American journal of preventive medicine
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Little is known about associations between the reasons parents refuse or delay vaccines for their children, their responsiveness to vaccine counseling, and their children's vaccination status at various ages. Since 2015, Michigan has required parents to attend education sessions at local health departments to receive nonmedical exemptions. This requirement provides an opportunity to study otherwise opaque aspects of vaccine refusal. ⋯ Different reasons for refusal are associated with different patterns of vaccination behavior. Furthermore, results suggest that education sessions may overcome vaccine refusal in some cases, and that distinct refusal reasons mark real differences in parental motivations regarding vaccination choices. These differences in parental motivations may indicate the existence of different sites for potential pro-vaccination interventions.
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As the burden of type 2 diabetes rises, there is increasing focus on improving the reach of evidence-based lifestyle interventions. Using nationally representative data, this study identifies how frequently at-risk adults are being referred to and participating in diabetes prevention programming, and explores correlates of referral, participation, and interest. ⋯ Although more than one quarter of adults likely eligible for diabetes prevention programming express interest in participating, few are being referred and fewer still have participated. This underscores the need for efforts to enhance program referral and access.
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This study describes characteristics of nonfatal self-inflicted injuries and incidence of repeat self-inflicted injuries among a large convenience sample of youth (aged 10-24 years) with Medicaid or commercial insurance. ⋯ Approximately one in ten youth repeated self-inflicted injury within 1 year and nearly half of youth with clinically treated self-inflicted injuries never received care in hospitals or emergency departments. Physicians and families should be aware of risk factors for repeat self-inflicted injury, including mental health comorbidities. Multilevel strategies are needed to prevent youth self-inflicted injuries.
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Meta Analysis
Physical Activity Levels and New Public Transit: A Systematic Review and Meta-analysis.
Physical inactivity is a public health concern as it contributes to the rising burden of noncommunicable diseases. Introducing new public transportation options, such as extending or building new light rail or bus rapid transit stations, could encourage commuters to walk to and from public transit stops, thus increasing their physical activity levels. Despite previous research generally finding positive associations between public transit usage and physical activity levels, few have summarized the association between introducing new public transportation options and different intensities of physical activity. This study aimed to systematically review the current evidence and perform a meta-analysis on this association. ⋯ Results show new public transit options can substantially contribute to increasing low- to moderate-intensity exercise levels, which has the potential to improve health on a population scale.
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Local Wellness Policies are school-district documents containing guidelines for schools to promote nutrition/physical activity. In cross-sectional studies, schools with wellness committees are more likely to implement Local Wellness Policies. This prospective cohort study examines associations between wellness committee status over time and change in Local Wellness Policy implementation using a biennial, statewide survey. ⋯ Forming and maintaining wellness committees encourages Local Wellness Policy implementation and should be a recommended strategy for school wellness promotion.