Evaluating “Not in Mama\u27s Kitchen” Second-Hand Smoke Campaign in Georgia

In 2003-2005, the Association of Black Cardiologists, Inc. initiated the Not in Mama’s Kitchen (NIMK) second-hand smoke (SHS) prevention campaign in Georgia as part of their effort to reduce exposure to SHS in African American communities statewide. This initiative was evaluated using baseline data from pledge cards as well as data from a self-administered mail survey of 1,000 campaign participants. 14,770 Georgians participated in NIMK, signing pledges to make their homes and cars smoke free. Majorities of those surveyed followed through with their pledge, banning tobacco use in their homes (76.1%) and cars (80.2%). The program was cited by 65.4% of respondents as being instrumental to their decision to ban smoking and by 81.6% as an important source of information on the dangers of SHS. Participants even became advocates, with 74.3% reporting talking to family and/or friends about the dangers of SHS and encouraging them to make their own homes smoke-free

Vital Exhaustion as a Risk Factor for Adverse Cardiac Events (from the Atherosclerosis Risk In Communities [ARIC] Study)

Vital exhaustion, defined as excessive fatigue, feelings of demoralization, and increased irritability, has been identified as a risk factor for incident and recurrent cardiac events, but there are no prospective studies of this association in United States samples. We examined the predictive value of vital exhaustion for incident myocardial infarction or fatal coronary heart disease (CHD) among middle-aged men and women in four US communities. Participants were 12,895 black or white men and women enrolled in the Atherosclerosis Risk In Communities (ARIC) Study cohort and followed for the occurrence of cardiac morbidity and mortality from 1990 through 2002 (maximum follow-up = 13.0 years). Vital exhaustion was assessed using the 21-item Maastricht Questionnaire, and partitioned into approximate quartiles for statistical analyses. High vital exhaustion (the fourth quartile) predicted adverse cardiac events in age-, gender-, and race-center-adjusted analyses (1.69 [95% C.I: 1.40 to 2.05]) and in analyses further adjusted for educational level, body mass index, plasma low density lipoprotein-and high density lipoprotein-cholesterol, systolic and diastolic blood pressure levels, diabetes mellitus, cigarette smoking status, and pack-years of cigarette smoking (1.46 [95% C.I: 1.20 to 1.79]). The risk for adverse cardiac events increased monotonically from the first through the fourth quartile of vital exhaustion. The probabilities of adverse cardiac events over time were significantly higher in people with high vital exhaustion compared to those with low exhaustion (p = 0.002). In conclusion, vital exhaustion predicts the long-term risk for adverse cardiac events in men and women, independent of the established biomedical risk factors

Clinical outcomes of COVID-19 and influenza in hospitalized children <5 years in the US

IntroductionWe compared hospitalization outcomes of young children hospitalized with COVID-19 to those hospitalized with influenza in the United States.MethodsPatients aged 0-&lt;5 years hospitalized with an admission diagnosis of acute COVID-19 (April 2021-March 2022) or influenza (April 2019-March 2020) were selected from the PINC AI Healthcare Database Special Release. Hospitalization outcomes included length of stay (LOS), intensive care unit (ICU) admission, oxygen supplementation, and mechanical ventilation (MV). Inverse probability of treatment weighting was used to adjust for confounders in logistic regression analyses.ResultsAmong children hospitalized with COVID-19 (n = 4,839; median age: 0 years), 21.3% had an ICU admission, 19.6% received oxygen supplementation, 7.9% received MV support, and 0.5% died. Among children hospitalized with influenza (n = 4,349; median age: 1 year), 17.4% were admitted to the ICU, 26.7% received oxygen supplementation, 7.6% received MV support, and 0.3% died. Compared to children hospitalized with influenza, those with COVID-19 were more likely to have an ICU admission (adjusted odds ratio [aOR]: 1.34; 95% confidence interval [CI]: 1.21–1.48). However, children with COVID-19 were less likely to receive oxygen supplementation (aOR: 0.71; 95% CI: 0.64–0.78), have a prolonged LOS (aOR: 0.81; 95% CI: 0.75–0.88), or a prolonged ICU stay (aOR: 0.56; 95% CI: 0.46–0.68). The likelihood of receiving MV was similar (aOR: 0.94; 95% CI: 0.81, 1.1).ConclusionsHospitalized children with either SARS-CoV-2 or influenza had severe complications including ICU admission and oxygen supplementation. Nearly 10% received MV support. Both SARS-CoV-2 and influenza have the potential to cause severe illness in young children

Methodologies for Improving Response Rates in Surveys of Physicians: A Systematic Review

