Effectiveness Of Primary Prevention Interventions Research Articles

Trends of mortality from external causes in the Umbria region of Italy: 1994-2004

The aim of the present paper is to analyse the mortality from external causes in the Umbria region, from 1994 to 2004, in order to have an indication of the effectiveness of primary prevention interventions. Sex and cause-specific AADR (the age-adjusted death rates) and YPLL rates (the age-adjusted rates of years of potential life lost up to 74 yrs) time trends were analysed by means of joinpoint regression utilising SEER software. The expected annual percent change and its significance were also calculated. The cause groups examined were: all external causes, transport accidents, falls, accidental poisoning and exposure to noxious substances, intentional self-harm and assault. The age-adjusted death rates from the selected external causes showed, in both sexes, a decreasing trend. The joinpoint regression of AADR indicated that all statistically significant variations are declining. For the AADR cause group significant decreases were found in all external combined and poisoning causes for both sexes, transport accidents and falls for females. Among males the age-adjusted YPLL rates showed significant decreases for all external causes combined (EACP = -2.8%). This analysis provides a useful tool to evaluate the effectiveness of interventions performed in the last decade and indicates that further assessment and monitoring are needed.

Are interventions to improve cardiovascular disease risk factors in premenopausal women effective? A systematic review and meta-analysis

ObjectivesNon-traditional risk factors place young women at increased risk of cardiovascular disease (CVD) over their lifetime. The current study undertakes a systematic review and meta-analysis of randomised controlled trials (RCTs)...

Key facets to build up eHealth and mHealth interventions to enhance physical activity, sedentary behavior and nutrition in healthy subjects \u2013 an umbrella review

BackgroundElectronic (eHealth) and mobile (mHealth) health interventions can provide a large coverage, and are promising tools to change health behavior (i.e. physical activity, sedentary behavior and healthy eating). However, the determinants of intervention effectiveness in primary prevention has not been explored yet. Therefore, the objectives of this umbrella review were to evaluate intervention effectiveness, to explore the impact of pre-defined determinants of effectiveness (i.e. theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions), and to provide recommendations for future research and practice in the field of primary prevention delivered via e/mHealth technology.MethodsPubMed, Scopus, Web of Science and the Cochrane Library were searched for systematic reviews and meta-analyses (reviews) published between January 1990 and May 2020. Reviews reporting on e/mHealth behavior change interventions in physical activity, sedentary behavior and/or healthy eating for healthy subjects (i.e. subjects without physical or physiological morbidities which would influence the realization of behaviors targeted by the respective interventions) were included if they also investigated respective theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions. Included studies were ranked concerning their methodological quality and qualitatively synthesized.ResultsThe systematic search revealed 11 systematic reviews and meta-analyses of moderate quality. The majority of original research studies within the reviews found e/mHealth interventions to be effective, but the results showed a high heterogeneity concerning assessment methods and outcomes, making them difficult to compare. Whereas theoretical foundation and behavior change techniques were suggested to be potential positive determinants of effective interventions, the impact of social context remains unclear. None of the reviews included just-in-time adaptive interventions.ConclusionFindings of this umbrella review support the use of e/mHealth to enhance physical activity and healthy eating and reduce sedentary behavior. The general lack of precise reporting and comparison of confounding variables in reviews and original research studies as well as the limited number of reviews for each health behavior constrains the generalization and interpretation of results. Further research is needed on study-level to investigate effects of versatile determinants of e/mHealth efficiency, using a theoretical foundation and additionally explore the impact of social contexts and more sophisticated approaches like just-in-time adaptive interventions.Trial registrationThe protocol for this umbrella review was a priori registered with PROSPERO: CRD42020147902.

Effectiveness of a prevention program in the incidence of cardiovascular outcomes in a low-income population from Colombia: a real-world\xa0propensity score-matched cohort study

