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  Subjects -> HEALTH AND SAFETY (Total: 1290 journals)
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HEALTH AND SAFETY (520 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 9)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access  
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 20)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 4)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 3)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Health Economics     Full-text available via subscription   (Followers: 11)
American Journal of Health Education     Hybrid Journal   (Followers: 26)
American Journal of Health Promotion     Hybrid Journal   (Followers: 22)
American Journal of Health Studies     Full-text available via subscription   (Followers: 9)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 21)
American Journal of Public Health     Full-text available via subscription   (Followers: 181)
American Journal of Public Health Research     Open Access   (Followers: 26)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 9)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 2)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 6)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 2)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 1)
Behavioral Healthcare     Full-text available via subscription   (Followers: 5)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 7)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 18)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 7)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 16)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Canadian Family Physician     Partially Free   (Followers: 12)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 11)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 18)
Case Reports in Women's Health     Open Access   (Followers: 2)
Case Studies in Fire Safety     Open Access   (Followers: 12)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
Central European Journal of Public Health     Full-text available via subscription   (Followers: 4)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia y Cuidado     Open Access  
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 1)
Conflict and Health     Open Access   (Followers: 8)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 13)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 16)
EcoHealth     Hybrid Journal   (Followers: 3)
Education for Health     Open Access   (Followers: 4)
electronic Journal of Health Informatics     Open Access   (Followers: 4)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access  
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 3)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 3)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 1)
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 2)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 9)
Evidence-based Medicine & Public Health     Open Access   (Followers: 5)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 3)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 10)
Frontiers in Public Health     Open Access   (Followers: 7)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 11)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 5)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 8)
Global Journal of Public Health     Open Access   (Followers: 10)
Global Medical & Health Communication     Open Access  
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 3)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 15)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 8)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 7)
Health and Social Work     Hybrid Journal   (Followers: 48)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 12)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 11)
Health Issues     Full-text available via subscription   (Followers: 1)
Health Policy     Hybrid Journal   (Followers: 33)
Health Policy and Technology     Hybrid Journal   (Followers: 1)
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 21)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10)
Health Promotion Practice     Hybrid Journal   (Followers: 15)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 46)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 39)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 10)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Sciences and Disease     Open Access   (Followers: 2)
Health Services Insights     Open Access   (Followers: 2)
Health Systems     Hybrid Journal   (Followers: 2)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 11)
Health, Risk & Society     Hybrid Journal   (Followers: 11)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 10)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 3)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 2)
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 6)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 5)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 32)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 2)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 7)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 5)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 20)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 14)
International Journal of Health & Allied Sciences     Open Access   (Followers: 2)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 7)
International Journal of Health Geographics     Open Access   (Followers: 6)
International Journal of Health Policy and Management     Open Access   (Followers: 2)
International Journal of Health Professions     Open Access   (Followers: 2)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 12)

        1 2 3 | Last

Journal Cover American Journal of Preventive Medicine
  [SJR: 2.764]   [H-I: 154]   [21 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0749-3797
   Published by Elsevier Homepage  [3043 journals]
  • Perceived Neighborhood Social Cohesion and Preventive Healthcare Use
    • Authors: Eric S. Kim; Ichiro Kawachi
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Eric S. Kim, Ichiro Kawachi
      Introduction Neighborhood social cohesion has been linked with better health and health behaviors, but its association with patterns of preventive healthcare use remains understudied. The hypothesis was that people with higher perceived neighborhood social cohesion would display increased use of preventive healthcare services. Methods Participants (N=7,168) were drawn from the 2006 wave of the Health and Retirement Study—a prospective and nationally representative panel study of American adults aged >50 years—and tracked for one wave (2 years). Analyses were conducted in 2016. Results After adjusting for sociodemographic factors and baseline health, each SD increase in neighborhood social cohesion was associated with a higher likelihood that people would obtain influenza vaccinations (OR=1.09, 95% CI=1.04, 1.15) or cholesterol tests (OR=1.10, 95% CI=1.02, 1.19). Further, women were more likely to receive mammograms/x-rays (OR=1.10, 95% CI=1.01, 1.19) or Pap tests (OR=1.08, 95% CI=1.00, 1.17). However, men were not more likely to receive prostate exams (OR=1.06, 95% CI=0.96, 1.17). Conclusions With additional research, findings from this study may inform the development of new strategies that increase the use of preventive healthcare services and enhance the quality of life among people moving through the ranks of this aging society.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.01.007
  • National Disparities in Colorectal Cancer Screening Among Obese Adults
    • Authors: Ryan G. Seibert; Amresh D. Hanchate; Jonathan P. Berz; Paul C. Schroy
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Ryan G. Seibert, Amresh D. Hanchate, Jonathan P. Berz, Paul C. Schroy
      Introduction Obesity is a major risk factor for colorectal cancer (CRC), particularly among men. The purpose of this study was to characterize the prevalence of guideline-adherent CRC screening among obese adults using nationally representative data, assess trends in screening strategies, and identify obesity-specific screening barriers. Methods Data from 8,550 respondents aged 50–75 years in the 2010 National Health Interview Survey, representing >70 million adults, were analyzed in 2015 using multivariable logistic regression. Prevalence of guideline-adherent CRC screening, endoscopic versus fecal occult blood test screening, and reasons for non-adherence were compared across BMI categories. Results Obese class III men (BMI ≥40), compared with normal-weight men, were significantly less likely to be adherent to screening guidelines (38.7% vs 55.8%, AOR=0.35, 95% CI=0.17, 0.75); less likely to have used an endoscopic test (36.7% vs 53.0%, AOR=0.37, 95% CI=0.18, 0.79); and had a trend toward lower fecal occult blood test use (4.2% vs 8.9%, AOR=0.42, 95% CI=0.14, 1.27). Among women, odds of guideline adherence and use of different screening modalities were similar across all BMI categories. Reasons for non-adherence differed by gender and BMI; lacking a physician screening recommendation differed significantly among men (29.7% obese class III vs 15.4% non-obese, p=0.04), and pain/embarrassment differed significantly among women (11.6% obese class III vs 2.6% non-obese, p=0.002). Conclusions Despite elevated risk, severely obese men were significantly under-screened for CRC. Addressing the unique screening barriers of obese adults may promote screening uptake and lessen disparities among the vulnerable populations most affected by obesity.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.01.006
  • An Out-of-Pocket Cost Removal Intervention on Fecal Occult Blood Test
    • Authors: Takahiro Tabuchi; Hiroshi Murayama; Takahiro Hoshino; Tomio Nakayama
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Takahiro Tabuchi, Hiroshi Murayama, Takahiro Hoshino, Tomio Nakayama
      Introduction To date, no comparative study has assessed the impact of a cost-removal intervention on fecal occult blood testing (FOBT). In 2012, the Japanese government introduced a nationwide project to remove out-of-pocket costs for FOBT. The study objective was to evaluate the differential impact of the intervention on FOBT attendance in the total population and various subgroups. Methods This study analyzed 309,103 people in national, repeated cross-sectional studies, observed pre- and post-intervention (2010 and 2013), using covariate-adjusted difference-in-differences estimates to compare intervention and no-intervention groups. The outcome measure was uptake of FOBT attendance resulting from the intervention. Stratified analyses were conducted according to sociodemographic and health-related characteristics. Results The intervention was associated with significantly positive uptake of FOBT in both genders, but the impact was greater in women than men: 6.7% (95% CI=5.2, 8.1) for women and 2.7% (95% CI=1.1, 4.3) for men in the covariate-adjusted models. Post-intervention, attendance increased in almost all subgroups in women. However, among men, some socially advantaged subgroups, such as high expenditure, high education, and public officers, showed no effect. Some subgroups such as current smokers and less than high school education were identified as hard-to-reach populations that may be less sensitive to the intervention, irrespective of gender. Conclusions This is the first comparative study of cost-removal intervention for uptake of FOBT. The intervention may increase FOBT attendance. However, the size of the effect is not great, especially in men, and differential effects occurred across subgroups including gender and socioeconomic differences.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.01.004
  • Effectiveness of Switching Smoking-Cessation Medications Following Relapse
    • Authors: Bryan W. Heckman; K. Michael Cummings; Karin A. Kasza; Ron Borland; Jessica L. Burris; Geoffrey T. Fong; Ann McNeill; Matthew J. Carpenter
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Bryan W. Heckman, K. Michael Cummings, Karin A. Kasza, Ron Borland, Jessica L. Burris, Geoffrey T. Fong, Ann McNeill, Matthew J. Carpenter
      Introduction Nicotine dependence is a chronic disorder often characterized by multiple failed quit attempts (QAs). Yet, little is known about the sequence of methods used across multiple QAs or how this may impact future ability to abstain from smoking. This prospective cohort study examines the effectiveness of switching smoking-cessation medications (SCMs) across multiple QAs. Methods Adult smokers (aged ≥18 years) participating in International Tobacco Control surveys in the United Kingdom, U.S., Canada, and Australia (N=795) who: (1) completed two consecutive surveys between 2006 and 2011; (2) initiated a QA at least 1 month before each survey; and (3) provided data for the primary predictor (SCM use during most recent QA), outcome (1-month point prevalence abstinence), and relevant covariates. Analyses were conducted in 2016. Results Five SCM user classifications were identified: (1) non-users (43.5%); (2) early users (SCM used for initial, but not subsequent QA; 11.4%); (3) later users (SCM used for subsequent, but not initial QA; 18.4%); (4) repeaters (same SCM used for both QAs; 10.7%); and (5) switchers (different SCM used for each QA; 14.2%). Abstinence rates were lower for non-users (15.9%, OR=0.48, p=0.002), early users (16.6%, OR=0.27, p=0.03), and repeaters (12.4%, OR=0.36, p=0.004) relative to switchers (28.5%). Conclusions Findings suggest smokers will be more successful if they use a SCM in QAs and vary the SCM they use across time. That smokers can increase their odds of quitting by switching SCMs is an important message that could be communicated to smokers.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.01.038
  • Reduction in Cardiovascular Risk Among Latino Participants in a
           Community-Based Intervention Linked With Clinical Care
    • Authors: Mori J. Krantz; Brenda Beaty; Stephanie Coronel-Mockler; Bonnie Leeman-Castillo; Kelly Fletcher; Raymond O. Estacio
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Mori J. Krantz, Brenda Beaty, Stephanie Coronel-Mockler, Bonnie Leeman-Castillo, Kelly Fletcher, Raymond O. Estacio
      Introduction Community Heart Health Actions for Latinos at Risk is a community health worker–led cardiovascular disease risk reduction program targeting low-income urban Latinos. The impact of community programs linked with clinical care has not been well characterized. Methods Community Heart Health Actions for Latinos at Risk provided 12 weeks of lifestyle education. Changes in risk factors were assessed before and after completion. Univariate, bivariate, and multivariate analyses were used to determine factors associated with changes in risk factors. Results From 2009 to 2013, a total of 1,099 participants were recruited and 768 had risk factors measured at baseline and 12 weeks. All analyses were performed in 2016. In participants with abnormal baseline risk factors, significant (all p<0.001) median reductions in systolic blood pressure (–11 mmHg, n=244); low-density lipoprotein cholesterol (–14 mg/dL, n=201); glucose (–8 mg/dL, n=454); triglycerides (–57 mg/dL, n=242); and Framingham risk score (–2.3%, n=301) were observed. Program completion (eight of 12 classes) was associated with the reduction in low-density lipoprotein cholesterol (p=0.03) and systolic blood pressure (p=0.01). After adjustment, low-density lipoprotein cholesterol reduction was greatest in participants newly prescribed lipid-lowering drugs (–30%, 95% CI= –48, –15). Conclusions A community health worker–led intervention lowered cardiovascular disease risk among vulnerable Latinos. Integration with primary care services was an essential program component.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.04.012
  • Nicotine Intake per Cigarette Smoked Among Smokers Nationally and in New
           York City
    • Authors: Brandon J. Restrepo
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Brandon J. Restrepo

