American journal of preventive medicine
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Randomized Controlled Trial
Patient Navigation for Colonoscopy Completion: Results of an RCT.
Colorectal cancer is a leading cause of cancer-related death in the U.S. Although screening reduces colorectal cancer incidence and mortality, screening rates among U.S. adults remain less than optimal, especially among disadvantaged populations. This study examined the efficacy of patient navigation to increase colonoscopy screening. ⋯ Navigation significantly improved colonoscopy screening completion among a racially diverse, low-income population. Results contribute to mounting evidence demonstrating the efficacy of patient navigation in increasing colorectal cancer screening. Screening can be further enhanced when navigation is combined with other evidence-based practices implemented in healthcare systems and the community.
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Comparative Study
Estimation of Breast Cancer Incident Cases and Medical Care Costs Attributable to Alcohol Consumption Among Insured Women Aged <45 Years in the U.S.
This study estimated the percentage of breast cancer cases, total number of incident cases, and total annual medical care costs attributable to alcohol consumption among insured younger women (aged 18-44 years) by type of insurance and stage at diagnosis. ⋯ Alcohol-attributable breast cancer has estimated medical care costs of nearly $150 million per year. The current findings could be used to support evidence-based interventions to reduce alcohol consumption in younger women.
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Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination has been recommended for adolescents in the U.S. since 2006. Information on Tdap vaccination by provider recommendation is limited. The purpose of this study is to assess recent Tdap vaccination by provider recommendation status among adolescents aged 13-17 years. ⋯ Provider recommendations were significantly associated with Tdap vaccination among adolescents aged 13-17 years. However, 43% of parents of adolescents did not receive a provider recommendation. Evidence-based strategies such as standing orders and provider reminders alone or health systems interventions in combination should be taken to improve provider recommendation and Tdap vaccination coverage.
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Health literacy, the degree to which individuals have the capacity to obtain, process, and understand health information and services needed to make health decisions, is an essential element for early adults (aged 18-44 years) to make informed decisions about cancer. Low health literacy is one of the social determinants of health associated with cancer-related disparities. Over the past several years, a nonprofit organization, a university, and a cancer center in a major urban environment have developed and implemented health literacy programs within healthcare systems and in the community. ⋯ Some of these programs have been cancer specific, including consumer education in such areas as cervical cancer, skin cancer, and breast cancer that are targeted to early adults across the cancer spectrum from prevention to treatment to survivorship. An example of consumer-driven health education that was tested for health literacy using a comic book-style photonovel on breast cancer with an intergenerational family approach for Chinese Americans is provided. Key lessons learned from the health literacy initiatives and overall conclusions of the health literacy initiatives are also summarized.
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Observational Study
Kids'Cam: An Objective Methodology to Study the World in Which Children Live.
This paper reports on a new methodology to objectively study the world in which children live. The primary research study (Kids'Cam Food Marketing) illustrates the method; numerous ancillary studies include exploration of children's exposure to alcohol, smoking, "blue" space and gambling, and their use of "green" space, transport, and sun protection. ⋯ This methodology enabled objective analysis of the world in which children live. The main arm examined the frequency and nature of children's exposure to food and beverage marketing and provided data on difficult to measure settings. The methodology will likely generate robust evidence facilitating more effective policymaking to address numerous public health concerns.