Preventive medicine
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Preventive medicine · Feb 2021
Core functions, knowledge bases and essential services: A proposed prescription for the evolution of the preventive medicine specialty.
The pandemonium from the 2020 pandemic calls for a greater emphasis on prevention, public health and population health. Yet the role of preventive medicine specialists, ideally qualified to lead this charge, remains difficult to situate within the houses of medicine and public health. To overcome this challenge to its identity and evolve to better tackle novel and on-going public health and population health problems, the authors propose that the specialty of preventive medicine should assert 3 core functions within preventive care; expand and modernize its knowledge base; and enhance its residency training accordingly. The authors also propose 10 essential services, not otherwise systematically provided by other specialties, that the preventive medicine specialty can optimally fulfill as its unique contributions within medicine and public health.
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Preventive medicine · Feb 2021
Comparative StudyA longitudinal study of psychological distress in the United States before and during the COVID-19 pandemic.
The COVID-19 pandemic has caused financial stress and disrupted daily life more quickly than any prior economic downturn and on a scale beyond any prior natural disaster. This study aimed to assess the impact of the pandemic on psychological distress and identify vulnerable groups using longitudinal data to account for pre-pandemic mental health status. Clinically significant psychological distress was assessed with the Kessler-6 in a national probability sample of adults in the United States at two time points, February 2019 (T1) and May 2020 (T2). ⋯ Increase in psychological distress above T1 was associated with gender, age, household income, and census region. Equal numbers of people experienced serious psychological distress in 30-days during the pandemic as did over an entire year prior to the pandemic. Mental health services and research efforts should be targeted to those with a history of mental health conditions and groups identified as at high risk for increases in distress above pre-pandemic levels.
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Preventive medicine · Feb 2021
ReviewPotential health-related behaviors for pre-school and school-aged children during COVID-19 lockdown: A narrative review.
As a consequence of the COVID-19 pandemic, different measures have been implemented by governments from each affected country. Such measures usually involve restrictions on the movement of citizens, and have had a profound effect on usual activities and timetables. As a result of school closures and strict restrictions regarding going outside home, children have been one of the most disadvantaged population groups during the lockdown period. ⋯ This review depicts the potential health-related behaviors according to related literature, and put the focus on future short and long-term sequels of social isolation. Socio-affective complications and insufficient physical activity are underscored as two of the main concerns, particularly among socio-economic deprived children. Both issues could be effectively addressed with either adequate parental or community guidance.
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Preventive medicine · Feb 2021
ReviewInterventions using mHealth strategies to improve screening rates of cervical cancer: A scoping review.
MHealth interventions are extensively used to inform and remind women about cervical cancer and their upcoming screening appointments. Our scoping review aims to examine the effectiveness these interventions targeted to increase the uptake of cervical cancer screening along with its barriers and facilitators. We searched 4 databases (PsycINFO. ⋯ Qualitative studies suggested participants prefer particular communication mediums, and they were concerned about privacy and confidentiality issues when text messages were sent with their health information. Findings suggest mHealth interventions may be an effective strategy to reach women for improving their cervical cancer uptake. Barriers including transportation cost, inaccessibility, and inability to come for walk-in appointments in the health clinics need to be addressed, beyond reminders, in mobile phone-based interventions to facilitate their presence in their next appointment.
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Preventive medicine · Feb 2021
Aligning social and health care services: The case of community care connections.
The Community Care Connections (CCC) program aims to align social and healthcare services to improve health outcomes in older adults with complex medical and social needs. This study assessed changes in healthcare utilization before and after CCC program participation. Between June 2016 and March 2019, 1214 adults with complete data who provided informed consent participated in the CCC program. ⋯ ED visits decreased by 37% (Change = -0.140, 95% CI = -0.209, -0.070) for those with hypertension and by 30% (Change = -0.109, 95% CI = -0.199, -0.020) for those with high cholesterol, while observation stays decreased by 46% (Change = -0.118, 95% CI = -0.185, -0.052) for those with diabetes and by 44% (Change = -0.082, 95% CI = -0.150, -0.014) for those with high cholesterol during the post period. Connecting older adults with social services through the healthcare delivery system may lead to decreases in hospitalizations, ED visits, and observation stays. Implementation of cross-sector partnerships that address non-clinical factors that impact the health of older adults may reduce the use of costly healthcare services.