      PubDate: 2017-07-26T01:03:12Z
      DOI: 10.1016/j.amepre.2016.12.007
  • Flavored Tobacco Product Use in Youth and Adults: Findings From the First
           Wave of the PATH Study (2013–2014)
    • Authors: Andrea C. Villanti; Amanda L. Johnson; Bridget K. Ambrose; K. Michael Cummings; Cassandra A. Stanton; Shyanika W. Rose; Shari P. Feirman; Cindy Tworek; Allison M. Glasser; Jennifer L. Pearson; Amy M. Cohn; Kevin P. Conway; Raymond S. Niaura; Maansi Bansal-Travers; Andrew Hyland
      Pages: 139 - 151
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Andrea C. Villanti, Amanda L. Johnson, Bridget K. Ambrose, K. Michael Cummings, Cassandra A. Stanton, Shyanika W. Rose, Shari P. Feirman, Cindy Tworek, Allison M. Glasser, Jennifer L. Pearson, Amy M. Cohn, Kevin P. Conway, Raymond S. Niaura, Maansi Bansal-Travers, Andrew Hyland
      Introduction The 2009 Family Smoking Prevention and Tobacco Control Act banned characterizing flavors other than menthol in cigarettes but did not restrict their use in other forms of tobacco (e.g., smokeless, cigars, hookah, e-cigarettes). Methods A cross-sectional analysis of Wave 1 data from 45,971 U.S. adults and youth, aged ≥12 years in the Population Assessment of Tobacco and Health (PATH) Study collected in 2013–2014, was conducted in 2016. This study examined (1) the prevalence and reasons for use of flavored tobacco products; (2) the proportion of ever tobacco users reporting that their first product was flavored; and (3) correlates of current flavored tobacco product use. Results Current flavored (including menthol) tobacco product use was highest in youth (80%, aged 12–17 years); and young adult tobacco users (73%, aged 18–24 years); and lowest in older adult tobacco users aged ≥65 years (29%). Flavor was a primary reason for using a given tobacco product, particularly among youth. Eighty-one percent of youth and 86% of young adult ever tobacco users reported that their first product was flavored versus 54% of adults aged ≥25 years. In multivariable models, reporting that one’s first tobacco product was flavored was associated with a 13% higher prevalence of current tobacco use among youth ever tobacco users and a 32% higher prevalence of current tobacco use among adult ever users. Conclusions These results add to the evidence base that flavored tobacco products may attract young users and serve as starter products to regular tobacco use.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.01.026
  • Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional
           Analysis Among U.S. Workers Aged ≥45 Years
    • Authors: Leslie A. MacDonald; Stephen Bertke; Misty J. Hein; Suzanne Judd; Sherry Baron; Robert Merritt; Virginia J. Howard
      Pages: 152 - 161
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Leslie A. MacDonald, Stephen Bertke, Misty J. Hein, Suzanne Judd, Sherry Baron, Robert Merritt, Virginia J. Howard
      Introduction Identification of groups with poor cardiovascular health (CVH) can inform where and how to target public health efforts. National prevalence estimates of CVH were derived for clinical (blood glucose, total cholesterol, blood pressure) and behavioral (BMI, diet quality, physical activity, smoking) factors among U.S. workers aged ≥45 years. Methods This cross-sectional analysis included 6,282 employed black and white men and women aged ≥45 years enrolled in the national population-based REasons for Geographic And Racial Differences in Stroke study from 2003 to 2007. Each CVH factor was scored as ideal (2); intermediate (1); or poor (0) according to American Heart Association criteria, and summed to define optimal composite scores: CVH (sum, 10–14); clinical (sum, 5–6); and behavioral (sum, 6–8) health. Occupational data were collected 2011–2013. Analyses were conducted in 2016. Results Only 14% met ideal criteria for all three clinical health factors, and none met ideal criteria for all four behavioral health factors. Sales and low status office workers had a low prevalence of optimal CVH. Service workers in protective services and the food preparation and serving occupations had a low prevalence of optimal clinical health; computer and healthcare support workers had a low prevalence of optimal behavioral health. Conclusions The prevalence of optimal CVH among middle-aged and older workers in the U.S. is low, but considerable differences exist by occupation. Targeted public health interventions may improve the CVH of at-risk older workers with different clinical and behavioral risk factor profiles employed in diverse occupational settings.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.02.022
  • Human Papillomavirus Vaccine Uptake: Increase for American Indian
           Adolescents, 2013–2015
    • Authors: Jasmine L. Jacobs-Wingo; Cheyenne C. Jim; Amy V. Groom
      Pages: 162 - 168
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Jasmine L. Jacobs-Wingo, Cheyenne C. Jim, Amy V. Groom
      Introduction Although Indian Health Service, tribally-operated, and urban Indian (I/T/U) healthcare facilities have higher human papillomavirus (HPV) vaccine series initiation and completion rates among adolescent patients aged 13–17 years than the general U.S. population, challenges remain. I/T/U facilities have lower coverage for HPV vaccine first dose compared with coverage for other adolescent vaccines, and HPV vaccine series completion rates are lower than initiation rates. Researchers aimed to assist I/T/U facilities in identifying interventions to increase HPV vaccination series initiation and completion rates. Study design Best practice and intervention I/T/U healthcare facilities were identified based on baseline adolescent HPV vaccine coverage data. Healthcare professionals were interviewed about barriers and facilitators to HPV vaccination. Researchers used responses and evidence-based practices to identify and assist facilities in implementing interventions to increase adolescent HPV vaccine series initiation and completion. Coverage and interview data were collected from June 2013 to June 2015; data were analyzed in 2015. Setting/participants I/T/U healthcare facilities located within five Indian Health Service regions. Intervention Interventions included analyzing and providing feedback on facility vaccine coverage data, educating providers about HPV vaccine, expanding access to HPV vaccine, and establishing or expanding reminder recall and education efforts. Main outcome measures Impact of evidence-based strategies and best practices to support HPV vaccination. Results Mean baseline first dose coverage with HPV vaccine at best practice facilities was 78% compared with 46% at intervention facilities. Mean third dose coverage was 48% at best practice facilities versus 19% at intervention facilities. Intervention facilities implemented multiple low-cost, evidence-based strategies and best practices to increase vaccine coverage. At baseline, most facilities used electronic provider reminders, had standing orders in place for administering HPV vaccine, and administered tetanus, diphtheria, and acellular pertussis and HPV vaccines during the same visit. At intervention sites, mean coverage for HPV initiation and completion increased by 24% and 22%, respectively. Conclusions A tailored multifaceted approach addressing vaccine delivery processes and patient and provider education may increase HPV vaccine coverage.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.01.024
  • Heavy Drinking in Young Adulthood Increases Risk of Transitioning to
    • Authors: Tera L. Fazzino; Kimberly Fleming; Kenneth J. Sher; Debra K. Sullivan; Christie Befort
      Pages: 169 - 175
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Tera L. Fazzino, Kimberly Fleming, Kenneth J. Sher, Debra K. Sullivan, Christie Befort
      Introduction Heavy episodic alcohol use during young adulthood may contribute to excess weight gain and transition from healthy weight to overweight/obesity. This study is the first to evaluate the association between heavy episodic drinking during early adulthood and transition to overweight/obese status 5 years later using data from the U.S. National Longitudinal Study of Adolescent to Adult Health. Methods The study used data from Waves III and IV, when participants were aged 18–26 and 24–32 years, respectively. The final sample consisted of 7,941 participants with measured height/weight who reported ever drinking alcohol. Multinomial logistic regression models tested the association between heavy episodic drinking and risk of transitioning to an unhealthy weight class. Results Heavy episodic drinking was associated with 41% higher risk of transitioning from normal weight to overweight (relative risk ratio, 1.41; 95% CI=1.13, 1.74; p=0.002) and 36% higher risk of transitioning from overweight to obese by Wave IV (relative risk ratio, 1.36; 95% CI=1.09, 1.71; p=0.008), compared with individuals not drinking heavily, while accounting for covariates. Heavy episodic drinking was associated with 35% higher risk of maintaining obesity (relative risk ratio, 1.35; CI=1.06, 1.72; p=0.016) and gaining excess weight (OR=1.20, 95% CI=1.03, 1.39, p=0.02). Conclusions Regular heavy episodic drinking in young adulthood is associated with higher risk of gaining excess weight and transitioning to overweight/obesity. Obesity prevention efforts should address heavy drinking as it relates to caloric content and risk of transitioning to an unhealthy weight class.

