The Practice Gap: National Estimates of Screening and Counseling for Alcohol, Tobacco, and Obesity

Shafer, Paul; Borsky, Amanda; Ngo‐Metzger, Quyen; Miller, Therese; Meyers, David

doi:10.1370/afm.2363

Cited by 12 publications

(9 citation statements)

References 7 publications

(7 reference statements)

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“…An irregular dieting increases the burden on the body (15). For instance, skipping breakfast on weekends for an extended period may be bad for the digestive system (16). A result of study in South Africa indicated that irregular consumption of weekday breakfasts was associated with an increased risk of being overweight and obese among adolescents (15).…”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitude, and practice of obesity among university students

Xue

Zhang

et al. 2021

Ann Palliat Med

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Background: Obesity, as an epidemic disease, is distributed among all age groups, including children, adolescents, adults, and the elderly. The goal of this study was to investigate the knowledge, attitude, and practice (KAP) concerning obesity among university students.Methods: In total, 1,317 questionnaires were filled out by 1,317 (466 male and 851 female) randomly selected students aged range from 16 to 24. All participants agreed to provide personal information in this study. A self-designed questionnaire was applied to collect demographic characteristics and assess the KAP of obesity. Gender, height, weight, grade, sleep and income were included in the population questionnaire.Descriptive statistics was used to analyze the respondent rate of KAP among students.Results: In the survey, 64.9% of respondents believed that obesity was a disease. Only a few people cared about their body shape. Most of the participants in the study had practices that were detrimental to their health, including irregular dieting (52.9%), surfing the internet, and playing games (58.5%) in their spare time.Conclusions: This study identified that lacking knowledge of obesity was common among college students. Most respondents had a positive attitude about preventing obesity by focusing on dieting and exercise. Thus, education related to obesity should be strengthening among university students to translate attitude into practice.

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Section: Discussionmentioning

confidence: 99%

Knowledge, attitude, and practice of obesity among university students

Xue

Zhang

et al. 2021

Ann Palliat Med

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“…Failure to address comorbid psychiatric comorbidities, which are common in the setting of substance use disorders, also limits detection and treatment (30). The difficulties in screening for AUD and its end-organ manifestations are reinforced by studies showing that less than half of American adults are receiving recommended screening for alcohol misuse and that ALD is diagnosed at a later stage compared with other etiologies of liver disease (31,32). In addition to issues with underdiagnosis, treatments are limited in ALD.…”

Section: Discussionmentioning

confidence: 99%

Rising Mortality From Alcohol-Associated Liver Disease in the United States in the 21st Century

et al. 2019

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In contrast with other developed nations, life expectancy is decreasing in the United States, in part due to increasing mortality from alcohol-associated liver disease (ALD). Up-to-date estimates of ALD mortality are necessary for setting public health priorities to reverse this concerning trend. We therefore aimed to assess current (2017) estimates of ALD mortality and temporal trends from 1999 to 2017. METHODS:Using national data from the Centers for Disease Control and Prevention, we analyzed stratified ALD mortality rates between 1999 and 2017. We determined the age-adjusted death rates, stratified by sex and categorized by age, race/ethnicity, urbanization, and census region. We also identified statistically significant changes in the annual rate difference (ARD), annual percentage change (APC), and average APC in ALD mortality. RESULTS:In 2017, mortality from ALD was higher than any other year since 1999 with age-adjusted rates of 13.1 per 100,000 (95% confidence interval [CI] 12.9-13.3) in men and 5.6 per 100,000 (95% CI 5.4-5.7) in women. Mortality was highest among men and women who were middle aged, Native American, and from rural areas. Since 2006, ALD mortality has increased in almost every age group and race with the exception of non-Hispanic black men. Absolute increases in mortality rates have been particularly pronounced in Native American women (2005-2017 ARD 0.8, 95% CI 0.6-0.9), non-Hispanic/white men (2006-2017 ARD 0.4, 95% CI 0.3-0.4), and non-Hispanic/white women (2013-2017 ARD 0.4, 95% CI 0.3-0.5). DISCUSSION:Mortality from ALD is increasing over time in most demographic groups. Increased effort is needed to develop targeted public health strategies to address high and increasing ALD mortality.

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“…Many studies found that the largest weight losses were achieved with high-intensity counseling by PCPs and referral of interested individuals to appropriate interventions [ 9 - 13 ]. However, a study of a nationally representative sample of adults aged 35 years and older found that, despite more adults reported being screened for obesity (78.6%) and of those screened, nearly 40% had a BMI of 30 kg/m 2 or higher (39.2%), only slightly more than one-half (53.5%) of obese adults screened reported receiving counseling about weight management [ 14 ]. Furthermore, BMI is the most preferred screening tool, though literature indicates it could be a poor indicator of cardiovascular disease and overall mortality risk [ 7 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring a Need for a Cardiometabolic Disease Staging System as a Computerized Clinical Decision Support Tool: Qualitative Study

Karabukayeva¹,

Anderson²,

Hall³

et al. 2022

JMIR Form Res

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Background Although cardiometabolic diseases are leading causes of morbidity and mortality in the United States, computerized tools for risk assessment of cardiometabolic disease are rarely integral components of primary care practice. Embedding cardiometabolic disease staging systems (CMDS) into computerized clinical decision support systems (CDSS) may assist with identifying and treating patients at greatest risk for developing cardiometabolic disease. Objective This study aimed to explore the current approach to medical management of obesity and the need for CMDS designed to aid medical management of people living with obesity, at risk of being obese, or diabetic at the point of care. Methods Using a general inductive approach, this qualitative research study was guided by an interpretive epistemology. The method included semistructured, in-depth interviews with primary care providers (PCPs) from university-based community health clinics. The literature informed the interview protocol and included questions on PCPs’ experiences and the need for a tool to improve their ability to manage and prevent complications from overweight and obesity. Results PCPs (N=10) described their current approaches and emphasized behavioral treatments consisting of combined diet, physical activity, and behavior therapy as the first line of treatment for people who were overweight or obese. Results suggest that beneficial features of CDSS include (1) clinically relevant and customizable support, (2) provision of a comprehensive medical summary with trends, (3) availability of patient education materials and community resources, and (4) simplicity and ease of navigation. Conclusions Implementation of a CMDS via a CDSS could enable PCPs to conduct comprehensive cardiometabolic disease risk assessments, supporting clinical management of overweight, obesity, and diabetes. Results from this study provide unique insights to developers and researchers by identifying areas for design optimization, improved end user experience, and successful adoption of the CDSS.

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The Practice Gap: National Estimates of Screening and Counseling for Alcohol, Tobacco, and Obesity

Cited by 12 publications

References 7 publications

Knowledge, attitude, and practice of obesity among university students

Knowledge, attitude, and practice of obesity among university students

Rising Mortality From Alcohol-Associated Liver Disease in the United States in the 21st Century

Exploring a Need for a Cardiometabolic Disease Staging System as a Computerized Clinical Decision Support Tool: Qualitative Study

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