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HEALTH AND SAFETY (538 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: 10)
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: 11)
Advances in Public Health     Open Access   (Followers: 23)
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: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Ageing & Society     Hybrid Journal   (Followers: 37)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 4)
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: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 32)
American Journal of Health Promotion     Hybrid Journal   (Followers: 24)
American Journal of Health Sciences     Open Access   (Followers: 6)
American Journal of Health Studies     Full-text available via subscription   (Followers: 11)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 26)
American Journal of Public Health     Full-text available via subscription   (Followers: 229)
American Journal of Public Health Research     Open Access   (Followers: 29)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4)
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: 2)
Archive of Community Health     Open Access  
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: 3)
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: 3)
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: 6)
Behavioral Healthcare     Full-text available via subscription   (Followers: 6)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 9)
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: 20)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 8)
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: 17)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 11)
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 12)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 20)
Case Reports in Women's Health     Open Access   (Followers: 3)
Case Studies in Fire Safety     Open Access   (Followers: 15)
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: 10)
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   (Followers: 1)
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: 2)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access  
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 3)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access   (Followers: 3)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 12)
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: 17)
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: 19)
EcoHealth     Hybrid Journal   (Followers: 4)
Education for Health     Open Access   (Followers: 5)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 4)
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   (Followers: 2)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 4)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 5)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 19)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 3)
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: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 6)
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: 6)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Food and Public Health     Open Access   (Followers: 11)
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: 9)
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: 16)
Global Journal of Health Science     Open Access   (Followers: 9)
Global Journal of Public Health     Open Access   (Followers: 12)
Global Medical & Health Communication     Open Access   (Followers: 1)
Global Mental Health     Open Access   (Followers: 5)
Global Security : Health, Science and Policy     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: 16)
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: 9)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 7)
Health and Social Work     Hybrid Journal   (Followers: 55)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 2)
Health Care Analysis     Hybrid Journal   (Followers: 14)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 16)
Health Issues     Full-text available via subscription   (Followers: 2)
Health Notions     Open Access  
Health Policy     Hybrid Journal   (Followers: 41)
Health Policy and Technology     Hybrid Journal   (Followers: 3)
Health Professional Student Journal     Open Access   (Followers: 2)
Health Promotion International     Hybrid Journal   (Followers: 22)
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: 16)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 50)
Health Psychology Research     Open Access   (Followers: 19)
Health Psychology Review     Hybrid Journal   (Followers: 42)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 12)
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: 3)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 13)
Health, Risk & Society     Hybrid Journal   (Followers: 11)
Healthcare     Open Access   (Followers: 2)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 9)
Healthy-Mu Journal     Open Access  
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: 11)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 6)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 4)
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: 5)
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: 35)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 2)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 8)
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)

