American journal of preventive medicine
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Health economic evaluations (e.g., cost-effectiveness analysis) can guide the efficient use of resources to improve health outcomes. This study aims to summarize the content and quality of interpersonal violence prevention economic evaluations. ⋯ Comprehensive data collection on violence averted and intervention costs in experimental settings can increase opportunities to identify interventions that generate long-term value. More comprehensive estimates of the cost of violence can improve opportunities to demonstrate how prevention investment can be offset through avoided future costs. Better adherence to health economic evaluation reporting standards can enhance comparability across studies and may increase the likelihood that economic evidence is included in violence prevention decision making.
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Diabetes incidence differs by race in the U.S., with a persistent reported Black-White disparity. However, the factors that contribute to this excess risk in middle-aged and older adults are unclear. ⋯ The racial disparity in diabetes incidence remained after accounting for individual and neighborhood factors. Further investigation of additional factors underlying this racial disparity is needed to inform multilevel strategies for diabetes prevention.
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Human papillomavirus-vaccinated cohorts, irrespective of age, will likely reduce their subsequent screening requirements, thus opening opportunities for global cost reduction and program sustainability. The determinants of uptake and completion of a 3-dose human papillomavirus vaccination program by adult women in a European context were estimated. ⋯ Acceptance and schedule completion were largely dependent on recruitment method, achieved coverage of national vaccination programs, and personal relationship status. Knowledge of benefits and safety reassurance may be critical to expanding vaccination target ages. Study results suggest that there are no major opinion barriers in adult women to human papillomavirus vaccination, especially when vaccination is offered face to face in healthcare settings.
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Little is known about how clinicians make low-dose computed tomography lung cancer screening decisions in practice. Investigators assessed the factors associated with real-world decision making, hypothesizing that lung cancer risk and comorbidity would not be associated with agreeing to or receiving screening. Though these factors are key determinants of the benefit of lung cancer screening, they are often difficult to incorporate into decisions without the aid of decision tools. ⋯ Substantial variation was found in Veterans agreeing to and receiving lung cancer screening during the Veterans Affairs Lung Cancer Screening Demonstration Project. This variation was not explained by differences in key determinants of patient benefit, whereas the facility and clinician advising the patient had a large impact on lung cancer screening decisions.
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Smoking remains a strong risk factor for premature death. This study examines the associations of nondaily smoking, daily smoking, and smoking cessation with the risks of mortality from all causes, cardiovascular disease, and cancer. ⋯ This study suggests that nondaily smokers have a higher risk of all-cause mortality. The association of daily smoking with the risk of mortality increased as the number of cigarettes smoked per day increased. Among former smokers, the risk decreased with longer cessation. Tobacco control efforts should be targeted not only toward daily smokers but also toward nondaily smokers to reduce the risk of premature death owing to smoking.