Preventive medicine
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Preventive medicine · Oct 2017
Where Latin Americans are physically active, and why does it matter? Findings from the IPEN-adult study in Bogota, Colombia; Cuernavaca, Mexico; and Curitiba, Brazil.
Latin America (LA) has a unique structural, political, cultural and social environment. This study aimed to identify the places where Latin American adults are physically active; and to determine the association of using public- and restricted-access places with physical activity (PA). We used data from the International PA Environment Network study in Bogota, Colombia (n=1000, accelerometry=249); Cuernavaca, Mexico (n=677, accelerometry=652); and Curitiba, Brazil (n=697, accelerometry=331) (2010-2011). ⋯ Our study highlights the importance of public-access places for PA in LA. In some contexts, places for social interaction may be as important for PA as places for exercise/sport. Strategies increasing the availability, accessibility and quality of these places may effectively promote PA in LA.
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Preventive medicine · Oct 2017
Randomized Controlled TrialThe effect of interactive reminders on medication adherence: A randomized trial.
Expanding on evidence that interventions to improve health are more effective when informed by behavioral science, we explore whether reminders designed to harness behavioral science principles can improve medication adherence. We conducted a randomized controlled trial with 46,581 U. S. participants with commercial or Medicare Advantage insurance from Humana. ⋯ The reminders increased medication adherence by 0.7 pills per dollar spent over our 181day study period. Trial registry name: Effect of Reminders on Adherence. Registration identification number: NCT02411006 URL for the registry: https://clinicaltrials.gov/ct2/show/NCT02411006.
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Preventive medicine · Oct 2017
Effectiveness of a scaled up physical activity intervention in Brazil: A natural experiment.
Physical inactivity causes 5.3 million deaths annually worldwide. We evaluated the impact on population leisure-time physical activity (LTPA) of scaling up an intervention in Brazil, Academia das Cidades program (AC-P). AC-P is a health promotion program classified as physical activity classes in community settings which started in the state of Pernambuco state in 2008. ⋯ The odds of reaching recommended LTPA increased with AC-P participation and knowledge about AC-P. AC-P exposure is associated with increased population LTPA. Extending AC-P to all cities could potentially impact non-communicable diseases in Brazil.
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Preventive medicine · Oct 2017
Double jeopardy: Predictors of elevated lethality risk among intimate partner violence victims seen in emergency departments.
Many intimate partner homicide victims visit emergency departments (EDs) prior to their deaths, yet their lethality risk is not well understood. eHealth interventions for intimate partner violence (IPV) improve provider information, tailor care to victim need and link victims to services. We analyzed ED patients' lethality risk using one such intervention, Domestic Violence Report and Referral (DVRR). DVRR records were assessed for 263 female patients aged 16 and older seen for IPV at an urban, high-traffic, Northern California ED in 2014-15. ⋯ Multiple linear regression models indicated that increasing victim age (β=0.20/year; 95% CI: 0.11-0.29), children's presence at home (β=2.61, 95% CI: 0.63-4.58), and perpetrator reported as dating partner (β=4.50, 95% CI: 1.62-7.38) or ex-partner (β=4.38, 95% CI: 1.10-7.66) were significantly associated with the DA score (p<0.05). Use of DA scores as ED risk assessment tools in response to IPV victimization could help hospital staff and IPV advocates direct resources toward highest-need patients, improving health outcomes without additional burden on hospitals. These results also foreground eHealth interventions' utility in linking providers and IPV advocates and reducing the risk of intimate partner homicide.
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Preventive medicine · Oct 2017
Estimation and development of 10- and 20-year cardiovascular mortality risk models in an industrial male workers database.
We examined the performance of the Framingham Heart Study (FHS) and the European Systematic Coronary Risk Evaluation (SCORE) models for cardiovascular disease (CVD) mortality prediction in Israeli industrial workers, and developed and validated new risk prediction models for CVD mortality incidence in the same population. Our database was a longitudinal Israeli industrial cohort (CORDIS cohort) of 4809 adult males followed-up for 22years. Performance of the FHS and the SCORE prediction models was analyzed by insertion of the CORDIS cohort measurements to each model separately. ⋯ No significant differences were found between the two models. In conclusion, the CVD mortality risk prediction scoring systems tailored for the Israeli workers population demonstrated good performance. Additional studies to externally validate these algorithms will indicate which of these quantitative risk estimation platforms should be used in specific settings.