Preventive Health Topics Research Articles

The Impact of a Student-Led Health Education Clinic on the Health Literacy and Behaviors of a Rural Community in the State of Pennsylvania, USA.

Rural populations experience a number of disparities that place them at increased risk of morbidity and mortality related to chronic disease, including lower health literacy and greater distance to medical care. Community-based free healthcare education can offer targeted preventive care to these vulnerable populations; however, limited quantitative research exists measuring their impact, specifically on health literacy and likelihood for behavior change. To investigate this, a student-led health education clinic was held in January 2023 in the rural community of Lykens, Pennsylvania by the Student-run and Collaborative Outreach Program for Health Equity (SCOPE). Fifty-five pre- and post-clinic surveys using Likert-style questions measured the knowledge and likelihood of behavioral change for several preventive health topics, including hypertension, diabetes mellitus, cancer screenings, childhood vaccinations, skin cancer, mental health, addiction, and nutrition. From pre- to post-clinic, there was a significant increase in knowledge of hypertension (p = 0.023) and diabetes (p = 0.014), likelihood of attending cancer screenings (p = 0.038), and confidence in identifying cancerous moles (p = < 0.001). There was a non-significant increase in understanding of mental health and nutrition, and no change in understanding of addiction or childhood vaccinations. It is likely that the level of interaction in education provided and relevance of information to participants contributed to effective uptake of information. The results demonstrate an immediate impact on health literacy and likelihood of behavioral change for several important preventive health topics, and advocate for the use of student-run healthcare interventions in addressing the prevalence of chronic disease in rural communities.

The Cost of Diversity: An Analysis of Representation and Cost Barriers in Stock Photo Libraries for Health Education Materials, 2021.

Ineffective health communication can drive health disparities and limit the effectiveness of interventions to reduce them. Stock photo libraries are a critical tool for developers of patient education, health education, and intervention materials. It is not clear how well stock photo libraries represent communities bearing disproportionate burdens of disease. We conducted a search using five popular stock image libraries (Adobe Stock Images, Canva, Getty Images, Microsoft Office Image Library, and Pixabay) in November 2021 to evaluate diversity and representation in health-related stock photos. We searched for the following five key preventive health topics: healthy eating, exercising, quitting smoking, vaccination, and pregnancy. The images (N = 495) were coded for age, gender presentation, representation of perceived minoritized racial/ethnic identity, skin color using the Massey-Martin skin color scale, markers of high socioeconomic status (SES), and access costs. Results. The representation of perceived minoritized people, darker skin color, and inclusion of markers of high SES varied greatly by the search term and library. Images predominately portrayed young adults and adults, with limited representation of other age groups. Images in libraries with any paywall were significantly more likely to depict a person of perceived minoritized racial/ethnic identity and depict darker skin colors, and were significantly less likely to contain markers of high SES identity than images in libraries that were free to use. We found that it costs more to develop culturally relevant health education materials for minoritized populations and groups that do not represent high SES populations. This may hinder the development of effective communication interventions.

A Re-design Proposal for the ‘Occupational’ &amp; ‘Environmental’ Medicine syllabus under ‘Community Medicine’ subject of the third-year MBBS curriculum in Bangladesh: Suggesting to apply ‘PBLs’, ‘Blended-learning (or, flipped classroom)’ and ‘Guest-lectures’