        1 2 3 | Last

Journal Cover American Journal of Preventive Medicine
  [SJR: 2.764]   [H-I: 154]   [26 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0749-3797
   Published by Elsevier Homepage  [3177 journals]
  • Evaluating Evidence on Intermediate Outcomes: Considerations for Groups
           Making Healthcare Recommendations
    • Authors: Daniel E. Jonas; Renée M. Ferrari; Roberta C. Wines; Kim T. Vuong; Anne Cotter; Russell P. Harris
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1
      Author(s): Daniel E. Jonas, Renée M. Ferrari, Roberta C. Wines, Kim T. Vuong, Anne Cotter, Russell P. Harris
      Introduction Groups making recommendations need evidence about whether preventive services improve health outcomes (HOs). When such evidence is not available, groups may choose to evaluate evidence about effects on intermediate outcomes (IOs) and the link between IOs and HOs. This paper aims to describe considerations for assessing the evidence linking changes in IOs to changes in HOs. Methods Working definitions of IOs, HOs, and other outcomes were developed. All current U.S. Preventive Services Task Force (USPSTF) recommendations through April 2016 were examined to identify how evidence of the IO–HO link was gathered and the criteria that appeared to be used to determine the adequacy of the evidence. Methods of other expert and recommendation-making groups were also examined. Results Forty-four USPSTF recommendations involved a relevant IO–HO link. The approaches used most commonly to gather evidence about the link were selected review (19 of 44, 43%) and systematic review (12 of 44, 27%). Some key considerations when assessing the adequacy of evidence about the IO–HO link include adjustment for confounding, proximity of the IO to the HO in the causal pathway, and independence of IO–HO relationship from specific treatments. Conclusions Considerations were identified for recommendation-making groups to use when gathering and assessing the adequacy of evidence about the IO–HO link. Using a standard set of written principles could improve the transparency of assessments of the IO–HO link, especially if used together with judgment in a reasoned conjecture and refutation process. Ideally, the process would result in an estimate of the magnitude of change in HOs that is expected for specified changes in IOs.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.033
  • Post-traumatic Stress Disorder by Gender and Veteran Status
    • Authors: Keren Lehavot; Jodie G. Katon; Jessica A. Chen; John C. Fortney; Tracy L. Simpson
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Keren Lehavot, Jodie G. Katon, Jessica A. Chen, John C. Fortney, Tracy L. Simpson
      Introduction Population-based data on the prevalence, correlates, and treatment utilization of post-traumatic stress disorder by gender and veteran status are limited. With changes in post-traumatic stress disorder diagnostic criteria in 2013, current information from a uniform data source is needed. Methods This was a secondary analysis of the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, which consisted of in-person interviews that were conducted with a representative sample of U.S. adults. The Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-5 Version was used to assess past-year and lifetime post-traumatic stress disorder among veterans (n=3,119) and civilians (n=32,982). Data were analyzed from January to March 2017. Results Adjusting for age and race/ethnicity, women veterans reported the highest rates of lifetime and past-year post-traumatic stress disorder (13.4%, 95% CI=8.8%, 17.9%, and 11.7%, 95% CI=7.1%, 16.4%) compared with women civilians (8.0%, 95% CI=7.4%, 8.6%, and 6.0%, 95% CI=5.5%, 6.6%); men veterans (7.7%, 95% CI=6.5%, 8.8%, and 6.7%, 95% CI=5.7%, 7.8%); and men civilians (3.4%, 95% CI=3.0%, 3.9%, and 2.6%, 95% CI=2.2%, 2.9%). Traumatic event exposure, correlates of lifetime post-traumatic stress disorder, and treatment seeking varied across subgroups. Men and women veterans were more likely than civilians to use a variety of treatment sources, with men civilians being least likely to seek treatment and men veterans exhibiting the longest delay in seeking treatment. Conclusions Post-traumatic stress disorder is a common mental health disorder that varies by gender and veteran status. Women veterans’ high rates of post-traumatic stress disorder highlight a critical target for prevention and intervention, whereas understanding treatment barriers for men veterans and civilians is necessary.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.09.008
  • Health Insurance Status and Clinical Cancer Screenings Among U.S. Adults
    • Authors: Guixiang Zhao; Catherine A. Okoro; Jun Li; Machell Town
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Guixiang Zhao, Catherine A. Okoro, Jun Li, Machell Town
      Introduction Health insurance coverage is linked to clinical preventive service use. This study examined cancer screenings among U.S. adults by health insurance status. Methods The Behavioral Risk Factor Surveillance System collected data on healthcare access and cancer screenings from 42 states and the District of Columbia in 2014. Data analyses were conducted in 2016. Participants’ health insurance status during the preceding 12 months was categorized as adequately insured, underinsured, or never insured. Primary type of insurance coverage was categorized as employer-based or Medicare (aged ≥65 years), self-purchased plan, Medicaid/Medicare (aged <65 years), and other public insurance. Clinical cancer screenings were assessed following the U.S. Preventive Services Task Force recommendations. Results Compared with adequately insured adults, underinsured and never insured women were 6% (p<0.001) and 41% (p<0.001) less likely to receive breast cancer screening, respectively; 1% (p<0.05) and 19% (p<0.001) less likely to receive cervical cancer screening, respectively; and 3% (p<0.01) and 47% (p<0.001) less likely to receive colorectal cancer screening, respectively; underinsured and never insured men were 6% (p<0.001) and 52% (p<0.001) less likely to receive colorectal cancer screening, respectively. Compared with adults with employer-based insurance/Medicare (aged ≥65 years), women with all other types of insurance were less likely to receive breast and cervical cancer screenings; women and men with self-purchased plans were less likely to receive colorectal cancer screening; however, men with other public insurance were more likely to receive colorectal cancer screening. Conclusions Disparities in cancer screenings by health insurance status and type of insurance exist among U.S. adults. Greater efforts to increase screening rates and to reduce disparities in cancer screenings are an important strategy to help improve overall population health.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.024
  • Challenges in Developing U.S. Preventive Services Task Force Child Health
    • Authors: Alex R. Kemper; Alex H. Krist; Chien-Wen Tseng; Matthew W. Gillman; Iris R. Mabry-Hernandez; Michael Silverstein; Roger Chou; Paula Lozano; B. Nedrow Calonge; Tracy A. Wolff; David C. Grossman
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1
      Author(s): Alex R. Kemper, Alex H. Krist, Chien-Wen Tseng, Matthew W. Gillman, Iris R. Mabry-Hernandez, Michael Silverstein, Roger Chou, Paula Lozano, B. Nedrow Calonge, Tracy A. Wolff, David C. Grossman
      The U.S. Preventive Services Task Force (USPSTF) uses an objective evidence-based approach to develop recommendations. As part of this process, the USPSTF also identifies important research gaps in scientific evidence. In March 2016, the USPSTF convened an expert panel to discuss its portfolio of child and adolescent recommendations and identify unique methodologic issues when evaluating evidence regarding children and adolescents. The panel identified key domains of challenges, including measuring patient-centered health outcomes; identifying intermediate outcomes predictive of important health outcomes; evaluating the long time horizon needed to assess the balance of benefits and harms; understanding trajectories of growth and development that result in unique windows of time when expected benefits or harms of a preventive service can vary; and considering the perspectives of other individuals who might be affected by the delivery of a preventive service to a child or adolescent. Although the expert panel expressed an interest in being able to make more recommendations for or against preventive services for children and adolescents, it also reinforced the importance of ensuring recommendations were based on sound and sufficient evidence to ensure greatest benefit and minimize unnecessary harms. Accordingly, the need to highlight areas with insufficient evidence is as important as making recommendations. Having identified these key challenges, the USPSTF and other organizations issuing guidelines have an opportunity to advance their methods of evidence synthesis and identified evidence gaps represent important opportunities for researchers and policy makers.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.023
  • Large Health Systems’ Prevention Guideline Implementation: A
           Qualitative Study
    • Authors: Julia A. Doherty; Sally J. Crelia; Mark W. Smith; Sarah F. Rosenblum; Ellen M. Rumsey; Iris R. Mabry-Hernandez; Quyen Ngo-Metzger
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1
      Author(s): Julia A. Doherty, Sally J. Crelia, Mark W. Smith, Sarah F. Rosenblum, Ellen M. Rumsey, Iris R. Mabry-Hernandez, Quyen Ngo-Metzger
      Introduction Health systems now employ more than half of U.S. physicians. They have the potential to affect primary care through decision support and financial incentives around clinical prevention guidelines. The processes by which they respond to and implement clinical guidelines remain largely unexplored. Methods In 2015, the research team conducted and analyzed interviews with quality leaders from eight hospital-based systems and one physician organization which together employ >33,000 physicians and serve >15 million patients. Executives explained organizational processes to adapt, adopt, disseminate, and incentivize adherence to preventive services guidelines. Results Nearly all have a formal process for reviewing and refining guidelines, developing clinician support, and disseminating the approved guidelines. Internal and external factors like organizational structure, patient demographics, and payer contracts affect the review processes and resulting guideline adaptations. Challenges to guideline uptake include competing demands on clinician time and the absence of accurate and timely patient data in accessible and user-friendly formats. Interviewees reported that engaging clinicians in guideline review is critical to successful implementation. Electronic health record reminders represent the primary tool for guideline dissemination and reinforcement. Interviewees reported widespread use of performance monitoring and feedback to clinicians, with varying levels of success. Most organizations use financial incentives tied to performance for some of their clinicians, although details vary widely depending on network structures and contractual arrangements. Conclusions Health systems play a critical intermediary role between guideline-developing organizations and practicing clinicians. Strengthening the adoption of guidelines requires attention to many factors beyond care delivery.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.07.025
  • Fifteen-year Weight and Disordered Eating Patterns Among Community-based
    • Authors: Andrea B. Goldschmidt; Melanie M. Wall; Tse-Hwei J. Choo; E. Whitney Evans; Elissa Jelalian; Nicole Larson; Dianne Neumark-Sztainer
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Andrea B. Goldschmidt, Melanie M. Wall, Tse-Hwei J. Choo, E. Whitney Evans, Elissa Jelalian, Nicole Larson, Dianne Neumark-Sztainer
      Introduction The current study aims to characterize weight-change trajectories and their concomitant associations with prospectively measured dieting and other disordered eating behaviors among initially nonoverweight adolescents during the transition to adulthood. Methods A population-based sample (n=1,091) self-reported their height/weight, dieting, unhealthy weight-control behaviors, and binge eating at 5-year intervals between 1998/1999 and 2013/2014, spanning early/middle adolescence through middle/late young adulthood. Data were analyzed in 2016/2017. Results Groups were categorized as those who were never overweight (n=562), were overweight during at least one measurement point and gained weight more rapidly (n=246) or gradually (n=238) than their peers, or were overweight during at least one measurement point but returned to nonoverweight status by middle/late young adulthood (n=45). Thus, nearly half of adolescents became overweight during the transition to adulthood. Those who were never overweight had the lowest rates of dieting (males: F[9, 1,314]=2.54, p=0.0069, females: F[9, 1,927]=3.02, p=0.0014) and unhealthy weight-control behaviors (males: F[9, 1,313]=3.30, p=0.0005, females: F[9, 1,927]=3.02, p=0.0014), whereas some of these behaviors tended to track with weight gain in rapid and gradual weight gainers. Conclusions Although adolescents who are already overweight are most frequently targeted for weight-gain prevention and early intervention programs, results suggest that healthy lifestyle interventions could also benefit individuals who may be perceived as low risk for overweight in adulthood by nature of being nonoverweight in adolescence. Dieting and unhealthy weight-control behaviors tended to be associated with weight gain, suggesting that they are ineffective in addition to being potentially harmful.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.09.005
  • Weight Status and Cigarette and Electronic Cigarette Use in Adolescents
    • Authors: Joanne Delk; MeLisa R. Creamer; Cheryl L. Perry; Melissa B. Harrell
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Joanne Delk, MeLisa R. Creamer, Cheryl L. Perry, Melissa B. Harrell
      Introduction Research shows that adolescents who are overweight or obese may be at greater risk of cigarette smoking, and that this relationship may vary by gender. However, this relationship is understudied for electronic cigarettes (e-cigarettes). Given the high rate of adolescent obesity and the rise in e-cigarette use in adolescents, this relationship should be investigated. Methods Data are from the third wave (collected October 2015–January 2016) of the Texas Adolescent Tobacco and Marketing Surveillance system. Students were in the seventh, ninth, and 11th grades (n=2,733) from five counties surrounding four major Texas metropolitan areas (Houston, Austin, San Antonio, Dallas). Weighted logistic regression was used to determine if weight status (healthy weight, overweight, or obese) was correlated with ever and past 30–day cigarette or e-cigarette use, controlling for sociodemographics. Models were stratified by gender. Data analyses were conducted in March 2017. Results Compared with healthy-weight boys, obese boys had higher odds of past 30–day e-cigarette use (AOR=3.45, 95% CI=1.34, 8.33) and cigarette smoking (AOR=4.52, 95% CI=1.32, 15.51). There was no significant relationship between weight status and cigarette or e-cigarette use in girls. Conclusions This study supports that there is a positive relationship between weight status and past 30–day cigarette and e-cigarette use for boys, but that there is no association for girls.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.09.007
  • Preventive Service Use Among People With and Without Serious Mental
    • Authors: Bobbi Jo H. Yarborough; Nancy A. Perrin; Scott P. Stumbo; John Muench; Carla A. Green
      Pages: 1 - 9
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Bobbi Jo H. Yarborough, Nancy A. Perrin, Scott P. Stumbo, John Muench, Carla A. Green
