American journal of preventive medicine
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Youth suicide rates have risen steadily in recent decades, with suicide attempts representing a significant risk factor for future mortality. Sexual violence exposure further elevates this risk. This study investigated the efficacy of Sources of Strength, a school-based peer-led program, for reducing suicide attempts school wide as well as specifically among youth with recent sexual violence exposure. ⋯ Sources of Strength effectively reduced suicide attempts in high-school students overall, suggesting its potential for population-level impact. This is especially important in the face of steadily rising suicide attempt and fatality rates among adolescents and young adults. However, a cautious interpretation of the evidence suggests that Sources of Strength may not prevent attempts among students with recent sexual violence contact victimization, highlighting the need for additional intervention work for this high-risk group.
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The potential impact of an in-development 24-valent pneumococcal conjugate vaccine compared with that of currently recommended vaccines in older adults is unclear. Similar to most currently available pneumococcal conjugate vaccines, 24-valent pneumococcal conjugate vaccine's formulation is based on childhood pneumococcal disease epidemiology. Decision analysis techniques were used to estimate 24-valent pneumococcal conjugate vaccine cost-effectiveness and public health effects in U.S. older adults. ⋯ In older adults, 24-valent pneumococcal conjugate vaccine was clinically and economically unfavorable compared with 21-valent pneumococcal conjugate vaccine, which covers more adult disease-causing pneumococcal serotypes and is less susceptible to childhood vaccination indirect effects.
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With advancement of medicine, alternative exposures or interventions are emerging with respect to a common outcome, and there are needs to formally test the difference in the associations of multiple exposures. ⋯ The proposed duplication-method-based approach offers a flexible, formal statistical test for heterogeneity in the associations of multiple exposures with the common outcome with minimal assumptions.
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Maternal lifestyle behaviors can affect blood pressure with consequences for maternal and offspring health. The aim of this study was to investigate the effectiveness of the Smarter Pregnancy digital lifestyle coaching program on maternal blood pressure during the first trimester. ⋯ The use of Smarter Pregnancy is associated with consistent but small reductions in maternal blood pressure during the first trimester, supporting further implementation in health care.
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Intellectual and Developmental Disabilities (IDD) have been associated with high cardiometabolic risk in adults, but there is little data on youth. This study describes the prevalence of cardiometabolic risk factors among pediatric patients with and without IDD receiving care in a large, primarily rural health system. ⋯ This study reports disparities in risk between pediatric patients with and without IDD. Future research and intervention programs should focus on young people with IDD to prevent adverse cardiometabolic outcomes later in life.