Preventive medicine
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Preventive medicine · Aug 2020
Meta AnalysisViolence and obesogenic behavior among adolescents aged 12-15 years from 62 countries: A global perspective.
Exposure to violence may be associated with increased risk for obesogenic behavior among adolescents but studies providing a global perspective are lacking. The aim of this work was to assess the relationship between violence and obesogenic behaviors among young adolescents from 62 countries. Cross-sectional data from the Global School-based Student Health Survey 2009-2016 were analyzed. ⋯ In contrast, intentional injury (OR = 0.72; 95%CI = 0.64-0.81) and physical fight (OR = 0.90; 95%CI = 0.86-0.95) were associated with lower odds for low physical activity. In this large global sample of adolescents, exposure to violence was associated with all obesogenic behaviors apart from low physical activity. Multidimensional government programs and policies addressing exposure to violence among young adolescents may lead to reduction in obesogenic behavior and hence curtail the global obesity epidemic.
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Preventive medicine · Aug 2020
Randomized Controlled TrialReactions to graphic and text health warnings for cigarettes, sugar-sweetened beverages, and alcohol: An online randomized experiment of US adults.
We aimed to examine reactions to graphic versus text-only warnings for cigarettes, SSBs, and alcohol. A convenience sample of US adults completed an online survey in 2018 (n = 1352 in the analytic sample). We randomly assigned participants to view a: 1) text-only warning without efficacy information (i.e., message intended to increase consumers' confidence in their ability to stop using the product), 2) text-only warning with efficacy information, 3) graphic warning without efficacy information, or 4) graphic warning with efficacy information. ⋯ Compared to SSB and alcohol warnings, cigarette warnings led to higher perceived message effectiveness, believability, fear, thinking about harms, policy support, and greater reductions in product appeal (all p < .05). The efficacy information did not influence any outcomes. Graphic warnings out-performed text-only warnings on key predictors of behavior despite causing more reactance.
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Preventive medicine · Aug 2020
Randomized Controlled TrialRandomized controlled trial evaluating an intervention supporting implementation of sun safety policies in California public elementary schools.
Solar ultraviolet radiation (UV) exposure is the primary risk factor for skin cancer and children receive about one-quarter of lifetime UV exposure before age 18. Thus, skin cancer prevention is essential for children. The objective of this study was to test an intervention to facilitate implementation of district sun safety policies. ⋯ In sum, the intervention increased sun safety practices in public elementary schools. Trial Registration. This study is registered in ClinicalTrials.gov, www.clinicaltrials.gov, with the identification number of NCT03243929.
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Preventive medicine · Aug 2020
Occupation, employment status, and "despair"-associated mortality risk among working-aged U.S. adults, 1997-2015.
The recent rise in U. S. midlife mortality has been conceptualized as a "working-class" crisis, defined by increasing mortality among blue-collar and/or unemployed workers and the decline of manual labor; yet research on the topic overwhelmingly focuses on educational attainment as the key socioeconomic determinant of midlife mortality, especially among "despair"-related deaths. The present study addresses this gap by using data on 360,146 adults ages 25-64 from restricted-use National Health Interview Survey-Linked Mortality Files (1997-2015; average follow-up 9.87 years) to estimate associations between individuals' occupation and employment status and alcoholic liver disease, suicide, or accidental poisoning mortality risk, net of confounders. ⋯ Critically, the fact that individuals' occupations and employment status are independently associated with midlife mortality due to deaths of despair - especially accidental poisoning - highlights the need for measures of socioeconomic status beyond educational attainment and income in understanding rising midlife mortality. Moreover, policies addressing working-aged mortality must target particular workplace contexts and the consequences of unemployment, both of which affect a large and growing segment of the working-aged U. S. population.
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Preventive medicine · Aug 2020
Embracing the complexity of modifiable risk reduction: A registry of modifiable risks for 0-12 month infants.
Despite relatively high medical expenditures, the United States performs poorly on population health indicators relative to many other countries. A key step in addressing this situation involves determining impactful and cost-effective interventions for at-risk populations. This requires an understanding of medical, social, behavioral health and safety domains of risk. ⋯ Comprehensive risk registries such as the one presented here can enhance our collective efforts to identify and mitigate risks for specific populations. Such registries can also support research to build understandings of the impact of risks, individually and in interconnected signature combinations. The risk registry presented here and the enhanced understandings flowing from it may yield useful insights for clinicians, social service providers and researchers seeking a whole person approach to care, as well as for payers and policymakers seeking to enable health policy and payment reforms to improve population health.