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Annals of Internal Medicine Oct 2022The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is intended to improve maternal and child health outcomes. In 2009, the WIC food... (Review)
Review
BACKGROUND
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is intended to improve maternal and child health outcomes. In 2009, the WIC food package changed to better align with national nutrition recommendations.
PURPOSE
To determine whether WIC participation was associated with improved maternal, neonatal-birth, and infant-child health outcomes or differences in outcomes by subgroups and WIC enrollment duration.
DATA SOURCES
Search (January 2009 to April 2022) included PubMed, Embase, CINAHL, ERIC, Scopus, PsycInfo, and the Cochrane Central Register of Controlled Trials.
STUDY SELECTION
Included studies had a comparator of WIC-eligible nonparticipants or comparison before and after the 2009 food package change.
DATA EXTRACTION
Paired team members independently screened articles for inclusion and evaluated risk of bias.
DATA SYNTHESIS
We identified 20 observational studies. We found: moderate strength of evidence (SOE) that maternal WIC participation during pregnancy is likely associated with lower risk for preterm birth, low birthweight infants, and infant mortality; low SOE that maternal WIC participation may be associated with a lower likelihood of inadequate gestational weight gain, as well as increased well-child visits and childhood immunizations; and low SOE that child WIC participation may be associated with increased childhood immunizations. We found low SOE for differences in some outcomes by race and ethnicity but insufficient evidence for differences by WIC enrollment duration. We found insufficient evidence related to maternal morbidity and mortality outcomes.
LIMITATION
Data are from observational studies with high potential for selection bias related to the choice to participate in WIC, and participation status was self-reported in most studies.
CONCLUSION
Participation in WIC was likely associated with improved birth outcomes and lower infant mortality, and also may be associated with increased child preventive service receipt.
PRIMARY FUNDING SOURCE
Agency for Healthcare Research and Quality. (PROSPERO: CRD42020222452).
Topics: Child; Female; Humans; Infant; Infant, Newborn; Pregnancy; Food Assistance; Premature Birth; Program Evaluation; Nutrition Policy; Observational Studies as Topic
PubMed: 36063550
DOI: 10.7326/M22-0604 -
Preventing Chronic Disease Aug 2022Policy, systems, and environmental (PSE) change approaches frequently address healthy eating and active living (HEAL) priorities. However, the health effects of PSE HEAL... (Review)
Review
INTRODUCTION
Policy, systems, and environmental (PSE) change approaches frequently address healthy eating and active living (HEAL) priorities. However, the health effects of PSE HEAL initiatives are not well known because of their design complexity and short duration. Planning and evaluation frameworks can guide PSE activities to generate collective impact. We applied a systematic mapping review to the Individual plus PSE Conceptual Framework for Action (I+PSE) to describe characteristics, achievements, challenges, and evaluation strategies of PSE HEAL initiatives.
METHODS
We identified peer-reviewed articles published from January 2009 through January 2021 by using CINAHL, Web of Science, MEDLINE, PsycINFO, and CAB Abstracts databases. Articles describing implementation and results of PSE HEAL initiatives were included. Activities were mapped against I+PSE components to identify gaps in evaluation efforts.
RESULTS
Independent reviewers examined 437 titles and abstracts; 52 peer-reviewed articles met all inclusion criteria. Twenty-four focused on healthy eating, 5 on active living, and 23 on HEAL. Descriptive analyses identified federal funding of initiatives (typically 1-3 years), multisector settings, and mixed-methods evaluation strategies as dominant characteristics. Only 11 articles reported on initiatives that used a formal planning and evaluation framework. Achievements focused on partnership development, individual behavior, environmental or policy changes, and provision of technical assistance. Challenges included lack of local coalition and community engagement in initiatives and evaluation activities and insufficient time and resources to accomplish objectives. The review team noted vague or absent descriptions of evaluation activities, resulting in questionable characterizations of processes and outcomes. Although formation of partnerships was the most commonly reported accomplishment, I+PSE mapping revealed a lack of engagement assessment and its contributions toward initiative impact.
CONCLUSION
PSE HEAL initiatives reported successes in multiple areas but also challenges related to partnership engagement and community buy-in. These 2 areas are essential for the success of PSE HEAL initiatives and need to be adequately evaluated so improvements can be made.
Topics: Diet, Healthy; Humans; Policy
PubMed: 36007254
DOI: 10.5888/pcd19.210466 -
American Journal of Public Health Jul 2016Health disparities are aggravated when prevention and care initiatives fail to reach those they are intended to help. Groups can be classified as hardly reached... (Review)
Review
BACKGROUND
Health disparities are aggravated when prevention and care initiatives fail to reach those they are intended to help. Groups can be classified as hardly reached according to a variety of circumstances that fall into 3 domains: individual (e.g., psychological factors), demographic (e.g., socioeconomic status), and cultural-environmental (e.g., social network). Several reports have indicated that peer support is an effective means of reaching hardly reached individuals. However, no review has explored peer support effectiveness in relation to the circumstances associated with being hardly reached or across diverse health problems.
