Pub Date : 2025-01-16DOI: 10.1016/j.ypmed.2025.108226
Wenwei Zuo, Xuelian Yang
Objective: This study aimed to assess the relationship between the independent effects of dietary quality (DQ) (Healthy Eating Index [HEI]-2015) and physical activity (PA) and their joint effects and the risk of obstructive sleep apnea (OSA).
Methods: This cross-sectional study collected information on participants with complete DQ, PA, and OSA diagnostic data from the 2015 to 2020 National Health and Nutrition Examination Survey (NHANES). We used multivariate logistic regression modeling to explore the relationship between the independent and joint effects of DQ and PA and OSA. In addition, sensitivity analyses were conducted to further validate the robustness of the results.
Results: A total of 8050 participants were included in this study, 3930 males and 4120 females. After adjusting for confounders, qualified DQ and high-level PA were significantly associated with a lower risk of OSA, with an odd ratio (OR) of 0.860 (95 % CI: 0.759-0.974) and 0.849 (95 % CI: 0.751-0.961), respectively. In the combined analysis, qualified DQ and high-level PA significantly reduced the risk of OSA (OR: 0.705, 95 % CI: 0.591-0.842). The sensitivity analysis results were consistent with the original results, further validating our findings.
Conclusions: The results of this study demonstrated that the combination of qualified DQ and high-level PA was significantly associated with a reduced risk of OSA. This finding emphasized the importance of a healthy lifestyle in the prevention of OSA.
{"title":"Joint association of diet quality and physical activity with obstructive sleep apnea: A cross-sectional study.","authors":"Wenwei Zuo, Xuelian Yang","doi":"10.1016/j.ypmed.2025.108226","DOIUrl":"https://doi.org/10.1016/j.ypmed.2025.108226","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the relationship between the independent effects of dietary quality (DQ) (Healthy Eating Index [HEI]-2015) and physical activity (PA) and their joint effects and the risk of obstructive sleep apnea (OSA).</p><p><strong>Methods: </strong>This cross-sectional study collected information on participants with complete DQ, PA, and OSA diagnostic data from the 2015 to 2020 National Health and Nutrition Examination Survey (NHANES). We used multivariate logistic regression modeling to explore the relationship between the independent and joint effects of DQ and PA and OSA. In addition, sensitivity analyses were conducted to further validate the robustness of the results.</p><p><strong>Results: </strong>A total of 8050 participants were included in this study, 3930 males and 4120 females. After adjusting for confounders, qualified DQ and high-level PA were significantly associated with a lower risk of OSA, with an odd ratio (OR) of 0.860 (95 % CI: 0.759-0.974) and 0.849 (95 % CI: 0.751-0.961), respectively. In the combined analysis, qualified DQ and high-level PA significantly reduced the risk of OSA (OR: 0.705, 95 % CI: 0.591-0.842). The sensitivity analysis results were consistent with the original results, further validating our findings.</p><p><strong>Conclusions: </strong>The results of this study demonstrated that the combination of qualified DQ and high-level PA was significantly associated with a reduced risk of OSA. This finding emphasized the importance of a healthy lifestyle in the prevention of OSA.</p>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":" ","pages":"108226"},"PeriodicalIF":4.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009822","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}
Pub Date : 2025-01-11DOI: 10.1016/j.ypmed.2025.108224
Yihong Bai, Peiya Cao, Chungah Kim, Kristine Ienciu, Inthuja Selvaratnam, Alex Abramovich, Brittany Jakubiec, David J Brennan, Antony Chum
Introduction: Activity limitations among transgender and non-binary individuals remain largely unexplored using population-based samples. This study examines the risk of activity limitations across different gender identities in Canada.
Method: Using data from the 2021 Canadian long-form Census, logistic regressions estimated the adjusted odds of reporting activity limitations (seeing, hearing, mobility/dexterity, mental, cognitive, and other) across gender identities.
Results: Non-binary individuals assigned female at birth (AFAB) had the highest predicted probability of reporting any activity limitations (76.13 %), followed by non-binary individuals assigned male at birth (AMAB) at 61.56 %, transgender men (44.71 %), and transgender women (34.41 %). Cisgender men (19.31 %) and cisgender women (21.98 %) had the lowest probabilities. Mental limitations showed the largest disparity, with 39.4 % of non-binary AFAB individuals affected, compared to 4.9 % of cisgender men. These findings highlight significant disparities in activity limitations across gender identities.
Conclusion: Non-binary and transgender individuals are most at risk for activity limitations. These findings underscore the need for targeted policies to address challenges faced by gender-diverse populations. Future research should investigate the mechanisms behind these disparities. Healthcare policies must prioritize culturally competent, transgender-inclusive care to reduce disparities in activity limitations.
