Journal of public health (Oxford, England)最新文献

Background: The TRACE (Targeted Research for Addictive and Compulsive Eating) intervention was evaluated in a 3-month randomized controlled trial which demonstrated significant improvement in Yale Food Addiction Scale scores favoring dietitian-led telehealth (active intervention) compared with passive and control groups. This study aimed to determine intervention costs and cost-utility.

Methods: Costs of each intervention (2021$AUD) and incremental net monetary benefit (iNMB; incremental benefit, defined as Quality-Adjusted Life Years (QALY) gained, multiplied by willingness to pay threshold minus incremental cost) were calculated to estimate differences between groups.

Results: The active intervention (n = 38) cost $294 (95% UI: $266, $316) per person compared to $47 (95% UI: $40, $54) in the passive intervention (n = 24), and $26 in the control group (n = 37). At a cost-effectiveness threshold of $50 000 per QALY score gained, the active intervention iNMB was -$186 (95% UI: -$1137, $834) and the passive group $127 (95% UI: -$1137, $834). Compared to the control group, estimates indicate a 30% chance of the active intervention, and a 60% chance of the passive intervention being cost effective.

Conclusion: Although the overall cost of the active intervention was low, this was not considered cost-effective in comparison to the passive intervention, given small QALY score gains.

Trial registration: Australia New Zealand Clinical Trial Registry ACTRN12621001079831.

Background: This study aimed to investigate the associations of time from waking to the first cigarette (TWFC) with all-cause mortality, cardiovascular disease (CVD) mortality and incident CVD among people smoking.

Methods: Data were from the UK Biobank, including 32 519 people smoking aged 40-70 years. TWFC was investigated using a touch-screen questionnaire. Outcomes included all-cause mortality and mortality from and incidence of CVD, ischemic heart disease (IHD) and stroke.

Results: Compared with participants reporting TWFC >120 min, those reporting TWFC between 61 and 120 min (HR, 1.30; 95% CI, 1.10-1.53), TWFC between 5 and 60 min (1.48, 1.30-1.70) and TWFC <5 min (1.65, 1.42-1.93) had a higher risk of all-cause mortality. Compared with participants reporting TWFC >120 min, those reporting TWFC between 5 and 60 min and TWFC <5 min had higher risks of CVD and IHD mortality and incident CVD and IHD, but those reporting TWFC between 61 and 120 min did not. The associations of TWFC with stroke mortality and incident stroke were not observed.

Conclusion: In this cohort study, a shorter TWFC was associated with higher risks of all-cause mortality, mortality from CVD and IHD, as well as incident CVD and IHD.

Background: Measuring health literacy can inform interventions to address health inequities. This study used cluster analysis to examine health literacy data to determine if it can provide more insightful information than standard descriptive analysis to better inform intervention development.

Methods: Using data from the Australian National Health Survey (2018), this study compared descriptive analysis and cluster analysis results of two states-New South Wales (NSW) and Victoria-generated from the Health Literacy Questionnaire (HLQ). Based on the nine scale scores of the HLQ, a hierarchical cluster analysis using Ward's method for linkage was undertaken.

Results: The number of NSW and Victoria respondents was 1018 and 923, respectively. The nine HLQ scale full sample mean scores from both states were similar. However, the cluster analyses identified 11 clusters for NSW and 12 clusters for Victoria. While six clusters from each state presented similar health literacy patterns, five and six clusters from NSW and Victoria, respectively, displayed unique health literacy patterns.

Conclusions: The results demonstrate that descriptive analysis only provides an overview and may lead to one-size-fits-all interventions. The varying health literacy patterns among subgroups resulting from the cluster analysis pave the way to inform tailored actions to improve health equity.