      Introduction People with serious mental illnesses experience excess morbidity and premature mortality resulting from preventable conditions. The goal was to examine disparities in preventive care that might account for poor health outcomes. Methods In this retrospective cohort study, adults (N=803,276) served by Kaiser Permanente Northwest and federally qualified health centers/safety-net community health clinics were categorized into five groups: schizophrenia spectrum disorders, bipolar disorders/affective psychoses, anxiety disorders, nonpsychotic unipolar depression, and reference groups with no evidence of these specific mental illnesses. The primary outcome was overall preventive care-gap rate, the proportion of incomplete preventive services for which each patient was eligible in 2012–2013. Secondary analyses examined Kaiser Permanente Northwest data from 2002 to 2013. Data were analyzed in 2015. Results Controlling for patient characteristics and health services use, Kaiser Permanente Northwest mean care-gap rates were significantly lower for bipolar disorders/affective psychoses (mean=18.6, p<0.001) and depression groups (mean=18.6, p<0.001) compared with the reference group. Schizophrenia (mean=19.4, p=0.236) and anxiety groups (mean=19.9, p=0.060) did not differ from the reference group (mean=20.3). In community health clinics, schizophrenia (mean=34.1, p<0.001), bipolar/affective psychosis (mean=35.7, p<0.001), anxiety (mean=38.5, p<0.001), and depression groups (mean=36.3, p<0.001) had significantly lower care-gap rates than those in the reference group (mean=40.0). Secondary analyses of diabetes and dyslipidemia screening trends in Kaiser Permanente Northwest showed diagnostic groups consistently had fewer care gaps than patients in the reference group. Conclusions In vastly different settings, individuals with serious mental illnesses received preventive services at equal or better rates than the general population.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.020
  • Walking in Relation to Mortality in a Large Prospective Cohort of Older
           U.S. Adults
    • Authors: Alpa V. Patel; Janet S. Hildebrand; Corinne R. Leach; Peter T. Campbell; Colleen Doyle; Kerem Shuval; Ying Wang; Susan M. Gapstur
      Pages: 10 - 19
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Alpa V. Patel, Janet S. Hildebrand, Corinne R. Leach, Peter T. Campbell, Colleen Doyle, Kerem Shuval, Ying Wang, Susan M. Gapstur
      Introduction Engaging in >150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity weekly is recommended for optimal health. The relationship between walking, the most common activity especially for older adults, and total mortality is not well documented. Methods Data from a large U.S. prospective cohort study including 62,178 men (mean age 70.7 years) and 77,077 women (mean age 68.9 years), among whom 24,688 men and 18,933 women died during 13 years of follow-up (1999–2012), were used to compute multivariable-adjusted hazard rate ratios and 95% CIs for walking as the sole form of activity or adjusted for other moderate- or vigorous-intensity physical activity in relation to total and cause-specific mortality (data analysis 2015–2016). Results Inactivity compared with walking only at less than recommended levels was associated with higher all-cause mortality (hazard rate ratio=1.26, 95% CI=1.21, 1.31). Meeting one to two times the recommendations through walking only was associated with lower all-cause mortality (hazard rate ratio=0.80, 95% CI=0.78, 0.83). Associations with walking adjusted for other moderate- or vigorous-intensity physical activity were similar to walking only. Walking was most strongly associated with respiratory disease mortality followed by cardiovascular disease mortality and then cancer mortality. Conclusions In older adults, walking below minimum recommended levels is associated with lower all-cause mortality compared with inactivity. Walking at or above physical activity recommendations is associated with even greater decreased risk. Walking is simple, free, and does not require any training, and thus is an ideal activity for most Americans, especially as they age.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.019
  • HPV Vaccination Among Foreign-Born Women: Examining the National Health
           Interview Survey 2013–2015
    • Authors: Leslie E. Cofie; Jacqueline M. Hirth; Fangjian Guo; Abbey B. Berenson; Kyriakos Markides; Rebeca Wong
      Pages: 20 - 27
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Leslie E. Cofie, Jacqueline M. Hirth, Fangjian Guo, Abbey B. Berenson, Kyriakos Markides, Rebeca Wong
      Introduction Human papillomavirus vaccination is less prevalent among foreign-born than U.S.-born women and may lead to disparities in human papillomavirus−related cancers in the future. There is limited research on factors associated with vaccination uptake between these two groups. This study examined the association between place of birth and human papillomavirus vaccine uptake, and what determinants of vaccination attenuate this relationship. Methods The 2013–2015 National Health Interview Survey data on women was analyzed in 2016, to determine differences in prevalence of human papillomavirus vaccination between foreign- and U.S.-born women. Multivariate binary logistic regression analysis was used to examine the association between foreign-born status and human papillomavirus vaccine initiation, after controlling for health insurance status, having a usual source of care, obstetrician/gynecologist visits, Pap tests, length of U.S. residency, and citizenship. Results Human papillomavirus vaccination prevalence varied significantly among women born in different regions of the world. European and South-American women had the highest vaccination rates among all foreign-born women. Compared with U.S.-born women, foreign-born women were significantly less likely to report human papillomavirus vaccine initiation. This relationship was partially attenuated after adjusting for the covariates. Among foreign-born women, Asians were significantly less likely to report human papillomavirus vaccination uptake than white women. Additionally, living in the U.S. for >5 years was significantly associated with vaccine initiation, but attenuated by U.S. citizenship status. Conclusions Public health interventions to improve human papillomavirus vaccination need to be developed to address multicultural audiences with limited access to health insurance and health care.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.017
  • Trends in Sodium Content of Menu Items in Large Chain Restaurants in the
    • Authors: Julia A. Wolfson; Alyssa J. Moran; Marian P. Jarlenski; Sara N. Bleich
      Pages: 28 - 36
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Julia A. Wolfson, Alyssa J. Moran, Marian P. Jarlenski, Sara N. Bleich
      Introduction Consuming too much sodium is associated with increased risk for cardiovascular disease, and restaurant foods are a primary source of sodium. This study assessed recent trends in sodium content of menu items in U.S. chain restaurants. Methods Data from 21,557 menu items in 66 top-earning chain restaurants available from 2012 to 2016 were obtained from the MenuStat project and analyzed in 2017. Generalized linear models were used to examine changes in calorie-adjusted, per-item sodium content of menu items offered in all years (2012–2016) and items offered in 2012 only compared with items newly introduced in 2013, 2014, 2015, and 2016. Results Overall, calorie-adjusted sodium content in newly introduced menu items declined by 104 mg from 2012 to 2016 (p<0.02). However, the magnitude and direction of these changes varied by menu category and restaurant type; sodium content, particularly for main course items, was high. Sodium declined by 83 mg in fast food restaurants, 19 mg in fast casual restaurants, and 163 mg in full service restaurants. Sodium in appetizer and side items newly introduced in 2016 increased by 266 mg compared with items on the menu in 2012 only (p<0.01). Sodium in main courses newly introduced in 2016 declined by 124 mg compared with items on the menu in 2012 only (p=0.01), with the greatest decline, 207 mg (p=0.03), among salads. Conclusions Average, adjusted, per-item sodium content was lower in newly introduced items in large chain restaurants. However, sodium content of core and new menu items remain high, and reductions are inconsistent across menu categories and restaurant types.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.018
  • Use of Welcome to Medicare Visits Among Older Adults Following the
           Affordable Care Act
    • Authors: Arpit Misra; Jennifer T. Lloyd; Larisa M. Strawbridge; Suzanne G. Wensky
      Pages: 37 - 43
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Arpit Misra, Jennifer T. Lloyd, Larisa M. Strawbridge, Suzanne G. Wensky
      Introduction To encourage greater utilization of preventive services among Medicare beneficiaries, the 2010 Affordable Care Act waived coinsurance for the Welcome to Medicare visit, making this benefit free starting in 2011. The objective of this study was to determine the impact of the Affordable Care Act on Welcome to Medicare visit utilization. Methods A 5% sample of newly enrolled fee-for-service Medicare beneficiaries for 2005–2016 was used to estimate changes in Welcome to Medicare visit use over time. An interrupted time series model examined whether Welcome to Medicare visits increased significantly after 2011, controlling for pre-intervention trends and other autocorrelation. Results Annual Welcome to Medicare visit rates began at 1.4% in 2005 and increased to 12.3% by 2016. The quarterly Welcome to Medicare visit rate, which was almost 1% at baseline, was increasing by 0.06% before the 2011 Affordable Care Act provision (p<0.001). Immediately following the 2011 Affordable Care Act provision, the rate increased by about 1% in the first quarter of 2011 (intercept, p<0.001), followed by an increase of 0.13% every subsequent quarter (slope, p<0.001). This general trend was observed in subgroup analyses, although this trend varied by subgroups where the pre−Affordable Care Act trends of lower utilization persisted over time for non-whites and improved less quickly for men, regions other than Northeast, and beneficiaries without any supplemental insurance. Conclusions The Affordable Care Act, and perhaps the removal of cost sharing, was associated with increased use of the Welcome to Medicare visit; however, even with the increased use, there is room for improvement.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.030
  • School-Based Health Centers, Depression, and Suicide Risk Among
    • Authors: Mallie J. Paschall; Melina Bersamin
      Pages: 44 - 50
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Mallie J. Paschall, Melina Bersamin
      Introduction This study examined whether increasing availability of mental health services at school-based health centers in Oregon public schools would be associated with a decrease in the likelihood of depressive episodes and suicide risk among adolescents. Methods The study included 168 Oregon public schools that participated in the Oregon Healthy Teens Survey in 2013 and 2015. Twenty-five schools had a school-based health center, and 14 of those schools increased the availability of mental health services from 2013 to 2015. The Oregon Healthy Teens Survey included questions about having a depressive episode, suicidal ideation, and attempting suicide in the past year. Multilevel logistic regression analyses were conducted in 2017 to examine associations between increasing mental health services and the likelihood of past year depressive episodes, suicidal ideation, and suicide attempts. Analyses also compared student subgroups defined by demographic characteristics (e.g., gender). Results Students at school-based health center schools that increased availability of mental health services were less likely to report depressive episodes (OR=0.88, p<0.01), suicidal ideation (OR=0.84, p<0.01), and suicide attempts (OR=0.82, p<0.01) from 2013 to 2015 compared with all other schools. Significant risk reductions in past year depressive episodes and suicidal ideation were also observed in school-based health center schools that increased availability of mental health services relative to other schools with school-based health centers. No significant differences were observed for student demographic subgroups. Conclusions This study suggests that increasing availability of school-based mental health services can help to reduce depressive episodes and suicide risk among adolescents.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.022
  • Fall Risk Factors in Mid-Age Women: The Australian Longitudinal Study on
           Women’s Health
    • Authors: Anthea M. White; Leigh R. Tooth; G.M.E.E. (Geeske) Peeters
      Pages: 51 - 63
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Anthea M. White, Leigh R. Tooth, G.M.E.E. (Geeske) Peeters
      Introduction In contrast to older adults, little is known about risk factors for falls in adults aged 50–64 years, despite a high prevalence of falls in this age group. The aim was to identify risk factors for falls in mid-age women and explore how associations change with age. Methods Data were analyzed in 2016 from women aged 50–55 years in 2001 (born 1946–1951) in the Australian Longitudinal Study on Women’s Health. The predictor variables were health-related factors (measured 2001, 2004, 2007, 2010) and the outcome was falls in the past 12 months (measured 2004, 2007, 2010, 2013). Prospective associations between predictor variables and falls measured 3 years later were analyzed using logistic regression with complete data for 4,629, 7,096, 5,911, and 5,774 participants. Results In surveys, 20.5% (2004), 30.7% (2007), 30.5% (2010), and 26.6% (2013) of women reported a fall in the previous 12 months. In the univariable models, most factors were associated with falls 3 years later. In the multivariable models, higher odds of falling were found for overweight and obese women compared with healthy weight women at all survey intervals (OR range, 1.15–1.43). Impaired vision (OR range, 1.25–1.35) and poor physical functioning (OR range, 1.24–1.66) were associated with falls at three survey intervals. Depression (OR range, 1.31–1.42), leaking urine (OR range, 1.25–1.49), stiff/painful joints (OR range, 1.26–1.62), severe tiredness (OR range, 1.29–1.49), osteoporosis (OR range, 1.25–1.52), and hormone replacement therapy (OR range, 0.69–0.79) were associated with falls at two survey intervals. There was no obvious age-related increase or decrease in the number of statistically significant associations. Conclusions Identified fall risk factors varied over time, highlighting that falling involves a complex interplay of risk factors in mid-age women.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.10.009
  • An Electronic Health Record−Based Strategy to Address Child Tobacco
           Smoke Exposure
    • Authors: E. Melinda Mahabee-Gittens; Judith W. Dexheimer; Meredith Tabangin; Jane C. Khoury; Ashley L. Merianos; Lara Stone; Gabe T. Meyers; Judith S. Gordon
      Pages: 64 - 71
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): E. Melinda Mahabee-Gittens, Judith W. Dexheimer, Meredith Tabangin, Jane C. Khoury, Ashley L. Merianos, Lara Stone, Gabe T. Meyers, Judith S. Gordon
      Introduction A high proportion of children presenting to pediatric urgent cares are exposed to tobacco smoke. An electronic health record−based clinical decision support system for nurses to facilitate guideline-based tobacco smoke exposure screening and counseling for caregivers who smoke was designed and evaluated. Design A mixed-methods, 3-month, prospective study that began in November 2015, data were analyzed in June 2016. Setting/participants Five urgent cares that were part of a large children’s hospital in Cincinnati, OH. Participants were urgent care nurses. Intervention The clinical decision support system prompted nurses to Ask, Advise, Assess, and Assist caregivers to quit smoking. Monthly feedback reports were also provided. Main outcome measure Clinical decision support system use rates, nurses’ attitudes towards tobacco smoke exposure intervention, and percentage of children screened and caregivers counseled. Results All nurses used the clinical decision support system. Compared with Month 1, nurses were twice as likely to advise and assess during Months 2 and 3. There was significant improvement in nurses feeling prepared to assist caregivers in quitting. Nurses reported that feedback reports motivated them to use the clinical decision support system, and that it was easy to use. Almost 65% of children were screened for tobacco smoke exposure; 19.5% screened positive. Of caregivers identified as smokers, 26% were advised to quit and 29% were assessed for readiness to quit. Of those assessed, 67% were interested in quitting, and of those, 100% were assisted. Conclusions A clinical decision support system increased rates of tobacco smoke exposure screening and intervention in pediatric urgent cares. Rates might further improve by incorporating all components of the clinical decision support system into the electronic health record. Trial Registration This study is registered at NCT02489708.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.011
