American journal of preventive medicine
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Randomized Controlled Trial
The Community Diabetes Education (CoDE) program: cost-effectiveness and health outcomes.
Limited evidence exists regarding the long-term effects of community health worker-led diabetes management programs on health outcomes and cost-effectiveness, particularly in low-income, ethnic minority populations. ⋯ A simulated clinical trial suggests that a community health worker-led diabetes intervention is a cost-effective way to reduce diabetes-related complications for uninsured Mexican Americans during a 20-year horizon in comparison to usual medical care.
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Accidents are one of the leading causes of death among U.S. active-duty Army soldiers. Evidence-based approaches to injury prevention could be strengthened by adding person-level characteristics (e.g., demographics) to risk models tested on diverse soldier samples studied over time. ⋯ Adding more refined person-level and situational risk indicators to current models could enhance understanding of accident death risk specific to soldier rank and deployment status. Stable predictors could help identify high risk of accident deaths in future cohorts of Regular Army soldiers.
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Policies to enhance bicycling are correlated with health outcomes. Research has yet to provide an adequate, empirically derived explanation for this finding. ⋯ The results of this study suggest that large cities with more policies aimed at promoting bicycling have fewer overweight/obese residents, partially because the policies are related to supportive bicycling infrastructures that promote bicycling to work.
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The amount of time spent on food preparation and cooking may have implications for diet quality and health. However, little is known about how food-related time use relates to food consumption and spending, either at restaurants or for food consumed at home. ⋯ The findings indicate that time might be an essential ingredient in the production of healthier eating habits among adults. Further research should investigate the determinants of spending time on food preparation.
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Screen time (including TV viewing/computer use) may be adversely associated with metabolic and mental health in children. ⋯ Screen time in excess of public health guidelines was highly prevalent, particularly among boys, those who were overweight or obese, and those with mothers of lower educational attainment. The population-attributable risk associated with this exposure is potentially high; further efforts to understand the determinants of within- and between-country variation in these behaviors and inform the development of effective behavior change intervention programs is warranted.