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Revello, Maria Grazia, Valentina Frisina, Giovanna Oggè, Alessia Arossa, and Milena Furione. "An effective and feasible approach to prevention of primary cytomegalovirus infection in pregnancy." Microbiology Australia 36, no. 4 (2015): 179. http://dx.doi.org/10.1071/ma15063.
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In the absence of a cytomegalovirus (CMV) vaccine, other strategies for prevention of primary infection in pregnancy should be considered. Behavioural interventions have been reported to significantly decrease seroconversion rate among seronegative pregnant women. We report here on a recently completed controlled study in which seronegative women at high risk of infection because of close contacts with children <36 months, were identified and informed about risky and protective behaviours. Informed women seroconverted at a significantly lower rate than non-informed women.
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Jorgensen, Michael P., Fergal T. O'Hagan, and Hugo Lehmann. "Concussion beliefs in varsity athletes: Identifying the good, the bad and the ugly." Journal of Concussion 1 (January 2017): 205970021773025. http://dx.doi.org/10.1177/2059700217730257.
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Objective Identify and describe attitudes and intentions towards personal concussion risk and protective behaviours among varsity athletes. Determine subgroups of athletes characterized by problematic intentions towards concussion prevention and management behaviours. Design Cross-sectional survey. Main outcome measures Varsity athletes ( N = 175; 60% male; 55.4% contact athletes; 56.6% history of concussion) completed a survey examining attitudes and intentions towards personal risk and concussion-management behaviours. Cluster and discriminant analyses were used to identify athlete risk response subgroups on intention items. The clusters were examined for differences in attitudes towards concussion prevention behaviours, demographics and concussion exposure. Results A substantially problematic subgroup of athletes (28% of the sample) reported low intent to engage in post concussion management practices or primary prevention behaviours. These individuals reported high concussion-risk acceptance and very low belief in the efficacy of concussion-management behaviours. They were also more likely to have sustained a concussion. Two other clusters demonstrated more acceptable behavioural intentions towards concussion prevention and management, with one holding model attitudes and intentions. Conclusions Varsity athletes exhibit one of three different patterns of intentions and attitudes towards concussion prevention and management behaviours. Athletes in one of these groups are at much greater risk of concussion injury and poorly follow recommended treatments. Intervention programmes need to target and aim to change these problematic intentions and attitudes to improve the effectiveness of concussion prevention and injury management.
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Green, Adèle C., Maria Celia B. Hughes, Lena A. von Schuckmann, Kiarash Khosrotehrani, and B. Mark Smithers. "Clustering of prevention behaviours in patients with high-risk primary melanoma." Psycho-Oncology 27, no. 5 (November 7, 2017): 1442–49. http://dx.doi.org/10.1002/pon.4565.
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Darun, Pamorn, Nittaya Klongkayun, Rattikan Darun, and Arwut Boontien. "Effect of Health Education on Health Perception and Preventive Health Behaviour of Populations at risk of Cholangiocarcinoma in Si Samran Subdistrict, Porncharoen District, Bueng Kan Province, Thailand." Matters of Behaviour 7, no. 8 (January 3, 2019): 1–5. http://dx.doi.org/10.26455/mob.v7i8.29.
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People in Si Samran subdistrict, Porncharoen district, Bueng Kan province have little awareness and perception of risk and severity of cholangiocarcinoma (CCA). They still eat raw fish or other menu cooked with raw fish. Therefore, CCA prevention campaign should be done to enhance awareness and perception of this disease in order to reduce raw fish consuming behaviours. This study aimed to evaluate the effect of health education to populations at risk of CCA in Si Samran subdistrict by comparing health perception and preventive health behaviours before and after receiving health education. This study recruited 76 participants by purposive sampling technique to attend the health education for stop eating raw fish workshop. The workshop was applied based on the theory of Health Belief Model (HBM) and the activities comprised lecture of 1) signs and symptoms of CCA, 2) risk factors of CCA, 3) benefits of CCA prevention and group discussion about CCA preventive behaviours and barriers of behaviour modification. Data were collected with the questionnaire before and 3 months after the workshop. The questionnaire was adopted from Sangprach’s questionnaire which had been already tested for reliability (overall Cronbach’s alpha coefficient = 0.89). Descriptive statistics were used to describe personal demographic data, level of health perception regarding CCA and level of CCA preventive behaviours. Inferential statistics (paired samples t-test) were used to compare the level of health perception regarding CCA and level of CCA preventive behaviours before and after attending the workshop. The results showed that a majority of 76 participants were female (68.4%), age group 40-50 years old (51.3%), married (89.5%), finished primary school (76.3%), employed in agriculture (61.8%), and had income more than 10,000 bath/month (40.8%). Participants had a higher level of 3 parts of health perception regarding CCA after the workshop, including perceived susceptibility, perceived severity and perceived barriers but demonstrated a lower level of many CCA preventive behaviours except the behaviour “You do not eat mouldy food” level that was higher after attending the workshop. The recommendation for CCA preventive behaviour improvement is that health education should be focused on the elimination of obstacles or barriers in the community which obstructed the behaviour modification.
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BOONTEM, Phagapun, Penprapa SUTHAMMA, and Narunest JURAKARN. "The Effectiveness of Life Skills Program on Life Skills to Prevent Risky Sexual Behaviours in Primary School Students, Thailand." Walailak Journal of Science and Technology (WJST) 16, no. 8 (January 14, 2018): 545–50. http://dx.doi.org/10.48048/wjst.2019.4327.
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Risky sexual behaviors are a very serious problem, especially in youth and adolescence. This study aims to compare the effects of and integrated sex education and life skills program on life skills to prevent risky sexual behaviors in primary school students. Design: The study was conducted using a quasi-experimental, pre-posttest 2-group design. Sample: 34 primary students were in the control group, and 34 primary students were in the experiment group. Intervention: The experimental group participated in the integrated sex education and life skill program to promote life skills and prevent risky sexual behaviors, while the control group participated in the usual educational program regarding sexual and reproductive health that already exists in schools. Measurements: The data on both groups were gathered through questionnaires assessing demographic characteristics and life skills for preventive risky sexual behaviors. Results: The results revealed significant differences between the experimental and control groups (t-test = 2.39, p-value < 0.05) 3 months after the life skills programs, while no significant difference was noted in the experimental group (mean difference = -2.53, p-value > 0.05). Conclusions: The integrated sex education and life skill program posed potential utility for primary students and also capable provision for further study for other groups.
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Williams Merten, Julie, Jessica L. King, Kim Walsh-Childers, Melissa J. Vilaro, and Jamie L. Pomeranz. "Skin Cancer Risk and Other Health Risk Behaviors." American Journal of Lifestyle Medicine 11, no. 2 (June 23, 2016): 182–96. http://dx.doi.org/10.1177/1559827615594350.
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Purpose. To present results of a scoping review focused on skin cancer risk behaviors and other related health risk behaviors. Skin cancer is highly preventable, yet it is the most common form of cancer in the United States with melanoma rates increasing. Limited research has been conducted examining the relationship between skin cancer prevention behaviors and other health risks, yet multiple behavioral health risk interventions have shown great promise for health promotion and reduced health care costs. Methods. Online databases were searched for research articles on skin cancer risk behaviors and related health risk behaviors. Results. Thirty-seven articles met inclusion criteria examining skin cancer behaviors including risk, sun protection behaviors, sunburn, and indoor tanning. The majority of existing studies focused on the relationship between skin cancer prevention behaviors and physical activity, body mass index, smoking, and alcohol abuse. Adults were the primary population of interest with some studies of adolescents. Conclusions. Poor skin cancer prevention behaviors were associated with alcohol use, marijuana use, and smoking among adolescents and adults. Studies on body mass index and physical activity had mixed relationships with skin cancer prevention behaviors and warrant further investigation. Indoor tanning was associated with other risky behaviors but other skin cancer prevention behaviors were not studied.
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LUDMAN, E., W. KATON, T. BUSH, C. RUTTER, E. LIN, G. SIMON, M. VON KORFF, and E. WALKER. "Behavioural factors associated with symptom outcomes in a primary care-based depression prevention intervention trial." Psychological Medicine 33, no. 6 (July 31, 2003): 1061–70. http://dx.doi.org/10.1017/s003329170300816x.
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Background. A randomized trial of a primary care-based intervention to prevent depression relapse resulted in improved adherence to long-term antidepressant medication and depression outcomes. We evaluated the effects of this intervention on behavioural processes and identified process predictors of improved depressive symptoms.Method. Patients at high risk for depression recurrence or relapse following successful acute phase treatment (N=386) were randomly assigned to receive a low intensity 12-month intervention or continued usual care. The intervention combined education about depression, shared decision-making regarding use of maintenance pharmacotherapy and cognitive-behavioural strategies to promote self-management. Baseline, 3, 6, 9 and 12-month interviews assessed patients' self-care practices, self-efficacy for managing depression and depressive symptoms.Results. Intervention patients had significantly greater self-efficacy for managing depression (P<0·01) and were more likely to keep track of depressive symptoms (P<0·0001), monitor early warning signs (P<0·0001), and plan for coping with high risk situations (P<0·0001) at all time points compared to usual care control patients. Self-efficacy for managing depression (P<0·0001), keeping track of depressive symptoms (P=0·05), monitoring for early warning signs (P=0·01), engaging in pleasant activities (P<0·0001) and engaging in social activities (P<0·0001) positively predicted improvements in depression symptom scores.Conclusions. A brief intervention designed to target cognitive-behavioural factors and promote adherence to pharmacotherapy in order to prevent depression relapse was highly successful in changing several behaviours related to controlling depression. Improvements in self-efficacy and several self-management behaviours that were targets of the intervention were significantly related to improvements in depression outcome.
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Lang, Junjie, Lairun Jin, and Yingshui Yao. "Comparative efficacy of interventions for reducing injection and sexual risk behaviours to prevent HIV in injection drug users: protocol for Bayesian network meta-analysis." BMJ Open 9, no. 1 (January 2019): e022811. http://dx.doi.org/10.1136/bmjopen-2018-022811.
