Different outcomes for different interventions with different focus!— A cross-country comparison of community interventions in rural Swedish and US populations

Objectives: There is a need among healthcare providers to acquire more knowledge about small-scale and low budget community intervention programmes. This paper compares risk factor outcomes in Swedish and US intervention programmes for the prevention of cardiovascular disease (CVD). The aim was to explore how different intervention programme profiles affect outcome. Methods: Using a quasi-experimental design, trends in risk factors and estimated CVD risk in two intervention areas (Norsjö, Sweden and Otsego- Schoharie County, New York state) are compared with those in reference areas (Northern Sweden region and Herkimer County, New York state) using serial cross-sectional studies and panel studies. Results: The programmes were able to achieve significant changes in CVD risk factors that the local communities recognized as major concerns: changing eating habits in the Swedish population and reducing smoking in the US population. For the Swedish cross-sectional follow-up study cholesterol reduction was 12%, compared to 5% in the reference population ( p for trend differences < 0.000) . The significantly higher estimated CVD risk (as assessed by risk scores) at baseline in the intervention population was below that of the Swedish reference population after 5 years of intervention. The Swedish panel study provided the same results. In the US, both the serial cross-sectional and panel studies showed a >10% decline in smoking prevalence in the intervention population, while it increased slightly in the reference population. When pooling the serial cross-sectional studies the estimated risk reduction (using the Framingham risk equation) was significantly greater in the intervention populations compared to the reference populations. Conclusions: The overall pattern of risk reduction is consistent and suggests that the two different models of rural county intervention can contribute to significant risk reduction. The Swedish programme had its greatest effect on reduction of serum cholesterol levels whereas the US programme had its greatest effect on smoking prevention and cessation. These outcomes are consistent with programmatic emphases. Socially less privileged groups in these rural areas benefited as much or more from the interventions as those with greater social resources.

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COVID-19 Testing, Epidemic Features, Hospital Outcomes, and Household Prevalence, New York State—March 2020

Clinical Infectious Diseases ◽

10.1093/cid/ciaa549 ◽

2020 ◽

Vol 71 (8) ◽

pp. 1953-1959 ◽

Cited By ~ 23

Author(s):

Eli S Rosenberg ◽

Elizabeth M Dufort ◽

Debra S Blog ◽

Eric W Hall ◽

Dina Hoefer ◽

...

Keyword(s):

Risk Factors ◽

New York ◽

New York State ◽

Metropolitan Region ◽

Hospital Outcomes ◽

York State ◽

Healthcare Settings ◽

Specimen Collection ◽

Home Testing ◽

The Us

Abstract Background The US’ coronavirus disease 2019 (COVID-19) epidemic has grown extensively since February 2020, with substantial associated hospitalizations and mortality; New York State has emerged as the national epicenter. We report on the extent of testing and test results during the month of March in New York State, along with risk factors, outcomes, and household prevalence among initial cases subject to in-depth investigations. Methods Specimen collection for COVID-19 testing was conducted in healthcare settings, community-based collection sites, and by home testing teams. Information on demographics, risk factors, and hospital outcomes of cases was obtained through epidemiological investigations and an electronic medical records match, and summarized descriptively. Active testing of initial case’s households enabled estimation of household prevalence. Results During March in New York State, outside of New York City, a total of 47 326 persons tested positive for severe acute respiratory syndrome coronavirus 2, out of 141 495 tests (33% test-positive), with the highest number of cases located in the metropolitan region counties. Among 229 initial cases diagnosed through 12 March, by 30 March 13% were hospitalized and 2% died. Testing conducted among 498 members of these case’s households found prevalent infection among 57%, excluding first-reported cases 38%. In these homes, we found a significant age gradient in prevalence, from 23% among those < 5 years to 68% among those ≥ 65 years (P < .0001). Conclusions New York State faced a substantial and increasing COVID-19 outbreak during March 2020. The earliest cases had high levels of infection in their households and by the end of the month, the risks of hospitalization and death were high.