{"title":"Gender identity and activity limitations: A national study on transgender and non-binary Canadians.","authors":"Yihong Bai, Peiya Cao, Chungah Kim, Kristine Ienciu, Inthuja Selvaratnam, Alex Abramovich, Brittany Jakubiec, David J Brennan, Antony Chum","doi":"10.1016/j.ypmed.2025.108224","DOIUrl":"10.1016/j.ypmed.2025.108224","url":null,"abstract":"<p><strong>Introduction: </strong>Activity limitations among transgender and non-binary individuals remain largely unexplored using population-based samples. This study examines the risk of activity limitations across different gender identities in Canada.</p><p><strong>Method: </strong>Using data from the 2021 Canadian long-form Census, logistic regressions estimated the adjusted odds of reporting activity limitations (seeing, hearing, mobility/dexterity, mental, cognitive, and other) across gender identities.</p><p><strong>Results: </strong>Non-binary individuals assigned female at birth (AFAB) had the highest predicted probability of reporting any activity limitations (76.13 %), followed by non-binary individuals assigned male at birth (AMAB) at 61.56 %, transgender men (44.71 %), and transgender women (34.41 %). Cisgender men (19.31 %) and cisgender women (21.98 %) had the lowest probabilities. Mental limitations showed the largest disparity, with 39.4 % of non-binary AFAB individuals affected, compared to 4.9 % of cisgender men. These findings highlight significant disparities in activity limitations across gender identities.</p><p><strong>Conclusion: </strong>Non-binary and transgender individuals are most at risk for activity limitations. These findings underscore the need for targeted policies to address challenges faced by gender-diverse populations. Future research should investigate the mechanisms behind these disparities. Healthcare policies must prioritize culturally competent, transgender-inclusive care to reduce disparities in activity limitations.</p>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":" ","pages":"108224"},"PeriodicalIF":4.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979742","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}
Pub Date : 2024-12-31DOI: 10.1016/j.ypmed.2024.108214
Ani S Movsisyan Vernon, Laura Fejerman, Jeffrey S Hoch, Theresa H Keegan
Objective: To observe stage at diagnosis and cancer-specific survival for common cancers among Armenians in California.
Methods: We used the Armenian Surname List and birthplace information in the California Cancer Registry to identify Armenians with stomach, lung, colorectal, and bladder cancers diagnosed during 1988-2019. We used multivariable logistic regression models to calculate odds of late-stage diagnoses among Armenian and non-Armenian, non-Hispanic White patients and examine the association of sociodemographic factors with late-stage diagnoses among the Armenian patient population. We used Cox proportional hazards models to calculate cancer-specific survival among Armenian patients compared to non-Armenian, non-Hispanic White patients.
Results: Of the 639,224 cancer diagnoses identified, 6642 were among Armenian patients. Armenian individuals were more likely to be diagnosed with late-stage colorectal (OR = 1.12, 95 % CI = 1.03-1.22), lung (OR = 1.26, 95 % CI = 1.12-1.42), and stomach (OR = 1.43, 95 % CI = 1.17-1.74) cancers. Among Armenian patients, low nSES and public insurance were associated with late-stage diagnoses. Armenian individuals had better survival than non-Armenian, non-Hispanic White individuals for stomach (HR = 0.85, 95 % CI = 0.76-0.94), lung (HR = 0.86, 95 % CI = 0.82-0.91), colorectal (HR = 0.82, 95 % CI = 0.77-0.88), and bladder (HR = 0.87, 95 % CI = 0.76-0.99) cancers.
Conclusion: While Armenian patients were at greater risk of late-stage diagnoses of colorectal, lung, and stomach cancers, they had better survival compared to non-Armenian, non-Hispanic White patients. Further research is needed to understand factors impacting survival in Armenian individuals, including genetic, behavioral, and social factors. Our findings of lower nSES and public health insurance associated with late-stage diagnoses suggest a need for increased access to care and cancer screening among the Armenian population in California.
