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Start Over Descriptor "Vorbeugung" Publisher german medical science gms publishing house
2 results on '"Vorbeugung"'

1. Prävention des Alkoholmissbrauchs von Kindern, Jugendlichen und jungen Erwachsenen

Author

Korczak, Dieter, Steinhauser, Gerlinde, and Dietl, Markus

Subjects
economic evaluation, universal prevention, TECHNOLOGY ASSESSMENT, BIOMEDICAL, drinking, validation studies as topic, models, economic, Methodik, Meta-Analyse, randomisierte kontrollierte Studie, ECONOMICS, MEDICAL, Effizienz, Koma-Trinken, judgment, specifity, youth, HTA, Diagnose, lcsh:R855-855.5, kontrollierte klinische Studien, medical evaluation, behaviour therapy, Jugendliche, methods, placebos, multicenter studies as topic, ökonomische Bewertung, prospektive Studien, HTA report, alkoholinduzierte Störungen, SINGLE-BLIND METHOD, Genauigkeitsstudie, health economic studies, DOPPELBLINDMETHODE, alcohol drinking, systematische Übersicht, MULTIZENTRISCHE STUDIEN, META-ANALYSIS AS TOPIC, ADOLESZENT, PSYCHOTHERAPY, GROUP, meta analysis, school-based prevention, evidence based medicine, blood alcohol level, costs, randomized controlled study, randomised clinical trial, gesundheitsökonomische Studien, Alkoholbesteuerung, Methoden, psychologic disorder, Jugendalkoholismus, cost-benefit analyses, cross-over trials, high school, Programmbewertung, alcoholism, cost effectiveness, early adulthood, Beurteilung, health, cognitive behavioural therapy, trial, protection, controlled clinical trials as topic, ELTERN, Saufen, DOUBLE-BLIND METHOD, Kosten und Kostenanalyse, Kosten-Nutzen-Analyse, community, young adult, GESUNDHEITSPOLITIK, randomisierter Versuch, Alkoholprävention, universelle Prävention, trial, cross-over, review, Kurzintervention, effectiveness, Alkoholpräventionsprogramme, socioeconomic factors, PSYCHOTHERAPIE, Prävention, health problem, Schutz, Entscheidungsfindung, PLAZEBOS, VALIDIERUNGSSTUDIEN, Verhältnisprävention, MENSCH, Delirium, binge drinking, meta-analysis, sektorübergreifende Prävention, PROGRAMMEVALUIERUNG, Jugend, evaluation studies as topic, alcohol policy, economic, alcohol abuse, mulitcentre, medizinische Beurteilung, intoxication, prevention, Kostenanalyse, cost analysis, Schulen, Halbwüchsige, law, cross-over studies, benefit, Prophylaxe, risk assessment, program evaluation, Kosten, kontrollierte klinische Versuche, cost-cutting, media campaign, cost reduction, Alkoholabusus, primäre Prävention, COST-BENEFIT ANALYSIS, Alkoholabstinenz, lcsh:Medical technology, alcohol consumption, school, boy, rehabilitation, blinding, crossover, undergraduates, Präventionsprogramme, Verhaltensprävention, Cross-over-Studien, STUDENTEN, Technologiebewertung, Plazeboeffekt, aggressiveness, technology assessment, economic aspect, ethics, randomised trial, psychotherapy, kids, HUMAN RIGHTS, METAANALYSE, Werbung, alkoholbedingte Störungen, juristische Aspekte, TRINKVERHALTEN, Kostenreduktion, Krankheitskosten, psychische Störung, alcohol dependence, efficacy, Konsum, randomized controlled trials as topic, Aggressionspotential, Pharmaökonomie, multicenter, medical, community-based prevention, HTA-Bericht, behavior therapy, Gesetz, cross-over, social aspects, alcoholic intoxication, child, controlled clinical study, TECHNOLOGIE, MEDIZINISCHE, Modelle, ökonomische, clinical trials as topic, treatment, alcohol-related problems, Gesundheitsproblem, medizinische Technologie, alcohol misuse, social economic factors, Recht, ddc: 610, problematischer Alkoholkonsum, Komasaufen, Wirksamkeit, prophylaxis, Motivationsintervention, universities, pre-teen, alcohol use disorder, randomized clinical study, at-risk college drinkers, medical assessment, Alkoholmissbrauch, Gesundheit, Universität, random, social care, alcohol dependency, adolescent, Alkoholpolitik, Risikotrinker, Effektivität, behavioral