Preventive medicine最新文献

Associations between state tobacco control measures and cigarette purchases by U.S. households, 2015–2021

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-04-14 DOI: 10.1016/j.ypmed.2025.108291

Rishika Chakraborty , Yan Li , Yan Wang , Carla Berg , Sabrina Zhang , Debra Bernat , Y. Tony Yang

Objective

While effects of key tobacco control policies are well-documented, limited research has explored their varying associations across different policy contexts over time. This is crucial given the diverse and evolving tobacco control contexts across states and over time. We evaluated the association between state-level tobacco control measures and cigarette purchases in the US from 2015 to 2021.

Methods

We analyzed NielsenIQ Consumer Panel data from 10,187 households that purchased cigarettes in 2015–2021. State-level tobacco control policy scores for smoke-free laws, taxes, prevention/control funding, and cessation services were obtained from the American Lung Association's State of Tobacco Control reports. Censored regression models, reporting adjusted beta estimates and 95 % confidence intervals (CI), estimated the associations between each tobacco control measure and annual household cigarette purchases, adjusting for sociodemographics (household composition, marital status, age, education, race/ethnicity, annual income, and internet connection) and accounting for clustering within households and states.

Results

Higher scores for smoke-free laws (adjusted beta = −1.00, 95 % CI = -1.73, −0.27), taxes (adjusted beta = −1.23, 95 % CI = -1.88, −0.58), and prevention/control funding (adjusted beta = −0.22, 95 % CI = -0.38, −0.06) were associated with fewer cigarette purchases over time. In the model considering all four measures together, higher tax score was associated with fewer cigarette purchases over time (adjusted beta = −0.96, 95 % CI = -1.73, −0.87).

Conclusions

Smoke-free laws, taxation, and prevention/control funding play critical roles in lowering cigarette purchases, while access to cessation services alone may not drive behavioral change. These findings highlight the need for comprehensive tobacco control efforts and renewed policy action to curb cigarette use.

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引用次数: 0

Psychological distress as a risk factor for incident cardiometabolic disease and multimorbidity in the population-based Tromsø Study in Norway

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-04-09 DOI: 10.1016/j.ypmed.2025.108282

Safak Caglayan , Ole K. Grønli , Anne Høye

Objective

It is unclear whether psychological distress is an independent risk factor for cardiometabolic disease and multimorbidity. This cohort study investigated the relationship of psychological distress with incident cardiometabolic disease and multimorbidity.

Methods

All individuals who participated in the sixth survey of the Tromsø Study, conducted in Norway in 2007–2008, and completed the 10-item version of Hopkins Symptom Checklist (HSCL-10) were included. In total, 5264 individuals who had no cardiometabolic diseases, i.e. atrial fibrillation, coronary artery disease (CAD), diabetes, hypertension, and stroke, at baseline, and participated in the seventh survey (2015–2016) were included in the final study population. Multivariable logistic regression models were fitted to assess association of HSCL-10 score and clinically relevant psychological distress (HSCL-10 ≥ 1.85) with cardiometabolic disease and multimorbidity.

Results

At baseline, 325 (6.2%) individuals had psychological distress. Psychological distress was negatively correlated with higher education, exercise frequency, and systolic blood pressure and positively correlated with smoking and alcohol use. Incidence of cardiometabolic disease and multimorbidity was 23.7% (N = 1246) and 3.9% (N = 204), respectively. Psychological distress was linked to cardiometabolic disease (OR, 2.08; 95% CI, 1.56–2.76) and multimorbidity (OR, 2.32; 95% CI, 1.32–4.08). Furthermore, psychological distress was associated with incident atrial fibrillation, diabetes, and hypertension whereas no significant association was found with CAD and stroke. Among the psychological distress symptoms, feeling hopeless about the future was associated with incident atrial fibrillation, hypertension, and CAD.

Conclusions

Our findings emphasize psychological distress as an independent risk factor for cardiometabolic disease and multimorbidity.

