Adoption, Sustainability, and Dissemination of Chronic Disease Prevention Policies in Community-Based Organizations.

Introduction. Despite increasing interest in structural (policy, systems, and environmental) changes to improve health, little attention has focused on the adoption, implementation, sustainability, and potential for dissemination of these changes among local community-based organizations. Method. A mixed methods approach was used for this process evaluation. Representatives of nine community-based organizations were surveyed using closed-ended questions and in-depth qualitative interviews to describe 32 policy changes. Diffusion of Innovation theory was used to inform the development of survey questions and the interview guide. Results. Policies adopted by local community-based organizations concerned types of food/beverages provided to staff/clients, methods to encourage physical activity, breastfeeding support, and tobacco control. The majority of the policies were either fully (66%) or partially (31%) implemented 1 year after their initial adoption. In general, participants somewhat/strongly agreed that policies had characteristics that predict sustainability/diffusion (relative advantage, compatibility, complexity, trialability, observability). In-depth interview responses described a generally smooth process for policy adoption and high levels of optimism for continued sustainability but revealed few efforts to disseminate the policies beyond the original organization. Conclusions. Structural changes in community-based organizations are a valuable tool for encouraging healthy changes in communities and have great potential to be adopted, sustained, and diffused.

Population Health Management Tools to Support School-Based Oral Health Partnerships and Address Disparities.

BACKGROUND: Dental caries (cavities) experience is prevalent in US children, and national data show rates to be increasing among young children. Disparities are found for those in the low-income and non-Hispanic Black and Hispanic/Latinx groups. Use of caries prevention, specifically dental sealants, is low, even among school-based programs. CONTRIBUTIONS TO THEORY: A population health management (PHM) framework may support targeted school-based case management to reduce oral health disparities. PHM-oriented tools were applied to a school-based oral health intervention and developed into a conceptual model. From 2014 to 2019, Chicago-based Oral Health Forum (OHF) developed a case management intervention in schools, utilizing PHM tools. Through programmatic and school-based partnerships, the PHM tools informed intervention to incorporate community-based organizations, case management staffing, oral health education, targeted community outreach, and Community Dental Health Coordinators' training. CONCLUSIONS: Through a PHM framework, school-based oral health partnerships targeting high-need children was implemented. Use of PHM tools in school-based health programs should be considered in other high caries schools.

Chronic disease prevention and control literacy among residents in Taizhou City / 预防医学

Objective@#To investigate the level of chronic disease prevention and control literacy and its influencing factors among residents in Taizhou City, Zhejiang Province, so as to provide insights into formulating health education strategies on chronic diseases. @*Methods@#A total of 32 313 permanent residents at ages of 15 to 69 years were sampled in Taizhou City using the multi-stage stratified random sampling method and probability proportionate to size sampling method (PPS). Subjects' demographic characteristics and chronic disease prevention and control literacy were collected using the national health literacy surveillance questionnaire. The levels of chronic disease prevention and control literacy from 2017 to 2022 were evaluated and standardized by the population data provided by Taizhou Municipal Bureau of Statistics. Factors affecting the chronic disease prevention and control literacy were identified using a multivariable logistic regression model. @*Results@#Totally 32 313 questionnaires were distributed, and 32 258 valid questionnaires were recovered, with an effective recovery rate of 99.83%. The median age of participants was 51.00 (interquartile range, 19.00) years. There were 15 754 men (48.84%) and 16 504 women (51.16%), and 11 060 urban residents (34.29%) and 21 198 rural residents (65.71%). Farmer was the predominant occupation (16 003 residents, 49.61%). The level of chronic disease prevention and control literacy among residents in Taizhou City was 32.97%, which was 22.58%, 26.41%, 33.48%, 34.44%, 38.53% and 39.68% from 2017 to 2022, respectively, showing an upward trend (P<0.05) with a cumulative growth rate of 17.10%. Multivariable logistic regression analysis showed that age (15 to 24 years, OR=1.566, 95%CI: 1.309-1.874; 25 to 34 years, OR=1.345, 95%CI: 1.173-1.542; 35 to 44 years, OR=1.482, 95%CI: 1.311-1.675; 45 to 54 years, OR=1.203, 95%CI: 1.078-1.343), educational level (primary school, OR=1.728, 95%CI: 1.546-1.932; junior high school, OR=2.211, 95%CI: 1.977-2.472; high school/vocational high school/technical secondary school, OR=3.368, 95%CI: 2.972-3.817; college or above, OR=7.271, 95%CI: 6.313-8.373), occupation (farmer, OR=0.739, 95%CI: 0.663-0.825; others, OR=0.778, 95%CI: 0.694-0.872), place of residence (urban areas, OR=0.903, 95%CI: 0.852-0.956) and annual household income (30 000 to 49 999 Yuan, OR=1.138, 95%CI: 1.030-1.259; 50 000 to 99 999 Yuan, OR=1.239, 95%CI: 1.143-1.342; 100 000 to 199 999 Yuan, OR=1.445, 95%CI: 1.334-1.566; 200 000 Yuan and above, OR=1.803, 95%CI: 1.629-1.997) were influencing factors for chronic disease prevention and control literacy. @* Conclusions @#The level of chronic disease prevention and control literacy among residents in Taizhou City shows an upward trend from 2017 to 2022, with age, educational level, occupation, place of residence and annual household income as the influencing factors.