measures, Rausch, alcohol-related disorders, Risikoabschätzung, blood alcohol, Motivierungsprogramm, biomedical technology assessment, KOGNITIVE THERAPIE, Pflege, humans, report, Schulkultur, ALKOHOLGENUß, Ökonomie, Übersichtsliteratur, review literature as topic, clinical trial, health policy, Rechte, technology, family therapy, Kostensenkung, randomisierte kontrollierte Studien, SOZIALÖKONOMISCHE FAKTOREN, Sozialmedizin, Alkoholmißbrauch, Aggressionspotenzial, randomisierte Zuordnung, Minderjährige, Jugendschutzgesetz, Komatrinken, schools, Alkoholsucht, Article, Blutalkohol, Zufall, Behandlung, FAMILIE, selective prevention, health technology assessment, HTA-report, validation studies, Gesundheitsökonomie, Alkoholzufuhr, COGNITIVE THERAPY, KIND, alcohol use, FAMILIENTHERAPIE, randomized clinical trial, sensitivity, riskanter Alkoholkonsum, TECHNOLOGIE, randomized controlled trial, underage, Trunksucht, Nutzen, tax on alcohol, sozioökonomische Faktoren, alkoholbezogene Probleme, VERHALTENSTHERAPIE, SCHULEN UND AUSBILDUNGSSTÄTTEN, health economics, motivation programme, schulbasierte Prävention, ALKOHOLVERGIFTUNG, ALKOHOLISMUS, randomised controlled study, parents, RANDOMISIERUNG, Sensitivität, PSYCHOTHERAPIE, GRUPPEN, randomised clinical study, research article, technology evaluation, alcohol addiction, evidence-based medicine, UNIVERSITÄTEN, Alkoholintoxikation, CT, sozio-ökonomische Faktoren, potential of aggressiveness, EBM, TECHNIKFOLGEN-ABSCHÄTZUNG, BIOMEDIZINISCHE, Forschungsartikel, Placeboeffekt, Multikomponentenprogramm, blood alcohol concentration, costs and cost analysis, decision making, socioeconomics, teenager, Alkoholkonsum, Evaluationsstudien, Sozioökonomie, care, ÖKONOMIE, ÄRZTLICHE, cost control, therapy, controlled clinical trial, blinded trial, economics, infant, hazardous drinking, placebo, research-article, random allocation, randomized study, alcoholic, family, intoxication, alcoholic, diagnosis, Alkoholsteuer, sector-based prevention, JUNGER ERWACHSENER, multicenter trial, Kostenminimierung, social therapy, alcohol intervention, Interventionsprogramme, extraordinary tax, TECHNOLOGY, MEDICAL, Vorsorge, youth alcoholism, lcsh:R723-726, prohibition, technical report, 610 Medical sciences, Medicine, brief motivational intervention, meta analysis as topic, KLINISCHE STUDIEN, MENSCHENRECHTE, evidenzbasierte Medizin, JURISPRUDENCE, binge-drinking, tax increase, Intervention, Plazebo, randomization, biomedical, verblindet, medical costs, Jugendkriminalität, HTA Bericht, trial, crossover, Alkoholabhängigkeit, soziale Aspekte, Aggressivität, alcohol prevention programs, Gemeinschaft, sickness costs, randomisation, EINFACHBLINDMETHODE, Alkoholgenuss, blinded study, accident, clinical study, prospective studies, CCT, inebriation, rights, lcsh:Medical philosophy. Medical ethics, randomised controlled trial, randomisierte klinische Studie, indikative Prävention, primary prevention, verhaltenbezogene Maßnahmen, indicative prevention, systematic review, medizinische Bewertung, cost, randomized trial, gemeindenahe Prävention, students, juridical, drinking behavior, Kosteneffektivität, Kosten-Effektivität, Technologiebeurteilung, RECHTSPRECHUNG, at-risk drinking, randomisierte Studie, Therapie, prevention campaign, RCT, Ethik, cognitive behavior therapy, Alkoholverbrauch, ethical aspects, abstinence from alcohol, drinking behaviour, Technikfolgenabschätzung, biomedizinische, Steuererhöhung, models, Übersichtsarbeit, social skills, Medien, Spezifität, cost-effectiveness, GUTACHTENBASIERTE MEDIZIN, Vorbeugung, school culture, randomised study, review literature, Heranwachsende, Sondersteuer, blinded, pharmaeconomics, alcohol taxation, efficiency, Alkoholrausch, academic review, Koma-Saufen, placebo effect, Kostenkontrolle
Abstract

