American journal of preventive medicine
-
Understanding the role of sociologic, structural, and biomedical factors that influence the length of time from HIV infection to diagnosis and reducing the time from infection to diagnosis are critical for achieving the goals of the Ending the HIV Epidemic initiative. In a retrospective analysis, the length of time from HIV infection to diagnosis and its association with individual- and facility-level attributes are determined. ⋯ Providing access to expanded testing, including rapid testing in nonclinical settings, is likely to result in a decrease in the length of time a person is unaware of their HIV infection and thus reduce onward transmission of HIV infection.
-
Hepatitis B vaccination is routinely recommended for adults with diabetes mellitus aged <60 years and for those aged ≥60 years at the discretion of their healthcare provider. The purpose of this study is to assess hepatitis B vaccination coverage among adults with and without diabetes mellitus. ⋯ Self-reported hepatitis B vaccination coverage among adults with diabetes mellitus remains suboptimal. Healthcare providers should assess patients' diabetes status, recommend and offer needed vaccinations to patients, or refer them to alternate sites for vaccination.
-
Despite the growing recognition of the importance of neighborhood conditions for cardiometabolic health, causal relationships have been difficult to establish owing to a reliance on cross-sectional designs and selection bias. This is the first natural experiment to examine the impact of neighborhood revitalization on cardiometabolic outcomes in residents from 2 predominantly African American neighborhoods, one of which has experienced significant revitalization (intervention), whereas the other has not (comparison). ⋯ Investing in disadvantaged neighborhoods has been suggested as a strategy to reduce health disparities. Using a natural experiment, findings suggest that improving neighborhood conditions may have a mixed impact on certain aspects of cardiometabolic health. Findings underscore the importance of examining the upstream causes of health disparities using rigorous designs and longer follow-up periods that provide more powerful tests of causality.
-
Supervised injection facilities are harm reduction interventions that allow people who inject drugs to use previously obtained substances under the supervision of health professionals. Although currently considered illegal under U.S. federal law, several U.S. cities are considering implementing supervised injection facilities anyway as a response to the escalating overdose crisis. The objective of this review is to determine the effectiveness of supervised injection facilities, compared with that of control conditions, for harm reduction and community outcomes. ⋯ For people who inject drugs, supervised injection facilities may reduce the risk of overdose morbidity and mortality and improve access to care while not increasing crime or public nuisance to the surrounding community.
-
Depression is a prevalent condition for which screening rates remain low and disparities in screening exist. This study examines the impacts of a medical assistant screening protocol on the rates of depression screening, overall and by sociodemographic groups, in a primary care setting. ⋯ Implementation of a medical assistant protocol in a primary care setting may significantly increase depression screening rates while mitigating or removing sociodemographic disparities.