American journal of preventive medicine
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Over-reliance on decontextualized, standardized implementation of efficacy evidence has contributed to slow integration of evidence-based interventions into health policy and practice. This article describes an "evidence integration triangle" (EIT) to guide translation, implementation, prevention efforts, comparative effectiveness research, funding, and policymaking. ⋯ At the center of the EIT is active engagement of key stakeholders and scientific evidence and attention to the context in which a program is implemented. The EIT model is a straightforward framework to guide practice, research, and policy toward greater effectiveness and is designed to be applicable across multiple levels-from individual-focused and patient-provider interventions, to health systems and policy-level change initiatives.
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Disparities in receipt of preventive services by people with mental illness have been documented previously. However, whether these disparities extend to screening mammography among individuals experiencing comparable barriers to accessing care has not been examined fully. ⋯ Medicaid beneficiaries with mental illness constitute a particularly vulnerable population for suboptimal breast cancer screening.
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Approximately 22% of U.S. young adults (aged 18-24 years) are smokers. Young adults typically display an interest in quitting, but it is unknown whether the evidence-based cessation programs designed for adults will be equally effective for young adults. This meta-analysis investigated the efficacy of smoking-cessation programs for this population. ⋯ Although young adults tend to underutilize evidence-based cessation treatments, the current meta-analysis showed that these treatments should be as effective for young adults as they are for the general adult population. Thus, it may be useful to focus on motivating young adults to seek cessation treatment to increase utilization.
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Randomized Controlled Trial
Healthcare costs around the time of smoking cessation.
The Affordable Care Act mandates that new insurance plans cover smoking-cessation therapy without cost-sharing. Previous cost difference estimates, which show a spike around the time of cessation, suggest premiums might rise as a result of covering these services. ⋯ The inclusion of smoking-cessation therapy does not appear to raise short-term healthcare costs. By the sixth quarter post-quit, sustained quitters were less costly than trial participants who continued smoking.
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Limited evidence exists on the metabolic and cardiovascular risk correlates of commuting by vehicle, a habitual form of sedentary behavior. ⋯ Commuting distance was adversely associated with physical activity, CRF, adiposity, and indicators of metabolic risk.