      PubDate: 2017-07-26T01:03:12Z
      DOI: 10.1016/j.amepre.2017.02.007
  • Primary Enforcement of Mandatory Seat Belt Laws and Motor Vehicle Crash
    • Authors: Sam Harper; Erin C. Strumpf
      Pages: 176 - 183
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Sam Harper, Erin C. Strumpf
      Introduction Policies that allow directly citing motorists for seat belt non-use (primary enforcement) have been shown to reduce motor vehicle crash deaths relative to secondary enforcement, but the evidence base is dated and does not account for recent improvements in vehicle designs and road safety. The purpose of this study was to test whether recent upgrades to primary enforcement still reduce motor vehicle crash deaths. Methods In 2016, researchers used motor vehicle crash death data from the Fatal Analysis Reporting System for 2000–2014 and calculated rates using both person- and exposure-based denominators. Researchers used a difference-in-differences design to estimate the effect of primary enforcement on death rates, and estimated negative binomial regression models, controlling for age, substance use involvement, fixed state characteristics, secular trends, state median household income, and other state-level traffic safety policies. Results Models adjusted only for crash characteristics and state-level covariates models showed a protective effect of primary enforcement (rate ratio, 0.88, 95% CI=0.77, 0.98; rate difference, –1.47 deaths per 100,000 population, 95% CI= –2.75, –0.19). After adjustment for fixed state characteristics and secular trends, there was no evidence of an effect of upgrading from secondary to primary enforcement in the whole population (rate ratio, 0.98, 95% CI=0.92, 1.04; rate difference, –0.22, 95% CI= –0.90, 0.46) or for any age group. Conclusions Upgrading to primary enforcement no longer appears protective for motor vehicle crash death rates.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.02.003
  • Anti-bullying Policies and Disparities in Bullying: A State-Level Analysis
    • Authors: Mark L. Hatzenbuehler; Javier E. Flores; Joseph E. Cavanaugh; Angela Onwuachi-Willig; Marizen R. Ramirez
      Pages: 184 - 191
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Mark L. Hatzenbuehler, Javier E. Flores, Joseph E. Cavanaugh, Angela Onwuachi-Willig, Marizen R. Ramirez
      Introduction Recent research suggests that anti-bullying laws may be effective in reducing risk of bullying victimization among youth, but no research has determined whether these laws are also effective in reducing disparities in bullying. The aim of this paper was to evaluate the effectiveness of anti-bullying legislation in reducing disparities in sex- and weight-based bullying and cyberbullying victimization. Methods Data on anti-bullying legislation were obtained from the U.S. Department of Education, which commissioned a systematic review of 16 key components of state laws in 2011. States were also categorized based on whether their legislation enumerated protected groups and, if so, which groups were enumerated. These policy variables from 28 states were linked to individual-level data on bullying and cyberbullying victimization from students in 9th through 12th grade participating in the 2011 Youth Risk Behavior Surveillance System study (N=79,577). Analyses were conducted in 2016. Results There was an absence of any kind of moderating effect of anti-bullying legislation on weight-based disparities in bullying and cyberbullying victimization. Only state laws with high compliance to Department of Education enumeration guidelines were associated with lower sex-based disparities in bullying victimization. Conclusions Anti-bullying policies were not associated with lower weight-based disparities in bullying and cyberbullying victimization among youth, and only one form of policies (high compliance to Department of Education enumeration guidelines) was associated with lower sex-based disparities in bullying victimization. Results therefore suggest that anti-bullying legislation requires further refinement to protect youth who are vulnerable to bullying victimization.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.02.004
  • Smoking-Cessation Assistance: Before and After Stage 1 Meaningful Use
    • Authors: Steffani R. Bailey; John D. Heintzman; Miguel Marino; R. Lorie Jacob; Jon E. Puro; Jennifer E. DeVoe; Tim E. Burdick; Brian L. Hazlehurst; Deborah J. Cohen; Stephen P Fortmann
      Pages: 192 - 200
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Steffani R. Bailey, John D. Heintzman, Miguel Marino, R. Lorie Jacob, Jon E. Puro, Jennifer E. DeVoe, Tim E. Burdick, Brian L. Hazlehurst, Deborah J. Cohen, Stephen P Fortmann
      Introduction Brief smoking-cessation interventions in primary care settings are effective, but delivery of these services remains low. The Centers for Medicare and Medicaid Services’ Meaningful Use (MU) of Electronic Health Record (EHR) Incentive Program could increase rates of smoking assessment and cessation assistance among vulnerable populations. This study examined whether smoking status assessment, cessation assistance, and odds of being a current smoker changed after Stage 1 MU implementation. Methods EHR data were extracted from 26 community health centers with an EHR in place by June 15, 2009. AORs were computed for each binary outcome (smoking status assessment, counseling given, smoking-cessation medications ordered/discussed, current smoking status), comparing 2010 (pre-MU), 2012 (MU preparation), and 2014 (MU fully implemented) for pregnant and non-pregnant patients. Results Non-pregnant patients had decreased odds of current smoking over time; odds for all other outcomes increased except for medication orders from 2010 to 2012. Among pregnant patients, odds of assessment and counseling increased across all years. Odds of discussing or ordering of cessation medications increased from 2010 compared with the other 2 study years; however, medication orders alone did not change over time, and current smoking only decreased from 2010 to 2012. Compared with non-pregnant patients, a lower percentage of pregnant patients were provided counseling. Conclusions Findings suggest that incentives for MU of EHRs increase the odds of smoking assessment and cessation assistance, which could lead to decreased smoking rates among vulnerable populations. Continued efforts for provision of cessation assistance among pregnant patients is warranted.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.02.006
  • Individual- and Area-Level SES in Diabetes Risk Prediction: The
           Multi-Ethnic Study of Atherosclerosis
    • Authors: Paul J. Christine; Rebekah Young; Sara D. Adar; Alain G. Bertoni; Michele Heisler; Mercedes R. Carnethon; Rodney A. Hayward; Ana V. Diez Roux
      Pages: 201 - 209
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Paul J. Christine, Rebekah Young, Sara D. Adar, Alain G. Bertoni, Michele Heisler, Mercedes R. Carnethon, Rodney A. Hayward, Ana V. Diez Roux
      Introduction The purpose of this study was to evaluate if adding SES to risk prediction models based upon traditional risk factors improves the prediction of diabetes. Methods Risk prediction models without and with individual- and area-level SES predictors were compared using the prospective Multi-Ethnic Study of Atherosclerosis. Cox proportional hazards models were utilized to estimate hazard ratios for SES predictors and to generate 10-year predicted risks for 5,021 individuals without diabetes at baseline followed from 2000 to 2012. C-statistics were used to compare model discrimination, and the proportion of individuals reclassified into higher or lower risk categories with the addition of SES predictors was calculated. The accuracy of risk prediction by SES was assessed by comparing observed and predicted risks across tertiles of the SES variables. Statistical analyses were performed in 2015–2016. Results Over a median of 9.2 years of follow-up, 615 individuals developed diabetes. Individual- and area-level SES variables did not significantly improve model discrimination or reclassify substantial numbers of individuals across risk categories. Models without SES predictors generally underestimated risk for low-SES individuals or individuals residing in low-SES areas (underestimates ranging from 0.31% to 1.07%) and overestimated risk for high-SES individuals or individuals residing in high-SES areas (overestimates ranging from 0.70% to 1.30%), and the addition of SES variables largely mitigated these differences. Conclusions Standard diabetes risk models may underestimate risk for low-SES individuals and overestimate risk for those of high SES. Adding SES predictors helps correct this systematic misestimation, but may not improve model discrimination.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.04.019
  • Booster Seat Effectiveness Among Older Children: Evidence From Washington
    • Authors: D. Mark Anderson; Lindsay L. Carlson; Daniel I. Rees
      Pages: 210 - 215
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): D. Mark Anderson, Lindsay L. Carlson, Daniel I. Rees
      Introduction The American Academy of Pediatrics has recommended that children as old as 12 years use a booster seat when riding in motor vehicles, yet little is known about booster seat effectiveness when used by older children. This study estimated the association between booster use and injuries among children aged 8–12 years who were involved in motor vehicle crashes. Methods Researchers analyzed data on all motor vehicle crashes involving children aged 8–12 years reported to the Washington State Department of Transportation from 2002 to 2015. Data were collected in 2015 and analyzed in 2016. Children who were in a booster seat were compared with children restrained by a seat belt alone. Logistic regression was used to adjust for potential confounders. Results In unadjusted models, booster use was associated with a 29% reduction in the odds of experiencing any injury versus riding in a seat belt alone (OR=0.709, 95% CI=0.675, 0.745). In models adjusted for potential confounders, booster use was associated with a 19% reduction in the odds of any injury relative to riding in a seat belt alone (OR=0.814, 95% CI=0.749, 0.884). The risk of experiencing an incapacitating/fatal injury was not associated with booster use. Conclusions Children aged 8–12 years involved in a motor vehicle crash are less likely to be injured if in a booster than if restrained by a seat belt alone. Because only 10% of U.S. children aged 8–12 years use booster seats, policies encouraging their use could lead to fewer injuries.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.02.023
  • Job Characteristics Associated With Self-Rated Fair or Poor Health Among
           U.S. Workers
    • Authors: Sara E. Luckhaupt; Toni Alterman; Jia Li; Geoffrey M. Calvert
      Pages: 216 - 224
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Sara E. Luckhaupt, Toni Alterman, Jia Li, Geoffrey M. Calvert
      Introduction Approximately 60% of the U.S. adult population is employed. Many aspects of a person’s job may influence health, but it is unclear which job characteristics are most strongly associated with health at a population level. The purpose of this study was to identify important associations between job characteristics and workers’ self-rated health in a nationally representative survey of U.S. workers. Methods Data from the 2010 National Health Interview Survey were used to calculate weighted prevalence rates for self-reported fair/poor health for five categories of job characteristics: occupation; pay/benefits (economic); work organization; chemical/environmental hazards; and psychosocial factors. Backward elimination methods were used to build a regression model for self-reported health with the significant job characteristics, adjusting for sociodemographic variables and health behaviors. Data were collected in 2010 and analyzed in 2012–2016. Results After adjusting for covariates, workers were more likely to have fair/poor health if they were employed in business operations occupations (e.g., buyers, human resources workers, event planners, marketing specialists; adjusted prevalence ratio [APR]=1.85, 95% CI=1.19, 2.88); had no paid sick leave (APR=1.35, 95% CI=1.11, 1.63); worried about becoming unemployed (APR=1.43, 95% CI=1.22, 1.69); had difficulty combining work and family (APR=1.23, 95% CI=1.01, 1.49); or had been bullied/threatened on the job (APR=1.82, 95% CI=1.44, 2.29). Conclusions Occupation, lack of paid sick leave, and multiple psychosocial factors were associated with fair/poor health among U.S. workers at the population level in 2010. Public health professionals and employers should consider these factors when developing interventions to improve worker health.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.03.023
  • Sexual and Behavioral Health Disparities Among Sexual Minority
           Hispanics/Latinos: Findings From the National Health and Nutrition
           Examination Survey, 2001–2014
    • Authors: Omar Martinez; Ji Hyun Lee; Frank Bandiera; E. Karina Santamaria; Ethan C. Levine; Don Operario
      Pages: 225 - 231
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Omar Martinez, Ji Hyun Lee, Frank Bandiera, E. Karina Santamaria, Ethan C. Levine, Don Operario
      Introduction Hispanics/Latinos (henceforth, Latinos) are the largest minority group in the U.S. With growing health disparities among this group, the highest burden remains among sexual and gender minority Latinos. Differences regarding sexual orientation have not been fully explored within this group using national representative samples. This study analyzed sexual and behavioral health disparities associated with sexual minority status among Latinos in the U.S. Methods The study included data from 5,598 Latino adults who participated in the 2001–2014 waves of the National Health and Nutrition Examination Survey. Data analysis was conducted in 2016. Bivariate and multivariable logistic regression analyses examined the prevalence of HIV, sexually transmitted infections, mental health problems, cigarette smoking, and alcohol/illicit drug use among sexual minorities and heterosexual Latino adults. Sexual minorities were defined as “gay, lesbian, and bisexual” (GLB) and “other” non-heterosexual groups. Results GLB Latinos reported higher prevalence of mental health problems and cigarette smoking compared with heterosexuals. After adjusting for covariates, GLB Latinos had greater odds of testing positive for HIV, lifetime diagnosis of sexually transmitted infections, poor mental health outcomes, cigarette smoking (including lifetime and current smoking status), and illicit drug use than heterosexuals. Conclusions The disproportionate impact of health disparities among Latinos varies significantly by sexual orientation, with GLB individuals facing elevated prevalence. In particular, elevated odds for HIV/sexually transmitted infections, mental health problems, smoking, and illicit substance use were found. Further research, including longitudinal studies to understand the trajectories of risks, is needed to identify intervention opportunities in this population.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.01.037
  • The Effects of Feedback on Adherence to Treatment: A Systematic Review and
           Meta-analysis of RCTs
    • Authors: Mansha D. Seewoodharry; Gail D.E. Maconachie; Clare L. Gillies; Irene Gottlob; Rebecca J. McLean
      Pages: 232 - 240
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Mansha D. Seewoodharry, Gail D.E. Maconachie, Clare L. Gillies, Irene Gottlob, Rebecca J. McLean
      Context The aim of this systematic review is to determine whether providing feedback, guided by subjective or objective measures of adherence, improves adherence to treatment. Evidence acquisition Data sources included MEDLINE, Embase, CINAHL, and PsycINFO, and reference lists of retrieved articles. Only RCTs comparing the effect of feedback on adherence outcome were included. Three independent reviewers extracted data for all potentially eligible studies using an adaptation of the Cochrane Library data extraction sheet. The primary outcome, change in adherence, was obtained by measuring the difference between adherence at baseline visit (prior to feedback) and at the last visit (post-feedback). Evidence synthesis Twenty-four studies were included in the systematic review, and 16 found a significant improvement in adherence in the intervention group (change in adherence range, –13% to +22%), whereas adherence worsened in the control group (change in adherence range, –32% to 10.2%). Meta-analysis included six studies, and the pooled effect showed that mean percentage adherence increased by 10.02% (95% CI=3.15%, 16.89%, p=0.004) more between baseline and follow-up in the intervention groups compared with control groups. Meta-regression confirmed that study quality, form of monitoring adherence, delivery of feedback, or study duration did not influence effect size. Conclusions Feedback guided by objective or subjective measures of adherence improves adherence and, perhaps more importantly, prevents worsening of adherence over time even when only small absolute improvements in adherence were noted. Increased use of feedback to improve treatment adherence has the potential to reduce avoidable healthcare costs caused by non-adherence.

