USPSTF II Across the Lifespan

• USPSTF Breastfeeding Interventions

  Population: Pregnant women, new mothers and their children

  
  

  B - recommends providing interventions during pregnancy and after birth to support breastfeeding
• Breastfeeding - Primary Care Interventions

  Goal is to bf exclusively for 6 months followed by continued for 1 yr

  Benefits: reduction in breast and ovarian cancer and DM2 for mother, fewer ear infections, atopic dermatitis, lower respiratory tract infections and GI infections in infants, less likely to have chronic conditions like asthma, T2DM, HTN and obesity

  
  

  Interventions: promoting benefits, providing practical advice, direct support on how to breast feed, providing psychological support
• Breastfeeding Primary Care Interventions- Professional Support


  1 on 1 counseling provided by health professional, providing education about benefits of breast feeding, psychological support, provision of supplies, direct support during breast feeding
• BF Primary Care Interventions - Peer Support


  provides 1 on 1 counseling from a layperson; mom w/ success and similar background as pt. Peer has received training. May be delivered through variety of stages, settings and methods
• BF Primary Care Interventions - Formal Education


  Formalized program to convey general breast feeding knowledge; mostly in prenatal period. Offered in group sessions, can be media and print materials. Directed at mother but can be other family members. Focuses on benefits of BF, skills and managing complications
• USPSTF CVD Risk Screening w/ ECG

  Population: adults at low risk of CVD Events

  D - recommends against screening w/ resting or exercise ECG to prevent CVD events in asymptomatic adults at low risk

  Population: adults at intermediate or high risk of CVD events

  I - concludes that current evidence is insufficient to assess the balance of benefits and harms of screening
• CVD encompasses atherosclerotic conditions like coronary heart disease (angina or MI), cerebral vascular disease, and peripheral artery disease.

  CVD is most common COD (cause of death) among adults.

  Framingham Risk Score first line, adding ECG no additional help
• Risk Factors for CHD: older age, male sex, HTN, smoking, abnormal lipid levels, DM, obesity, sedentary lifestyle
• CVD Risk Screening

  Invasive confirmatory tests and treatment due to false positive

  Treatment is lifestyle modifications and medications in asymptomatic adults at increased risk - lipid lowering med, ASA, HTN management, tobacco cessation