American journal of preventive medicine
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Enhanced prenatal/postnatal care home visiting programs for Medicaid-insured women have significant positive impacts on care and health outcomes. However, enhanced prenatal care participation rates are typically low, enrolling <30% of eligible women. This study investigates the impacts of a population-based systems approach on timely enhanced prenatal care participation and other healthcare utilization. ⋯ A population systems approach improved selected enhanced prenatal care participation and service utilization for Medicaid-insured women in a county population, those in practices with established clinical-community linkages, and Black women.
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Grip strength is the most commonly used muscle strength proxy in clinical research. However, evidence regarding the associations of grip strength with cancer has been mainly restricted to overall cancer risk. Therefore, this study aims to evaluate the associations between grip strength relative to BMI and 15 cancer sites as well as with all-cause cancer mortality. ⋯ Grip strength relative to BMI was associated with incidence and mortality from endometrial, gallbladder, colorectal, liver, all-cause cancer, and breast and kidney cancer incidence, independent of major confounding factors, including comorbidity, diet, and physical activity.
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Observational Study
Community Health Centers' Performance in Cancer Screening and Prevention.
Little is known about what clinic-level factors differentiate community health centers that achieve high performance on cancer-preventive care metrics. This study aims to describe the longitudinal trends in the delivery of 3 cancer-preventive care metrics (cervical and colorectal cancer screenings and tobacco-cessation intervention) and define and compare community health centers with high cancer-preventive care performance with those with low cancer-preventive care performance. ⋯ Very few community health centers meet all Healthy People 2020 goals in cancer screenings and may struggle to achieve the 2030 goals. Very few indicators differentiated high performers from low performers.
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In 2013, the U.S. Preventive Services Task Force again recommended alcohol misuse screening and provision of brief behavioral counseling interventions to those engaged in risky drinking for all adults aged ≥18 years in primary care. This report presents national estimates of the provision of alcohol screening and brief intervention by U.S. primary care physicians, the screening methods, and the resources they identified as helpful in implementing alcohol/substance screening and intervention in primary care settings. ⋯ Less than 40% of primary care physicians who screened patients for alcohol misuse reported always intervening with patients who screened positive for risky alcohol use. Collection of data on resources that primary care physicians report as being helpful for alcohol/substance screening and intervention implementation may be useful in continuous improvement efforts.
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Routine HIV testing is expected to facilitate early diagnosis and treatment. Nevertheless, to date, limited data are available on the presumed benefit of early detection with improved outcomes through routine HIV testing. ⋯ Routine HIV testing was associated with highly favorable outcomes, including decreased late diagnosis, lower HIV-related mortality, and lower all-cause mortality, among people diagnosed with HIV infection. Under universal health coverage, expanding routine HIV testing in well-targeted settings may improve both HIV epidemic control for society and clinical outcomes for people living with HIV.