Participation In Prevention Programs Research Articles

App-Based Addiction Prevention at German Vocational Schools: Implementation and Reach for a Cluster-Randomized Controlled Trial.

This article examines the implementation, participation rates, and potential determinants of participation in the digital addiction prevention program "ready4life." A two-arm cluster-randomized trial recruited German vocational students via class-based strategies. Intervention group received 16 weeks of in-app coaching; the control group received health behavior information, with coaching offered after 12 months. Potential determinants of participation were analyzed based on class and individual characteristics. Out of 525 contacted schools, 35 participated, enrolling 376 classes. Implementation during the pandemic required flexible adjustments, with 49.7% of introductions conducted in person, 43.1% digitally via online streaming, and 7.2% received a video link via email. Despite challenges, 72.3% of the vocational students downloaded the app, and 46.7% gave informed consent. Participation rates were highest among (associate) professionals, vocational grammar school classes, classes introduced by females, younger individuals, members of the project team, and classes introduced face-to-face. Female gender, lower social competencies, lifetime cannabis use, higher problematic internet use, and higher perceived stress were associated with higher individual participation. The study highlights the importance of proactive outreach and personalized interventions for addiction prevention programs in vocational schools. While reached students aligned with the aims of the app, tailored recruitment strategies could enhance engagement among under-represented groups. The trial was registered in the German Clinical Trials Register (DRKS): DRKS00022328; registration date 09.10.2020.

Predictors of fall protection motivation among older adults in rural communities in a middle-income country: A cross-sectional study using the Protection Motivation Theory.

To evaluate factors associated with fall protection motivation to engage in fall preventive behaviour among rural community-dwelling older adults aged 55 and above using the protection motivation theory scale. A cross-sectional study. The study was conducted in a healthcare clinic in Malaysia, using multistage random sampling from November 2021 to January 2022. Three hundred seventy-five older adults aged 55 and older were included in the final analysis. There were 31 items in the final PMT scale. The analysis was performed within the whole population and grouped into 'faller' and 'non-faller', employing IBM SPSS version 26.0 for descriptive, independent t-test, chi-square, bivariate correlation and linear regressions. A total of 375 older participants were included in the study. Fallers (n = 82) and non-fallers (n = 293) show statistically significant differences in the characteristics of ethnicity, assistive device users, self-rating of intention and participation in previous fall prevention programmes. The multiple linear regression model revealed fear, coping appraisal and an interaction effect of fear with coping appraisal predicting fall protection motivation among older adults in rural communities. Findings from this study demonstrated that coping appraisal and fear predict the protection motivation of older adults in rural communities. Older adults without a history of falls and attaining higher education had better responses in coping appraisal, contributing to a reduction in perceived rewards and improving protection motivation. Conversely, older adults from lower education backgrounds tend to have higher non-preventive behaviours, leading to a decline in fall protection motivation. These results contribute important information to nurses working with older adults with inadequate health literacy in rural communities, especially when planning and designing fall prevention interventions. The findings would benefit all nurses, healthcare providers, researchers and academicians who provide care for older adults. Participants were briefed about the study, and their consent was obtained. They were only required to answer the questionnaire through interviews. Older individuals aged fifty-five and above in rural communities at the healthcare clinic who could read, write or understand Malay or English were included. Those who were suffering from mental health problems and refused to participate in the study were excluded from the study. Their personal information remained classified and not recorded in the database during the data entry or analysis.

IDF23-0528 Participation in a long-lasting community-based diabetes prevention program during the COVID-19 pandemic

IDF23-0528 Participation in a long-lasting community-based diabetes prevention program during the COVID-19 pandemic

The effect of parental diabetes prevention program participation on weight loss in dependent children: a prospective cohort study

