Crash rates among teenagers are highly elevated during the first months of licensure. Parent-imposed driving restrictions on initial driving privileges can reduce exposure to high-risk driving ...conditions, thus reducing crash risk while teens' driving proficiency develops. This report describes the effect of the Checkpoints Program on driving limits and outcomes. Connecticut teens who obtained a learners permit over a 9-month period were recruited, providing a final sample of 3743 who obtained driver licenses. Families were randomized to the intervention or comparison condition. Intervention families received by mail a series of persuasive communications related to high-risk teen driving and a parent-teen driving agreement, while comparison families received on the same schedule general information on driving and vehicle maintenance. Relative to the comparison group, teens and parents in the Checkpoints Program reported significantly greater limits on high-risk teen driving conditions at licensure, 3-, and 6-months post-licensure; and intervention teens reported significantly less risky driving at each reporting period. By the 12-month follow up teens in the intervention group were significantly less likely than those in the comparison group to have had a traffic violation. However, no treatment group effect was found for crashes. This is the first study to report significant effects on teen driving behavior and performance of education designed to increase parental-imposed teen driving limits.
Background: Clinical practice guidelines and quality measures provide recommendations for physicians addressing osteoporosis management. This study explored the alignment of osteoporosis clinical ...practice in a primary care geriatric clinic with recommended guidelines. Methods: This retrospective chart review included 388 patients 65 or older from a primary care geriatric clinic diagnosed with osteopenia or osteoporosis, with or without a fragility fracture. Data included history of falls and use of DXA scans, FRAX® fracture risk assessment tool, osteoporosis medication, and fall risk mitigation plans. Results: For age-related primary fracture prevention, 68% of women and 87% of men had documented DXA scans, and 45% of patients diagnosed with osteoporosis and 42% determined at high risk were prescribed osteoporosis medication. For secondary fracture prevention, 72% of women aged 67 to 85 had DXA scans and 21% were prescribed osteoporosis medication. Only 10% of patients with a history of falls had documented fall risk management plans. Conclusion: Although showing higher rates of primary and secondary prevention outcomes than did research results from general primary care, gaps were identified for high fracture risk patients and fall risk management documentation. Medical record review may not provide sufficient data to capture factors influencing decision-making for fracture prevention.
Purpose. Research shows that smoking during pregnancy is related to mental health diagnoses. The purpose of this study was to assess whether current general mental health status is related to current ...smoking status in pregnant women after controlling for other factors related to both mental health and tobacco use during pregnancy. Methods. This cross-sectional analysis used 2017 Behavioral Risk Factor Surveillance Survey (BRFSS) data for 621 pregnant women aged 18-38 from Florida (N=136), Kansas (N=116), Minnesota (N=105), Nebraska (N=90), New York (N=78), and Utah (N=96). Multiple logistic regression analysis was used to assess the relationship between current mental health status and current tobacco use, while controlling for state, depression diagnosis, routine checkup, healthcare plan, age, marital status, ethnicity/race, education level, income level, and employment status. Results. Overall, very few participants reported current smoking (6%) and about one-third reported low or moderate mental health status in the past 30 days. Adjusted results indicated that those who reported high mental health status were about 3 times less likely (OR=0.29, 95% CI=0.09, 0.88) to report current smoking status compared to those who reported low mental health status. Conclusions. Overall, current mental health status was highly related to current smoking status in pregnant women. Clinicians in obstetrics may expect a very low proportion of pregnant women to report smoking and up to one-third to report low or moderate current general mental health status. Given that current mental health issues and current tobacco use may harm both mother and child, be highly related in pregnant women, and change throughout the pregnancy, pregnant women should be screened automatically for both at each visit.
Objectives:
While physical activity is important for health, many women do not meet recommended levels, particularly mothers. The purpose of this study was to assess whether physical activity levels ...differ by number of children at home in women aged 25–44 in the general US population.
Methods:
This cross-sectional analysis used 2017 Behavioral Risk Factor Surveillance System data for females aged 25–44 (N = 6266) from California, Colorado, New York, Texas, and Utah. Ordered logistic regression analysis assessed the relationship between physical activity levels and number of children at home while controlling for state and demographic, socioeconomic, and health-related factors.
Results:
About half of participants reported “inactive” or “insufficiently active” physical activity levels and about two-thirds reported having one or more children at home. The results of adjusted analysis indicated that physical activity level was significantly related to having one child (adjusted odds ratio = 0.75, 95% confidence interval = 0.63, 0.89), two children (adjusted odds ratio = 0.79; 95% confidence interval = 0.67, 0.93), and three or more children (adjusted odds ratio = 0.80, 95% confidence interval = 0.67, 0.94) at home.
Conclusion:
Overall, physical activity levels were significantly related to presence of children at home for women aged 25–44, but increasing number of children at home did not impact effect size. For women aged 25–44 in a primary care setting, a moderate prevalence of inactive or insufficiently active physical activity may be expected. Providers should address physical activity with all patients in this target population during well-visits, but particularly for women with children at home; educate patients about the health benefits of regular physical activity; and provide resources that will help them integrate physical activity into their daily lifestyles.
Objectives:
Fruit and vegetable consumption may impact development of diabetes, but limited research has addressed whether daily consumption of fruits and vegetables differs by those with and without ...diabetes, especially within high-risk groups. Thus, the purpose of this study was to determine whether daily fruit and vegetable consumption differs by diabetes status in middle-aged females in the general US population.
Methods:
This cross-sectional analysis used 2017 Behavioral Risk Factor Surveillance System data for females ages 45–64 years old in Arizona (n = 2609), Florida (n = 3768), Georgia (n = 1018), and Texas (n = 2092). Multiple logistic regression analysis by state assessed the relationship between the daily consumption of fruit (fruit, 100% fruit juice) and vegetables (green leafy or lettuce salad, potatoes, other vegetables) and diabetes status, while controlling for health status, health behaviors, demographic factors, and socioeconomic status.
