Preventive medicine
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Preventive medicine · Jul 2018
Childhood poverty, catecholamines, and substance use among African American young adults: The protective effect of supportive parenting.
From a sample of African American families living in the rural South, this study tested the hypothesis that growing up in poverty is associated with heightened biological stress levels in youth that, in turn, forecast elevations in drug use in young adulthood. Supportive parenting during adolescence was hypothesized to protect youth's biological stress levels from rising in the context of poverty. African American youth and their primary caregivers from 385 families participated in a 14-year prospective study that began when youth were 11 years of age. ⋯ Conditional indirect effects confirmed a developmental cascade linking family poverty, youth catecholamine levels, and increases in substance use for youth who did not receive high levels of supportive parenting. Current results suggest that, for some African American youth, substance use vulnerability may develop "under the skin" from stress-related biological weathering years before elevated drug use. Receipt of supportive parenting, however, can protect rural African American youth from biological weathering and its subsequent effects on increases in substance use during adulthood.
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Preventive medicine · Jul 2018
E-cigarette openness, curiosity, harm perceptions and advertising exposure among U.S. middle and high school students.
Understanding factors associated with youth e-cigarette openness and curiosity are important for assessing probability of future use. We examined how e-cigarette harm perceptions and advertising exposure are associated with openness and curiosity among tobacco naive youth. Findings from the 2015 National Youth Tobacco Survey (NYTS) were analyzed. ⋯ Respondents who reported high exposure to e-cigarette advertising in stores had greater odds of being open to e-cigarette use (OR = 1.22, 95% CI = 1.03, 1.44) and highly curious (OR = 1.25, 95% CI = 1.01, 1.53) compared to those not highly exposed. These findings demonstrate that youth exposed to e-cigarette advertising are open and curious to e-cigarette use. These findings could help public health practitioners better understand the interplay of advertising exposure and harm perceptions with curiosity and openness to e-cigarette use in a rapidly changing marketplace.
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Preventive medicine · Jul 2018
Socioeconomic status and adolescent e-cigarette use: The mediating role of e-cigarette advertisement exposure.
Among adolescents, low socioeconomic status (SES) is associated with greater exposure to tobacco cigarette advertising and cigarette use. However, associations among SES, e-cigarette advertising and e-cigarette use are not well understood. This study examined exposure to e-cigarette advertisements as a mediator of the relationship between SES and adolescent e-cigarette use. ⋯ Mediation was supported (indirect effect: β = 0.01, SE = 0.00, 95% CI [0.001, 0.010], p = 0.02), such that higher SES was associated with greater recent advertising exposure, which, in turn, was associated with greater frequency of e-cigarette use. Our study suggests that regulations to reduce youth exposure to e-cigarette advertisement may be especially relevant to higher SES youth. Future research should examine these associations longitudinally and evaluate which types of advertisements target different SES groups.
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Preventive medicine · Jul 2018
Deriving a clinical prediction rule to target sexual healthcare to women attending British General Practices.
Some women attending General Practices (GPs) are at higher risk of unintended pregnancy (RUIP) and sexually transmitted infections (STI) than others. A clinical prediction rule (CPR) may help target resources using psychosocial questions as an acceptable, effective means of assessment. The aim was to derive a CPR that discriminates women who would benefit from sexual health discussion and intervention. ⋯ RUIP was predicted by 5 questions including sexual debut <16 years, and emergency contraception use in the last 6 months (C-statistic = 0.70, sensitivity = 69% and specificity = 57%). 2PP was better discriminated than RUIP but neither to a clinically-useful degree. The finding that different psychosocial factors predicted each outcome has implications for prevention strategies. Further research should investigate causal links between psychosocial factors and sexual risk.
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Preventive medicine · Jul 2018
Change in physical activity and accumulation of cardiometabolic risk factors.
This study aims to examine the association between change in physical activity over time and accumulation of cardiometabolic risk factors. Four consecutive surveys (Time 1 to 4) were conducted with 4-year intervals in 1997-2013 (the Finnish Public Sector study). Physical activity of 15,634 cardio-metabolically healthy participants (mean age 43.3 (SD 8.7) years, 85% women) was assessed using four-item survey measure and was expressed as weekly metabolic equivalent (MET) hours in Time 1, 2, and 3. ⋯ Compared to maintenance of low physical activity, increase in physical activity from low baseline activity level was associated with decreased accumulation of cardiometabolic risk factors in a dose-response manner (cumulative odds ratio [cOR] = 0.73, 95% CI 0.59-0.90 for low-to-moderate and cOR = 0.67, 95% CI 0.49-0.89 for low-to-high, P for trend 0.0007). Decrease in physical activity level from high to low was associated with increased accumulation of cardiometabolic risk factors (cOR = 1.60, 95% CI 1.27-2.01) compared to those who remained at high activity level. Thus even a modest long-term increase in physical activity was associated with reduction in cardiometabolic risk whereas decrease in physical activity was related to increased risk.