      PubDate: 2017-07-26T01:03:12Z
      DOI: 10.1016/j.amepre.2017.03.005
  • Neighborhood Environment and Cognition in Older Adults: A Systematic
    • Authors: Lilah M. Besser; Noreen C. McDonald; Yan Song; Walter A. Kukull; Daniel A. Rodriguez
      Pages: 241 - 251
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Lilah M. Besser, Noreen C. McDonald, Yan Song, Walter A. Kukull, Daniel A. Rodriguez
      Context Some evidence suggests that treating vascular risk factors and performing mentally stimulating activities may delay cognitive impairment onset in older adults. Exposure to a complex neighborhood environment may be one mechanism to help delay cognitive decline. Evidence acquisition PubMed, Web of Science, and ProQuest Dissertation and Theses Global database were systematically reviewed, identifying 25 studies published from February 1, 1989 to March 5, 2016 (data synthesized, May 3, 2015 to October 7, 2016). The review was restricted to quantitative studies focused on: (1) neighborhood social and built environment and cognition; and (2) community-dwelling adults aged ≥45 years. Evidence synthesis The majority of studies were cross-sectional, U.S.-based, and found at least one significant association. The diversity of measures and neighborhood definitions limited the synthesis of findings in many instances. Evidence was moderately strong for an association between neighborhood SES and cognition, and modest for associations between neighborhood demographics, design, and destination accessibility and cognition. Most studies examining effect modification found significant associations, with some evidence for effect modification of the neighborhood SES−cognition association by individual-level SES. No studies had low risk of bias and many tested multiple associations that increased the chance of a statistically significant finding. Considering the studies to date, the evidence for an association between neighborhood characteristics and cognition is modest. Conclusions Future studies should include longitudinal measures of neighborhood characteristics and cognition; examine potential effect modifiers, such as sex and disability; and study mediators that may help elucidate the biological mechanisms linking neighborhood environment and cognition.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.02.013
  • Geographic Information Systems to Assess External Validity in Randomized
    • Authors: Margaret R. Savoca; David A. Ludwig; Stedman T. Jones; K. Jason Clodfelter; Joseph B. Sloop; Linda Y. Bollhalter; Alain G. Bertoni
      Pages: 252 - 259
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Margaret R. Savoca, David A. Ludwig, Stedman T. Jones, K. Jason Clodfelter, Joseph B. Sloop, Linda Y. Bollhalter, Alain G. Bertoni
      Introduction To support claims that RCTs can reduce health disparities (i.e., are translational), it is imperative that methodologies exist to evaluate the tenability of external validity in RCTs when probabilistic sampling of participants is not employed. Typically, attempts at establishing post hoc external validity are limited to a few comparisons across convenience variables, which must be available in both sample and population. A Type 2 diabetes RCT was used as an example of a method that uses a geographic information system to assess external validity in the absence of a priori probabilistic community-wide diabetes risk sampling strategy. Methods A geographic information system, 2009–2013 county death certificate records, and 2013–2014 electronic medical records were used to identify community-wide diabetes prevalence. Color-coded diabetes density maps provided visual representation of these densities. Chi-square goodness of fit statistic/analysis tested the degree to which distribution of RCT participants varied across density classes compared to what would be expected, given simple random sampling of the county population. Analyses were conducted in 2016. Results Diabetes prevalence areas as represented by death certificate and electronic medical records were distributed similarly. The simple random sample model was not a good fit for death certificate record (chi-square, 17.63; p=0.0001) and electronic medical record data (chi-square, 28.92; p<0.0001). Generally, RCT participants were oversampled in high−diabetes density areas. Conclusions Location is a highly reliable “principal variable” associated with health disparities. It serves as a directly measurable proxy for high-risk underserved communities, thus offering an effective and practical approach for examining external validity of RCTs.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.01.001
  • Proposed Medicare Coverage for Diabetes Prevention: Strengths,
           Limitations, and Recommendations for Improvement
    • Authors: Natalie D. Ritchie; Edward P. Havranek; Susan L. Moore; Rocio I. Pereira
      Pages: 260 - 263
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Natalie D. Ritchie, Edward P. Havranek, Susan L. Moore, Rocio I. Pereira