The reported illnesses and injuries attributed to environmental and occupational factors is a major health challenge being experienced globally over the years.1 In current decade, Bangladesh has experienced a number of environmental and occupational health-related hazards that not only have cost huge government involvement, medically and financially but also caused international bodies to intervene into local affairs (see Table 1). These unprecedented events often question how prepared are young Bangladeshi doctors if they are to receive and manage disaster-victims at real time.2 Globally, ‘Occupational and Environmental Medicine (OEM)’ subject is lectured at third-year of the MBBS course during ‘Population Health’ or ‘Community Medicine’ rotation. Efficient, effective and enjoyable learning on OEM-topics can equip future doctors with important basic knowledge and required practical skills that are necessary to manage cases/victims from pandemic, work-hazards or disasters. Students’ positive engagement with OEM may raise their interest with specialist careers in Community Medicine (Com-Med). Some developed-country studies3-7 reported that students who went through problem-based-learning (PBL) tutored classes made better academic performance on Preventive Medicine, Public Health and Community Health topics than those who had experienced traditionally lecture-tutored curriculum. An Indian study done by Joseph et al.8 documented similar findings. The purpose of this review paper is to appraise current OEM-syllabus under the Com-Med curriculum in Bangladesh and scope, whether the PBLs or case-based-learning (CBLs) model could be appropriate if applied through ‘blended-learning’ or, ‘flipped-classroom (backed by audio-video supports)’ format. This literature-evidenced, student-centred teaching model expectedly would improve students’ practically-oriented learning via their in-class working over real-life cases/problems. Ideally, these cases would be constructed by content-experts and delivered initially by guest-lecturers.&#x0D; Bangladesh Journal of Medical Education Vol.12(1) 2021: 50-67

Many Parents Would Accept Sexually Transmitted Infection Screening for Their Adolescent at a Pediatric Office Visit

PurposeSexually active adolescents are at risk for sexually transmitted infections (STIs), yet screening is infrequently performed during pediatric visits. Lack of parent support and confidentiality are barriers. We explored whether parents of 15- to 17-year-olds would accept chlamydia and gonorrhea screening for their adolescent during a pediatric visit and assessed parental views on the importance of sexual health services. MethodsA survey of 168 parents of adolescents was conducted during an outpatient pediatric office visit in Western Pennsylvania. ResultsMost parents (63%) accept STI screening for their adolescent during a pediatric visit, and 73% think it is important that adolescents spend time alone with their provider. Parents ranked the importance of discussing sexual health as high as other preventive health topics. ConclusionsGiven the burden of STIs among adolescents, pediatricians should use this information to facilitate STI screening during office visits, secure time alone with their patients, and offer sexual health counseling.

Examining US Pediatric Residents’ Oral Health Care Knowledge, Training, Practices and Perceptions

Pediatric residents nationwide (n=187) completed an anonymous survey designed to assess their confidence and knowledge surrounding oral health topics, level of oral health training in residency, attitudes regarding pediatricians’ role in oral health care, and likelihood of performing specific oral health tasks. On average, pediatric residents reported feeling “moderately knowledgeable” about preventive oral health topics and “slightly knowledgeable” about developmental oral health topics. Overall, residents answered 62% of preventive oral health questions and 46% of developmental oral health questions correctly. Residents reported receiving low levels of oral health training, with 5 out of 9 oral health topics covered by fewer than 50% of respondents. Most residents agreed that pediatricians play an important role in oral health care but fewer residents routinely performed oral health tasks. Increased emphasis on this subject in residency education is essential for the promotion of children’s oral health.

My Tooth Got Knocked Out! Inadequate Knowledge among Pediatric Residents on Preventive Oral Health Topics

Background: In order to diminish morbidities associated with poor oral health in the pediatric patient population, pediatricians must be knowledgeable about preventive oral health (POH). Without a satisfactory knowledge of POH, pediatric residents (PR) cannot incorporate preventive interventions into their practices and effectively address pediatric oral health needs. Our study assessed the extent to which PR are knowledgeable about POH. Methods: 65 pediatric residency programs in 35 states were emailed an anonymous survey. PR were asked to answer a series of multiple-choice questions (MCQ), each …

My Tooth Got Knocked Out! Inadequate Knowledge among Pediatric Residents on Preventive Oral Health Topics

My Tooth Got Knocked Out! Inadequate Knowledge among Pediatric Residents on Preventive Oral Health Topics

Strategies to reach marginalized women for cervical cancer screening: A qualitative study of stakeholder perspectives.