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Risk Factors Associated With Rehospitalization in the Elderly Using Chart-Abstracted Data and the New York State Patient Data System

Care Management Journals ◽

10.1891/1521-0987.12.3.122 ◽

2011 ◽

Vol 12 (3) ◽

pp. 122-127 ◽

Cited By ~ 2

Author(s):

Steven Lascher ◽

Dionesia Mamais ◽

Samir Ahmed Qasim ◽

Robert Lin ◽

Ariel Teitel

Keyword(s):

Risk Factors ◽

New York ◽

New York State ◽

The Elderly ◽

Patient Data ◽

Data System ◽

York State ◽

Factors Associated

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Prevalence and risk factors forStaphylococcus aureuscolonization in individuals entering maximum-security prisons

Epidemiology and Infection ◽

10.1017/s0950268813001544 ◽

2013 ◽

Vol 142 (3) ◽

pp. 484-493 ◽

Cited By ~ 13

Author(s):

D. V. MUKHERJEE ◽

C. T. A. HERZIG ◽

C. Y. JEON ◽

C. J. LEE ◽

Z. L. APA ◽

...

Keyword(s):

Risk Factors ◽

New York ◽

Staphylococcus Aureus ◽

Population Control ◽

New York State ◽

York State ◽

Maximum Security ◽

Younger Age ◽

Fair Poor ◽

Mrsa Colonization

SUMMARYTo assess the prevalence and risk factors for colonization withStaphylococcus aureusin inmates entering two maximum-security prisons in New York State, USA, inmates (N = 830) were interviewed and anterior nares and oropharyngeal samples collected. Isolates were characterized usingspatyping. Overall, 50·5% of women and 58·3% of men were colonized withS. aureusand 10·6% of women and 5·9% of men were colonized with MRSA at either or both body sites. Of MSSA isolates, the major subtypes werespatype 008 and 002. Overall, risk factors forS. aureuscolonization varied by gender and were only found in women and included younger age, fair/poor self-reported general health, and longer length of prior incarceration. Prevalence of MRSA colonization was 8·2%, nearly 10 times greater than in the general population. Control of epidemicS. aureusin prisons should consider the constant introduction of strains by new inmates.

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Community stroke education practices in New York State designated stroke centres

Health Education Journal ◽

10.1177/0017896919850213 ◽

2019 ◽

Vol 78 (8) ◽

pp. 1012-1019

Author(s):

Olajide Williams ◽

Ellyn Leighton-Herrmann Quinn ◽

Anna Colello ◽

Crismely Perdomo ◽

Ji Chong ◽

...

Keyword(s):

New York ◽

Best Practice ◽

Systems Of Care ◽

New York State ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

York State ◽

Stroke Education ◽

Stroke Systems Of Care

Objective: Community stroke education is a regulated, integral component of stroke systems of care. However, little is known about the types of activities conducted by hospitals. This study was designed to examine the annual requirement for community stroke education among New York State’s 119 designated Primary Stroke Centres and identify areas for improvement that may have an implication on stroke outcomes. Design: Cross-sectional survey design Setting: All 119 New York State designated Primary Stroke Centres were invited to participate. Methods: Participating hospitals completed a 29-item online questionnaire assessing multiple domains related to community stroke education including hospital characteristics, allocated resources, implementation barriers, current community stroke education practices and willingness to adopt best practice guidelines. Data were analysed using univariate descriptive and chi-square statistics. Results: Eighty-eight percent of hospitals completed the survey (105/119). Respondents were mostly stroke coordinators and stroke directors. Stroke outreach education was conducted two to four times per year in 58% of the hospitals ( n = 69). Community stroke education included behavioural risk factor modification, the detection of stroke risk through screening and stroke preparedness education at health fairs. Although 95% of hospitals ( n = 98) reported using at least one best practice approach for these activities, evaluation was generally poor, with only about 23% ( n = 24) implementing outcome-specific assessments. Major barriers to stroke outreach were inadequate staffing, time constraints and lack of funding. Conclusion: Hospital-driven community stroke education efforts occur infrequently and are poorly evaluated. This component of stroke systems of care would benefit from guidelines from regulatory agencies, which currently do not exist.

