American journal of preventive medicine
-
This study examined patterns of use of three adult preventive services-influenza vaccination, pneumococcal polysaccharide vaccination, and colorectal cancer (CRC) screening; factors associated with different use patterns; and reasons for non-use. ⋯ Rates of influenza and pneumonia vaccination and CRC screening are suboptimal. This is especially apparent when examining the combined use of these services. Patient and provider activation and the new "Welcome to Medicare" benefit are among the strategies that may improve use of these services among older Americans. Ongoing monitoring and further research are required to determine the most effective approaches.
-
HIV risk-reduction efforts have traditionally focused on the individual. The need for including the role of the social context and community is being recognized. Social capital provides social relationships and potential resources that may hinder or trigger risk or protective health behaviors, especially for individuals with limited economic means. ⋯ Individual actions and community context must be considered simultaneously when facilitating and assessing behavioral interventions.
-
Questions regarding the nature of the association between drug use and risk of homelessness remain unresolved and have important policy implications. ⋯ The role of homelessness as a risk factor for drug use initiation should be further explored. Efforts to prevent homelessness may also contribute to the prevention of drug abuse.
-
Randomized Controlled Trial
The multiphase optimization strategy (MOST) and the sequential multiple assignment randomized trial (SMART): new methods for more potent eHealth interventions.
In this article two new methods for building and evaluating eHealth interventions are described. The first is the Multiphase Optimization Strategy (MOST). It consists of a screening phase, in which intervention components are efficiently identified for inclusion in an intervention or for rejection, based on their performance; a refining phase, in which the selected components are fine tuned and issues such as optimal levels of each component are investigated; and a confirming phase, in which the optimized intervention, consisting of the selected components delivered at optimal levels, is evaluated in a standard randomized controlled trial. ⋯ A SMART trial can be used to identify the best tailoring variables and decision rules for an adaptive intervention empirically. Both the MOST and SMART approaches use randomized experimentation to enable valid inferences. When properly implemented, these approaches will lead to the development of more potent eHealth interventions.
-
Randomized Controlled Trial
Substance-use outcomes at 18 months past baseline: the PROSPER Community-University Partnership Trial.
The study's objective was to examine the effects of "real-world," community-based implementation of universal preventive interventions selected from a menu, including effects specific to higher- and lower-risk subsamples. ⋯ Community-based implementation of brief universal interventions designed for general populations has potential for public health impact by reducing substance use among adolescents.