Preventive medicine
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Preventive medicine · Oct 2020
Behavioral economics informed message content in text message reminders to improve cervical screening participation: Two pragmatic randomized controlled trials.
The objective of the reported research was to assess the impact of text message (SMS) reminders and their content on cervical screening rates. Women invited for cervical screening in Northwest London from February-October 2015 were eligible. 3133 women aged 24-29 (Study 1) were randomized (1, 1) to 'no SMS' (control), or a primary care physician (PCP) endorsed SMS (SMS-PCP). 11,405 women aged 30-64 (Study 2), were randomized (1, 1:1:1:1:1:1) to either: no SMS, an SMS without manipulation (SMS), the SMS-PCP, an SMS with a total or proportionate social norm (SMS-SNT or SMS-SNP), or an SMS with a gain-framed or loss-framed message (SMS-GF and SMS-LF). The primary outcome was participation at 18 weeks. ⋯ The results from this trial have already been used to designing effective policy for cervical cancer screening. The NHS Cervical Screening Programme started running a London-wide screening SMS campaign which was based on the cervical screening trial described here. According to figures published by Public Health England, after six months attendance increased by 4.8%, which is the equivalent of 13,400 more women being screened at 18 weeks.
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Preventive medicine · Oct 2020
Rural-urban differences in estimated life expectancy associated with neighborhood-level cumulative social and environmental determinants.
Diverse neighborhood-level environmental and social impacts on health are well documented. While studies typically examine these impacts individually, examining potential health impacts from multiple sources as a whole can provide a broader context of overall neighborhood-level health impacts compared to examining each component independently. ⋯ Among urban census tract neighborhoods, a difference of nearly 5 years was estimated between neighborhoods with the least health promoting cumulative health impacts compared to neighborhoods with the most health promoting cumulative health impacts. Differences were observed between rural and urban census tract neighborhoods, with rural areas having less variability in expected life expectancy associated with neighborhood-level cumulative potential health impacts compared to urban areas.
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Preventive medicine · Oct 2020
Are one-year changes in adherence to the 24-hour movement guidelines associated with flourishing among Canadian youth?
Movement behaviours (e.g., physical inactivity, short sleep duration, high screen time) are associated with mental illness but less is known about the relationship between health behaviours and positive mental health constructs such as flourishing. This study examines if changes in adherence to the Canadian 24-Hour Movement Behaviour Guidelines for Children and Youth (moderate-to-vigorous physical activity (MVPA), total screen time (ST), sleep) are associated with changes in youth flourishing over one year. Students (N = 2292) were recruited from 12 secondary schools in Canada participating in the COMPASS study. ⋯ Reducing ST was associated with higher flourishing for males only relative to other males who continued to exceed the ST guidelines (Est:2.23, SE:1.04, p < .03). Longer sleep duration had the most consistent association with greater flourishing among females (Est:1.02, SE:0.3, p < .001) and males (Est:0.93, SE:0.34, p < .006), highlighting sleep as a public health priority in the context of 24-hour movement behaviours. These findings contribute to increasing calls for research examining positive mental health constructs independent of mental illness.
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Preventive medicine · Oct 2020
Lower rates of neural tube defects in Israel following folic acid supplementation policy.
Neural tube defects (NTDs) are common and disabling congenital malformations that remain a public health challenge despite prevention efforts. In 2000, The Israeli Ministry of Health published recommendations on daily folic acid (FA) supplementation for women of reproductive age and established a national NTD registry. This study aims to evaluate the long-term impact of the FA supplementation policy on NTD rates in Israel and the need for further intervention. ⋯ Nonetheless, Israeli NTD rates remain higher than in other developed countries. FA interventions should continue to be vigorously implemented, especially in vulnerable populations. The global success of mandatory fortification of grain strongly advocates its consideration in Israel.
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Preventive medicine · Oct 2020
The impact of STI test results and face-to-face consultations on subsequent behavior and psychological characteristics.
Sexually transmitted infection (STI) testing without face-to-face counselling is increasingly offered at sexual health centers (SHC), and ordering self-sampling tests online is becoming more popular. However, the impact of testing without counselling on behavior is unknown. We examine the impact of STI testing with and without consultation and the combined effect of a positive test result and treatment consultation, on behavioral and psychological characteristics over time. ⋯ Furthermore, condom use increased in chlamydia positive, and decreased in chlamydia negative participants. A treatment consultation/positive test result had a risk-reducing impact on behavioral and psychological characteristics, whereas the impact of a test consultation was limited. Since the majority of young heterosexuals test chlamydia negative, alternative interventions (e.g., online) achieving risk-reducing behavior change targeted to individuals who tested negative are needed.