American journal of preventive medicine
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Little is known about the relationships between annual visit-to-visit blood pressure variability and heart failure subphenotypes. The aim of this analysis was to examine the association between blood pressure variability and incident heart failure with preserved and reduced ejection fraction. ⋯ Greater systolic blood pressure variability was associated with a higher risk of heart failure with preserved ejection fraction independent of mean blood pressure and coronary events interim to heart failure hospitalization.
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Although smoking prevalence is lower among Hispanic adults than among non-Hispanic White adults, smoking remains a leading cause of preventable death among older Hispanics. This study examines the differences in tobacco assessment and smoking-cessation assistance among older patients seen in community health centers by ethnicity and language preference. ⋯ Significant disparities were found in tobacco assessment and cessation assistance by ethnicity and language preference among older adults seen in safety-net clinics. Future research is needed to understand the etiology of these smoking-related disparities.
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Despite efforts to identify and address the social needs of patients in U.S. healthcare settings, researchers consistently find high rates of patients who decline social interventions after reporting that they have unmet social needs. It is an open question as to why people who screen positive for social risks decline assistance. This question was qualitatively explored in a community health center in Rhode Island. ⋯ Barriers to patients' acceptance of services to support social needs were influenced by multiple factors, both internal and external to the health center. These findings can inform best practices related to and the reliability of social risk screening processes in clinic settings to promote social justice and ensure health equity.
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The opioid epidemic has resulted in significant morbidity and mortality in the U. S. Health systems, policymakers, payers, and public health have enacted numerous strategies to reduce the harms of opioids, including opioid use disorder (OUD). ⋯ Key tertiary prevention strategies include the expansion of harm reduction services, including expanding naloxone availability and syringe exchange programs. The ACPM Opioid Workgroup also identifies opportunities for de-implementation, in which historical and current practices may be ineffective or causing harm. De-implementation strategies include reducing inappropriate opioid prescribing; avoiding mandatory one-size-fits-all policies; eliminating barriers to medications for OUD, debunking the myth of detoxification as a primary solo treatment for opioid use disorder; and destigmatizing care practices and policies to better treat people with OUD.