IntroductionObesity has reached epidemic proportions in children and adolescents in the United States. Children’s behaviors are strongly influenced by parental behaviors, and weight loss in parents is positively associated with weight changes in their overweight/obese children. Research is limited on how parents’ National Diabetes Prevention Program (DPP) participation affects the health outcomes of their dependent children. Analyzing the impact of parental DPP participation on weight loss in their dependent children may provide valuable insight into an important secondary benefit of DPP participation.MethodsIn this study, we identified 128 adults with prediabetes who were offered the opportunity to participate in a DPP (n = 54 DPP participants and n = 74 DPP non-participants) and who had at least one child 3 to 17 years of age living with them. Age and BMI percentile for dependent children were collected from insurance claims data for 203 children (n = 90 children of DPP participants and n = 113 children of DPP non-participants). Parental practices related to diet and physical activity were assessed by surveys.ResultsThere were no significant changes in BMI percentiles of overweight or obese children (i.e. BMI percentile ≥ 50%) of DPP participants vs DPP non-participants with prediabetes over one-year. Parents who enrolled and did not enroll in the DPP did not report differences in their parenting practices related to diet and physical activity.DiscussionThese results are not consistent with the literature that suggests parent-based interventions may influence their children’s weight trajectories. Limitations include small sample size, short time span of intervention, and limited availability of additional health/biographic data on dependent children. Future studies should collect primary outcome data on children, investigate whether there is a minimum duration of parental involvement and level of parental adherence, and assess the effect of parent–child dynamics on child weight trajectories.

Indikative Präventionsprogramme zur Förderung der seelischen Gesundheit im Vor- und Grundschulalter: Teilnahmebereitschaft von Kinderärzt*innen und Familien an einer innovativen Versorgungskette

ZusammenfassungHintergrundPsychische Auffälligkeiten beginnen häufig im Kindesalter und können in psychische Störungen münden. Vorhandene Präventionsangebote werden trotz Wirksamkeit nur spärlich in Anspruch genommen. Ziel war zu prüfen, inwiefern durch die Etablierung einer Versorgungskette Risikokinder frühzeitig identifiziert und Präventionsmaßnahmen zugewiesen werden können, sowie inwieweit indikative Präventionsprogramme schlussendlich in Anspruch genommen werden.MethodenIn einer prospektiven Implementationsstudie wurde während der regulären U9- bis U11-Gesundheitsuntersuchungen (Altersbereich: 5–10 Jahre) der „Strengths and Difficulties Questionnaire“ als Screeninginstrument an Familien ausgegeben. Diese erhielten von ihren Kinderärzt*innen unmittelbar eine Ergebnisrückmeldung und im Falle von grenzwertig auffälligen emotionalen oder Verhaltensproblemen eine Empfehlung für ein indikatives Präventionsprogramm. Vor Programmteilnahme fand im Vorgespräch eine Indikationsprüfung statt.ErgebnisseIm Raum Dresden beteiligten sich n = 46 (38,7 %) Kinderärzt*innen am Projekt. In n = 28 Kinderarztpraxen nahmen n = 3231 (86,4 %) Familien am Screening teil, n = 864 (26,7 %) Kinder, deren Familien eine Ergebnisrückmeldung erhielten, bekamen eine Präventionsempfehlung. Zur Präventionsprogrammteilnahme meldeten sich n = 118/864 (13,7 %) Familien selbstständig. n = 215/624 (35,5 %) zeigten Interesse nach projektinitiierter Kontaktaufnahme. Über andere Zugangswege kamen n = 139 Teilnahmeanfragen. n = 337 (n = 461; über alle Zugangswege) Vorgespräche wurden geführt. Schließlich nahmen n = 237 (n = 337) Kinder ein indikatives Präventionsprogramm in Anspruch.SchlussfolgerungEine Ausweitung der Vorsorgeuntersuchung auf psychische Auffälligkeiten ist umsetzbar, nützlich und erfährt breite Akzeptanz. Um eine Versorgungskette einzurichten, sollte eine Angebotsstruktur etabliert werden, um damit die Zuweisung zu und Inanspruchnahme von Präventionsmaßnahmen zu ermöglichen.

Acceptability to Healthcare Professionals of Home-Based HPV Self-Sampling for Cervical Screening: A French Qualitative Study Conducted in an Area with Low Access to Health Services.

Self-sampling may improve participation in cervical cancer secondary prevention programs by women who do not respond or respond irregularly when invited to contact a health professional for the collection of a cervical specimen. It could also help resolve access problems in areas with a low physician density. The present qualitative study examined barriers to screening, effective screening strategies, and the advantages and disadvantages of sending women urine or vaginal self-sampling kits in two medically underserved administrative departments in France (Mayenne and Sarthe) showing low cervical screening coverage. As part of the CapU4 randomized trial, a team of psychologists investigated the attitudes and experiences of 59 healthcare professionals (gynecologists, general practitioners, and midwives) through semi-structured interviews. Results indicated that health professionals believe that self-sampling may address the issues of low physician density and underscreening by removing logistical, organizational, financial, and psychological obstacles. They confirmed trust in the use of vaginal self-sampling, with urine self-sampling as an alternative solution (e.g., for women with vaginismus). The health professionals also identified several limitations of the self-sampling kit that will need to be addressed in future screening campaigns (incomplete kit, complex instructions, poor anatomical knowledge, and obesity).

