American journal of preventive medicine
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Randomized Controlled Trial
Cardiovascular Disease Guideline Adherence: An RCT Using Practice Facilitation.
Practice facilitation is a promising practice transformation strategy, but further examination of its effectiveness in improving adoption of guidelines for multiple cardiovascular disease risk factors is needed. The objective of the study is to determine whether practice facilitation is effective in increasing the proportion of patients meeting the Million Hearts ABCS outcomes: (A) aspirin when indicated, (B) blood pressure control, (C) cholesterol management, and (S) smoking screening and cessation intervention. ⋯ Increasing the impact of practice facilitation programs that target multiple risk factors may require a longer, more intense intervention and greater attention to external policy and practice context.
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Although neighborhood crime has been associated with mental health problems, longitudinal research utilizing objective measures of small-area crime and mental health service use is lacking. This study examines how local crime is associated with newly prescribed psychotropic medications in a large longitudinal sample of Scottish adults and explores whether the relationships vary between sociodemographic groups. ⋯ Local crime is an important predictor of mental health, independent of individual and other contextual risk factors. Place-based crime prevention and targeting vulnerable groups may have benefits for population mental health.
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This study examines the implementation of North Carolina's statewide naloxone standing order and identifies community characteristics associated with pharmacy stocking and willingness to sell naloxone under the standing order. ⋯ Though more than half of the pharmacies in North Carolina participate in the standing order for naloxone, efforts to identify the best practices for ensuring widespread implementation of statewide standing orders for naloxone are warranted.
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Research has documented the health benefits of physical activity among older adults, but the relationship between physical activity and healthcare costs remains unexplored at the population level. Using data from 50 U.S. states and the District of Columbia, this study investigates the extent to which physical activity prevalence is associated with healthcare costs among older adults. ⋯ Results revealed a time lag effect highlighted by a delayed inverse relationship between state-level physical activity prevalence and healthcare costs among older adults. This evidence offers governments and communities new insights to guide policymaking on long-term public investment in physical activity intervention programs.
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This study examines the association between current e-cigarette use at baseline and regular cigarette smoking at follow-up among U.S. youth. ⋯ Current e-cigarette use among U.S. youth is associated with higher odds of transitioning to regular cigarette smoking, likely reflecting robust transitions rather than experimentation. These results suggest that promoting e-cigarettes as the current practice for tobacco harm reduction will likely have the unintended consequence of initiating youth cigarette smokers.