American journal of preventive medicine
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Randomized Controlled Trial
Effectiveness of a multimodal online well-being intervention: a randomized controlled trial.
Well-being encompasses physical, psychological, and social aspects of health and predicts healthcare utilization and expenditures. Despite their potential clinical impact, interventions that leverage social network effects to target well-being are uncommon. ⋯ A multimodal online intervention leveraging social network effects significantly improved well-being over control. Higher levels of participation as well as increasing levels of social integration were associated with greater improvement in well-being.
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Current, ongoing national surveys do not include questions about end-of-life (EOL) issues. In particular, population-based data are lacking regarding the factors associated with advance directive completion. ⋯ These data indicate racial and educational disparities in advance directive completion and highlight the need for education about their role in facilitating EOL decisions.
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Comparative Study
A new scale of the U.S. alcohol policy environment and its relationship to binge drinking.
Of outcomes related to excessive drinking, binge drinking accounts for approximately half of alcohol-attributable deaths, two thirds of years of potential life lost, and three fourths of economic costs. The extent to which the alcohol policy environment accounts for differences in binge drinking in U.S. states is unknown. ⋯ The composite measure(s) of the alcohol policy environment have internal and construct validity. Higher APS scores (representing stronger policy environments) were associated with less adult binge drinking and accounted for a substantial proportion of the state-level variation in binge drinking among U.S. states.
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The challenge of weight-loss maintenance is well known, but few studies have followed successful weight losers over an extended period or evaluated the effect of behavior change on weight trajectories. ⋯ The majority of weight lost by NWCR members is maintained over 10 years. Long-term weight-loss maintenance is possible and requires sustained behavior change.
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Breast cancer is the second-leading cause of cancer-related deaths among women aged <50 years. Studies on the effects of breast cancer mortality among young women are limited. ⋯ Considering the effect of breast cancer on women of working age and the disproportionate impact on black women, more age-appropriate interventions with multiple strategies are needed to help reduce these substantial health and economic burdens, improve survival, and in turn reduce productivity costs associated with premature death.