Preventive medicine
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Preventive medicine · Jan 2021
Disentangling individual, school, and neighborhood effects on screen time among adolescents and young adults in the United States.
To examine the association between individual, neighborhood, and school-level influences on individual screen time among adolescents and young adults (AYAs) in the National Longitudinal Study of Adolescent to Adult Health. ⋯ We found that individual-level factors most influence youth screen time, with smaller contributions from school factors.
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Preventive medicine · Jan 2021
Randomized Controlled TrialGiven a choice between self-sampling at home for HPV testing and standard of care screening at the clinic, what do African American women choose? Findings from a group randomized controlled trial.
The goals of this study were to: (1) evaluate adherence to cervical cancer screening using a patient-centered approach that provided a choice of self-sampling at home for human papillomavirus (HPV) testing or standard of care screening at the local health department ('Choice') versus only standard of care screening at the local health department ('SCS') among un/under-screened African-American women; and (2) examine whether women given a choice were more likely to choose and adhere to self-sampling for HPV testing. We conducted a group randomized trial among un/under-screened African-American women in the Mississippi Delta, with "town" as the unit of randomization (12 towns). Both interventions (i.e., 'Choice' versus 'SCS') were delivered by Community Health Workers (CHWs) through a door-to-door approach. ⋯ Women in the 'Choice' arm were significantly more likely to choose (76%) and adhere to self-sampling at home for HPV testing (48% adherence) compared to standard of care screening at the local health department (7.5% adherence). A theory-driven, CHW-led intervention can effectively promote cervical cancer screening among un/under-screened African-American women in a rural setting when women are provided with a choice between two screening modalities. Clinical Trials Registration: NCT03713710.
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Preventive medicine · Jan 2021
ReviewPrimary care prevention of cardiovascular risk behaviors in adolescents: A systematic review.
Adolescence is associated with behavioral changes offering opportunities for prevention of cardiovascular risk behaviors. Primary care physicians are ideally placed to deliver preventive interventions to adolescents. The objective was to systematically review the evidence about effectiveness of primary care-led interventions addressing the main cardiovascular risk behaviors in adolescents: physical activity, sedentary behaviors, diet and smoking. ⋯ Risk of bias was mostly unclear for most studies. There is little evidence for specific interventions on adolescents' cardiovascular risk behaviors in primary care, mainly due to studies' methodological limitations. Further research should investigate the effectiveness of opportunistic primary care-based interventions as compared to more complex interventions, and address the methodological shortcomings identified in this review.
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Preventive medicine · Jan 2021
Effects of e-cigarette use on cigarette smoking among U.S. youth, 2004-2018.
To determine if the declining trend in U.S. youth cigarette smoking changed after e-cigarettes were introduced, and if youth e-cigarette users would have been likely to smoke cigarettes based on psychosocial and demographic predictors of smoking. ⋯ The introduction of e-cigarettes was followed by a slowing decline in current cigarette smoking, a stall in combined cigarette and e-cigarette use, and an accelerated decline in ever cigarette smoking. Traditional psychosocial risk factors for cigarette smoking suggest that e-cigarette users do not fit the traditional risk profile of cigarette smokers.
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Preventive medicine · Jan 2021
The effect of interpersonal communication in tobacco control campaigns: A longitudinal mediation analysis of a Ghanaian adolescent population.
This study examined the effectiveness of anti-smoking messages in positively shifting perceptions of risks related to smoking among adolescents in urban Ghana, both directly through exposure to messaging and indirectly through catalyzing discussions among peers and adults. We used data from two waves of a population-based survey of 3775 adolescent girls and 3279 adolescent boys aged 13-16 years in the urban areas of Accra, Teshie, Kumasi and Sunyani in Ghana. Using an interviewer-directed questionnaire, information was collected on sociodemographic characteristics, tobacco knowledge, exposure to messages about tobacco, frequency of conversations with peers and adults about the health risks associated with smoking, as well as beliefs and attitudes towards smoking. ⋯ Conversations with adults were never found to significantly mediate smoking prevention campaigns effects in this sample of Ghanaian adolescents. Behavior change communication programs that rely solely on traditional mass media can miss important opportunities for shifting smoking risk perceptions and sharing information on the harms of smoking. Evaluations that ignore the indirect effects of conversations among peers mediating campaign effects may fail to identify important channels that can be targeted and triggered by mass and social media tobacco control campaigns.