目的目前尚不清楚心理困扰是否是心脏代谢疾病和多病症的独立风险因素。这项队列研究调查了心理困扰与心血管代谢疾病和多病发生之间的关系。方法纳入所有参加了2007-2008年在挪威进行的特罗姆瑟研究第六次调查并填写了10项霍普金斯症状检查表（HSCL-10）的人。共有5264人在基线时未患有心血管代谢疾病，即心房颤动、冠状动脉疾病（CAD）、糖尿病、高血压和中风，并参加了第七次调查（2015-2016年），这些人被纳入最终研究人群。研究人员拟合了多变量逻辑回归模型，以评估 HSCL-10 评分和临床相关心理困扰（HSCL-10 ≥ 1.85）与心脏代谢疾病和多病症的关系。心理困扰与受教育程度、运动频率和收缩压呈负相关，与吸烟和酗酒呈正相关。心脏代谢疾病和多病发生率分别为 23.7%（N = 1246）和 3.9%（N = 204）。心理困扰与心脏代谢疾病（OR，2.08；95% CI，1.56-2.76）和多病（OR，2.32；95% CI，1.32-4.08）有关。此外，心理困扰与心房颤动、糖尿病和高血压的发生有关，而与冠状动脉硬化和中风则无明显关联。在心理困扰症状中，对未来感到绝望与心房颤动、高血压和 CAD 的发生有关。

{"title":"Psychological distress as a risk factor for incident cardiometabolic disease and multimorbidity in the population-based Tromsø Study in Norway","authors":"Safak Caglayan , Ole K. Grønli , Anne Høye","doi":"10.1016/j.ypmed.2025.108282","DOIUrl":"10.1016/j.ypmed.2025.108282","url":null,"abstract":"<div><h3>Objective</h3><div>It is unclear whether psychological distress is an independent risk factor for cardiometabolic disease and multimorbidity. This cohort study investigated the relationship of psychological distress with incident cardiometabolic disease and multimorbidity.</div></div><div><h3>Methods</h3><div>All individuals who participated in the sixth survey of the Tromsø Study, conducted in Norway in 2007–2008, and completed the 10-item version of Hopkins Symptom Checklist (HSCL-10) were included. In total, 5264 individuals who had no cardiometabolic diseases, i.e. atrial fibrillation, coronary artery disease (CAD), diabetes, hypertension, and stroke, at baseline, and participated in the seventh survey (2015–2016) were included in the final study population. Multivariable logistic regression models were fitted to assess association of HSCL-10 score and clinically relevant psychological distress (HSCL-10 ≥ 1.85) with cardiometabolic disease and multimorbidity.</div></div><div><h3>Results</h3><div>At baseline, 325 (6.2%) individuals had psychological distress. Psychological distress was negatively correlated with higher education, exercise frequency, and systolic blood pressure and positively correlated with smoking and alcohol use. Incidence of cardiometabolic disease and multimorbidity was 23.7% (<em>N</em> = 1246) and 3.9% (<em>N</em> = 204), respectively. Psychological distress was linked to cardiometabolic disease (OR, 2.08; 95% CI, 1.56–2.76) and multimorbidity (OR, 2.32; 95% CI, 1.32–4.08). Furthermore, psychological distress was associated with incident atrial fibrillation, diabetes, and hypertension whereas no significant association was found with CAD and stroke. Among the psychological distress symptoms, feeling hopeless about the future was associated with incident atrial fibrillation, hypertension, and CAD.</div></div><div><h3>Conclusions</h3><div>Our findings emphasize psychological distress as an independent risk factor for cardiometabolic disease and multimorbidity.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"195 ","pages":"Article 108282"},"PeriodicalIF":4.3,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Potentially preventable hospitalizations among American Indian and Alaska Native adults, 2016–2021

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-04-07 DOI: 10.1016/j.ypmed.2025.108281

Bionca M. Davis , Sara Bressler , Andria Apostolou , Dana Bruden , Michael G. Bruce , Marc Fischer

Objective

Potentially preventable hospitalizations are inpatient admissions for a standard set of selected acute illnesses and chronic conditions that might have been avoided with preventive care or outpatient management. During 2010–2012, Alaska Native adults had higher rates of potentially preventable hospitalizations compared to other adults in Alaska. We evaluated potentially preventable hospitalizations among American Indian/Alaska Native (AI/AN) adults in the United States during 2016–2021.

