American journal of preventive medicine
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Numerous authoritative reports have identified environmental and policy interventions as the most promising strategies for creating population-wide improvements in diet, physical activity, and obesity. Yet many methodologic challenges to conducting environmental and policy research must be overcome to enable this area of study to advance. A meeting titled "Study Designs and Analytic Strategies for Environmental and Policy Research on Obesity, Physical Activity, and Diet" was held April 8, 2008. ⋯ Training for investigators in the use of appropriate statistical methods for complex designs and interdisciplinary collaboration were recommended. Methodologic research priorities included the development of measures of policy, health impact assessments, and the investigation of policy adoption and implementation. The results of this conference can be used to improve the quality and quantity of environmental and policy research as well as the translation to action to control obesity.
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The Robert Wood Johnson Foundation requested this utilization-focused evaluation of its Active Living Research (ALR) program. This evaluation reports on the trajectory of influence of past and future ALR outcomes on field-building and policy contributions as well as on possible users of completed and disseminated ALR products. ⋯ Policy-relevant research can make contributions to policymakers' thinking but almost never causes a change by itself. Five years after the original authorization of ALR, there is ample evidence of its recognition as a resource by key players, its field-building influence, and its contributions to policy discussions. All these bear promise for a broader contribution to obesity prevention. Recommendations for increasing ALR's impact on policy and practice are offered.
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Passive smoking is a major risk factor for coronary heart disease (CHD), and existing estimates are out of date due to recent and substantial changes in the level of exposure. ⋯ Passive smoking remains a substantial clinical and economic burden in the U.S.
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Comparative Study
Rural-urban differences in injury hospitalizations in the U.S., 2004.
Despite prior research demonstrating higher injury-mortality rates among rural populations, few studies have examined the differences in nonfatal injury risk between rural and urban populations. The objective of this study was to compare injury-hospitalization rates between rural and urban populations using population-based national estimates derived from patient-encounter data. ⋯ These findings highlight the substantial burden imposed by injury on the U.S. population and the significantly increased risk for those residing in rural locations. Prevention and intervention efforts in rural areas should be expanded and should focus on risk factors unique to these populations.
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The overall suicide rate in the U.S. increased by 6% between 1981 and 1986 and declined by 18% between 1986 and 1999. Detailed descriptions of recent trends in suicide are lacking, especially with regard to the method of suicide. Information is needed on the major changes in rates of suicide in specific population groups in recent years (1999-2005). ⋯ The differential increases by age, race, gender, and method underscore a change in the epidemiology of suicide.Whites aged 40-64 years have recently emerged as a new high-risk group for suicide. Although firearms remain the most common method of suicide, the notable increases in suicide by poisoning in men and hanging/suffocation in women deserve prevention attention [corrected].