Background: Depression is a common mental disorder that significantly contributes to the global burden of disease. Studies have consistently reported that migrant workers experience higher levels of depressive symptoms, especially women. Aims: This study aimed to examine the mediation role of sexual self-efficacy on the relationship between psychological wellbeing, and depressive symptoms among young female migrant workers in Vietnam’s industrial zones. Methods: A cross-sectional study was conducted among 1061 female migrant workers aged 18 to 29 from January to November 2020 in Hanoi, Vietnam. Anonymous interview questionnaires were used to collect data on demographic characteristics, psychosocial wellbeing (PWB), sexual self-efficacy, and depressive symptoms. Mediation analysis was conducted to explore the mediation effect of sexual self-efficacy on the relationship between PWB and depressive symptoms. Results: Nearly 8% of the female migrant workers reported experiencing depressive symptoms. The final mediation model showed that the effect of overall psychological wellbeing on depressive symptoms was partially mediated by sexual self-efficacy. Specifically, 4.1% of the effect of overall PWB on depressive symptoms was mediated through sexual self-efficacy. In the PWB subdimension analyses, sexual self-efficacy mediated 14.3% of the effect of personal growth, 8.8% of the effect of purpose in life, 8.0% of the effect of autonomy, and 7.8% of the effect of environmental mastery on depressive symptoms, respectively. Conclusion: The study findings demonstrate that sexual self-efficacy plays an important role in the relationship between psychosocial wellbeing and depressive symptoms among female migrant workers in industrial zones in Vietnam. Improving psychosocial wellbeing and promoting sexual health including sexual self-efficacy should be prioritized when addressing depressive symptoms and mental health concerns among industrial zone female migrant workers in Vietnam, which may also be applicable in other low- and middle-income countries with similar socio-cultural settings.

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Objectives: This study examines the impact of reference pricing on the price and spending for in vitro laboratory tests for a large private employer in the United States. MethOds: We obtained comprehensive laboratory and medical claims for employees of a major US firm from 2009 to 2013. Each claim contained the CPT code for the test, the price paid (allowed charge), and the identity and the location of the laboratory. We matched lab claims to medical claims for the patients, obtaining information on age, gender, diagnoses and co-morbidities (ICD9). Beginning in January 2011, the firm limited its payment for 566 in vitro laboratory tests to the 60th percentile in the price distribution for each test across national laboratories, hospital-based laboratories, and freestanding local laboratories. Reference-priced tests generated 99,225 individual patient assays and insurance claims. Another 247 types of in vitro tests were exempted from reference pricing; these generated 33,480 individual patient assays and insurance claims. We used difference-indifference multivariable regression analysis (GLM with log link and gamma distribution) to measure the rate of change in prices paid per test for laboratory tests subject to reference pricing, compared to the change in prices paid for laboratory tests exempted from reference pricing. Results: Reference pricing led to a 17.8% (p< .001) reduction in laboratory test prices paid in the first year after implementation. By the second year, this had increased to 21.6% (p< .001) and by the third year to a 27.7% (p< .001) reduction. In the three years after implementation of reference pricing, the employer saved 18.5% in spending compared to what it would have spent had the prices of reference-priced tests continued to increase at the same rate as non-reference priced tests. cOnclusiOns: Reference pricing reduces prices paid per test and total spending on laboratory tests in the United States.