American journal of preventive medicine
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Randomized Controlled Trial
Randomized Trial to Reduce Risky Sexual Behavior Among Justice-Involved Adolescents.
Justice-involved adolescents are at high risk for sexually transmitted infections; one primary reason is co-occurring substance use. This study investigates the additive benefit of including alcohol and cannabis use content in a theory-based sexual risk reduction intervention, delivered using group-based motivational enhancement therapy. ⋯ All 3 interventions were associated with decreased sexual risk up to 1 year later, suggesting that the intervention modality (motivational enhancement therapy) may resonate with this population beyond the specific substance use content. This single-session manualized intervention can be readily disseminated to juvenile justice settings.
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This study examines individual- and practice-level predictors of screening modality among 1,484 Medicaid enrollees who initiated colorectal cancer screening (fecal immunochemical test/fecal occult blood tests or colonoscopy) within a year of turning age 50 years. Understanding screening modality patterns for patients and health systems can help optimize colorectal cancer screening initiatives that will lead to high screening completion rates. ⋯ Among newly age-eligible Medicaid enrollees who received colorectal cancer screening, non-White, non-Hispanic individuals were less likely and male enrollees and those with ≥4 primary care visits were more likely to undergo colonoscopy versus fecal immunochemical test/fecal occult blood test. Colonoscopy also was the more common modality among adults whose primary care clinic had an endoscopy facility in the same ZIP code. Future research is needed to fully understand patient, provider, and practice preferences regarding screening modality.
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This study examines the dose-response relationship between moderate-to-vigorous physical activity and cardiometabolic measures in adolescents. ⋯ Among several significant dose-response relationships between physical activity and cardiometabolic health in adolescents, consistent and often nonlinear relationships were identified for BMI, with inflection points at 90-150 minutes of objective moderate-to-vigorous physical activity. Notable differences in associations and linearity were identified by sex and physical activity measure (objective or self-reported). These results support calls for any increase in physical activity among adolescents and suggest that recommendations closer to the adult guidelines of 150 weekly minutes of physical activity may be health promoting and more attainable for youth than the current recommendation of 420 weekly minutes.
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The U.S. immigrant paradox shows worsening health across generations, with U.S.-born Latinx having poorer health outcomes than immigrants. Adverse childhood experiences are associated with increased health risk over the life course, warranting further investigation. This study examines adverse childhood experience distribution across generations in a community sample of first-, second-, and +third-generation Latinx youth. ⋯ Preventing health disparities among immigrant-origin youth requires understanding the impact of adverse childhood experiences on Latinx youth across generations. Results highlight associations among a Latinx youth community sample, suggesting variations in experiences across generations. Household factors in childhood may be key targets for interventions aimed at improving the outcomes observed in later generations for Latinx families.
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This study examines whether differences exist by sex in support for specific gun policies aimed at reducing gun violence. ⋯ This survey is the first to explore differences in public support for specific gun policies between women and men. Policy support was substantially higher among women than men and higher among gun owners who are women compared with men. These findings provide important context for understanding differences in public opinion and suggest the need to tailor messages that will resonate within demographic groups.