Methods

We used hospital discharge data from the Indian Health Service National Patient Information Reporting System (NPIRS) to calculate and compare average annual age-adjusted rates of potentially preventable hospitalizations per 1000 AI/AN adults for two acute conditions (community-acquired pneumonia and urinary tract infection) and four chronic conditions (diabetes, heart failure, asthma/chronic obstructive pulmonary disease, and hypertension).

Results

Of 310,889 hospitalizations among AI/AN adults, 40,400 (13 %) were defined as potentially preventable for an annual rate of 7.6 per 1000 persons. Rates were stable during 2016–2019 (8.7 per 1000) but declined during 2020–2021 (5.9 per 1000), likely related to the COVID-19 pandemic. Older adults and rural residents had significantly higher rates of potentially preventable hospitalizations across all six conditions assessed, with community-acquired pneumonia having the highest hospitalization rate among adults aged ≥65 years (5.2 per 1000).

Conclusions

Targeted preventive care and appropriate outpatient management for AI/AN elders living in rural areas might help improve health and reduce medical costs through decreased hospitalizations. Vaccination against respiratory infections could have the greatest impact in reducing preventable hospitalizations among AI/AN adults.

{"title":"Potentially preventable hospitalizations among American Indian and Alaska Native adults, 2016–2021","authors":"Bionca M. Davis , Sara Bressler , Andria Apostolou , Dana Bruden , Michael G. Bruce , Marc Fischer","doi":"10.1016/j.ypmed.2025.108281","DOIUrl":"10.1016/j.ypmed.2025.108281","url":null,"abstract":"<div><h3>Objective</h3><div>Potentially preventable hospitalizations are inpatient admissions for a standard set of selected acute illnesses and chronic conditions that might have been avoided with preventive care or outpatient management. During 2010–2012, Alaska Native adults had higher rates of potentially preventable hospitalizations compared to other adults in Alaska. We evaluated potentially preventable hospitalizations among American Indian/Alaska Native (AI/AN) adults in the United States during 2016–2021.</div></div><div><h3>Methods</h3><div>We used hospital discharge data from the Indian Health Service National Patient Information Reporting System (NPIRS) to calculate and compare average annual age-adjusted rates of potentially preventable hospitalizations per 1000 AI/AN adults for two acute conditions (community-acquired pneumonia and urinary tract infection) and four chronic conditions (diabetes, heart failure, asthma/chronic obstructive pulmonary disease, and hypertension).</div></div><div><h3>Results</h3><div>Of 310,889 hospitalizations among AI/AN adults, 40,400 (13 %) were defined as potentially preventable for an annual rate of 7.6 per 1000 persons. Rates were stable during 2016–2019 (8.7 per 1000) but declined during 2020–2021 (5.9 per 1000), likely related to the COVID-19 pandemic. Older adults and rural residents had significantly higher rates of potentially preventable hospitalizations across all six conditions assessed, with community-acquired pneumonia having the highest hospitalization rate among adults aged ≥65 years (5.2 per 1000).</div></div><div><h3>Conclusions</h3><div>Targeted preventive care and appropriate outpatient management for AI/AN elders living in rural areas might help improve health and reduce medical costs through decreased hospitalizations. Vaccination against respiratory infections could have the greatest impact in reducing preventable hospitalizations among AI/AN adults.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"195 ","pages":"Article 108281"},"PeriodicalIF":4.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors associated with human papillomavirus (HPV) patient-clinician communication and HPV vaccine uptake among adults in the United States 美国成年人中与人类乳头瘤病毒 (HPV) 患者和医生沟通以及 HPV 疫苗接种率相关的因素。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-04-04 DOI: 10.1016/j.ypmed.2025.108280

Heather N. Owens , Naomi C. Brownstein , Junmin Whiting , Mariana Arevalo , Monica L. Kasting , Susan T. Vadaparampil , Katharine J. Head , Shannon M. Christy

Objective

Human papillomavirus (HPV) vaccine is approved for those aged 9–45 years. However, HPV vaccine uptake remains suboptimal in the United States (U.S.), particularly among young and mid-age adults. This paper describes HPV vaccine patient-clinician communication, clinician recommendation receipt, and HPV vaccine uptake among U.S. adults who were eligible for the HPV vaccine as adults.

