American journal of preventive medicine
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The Guide to Community Preventive Services recommends combined built environment approaches to increase physical activity, including new or enhanced transportation infrastructure (e.g., sidewalks) and land use and environmental design interventions (e.g., close proximity of local destinations). The aim of this brief report is to provide nationally representative estimates of two types of built environment supports for physical activity: near-home walkable infrastructure and destinations, from the 2015 National Health Interview Survey. ⋯ Many U.S. adults report walkable built environment elements near their home; future efforts might target areas with many older adult residents or those living in the South.
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Influenza vaccination rates remain below Healthy People 2020 goals. This project sought to systematically review economic evaluations of healthcare-based quality improvement interventions for improving influenza vaccination uptake among general populations and healthcare workers. ⋯ Quality improvement interventions for influenza vaccination involve per-enrollee costs that are similar to the cost of the vaccine itself ($11.78-$36.08/dose). Based on limited available evidence in general populations, quality improvement interventions may be cost saving to cost effective for the health system.
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The U.S. Preventive Services Task Force recommends that primary care providers screen unaffected women with a family history of BRCA mutation-associated cancers, but without a personal history of BRCA-related cancer, for referral to genetic counseling and potential genetic testing. ⋯ Despite a decade-old U.S. Preventive Services Task Force recommendation, few unaffected women at risk for BRCA-associated cancer report discussing genetic testing with a provider.
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Several studies have identified disparities in human papillomavirus (HPV)-related outcomes by nativity status (i.e., U.S.- versus foreign-born). However, few studies have explored whether vaccination differences exist by nativity status. Vaccination disparities have the potential to exacerbate HPV-related cancer disparities in the long term if left unaddressed. Therefore, the authors investigated whether there were significant differences in HPV vaccination initiation (one or more doses) and completion (three or more doses) between U.S.-born and foreign-born men and women. ⋯ The demographic, socioeconomic, and healthcare factors included in this study did not appear to account fully for observed disparities. Future research is needed to understand other factors that may contribute to nativity status disparities in HPV vaccination.