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IntroductionDrug users are more vulnerable to AIDS than the general population. While several interventions are effective for addressing HIV in injection drug users, no meta-analysis has yet been performed to compare interventions and determine the relative benefits of each. We intend to conduct a Bayesian network meta-analysis to compare all available interventions evaluated by a randomised controlled trial for reducing injection and risky sexual behaviours for the prevention of HIV in injection drug users.Methods and analysisStudies will be retrieved by searching the following databases: MEDLINE, Embase, PsycINFO and Cochrane Central Register of Controlled Trials. The search will be performed between May and July 2018 for the literature published between 1980 and May 2018. Two authors will extract data independently. Primary outcome measures will be injection risk behaviour and HIV risk behaviour. HIV seroconversion, confirmed using an antibody test, will be the secondary outcome. Bayesian network meta-analyses will be conducted using the Markov Chains Monte Carlo method. The Cochrane revised tool, Risk of Bias, will be used to assess the risk of bias. Grading of Recommendations Assessment, Development and Evaluation will be used to assess evidence quality.Ethics and disseminationThe results of this study will be disseminated at professional conferences and via publications in peer-reviewed journals. This study will not include any confidential personal data or data on human trials; therefore, ethical approval is not required.PROSPERO registration numberCRD42018086999.
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Kinsman, Leigh, Rachel Tham, Julie Symons, Mike Jones, Stephen Campbell, and Ann Allenby. "Prevention of cardiovascular disease in rural Australian primary care: an exploratory study of the perspectives of clinicians and high-risk men." Australian Journal of Primary Health 22, no. 6 (2016): 510. http://dx.doi.org/10.1071/py15091.
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Rural primary care services have the potential to play a major role in reducing the gap in cardiovascular disease (CVD) outcomes between rural and metropolitan Australians, particularly in men at high risk of CVD. The aim of this study was to explore the self-reported behaviours and satisfaction with their general practice/practitioner of men at high risk of CVD, and attitudes of rural primary care clinicians regarding the role of primary care in CVD prevention. This observational research was addressed through survey questionnaires with rural men at high risk of CVD and semi-structured interviews with rural primary care clinicians. Fourteen rural primary care practices from towns with populations less than 25000 participated. One hundred and fifty-eight high-risk men completed the questionnaire. Their responses demonstrated poorly controlled risk factors despite a willingness to change. Alternatively, rural primary care clinicians (n=20) reported that patients were unlikely to change and that illness-based funding models inhibited cardiovascular preventive activities. Australians living in rural areas have worse CVD outcomes. In addition, there is a disparity in the assumptions of health providers and male patients at high risk of CVD in rural areas. This necessitates innovative rural primary care models that include a blended payment system that incentivises or funds preventive care alongside an emphasis on lifestyle advice, as well as an explicit strategy to influence clinician and patient behaviour to help address the disparity.
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Cooper, Christina, Monique Lhussier, Janet Shucksmith, and Susan Mary Carr. "Protocol for a realist review of complex interventions to prevent adolescents from engaging in multiple risk behaviours." BMJ Open 7, no. 9 (September 2017): e015477. http://dx.doi.org/10.1136/bmjopen-2016-015477.
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ObjectivesAdolescent risk behaviours are a key health concern. The purpose of this research is to gaina deeper understanding of how, why, for whom, and inwhat circumstances complex adolescent risk behaviourprevention programmes are most successful.Methods and analysisTo understand how adolescent risk behaviour prevention programmes work in a reallife context, a realist synthesis will be undertaken, operationalised in four phases.Phase oneDeveloping a framework to map the theoretical and conceptual landscape of adolescent risk behaviour prevention. Guided by stakeholder consultation.Phase twoFormulating initial programme theories through exploration of the literature, along with primary data from professional stakeholder interviews.Phase threeRefining programme theories through more purposeful, in depth screening of the literature, along with primary qualitative data, from young people and professionals. Data will be collected through semi structured focus groups, to explore specific elements of the emerging programme theories.Phase fourTesting programme theories through interviews with youth workers, following consultation with young people, using vignettes to explore the relationship between specific programme theories. This relatively novel method of primary and secondary data integration within a realist synthesis will provide deeper insight in to young peoples lived experience of risk behaviour prevention programmes, while maintaining transparency in the process of programme theory development.Data analysisA realist logic of analysis will be used to align data from each phase with context mechanism outcome configurations or specific elements thereof. Substantive theory will then be sought to understand and explain the findings.Ethics and disseminationThis study has been approved by the Ethics committee at Northumbria University, UK. Findings will be disseminated through knowledge exchange with stakeholders, publications in peer-reviewed journals, conference presentations, and formal and informal reports.
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Primiero, Clare A., Tatiane Yanes, Anna Finnane, H. Peter Soyer, and Aideen M. McInerney-Leo. "A Systematic Review on the Impact of Genetic Testing for Familial Melanoma I: Primary and Secondary Preventative Behaviours." Dermatology 237, no. 5 (2021): 806–15. http://dx.doi.org/10.1159/000513919.
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<b><i>Background:</i></b> Increasing availability of panel testing for known high-penetrance familial melanoma genes has made it possible to improve risk awareness in those at greatest risk. Prior to wider implementation, the role of genetic testing in preventing melanoma, through influencing primary and secondary preventative behaviours, requires clarification. <b><i>Methods:</i></b> Database searches of PubMed, Embase, CINAHL, PsycINFO and the Cochrane Library were conducted for studies describing preventative behaviour outcomes in response to genetic testing for melanoma risk. Publications describing original research of any study type were screened for eligibility. <b><i>Results:</i></b> Eighteen publications describing 11 unique studies were reviewed. Outcomes assessed are based on health behaviour recommendations for those at increased risk: adherence to sun-protective behaviour (SPB); clinical skin examinations (CSE); skin self-examinations (SSE); and family discussion of risk. Overall, modest increases in adherence to primary prevention strategies of SPB were observed following genetic testing. Importantly, there were no net decreases in SPB found amongst non-carriers. For secondary preventative behaviour outcomes, including CSE and SSE, increases in post-test intentions and long-term adherence were reported across several subgroups in approximately half of the studies. While this increase reached significance in mutation carriers in some studies, one study reported a significant decline in annual CSE adherence of non-mutation carriers. <b><i>Conclusions:</i></b> Evidence reviewed suggests that genetic testing has a modestly positive impact on preventative behaviour in high-risk individuals. Furthermore, improvements are observed regardless of mutation carrier status, although greater adherence is found in carriers. While additional studies of more diverse cohorts would be needed to inform clinical recommendations, the findings are encouraging and suggest that genetic testing for melanoma has a positive impact on preventative behaviours.
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Bellhouse, Sarah, Rhiannon E. Hawkes, Sacha J. Howell, Louise Gorman, and David P. French. "Breast Cancer Risk Assessment and Primary Prevention Advice in Primary Care: A Systematic Review of Provider Attitudes and Routine Behaviours." Cancers 13, no. 16 (August 18, 2021): 4150. http://dx.doi.org/10.3390/cancers13164150.
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Implementing risk-stratified breast cancer screening is being considered internationally. It has been suggested that primary care will need to take a role in delivering this service, including risk assessment and provision of primary prevention advice. This systematic review aimed to assess the acceptability of these tasks to primary care providers. Five databases were searched up to July–August 2020, yielding 29 eligible studies, of which 27 were narratively synthesised. The review was pre-registered (PROSPERO: CRD42020197676). Primary care providers report frequently collecting breast cancer family history information, but rarely using quantitative tools integrating additional risk factors. Primary care providers reported high levels of discomfort and low confidence with respect to risk-reducing medications although very few reported doubts about the evidence base underpinning their use. Insufficient education/training and perceived discomfort conducting both tasks were notable barriers. Primary care providers are more likely to accept an increased role in breast cancer risk assessment than advising on risk-reducing medications. To realise the benefits of risk-based screening and prevention at a population level, primary care will need to proactively assess breast cancer risk and advise on risk-reducing medications. To facilitate this, adaptations to infrastructure such as integrated tools are necessary in addition to provision of education.
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Hendriksen, Ellen Setsuko, A. K. Sri Krishnan, Snigda Vallabhaneni, Sethu Johnson, Sudha Raminani, N. Kumarasamy, Suniti Solomon, Kenneth K. H. Mayer, and Steven S. Safren. "Primary prevention lessons learned from those with HIV in Chennai, India." Sexual Health 8, no. 2 (2011): 199. http://dx.doi.org/10.1071/sh10015.
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Background As each HIV-infected individual represents a breakdown of HIV primary prevention measures, formative data from representative individuals living with HIV can help shape future primary prevention interventions. Little is known about sexual behaviours and other transmission risk factors of high-risk group members who are already HIV-infected in Chennai, India. Methods: Semi-structured qualitative interviews were conducted with 27 HIV-infected individuals representing each high-risk group in Chennai (five men who have sex with men (MSM), five female commercial sex workers (CSW), four truckers and other men who travel for business, four injecting drug users (IDU), five married male clients of CSW, and four wives of CSW clients, MSM, truckers, and IDU). Results: Themes relevant to HIV primary prevention included: (1) HIV diagnosis as the entry into HIV education and risk reduction, (2) reluctance to undergo voluntary counselling and testing, (3) gender and sexual roles as determinants of condom use, (4) misconceptions about HIV transmission, and (5) framing and accessibility of HIV education messages. Conclusions: These qualitative data can be used to develop hypotheses about sexual risk taking in HIV-infected individuals in South India, inform primary prevention intervention programs, and improve primary prevention efforts overall.
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Krasnoselskikh, T. V., and A. V. Shaboltas. "MULTIDISCIPLINARY APPROACH TO THE PREVENTION OF SEXUALLY TRANSMITTED INFECTIONS AND BLOOD-BORNE INFECTIONS." HIV Infection and Immunosuppressive Disorders 10, no. 4 (January 16, 2019): 100–112. http://dx.doi.org/10.22328/2077-9828-2018-10-4-100-112.
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Until recently in Russia the general methodology for the prevention of sexually transmitted infections (STIs) including HIV-infection and blood-borne infections (BBI) has not been developed and targeted preventive interventions aimed at vulnerable populations have not been applied. As a rule, domestic researchers have been confined to detailed analysis of epidemiological data on the prevalence of STIs and other socially significant diseases in general population and their clinical features without offering social prevention technologies. Meanwhile, a large number of scientific researches aimed at improving the prevention strategies for STI/BBI and comprehensive preventive programs combining biomedical and behavioral components are being carried out all over the world. Unfortunately, preventive programs developed abroad cannot be mechanically introduced into the practice of Russian health care system. The programs should be adapted and implemented in the context of the socioeconomic and cultural uniqueness of Russia. The current epidemic situation necessitates switching from secondary and tertiary STI/BBI prevention and traditional biomedical approach to primary prevention and multidisciplinary approach. The multidisciplinary approach to healthy life style promotion and prevention of self-destructive behaviors including alcohol and drug use and risky sexual practices is a new branch of medicine. The presented article is aimed to analyze theoretical, methodological and practical aspects of the development, implementation and effectiveness evaluation of behavioral preventive interventions focused on socially significant infections.
