Preventive medicine
-
Preventive medicine · Nov 2023
Meta AnalysisContingency management interventions for abstinence from cigarette smoking in pregnancy and postpartum: A systematic review and meta-analysis.
Contingency management is one of the most effective treatments for substance use disorders in not-pregnant people. The most recent quantitative review of its efficacy among pregnant and postpartum women who smoke cigarettes concluded with moderate certainty that those receiving contingent financial incentives were twice as likely to be abstinent compared with controls. We aimed to update and extend previous reviews. ⋯ There was high certainty evidence that women receiving incentives were more likely to be abstinent than controls at the last antepartum assessment (12 RCTs; RR = 2.43, 95% CI 2.04-2.91, n = 2941, I2 = 0.0%) and moderate certainty evidence at the longest postpartum assessment while incentives were still available (five RCTs; RR = 2.72, 1.47-5.02, n = 659, I2 = 44.5%), and at the longest postpartum follow-up after incentives were discontinued (six RCTs; RR = 1.93, 1.08-3.46, n = 1753, I2 = 51.8%). Pregnant women receiving incentives are twice as likely to achieve smoking abstinence during pregnancy suggesting this intervention should be standard care for pregnant women who smoke. The results also demonstrate that abstinence continues into the postpartum period, including after incentives are discontinued, but more trials measuring outcomes in the postpartum period are needed to strengthen this conclusion.
-
Preventive medicine · Nov 2023
Meta AnalysisA call to action: Contingency management to improve post-release treatment engagement among people with opioid use disorder who are incarcerated.
People with opioid use disorder (OUD) are overrepresented in US correctional facilities and experience disproportionately high risk for illicit opioid use and overdose after release. A growing number of correctional facilities offer medication for OUD (MOUD), which is effective in reducing these risks. However, a recent evaluation found that <50% of those prescribed MOUD during incarceration continued MOUD within 30 days after release, demonstrating a need to improve post-release continuity of care. ⋯ Indeed, a prior meta-analysis demonstrates a dose-response relationship between the magnitude and immediacy of reward and CM effectiveness. Thus, CM involving larger and more immediately delivered rewards are likely necessary to improve MOUD adherence during the critical period following release from incarceration. Future research on the effectiveness and implementation of CM to improve MOUD retention after release from incarceration is warranted.
-
Preventive medicine · Aug 2023
Review Meta AnalysisDrinking behaviors of Chinese adolescents over the past three decades: A systematic review and meta-analysis.
Adolescent drinking is a major worldwide public health challenge. China is home to the world's second largest youth population, but relatively little is known about adolescent drinking behaviors. This study examined (1) prevalence rates and sex and age differences in drinking behaviors among Chinese adolescents over the past three decades and (2) whether underage drinking declined following the enactment of a strict national underage drinking policy in 2006. ⋯ The findings suggest that prevalence rates of drinking behaviors remain high among Chinese adolescents but are lower than among European or North American adolescents. The 2006 Chinese national policy to reduce underage drinking did not measurably alter patterns of underage drinking. Implications for prevention, research, and policy are discussed.
-
Preventive medicine · Jul 2023
Review Meta AnalysisThe influence of overweight and obesity on participation in cervical cancer screening: A systematic review and meta-analysis.
The prevalence of obesity is increasing worldwide. The incidence of cervical cancer has decreased after implementation of cervical cancer screening, however, obese women have higher risk of cervical cancer than women of normal weight. This might be caused by a lower participation rate in cervical cancer screening. ⋯ In conclusion, obese women are less likely to participate in cervical cancers screening compared to women of normal weight. In addition, the likelihood of adherence to screening recommendations decreases with increasing obesity class. This stresses the need for targeted intervention to increase screening adherence for overweight and obese women.
-
Preventive medicine · Jul 2023
Review Meta AnalysisInterventions to increase colorectal cancer screening adherence in low-income settings within the United States: A systematic review and meta-analysis.
The USPS Task Force recommends screening for colorectal cancer (CRC) in adults aged 45-75. Screening rates are low in underserved populations. We conducted a systematic review of interventions to increase CRC screening adherence in low-income settings in US. ⋯ Telephone reminders are slightly more effective than reminder letters (RR 1.16, 95% CI 1.02, 1.33), but there is no difference between personal or automated phone calls (RR 1.17, 95% CI 0.74, 1.84). Mailed outreach and patient navigation are the most effective strategies to improve colorectal cancer screening in low-income populations. There was significant heterogeneity between studies, likely due to differences in intervention design, screening tests, and follow-up.