Journal of Epidemiology最新文献

Background: Despite guideline recommendations to deliver cessation advice, implementation in Japan remains inconsistent. We examined tobacco use prevalence, receipt of healthcare providers' advice, and its association with quit attempts.

Methods: We analyzed the 2024 wave of a nationwide web-based survey (N=27,374; ages 16-74). Non-probability quota sampling and post-stratification weighting were used to approximate national population distributions. Current (past-30-day) tobacco use was assessed for heated tobacco products (HTPs), cigarettes, non-cigarette combustible tobacco, and dual use (HTPs plus combustible). Exposure was receipt of healthcare providers' advice, and outcome was quit attempt in the past year. Associations were analyzed using multivariable Poisson regression to obtain adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs).

Results: Overall, 24.2% reported current any tobacco product use: 12.9% HTPs, 17.8% cigarettes, 3.7% non-cigarette combustible, and 7.3% dual use. Among any tobacco users (N=6,361), 13.2% received advice and 26.7% attempted to quit. Among any tobacco users currently receiving medical care (N=2,779), 20.9% received advice, primarily from doctors (10.3%) and nurses (8.0%), and 29.9% attempted to quit. Compared with no advice, quit attempts were more likely when advice came from one professional (APR, 1.28; 95% CI, 1.05-1.58) or multiple professionals (APR, 1.61; 95% CI, 1.17-2.23). Exclusive HTP users were less likely than exclusive combustible tobacco smokers to attempt quitting (APR, 0.57; 95% CI, 0.41-0.81).

Conclusion: Receipt of providers' advice remains low in Japan yet is strongly associated with quit attempts, especially with multi-professional involvement. Policy, training, and system-level supports are needed to strengthen provider engagement.

Background: In Korea, grandparents often play a crucial role in childrearing. Therefore, this study investigated the association between family structure and obesity among Korean adolescents.

Methods: Data were analyzed from 3,328 adolescents (1,783 male adolescents and 1,545 female adolescents, aged 10-18 years) who participated in the Korea National Health and Nutrition Examination Survey from 2018 to 2023. Overweight and obesity were defined as a body mass index ≥85^th and ≥95^th percentiles, respectively, based on the 2017 Korean Growth Charts. Family structure was categorized as follows: living with both parents; living with a single parent; living with grandparents and parents; or living with grandparents only. Multivariable logistic regression was used to assess associations, adjusting for age and household income, number of siblings, region, parental education level, frequency of eating out, and regular breakfast intake.

Results: The prevalence of obesity was 15.0% (17.7% in male adolescents and 12.1% in female adolescents). Male adolescents living with grandparents and parents were more likely to be overweight (odds ratio [OR] 2.36; 95% confidence interval [CI], 1.46-3.81) or obese (OR 2.47; 95% CI, 1.46-4.19) than those living with both parents, whereas no significant associations with family structure were observed in female adolescents.

Conclusion: Korean adolescents living with grandparents had higher odds of being overweight or obese. Accordingly, further research is warranted to explore how family structure influences adolescent obesity.

Background: Limited information has been shown quantitatively assessed factors associated with the risk of secondary transmission in measles index cases.

Method: We collected data on measles index cases reported in Osaka Prefecture between November 2018 and March 2019, along with their close contacts. Secondary attack rates (SARs) in contacts of index cases were calculated and compared depending on the vaccination status, classical or modified measles and other risk factors in index cases. For the multivariate analyses, we used binary logistic regression to adjust for these potential confounding factors on the secondary transmission and calculated the adjusted odds ratio (aOR) for the SARs.

Result: A total of 105 index cases were included, involving 9,846 close contacts, with 72 secondary cases identified. A significant negative association between the number of vaccinations received by index cases and the risk of secondary infection in his/her close contacts (p < 0.01). Index cases who had received one vaccine dose had an aOR of 0.22 (95% CI: 0.08-0.65), while those with two or more doses had an aOR of 0.25 (95% CI: 0.07-0.85). Index cases who did not exhibit all three classic measles symptoms had a significantly lower risk of causing secondary infections compared to those who presented with all three symptoms (aOR: 0.12, 95% CI: 0.03-0.39).