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Pratt, D., N. Tarrier, G. Dunn, Y. Awenat, J. Shaw, F. Ulph, and P. Gooding. "Cognitive–behavioural suicide prevention for male prisoners: a pilot randomized controlled trial." Psychological Medicine 45, no. 16 (July 13, 2015): 3441–51. http://dx.doi.org/10.1017/s0033291715001348.
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Background.Prisoners have an exceptional risk of suicide. Cognitive–behavioural therapy for suicidal behaviour has been shown to offer considerable potential, but has yet to be formally evaluated within prisons. This study investigated the feasibility of delivering and evaluating a novel, manualized cognitive–behavioural suicide prevention (CBSP) therapy for suicidal male prisoners.Method.A pilot randomized controlled trial of CBSP in addition to treatment as usual (CBSP; n = 31) compared with treatment as usual (TAU; n = 31) alone was conducted in a male prison in England. The primary outcome was self-injurious behaviour occurring within the past 6 months. Secondary outcomes were dimensions of suicidal ideation, psychiatric symptomatology, personality dysfunction and psychological determinants of suicide, including depression and hopelessness. The trial was prospectively registered (number ISRCTN59909209).Results.Relative to TAU, participants receiving CBSP therapy achieved a significantly greater reduction in suicidal behaviours with a moderate treatment effect [Cohen's d = −0.72, 95% confidence interval −1.71 to 0.09; baseline mean TAU: 1.39 (s.d. = 3.28) v. CBSP: 1.06 (s.d. = 2.10), 6 months mean TAU: 1.48 (s.d. = 3.23) v. CBSP: 0.58 (s.d. = 1.52)]. Significant improvements were achieved on measures of psychiatric symptomatology and personality dysfunction. Improvements on psychological determinants of suicide were non-significant. More than half of the participants in the CBSP group achieved a clinically significant recovery by the end of therapy, compared with a quarter of the TAU group.Conclusions.The delivery and evaluation of CBSP therapy within a prison is feasible. CBSP therapy offers significant promise in the prevention of prison suicide and an adequately powered randomized controlled trial is warranted.
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Flowers, Paul, Olivia Wu, Karen Lorimer, Bipasha Ahmed, Hannah Hesselgreaves, Jennifer MacDonald, Sandi Cayless, et al. "The clinical effectiveness of individual behaviour change interventions to reduce risky sexual behaviour after a negative human immunodeficiency virus test in men who have sex with men: systematic and realist reviews and intervention development." Health Technology Assessment 21, no. 5 (January 2017): 1–164. http://dx.doi.org/10.3310/hta21050.
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AbstractBackgroundMen who have sex with men (MSM) experience significant inequalities in health and well-being. They are the group in the UK at the highest risk of acquiring a human immunodeficiency virus (HIV) infection. Guidance relating to both HIV infection prevention, in general, and individual-level behaviour change interventions, in particular, is very limited.ObjectivesTo conduct an evidence synthesis of the clinical effectiveness of behaviour change interventions to reduce risky sexual behaviour among MSM after a negative HIV infection test. To identify effective components within interventions in reducing HIV risk-related behaviours and develop a candidate intervention. To host expert events addressing the implementation and optimisation of a candidate intervention.Data sourcesAll major electronic databases (British Education Index, BioMed Central, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Educational Resource Index and Abstracts, Health and Medical Complete, MEDLINE, PsycARTICLES, PsycINFO, PubMed and Social Science Citation Index) were searched between January 2000 and December 2014.Review methodsA systematic review of the clinical effectiveness of individual behaviour change interventions was conducted. Interventions were examined using the behaviour change technique (BCT) taxonomy, theory coding assessment, mode of delivery and proximity to HIV infection testing. Data were summarised in narrative review and, when appropriate, meta-analysis was carried out. Supplemental analyses for the development of the candidate intervention focused on post hoc realist review method, the assessment of the sequential delivery and content of intervention components, and the social and historical context of primary studies. Expert panels reviewed the candidate intervention for issues of implementation and optimisation.ResultsOverall, trials included in this review (n = 10) demonstrated that individual-level behaviour change interventions are effective in reducing key HIV infection risk-related behaviours. However, there was considerable clinical and methodological heterogeneity among the trials. Exploratory meta-analysis showed a statistically significant reduction in behaviours associated with high risk of HIV transmission (risk ratio 0.75, 95% confidence interval 0.62 to 0.91). Additional stratified analyses suggested that effectiveness may be enhanced through face-to-face contact immediately after testing, and that theory-based content and BCTs drawn from ‘goals and planning’ and ‘identity’ groups are important. All evidence collated in the review was synthesised to develop a candidate intervention. Experts highlighted overall acceptability of the intervention and outlined key ways that the candidate intervention could be optimised to enhance UK implementation.LimitationsThere was a limited number of primary studies. All were from outside the UK and were subject to considerable clinical, methodological and statistical heterogeneity. The findings of the meta-analysis must therefore be treated with caution. The lack of detailed intervention manuals limited the assessment of intervention content, delivery and fidelity.ConclusionsEvidence regarding the effectiveness of behaviour change interventions suggests that they are effective in changing behaviour associated with HIV transmission. Exploratory stratified meta-analyses suggested that interventions should be delivered face to face and immediately after testing. There are uncertainties around the generalisability of these findings to the UK setting. However, UK experts found the intervention acceptable and provided ways of optimising the candidate intervention.Future workThere is a need for well-designed, UK-based trials of individual behaviour change interventions that clearly articulate intervention content and demonstrate intervention fidelity.Study registrationThe study is registered as PROSPERO CRD42014009500.FundingThe National Institute for Health Research Health Technology Assessment programme.
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Suntornsut, Pornpan, Prapit Teparrukkul, Gumphol Wongsuvan, Wipada Chaowagul, Susan Michie, Nicholas P. J. Day, and Direk Limmathurotsakul. "Effectiveness of a multifaceted prevention programme for melioidosis in diabetics (PREMEL): A stepped-wedge cluster-randomised controlled trial." PLOS Neglected Tropical Diseases 15, no. 6 (June 25, 2021): e0009060. http://dx.doi.org/10.1371/journal.pntd.0009060.
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Background Melioidosis, an often-fatal infectious disease caused by the environmental Gram-negative bacillus Burkholderia pseudomallei, is endemic in tropical countries. Diabetes mellitus and environmental exposure are important risk factors for melioidosis acquisition. We aim to evaluate the effectiveness of a multifaceted prevention programme for melioidosis in diabetics in northeast Thailand. Methodology/Principal findings From April 2014 to December 2018, we conducted a stepped-wedge cluster-randomized controlled behaviour change trial in 116 primary care units (PCUs) in Ubon Ratchathani province, northeast Thailand. The intervention was a behavioural support group session to help diabetic patients adopt recommended behaviours, including wearing rubber boots and drinking boiled water. We randomly allocated the PCUs to receive the intervention starting in March 2016, 2017 and 2018. All diabetic patients were contacted by phone yearly, and the final follow-up was December 2018. Two primary outcomes were hospital admissions involving infectious diseases and culture-confirmed melioidosis. Of 9,056 diabetics enrolled, 6,544 (72%) received a behavioural support group session. During 38,457 person-years of follow-up, we observed 2,195 (24%) patients having 3,335 hospital admissions involved infectious diseases, 80 (0.8%) melioidosis, and 485 (5%) deaths. In the intention-to-treat analysis, implementation of the intervention was not associated with primary outcomes. In the per-protocol analysis, patients who received a behavioural support group session had lower incidence rates of hospital admissions involving infectious diseases (incidence rate ratio [IRR] 0.89; 95%CI 0.80–0.99, p = 0.03) and of all-cause mortality (IRR 0.54; 95%CI 0.43–0.68, p<0.001). However, the incidence rate of culture-confirmed melioidosis was not significantly lower (IRR 0.96, 95%CI 0.46–1.99, p = 0.66). Conclusions/Significance Clear benefits of this multifaceted prevention programme for melioidosis were not observed. More compelling invitations for the intervention, modification of or addition to the behaviour change techniques used, and more frequent intervention may be needed. Trial registration This trial is registered with ClinicalTrials.gov, number NCT02089152.
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Baum, Fran, and Matthew Fisher. "Are the national preventive health initiatives likely to reduce health inequities?" Australian Journal of Primary Health 17, no. 4 (2011): 320. http://dx.doi.org/10.1071/py11041.
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This paper examines commitments to address health inequities within current (2008–11) Australian government initiatives on health promotion and chronic disease prevention. Specifically, the paper considers: the Council of Australian Governments’ ‘National partnership agreement on preventive health’; the National Preventative Health Taskforce report, ‘Australia: the healthiest country by 2020’; and the Australian Government’s response to the taskforce report, ‘Taking preventative action’. Arising from these is the recent establishment of the Australian National Preventive Health Agency. Together, these measures represent a substantial public investment in health promotion and disease prevention. The present paper finds that these initiatives clearly acknowledge significantly worse health outcomes for those subject to social or economic disadvantage, and contain measures aimed to improve health outcomes among Indigenous people and those in low socioeconomic status communities. However, we argue that, as a whole, these initiatives have (thus far) largely missed an opportunity to develop a whole of government approach to health promotion able to address upstream social determinants of health and health inequities in Australia. In particular, they are limited by a primary focus on individual health behaviours as risk factors for chronic disease, with too little attention on the wider socioeconomic and cultural factors that drive behaviours, and so disease outcomes, in populations.
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Olstad, Dana Lee, and Linda McCargar. "Prevention of overweight and obesity in children under the age of 6 yearsA report commissioned by the Canadian Council of Food and Nutrition." Applied Physiology, Nutrition, and Metabolism 34, no. 4 (August 2009): 551–70. http://dx.doi.org/10.1139/h09-016.
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Although obesity was rarely observed among children 30 years ago, it is now evident among Canadian children of all ages. Currently, 15.2% of 2- to 5-year-old children are overweight, whereas 6.3% are obese. Limited data suggest that poor dietary and physical activity patterns are increasing obesity risk among these young children. Body weight and lifestyle behaviours are known to track from childhood to adulthood, thereby increasing the risk for obesity and other chronic diseases later in life. Intrauterine life, infancy, and the preschool years may all include critical periods that program the long-term regulation of energy balance, and therefore obesity-prevention strategies should be initiated in utero and continue throughout childhood and adolescence. Although single-strategy obesity-prevention initiatives have had limited success, programs that target multiple behaviours may help reduce body weight and body fat among young children. Parental involvement is key to the success of obesity-prevention programs at a young age, as parents have primary control over their children’s food and activity environments. Accordingly, parental obesity is the best predictor of childhood obesity. Parents should be encouraged to teach and role model healthy lifestyle behaviours for their young children. Health professionals can also be involved in obesity prevention, as they are ideally placed to identify young children at risk for obesity. By calculating and plotting the body mass index for all children, and initiating obesity-prevention strategies in utero, health professionals can help curb the rise in overweight and obesity among young children.
