July 25, 2024

The following is a summary of “BETTER LIFE- guidelines for chronic disease preventive care for people aged 18–39 years: A Literature Review,” published in the June 2024 issue of Primary Care by Moqueet et al.


The original ‘BETTER’ (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care) approach involved a prevention-focused consultation between participants aged 40-65 years and a “Prevention Practitioner” (PP). This initiative empowered participants to set and achieve prevention and screening goals for cancers and chronic diseases. BETTER was successfully adapted for economically deprived communities in Canada, and it is known as BETTER HEALTH. The objective was to review guidelines to adapt the BETTER HEALTH approach for younger adults aged 18-39 years living with lower incomes—a demographic experiencing earlier mortality due to a higher prevalence of preventable chronic diseases compared to their higher-income peers.

Researchers searched multiple electronic databases and grey literature for clinical practice guidelines on prevention and screening, focusing on publications in English from 2008 to 2020 from Canada, Australia, Ireland, New Zealand, Scotland, the United States, and England. Guidelines were included if they addressed prevention or screening. The quality of these guidelines was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool. Data were extracted from sources scoring 5 or higher, including publication details, recommendations, and quality/level of evidence as reported by authors. Final recommendations were harmonized with input from diverse stakeholders, including co-investigators, PPs, and the Community Advisory Committee.

A total of 85 guidelines were included, resulting in a comprehensive list of 42 recommendations for adults aged 18-39 years across 21 topics. These recommendations covered many areas, including cancers, cardiovascular disease, diabetes, obesity, lifestyle factors (alcohol consumption, healthy nutrition, physical activity), healthy relationships and sexuality, immunization, oral health, social determinants of health, and substance use.

This review identified evidence-based guidelines for individual-level prevention and screening actions specifically tailored for adults aged 18-39, particularly those living with lower incomes. These guidelines will directly inform the development and implementation of the BETTER LIFE intervention, which aims to reduce the incidence and impact of chronic diseases in this vulnerable population.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02471-9

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