Background Despite many activities to prevent risky alcohol consumption among adolescents and young adults there is an increase of alcohol intoxications in the group of ten to twenty year old juveniles. Objectives This report gives an overview about the recent literature as well as the German federal prevention system regarding activities concerning behavioral and policy prevention of risky alcohol consumption among children, adolescents and young adults. Furthermore, effective components of prevention activities are identified and the efficiency and efficacy of ongoing prevention programs is evaluated. Methods A systematic literature review is done in 34 databases using Bool’sche combinations of the key words alcohol, prevention, treatment, children, adolescents and young adults. Results 401 studies were found and 59 studies were selected for the health technology assessment (HTA). Most of the studies are done in USA, nine in Germany. A family strengthening program, personalized computer based intervention at schools, colleges and universities, brief motivational interventions and policy elements like increase of prices and taxes proved effective. Discussion Among the 59 studies there are three meta-analyses, 15 reviews, 17 randomized controlled trials (RCT) and 18 cohort studies. Despite the overall high quality of the study design, many of them have methodological weaknesses (missing randomization, missing or too short follow-ups, not clearly defined measurement parameters). The transferability of US-results to the German context is problematic. Only a few prevention activities reach a sustainable reduction of frequency and/or amount of alcohol consumption. Conclusion The HTA-report shows the need to develop specific and target group focused prevention activities for the German situation. Essential for that is the definition of target goals (reduction of consumption, change of behaviour) as well as the definition and empirical validation of risky alcohol consumption. The efficacy of prevention activities should be proven before they are launched. At present activities for the reduction or prevention of risky alcohol consumption are not sufficiently evaluated in Germany concerning their sustainable efficacy., GMS Health Technology Assessment; 7:Doc04; ISSN 1861-8863

Published
2011

2. Der Effektivität von Maßnahmen im Rahmen primärer Prävention am Beispiel kardiovaskulärer Erkrankungen und des metabolischen Syndroms