Self-sampling for human papillomavirus (hpv) has the potential to reach marginalized populations that are underserved for cervical cancer screening. However, before implementing an alternative screening strategy such as self-sampling for under- and never-screened women, the key processes, facilitators, and barriers to reform need to be understood. A descriptive qualitative study was conducted that involved semi-structured interviews with Canadian and international cancer screening health care providers and policy-makers. Respondents were purposively selected from a list of thirty stakeholders generated through an environmental scan. The interviews were transcribed verbatim and analyzed using directed content analysis. Nineteen stakeholders participated in the interviews. Most respondents thought that self-sampling was an appropriate cervical screening alternative for hard-to-reach populations, as it addressed barriers to cervical screening related to various social determinants of health. All respondents emphasized that transitioning to hpv primary screening would catalyze a policy shift towards self-sampling. Clinician respondents were less enthusiastic about self-sampling strategies since that discouraged women's appointments with primary care providers, because cervical screening offered an opportunity to discuss other preventive health topics. There also was little consensus between respondents on whether the state of evidence was satisfactory to integrate a self-sampling option into policy, or whether more Canadian research was needed. Canadian cervical cancer screening stakeholders should collaborate to identify the knowledge gaps that researchers should address and leverage the existing literature to implement tailored, patient-centred alternative cervical screening strategies. The transition to hpv primary screening would be a key first step in the broad implementation of hpv self-sampling in Canada.

The American College of Preventive Medicine Policy Recommendations on Public Health Funding

The American College of Preventive Medicine Policy Committee makes policy guidelines and recommendations on Preventive Medicine and Public Health topics for Public Health decision makers. After a review of the current evidence available in 2016, the College is providing policy recommendations designed to inform public health investment. The American College of Preventive Medicine advocates for policies that recognize the health and economic value of public health funding and promote investment in these vital capabilities. Shortfalls in public health infrastructure, particularly workforce funding, must be corrected to ensure lasting benefits. Contingency funding for public health emergencies should be established and fully funded to adequately respond to emerging threats.

Practice Policy Statement: Integrating Effective Weight Management Into Practice.

The American College of Preventive Medicine Prevention Practice Committee contributes to policy guidelines and recommendations on preventive health topics for clinicians and public health decision makers. As an update to a previously published statement on weight management counseling of overweight adults, the College is providing a consensus-based recommendation designed to more effectively integrate weight management strategies into clinical practice and to incorporate referrals to effective evidence-based community and commercial weight management programs. The goal is to empower providers to include lifestyle interventions as part of the foundation of clinical practice.

The American College of Preventive Medicine Position Statement on Hepatitis C Virus Infection.

The American College of Preventive Medicine Prevention Practice Committee contributes to policy guidelines and recommendations on preventive health topics for clinicians and public health decision makers. After review of the currently available evidence, the College is providing a consensus-based set of recommendations designed to increase screening for and prevention of hepatitis C virus infection, increase linkage to care, improve access to treatment, and encourage development of hepatitis C virus-related quality measures.

54. Are Health Providers Meeting the Perceived Adolescent Preventive Health Needs of Parents of Adolescents?

We compared parental recall of adolescent preventive health topics that a pediatric provider had discussed with the parents to topics identified by parents as those most important for them to receive information about to ensure the health of their child.

