Preventive medicine
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Preventive medicine · Jun 2018
Behavioral and mental health risk factor profiles among diverse primary care patients.
Behavioral and mental health risk factors are prevalent among primary care patients and contribute substantially to premature morbidity and mortality and increased health care utilization and costs. Although prior studies have found most adults screen positive for multiple risk factors, limited research has attempted to identify factors that most commonly co-occur, which may guide future interventions. The purpose of this study was to identify subgroups of primary care patients with co-occurring risk factors and to examine sociodemographic characteristics associated with these subgroups. ⋯ Patients in the Substance Use class tended to be younger, male, African American, unmarried, and less educated. African Americans were over 7 times more likely to be in the Dietary Risk versus Lower Risk class (OR 7.7, 95% CI 4.0-14.8). Given the heavy burden of behavioral health issues in primary care, efficiently addressing co-occurring risk factors in this setting is critical.
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Preventive medicine · Jun 2018
Subjective neighborhood assessment and physical inactivity: An examination of neighborhood-level variance.
Research suggests a linkage between perceptions of neighborhood quality and the likelihood of engaging in leisure-time physical activity. Often in these studies, intra-neighborhood variance is viewed as something to be controlled for statistically. However, we hypothesized that intra-neighborhood variance in perceptions of neighborhood quality may be contextually relevant. ⋯ Neighborhoods where the aggregated perception of neighborhood quality was poor also had a larger proportion of residents reporting being physically inactive. However, higher degrees of disagreement among residents within neighborhoods about their neighborhood quality was significantly associated with a lower proportion of residents reporting being physically inactive (p=0.001). Our results suggest that intra-neighborhood variability may be contextually relevant in studies seeking to better understand the relationship between neighborhood quality and behaviors sensitive to neighborhood environments, like physical activity.
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Preventive medicine · Jun 2018
Social capital and obesity among adults: Longitudinal findings from the Montreal neighborhood networks and healthy aging panel.
Curbing the worldwide increase in obesity requires upstream social interventions that modify the environment in which obesity emerges. Recent studies have suggested that social capital and networks may influence a person's risk of obesity. Yet, few longitudinal studies have assessed whether social capital and networks reduce obesity risk in adult populations. ⋯ Adults with higher network diversity (OR: 0.83, 95% CI: 0.72-0.96) and high generalized trust (OR: 0.52, 95% CI: 0.35-0.77) were at a lower the risk of obesity. The current study confirmed that higher network capital and trust were protective against obesity, while having kin ties was not. Disentangling the multidimensional role that social capital plays can lead to more effective interventions to reduce obesity.
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Preventive medicine · Jun 2018
Predictors of non-adherence to colorectal cancer screening among immigrants to Ontario, Canada: a population-based study.
Though colorectal cancer (CRC) screening rates have increased over time in Ontario, Canada, immigrants continue to have lower rates of screening. This study examines the association between non-adherence to CRC screening and immigration, socio-demographic, healthcare utilization, and primary care physician characteristics among immigrants to Ontario. This is a population-based retrospective cross-sectional study that uses healthcare administrative databases housed at the Institute for Clinical Evaluative Sciences. ⋯ Compared to those from the United States, Australia, and New Zealand, immigrants from most other world regions, particularly Eastern Europe and Central Asia (ARR 1.28, 95%CI 1.21-1.37), had higher risks of non-adherence. Non-immigration factors such as low healthcare use and lack of primary care enrolment also increased the risk of non-adherence to screening. These findings can be used to inform future efforts to improve uptake of CRC screening among immigrant groups.
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Preventive medicine · Jun 2018
Disparities in knowledge about the health effects of smoking among adolescents following the release of new pictorial health warning labels.
This paper examined knowledge about the health effects of smoking among health equity groups following the 2012 introduction of refreshed pictorial health warning labels (HWLs) in Canada. Data are from the 2012/2013 Youth Smoking Survey a representative school-based survey of 47,203 adolescents in Grades 6-12 in nine provinces. Regression models examined overall knowledge about eight health effects of smoking included in the HWLs. ⋯ There are significant disparities in knowledge about the health effects of smoking by health equity groups particularly among non-smoking adolescents. Warning labels have the potential to reduce disparities in knowledge about the health effects of smoking when exposure to the warning labels is universal. Complementary strategies such as mass media campaigns are needed to address disparities in knowledge.