Preventive medicine
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Preventive medicine · Dec 2020
Observational StudyLongitudinal effects of a nationwide lifestyle intervention program on cardiometabolic outcomes in Japan: An observational cohort study.
The Japanese government launched a nationwide health screening and lifestyle intervention program in 2008 to prevent and reduce metabolic syndrome in at-risk individuals. This study examined the longitudinal effects of the program's lifestyle interventions on metabolic outcomes using health insurance data from one prefecture. The study population comprised 16,317 individuals aged 40-74 years who met the recommendation criteria for the interventions between 2009 and 2015. ⋯ The aHRs (95%CI) for metabolic syndrome incidence were 0.84 (0.75-0.94), 0.80 (0.71-0.91), and 0.67 (0.51-0.89) for overall, motivational, and intensive interventions, respectively. The interventions reduced body mass index and waist circumference, but had modest effects on blood lipids, blood glucose, and hemoglobin A1c levels; blood pressure was unaffected. These interventions represent an effective strategy to prevent the progression of preclinical metabolic syndrome, but further studies are needed to evaluate their long-term preventive effects on cardiovascular disease and diabetes.
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Preventive medicine · Dec 2020
Correlates of school gun carrying among black, Hispanic, and white male adolescents: Evidence from a nationally representative sample of youth.
Previous studies have found that individual, environmental, geographic, and demographic factors correlate with adolescent gun carrying. Comparatively less research has focused on identifying correlates of adolescent gun carrying to schools. The current study examined whether previously identified factors associated with adolescent gun carrying similarly predict adolescent school gun carrying. ⋯ Future research should attempt to replicate these and other studies findings across diverse samples of adolescents and identify other potential correlates of adolescent school gun carrying not previously addressed. PUBLIC SIGNIFICANCE STATEMENT: Mental health, school-level, and geographic factors are associated with school guncarrying differentially across race and ethnicity. Programming efforts may benefit fromconsidering the influence of race/ethnicity on dynamic risk factors for school guncarrying when designing and implementing school safety measures.
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Preventive medicine · Dec 2020
Randomized Controlled TrialFit and strong! plus: Twelve and eighteen month follow-up results for a comparative effectiveness trial among overweight/obese older adults with osteoarthritis.
This comparative effectiveness trial compared the longer-term effectiveness (12 and 18 months) of the standard Fit & Strong! physical activity program to Fit & Strong. Plus, which combined physical activity and dietary weight loss. Outcomes were weight, diet quality, physical activity, osteoarthritis symptoms, performance measures, and anxiety/depression. ⋯ African American older adults in the F&S. Plus arm showed sustained modest improvements in weight, waist circumference, and lower extremity strength at 12 months and in lower extremity strength at 18 months compared to F&S!. Implications for the translation of evidence-based programs into community settings to support healthy behaviors in older adults are discussed.
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Preventive medicine · Dec 2020
ReviewSuicidal behaviors and ideation during emerging viral disease outbreaks before the COVID-19 pandemic: A systematic rapid review.
The current COVID-19 pandemic is the most severe pandemic of the 21st century, on track to having a rising death toll. Beyond causing respiratory distress, COVID-19 may also cause mortality by way of suicide. The pathways by which emerging viral disease outbreaks (EVDOs) and suicide are related are complex and not entirely understood. ⋯ Overall, we found scarce and weak evidence for an increased risk of deaths by suicide during EVDOs. Our results inform the need to orient public health policies toward suicide prevention strategies targeting the psychosocial effects of EVDOs. High-quality research on suicide risk and prevention are warranted during the current pandemic.
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Preventive medicine · Dec 2020
Private/marketplace insurance in community health centers 5 years post-affordable care act in medicaid expansion and non-expansion states.
Community health centers (CHCs) play an important role in providing care for the safety net population. After implementation of the Affordable Care Act, many patients gained insurance through state and federal marketplaces. Using electronic health record data from 702,663 patients in 257 clinics across 20 states, we sought to explore the following differences between Medicaid expansion and non-expansion state CHCs: (1) trends in private/marketplace insurance post-expansion, and (2) whether CHC patients retain private/marketplace insurance. ⋯ While a greater percentage of patients in non-expansion states retained private/marketplace insurance than in expansion states, a greater percentage of those who did not retain it became uninsured. In comparison, a greater percentage of patients in expansion states who lost private/marketplace insurance gained other types of health insurance. CHCs' ability to provide adequate care for vulnerable populations relies, in part, on federal grants as well as reimbursement from insurers: decreases in either could result in reduced capacity or quality of care for patients seen in CHCs.