Preventive medicine
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Preventive medicine · May 2023
Randomized Controlled TrialEvaluation of behavioral economic strategies to raise influenza vaccination rates across a health system: Results from a randomized clinical trial.
Influenza vaccination rates are low. Working with a large US health system, we evaluated three health system-wide interventions using the electronic health record's patient portal to improve influenza vaccination rates. We performed a two-arm RCT with a nested factorial design within the treatment arm, randomizing patients to usual-care control (no portal interventions) or to one or more portal interventions. ⋯ After adjusting for age, gender, insurance, race, ethnicity, and prior influenza vaccination, none of the interventions increased vaccination rates. We conclude that patient portal interventions to remind patients to receive influenza vaccine during the COVID-19 pandemic did not raise influenza immunization rates. More intensive or tailored interventions are needed beyond portal innovations to increase influenza vaccination.
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Preventive medicine · May 2023
ReviewParticipation, barriers, and facilitators of cancer screening among LGBTQ+ populations: A review of the literature.
The LGBTQ+ community is at higher risk of certain cancers but is less likely to participate in screening programs or engage with preventive healthcare. Despite this, the barriers and facilitators to cancer screening are not well understood in this population. We conducted a literature review of research related to LGBTQ+ participation in cancer screening, as well as barriers and facilitators to participation. ⋯ Barriers to participation were found at the individual-, provider-, and administrator-level, and good communication with a healthcare provider was the strongest facilitator. These results provide reasonable first steps toward improving participation rates for LGBTQ+ populations in cancer screening. Patient-centered approaches should draw on core guiding principles to inform the provision of care, including anticipating LGBTQ+ patients, improving knowledge about care for these patients, and confronting individually-held biases that may affect care, in order to improve care experiences and participation rates in preventive services.
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Preventive medicine · May 2023
E-cigarette preemption laws: Limiting local communities from protecting youth.
E-cigarette use is prevalent among youth in the United States. Historically, local communities have been a catalyst for adopting evidence-based tobacco control policies. However, some states have ceiling preemption laws that prevent more stringent statutes from being enacted at the city or county level and inhibit tobacco control efforts. ⋯ Of these states, 19 preempt advertising regulations, 11 preempt licensure requirements, four preempt ordinances for indoor clean air, and 21 preempt youth access. A broad range of terms was employed to describe preemption, yet few states explicitly used the term "preempt." E-cigarette ceiling preemption laws inhibit public health progress and prevent local authorities from addressing the popularity of e-cigarettes among adolescents. States without preemption laws should be encouraged to adopt language that expressly saves local authority.
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Preventive medicine · May 2023
ReviewDigital eye strain in young screen users: A systematic review.
Digital eye strain (DES) or computer vision syndrome (CVS) is a phenomenon linked to ever increasing digital screen use globally, affecting a large number of individuals. Recognizing causative and alleviating factors of DES may help establish appropriate policies. We aimed to review factors that aggravate or alleviate DES symptoms in young, i.e. pre-presbyopic (< 40 years old), digital device users. ⋯ It appears advisable to optimize ergonomic parameters and restrict screen use duration, for minimizing DES symptoms. Health professionals and policy makers may consider recommending such practices for digital screen users at work or leisure. There is no evidence for use of blue-blocking filters.
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Preventive medicine · May 2023
ReviewA systematic review of the association between smoking exposure and HPV-related cervical cell abnormality among women living with HIV: Implications for prevention strategies.
This study aims to evaluate the association between smoking exposure and human papillomavirus (HPV)-related cervical abnormalities among women living with HIV (WLWH). By conducting a systematic review of the current literature, we evaluated the association between current active smoking and/or exposure to secondhand smoke (SHS) and the risk of cervical HPV incidence, prevalence, and clearance, as well as high-grade cervical intraepithelial neoplasm (HGCIN) incidence, prevalence, progression, and regression among WLWH. We conducted the literature search in Ovid Medline, Embase, and Scopus following the PRISMA guidelines. ⋯ We did not identify any study that evaluated the association between SHS exposure and HPV-related cervical abnormalities among WLWH. Active smoking increases the risk of HPV infection and pre-cancer lesion development in WLWH. Considering smoking as an additional risk factor when designing tailored cervical cancer screening programs for WLWH is necessary in high smoking prevalence regions.