Abstract：
:The Patient Protection and Affordable Care Act (ACA) has increased insurance coverage among underserved individuals, but the effect of ACA on cancer diagnosis is currently debated, particularly in Medicaid non-expansion states. Therefore, we aimed to assess the effect of ACA implementation on stage at diagnosis among underserved cancer patients in Texas, a Medicaid non-expansion state. We used data from the institutional registry of the JPS Center for Cancer Care, which serves an urban population of underserved cancer patients. Eligible individuals were aged 18 to 64 years and diagnosed with a first primary invasive solid tumor between 2008 and 2015. We used a natural experiment framework and interrupted time-series analysis to assess level (i.e. immediate) and slope (over time) changes in insurance coverage and cancer stage at diagnosis between pre- and post-ACA periods. Our study population comprised 4808 underserved cancer patients, of whom 51% were racial/ethnic minorities. The prevalence of uninsured cancer patients did not immediately change after ACA implementation but modestly decreased over time (PR = 0.94; 95% CL: 0.90, 0.98). The prevalence of early- and advanced-stage diagnosis did not appreciably change overall or when stratified by screen-detectable cancers. Our results suggest that ACA implementation decreased the prevalence of uninsured cancer patients but had little effect on cancer stage at diagnosis in an underserved population. Given that Texas is a Medicaid non-expansion state, Medicaid expansion and alternative approaches may need to be further explored to improve earlier cancer diagnosis among underserved individuals.
journal_name
Prev Medjournal_title
Preventive medicineauthors
Lu Y,Jackson BE,Gehr AW,Cross D,Neerukonda L,Tanna B,Ghabach B,Ojha RPdoi
10.1016/j.ypmed.2019.06.006subject
Has Abstractpub_date
2019-09-01 00:00:00pages
105748eissn
0091-7435issn
1096-0260pii
S0091-7435(19)30216-6journal_volume
126pub_type
杂志文章abstract：OBJECTIVE:To describe recent trends in the prevalence and risk factors of obstetric anal sphincter ruptures during between 1997 and 2007 in Finland. METHOD:We analyzed a population-based register of 514,741 women with singleton vaginal deliveries recorded in the Finnish Medical Birth Register. Primiparous (n=2315) and...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2009.10.005
更新日期：2009-12-01 00:00:00
abstract：:The benefits of physical activity are established, however, increasing population physical activity levels remains a challenge. Participating in activities that are enjoyable and multidimensional, such as dancing, are associated with better adherence. However, the extent to which the general population participates in...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2017.11.005
更新日期：2018-01-01 00:00:00
abstract：:Because of remarkable advances in the treatment of preterm birth, physicians increasingly encounter adult patients who were born preterm. However, research now shows that improved early survival may come at the expense of future health risks, including increased respiratory, cardiovascular, and kidney disease, diabete...
journal_title：Preventive medicine
pub_type： 信件
doi：10.1016/j.ypmed.2016.08.024
更新日期：2016-10-01 00:00:00
abstract：:The purpose of this research is to investigate peer-to-peer sexual violence victimization and perpetration among male and female adolescents in a large, racially and economically diverse, community-based sample. Using cross-sectional data over a four-year period (2009-2013) from a regional sample of middle school and ...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2018.08.032
更新日期：2018-11-01 00:00:00
abstract：:In this paper we review the published literature with respect to cervical cancer screening intervention research. Mass media campaigns appear to work best in promoting cervical cancer screening when multiple media are used, when they promote specific screening programs that eliminate or reduce access barriers, or when...
journal_title：Preventive medicine
pub_type： 杂志文章,评审
doi：10.1006/pmed.1997.0251
更新日期：1998-01-01 00:00:00
abstract：:Airbnb hosts rent their homes to guests as an alternative to traditional hospitality settings. Airbnb venues are not uniformly regulated for allowing smoking or requiring fire-safety amenities. This study quantified the reported prevalence of fire-safety amenities in 413,339 Airbnb venues that allow smoking in 43 citi...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2019.02.021
更新日期：2019-06-01 00:00:00
abstract：BACKGROUND:Nutrition education tailored to individual characteristics of people might be more effective than general nutrition education. Nowadays, the use of computers makes individualized feedback available for larger groups. METHODS:The impact of tailored nutrition information on changes in fat, vegetable, and frui...