  • Social Policy Expenditures and Life Expectancy in High-Income Countries
    • Authors: Megan M. Reynolds; Mauricio Avendano
      Pages: 72 - 79
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Megan M. Reynolds, Mauricio Avendano
      Introduction The U.S. spends more than any other country on health care, yet Americans have lower life expectancy than people in most industrialized countries. Recent studies suggest that lower expenditures on social policies in the U.S. may contribute to less-favorable trends in life expectancy. This study tests the hypothesis that greater social spending will be positively associated with life expectancy across the countries of the Organisation of Economic Co-operation and Development and that the magnitude of these associations will outweigh those between government healthcare spending and life expectancy. Methods In 2016, longitudinal data on six domains of social expenditures for the U.S. and 19 other wealthy nations between 1980 and 2010 were used to estimate the associations between prior year expenditures on education, family, unemployment, incapacity, old age, and active labor market programs, and period life expectancy using fixed effects models. Results Controlling for a wide set of confounders and government healthcare expenditures, a 1% increase in prior year education expenditures was associated with 0.160 (95% CI=0.033, 0.286) of a year gain in life expectancy, whereas a 1% increase in prior year incapacity benefit expenditures was associated with 0.168 (95% CI=0.003, 0.333) of a year gain in life expectancy. Counterfactual models suggest that if the U.S. were to increase expenditures on education and incapacity to the levels of the country with the maximum expenditures, life expectancy would increase to 80.12 years. Conclusions The U.S. life expectancy lag could be considerably smaller if U.S. expenditures on education and incapacity programs were comparable with those in other high-income countries.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.09.001
  • Cost Benefit of Comprehensive Primary and Preventive School-Based Health
    • Authors: William V. Padula; Katherine A. Connor; Josiah M. Mueller; Jonathan C. Hong; Gabriela Calderon Velazquez; Sara B. Johnson
      Pages: 80 - 86
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): William V. Padula, Katherine A. Connor, Josiah M. Mueller, Jonathan C. Hong, Gabriela Calderon Velazquez, Sara B. Johnson
      Introduction The Rales Health Center is a comprehensive school-based health center at an urban elementary/middle school. Rales Health Center provides a full range of pediatric services using an enriched staffing model consisting of pediatrician, nurse practitioner, registered nurses, and medical office assistant. This staffing model provides greater care but costs more than traditional school-based health centers staffed by part-time nurses. The objective was to analyze the cost benefit of Rales Health Center enhanced staffing model compared with a traditional school-based health center (standard care), focusing on asthma care, which is among the most prevalent chronic conditions of childhood. Methods In 2016, cost-benefit analysis using a decision tree determined the net social benefit of Rales Health Center compared with standard care from the U.S. societal perspective based on the 2015–2016 academic year. It was assumed that Rales Health Center could handle greater patient throughput related to asthma, decreased prescription costs, reduced parental resources in terms of missed work time, and improved student attendance. Univariate and multivariate probabilistic sensitivity analyses were conducted. Results The expected cost to operate Rales Health Center was $409,120, compared with standard care cost of $172,643. Total monetized incremental benefits of Rales Health Center were estimated to be $993,414. The expected net social benefit for Rales Health Center was $756,937, which demonstrated substantial societal benefit at a return of $4.20 for every dollar invested. This net social benefit estimate was robust to sensitivity analyses. Conclusions Despite the greater cost associated with the Rales Health Center’s enhanced staffing model, the results of this analysis highlight the cost benefit of providing comprehensive, high-quality pediatric care in schools, particularly schools with a large proportion of underserved students.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.025
  • Associations Between Neighborhood Environment, Health Behaviors, and
    • Authors: Shaneda Warren Andersen; William J. Blot; Xiao-Ou Shu; Jennifer S. Sonderman; Mark Steinwandel; Margaret K. Hargreaves; Wei Zheng
      Pages: 87 - 95
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Shaneda Warren Andersen, William J. Blot, Xiao-Ou Shu, Jennifer S. Sonderman, Mark Steinwandel, Margaret K. Hargreaves, Wei Zheng
      Introduction Considering the joint association of neighborhood socioeconomic environment and individual-level health behaviors with health outcomes may help officials design effective disease prevention strategies. This study evaluates the joint influences of neighborhood socioeconomic environment and individual health behaviors on mortality in a cohort primarily comprising people with low individual-level SES. Methods The prospective Southern Community Cohort Study includes 77,896 white and African American participants recruited in the years 2002–2009; 55% of participants had a household income <$15,000 at baseline interview. Mortality from cancer (n=2,471), cardiovascular diseases (n=3,005), and all-causes (n=10,099) was identified from the National Death Index through December 31, 2013 (median follow-up, 8 years). Data were analyzed in 2016 and 2017. Associations were assessed between mortality, a neighborhood deprivation index composed of 11 census tract-level variables, five health behaviors, and a composite healthy lifestyle score. Results Living in a neighborhood with the greatest socioeconomic disadvantage was associated with higher all-cause mortality in both men (hazard ratio=1.41, 95% CI=1.27, 1.57) and women (hazard ratio=1.77, 95% CI=1.57, 2.00). Associations were attenuated after adjustment for individual-level SES and major risk factors (hazard ratio for men=1.09, 95% CI=0.98, 1.22, and hazard ratio for women=1.26, 95% CI=1.12, 1.42). The dose–response association between neighborhood disadvantage and mortality was less apparent among smokers. Nevertheless, individuals who lived in disadvantaged neighborhoods and had the unhealthiest lifestyle scores experienced the highest mortality. Conclusions Disadvantaged neighborhood socioeconomic environments are associated with increased mortality in a cohort of individuals of low SES. Positive individual-level health behaviors may help negate the adverse effect of disadvantage on mortality.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.09.002
  • Reducing Preventable Hospitalization and Disparity: Association With Local
           Health Department Mental Health Promotion Activities
    • Authors: Jie Chen; Robin Bloodworth; Priscilla Novak; Benjamin Le Cook; Howard H. Goldman; Michael S. Rendall; Stephen B. Thomas; Charles F. Reynolds
      Pages: 103 - 112
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Jie Chen, Robin Bloodworth, Priscilla Novak, Benjamin Le Cook, Howard H. Goldman, Michael S. Rendall, Stephen B. Thomas, Charles F. Reynolds
      Introduction Serving as the center of community-engaged health programs, local health departments can play a critical role in promoting community mental health. The objectives of this study were to explore the association between local health department activities and (1) preventable hospitalizations for individuals with mental disorders, and (2) associated racial disparities in preventable hospitalizations. Method Employing the linked data sets of the 2012–2013 Healthcare Cost and Utilization Project state inpatient discharge file of the State of Maryland, the National Association of County and City Health Officials Profiles Survey, the Area Resource File, and U.S. Census data, the authors estimated the association between local health department activities (i.e., provision of mental health preventive care and community mental health promotion) and the reduction of the preventable hospitalizations for ambulatory care–sensitive conditions and coexisting mental disorders. All the data analyses were conducted during September 2016–August 2017. Results Multilevel regression showed that local health departments’ provision of mental health preventive care (OR=0.76, 95% CI=0.63, 0.92) and mental health promotion activities (OR=0.77, 95% CI=0.62, 0.94) were significantly associated with lower rates of preventable hospitalizations for individuals with ambulatory care–sensitive conditions and coexisting mental disorders. Decomposition results suggested that local health departments’ direct provision of mental health preventive care could reduce 9% of the racial disparities. Conclusions Improving care coordination and integration are essential to meeting the growing demands for healthcare access, while controlling costs and improving quality of service delivery. These results suggest that it will be effective to engage local health departments in the integrated behavioral health system.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.10.011
  • Attitudes Toward Smoke-Free Public Housing Among U.S. Adults, 2016
    • Authors: Teresa W. Wang; Pamela R. Lemos; Simon McNabb; Brian A. King
      Pages: 113 - 118
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Teresa W. Wang, Pamela R. Lemos, Simon McNabb, Brian A. King
      Introduction Effective February 2017, the U.S. Department of Housing and Urban Development published a rule requiring each public housing agency to implement a smoke-free policy within 18 months. This study assessed the prevalence and determinants of favorability toward smoke-free public housing among U.S. adults. Methods Data from 2016 Summer Styles, a nationally representative web-based survey conducted among adults (N=4,203) were analyzed in 2017. Participants were asked: Do you favor or oppose prohibiting smoking in public housing, including all indoor areas of living units, common areas, and office buildings, as well as in all outdoor areas within 25 feet of buildings' Multivariate Poisson regression was used to calculate adjusted prevalence ratios of favorability (strongly or somewhat). Results Overall, 73.7% of respondents favored smoke-free public housing. Favorability was 44.3% among current cigarette smokers, 73.2% among former smokers, and 80.4% among never smokers. The adjusted likelihood of favorability was greater among non-Hispanic, non-black racial/ethnic minorities than whites, and among those in the West than the Northeast (p<0.05). Favorability was lower among adults with a high school education or less compared with those with a college degree, adults with annual household income <$15,000 than those with income ≥$60,000, multiunit housing residents than non-multiunit housing residents, current cigarette smokers than never smokers, and current non-cigarette tobacco product users than never users (p<0.05). Conclusions Most U.S. adults favor prohibiting smoking in public housing. These data can inform the implementation and sustainment of smoke-free policies to reduce the public health burden of tobacco smoking in public housing.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.026
  • Tdap Vaccination Among Healthcare Personnel—21 States, 2013
    • Authors: Alissa C. O’Halloran; Peng-jun Lu; Sarah A. Meyer; Walter W. Williams; Pamela K. Schumacher; Aaron L. Sussell; Jan E. Birdsey; Winifred L. Boal; Marie Haring Sweeney; Sara E. Luckhaupt; Carla L. Black; Tammy A. Santibanez
      Pages: 119 - 123
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Alissa C. O’Halloran, Peng-jun Lu, Sarah A. Meyer, Walter W. Williams, Pamela K. Schumacher, Aaron L. Sussell, Jan E. Birdsey, Winifred L. Boal, Marie Haring Sweeney, Sara E. Luckhaupt, Carla L. Black, Tammy A. Santibanez
      Introduction Outbreaks of pertussis can occur in healthcare settings. Vaccinating healthcare personnel may be helpful in protecting healthcare personnel from pertussis and potentially limiting spread to others in healthcare settings. Methods Data from 21 states using the 2013 Behavioral Risk Factor Surveillance System industry/occupation module were analyzed in 2016. Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination status was self-reported by healthcare personnel along with their occupation, healthcare setting/industry, demographics, and access to care factors. To compare groups, t-tests were used. The median state response rate was 44.0%. Results Among all healthcare personnel, 47.2% were vaccinated for Tdap. Physicians had higher Tdap coverage (66.8%) compared with all other healthcare personnel except nurse practitioners and registered nurses (59.5%), whose coverage did not statistically differ from that of physicians. Tdap vaccination coverage was higher among workers in hospitals (53.3%) than in long-term care facilities (33.3%) and other clinical settings, such as dentist, chiropractor, and optometrist offices (39.3%). Healthcare personnel who were younger, who had higher education, higher annual household income, a personal healthcare provider, and health insurance had higher Tdap vaccination coverage compared with reference groups. Tdap vaccination coverage among healthcare personnel in 21 states ranged from 30.6% in Mississippi to 65.9% in Washington. Conclusions Improvement in Tdap vaccination among healthcare personnel is needed to potentially reduce opportunities for spread of pertussis in healthcare settings. On-site workplace vaccination, offering vaccines free of charge, and promoting vaccination may increase vaccination among healthcare personnel.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.09.017
  • Mobile Technology for Treatment Augmentation in Veteran Smokers With
           Posttraumatic Stress Disorder
    • Authors: Ellen Herbst; David Pennington; Eric Kuhn; Shannon E. McCaslin; Kevin Delucchi; Steven L. Batki; Benjamin Dickter; Timothy Carmody
      Pages: 124 - 128
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Ellen Herbst, David Pennington, Eric Kuhn, Shannon E. McCaslin, Kevin Delucchi, Steven L. Batki, Benjamin Dickter, Timothy Carmody
      Introduction The purpose of this study is to examine the feasibility and acceptability of incorporating a mobile application, Stay Quit Coach, into an integrated care smoking-cessation treatment protocol for veterans with posttraumatic stress disorder (PTSD). Methods Participants included veteran smokers aged 18–69 years with PTSD. The integrated care protocol includes eight weekly PTSD-informed cognitive behavioral therapy sessions for smoking cessation, followed by monthly booster sessions and a prescription for standard smoking-cessation medications if desired. Participants used Stay Quit Coach as desired. Outcome measures at 3-month follow-up included: adherence (sessions attended), 30-day point-prevalence abstinence bioverified with carbon monoxide <6 parts per million, past-30 day mean daily cigarette use, exhaled carbon monoxide, nicotine dependence, and PTSD symptom severity. Repeated outcomes were analyzed with random-intercept linear mixed models. Data were collected in 2015–2016 and analyses were conducted in 2016–2017. Results Participants (n=20) were 95% male and 5% female; mean age 41.4 (SD=16.2) years. Thirteen participants (65%) attended all scheduled sessions, four (20%) did not adhere to the protocol on schedule, and three (15%) were lost to follow-up. At 3-month follow-up, six of 17 completers (35.3%) had bioverified 30-day point-prevalence abstinence. Nicotine dependence, carbon monoxide levels, and past 30-day cigarette use significantly decreased and PTSD symptoms were unchanged from baseline to follow-up. Participants self-reported using Stay Quit Coach 2.5 (SD=2.2) days/week; 15 of 17 (88.2%) reported using Stay Quit Coach <30 minutes/week; two of 17 (11.8%) reported using Stay Quit Coach 30–60 minutes/week. Conclusions Although results must be interpreted with caution given the lack of control group and small sample size, findings indicate that integrating Stay Quit Coach into integrated care was feasible and acceptable.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.016