Evaluation and Improvement Strategies on Chronic Disease Prevention and Control Efficiency of Primary Health Service Institutions in Shandong / 中国卫生经济

Objective: To analyze the efficiency of chronic disease prevention and control of primary health service institutions in Shandong, and provide policy references. Methods:Using CRS and VRS models from DEA to analyze the representative input and output indicators in primary health Service institutions. Results: The overall efficiency of chronic disease prevention and control in primary health service institutions is low, and the actual output was insufficient compared with the target output. Conclusion: Strengthening chronic disease control measures in high-risk group and establishing management mechanism leaded by the goal of chronic prevention and control in order to achieve optimal allocation of resources.

Efecto del consumo de linaza en el perfil lipídico, el control del cáncer y como terapia de reemplazo hormonal en la menopausia: una revisión sistemática de ensayos clínicos aleatorizados / Effect of flaxseed consumption on lipid profile, the control of cancer and hormone replacement therapy in menopause: a systematic review of randomized controlled trials

Objetivo: evaluar los efectos del consumo de linaza sobre el perfil lipídico, control del cáncer y como reemplazo hormonal en la menopausia y en la andropausia. Materiales y metódos: se realizó una revisión sistemática de ensayos clínicos aleatorizados que examinaron los efectos del consumo de linaza sobre el peso corporal, la concentración de lípidos sanguíneos, el control del cáncer y los síntomas menopáusicos, usando las bases de datos de PubMed, Lilacs, OPS, OMS y Cochrane, publicados entre el 1 de enero de 2000 y el 30 de junio de 2010. A los artículos que cumplieron con criterios de inclusión se les evaluó su calidad metodológica. Resultados: fueron incluidos 49 artículos. Los estudios reportan que el consumo de linaza genera pequeños cambios en la concentración de los lípidos sanguíneos, mejora la sintomatología en mujeres menopáusicas, promueve la reducción de índices de proliferación tumoral y el aumento de apoptosis en cáncer de mama y próstata. Conclusiones: los resultados aún no son suficientes para recomendar el uso de la linaza para el control de la hipercolesterolemia en pacientes dislipidémicos. La evidencia favorece la linaza como una alternativa en la terapia coadyuvante del tratamiento del cáncer de mama y de próstata, y en la reducción de síntomas durante la menopausia.

Objective:To evaluate the effects of flaxseed consumption in changing the lipid profile, cancer control and hormone replacement therapy at menopause and andropause in individuals of all ages. Materials and methods:We conducted a systematic review of randomized controlled trials that examined the effects of flaxseed consumption on body weight reduction, change in blood lipid levels, cancer control and menopausal symptoms. We used Pub-Med, Lilacs, the libraries of PAHO and WHO, and clinical trials published in Cochrane between January 1, 2000 and June 30, 2010. The articles that met the inclusion criteria were assessed for methodological quality. Results: We included 49 articles. Studies reported that flaxseed consumption generates small changes in blood lipid concentrations, improvement in menopausal symptoms, promotes the reduction of tumor proliferation rates and increased apoptosis in breast and prostate cancer. Conclusions: The results are not yet sufficient to recommend the use of flaxseed for the control of hypercholesterolemia in patients with dyslipidemia. The evidence favors flaxseed as an alternative adjuvant therapy for breast and prostate cancer treatment, and reduction of menopause symptoms.