Preventive medicine
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Preventive medicine · May 2022
Self-perception of health and physical activity among adults before and amidst the COVID-19 pandemic: United States, 2019-2020.
The compounded impact of the COVID-19 lockdowns on self-perception of health (SPoH) and physical activity (PA) levels among U. S. adults remains to be explored. We sought to: (1) describe the SPoH and PA levels among U. ⋯ Negative SPoH were associated with lack of moderate exercise, and lack of muscle-strengthening training among U. S. adults before and amidst the pandemic. Pandemic policies and recommendations should include and facilitate PA, specifically among vulnerable populations.
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Preventive medicine · May 2022
Randomized Controlled TrialA multilevel, low literacy dual language intervention to promote colorectal cancer screening in community clinics in Florida: A randomized controlled trial.
One of the largest disparities in cancer mortality in the United States occurs with colorectal cancer (CRC). The objectives of this multilevel two-arm intervention trial were to compare the efficacy of two interventions to promote CRC screening (CRCS) with fecal immunochemical test (FIT) and examine sociodemographic and psychosocial predictors of FIT screening. Individuals ages 50-75 (n = 326) who were not up-to-date with CRCS, could understand English or Spanish, and were at average CRC risk were recruited from two federally qualified health centers (FQHCs) in Florida. ⋯ Multilevel approaches that include EMR prompts, reminders, FIT access, and provision of low-literacy, language-concordant education can support efforts to improved community clinics' CRCS rates. Future efforts should focus on repeat FIT screening. Trial registration: The trial was registered at ClinicalTrials.gov (NCT03906110).
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Preventive medicine · May 2022
Dietary patterns, genetic risk, and incidence of obesity: Application of reduced rank regression in 11,735 adults from the UK Biobank study.
Few studies have derived dietary patterns based on intake of discretionary foods and beverages and examined associations with genetic risk and obesity. We examined associations between dietary patterns based on discretionary foods, saturated fatty acids (SFA), and fiber, with a polygenetic risk score (PRS) for obesity and risk of overall obesity, central obesity and high body fat (BF) up to 9.7 years later. Data from 11,735 adults from the UK Biobank cohort study were used. ⋯ DP3, correlated positively with SFA and fiber, inversely with discretionary foods, was associated with lower risk of central obesity (hazard ratio: 0.92; 95% confidence interval: 0.87, 0.98). There was limited evidence of interactions with PRS. A dietary pattern high in high-SFA and low-fiber discretionary foods and beverages was associated with higher risk of obesity, independent of genetic predisposition.
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Preventive medicine · May 2022
Missed routine pediatric care and vaccinations in US children during the first year of the COVID-19 pandemic.
The COVID-19 pandemic has decreased uptake of pediatric preventive care, including immunizations. We estimate the prevalence of missed pediatric routine medical visits and vaccinations over the first year of the COVID-19 pandemic. We conducted a cross-sectional online survey of 2074 US parents of children ≤12 years in March 2021 to measure the proportion of children who missed pediatric care and vaccinations over the first 12 months of the COVID-19 pandemic. ⋯ Compared to the 2019-20 flu season, pediatric influenza vaccination decreased in 2020-21 (51.3% vs. 62.2%; p < 0.0001). A high proportion of US children ≤12 years missed routine pediatric care during the COVID-19 pandemic. Catch-up efforts are needed to ensure continuity of preventive care for all children.
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Preventive medicine · May 2022
Randomized Controlled TrialThe association between the obesogenic environment and 6-month and 24-month weight change in a rural weight loss intervention trial in the United States.
The unique obesogenic environment may influence the ability to effectively maintain weight loss in rural areas. The aim of this study was to examine the contextual relationship of neighborhood disadvantage, distance to supermarkets and supercenters, and fast food, dollar store, and exercise facility environments on weight loss following a weight-loss intervention in the United States. This analysis (n = 1177) linked weight loss outcomes from a rural, primary care-based randomized controlled trial to contextual data collected from residential addresses. ⋯ Contextual variables were not significantly related to percent weight loss overall across treatment arms. Participants living in a 5-mile buffer to dollar stores experienced approximately a 2% (p < 0.05) lower weight loss, but only in the least effective counseling arm (individual clinic visits), while controlling for both individual and contextual factors. Our results suggest that specific contextual variables in rural populations may play an important role in moderating weight loss outcomes especially under the conditions of less effective interventions.