American journal of preventive medicine
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Data to assess factors associated with differences in coronary heart disease mortality between Caucasians and African Americans are limited. We assessed risks for sudden, nonsudden, and other coronary death between Caucasians and African Americans in relation to known risk factors for coronary disease and socioeconomic status. ⋯ Broad public health efforts are needed to address these causes of excess mortality.
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Women, and particularly African-American women, may be less physically active than what is ideal. Knowledge of factors that influence physical activity is valuable information to those planning and administering exercise promoting interventions. ⋯ Those planning interventions targeting female adolescents should consider employing distinct strategies for specific ethnic group and age subgroups. Opportunities for physicians to have an impact on the physical activity of female adolescents includes using their community standing to influence school policies and to counsel female patients individually during office visits.
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To understand the causes of low childhood immunization rates, physicians were interviewed about their knowledge, attitudes, and self-reported immunization practices. ⋯ If the Healthy People 2000 goal to eliminate indigenous cases of measles is to be achieved, free vaccine supplies and increased provider education are needed.
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Randomized Controlled Trial Clinical Trial
Effect of a cancer screening intervention conducted by lay health workers among inner-city women.
We conducted a randomized controlled trial to determine if an in-home educational intervention conducted by lay health workers (LHWs) could increase adherence among low-income, inner-city, African-American women to breast and cervical cancer screening schedules. ⋯ LHWs' intervention appeared to improve the rate at which inner-city women obtained CBEs and mammograms, but had no effect on Pap smears. A high attrition rate weakened our ability to make conclusive statements about the exact impact of the intervention.
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Prevention is being promoted as a means to improve health status and to save health care costs. Economic evaluations of prevention (i.e., cost-effectiveness and cost-benefit analyses) indicate that some prevention activities, like many treatments, do not save money, although many are relatively cost-effective. It has been suggested, however, that prevention is held to a higher standard than treatment because prevention programs are expected to demonstrate cost savings, and that the methods of economic evaluation understate the cost-effectiveness of prevention. Although the converse assertion is less commonly made, economic evaluations may also overstate the cost-effectiveness of prevention. The purpose of this article is to examine how the methods of economic evaluation may systematically understate, or overstate, the cost-effectiveness (or net benefits) of prevention. ⋯ We conclude that the methods of economic evaluation may both understate and overstate the cost-effectiveness of prevention.