      PubDate: 2017-07-26T01:03:12Z
      DOI: 10.1016/j.amepre.2017.02.005
  • Food Insecurity and Mental Health Status: A Global Analysis of 149
    • Authors: Andrew D. Jones
      Pages: 264 - 273
      Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2
      Author(s): Andrew D. Jones
      Introduction This study sought to determine the association of individual-level food insecurity (FI) with mental health status across all global regions. Methods Cross-sectional data were analyzed in 2016 from the 2014 Gallup World Poll, a series of globally implemented, nationally representative surveys. FI was assessed using the Food Insecurity Experience Scale Survey Module for Individuals, an eight-question psychometric scale reporting individuals’ experiences of FI. Individual-level composite indices of mental health, the Negative Experience Index and Positive Experience Index (0–100 scale), were calculated based on responses to five questions of respondents’ recent negative and positive experiences, respectively, associated with depression and mental distress. Results The prevalence of any FI ranged from 18.3% in East Asia to 76.1% in Sub-Saharan Africa. In global analyses (149 countries) using adjusted multiple regression analyses, FI was associated in a dose–response fashion with poorer scores on the mental health indices (coefficient [95% CI]: Negative Experience Index: mild FI, 10.4 [9.5, 11.2]; moderate FI, 17.7 [16.4, 19.0]; severe FI, 24.5 [22.7, 26.3]; Positive Experience Index: mild FI, –8.3 [–9.3, –7.4]; moderate FI, –12.6 [–13.8, –11.3]; severe FI, –16.2 [–17.9, –14.5]). Within-region analyses (11 regions) consistently demonstrated the same trends. Conclusions FI is associated with poorer mental health and specific psychosocial stressors across global regions independent of SES. The numerous pathways via which FI may contribute to common mental disorders, and the broad social implications of FI linked to cultural norms and self-efficacy, may contribute to the cross-cultural consistency of the findings.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.04.008
  • Social Media Use and Perceived Social Isolation Among Young Adults in the
    • Authors: Brian A. Primack; Ariel Shensa; Jaime E. Sidani; Erin O. Whaite; Liu yi Lin; Daniel Rosen; Jason B. Colditz; Ana Radovic; Elizabeth Miller
      Pages: 1 - 8
      Abstract: Publication date: July 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 1
      Author(s): Brian A. Primack, Ariel Shensa, Jaime E. Sidani, Erin O. Whaite, Liu yi Lin, Daniel Rosen, Jason B. Colditz, Ana Radovic, Elizabeth Miller
      Introduction Perceived social isolation (PSI) is associated with substantial morbidity and mortality. Social media platforms, commonly used by young adults, may offer an opportunity to ameliorate social isolation. This study assessed associations between social media use (SMU) and PSI among U.S. young adults. Methods Participants were a nationally representative sample of 1,787 U.S. adults aged 19–32 years. They were recruited in October–November 2014 for a cross-sectional survey using a sampling frame that represented 97% of the U.S. population. SMU was assessed using both time and frequency associated with use of 11 social media platforms, including Facebook, Twitter, Google+, YouTube, LinkedIn, Instagram, Pinterest, Tumblr, Vine, Snapchat, and Reddit. PSI was measured using the Patient-Reported Outcomes Measurement Information System scale. In 2015, ordered logistic regression was used to assess associations between SMU and SI while controlling for eight covariates. Results In fully adjusted multivariable models that included survey weights, compared with those in the lowest quartile for SMU time, participants in the highest quartile had twice the odds of having greater PSI (AOR=2.0, 95% CI=1.4, 2.8). Similarly, compared with those in the lowest quartile, those in the highest quartile of SMU frequency had more than three times the odds of having greater PSI (AOR=3.4, 95% CI=2.3, 5.1). Associations were linear (p<0.001 for all), and results were robust to all sensitivity analyses. Conclusions Young adults with high SMU seem to feel more socially isolated than their counterparts with lower SMU. Future research should focus on determining directionality and elucidating reasons for these associations.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.01.010
  • Dietary and Physical Activity Counseling Trends in U.S. Children,
    • Authors: Adebowale Odulana; William T. Basco; Kinfe G. Bishu; Leonard E. Egede
      Pages: 9 - 16
      Abstract: Publication date: July 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 1
      Author(s): Adebowale Odulana, William T. Basco, Kinfe G. Bishu, Leonard E. Egede
      Introduction In 2007 and 2010, Expert Committee and U.S. Preventive Services Task Force guidelines were released, respectively, urging U.S. practitioners to deliver preventive obesity counseling for children. This study determined the frequency and evaluated predictors of receiving counseling for diet and physical activity among a national sample of children from 2002 to 2011. Methods Children aged 6–17 years were used from the 2002–2011 Medical Expenditure Panel Surveys and analyzed in 2016. Parental report of two questions assessed whether children received both dietary and exercise counseling from the provider. Children were grouped by weight category. Bivariate analyses compared the frequency of receiving counseling; logistic regression evaluated predictors of receiving counseling. Results The sample included 36,114 children; <50% of children received counseling. Across all time periods, children were more likely to receive counseling with increasing weight. Logistic regression models showed that obese children had greater odds of receiving counseling versus normal-weight children, even after adjusting for covariates. Additional significant positive correlates of receiving counseling were Hispanic ethnicity, living in an urban setting, and being in the highest income stratum. Being uninsured was associated with lower odds of counseling. Years 2007–2009 and 2010–2011 were associated with increased counseling versus the benchmark year category in the multivariable model. Conclusions Counseling appears more likely with greater weight and increased after both guidelines in 2007 and 2010. Overall counseling rates for children remain low. Future work should focus on marginalized groups, such as racial and ethnic minorities and rural populations.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.01.039
  • Effect of Maryland’s 2011 Alcohol Sales Tax Increase on
           Alcohol-Positive Driving
    • Authors: Marie-Claude Lavoie; Patricia Langenberg; Andres Villaveces; Patricia C. Dischinger; Linda Simoni-Wastila; Kathleen Hoke; Gordon S. Smith
      Pages: 17 - 24
      Abstract: Publication date: July 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 1
      Author(s): Marie-Claude Lavoie, Patricia Langenberg, Andres Villaveces, Patricia C. Dischinger, Linda Simoni-Wastila, Kathleen Hoke, Gordon S. Smith
      Introduction The 2011 Maryland alcohol sales tax increase from 6% to 9% provided an opportunity to evaluate the impact on rates of alcohol-positive drivers involved in injury crashes. Methods Maryland police crash reports from 2001 to 2013 were analyzed using an interrupted time series design and a multivariable analysis employing generalized estimating equations models with a negative binomial distribution. Data were analyzed in 2014–2015. Results There was a significant gradual annual reduction of 6% in the population-based rate of all alcohol-positive drivers (p<0.03), and a 12% reduction for drivers aged 15–20 years (p<0.007), and 21–34 years (p<0.001) following the alcohol sales tax increase. There were no significant changes in rates of alcohol-positive drivers aged 35–54 years (rate ratio, 0.98; 95% CI=0.89, 1.09). Drivers aged ≥55 years had a significant immediate 10% increase in the rate of alcohol-positive drivers (rate ratio, 1.10; 95% CI=1.04, 1.16) and a gradual increase of 4.8% per year after the intervention. Models using different denominators and controlling for multiple factors including a proxy for unmeasured factors found similar results overall. Conclusions The 2011 Maryland alcohol sales tax increase led to a significant reduction in the rate of all alcohol-positive drivers involved in injury crashes especially among drivers aged 15–34 years. This is the first study to examine the impact of alcohol sales taxes on crashes; previous research focused on excise tax. Increasing alcohol taxes is an important but often neglected intervention to reduce alcohol-impaired driving.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2016.12.011
  • The Built Environment and Cognitive Disorders: Results From the Cognitive
           Function and Ageing Study II
    • Authors: Yu-Tzu Wu; A. Matthew Prina; Andy Jones; Fiona E. Matthews; Carol Brayne
      Pages: 25 - 32
      Abstract: Publication date: July 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 1
      Author(s): Yu-Tzu Wu, A. Matthew Prina, Andy Jones, Fiona E. Matthews, Carol Brayne
      Introduction Built environment features have been related to behavior modification and might stimulate cognitive activity with a potential impact on cognitive health in later life. This study investigated cross-sectional associations between features of land use and cognitive impairment and dementia, and also explored urban and rural differences in these associations. Methods Postcodes of the 7,505 community-based participants (aged ≥65 years) in the Cognitive Function and Ageing Study II (collected in 2008–2011) were linked to environmental data from government statistics. Multilevel logistic regression investigated associations between cognitive impairment (defined as Mini-Mental State Examination score ≤25) and dementia (Geriatric Mental Status and Automatic Geriatric Examination for Computer-Assisted Taxonomy organicity level ≥3) and land use features, including natural environment availability and land use mix, fitting interaction terms with three rural/urban categories. Data were analyzed in 2015. Results Associations between features of land use and cognitive impairment were not linear. After adjusting for individual-level factors and area deprivation, living in areas with high land use mix was associated with a nearly 30% decreased odds of cognitive impairment (OR=0.72, 95% CI=0.58, 0.89). This was similar, yet non-significant, for dementia (OR=0.70, 95% CI=0.46, 1.06). In conurbations, living in areas with high natural environment availability was associated with 30% reduced odds of cognitive impairment (OR=0.70, 95% CI=0.50, 0.97). Conclusions Non-linear associations between features of land use and cognitive impairment were confirmed in this new cohort of older people in England. Both lack of and overload of environmental stimulation may be detrimental to cognition in later life.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2016.11.020
  • Impact of Age at Smoking Initiation on Smoking-Related Morbidity and
           All-Cause Mortality
    • Authors: Seung Hee Choi; Manfred Stommel
      Pages: 33 - 41
      Abstract: Publication date: July 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 1
      Author(s): Seung Hee Choi, Manfred Stommel
      Introduction Using a nationally representative sample of U.S. adults, the aims of this study were to examine the impact of early smoking initiation on the development of self-reported smoking-related morbidity and all-cause mortality. Methods National Health Interview Survey data from 1997 through 2005 were linked to the National Death Index with follow-up to December 31, 2011. Two primary dependent variables were smoking-related morbidity and all-cause mortality; the primary independent variable was age of smoking initiation. The analyses included U.S. population of current and former smokers aged ≥30 years (N=90,278; population estimate, 73.4 million). The analysis relied on fitting logistic regression and Cox proportional hazards models. Results Among the U.S. population of smokers, 7.3% started smoking before age 13 years, 11.0% at ages 13–14 years, 24.2% at ages 15–16 years, 24.5% at ages 17–18 years, 14.5% at ages 19–20 years, and 18.5% at ages ≥21 years. Early smoking initiation before age 13 years was associated with increased risks for cardiovascular/metabolic (OR=1.67) and pulmonary (OR=1.79) diseases as well as smoking-related cancers (OR=2.1) among current smokers; the risks among former smokers were cardiovascular/metabolic (OR=1.38); pulmonary (OR=1.89); and cancers (OR=1.44). Elevated mortality was also related to early smoking initiation among both current (hazard ratio, 1.18) and former smokers (hazard ratio, 1.19). Conclusions Early smoking initiation increases risks of experiencing smoking-related morbidities and all-cause mortality. These risks are independent of demographic characteristics, SES, health behaviors, and subsequent smoking intensity. Comprehensive tobacco control programs should be implemented to prevent smoking initiation and promote cessation among youth.