Methods

U.S. adults up to age 45 and who were aged 18+ when the HPV vaccine was approved were recruited for an online survey (n = 1107) between February–March 2021. Multivariable logistic regression analyses were used to assess: (1) clinician-patient HPV vaccination discussions; (2) ever having received an HPV vaccine recommendation from a clinician; and (3) HPV vaccine uptake.

Results

Thirty-four percent of participants reported having prior HPV vaccine discussions with a clinician, 31.1 % reporting ever having received a clinician recommendation for the vaccine, and only 23.8 % reported receiving the vaccine. Receiving the HPV vaccine was positively associated with prior HPV vaccine discussions (aOR: 2.93; 95 % CI: 1.98–4.35) and ever receiving an HPV vaccine recommendation from a clinician (aOR: 10.64; 95 % CI: 7.14–15.88). Additional factors consistently associated with all three models (discussing, receiving a clinician recommendation, and vaccine uptake) include higher HPV vaccine knowledge and higher HPV vaccine embarrassment.

Conclusions

Unvaccinated age-eligible adults represent a missed opportunity for HPV-related cancer prevention. Interventions to support clinicians providing care to young and mid-age adults are needed to increase clinician discussions and recommendations of the HPV vaccine and patient uptake of the HPV vaccine.

{"title":"Factors associated with human papillomavirus (HPV) patient-clinician communication and HPV vaccine uptake among adults in the United States","authors":"Heather N. Owens , Naomi C. Brownstein , Junmin Whiting , Mariana Arevalo , Monica L. Kasting , Susan T. Vadaparampil , Katharine J. Head , Shannon M. Christy","doi":"10.1016/j.ypmed.2025.108280","DOIUrl":"10.1016/j.ypmed.2025.108280","url":null,"abstract":"<div><h3>Objective</h3><div>Human papillomavirus (HPV) vaccine is approved for those aged 9–45 years. However, HPV vaccine uptake remains suboptimal in the United States (U.S.), particularly among young and mid-age adults. This paper describes HPV vaccine patient-clinician communication, clinician recommendation receipt, and HPV vaccine uptake among U.S. adults who were eligible for the HPV vaccine as adults.</div></div><div><h3>Methods</h3><div>U.S. adults up to age 45 and who were aged 18+ when the HPV vaccine was approved were recruited for an online survey (<em>n</em> = 1107) between February–March 2021. Multivariable logistic regression analyses were used to assess: (1) clinician-patient HPV vaccination discussions; (2) ever having received an HPV vaccine recommendation from a clinician; and (3) HPV vaccine uptake.</div></div><div><h3>Results</h3><div>Thirty-four percent of participants reported having prior HPV vaccine discussions with a clinician, 31.1 % reporting ever having received a clinician recommendation for the vaccine, and only 23.8 % reported receiving the vaccine. Receiving the HPV vaccine was positively associated with prior HPV vaccine discussions (aOR: 2.93; 95 % CI: 1.98–4.35) and ever receiving an HPV vaccine recommendation from a clinician (aOR: 10.64; 95 % CI: 7.14–15.88). Additional factors consistently associated with all three models (discussing, receiving a clinician recommendation, and vaccine uptake) include higher HPV vaccine knowledge and higher HPV vaccine embarrassment.</div></div><div><h3>Conclusions</h3><div>Unvaccinated age-eligible adults represent a missed opportunity for HPV-related cancer prevention. Interventions to support clinicians providing care to young and mid-age adults are needed to increase clinician discussions and recommendations of the HPV vaccine and patient uptake of the HPV vaccine.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"195 ","pages":"Article 108280"},"PeriodicalIF":4.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Associations of urinary incontinence, physical activity and cardiovascular disease risk among women in the United States

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-04-03 DOI: 10.1016/j.ypmed.2025.108277

Lisa L. VanWiel , Lucas J. Carr , Dale S. Bond , Yin Wu , Elena Tunitsky-Bitton , Paul Tulikangas , Adam C. Steinberg , Kara M. Whitaker

Objective

Urinary incontinence (incontinence) is a common condition among women which may contribute to low moderate-to-vigorous physical activity (MVPA). Thus, women with incontinence may have increased risk for inactivity and related cardiovascular disease (CVD). The objective of this study was to determine the associations of incontinence with MVPA and CVD risk.