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Oldenburg, Brian. "Health Promotion and Disease Prevention in the Primary Health Care Setting: Setting the Scene." Behaviour Change 11, no. 3 (September 1994): 129–31. http://dx.doi.org/10.1017/s0813483900005027.
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Last (1983) defines public health as: the efforts organised by society to protect, promote and restore the public's health. It is the combination of sciences, skills and beliefs that are directed to the maintenance and improvement of the health of all people through collective or social actions. The programs, services and institutions involved emphasise the prevention of disease and the health needs of the population as a whole. Public health activities change with changing technology and values, but the goals remain the same: to reduce the amount of disease, premature death and disability in the population. (p.45)Recommended goals and targets for addressing national public health problems and directed at reducing the amount of death and premature death have been proposed in many countries over the past 10 years, including the United States of America (United States Department of Health and Human Services, 1990), the United Kingdom (Department of Health, 1992), Canada (Ontario Premiers' Council on Health, 1987) and Australia (Nutbeam, Wise, Bauman, Harris, & Leeder, 1993). In Australia for example, over the past 2 years, much attention has been directed at health outcomes related to cardiovascular disease, cancers, accidents and injuries and mental health. All of these reports have emphasised the importance of changing those lifestyle and related risk factors associated with preventable causes of death. Priority lifestyle areas that have been identified include physical inactivity, diet and nutrition, smoking, alcohol and other drug use, safety behaviours, sun protective behaviours, appropriate use of medicines, immunisation, sexuality and reproductive health, oral hygiene, and mental health. Priority populations and appropriate settings for intervening in these areas have also been identified.
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Pankonin, Christopher A. "Sharing Common Principles: Blending the Primary Health Care and Harm Reduction Paradigms to Meet Common Health Goals in HIV/AIDS Prevention." Australian Journal of Primary Health 12, no. 3 (2006): 34. http://dx.doi.org/10.1071/py06043.
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HIV/AIDS continues to spread globally and deeply affecting resource-poor settings, with over 90% of cases occurring in developing countries. In these areas, primary health care remains the preferred model of health care delivery; advocating core principles including community involvement, equity, and an emphasis on disease prevention while providing basic medical treatment. The harm reduction paradigm shares key principles with primary health care, and as this paper will argue, a combined comprehensive HIV prevention strategy would provide a holistic and particularly effective approach to HIV prevention. The most important improvement achieved through a combined HIV prevention strategy is by providing the community with an increased number of social services including housing and employment services, financial counselling, mental health counselling, and referrals to additional medical services. In also addressing the social determinants of health, a combined primary health care and harm reduction approach act to provide a holistic disease prevention strategy that also seeks to address the conditions that lead to increased risk-taking behaviours. Additional evidence indicating a successful comprehensive prevention strategy remains closely tied to measures of effectiveness, including improvements in HIV prevalence and incidence rates, needle and syringe coverage, and treatment services for HIV/AIDS patients.
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Stone, Rebecca, Yunmi Chung, and Benjamin Ansa. "Syphilis Trends in the Central Savannah River Area (CSRA) of Georgia and South Carolina, USA." Journal of Clinical Medicine 7, no. 8 (July 31, 2018): 190. http://dx.doi.org/10.3390/jcm7080190.
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There has been an alarming resurgence of early syphilis since 2000, especially in the southeast region, which has one of the highest rates of primary and secondary syphilis in the United States of America (USA). Although the Central Savannah River Area (CSRA) is the second most populous area in Georgia with a large presence of health care facilities, its counties have one of the lowest overall rankings in health outcomes. This study examined the syphilis rates and trends in the CSRA. Data from the Centers for Disease Control and Prevention (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention’s AtlasPlus was used. Cases of primary and secondary syphilis diagnosed during 2010–2015 were analyzed to describe reported syphilis among CSRA residents. In the CSRA, between 2010 and 2015, the incidence rate of primary and secondary syphilis increased from 5.9 to 9.4 cases per 100,000 population. The lowest rate of syphilis was observed in 2011 (2.7 cases per 100,000) and the highest rate in 2015. In 2015, the highest syphilis rates were observed among males (15.9 per 100,000), non-Hispanic blacks (16.9 per 100,000), and persons between the ages 20–24 years (34.5 per 100,000). The relevance of preventive measures has been widely communicated, yet it is clear that risk-taking sexual behavior is on the rise. Greater effort is warranted to reduce risky behaviors that promote the transmission of syphilis, including areas outside of major metropolitan areas.
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Fernández-Montalvo, Javier, María Alicia Peñalva-Vélez, and Itziar Irazabal. "Internet Use Habits and Risk Behaviours in Preadolescence." Comunicar 22, no. 44 (January 1, 2015): 113–21. http://dx.doi.org/10.3916/c44-2015-12.
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A striking increase in the use of new information and communication technology has come about in recent years. This study analysed the characteristics and habits of Internet use in a sample of pre-adolescents between 10 and 13 years of age, enrolled in the 6th grade of primary school in Navarra (Spain). Likewise, the existence of differential patterns in Internet use by sex was analysed, and risk behaviours were detected. The sample was composed of 364 students (206 boys and 158 girls) who were evaluated at their schools. Information about socio-demographic characteristics, Internet use habits, and online behaviours was collected using a data-gathering tool specifically designed for the study. The results demonstrated high Internet use by the adolescents studied. Girls used the Internet more for social relationships, whereas boys tended to use it differently, including accessing online games. Moreover, some risky behaviours were found, including interactions with strangers, giving out personal information, and sending photos and videos. Likewise, behaviours associated with «cyber-bullying» were detected. These results indicate the necessity of establishing prevention programs for safe and responsible Internet use. En los últimos años se ha producido un aumento espectacular del uso de las nuevas tecnologías de la información y de la comunicación. En este estudio se analizaron las características y el patrón del uso de Internet en una muestra de preadolescentes de entre 10 y 13 años, que cursan 6º curso de Educación Primaria en Navarra (España). Asimismo, se analizó la existencia de un perfil diferencial en el uso de Internet en función del sexo y se detectó la existencia de conductas de riesgo. La muestra estaba compuesta por 364 estudiantes (206 chicos y 158 chicas), que fueron evaluados en sus centros educativos. Se recogió información sobre las características sociodemográficas, los hábitos de uso de Internet y los comportamientos desarrollados en la Red a través de un instrumento de recogida de datos diseñado específicamente para la investigación. Los resultados mostraron un uso elevado de Internet por parte de los adolescentes estudiados. Las chicas usaban más Internet para las relaciones sociales, mientras que los chicos tendían a darle otro tipo de usos, como el acceso a juegos online. Además, se encontraron algunas conductas de riesgo, como quedar con desconocidos, dar datos personales o enviar fotos y vídeos. Asimismo, se encontraron comportamientos relacionados con el «ciberbullying». Estos resultados indican la necesidad de establecer programas de prevención para el uso seguro y responsable de Internet.
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Jordans, M., S. Rathod, A. Fekadu, G. Medhin, F. Kigozi, B. Kohrt, N. Luitel, et al. "Suicidal ideation and behaviour among community and health care seeking populations in five low- and middle-income countries: a cross-sectional study." Epidemiology and Psychiatric Sciences 27, no. 4 (February 16, 2017): 393–402. http://dx.doi.org/10.1017/s2045796017000038.
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AimsSuicidal behaviour is an under-reported and hidden cause of death in most low- and middle-income countries (LMIC) due to lack of national systematic reporting for cause-specific mortality, high levels of stigma and religious or cultural sanctions. The lack of information on non-fatal suicidal behaviour (ideation, plans and attempts) in LMIC is a major barrier to design and implementation of prevention strategies. This study aims to determine the prevalence of non-fatal suicidal behaviour within community- and health facility-based populations in LMIC.MethodsTwelve-month prevalence of suicidal ideation, plans and attempts were established through community samples (n = 6689) and primary care attendees (n = 6470) from districts in Ethiopia, Uganda, South Africa, India and Nepal using the Composite International Diagnostic Interview suicidality module. Participants were also screened for depression and alcohol use disorder.ResultsWe found that one out of ten persons (10.3%) presenting at primary care facilities reported suicidal ideation within the past year, and 1 out of 45 (2.2%) reported attempting suicide in the same period. The range of suicidal ideation was 3.5–11.1% in community samples and 5.0–14.8% in health facility samples. A higher proportion of facility attendees reported suicidal ideation than community residents (10.3 and 8.1%, respectively). Adults in the South African facilities were most likely to endorse suicidal ideation (14.8%), planning (9.5%) and attempts (7.4%). Risk profiles associated with suicidal behaviour (i.e. being female, younger age, current mental disorders and lower educational and economic status) were highly consistent across countries.ConclusionThe high prevalence of suicidal ideation in primary care points towards important opportunities to implement suicide risk reduction initiatives. Evidence-supported strategies including screening and treatment of depression in primary care can be implemented through the World Health Organization's mental health Global Action Programme suicide prevention and depression treatment guidelines. Suicidal ideation and behaviours in the community sample will require detection strategies to identify at risks persons not presenting to health facilities.
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Gallagher, Robyn, Clara Chow, Helen Parker, Lis Neubeck, David Celermajer, Julie Redfern, Geoffrey Tofler, et al. "Design and rationale of the MyHeartMate study: a randomised controlled trial of a game-based app to promote behaviour change in patients with cardiovascular disease." BMJ Open 9, no. 5 (May 2019): e024269. http://dx.doi.org/10.1136/bmjopen-2018-024269.
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IntroductionRecurrence of cardiac events is common after a first event, leading to hospitalisations and increased health burden. Patients have difficulties achieving the lifestyle changes required for secondary prevention and access to secondary prevention programs is limited. This study aims to evaluate the impact of a game-based mobile app, MyHeartMate, which is designed to motivate engagement in secondary prevention behaviours for cardiovascular risk factors.Methods and analysisThe MyHeartMate study is a randomised controlled trial with 6-month follow-up and blinded assessment of the primary outcome. Participants (n=394) with coronary heart disease will be recruited from hospitals in metropolitan Sydney and randomly allocated to standard care or the MyHeartMate app intervention. The intervention group will receive the app, which uses game techniques to promote engagement and lifestyle behaviour change for secondary prevention. The primary outcome is difference between the groups in physical activity (metabolic equivalent of task minutes/week) at 6 months. Secondary outcomes include change in low-density lipoprotein cholesterol, systolic blood pressure, medication adherence, body mass index, waist circumference, mood and dietary changes at 6 months. Data on app engagement, and patient perspectives of usability and acceptability, will also be analysed.Ethics and disseminationThe study has received ethics approval from Northern Sydney Local Health District Human Research Ethics Committee. The study findings will be disseminated via peer-reviewed publications and presentation at international scientific meetings/conferences.Trial registration numberACTRN12617000869370; Pre-results.
