Preventive medicine
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Preventive medicine · Dec 2022
Economic analysis of financial incentives for smoking cessation during pregnancy and postpartum.
Higgins and colleagues' recently-completed randomized controlled trial and pooled data with 4 related trials of smoking cessation in pregnant women in Vermont (USA) showed that abstinence-contingent financial incentives (FI) increased abstinence over control conditions from early pregnancy through 24-weeks postpartum. Control conditions were best practices (BP) alone in the recent trial and payments provided independent of smoking status (noncontingently) in the others. This paper reports economic analyses of abstinence-contingent FI. ⋯ Each dollar invested in abstinence-contingent FI over control smoking-cessation programs yielded $4.20 in economic benefits in the recent trial and $11.90 in the pooled trials (very favorable benefit-cost ratios). Medicaid and commercial insurers may wish to consider covering financial incentives for smoking abstinence as a cost-effective service for pregnant beneficiaries who smoke. Trial Registration: ClinicalTrials.gov identifier: NCT02210832.
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Preventive medicine · Dec 2022
Reimagining public safety: Public opinion on police reform and gun violence prevention by race and gun ownership in the United States.
Inequitable experiences of community gun violence and victimization by police use of force led to nationwide calls to "reimagine public safety" in 2020. In January 2021, we examined public support among U. S. adults for 7 policy approaches to reforming policing and investing in community gun violence prevention. ⋯ Gun owners overall reported lower support for public safety reforms and investments than respondents who did not own guns, but this distinction was found to be driven by White gun owners. The views of Black gun owners were indistinguishable from Black non-owners and were similar to White non-owners on most issues. These findings suggest that broad public support exists for innovative violence reduction strategies and public safety reforms.
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Preventive medicine · Dec 2022
Firearm safety counseling among caregivers of high-school age teens: Results from a National Survey.
Firearms are the leading cause of death for high-school age teens. To inform prevention efforts, we characterize the prevalence of healthcare provider (HCP) counseling of caregivers of teens around firearm safety, safety conversation elements, and caregiver receptivity towards counseling. A cross-sectional web survey (6/24/2020-7/22/2020) was conducted among caregivers (n = 2924) of teens (age:14-18). ⋯ Caregivers of teens with prior firearm safety training (aOR = 0.50;95%CI = 0.31-0.80) were less likely to agree that firearm safety was an important preventative health topic. In conclusion, few caregivers receive preventive counseling on firearm safety from their teen's HCP, with trust a key barrier to effective intervention delivery. Future research, in addition to understanding barriers and establishing effective strategies to increase safety practices, should focus on increasing provider counseling competency.
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Preventive medicine · Dec 2022
Effects of building demolitions on firearm violence in Detroit, Michigan.
Former industrial cities facing economic challenges and depopulation often experience high levels of firearm and other forms of violence. Within these cities, violent crime often clusters in neighborhoods affected by high levels of vacant and abandoned housing. This study estimates the effects of building demolition in Detroit, Michigan on the subsequent risk of violent crime using property-level data and longitudinal targeted maximum likelihood estimation. ⋯ Estimates suggest the risk for all crime types tested would have been statistically indistinguishable from the observed crime risk had demolitions in the prior 1-3 quarters of 2017 not occurred. Our results run counter to most previous research on this topic, which tends to show a protective effect of demolition on violent crime. Understanding why our results differ may provide important insights into the types of demolition programs with the greatest potential to reduce violent crime.
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Preventive medicine · Dec 2022
Extreme risk protection orders, race/ethnicity, and equity: Evidence from California.
Extreme risk protection orders (ERPOs) provide a civil mechanism to temporarily remove firearm access from individuals at high risk of harming themselves or others. Evidence and theory suggest that ERPOs can prevent firearm-related harm, but the policy's impact on racial/ethnic equity is largely unknown. To examine potential inequities by race/ethnicity in public perceptions and use of California's ERPO law, we drew on two complementary data sources: 1) a 2020 state-representative survey of California adults, and 2) ERPO court documents for the first 3 years of policy implementation (2016-2018). ⋯ Similarly, review of ERPO court documents revealed that no family or household members served as petitioners for Black and Hispanic/Latinx ERPO respondents. Additionally, Black respondents were the least likely to have documented access to a firearm and legal representation in court. Racial/ethnic equity in ERPO use may be improved by reducing barriers to petitioning, incorporating non-law enforcement intervention professionals like behavioral health specialists into the ERPO process, providing legal assistance to respondents and petitioners, and investing in the social safety net.