American journal of preventive medicine
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Randomized Controlled Trial
Cardiovascular Disease Guideline Adherence: An RCT Using Practice Facilitation.
Practice facilitation is a promising practice transformation strategy, but further examination of its effectiveness in improving adoption of guidelines for multiple cardiovascular disease risk factors is needed. The objective of the study is to determine whether practice facilitation is effective in increasing the proportion of patients meeting the Million Hearts ABCS outcomes: (A) aspirin when indicated, (B) blood pressure control, (C) cholesterol management, and (S) smoking screening and cessation intervention. ⋯ Increasing the impact of practice facilitation programs that target multiple risk factors may require a longer, more intense intervention and greater attention to external policy and practice context.
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Susceptibility, or openness to smoking, is a predictor of future smoking. This study examines within-gender racial/ethnic differences in smoking susceptibility over historical time (1999-2018) and developmental age (11-18 years). ⋯ Twenty-year racial/ethnic differences in smoking susceptibility were evident, particularly among girls, but were mostly equivalent between genders over developmental age. Targeting susceptible adolescents with gender-, race/ethnic-, and age-tailored prevention efforts may prevent or delay adolescents' transition to tobacco use and reduce tobacco-related disparities.
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Randomized Controlled Trial
Reducing Both Food Insecurity and Excess Body Weight in Costa Rican Women: A Cluster Randomized Trial.
The coexistence of food insecurity and excess body weight has been well documented in women. Both food insecurity and excess body weight have multiple consequences for physical and mental health. Concerns have been raised about interventions aimed to reduce food insecurity because these interventions might contribute to excess body weight, particularly in adult women. The purpose of this study was to develop, implement, and evaluate an intervention to simultaneously reduce food insecurity and body weight through alleviating discouragement-which women described as feeling sad, depressed, hopeless, and lacking drive to do important activities, such as finding a job or studying more-by increasing women's empowerment. ⋯ The intensive intervention was effective in simultaneously reducing food insecurity and excess body weight. Educational components should be added to interventions aimed to reduce food insecurity.
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Exposure to violence victimization may help explain disparities of substance use among gender-nonconforming youth (i.e., those whose gender expression differs from societal expectations). ⋯ School-based substance use prevention programs may benefit from strategies that support gender diversity and reduce violence victimizations experienced by gender-nonconforming students, by providing a safe and supportive school environment.
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Cigarette smoking remains more common among individuals with depression. This study investigates whether cigarette quit ratios and cigarette use prevalence have changed differentially by depression status during the past decade. ⋯ Quit ratios are increasing and smoking prevalence is decreasing overall, yet disparities by depression status remain significant. Disparities in quit ratio may be one contributing factor to the elevated prevalence of smoking among those with depression. Innovative tobacco control approaches for people with depression appear long overdue.