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Incidence and Risk Factors for Peripheral Nerve Injury After 383,000 Total Knee Arthroplasties Using a New York State Database (SPARCS)

The Journal of Arthroplasty ◽

10.1016/j.arth.2019.05.008 ◽

2019 ◽

Vol 34 (10) ◽

pp. 2473-2478 ◽

Cited By ~ 2

Author(s):

Alexander B. Christ ◽

Yu-fen Chiu ◽

Amethia Joseph ◽

Geoffrey H. Westrich ◽

Stephen Lyman

Keyword(s):

Risk Factors ◽

New York ◽

Peripheral Nerve ◽

Nerve Injury ◽

Peripheral Nerve Injury ◽

New York State ◽

Total Knee Arthroplasties ◽

York State ◽

Total Knee

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Geographic Variation in the Utilization and Choice of Procedures for Treating Coronary Artery Disease in New York State

Journal of Health Services Research & Policy ◽

10.1177/135581969700200303 ◽

1997 ◽

Vol 2 (3) ◽

pp. 137-143 ◽

Cited By ~ 8

Author(s):

Edward L. Hannan ◽

Dinesh Kumar ◽

Keyword(s):

Risk Factors ◽

New York ◽

Coronary Artery ◽

Artery Bypass ◽

New York State ◽

Geographic Variations ◽

Patient Risk ◽

York State ◽

Geographical Variations ◽

Choice Of Procedure

Objectives: To examine geographical variations in rates of coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA) in New York State, and to examine variations in the choice between these two procedures. Methods: A retrospective analysis of data from the New York registries for CABG and angioplasty was conducted. Rates were compared for 12 different regions of the state to assess geographic variations. To assess variations in the choice of procedure, frequencies of each procedure by region were compared with expected frequencies obtained by a logistic regression model that related procedure performance to various patient risk factors. Results: There was more than a three-fold variation in age/sex adjusted CABG rates and more than a two-fold variation in age/sex adjusted angioplasty rates among regions. The regional percentages of patients undergoing CABG rather than PTCA ranged from 49% to 70%, and most of the disparity was not related to patient risk factors. Instead, the disparity was largely a result of differences in racial composition and the hospitalization rate for myocardial infarctions. Conclusions: There is considerable regional variation in New York in the tendency to use aggressive cardiac procedures and in the choice of which procedure to use, and these differences are mostly unrelated to patient need.

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The Otsego-Schoharie healthy heart program: prevention of cardiovascular disease in the rural US

Scandinavian Journal of Public Health ◽

10.1177/14034948010290021501 ◽

2001 ◽

Vol 29 (56_suppl) ◽

pp. 21-32 ◽

Cited By ~ 18

Author(s):

A.N. Nafziger ◽

T.A. Erb ◽

P.L. Jenkins ◽

C. Lewis ◽

T.A. Pearson

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Risk Reduction ◽

Rural Population ◽

Intervention Program ◽

Community Intervention ◽

Panel Study ◽

New York State ◽

Cross Sectional ◽

Cross Sectional Studies

Objectives: To describe a rural, hospital-based public health intervention program and to evaluate its effectiveness in cardiovascular disease (CVD) risk reduction using cross-sectional studies and a panel study. Methods: A rural population of 158,000 located in New York state comprised the intervention population. A similar but separate population was used for reference. A multifaceted, multimedia 5-year program provided health promotion and education initiatives to increase physical activity, decrease smoking, improve nutrition, and identify hypercholesterolemia and hypertension. To evaluate the effectiveness of the intervention, surveys were conducted at baseline in 1989 (cross-sectional) and at follow-up in 1994- 95 (cross-sectional and panel). For cross-sectional studies, a random sample of adults was obtained using a three-stage cluster design. Self-reported and objective risk factor measurements were obtained. Comparison of pre- to post- changes in intervention versus reference populations was done using 2× 2randomized block ANOVA, 2 × 2 mixed ANOVA, and extension of the McNemar test. Results: Smoking prevalence declined (from 27.9% to 17.6%) in the intervention population. Significant adverse trends were observed for high-density lipoprotein cholesterol and triglycerides. Systolic blood pressure was reduced while diastolic blood pressure remained stable. Body mass index increased significantly in both populations. Conclusions: This rural, 5-year CVD community intervention program decreased smoking. The risk reduction may be attributable to tailoring of a multifaceted approach (multiple risk factors, multiple messages, and multiple population subgroups) to a target rural population. The study period was too short to identify changes in CVD morbidity and mortality.

