American journal of preventive medicine
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This study assesses the following among primary care physicians: (1) the use of evidence-based strategies to improve adult vaccination rates, (2) the number of strategies employed simultaneously, and (3) characteristics associated with assessing adult vaccinations at each visit. ⋯ Several strategies are being used to increase adult vaccination, particularly for the influenza vaccine. Investment in implementing standing orders and electronic clinical decision support for all routine adult vaccinations could help facilitate assessment of adult vaccinations at each visit and potentially improve adult vaccination rates.
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Randomized Controlled Trial
Improving Colorectal Cancer Screening in a Rural Setting: A Randomized Study.
Colorectal cancer screening has been shown to prevent or detect early colorectal cancer and reduce mortality; yet, adherence to screening recommendations remains low, particularly in rural settings. ⋯ A mailed motivational messaging letter with a low-cost screening alternative increased colorectal cancer screening in this largely rural community with generally poor adherence to screening recommendations. Mailed colorectal cancer screening reminders using motivational messaging may be an effective method for increasing screening and reducing rural colorectal cancer disparities.
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Despite the safety and efficacy of the human papillomavirus vaccine, thousands are impacted by human papillomavirus and its related cancers. Rural regions have disproportionately low rates of human papillomavirus vaccination. Primary care clinics play an important role in delivering the human papillomavirus vaccine. A positive deviance approach is used to identify workflows, organizational factors, and communication strategies in rural clinics with higher human papillomavirus vaccine up-to-date rates. Positive deviance is a process by which exceptional behaviors and strategies are identified to understand factors that enable success. ⋯ Positive deviance identified characteristics associated with higher human papillomavirus vaccine up-to-date rates in rural primary care clinics. These findings provide guidance for rural clinics to inform human papillomavirus vaccination quality improvement interventions.
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Sugar-sweetened beverages are a key driver of obesity. Portion-size regulations typically limit the volume of unsealed sugar-sweetened beverage containers to 16 fluid ounces. These regulations could reduce sugar-sweetened beverage consumption, but whom these policies would affect remains unknown. This study evaluates demographic groups likely affected by hypothetical national portion-size regulations modeled on policy language and scopes from New York City and California. ⋯ Portion-size regulations would likely have a greater effect on younger, male, and less-educated adults. Policy effects would likely be larger if these regulations are written to encompass more food sources.