Although physician surveys are an important tool in health services and policy research, they are often characterized by low response rates. The authors conducted a systematic review of 66 published reports of efforts to improve response rates to physician surveys. Two general strategies were explored in this literature: incentive and design-based approaches. Even small financial incentives were found to be effective in improving physician response. Token nonmonetary incentives were much less effective. In terms of design strategies, postal and telephone strategies have generally been more successful than have fax or Web-based approaches, with evidence also supporting use of mixed-mode surveys in this population. In addition, use of first-class stamps on return envelopes and questionnaires designed to be brief, personalized, and endorsed by legitimizing professional associations were also more likely to be successful. Researchers should continue to implement design strategies that have been documented to improve the survey response of physicians

Statewide prevalences of concern about enough food, 1996-1999.

OBJECTIVE: Food insecurity is defined as not having access at all times to enough food for an active and healthy life-style. A Healthy People 2010 objective is to increase food security and reduce the risk of hunger for all households. The objective of this study was to characterize the prevalence of concern about enough food and its association with other sociodemographic and health characteristics at the state level. METHODS: Adult respondents participating in the Behavioral Risk Factor Surveillance System survey provided information on concern about enough food from nine states from 1996 through 1999. RESULTS: Overall, the prevalence of concern about enough food ranged from 3.1% to 11.8% for individual states. Across states, low household income was the strongest predictor of concern about enough food. The odds of being concerned about enough food were generally higher among respondents who were female, younger, and without health care coverage. The odds were generally lower among those reporting excellent or very good general health and among non-Hispanic whites. CONCLUSION: Food security scales could be used at the state level to track progress for the Healthy People 2010 objective of reducing food insecurity and hunger across American households

Impact of a Diabetes Disease Management Program by Race and Ethnicity

Background: In the US, diabetes mellitus affects people in all racial and ethnic groups, but the prevalence and risk of complications are considerably higher among African Americans, Hispanics, American Indians, and Alaskan Natives. This study aimed to evaluate the impact of enrollment for at least 1 calendar year in a diabetes disease management program (DDMP) in a large, commercially insured, managed care population. We assessed changes in utilization of preventive services and adoption of diabetes self-management behaviors by race and ethnicity. Methods: Participants were aged >17 years and had type 1 or 2 diabetes. They were enrolled in a targeted, high-risk level DDMP between January 2003 and September 2003 and were enrolled in the managed care organization (MCO) for a 2-year period beginning 1 year prior to their enrollment in the DDMP. At baseline, 19_483 MCO enrollees who were participating in the targeted high-risk level DDMP were mailed a 40-item, self-administered baseline survey, which took between 10 and 15 minutes to complete. Baseline results are reported elsewhere. One year later, in June 2004, 5174 of the baseline responders were mailed a slightly modified version of the 40-item survey. The survey measured use of eight preventive services (cholesterol test, dental examination, dilated eye examination, urinalysis, foot examination, influenza vaccination, pneumococcal vaccination, and glycated hemoglobin testing) and engagement in four self-management behaviors (blood glucose tests, diet monitoring, exercise, and smoking avoidance). Results: Of the 5174 follow-up surveys mailed, 1961 (37.9%) were eligible for comparative analysis. Blacks and Hispanics reported more annual healthcare visits (average of 6.2 and 6.5, respectively) compared with Whites (average of 5.0, p_Diabetes-mellitus, Disease-management-programme-evaluation, Disease-management-programmes, Ethnic-groups

Understanding the Barriers and Attitudes toward Influenza Vaccine Uptake in the Adult General Population: A Rapid Review

Influenza is a common respiratory infection associated with a substantial clinical, humanistic, and economic burden globally. Vaccines are essential to prevent and control influenza and are recommended by public-health agencies, such as the WHO and US CDC; however, vaccination rates vary considerably across the globe. This review aimed to investigate the perceived barriers and attitudes to influenza vaccination in the global population, in order to identify strategies that may improve influenza vaccination coverage. A structured literature search was undertaken to identify studies that reported on patient-reported attitudes towards influenza vaccination, focused on the adult general population in 16 prespecified countries. Eighty studies were included in this review. Negative attitude towards healthcare were found to be the most agreed upon barrier to vaccine uptake (31.1% agreement). The most agreed promoter of influenza vaccination was trust in healthcare services (62.0% agreement). Approximately 50% of participants intended to receive the influenza vaccine in the following season. To improve influenza vaccination coverage, healthcare workers must strengthen the foundation of substantial trust in healthcare services and provide educational materials that improve influenza vaccination knowledge among the adult general population