Conclusion: The indirect protective effect of measles vaccination would present important evidence supporting the further strengthening of vaccination policies.

Background: More research is needed to clarify the health effects of dietary carotenoid intakes, and this requires the use of high-quality assessments of habitual dietary intake. Cohort studies from the Tohoku Medical Megabank Organization included a self-administered food frequency questionnaire (TMM-FFQ) for community-dwelling adults. This study evaluated the validity of carotenoid intakes derived from the TMM-FFQ using serum carotenoid concentrations as the gold standard.

Methods: In Miyagi Prefecture, 88 men and 124 women aged ≥20 years voluntarily agreed to participate in the study and provided completed TMM-FFQs and blood samples in 2019 and 2021. Carotenoids examined included α-carotene, β-carotene, β-cryptoxanthin, and lycopene. Intraclass correlation coefficients (ICCs) were calculated to assess correlations between serum concentrations in 2019 and 2021. Spearman's rank correlation coefficients were calculated to evaluate the correlations between energy-adjusted dietary carotenoid intakes from the TMM-FFQ in 2021 and the average serum carotenoid concentrations in 2019 and 2021, with correction for the attenuating effect of random within-individual variation.

Results: The ICCs between serum concentrations over the 2 years were >0.50 for all carotenoids. Among men, correlation coefficients were 0.33 for α-carotene, 0.42 for β-carotene, 0.50 for β-cryptoxanthin, and -0.09 for lycopene. Among women, the coefficients were lower than those for men, except for lycopene: 0.11 for α-carotene, 0.23 for β-carotene, 0.21 for β-cryptoxanthin, and 0.28 for lycopene.

Conclusion: The TMM-FFQ demonstrated reasonable validity for assessing intakes of α-carotene, β-carotene, and β-cryptoxanthin among men, but not among women, in the TMM cohort studies when using serum concentrations as the gold standard.

Background: The potential impacts of polygenic scores (PGS) on health-behavior changes are not fully understood. The Iwate PGS Assessment and Risk Communication Study aims to investigate the effects of reporting PGS-based risk for ischemic stroke on health behaviors.

Methods: Participants wishing to know their PGS-based ischemic stroke risk were recruited from health checkup venues for workers in Iwate Prefecture in 2023. Health checkup data, biospecimens, and questionnaire responses were collected for biochemical testing, genotyping, and storage in the Tohoku Medical Megabank integrated biobank. The risk was calculated using an integrative PGS model for East Asians. Participants were randomly assigned to two groups, and one group received their risk report as the intervention group. The impacts of the risk notification will be investigated in follow-up surveys.

Results: Of 3,599 workers, 2,088 participated in the study (consent rate: 58.0%). The demographic profile of the eligible 2,083 participants was as follows: 80.7% males, and dominance of participants aged 18-29 years (25.2%), in their 30's (25.3%), and in their 40's (24.7%). Two hundred participants (9.7%) had a risk of 1.0 as the reference; 57 (2.7%), 927 (44.7%), and 888 (42.9%) participants had 2.1-3.4-, 1.4-1.9-, and <1.0-fold that risk, respectively.

Conclusion: We collected health information and biospecimens from over 2,000 workers and disclosed the PGS-based ischemic stroke risk. Behavioral effects will be evaluated 1 year after disclosure, with follow-up until 2030. As Japan's first large-scale PGS risk communication study, it will provide initial insights for implementing PGS in personalized preventive medicine.

Background: Non-random participation can undermine the representativeness of seroepidemiological surveys. Despite their critical role in estimating disease spread during pandemics, non-response bias and methods to correct it require further investigation. This study aimed to examine sociodemographic characteristics and coronavirus disease 2019 (COVID-19)-related factors influencing participation in a seroepidemiological survey.