OBJECTIVES
To conduct a systematic review assessing the reach and effectiveness of peer support among hardly reached individuals, as well as peer support strategies used.
SEARCH METHODS
Three systematic searches conducted in PubMed identified studies that evaluated peer support programs among hardly reached individuals. In aggregate, the searches covered articles published from 2000 to 2015.
SELECTION CRITERIA
Eligible interventions provided ongoing support for complex health behaviors, including prioritization of hardly reached populations, assistance in applying behavior change plans, and social-emotional support directed toward disease management or quality of life. Studies were excluded if they addressed temporally isolated behaviors, were limited to protocol group classes, included peer support as the dependent variable, did not include statistical tests of significance, or incorporated comparison conditions that provided appreciable social support.
DATA COLLECTION AND ANALYSIS
We abstracted data regarding the primary health topic, categorizations of hardly reached groups, program reach, outcomes, and strategies employed. We conducted a 2-sample t test to determine whether reported strategies were related to reach.
RESULTS
Forty-seven studies met our inclusion criteria, and these studies represented each of the 3 domains of circumstances assessed (individual, demographic, and cultural-environmental). Interventions addressed 8 health areas, most commonly maternal and child health (25.5%), diabetes (17.0%), and other chronic diseases (14.9%). Thirty-six studies (76.6%) assessed program reach, which ranged from 24% to 79% of the study population. Forty-four studies (94%) reported significant changes favoring peer support. Eleven strategies emerged for engaging and retaining hardly reached individuals. Among them, programs that reported a strategy of trust and respect had higher participant retention (82.8%) than did programs not reporting such a strategy (48.1%; Pā=ā.003). In 5 of the 6 studies examining moderators of the effects of peer support, peer support benefits were greater among individuals characterized by disadvantage (e.g., low health literacy).
CONCLUSIONS
Peer support is a broad and robust strategy for reaching groups that health services too often fail to engage. The wide range of audiences and health concerns among which peer support is successful suggests that a basis for its success may be its flexible response to different contexts, including the intended audience, health problems, and setting.
PUBLIC HEALTH IMPLICATIONS
The general benefits of peer support and findings suggesting that it may be more effective among those at heightened disadvantage indicate that peer support should be considered in programs intended to reach and benefit those too often hardly reached. Because engendering trust and respect was significantly associated with participant retention, programs should emphasize this strategy.
Topics: Culture; Environment; Health Behavior; Health Education; Humans; Mental Disorders; Peer Group; Social Support; Socioeconomic Factors; Vulnerable Populations
PubMed: 27196645
DOI: 10.2105/AJPH.2016.303180 -
BMJ Clinical Evidence Mar 2007Many people diagnosed with sexually transmitted disease do not have symptoms, and may not inform their past or current sexual partners of their diagnosis, or routinely... (Review)
Review
INTRODUCTION
Many people diagnosed with sexually transmitted disease do not have symptoms, and may not inform their past or current sexual partners of their diagnosis, or routinely use condoms. Several strategies have been used to notify and treat partners of people diagnosed with sexually transmitted diseases, but only a limited number of RCTs of their effectiveness have been undertaken.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of different partner notification strategies in people with different sexually transmitted diseases? What can be done to improve the effectiveness of patient referral? We searched: Medline, Embase, The Cochrane Library and other important databases up to April 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found seven systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: contract referral, educational videos, information pamphlets, outreach assistance, patient referral, patient referral via different types of healthcare professionals, provider referral, telephone reminders, and contact cards.
Topics: Contact Tracing; United States; United States Food and Drug Administration
PubMed: 19454056
DOI: No ID Found -
Reviews of Infectious Diseases 1991Acute lower respiratory infection in children is a major cause of morbidity and mortality in developing countries. Viral and bacterial agents incite characteristic host... (Review)
Review
Acute lower respiratory infection in children is a major cause of morbidity and mortality in developing countries. Viral and bacterial agents incite characteristic host responses at the level of the bronchi, bronchioles, alveolar walls, and air spaces that correlate with the clinical course. A systematic review of histopathologic features will enhance the understanding of the pathogenetic mechanisms and cofactors that influence the disease process, particularly how tissue injury may be influenced by nutritional status and access to antibiotics. Research priorities include immunologic assessment, micronutrient assays, and standardized autopsies in developing countries. DNA probes for organisms and immunocytochemical identification of cell markers in tissue promise a new era in microscopic visualization of pathogen-host interactions. International collaborative research between ministries of public health and medical universities must be encouraged as a means of providing technical assistance and of advancing new knowledge. Systematic standardized autopsy studies from multiple geographic areas may help define pathologic mechanisms, monitor the natural history of disease, and evaluate interventions in diverse populations.
