Preventive medicine
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Preventive medicine · Oct 2022
Student tobacco use, secondhand smoke exposure, and policy beliefs before and after implementation of a tobacco-free campus policy: Analysis of five U.S. college and university campuses.
The adoption of comprehensive tobacco policies by colleges and universities may help reduce student tobacco use. To this end, The American Cancer Society's Tobacco-Free Generation Campus Initiative (TFGCI) awarded grants to 106 higher learning institutions to adopt 100% tobacco-free campus policies. This study measured changes in student tobacco use, reported exposure to secondhand smoke, and support for types of tobacco policies among five TFGCI grantee institutions who implemented 100% tobacco-free policies. ⋯ Tobacco-free campus policies can be associated with decreases in tobacco product use and environmental smoke exposure. The extent of their effectiveness may vary by product and the inclusion of tailored messaging, cessation support, and enforcement approaches. To discourage use of these products among students, colleges and universities should adopt 100% tobacco-free policies, monitor product use trends, offer cessation support and messaging customized for specific groups and products, and utilize a comprehensive enforcement strategy.
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Preventive medicine · Oct 2022
ReviewCan positive psychological interventions improve health behaviors? A systematic review of the literature.
Positive psychological interventions (PPIs), which aim to cultivate psychological well-being, have the potential to improve health behavior adherence. This systematic review summarized the existing literature on PPI studies with a health behavior outcome to examine study methodology, quality, and efficacy. Of the 27 identified studies, 20 measured physical activity, eight measured medication adherence, seven measured diet, and three measured smoking (eight targeted multiple behaviors). ⋯ In summary, PPIs are being increasingly studied as a strategy to enhance health behavior adherence. The existing literature is limited by small sample size, low study quality and inconsistent intervention content and outcome measurement. Future research should establish the most effective components of PPIs that can be tailored to different populations, use objective health behavior measurement, and robustly examine the effects of PPIs on health behaviors in fully powered RCTs.
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Preventive medicine · Oct 2022
Expanding COVID-19 vaccine access to underserved populations through implementation of mobile vaccination units.
COVID-19 has disproportionately impacted underserved populations, including racial/ethnic minorities. Prior studies have demonstrated that mobile health units are effective at expanding preventive services for hard-to-reach populations, but this has not been studied in the context of COVID-19 vaccination. Our objective was to determine if voluntary participants who access mobile COVID-19 vaccination units are more likely to be racial/ethnic minorities and adolescents compared with the general vaccinated population. ⋯ The median (IQR) age of participants was 31 (16-46) years, 1016 (51%) were female, 1575 (80%) were non-White, and 1126 (57%) were Hispanic. Participants in the mobile vaccination units were more likely to be younger (p < 0.001), non-White race (p < 0.001), and Hispanic ethnicity (p < 0.001) compared with the general vaccinated population of the state and target communities. This study suggests that mobile vaccination units have the potential to improve access to COVID-19 vaccination for diverse populations.
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Preventive medicine · Oct 2022
ReviewPrecision health in behaviour change interventions: A scoping review.
Precision health seeks to optimise behavioural interventions by delivering personalised support to those in need, when and where they need it. Conceptualised a decade ago, progress toward this vision of personally relevant and effective population-wide interventions continues to evolve. This scoping review aimed to map the state of precision health behaviour change intervention research. ⋯ Data was mostly behavioural or lifestyle (20/31, 65%), and physiologic, biochemical or clinical (15/31, 48%), with no studies utilising genetic/genomic data. This review demonstrated that precision health behaviour change interventions remain dependent on human-led, low-tech personalisation, and have not fully considered the interaction between behaviour and the social and environmental contexts of individuals. Further research is needed to understand the relationship between personalisation and intervention effectiveness, working toward the development of sophisticated and scalable behaviour change interventions that have tangible public health impact.
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Preventive medicine · Oct 2022
ReviewThe cognitive dissonance discourse of evolving terminology from colonial medicine to global health and inaction towards equity - A Preventive Medicine Golden Jubilee Article.
We discuss the evolution of terminology, beginning with colonial medicine and ending with global health. We describe how global health's definition evolved to include language on autonomy, power, and health equity. Specifically, we studied the websites of the twenty-five‑leading national (N = 5), multilateral (N = 5), philanthropic (N = 5), non-governmental organizations (N = 5) in research, health service delivery, and advocacy, and academic institutions (N = 5) within global health to understand their history, places of critical operations, budget, organizational structure, leadership, mission, policies, and representation of the global south. ⋯ We underscore that the epistemological-praxis disconnect creates organizational psychology akin to cognitive dissonance within individuals, particularly among practitioners from the global south. This dissonance perpetuates inequity across global health organizations uniquely structurally impedes decolonization by and in the institutions that promote global health, and undermines the achievement of current goals across the global health system. To truly decolonize global health, researchers must measure and study changes in how organizations operationalize their goals, structures, policies, and administrative processes to address equity and social justice across all sectors of the global health system.