American journal of preventive medicine
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In 1999, Determinants of Community Health was introduced at the Faculty of Medicine, University of Toronto. The course spanned all 4 years of the undergraduate curriculum and focused on addressing individual patient and community needs, prevention and population health, and diverse learning contexts. ⋯ For the same amount of curricular time, an integrated spiral curriculum for teaching public health appears to be more effective than traditional approaches.
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In an era of substantial reform to the nation's health system, there has never been a greater need for physicians to understand public health. One way to foster public health in medical education is to utilize the resources within General Preventive Medicine and Public Health (PM) residency programs. Trained in public health and clinical medicine, PM physicians are uniquely positioned to bridge these disciplines. ⋯ These results suggest that PM residency programs are an underutilized resource in fostering public health in medical education, especially on engagement at the level of graduate medical education. Strategies to improve engagement should consider the nine criteria outlined in this study, as well as common barriers.
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The Food and Drug Administration currently is assessing the public health impact of menthol cigarettes. Whether menthol cigarettes pose increased barriers to quitting is a critical issue because previous declines in smoking prevalence have stalled. ⋯ Smoking menthol cigarettes is associated with decreased cessation at the population level, and this association is more pronounced among black and Puerto Rican smokers. These findings support the recent calls to ban menthol flavoring in cigarettes.
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Randomized Controlled Trial Multicenter Study
Lay health educators translate a weight-loss intervention in senior centers: a randomized controlled trial.
Older adults have high obesity rates and respond well to evidence-based weight-loss programs, such as the Diabetes Prevention Program (DPP) Lifestyle intervention. The goal of this study was to determine whether a translation of the DPP Lifestyle program delivered by lay health educators and conducted in senior centers is effective in promoting weight loss among older adults. ⋯ A behavioral lifestyle weight-loss intervention delivered by a lay health educator offers a promising vehicle for translation of evidence-based obesity treatment programs in underserved areas.
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Randomized Controlled Trial
Neighborhood and parental supports for physical activity in minority adolescents.
Few studies have examined environmental, home, and parental supports for physical activity in underserved adolescents (low income, ethnic minority). Given the increasing incidence of obesity in minority adolescents, it is important to better understand ecologic determinants of physical activity in these youth. This study used an ecologic model to evaluate the significance of neighborhood, home, and parental supports for physical activity on moderate-to-vigorous (MV) physical activity in underserved adolescents. ⋯ Support from parents and neighborhood quality are both associated with increased physical activity in underserved adolescents.