Topics: Acute Disease; Bronchiolitis; Bronchopneumonia; Child; Cytomegalovirus Infections; Developing Countries; Humans; Pneumonia; Pneumonia, Aspiration; Pneumonia, Pneumococcal; Pneumonia, Viral; Pulmonary Fibrosis; Vitamin A Deficiency
PubMed: 1650493
DOI: 10.1093/clinids/13.supplement_6.s470 -
European Journal of Surgical Oncology :... Aug 2021Head and neck cancers (HNC) are relatively fast-growing tumours, and delay in treatment initiation is associated with tumour progression and adverse outcome. An overview...
INTRODUCTION
Head and neck cancers (HNC) are relatively fast-growing tumours, and delay in treatment initiation is associated with tumour progression and adverse outcome. An overview of factors contributing to delay can provide critical insights on necessary adjustments to optimize care pathways. This systematic review aims to identify factors associated with delay and summarize the effect of delay on oncological outcome measures.
METHODS
A search strategy was conducted according to PRISMA guidelines to search electronic databases for studies assessing the carepathway interval (days between first visit in head and neck oncology center and treatment initiation) and/or time-to-treatment-initiation interval (days between histological diagnosis and treatment initiation) and 1) determinants of delay and/or 2) effect of delay on outcome within these timeframes. Due to heterogeneity between included studies, a meta-analysis was not possible.
RESULTS
Fifty-two studies were eligible for quantitative analysis. Non-Caucasian race, academic setting, Medicaid/no insurance and radiotherapy as primary treatment were associated with delay. Advanced tumour stage was related to increased time-to-treatment initiation in the four common sites combined (oral cavity, oropharynx, hypopharynx, larynx). Separate determinants for delay in different tumour locations were identified. In laryngeal, oral cavity cancer and the four common HNC sites combined, delay in start of treatment is associated with decreased overall survival, although no cut-off time point could be determined.
CONCLUSION
Race, facility type, type of insurance and radiotherapy as primary treatment were associated with delay and subsequent inferior survival in the four common sites combined.
Topics: Academic Medical Centers; Ethnic and Racial Minorities; Ethnicity; Head and Neck Neoplasms; Humans; Insurance, Health; Medicaid; Medically Uninsured; Neoplasm Staging; Radiotherapy; Risk Factors; Squamous Cell Carcinoma of Head and Neck; Survival Rate; Time-to-Treatment; United States
PubMed: 33715909
DOI: 10.1016/j.ejso.2021.02.029 -
International Journal of Environmental... Feb 2022This systematic review and meta-analysis aimed to determine the prevalence of violence perpetrated by healthcare workers (HCWs) against patients in long-term care (LTC).... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis aimed to determine the prevalence of violence perpetrated by healthcare workers (HCWs) against patients in long-term care (LTC). For this purpose, five relevant databases were searched. Two reviewers extracted data from the included articles independently and assessed their quality. Overall and subgroup random-effects pooled prevalence meta-analyses were performed. A series of meta-analyses stratified by study quality were also performed due to high heterogeneity. Nineteen articles were included, physical restraint (22%; CI: 15-29), verbal abuse (22%; CI: 16-28), and neglect (20%; CI: 15-26) attained the highest overall prevalence, while sexual abuse was less reported (2%; CI: 1-3). The prevalence of witnessed violence is generally higher than those reported by HCWs, and patients and their relatives reported fewer cases of violence than HCWs. Differences in violence perpetrated among LTC settings were found. Neglect (64%; CI: 56-72) and financial abuse (7%; CI: 3-12) reported by HCWs were higher in home care, while verbal abuse (21%; CI: 7-39) reported by patients or their families was higher in nursing homes. Our findings highlight that violence perpetrated by HCWs toward patients represents a significant concern in LTC, suggesting the adoption of reliable monitoring approaches and provision of assistance to victims in reporting abuse.
Topics: Health Personnel; Humans; Long-Term Care; Physical Abuse; Prevalence; Professional-Patient Relations; Workplace Violence
PubMed: 35206547
DOI: 10.3390/ijerph19042357 -
The American Journal of Occupational... Jan 2022Interventions that promote function, medication reconciliation, and skin integrity assist occupational therapy practitioners in demonstrating professional value,...
IMPORTANCE
Interventions that promote function, medication reconciliation, and skin integrity assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing health care costs.
OBJECTIVE
In this systematic review, we focus on three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: functional status, medication reconciliation, and skin integrity.