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Barden, Craig, Keith A. Stokes, and Carly D. McKay. "Utilising a Behaviour Change Model to Improve Implementation of the Activate Injury Prevention Exercise Programme in Schoolboy Rugby Union." International Journal of Environmental Research and Public Health 18, no. 11 (May 26, 2021): 5681. http://dx.doi.org/10.3390/ijerph18115681.
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The Health Action Process Approach (HAPA) is a behaviour change model showing promise in positively changing youth sport coaches’ injury prevention behaviours. This study incorporated the HAPA model into coach training workshops for Activate, an efficacious rugby injury prevention programme. Primary aims were to investigate the effect of the workshop on schoolboy rugby union coaches’ (1) perceptions towards injury risk and prevention, (2) Activate adoption and adherence. Secondary aims were to (3) assess the differences in post-season HAPA constructs between workshop attendees and non-attendees, (4) explore associations between HAPA constructs and Activate adherence. In the pre-season, all participants (n = 76) completed a baseline survey, with 41 coaches electing to attend a workshop. Participants completed a post-season survey assessing HAPA constructs and Activate adoption and adherence throughout the season. The workshop did not affect coach perceptions of injury risk and prevention. Attendees had significantly greater rates of Activate adoption (95% vs. 54% χ2 = 17.42, p < 0.01) and adherence (median = 2 sessions vs. ≤1 session per week; z = 3.45, p = 0.03) than non-attendees. At post-season, attendees had significantly greater task self-efficacy (z = −3.46, p < 0.05) and intention (z = −4.33, p < 0.05) to use Activate. These results support the delivery of coach workshops that utilise a behaviour change model to maximise programme implementation.
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Hay, Phillipa, and Deborah Mitchison. "Eating Disorders and Obesity: The Challenge for Our Times." Nutrients 11, no. 5 (May 11, 2019): 1055. http://dx.doi.org/10.3390/nu11051055.
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Public health concerns largely have disregarded the important overlap between eating disorders and obesity. This Special Issue addresses this neglect and points to how progress can be made in preventing and treating both. Thirteen primary research papers, three reviews, and two commentaries comprise this Special Issue. Two commentaries set the scene, noting the need for an integrated approach to prevention and treatment. The empirical papers and reviews fall into four broad areas of research: first, an understanding of the neuroscience of eating behaviours and body weight; second, relationships between disordered eating and obesity risk; third, new and integrated approaches in treatment; and fourth, assessment. Collectively, the papers highlight progress in science, translational research, and future research directions.
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Teesson, Maree, Katrina E. Champion, Nicola C. Newton, Frances Kay-Lambkin, Cath Chapman, Louise Thornton, Tim Slade, et al. "Study protocol of the Health4Life initiative: a cluster randomised controlled trial of an eHealth school-based program targeting multiple lifestyle risk behaviours among young Australians." BMJ Open 10, no. 7 (July 2020): e035662. http://dx.doi.org/10.1136/bmjopen-2019-035662.
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IntroductionLifestyle risk behaviours, including alcohol use, smoking, poor diet, physical inactivity, poor sleep (duration and/or quality) and sedentary recreational screen time (‘the Big 6’), are strong determinants of chronic disease. These behaviours often emerge during adolescence and co-occur. School-based interventions have the potential to address risk factors prior to the onset of disease, yet few eHealth school-based interventions target multiple behaviours concurrently. This paper describes the protocol of the Health4Life Initiative, an eHealth school-based intervention that concurrently addresses the Big 6 risk behaviours among secondary school students.Methods and analysisA multisite cluster randomised controlled trial will be conducted among year 7 students (11–13 years old) from 72 Australian schools. Stratified block randomisation will be used to assign schools to either the Health4Life intervention or an active control (health education as usual). Health4Life consists of (1) six web-based cartoon modules and accompanying activities delivered during health education (once per week for 6 weeks), and a smartphone application (universal prevention), and (2) additional app content, for students engaging in two or more risk behaviours when they are in years 8 and 9 (selective prevention). Students will complete online self-report questionnaires at baseline, post intervention, and 12, 24 and 36 months after baseline. Primary outcomes are consumption of sugar-sweetened beverages, moderate-to-vigorous physical activity, sleep duration, sedentary recreational screen time and uptake of alcohol and tobacco use.Ethics and disseminationThis study has been approved by the University of Sydney (2018/882), NSW Department of Education (SERAP no. 2019006), University of Queensland (2019000037), Curtin University (HRE2019-0083) and relevant Catholic school committees. Results will be presented to schools and findings disseminated via peer-reviewed journals and scientific conferences. This will be the first evaluation of an eHealth intervention, spanning both universal and selective prevention, to simultaneously target six key lifestyle risk factors among adolescents.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12619000431123), 18 March 2019.
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Direito, Artur, Jonathan Rawstorn, Jacqueline Mair, Reza Daryabeygi-Khotbehsara, Ralph Maddison, and E. Shyong Tai. "Multifactorial e- and mHealth interventions for cardiovascular disease primary prevention: Protocol for a systematic review and meta-analysis of randomised controlled trials." DIGITAL HEALTH 5 (January 2019): 205520761989048. http://dx.doi.org/10.1177/2055207619890480.
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Objective Cardiovascular diseases (CVD) are a leading cause of mortality and disease burden. Preventative interventions to augment the population-level adoption of health lifestyle behaviours that reduce CVD risk are a priority. Face-to-face interventions afford individualisation and are effective for improving health-related behaviours and outcomes, but they are costly and resource intensive. Electronic and mobile health (e- and mHealth) approaches aimed at modifying lifestyle risk factors may be an effective and scalable approach to reach many individuals while preserving individualisation. This systematic review aims to (a) determine the effectiveness of multifactorial e- and mHealth interventions on CVD risk and on lifestyle-related cardiometabolic risk factors and self-management behaviours among adults without CVD; and (b) describe the evidence on adverse events and on the cost-effectiveness of these interventions. Methods Methods were detailed prior to the start of the review in order to improve conduct and prevent inconsistent decision making throughout the review. This protocol was prepared following the PRISMA-P 2015 statement. MEDLINE, CINAHL, Embase, PsycINFO, Web of Science, Cochrane Public Health Group Specialised Register and CENTRAL electronic databases will be searched between 1991 and September 2019. Eligibility criteria are: (a) population: community-dwelling adults; (b) intervention/comparison: randomised controlled trials comparing e- or mHealth CVD risk preventative interventions with usual care; and (c) outcomes: modifiable CVD risk factors. Selection of study reports will involve two authors independently screening titles and abstracts, followed by a full-text review of potentially eligible reports. Two authors will independently undertake data extraction and assess risk of bias. Where appropriate, meta-analysis of outcome data will be performed. Discussion This protocol describes the pre-specified methods for a systematic review that will provide quantitative and narrative syntheses of current multifactorial e- and mHealth CVD preventative interventions. A systematic review and meta-analysis will be conducted following the methods outlined in the Cochrane Handbook for Systematic Reviews of Interventions and reported according to PRISMA guidelines.
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Baxter, Amanda J., Meredith G. Harris, Yasmin Khatib, Traolach S. Brugha, Heidrun Bien, and Kamaldeep Bhui. "Reducing excess mortality due to chronic disease in people with severe mental illness: Meta-review of health interventions." British Journal of Psychiatry 208, no. 4 (April 2016): 322–29. http://dx.doi.org/10.1192/bjp.bp.115.163170.
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BackgroundPeople with severe mental illness (SMI) have high rates of chronic disease and premature death.AimsTo explore the strength of evidence for interventions to reduce risk of mortality in people with SMI.MethodIn a meta-review of 16 systematic reviews of controlled studies, mortality was the primary outcome (8 reviews). Physiological health measures (body mass index, weight, glucose levels, lipid profiles and blood pressure) were secondary outcomes (14 reviews).ResultsAntipsychotic and antidepressant medications had some protective effect on mortality, subject to treatment adherence. Integrative community care programmes may reduce physical morbidity and excess deaths, but the effective ingredients are unknown. Interventions to improve unhealthy lifestyles and risky behaviours can improve risk factor profiles, but longer follow-up is needed. Preventive interventions and improved medical care for comorbid chronic disease may reduce excess mortality, but data are lacking.ConclusionsImproved adherence to pharmacological and physical health management guidelines is indicated.
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Pulimeno, Manuela, Prisco Piscitelli, Salvatore Colazzo, Annamaria Colao, and Alessandro Miani. "School as ideal setting to promote health and wellbeing among young people." Health Promotion Perspectives 10, no. 4 (November 7, 2020): 316–24. http://dx.doi.org/10.34172/hpp.2020.50.
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Background: Nowadays, young people face several health challenges. As children and teenagers spend most of their time in the classroom, schools may have the opportunity to positively influence students’ quality of life, playing a crucial role in fostering their health. The aim of this review was to analyze evidence that demonstrated why school is the ideal setting for thepromotion of young generations’ wellbeing. Methods: We have reviewed the available literature about health promotion in school setting, searching for articles and books published from 1977 to 2020. A total of 74 articles and 17books were selected and assessed. Results: The promotion of students’ wellbeing could reduce the prevalence of measurable unhealthy outcomes and improve their academic achievements. At least 80% of all cases of heart diseases, strokes, type 2 diabetes and one third of all cancers can be prevented through health education. In this perspective, primary prevention and health promotion should start as early as possible, finding in the school the ideal setting of action. Effective school-based preventive approaches should raise students’ motivation towards a personal interiorization of health knowledge and develop in young people a critical thinking about harmful consequences of the most common risky behaviours. Educators should receive adequate training concerning health topics and become expert in the most innovative approaches to effectively engage students in adopting healthy lifestyles. Conclusion: As primary educational institution, school should integrate students’ health promotion in its ordinary teaching and learning practices in the perspective of "better health through better schools".
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Lussier, Patrick, Stacy Tzoumakis, Jay Healey, Ray Corrado, and Pratibha Reebye. "PRE/PERINATAL ADVERSITIES AND BEHAVIOURAL OUTCOMES IN EARLY CHILDHOOD: PRELIMINARY FINDINGS FROM THE VANCOUVER LONGITUDINAL STUDY." International Journal of Child, Youth and Family Studies 2, no. 1/2 (January 31, 2011): 36. http://dx.doi.org/10.18357/ijcyfs21/220115426.
