Preventive medicine
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Preventive medicine · Jan 2022
Public support for U.S. social safety net policies throughout the COVID-19 pandemic.
COVID-19 has stretched the U. S. social safety net and prompted federal legislation designed to ameliorate the pandemic's health and economic impacts. We surveyed a nationally representative cohort of 1222 U. ⋯ Declines in support for these two policies were concentrated among those with higher incomes, more education, in better health status, the employed, and those with health insurance. The share of respondents believing in a strong role of government also declined from 33% in April to 26% in November 2020 (p > 0.05). Despite these shifts, we observed consistent majority support for several policies enacted during the pandemic, including guaranteeing paid sick leave and business tax credits, as well as employment-related policies.
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Preventive medicine · Jan 2022
ReviewReducing lifestyle risk behaviours in disadvantaged groups in high-income countries: A scoping review of systematic reviews.
High prevalence of risk behaviours may exacerbate existing poor health in disadvantaged groups. We aimed to identify and bring together systematic reviews with a focus on reducing risk behaviours in disadvantaged groups and highlight where evidence is lacking. We searched MEDLINE and Embase up to October 2020, with supplementary searching in Epistemonikos and Health Systems Evidence. ⋯ Few reviews targeted alcohol use. There was limited evidence on barriers and facilitators to behaviour change. This suggests there is insufficient evidence to inform policy and practice and new reviews or primary studies may be required.
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Preventive medicine · Jan 2022
Associations between severe food insecurity and disordered eating behaviors from adolescence to young adulthood: Findings from a 10-year longitudinal study.
Emerging evidence suggests a cross-sectional association between food insecurity (FI) and disordered eating among adults, while evidence among adolescents is limited. Longitudinal research is needed to elucidate the temporality of this relationship and clarify whether the association differs by age. Three waves of prospective data came from 1813 participants in the Project EAT (Eating and Activity in Teens and Young Adults) cohort study. ⋯ Longitudinally, severe FI significantly predicted 1.41 (95% CI: 1.05-1.90) times greater prevalence of binge eating five years later after accounting for prior binge eating. Effect modification by age indicated a stronger cross-sectional association between severe FI and unhealthy weight-control behaviors among younger participants. Results support a cross-sectional link between severe FI and disordered eating and provide longitudinal evidence suggesting severe FI is a risk factor for binge eating.
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Preventive medicine · Jan 2022
ReviewComparative assessment of test characteristics of cervical cancer screening methods for implementation in low-resource settings.
Cervical cancer disproportionately affects low-resource settings. Papanicolaou, human papillomavirus (HPV), and visual inspection of cervix with acetic acid (VIA) testing, each with different characteristics, will reduce cervical cancer burden. We conducted a critical literature review using PubMed, Cochrane, WHO, and grey literature from 1994 to 2020. ⋯ Affordable smartphones eliminate this barrier, enhance training through mentorship, and advance continuing education and peer-to-peer training. Smartphone-based VIA facilitates cervical image storage for patient education, health promotion, record-keeping, follow-up care, remote expert support, and quality control to improve VIA reliability and reproducibility and reduce mis-diagnoses and burden to health systems. Rather than ranking screening methods using test characteristics alone in study or higher-resource settings, we advocate for scalable strategies that maximize reliability and access and reduce cost and human resources.
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Preventive medicine · Jan 2022
Can internet use reduce the incidence of cognitive impairment? Analysis of the EpiFloripa Aging Cohort Study (2009-2019).
This study aims to estimate the effect of internet use on the incidence of cognitive impairment in older adults. Data are from the EpiFloripa Aging Cohort Study which has been following a population-based sample of older adults (60+) residing in Florianópolis, southern Brazil, for ten years. The outcome was the incidence of cognitive decline in follow-up waves measured by the Mini-Mental State Examination using cutoff points according to education. ⋯ Despite the aging of this cohort, the prevalence of internet users increased from 26.4% in Wave 1 to 32.8% in Wave 2 and 46.8% in Wave 3. The risk of cognitive impairment in Wave 2 or Wave 3 was 70% lower for older adults who used the internet in the previous wave, adjusted for sex, age, years of education, household income, and self-reported comorbidities (IRR = 0.30; 95% CI: 0.15-0.61; p = 0.001). Internet use was associated with a decline in the incidence of cognitive impairment among older adults living in the urban areas of southern Brazil after a period of ten years.