Preventive medicine
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Preventive medicine · Oct 2016
Tobacco advertising, promotion, and sponsorship (TAPS) exposure, anti-TAPS policies, and students' smoking behavior in Botswana and South Africa.
We examined the change over time in tobacco advertising, promotion and sponsorship exposure and the concurrent changes in cigarette smoking behavior among students age 13 to 15years in two African countries with different anti-tobacco advertising, promotion and sponsorship policies. In South Africa, anti-tobacco advertising, promotion and sponsorship policies became more comprehensive over time and were more strictly enforced, whereas the partial anti-tobacco advertising, promotion and sponsorship policies adopted in Botswana were weakly enforced. ⋯ Enforcement of strong anti-tobacco advertising, promotion and sponsorship policies is a vital component of effective tobacco control programs in Africa. Such regulations, if effectively implemented, can reduce tobacco advertising, promotion and sponsorship exposure among adolescents and may influence cigarette smoking behavior.
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Preventive medicine · Oct 2016
Randomized Controlled TrialEffect of general health screening and lifestyle counselling on incidence of diabetes in general population: Inter99 randomised trial.
We aimed to examine the effect of a large population-based multifactorial screening and lifestyle intervention programme on 10-year incidence of diabetes. In a randomised trial of the general Danish population initiated in 1999-2001 59,616 men and women aged 30-60years were assigned to a five year screening and lifestyle counselling programme (n=11,629) or control group (n=47,987) and followed for ten years in nationwide registers. Intention to treat was applied and risk of diabetes was modeled by Cox regression and expressed as hazard ratios (HRs). ⋯ We observed no difference in incidence of diabetes between the groups in the follow-up intervals from 1 to 6years or after 6-10years (HR=0.94, 0.83 to 1.06; HR=1.03, 0.91 to 1.17). Inviting the general population to participate in a repeated screening and lifestyle counselling programme over five years did not result in lower incidence of diabetes after 10years of follow-up. As expected, significantly more individuals were diagnosed with diabetes in the intervention group during the first year, but this was not followed by a decrease in the following years.
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Preventive medicine · Oct 2016
Pragmatic Clinical TrialAgainst colorectal cancer in our neighborhoods (ACCION): A comprehensive community-wide colorectal cancer screening intervention for the uninsured in a predominantly Hispanic community.
Colorectal cancer (CRC) is the second leading cause of cancer deaths in the USA. Screening is widely recommended but underutilized, particularly among the low income, the uninsured, recent immigrants and Hispanics. The study objective was to determine the effectiveness of a comprehensive community-wide, bilingual, CRC screening intervention among uninsured predominantly Hispanic individuals. ⋯ No educational group differences were observed. Covariate adjustment did not significantly alter the effect. A multicomponent community-wide, bilingual, CRC screening intervention significantly increased CRC screening in an uninsured predominantly Hispanic population.
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Preventive medicine · Oct 2016
Feedback from physical activity monitors is not compatible with current recommendations: A recalibration study.
Wearable devices to self-monitor physical activity have become popular with individuals and healthcare practitioners as a route to the prevention of chronic disease. It is not currently possible to reconcile feedback from these devices with activity recommendations because the guidelines refer to the amount of activity required on top of normal lifestyle activities (e.g., 150 minutes of moderate-to-vigorous intensity activity per week over-and-above normal moderate-to-vigorous lifestyle activities). The aim of this study was to recalibrate the feedback from self-monitoring. ⋯ This study demonstrates that feedback from sophisticated wearable devices is incompatible with current physical activity recommendations. Without adjustment, people will erroneously form the view that they are exceeding recommendations by several fold. A more appropriate target from self-monitoring that accounts for normal moderate-to-vigorous lifestyle activities is ~1000 minutes per week, which represents ~15% of waking time.
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Preventive medicine · Oct 2016
Active school transport and fast food intake: Are there racial and ethnic differences?
To investigate whether active school transport was associated with fast food consumption, and to examine differences across racial/ethnic groups. ⋯ AST appears to be a risk factor for fast food intake, and may expose some ethnic groups more than others to increased opportunity to purchase and consume fast food. Programs and policies to promote AST among adolescents should incorporate efforts to encourage healthy eating and discourage concentration of fast food outlets near schools.