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Several pre/perinatal factors (e.g., birth complications, maternal substance use, low birth weight) have been associated with early neuropsychological deficits and negative behavioural outcomes in infancy, childhood, and adolescence. The current study examines the relationship between maternal substance use during pregnancy and its impact on physical aggression and sexual behaviours in a sample of preschoolers. This study is based on a sample of children (<em>n</em> = 129), boys and girls, recruited as part of the KD-BEAR project, an ongoing longitudinal study conducted in Vancouver, British Columbia, Canada. The sample consisted of clinical referrals for an externalizing disorder and children recruited in daycares located in at-risk neighbourhoods. Semi-structured interviews were completed with the primary caregiver. A series of structural equation modelling showed that children showing higher levels of physical aggression and sexual behaviours were more likely to have been exposed to maternal substance use and pregnancy-related complications. Implications of the study are discussed in light of the scientific literature on the early prevention of aggression and violence.
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Miligi, Lucia. "Ultraviolet Radiation Exposure: Some Observations and Considerations, Focusing on Some Italian Experiences, on Cancer Risk, and Primary Prevention." Environments 7, no. 2 (January 22, 2020): 10. http://dx.doi.org/10.3390/environments7020010.
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Solar ultraviolet radiation may cause acute and chronic health effects on the skin, eyes, and also on the immune system. Actinic keratosis, non-melanoma skin cancers, and malignant melanoma are the main long-term adverse skin effects. In the white population, the most common type of cancer worldwide is skin cancer, and the incidence of this cancer has increased during the last decades. The most important risk factor responsible for this trend seems to be Ultraviolet Radiation (UVR). IARC has classified UVR as being carcinogenic to humans. UV radiation exposure is ubiquitous; to study skin cancer risk, it is important to take into account the fact that UV exposure may occur both for occupational activities but also during vacation or recreational activities. Furthermore, exposure to artificial UVR such as those emitted by artificial devices, classified by IARC as carcinogenic to humans, is also to be considered. Due to the prominent role of UVR, primary prevention of skin cancer is very suitable, because when following specific rules this risk factor can be reduced. The incidence rate of skin cancer is higher in people with fair skin. Outdoor workers exposed to solar UVR are at risk of developing skin cancer, particularly non-melanoma skin cancers, and welders exposed to artificial UVR are at risk of developing ocular melanoma. A specific project on solar UVR risk in outdoor workers in Tuscany, Italy, has shown that outdoor workers had an unsatisfactory sun protection behaviour. The project demonstrates the complexity of studying UVR exposure and recommended the need for prevention programs. Risk increases with increasing ambient solar radiation and with unsafe behaviours in the sun or when using artificial UVR (e.g., sunbeds). Effective prevention strategies have to be adopted both for the outdoor workers and for the general population exposed to UVR. A standardized program of proven efficacy, such as that implemented in Australia, should also be implemented in other countries. All these strategies could contribute to the aim of decreasing the morbidity and mortality of cancers associated with this exposure. The aim of this paper is to provide an overview of UVR exposure risk, particularly occupational risk, and to give some elements to understand the complexity of the relation between UVR exposure and cancer risk, as well as to outline primary prevention measures, focusing also on Italian experiences that could be useful for providing additional elements of knowledge on this topic.
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Ehiri, John E., Halimatou S. Alaofè, Victoria Yesufu, Mobolanle Balogun, Juliet Iwelunmor, Nidal A.-Z. Kram, Breanne E. Lott, and Olayinka Abosede. "AIDS-related stigmatisation in the healthcare setting: a study of primary healthcare centres that provide services for prevention of mother-to-child transmission of HIV in Lagos, Nigeria." BMJ Open 9, no. 5 (May 17, 2019): e026322. http://dx.doi.org/10.1136/bmjopen-2018-026322.
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ObjectiveTo assess AIDS stigmatising attitudes and behaviours by prevention of mother-to-child transmission (PMTCT) service providers in primary healthcare centres in Lagos, Nigeria.DesignCross-sectional survey.SettingThirty-eight primary healthcare centres in Lagos, Nigeria.ParticipantsOne hundred and sixty-one PMTCT service providers.Outcome measuresPMTCT service providers’ discriminatory behaviours, opinions and stigmatising attitudes towards persons living with HIV/AIDS (PLWHAs), and nature of the work environment (HIV/AIDS-related policies and infection-control guidelines/supplies).ResultsReported AIDS-related stigmatisation was low: few respondents (4%) reported hearing coworkers talk badly about PLWHAs or observed provision of poor-quality care to PLWHAs (15%). Health workers were not worried about secondary AIDS stigmatisation due to their occupation (86%). Opinions about PLWHAs were generally supportive; providers strongly agreed that women living with HIV should be allowed to have babies if they wished (94%). PMTCT service providers knew that consent was needed prior to HIV testing (86%) and noted that they would get in trouble at work if they discriminated against PLWHAs (83%). A minority reported discriminatory attitudes and behaviours; 39% reported wearing double gloves and 41% used other special infection-control measures when providing services to PLWHAs. Discriminatory behaviours were correlated with negative opinions about PLWHAs (r=0.21, p<0.01), fear of HIV infection (r=0.16, p<0.05) and professional resistance (r=0.32, p<0.001). Those who underwent HIV training had less fear of contagion.ConclusionsThis study documented generally low levels of reported AIDS-related stigmatisation by PMTCT service providers in primary healthcare centres in Lagos. Policies that reduce stigmatisation against PLWHA in the healthcare setting should be supported by the provision of basic resources for infection control. This may reassure healthcare workers of their safety, thus reducing their fear of contagion and professional resistance to care for individuals who are perceived to be at high risk of HIV.
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Robinson, Peter G., Gail V. A. Douglas, Barry J. Gibson, Jenny Godson, Karen Vinall-Collier, Sue Pavitt, and Claire Hulme. "Remuneration of primary dental care in England: a qualitative framework analysis of perspectives of a new service delivery model incorporating incentives for improved access, quality and health outcomes." BMJ Open 9, no. 10 (October 2019): e031886. http://dx.doi.org/10.1136/bmjopen-2019-031886.
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ObjectiveThis study aimed to describe stakeholder perspectives of a new service delivery model in primary care dentistry incorporating incentives for access, quality and health outcomes.DesignData were collected through observations, interviews and focus groups.SettingThis was conducted under six UK primary dental care practices, three working under the incentive-driven contract and three working under the traditional activity-based contract.ParticipantsObservations were made of 30 dental appointments. Eighteen lay people, 15 dental team staff and a member of a commissioning team took part in the interviews and focus groups.ResultsUsing a qualitative framework analysis informed by Andersen’s model of access, we found oral health assessments influenced patients’ perceptions of need, which led to changes in preventive behaviour. Dentists responded to the contract, with greater emphasis on prevention, use of the disease risk ratings in treatment planning, adherence to the pathways and the utilisation of skill-mix. Participants identified increases in the capacity of practices to deliver more care as a result. These changes were seen to improve evaluated and perceived health and patient satisfaction. These outcomes fed back to shape people’s predispositions to visit the dentist.ConclusionThe incentive-driven contract was perceived to increase access to dental care, determine dentists’ and patients’ perceptions of need, their behaviours, health outcomes and patient satisfaction. Dentists face challenges in refocusing care, perceptions of preventive dentistry, deployment of skill mix and use of the risk assessments and care pathways. Dentists may need support in these areas and to recognise the differences between caring for individual patients and the patient-base of a practice.
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Kvillemo, Pia, Anna K. Strandberg, Johanna Gripenberg, Anne H. Berman, Charlotte Skoglund, and Tobias H. Elgán. "Effects of an automated digital brief prevention intervention targeting adolescents and young adults with risky alcohol and other substance use: study protocol for a randomised controlled trial." BMJ Open 10, no. 5 (May 2020): e034894. http://dx.doi.org/10.1136/bmjopen-2019-034894.
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IntroductionAdolescence and young adulthood is a period in life when individuals may be especially vulnerable to harmful substance use. Several critical developmental processes are occurring in the brain, and substance use poses both short-term and long-term risks with regard to mental health and social development. From a public health perspective, it is important to prevent or delay substance use to reduce individual risk and societal costs. Given the scarcity of effective interventions targeting substance use among adolescents and young adults, cost-effective and easily disseminated interventions are warranted. The current study will test the effectiveness of a fully automated digital brief intervention aimed at reducing alcohol and other substance use in adolescents and young adults aged 15 to 25 years.Methods and analysisA two-arm, double-blind, randomised controlled trial design is applied to assess the effectiveness of the intervention. Baseline assessment, as well as 3-month and 6-month follow-up, will be carried out. The aim is to include 800 participants with risky substance use based on the screening tool CRAFFT (Car,Relax, Alone, Forget, Friends, Trouble). Recruitment, informed consent, randomisation, intervention and follow-up will be implemented online. The primary outcome is reduction in alcohol use, measured by Alcohol Use Disorders Identification Test total score. Secondary outcomes concern binge drinking, frequency of alcohol consumption, amount of alcohol consumed a typical day when alcohol is consumed, average daily drinks per typical week, other substance use, mental health, sexual risk behaviours and perceived peer pressure. Moreover, the study involves analyses of potential moderators including perfectionism, openness to parents, help-seeking and background variables.Ethics and disseminationThe study was approved by the Swedish Ethical Review Authority (no. 2019–03249). The trial is expected to expand the knowledge on digital preventive interventions for substance using adolescents and young adults. Results will be disseminated in research journals, at conferences and via the media.Trial registration number24 September 2019, ISRCTN91048246; Pre-results.
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Cornelius, Judith, Anna Kennedy, and Ryan Wesslen. "An Examination of Twitter Data to Identify Risky Sexual Practices Among Youth and Young Adults in Botswana." International Journal of Environmental Research and Public Health 16, no. 4 (February 23, 2019): 656. http://dx.doi.org/10.3390/ijerph16040656.
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Botswana has the third highest rate of HIV infection, as well as one of the highest mobile phone density rates in the world. The rate of mobile cell phone adoption has increased three-fold over the past 10 years. Due to HIV infection rates, youth and young adults are the primary target for prevention efforts. One way to improve prevention efforts is to examine how risk reduction messages are disseminated on social media platforms such as Twitter. Thus, to identify key words related to safer sex practices and HIV prevention, we examined three months of Twitter data in Botswana. 1 December 2015, was our kick off date, and we ended data collection on 29 February 2016. To gather the tweets, we searched for HIV-related terms in English and in Setswana. From the 140,240 tweets collected from 251 unique users, 576 contained HIV-related terms. A representative sample of 25 active Twitter users comprised individuals, one government site and 2 organizations. Data revealed that tweets related to HIV prevention and AIDS did not occur more frequently during the month of December when compared to January and February (t = 3.62, p > 0.05). There was no significant difference between the numbers of HIV related tweets that occurred from 1 December 2015 to 29 February 2016 (F = 32.1, p > 0.05). The tweets occurred primarily during the morning and evening hours and on Tuesdays followed by Thursdays and Fridays. The least number of tweets occurred on Sunday. The highest number of followers was associated with the Botswana government Twitter site. Twitter analytics was found to be useful in providing insight into information being tweeted regarding risky sexual behaviors.