Determinants for participation in a prevention and early detection programme for children and adolescents in Germany: does social background play a role?

Early detection examinations and prevention are particularly important in childhood and adolescence, as certain diseases are already developing and health-related attitudes and behaviour patterns are formed and implemented. Despite the importance of screening and prevention, not all families use the available services and programmes. The aim of this study is to identify factors associated with participation in an early detection and prevention programme for children and adolescents, as well as factors associated with actual uptake of an examination. The analyses are based on questionnaire data of an online survey of participants and non-participants. Descriptive analyses and logistic regression models are conducted on a defined sample (n = 1,289). The results show that both groups differ with regard to several factors: age, chronic diseases, federal state, living space, number of siblings, country of birth, migration background, language spoken at home, mother’s occupational status, household income, treatment duration, and trust in treating physician. Regression I shows that participation in the programme is significantly associated with higher age, language spoken at home, mother’s occupational status and greater trust in the treating physician. The latter demonstrates the highest predictive power. Regression II indicates that the actual uptake of an examination among participants is significantly affected by age, federal state and father’s occupational status. Overall, the results of this study show that social background partly plays a role in participation, but that factors such as trust in the treating physician also have a significant impact. For the future, further research on the factors influencing participation in screening and prevention services or programmes for children and adolescents is important in order to develop strategies to overcome existing barriers and thus reach groups that have not been reached yet. In this context, trust in the treating physician and his or her influence on decision-making should in particular be considered.

Knowledge and awareness of anterior cruciate ligament injury among Turkish professional athletes: an online survey

ABSTRACT The purpose of this study was to assess the awareness and knowledge of professional team sport athletes about ACL injuries, injury prevention programs, and the return to sports after ACL injuries. A total of 419 athletes representing soccer, basketball, volleyball and handball sports were included in the study. We utilized a 15-item self-report survey to assess the awareness of athletes about ACL injury, ACL injury prevention program, and return to sport after ACL injuries. Male and soccer players participated in prevention programs more than female athletes (p = 0.001). Participation in prevention programs was significantly higher in the ≥ 18 years old group than in the < 18 years old group (p = 0.040). Participants who were informed about ACL injuries were 8.4 times more likely to participate in the ACL injuries prevention program than others (OR: 8.38, 95% CI: 3.823–18.376, p < 0.001). The majority of participants believed that return to sport after ACL injury takes 6 months and 81.4% of them thought that it is not possible to do sport without an ACL. This study revealed that the awareness and performance of ACL prevention training programs among professional team sport athletes were insufficient. The athletes’ knowledge regarding return to sports after ACL injuries was also inadequate. Improving athletes’ knowledge of ACL injuries may lead to increased participation in ACL injury prevention programs. Thus, the provision of tailored educational interventions to athletes could potentially enhance their awareness and understanding of ACL injuries, consequently contributing towards the prevention of such injuries.

Impact of the COVID-19 Pandemic on Training Sessions of Young Japanese Handball Players: A Questionnaire-Based Retrospective Cohort Study

Background: The training environment for handball, particularly for young athletes, was affected by the COVID-19 pandemic in 2019 and 2020. Objectives: This study aimed to investigate the training sessions, injury incidence, and injury prevention program participation of youth handball teams during the COVID-19 pandemic and assess the barriers and factors influencing the motivation to perform such programs. Methods: This retrospective questionnaire-based cohort study included participants in the national handball championship in Japan in March 2021. The respondents included 48 coaches and 745 players from 66 teams. The coaches were asked questions about changes in the training time and intensity during the pandemic. The players were asked questions about barriers and motivational factors for performing the prevention exercises. Results: We found that 66.7% of the teams reduced their training time during the pandemic, while 45.8% reduced their training intensity. Owing to the COVID-19 pandemic, 91.7% of all teams experienced game cancellations, and player contact decreased in 33.3% of the teams. The main reason for not performing these exercises was a lack of knowledge on how to perform them correctly, as reported by 52.1% of the respondents. The main motivational factors were handball movement-related exercises (51.7%) and improved physical fitness (32.7%). Conclusions: The COVID-19 pandemic influenced the training sessions of Japanese youth handball teams in many ways. Education on correctly performing injury prevention program exercises is a key factor in maximizing the adoption of such programs. In addition, injury prevention exercises must be handball-specific to ensure that players are motivated to keep performing such exercises.

