Preventive medicine
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Preventive medicine · Sep 2022
US Mass public shootings since Columbine: victims per incident by race and ethnicity of the perpetrator.
White individuals in the United States (US) have historically had disproportionate access to firearms. The real-life availability of firearms, including those most lethal, may still be greater among White populations, manifesting in the number of victims in shootings. We compared the severity of US mass public shootings since Columbine by race and/or ethnicity of the perpetrator using The Violence Project Database of Mass Shooters, assessing fatalities (minimum four), total victims, type, and legal status of guns used. ⋯ White shooters were overrepresented in mass public shootings with the most victims, typically involving legally owned assault rifles. To better understand the consequences when firearms are readily available, including assault rifles, we need a database of all US gun violence. Our assessment of total victims beyond fatalities emphasizes the large number of US gun violence survivors and the need to understand their experiences to capture the full impact of gun violence.
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Preventive medicine · Sep 2022
Factors associated with unvaccinated caregivers who plan to vaccinate their children.
Vaccine hesitancy is complex and a threat to global public health during the ongoing COVID-19 pandemic. Our objective was to determine factors associated with caregivers' willingness to vaccinate children despite not being immunized themselves against COVID-19. The International COVID-19 Parental Attitude Study (COVIPAS), a multinational cohort study, recruited caregivers of children 0-18 years old in 21 Emergency Departments (EDs) in USA, Canada, Israel, and Switzerland during November-December 2021. ⋯ Unvaccinated caregivers with children that had their childhood vaccines up-to-date (OR 3.03 (1.36, 8.09), p = 0.01), and those very worried their child has COVID-19 in the ED (OR 3.11 (1.44, 6.34), p < 0.01) were much more likely to plan to immunize their children. Primary care providers and public health agencies should not assume that unvaccinated parents will not vaccinate their children. Determining child's vaccination status and parental level of concern about COVID-19 may help identify caregivers who are open to give their children the vaccine.
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Preventive medicine · Sep 2022
Perceived mental health impacts of the COVID-19 pandemic: The roles of social support and social engagement for working age adults in the United States.
In this paper we assess if two protective mechanisms for mental health - social support and social engagement - are associated with lower risk of reporting worsening mental health as a result of the pandemic. Using a demographically representative sample of working age adults in the United States (N = 4014) collected in February and March of 2021, we use logistic regression models to predict self-reported worsening mental health as a result of the pandemic using social support - measured as instrumental and emotional support - and social engagement. We use additional stratified models to determine if these relationships are consistent across rural-urban areas. ⋯ However, among rural working age adults, only emotional support and high levels of instrumental support were significantly associated with lower odds of worsening mental health. Findings suggest that while emotional support may be effective for working age adults in lowering risk of worsening mental health from the pandemic, social engagement may not be for rural residents. The results support use of mental health promotion and prevention approaches that bolster emotional support through familial and local social networks, and raises caution about the efficacy of social engagement approaches in rural contexts.
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Preventive medicine · Sep 2022
Modelling cost-effective strategies for minimising socioeconomic inequalities in colorectal cancer screening outcomes in England.
Colorectal cancer (CRC) incidence and mortality is higher in socioeconomically deprived groups for a variety of reasons, but is exacerbated by poorer screening uptake. However, many strategies for improving screening participation exist. This analysis aimed to model the impact of screening on CRC inequalities in England and then compare different strategies for increasing participation, to determine the most cost-effective methods for reducing screening-induced inequalities. ⋯ Annual re-invitation of non-participants was most cost-effective for promoting particiption (incremental cost-effectiveness ratio = £4404 per quality-adjusted life-year), reducing CRC mortality (11,129 deaths averted), and reducing screening-induced inequality (slope of inequalities reduced from 20.80 to 19.38), although it required 42% more screening kits to be sent out. Other strategies were cost-effective compared with screening alone, and improved CRC outcomes, but had varying impacts on inequalities. Whilst bowel cancer screening increases socioeconomic inequalities in CRC mortality, effective and cost-effective strategies are available for mitigating screening-induced inequalities.
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Preventive medicine · Sep 2022
Effects of a lifestyle intervention on depression and anxiety among adults at risk for diabetes in India: A secondary analysis of the Kerala Diabetes Prevention Program.
The impact of lifestyle interventions on diabetes and mental health conditions have been documented among people with diabetes. However, the mental health benefits of lifestyle interventions designed for diabetes prevention have not been systematically investigated among people at high risk of diabetes, particularly in low- and middle-income countries. We examined the effects of a 12-month peer support lifestyle intervention designed for diabetes prevention on depression and anxiety symptomology in the sample population of the Kerala Diabetes Prevention Program. ⋯ Among those with mild-severe symptoms at baseline, the intervention group had a significantly higher reduction of depressive symptoms (mean diff score = -1.55; 95% CI -2.50, -0.6; P = 0.001) and anxiety symptoms (mean diff score = -1.64; 95% CI -2.76, -0.52; P = 0.004) at 12 months. The effect was sustained at 24 months for depression, but not anxiety. Lifestyle interventions designed for prevention of diabetes might improve depressive and anxiety symptoms in the short-term, particularly among those with mild-severe symptoms.