American journal of preventive medicine
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Randomized Controlled Trial Multicenter Study
Aid-assisted decision making and colorectal cancer screening: a randomized controlled trial.
Shared decision making (SDM) is a widely recommended yet unproven strategy for increasing colorectal cancer (CRC) screening uptake. Previous trials of decision aids to increase SDM and CRC screening uptake have yielded mixed results. ⋯ Decision aid-assisted SDM has a modest impact on CRC screening uptake. A decision aid plus personalized risk assessment tool is no more effective than a decision aid alone.
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Randomized Controlled Trial Comparative Study
Cigarette warning label policy alternatives and smoking-related health disparities.
Pictorial health warning labels on cigarette packaging have been proposed for the U.S., but their potential influences among populations that suffer tobacco-related health disparities are unknown. ⋯ Pictorial health warning labels with graphic images have the most-pronounced short-term impacts on adult smokers, including smokers from groups that have in the past been hard to reach.
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The 2-1-1 helpline is a social services innovation that has spread rapidly throughout the U.S. Policy diffusion theory suggests that policymakers seek to reduce uncertainty by anticipating the effects of a proposed innovation through tools such as cost-benefit analyses. Few policy diffusion studies have examined use of information, such as cost-benefit analyses, in the diffusion process. The purpose of this study is to examine how cost-benefit analyses were used during the rapid diffusion of 2-1-1 across states. The paper also describes components of 2-1-1 cost-benefit analyses. ⋯ The diffusion of 2-1-1 helplines in the U.S. has been influenced by interjurisdictional exchange of cost-benefit analyses, in both the creation of original analyses and/or the referencing of previous work.
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Research is needed to understand parental factors influencing human papillomavirus (HPV) vaccination, particularly in groups with a higher burden of cervical cancer. ⋯ Findings indicate low levels of vaccination among 2-1-1 callers. Increased understanding of determinants of HPV vaccination in low-income minority groups can guide interventions to increase coverage. Because 2-1-1 informational and referral services networks reach populations considered medically underserved, 2-1-1 can serve as a community hub for informing development of and implementing approaches aimed at hard-to-reach groups.
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The extent to which the prevalence of smoking in Canada varies across geographic areas independently of individual characteristics has not been quantified. ⋯ Geographic variation in smoking remained after accounting for individual, socioeconomic, and demographic characteristics, suggesting the importance of place, at the level of provinces and communities in Canada. Remaining community variation in smoking was largely attenuated after accounting for collective family norms discouraging smoking. Area-level influences such as the social and/or environmental conditions of provinces and communities may be important sources of variation in smoking and therefore need to be considered if rates of smoking are to be modified.