Preventive medicine
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Preventive medicine · Feb 2023
Randomized Controlled TrialNeighborhood socioeconomic status and the effectiveness of colorectal cancer screening outreach with mailed fecal immunochemical tests within a safety net healthcare system in San Francisco, CA: A subgroup analysis of a randomized controlled trial.
Neighborhood context shapes opportunities and barriers for residents to access healthcare and cancer screening. Neighborhood socioeconomic status (nSES) is associated with disparities in colorectal cancer (CRC) screening, but the extent to which the effectiveness of specific screening interventions vary by nSES has not been studied. ⋯ Compared to usual care, the outreach intervention improved FIT test completion at one year (58.7% vs 38.4%; OR 2.32 [2.14, 2.52]) but its effectiveness did not vary substantially by nSES quintile (adjusted OR Q1 2.64 [2.30, 3.04]; Q2 2.43 [2.04, 2.90]; Q3 2.31 [1.84, 2.89]; Q4 2.47 [1.86, 3.28]; Q5 2.64 [1.83, 3.81]; Wald test for interaction p = 0.87). The implementation of mailed FIT outreach has the potential to increase CRC screening completion without leading to disparities in screening related to nSES (ClinicalTrials.gov NCT02613260).
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Preventive medicine · Feb 2023
ReviewThe nature and impact of patient and public involvement in cancer prevention, screening and early detection research: A systematic review.
Patient and public involvement can produce high-quality, relevant research that better addresses the needs of patients and their families. This systematic review investigated the nature and impact of patient and public involvement in cancer prevention, screening and early detection research. Two patient representatives were involved as members of the review team. ⋯ Reporting quality was sub-optimal, largely due to failure to consider challenges. This review found that high-level involvement of patients and the public in cancer prevention, screening and early detection research is feasible and has several advantages. However, improvements are needed to encourage involvement across the research cycle, and in evaluating and reporting its impact.
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Preventive medicine · Feb 2023
ReviewTelehealth interventions for physical activity and exercise participation in postpartum women: A quantitative systematic review.
Postpartum women are one of the least physically active vulnerable populations globally and telehealth has been proposed as a potential method of delivering effective exercise interventions for this population. However, clinical practice guidelines are based upon the recommendations for the general population and therefore, the most efficacious exercise dose and the delivery method for this population is unclear. This quantitative systematic review will examine the implementation and outcomes of telehealth exercise interventions in the postpartum population to synthesise the degree to which these outcomes have been assessed and evaluated. ⋯ Only one intervention utilised modern video conferencing as the primary telehealth communication method. With the minimal assessment of health-related outcomes, there is limited scope to assess the effectiveness of these interventions for postpartum women. Future research interventions need to be reported according to a validated trial reporting system and focus on relevant health related outcomes including postpartum depressive symptoms, quality of life, cardiovascular fitness, muscular strength and body composition.
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Preventive medicine · Feb 2023
Multicenter Study Observational StudyPerformance of a targeted methylation-based multi-cancer early detection test by race and ethnicity.
Disparities in cancer screening and outcomes based on factors such as sex, socioeconomic status, and race and ethnicity in the United States are well documented. A blood-based multi-cancer early detection (MCED) test that detects a shared cancer signal across multiple cancer types and also predicts the cancer signal origin was developed and validated in the Circulating Cell-free Genome Atlas study (CCGA; NCT02889978). CCGA is a prospective, multicenter, case-control, observational study with longitudinal follow-up (overall N = 15,254). ⋯ The sensitivity for cancer signal detection across groups ranged from 43.9% [n = 57; 95% CI: 31.8-56.7%] to 63.0% [n = 192; 95% CI: 56.0-69.5%] and generally increased with clinical stage. The MCED test had consistently high specificity and similar sensitivity across racial and ethnic groups, though results are limited by sample size for some groups. Results support the broad applicability of this MCED test and clinical implementation on a population scale as a complement to standard screening.
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Preventive medicine · Feb 2023
Anticipatory concerns about violence within social networks: Prevalence and implications for prevention.
Most research on exposure to violence focuses on direct victimization, offending, or witnessed violence, yet many people also experience concerns about potential violence in their environments and social networks. Using a state-representative survey of California adults (n = 2870) administered in July 2020, we estimate the prevalence of anticipatory concerns about violence within respondents' social networks and describe characteristics of the persons at perceived risk of violence, reasons for respondents' concerns, and actions undertaken by respondents to reduce that risk. Approximately 1 in 5 respondents knew at least one person, usually a friend or extended family member, whom they perceived to be at risk of other- or self-directed violence. ⋯ Most respondents reported having taken action to reduce the risk of violence, including providing resources and asking family or friends to help; few acted to reduce access to lethal means. The most common reasons for inaction were the perception that a dangerous situation was unlikely and that it was a personal matter. Our findings can help inform a broader understanding of exposure to violence and interventions that leverage the knowledge of those close to persons at risk to prevent violence.