American journal of preventive medicine
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Multicenter Study
Sedentary Time and Physical Activity Associations Between Child Care Educators and Children.
This study examines the associations between objectively measured sedentary time and physical activity among child care educators and children in their direct care and aims to determine if the associations differed between toddlers (aged 19-35 months) and preschoolers (aged 36-60 months). ⋯ The educators' sedentary time and moderate to vigorous-intensity physical activity may have a small but potentially meaningful influence on children's moderate to vigorous-intensity physical activity because educators directly care for multiple children. Targeting these educator behaviors may be one strategy to increase children's moderate to vigorous-intensity physical activity during child care.
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Comparative Study
Measuring the Incidence of Child Maltreatment Using Linked Data: A Two-State Comparison.
Measuring and comparing the incidence of child maltreatment is challenging. Linkage of statewide birth cohorts with Child Protective Services reports to study incident child maltreatment over the life course are becoming more common. This study compares the reported incidence between 2 states derived from population-based administrative data linkages. ⋯ Much of the difference in risk for child maltreatment observed between Alaska and California is most likely due to variation in the population structure by race as opposed to modifiable factors. Standardization is a simple method to adjust for population structure differences. This study contributes to the growing body of knowledge regarding the use of linked administrative data to study maltreatment and provides insights into considerations for making comparisons or conducting cross-jurisdictional analyses based on commonly aligned data sets.
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Physical activity is known to be inversely associated with cigarette smoking among young people. However, evidence is not clear about the association between physical activity and e-cigarette use. Young people who otherwise lead a healthy lifestyle are attracted to e-cigarettes for nicotine or flavor consumption given the low harm perceptions associated with e-cigarette use. This is of concern given the potentially serious adverse health consequences of some forms of e-cigarette use. This study tested the hypotheses that increased physical activity is associated with lower levels of cigarette and e-cigarette use, both cross-sectionally and prospectively. ⋯ The prospective association between increased physical activity at baseline and higher e-cigarette use 6 months later is of concern. More research is needed to determine if this finding is replicable. Some plausible reasons for the observed associations are discussed.
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Randomized Controlled Trial Multicenter Study
Effect of an Intervention for Obesity and Depression on Patient-Centered Outcomes: An RCT.
An integrated collaborative care intervention was successful for treating comorbid obesity and depression. The effect of the integrated intervention on secondary outcomes of quality of life and psychosocial functioning were examined, as well as whether improvements in these secondary outcomes were correlated with improvements in the primary outcomes of weight and depressive symptoms. ⋯ An integrated collaborative care intervention for obesity and depression that was shown previously to improve weight and depressive symptoms may also confer benefits for quality of life and psychosocial functioning over 6 months.
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The Patient Protection and Affordable Care Act increases healthcare access and includes provisions that directly impact access to and cost of evidence-based colorectal cancer screening. The Affordable Care Act's removal of cost sharing for colorectal cancer screening as well as Medicaid expansion have been hypothesized to increase screening and improve other health outcomes. However, since its passage in 2010, there is little consensus on the Affordable Care Act's impact. ⋯ Free preventive colorectal cancer screening and Medicaid expansion because of passage of the Affordable Care Act have been, in general, positively associated with modest improvements in screening rates across the country. Future studies are needed that investigate the longer-term impact of the Affordable Care Act on colorectal cancer morbidity and mortality rates, as screening is only the first step in treatment of cancerous and precancerous lesions, preventing them from progressing. Moreover, more studies examining subpopulations are needed to better assess where gaps in care remain.