目的：观察加州亚美尼亚人常见癌症的诊断分期和肿瘤特异性生存率。方法：我们使用加州癌症登记处的亚美尼亚姓氏列表和出生地信息来识别1988-2019年诊断为胃癌、肺癌、结直肠癌和膀胱癌的亚美尼亚人。我们使用多变量逻辑回归模型来计算亚美尼亚人和非亚美尼亚人、非西班牙裔白人患者的晚期诊断几率，并检验亚美尼亚患者群体中社会人口统计学因素与晚期诊断的关系。我们使用Cox比例风险模型来计算亚美尼亚患者与非亚美尼亚、非西班牙裔白人患者的癌症特异性生存率。结果：在确诊的639,224例癌症诊断中，有6642例是亚美尼亚患者。亚美尼亚的个体更有可能被诊断为晚期结直肠(或 = 1.12,95 CI % = 1.03 - -1.22)、肺(或 = 1.26,95 CI % = 1.12 - -1.42),和胃(或 = 1.43,95 CI % = 1.17 - -1.74)癌症。在亚美尼亚患者中，低nSES和公共保险与晚期诊断相关。亚美尼亚人比non-Armenian更好的生存,非西班牙裔白人个体对胃(HR = 0.85,95 CI % = 0.76 - -0.94)、肺(HR = 0.86,95 CI % = 0.82 - -0.91),结肠直肠(HR = 0.82,95 CI % = 0.77 - -0.88),和膀胱(HR = 0.87,95 CI % = 0.76 - -0.99)癌症。结论：虽然亚美尼亚人晚期诊断为结直肠癌、肺癌和胃癌的风险更高，但与非亚美尼亚人、非西班牙裔白人患者相比，他们的生存率更高。需要进一步的研究来了解影响亚美尼亚人生存的因素，包括遗传、行为和社会因素。我们的研究发现，较低的nSES和公共健康保险与晚期诊断相关，这表明加州亚美尼亚人口需要增加获得护理和癌症筛查的机会。
{"title":"Stage at diagnosis and cancer-specific survival for stomach, lung, colorectal, and bladder cancers among Armenians in California.","authors":"Ani S Movsisyan Vernon, Laura Fejerman, Jeffrey S Hoch, Theresa H Keegan","doi":"10.1016/j.ypmed.2024.108214","DOIUrl":"10.1016/j.ypmed.2024.108214","url":null,"abstract":"<p><strong>Objective: </strong>To observe stage at diagnosis and cancer-specific survival for common cancers among Armenians in California.</p><p><strong>Methods: </strong>We used the Armenian Surname List and birthplace information in the California Cancer Registry to identify Armenians with stomach, lung, colorectal, and bladder cancers diagnosed during 1988-2019. We used multivariable logistic regression models to calculate odds of late-stage diagnoses among Armenian and non-Armenian, non-Hispanic White patients and examine the association of sociodemographic factors with late-stage diagnoses among the Armenian patient population. We used Cox proportional hazards models to calculate cancer-specific survival among Armenian patients compared to non-Armenian, non-Hispanic White patients.</p><p><strong>Results: </strong>Of the 639,224 cancer diagnoses identified, 6642 were among Armenian patients. Armenian individuals were more likely to be diagnosed with late-stage colorectal (OR = 1.12, 95 % CI = 1.03-1.22), lung (OR = 1.26, 95 % CI = 1.12-1.42), and stomach (OR = 1.43, 95 % CI = 1.17-1.74) cancers. Among Armenian patients, low nSES and public insurance were associated with late-stage diagnoses. Armenian individuals had better survival than non-Armenian, non-Hispanic White individuals for stomach (HR = 0.85, 95 % CI = 0.76-0.94), lung (HR = 0.86, 95 % CI = 0.82-0.91), colorectal (HR = 0.82, 95 % CI = 0.77-0.88), and bladder (HR = 0.87, 95 % CI = 0.76-0.99) cancers.</p><p><strong>Conclusion: </strong>While Armenian patients were at greater risk of late-stage diagnoses of colorectal, lung, and stomach cancers, they had better survival compared to non-Armenian, non-Hispanic White patients. Further research is needed to understand factors impacting survival in Armenian individuals, including genetic, behavioral, and social factors. Our findings of lower nSES and public health insurance associated with late-stage diagnoses suggest a need for increased access to care and cancer screening among the Armenian population in California.</p>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":" ","pages":"108214"},"PeriodicalIF":4.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922616","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}
Pub Date : 2024-11-28DOI: 10.1016/j.ypmed.2024.108186
Yuying Wu , Yanyan Zhang , Yang Zhao , Xing Zhang , Minqi Gu , Weifeng Huo , Xueru Fu , Xi Li , Botang Guo , Jianxin Li , Xiangfeng Lu , Fulan Hu , Dongsheng Hu , Ming Zhang
Purpose
Our study aimed to identify the trajectory patterns of lipid accumulation product (LAP) and investigate their association with the incident risk of type 2 diabetes mellitus (T2DM) in China.
Methods
This study included 37,316 eligible participants, with data collected between1998 and 2021. The LAP trajectory patterns were identified through latent mixture modeling. Logistic regression models were used to examine the association between different LAP trajectory patterns and the incident risk of T2DM.
Results
Over an average period of 12.7 years, 3195 participants developed T2DM. Four LAP trajectory patterns were identified: low stable, moderate slow-increasing, high decreasing, and moderate fast-increasing. After adjusting for demographic and clinical confounders, the odds ratios (ORs) and 95 % confidence intervals (CIs) for T2DM were 1.67 (1.50, 1.86) for the moderate slow-increasing group, 1.63 (1.38, 1.94) for the high decreasing group, and 2.43 (2.07, 2.85) for the moderate fast-increasing group compared with the low stable group. Similar trajectory patterns were found in sex-specific populations as in the general population, while the elevated LAP trajectory pattern was more strongly associated with an increase in the incident risk of T2DM in females.
