Preventive medicine
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Preventive medicine · Nov 2022
Limits of prenatal care coordination for improving birth outcomes among Medicaid participants.
Maternity Care Homes (MCHs) intend to address clinical and psychosocial needs for perinatal patients and are commonly implemented for Medicaid beneficiaries. Rigorous evidence supporting MCHs' effectiveness for improving birth outcomes is thin, but most studies consider only clinical and demographic factors from administrative data. To assess birth outcomes with controls for psychosocial variables known to affect them, this paper considers quantitative participant-level data from the Strong Start for Mothers and Newborns prenatal care initiative, with qualitative case study data to further contextualize results. ⋯ In group prenatal care, White participants showed lower rates of preterm birth (p < .01) and Black participants showed lower rates of low birthweight (p < .05) relative to MCH participants. Strong Start participants reported appreciation for MCH care managers' support, but community and clinical referrals often had long waiting lists or were inaccessible. Transformative care models focusing on provider continuity, relationship building, and patient activation may offer more promise for improving birth outcomes than supplementing medical models with care management and other resources.
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Preventive medicine · Nov 2022
Curiosity, use, and perceptions of "tobacco-free nicotine" E-cigarettes among U.S. young adults.
This study determined whether young adults perceptions of how tobacco free nicotine (TFN) compared to tobacco-derived nicotine (TDN) were associated with curiosity to try or use TFN e-cigarettes. U. S. young adults aged 18-25 years (n = 1176) completed an online survey in October 2021. ⋯ Adjusted models did not show differences in perceptions between those who had tried TFN and those who were curious to try TFN. Young adults who were curious to try or had used TFN had more positive perceptions of TFN. As it is currently unclear whether synthetic nicotine carries the same health risks as TDN, ongoing surveillance of TFN uptake among young adults is warranted.
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Preventive medicine · Nov 2022
The role of housing characteristics in racial and ethnic disparities in SARS-CoV-2 antibody seropositivity among New York City adults: A population representative study.
Black and Latino populations have been disproportionately burdened by COVID-19 morbidity and mortality. Subsidized housing, crowding, and neighborhood poverty might be associated with increased COVID-19 transmission and play a role in observed racial and ethnic disparities, yet research is limited. Our study investigated whether these housing variables mediate the relationship between race and ethnicity and SARS-CoV-2 antibody seropositivity among New York City (NYC) adults. ⋯ While living in crowded housing and high-poverty neighborhoods contributed to racial and ethnic disparities in seropositivity the estimated contribution from living in subsidized housing was -9% (Black) and - 14% (Latino). Our findings revealed racial and ethnic disparities in seropositivity of SARS-CoV-2 antibodies among NYC adults. Unlike crowding and neighborhood poverty, living in subsidized housing did not explain racial and ethnic disparities in COVID-19.
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Preventive medicine · Nov 2022
Home e-cigarette rules and youth's vulnerability to initiate and sustain e-cigarette use.
Existing studies of the impact of home rules on youth's vulnerability to e-cigarette use were based on cross-sectional data, youth or parent reports alone, as well as youth's perceptions and susceptibility. This study capitalizes on the restricted-use data of the Population Assessment of Tobacco and Health (PATH) Study to examine the longitudinal association between home rules for e-cigarette use and youth's vulnerability including initiation of use and regular use two years later. Secondary analysis was conducted on 1203 parent-youth pairs who participated in both Wave 4 (2016-2018) and Wave 5 (2018-2019) assessment of the PATH Study and while the youth were age 12-16 at Wave 4. ⋯ The results show that having a strict home rule for e-cigarette use was associated with youth's heightened level of perceived injunctive norms (β = 0.22, p < 0.01), higher expectancy of harmfulness (β = 0.28, p < 0.01) and lower odds for regular e-cigarette use (OR = 0.36, p < 0.05). In conclusion, the findings of this study support the potential protective effects of implementing a strict home rule for e-cigarette use. Future intervention efforts may promote parents' awareness of the potential protective effects of a strict home e-cigarette rule on youth's normative belief, harm expectancy, and behavior of e-cigarette use.
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Preventive medicine · Nov 2022
Physical inactivity amplifies the negative association between sleep quality and depressive symptoms.
Poor sleep quality and physical inactivity are known risk factors for depressive symptoms. Yet, whether these factors differently contribute to depressive symptoms and whether they interact with one another remains unclear. Here, we examined how sleep quality and physical activity influence depressive symptoms in 79,274 adults 50 years of age or older (52.4% women) from the Survey of Health, Aging and Retirement in Europe (SHARE) study. ⋯ The negative association between poor sleep quality and higher depressive symptoms was stronger in physically inactive than active participants. These findings suggest that, in adults 50 years of age or older, both poor sleep quality and physical inactivity are related to an increase in depressive symptoms. Moreover, the detrimental association between poor sleep quality and depressive symptoms is amplified in physically inactive individuals.