journal_title：Preventive medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1006/pmed.1996.0052
更新日期：1996-05-01 00:00:00
abstract：BACKGROUND:The benefits of childhood physical activity include fitness, weight control, and exercise habits that may carry over into adulthood. School physical education is the primary program responsible for training the nation's youth to be physically active and national objectives call for students to be engaged in ...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1006/pmed.1994.1059
更新日期：1994-07-01 00:00:00
abstract：OBJECTIVES:We report prevalence rates and correlates of cigarette smoking among a population-based sample of Chinese- and Filipino-American adults together with rates found in other racial/ethnic groups in California. METHODS:All analyses are based on the 2001 California Health Interview Survey. RESULTS:The proportio...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2005.01.014
更新日期：2005-08-01 00:00:00
abstract：BACKGROUND:Knowledge about the prevalence, co-occurrence, and correlates of lifestyle related behaviors of overweight women is needed to inform the design of health promotion interventions for weight loss. METHODS:Cross-sectional study involves 394 overweight and obese women, aged 18 to 55 (mean age=41.26), 39% from m...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2007.10.005
更新日期：2008-03-01 00:00:00
abstract：:Suicide rates are high in later life, particularly among older men. Mood disorders are known risk factors, but the risk of suicide associated with poor physical health remains unclear. We completed a cohort study of a community representative sample of 38,170 men aged 65-85 in 1996 who were followed for up to 16years....
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2016.09.022
更新日期：2016-12-01 00:00:00
abstract：PURPOSE:Racial and ethnic disparities in influenza vaccination among the elderly are well documented, but their impact on minority mortality is unknown. METHODS:We model racial and ethnic parity in influenza vaccination on reduction in annual minority deaths among the elderly using age-, sex-, race-, and ethnicity-spe...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2007.03.007
更新日期：2007-07-01 00:00:00
abstract：BACKGROUND:This study seeks to measure exposure to secondhand smoke and to evaluate potential differences in knowledge, attitudes, and tolerance of secondhand smoke among subgroups of Asian Americans in the Delaware Valley region of Pennsylvania and New Jersey. METHODS:A cross-sectional study was conducted among 1374 ...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2004.11.022
更新日期：2005-08-01 00:00:00
abstract：BACKGROUND:The workplace provides a useful setting for early identification and intervention with individuals who have unhealthy lifestyles. The objective was to evaluate the effects of a workplace-based lifestyle intervention (Workscreen) to reduce excessive drinking. METHOD:There were eight Australia Post networks r...
journal_title：Preventive medicine
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1006/pmed.1999.0587
更新日期：2000-01-01 00:00:00
abstract：OBJECTIVE:Women that have a first-degree relative diagnosed with breast cancer at an early age are at increased risk of the disease, yet they often lack information about their personal risk of breast cancer and early detection measures. An intervention to provide objective risk information, reduce worries, and promote...
journal_title：Preventive medicine
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ypmed.2006.07.002
更新日期：2006-11-01 00:00:00
abstract：OBJECTIVE:To review the published literature on the effectiveness of web-based interventions designed to decrease consumption of alcohol and/or prevent alcohol abuse. METHOD:Relevant articles published up to, and including, May 2006 were identified through electronic searches of Medline, PsycInfo, Embase, Cochrane Lib...
