Search

Objectives. We evaluated an intervention designed to identify patients at risk for hepatitis C virus (HCV) through a risk screener used by primary care providers. Methods. A clinical reminder sticker prompted physicians at 3 urban clinics to screen patients for 12 risk factors and order HCV testing if any risks were present. Risk factor data were collected from the sticker; demographic and testing data were extracted from electronic medical records. We used the t test, v2 test, and rank-sum test to compare patients who had and had not been screened and developed an analytic model to identify the incremental value of each element of the screener. Results. Among screened patients, 27.8% (n = 902) were identified as having at least 1 risk factor. Of screened patients with risk factors, 55.4% (n = 500) were tested for HCV. Our analysis showed that 7 elements (injection drug use, intranasal drug use, elevated alanine aminotransferase, transfusions before 1992, ‡ 20 lifetime sex partners, maternal HCV, existing liver disease) accounted for all HCV infections identified. Conclusions. A brief risk screener with a paper-based clinical reminder was effective in increasing HCV testing in a primary care setting. [ABSTRACT FROM AUTHOR]

Objectives. To determine the number and type of US workers taking maternity or paternity leave. Methods. We created a publicly available ecological long-term series for measuring parental leave from 1994 to 2015 by using the Current Population Survey, which interviews about 60 000 randomly selected households monthly. Results. The average month from 1994 to 2015 saw 273 000 women and 13 000 men on maternity or paternity leave. Maternity leave rates per 10 000 births showed no trend over 22 years (mean = 677.6). Paternity figures increased by a factor of 3, but started from a small base (14.7-54.6).We observed no national impact on maternity or paternity leave after implementation of state laws that provided paid leave. About half (51.1%) of employees on maternity or paternity leave during 2015 received paid time off. The typical woman on maternity leave was older, more likely married, more likely non-Hispanic White, and more educated than the typical woman who gave birth. Conclusions. Although the US economy has expanded dramatically since 1994, this improvement does not appear to have translated into more women taking maternity leave. [ABSTRACT FROM AUTHOR]

Objectives. To evaluate the impacts of an enhanced version of the Family Life and Sexuality Module of the HealthTeacher middle school curriculum. Methods. We conducted a cluster randomized trial of Chicago, Illinois, middle schools. We randomly assigned schools to a treatment group that received the intervention during the 2010-2011 school year or a control group that did not. The primary analysis sample included 595 students (7 schools) in the treatment group and 594 students (7 schools) in the control group. Results. Students in the treatment schools reported greater exposure to information on reproductive health topics such as sexually transmitted infections (STIs; 78% vs 60%; P< .01), abstinence (64% vs 37%; P< .01), and birth control (45% vs 29%; P< .01). They also reported higher average scores on an index of knowledge of contraceptive methods and STI transmission (0.5 vs 0.3; P= .02). We found no statistically significant differences in rates of sexual intercourse (12%vs12%;P= .99),oral sex (12%vs9%;P= .18), or other intermediateoutcomes. Results. Students in the treatment schools reported greater exposure to information on reproductive health topics such as sexually transmitted infections (STIs; 78% vs 60%; P< .01), abstinence (64% vs 37%; P< .01), and birth control (45% vs 29%; P< .01). They also reported higher average scores on an index of knowledge of contraceptive methods and STI transmission (0.5 vs 0.3; P= .02). We found no statistically significant differences in rates of sexual intercourse (12%vs12%;P= .99),oral sex (12%vs9%;P= .18), or other intermediateoutcomes. [ABSTRACT FROM AUTHOR]

Objectives. We examined relationships between implementation of tobacco quitline practices, levels of evidence of practices, and quitline reach and spending. Methods. In June and July 2009, a total of 176 quitline funders and providers in the United States and Canada completed a survey on quitline practices, in particular quitline-level implementation for the reported practices. From these data, we selected and categorized evidence-based and emerging quitline practices by the strength of the evidence for each practice to increase quitline efficacy and reach. Results. The proportion of quitlines implementing each practice ranged from 3% (text messaging) to 92% (providing a multiple-call protocol). Implementation of practices showing higher levels of evidence for increasing either reach or efficacy showed moderate but significant positive correlations with both reach outcomes and spending levels. The strongest correlation was between reach outcomes and spending levels (r = 0.80; P < .01). Conclusions. The strong relationship between quitline spending and reach reinforces the need to increase quitline funding to levels commensurate with national cessation goals. [ABSTRACT FROM AUTHOR]

Objectives. We compared rates of smoking for 2 groups of youths aged 12 to 14 years: those involved in the child welfare system (CW) and their counterparts in the community population. We then investigated factors associated with smoking for each group. Methods. We drew data from 2 national-level US sources: the National Survey of Child and Adolescent Well-Being and the National Longitudinal Study of Adolescent Health. We estimated logistic regression models for 3 binary outcome measures of smoking behavior: lifetime, current, and regular smoking. Results. CW-involved youths had significantly higher rates of lifetime smoking (43% vs 32%) and current smoking (23% vs 18%) than did youths in the community population. For CW-involved youths, delinquency and smoking were strongly linked. Among youths in the community population, multiple factors, including youth demographics and emotional and behavioral health, affected smoking behavior. Conclusions. Smoking prevalence was notably higher among CW-involved youths than among the community population. In light of the persistent public health impact of smoking, more attention should be focused on identification of risk factors for prevention and early intervention efforts among the CW-involved population. [ABSTRACT FROM AUTHOR]