American journal of preventive medicine
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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.
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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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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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Multicenter Study
Availability of Safety-net Sexually Transmitted Disease Clinical Services in the U.S., 2018.
Safety-net sexually transmitted disease services can prevent transmission of sexually transmitted disease. This study assesses the availability of safety-net sexually transmitted disease clinical services across the U.S. ⋯ One-third of local health departments reported no safety-net sexually transmitted disease services or were not aware of the services, and availability of specific services varied. Without an expansion of resources, local health departments might explore collaborations with healthcare systems and innovations in testing to expand sexually transmitted disease services.
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Multicenter Study
Prenatal Drinking in the Northern Plains: Differences Between American Indian and Caucasian Mothers.
Prenatal alcohol exposure is associated with adverse pregnancy outcomes such as fetal alcohol spectrum disorders. The study characterizes the pattern and risk factors of alcohol use during pregnancy for American Indian and Caucasian mothers in the Northern Plains. ⋯ Alcohol use was more prevalent among Caucasian mothers. Among those who consumed alcohol during pregnancy, American Indian mothers consumed larger quantities. Change of residence was found to be the sole risk factor for prenatal drinking among American Indian mothers, whereas different and multiple risk factors were found for Caucasian mothers.