Engaging community-dwelling older adults in fall prevention programs: a qualitative study on strategies promoting participation in fall prevention programs among community-dwelling older adults.

Fall rates and fall-related injuries among community-dwelling older adults (≥65 years) are expected to increase rapidly, due to the aging population worldwide. Fall prevention programs (FPPs), consisting of strength and balance exercises, have been proven effective in reducing fall rates among older adults. However, these FPPs have not reached their full potential as most programs are under-enrolled. Therefore, this study aims to identify promising strategies that promote participation in FPPs among community-dwelling older adults. This is an exploratory qualitative study. Previously, barriers and facilitators for participation in FPPs by older adults had been identified. Next, six strategies had been designed using the Intervention Mapping approach: (1) reframing; (2) informing about benefits; (3) raising awareness of risks; (4) involving social environment; (5) offering tailored intervention; (6) arranging practicalities. Strategies were validated during semi-structured interviews with community-dwelling older adults (n = 12) at risk of falling. Interviews were audio-recorded, transcribed, and analyzed following a qualitative thematic methodology, with a hybrid approach. All strategies were considered important by at least some of the respondents. However, two strategies stood out: (1) reframing 'aging' and 'fall prevention': respondents preferred to be approached differently, taking a 'life course' perspective about falls, and avoiding confronting words; and (2) 'informing about benefits' (e.g., 'living independently for longer'); which was mentioned to improve the understanding of the relevance of participating in FPPs. Other strategies were considered important to take into account too, but opinions varied more strongly. This study provides insight into potential strategies to stimulate older adults to participate in FPPs. Results suggest that reframing 'aging' and 'fall prevention' may facilitate the dialogue about fall prevention, by communicating differently about the topic, for example 'staying fit and healthy', while focusing on the benefits of participating in FPPs. Gaining insight into the strategies' effectiveness and working mechanisms is an area for future research. This could lead to practical recommendations and help professionals to enhance older adults' participation in FPPs. Currently, the strategies are further developed to be applied and evaluated for effectiveness in multiple field labs in a central Dutch region (Utrecht).

Mixed-Methods Evaluation of Father Participation in an Adolescent Obesity Prevention Program With Multiple Delivery Methods.

Padres Preparados, Jóvenes Saludables was a Latino family-based obesity prevention intervention implemented from 2017 to 2020 across eight programs in-person only, in a blended format (online/in-person), and online only. The intervention aimed to enhance father parenting skills to improve adolescent diet and activity behaviors. Mothers were encouraged to attend. Factors associated with participation were explored using a mixed-methods, qualitative (focus group/individual interviews by Zoom) and quantitative (process evaluation) design. Eleven focus group and 24 individual interviews were completed after participation with 24 fathers, 27 mothers, and 40 adolescents with responses not sorted by delivery method before analysis. Binomial logistic regression models examined associations between fathers' program completion and predictor variables of delivery characteristics, father demographic characteristics, and family attendance patterns. Parents were married (96% fathers, 76% mothers), had low income, a high school education or less (68% fathers, 81% mothers), and had lived in the United States a mean of 19 years. Parents were motivated to participate to improve health, and to be involved with and improve communication with their child. Common barriers to participation were work and life priorities and programmatic factors including scheduling conflicts and technological issues. Participation was greater for fathers attending sessions in-person compared with online only (OR = 11.6). Fathers were more likely to participate if they attended sessions with family members vs. not attending with family members (OR = 7.2). To maximize participation, findings suggest involving multiple parents/caregivers and adolescents, addressing contextual and programmatic barriers, and promoting benefits of better health and relations with family members.

Cooking behaviours after Diabetes Prevention Program (DPP) participation among DPP participants in Baltimore, MD.

