American journal of preventive medicine
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In 2021, the USPSTF lowered the recommended age of colorectal cancer (CRC) screening initiation from 50 to 45 years. We assessed clinician response to the updated guideline in a major health system. ⋯ Rapidly following the guideline change, clinicians increased their screening ordering rate for 45-49-year-olds, indicating almost complete uptake of the recommendation.
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In 2016, Oregon developed an innovative policy to improve care for Medicaid patients with back pain. The objective of this study was to identify factors associated with dose reduction and discontinuation among Medicaid patients using chronic opioid therapy following implementation of this policy. ⋯ Most Medicaid beneficiaries had a dose reduction following implementation of Oregon's back pain policy. Opioid discontinuation was associated with factors that suggest providers pursue this strategy for patients at higher overdose risk.
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High tobacco smoking prevalence in people with low SES or serious psychological distress (SPD) in the U.S. may increase cardiovascular disease (CVD) risk among these marginalized subpopulations. We estimate how smoking disparities contribute to CVD disparities. ⋯ Interventions focused on reducing smoking disparities could substantially reduce CVD in marginalized subpopulations.
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Although posttraumatic stress disorder (PTSD) and depression are prominent mental health conditions affecting United States service members, only a subset of individuals with these conditions utilize mental healthcare services. Identifying factors associated with mental healthcare utilization may elucidate military subgroups with unmet mental healthcare needs. ⋯ One-third of service members with PTSD or depression symptoms reported any mental healthcare use, highlighting the need to identify factors that may impede or delay treatment. Racial and ethnic disparities in treatment utilization persist as do differences in utilization by military characteristics. Further research and initiatives are necessary to identify potential service-specific or cultural barriers and provide equitable quality and access to needed mental health services within the Military Health System.
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The US has required chain food establishments-including supermarkets-to display calorie labels on prepared (i.e., ready-to-eat) foods since 2018. Implementation of this supermarket calorie labeling policy reduced purchases of prepared foods from supermarkets, but it remains unknown whether the policy is cost-effective. ⋯ A policy requiring calorie labels on prepared foods in supermarkets was projected to be cost-saving or cost-effective and lead to reductions in obesity across all racial, ethnic, and income groups.