BackgroundCardiovascular diseases (CVDs) and diabetes mellitus (DM) are among the leading cause of morbidity and mortality in low-and-middle-income countries (LMICs) but evidence in these contexts regarding the effectiveness of primary prevention interventions taking into account patient adherence is scarce. We aimed to evaluate the effectiveness of a cardiovascular risk management program (De Todo Corazón - DTC program) in the incidence of the first cardiovascular outcome (CVO) in a low-income population from the Caribbean region of Colombia using adherence as the main variable of exposure.MethodsA retrospective propensity score-matched cohort study was conducted. Adult patients with a diagnosis of hypertension (HTA), diabetes mellitus (DM), chronic kidney disease (CKD), or dyslipidemia affiliated to the DTC program between 2013 and 2018 were considered as the study population. Patients with 30 to 76 years, without a history of CVOs, and with more than 6 months of exposure to the program were included. The main outcome of interest was the reduction in the risk of CVOs (stroke, myocardial infarction, or congestive heart failure) based on the adherence to the intervention (attendance to medical appointments with health care professionals and the control of cardiovascular risk factors). Kaplan Meier curves and propensity score-matched Cox regression models were used to evaluate the association between adherence and the incidence of CVOs.ResultsA total of 52,507 patients were included. After propensity score matching, a sample of 35,574 patients was analyzed. Mean (SD) exposure time was 1.97 (0.92) years. Being adherent to the program was associated to a 85.4, 71.9, 32.4 and 78.9% risk reduction of in the low (HR 0.14; 95% CI 0.05–0.37; p < 0.001), medium (HR 0.28; 95% CI 0.21–0.36; p < 0.001), high-risk with DM (HR 0.67; 95% CI 0.43–1.04; p = 0.075) and hig-risk without DM (HR 0.21; 95% CI 0.09–0.48; p < 0.001) categories, respectively.ConclusionsThe DTC program is effective in the reduction of the risk of CVOs. Population-based interventions may be an important strategy for the prevention of CVOs in underserved populations in the context of LMICs. A more exhaustive emphasis on the control of diabetes mellitus should be considered in these strategies.

109 Near-fatal suicide attempts among Canadian Youth: A CPSP Study

Abstract Background Suicide is the second leading cause of death among Canadian adolescents. Youth who make near fatal suicide attempts, such as those requiring intensive care unit (ICU) level care, are the closest proxy to those that die by suicide; however, there is limited data on this group. Objectives To evaluate the minimum incidence rate and patterns of presentation of youth (under 18 years of age) admitted to the ICU for medically serious self-inflicted injury. Design/Methods From January 2017 to December 2018, over 2,700 paediatricians/subspecialist members of the Canadian Paediatric Surveillance Program were electronically surveyed on a monthly basis regarding cases of medically serious self-harm. Participants completed a detailed questionnaire about the reported case and descriptive statistics were used for analyses. Results Ninety-four cases (71 female; mean age 15.2 years) of confirmed (n=87) and suspected/probable (n=7) medically serious self-harm were reported. The majority (87%) of cases were reported from 4 out of 13 provinces and territories in Canada (Alberta, British Columbia, Ontario, Quebec). There were 11 deaths by suicide (M&amp;gt;F; p&amp;lt;.05). Medication ingestion was the most common method of self-harm among females (76% F vs. 52% M; p=.03) compared with hanging among males (14% F vs. 39% M; p=.009). More females than males had a prior suicide attempt (62% F vs. 32% M; p=.07) and a history of non-suicidal self-injury (NSSI) (65% F vs. 14% M; p&amp;lt;.05), although only history of NSSI reached significance. More females than males had a past psychiatric diagnosis (77% F vs. 55% M; p=.05), and past use of mental health services (69% F vs. 30% M; p&amp;lt;.001), although only service use reached significance. Half of the youth left evidence of intent (54%) and 33% of parents of included youth were aware that their child was considering suicide. Family conflict was the most common precipitating factor for suicide attempt in both females and males (46%). Conclusion These Canadian findings are consistent with international epidemiologic data that observe a gender paradox of higher rates of suicide attempts in females and greater mental health care engagement but increased suicide mortality in males with decreased involvement with mental health care. This study suggests that family conflict is a potential target for suicide prevention interventions among youth. Future research focusing on gender-specificity in risk factor identification and effectiveness of primary prevention interventions among youth is warranted.

Effectiveness of nurse-led healthy aging strategies for older adults living in the community: a systematic review protocol.

REVIEW QUESTION / OBJECTIVE The objective of this quantitative systematic review is to identify and synthesize the evidence on the effectiveness of nurse-led healthy aging strategies for older adults living in the community. More specifically, the objectives of this systematic review are to identify and synthesize the evidence on: 1) The effectiveness of health promotion interventions, delivered or co-delivered by a nurse, on healthy aging outcomes such as wellbeing and/or the physical, mental, spiritual and/or social health of older adults living in the community. 2) The effectiveness of primary prevention interventions, delivered or co-delivered by a nurse, on healthy aging outcomes such as wellbeing and/or the physical, mental, spiritual and/or social health of older adults living in the community. 3) The effectiveness of interventions, combining health promotion and primary prevention, delivered or co-delivered by a nurse, on healthy aging outcomes, such as wellbeing and/or the physical, mental, spiritual and/or social health of older adults living in the community. INCLUSION CRITERIA Types of participants This review will consider studies including male and female adults aged 50 or older, living in the community, and irrespective of the nursing care they may otherwise receive, were offered a nursing intervention for healthy aging. In this review, older people with a terminal illness, hospitalized in-patients, people living in nursing or other institutional living facilities, and older adults with impaired cognition, as measured by Mini Mental State examination, that prevents them from taking an active part in society and enjoying independent living will be excluded. Types of intervention(s)/phenomena TRUNCATED AT 250 WORDS

