Disease Prevention / Health Promotion

Interventions, education and incentives that promote healthy behaviors and improve health outcomes.

Complications and Failure to Rescue After Abdominal Surgery for Trauma in Obese Patients

Mar. 11, 2020

Elinore J. Kaufman, Justin S. Hatchimonji, Lucy W. Ma, Jesse Passman, Daniel N. Holena

Abstract [from journal]

Background: Although obesity is considered an epidemic in the United States, there is mixed evidence regarding the impact of obesity on outcomes after traumatic injury and major surgery. We hypothesized that obese patients undergoing trauma laparotomy would be at increased risk of failure to rescue (FTR), defined as death after a complication.

Methods: We analyzed trauma registry data for adult patients who underwent abdominal exploration for trauma at all 30 level I and II Pennsylvania trauma centers, 2011-


The Association between Adolescent Football Participation and Early Adulthood Depression

Dylan S. Small, PhD
Mar. 10, 2020

Sameer K. Deshpande, Raiden B. Hasegawa, Jordan Weiss, Dylan S. Small

Abstract [from journal]

Concerned about potentially increased risk of neurodegenerative disease, several health professionals and policy makers have proposed limiting or banning youth participation in American-style tackle football. Given the large affected population (over 1 million boys play high school football annually), careful estimation of the long-term health effects of playing football is necessary for developing effective public health policy. Unfortunately, existing attempts to estimate these effects tend not to generalize to current participants because they


Screening for Intimate Partner Violence in a Pediatric ED: A Quality Improvement Initiative

Mar. 6, 2020

Christina Mancheno, Brenna Aumaier, Ashlee Murray

Abstract [from journal]

Objective: Intimate partner violence (IPV) is a serious public health concern and impacts the entire family unit, particularly children. We implemented an IPV screening and referral program in an urban pediatric emergency department (ED) and aimed to screen 30% of patient families for IPV by January 1, 2017.

Methods: We used a quality improvement initiative using a nonverbal screening card to screen families when the caregiver was the sole adult present and spoke English and/or Spanish, and the patient was


A Systematic Literature Review of Factors Affecting the Timing of Menarche: The Potential for Climate Change to Impact Women's Health

Mary Regina Boland
Mar. 5, 2020

Silvia P. Canelón, Mary Regina Boland

Abstract [from journal]

Menarche is the first occurrence of a woman's menstruation, an event that symbolizes reproductive capacity and the transition from childhood into womanhood. The global average age for menarche is 12 years and this has been declining in recent years. Many factors that affect the timing menarche in girls could be affected by climate change. A systematic literature review was performed regarding the timing of menarche and four publication databases were interrogated: EMBASE, SCOPUS, PubMed, and Cochrane Reviews. Themes were identified from 112 articles


Parent Moral Distress in Serious Pediatric Illness: A Dimensional Analysis

Connie M. Ulrich, PhD, RN, FAAN
Mar. 5, 2020

Kim Mooney-Doyle, Connie M. Ulrich

Abstract [from journal]

Background: Moral distress is an important and well-studied phenomenon among nurses and other healthcare providers, yet the conceptualization of parental moral distress remains unclear.

Objective: The objective of this dimensional analysis was to describe the nature of family moral distress in serious pediatric illness.

Design and Methods: A dimensional analysis of articles retrieved from a librarian-assisted systematic review of Scopus, CINAHL, and PsychInfo was conducted, focusing on


Vaccine Exemption Requirements and Parental Vaccine Attitudes: An Online Experiment

Mar. 4, 2020

Alison M. Buttenheim, Caroline M. Joyce, José Ibarra, Jessica Agas, Kristen Feemster, Lori K. Handy, Avnika B. Amin, Saad B. Omer

Abstract [from journal]

Increases in vaccine hesitancy and vaccine-preventable disease outbreaks have focused attention on state laws governing school-entry vaccine mandates and the allowable exemptions (medical and nonmedical) from those mandates. There is substantial variation in the type of exemptions available in each state, and states with more rigorous or burdensome exemption requirements generally have lower exemption rates. States have little evidence, however, about how vaccine-hesitant parents respond to different requirements. Despite recent efforts to formulate "


Beyond Band-Aids for Bullet Holes: Firearm Violence As a Public Health Priority

Mar. 1, 2020

Elinore J. KaufmanTherese S. Richmond

Abstract [from journal]

Objectives: To review the public health approach to preventing and treating firearm violence.

Data Sources: Peer-reviewed, published scholarship and federal data systems.

Study Selection: English-language, indexed research articles on the epidemiology, risk, prevention, and consequences of firearm violence.

