American journal of preventive medicine
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Recent data suggest that the onset of cigarette smoking is now more likely during young adulthood than adolescence. Additionally, the landscape of delivering smoking-cessation interventions has changed in the past decade, with the emergence of mobile phone and web-based approaches. The objective of this study is to update a 2010 systematic review of smoking-cessation interventions for U.S. young adults (aged 18-24 years). ⋯ Of 32 included studies, 9 demonstrated efficacy of smoking cessation or reduction in U.S. young adults. There were no eligible pharmacologic interventions included in this review. Findings support the promise of 3 approaches for young adult cessation not included in the prior review: text message interventions, sustained quit-and-win contests, and multiple behavior interventions.
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Randomized Controlled Trial
The Strong Hearts, Healthy Communities Program 2.0: An RCT Examining Effects on Simple 7.
Rural women have higher rates of cardiovascular disease than their nonrural counterparts, partially because of their social and environmental contexts. The study objective is to test a refined version of the multilevel Strong Hearts, Healthy Communities intervention, which used extensive process and outcome evaluation data from the original randomized trial to optimize effectiveness as measured by improved Simple 7 score, a composite measure of cardiovascular disease risk. ⋯ These findings highlight the importance of rigorously evaluating programs in real-world community settings and, when appropriate, revising and retesting interventions to optimize dissemination potential.
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Opioid and sedative/hypnotic drug overdoses are major causes of morbidity in the U.S. This study compares 12-month incidence of fatal unintentional drug overdose, suicide, and other mortality among emergency department patients presenting with nonfatal opioid or sedative/hypnotic overdose. ⋯ Emergency department patients with nonfatal opioid or sedative/hypnotic drug overdose have exceptionally high risks of death from unintentional overdose, suicide, and other causes. Emergency department-based interventions offer potential for reducing these patients' overdose and other mortality risks.
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This study examined associations of both medical and nonmedical financial hardships with healthcare utilization and self-rated health among cancer survivors. ⋯ Higher medical and nonmedical financial hardships are independently associated with more emergency department visits, lower receipt of some preventive services, and worse self-rated health in cancer survivors. With growing healthcare costs, unmet medical and nonmedical financial needs may worsen health disparities among cancer survivors.
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Addressing veteran homelessness is a major federal priority, but there has been little research on the period between military discharge and homelessness. There are public concerns about new waves of homelessness among recent veterans and questions about a possible sleeper effect, that is, a delayed risk that becomes stronger with time. ⋯ There appears to be a sleeper effect in veteran homelessness after military discharge. The primary and secondary preventions focused on chronic health conditions, and social adjustment may be needed to address homelessness among recent veterans.