      PubDate: 2017-06-21T14:45:31Z
      DOI: 10.1016/j.amepre.2016.12.009
  • Physical Activity and Abnormal Blood Glucose Among Healthy Weight Adults
    • Authors: Arch G. Mainous; Rebecca J. Tanner; Stephen D. Anton; Ara Jo; Maya C. Luetke
      Pages: 42 - 47
      Abstract: Publication date: July 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 1
      Author(s): Arch G. Mainous, Rebecca J. Tanner, Stephen D. Anton, Ara Jo, Maya C. Luetke
      Introduction Physical activity has been linked to prevention and treatment of prediabetes and diabetes in overweight and obese adults. This study examines the relationship between low physical activity levels and risk of abnormal blood glucose (prediabetes or undiagnosed diabetes) in healthy weight adults. Methods Data from the 2014 Health Survey for England were analyzed in July 2016, focusing on adults with a BMI ≥18.5 and <25 who had never been diagnosed with diabetes (N=1,153). Abnormal blood glucose was defined as hemoglobin A1c ≥5.7. Physical activity was measured through the International Physical Activity Questionnaire. Bivariate analyses and Poisson models were conducted on the effect of physical activity on abnormal blood glucose, controlling for age, sex, waist to hip ratio, sitting time, age X physical activity interaction, sex X physical activity, and race. Results Abnormal blood glucose was detected in 23.7% of individuals with low activity levels, 14.8% of those with medium activity levels, and 12.2% of those with high activity levels (p<0.003). Similarly, 25.4% of inactive individuals (physically active for <30 minutes per week) were more likely to have abnormal blood glucose levels than active individuals (13.4%, p<0.0001). Higher physical activity was associated with a lower likelihood of abnormal blood glucose in an adjusted Poisson regression. Conclusions Among healthy weight adults, low physical activity levels are significantly associated with abnormal blood glucose (prediabetes and undiagnosed diabetes). These findings suggest that healthy weight individuals may benefit from physical exercise.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2016.11.027
  • Addressing the Nation’s Opioid Epidemic: Lessons from an Unsanctioned
           Supervised Injection Site in the U.S.
    • Authors: Alex H. Kral; Peter J. Davidson
      Abstract: Publication date: Available online 8 August 2017
      Source:American Journal of Preventive Medicine
      Author(s): Alex H. Kral, Peter J. Davidson

