American journal of preventive medicine
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Randomized Controlled Trial Comparative Study
Randomized Trial of a Fitbit-Based Physical Activity Intervention for Women.
Direct-to-consumer mHealth devices are a potential asset to behavioral research but rarely tested as intervention tools. This trial examined the accelerometer-based Fitbit tracker and website as a low-touch physical activity intervention. The purpose of this study is to evaluate, within an RCT, the feasibility and preliminary efficacy of integrating the Fitbit tracker and website into a physical activity intervention for postmenopausal women. ⋯ The Fitbit was well accepted in this sample of women and associated with increased physical activity at 16 weeks. Leveraging direct-to-consumer mHealth technologies aligned with behavior change theories can strengthen physical activity interventions.
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Multicenter Study
HIV Infection Status as a Predictor of Hepatitis C Virus RNA Testing in Primary Care.
Receipt of hepatitis C virus (HCV) RNA testing following a positive HCV antibody (anti-HCV+) test result to establish current infection is a quality indicator for HCV-related care. This study examines HIV infection status as a predictor of HCV RNA test receipt after an anti-HCV+ result in the primary care setting. ⋯ HIV infection status is independently associated with the likelihood of receiving HCV RNA testing following an anti-HCV+ result. One quarter of anti-HCV+ patients who were also HIV-positive and one third of their HIV-negative counterparts, respectively, did not receive testing to establish active HCV infection, which is imperative for appropriate care and treatment.
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The purpose of this review is to summarize the empirical research on neighborhood-level factors and dating violence among adolescents and emerging adults to guide future research and practice. ⋯ Existing research suggests that neighborhood factors may be associated with dating violence. However, there is a limited body of research on the neighborhood context of dating violence, and more rigorous research is needed.
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U. S. Preventive Services Task Force (USPSTF) clinical guidelines at present rarely assign the highest grade recommendation to behavioral counseling interventions for chronic disease prevention or risk reduction because of concerns about the certainty and quality of the evidence base. ⋯ As members of the Society of Behavioral Medicine (SBM)--a multidisciplinary scientific organization committed to improving population health through behavior change--we review the USPSTF mandate and current recommendations for behavioral counseling interventions and provide a perspective for the future that calls for concerted and coordinated efforts among SBM, USPSTF, and other organizations invested in the rapid and wider uptake of beneficial, feasible, and referable primary care-focused behavioral counseling interventions. This perspective highlights five areas for further development, including (1) behavioral counseling-focused practice-based research networks; (2) promotion of USPSTF evidence standards and the increased use of pragmatic RCT design; (3) quality control and improvement procedures for behavioral counseling training; (4) systematic research on effective primary care-based collaborative care models; and (5) methodologic innovations that capitalize on disruptive technologies and healthcare transformation. Collective efforts to improve the health of all Americans in the 21st century and beyond must ensure that effective, feasible, and referable behavioral counseling interventions are embedded in modern primary care practice.
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Randomized Controlled Trial
Applying the Pragmatic-Explanatory Continuum Indicator Summary Model in a Primary Care-Based Lifestyle Intervention Trial.
The majority of adults in the U. S. can be classified as overweight or obese (68%), putting them at risk for Type 2 diabetes, cardiovascular diseases, and other adverse health outcomes. The U. ⋯ We used our recently completed trial, Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care (E-LITE), as a case study and assessed the domains of PRECIS to explore the degree to which we felt it achieved its intended pragmatic design (completed in December 2014). Overall, the systematic assessment using the PRECIS tool revealed that the E-LITE trial design was very pragmatic in nature. Its results and the subsequent adoption of the intervention into actual practice also suggest high potential for implementation of primary care interventions.