  • Injuries From Physical Abuse: National Survey of Children’s Exposure
           to Violence I–III
    • Authors: Thomas R. Simon; Anne Shattuck; Akadia Kacha-Ochana; Corinne F. David-Ferdon; Sherry Hamby; Megan Henly; Melissa T. Merrick; Heather A. Turner; David Finkelhor
      Pages: 129 - 132
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Thomas R. Simon, Anne Shattuck, Akadia Kacha-Ochana, Corinne F. David-Ferdon, Sherry Hamby, Megan Henly, Melissa T. Merrick, Heather A. Turner, David Finkelhor
      Introduction Official data sources do not provide researchers, practitioners, and policy makers with complete information on physical injury from child abuse. This analysis provides a national estimate of the percentage of children who were injured during their most recent incident of physical abuse. Methods Pooled data from three cross-sectional national telephone survey samples (N=13,052 children) included in the National Survey of Children’s Exposure to Violence completed in 2008, 2011, and 2014 were used. Results Analyses completed in 2016 indicate that 8.4% of children experienced physical abuse by a caregiver. Among those with injury data, 42.6% were injured in the most recent incident. No differences in injury were observed by sex, age, race/ethnicity, or disability status. Victims living with two parents were less likely to be injured (27.1%) than those living in other family structures (53.8%–59%, p<0.001). Incidents involving an object were more likely to result in injury (59.3% vs 38.5%, p<0.05). Injured victims were significantly more likely to experience substantial fear (57.3%) than other victims (34.4%, p<0.001). Conclusions A substantial percentage of physical abuse victims are physically hurt to the point that they still feel pain the next day, are bruised, cut, or have a broken bone. Self-report data indicate this is a more common problem than official data sources suggest. The lack of an object in an incident of physical abuse does not protect a child from injury. The results underscore the impact of childhood physical abuse and the importance of early prevention activities.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.031
  • Improving Health Screening Uptake in Men: A Systematic Review and
    • Authors: Chin Hai Teo; Chin Jun Ling; Chirk Jenn Ng
      Pages: 133 - 143
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Chin Hai Teo, Chin Jun Ling, Chirk Jenn Ng
      Context Globally, uptake of health screening in men remains low and the effectiveness of interventions to promote screening uptake in men is not well established. This review aimed to determine the effectiveness of interventions in improving men’s uptake of and intention to undergo screening, including interventions using information and communication technology and a male-sensitive approach. Evidence acquisition Studies were sourced from five electronic databases (October 2015), experts, and references of included studies. This study included RCTs or cluster RCTs that recruited men and reported uptake of or intention to undergo screening. Two researchers independently performed study selection, appraisal, and data extraction. The interventions were grouped into those that increase uptake and those that promote informed decision making. They were further sub-analyzed according to types of intervention, male-sensitive, and web- and video-based interventions. The analysis was completed in December 2016. Evidence synthesis This review included 58 studies. Most studies were on prostate cancer (k=31) and HIV (k=11) screening. Most of the studies had low methodologic quality (79.3%) and after excluding them from the analysis, one study found that educational intervention (which was also male-sensitive) was effective in improving men’s intention to screen (risk ratio=1.36, 95% CI=1.23, 1.50, k=1) and partner educational intervention increased men’s screening uptake (risk ratio=1.77, 95% CI=1.48, 2.12, k=1). Video-based educational interventions reduced prostate cancer screening uptake (risk ratio=0.89, 95%CI=0.80, 0.99, k=1) but web-based interventions did not change men’s screening intention or uptake. Conclusions This review highlights the need to conduct more robust studies to provide conclusive evidence on the effectiveness of different interventions to improve men’s screening behavior.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.08.028
  • Differential Associations of Adverse Childhood Experience on Maternal
    • Authors: Nicole M. Racine; Sheri L. Madigan; Andre R. Plamondon; Sheila W. McDonald; Suzanne C. Tough
      Abstract: Publication date: Available online 3 January 2018
      Source:American Journal of Preventive Medicine
      Author(s): Nicole M. Racine, Sheri L. Madigan, Andre R. Plamondon, Sheila W. McDonald, Suzanne C. Tough
      Introduction The current study examined whether three distinct antecedent factors related to maternal adverse childhood experiences were differentially associated with maternal health and psychosocial outcomes in the antepartum period. It was hypothesized that all three adverse childhood experience factors would be positively associated with poor health prior to pregnancy, poor reproductive health history, and health complications and psychosocial difficulties during pregnancy. Methods Data from 1,994 women (mean age=30.87 years) and their infants were collected from a prospective longitudinal cohort from 2008 to 2011. Pregnant women completed self-report questionnaires and a healthcare professional assessed the mothers’ health prior to pregnancy, reproductive history, and pregnancy complications. Results Data analyses were conducted from December 2016 to March 2017. Path analysis demonstrated that women who had experience with physical/emotional abuse in childhood were significantly more likely to enter pregnancy with a chronic health condition (AOR=1.25, 95% CI=1.02, 1.54) and to have psychosocial difficulties in their pregnancy (AOR=1.60, 95% CI=1.34, 1.89). Women who were exposed to household dysfunction in childhood were also significantly more likely to experience psychosocial difficulties during pregnancy (AOR=2.33, 95% CI=1.49, 3.65). There was no association between exposure to sexual abuse and maternal health or mental health outcomes. Conclusions Adverse childhood experience categories differentially predicted maternal health and psychosocial outcomes prior to and during pregnancy. The overall variance accounted for by adverse childhood experiences was small (3%–19%), suggesting that factors other than childhood adversity likely contribute to maternal health.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.10.028
  • Randomized Trial to Reduce Air Particle Levels in Homes of Smokers and
    • Authors: Suzanne C. Hughes; John Bellettiere; Benjamin Nguyen; Sandy Liles; Neil E. Klepeis; Penelope J.E. Quintana; Vincent Berardi; Saori Obayashi; Savannah Bradley; C. Richard Hofstetter; Melbourne F. Hovell
      Abstract: Publication date: Available online 2 January 2018
      Source:American Journal of Preventive Medicine
      Author(s): Suzanne C. Hughes, John Bellettiere, Benjamin Nguyen, Sandy Liles, Neil E. Klepeis, Penelope J.E. Quintana, Vincent Berardi, Saori Obayashi, Savannah Bradley, C. Richard Hofstetter, Melbourne F. Hovell
      Introduction Exposure to fine particulate matter in the home from sources such as smoking, cooking, and cleaning may put residents, especially children, at risk for detrimental health effects. A randomized clinical trial was conducted from 2011 to 2016 to determine whether real-time feedback in the home plus brief coaching of parents or guardians could reduce fine particle levels in homes with smokers and children. Design A randomized trial with two groups—intervention and control. Setting/participants A total of 298 participants from predominantly low-income households with an adult smoker and a child aged <14 years. Participants were recruited during 2012–2015 from multiple sources in San Diego, mainly Women, Infants and Children Program sites. Intervention The multicomponent intervention consisted of continuous lights and brief sound alerts based on fine particle levels in real time and four brief coaching sessions using particle level graphs and motivational interviewing techniques. Motivational interviewing coaching focused on particle reduction to protect children and other occupants from elevated particle levels, especially from tobacco-related sources. Main outcome measures In-home air particle levels were measured by laser particle counters continuously in both study groups. The two outcomes were daily mean particle counts and percentage time with high particle concentrations (>15,000 particles/0.01 ft3). Linear mixed models were used to analyze the differential change in the outcomes over time by group, during 2016–2017. Results Intervention homes had significantly larger reductions than controls in daily geometric mean particle concentrations (18.8% reduction vs 6.5% reduction, p<0.001). Intervention homes’ average percentage time with high particle concentrations decreased 45.1% compared with a 4.2% increase among controls (difference between groups p<0.001). Conclusions Real-time feedback for air particle levels and brief coaching can reduce fine particle levels in homes with smokers and young children. Results set the stage for refining feedback and possible reinforcing consequences for not generating smoke-related particles. Trial registration This study is registered at NCT01634334.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.10.017
  • Changes in Sitting Time and Cardiovascular Mortality in Older Adults
    • Authors: Verónica Cabanas-Sánchez; Pilar Guallar-Castillón; Sara Higueras-Fresnillo; Fernando Rodríguez-Artalejo; David Martínez-Gómez
      Abstract: Publication date: Available online 2 January 2018
      Source:American Journal of Preventive Medicine
      Author(s): Verónica Cabanas-Sánchez, Pilar Guallar-Castillón, Sara Higueras-Fresnillo, Fernando Rodríguez-Artalejo, David Martínez-Gómez
      Introduction Prolonged sitting time has demonstrated consistent associations with increased risk of cardiovascular disease and mortality, but most previous studies have analyzed these associations assessing sitting time at one single point and providing scarce evidence on causal links. The main objective of this study was to analyze the association of 2-year changes in sitting time with subsequent long-term cardiovascular disease mortality in older adults. Methods The analyses were conducted with 2,657 individuals with complete data. Sitting time and physical activity were assessed by questionnaire. Changes in sitting time were classified into consistently sedentary (high sitting time in 2001 and 2003); newly sedentary (low sitting time in 2001 and high sitting time in 2003); formerly sedentary (high sitting time in 2001 and low sitting time in 2003); and consistently nonsedentary (low sitting time in 2001 and 2003). The associations between change in sitting time and cardiovascular disease mortality were summarized with hazard ratios and their 95% CIs obtained from Cox regression. The combined effect of changes in sitting time and physical activity on cardiovascular disease mortality was also examined. Results Compared with consistently sedentary participants, those who were consistently nonsedentary had a 33% (hazard ratio=0.67, 95% CI=0.46, 0.96) lower risk of cardiovascular disease death. In combined analyses, consistent nonsedentariness was associated with reduced cardiovascular disease mortality in participants with physical activity less than the median (hazard ratio=0.62, 95% CI=0.39, 1.00) and greater than or equal to the median (hazard ratio=0.49, 95% CI=0.31, 0.79). Formerly sedentary participants with physical activity greater than or equal to the median had a 48% lower cardiovascular disease mortality. Conclusions Among older adults, maintaining low sitting time should be promoted to reduce cardiovascular disease mortality.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.10.010
  • Simulating the Impact of Sugar-Sweetened Beverage Warning Labels in Three
    • Authors: Bruce Y. Lee; Marie C. Ferguson; Daniel L. Hertenstein; Atif Adam; Eli Zenkov; Peggy I. Wang; Michelle S. Wong; Joel Gittelsohn; Yeeli Mui; Shawn T. Brown
      Abstract: Publication date: Available online 14 December 2017
      Source:American Journal of Preventive Medicine
      Author(s): Bruce Y. Lee, Marie C. Ferguson, Daniel L. Hertenstein, Atif Adam, Eli Zenkov, Peggy I. Wang, Michelle S. Wong, Joel Gittelsohn, Yeeli Mui, Shawn T. Brown
      Introduction A number of locations have been considering sugar-sweetened beverage point-of-purchase warning label policies to help address rising adolescent overweight and obesity prevalence. Methods To explore the impact of such policies, in 2016 detailed agent-based models of Baltimore, Philadelphia, and San Francisco were developed, representing their populations, school locations, and food sources, using data from various sources collected between 2005 and 2014. The model simulated, over a 7-year period, the mean change in BMI and obesity prevalence in each of the cities from sugar-sweetened beverage warning label policies. Results Data analysis conducted between 2016 and 2017 found that implementing sugar-sweetened beverage warning labels at all sugar-sweetened beverage retailers lowered obesity prevalence among adolescents in all three cities. Point-of-purchase labels with 8% efficacy (i.e., labels reducing probability of sugar-sweetened beverage consumption by 8%) resulted in the following percentage changes in obesity prevalence: Baltimore: −1.69% (95% CI= −2.75%, −0.97%, p<0.001); San Francisco: –4.08% (95% CI= −5.96%, −2.2%, p<0.001); Philadelphia: −2.17% (95% CI= −3.07%, −1.42%, p<0.001). Conclusions Agent-based simulations showed how warning labels may decrease overweight and obesity prevalence in a variety of circumstances with label efficacy and literacy rate identified as potential drivers. Implementing a warning label policy may lead to a reduction in obesity prevalence. Focusing on warning label design and store compliance, especially at supermarkets, may further increase the health impact.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.11.003
  • Hospital Emergency Department Lethal Means Counseling for Suicidal
    • Authors: Carol W. Runyan; Ashley Brooks-Russell; Gregory Tung; Sara Brandspigel; Marian E. Betz; Douglas K. Novins; Robert Agans
      Abstract: Publication date: Available online 14 December 2017
      Source:American Journal of Preventive Medicine
      Author(s): Carol W. Runyan, Ashley Brooks-Russell, Gregory Tung, Sara Brandspigel, Marian E. Betz, Douglas K. Novins, Robert Agans
      Introduction Lethal means counseling of suicidal individuals in emergency departments has the potential to reduce suicide. This study examines the provision of lethal means counseling and the presence of written protocols in a region with high rates of both firearm ownership and suicide. Methods In 2015–2016, emergency department nurse managers in hospital-based emergency departments throughout eight states were surveyed using an 80-item survey developed through qualitative interviews and pilot testing. Questions focused on discharge counseling with suicidal patients and the presence of written protocols. Using survey weights to adjust for nonresponse, relationships of protocols with counseling practices were examined. Results Data were obtained from 52.3% of all 363 eligible hospital emergency departments in the region. Among facilities that discharge suicidal patients, 79.7% (95% CI=75.0%, 84.4%) reported asking about access to firearms and 68.9% (95% CI=62.9%, 74.8%) counsel about safe storage when patients reported access. Forty-four percent of emergency departments reported having written protocols for lethal means counseling. Presence of written protocols was associated with a higher rate of counseling for all suicidal patients even if they were not planning to use a gun (45.0% [95% CI=33.4%, 56.7%] in hospitals with protocols vs 21.5% [95% CI=14.9%, 29.0%] in facilities without protocols). Conclusions There are significant gaps in attention to lethal means counseling in emergency departments. This signals an opportunity to increase consistency and thoroughness of care for suicidal patients in the emergency department and for leadership from key professional organizations to advocate for protocols.