Conclusion
Individuals with moderate fast-increasing LAP trajectory patterns had a 2.4 times higher risk of developing T2DM compared to those with low stable LAP patterns. More attention should be paid to preventing T2DM in people with high levels of LAP, especially females, the elderly, drinkers, and people with a history of diabetes.
{"title":"Elevated lipid accumulation product trajectory patterns are associated with increasing incident risk of type 2 diabetes mellitus in China","authors":"Yuying Wu , Yanyan Zhang , Yang Zhao , Xing Zhang , Minqi Gu , Weifeng Huo , Xueru Fu , Xi Li , Botang Guo , Jianxin Li , Xiangfeng Lu , Fulan Hu , Dongsheng Hu , Ming Zhang","doi":"10.1016/j.ypmed.2024.108186","DOIUrl":"10.1016/j.ypmed.2024.108186","url":null,"abstract":"<div><h3>Purpose</h3><div>Our study aimed to identify the trajectory patterns of lipid accumulation product (LAP) and investigate their association with the incident risk of type 2 diabetes mellitus (T2DM) in China.</div></div><div><h3>Methods</h3><div>This study included 37,316 eligible participants, with data collected between1998 and 2021. The LAP trajectory patterns were identified through latent mixture modeling. Logistic regression models were used to examine the association between different LAP trajectory patterns and the incident risk of T2DM.</div></div><div><h3>Results</h3><div>Over an average period of 12.7 years, 3195 participants developed T2DM. Four LAP trajectory patterns were identified: low stable, moderate slow-increasing, high decreasing, and moderate fast-increasing. After adjusting for demographic and clinical confounders, the odds ratios (ORs) and 95 % confidence intervals (CIs) for T2DM were 1.67 (1.50, 1.86) for the moderate slow-increasing group, 1.63 (1.38, 1.94) for the high decreasing group, and 2.43 (2.07, 2.85) for the moderate fast-increasing group compared with the low stable group. Similar trajectory patterns were found in sex-specific populations as in the general population, while the elevated LAP trajectory pattern was more strongly associated with an increase in the incident risk of T2DM in females.</div></div><div><h3>Conclusion</h3><div>Individuals with moderate fast-increasing LAP trajectory patterns had a 2.4 times higher risk of developing T2DM compared to those with low stable LAP patterns. More attention should be paid to preventing T2DM in people with high levels of LAP, especially females, the elderly, drinkers, and people with a history of diabetes.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108186"},"PeriodicalIF":4.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743015","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}
Pub Date : 2024-11-26DOI: 10.1016/j.ypmed.2024.108185
Cormac Monaghan , Rafael de Andrade Moral , Joanna McHugh Power
Objective
Maintaining health preventive behaviours in later life reduces the risk of non-communicable diseases. However, these behaviours often require effort and discipline to adopt and may be prone to procrastination. This study examined whether procrastination affected engagement in health preventive behaviours among older adults.
Methods
We applied generalised additive models to data from the 2020 wave of the United States Health and Retirement Study. Our analytic sample consisted of adults aged 50+ (n = 1338; mean = 68.24; range = 50–95). Our analysis focused on six health preventive behaviours: prostate exams, mammograms, cholesterol screenings, pap smears, flu shots, and dental visits.
Results
Procrastination was associated with less frequent engagement in mammograms and cholesterol screenings among women, though it had no significant association with pap smears or flu shots. Additionally, procrastination interacted with depression reducing the likelihood of prostate exams in men and dental visits in both men and women, such that individuals with high procrastination and low depression were associated with less frequent engagement in both preventive health behaviours.
Conclusions
Procrastination may be a behavioral risk factor for maintaining optimal health in older adults. Given that procrastination is a potentially modifiable behaviour, interventions aimed at reducing procrastination, such as simplifying tasks or providing default appointment, could improve engagement in critical health preventive behaviours.