Author

Korczak, Dieter, Dietl, Markus, and Steinhauser, Gerlinde

Subjects
Stoffwechselstörung, LIPIDSTOFFWECHSEL, Risikoabschätzung, Methodik, models, economic, Meta-Analyse, nutritional physiological phenomena, Blutglukose, randomisierte kontrollierte Studie, biomedical technology assessment, Effizienz, Pflege, humans, judgment, specifity, Präventionsprogramm, Lebensqualität, Übergewicht, Ökonomie, Übersichtsliteratur, HTA, review literature as topic, clinical trial, health policy, Rechte, BLUTGLUCOSE, Diagnose, lcsh:R855-855.5, prevention research, diabetes mellitus, technology, metabolisches Syndrom, Kostensenkung, cerebrovascular accident, randomisierte kontrollierte Studien, SOZIALÖKONOMISCHE FAKTOREN, HYPERTONIE, ZEREBROVASKULÄRER INSULT, kontrollierte klinische Studien, medical evaluation, randomisierte Zuordnung, Metaanalyse, Article, methods, insult, multizentrische Studien, Zufall, Behandlung, Technikfolgen-Abschätzung, biomedizinische, health education, multicenter studies as topic, prospektive Studien, health technology assessment, validation studies, HERZKRANKHEITEN, Gesundheitsökonomie, Genauigkeitsstudie, LEBENSSTIL, life style, health economic studies, Fettstoffwechsel, randomized clinical trial, sensitivity, systematische Übersicht, cardiovascular diseases, Gesundheitsziele, META-ANALYSIS AS TOPIC, TECHNOLOGIE, quality of life, randomized controlled trial, life qualities, GESUNDHEITSWESEN, Insulinresistenz, meta analysis, Ernährung, evidence based medicine, health care sector, costs, Apoplexie, Gesundheitsaktion, PLACEBOS, sozioökonomische Faktoren, randomised clinical trial, METABOLISCHES SYNDROM X, Fettleibigkeit, gesundheitsökonomische Studien, Methoden, VERHALTENSTHERAPIE, Zuckerkrankheit, health economics, preventive care, kardiovaskuläre Erkrankungen, Lebensqualitäten, adiposity, cost effectiveness, Beurteilung, Verblindung, health, RANDOMISIERUNG, Sensitivität, RANDOM ALLOCATION, research article, controlled clinical trials as topic, Kosten und Kostenanalyse, Kosten-Nutzen-Analyse, technology evaluation, GESUNDHEITSPOLITIK, movement, evidence-based medicine, Herzkrankheit, randomisierter Versuch, CT, sozio-ökonomische Faktoren, EBM, Forschungsartikel, review, effectiveness, socioeconomic factors, Placeboeffekt, Prävention, preventive medicine, costs and cost analysis, decision making, socioeconomics, relaxation, Entscheidungsfindung, Mensch, PLAZEBOS, Evaluationsstudien, VALIDIERUNGSSTUDIEN, Präventivmedizin, Sozioökonomie, overweight, care, ÖKONOMIE, ÄRZTLICHE, cost control, therapy, controlled clinical trial, Technologie, medizinische, economics, meta-analysis, health campaign, PROGRAMMEVALUIERUNG, evaluation studies as topic, placebo, Entspannung, health care action, metabolic syndrome X, research-article, Bluthochdruck, economic, Bewegung, apoplexia, Gesundheitskampagne, GESUNDHEITSFÖRDERUNG, medizinische Beurteilung, technology assessment, biomedical, multicenter trial, Kostenminimierung, prevention, Kostenanalyse, cost analysis, Vorsorge, lcsh:R723-726, HERZ-KREISLAUF-KRANKHEITEN, Prophylaxe, risk assessment, program evaluation, technical report, 610 Medical sciences, Medicine, meta analysis as topic, Kosten, kontrollierte klinische Versuche, kardiovaskuläre Erkrankung, cost-cutting, KLINISCHE STUDIEN, Blutzucker, evidenzbasierte Medizin, Primärprävention, cost reduction, primäre Prävention, COST-BENEFIT ANALYSIS, hypertension, lcsh:Medical technology, effectiveness, cost, Gesundheitsfinanzierung, PLAZEBOEFFEKT, randomization, biomedical, verblindet, medical costs, rehabilitation, apoplexy, blinding, program effectiveness, sickness costs, randomisation, crossover, Technologiebewertung, accident, technology assessment, economic aspect, Reha, ethics, randomised trial, prospective studies, CCT, Gesundheitserziehung, lcsh:Medical philosophy. Medical ethics, Programmeffektivität, randomised controlled trial, randomisierte klinische Studie, Kostenreduktion, Krankheitskosten, health promotion, efficacy, primary prevention, kontrollierte klinische Studie, randomized controlled trials as topic, Pharmaökonomie, heart disease, cross-over-Studien, medical, systematic review, insulin resistance, medizinische Bewertung, cost, lipid metabolism, behavior therapy, randomized trial, blood glucose, cross-over, heart diseases, Modelle, ökonomische, technology, medical, clinical trials as topic, treatment, juridical, CROSS-OVER STUDIES, medizinische Technologie, Kosteneffektivität, Kosten-Effektivität, prevention program, stroke, Technologiebeurteilung, social economic factors, Recht, ddc: 610, economics, medical, Gesundheitssektor, randomisierte Studie, Präventionsforschung, lipometabolism, Wirksamkeit, prophylaxis, Therapie, RCT, Ethik, Schlaganfall, blood sugar, metabolic syndrome, Kosten- Effektivität, models, Übersichtsarbeit, Spezifität, VALIDATION STUDIES AS TOPIC, cost-effectiveness, GUTACHTENBASIERTE MEDIZIN, GESUNDHEIT, Vorbeugung, medical assessment, random, review literature, Hirnschlag, klinische Studie, blinded, pharmaeconomics, ökonomischer Aspekt, efficiency, placebo effect, Kostenkontrolle, Effektivität, high blood pressure
Abstract