Methods

This retrospective observational study used electronic medical records to capture data on incontinence diagnosis, self-reported MVPA using the Exercise Vital Sign, CVD risk factors and diagnosis using ICD-10 codes, and demographic information from July 2022–June 2024 in Connecticut. Multinomial logistic regression assessed the association of incontinence and MVPA classification (inactive: 0 min/week, insufficiently active: 1–149 min/week, and active ≥150 min/week). Logistic regression models assessed associations of incontinence with CVD risk calculator components and diagnosed CVD. All models adjusted for age, race, body mass index, and tobacco use.

Results

Of 20,155 women who were included in analysis (mean age 50.36 ± 16.42 years), 5.4 % had an incontinence diagnosis. Compared to those without incontinence, those with incontinence did not differ in MVPA classification, but had greater odds of type two diabetes (aOR 1.25, 95 % CI: 1.06–1.48), dyslipidemia (aOR 1.37, 95 % CI: 1.19–1.58), stroke (aOR 1.55, 95 % CI: 1.06–2.25), and coronary artery bypass grafts (aOR 3.17, 95 % CI: 1.45–6.95) after adjustment.

Conclusions

Incontinence was not associated with MVPA classification but was associated with inactivity related CVD risk factors and cardiometabolic comorbid conditions. Future studies should investigate potential mechanisms of this association including incontinence severity, activity intensity, and chronic inflammation.

{"title":"Associations of urinary incontinence, physical activity and cardiovascular disease risk among women in the United States","authors":"Lisa L. VanWiel , Lucas J. Carr , Dale S. Bond , Yin Wu , Elena Tunitsky-Bitton , Paul Tulikangas , Adam C. Steinberg , Kara M. Whitaker","doi":"10.1016/j.ypmed.2025.108277","DOIUrl":"10.1016/j.ypmed.2025.108277","url":null,"abstract":"<div><h3>Objective</h3><div>Urinary incontinence (incontinence) is a common condition among women which may contribute to low moderate-to-vigorous physical activity (MVPA). Thus, women with incontinence may have increased risk for inactivity and related cardiovascular disease (CVD). The objective of this study was to determine the associations of incontinence with MVPA and CVD risk.</div></div><div><h3>Methods</h3><div>This retrospective observational study used electronic medical records to capture data on incontinence diagnosis, self-reported MVPA using the Exercise Vital Sign, CVD risk factors and diagnosis using ICD-10 codes, and demographic information from July 2022–June 2024 in Connecticut. Multinomial logistic regression assessed the association of incontinence and MVPA classification (inactive: 0 min/week, insufficiently active: 1–149 min/week, and active ≥150 min/week). Logistic regression models assessed associations of incontinence with CVD risk calculator components and diagnosed CVD. All models adjusted for age, race, body mass index, and tobacco use.</div></div><div><h3>Results</h3><div>Of 20,155 women who were included in analysis (mean age 50.36 ± 16.42 years), 5.4 % had an incontinence diagnosis. Compared to those without incontinence, those with incontinence did not differ in MVPA classification, but had greater odds of type two diabetes (aOR 1.25, 95 % CI: 1.06–1.48), dyslipidemia (aOR 1.37, 95 % CI: 1.19–1.58), stroke (aOR 1.55, 95 % CI: 1.06–2.25), and coronary artery bypass grafts (aOR 3.17, 95 % CI: 1.45–6.95) after adjustment.</div></div><div><h3>Conclusions</h3><div>Incontinence was not associated with MVPA classification but was associated with inactivity related CVD risk factors and cardiometabolic comorbid conditions. Future studies should investigate potential mechanisms of this association including incontinence severity, activity intensity, and chronic inflammation.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108277"},"PeriodicalIF":4.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Changes in the food environment surrounding schools in four New Jersey school districts between school years 2012–13 and 2019–20 2012-13 学年至 2019-20 学年期间新泽西州四个学区学校周边食品环境的变化。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-04-02 DOI: 10.1016/j.ypmed.2025.108278

Francesco Acciai , Montserrat Ganderats-Fuentes , Punam Ohri-Vachaspati

Objectives

While public health policies have mostly targeted the food environment within schools, recent research shows that the food environment surrounding schools is also related to children's diet and health outcomes. The goal of this paper was to examine the changes in the food environment around schools from school year 2012–13 to 2019–20 in four New Jersey school districts.