目的在晚年保持健康预防行为可降低罹患非传染性疾病的风险。然而，这些行为往往需要付出努力和遵守纪律才能养成，而且很容易出现拖延现象。本研究探讨了拖延是否会影响老年人参与健康预防行为：我们对美国健康与退休研究 2020 年的数据采用了广义加法模型。我们的分析样本包括 50 岁以上的成年人（n = 1338；平均值 = 68.24；范围 = 50-95）。我们的分析侧重于六种健康预防行为：前列腺检查、乳房 X 光检查、胆固醇筛查、子宫颈抹片检查、流感疫苗注射和牙科就诊：结果：拖延与女性较少参加乳房 X 光检查和胆固醇筛查有关，但与子宫颈抹片检查和流感疫苗注射没有明显关系。此外，拖延症与抑郁症相互作用，降低了男性前列腺检查和男女牙科就诊的可能性，因此拖延症严重而抑郁症严重的人参与这两种预防性健康行为的频率都较低：结论：拖延可能是老年人保持最佳健康状态的一个行为风险因素。鉴于拖延可能是一种可改变的行为，旨在减少拖延的干预措施，如简化任务或提供默认预约，可提高参与关键健康预防行为的频率。
{"title":"Procrastination and preventive health-care in the older U.S. population","authors":"Cormac Monaghan , Rafael de Andrade Moral , Joanna McHugh Power","doi":"10.1016/j.ypmed.2024.108185","DOIUrl":"10.1016/j.ypmed.2024.108185","url":null,"abstract":"<div><h3>Objective</h3><div>Maintaining health preventive behaviours in later life reduces the risk of non-communicable diseases. However, these behaviours often require effort and discipline to adopt and may be prone to procrastination. This study examined whether procrastination affected engagement in health preventive behaviours among older adults.</div></div><div><h3>Methods</h3><div>We applied generalised additive models to data from the 2020 wave of the United States Health and Retirement Study. Our analytic sample consisted of adults aged 50+ (<em>n</em> = 1338; mean = 68.24; range = 50–95). Our analysis focused on six health preventive behaviours: prostate exams, mammograms, cholesterol screenings, pap smears, flu shots, and dental visits.</div></div><div><h3>Results</h3><div>Procrastination was associated with less frequent engagement in mammograms and cholesterol screenings among women, though it had no significant association with pap smears or flu shots. Additionally, procrastination interacted with depression reducing the likelihood of prostate exams in men and dental visits in both men and women, such that individuals with high procrastination and low depression were associated with less frequent engagement in both preventive health behaviours.</div></div><div><h3>Conclusions</h3><div>Procrastination may be a behavioral risk factor for maintaining optimal health in older adults. Given that procrastination is a potentially modifiable behaviour, interventions aimed at reducing procrastination, such as simplifying tasks or providing default appointment, could improve engagement in critical health preventive behaviours.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108185"},"PeriodicalIF":4.3,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-26DOI: 10.1016/j.ypmed.2024.108184
Deborah A. Cohen , Robert Zarr , Erika Estrada , Haoyuan Zhong , Bing Han
Objective
Electronic media is constantly evolving and has become an integral part of people's lives, especially among youth. This cross-sectional observational study assessed the association between electronic media use, health behaviors and outcomes, specifically, physical activity, stress and cognitive function among youth from an under-resourced community.
Methods
Participants ages six-sixteen were recruited from a Federally Qualified Health Center to participate in a study to promote park prescriptions with data collection between 2020 and 2024. At baseline, both intervention and control participants were asked to wear an accelerometer for one week and complete surveys about their electronic media time, stress, and cognitive function. We estimated the associations between electronic media use and health outcomes using cross-sectional multiple regressions.
Results
Among the 441 participants, the average amount of electronic media use was 48.6 h per week (95 % CI: 46.0, 51.1), with children ages 6–9 engaging in 37.3 h per week (95 % CI: 34.5, 40.2) and youth ages 10–16 engaging in 56.4 h per week of electronic media time (95 % CI: 52.9, 59.9). Average daily MVPA was 16.6 min (95 % CI: 15.4, 17.8). Electronic media use time was negatively associated with MVPA and with cognitive function for all age groups. Electronic media time was only associated with stress for youth over age 10.
Conclusion
The associations among electronic media, MVPA, cognitive function and stress were statistically significant, but relatively modest. Future research should examine whether reducing time on electronic media will have a positive impact on physical activity and mental health outcomes.
{"title":"Association of children's electronic media use with physical activity, cognitive function, and stress","authors":"Deborah A. Cohen , Robert Zarr , Erika Estrada , Haoyuan Zhong , Bing Han","doi":"10.1016/j.ypmed.2024.108184","DOIUrl":"10.1016/j.ypmed.2024.108184","url":null,"abstract":"<div><h3>Objective</h3><div>Electronic media is constantly evolving and has become an integral part of people's lives, especially among youth. This cross-sectional observational study assessed the association between electronic media use, health behaviors and outcomes, specifically, physical activity, stress and cognitive function among youth from an under-resourced community.</div></div><div><h3>Methods</h3><div>Participants ages six-sixteen were recruited from a Federally Qualified Health Center to participate in a study to promote park prescriptions with data collection between 2020 and 2024. At baseline, both intervention and control participants were asked to wear an accelerometer for one week and complete surveys about their electronic media time, stress, and cognitive function. We estimated the associations between electronic media use and health outcomes using cross-sectional multiple regressions.</div></div><div><h3>Results</h3><div>Among the 441 participants, the average amount of electronic media use was 48.6 h per week (95 % CI: 46.0, 51.1), with children ages 6–9 engaging in 37.3 h per week (95 % CI: 34.5, 40.2) and youth ages 10–16 engaging in 56.4 h per week of electronic media time (95 % CI: 52.9, 59.9). Average daily MVPA was 16.6 min (95 % CI: 15.4, 17.8). Electronic media use time was negatively associated with MVPA and with cognitive function for all age groups. Electronic media time was only associated with stress for youth over age 10.</div></div><div><h3>Conclusion</h3><div>The associations among electronic media, MVPA, cognitive function and stress were statistically significant, but relatively modest. Future research should examine whether reducing time on electronic media will have a positive impact on physical activity and mental health outcomes.</div><div><strong>Clinical trials registry number:</strong> #NCT04114734.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108184"},"PeriodicalIF":4.3,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732099","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}
Pub Date : 2024-11-23DOI: 10.1016/j.ypmed.2024.108183
Heather A. Hartman , Laura A. Seewald , Philip Stallworth , Daniel B. Lee , Marc A. Zimmerman , Peter F. Ehrlich , Maureen A. Walton , Kenneth Resnicow , Patrick M. Carter
Introduction
Firearm injuries are a leading cause of death for youth/young-adults. We utilized latent class analysis to identify distinct motivational/behavioral patterns of firearm possession in a youth/young-adult emergency department sample to inform prevention strategies.