journal_title：Preventive medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ypmed.2008.01.005
更新日期：2008-07-01 00:00:00
abstract：OBJECTIVE:In Europe, the demand for informal care is high and will increase because of the ageing population. Although caregiving is intended to contribute to the care recipient's health, its effects on the health of older European caregivers are not yet clear. This study explores the association between providing info...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2014.10.028
更新日期：2015-01-01 00:00:00
abstract：:To evaluate the relationship between self-reported exposure to environmental tobacco smoke and saliva cotinine concentrations, we studied 186 nonsmokers. Each participant completed an exposure questionnaire, kept a daily exposure diary for 7 days, and provided a saliva sample for cotinine analysis. Salivary cotinine c...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1006/pmed.1994.1005
更新日期：1994-01-01 00:00:00
abstract：BACKGROUND:Physical activity has been shown to attenuate the association between overweight/obesity and mortality. Much less is known, however, on how the duration of overweight/obesity potentially alters this association, which was the purpose of this study. METHODS:The 1999-2006 NHANES was used and 11,057 adults (ag...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2015.12.002
更新日期：2016-02-01 00:00:00
abstract：BACKGROUND:This study determines if body composition and lifestyle are risk factors for low radius-bone mineral density (R-BMD) and evaluates the role of body composition in the age-related decline of R-BMD. METHODS:Data on age, menopausal status, fat mass, lean body mass (LBM), drinking, smoking, and occupation were ...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1006/pmed.1997.0170
更新日期：1997-09-01 00:00:00
abstract：:Although cigarette and smokeless tobacco use are recognized as major problems among school-age youth, few nationwide or statewide data exist on the prevalence and patterns of use. To determine the patterns of tobacco use among children and adolescents in Missouri, self-report information was obtained from a representa...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/0091-7435(90)90018-f
更新日期：1990-03-01 00:00:00
abstract：:This investigation examined the relationship between lifestyle, as defined by common health habits, and symptoms of depression in a general community sample. The study was conducted using data from a longitudinal survey involving four interviews of 1,003 Los Angeles County adults. The survey focused on the epidemiolog...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/0091-7435(88)90061-8
更新日期：1988-03-01 00:00:00
abstract：OBJECTIVE:To compare European students' personal use and approval of illicit substance use with their perceptions of peer behaviours and attitudes, and investigate whether perceptions of peer norms are associated with personal use of illicit substances and attitudes. METHOD:This study used baseline data from the Socia...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2014.07.039
更新日期：2014-10-01 00:00:00
abstract：BACKGROUND:Measurement of expired-air carbon monoxide (EACO) is commonly used to ascertain non-smoking status, although it can also reflect exposures not related to smoking. Our aim was to assess 16-year mortality according to EACO measured at baseline, in a general population. METHODS:Our analysis was based on the Th...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2015.09.001
更新日期：2015-12-01 00:00:00
abstract：OBJECTIVE:In order to understand the factors that differentiate adolescents who have tried smoking from those who have become established smokers, this study examined which student- and school-level factors differentiated current smokers from experimental smokers among a nationally representative sample of Canadian sec...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2013.04.022
更新日期：2013-08-01 00:00:00
abstract：:We described the prevalence of overweight and obesity among low-income women in rural West Virginia (WV) and urban Los Angeles County (LA County). Both communities participated in the national Communities Putting Prevention to Work program during 2010-2012. In each community, we completed health assessments on adult w...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2014.02.016
更新日期：2014-10-01 00:00:00
abstract：OBJECTIVE:To evaluate whether 5 combined healthy lifestyle factors (not smoking, moderate drinking, eating minimum salt-preserved foods, being physically active, and having appropriate body mass index) are associated with reduced risk of cancer. METHODS:Participants were enrolled in the Japan Public Health Center Stud...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2011.11.003
更新日期：2012-02-01 00:00:00
abstract：:Curiosity is a potential risk factor for electronic cigarette (e-cigarette) use, which has increased considerably among US youth in recent years. We examined the relationship between curiosity about e-cigarettes and perceived harm, comparative addictiveness, and e-cigarette advertisement exposure. Data came from the 2...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2016.05.001
更新日期：2016-08-01 00:00:00
abstract：:Three studies were conducted to evaluate the effectiveness of competition as a method of weight loss at the worksite. Study 1 found team competitions more effective than either cooperation or individual competition for men, and more effective than individual competition for women. Study 2 replicated the effectiveness ...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/0091-7435(89)90006-6
更新日期：1989-07-01 00:00:00
abstract：OBJECTIVE:To investigate whether political mistrust in the Riksdag (the national parliament in Sweden) is an independent characteristic of cannabis smokers, or whether it reflects low confidence in people in general, and therefore low social capital. METHOD:The 2004 public health survey in Skåne is a cross-sectional p...
journal_title：Preventive medicine
pub_type： 杂志文章
doi：10.1016/j.ypmed.2008.02.003
更新日期：2008-06-01 00:00:00