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Spatiotemporal Characteristics and Risk Factors of the COVID-19 Pandemic in New York State: Implication of Future Policies

ISPRS International Journal of Geo-Information ◽

10.3390/ijgi10090627 ◽

2021 ◽

Vol 10 (9) ◽

pp. 627

Author(s):

Anran Zheng ◽

Tao Wang ◽

Xiaojuan Li

Keyword(s):

Risk Factors ◽

New York ◽

Environmental Factors ◽

Spatial Autocorrelation ◽

Disease Transmission ◽

New York State ◽

Space Time ◽

Spatiotemporal Pattern ◽

York State ◽

Time Scan

The Coronavirus disease 2019 (COVID-19) has been spreading in New York State since March 2020, posing health and socioeconomic threats to many areas. Statistics of daily confirmed cases and deaths in New York State have been growing and declining amid changing policies and environmental factors. Based on the county-level COVID-19 cases and environmental factors in the state from March to December 2020, this study investigates spatiotemporal clustering patterns using spatial autocorrelation and space-time scan analysis. Environmental factors influencing the COVID-19 spread were analyzed based on the Geodetector model. Infection clusters first appeared in southern New York State and then moved to the central western parts as the epidemic developed. The statistical results of space-time scan analysis are consistent with those of spatial autocorrelation analysis. The analysis results of Geodetector showed that both temperature and population density were strong indications of the monthly incidence of COVID-19, especially in March and April 2020. There is a trend of increasing interactions between various risk factors. This study explores the spatiotemporal pattern of COVID-19 in New York State over ten months and explains the relationship between the disease transmission and influencing factors.

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Availability and Utilization of Automated External Defibrillators in New York State Schools

Frontiers in Pediatrics ◽

10.3389/fped.2021.711124 ◽

2021 ◽

Vol 9 ◽

Author(s):

Milla Arabadjian ◽

Stephanie Serrato ◽

Mark V. Sherrid

Keyword(s):

New York ◽

Demographic Data ◽

New York State ◽

Policy Implications ◽

Cross Sectional ◽

Term Survival ◽

Long Term Survival ◽

Automated External Defibrillators ◽

York State

Background: Use of automated external defibrillators (AEDs) in out-of-hospital cardiac arrests (OHCAs) improve survival. Professional health organizations recommend that AEDs be available in crowded places, including schools but currently only 18 US states require them. Sudden cardiac arrest (SCA) research in the school-age population has largely focused on school sub-groups, leaving out the majority of US students and adults working in schools. New York State (NYS) has one of the largest student populations in the US. Our objective was to gain epidemiologic data on SCA across a variety of school levels and examine the availability and utilization of AEDs in a state that requires them.Methods: This was an observational, cross-sectional study utilizing an electronic survey. We included NYS school nurses and collected electronic surveys in January-March, 2018. We analyzed demographic data of school characteristics, SCA occurrences and AED use and availability.Results: Of 876 respondents (36.1% response rate), 71 (8.2%) reported SCAs, with 41 occurring in adults. AEDs were deployed in 59 of 71 (84.3%) events, 40 individuals had long-term survival. Most SCAs occurred in middle-schools. School size or number of AEDs/school had no bearing on short-term or long-term survival. AEDs were widely available in private schools, though this was not required by state law.Conclusions: Our data suggest a need for more comprehensive examination of SCA in US schools. Research comparing the availability and utilization of school AEDs between states that do and do not require them is needed and may have important clinical and policy implications for SCA emergency preparedness in US schools.

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