Preventive medicine
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Preventive medicine · Dec 2021
Prospective associations between sedentary behavior and physical activity in adolescence and sleep duration in adulthood.
The purpose of this prospective study was to investigate whether sedentary screen time (SST) and physical activity in adolescence were related to sleep duration in adulthood and whether these associations varied by sex. We analyzed data from 9279 adolescents who participated in Waves I and V of the National Longitudinal Study of Adolescent Health (Add Health) in the United States. SST was measured by reported hours spent watching television/videos or playing video/computer games per week. ⋯ The association between 22 or more hours per week SST in adolescence and later short sleep varied by sex (RRR = 0.75, 95% CI: 0.58-0.95) and was significantly stronger among males. Measures of physical activity in adolescence did not predict sleep duration. Decreasing adolescents' SST to prevent suboptimal sleep later in development may be a target for further investigation, particularly for males.
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In 2012, United States consensus guidelines were modified to recommend that cervical cancer screening not begin before age 21 and, since 2014, the Health Effectiveness Data and Information Set (HEDIS), a health plan quality measurement too, has included a measure for non-recommended cervical cancer screening among females ages 16-20. Our goal was to describe prevalence over time of cervical cancer screening before age 21 following the 2012 guideline change, and provide information to help understand how rapidly new guidelines may be disseminated and implemented into clinical practice. We used longitudinal clinical and administrative data from three diverse healthcare systems in the Population-based Research to Optimize the Screening Process (PROSPR II) consortium to examine annual trends in screening before age 21. ⋯ The observed steady decline suggests growing adherence to the 2012 consensus guidelines. This trend was consistent across diverse geographic regions, healthcare systems, and patient populations, strengthening the generalizability of the results; however, since we only had 1-2 years of study data prior to the consensus guidelines, we cannot discern whether screening under age 21 was already in decline. Nonetheless, these results provide data to compare with other guideline changes to de-implement non-recommended screening practices.
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Preventive medicine · Dec 2021
Physical activity and cutaneous melanoma risk: A Norwegian population-based cohort study.
Physical activity (PA) is an important factor in cancer prevention, but positive association between PA and risk of cutaneous melanoma found in recent studies may complicate this strategy. Ultraviolet radiation (UVR) exposure during outdoor PA is a plausible explanation for a positive association. We investigated the associations between PA, UVR and melanoma risk in the Norwegian Women and Cancer cohort. ⋯ Seasonal PAs were not associated with melanoma risk. In conclusion, we found positive associations between overall PA and sunbathing vacations and indoor tanning, and, unlike literature, inverse association between overall PA and sunburns. Our results do not support a positive association between PA and melanoma risk in Norwegian women.
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Preventive medicine · Dec 2021
The association between social needs and chronic conditions in a large, urban primary care population.
There is consensus that social needs influence health outcomes, but less is known about the relationships between certain needs and chronic health conditions in large, diverse populations. This study sought to understand the association between social needs and specific chronic conditions using social needs screening and clinical data from Electronic Health Records. Between April 2018-December 2019, 33,550 adult (≥18y) patients completed a 10-item social needs screener during primary care visits in Bronx and Westchester counties, NY. ⋯ For example, those with transportation needs were 84% more likely to have an alcohol/drug use disorder diagnosis (95% CI: 1.59, 2.13) and 41% more likely to smoke (95% CI: 1.25, 1.58). Specific social needs may influence clinical issues in distinct ways. These findings suggest that health systems need to develop strategies that address unmet social need in order to optimize health outcomes, particularly in communities with a dual burden of poverty and chronic disease.
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Preventive medicine · Dec 2021
Political affiliation and risk taking behaviors among adults with elevated chance of severe complications from COVID-19.
This study determines whether COVID-related risk-taking behavior was different among Republicans, Democrats, and Independents, in adults with elevated chance of severe complications from COVID-19. Using US national survey data collected September 30-October 27, 2020 (N = 6095), behaviors in the prior week examined were: 7 potentially risky activities, mask wearing anywhere, and mask wearing while undertaking each activity. Differences among political affiliations were estimated for adults with 0 and with ≥1 medical risk factors for severe complications, adjusting for sociodemographic factors. ⋯ While undertaking each specific activity, the adjusted percentage of at-risk adults never wearing a mask was higher for Republicans than Democrats: 24% vs 8% at bar/club; 6% vs 0% at grocery/pharmacy; 63% vs 30% visiting at friend's home; 68% vs 41% hosting visitors; 30% vs 5% at gathering of ≥10 people; 25% vs 11% while within 6 ft of someone they do not live with. Rates of mask wearing among political Independents were between rates among Democrats and Republicans. Efforts to reduce COVID-related risky behavior should recognize that although Republicans take more risks, rates of mask wearing at common activities are low across political affiliations, even for populations vulnerable to severe complications.