Preventive medicine
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Preventive medicine · Sep 2003
The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900.
We examined the relationship of the number of adverse childhood experiences (ACE score) to six health problems among four successive birth cohorts dating back to 1900 to assess the strength and consistency of these relationships in face of secular influences the 20th century brought in changing health behaviors and conditions. We hypothesized that the ACE score/health problem relationship would be relatively "immune" to secular influences, in support of recent studies documenting the negative neurobiologic effects of childhood stressors on the developing brain. ⋯ Growing up with ACEs increased the risk of numerous health behaviors and outcomes for 20th century birth cohorts, suggesting that the effects of ACEs on the risk of various health problems are unaffected by social or secular changes. Research showing detrimental and lasting neurobiologic effects of child abuse on the developing brain provides a plausible explanation for the consistency and dose-response relationships found for each health problem across birth cohorts, despite changing secular influences.
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Preventive medicine · Sep 2003
The problem is getting us to stop. What teens say about smoking cessation.
Low participation and high dropout in many teen cessation programs may be due to lack of fit between teens' needs and the way programs are delivered. Qualitative studies, designed to identify and understand preferences of intervention participants and barriers to participation, offer opportunities to customize programs and improve their reach and effectiveness. ⋯ Teen smokers can supply valuable information to improve youth cessation programs to fit teen lifestyles, respect the challenges teens face, and acknowledge their choice in making the decision to quit.
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Preventive medicine · Sep 2003
Model for incorporating social context in health behavior interventions: applications for cancer prevention for working-class, multiethnic populations.
This article proposes a conceptual framework for addressing social contextual factors in cancer prevention interventions, and describes work that operationalizes this model in interventions for working class, multiethnic populations. ⋯ By illuminating the pathways by which social contextual factors influence health behaviors, it will be possible to enhance the effectiveness of interventions aimed at reducing social inequalities in risk behaviors.
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Exercise counselling is not frequently conducted by family physicians in several countries. Little is known about the exercise counselling practices of family physicians in Canada. The objective of this study was to assess physician confidence, current versus desired practice, and barriers related to the counselling of exercise by family physicians in Canada. ⋯ Family physicians indicated their current level of exercise counselling is suboptimal and confidence levels in exercise counselling were not high. Future educational opportunities for physicians may assist in improving exercise counselling.