DATA SOURCES
We conducted a search of the literature published between 2009 and 2019 in CINAHL, Cochrane, MEDLINE, PsycINFO, OTseeker, and Scopus. We also hand searched the systematic reviews and meta-analyses in our search results for articles that met our inclusion criteria. Study Selection and Data Collection: This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
FINDINGS
We found 47 articles that address the three outcome areas. Regarding functional status, low strength of evidence is available for cognition and functional mobility interventions to support functional performance, moderate strength of evidence supports interventions for vision, and moderate evidence supports task-oriented and individualized interventions to promote activities of daily living (ADL) outcomes among people with neurological conditions. Strong strength of evidence supports individualized occupational therapy interventions focusing on medication adherence. Low strength of evidence was found for occupational therapy interventions to reduce pressure ulcers and promote skin integrity. Conclusion and Relevance: The evidence supports occupational therapy interventions to improve functional status in ADLs and medication management. Additional research is needed that examines the outcomes of occupational therapy interventions for other areas of function and skin integrity. What This Article Adds: We found evidence to support occupational therapy interventions that align with value-based measures in the three outcome areas of interest. The effectiveness of these interventions highlights the viability of occupational therapy as an essential profession and the worth of occupational therapy to the public, potential clients, and payers.
Topics: Activities of Daily Living; Aged; Functional Status; Humans; Medicare; Medication Reconciliation; Occupational Therapy; Subacute Care; United States
PubMed: 35019969
DOI: 10.5014/ajot.2022.049324 -
International Journal of Environmental... Sep 2018As the number of migrants worldwide increases, it is worthwhile to examine the extent to which depression has affected this group of often vulnerable individuals. The... (Meta-Analysis)
Meta-Analysis
As the number of migrants worldwide increases, it is worthwhile to examine the extent to which depression has affected this group of often vulnerable individuals. The purpose of this systematic review and meta-analysis is to examine the aggregate prevalence of depression among international migrants and to explore the variations in prevalence with demographic and educational factors. A search was conducted on the online databases PubMed and ScienceDirect whole using the terms "depression", "depressive disorder", "immigration", "immigrant", "migration", and "migrant". A total of 25 studies met our inclusion criteria. A random-effects model meta-analysis calculated an aggregate prevalence of 15.6% among migrants. Heterogeneity was identified by meta-regression and subgroup analyses, and the level of educational attainment, employment status, and length of residency spent in country of migration were found to be significant moderators contributing to depression prevalence. In conclusion, newly arrived migrants appear to be susceptible to developing depression and it is imperative that more in the form of preventive strategies and increased assistance be incorporated to ensure their psychological wellbeing and improve their mental health outcomes. Further research should be conducted to better understand the risk of psychiatric disorders among members of this subpopulation.
Topics: Depression; Depressive Disorder; Emigration and Immigration; Female; Humans; Male; Models, Statistical; Prevalence; Risk Factors; Transients and Migrants; Vulnerable Populations
PubMed: 30213071
DOI: 10.3390/ijerph15091986 -
Occupational Therapy International Mar 2012Occupational therapists have recognized the benefits that service dogs can provide people with disabilities. There are many anecdotal publications extolling the benefits... (Review)
Review
Occupational therapists have recognized the benefits that service dogs can provide people with disabilities. There are many anecdotal publications extolling the benefits of working with service dogs, but few rigorous studies exist to provide the evidence of the usefulness of this type of assistive technology option. This systematic review evaluates the published research that supports the use of service dogs for people with mobility-related physical disabilities. Articles were identified by computerized search of PubMed, CINAHL, PsycINFO, OT Seeker, the Cochrane Database of Systematic Reviews, SportDiscus, Education Research Complete, Public Administration Abstracts, Web of Knowledge and Academic Search Premier databases with no date range specified. The keywords used in the search included disabled persons, assistance dogs or service dogs and mobility impairments. The reference lists of the research papers were checked as was the personal citation database of the lead author. Twelve studies met the inclusion criteria and whereas the findings are promising, they are inconclusive and limited because of the level of evidence, which included one Level I, six Level III, four Level IV and one Level V. All of the studies reviewed had research design quality concerns including small participant sizes, poor descriptions of the interventions, outcome measures with minimal psychometrics and lack of power calculations. Findings indicated three major themes including social/participation, functional and psychological outcomes; all of which are areas in the occupational therapy scope of practice. Occupational therapists may play a critical role in referral, assessment, assisting clients and consulting with training organizations before, during and after the service dog placement process. In order for health care professionals to have confidence in recommending this type of assistive technology, the evidence to support such decisions must be strengthened.
Topics: Animals; Disabled Persons; Dogs; Evidence-Based Practice; Humans; Mobility Limitation; Occupational Therapy; Social Participation
PubMed: 21858889
DOI: 10.1002/oti.323