American journal of preventive medicine
-
Childhood obesity continues to be a significant public health issue in the U.S. and is associated with short- and long-term adverse health outcomes. A number of states have implemented school-based BMI screening programs. However, these programs have been criticized for not being effective in improving students' BMI or reducing childhood obesity. One potential benefit, however, of screening programs is the identification of younger children at risk of obesity as they age. ⋯ Data from the Arkansas BMI screening program greatly improve the ability to identify children at greatest risk of future obesity to the extent that better prediction can be translated into more effective policy and better health outcomes. This is a heretofore unexamined benefit of school-based BMI screening.
-
Cancer is the second leading cause of death in the U. S. Utilizing family health history in cancer prevention holds promise in lessening the burden of cancer. ⋯ Positive ratings and feedback were also reported by the community health workers. Findings from this pilot study suggest that wider training is warranted for educating more community health workers in the U. S.
-
Previously estimated effects of social distancing do not account for changes in individual behavior before the implementation of stay-at-home policies or model this behavior in relation to the burden of disease. This study aims to assess the asynchrony between individual behavior and government stay-at-home orders, quantify the true impact of social distancing using mobility data, and explore the sociodemographic variables linked to variation in social distancing practices. ⋯ This retrospective analysis of mobility patterns found that social distancing behavior occurred well before the onset of government stay-at-home dates. This asynchrony leads to the underestimation of the impact of social distancing. Sociodemographic characteristics associated with delays in social distancing can help explain the disproportionate case burden and mortality among vulnerable communities.
-
Patients who use tobacco are too rarely connected with tobacco use treatment during healthcare visits. Electronic health record enhancements may increase such referrals in primary care settings. This project used the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework to assess the implementation of a healthcare system change carried out in an externally valid manner (executed by the healthcare system). ⋯ Real-world implementation of an electronic health record-based electronic referral system markedly increased readiness to quit assessment and quitline referral rates in primary care patients. Future research should focus on implementation methods that produce more consistent implementation and better maintenance of electronic referral.
-
The general efficacy of quitlines has been widely demonstrated, but uncertainty exists regarding how quitlines might best intervene for persons with mental health conditions. A total of 1 in 5 people in the U.S. has a diagnosable psychiatric disorder. These individuals smoke at 2‒4 times the rate of smoking among those without a mental health condition and face high rates of related death and disability. About half of quitline callers self-report a mental health condition, but until recently, quitline protocols tailored to these smokers did not exist. ⋯ Tailored mental health quitline programs present a promising framework for testing the services that address psychiatric symptoms as well as other frequent population characteristics such as chronic illness. Implications for increasing reach to the often underserved population with a mental health condition are discussed.