Preventive medicine
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Preventive medicine · Feb 2020
Predictors of overall and test-specific colorectal Cancer screening adherence.
This study investigated predictors of overall and test-specific colorectal cancer screening (CRCS). Stool blood test (SBT) and/or colonoscopy screening were offered to primary care patients in two randomized controlled trials which assessed the impact of behavioral interventions on screening. Data were obtained through surveys and electronic medical records. ⋯ Intervention exposure, sociodemographic background, and screening decision stage predicted overall CRCS adherence. Gender and test preference also affected test-specific screening adherence. Interactions involving race and test preference suggest that it is important to provide both colonoscopy and SBT screening options to patients, particularly African Americans.
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Preventive medicine · Feb 2020
Evaluation of a pragmatic trial of a collaborative school-based obesity prevention intervention in a low-income urban district.
Broader adoption of effective school-based obesity prevention interventions is critical to the success of ongoing efforts to address the childhood obesity epidemic. School-level barriers to adopting evidence-based interventions may be overcome by empowering school-level leaders to select appropriate intervention components. We used a quasi-experimental pragmatic trial design to evaluate a tailored obesity prevention intervention in 9 schools in a mid-sized urban school district in upstate New York from fall 2013 to spring 2016. ⋯ The intervention led to a change of -0.27 (p = 0.026, 95% Confidence Interval (CI): -0.51, -0.03) and -0.28 (p = 0.031, 95% CI: -0.54, -0.03) BMI units in spring 2014 and fall 2014, respectively. There were no significant differences between intervention and control from spring 2015 to spring 2016. Despite the lack of sustained effects on BMI, we demonstrated the potential of supporting school leaders in a low-income district to implement supportive policy and practice changes and of using an existing BMI screening system to reduce the burden of health promotion evaluation.
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Preventive medicine · Feb 2020
A nationwide investigation of the impact of the tipped worker subminimum wage on infant size for gestational age.
Tipped workers, primarily women of reproductive-age, can be paid a "subminimum wage" 71% lower than the federal minimum wage. We estimated the effects of increasing the state-level tipped worker subminimum wage (federally, $2.13 per hour) on infant size for gestational age in the US as infants born small or large are at risk for poor health across the lifecourse. Utilizing unconditional quantile regression and difference-in-differences analysis of data from 2004 to 2016 Vital Statistics Natality Files (N = 41,219,953 mother-infant dyads), linked to state-level wage laws, census, and antipoverty policy data, we estimated the effect of increasing the subminimum wage on birthweight standardized for gestational age (BWz). ⋯ Increases in the subminimum wage affected the BWz distribution. When compared to a static wage of $2.13 for the duration of the study period, wage set to 100% of the federal minimum ($5.15-$7.25) was associated with an increase in BWz of 0.024 (95% CI: 0.004, 0.045) for the smallest infants and a decrease by 0.041 (95% CI: -0.054, -0.029) for the largest infants. Increasing the subminimum wage may be one strategy to promote healthier birthweight in infants.
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Preventive medicine · Feb 2020
Associations of sedentary behavior in leisure and occupational contexts with symptoms of depression and anxiety.
Sedentary behaviors (SB) can be associated with poorer mental health, but it remains unclear whether contexts for these behaviors may be important. We assessed relationships of SB in leisure-time and occupational contexts with frequent symptoms of depression and anxiety. Data originate from the Swedish Health Profile Assessment (HPA) database, a health assessment offered to employees working for companies or organizations connected to healthcare services. ⋯ Associations of 'overall' SB with depression/anxiety symptoms mirrored the dose-response relationship for leisure-time SB. Exercise frequency attenuated the association for leisure-time SB only, but it remained statistically significant. Adults who spend ≥50% of their leisure-time in sedentary pursuits experience more frequent symptoms of depression and anxiety, compared to those who are less sedentary in that context.