Preventive medicine
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Preventive medicine · Dec 2022
A comprehensive electronic health record-enabled smoking treatment program: Evaluating reach and effectiveness in primary care in a multiple baseline design.
Effective treatments for smoking cessation exist but are underused. Proactive chronic care approaches may enhance the reach of cessation treatment and reduce the prevalence of smoking in healthcare systems. This pragmatic study evaluated a population-based Comprehensive Tobacco Intervention Program (CTIP) implemented in all (6) adult primary care clinics in a Madison, Wisconsin, USA healthcare cooperative, assessing treatment reach, reach equity, and effectiveness in promoting smoking cessation. ⋯ Telephone treatment reach was particularly high in historically underserved groups, including African-American, Hispanic, and Medicaid-eligible patients. Implementation of a comprehensive, opt-out, chronic-care program aimed at all patients who smoke was associated with increases in the rates of pharmacotherapy and counseling delivery and quitting smoking. Proactive outreach may help reduce disparities in treatment access.
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Preventive medicine · Dec 2022
Patterns of household gun ownership and firearm suicide among black men compared to white men.
Little is known about the patterns of household gun ownership among Black Americans, so little is known about the relationship between the patterns of Black household gun ownership and the patterns of Black firearm suicide. We analyze data from the 2001-2004 Behavioral Risk Factor Surveillance System, the first and last years for which a gun question was part of the core questions. ⋯ While gun ownership increases with age, adult male Black firearm suicide rates are highest in the younger age group-an age group that also has a high proportion of suicides that are firearm suicides. Differences in unadjusted demographic patterns in firearm suicide between Black men and White men cannot be explained by differences in the self-reported patterns of household gun ownership.
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Preventive medicine · Dec 2022
Extreme risk protection orders in response to threats of multiple victim/mass shooting in six U.S. states: A descriptive study.
Extreme risk protection orders (ERPOs), also known as red flag laws, are a potential tool to prevent firearm violence, including mass shootings, but little is currently known about the extent of their use in cases of mass shooting threats or about the threats themselves. We collected and abstracted information from ERPO cases from six states (California, Colorado, Connecticut, Florida, Maryland, and Washington). Ten percent (N = 662) of all ERPO cases (N = 6787) were in response to a threat of killing at least 3 people. ⋯ The most common target for a multiple victim/mass shooting threat was a K-12 school, followed by businesses, then intimate partners and their children and families. Judges granted 93% of petitions that involved these threats at the temporary ERPO stage and, of those cases in which a final hearing was held, judges granted 84% of final ERPOs. While we cannot know how many of the 662 ERPO cases precipitated by a threat would have resulted in a multiple victim/mass shooting event had ERPO laws not been used to prohibit the purchase and possession of firearms, the study provides evidence at least that ERPOs are being used in six states in a substantial number of these kinds of cases that could have ended in tragedy.
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Preventive medicine · Dec 2022
Effect of flavored E-cigarette bans in the United States: What does the evidence show?
The United States federal government, along with many state and local governments, have passed restrictions on electronic cigarette ("e-cigarette") sales with the stated purpose of preventing youth use of these products. The justification for these restrictions includes the argument that youth e-cigarette use will re-normalize youth smoking, leading to increased rates of cigarette smoking by teenagers. However, in this paper, we propose an evidence-based version of this model based on several years' worth of longitudinal and econometric research, which suggests that youth e-cigarette use has instead worked to replace a culture of youth smoking. From this analysis, we propose a re-evaluation of current policies surrounding e-cigarette sales so that declines in e-cigarette use will not come at the cost of increasing cigarette use among youth and adults.
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Preventive medicine · Dec 2022
Randomized Controlled TrialRandomized clinical trial examining the efficacy of adding financial incentives to best practices for smoking cessation among pregnant and newly postpartum women.
We report results from a single-blinded randomized controlled trial examining financial incentives for smoking cessation among 249 pregnant and newly postpartum women. Participants included 169 women assigned to best practices (BP) or BP plus financial incentives (BP + FI) for smoking cessation available through 12-weeks postpartum. A third condition included 80 never-smokers (NS) sociodemographically-matched to women who smoked. ⋯ Reliability analyses supported the efficacy of financial incentives for increasing abstinence antepartum and postpartum and decreasing SGA deliveries; external-validity analyses supported relationships between antepartum cessation and SGA risk. Adding financial incentives to Best Practice increases smoking cessation among antepartum and postpartum women and improves other maternal-infant outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02210832.