      PubDate: 2018-01-03T22:00:35Z
      DOI: 10.1016/j.amepre.2017.10.023
  • Advancing the Methods of the U.S. Preventive Services Task Force
    • Authors: Alex H. Krist; Kirsten Bibbins-Domingo; Tracy A. Wolff; Iris R. Mabry-Hernandez
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1
      Author(s): Alex H. Krist, Kirsten Bibbins-Domingo, Tracy A. Wolff, Iris R. Mabry-Hernandez

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.10.012
  • Update on the Methods of the U.S. Preventive Services Task Force: Linking
           Intermediate Outcomes and Health Outcomes in Prevention
    • Authors: Tracy A. Wolff; Alex H. Krist; Michael LeFevre; Daniel E. Jonas; Russell P. Harris; Albert Siu; Douglas K. Owens; Matthew W. Gillman; Mark H. Ebell; Jessica Herzstein; Roger Chou; Evelyn Whitlock; Kirsten Bibbins-Domingo
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1
      Author(s): Tracy A. Wolff, Alex H. Krist, Michael LeFevre, Daniel E. Jonas, Russell P. Harris, Albert Siu, Douglas K. Owens, Matthew W. Gillman, Mark H. Ebell, Jessica Herzstein, Roger Chou, Evelyn Whitlock, Kirsten Bibbins-Domingo
      The U.S. Preventive Services Task Force (USPSTF) is an independent body of experts who make evidence-based recommendations about clinical preventive services using a transparent and objective process. Developing recommendations on a clinical preventive service requires evidence of its effect on health outcomes. Health outcomes are symptoms, functional levels, and conditions that affect a patient’s quantity or quality of life and are measured by assessments of physical or psychologic well-being. Intermediate outcomes are pathologic, physiologic, psychologic, social, or behavioral measures related to a preventive service. Given the frequent lack of evidence on health outcomes, the USPSTF uses evidence on intermediate outcomes when appropriate. The ultimate goal is to determine precisely a consistent relationship between the direction and magnitude of change in an intermediate outcome with a predictable resultant direction and magnitude of change in the health outcomes. The USPSTF reviewed its historical use of intermediate outcomes, reviewed methods of other evidence-based guideline-making bodies, consulted with other experts, and reviewed scientific literature. Most important were the established criteria for causation, tenets of evidence-based medicine, and consistency with its current standards. Studies that follow participants over time following early treatment, stratify patients according to treatment response, and adjust for important confounders can provide useful information about the association between intermediate and health outcomes. However, such studies remain susceptible to residual confounding. The USPSTF will exercise great caution when making a recommendation that depends on the evidence linking intermediate and health outcomes because of inherent evidence limitations.