Methods
Cross-sectional data were obtained from surveys conducted among youth/young-adults (age = 16–29; n = 1311) seeking emergency department treatment (7/10/2017–6/25/2018). Latent class analysis was performed for individuals reporting firearm possession (n = 223) using five variables: carriage frequency, social carriage, risky firearm behaviors, ownership/carriage for protection, and recreational ownership/carriage. Descriptive statistics were examined.
Results
In this sample, 17.0 % reported having firearms (age-22.7; 48.0 %-male; 49.3 %-Black; 52.5 %-public assistance). Latent class analysis identified four classes: 1-recreational possession (n = 51); 2-possession for protection with low carriage (n = 60); 3-carriage for protection with low risky firearm behaviors (n = 76); and 4-carriage for protection with high risky firearm behaviors (n = 36). Class-1 (recreational possession) had low firearm victimization, violence exposure, and community violence. This class primarily kept long-guns with secure storage patterns. Class-2 (protection with low carriage) were mostly female youth/young-adults with children and reported moderately high rates of violence exposure. Nearly 20 % stored their firearm unlocked. Class-3 and -4 endorsed firearm carriage for protection, with Class-4 also engaging in risky firearm behaviors. Both classes had high violence exposure; however, Class-4 had higher risk profiles including higher marijuana misuse, mental health symptoms, and firearm victimization.
Conclusions
Among an emergency department sample, four distinct firearm possession classes emerged with different risk levels. Understanding firearm behaviors and risk/protective factors is critical to tailoring healthcare-focused interventions to address individual needs and reduce injury risk.
{"title":"Firearm possession among emergency department youth and young adults: A latent class analysis","authors":"Heather A. Hartman , Laura A. Seewald , Philip Stallworth , Daniel B. Lee , Marc A. Zimmerman , Peter F. Ehrlich , Maureen A. Walton , Kenneth Resnicow , Patrick M. Carter","doi":"10.1016/j.ypmed.2024.108183","DOIUrl":"10.1016/j.ypmed.2024.108183","url":null,"abstract":"<div><h3>Introduction</h3><div>Firearm injuries are a leading cause of death for youth/young-adults. We utilized latent class analysis to identify distinct motivational/behavioral patterns of firearm possession in a youth/young-adult emergency department sample to inform prevention strategies.</div></div><div><h3>Methods</h3><div>Cross-sectional data were obtained from surveys conducted among youth/young-adults (age = 16–29; <em>n</em> = 1311) seeking emergency department treatment (7/10/2017–6/25/2018). Latent class analysis was performed for individuals reporting firearm possession (<em>n</em> = 223) using five variables: carriage frequency, social carriage, risky firearm behaviors, ownership/carriage for protection, and recreational ownership/carriage. Descriptive statistics were examined.</div></div><div><h3>Results</h3><div>In this sample, 17.0 % reported having firearms (age-22.7; 48.0 %-male; 49.3 %-Black; 52.5 %-public assistance). Latent class analysis identified four classes: 1-recreational possession (<em>n</em> = 51); 2-possession for protection with low carriage (<em>n</em> = 60); 3-carriage for protection with low risky firearm behaviors (<em>n</em> = 76); and 4-carriage for protection with high risky firearm behaviors (<em>n</em> = 36). Class-1 (recreational possession) had low firearm victimization, violence exposure, and community violence. This class primarily kept long-guns with secure storage patterns. Class-2 (protection with low carriage) were mostly female youth/young-adults with children and reported moderately high rates of violence exposure. Nearly 20 % stored their firearm unlocked. Class-3 and -4 endorsed firearm carriage for protection, with Class-4 also engaging in risky firearm behaviors. Both classes had high violence exposure; however, Class-4 had higher risk profiles including higher marijuana misuse, mental health symptoms, and firearm victimization.</div></div><div><h3>Conclusions</h3><div>Among an emergency department sample, four distinct firearm possession classes emerged with different risk levels. Understanding firearm behaviors and risk/protective factors is critical to tailoring healthcare-focused interventions to address individual needs and reduce injury risk.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108183"},"PeriodicalIF":4.3,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716709","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}
Pub Date : 2024-11-23DOI: 10.1016/j.ypmed.2024.108182
Elyse N. Llamocca , Andrew S. Bossick , Denise White Perkins , Brian K. Ahmedani , Rob Behrendt , Anna Bloemen , Angela Murphy , Aishwarya Kulkarni , Elizabeth Lockhart
Background
National mandates require screening for and addressing health-related social needs (HRSNs) in healthcare settings. However, differences in HRSN screening process (i.e., completed screenings, screening results, documented offer of assistance, documented assistance request) have been reported by population subgroup. Knowledge of the most effective HRSN screening and intervention methods is limited. We sought to describe differences in completed HRSN screenings, screening results, and assistance request rates across patient and healthcare visit characteristics.
