Preventive medicine
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Preventive medicine · May 2022
What makes people quit tobacco and succeed at it? An exploratory analysis of smoked and smokeless tobacco from India.
Tobacco cessation is a key component of WHO's Framework Convention on Tobacco Control. However, success rates decline significantly from intending to quit tobacco, through attempting and becoming a successful quitter. Among Indian adults, the prevalence of smoking and smokeless tobacco use was 10.7% and 21.4% respectively in 2016. ⋯ Being a former smoker/smokeless tobacco user was positively connected with attempting to quit the current use of the other tobacco form. We recommend strategies to promote smoke-free homes, and incorporating 'tobacco cessation advocacy' into the curriculum of health care workers. Strengthening the tobacco control law and program promulgated in India since 2003 and its implementation would significantly promote tobacco cessation.
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Preventive medicine · May 2022
Randomized Controlled TrialThe association between the obesogenic environment and 6-month and 24-month weight change in a rural weight loss intervention trial in the United States.
The unique obesogenic environment may influence the ability to effectively maintain weight loss in rural areas. The aim of this study was to examine the contextual relationship of neighborhood disadvantage, distance to supermarkets and supercenters, and fast food, dollar store, and exercise facility environments on weight loss following a weight-loss intervention in the United States. This analysis (n = 1177) linked weight loss outcomes from a rural, primary care-based randomized controlled trial to contextual data collected from residential addresses. ⋯ Contextual variables were not significantly related to percent weight loss overall across treatment arms. Participants living in a 5-mile buffer to dollar stores experienced approximately a 2% (p < 0.05) lower weight loss, but only in the least effective counseling arm (individual clinic visits), while controlling for both individual and contextual factors. Our results suggest that specific contextual variables in rural populations may play an important role in moderating weight loss outcomes especially under the conditions of less effective interventions.
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Preventive medicine · May 2022
Support for evidence-informed opioid policies and interventions: The role of racial attitudes, political affiliation, and opioid stigma.
Political affiliation, racial attitudes, and opioid stigma influence public support for public health responses to address opioid use disorders (OUD). Prior studies suggest public perceptions of the opioid epidemic are less racialized and less politically polarized than were public perceptions of the crack cocaine epidemic. Analyzing a cross-sectional, nationally representative sample (n = 1161 U. ⋯ Black respondents were also less likely to support expanding Medicaid funding, increasing government spending to provide services for people living with OUD, and of distributing naloxone. Our finding suggest that negative attitudes towards African-Americans and political differences remain important factors of public opinion on responding to the OUD epidemic, even after controlling for opioid stigma. Our findings also suggest that culturally-competent dialogue within politically conservative and Black communities may be important to engage public support for evidence-informed treatment and prevention.
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Preventive medicine · May 2022
Meta AnalysisRisk factors for incident cardiovascular events among adults in low- and middle-income countries: A systematic review and Meta-analysis of prospective cohort studies.
The relative contributions of risk factors for cardiovascular events at a population level has received little attention in low- and middle-income countries (LMICs). We estimated the population attributable fraction (PAF) of risk factors associated with incident cardiovascular events in LMICs. We searched six databases for relevant articles, supplemented with a manual search of reference lists. ⋯ A substantial proportion of incident cardiovascular events were linked to traditional metabolic and behavioural modifiable risk factors. However, other novel risk factors also appear to contribute. Targeting of these established and novel risk factors has the potential to reduce the burden of CVD in LMICs.
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Preventive medicine · May 2022
Randomized Controlled TrialA multilevel, low literacy dual language intervention to promote colorectal cancer screening in community clinics in Florida: A randomized controlled trial.
One of the largest disparities in cancer mortality in the United States occurs with colorectal cancer (CRC). The objectives of this multilevel two-arm intervention trial were to compare the efficacy of two interventions to promote CRC screening (CRCS) with fecal immunochemical test (FIT) and examine sociodemographic and psychosocial predictors of FIT screening. Individuals ages 50-75 (n = 326) who were not up-to-date with CRCS, could understand English or Spanish, and were at average CRC risk were recruited from two federally qualified health centers (FQHCs) in Florida. ⋯ Multilevel approaches that include EMR prompts, reminders, FIT access, and provision of low-literacy, language-concordant education can support efforts to improved community clinics' CRCS rates. Future efforts should focus on repeat FIT screening. Trial registration: The trial was registered at ClinicalTrials.gov (NCT03906110).