A structured women's preventive health clinic for residents: a quality improvement project designed to meet training needs and improve cervical cancer screening rates

Multiple resident-related factors contribute to 'missed opportunities' in providing comprehensive preventive care for female patients, including comfort level, knowledge and experience--all of which are compounded by resident turnover rates. Of particular concern among Internal Medicine (IM) residents is their knowledge and comfort level in performing pelvic exams. To evaluate the impact of a quality improvement project of implementing a Women's Preventive Health Clinic (WPHC) on addressing gaps identified by needs assessments: residents' comfort and knowledge with female preventive care and cervical cancer screening. The WPHC, a multidisciplinary weekly clinic, focused on preventive services for women with chronic conditions. The alternating didactic and clinic sessions emphasised women's preventive health topics for IM residents. Sixty-three IM residents participated in WPHC between 2002 and 2005. Pre- and post-test design was used to assess resident knowledge and comfort levels. Cervical cancer screening rates of residents' patients were assessed pre- and post-WPHC initiation. There was a significant improvement in general knowledge (64% correct at pretest vs 73% at post-test, p=0.0002), resident comfort level in discussing women's health topics and performing gynaecological exams (p<0.0002). Cervical cancer screening rates among IM residents' patients improved from 54% (pre-WPHC initiation) to 65% (post-WPHC initiation period). The results indicate that a focused resident preventive programme can meet gaps identified by education and needs assessments, and simultaneously have a positive impact on cervical cancer screening rates and thus may serve as a model for other residency programmes.

Development of a Breast and Cervical Cancer Screening Intervention for Vietnamese American Women

Community-based participatory research (CBPR) is a collaborative partnership approach to research that combines the efforts of researchers and stakeholders. CBPR can effectively be used to target local community populations in increasing knowledge and improving behaviors in cancer prevention as participants have a voice and active role in the research process. This article describes how CBPR was used in the development, implementation, and evaluation of a pilot intervention for breast and cervical cancer screening among a Vietnamese female population. The authors outline the use of CBPR in three phases: (a) the identification of preventive health topics important in the local Vietnamese community, (b) the development and administration of a survey to gain a deeper understanding of barriers to breast and cancer screening among Vietnamese women, and (c) the development of a culturally appropriate pilot intervention to promote cancer screening behavior among a local Vietnamese population. In Study 1, it was found that Vietnamese women experienced disparities in breast and cervical cancer screening. In Study 2, it was found that having health insurance and a regular physician were predictive of breast and cervical cancer screening. It was also found that participants had low levels of acculturation and lacked cancer screening knowledge. In Study 3, it was found that the culturally relevant intervention used in this study improved cancer screening-related outcomes in knowledge, self-efficacy, intention, and behavior.

Adolescent Preventive Services: Rates and Disparities in Preventive Health Topics Covered during Routine Medical Care in a California Sample

Purpose The objective was to examine rates and disparities in preventive health topics covered during routine medical care for adolescents, using a California sample. Methods Utilizing 2003 California Health Interview Survey data, the sample included 2192 adolescents attending a physical exam within the past 6 months. Adolescents reported whether nine health topics: tobacco, alcohol, drugs, seatbelts, helmets, violence, exercise, nutrition, and sexually transmitted diseases (STDs) were discussed during their most recent physical exam. Outcomes were rates of health topics discussed and disparities in rates based on age, gender, race/ethnicity, income level, and insurance status. Results Rates ranged from 15% (violence) to 76% (nutrition, exercise). Compared to older teens, younger teens reported discussing safety more, but substances, nutrition, and STDs less. Compared to males, females reported discussing tobacco and helmets less, but exercise and STDs more. Compared to white youths, Hispanic youths reported more discussion of most topics, black youths reported more discussion of nutrition and less of violence, and Asian youths reported more discussion of seatbelts and helmets. Lower income and uninsured groups reported more discussion of health topics compared to higher income and insured groups. Conclusions Rates of coverage of health topics are below recommended levels. Contrary to expectations, minority, uninsured, and lower income groups reported higher rates of discussing health topics. Strategies to increase the coverage of preventive health topics during routine medical care should address these findings.