Methods
We examined data from all patients aged ≥18 years and residing in the US receiving services at a large, Midwestern healthcare system with a goal to screen all patients for HRSN at least once annually between July 2021–June 2023 (n = 1,190,488). We examined the proportion of patients with any HRSN screening, with any reported HRSN, asked whether they wanted assistance, or who requested assistance for a reported HRSN stratified by patient demographics and healthcare visit characteristics (i.e., payer, screening location, who completed the screening).
Results
Less than half of eligible patients (47.0 %) were screened for HRSNs. About one-sixth (16.9 %) reported any HRSN. Although most patients reporting HRSNs were asked whether they wanted assistance, only about one-quarter (26.8 %) responded affirmatively. Proportions included in each step of the HRSN screening process significantly differed by patient and healthcare visit characteristics.
Discussion
This study is one of the first to investigate various steps of a population-wide HRSN screening program. Our findings suggest that examining differences in HRSN screening process by population subgroup is key to addressing HRSNs through a health equity lens.
{"title":"Health-related social needs screening, reporting, and assistance in a large health system","authors":"Elyse N. Llamocca , Andrew S. Bossick , Denise White Perkins , Brian K. Ahmedani , Rob Behrendt , Anna Bloemen , Angela Murphy , Aishwarya Kulkarni , Elizabeth Lockhart","doi":"10.1016/j.ypmed.2024.108182","DOIUrl":"10.1016/j.ypmed.2024.108182","url":null,"abstract":"<div><h3>Background</h3><div>National mandates require screening for and addressing health-related social needs (HRSNs) in healthcare settings. However, differences in HRSN screening process (i.e., completed screenings, screening results, documented offer of assistance, documented assistance request) have been reported by population subgroup. Knowledge of the most effective HRSN screening and intervention methods is limited. We sought to describe differences in completed HRSN screenings, screening results, and assistance request rates across patient and healthcare visit characteristics.</div></div><div><h3>Methods</h3><div>We examined data from all patients aged ≥18 years and residing in the US receiving services at a large, Midwestern healthcare system with a goal to screen all patients for HRSN at least once annually between July 2021–June 2023 (<em>n</em> = 1,190,488). We examined the proportion of patients with any HRSN screening, with any reported HRSN, asked whether they wanted assistance, or who requested assistance for a reported HRSN stratified by patient demographics and healthcare visit characteristics (i.e., payer, screening location, who completed the screening).</div></div><div><h3>Results</h3><div>Less than half of eligible patients (47.0 %) were screened for HRSNs. About one-sixth (16.9 %) reported any HRSN. Although most patients reporting HRSNs were asked whether they wanted assistance, only about one-quarter (26.8 %) responded affirmatively. Proportions included in each step of the HRSN screening process significantly differed by patient and healthcare visit characteristics.</div></div><div><h3>Discussion</h3><div>This study is one of the first to investigate various steps of a population-wide HRSN screening program. Our findings suggest that examining differences in HRSN screening process by population subgroup is key to addressing HRSNs through a health equity lens.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108182"},"PeriodicalIF":4.3,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716719","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}
Pub Date : 2024-11-17DOI: 10.1016/j.ypmed.2024.108179
Yong-Hao Yeo , Boon-Jian San , Ela Ahmad , Min-Choon Tan , Yuh-Miin Sin , Milena Jani , Richard J. Bloomingdale
Objective
Our study aimed to assess the heart failure/cardiomyopathy-related population-level mortality trends among patients with obesity in the United States and disparities across demographics.
Methods
We queried the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database among adults aged ≥25 from 1999 to 2019. Heart failure/cardiomyopathy were listed as the main causes of death, with obesity as a contributing cause. We calculated age-adjusted mortality rates (AAMR) per 100,000 individuals and estimated the average annual percent change (AAPC). We also evaluated the social vulnerability of United States counties (2014–2018).
