Preventive medicine
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Preventive medicine · Jan 2021
ReviewPrimary care prevention of cardiovascular risk behaviors in adolescents: A systematic review.
Adolescence is associated with behavioral changes offering opportunities for prevention of cardiovascular risk behaviors. Primary care physicians are ideally placed to deliver preventive interventions to adolescents. The objective was to systematically review the evidence about effectiveness of primary care-led interventions addressing the main cardiovascular risk behaviors in adolescents: physical activity, sedentary behaviors, diet and smoking. ⋯ Risk of bias was mostly unclear for most studies. There is little evidence for specific interventions on adolescents' cardiovascular risk behaviors in primary care, mainly due to studies' methodological limitations. Further research should investigate the effectiveness of opportunistic primary care-based interventions as compared to more complex interventions, and address the methodological shortcomings identified in this review.
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Preventive medicine · Jan 2021
Effects of e-cigarette use on cigarette smoking among U.S. youth, 2004-2018.
To determine if the declining trend in U.S. youth cigarette smoking changed after e-cigarettes were introduced, and if youth e-cigarette users would have been likely to smoke cigarettes based on psychosocial and demographic predictors of smoking. ⋯ The introduction of e-cigarettes was followed by a slowing decline in current cigarette smoking, a stall in combined cigarette and e-cigarette use, and an accelerated decline in ever cigarette smoking. Traditional psychosocial risk factors for cigarette smoking suggest that e-cigarette users do not fit the traditional risk profile of cigarette smokers.
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Preventive medicine · Jan 2021
The effect of interpersonal communication in tobacco control campaigns: A longitudinal mediation analysis of a Ghanaian adolescent population.
This study examined the effectiveness of anti-smoking messages in positively shifting perceptions of risks related to smoking among adolescents in urban Ghana, both directly through exposure to messaging and indirectly through catalyzing discussions among peers and adults. We used data from two waves of a population-based survey of 3775 adolescent girls and 3279 adolescent boys aged 13-16 years in the urban areas of Accra, Teshie, Kumasi and Sunyani in Ghana. Using an interviewer-directed questionnaire, information was collected on sociodemographic characteristics, tobacco knowledge, exposure to messages about tobacco, frequency of conversations with peers and adults about the health risks associated with smoking, as well as beliefs and attitudes towards smoking. ⋯ Conversations with adults were never found to significantly mediate smoking prevention campaigns effects in this sample of Ghanaian adolescents. Behavior change communication programs that rely solely on traditional mass media can miss important opportunities for shifting smoking risk perceptions and sharing information on the harms of smoking. Evaluations that ignore the indirect effects of conversations among peers mediating campaign effects may fail to identify important channels that can be targeted and triggered by mass and social media tobacco control campaigns.
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Preventive medicine · Jan 2021
Disparities in health behaviors and outcomes at the intersection of race and sexual identity among women: Results from the 2011-2016 National Health and Nutrition Examination Survey.
The purpose of this study was to explore potential differences in health behaviors and outcomes of sexual minority women (SMW) of color compared to White SMW, heterosexual women of color, and White heterosexual women. Data from 4878 women were extracted from the 2011 to 2016 National Health and Nutritional Examination Survey. The four-category independent variable (SMW of color, White SMW, heterosexual women of color, and White heterosexual women) was included in binary and multinomial logistic regression models predicting fair/poor self-reported health status, depression, cigarette smoking, alcohol, cannabis, and illicit drug use. ⋯ In contrast, White SMW had significantly greater odds of depression, current smoking and cannabis and illicit drug use. Results of post-hoc tests indicated that the adjusted ORs for SMW of color differed significantly from those of White SMW for all outcomes, and did not differ significantly from those for heterosexual women of color for any outcome other than no binge drinking (OR = 0.34 vs. 0.67, p < 0.01) and current cannabis use (OR = 0.93 vs. 0.44, p < 0.01). SMW of color are more similar to heterosexual women of color than to White SMW in terms of depression, substance use, and self-reported health.
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Preventive medicine · Jan 2021
Five-year changes in support for tobacco control policy options among students, faculty and staff at a public university.
Over 2500 U. S. colleges and universities have instituted smoke-free (prohibiting combustible tobacco) or tobacco-free (prohibiting all tobacco) campus policies, and support for such policies by students, faculty and staff is an essential ingredient for successful implementation. Cross-sectional studies have found that these policies are well supported, but longitudinal studies that track change in support over time are rare. ⋯ Increases in support for the tobacco-free option were particularly large. Results are discussed in light of theories of social norm change. These findings provide evidence from one university that tobacco control policies, especially those making a campus fully tobacco-free, increase in popularity over time.