American journal of preventive medicine
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Randomized Controlled Trial Clinical Trial
Evaluation of a hospital-based youth violence intervention.
To decrease adolescent morbidity and mortality and improve the quality of life, a violence-prevention consultation is offered to hospitalized victims of nondomestic violence. The context is a violence-prevention team approach to patient assessment, treatment, and follow-up. Psychoeducational counseling emphasizes the individual through a cognitive behavioral approach and also recognizes the individual in the proximal social setting through referrals to community resources. ⋯ No statistically significant differences between intervention subjects and nonintervention controls in terms of baseline variables have been observed. For inner-city adolescent victims of violent assaults, a hospital-based intervention offers a unique opportunity for reduction of the incidence of reinjury. We describe the elements of the intervention, including the theoretical basis and implementation; detail the overall evaluation design including modifications; and present preliminary analyses of baseline data.
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Previously published reports strongly suggest that being overweight is a risk factor for coronary heart disease, hypertension, diabetes, gallstones, and osteoarthritis in women. Substantial health care and medication costs are associated with these chronic health conditions. We used an incidence-based analysis to estimate the excess costs associated with women maintaining an overweight status during the 25-year period from age 40 to 65 years. ⋯ The results of this study indicate that an estimated $16 billion will be spent during the next 25 years treating health outcomes associated with overweight in middle-aged women in the United States. Thus, a substantial health burden is associated with the increasing prevalence of overweight women in the United States. Preventing excess coronary heart disease, gall-stones, osteoarthritis, hypertension, and diabetes through prevention of weight gain, particularly among reproductive-aged women, may be a cost-effective strategy.
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Self Enhancement, Inc., is a grassroots, community-service organization working in the most disadvantaged high-risk community in Portland, Oregon. Its violence-prevention program targets middle-school and high-school students by providing classroom and community activities to these young people. These activities are designed to enhance protective factors and build resilience in youths to enable them to attain healthy and productive lives and to resist the threats of gangs, violence, and drugs. ⋯ Baseline indicators of violence-related behaviors clearly indicate the need for intervention in this highly disadvantaged, African-American community. Through its historical presence and recent program development efforts, Self Enhancement, Inc., is well positioned to make a difference in the lives of these young people. The equivalence of program and comparison group students on baseline indicators of violence bodes well for an unequivocal assessment of program effectiveness over time.
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We examine racial and ethnic variations in use of screening mammography. We first review recent literature on Blacks', Hispanics', and non-Hispanic Whites' mammography use. Here we extend that body of literature through use of a comprehensive national database and discussion of the implications of race- and nonrace-stratified mammography modeling. ⋯ Researchers must give explicit attention, both empirically and methodologically, to how race and ethnicity interact with sociodemographic factors, health practices, and access to health care to refine our understanding of barriers to breast cancer screening. Common barriers to routine screening may be perceived differently by Black, Hispanic, and White women and may contribute to underuse of mammography in distinct ways.