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.08.032
  • Update on the Methods of the U.S. Preventive Services Task Force: Methods
           for Understanding Certainty and Net Benefit When Making Recommendations
    • Authors: Alex H. Krist; Tracy A. Wolff; Daniel E. Jonas; Russell P. Harris; Michael L. LeFevre; Alex R. Kemper; Carol M. Mangione; Chien-Wen Tseng; David C. Grossman
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1
      Author(s): Alex H. Krist, Tracy A. Wolff, Daniel E. Jonas, Russell P. Harris, Michael L. LeFevre, Alex R. Kemper, Carol M. Mangione, Chien-Wen Tseng, David C. Grossman
      Since the 1980s, the U.S. Preventive Services Task Force (USPSTF) has developed and used rigorous methods to make evidence-based recommendations about preventive services to promote health and well-being for all Americans. Recommendations are based on the evidence of magnitude of net benefit (benefits minus harms). Expert opinion is not substituted when evidence is lacking. Evidence gaps are common. Few preventive services are supported by high-quality studies that directly and comprehensively determine the overall magnitude of benefits and harms in the same study. When assessing the body of evidence, studies may not have been conducted in primary care settings, studies may not have sufficiently included populations of interest, and long-term outcomes may not have been directly assessed. When direct evidence is not available, the USPSTF uses the methodologies of applicability to determine whether evidence can be generalized to an asymptomatic primary care population; coherence to link bodies of evidence and create an indirect evidence pathway; extrapolation to make inferences across the indirect evidence pathway, extend evidence to populations not specifically studied, consider service delivery intervals, and infer long-term outcomes; and conceptual bounding to set theoretical lower or upper limits for plausible benefits or harms. The USPSTF extends the evidence only so far as to maintain at least moderate certainty that its findings are preserved. This manuscript details with examples of how the USPSTF uses these methods to make recommendations that truly reflect the evidence.

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.09.011
  • The Use of Rapid Review Methods for the U.S. Preventive Services Task
    • Authors: Carrie D. Patnode; Michelle L. Eder; Emily S. Walsh; Meera Viswanathan; Jennifer S. Lin
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1
      Author(s): Carrie D. Patnode, Michelle L. Eder, Emily S. Walsh, Meera Viswanathan, Jennifer S. Lin
      Rapid review products are intended to synthesize available evidence in a timely fashion while still meeting the needs of healthcare decision makers. Various methods and products have been applied for rapid evidence syntheses, but no single approach has been uniformly adopted. Methods to gain efficiency and compress the review time period include focusing on a narrow clinical topic and key questions; limiting the literature search; performing single (versus dual) screening of abstracts and full-text articles for relevance; and limiting the analysis and synthesis. In order to maintain the scientific integrity, including transparency, of rapid evidence syntheses, it is imperative that procedures used to streamline standard systematic review methods are prespecified, based on sound review principles and empiric evidence when possible, and provide the end user with an accurate and comprehensive synthesis. The collection of clinical preventive service recommendations maintained by the U.S. Preventive Services Task Force, along with its commitment to rigorous methods development, provide a unique opportunity to refine, implement, and evaluate rapid evidence synthesis methods and add to an emerging evidence base on rapid review methods. This paper summarizes the U.S. Preventive Services Task Force’s use of rapid review methodology, its criteria for selecting topics for rapid evidence syntheses, and proposed methods to streamline the review process.

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.07.024
  • Framework for Using Risk Stratification to Improve Clinical Preventive
           Service Guidelines
    • Authors: Jennifer S. Lin; Corinne V. Evans; David C. Grossman; Chien-Wen Tseng; Alex H. Krist
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1
      Author(s): Jennifer S. Lin, Corinne V. Evans, David C. Grossman, Chien-Wen Tseng, Alex H. Krist
      People should only receive a preventive service if the potential benefits of the service outweigh the potential harms. Both benefits and risks may vary for different populations. Thus, it is clinically important to understand when and how guidelines for preventive services should be stratified according to the underlying risk of the population. For example, preventive services may be risk stratified with specific clinical recommendations based on age, sex, race/ethnicity, family history, genotype, behavior risks, or comorbidities. This paper articulates the conceptual approach and practical tools that were developed for consideration by the U.S. Preventive Services Task Force to determine if and how risk stratification should be incorporated into clinical guidelines. This approach is described in an algorithm with six sequential questions: (1) Are there clinically relevant subpopulations' (2) Are there credible subgroup analyses for these subpopulations' (3) Do subgroup analyses show clinically important differences' (4) Do these differences result in variation of net benefit, or does the evidence only exist in persons with a narrow spectrum of risk' (5) Can the subpopulations be easily identified' and (6) Does a well-validated multivariate risk tool improve identification of clinically relevant subpopulations compared with a simpler approach' This framework allows for a systematic approach to determine if and how to incorporate evidence for specific populations, a consistent application of critical thinking about this evidence, and transparent communication about the derivation of risk-stratified recommendations or evidence gaps.

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.07.023
  • Collaborative Modeling: Experience of the U.S. Preventive Services Task
    • Authors: Diana B. Petitti; Jennifer S. Lin; Douglas K. Owens; Jennifer M. Croswell; Eric J. Feuer
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1
      Author(s): Diana B. Petitti, Jennifer S. Lin, Douglas K. Owens, Jennifer M. Croswell, Eric J. Feuer
      Models can be valuable tools to address uncertainty, trade-offs, and preferences when trying to understand the effects of interventions. Availability of results from two or more independently developed models that examine the same question (comparative modeling) allows systematic exploration of differences between models and the effect of these differences on model findings. Guideline groups sometimes commission comparative modeling to support their recommendation process. In this commissioned collaborative modeling, modelers work with the people who are developing a recommendation or policy not only to define the questions to be addressed but ideally, work side-by-side with each other and with systematic reviewers to standardize selected inputs and incorporate selected common assumptions. This paper describes the use of commissioned collaborative modeling by the U.S. Preventive Services Task Force (USPSTF), highlighting the general challenges and opportunities encountered and specific challenges for some topics. It delineates other approaches to use modeling to support evidence-based recommendations and the many strengths of collaborative modeling compared with other approaches. Unlike systematic reviews prepared for the USPSTF, the commissioned collaborative modeling reports used by the USPSTF in making recommendations about screening have not been required to follow a common format, sometimes making it challenging to understand key model features. This paper presents a checklist developed to critically appraise commissioned collaborative modeling reports about cancer screening topics prepared for the USPSTF.

