Clinical Preventive Medicine
Effects of a Digital Diabetes Prevention Program: An RCT
In light of the need to expand the reach and access of clinically proven digital Diabetes Prevention Programs (d-DPPs) and the need for rigorous evidence of effectiveness, the purpose of this study was to determine the effectiveness of a digital Diabetes Prevention Program for improving weight, HbA1c, and cardiovascular risk factors among people with prediabetes compared to enhanced standard care plus waitlist control.Trend in Blood Pressure Control Post Antihypertensive Drug Initiation in the U.S.
The aim of this study is to evaluate the temporal trends in systolic blood pressure control over 18 months after blood pressure‒lowering drug initiation in the U.S. population.Trends in the Impact of Medicaid Expansion on the Use of Clinical Preventive Services
This study aims to evaluate the trends in the impact of Medicaid expansion on the use of selected recommended clinical preventive services and examine the differences in use by income level over time.Cardiovascular Disease Preventive Services Among Smaller Primary Care Practices
Cardiovascular disease preventive services (aspirin use, blood pressure control, and smoking-cessation support) are crucial to controlling cardiovascular diseases. This study draws from 1,248 small-to-medium-sized primary care practices participating in the EvidenceNOW Initiative from 2015-2016 across 12 states to provide practice-level aspirin use, blood pressure control, and smoking-cessation support estimates; report the percentage of practices that meet Million Hearts targets; and identify the practice characteristics associated with better performance.Diagnoses and Treatment After Depression Screening in Primary Care Among Youth
Depression screening is universally recommended for adolescents presenting in primary care settings in the U.S. However, little is known about how depression screening affects the likelihood of being diagnosed with a mental disorder or accessing mental health care over time.Alcohol Screening and Brief Intervention: Office-Based Primary Care Physicians, U.S., 2015–2016
In 2013, the U.S. Preventive Services Task Force again recommended alcohol misuse screening and provision of brief behavioral counseling interventions to those engaged in risky drinking for all adults aged ≥18 years in primary care. This report presents national estimates of the provision of alcohol screening and brief intervention by U.S. primary care physicians, the screening methods, and the resources they identified as helpful in implementing alcohol/substance screening and intervention in primary care settings.Community Health Centers’ Performance in Cancer Screening and Prevention
Little is known about what clinic-level factors differentiate community health centers that achieve high performance on cancer-preventive care metrics. This study aims to describe the longitudinal trends in the delivery of 3 cancer-preventive care metrics (cervical and colorectal cancer screenings and tobacco-cessation intervention) and define and compare community health centers with high cancer-preventive care performance with those with low cancer-preventive care performance.Disparities in Colorectal Cancer Screening in Latinos and Non-Hispanic Whites
Colorectal cancer is the second leading cause of cancer deaths in Latinos in the U.S., but it is unclear, from previous research, whether Latinos have differing rates of colorectal cancer screening methods from those of non-Hispanic Whites.Routine HIV Testing and Outcomes: A Population-Based Cohort Study in Taiwan
Routine HIV testing is expected to facilitate early diagnosis and treatment. Nevertheless, to date, limited data are available on the presumed benefit of early detection with improved outcomes through routine HIV testing.Association Between Dense Breast Legislation and Cancer Stage at Diagnosis
Many states have mandated breast density notification and insurance coverage for additional screening; yet, the association between such legislation and stage of diagnosis for breast cancer is unclear. This study investigates this association and examines the differential impacts among different age and race/ethnicity subgroups.Tobacco Treatment Guideline Use and Predictors Among U.S. Physicians by Specialty
Physicians play a critical role in tobacco treatment, being a frequent link to smokers and a trusted source of information. Unfortunately, barriers exist that limit physicians’ implementation of evidence-based interventions. This study examines the implementation and predictors of the Ask, Advise, Assess, Assist, Arrange model of tobacco treatment clinical guidelines among U.S. physicians.Optimizing Texting Interventions for Melanoma Prevention and Early Detection: A Latin Square Crossover RCT
Text messaging is an effective way to reach large populations with health promotion support. This study aims to establish the optimal text messaging intervention to achieve behavior change in young adults at risk of skin cancer.Capturing the Rest: Inpatient Mammography for Nonadherent Hospitalized Women
More than a third of hospitalized women are overdue or nonadherent to breast cancer screening guidelines, and almost a third of them are also at high risk for developing breast cancer. The purpose of this study is to evaluate the feasibility of coordinating inpatient breast cancer screening mammography for these women before their discharge from the hospital.State- and Provider-Level Racism and Health Care in the U.S.