The Role of Primary Prevention in Decreasing HCV Related Disease Burden in Pakistan

Objective: To identify the most effective primary preventive interventions for reducing the disease burden of HCV infection in Pakistan. Study Design: Literature Review. Methods: A comprehensive review of the published literature on the effectiveness of primary prevention interventions to reduce the incidence and prevalence of HCV infection was undertaken by using the scientific data bases. Results: The review identified 15 relevant studies. These studies identified the key risk factors responsible for high disease burden of HCV infection in Pakistan, that is, therapeutic injections, unsafe medical/surgical practices, needle stick injuries, unscreened blood transfusions, poor knowledge and risk awareness. Conclusion: There is an immense need of further research and pragmatic guidance for policy makers to evaluate the effectiveness of primary prevention in reducing the transmission of HCV infection. The government of Pakistan and main health authorities should intervene more effectively to control the high rates of HCV infection. Safe injection practices along with safe medical/surgical practices; safe blood supply and risk awareness among the general population should be the main priorities for preventing the spread of HCV infection in Pakistan.

STRUCTURE OF THE DIFFERENCE IN BODY WEIGHT OF CERTAIN CATEGORIES OF URBAN POPULATION

From the results of measurements of height, weight and body mass index of 1119 inhabitants of a large industrial center older than 45 years was characterized the frequency of normal body weight, overweight and obesity taking into account of sex and age characteristics. It was revealed that 23.6 % of the urban population has a normal body weight, 39.7 % — overweight, 36.7 % — obesity of varying severity. It was proved the necessity to increase the activity and effectiveness of primary prevention interventions aimed to normalization of body weight among men under the age of 45 years and women 45 to 55 years, as well as work on the early detection of pathologies associated with obesity in men and women in these age groups.

WITHDRAWN: Primary prevention for alcohol misuse in young people.

Alcohol misuse is a cause of concern for health services, policy makers, prevention workers, the criminal justice system, youth workers, teachers and parents. 1. To identify and summarize rigorous evaluations of psychosocial and educational interventions aimed at the primary prevention of alcohol misuse by young people. 2. To assess the effectiveness of primary prevention interventions over the longer-term (> 3 years). Databases searched (no time limits): Project CORK, BIDS, PSYCLIT, ERIC, ASSIA, MEDLINE, FAMILY-RESOURCES-DATABASE, HEALTH-PERIODICALS-DATABASE, EMBASE, BIDS, Dissertation-Abstracts, SIGLE, DRUG-INFO, SOMED, Social-Work-Abstracts, National-Clearinghouse-on-Alcohol-and-Drug-Information, Mental-Health-Abstracts, DRUG-database, ETOH (all searched Feb-June 2002). 1. randomised controlled and non-randomised controlled and interrupted time series designs. 2. educational and psychosocial primary prevention interventions for young people up to 25 years old. 3. alcohol-specific or generic (drugs; lifestyle) interventions providing alcohol outcomes reported. 4. alcohol outcomes: alcohol use, age of alcohol initiation, drinking 5+ drinks on any one occasion, drunkeness, alcohol related violence, alcohol related crime, alcohol related risky behaviour. Stage 1: All papers screened by one reviewer against inclusion criteria. Stage 2: For those papers that passed Stage 1, key information was extracted from each paper by 2-3 reviewers. 20 of the 56 studies included showed evidence of ineffectiveness. No firm conclusions about the effectiveness of prevention interventions in the short- and medium-term were possible. Over the longer-term, the Strengthening Families Program (SFP) showed promise as an effective prevention intervention. The Number Needed to Treat (NNT) for the SFP over 4 years for three alcohol initiation behaviours (alcohol use, alcohol use without permission and first drunkeness) was 9 (for all three behaviours). One study also highlighted the potential value of culturally focused skills training over the longer-term (NNT=17 over three-and-a-half years for 4+ drinks in the last week). 1. Research into important outcome variables needs to be undertaken. 2. Methodology of evaluations needs to be improved. 3. The Strengthening Families Programme needs to be evaluated on a larger scale and in different settings. 4. Culturally-focused interventions require further development and rigorous evaluation. 5. An international register of alcohol and drug misuse prevention interventions should be established and criteria agreed for rating prevention intervention in terms of safety, efficacy and effectiveness.