The Diabetes Prevention Program (DPP) is a widely implemented 12-month behavioural weight loss programme for individuals with prediabetes. The DPP covers nutrition but does not explicitly incorporate cooking skills education. The objective of the current study is to describe food and cooking skills (FACS) and strategies of recent DPP participants. Photo-elicitation in-depth interviews were conducted from June to August, 2021. Baltimore, MD, USA. Thirteen Black women who participated in DPP. The DPP curriculum influenced participants' healthy cooking practices. Many participants reported shifting from frying foods to air-frying and baking foods to promote healthier cooking and more efficient meal preparation. Participants also reported that their participation in DPP made them more mindful of consuming fruits and vegetables and avoiding foods high in carbohydrates, fats, sugars and Na. With respect to food skills, participants reported that they were more attentive to reading labels and packaging on foods and assessing the quality of ingredients when grocery shopping. Overall, participants reported changing their food preferences, shopping practices and cooking strategies to promote healthier eating after completing the DPP. Incorporating hands-on cooking skills and practices into the DPP curriculum may support sustained behaviour change to manage prediabetes and prevent development of type 2 diabetes among participants.

Complex, Varied and Evolving Manifestations of Food Agency in Daily Life Among Diabetes Prevention Program Participants in Baltimore, Maryland

ObjectiveTo characterize food agency (one's capacity to procure and prepare food in particular contexts) among Diabetes Prevention Program (DPP) participants and gather perspectives about experiences with DPP. DesignPhotograph-elicitation in-depth interviews and survey measures. SettingBaltimore, Maryland (June–August 2021). ParticipantsBlack women (n = 13) who participated in DPP. Phenomenon of InterestFood agency and strategies used to procure and prepare food and the influence of DPP on daily food behaviors. Surveys measured food agency using the Cooking and Food Provisioning Action Scale and cooking behaviors. AnalysisThematic analysis of qualitative in-depth interviews and descriptive statistics for quantitative measures. ResultsAs quantitative and qualitative data revealed, participants were frequent and confident cooks with high food agency. Participants viewed cooking as a key strategy for healthy eating and desired more hands-on cooking instruction within DPP to develop new healthy cooking skills. The primary barriers identified were related to lack of time or energy. Food procurement and preparation practices shifted over time, and DPP was a key influence on current behaviors. Conclusions and ImplicationsFood agency is complex and manifests heterogeneously in daily life. A life course, contextual, and food agency-based approach could be considered for future diabetes prevention interventions.

Using Peer Support to Prevent Diabetes: Results of a Pragmatic RCT

High-contact structured diabetes prevention programs are effective in lowering weight and HbA1cs, yet their intensity level can create barriers to participation. Peer support programs improve clinical outcomes among adults with Type 2 diabetes, but their effectiveness in diabetes prevention is unknown. This study examined whether a low-intensity peer support program improved outcomes more than enhanced usual care in a diverse population with prediabetes. The intervention was tested in a pragmatic 2-arm RCT. Participants were adults with prediabetes at three healthcare centers. Participants randomized to the enhanced usual care arm received educational materials. Participants in the Using Peer Support to Aid in Prevention and Treatment in Prediabetes arm were matched with a peer supporter: another patient who had made healthy lifestyle changes and was trained in autonomy-supportive action planning. Peer supporters were instructed to provide weekly telephone support to their peers on specific action steps toward behavioral goals for 6 months, then monthly support for 6 months. Changes in primary outcomes of weight and HbA1c and secondary outcomes of enrollment in formal diabetes prevention programs, self-reported diet, physical activity, health-specific social support, self-efficacy, motivation, and activation at 6 and 12 months were examined. Data collection occurred from October 2018 to March 2022, with analyses completed in September 2022. Among 355 randomized patients, in intention-to-treat analyses, there were no between-group differences in HbA1c or weight changes at 6 and 12 months. Using Peer Support to Aid in Prevention and Treatment in Prediabetes participants were more likely to enroll in structured programs at 6 (AOR=2.45, p=0.009) and 12 (AOR=2.21, p=0.016) months and to report eating whole grains at 6 (4.49, p=0.026) and 12 (4.22, p=0.034) months. They reported greater improvements in perceived social support for diabetes prevention behaviors at 6 (6.39, p<0.001) and 12 (5.48, p<0.001) months, with no differences in other measures. A stand-alone, low-intensity peer support program improved social support and participation in formal diabetes prevention programs but not weight or HbA1c. It will be important to examine whether peer support could effectively complement higher-intensity, structured diabetes prevention programs. This trial is registered at ClinicalTrials.gov, NCT03689530. Full protocol available at https://clinicaltrials.gov/ct2/show/NCT03689530.