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.06.010
  • Geographic Variation in Opioid and Heroin Involved Drug Poisoning
           Mortality Rates
    • Authors: Christopher J. Ruhm
      Abstract: Publication date: Available online 7 August 2017
      Source:American Journal of Preventive Medicine
      Author(s): Christopher J. Ruhm
      Introduction An important barrier to formulating effective policies to address the rapid rise in U.S. fatal overdoses is that the specific drugs involved are frequently not identified on death certificates. This analysis supplies improved estimates of state opioid and heroin involved drug fatality rates in 2014, and changes from 2008 to 2014. Methods Reported mortality rates were calculated directly from death certificates and compared to corrected rates that imputed drug involvement when no drug was specified. The analysis took place during 2016–2017. Results Nationally, corrected opioid and heroin involved mortality rates were 24% and 22% greater than reported rates. The differences varied across states, with particularly large effects in Pennsylvania, Indiana, and Louisiana. Growth in corrected opioid mortality rates, from 2008 to 2014, were virtually the same as reported increases (2.5 deaths per 100,000 people) whereas changes in corrected heroin death rates exceeded reported increases (2.7 vs 2.3 per 100,000). Without corrections, opioid mortality rate changes were considerably understated in Pennsylvania, Indiana, New Jersey, and Arizona, but dramatically overestimated in South Carolina, New Mexico, Ohio, Connecticut, Florida, and Kentucky. Increases in heroin death rates were understated in most states, and by large amounts in Pennsylvania, Indiana, New Jersey, Louisiana, and Alabama. Conclusions The correction procedures developed here supply a more accurate understanding of geographic differences in drug poisonings and supply important information to policymakers attempting to reduce or slow the increase in fatal drug overdoses.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.06.009
  • Combined Healthy Behaviors and Healthcare Services Use in Older Adults
    • Authors: Ana Hernández-Aceituno; Raúl F. Pérez-Tasigchana; Pilar Guallar-Castillón; Esther López-García; Fernando Rodríguez-Artalejo; José R. Banegas
      Abstract: Publication date: Available online 31 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): Ana Hernández-Aceituno, Raúl F. Pérez-Tasigchana, Pilar Guallar-Castillón, Esther López-García, Fernando Rodríguez-Artalejo, José R. Banegas
      Introduction Data on the combined impact of healthy behaviors on healthcare use in older adults are limited. Methods Study with community-dwelling individuals aged ≥60 years from the Spanish Seniors-ENRICA cohort, recruited in 2008–2010, followed through 2012–2013, and analyzed in 2016 (N=2,021). At baseline, the following healthy behaviors were self-reported: three traditional (never smoking, being physically active, having a healthy diet) and three emerging (sleeping 7–8 hours/day, sitting <8 hours/day, not living alone). Outcomes were self-reported polypharmacy (five or more drugs per day), primary care physician visits (one or more per month), medical specialist visits (more than one per year), and hospitalization (one or more in the last year). The associations between baseline healthy behaviors and healthcare services used in 2012–2013 were summarized with ORs and 95% CIs from multiple logistic regression, adjusting for demographics, lifestyles, comorbidities, and baseline health services used. Results Most single healthy behaviors were associated with lower use of most health services. Compared with participants with zero or one healthy behavior, those with five or six healthy behaviors showed lower risk of polypharmacy (OR=0.46, 95% CI=0.24, 0.85, p-trend=0.001), visits to the primary care physician (OR=0.50, 95% CI=0.26, 0.96, p-trend=0.013), and hospitalization (OR=0.50, 95% CI=0.24, 1.01, p-trend=0.016). No association was found with visits to the medical specialist. Conclusions The combination of five to six healthy behaviors in older adults is associated with half the risk of polypharmacy and using several healthcare services. In an era of constrained resources in most countries, this information may help inform health policy to control healthcare spending in the future.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.06.023
  • Stigma and Health-Related Quality of Life in Sexual Minorities
    • Authors: S. Bryn Austin; Allegra R. Gordon; Najat J. Ziyadeh; Brittany M. Charlton; Sabra L. Katz-Wise; Mihail Samnaliev
      Abstract: Publication date: Available online 28 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): S. Bryn Austin, Allegra R. Gordon, Najat J. Ziyadeh, Brittany M. Charlton, Sabra L. Katz-Wise, Mihail Samnaliev
      Introduction Stigma against sexual minorities is well documented, but its long-term consequences for health-related quality of life (HRQL) are unknown. This study examined stigma-related predictors of sexual orientation disparities in HRQL and their contribution to young adult HRQL disparities. Methods In 2013, participants (N=7,304, aged 18–31 years) reported sexual orientation (completely heterosexual [CH], mostly heterosexual, bisexual, and lesbian/gay). The EQ5D-5L, preference weighted for the U.S. population, was used to assess HRQL (range, –0.109 [worse than dead] to 1 [full health]). In prior waves conducted during adolescence, participants reported past-year bullying victimization (range, 1 [never] to 5 [several times/week]) and subjective social status (SSS) in their school (range, 1 [top] to 10 [bottom]). Analyses conducted in 2016 used longitudinal, multivariable linear and logistic regression to assess the contribution of bullying victimization and SSS in adolescence to sexual orientation disparities in HRQL in young adulthood, controlling for confounders and stratified by gender. Results Compared with CHs, both female and male sexual minorities reported more bullying victimization and lower SSS in adolescence and lower HRQL in young adulthood (HRQL score among women: mostly heterosexual, 0.878; bisexual, 0.839; lesbian, 0.848; CH, 0.913; HRQL score among men: mostly heterosexual, 0.877; bisexual, 0.882; gay, 0.890; CH, 0.925; all p-values <0.05). When bullying and SSS were added into multivariable models, orientation group effect estimates were attenuated substantially, suggesting bullying and lower SSS in adolescence partly explained HRQL disparities in young adulthood. Conclusions Stigma-related experiences in adolescence may have lasting adverse effects on sexual minority health in adulthood.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.05.007
  • Differences in U.S. Suicide Rates by Educational Attainment,
    • Authors: Julie A. Phillips; Katherine Hempstead
      Abstract: Publication date: Available online 27 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): Julie A. Phillips, Katherine Hempstead
      Introduction The purpose of this study was to document the association between education and suicide risk, in light of rising suicide rates and socioeconomic differentials in mortality in the U.S. Methods Differentials and trends in U.S. suicide rates by education were examined from 2000 to 2014 using death certificate data on 442,135 suicides from the National Center for Health Statistics and Census data. Differences in the circumstances and characteristics of suicide deaths by education were investigated using 2013 data from the National Violent Death Reporting System for nine states. Analyses were conducted in 2016. Results Between 2000 and 2014, men and women aged ≥25 years with at least a college degree exhibited the lowest suicide rates; those with a high school degree displayed the highest rates. Men with a high school education were twice as likely to die by suicide compared with those with a college degree in 2014. The education gradient in suicide mortality generally remained constant over the study period. Interpersonal/relationship problems and substance abuse were more common circumstances for less educated decedents. Mental health issues and job problems were more prevalent among college-educated decedents. Conclusions The findings highlight the importance of social determinants in suicide risk, with important prevention implications.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.04.010
  • Use and Perceptions of Caffeinated Energy Drinks and Energy Shots in
    • Authors: Danielle Wiggers; Jessica L. Reid; Christine M. White; David Hammond
      Abstract: Publication date: Available online 26 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): Danielle Wiggers, Jessica L. Reid, Christine M. White, David Hammond
      Introduction In Canada, energy drinks and energy shots are currently classified and regulated differently (food and drugs versus natural health products, respectively), on the assumption that they are used and perceived differently. The current study examined potential differences in use and perceptions of energy drinks and shots. Methods An online survey was conducted in 2015 using a national commercial online panel of youth and young adults aged 12–24 years (n=2,040 retained for analysis in 2016). Participants were randomized to view an image of an energy shot or drink, and were asked about 14 potential reasons for using the product. Past consumption of each product was also assessed. Chi-square and t-tests were conducted to examine differences in use and perceptions between products. Results Overall, 15.6% of respondents reported using both energy shots and drinks. Of all respondents, <1% had tried only energy shots, whereas 58.0% had tried only energy drinks. For each product, the most commonly reported reasons for use were “to stay awake” and “to increase concentration or alertness.” Out of 14 potential reasons for use, respondents were significantly more likely to endorse seven of the reasons for energy drinks rather than shots; however, the magnitude of these differences was modest and the ordering of the reasons for use of each product was comparable. Conclusions Despite differences in prevalence of ever-use of energy shots and drinks, consumption patterns and perceived reasons for using the products are similar. The findings provide little support for regulating energy shots differently than energy drinks.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.05.021
  • Deaths Due to Screenable Cancers Among People Living With HIV Infection,
           Florida, 2000–2014
    • Authors: Mary Jo Trepka; Rehab Auf; Kristopher P. Fennie; Diana M. Sheehan; Lorene M. Maddox; Theophile Niyonsenga
      Abstract: Publication date: Available online 24 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): Mary Jo Trepka, Rehab Auf, Kristopher P. Fennie, Diana M. Sheehan, Lorene M. Maddox, Theophile Niyonsenga
      Introduction Because of antiretroviral therapy, people living with HIV infection are surviving longer and are at higher risk for chronic diseases. This study’s objective was to assess the magnitude of deaths due to cancers for which there are screening recommendations for people living with HIV in Florida. Methods Florida Department of Health Enhanced HIV/AIDS Reporting System data were matched with Department of Health Vital Records and the National Death Index to identify deaths and their causes through 2014. The sex-specific and cause-specific mortality rates and indirect standardized mortality ratios (SMRs, using U.S. mortality rates as a standard) were calculated during 2016 for people reported with HIV infection 2000–2014. Results Despite the competing risk of HIV mortality, among the 25,678 females, there was a higher risk of cervical (SMR=6.32, 95% CI=4.63, 8.44), colorectal (SMR=2.05, 95% CI=1.44, 2.83), liver (SMR=8.96, 95% CI=5.39, 14.03), and lung (SMR=5.82, 95% CI=4.80, 6.96) cancer mortality and lower risk of breast cancer mortality (SMR=0.57, 95% CI=0.42, 0.76). Among 63,493 males, there was a higher risk of liver (SMR=5.50, 95% CI=4.47, 6.70) and lung (4.63, 95% CI=4.11, 5.19) cancer mortality. Among males, the lung cancer SMR significantly declined 2000–2014 (p<0.05), but was still high in 2012–2014 (SMR=3.59, 95% CI=2.87, 4.43). Conclusions These results indicate the importance of primary and secondary cancer prevention during primary care for people living with HIV infection.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.05.018
  • Federally Qualified Health Center Substitution of Local Health Department
    • Authors: Jeremy W. Snider; Betty R. Bekemeier; Douglas A. Conrad; David E. Grembowski
      Abstract: Publication date: Available online 24 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): Jeremy W. Snider, Betty R. Bekemeier, Douglas A. Conrad, David E. Grembowski
      Introduction Strategic and budgetary considerations have shifted local health departments (LHDs) away from safety net clinical services and toward population-focused services. Federally Qualified Health Centers (FQHCs) play an increasing role in the safety net, and may complement or substitute for LHD clinical services. The authors examined the association between FQHC service levels in communities and the presence of specific LHD clinical services in 2010 and 2013. Methods Data from LHD surveys and FQHC service data were merged for 2010 and 2013. Multivariate regression and instrumental variable methods were used to examine FQHC service levels that might predict related LHD service presence or discontinuation from 2010 to 2013. Results There were modest reductions in LHD service presence and increases in FQHC service volume over the time period. LHD primary care and dental service presence were inversely associated with higher related FQHC service volume. LHD prenatal care service presence, as well as a measure of change in general service approach, were not significantly associated with FQHC service volume. Conclusions LHDs were less likely to provide certain clinical services where FQHCs provide a greater volume of services, suggesting a substitution effect. However, certain clinical services, such as prenatal care, may complement the public health mission—and LHDs may be strategically placed to continue to deliver these services.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.06.006
  • Concussion Rates in U.S. Middle School Athletes, 2015–2016 School
    • Authors: Zachary Y. Kerr; Nelson Cortes; Amanda M. Caswell; Jatin P. Ambegaonkar; Kaitlin Romm Hallsmith; A. Frederick Milbert; Shane V. Caswell
      Abstract: Publication date: Available online 22 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): Zachary Y. Kerr, Nelson Cortes, Amanda M. Caswell, Jatin P. Ambegaonkar, Kaitlin Romm Hallsmith, A. Frederick Milbert, Shane V. Caswell
      Introduction Concussion incidence estimates in middle school sports settings are limited. This study examines concussion incidence in nine U.S. middle schools during the 2015–2016 school year. Methods Concussion data originated from nine public middle schools in Prince William County, Virginia, during the 2015–2016 school year. Certified athletic trainers collected concussion and athlete exposure (AE) data in school-sanctioned games and practices in boys’ baseball, basketball, football, soccer, track, and wrestling; and girls’ basketball, cheerleading, soccer, softball, track, and volleyball. Athletic trainers also acquired data on non–school sanctioned sport concussions. In 2017, concussion rates were calculated per 1,000 AEs. Injury rate ratios with 95% CIs compared rates between games and practices and by sex. Results Overall, 73 concussions were reported, of which 21.9% were from non–school sanctioned sport settings. The 57 remaining game and practice concussions were reported during 76,384 AEs, for a concussion rate of 0.75/1,000 AEs. Football had the highest concussion rate (2.61/1,000 AEs). Concussion rates were higher in games versus practices (injury rate ratio=1.83, 95% CI=1.06, 3.15), and in girls versus boys in sex-comparable sports, i.e., baseball/softball, basketball, soccer, and track (injury rate ratio=3.73, 95% CI=1.24, 11.23). Conclusions Current findings parallel those found in high school and college sports settings in that higher concussion rates were reported in girls and competitions. However, concussion rates exceeded those recently reported in high school and youth league settings, highlighting the need for continued research in the middle school sports setting. Given that one in five concussions were from non–school sanctioned sport settings, prevention efforts in middle school sports settings should consider sport and non-sport at-risk exposure.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.05.017
  • Yoga for Military Veterans with Chronic Low Back Pain: A Randomized
           Clinical Trial
    • Authors: Erik J. Groessl; Lin Liu; Douglas G. Chang; Julie L. Wetherell; Jill E. Bormann; J. Hamp Atkinson; Sunita Baxi; Laura Schmalzl
      Abstract: Publication date: Available online 20 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): Erik J. Groessl, Lin Liu, Douglas G. Chang, Julie L. Wetherell, Jill E. Bormann, J. Hamp Atkinson, Sunita Baxi, Laura Schmalzl
      Introduction Chronic low back pain (cLBP) is prevalent, especially among military veterans. Many cLBP treatment options have limited benefits and are accompanied by side effects. Major efforts to reduce opioid use and embrace nonpharmacological pain treatments have resulted. Research with community cLBP patients indicates that yoga can improve health outcomes and has few side effects. The benefits of yoga among military veterans were examined. Design Participants were randomized to either yoga or delayed yoga treatment in 2013–2015. Outcomes were assessed at baseline, 6 weeks, 12 weeks, and 6 months. Intention-to-treat analyses occurred in 2016. Setting/Participants One hundred and fifty military veterans with cLBP were recruited from a major Veterans Affairs Medical Center in California. Intervention Yoga classes (with home practice) were led by a certified instructor twice weekly for 12 weeks, and consisted primarily of physical postures, movement, and breathing techniques. Main outcome measures The primary outcome was Roland−Morris Disability Questionnaire scores after 12 weeks. Pain intensity was identified as an important secondary outcome. Results Participant characteristics were mean age 53 years, 26% were female, 35% were unemployed or disabled, and mean back pain duration was 15 years. Improvements in Roland−Morris Disability Questionnaire scores did not differ between the two groups at 12 weeks, but yoga participants had greater reductions in Roland−Morris Disability Questionnaire scores than delayed treatment participants at 6 months −2.48 (95% CI= −4.08, −0.87). Yoga participants improved more on pain intensity at 12 weeks and at 6 months. Opioid medication use declined among all participants, but group differences were not found. Conclusions Yoga improved health outcomes among veterans despite evidence they had fewer resources, worse health, and more challenges attending yoga sessions than community samples studied previously. The magnitude of pain intensity decline was small, but occurred in the context of reduced opioid use. The findings support wider implementation of yoga programs for veterans. Trial registration This study is registered at NCT02524158.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.05.019
  • A Systematic Review of Interventions on Patients’ Social and
           Economic Needs
    • Authors: Laura M. Gottlieb; Holly Wing; Nancy E. Adler
      Abstract: Publication date: Available online 5 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): Laura M. Gottlieb, Holly Wing, Nancy E. Adler
      Context Healthcare systems are experimenting increasingly with interventions to address patients’ social and economic needs. This systematic review examines how often and how rigorously interventions bridging social and medical care have been evaluated. Evidence acquisition The review included literature from PubMed published between January 2000 and February 2017. Additional studies were identified by reference searches and consulting local experts. Included studies were based in the U.S.; addressed at least one social or economic determinant of health (e.g., housing, employment, food insecurity); and were integrated within the medical care delivery system. Data from included studies were abstracted in June 2015 (studies published January 2000–December 2014) and in March 2017 (studies published January 2015–February 2017). Evidence synthesis Screening of 4,995 articles identified 67 studies of 37 programs addressing social needs. Interventions targeted a broad range of social needs and populations. Forty studies involved non-experimental designs. There was wide heterogeneity in outcome measures selected. More studies reported findings associated with process (69%) or social or economic determinants of health (48%) outcomes than health (30%) or healthcare utilization or cost (27%) outcomes. Studies reporting health, utilization, or cost outcomes reported mixed results. Conclusions Healthcare systems increasingly incorporate programs to address patients’ social and economic needs in the context of care. But evaluations of these programs to date focus primarily on process and social outcomes and are often limited by poor study quality. Higher-quality studies that include common health and healthcare utilization outcomes would advance effectiveness research in this rapidly expanding field.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.05.011
  • Community Policies and Programs to Prevent Obesity and Child Adiposity
    • Authors: Edward A. Frongillo; Stephen B. Fawcett; Lorrene D. Ritchie; S. Sonia Arteaga; Catherine M. Loria; Russell R. Pate; Lisa V. John; Warren J. Strauss; Maria Gregoriou; Vicki L. Collie-Akers; Jerry A. Schultz; Andrew J. Landgraf; Jyothi Nagaraja
      Abstract: Publication date: Available online 5 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): Edward A. Frongillo, Stephen B. Fawcett, Lorrene D. Ritchie, S. Sonia Arteaga, Catherine M. Loria, Russell R. Pate, Lisa V. John, Warren J. Strauss, Maria Gregoriou, Vicki L. Collie-Akers, Jerry A. Schultz, Andrew J. Landgraf, Jyothi Nagaraja
      Introduction Evidence regarding impact of community policies and programs (CPPs) to prevent child obesity is limited, and which combinations of strategies and components are most important is not understood. The Healthy Communities Study was an observational study to assess relationships of characteristics and intensity of CPPs with adiposity, diet, and physical activity in children, taking advantage of variation across the U.S. in community actions to prevent child obesity. The study examined the association of CPPs to prevent child obesity with measured BMI and waist circumference, hypothesizing that communities with more-comprehensive CPPs would have children with lower adiposity. Methods The study included 130 communities selected by probability-based sampling or because of known CPPs targeting child obesity. Data were collected at home visits on 5,138 children during 2013–2015. CPPs were scored for multiple attributes to create a CPP intensity score. A CPP target behavior score reflected the number of distinct target behaviors addressed. Scores were standardized with the smallest observed score across communities being 0 and the largest 1. Multilevel regression analysis in 2016 adjusted for community, household, and individual characteristics. Results Higher CPP target behavior score was significantly associated with lower BMI and waist circumference in a dose−response relationship, with magnitude for the past 3 years of CPPs of 0.843 (p=0.013) for BMI and 1.783 cm (p=0.020) for waist circumference. Conclusions This study provides plausible evidence that comprehensive CPPs targeting a greater number of distinct physical activity and nutrition behaviors were associated with lower child adiposity.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.05.006
  • Associations Between County Wealth, Health and Social Services Spending,
           and Health Outcomes
    • Authors: J. Mac McCullough; Jonathon P. Leider
      Abstract: Publication date: Available online 5 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): J. Mac McCullough, Jonathon P. Leider
      Introduction Each year, the County Health Rankings rate the health outcomes of each county in the U.S. A common refrain is that poor counties perform worse than wealthier ones. This article examines that assumption and specifically analyzes characteristics of counties that have performed better in terms of health outcomes than their wealth alone would suggest. Methods Data from the 2013 County Health Rankings were used, as were 2012 financial and demographic information collected by the U.S. Census Bureau. A logistic model was constructed to examine the odds of a county “overperforming” in the rankings relative to community wealth. Analyses were performed in 2016. Results Communities that were wealthier performed better on the rankings. However, more than 800 of 3,141 counties overperformed by ranking in a better health outcomes quartile than their county’s wealth alone would suggest. Regression analyses found that for each additional percentage point of total public spending that was allocated toward community health care and public health, the odds of being an overperformer increased by 3.7%. Conclusions Community wealth correlates with health, but not always. Population health outcomes in hundreds of counties overperform what would be expected given community wealth alone. These counties tend to invest more in community health care and public health spending and other social services. Although the level of a community’s wealth is outside the control of practitioners, shifting the proportion of spending to certain social services may positively impact population health.