Methods: We analyzed data from a national COVID-19 seroepidemiological survey in Japan between December 2022 and March 2023. We performed multivariable logistic regression analyses to estimate adjusted odds ratios (aOR) and their confidence intervals (CIs) after variable selection with the Group Least Absolute Shrinkage and Selection Operator.

Results: Among 6,091 participants, factors associated with higher odds of seroepidemiological surveys participation included being female (aOR 2.08; 95% CI, 1.25-3.47), living in larger households versus living alone (two: aOR 2.34; 95% CI, 1.20-4.55; four or above: aOR 2.05; 95% CI, 1.03-4.06), higher education levels versus junior high school education (high school: aOR 2.66; 95% CI, 1.06-6.15; junior colleges, technical colleges, vocational schools: aOR 5.51; 95% CI, 1.94-15.07; university and above: aOR 3.30; 95% CI, 1.26-7.98), and having a higher household income versus earning <2 million yen (2-4 million yen: aOR 3.32; 95% CI, 1.52-7.33; 4-6 million yen: aOR 2.73; 95% CI, 1.20-6.23, ≥6 million yen: aOR 4.51; 95% CI, 1.91-10.59). Lower seroepidemiological survey participation odds were observed in those hesitant or unwilling to vaccinate (aOR 0.16; 95% CI, 0.09-0.29) and those perceiving a higher COVID-19 positivity rate among close contacts (aOR 0.98; 95% CI, 0.98-0.99).

Conclusion: Education, income, household size, sex, vaccination status, and perceived infection risk influenced seroepidemiological survey participation. The findings highlight the need to account for non-response bias using weighted methods like inverse probability weighting.

Background: Resilience is an important ability in reducing subsequent health risks from poverty. This study aimed to examine whether reading books in fourth grade boosts resilience in sixth grade and whether poverty status modifies the association.

Methods: We used a part of longitudinal data from 2018 to 2020 from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study. In this analysis, we used all fourth-grade elementary school students and their caregivers' follow-up data (n = 3,136 9- to 10-year-olds; 49.6% boys; follow-up rate: 87%). Poverty and the number of books read in fourth grade were assessed at baseline. Child resilience in fourth and sixth grade was assessed by caregivers using the Children's Resilient Coping Scale.

Results: In fourth grade, 20% of children read no books, while 15% read 4 or more books per week. Children who read more books at baseline became more resilient in sixth grade, even after adjustment of resilience in fourth grade. Poverty in fourth grade was associated with lower resilience in both fourth and sixth grade; however, when stratified by poverty status, the number of books read was significantly associated with higher resilience only among children in poverty (eg, coefficient 5.13; 95% confidence interval CI, 1.20-9.06 for ≥4 books vs none).

Conclusion: For elementary school children in Japan, reading books boosts resilience, especially among children in poverty. Educational policy on reading books during elementary school may be important to address child poverty.

The Community Empowerment and Care for Well-being and Healthy Longevity (CEC) Study is an ongoing, multigenerational, population-based cohort designed to evaluate community-driven lifespan developmental care in a rapidly aging society. Conducted in Village T, Aichi Prefecture, Japan, whose demographic structure broadly resembles national patterns, the study includes residents from infancy to older adulthood. Since 2017, the CEC Study has maintained three age-specific sub-cohorts (0-19, 20-64, and ≥65 years), integrating questionnaire surveys, health examinations, home visits, and administrative records from medical, health, and long-term care systems. A total of 4,638 residents participated in the baseline survey, with 4,079 subjects responding.The study adopts a community empowerment approach in which residents serve as co-designers and co-implementers of local health initiatives through workshops, monitoring activities, and public feedback sessions. Triennial follow-up surveys and continuous administrative data linkage enable long-term tracking of health trajectories and contextual influences across the life course. The dataset provides detailed information on physical and cognitive function, mental health, lifestyle, social participation, and environmental factors.Although generalizability may be greatest for regions with demographic and socioeconomic profiles similar to Village T, the CEC Study offers a valuable platform for evaluating real-world, community-led health strategies. Its integration of longitudinal data with empowerment-oriented practice provides insights relevant to evidence-based community health policy and global healthy aging initiatives.