American journal of preventive medicine
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Randomized Controlled Trial
Patient trust in physician influences colorectal cancer screening in low-income patients.
Colorectal cancer (CRC) screening is effective but underutilized. Although physician recommendation is an important predictor of screening, considerable variation in CRC screening completion remains. ⋯ After controlling for traditional factors, trust in PCP remained the only significant driver of CRC screening completion in low-income patients. Interventions to promote CRC screening may be improved by including efforts to enhance patient trust in PCP.
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Review
A review of preschool children's physical activity and sedentary time using objective measures.
Identifying current physical activity levels and sedentary time of preschool children is important for informing government policy and community initiatives. This paper reviewed studies reporting on physical activity and time spent sedentary among preschool-aged children (2-5 years) using objective measures. ⋯ The considerable variation of prevalence estimates makes it difficult to determine the "true" prevalence of physical activity and sedentary time in preschool children. Future research should aim to reduce inconsistencies in the employed methodologies to better understand preschoolers' physical activity levels and sedentary behavior.
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An independent evaluation of the Healthy Weight Commitment Foundation (HWCF) marketplace pledge found that the participating companies met and exceeded their interim 2012 sales reduction pledge. ⋯ If the 16 HWCF companies had been able to maintain their pre-pledge trajectory, there should have been an additional 42 kcal/capita/day reduction in calories purchased from HWCF products in 2012 among households with children. A lack of change in total CPG calories purchased between 2011 and 2012 calls into question the sustainability of the decline and a need for continued monitoring.
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Randomized Controlled Trial
Increasing childhood influenza vaccination: a cluster randomized trial.
Since the 2008 inception of universal childhood influenza vaccination, national rates have risen more dramatically among younger children than older children and reported rates across racial/ethnic groups are inconsistent. Interventions may be needed to address age and racial disparities to achieve the recommended childhood influenza vaccination target of 70%. ⋯ A multi-strategy intervention that includes a practice improvement toolkit can significantly improve influenza vaccination uptake across age and racial groups without targeting specific groups, especially in practices with large percentages of minority children.
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An understanding of the individual and combined effects of a set of intervention components is important for moving the science of preventive medicine interventions forward. This understanding can often be achieved in an efficient and economical way via a factorial experiment, in which two or more independent variables are manipulated. The factorial experiment is a complement to the RCT; the two designs address different research questions. ⋯ Investigators in preventive medicine and related areas should begin considering factorial experiments alongside other approaches. Experimental designs should be chosen from a resource management perspective, which states that the best experimental design is the one that provides the greatest scientific benefit without exceeding available resources.