American journal of preventive medicine
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Home access to fruits/vegetables (FV) is a consistent predictor of adolescent FV intake, but many adolescents face barriers to home access. ⋯ Laws that require FV in school meals may improve FV intake, particularly among students with limited access to healthy foods at home.
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Review Meta Analysis
Workplace health promotion: a meta-analysis of effectiveness.
An unhealthy lifestyle may contribute to ill health, absence due to sickness, productivity loss at work, and reduced ability to work. Workplace health promotion programs (WHPPs) aim to improve lifestyle and consequently improve health, work ability, and work productivity. However, systematic reviews on intervention studies have reported small effects, and the overall evaluation of effectiveness of WHPPs is hampered by a large heterogeneity in interventions and study populations. This systematic review aims to investigate the influence of population, study and intervention characteristics, and study quality on the effectiveness of workplace health promotion programs. ⋯ The effectiveness of a WHPP is partly determined by intervention characteristics and statistical analysis. High-quality RCTs reported lower effect sizes. It is important to determine the effectiveness of WHPPs in RCTs of high quality.
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Black adolescents see more substance use in mainstream media but seem less responsive to it than other U.S. adolescents. Black-oriented media may be more personally relevant to them. ⋯ A prospective relationship was found between exposure to smoking in movies and smoking initiation. Among black adolescents in the U.S., this was only for black-oriented movies, suggesting the importance of personal relevance of the exposures. Parents, practitioners, and producers should be aware of these potential influences of media on black teen viewers.
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The 13-valent pneumococcal conjugate vaccine (PCV13) is approved by the U.S. Food and Drug Administration for adults, but its role in older adults is unclear. ⋯ Single-dose PCV13 strategies are likely to be economically reasonable in older adults.
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Although glycated hemoglobin (HbA1c) has been widely recommended for the diagnosis of diabetes, considerable ambiguity remains about how HbA1c should be used to identify people with prediabetes or other high-risk states for preventive interventions. The current paper provides a synthesis of the epidemiologic basis and the health and economic implications of using various HbA1c-based risk-stratification approaches for diabetes prevention. HbA1c predicts diabetes and related outcomes across a wide range of HbA1c values. ⋯ Although this clustering of eventual cases at the high end of the HbA1c risk distribution means that intervention resources will be more efficient when applied to the upper end of the distribution, no obvious threshold exists to prioritize people for preventive interventions. Thus, the choice of optimal thresholds is a tradeoff, wherein selecting a lower HbA1c cut-point will lead to a higher rate of eligibility and health benefits for more people, and a higher HbA1c cut-point will lead to fewer cases of diabetes prevented but greater "economic efficiency" in terms of diabetes cases prevented per intervention participant. Selection of optimal HbA1c thresholds also may change with the evolving science, as better evidence on the biologic effectiveness of lower-intensity interventions and effects of lifestyle interventions on additional outcomes could pave the way for a more comprehensive, tiered approach to risk stratification.