Preventive medicine
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Preventive medicine · Apr 2019
Randomized Controlled TrialHow should sugar-sweetened beverage health warnings be designed? A randomized experiment.
Health warnings are a promising strategy for reducing consumption of sugar-sweetened beverages (SSBs), but uncertainty remains about how to design warnings to maximize their impact. Warnings already implemented in Latin America use nutrient disclosures, while proposed U. S. warnings would describe the health effects of consuming SSBs. ⋯ The marker "WARNING" (ADE = 0.21) and the octagon shape (ADE = 0.08) also led to higher PME compared to warnings without these characteristics (ps < 0.001). The same pattern of results held for the secondary outcomes, fear and thinking about harms. SSB health warnings may have more impact if they describe health effects, use the marker "WARNING," and are octagon-shaped.
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Preventive medicine · Apr 2019
Dangerous weapons or dangerous people? The temporal associations between gun violence and mental health.
Despite the public, political, and media narrative that mental health is at the root of gun violence, evidence is lacking to infer a causal link. This study examines the temporal associations between gun violence (i.e., threatening someone with a gun and gun carrying) and mental health (i.e., anxiety, depression, stress, PTSD, hostility, impulsivity, and borderline personality disorder) as well the cross-sectional associations with gun access and gun ownership in a group of emerging adults. Waves 6 (2015) and 8 (2017) data were used from a longitudinal study in Texas, US. ⋯ Counter to public beliefs, the majority of mental health symptoms examined were not related to gun violence. Instead, access to firearms was the primary culprit. The findings have important implications for gun control policy efforts.
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Preventive medicine · Apr 2019
Comparative StudyThe importance of cholesterol follow-up testing under current statin treatment guidelines.
Under "treat to risk" goals, low-density (LDL)-cholesterol follow-up measurements monitor statin compliance rather than titration to target levels, however, there is little evidence showing that more-frequent monitoring reduces LDL-cholesterol. We therefore tested whether frequency of blood tests significantly predicted lipoprotein improvements in a large anonymized clinical laboratory database. Differences (∆ ± SE) in total cholesterol, triglycerides, and LDL-cholesterol between baseline and follow-up visits were calculated for 97,548 men and 110,424 women whose physicians sent blood to Boston Heart Diagnostics for analysis between 2010 and 2017. ⋯ Relative to baseline, significant decreases (P < 10-16) were observed for the 1st, 2nd, and 3rd follow-up measurements for total cholesterol (mean ± SE, men: -9.4 ± 0.1, -11.9 ± 0.2, -13.7 ± 0.3; women: -8.0 ± 0.1, -10.5 ± 0.2, -12.6 ± 0.3 mg/dL, respectively), triglycerides (men: -10.3 ± 0.4, -12.8 ± 0.5, -13.4 ± 0.7; women: -6.4 ± 0.2, -8.8 ± 0.4, -10.1 ± 0.5 mg/dL, respectively) and LDL-cholesterol (men: -7.8 ± 0.1, -9.9 ± 0.2, -11.1 ± 0.2; women: -6.9 ± 0.1, -9.0 ± 0.2, -10.7 ± 0.2 mg/dL, respectively). When adjusted for regression to the mean, 6.9%, 9.9% and 11.8% of men, and 5.7%, 9.7% and 11.5% of women, went from having an LDL-cholesterol ≥160 to <160 mg/dL for their 1st, 2nd, and 3rd follow-up measurements, respectively. We conclude that under usual physician care, total cholesterol, triglyceride, and LDL-cholesterol concentrations decreased progressively with increased physician monitoring within a large patient population.
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Preventive medicine · Apr 2019
ReviewRecruiting epidemiologists: A developmental perspective on expanding epidemiology exposure for adolescents.
Adolescents are at a unique developmental stage that is well-primed for epidemiology instruction. Although a handful of pioneers have focused on expanding epidemiology instruction to teen audiences, there are still no systematic efforts in the United States to attain this goal. ⋯ Through these efforts, we can leverage teens' natural interests in risk taking, health and wellness, and community change to learn population-level thinking. I posit that these measures can encourage widespread exposure to epidemiology principles, and also enhance the future of public health disciplines.
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Preventive medicine · Apr 2019
Comparative StudyHow race, ethnicity, and income moderate the relationship between urban vegetation and physical activity in the United States.
To facilitate physical activity interventions, researchers identify which factors associate with physical activity, such as vegetation levels of the surrounding environment. While most studies examining vegetation and physical activity find a positive correlation, the literature does not investigate how vegetation may have a varied effect on physical activity based on demographic composition. This study examined how race, ethnicity, and income moderate the relationship between both non-tree vegetation and tree canopy on the percentage of individuals participating in leisure-time physical activity per census tract. ⋯ Tracts were stratified into four types (Black + low income, Hispanic + low income, White + high income, and remaining) and assessed through multilevel modeling as to whether tract type moderated the relationship between vegetation and physical activity. Results showed that non-tree vegetation negatively associated with physical activity across all census tract types, while tree canopy exhibited a mixed association with physical activity, based on tract type. These findings can spur further research into how vegetation impacts physical activity of different demographic groups, and potentially inform greenspace and tree planting installments in those areas at greatest risk for physical inactivity-related diseases.