Methods

We analyzed data from 152 kindergarten – 12th grade public schools in Camden, Newark, New Brunswick, and Trenton for 2012–13 to 2019–20. Food outlets within 0.25-mile buffers around schools were classified into convenience stores, limited-service restaurants, small grocery stores, and upgraded convenience stores. Multivariable Poisson and negative binomial regression models were used to evaluate trends in food outlet prevalence over the study period.

Results

The number of convenience stores decreased by 6 % annually (exp(βi) = 0.94, 95 % CI: 0.91; 0.96), while the number of upgraded convenience stores (carrying a selection of healthier items) increased by 30 % annually (exp(βi) = 1.30, 95 % CI: 1.17; 1.44). Other outlet types, such as small grocery stores and limited-service restaurants, remained stable.

Conclusions

Although unhealthy outlets remained the most prevalent, there were improvements in the food environment around schools over the study period. Notably, these changes coincided with local policy initiatives aimed at improving healthy food offerings in convenience stores. Local policies can improve the food environment around schools by increasing access to healthier options. Policies aimed at improving the food environment around schools are crucial for supporting children's health and enhancing the effectiveness of school nutrition programs.

{"title":"Changes in the food environment surrounding schools in four New Jersey school districts between school years 2012–13 and 2019–20","authors":"Francesco Acciai , Montserrat Ganderats-Fuentes , Punam Ohri-Vachaspati","doi":"10.1016/j.ypmed.2025.108278","DOIUrl":"10.1016/j.ypmed.2025.108278","url":null,"abstract":"<div><h3>Objectives</h3><div>While public health policies have mostly targeted the food environment within schools, recent research shows that the food environment surrounding schools is also related to children's diet and health outcomes. The goal of this paper was to examine the changes in the food environment around schools from school year 2012–13 to 2019–20 in four New Jersey school districts.</div></div><div><h3>Methods</h3><div>We analyzed data from 152 kindergarten – 12th grade public schools in Camden, Newark, New Brunswick, and Trenton for 2012–13 to 2019–20. Food outlets within 0.25-mile buffers around schools were classified into convenience stores, limited-service restaurants, small grocery stores, and upgraded convenience stores. Multivariable Poisson and negative binomial regression models were used to evaluate trends in food outlet prevalence over the study period.</div></div><div><h3>Results</h3><div>The number of convenience stores decreased by 6 % annually (exp(<em>βi</em>) = 0.94, 95 % CI: 0.91; 0.96), while the number of upgraded convenience stores (carrying a selection of healthier items) increased by 30 % annually (exp(<em>βi</em>) = 1.30, 95 % CI: 1.17; 1.44). Other outlet types, such as small grocery stores and limited-service restaurants, remained stable.</div></div><div><h3>Conclusions</h3><div>Although unhealthy outlets remained the most prevalent, there were improvements in the food environment around schools over the study period. Notably, these changes coincided with local policy initiatives aimed at improving healthy food offerings in convenience stores. Local policies can improve the food environment around schools by increasing access to healthier options. Policies aimed at improving the food environment around schools are crucial for supporting children's health and enhancing the effectiveness of school nutrition programs.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108278"},"PeriodicalIF":4.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of the leisure-time physical activity environment on odds of glycemic control among a nationwide cohort of United States veterans with a new type-2 diabetes diagnosis

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-03-29 DOI: 10.1016/j.ypmed.2025.108274

Stephanie L. Orstad , Priscilla M. D'antico , Samrachana Adhikari , Rania Kanchi , David C. Lee , Mark D. Schwartz , Sanja Avramovic , Farrokh Alemi , Brian Elbel , Lorna E. Thorpe

