Preventive medicine
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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
Dietary patterns, genetic risk, and incidence of obesity: Application of reduced rank regression in 11,735 adults from the UK Biobank study.
Few studies have derived dietary patterns based on intake of discretionary foods and beverages and examined associations with genetic risk and obesity. We examined associations between dietary patterns based on discretionary foods, saturated fatty acids (SFA), and fiber, with a polygenetic risk score (PRS) for obesity and risk of overall obesity, central obesity and high body fat (BF) up to 9.7 years later. Data from 11,735 adults from the UK Biobank cohort study were used. ⋯ DP3, correlated positively with SFA and fiber, inversely with discretionary foods, was associated with lower risk of central obesity (hazard ratio: 0.92; 95% confidence interval: 0.87, 0.98). There was limited evidence of interactions with PRS. A dietary pattern high in high-SFA and low-fiber discretionary foods and beverages was associated with higher risk of obesity, independent of genetic predisposition.
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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
Implications for health system resilience: Quantifying the impact of the COVID-19-related stay at home orders on cancer screenings and diagnoses in southeastern North Carolina, USA.
COVID-19 impacted hospital systems across the globe. Focus shifted to responding to increased healthcare demand while mitigating COVID-19 spread on their campuses. Mitigation efforts limited medical professional-patient interactions, including patient access to preventive cancer screenings. ⋯ After the SAH orders (H3), we estimated 232.5 more breast cancer screenings and 10.6 more breast cancer diagnoses. This work quantifies the impact of COVID-19 associated SAH orders on cancer screenings and diagnoses and suggests the potential for delayed or missed cancer diagnoses. This evident disruption in providing routine medical care also highlights the importance of strengthening health systems (or organizations) and improving resilience to natural disasters and infectious disease outbreaks.
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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.