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A national study that examined differences in Medicaid expansion vs. non-expansion states provides insights into factors influencing those disparities. The study found that, among adults up to age 64, those living below the poverty level (household income




Adult 18


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Among older adults (age 65 and older), the Medicare annual wellness visit was designed and implemented to promote evidence-based preventive care and address health risks in aging patients. These wellness visits incorporate screening for depression and fall risk that may exceed the scope of other preventive visits. Despite Medicare coverage for preventive services, increased use of preventive screening services has been modest to none within the past decade.


In addition, service delivery settings and allied health or non-traditional healthcare providers may be important determinants of uptake of recommended adult preventive screening services. In recent years, investigators have begun to explore the effects of providing preventive screenings outside of the usual clinical setting and by diverse allied health or non-traditional health care providers as one approach to increasing uptake. These settings include: pharmacies, colleges/universities, churches, beauty shops, barber shops, and other community settings. Furthermore, persistent gaps in rates of screening in rural compared to urban populations reflect the well documented challenges of providing clinical services, including screening, in rural settings. Studies have explored the use of a wide range of allied health and other providers in those settings including: lay health advisors/promotoras, traditional Native American healers, nurses, social workers, and pharmacists. Research has highlighted the need to consider the broader community context, both in terms of diverse settings and alternative providers, to ensure broader reach for evidence-based services (including screening) across the care continuum. The complex and multi-level environment in which patients receive care contributes to the likelihood that patients may get lost in the transitions of care and not complete the full process of screening.


U.S. populations are experiencing sex, racial and ethnic disparities in preventive screening across the adult lifespan. There is evidence that black and Hispanic young adults, as well as adults in other age categories fare better than whites in the receipt of a number of recommended preventive services. However, there are still high priority evidence gaps related to screening for chronic diseases among diverse populations such as African Americans (e.g., breast and prostate cancer screening). There are sex differences in preventive screening service utilization among young adults such that males are less likely than females to receive services. While existing research has documented a range of factors influencing disparities in receipt of screening across the continuum of the adult lifespan, recent research gaps have identified the need for studies designed to better understand mechanisms of disparities (e.g., demographic, social, cultural, place-based, or economic) in screening services across diverse populations and barriers to refine interventions designed to reduce disparities.


Scope of Research Institutes within the NIH have separately advanced FOAs related to either the increased use of recommended preventive screenings or overuse of specific screenings in target adult populations. These initiatives are very specific to each Institute and Center (IC) mission area. However, as common risk factors are being identified for many common diseases and as more evidence-based screening interventions are identified, trans-NIH efforts to advance this research may advance more rapid exchange of insights on effective approaches across different disease areas. Therefore, the topics being addressed under this FOA are most appropriate for a trans-NIH FOA effort that addresses the interests of multiple NIH ICs. In addition, because these topics are relevant to prevention across NIH, the development of this FOA is being coordinated by the NIH Office of Disease Prevention.


National Institute on Aging (NIA) The National Institute on Aging encourages experimental, observational, or interventional studies focused on adults in midlife and at older ages. Where this FOA addresses screening, other FOAs may be used to address over-screening (for example PA-18-005).


New data collection, novel interventions, or secondary analysis of existing datasets, such as the Health and Retirement Study or the Midlife in the U.S. (MIDUS) Study, that contain rich data on adults targeted by this FOA are encouraged. For a list of datasets sponsored by the NIA, see: -available-databases-aging-related-secondary-analyses-behavioral-and-social.


National Institute of Dental and Craniofacial Research (NIDCR) The dental office is a primary care setting that provides an opportunity for oral health practitioners to conduct preventive general health services, such as evidence-based screenings. Many adults in the U.S. may have a dental visit in a given year, but not a routine medical visit. Therefore, evidence-based health screenings in dental offices provide opportunities to identify individuals with undiagnosed or progressing chronic conditions, beyond those conditions specific to the head and neck region. Several studies have demonstrated the feasibility of conducting evidence-based screenings in the dental setting for chronic conditions, such as diabetes. Additionally, previous research indicates acceptability of screening for chronic conditions in a dental setting to both dental professionals and patients. NIDCR encourages observational studies focused on implementing screening and referral for diabetes, hypertension, and/or Human Immunodeficiency Virus (HIV) infection (screenings that have received an evidence-based grade by the U.S. Preventive Services Task Force) by oral health professionals in a dental setting. These studies could examine aspects of screening across the care continuum from: risk assessment, to detection, through initial referral, and seeking care with medical providers. Research that explores improving uptake of screening, referral, and follow-up with medical providers would be encouraged.


National Institute on Drug Abuse (NIDA) The United States Preventive Services Task Force (USPSTF) has concluded that the current evidence for screening adults for illicit drug use is insufficient, and does not recommend screening in primary care for adults (including pregnant women). There is a need for research to contribute to the evidence base on screening for illicit drug use and substance use disorder, prescription drug and opioid misuse, and opioid use disorder in adults, including pregnant women in primary and other healthcare settings. In addition, there is a need for research on screening in adults in settings beyond primary care, in settings where young adults work, access community services, engage in social and recreational activities, and particularly in settings that are utilized by vulnerable and at-risk populations. Of particular interest is research that focuses on screening for opioid misuse and opioid use disorder and linkage to prevention and treatment services.


Office of Disease Prevention (ODP) The Office of Disease Prevention encourages applications that have promise for increasing uptake of adult screening interventions targeting diverse populations. These interventions should have strong implications for disease prevention and make use of innovative design, measurement, and analytic methods relevant to the overall objectives of this funding opportunity announcement. Applications must also be relevant to the objectives of at least one of the participating NIH Institutes and Centers (IC) listed above. ODP does not award grants. Please contact one of the IC program contacts listed for questions related to funding.


The prevalence of obesity as measured by BMI among non-Hispanic Asian adults is consistently lower than that reported for non-Hispanic white, non-Hispanic black, and Hispanic adults. Although BMI is widely used as a measure of body fat, at a given BMI level, body fat may vary by sex, age, and race and Hispanic origin. In particular, research suggests that health risks may begin at a lower BMI among Asian persons compared with others (1,2).


The age matrix provides information on each state's age of majority, the age at which a juvenile can be prosecuted as an adult, and the maximum age of probation and parole. Updated March 15, 2023.


The figure below shows that the adult population grew in all regions during the 2000s and 2010s. The West experienced the fastest population change between 2010 and 2020, adding 7 million (13%) adults.


Interpretation: The findings in this report indicate that substantial variations exist at the regional and state level in the prevalence of adults who had suicidal thoughts, made plans to attempt suicide, and attempted suicide in the past year. Geographic differences in prevalence might be attributable to selective migration, sociodemographic composition of the population, or the local social environment (e.g., social relationship indicators such as divorce rates or resources for access to health care). These findings emphasize the importance of continued surveillance to collect locally relevant data on which to base prevention and control activities. 041b061a72


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