Objective. This study examined associations between access to leisure-time physical activity (LTPA) facilities and parks and repeated measures of glycated hemoglobin (A1C) over time, using follow-up tests among United States Veterans with newly diagnosed type-2 diabetes (T2D). Methods. Data were analyzed from 274,463 patients in the Veterans Administration Diabetes Risk cohort who were newly diagnosed with T2D between 2008 and 2018 and followed through 2023. Generalized estimating equations with a logit link function and binomial logistic regression were used to examine associations. Results. Patients were on average 60.5 years of age, predominantly male (95.0 %) and white (66.9 %), and had an average of 11.7 A1C tests during the study follow-up period. In high- and low-density urban communities, a one-unit higher LTPA facility density score was associated with 1 % and 3 % greater likelihood of in-range A1C tests during follow-up, respectively, but no association was observed among patients living in suburban/small town and rural communities. Across community types, closer park distance was not associated with subsequent greater odds of in-range A1C tests. Unexpectedly, in low-density urban areas, the likelihood of in-range A1C tests was 1 % lower at farther park distances. Conclusions. These results suggest that broader access to LTPA facilities, but not park proximity, may contribute in small ways to maintaining glycemic control after T2D diagnosis in urban communities. Tailored interventions may be needed to promote patients' effective use of LTPA facilities and parks.

研究目的本研究通过对新诊断为 2 型糖尿病（T2D）的美国退伍军人进行随访测试，研究了休闲时间体育活动（LTPA）设施和公园的使用与糖化血红蛋白（A1C）随时间变化的重复测量之间的关系：分析了退伍军人管理局糖尿病风险队列中 274,463 名患者的数据，这些患者在 2008 年至 2018 年期间新诊断为 T2D，并随访至 2023 年。研究使用了具有 logit 连接功能的广义估计方程和二项式逻辑回归来检验相关性：患者平均年龄为 60.5 岁，主要为男性（95.0%）和白人（66.9%），在研究随访期间平均进行了 11.7 次 A1C 测试。在高密度和低密度城市社区，LTPA 设施密度得分每增加一个单位，随访期间 A1C 测试结果在范围内的可能性就分别增加 1% 和 3%，但在郊区/小城镇和农村社区的患者中没有观察到相关性。在所有社区类型中，公园距离越近，A1C 检测结果不在范围内的几率越大。意想不到的是，在低密度的城市地区，公园距离越远，A1C检测在范围内的几率越低1%：这些结果表明，在城市社区确诊 T2D 后，更广泛地使用长跑锻炼设施（而非公园距离）可能对维持血糖控制有微小作用。可能需要采取有针对性的干预措施，以促进患者有效利用长跑锻炼设施和公园。

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引用次数: 0

Evaluating the predictive performance of different data sources to forecast overdose deaths at the neighborhood level with machine learning in Rhode Island

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-03-29 DOI: 10.1016/j.ypmed.2025.108276

John C. Halifax , Bennett Allen , Claire Pratty , Victoria Jent , Alexandra Skinner , Magdalena Cerdá , Brandon D.L. Marshall , Daniel B. Neill , Jennifer Ahern

Objectives

To evaluate the predictive performance of different data sources to forecast fatal overdose in Rhode Island neighborhoods, with the goal of providing a template for other jurisdictions interested in predictive analytics to direct overdose prevention resources.

Methods

We evaluated seven combinations of data from six administrative data sources (American Community Survey (ACS) five-year estimates, built environment, emergency medical services non-fatal overdose response, prescription drug monitoring program, carceral release, and historical fatal overdose data). Fatal overdoses in Rhode Island census block groups (CBGs) were predicted using two machine learning approaches: linear regressions and random forests embedded in a nested cross-validation design. We evaluated performance using mean squared error and the percentage of statewide overdoses captured by CBGs forecast to be in top percentiles from 2019 to 2021.

Results

Linear models trained on ACS data combined with one other data source performed well, and comparably to models trained on all available data. Those including emergency medical service, prescription drug monitoring program, or carceral release data with ACS data achieved a priori goals for percentage of statewide overdoses captured by CBGs prioritized by models on average.

Conclusions

Prioritizing neighborhoods for overdose prevention with forecasting is feasible using a simple-to-implement model trained on publicly available ACS data combined with only one other administrative data source in Rhode Island, offering a starting point for other jurisdictions.

