American journal of preventive medicine
-
Randomized Controlled Trial Comparative Study Clinical Trial
Impact of an educational program on the safety of high-risk, visually impaired, older drivers.
Older drivers (licensed drivers aged 60 years and older) have among the highest rates of motor vehicle collision involvement per mile driven of all age groups. Educational programs that promote safe driving strategies among seniors are a popular approach for addressing this problem, but their safety benefit has yet to be demonstrated. The objective of this study was to determine whether an individualized educational program that promoted strategies to enhance driver safety reduces the crash rate of high-risk older drivers. DESIGN/ SETTING: Randomized, controlled, single-masked intervention evaluation at an ophthalmology clinic. ⋯ An educational intervention that promoted safe-driving strategies among visually impaired, high-risk older drivers did not enhance driver safety, although it was associated with increased self-regulation and avoidance of challenging driving situations and decreased driving exposure by self-report.
-
Randomized Controlled Trial Multicenter Study Clinical Trial
The study designed by a committee: design of the Multisite Violence Prevention Project.
This article describes the research design of the Multisite Violence Prevention Project (MVPP), organized and funded by the National Center for Injury Prevention and Control (NCIPC) at the Centers for Disease Control and Prevention (CDC). CDC's objectives, refined in the course of collaboration among investigators, were to evaluate the efficacy of universal and targeted interventions designed to produce change at the school level. The project's design was developed collaboratively, and is a 2 x 2 cluster-randomized true experimental design in which schools within four separate sites were assigned randomly to four conditions: (1) no-intervention control group, (2) universal intervention, (3) targeted intervention, and (4) combined universal and targeted interventions. ⋯ The nesting of students within teachers, families, schools and sites created a number of challenges for designing and implementing the study. The final design represents both resolution and compromise on a number of creative tensions existing in large-scale prevention trials, including tensions between cost and statistical power, and between internal and external validity. Strengths and limitations of the final design are discussed.
-
Randomized Controlled Trial Clinical Trial
Weight and smoking cessation among low-income African Americans.
Concerns about weight gain have been a commonly cited barrier to cessation among white, affluent, female populations, but less is known about this relationship among minority smokers and those with low incomes. Although smoking cessation is strongly encouraged for this population, it often leads to weight gain. Cultural differences in weight standards and the high prevalence of weight-related health conditions (e.g., hypertension and diabetes) may influence concerns about smoking cessation-related weight gain. ⋯ Because post-cessation weight gain may be a serious health threat for this population, but weight gain was not a concern for these smokers, smoking-cessation interventions for low-income African-American smokers may need to incorporate weight-gain education and prevention.
-
Randomized Controlled Trial Clinical Trial
Primary care interventions to reduce television viewing in African-American children.
Data are lacking on primary care interventions to reduce children's television viewing. Low-income African-American children watch greater amounts of television than their peers. ⋯ This small pilot and feasibility study evaluated two promising primary care-based interventions to reduce television, videotape, and video game use among low-income African-American children. The effects on physical activity suggest that the behavioral intervention may be more effective.
-
Randomized Controlled Trial Clinical Trial
The use of nicotine-replacement therapy by hospitalized smokers.
No-smoking policies are mandatory in U.S. hospitals. Consequently, smokers who are hospitalized must temporarily stop smoking. Nicotine-replacement therapy (NRT) could help hospitalized smokers relieve nicotine withdrawal symptoms, comply with no-smoking policies, and sustain tobacco abstinence after discharge. The extent of NRT use in the hospital setting is unknown. We describe the prevalence and patterns of NRT use in hospitalized smokers. ⋯ NRT was rarely used in this hospital, even among those who could have benefited from it to treat nicotine-withdrawal symptoms. When NRT was used, relief of nicotine withdrawal, rather than assistance with smoking cessation, appeared to be the primary goal. Greater use of NRT could benefit the estimated 6.5 million smokers who are hospitalized annually by reducing nicotine withdrawal, encouraging smoking cessation, and ensuring compliance with hospital no-smoking policies.