      PubDate: 2017-08-14T21:54:03Z
      DOI: 10.1016/j.amepre.2017.05.005
  • Assessing Validity of the Fitbit Indicators for U.S. Public Health
    • Authors: Kelly R. Evenson; Fang Wen; Robert D. Furberg
      Abstract: Publication date: Available online 26 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): Kelly R. Evenson, Fang Wen, Robert D. Furberg

      PubDate: 2017-08-04T01:15:04Z
      DOI: 10.1016/j.amepre.2017.06.005
  • Information for CME Credit—Job Characteristics Associated With
           Self-Rated Fair or Poor Health Among US Workers
    • Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2

      PubDate: 2017-07-26T01:03:12Z
  • Information for CME Credit—The Effects of Feedback on Adherence to
           Treatment A Systematic Review and Meta-analysis of RCTs
    • Abstract: Publication date: August 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 2

      PubDate: 2017-07-26T01:03:12Z
  • Maternal Prepregnancy Weight and Children’s Behavioral and Emotional
    • Authors: Julianna Deardorff; Louisa H. Smith; Lucia Petito; Hyunju Kim; Barbara F. Abrams
      Abstract: Publication date: Available online 13 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): Julianna Deardorff, Louisa H. Smith, Lucia Petito, Hyunju Kim, Barbara F. Abrams
      Introduction This study investigated associations between maternal prepregnancy BMI and child behaviors at ages 9–11 years and examine interaction by race and gender. Methods The National Longitudinal Survey of Youth and the Children and Young Adults surveys are U.S.-based, ongoing longitudinal studies, initiated in 1979 and 1986, respectively. Mothers (n=2,952) reported pregnancy and child (n=5,660) developmental information at multiple time points. Child total, internalizing, and externalizing problems at ages 9–11 years were assessed using the Behavior Problems Index (BPI), collected biennially until 2012. Associations between prepregnancy BMI and child BPI outcomes were examined, as well as two- and three-way interactions by race and gender. Analyses were conducted in 2017. Results Boys whose mothers had higher prepregnancy weights exhibited higher total BPI and externalizing scores at ages 9–11 years versus those with normal-weight mothers. Boys with severely obese mothers had higher total BPI (mean difference=7.99, 95% CI=3.53, 12.46) and externalizing (mean difference=5.77, 95% CI=1.50, 10.04) scores. Prepregnancy underweight was associated with boys’ higher total BPI (mean difference=2.34, 95% CI=0.02, 4.66) and externalizing (mean difference=3.30, 95% CI=0.69, 5.91); these associations were not significant in sensitivity analyses. No associations emerged for girls or internalizing problems. Two-way interactions by race and three-way interactions by race and gender were not significant. Conclusions Maternal prepregnancy weight was associated with BPI level among boys. Boys with severely obese mothers exhibited markedly higher behavioral problems at ages 9–11 years versus those with normal-weight mothers, regardless of race. Maintaining healthy prepregnancy weight may be important for preventing boys’ deleterious behavior outcomes in middle childhood.

      PubDate: 2017-07-26T01:03:12Z
      DOI: 10.1016/j.amepre.2017.05.013
  • Prevention of Type 2 Diabetes in U.S. Hispanic Youth: A Systematic Review
           of Lifestyle Interventions
    • Authors: Jessica L. McCurley; Margaret A. Crawford; Linda C. Gallo
      Abstract: Publication date: Available online 5 July 2017
      Source:American Journal of Preventive Medicine
      Author(s): Jessica L. McCurley, Margaret A. Crawford, Linda C. Gallo
      Context Prevalence of type 2 diabetes mellitus (T2DM) in youth has increased rapidly in recent decades along with rises in childhood obesity. Disparities in risk and prevalence of T2DM are evident in Hispanic youth when compared with non-Hispanic whites. Targeted diabetes prevention programs have been recommended to reduce risk prior to adulthood in this population. This systematic review explores the effectiveness of lifestyle-based diabetes prevention interventions for Hispanic youth. Evidence acquisition PubMed, PsycINFO, Web of Science, and CENTRAL were searched from database inception to March 1, 2017, for studies that evaluated lifestyle-focused prevention trials targeting U.S. Hispanic youth under age 18 years. Fifteen publications met criteria for inclusion. Evidence synthesis Of the 15 studies, 11 were RCTs; four were uncontrolled. Interventions were heterogeneous in intensity, content, and setting. Duration of most trials was 12–16 weeks. Mean age of participants ranged from 9.8 to 15.8 years, sample sizes were generally small, and the majority of participants were overweight (BMI ≥85th percentile). Three studies reported statistically significant reductions in mean BMI, four in BMI z-score, and six in fasting glucose/insulin. Study quality was moderate to high. Effect sizes were generally small to medium. Conclusions Evidence for the impact of lifestyle-based diabetes prevention interventions targeting U.S. Hispanic youth remains limited. Few interventions demonstrated success in reducing BMI and glucose regulation and follow-up times were brief. More studies are needed that recruit larger samples sizes, extend follow-up times, explore innovative delivery modalities, and examine effectiveness across sex and age.

      PubDate: 2017-07-10T15:23:45Z
      DOI: 10.1016/j.amepre.2017.05.020
  • Information for CME Credit—The Built Environment and Cognitive
           Disorders: Results From the Cognitive Function and Ageing Study II
    • Abstract: Publication date: July 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 1

      PubDate: 2017-06-21T14:45:31Z
  • Information for CME Credit—Physical Activity and Abnormal Blood Glucose
           Among Healthy Weight Adults
    • Abstract: Publication date: July 2017
      Source:American Journal of Preventive Medicine, Volume 53, Issue 1

      PubDate: 2017-06-21T14:45:31Z
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