Preventive medicine
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Preventive medicine · Oct 2020
Risk factor control among Black and White adults with diabetes onset in older adulthood: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.
The objective of this study was to determine whether attainment of clinical and lifestyle targets varied by race and sex among adults with diabetes onset in older adulthood. This study included 1420 black and white adults from the REGARDS study without diabetes at baseline (2003-07) but with diabetes onset at the follow-up exam (2013-16). Attainment of clinical targets (A1c <8%; blood pressure < 140/90 mmHg; and statin use) and lifestyle targets (not smoking; physical activity≥ 4 times/week; and moderate/no alcohol use) was assessed at the follow-up exam. ⋯ For lifestyle factors, the non-smoking prevalence was similar by race and sex, while white men were more likely than white women to be physically active. Although the attainment of each clinical and lifestyle target separately was generally high among adults with diabetes onset in older adulthood, race and sex differences were apparent. Comprehensive management of clinical and lifestyle factors in people with diabetes remains suboptimal.
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Preventive medicine · Oct 2020
A quality improvement collaborative to increase human papillomavirus vaccination rates in local health department clinics.
Human papillomavirus (HPV) vaccination rates are well below the Healthy People 2020 goal of 80%. Vaccinating in settings other than primary care, such as local health departments (LHDs), may help achieve higher HPV immunization rates. We tested the effect of a quality improvement (QI) collaborative to reduce missed opportunities (MOs) for HPV vaccine in LHDs. ⋯ This project shows that strategies effective in reducing MO for HPV vaccine in primary care settings are also effective in LHD settings. Training LHD staff on these strategies may help the U. S. approach national goals for HPV vaccine coverage.
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Preventive medicine · Oct 2020
Risk factors for assaultive reinjury and death following a nonfatal firearm assault injury: A population-based retrospective cohort study.
Individuals with a firearm injury are at high risk of subsequent firearm victimization, but characteristics associated with sustaining recurrent firearm injuries are not well understood. In this retrospective cohort study, we sought to quantify the hazards of sustaining subsequent assaultive firearm injuries among people with an initial firearm assault injury and to identify characteristics associated with recurrent victimization. Using hospital discharge, emergency department, and mortality records, we identified and followed all individuals aged ≥15 years with a nonfatal firearm assault injury resulting in an emergency department visit or hospital admission in California, 2005-2013. ⋯ The estimated transition probability for 1 to 2+ nonfatal injuries reached 10% by 8.5 years post-index injury. The rate of subsequent nonfatal firearm assault injury was highest among men (hazard ratio [HR]: 3.87; 95% confidence interval [CI]: 2.63-5.69) and Blacks (vs. whites) (HR: 2.69; 95% CI: 1.99-3.64). Identification of additional risk markers will require more detailed individual-level data; nonetheless, this study supports the generalizability of findings from smaller studies, provides broad guidance for allocating scarce resources, and suggests that interventions on root causes of violence disparities may have downstream effects on recurrence.
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Preventive medicine · Oct 2020
Are one-year changes in adherence to the 24-hour movement guidelines associated with flourishing among Canadian youth?
Movement behaviours (e.g., physical inactivity, short sleep duration, high screen time) are associated with mental illness but less is known about the relationship between health behaviours and positive mental health constructs such as flourishing. This study examines if changes in adherence to the Canadian 24-Hour Movement Behaviour Guidelines for Children and Youth (moderate-to-vigorous physical activity (MVPA), total screen time (ST), sleep) are associated with changes in youth flourishing over one year. Students (N = 2292) were recruited from 12 secondary schools in Canada participating in the COMPASS study. ⋯ Reducing ST was associated with higher flourishing for males only relative to other males who continued to exceed the ST guidelines (Est:2.23, SE:1.04, p < .03). Longer sleep duration had the most consistent association with greater flourishing among females (Est:1.02, SE:0.3, p < .001) and males (Est:0.93, SE:0.34, p < .006), highlighting sleep as a public health priority in the context of 24-hour movement behaviours. These findings contribute to increasing calls for research examining positive mental health constructs independent of mental illness.
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Preventive medicine · Oct 2020
Exposure to tobacco content in episodic programs and tobacco and E-cigarette initiation.
While prior research suggests a relationship between exposure to tobacco content in movies and smoking, less is known about the impact of exposure to tobacco through episodic programs. This study assessed the relationship between exposure to tobacco content in programs on Netflix and broadcast or cable TV and initiation of combustible tobacco or e-cigarette use among young people. A nationally representative, longitudinal sample (ages 15-21 at baseline) was surveyed about exposure to episodic programs previously analyzed for the presence of tobacco and subsequent use of combustible tobacco and e-cigarettes. ⋯ Results suggest exposure to tobacco in episodic programs may impact future e-cigarette use. Ongoing monitoring of the impact of tobacco content in episodic programs is needed as the number of available programs continues to increase. Findings highlight the need for policy and advocacy efforts to reduce young people's exposure to tobacco content across all media platforms.