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Anderson, Ian, Vicki Atkinson, James D Best, Paul Briggs, Julie Calleja, Sharon Charles, Joyce Doyle, et al. "A Collaborative Cardiovascular Health Program for Aboriginal and Torres Strait Islander People in the Goulburn-Murray Region: Development and Risk Factor Screening at Indigenous Community Organisations." Australian Journal of Primary Health 13, no. 1 (2007): 9. http://dx.doi.org/10.1071/py07002.
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The Heart Health Project was developed in partnership between Aboriginal health and social organisations in the Goulburn-Murray region and university departments. The aims included screening for cardiovascular disease (CVD) risk factors, and evaluating community-directed interventions. We describe the development of the Heart Health Project and the results of risk factor screening among employees (n=66) of Aboriginal organisations during 2003-04. Screening identified few new cases of overt hypertension, diabetes or hypercholesterolaemia, but did find a large proportion of the survey sample who smoked, had evidence of periodontal disease or who had "high normal" levels of risk factors at a relatively young age, placing them at risk of developing overt disease. Barriers to diet and exercise behaviours thought to protect against CVD were documented. While appropriate planning made clinical follow-up relatively straightforward, effective referral of at-risk people to primary prevention programs was more difficult. The barriers to making diet and exercise changes need consideration in designing interventions for primary prevention of CVD, as does the importance of promoting heart health in a culturally relevant way. This can be achieved through community direction but long-term support for partnerships and intervention programs is required.
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Anderson, Ian, Vicki Atkinson, James D Best, Paul Briggs, Julie Calleja, Sharon Charles, Joyce Doyle, et al. "Program for Aboriginal and Torres Strait Islander People in the Goulburn-Murray Region: Development and Risk Factor Screening at Indigenous Community Organisations." Australian Journal of Primary Health 13, no. 1 (2007): 9. http://dx.doi.org/10.1071/py07002_erratum.
Full textAbstract:
The Heart Health Project was developed in partnership between Aboriginal health and social organisations in the Goulburn-Murray region and university departments. The aims included screening for cardiovascular disease (CVD) risk factors, and evaluating community-directed interventions. We describe the development of the Heart Health Project and the results of risk factor screening among employees (n=66) of Aboriginal organisations during 2003-04. Screening identified few new cases of overt hypertension, diabetes or hypercholesterolaemia, but did find a large proportion of the survey sample who smoked, had evidence of periodontal disease or who had ?high normal? levels of risk factors at a relatively young age, placing them at risk of developing overt disease. Barriers to diet and exercise behaviours thought to protect against CVD were documented. While appropriate planning made clinical follow-up relatively straightforward, effective referral of at-risk people to primary prevention programs was more difficult. The barriers to making diet and exercise changes need consideration in designing interventions for primary prevention of CVD, as does the importance of promoting heart health in a culturally relevant way. This can be achieved through community direction but long-term support for partnerships and intervention programs is required.
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Murphy, Declan C. "A comprehensive review of otorhinolaryngological global health concerns." Journal of Laryngology & Otology 133, no. 11 (October 21, 2019): 930–35. http://dx.doi.org/10.1017/s002221511900197x.
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AbstractBackgroundENT disease prevalence, risk factors and treatment vary between developed and developing countries. Health provision, particularly disease prevention strategies and surgery, in developing countries is poor, manifesting as a high frequency of common and preventable diseases. Healthcare systems in developing countries are unsustainable, and the technological advances that provide ENT surgery with novel diagnostic and treatment opportunities are inaccessible.ConclusionA multifaceted approach is essential to improve the care of patients with ENT diseases in developing countries. Public health efforts must focus on educating the local community, reducing high-risk behaviours and decreasing the frequency of preventable diseases. Governments must be pressured to prioritise the funding of long-term, sustainable efforts with effective disease prevention strategies. Providing local healthcare professionals with high-quality ENT training so that self-sustaining and low-cost care can be delivered, mainly in a primary care setting, is key.
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Herbert, Annie, Jon Heron, Christine Barter, Eszter Szilassy, Maria Barnes, Laura D. Howe, Gene Feder, and Abigail Fraser. "Risk factors for intimate partner violence and abuse among adolescents and young adults: findings from a UK population-based cohort." Wellcome Open Research 5 (January 21, 2021): 176. http://dx.doi.org/10.12688/wellcomeopenres.16106.3.
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Background: Approximately one-third of young people in the UK have suffered intimate partner violence and abuse (IPVA) on reaching adulthood. We need interventions to prevent IPVA in this population, but there is a lack of evidence on who is at greatest risk. Methods: We analysed questionnaire data from 3,279 participants of the Avon Longitudinal Study of Parents and Children population-based birth cohort. We estimated the prevalence of IPVA victimisation and perpetration by age 21, by sex, demographic, parenting, mental health, externalising behaviour (e.g. smoking), educational, employment, and adverse childhood factors. Results: Overall, 29% of males and 41% of females reported IPVA victimisation, with 20% and 25% reporting perpetration, respectively (16% and 22% both). The most common type of IPVA was emotional, followed by physical, then sexual. History of anxiety, self-harm, anti-social behaviour, cannabis or illicit (non-cannabis) drug use, or risky sexual behaviour among males and females were associated with a 50% increase in likelihood of IPVA (victimisation or perpetration). Males reporting depression, sexual abuse (not by an intimate partner), witnessing domestic violence, or parental separation were also more likely to experience IPVA. Extreme parental monitoring, high academic achievement during adolescence, and NEET (not being in education, employment, or training) status in young adulthood were associated with reduced risks of IPVA. Conclusions: A range of demographic, mental health, and behavioural factors were associated with increased prevalence of IPVA victimisation or perpetration. Further study of likely complex pathways from these factors to IPVA, to inform primary prevention, is needed.
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Morrison, Arianne, Ciarra Dortche, and Nada Fadul. "1289. Knowledge, Attitudes and Barriers of Pre-exposure Prophylaxis for HIV Infection Among Resident Physicians in Rural, Eastern North Carolina." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S394. http://dx.doi.org/10.1093/ofid/ofy210.1122.
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Abstract Background North Carolina bears a high burden of HIV and was ranked number 8 for the number of new infections in 2015. In 2014, the Centers for Disease Control and Prevention (CDC) published updated practice guidelines recommending the use of pre-exposure prophylaxis (PrEP) with daily oral dosing of tenofovir/emtricitabine to help prevent HIV infection in high-risk individuals. However, the use of PrEP in the primary care setting remains low and 1 in three primary care physicians is not aware of PrEP. The objective of our study was to evaluate PrEP knowledge among primary care resident physicians. Methods 149 resident physicians were surveyed at East Carolina University from the following specialties; Internal Medicine, Medicine-Pediatrics, Obstetrics Gynecology and Family Medicine. We collected participants’ age, biological sex, current residency program, and current year within the residency program. Results Sixty out 149 residents completed the online survey. 20% of residents had never heard of PrEP. 17% of residents did not feel comfortable discussing sexual preferences with their patients. 15% of residents thought prescribing would increase risky sexual behaviors and 12% would not prescribe PrEP to patients with multiple sexual partners. Only 3% of residents identified potential side effects of PrEP (e.g., an increase in creatinine levels or decrease in mineral bone density) as a reason to not prescribe PrEP. One resident had ever prescribed PrEP. 83% of residents wanted more information on PrEP and 95% of residents would be willing to prescribe PrEP if educational workshops were offered. Conclusion PrEP is an underutilized tool among resident physicians in Eastern, NC. We identified lack of knowledge of PrEP and concern for increased risky sexual behaviors as barriers to prescribing. Resident physicians require more education on PrEP in order to prescribe it to their patients. Disclosures All authors: No reported disclosures.
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Sturgiss, Elizabeth, Claire Deborah Madigan, Doug Klein, Nicholas Elmitt, and Kirsty Douglas. "Metabolic syndrome and weight management programs in primary care: a comparison of three international healthcare systems." Australian Journal of Primary Health 24, no. 5 (2018): 372. http://dx.doi.org/10.1071/py18021.
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Lifestyle behaviours are contributing to the increasing incidence of chronic disease across all developed countries. Australia, Canada and the UK have had different approaches to the role of primary care in the prevention and management of lifestyle-related diseases. Both obesity and metabolic syndrome have been targeted by programs to reduce individual risk for chronic disease such as type 2 diabetes. Three interventions are described – for either obesity or metabolic syndrome – that have varying levels of involvement of GPs and other primary care professionals. The structure of a healthcare system for example, financing and physical locations of primary care clinicians, shapes the development of primary care interventions. The type of clinicians involved in interventions, whether they work alone or in teams, is influenced by the primary care setting and resource availability. Australian clinicians and policymakers should take into account the healthcare system where interventions are developed when translating interventions to the Australian context.
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Montalto, Michael, David Dunt, Robyn Vafiadis, and Doris Young. "Disease Prevention and Health Promotion Activity During Consultations by Private and Community Health Centre General Practitioners." Australian Journal of Primary Health 2, no. 1 (1996): 41. http://dx.doi.org/10.1071/py96006.
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The aims of this study are to compare the rates of health promotion and disease prevention activity within Community Health Centre (CHC) and private general practice (GP) consultations. A prospective field�based observation study was designed using medical students as observers. Private and CHC general practitioners involved in the teaching of the medical students in metropolitan Melbourne were observed for one week of consecutive consultations. Primary preventive interventions or behaviours during GP consultations were recorded, based on best practice guidelines. Twenty two students acted as observers. Fifty-one general practitioners were observed, 20 from CHCs and 31 from private general practices. Inter-observer reliability was satisfactory. CHC general practitioners had higher rates of overall preventive activity. Of the four broad categories of activities coded, CHC general practitioners were significantly more likely to detect patients' risk status but no more likely to conduct casefinding examinations, make test recommendations and provide advice. Among the 46 specific activities coded, CHC general practitioners were more likely to detect their patients' exercise levels and dietary details, perform a pap smear, and give advice on smoking, alcohol and diet. It was not possible to determine to what extent doctor and patient characteristics, as distinct from practice setting, were responsible for these results. While CHC general practitioners had higher levels of preventive activity, the differences were not great. Patient-initiated disease prevention is an under-reported phenomenon which deserves further attention.
