Preventive medicine
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Preventive medicine · Apr 2021
Randomized Controlled TrialA lay health worker intervention to improve breast and cervical cancer screening among Latinas in El Paso, Texas: A randomized control trial.
We examined the effectiveness of a lay health worker (promotora)-delivered intervention on increasing breast and cervical cancer screening among low-income, primarily uninsured Latinas living in El Paso, Texas. ⋯ A promotora-delivered behavioral intervention, embedded in a community-based organization, increased mammography uptake in all women and Pap uptake among women 50 years and older in a sample of low-income Latinas. NCT04397744.
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Preventive medicine · Apr 2021
ReviewSystematic review on use of health incentives in U.S. to change maternal health behavior.
Use of financial incentives contingent on health outcomes has shown effective in health behavior change. Evidence-based information on the effect of incentive use for maternal health behavior change can inform whether and how to proceed with future research as well as incorporate incentive-based interventions in the existing healthcare system. This systematic literature review was conducted among prospective studies on incentive use for maternal health behavior change in a U. ⋯ The review showed that incentives such as vouchers and other financial incentives were effective in improving outcomes especially related to substance use, tobacco use, and breastfeeding. Mixed evidence was found in improving treatment adherence outcomes; however the studies with randomized trials on the outcome of treatment adherence also showed low certainty. Continued improvements need to be made in implementing an incentive-based approach in the context of comprehensive treatment and routine healthcare, exploring electronic- or mobile-based implementation of the approach, and implementing the approach for a wider variety of outcomes during both prenatal and postpartum periods.
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Preventive medicine · Apr 2021
ReviewImpact of postal correspondence letters on participation in cancer screening: a rapid review.
The purpose of this rapid review was to identify and synthesize evidence on the impact of postal correspondence letters on participation in cancer screening and to determine whether impact varied by cancer site or inclusion of the participant's physician's name within the letter (i.e., physician-linked). PubMed and the Cochrane Database of Systematic Reviews were searched for English-language systematic reviews and randomized controlled trials (RCTs) published up until October 2019. One reviewer completed citation screening and data extraction with 30% verification by a second reviewer. ⋯ Studies comparing physician-linked letters to no letters or usual practice reported similar effect estimates as those examining letters in general. Limited and inconsistent evidence was identified on the impact of physician-linked letters as compared to non-physician-linked letters on screening participation. Evidence identified in this rapid review, and other contextual and implementation considerations, may be useful for jurisdictions considering how to promote cancer screening participation.
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Preventive medicine · Apr 2021
Behavioural change, weight loss and risk of dementia: A longitudinal study.
Recent meta-analysis reported higher dementia risks associated with lower body mass index (BMI) and decreasing BMI. We examined to what extent these associations were attenuated by changes in behaviours and local environment. Multilevel discrete time-to-event models examined associations between baseline and change in BMI with dementia detected through prescription medications (source: Department of Human Services), hospitalisations and death certificates among 144,456 participants in the Sax Institute's 45 and Up Study. ⋯ Adherence to physical activity and sleep duration guidelines were associated with reduced dementia risk, but neither these, nor adjustment for other behaviours and local factors, explained the BMI-dementia association. In conclusion, we replicated the BMI-dementia findings from a recent meta-analysis and provide further support to preventive strategies focussed on increasing physical activity and improving sleep duration. Other potential environmental risk factors outside of socioeconomic and urban/rural circumstances warrant investigation.
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Preventive medicine · Apr 2021
ReviewPatient barriers and facilitators of colonoscopy use: A rapid systematic review and thematic synthesis of the qualitative literature.
Colonoscopy is the gold standard test in the diagnosis of colorectal cancer. Despite this, many people across the world decline the procedure when invited for screening, surveillance or diagnostic evaluation. The aim of this review was to characterise the barriers and facilitators of colonoscopy use described in the qualitative literature. ⋯ Key practical factors included cost, and whether colonoscopy was covered by the patient's healthcare insurance. Studies mostly focussed on screening colonoscopy in the USA, where there is no universal healthcare coverage. To better understand the barriers and facilitators in other contexts, further research is needed.