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.07.003
  • Conflicts of Interest in Clinical Guidelines: Update of U.S. Preventive
           Services Task Force Policies and Procedures
    • Authors: Quyen Ngo-Metzger; Virginia Moyer; David Grossman; Mark Ebell; Meghan Woo; Therese Miller; Tana Brummer; Joya Chowdhury; Elisabeth Kato; Albert Siu; William Phillips; Karina Davidson; Maureen Phipps; Kirsten Bibbins-Domingo
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1
      Author(s): Quyen Ngo-Metzger, Virginia Moyer, David Grossman, Mark Ebell, Meghan Woo, Therese Miller, Tana Brummer, Joya Chowdhury, Elisabeth Kato, Albert Siu, William Phillips, Karina Davidson, Maureen Phipps, Kirsten Bibbins-Domingo
      The U.S. Preventive Services Task Force (USPSTF) provides independent, objective, and scientifically rigorous recommendations for clinical preventive services. A primary concern is to avoid even the appearance of members having special interests that might influence their ability to judge evidence and formulate unbiased recommendations. The conflicts of interest policy for the USPSTF is described, as is the formal process by which best practices were incorporated to update the policy. The USPSTF performed a literature review, conducted key informant interviews, and reviewed conflicts of interest policies of ten similar organizations. Important findings included transparency and public accessibility; full disclosure of financial relationships; disclosure of non-financial relationships (that create the potential for bias and compromise a member’s objective judgment); disclosure of family members’ conflicts of interests; and establishment of appropriate reporting periods. Controversies in best practices include the threshold of financial disclosures, ease of access to conflicts of interest policies and declarations, vague definition of non-financial biases, and request for family members’ conflicts of interests (particularly those that are non-financial in nature). The USPSTF conflicts of interest policy includes disclosures for immediate family members, a clear non-financial conflicts of interest definition, long look-back period and application of the policy to prospective members. Conflicts of interest is solicited from all members every 4 months, formally reviewed, adjudicated, and made publicly available. The USPSTF conflicts of interest policy is publicly available as part of the USPSTF Procedure Manual. A continuous improvement process can be applied to conflicts of interest policies to enhance public trust in members of panels, such as the USPSTF, that produce clinical guidelines and recommendations.

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.06.034
  • U.S. Preventive Services Task Force Methods to Communicate and Disseminate
           Clinical Preventive Services Recommendations
    • Authors: Ann E. Kurth; Alex H. Krist; Amanda E. Borsky; Linda Ciofu Baumann; Susan J. Curry; Karina W. Davidson; Chyke A. Doubeni; John W. Epling; Tina Fan; Francisco A.R. García; Jessica Herzstein; William R. Phillips; Michael P. Pignone; Chien-Wen Tseng; Rachel Weinstein
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1
      Author(s): Ann E. Kurth, Alex H. Krist, Amanda E. Borsky, Linda Ciofu Baumann, Susan J. Curry, Karina W. Davidson, Chyke A. Doubeni, John W. Epling, Tina Fan, Francisco A.R. García, Jessica Herzstein, William R. Phillips, Michael P. Pignone, Chien-Wen Tseng, Rachel Weinstein
      The U.S. Preventive Services Task Force (USPSTF) issues evidence-based screening and prevention recommendations, and key to this task is dissemination and implementation of these recommendations. The Task Force has recommendations for more than 84 topics; each USPSTF Recommendation Statement includes a letter grade, a topline summary to guide clinician interpretation in practice, and a summary of gaps in evidence to help catalyze clinically relevant research. The USPSTF aims to update existing topics regularly and considers new topics to add each year. Clearly communicating and disseminating each recommendation is a critical task to ensure maximum benefit from use of the recommendations. The primary USPSTF audience is primary care clinicians. Over time, other audiences have become interested in the USPSTF and these entities have broad and diverse needs, necessitating a range of communication platforms and approaches. This includes engagement with and input from topic experts, primary care and federal partners, and the public to help shape the development of the recommendations. It also includes engagement of partners to disseminate USPSTF recommendations to help ensure that the primary care workforce remains up-to-date on USPSTF recommendations. This paper outlines the approaches used by the USPSTF to both solicit input (e.g., public comment periods), as well as to facilitate dissemination of its recommendations to help improve the health of all Americans (e.g., web-based and mobile application tools, journal publications, and annual reports to Congress).

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.07.004
  • U.S. Preventive Services Task Force Priorities for Prevention Research
    • Authors: Iris R. Mabry-Hernandez; Susan J. Curry; William R. Phillips; Francisco A. García; Karina W. Davidson; John W. Epling; Quyen Ngo-Metzger; Arlene S. Bierman
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1
      Author(s): Iris R. Mabry-Hernandez, Susan J. Curry, William R. Phillips, Francisco A. García, Karina W. Davidson, John W. Epling, Quyen Ngo-Metzger, Arlene S. Bierman
      The U.S. Preventive Services Task Force (USPSTF) makes recommendations about clinical preventive services. The USPSTF examines chains of direct and indirect evidence to demonstrate the effectiveness of a clinical preventive service. Missing links across the chains of evidence reflect gaps in the research. Evidence gaps can occur for preventive services that receive a letter grade recommendation and those that receive an I statement (insufficient evidence). This article describes the types of evidence gaps that the USPSTF encounters across its various recommendations and how the USPSTF identifies and communicates these gaps to researchers and policymakers, who can help generate the needed evidence. Common types of evidence gaps include limited evidence in primary care settings and populations, a lack of appropriate health outcomes, limited evidence linking behavior change to health outcomes, and a lack of evidence for effective preventive services in diverse populations. The USPSTF annual report to Congress focuses on the evidence gaps of new recommendations from the past year and is sent to leading research funding agencies. The Office of Disease Prevention at NIH uses this report to help direct future funding opportunities that may address these evidence gaps. The USPSTF plays a critical role in highlighting the information needed to advance the science to optimize the use of clinical preventive services in primary care.

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.08.014
  • Emergency Department Visits Involving Opioid Overdoses, U.S.,
    • Authors: Gery P. Guy; Emilia Pasalic; Kun Zhang
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Gery P. Guy, Emilia Pasalic, Kun Zhang

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.09.003
  • Vaccination Timeliness at Age 24 Months in Michigan Children Born
    • Authors: Abram L. Wagner; Amanda M. Eccleston; Rachel C. Potter; Robert G. Swanson; Matthew L. Boulton
      Pages: 96 - 102
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Abram L. Wagner, Amanda M. Eccleston, Rachel C. Potter, Robert G. Swanson, Matthew L. Boulton
      Introduction Delays in vaccination can stymie the development of herd immunity, and a large proportion of children in the U.S. are known not to receive vaccines on time. This study quantifies delays in vaccination, compares vaccination timeliness to the proportion of children vaccinated, and evaluates the impact of combination vaccine use and timely administration of hepatitis B vaccine birth dose on vaccine timeliness among Michigan children. Methods This retrospective cohort study used data from the Michigan Care Improvement Registry—the state immunization information system—for children born 2006–2010. Children aged 24 months as of December 31, 2012, were included. The proportion of children with timely administration of vaccine doses was calculated, and the mean days of vaccination delay with SD were reported. Results Among 620,592 Michigan children, 42.2% had received all vaccines, but only 13.2% were vaccinated on time by age 24 months. Children’s vaccinations were delayed an average of 59.2 (SD=91.2) days by age 24 months for all recommended vaccine doses. Children who received a timely hepatitis B vaccine birth dose or who received a combination vaccine had less delay in vaccination. Conclusions Michigan children have high vaccination coverage based on standard measures but few receive these vaccines on time. Promoting use of combination vaccines may improve parental compliance with timely vaccination of children.

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.09.014
  • Wearable Technology and Physical Activity in Chronic Disease:
           Opportunities and Challenges
    • Authors: Siobhan M. Phillips; Lisa Cadmus-Bertram; Dori Rosenberg; Matthew P. Buman; Brigid M. Lynch
      Pages: 144 - 150
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Siobhan M. Phillips, Lisa Cadmus-Bertram, Dori Rosenberg, Matthew P. Buman, Brigid M. Lynch

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.08.015
  • An Appreciation of the U.S. Preventive Services Task Force
    • Authors: Otis W. Brawley
      Pages: 151 - 152
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Otis W. Brawley

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.10.013
  • Guideline Recommendations for Preventive Healthcare Services:
           Understanding and Managing Conflict of Interest When Population Health
           Meets Personalized Medicine
    • Authors: Sheldon Greenfield
      Pages: 153 - 155
      Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1
      Author(s): Sheldon Greenfield

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.10.006
  • Information for CME Credit—HPV Vaccination Among Foreign-Born Women:
           Examining the National Health Interview Survey
    • Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1

      PubDate: 2017-12-26T17:58:56Z
  • Information for CME Credit—Use of Welcome to Medicare Visits Among Older
           Adults Following the Affordable Care Act
    • Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1

      PubDate: 2017-12-26T17:58:56Z
  • Acknowledgments
    • Abstract: Publication date: January 2018
      Source:American Journal of Preventive Medicine, Volume 54, Issue 1, Supplement 1

      PubDate: 2017-12-26T17:58:56Z
  • Moving the Message Beyond the Methods: Toward Integration of Unintended
           Pregnancy and Sexually Transmitted Infection/HIV Prevention
    • Authors: Riley J. Steiner; Nicole Liddon; Andrea L. Swartzendruber; Karen Pazol; Jessica M. Sales
      Abstract: Publication date: Available online 26 December 2017
      Source:American Journal of Preventive Medicine
      Author(s): Riley J. Steiner, Nicole Liddon, Andrea L. Swartzendruber, Karen Pazol, Jessica M. Sales

      PubDate: 2017-12-26T17:58:56Z
      DOI: 10.1016/j.amepre.2017.10.022
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