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Krüger, Karen, Niklas Leppkes, Sabine Gehrke-Beck, Wolfram Herrmann, Engi A. Algharably, Reinhold Kreutz, Christoph Heintze, and Iris Filler. "Improving long-term adherence to statin therapy: a qualitative study of GPs’ experiences in primary care." British Journal of General Practice 68, no. 671 (April 23, 2018): e401-e407. http://dx.doi.org/10.3399/bjgp18x696173.
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BackgroundStatins substantially reduce the risk of cardiovascular disease when taken regularly. Though statins are generally well tolerated, current studies show that one-third of patients discontinue use of statins within 2 years. A qualitative approach may improve the understanding of attitudes and behaviours towards statins, the mechanisms related to discontinuation, and how they are managed in primary care.AimTo identify factors related to statin discontinuation and approaches for long-term statin adherence.Design and settingA qualitative study of German GPs’ experiences with statin therapy in rural and urban settings in primary care.MethodSemi-structured interviews (n = 16) with purposefully recruited GPs were recorded, transcribed, and analysed using qualitative content analysis.ResultsSociodemographic patient factors, the nocebo effect, patient attitudes towards primary prevention, and negative media coverage had significant impacts on statin therapy according to GPs. To overcome these barriers, GPs described useful strategies combining patient motivation and education with person-centred care. GPs used computer programs for individual risk–benefit analyses in the context of shared decision making. They encouraged patients with strong concerns or perceived side effects to continue therapy with a modified medication regimen combined with individual therapy goals.ConclusionGPs should be aware of barriers to statin therapy and useful approaches to overcome them. They could be supported by guideline recommendations that are more closely aligned to primary care as well as comprehensible patient information about lipid-lowering therapy. Future studies, exploring patients’ specific needs and involving them in improving adherence behaviour, are recommended.
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Miller, Peter, Amy Pennay, Rebecca Jenkinson, Nicolas Droste, Tanya Chikritzhs, Stephen Tomsen, Phillip Wadds, et al. "Patron offending and intoxication in night-time entertainment districts (POINTED): A study protocol." International Journal of Alcohol and Drug Research 2, no. 1 (March 8, 2013): 69–76. http://dx.doi.org/10.7895/ijadr.v2i1.74.
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Miller, P., Pennay, A., Jenkinson, R., Droste, N., Chikritzhs, T., Tomsen, S., Wadds, P., Jones, S. C., Palmer, D., Barrie, L. & Lubman, D. I. (2013). Patron offending and intoxication in night-time entertainment districts (POINTED): A study protocol. International Journal of Alcohol and Drug Research, 2(1), 69-76. doi: 10.7895/ijadr.v2i1.74 (http://dx.doi.org/10.7895/ijadr.v2i1.74)Risky alcohol consumption is the subject of considerable community concern in Australia and internationally, particularly the risky drinking practices of young people consuming alcohol in the night-time economy. This study will determine some of the factors and correlates associated with alcohol-related risk-taking, offending and harm in and around licensed venues and night-time entertainment precincts across five Australian cities (three metropolitan and two regional). The primary aim of the study is to measure levels of pre-drinking, drinking in venues, intoxication, illicit drug use and potentially harmful drinking practices (such as mixing with energy drinks) of patrons in entertainment areas, and relating this to offending, risky behaviour and harms experienced. The study will also investigate the effects of license type, trading hours, duration of drinking episodes and geographical location on intoxication, offending, risk-taking and experience of harm. Data collection involves patron interviews (incorporating breathalysing and drug testing) with 7500 people attending licensed venues. Intensive venue observations (n=112) will also be undertaken in a range of venues, including pubs, bars and nightclubs. The information gathered through this study will inform prevention and enforcement approaches of policy makers, police and venue staff.
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Veldhuijzen, Nienke J., Chantal Ingabire, Stanley Luchters, Wilkister Bosire, Sarah Braunstein, Matthew Chersich, and Janneke van de Wijgert. "Anal intercourse among female sex workers in East Africa is associated with other high-risk behaviours for HIV." Sexual Health 8, no. 2 (2011): 251. http://dx.doi.org/10.1071/sh10047.
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Introduction Epidemiological and HIV prevention studies in sub-Saharan Africa have almost exclusively focussed on vaginal transmission of HIV, the primary mode of transmission in the region. Little is known about the prevalence of heterosexual anal intercourse (AI), its correlates and its role in the spread of HIV. Prevention messaging seldom, if ever, includes AI. Methods: Sexual and other risk behaviours (including frequency of AI) were assessed in two cross-sectional surveys of female sex workers (FSW) in Kigali, Rwanda (n = 800) and Mombasa, Kenya (n = 820). In addition, a subset of FSW surveyed in Kigali attended seven focus group discussions and four in-depth interviews. Results: AI was reported by 5.5% and 4.3% of FSW in the cross-sectional surveys, in Kigali and Mombasa, respectively. FSW practising AI reported multiple risk factors for HIV transmission: inconsistent condom use (odds ratio (OR) Kigali 5.9 (95% CI 1.4–24.7); OR Mombasa 2.1 (1.1–4.2)); more than five sexual partners in the past week (OR Kigali 4.3 (1.5–12.4); OR Mombasa 2.2 (1.1–4.3)); alcohol use before sex (OR Kigali 2.8 (1.4–5.8)); more than 5 years of female sex work (OR Mombasa 2.4 (1.2–4.9)); and history of genital symptoms in the past year (OR Mombasa 3.6 (1.7–7.9)). AI was, however, not associated with HIV prevalence (OR Kigali 0.9 (0.5–1.9); OR Mombasa 0.5 (0.2–1.2)). Negative connotations and stigma associated with AI were expressed during qualitative interviews. Conclusions: AI was associated with several indicators of sexual risk behaviour. Prevalence of AI was probably underreported due to social desirability bias. Stigma associated with AI poses methodological challenges in obtaining valid data.
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McDonald, Eileen M., Amanda Davani, Akisha Price, Patricia Mahoney, Wendy Shields, Rashelle J. Musci, Barry S. Solomon, Elizabeth A. Stuart, and Andrea C. Gielen. "Health education intervention promoting infant safe sleep in paediatric primary care: randomised controlled trial." Injury Prevention 25, no. 3 (September 22, 2017): 146–51. http://dx.doi.org/10.1136/injuryprev-2017-042421.
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BackgroundFew randomised controlled trials (RCTs) have been conducted to improve infant sleep practices. There is limited research on how best to integrate safe sleep information into routine paediatric anticipatory guidance delivered at well child visits (WCVs). This protocol paper describes the design of the Safe Start Study, which aims to evaluate the impact of safe sleep interventions on parents’ knowledge, beliefs and behaviours related to creating and maintaining a safe sleep environment for their infants.MethodsSafe Start is a three-group RCT comparing a safe sleep health education intervention delivered as part of the 2-week WCV, an attention-matched control group that receives a scald burn prevention intervention, and a standard of care group. A baseline survey is completed at the 2-week WCV; follow-up surveys and observations are completed in the home at 2–4 weeks and 2–3 months. Participants include mother–baby dyads attending a large urban paediatric primary care practice and their paediatricians. Primary outcomes are self-reported behaviours (baby sleeps alone, on back, in crib and in a smoke-free environment), observations of the sleep environment, paediatricians’ anticipatory guidance counselling about safe sleep and participants’ reported exposure to an existing city-wide safe sleep campaign.DiscussionProviding a theory-driven and evidenced-based safe sleep intervention is both a research and a clinical practice priority. This study will advance the application of educational and environmental interventions in the primary care setting to improve the safety of infant sleep environments in high-risk families.Trial registration numberNCT03070639; Pre-results.
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Herbert, Annie, Jon Heron, Christine Barter, Eszter Szilassy, Maria Barnes, Laura D. Howe, Gene Feder, and Abigail Fraser. "Risk factors for intimate partner violence and abuse among adolescents and young adults: findings from a UK population-based cohort." Wellcome Open Research 5 (July 22, 2020): 176. http://dx.doi.org/10.12688/wellcomeopenres.16106.1.
Full textAbstract:
Background: Approximately one-third of young people in the UK have suffered intimate partner violence and abuse (IPVA) on reaching adulthood. We need interventions to prevent IPVA in this population, but there is a lack of evidence on who is at greatest risk. Methods: We analysed questionnaire data from 3,279 participants of the Avon Longitudinal Study of Parents and Children population-based birth cohort. We estimated the prevalence of IPVA victimisation and perpetration by age 21, by sex, demographic, parenting, mental health, externalising behaviour (e.g. smoking), educational, employment, and adverse childhood factors. Results: Overall, 29% of males and 41% of females reported IPVA victimisation, with 20% and 25% reporting perpetration, respectively (16% and 22% both). The most common sub-type was emotional, followed by physical, then sexual. History of self-harm, anti-social behaviour, cannabis or illicit (non-cannabis) drug use among boys and girls was associated with a two-fold increase in likelihood of IPVA (victimisation or perpetration). Males reporting risky sexual behaviour, sexual abuse (not by an intimate partner), or witnessing domestic violence, and females reporting sexual minority status in adolescence were also twice as likely to experience IPVA. Extreme parental monitoring during adolescence was associated with a reduced risk of IPVA in males and females, as was not being in education, employment, or training for young adult men. Conclusions: A range of demographic, mental health, and behavioural factors were associated with increased prevalence of IPVA victimisation or perpetration. Further study of likely complex pathways from these factors to IPVA, to inform primary prevention, is needed.
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ATIMGA, Shimawua. "Literature and Health: Interrogating Public Health Behaviour." Nile Journal of English Studies 1, no. 1 (March 7, 2016): 14. http://dx.doi.org/10.20321/nilejes.v1i1.32.
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Health, ranks among primary issues on the top of developing nations’ agenda. While advancement in medicine and medical care surely increase assurance of wellness it is also acknowledged that the social context where the environmental, organizational and personal factors interact to affect health and general well-being can be better enhanced through an understanding of the health behaviours of such individuals and groups. Such understanding will further enhance intervention activities targeting the prevention, promotion and modification of people’s life styles and proportionately reduce their health risk behaviours. This study maintains that literature has never been aloof to public health advocacy. It illustrates this with the interrogations of public health behavior of Nigerian citizens replete in Ken Saro Wiwa’s collection of short stories titled Prisoners of Jebs and a Forest of Flowers. Using the Social Ecological theory the study analyses selected Short Stories from the two volumes. Wiwa is seen to have used the stories to question the health behavior of compatriots, and to advocate for adoption of better health attitudes. His stories therefore serve as an awakening call for the evolvement of multi-modal strategies for sustainable health.