American journal of preventive medicine
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Randomized Controlled Trial Clinical Trial
Evaluation of a hospital-based youth violence intervention.
To decrease adolescent morbidity and mortality and improve the quality of life, a violence-prevention consultation is offered to hospitalized victims of nondomestic violence. The context is a violence-prevention team approach to patient assessment, treatment, and follow-up. Psychoeducational counseling emphasizes the individual through a cognitive behavioral approach and also recognizes the individual in the proximal social setting through referrals to community resources. ⋯ No statistically significant differences between intervention subjects and nonintervention controls in terms of baseline variables have been observed. For inner-city adolescent victims of violent assaults, a hospital-based intervention offers a unique opportunity for reduction of the incidence of reinjury. We describe the elements of the intervention, including the theoretical basis and implementation; detail the overall evaluation design including modifications; and present preliminary analyses of baseline data.
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We examine racial and ethnic variations in use of screening mammography. We first review recent literature on Blacks', Hispanics', and non-Hispanic Whites' mammography use. Here we extend that body of literature through use of a comprehensive national database and discussion of the implications of race- and nonrace-stratified mammography modeling. ⋯ Researchers must give explicit attention, both empirically and methodologically, to how race and ethnicity interact with sociodemographic factors, health practices, and access to health care to refine our understanding of barriers to breast cancer screening. Common barriers to routine screening may be perceived differently by Black, Hispanic, and White women and may contribute to underuse of mammography in distinct ways.
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Race, ethnicity, and gender are significant indicators of occupational status, general health status, and thus, occupational health status. Although African-American women constitute only 6.8% of the total U. S. labor force, they hold 20% of the jobs in the health care industry and are disproportionately represented in those jobs that have the highest levels of workplace exposure to hazards. ⋯ In order to gain insight into the effects of race and gender on the occupational health status of African-American women health care workers, this article uses three data sources that provide different but complementary sources of information on the demographic characteristics of workers, location of categories of occupations, working conditions of jobs, and other job and worker characteristics. Given the concentration of African-American women in health care positions where there exists a greater likelihood of being exposed to occupational hazards, it is therefore both logical and appropriate for primary care physicians, especially those engaged in office-based practices, to identify this target population for special services and to be more aware of the type of health issues with which these patients are more likely to present and to experience during their working lives. Health care providers have a responsibility to assess occupational factors related to a patient's health problems and to incorporate this information into their treatment protocols and into the design and explanation of each patient's care plan.
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Randomized Controlled Trial Clinical Trial
Peer and community leader education to prevent youth violence.
The program described here tests the effectiveness of a community-based and school-based program to reduce violence among African-American and Hispanic adolescents. The program methods are based on social network theory research, which has found that key lay people in communities can be identified and trained to carry out prevention programs. The educational content is based on theories suggesting that characteristics of healthy, adaptive individuals and communities can be taught. ⋯ Within the past year, 6% of the adults had been punched or beaten. A large percentage of adolescents are victims and perpetrators of violence and are exposed to violence in their neighborhoods. Violence-prevention strategies can be implemented through collaborations among health departments, community-based organizations, universities, and schools.
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Previously published reports strongly suggest that being overweight is a risk factor for coronary heart disease, hypertension, diabetes, gallstones, and osteoarthritis in women. Substantial health care and medication costs are associated with these chronic health conditions. We used an incidence-based analysis to estimate the excess costs associated with women maintaining an overweight status during the 25-year period from age 40 to 65 years. ⋯ The results of this study indicate that an estimated $16 billion will be spent during the next 25 years treating health outcomes associated with overweight in middle-aged women in the United States. Thus, a substantial health burden is associated with the increasing prevalence of overweight women in the United States. Preventing excess coronary heart disease, gall-stones, osteoarthritis, hypertension, and diabetes through prevention of weight gain, particularly among reproductive-aged women, may be a cost-effective strategy.