Preventive medicine
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Preventive medicine · Jun 2023
Nicotine-related content in English language ENDS advertisements in the US: 2018-2020.
There is no standard way to communicate to consumers how much nicotine is present in electronic nicotine delivery systems (ENDS). This study assessed the inclusion of nicotine-related content, including nicotine strength, in a sample of English language ENDS advertisements that appeared in consumer and business-to-business outlets in the US during 2018-2020. The sample, provided by a media surveillance company, included ads from television, radio, newspapers, magazines (consumer and business-to-business), online platforms, outdoor/billboards, and direct-to-consumer emails. ⋯ Across the sample of ads, 15% reported nicotine strength in mg or mg/ml (n = 444), and 9% reported nicotine strength in percent (n = 260). Most ENDS ads do not include nicotine-related content. There is substantial variation in presentation of nicotine strength, which may present challenges for consumer understanding of absolute and relative nicotine-related content.
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Preventive medicine · Jun 2023
In-person school attendance and adolescent exposure to injury-related risk behaviors during the COVID-19 pandemic in the United States.
School closures during the COVID-19 pandemic have been reported to influence adolescents' behavioral health and may have altered their exposure to injury risk. We aimed to determine how in-person school attendance of individual adolescents in the United States during the pandemic was correlated with a range of risky health behaviors. We used self-reported data from adolescents 14-18 years old enrolled in grades 9-12 who participated in the 2020 Adolescent Behaviors and Experiences Survey. ⋯ Based on a multivariable analysis of 5202 students (65% attending school in-person) adjusted for age, sex, race, ethnicity, sexual orientation, parental unemployment, food insecurity, and homelessness, we found that in-person school attendance was associated with increased odds of every risk behavior except suicidal ideation and electronic bullying, with adjusted odds ratios ranging from 1.40 (95% confidence interval [CI]: 1.04, 1.88) for not wearing a seatbelt to 3.43 for IPV (95% CI: 1.97, 5.97). Our analyses demonstrate that in-person school attendance during the COVID-19 pandemic was associated with higher rates of risk behavior among adolescents. Further research is needed explore if this relationship is causal, and how these risks could be mitigated, as most adolescents have now returned to in-person schooling.
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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.