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
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.
-
Prescription drugs are one of the fastest growing healthcare costs in the United States. However, the long-term influence of child abuse and related traumatic stressors on prescriptions for psychotropic medications in adults has not been described. This study assessed the relationship of eight adverse childhood experiences (ACEs) to rates of prescriptions for psychotropic medications throughout adulthood. These ACEs included: abuse (emotional, physical, or sexual), witnessing domestic violence, growing up with substance abusing, mentally ill, or criminal household members, and parental separation/divorce. ⋯ The strong relationship of the ACE Score to increased utilization of psychotropic medications underscores the contribution of childhood experience to the burden of adult mental illness. Moreover, the huge economic costs associated with the use of psychotropic medications provide additional incentive to address the high prevalence and consequences of childhood traumatic stressors.