This study examines the associations between state-level and provider sources of racism and healthcare access and quality for non-Hispanic Black and White individuals.Trends in the Utilization of Recommended Clinical Preventive Services, 2011–2019
The Patient Protection and Affordable Care Act requires many health insurance plans to cover certain clinical preventive services in network with no cost sharing. This study describes the utilization trends of 8 clinical preventive services by insurance status and analyzes utilization disparities.Impact of the COVID-19 Pandemic on Chlamydia and Gonorrhea Screening in the U.S.
This study evaluates the impact of the COVID-19 pandemic on testing for common sexually transmitted infections. Specifically, changes are measured in chlamydia and gonorrhea testing and case detection among patients aged 14–49 years during the COVID-19 pandemic.Evidence-Based Interventions and Colorectal Cancer Screening Rates: The Colorectal Cancer Screening Program, 2015–2017
The Centers for Disease Control and Prevention administers the Colorectal Cancer Control Program to increase colorectal cancer screening rates among people aged 50–75 years in areas where rates are lower than state or national levels. The aim of this study is to better understand the effectiveness of specific Colorectal Cancer Control Program components.Screening Discordance and Characteristics of Patients With Housing-Related Social Risks
Healthcare systems are increasingly interested in identifying patients’ housing-related risks, but minimal information exists to inform screening question selection. The primary study aim is to evaluate discordance among 5 housing-related screening questions used in health care.A Community Health Worker–Led Multicomponent Program to Promote Cervical Cancer Screening in South Asian Women: A Cluster RCT
South Asian women in Hong Kong have low cervical cancer screening uptake because of multiple barriers to utilizing health resources. Interventions that effectively modify the cancer screening behaviors of this population are warranted. This study evaluates the effects of a community health worker–led multicomponent intervention on improving cervical cancer screening uptake among South Asian women in Hong Kong.Effect of 2 Interventions on Cervical Cancer Screening Guideline Adherence
This study sought to determine whether a provider mobile phone application, used with or without a patient educational tool accessed on a computer tablet, would promote adherence to guidelines for cervical cancer screening and management of abnormal cytology in young women.Motivational Interviewing in the Management of Type 2 Diabetes Mellitus and Arterial Hypertension in Primary Health Care: An RCT
Motivational interviewing is an effective style of collaborative communication for the promotion of lifestyle changes in the management of Type 2 diabetes and arterial hypertension. This study evaluates the effectiveness of motivational interviewing in the management of these conditions in primary health care.Availability of Adult Vaccination Services by Provider Type and Setting
Knowledge regarding the benefits for adult vaccination services under Medicaid's fee-for-service arrangement is dated; little is known regarding the availability of vaccination services for adult Medicaid beneficiaries in MCO arrangements. This study evaluates the availability of provider reimbursement benefits for adult vaccination services under fee-for-service and MCO arrangements for different types of healthcare providers and settings.Aspirin Use and Misuse for the Primary Prevention of Cardiovascular Diseases
Daily aspirin use for primary cardiovascular disease prevention is common among adults. Numerous clinical trials observe reduced cardiovascular disease with regular low-dose aspirin. The U.S. Preventive Services Task Force in 2016 published guidelines for aspirin use, but controversy exists about the side effects, and overuse or underuse may be common despite the guidelines. Using the Task Force recommendations, this paper describes the prevalence of appropriate aspirin use and physician advice in a population sample.Characteristics of Population Health Physicians and the Needs of Healthcare Organizations
Healthcare organizations are transitioning from fee-for-service, volume-based care toward value-based care and the Triple Aim. Physicians have critical roles as leaders and practitioners in this emerging field of population health management; however, the competencies required of these physicians are not well described. The purpose of this study is to explore the approaches of healthcare systems to population health–related functions, the competencies needed, and the characteristics of physicians who lead or staff these functions.Use of Machine Learning to Determine the Information Value of a BMI Screening Program
Childhood obesity continues to be a significant public health issue in the U.S. and is associated with short- and long-term adverse health outcomes. A number of states have implemented school-based BMI screening programs. However, these programs have been criticized for not being effective in improving students’ BMI or reducing childhood obesity. One potential benefit, however, of screening programs is the identification of younger children at risk of obesity as they age.