Benefits and Barriers Associated With Intention to Participate in Injury Prevention Programs in Reserve Officers’ Training Corps Cadets

Identification of factors which may influence participation in exercise-related injury prevention programs within Reserve Officers’ Training Corps (ROTC) cadets is an important step in improving adoption and adherence rates. Therefore, the purpose of the study was to identify factors associated with intention to participate in an exercise-related injury prevention program within ROTC cadets. Theory of planned behavior scale perceived benefits (B = 3.65, η2 = .36, p = .001) and Health Belief Model Scale perceived benefits (B = 3.46, η2 = .31, p = .01) had a large positive association with intention to participate. Theory of planned behavior scale perceived barriers (B = −2.28, η2 = .37, p = .001) had a large negative association with intention to participate. Implementation strategies for exercise-related injury prevention programs may need to focus on the benefits and barriers of participation to increase adoption and adherence.

Relationship between mental health disorder symptoms and negative cancer perceptions among U.S. adults.

Although much emphasis has been placed on the impact of ambiguity on cognitive processes, the impact of mental health disorder symptoms and racial/ethnic disparities in cancer perception of fatalism and ambiguity remains less explored. This study explored the association between mental health disorder symptoms and negative cancer perceptions. Also, we assessed differences in these outcomes within mental health disorder symptoms and racial/ethnic subgroups to investigate the association between cancer perceptions and the other covariates within the aforementioned subgroups. We used the 2019-2020 Health Information National Trends Survey data (N = 9,303) to assess the perception of cancer fatalism and cancer communication ambiguity and employed weighted multivariable logistic regression to determine the effects of mental health disorder symptoms using the Patient Health Questionnaire-4 (PHQ-4) scale on these negative cancer perceptions among United States adults. People with moderate [Adjusted Odds Ratio (AOR) = 1.58, 95% Confidence Interval (CI) = 1.09, 2.31] and severe anxiety/depression (AOR = 1.88, 95% CI = 1.12, 3.14) symptoms were more likely to have cancer fatalism perceptions than people with no anxiety/depression symptoms. People with mild (AOR = 1.33, 95% CI = 1.06, 1.69) or severe (AOR = 1.80, 95% CI = 1.03, 3.16) anxiety/depression symptoms were more likely to perceive cancer communication as ambiguous compared to people who had no anxiety/depression symptoms. The study showed that mental health status was associated with both cancer fatalism and perceived cancer communication ambiguity. This suggests that interventions aimed at reducing mental health disorder symptoms may potentially reduce these negative perceptions, thereby improving participation in cancer prevention programs.

Cost Savings and Reduced Health Care Utilization Associated with Participation in a Digital Diabetes Prevention Program in an Adult Workforce Population.

BackgroundThough in-person delivery of the Diabetes Prevention Program (DPP) has demonstrated medical cost savings, the economic impact of digital programs is not as well understood.ObjectiveThis study examines the impact of a digital DPP program on reducing all-cause health care costs and utilization among 2027 adult participants at 12 months.MethodsA longitudinal, observational analysis of health care claims data was conducted on a workforce population who participated in a digital diabetes prevention program. Differences in utilization and costs from the year prior to program delivery through 1 year after enrollment were calculated using medical claims data for digital DPP participants compared to a propensity matched cohort in a differences-in-differences model.ResultsAt 1 year, the digital DPP population had a reduction in all-cause health care spend of US$1169 per participant relative to the comparison group (P = 0.01), with US$699 of that savings coming from reduced inpatient spend (P = 0.001). Cost savings were driven by fewer hospital admissions and shorter length of stay (P < 0.001). No other significant results in cost differences were detected. There was a trend toward savings extending into the second year, but the savings did not reach statistical significance.ConclusionsThese results demonstrated significant short-term health care cost savings at 1 year associated with digital DPP program delivery.

Higher Adherence to Anterior Cruciate Ligament Injury Prevention Programs Is Associated With Lower Injury Rates: A Meta-Analysis and Meta-Regression.