HIV Prevention in the Clubhouse

HIV Prevention in the Clubhouse

Seconds for Care: Evaluation of Five Health Supervision Visit Topics Using a New Method

To describe content and time devoted to 5 preventive health topics during health supervision visits (HSVs). New software (Pediatric Health Supervision Timer Software, PHSTS) run in handheld computers was developed to record time and content while observing HSVs. 185 visits of children ages 2 to 10 years (58% Medicaid/self-pay) to 28 clinicians were observed at 6 practices. Parents were surveyed on demographics. Data on times and actions related to assessments and counseling of growth, diet, physical activity, safety, and tobacco were collected using PHSTS. The PHSTS method was well accepted (89% participation rate). Most visits included assessment/counseling for diet (95%), growth (84%), and safety (71%) and less often physical activity (52%) and tobacco (43%). Discussions occurring were short (median time [25th to 75th percentiles]: diet, 42 seconds [21 to 85 seconds]; safety, 24 seconds [11 to 61 seconds]; growth, 15 seconds [7 to 31 seconds]; physical activity, 12 seconds [5 to 22 seconds]; and tobacco, 3 seconds [2 to 6 seconds]). Clinicians expressed concerns about child weight during 18 of 33 visits (55%) that included an obese child and provided tobacco-related counseling at 6 of 30 visits (20%) that included a child living with a smoker. The PHSTS method was successfully used. Our observations found that limited time was devoted to assessment and counseling on key health topics during HSVs.

What We Discuss at Well-Child Visits

Primary care pediatricians are challenged by guidelines that recommend discussing many preventive-health topics during well-child visits. To assess

Predictors of preventive health knowledge among female emergency department patients

Study objectives: A broad sample of 18- to 55-year-old women seeking treatment at a high-volume, urban emergency department (ED) were invited to participate in a study with the goals of (1) defining the extent of their knowledge on the purpose and suggested intervals of preventive health screening modalities and contraceptive and sexually transmitted disease preventive techniques relevant to women; and (2) determining whether demographic characteristics and medical history predict their knowledge on these topics. Methods: Using published surveys on women's health topics as a template, the authors created an anonymous, written, multiple-choice, self-administered, English-language survey about Papanicolaou tests, breast self-examinations, mammograms, condoms, emergency contraception, and birth control. After the instrument was pilot tested, surveys were administered to 18- to 55-year-old English-speaking women seeking treatment in our ED during 66 8-hour shifts in July and August 2002, 32 4-hour shifts in October and November 2002, and 32 4-hour shifts in April and May 2003. To reflect the patient volume patterns for the ED, each day of the week was sampled equally, and shifts were sampled so that 25% of the 7 am to 11 am shifts, 50% of the 11 am to 11 pm shifts, and 25% of the 11 pm to 7 am shifts were represented. In addition to demographic questions, the women were asked about their medical history, including use of screening modalities, contraceptive and sexually transmitted disease preventive techniques, and knowledge-based questions on the who, why, when, and how often of the screening and preventive techniques recommended use. Surveys were entered into an Epi Info 2002 database and analyzed in STATA 7. Analyses included summary statistics and constructing multivariable logistic regression models to predict correct responses to the knowledge-based questions by using demographic characteristics and medical history variables as potential predictors. Results: Of 1,203 women approached to participate in the survey, 1,101 spoke English, and 780 (70.8%) of these agreed to complete all or part of the questionnaire. The majority of respondents were white, single, Catholic, and without health insurance. Most (62%) of the women in the sample were younger than 35 years ( P P Conclusion: Although women in this age group demonstrated strong knowledge on some preventive health topics, there were clear areas of knowledge deficit, particularly about mammograms and emergency contraception. Younger, nonwhite women without private insurance appear less likely to understand the purpose of and recommended intervals for preventive health screening modalities and contraceptive and sexually transmitted disease preventive techniques. During interaction with these subgroups, emergency physicians should be mindful of potential misunderstandings on these topics and address them accordingly.

Interest in Preventive Health Topics Changed in New York after the Disaster on September 11, 2001

Interest in Preventive Health Topics Changed in New York after the Disaster on September 11, 2001