Preventive medicine
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Preventive medicine · Dec 2021
Clinical TrialGroup prenatal care and improved birth outcomes: Results from a type 1 hybrid effectiveness-implementation study.
To compare birth outcomes for patients receiving Expect With Me (EWM) group prenatal care or individual care only, we conducted a type 1 hybrid effectiveness-implementation trial (Detroit and Nashville, 2014-2016). Participants entered care <24 weeks gestation, had singleton pregnancy, and no prior preterm birth (N = 2402). Mean participant age was 27.1 (SD = 5.77); 49.5% were Black; 15.3% were Latina; 59.7% publicly insured. ⋯ Post-hoc analyses indicated EWM patients utilizing the integrated information technology platform had lower risk for low birthweight infants (RR 0.47, 95% CI 0.24, 0.86) than non-users. Future research is needed to understand mechanisms by which group prenatal care improves outcomes, best practices for implementation, and health systems savings. Trial registration: ClinicalTrials.govNCT02169024.
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Preventive medicine · Dec 2021
Intentions to participate in cervical and colorectal cancer screening during the COVID-19 pandemic: A mixed-methods study.
Worldwide, cancer screening faced significant disruption in 2020 due to the COVID-19 pandemic. If this has led to changes in public attitudes towards screening and reduced intention to participate, there is a risk of long-term adverse impact on cancer outcomes. In this study, we examined previous participation and future intentions to take part in cervical and colorectal cancer (CRC) screening following the first national lockdown in the UK. ⋯ Interview participants expressed concerns about visiting healthcare settings but were keen to participate when screening programmes resumed. Intentions to participate in future screening were high and strongly associated with previous engagement in both programmes. As screening services recover, it will be important to monitor participation and to ensure people feel safe to attend.
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Preventive medicine · Dec 2021
Risk factors for multiple metabolic syndrome components in obese and non-obese Japanese individuals.
Many studies have reported that even non-obese individuals have multiple metabolic syndrome (MetS) components, such as hypertension, hyperglycemia, and lipid abnormalities have a higher cardiovascular disease mortality rate and incidence. However, the risk factors for multiple MetS components in non-obese individuals have not been sufficiently clarified. This study compared risk factors, including overall lifestyle habits, for multiple MetS components possession between obese and non-obese individuals. ⋯ The odds ratio of each risk factor, with the exception of walking speed and eating speed, tended to be higher in non-obese individuals than in obese individuals. The only risk factor specific to obese individuals was lack of regular exercise. These results suggest that almost all risk factors for possession of multiple MetS components were common to both obese and non-obese individuals, and the risk level of each risk factor tended to be higher in non-obese individuals.
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Preventive medicine · Dec 2021
Multimorbidity and obesity in older adults from six low- and middle-income countries.
Prevalence of multimorbidity (i.e., ≥2 chronic conditions), chronic diseases, and obesity is increasing in low- and middle-income countries (LMICs), posing a potential threat to the health of older adults living in these areas. This study hence investigates the unexplored association between obesity and multimorbidity among older adults from LMICs. Cross-sectional, community-based data from the WHO Study on global Ageing and adult health (SAGE) were analysed. ⋯ Significant associations emerged between obesity measures and five out of twelve chronic conditions. Results from this study underline the need to reduce obesity among older adults in areas where its prevalence is increasing, as it is associated with increased odds for multimorbidity. Future longitudinal research in this setting is required to assess the impact of obesity reduction on multimorbidity incidence.
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Preventive medicine · Dec 2021
Accuracy of combined molecular and morphology-based triage for HPV-positive women in routine cervical cancer screening services from Colombia.
WHO cervical cancer elimination goals comprise 70% of highly-sensitive screening coverage and 90% treatment of precancerous lesions. Triage for HPV-positive women may challenge sensitivity of screening algorithms and women's follow-up, particularly in low- and middle-income countries (LMIC) where screening quality and protocol adherence are frequently deficient. We aimed to determine the accuracy of triage for HPV positive women in routine screening services from Colombia by a prospective cross-sectional study. ⋯ Accuracy of cytology and visual inspection differ between screening units but parallel testing with HPV16/18/45 genotyping significantly increased their sensitivity (over 0.80). Morphology-based triage for HPV-positive women remains a suitable alternative for routine practice in LMIC if combined with HPV16/18/45-genotyping; however, point-of-care triage would be preferable to reduce losses to follow-up. HPV-mRNA triage deserves cost-benefit analyses.