Background The HTA-report (HTA = Health Technology Assessment) deals with the primary prevention of cardiovascular diseases and diabetes mellitus type 2. In 2009 approximately 356,000 people died in Germany due to cardiovascular diseases. According to estimations about 6.3 million people are suffering from diabetes mellitus type 2. The interventions that are subsidized by the public health insurance are mainly focused on sufficient physical activities, healthy nutrition, stress management and the reduction of the consumption of addictive drugs and luxury food. Objectives Which lifestyle-related measures and/or programmes for primary prevention of cardiovascular diseases and of the metabolic syndrome are effective? To what extent will the health status be improved by these offers? To what extent will existing health resources and skills be strengthened by these offers? Are there any differences regarding the effectiveness among the interventions with respect to different settings or subgroups? Which lifestyle-related interventions and/or programmes for primary prevention of cardiovascular diseases and of the metabolic syndrome are sustainable and cost-effective? Which outcome parameters are in the view of the contributors decisive for the evaluation of the effectiveness? In the view of the contributor are there different values between the outcome parameters? In the view of the payers and other actors are there different values between the outcome parameters? Which ethical and juridical factors have to be considered? Which social and/or socio-economic parameters influence the use of the services and effectiveness? Methods A systematic literature research is done in 35 databases. For the period 2005 to 2010, reviews, epidemiological and clinical studies as well as economical evaluations which deal with primary prevention programmes regarding cardiovascular diseases or the metabolic syndrome are included. Results 44 publications meet the inclusion criteria. These studies confirm the effectiveness of the primary prevention programmes. Physical activity programs seem to have a stronger effect than nutrition programmes. Psychological programmes prove as well effectiveness, if they include cognitive behaviour therapy. The identified economical studies indicate that programmes for cardiovascular prevention can be conducted cost-effectively. Interventions that focus on the general population turn out to be particularly cost-effective and sustainable. Discussion There is a wide range of primary preventive effective lifestyle-related interventions with high evidence. The outcomes and results are consistent with the recommendations of the two identified evidence-based guidelines regarding the recommendations on lifestyle and healthy nutrition. Furthermore, the cost-effectiveness of primary prevention services is proven. With regard to the economical studies it is however worth noting that this result is based on very few publications. The transferability has to be critically assessed as the studies mainly originate from the American health system. Conclusion On the whole a comprehensive setting approach with educative, somatic, psychosocial and activity therapeutic components is recommended. The sustainability of a prevention intervention must be ensured from programme to programme. Long-term studies are necessary to make valid statements regarding the sustainable effectiveness: There is an essential deficit in the current practiced evaluation of the use of primary prevention services provided by the health insurance – mainly regarding the comprehensive setting approach – regarding the evidence-based evaluation of the prescribed preventive interventions. With regard to the ethical, social and economical evaluation the research situation is deficient. The situation has to be particularly analyzed for the socially deprived and one has to respond to their specific needs for prevention., GMS Health Technology Assessment; 7:Doc02; ISSN 1861-8863

Published
2011

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