American journal of preventive medicine
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Randomized Controlled Trial
Efficacy of a weight-loss website based on positive deviance. A randomized trial.
Web-based interventions for weight control could promote more-widespread dissemination of weight-loss opportunities; however, they remain limited in effectiveness. Incorporating weight-control practices used by individuals with long-term weight-loss success ("positive deviants") may improve the efficacy of web-based weight control interventions. ⋯ User-generated weight-loss practices from "positive deviants" could promote weight control in web-based interventions; however, further research is needed to improve program efficacy.
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The past decade has brought substantial changes in how data related to a community's health are collected, stored, and used to inform decisions about health interventions. Despite these changes, the purpose of public health surveillance has remained constant for more than a century. ⋯ Surveillance is an important and necessary contributor to knowledge of a community's health. The public health system is responsible for ensuring that public health surveillance is conducted with appropriate practices and safeguards in order to maintain the public's trust.
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Despite strong evidence that clinical preventive services (CPS) reduce morbidity and mortality, CPS performance has not improved in adult primary care. In addition to implementing electronic health records (EHRs), key factors for improving CPS include providing actionable information at the point of care, technical support staff, and quality-improvement assistance. These resources are not typically available in small practices. ⋯ Delivery of CPS can increase in small primary care practices that implement an EHR that includes comprehensive quality-improvement support.
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Sickle cell disease (SCD) is a collection of inherited blood disorders that affect a substantial number of people in the U. S., particularly African Americans. People with SCD have an abnormal type of hemoglobin, Hb S, which polymerizes when deoxygenated, causing the red blood cells to become misshapen and rigid. ⋯ Such activities include establishing newborn screening (NBS) for SCD with all states currently having universal NBS programs. However, additional areas needing focus include strengthening surveillance and monitoring of disease occurrence and health outcomes, enhancing adherence to health maintenance guidelines, increasing knowledge and awareness among those affected, and improving healthcare access and utilization. These and other activities discussed in this paper can help strengthen public health efforts to address SCD.
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Insufficient sleep among adolescents is common and has adverse health and behavior consequences. Understanding associations of physical activity and sedentary behaviors with sleep duration could shed light on ways to promote sufficient sleep. ⋯ Daily physical activity for ≥60 minutes and limited computer use are associated with sufficient sleep among adolescents.