Preventive medicine
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Preventive medicine · Jun 2022
Randomized Controlled TrialOutreach to primary care patients in lung cancer screening: A randomized controlled trial.
Current guidelines recommend annual lung cancer screening (LCS), but rates are low. The current study evaluated strategies to increase LCS. This study was a randomized controlled trial designed to evaluate the effects of patient outreach and shared decision making (SDM) about LCS among patients in four primary care practices. ⋯ We observed a similar trend for appointment keeping, but the effect was not statistically significant (86% v. 76%; OR = 1.93; p = 0.351). Outreach contacts significantly increased LCS among primary care patients. Research is needed to assess the additional value of SDM on screening uptake.
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Preventive medicine · Jun 2022
Preventive care use among Hispanic adults with limited comfort speaking English: An analysis of the medical expenditure panel survey data.
Language barriers have been associated with worse access to healthcare and poorer health outcomes. To assess differences in access to care and utilization of healthcare services between Hispanic adults and non-Hispanic white adults (NHW), we used the Medical Expenditure Panel Survey (2013-2016) to compare Hispanic adults who expressed limited comfort speaking in English (LCE) with Hispanic adults who were comfortable speaking in English (CE) and NHW adults. Hispanic adults with CE were less likely than NHW adults to have a usual source of care, use preventive services, including cervical cancer screening, and healthcare services. ⋯ After adjustment, use of all cancer screening tests were similar. Eliminating disparities for Hispanic adults will require a multi-pronged approach to address access to healthcare and other social determinants of health, including poverty, employment discrimination, and educational inequities. The public health community can help improve health literacy, address barriers to care, and provide appropriate language assistance at point of care using culturally-competent means to promote greater utilization of preventive services, including demand for and delivery of cancer screenings.
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Preventive medicine · Jun 2022
Differential trends in US suicide rates, 1999-2020: Emerging racial and ethnic disparities.
Suicide is an important cause of mortality in the United States. This study aimed to examine US suicide trends by race and ethnicity from 1999 to 2020. Publicly available de-identified data were extracted from the CDC's Wide-ranging Online Data for Epidemiologic Research. ⋯ Based on suicide mechanism, recent trends have increased by firearm (APC = 1.7; 95% CI: 1.5, 2.0) and suffocation (APC = 3.8; 95% CI: 3.5, 4.1), decreased by drug poisoning (APC = -2.9; 95% CI: -3.9, -1.9), and stabilized by non-drug poisoning (APC = 0.6; 95% CI: -2.4, 3.7). Racial and ethnic disparities exist in suicide trends in the United States. Further research to identify individual and contextual factors for the differences may guide effective public health intervention efforts.
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Preventive medicine · Jun 2022
Review Meta AnalysisPsychological violence in dating relationships among adolescents: A systematic review and meta-analysis of prevention programs.
Teen Psychological Dating Violence (TPDV) is a serious public health concern. However, there is limited evidence on the capacity of programs to prevent this form of violence. This study aimed to conduct a systematic review and meta-analysis of RCTs to evaluate the efficacy of prevention programs for TPDV. ⋯ Significant differences in effect sizes were also associated with the type of scale used to assess TPDV. Current evidence suggests that intervention programs for TPDV may be effective, particularly when implemented at multiple levels. Further research focusing on refining tools to assess TPDV is needed.
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Preventive medicine · Jun 2022
ReviewA systematic review of the evidence on the effect of parental communication about health and health behaviours on children's health and wellbeing.
Parents report feeling unsure how best to talk with their children about sensitive health topics and may avoid such conversations; yet if children have questions or concerns about their health, talking to a parent could enhance their health and wellbeing. We investigated the effects of parental communications about health and health behaviours on children's health and wellbeing, and explored what strategies can encourage parents to communicate about health. We conducted a systematic review and narrative synthesis of research published between January 2008 and April 2020 from five databases. ⋯ No differences in outcomes were found according to child's gender or socio-economic status. Generally, parents were less confident in initiating, rather than continuing, conversations and were more likely to initiate conversations when they felt they had good topic knowledge. While the relatively small, diverse sample limits the strength of these findings, this review provides provisional support for approaches to promote positive parent-child communication about health that are associated with better child health and wellbeing.