Results:
Across states, relatively similar proportions of participants with and without diabetes reported daily fruit consumption (with: 58%–63%; without: 61%–68%) and daily vegetable consumption (with: 58%–63%; without: 61%–68%). The results of adjusted analyses indicated that daily fruit and vegetable consumption did not differ by diabetes status across states.
Conclusion:
Across states, daily fruit and vegetable consumption did not differ by diabetes status in middle-aged females. In the primary care setting, providers should educate all females ages 45–64 on the importance of eating fresh fruits and vegetables and may consider sharing information about flavonoid-rich fruit and vegetable consumption for diabetes.
Introduction: With limited research for mental health and alcohol use among veterans in the general population and none for elderly male veterans only, the purpose is to assess whether mental health ...differs by alcohol use in elderly male veterans in the general population. Method: This cross-sectional analysis uses 2017 Behavioral Risk Factor Surveillance System data for male veterans aged 65 and older in general population samples from Florida (n = 1,700), Maryland (n = 1,060), New York (n = 552), and Washington (n = 1,031). Multiple logistic regression by state assessed the relationship between mental health and alcohol use, after controlling for health-related, demographic, and socioeconomic factors. Results: Across states, most participants reported good mental health (80%-84%) and more than half reported drinking (53%-63%). Adjusted results indicated that mental health did not differ by alcohol use in any state; however, it was related to physical health and activity limitations across states. Conclusion: Overall, alcohol use was not related to mental health in elderly male veterans in the general population; however, physical health status and activity limitations were. Practitioners should always screen for alcohol use and should automatically screen for mental health, physical health, and activity limitations when symptoms present for any and assess concurrent treatment and management strategies.
Purpose. Middle-aged males and females with diabetes are more likely to have poor physical (PH) and mental health (MH); however, there is limited research determining the relationship between MH and ...PH and routine check-up in diabetic middle-aged adults, especially by gender. The purpose of this study was to determine whether PH and MH status differ by routine check-up in middle-aged (age 45–64) adults with diabetes in the general population. Methods. This cross-sectional analysis used data from the 2017 BRFSS conducted by the CDC for adults aged 45–64 who reported having diabetes in Florida ( N = 1183 ), Kentucky ( N = 617 ), Maryland ( N = 731 ), New York ( N = 593 ), and Ohio ( N = 754 ). Multiple logistic regression by state and gender was used to determine the relationship between MH and PH status and routine check-up while controlling for health-related, socioeconomic, and demographic factors. Results. Across states, up to one-half reported good PH (32–50%), over one-half reported good MH (46–67%), and most reported having a routine check-up (87–93%). Adjusted analysis indicated that MH and PH were not significantly related to routine check-up, but both were inversely related to having diabetes plus two other health conditions. Conclusions. Overall, routine check-up was not related to good PH and MH in this target population; however, a number of health conditions were inversely related to good PH and MH status. In a primary care setting for this target population, there may be a low to moderate prevalence of good PH and MH and a high prevalence of having a routine check-up and having multiple health conditions. It is recommended to automatically screen this target population for PH, MH, other chronic conditions, and physical activity and treat concurrently.
We describe intervention effects on parent limits on novice teenage driving.
We recruited parents and their 16-year-old children (n = 469) with learner's permits and randomized them from August 2000 ...to March 2003. Intervention families received persuasive newsletters related to high-risk teenage driving and a parent-teenager driving agreement; comparison families received standard information on driver safety. We conducted interviews when the adolescents obtained a learner's permit, upon licensure, and at 3, 6, and 12 months postlicensure.
Intervention parents and teenagers reported stricter limits on teen driving compared with the comparison group at 12 months, with direct effects through 3 months and indirect effects through 12 months postlicensure.
A simple behavioral intervention was efficacious in increasing parental restriction of high-risk teen driving conditions among newly licensed drivers.
There is limited information about how parents view teen driving risks and intend to handle these risks during the licensing process, and how they will respond to graduated licensing provisions.
...Parents in Connecticut were interviewed when their teens got their learner's permit. The survey was undertaken when the state did not have a midnight restriction or a passenger restriction.
Generally, parents were well aware of teen driving risks, thought parents should be thoroughly involved in the licensing process, and plan to be active participants themselves.
Parents were concerned about the risk of driving after midnight and already restrict that behavior. However, parents do not seem to see or understand the risks of having even one teen passenger in the vehicle.
The views and existing practices of parents need to be taken into account in deciding on the provisions of graduated licensing legislation and how to best ensure acceptance and compliance.
Can I Take the Car? Hartos, Jessica L.; Eitel, Patricia; Haynie, Denise L. ...
Journal of adolescent research,
05/2000, Letnik:
15, Številka:
3
Journal Article
Recenzirano
The goal of this study was to examine relations among problem-driving practices and parenting practices. Three hundred adolescents licensed 2 years or less were interviewed about driving behaviors, ...parenting practices, and orientations toward deviance. Factors significantly related to risky driving behaviors, traffic violations, and motor vehicle crashes included lower levels of parental monitoring and control, and lenient parental restrictions on driving (i.e., friends as passengers and driving curfews). Parental monitoring was among the subset of variables most useful in predicting risky driving behaviors. Violations were 4 times more likely with lenient restrictions related to frequency of friends as passengers and 2 times more likely with low parental control. Crashes were 7 times more likely with lenient restrictions related to frequency of friends as passengers. Overall, the findings suggest that adolescent problem driving is related to parenting practices.
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