Data Extraction: This narrative review includes findings related to the epidemiology and impact of firearm violence, focusing on short- and long-term outcomes


Firearm Laws and Illegal Firearm Flow between US States

Elinore Kaufman, U of Penn
Feb. 24, 2020

Erin G. Andrade, Mark H. Hoofnagle, Elinore Kaufman, Mark J. Seamon, Adam Pah, Christopher N. Morrison

Abstract [from journal]

Background: Considerable variation in firearm legislation exists. Prior studies show an association between stronger state laws and fewer firearm deaths. We hypothesized that firearms would flow from states with weaker laws to states with stronger laws based on proximity and population.

Methods: Crime gun trace data from 2015-2017 was accessed from the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) and compared to the count and composition of firearm legislation in 2015 among the contiguous 48 states


Facilitators and Barriers to Developing, Implementing, and Evaluating Healthy Vending Policies in Four Cities

Karen Glanz, PhD, MPH
Feb. 23, 2020

Sarah Green, Karen Glanz, Julie Bromberg 

Abstract [from journal]

Vending machines are a common source of low-nutrient, energy-dense snacks, and beverages. Many cities are beginning to adopt healthy vending policies in public areas, but evidence regarding best practices for developing, implementing, and evaluating these healthy vending polices is limited. This study used a mixed-methods, multiple case study design to examine healthy vending policies and initiatives in four cities. Data were collected between August 2017 and December 2017. Research staff worked with a designated contact person to coordinate site


Maternal Age Patterns of Preterm Birth: Exploring the Moderating Roles of Chronic Stress and Race/Ethnicity

Connie M. Ulrich, PhD, RN, FAAN
Feb. 22, 2020

Sangmi Kim, Eun-Ok Im, Jianghong Liu, Connie Ulrich

Abstract [from journal]

Background: Despite the suggested contribution of cumulative chronic stress to the racial/ethnic disparities in preterm birth (PTB), it is unclear how chronic stress, maternal age, and race/ethnicity are linked underlying PTB.

Purpose: We investigated the moderating effect of chronic stress on the maternal age-PTB association among non-Hispanic (N-H) White, N-H Black, Hispanic, and Asian women.

Methods: We analyzed the Washington State's Pregnancy Risk Assessment Monitoring System data


Adapting Andersen's Expanded Behavioral Model of Health Services Use to Include Older Adults Receiving Long-Term Services and Supports

Feb. 14, 2020

Jasmine L. TraversKaren B. Hirschman, Mary D. Naylor 

Abstract [from journal]

Background: Andersen's Expanded Behavioral Model of Health Services Use describes factors associated with the use of long-term services and supports (LTSS). This model, however, has only been tested on the intent to use such services among African-American and White older adults and not the actual use. Given the increasing diversity of older adults in the U.S., the ability to conceptualize factors associated with actual use of LTSS across racial/ethnic groups is critical.

Methods: We applied Andersen's Expanded


Cognitively Unimpaired Adults' Reactions to Disclosure of Amyloid PET Scan Results.

Jason Karlawish, MD of Penn Medicine
Feb. 13, 2020

Emily A. Largent, Kristin Harkins, Christopher H. van Dyck, Sara Hachey, Pamela Sankar, Jason Karlawish

Abstract [from journal]

Importance: Clinical guidelines currently recommend against amyloid imaging for cognitively unimpaired persons. The goal of Alzheimer's disease (AD) prevention, together with advances in understanding the pathophysiology of AD, however, has led to trials testing drugs in cognitively unimpaired persons who show evidence of AD biomarkers. Assuming the eventual success of such trials, millions of patients will be affected. There is a need to understand the effects of biomarker disclosure on those individuals.



Do Payor-Based Outreach Programs Reduce Medical Cost and Utilization?

Benjamin Ukert, University of Pennsylvania
Feb. 12, 2020

Benjamin Ukert, Guy David, Aaron Smith‐McLallen, Ravi Chawla

Abstract [from journal]

There is growing interest in using predictive analytics to drive interventions that reduce avoidable healthcare utilization. This study evaluates the impact of such an intervention utilizing claims from 2013 to 2017 for high-risk Medicare Advantage patients with congestive heart failure. A predictive algorithm using clinical and nonclinical information produced a risk score ranking for health plan members in 10 separate waves between July 2013 and May 2015. Each wave was followed by an outreach intervention. The varying capacity for outreach across


Unplanned Readmissions of Children With Epilepsy in the United States

Allison Willis, MD
Feb. 7, 2020

Sudha Kilaru Kessler, Leah J. Blank, Jennifer Glusman, Dylan Thibault, Shavonne Massey, Nicholas S. Abend, Christina L. Szperka, James A.G. Crispo, Allison W. Willis

Abstract [from journal]

Background: The burden and characteristics of unplanned readmission after epilepsy-related discharge in children in the United States is not known.

Methods: We undertook a retrospective cohort study of children aged one to 17 years discharged after a nonelective hospitalization for epilepsy, sampled from the Healthcare Cost and Utilization Project's 2013 and 2014 Nationwide Readmissions Database. Descriptive statistics and logistic regression models were used to examine the characteristics of initial