Preventive medicine
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Preventive medicine · Oct 2022
ReviewPrecision health in behaviour change interventions: A scoping review.
Precision health seeks to optimise behavioural interventions by delivering personalised support to those in need, when and where they need it. Conceptualised a decade ago, progress toward this vision of personally relevant and effective population-wide interventions continues to evolve. This scoping review aimed to map the state of precision health behaviour change intervention research. ⋯ Data was mostly behavioural or lifestyle (20/31, 65%), and physiologic, biochemical or clinical (15/31, 48%), with no studies utilising genetic/genomic data. This review demonstrated that precision health behaviour change interventions remain dependent on human-led, low-tech personalisation, and have not fully considered the interaction between behaviour and the social and environmental contexts of individuals. Further research is needed to understand the relationship between personalisation and intervention effectiveness, working toward the development of sophisticated and scalable behaviour change interventions that have tangible public health impact.
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Preventive medicine · Oct 2022
ReviewThe cognitive dissonance discourse of evolving terminology from colonial medicine to global health and inaction towards equity - A Preventive Medicine Golden Jubilee Article.
We discuss the evolution of terminology, beginning with colonial medicine and ending with global health. We describe how global health's definition evolved to include language on autonomy, power, and health equity. Specifically, we studied the websites of the twenty-five‑leading national (N = 5), multilateral (N = 5), philanthropic (N = 5), non-governmental organizations (N = 5) in research, health service delivery, and advocacy, and academic institutions (N = 5) within global health to understand their history, places of critical operations, budget, organizational structure, leadership, mission, policies, and representation of the global south. ⋯ We underscore that the epistemological-praxis disconnect creates organizational psychology akin to cognitive dissonance within individuals, particularly among practitioners from the global south. This dissonance perpetuates inequity across global health organizations uniquely structurally impedes decolonization by and in the institutions that promote global health, and undermines the achievement of current goals across the global health system. To truly decolonize global health, researchers must measure and study changes in how organizations operationalize their goals, structures, policies, and administrative processes to address equity and social justice across all sectors of the global health system.
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Preventive medicine · Oct 2022
The association of smoking cessation with mortality from pneumonia among middle-aged and elderly community residents: The Japan Collaborative Cohort (JACC) study.
Several studies have shown that smoking is a significant risk factor for pneumonia, but it is uncertain to what extent smoking cessation reduces the risk. This study aimed to investigate whether and to what extent smoking cessation is associated with reduced risk of mortality from pneumonia in a Japanese, prospective, community-based cohort. We examined 94,972 individuals (mean age, 57 years; women, 57%) who provided valid responses to a lifestyle questionnaire including questions about smoking. ⋯ Multivariable hazard ratios (95% confidence intervals) compared with the current smokers were 1.02 (0.72-1.45) for 0-1 year of smoking cessation at baseline, 0.92 (0.70-1.22) for 2-4 years, 0.95 (0.74-1.21) for 5-9 years, 0.71 (0.53-0.96) for 10-14 years, 0.63 (0.48-0.83) for 15 years or more, and 0.50 (0.36-0.70) for never-smokers. Although smoking increases the risk of pneumonia mortality, the present study showed that the risk of pneumonia mortality decreased with years of smoking cessation, eventually improving to levels similar to those of non-smokers for 10 years or more. Continued smoking cessation may be effective in preventing pneumonia deaths.
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Preventive medicine · Oct 2022
Changes in time spent walking and disability-free life expectancy in Japanese older people: The Ohsaki Cohort 2006 Study.
An increase in time spent walking is significantly associated with lower risks of mortality and disability. This study aimed to investigate the association between changes in time spent walking and disability-free life expectancy (DFLE) in community-dwelling older people. Thirteen-year follow-up data from a cohort study of 7105 Japanese older adults (age ≥ 65 years) in 2006 were analyzed. ⋯ The 2-year difference in DFLE did not change after the participants were stratified by body mass index, motor function, cognitive function, and history of diseases. Increase in time spent walking is associated with longer DFLE in Japanese older people. Encouraging simple physical activity such as walking at the population level could increase life-years lived in good health.
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Preventive medicine · Oct 2022
Differences in overdose deaths by intent: Unintentional & suicide drug poisonings in North Carolina, 2015-2019.
Comprehensive fatal overdose prevention requires an understanding of the fundamental causes and context surrounding drug overdose. Using a social determinants of health (SDOH) framework, this descriptive study examined unintentional and self-inflicted (i.e., suicide) overdose deaths in North Carolina (NC), focusing on specific drug involvement and contextual factors. Unintentional and suicide overdose deaths were identified using 2015-2019 NC death certificate data. ⋯ Overall, overdose deaths tended to occur in under-resourced counties across all SDOH domains, though unintentional overdoses occurred more often among residents of under-resourced counties than suicide overdoses, with differences most pronounced for economic stability-related factors. There are notable distinctions between unintentional and suicide overdose deaths in demographics and drug involvement, though the assessment of SDOH demonstrated that overdose mortality is broadly associated with marginalization across all domains. These findings highlight the value of allocating resources to prevention and intervention approaches that target upstream causes of overdose (e.g., housing first, violence prevention programs).