Preventive medicine
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Preventive medicine · Apr 2017
Randomized Controlled Trial"For whom was it effective?" Moderators of the effect of a school-based intervention on potential physical activity determinants among Brazilian students.
Knowledge about the effects of school-based interventions on modifiable physical activity (PA) determinants (e.g., social support), and whether the intervention effect differs according to students' characteristics (e.g., age and gender) are relevant PA promotion topics. This study aims to answer these topics among Brazilian students. This cluster-randomized controlled trial was conducted with 548 students in the intervention group and 537 in the control group (51.5% of boys; aged 11-18years). The four-month intervention included strategies focused on training teachers, opportunities for PA in the school environment, and health education. Potential PA determinants (attitude, self-efficacy, support of friends, parents, and teachers, perceived neighborhood environment and PA facilities in school) and moderators (gender, age, socioeconomic status (SES), and PA level at baseline) were assessed using self-reported instrument. Height and weight were measured to estimate the students' body mass index (BMI) status. Generalized linear models were used. In general, there was a significant and positive intervention effect for attitude, support of friends and teachers for PA, as well as PA facilities in school; effect size was 0.29, 0.24, 0.34, and 0.29, respectively (P<0.05). Age (support of friends, parents and teachers, and PA facilities in school), SES (support of friends and PA facilities in school), and BMI status (support of friends) were moderators of the intervention effect on some outcomes. In conclusion, the intervention improved potential PA determinants, but some changes occurred differently according to students' characteristics. These findings should be considered in PA policies in the school context.
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Preventive medicine · Nov 2016
Randomized Controlled TrialCorrelates of nicotine withdrawal severity in smokers during a smoke-free psychiatric hospitalization.
Psychiatric hospitals are increasingly adopting smoke-free policies. Tobacco use is common among persons with mental illness, and nicotine withdrawal (NW), which includes symptoms of depression, anxiety, anger/irritability, and sleep disturbance, may confound psychiatric assessment and treatment in the inpatient setting. This study aimed to characterize NW and correlates of NW severity in a sample of smokers hospitalized for treatment of mental illness in California. ⋯ Those who refused NRT reported milder cigarette dependence and stated no prior use of NRT. Among smokers hospitalized for mental illness, NW severity appears multidetermined, related to cigarette dependence, demographic variables, psychiatric symptom severity, and other substance use. Assessment and treatment of NW in the psychiatric hospital is clinically warranted and with extra attention to groups that may be more vulnerable or naïve to cessation pharmacotherapy.
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Preventive medicine · Oct 2016
Randomized Controlled TrialEffect of general health screening and lifestyle counselling on incidence of diabetes in general population: Inter99 randomised trial.
We aimed to examine the effect of a large population-based multifactorial screening and lifestyle intervention programme on 10-year incidence of diabetes. In a randomised trial of the general Danish population initiated in 1999-2001 59,616 men and women aged 30-60years were assigned to a five year screening and lifestyle counselling programme (n=11,629) or control group (n=47,987) and followed for ten years in nationwide registers. Intention to treat was applied and risk of diabetes was modeled by Cox regression and expressed as hazard ratios (HRs). ⋯ We observed no difference in incidence of diabetes between the groups in the follow-up intervals from 1 to 6years or after 6-10years (HR=0.94, 0.83 to 1.06; HR=1.03, 0.91 to 1.17). Inviting the general population to participate in a repeated screening and lifestyle counselling programme over five years did not result in lower incidence of diabetes after 10years of follow-up. As expected, significantly more individuals were diagnosed with diabetes in the intervention group during the first year, but this was not followed by a decrease in the following years.
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Preventive medicine · Oct 2016
Randomized Controlled TrialTraining fast or slow? Exercise for depression: A randomized controlled trial.
Exercise can be used to treat depression but there is a lack of evidence regarding the optimal intensity and mode. Our aim was to compare the effects of different exercise intensities on post-treatment depression severity. People aged 18-67years with mild to moderate depression (Patient Health Questionnaire-9 score of ≥10) participated in a single-blind, parallel randomized control trial lasting 12-weeks (Sweden 2011-2013). ⋯ At post-treatment, the light (-4.05 Confidence Interval (CI)=-5.94, -2.17), moderate (-2.08 CI=-3.98, -0.18) and vigorous exercise groups (-3.13 CI=-5.07, -1.19) had reduced their MADRS scores significantly more than TAU. No significant differences were found between the exercise groups, and no significant interaction effect was observed between group and gender. In conclusion, exercise, whether performed at a low (yoga or similar), moderate or vigorous intensity (aerobic training) is effective in treating mild to moderate depression and is at least as effective as treatment as usual by a physician.
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Preventive medicine · Sep 2016
Randomized Controlled TrialEffect of a smoking cessation intervention for women in subsidized neighborhoods: A randomized controlled trial.
To evaluate the effectiveness of a community based participatory research (CBPR) developed, multi-level smoking cessation intervention among women in subsidized housing neighborhoods in the Southeastern US. ⋯ This CBPR developed intervention showed potential to engage smokers and reduce smoking among women in these high-poverty neighborhoods. Effectiveness in promoting cessation in communities burdened with fiscal, environmental and social inequities remains a public health priority.