目标：评估不同数据源在预测罗德岛州居民区致命用药过量方面的预测性能，目的是为其他对预测分析感兴趣的辖区提供一个模板，以指导用药过量预防资源的使用：我们评估了来自六个行政数据源（美国社区调查 (ACS) 五年估计、建筑环境、紧急医疗服务非致命性用药过量响应、处方药监测计划、carceral release 和历史致命性用药过量数据）的七种数据组合。罗德岛州人口普查区组（CBGs）的致命用药过量预测采用了两种机器学习方法：线性回归和嵌套交叉验证设计中的随机森林。我们使用均方误差和预测 CBG 在 2019 年至 2021 年处于最高百分位数的全州过量用药百分比来评估性能：根据 ACS 数据和一个其他数据源训练的线性模型表现良好，与根据所有可用数据训练的模型不相上下。那些将紧急医疗服务、处方药监测计划或罪犯释放数据与 ACS 数据相结合的模型平均达到了模型优先考虑的 CBG 所捕获的全州过量用药百分比的先验目标：在罗德岛州，利用公开的 ACS 数据和仅有的一个其他行政数据源训练出的简单易用的模型，通过预测确定预防用药过量的优先社区是可行的，这为其他辖区提供了一个起点。

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引用次数: 0

The associations of long working hours and unhealthy diet with cardiometabolic outcomes and mortality in US workers

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-03-27 DOI: 10.1016/j.ypmed.2025.108275

Xiang Li , Jian Li , Xuyuehe Ren , Tong Xia , Onyebuchi A. Arah , Liwei Chen

Objectives

To examine independent and joint associations of long working hours (LWH) and EAT-Lancet diet with cardiometabolic outcomes and mortality in US workers.

Methods

This prospective cohort included US workers from the National Health and Nutrition Examination Survey, with cross-sectional baseline data from 1999 to March 2020. A subsample of participants from 1999 to 2018 was linked to the National Death Index, with mortality follow-up through December 2019. The independent and joint associations of LWH (≥ 55 vs. < 55 h/week) and EAT-Lancet diet scores (low vs. high) with cardiometabolic outcomes and mortality were estimated using multivariable logistic and Cox proportional hazards models, respectively.

Results

LWH was associated with higher odds of obesity (OR = 1.20; 95%CI = 1.07, 1.34) among all workers and higher CVD mortality among workers with high CVD risk at baseline (HR = 1.64, 95%CI = 0.79, 3.12). Low diet scores were associated with higher odds of obesity (OR = 1.34, 95%CI = 1.21, 1.42) and diabetes (OR = 1.33, 95%CI = 1.01, 1.76) among all workers. Working hours and diet scores were jointly associated with obesity and CVD mortality, indicating by the relative excess risk due to interaction greater than zero among all workers.

Conclusions

LWH and unhealthy diet are independent risk factors and may interact to exacerbate adverse cardiometabolic health outcomes.

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引用次数: 0

Exploring the mediating role of Charlson comorbidity index in the association between body mass index and depression in U.S. adults: NHANES 2007–2020

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-03-24 DOI: 10.1016/j.ypmed.2025.108273

Xianling Liu , Wei Zheng , Yan Sun , Yansong Li , Yiting Pan , Kai Wang , Miao Lu , Di Xu

Objective

The relationship among body mass index (BMI), Charlson comorbidity index (CCI), and depression forms a complex interplay that affects both physical and mental health. However, whether CCI mediates the association between BMI and depression remains unclear. In this study, we aimed to elucidate the mediating role of CCI in the relationship between BMI and depression.

Methods

This study used data from the National Health and Nutrition Examination Survey, a program of the National Center for Health Statistics in the United States, including 23,639 participants from 2007 to 2020. Wilcoxon rank-sum and Rao-Scott adjusted chi-square tests were employed to compare characteristics between adults with and without depression. Weighted logistic regression and restricted cubic spline models were applied to investigate the pairwise associations among BMI, CCI, and depression. Mediation analysis was performed to assess whether CCI mediated the relationship between BMI and depression.

Results

Of the 23,639 participants, 2128 (9.0 %) had depression. Significant associations were observed between BMI and CCI; CCI and depression; and BMI and depression (P < 0.001). A U-shaped relationship between BMI and depression odds was identified, with the lowest odds at a BMI of 23 kg/m². Mediation analysis revealed that CCI partially mediated the BMI-depression relationship, accounting for 19.5 % of the total effect.

Conclusions

The results suggest that CCI plays a mediating role in the association between BMI and depression, and that improved chronic disease management may be associated with lower odds of depression in high BMI populations.

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引用次数: 0