findings are true in nonwhite women. Using chart audit data, we examined the relationship between obesity and mammography and Pap smear screening among minority women. METHODS: Data from retrospective chart review of women in three urban New Jersey academic family medicine practices were analyzed (n = 1809) using hierarchical logistic regression models. Outcome measures were being up-to-date in mammography and Pap smears among obese and nonobese women. RESULTS: There was no difference in mammography rates among obese and nonobese women. Independent risk factors for not being up-to-date in mammography included age 40-49, smoking, and comorbidity. Obese women were less likely than nonobese women to be upto- date in Pap smears (69% vs. 77%, p = 0.001). In multivariate analysis, obesity was associated with 25% decreased odds of being up-to-date on Pap smears (OR, 0.75, 95% CI, 0.58-0.99, p = 0.041). Age >or=65 years was also associated with decreased odds of being up-to-date in Pap smears. Hispanic women had increased odds of being up-to-date in mammography (OR 2.43, 95% CI 1.63-3.63) and Pap smears (OR 1.94, 95% CI 1.24-3.03) compared with white women. CONCLUSIONS: Obesity was associated with decreased Pap smear screening but not with decreased mammography. Further studies are needed to determine barriers and effective interventions to improve screening in obese minority women.

Adult↗

Screening for domestic violence in a predominantly Hispanic clinical setting.

BACKGROUND: Domestic violence is a public health problem that is common across ethnic groups. The utility of validated screening tools to detect abuse in diverse populations remains largely unknown. OBJECTIVE: The purpose of the study was to test the reliability and validity of a brief 4-question instrument, HITS, among predominantly Hispanic women. METHODS: We conducted a cross-sectional study in an urban clinical setting. Two hundred and two women completed HITS and two other previously validated tools, the Index of Spouse Abuse-Physical Scale (ISA-P) and the Woman Abuse Screening Tool (WAST). Instruments were prepared in English and translated to Spanish. Reliability and validity of HITS were compared with the ISA-P and WAST. Performance measures of HITS were compared with the ISA-P or WAST as a criterion standard. RESULTS: Cronbach's alphas were 0.76 and 0.61 for the English version and Spanish version of HITS, respectively. When administered first and analysed alone, the Spanish version of HITS had a reliability of 0.71. For both English and Spanish versions HITS was significantly correlated to ISA-P and WAST. The English HITS version had a sensitivity of 86% and a specificity of 99%. A cut-off score of 5.5 for Spanish HITS version achieved a sensitivity of 100% and a specificity of 86%. CONCLUSIONS: HITS demonstrated good reliability and validity with ISA-P in English speaking patients. The Spanish version of HITS showed moderate reliability and good validity with WAST in Spanish speaking patients. HITS may help physicians detect abuse in predominantly Hispanic clinical settings.

Adult↗

The economic burden of hospitalizations associated with child abuse and neglect.

OBJECTIVES: This study assessed the economic burden of child abuse-related hospitalizations. METHODS: We compared inpatient stays coded with a diagnosis of child abuse or neglect with stays of other hospitalized children using the 1999 National Inpatient Sample of the Healthcare Costs and Utilization Project. RESULTS: Children whose hospital stays were coded with a diagnosis of abuse or neglect were significantly more likely to have died during hospitalization (4.0% vs 0.5%), have longer stays (8.2 vs 4.0 days), twice the number of diagnoses (6.3 vs 2.8), and double the total charges (19,266 vs 9513 US dollars) than were other hospitalized children. Furthermore, the primary payer was typically Medicaid (66.5% vs 37.0%). CONCLUSION: Earlier identification of children at risk for child abuse and neglect might reduce the individual, medical, and societal costs.

Age Distribution↗

Developmental trajectories of cigarette use from early adolescence into young adulthood.

This study identified developmental trajectories of cigarette smoking from early adolescence into young adulthood, and delineated whether risk factors derived from a social learning-problem behavior framework could differentiate among trajectories. Participants (N=374) were interviewed five times from age 12 until age 30/31. Using growth mixture modeling, three trajectory groups were identified--heavy/regular, occasional/maturing out, and non/experimental smokers. Being a female, having higher disinhibition, receiving lower grades, and more frequent use of alcohol or drugs significantly increased the probability of belonging to a smoking trajectory group compared with being a nonsmoker. Higher disinhibition and receiving lower grades also differentiated regular smokers from the rest of the sample. None of the risk factors distinguished occasional from regular smokers. When models were tested separately by sex, disinhibition, other drug use, and school grades were associated with smoking for both sexes. On the other hand, environmental factors, including socioeconomic status, parent smoking and friend smoking, were related to smoking for females but not for males. Sex differences in developmental trajectories and in smoking behavior among regular smokers were notable. Future research should examine transitions and turning points from adolescence to adulthood that may affect cessation and escalation differently for males and females.

Adolescent↗

Problem drinking and intimate partner violence.

OBJECTIVE: This study examined the role of problem drinking in intimate partner violence (IPV) perpetration and victimization for men and women. We assessed (1) whether the relationship between problem drinking and IPV was spurious and (2) if relationship dissatisfaction and partner drinking mediated the effects of problem drinking on IPV. METHOD: Five waves of longitudinal data from a nonclinical sample (N = 725; 400 women), aged 12 through 31 years, were analyzed to determine the effects of problem drinking on IPV after controlling for eight common risk factors. Regression analyses were conducted to determine whether relationship dissatisfaction and partner drinking patterns mediated the effects of problem drinking on IPV after controlling for these same risk factors. RESULTS: With controls, problem drinking significantly predicted perpetration and victimization for men and women. Partner drinking was not related to perpetration or victimization for men. For women, partner drinking was strongly related to perpetration and victimization. It fully mediated the effects of problem drinking on perpetration, but did not mediate these effects on victimization. Relationship dissatisfaction fully mediated the effects of problem drinking on male and female perpetration and partially mediated the effects on male victimization. Relationship dissatisfaction did not mediate the effects of problem drinking on female victimization. CONCLUSIONS: The relationship between problem drinking and IPV was not spurious for men or women. Heavier drinking by partners put women at greater risk for perpetration and victimization and mediated the effects of their own problem drinking on perpetration. Programs that prevent and treat problem drinking among young men should have a beneficial impact on reducing IPV.

Adolescent↗