American journal of preventive medicine
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Observational Study
Community Policies and Programs to Prevent Obesity and Child Adiposity.
Evidence regarding impact of community policies and programs (CPPs) to prevent child obesity is limited, and which combinations of strategies and components are most important is not understood. The Healthy Communities Study was an observational study to assess relationships of characteristics and intensity of CPPs with adiposity, diet, and physical activity in children, taking advantage of variation across the U.S. in community actions to prevent child obesity. The study examined the association of CPPs to prevent child obesity with measured BMI and waist circumference, hypothesizing that communities with more-comprehensive CPPs would have children with lower adiposity. ⋯ This study provides plausible evidence that comprehensive CPPs targeting a greater number of distinct physical activity and nutrition behaviors were associated with lower child adiposity.
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The Healthy, Hunger-Free Kids Act of 2010 gave the U.S. Department of Agriculture authority to regulate school wellness policies, which include nutritional standards for foods advertised in schools. Brand marketing programs, which encourage students to purchase a company's products in exchange for money or rewards, were not explicitly prohibited. This study assesses the nutritional quality of products participating in "Box Tops for Education" ("Box Tops"), one of the largest national brand marketing programs in schools. ⋯ Fewer than one third of Box Tops foods met the Smart Snacks standards. Schools should consider whether the benefit of participation outweighs the harm of exposing kids to unhealthful marketing. Alternatively, schools could opt not to participate unless companies limit redeemable products to household items or healthful options meeting the Smart Snacks standards.
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The associations of modifiable lifestyle risk factors with incident diabetes are not well investigated in African Americans (AAs). This study investigated the association of modifiable lifestyle risk factors (exercise, diet, smoking, TV watching, and sleep-disordered breathing burden) with incident diabetes among AAs. ⋯ A combination of modifiable lifestyle factors are associated with a lower risk of diabetes among AAs, particularly among those without obesity.
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HIV testing serves as an entry point for HIV care services for those who test HIV positive, and prevention services for those who test HIV negative. The Centers for Disease Control and Prevention recommends routine testing of adults and adolescents in healthcare settings. To identify missed opportunities for HIV testing at U.S. physicians' offices, data from the National Ambulatory Care Surveys from 2009 to 2012 were analyzed. ⋯ Important opportunities exist to increase HIV testing coverage at U.S. physicians' offices. Structural interventions, such as routine opt-out testing policies, electronic medical record notifications, and use of non-clinical staff for testing could be implemented to increase HIV testing in these settings.
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Firearm violence injures or kills 100,000 Americans each year. This paper applies the Host-Agent-Vector-Environment model to this issue. Research on firearm violence tends to focus on two elements-the host (i.e., victims of firearm violence) and the environment (i.e., gun policies)-but little attention has been paid to the agent (the gun and ammunition) or the vector (firearm manufacturers, dealers, and the industry lobby). ⋯ Trends in firearm manufacturing reveal a shift toward more-lethal weapons, and this trend is also observed in gun purchases and crime gun traces. This may reflect a societal shift in cultural practices and norms related to guns and could inform strategies to reduce firearm violence.