Background: Athletes who participate in sports that involve cutting and pivoting movements are particularly susceptible to anterior cruciate ligament (ACL) injury. Preventing this injury is the best way to combat its health consequences and costs. There may be a dose-response relationship between adherence and injury reduction. Purpose: We sought to examine whether athletes' adherence to injury prevention programs (IPPs) is associated with reductions in ACL and lower extremity (LE) injuries. Methods: We conducted a systematic review of the PubMed, EMBASE, and Cochrane Library databases, searching for studies published between 2011 and 2021. Studies were included if they reported on the use of an ACL IPP compared with a control group and recorded the rate of injuries to calculate a rate ratio, as well as adherence to the program as a percentage of sessions performed. For the meta-analysis, the rate ratios were pooled using the DerSimonian-Laird random-effects model. Results: For the 15 studies included (11 randomized controlled trials and 4 cohort studies), the random-effects model grouped athletes' adherence to an IPP as high (76% or more of the sessions), moderate (51%-75% of the sessions), and low (50% or fewer of the sessions). We found that athletes with the highest level of IPP adherence had a significantly lower incidence of ACL injury. The rate ratios for moderate and low adherence did not demonstrate a reduced incidence of ACL injury. Injury prevention program participation was also associated with a decrease in LE injury rates. Conclusion: This systematic review and meta-analysis found that athletes with high adherence to IPPs had reduced rates of ACL and LE injuries. Our findings suggest that educating coaches and athletes on the dose-dependent benefits of IPPs may promote the routine incorporation of these programs into warm-up sessions to decrease the risk of ACL and LE injuries.

Relationship of Subtalar Joint Range of Motion to Ankle Injuries in NBA G League and Collegiate Basketball Players.

This study sought to determine whether range of motion (ROM) of the ankle and subtalar joint complex (STJ) is correlated with ankle injuries in National Basketball Association (NBA) G-league and collegiate basketball players to identify an at-risk population that may benefit from participation in an ankle injury prevention program. This prospective cohort study encompassed 103 player-seasons (68 collegiate, 35 NBA G-League). Patient demographics, passive ankle and STJ range of motion measurements, anterior drawer, and talar tilt tests were collected at preseason physicals along with plain radiographs. Subtalar eversion and inversion measurements were added to assess the Combination Motion (CM) of the STJ and subtracted to calculate the Subtalar Difference (SD). We defined the ratio of CM to SD as Subtalar Mobility Index (SMI=CM/SD). Twenty-one ankle injuries occurred with 10 405 player exposures yielding an incidence of 2.11/1000 exposures, resulting in 113 days of missed playing time. No direct measures of ankle, subtalar, or combined motion were associated with risk of injury, rejecting our original hypothesis that increased STJ ROM would predispose to ankle injuries. However, we did find that athletes with CM >16 degrees in combination with either SD <6 degrees (P = .025) or SMI >3.75 (P = .032) were nearly 3 times more likely to have an ankle injury (3.14 vs 2.97, respectively). Using the predictive subtalar mobility thresholds found in this study may help identify at-risk players that may benefit from targeted ankle injury prevention programs. Level II, prospective cohort study.

Health Beliefs about COVID-19 Vaccination in the Geriatric Population

The Health Belief Model seeks an explanation for the lack of public participation in prevention programs; and as we get older, we are more exposed to different diseases, some of which, thanks to the development of vaccination schedules, can be prevented. However, due to the increase and dissemination of false beliefs, many people are against it. In March 2020, the WHO declares an emergency situation due to the number of COVID-19 cases, with high morbimortality rates affecting mainly the elderly, thus arising the need for a vaccine, generating beliefs towards it, either by ignorance, uncertainty and / or influence of third opinions, influencing its application. A total of 128 people were surveyed, of whom 50% were vaccinated and 50% were not; of those not vaccinated, they did not want to be vaccinated (45.7%) because of fear of adverse effects (32.7%), because they did not trust (26.5%), and because of lack of information (38.8%). On the other hand, of those vaccinated, 71.2% felt safer, 19.7% felt the same, and 9.1% felt less safe. The lack of information about vaccines as well as the yellowing of the adverse effects has increased the population that refuses to be vaccinated, increasing morbidity and mortality.