A review of the evidence for the effectiveness of primary prevention interventions for Hepatitis C among injecting drug users

BackgroundHepatitis C (HCV) prevalence is most common amongst injecting drug users where up to 98% of the population can be infected despite a low prevalence of HIV. This review considers the evidence for the effectiveness of primary prevention interventions to reduce incidence or prevalence of hepatitis C.MethodsSystematic review of the major electronic medical databases: Medline, EMBASE, PsycINFO, CINAHL and the Cochrane Library (Evidence Based Health). Either intervention or observational studies were included if they described an intervention targeting injecting drug using populations with the outcome to reduce either the prevalence or incidence of hepatitis C infection.Results18 papers were included in the final review from 1007 abstracts. Needle exchange programmes reduce the prevalence of HCV though prevalence remains high. Similarly the effectiveness of methadone maintenance treatment is only marginally effective at reducing HCV incidence. There is limited evidence evaluating either the effectiveness of behavioural interventions, bleach disinfectants, or drug consumption rooms.ConclusionPrimary prevention interventions have led to a reduction in HIV incidence, have been less effective at reducing HCV incidence. Global prevalence of HCV remains disturbingly high in injecting drug users. A robust response to the global health problem of HCV will require provision of new interventions. Behavioural interventions; distribution of bleach disinfectant; other injecting paraphernalia alongside sterile needle distribution; and evaluation of drug consumption rooms merit further expansion internationally and research activity to contribute to the emerging evidence base. Whilst the prevalence of HCV remains high, nevertheless many current interventions aimed at primary HCV prevention have been shown to be cost-effective due to their significant positive impact upon prevalence of HIV.

Primary prevention for alcohol misuse in young people.

Alcohol misuse is a cause of concern for health services, policy makers, prevention workers, the criminal justice system, youth workers, teachers and parents. 1. To identify and summarize rigorous evaluations of psychosocial and educational interventions aimed at the primary prevention of alcohol misuse by young people. 2. To assess the effectiveness of primary prevention interventions over the longer-term (> 3 years). Databases searched (no time limits): Project CORK, BIDS, PSYCLIT, ERIC, ASSIA, MEDLINE, FAMILY-RESOURCES-DATABASE, HEALTH-PERIODICALS-DATABASE, EMBASE, BIDS, Dissertation-Abstracts, SIGLE, DRUG-INFO, SOMED, Social-Work-Abstracts, National-Clearinghouse-on-Alcohol-and-Drug-Information, Mental-Health-Abstracts, DRUG-database, ETOH (all searched Feb-June 2002). 1. randomised controlled and non-randomised controlled and interrupted time series designs. 2. educational and psychosocial primary prevention interventions for young people up to 25 years old. 3. alcohol-specific or generic (drugs; lifestyle) interventions providing alcohol outcomes reported. 4. alcohol outcomes: alcohol use, age of alcohol initiation, drinking 5+ drinks on any one occasion, drunkeness, alcohol related violence, alcohol related crime, alcohol related risky behaviour. Stage 1: All papers screened by one reviewer against inclusion criteria. Stage 2: For those papers that passed Stage 1, key information was extracted from each paper by 2-3 reviewers. 20 of the 56 studies included showed evidence of ineffectiveness. No firm conclusions about the effectiveness of prevention interventions in the short- and medium-term were possible. Over the longer-term, the Strengthening Families Program (SFP) showed promise as an effective prevention intervention. The Number Needed to Treat (NNT) for the SFP over 4 years for three alcohol initiation behaviours (alcohol use, alcohol use without permission and first drunkeness) was 9 (for all three behaviours). One study also highlighted the potential value of culturally focused skills training over the longer-term (NNT=17 over three-and-a-half years for 4+ drinks in the last week). 1. Research into important outcome variables needs to be undertaken. 2. Methodology of evaluations needs to be improved. 3. The Strengthening Families Programme needs to be evaluated on a larger scale and in different settings. 4. Culturally-focused interventions require further development and rigorous evaluation. 5. An international register of alcohol and drug misuse prevention interventions should be established and criteria agreed for rating prevention intervention in terms of safety, efficacy and effectiveness.