Results
There were 29,334 deaths related to heart failure/cardiomyopathy among patients with comorbid obesity. The overall AAMR increased from 0.41 in 1999 to 0.94 in 2019, with an AAPC of 3.78 (95 % CI, 3.41–4.14). The crude mortality rate increase for heart failure/cardiomyopathy was greater in individuals with comorbid obesity than in those without. Males had a higher AAMR than females (0.78 vs 0.55). African Americans also had higher AAMR than Whites (1.35 vs 0.62). The AAMR was higher in rural areas than in urban regions (0.76 vs 0.66). The overall AAMR was higher in counties with social vulnerability index-Quartile 4 (SVI-Q4) (most vulnerable) (1.08) compared to SVI-Q1 (least vulnerable) (0.63) with a risk ratio of 1.71 (95 % CI: 1.61–1.83).
Conclusion
Heart failure/cardiomyopathy mortality in individuals with comorbid obesity was rising. Males, African Americans, and individuals from rural regions had higher AAMR than their counterparts.
{"title":"Heart failure and cardiomyopathy mortality trends and disparities among obese populations: A 20-year United States study","authors":"Yong-Hao Yeo , Boon-Jian San , Ela Ahmad , Min-Choon Tan , Yuh-Miin Sin , Milena Jani , Richard J. Bloomingdale","doi":"10.1016/j.ypmed.2024.108179","DOIUrl":"10.1016/j.ypmed.2024.108179","url":null,"abstract":"<div><h3>Objective</h3><div>Our study aimed to assess the heart failure/cardiomyopathy-related population-level mortality trends among patients with obesity in the United States and disparities across demographics.</div></div><div><h3>Methods</h3><div>We queried the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database among adults aged ≥25 from 1999 to 2019. Heart failure/cardiomyopathy were listed as the main causes of death, with obesity as a contributing cause. We calculated age-adjusted mortality rates (AAMR) per 100,000 individuals and estimated the average annual percent change (AAPC). We also evaluated the social vulnerability of United States counties (2014–2018).</div></div><div><h3>Results</h3><div>There were 29,334 deaths related to heart failure/cardiomyopathy among patients with comorbid obesity. The overall AAMR increased from 0.41 in 1999 to 0.94 in 2019, with an AAPC of 3.78 (95 % CI, 3.41–4.14). The crude mortality rate increase for heart failure/cardiomyopathy was greater in individuals with comorbid obesity than in those without. Males had a higher AAMR than females (0.78 vs 0.55). African Americans also had higher AAMR than Whites (1.35 vs 0.62). The AAMR was higher in rural areas than in urban regions (0.76 vs 0.66). The overall AAMR was higher in counties with social vulnerability index-Quartile 4 (SVI-Q4) (most vulnerable) (1.08) compared to SVI-Q1 (least vulnerable) (0.63) with a risk ratio of 1.71 (95 % CI: 1.61–1.83).</div></div><div><h3>Conclusion</h3><div>Heart failure/cardiomyopathy mortality in individuals with comorbid obesity was rising. Males, African Americans, and individuals from rural regions had higher AAMR than their counterparts.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108179"},"PeriodicalIF":4.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676630","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}
Pub Date : 2024-11-17DOI: 10.1016/j.ypmed.2024.108181
Ememgini Elo-Eghosa , Wei Li , Mohammad Ebrahimi Kalan , Nan Hu , Olatokunbo Osibogun
Background
Premature atherosclerotic cardiovascular disease (ASCVD) is increasing in young adults (<55 years old). While research suggests females who smoke cigarettes have a higher risk of ASCVD than males, studies on the impact of exclusive e-cigarette and dual use on premature ASCVD are limited. This study investigated the association between tobacco use and self-reported premature ASCVD and explored potential sex differences.
Methods
Using pooled data from 480,317 adults (ages 18–54; ∼50 % female) from the 2020–2022 Behavioral Risk Factor Surveillance System from the United States, logistic regression models assessed associations between cigarette and e-cigarette use patterns and self-reported premature ASCVD. Tobacco use categories were defined as: non-use, former use (cigarettes, e-cigarettes), and current use (cigarettes, e-cigarettes) and dual use. Self-reported premature ASCVD was defined as self-reported angina or coronary heart disease, heart attack, or stroke. Weighted analyses were conducted for the overall sample and stratified by sex.
Results
After controlling for potential confounders, former exclusive cigarette (adjusted OR: 1.47 [95 % CI 1.29, 1.67]), current exclusive cigarette (1.68 [1.47–1.94]) and current dual (2.03 [1.69–2.44]) use were associated with higher odds of self-reported premature ASCVD. There was no significant association for e-cigarette use. Sex-specific analyses revealed similar patterns but the magnitude of these associations varied between males and females.
Conclusion
Both sexes showed higher odds of self-reported premature ASCVD for dual and exclusive cigarette use. Although the cross-sectional design precludes causal inferences, the findings suggest comprehensive tobacco cessation programs tailored to diverse use patterns are needed to reduce the burden of premature ASCVD.
{"title":"Sex-specific associations of cigarettes and e-cigarettes use with self-reported premature atherosclerotic cardiovascular disease among adults aged 18–54 in the United States","authors":"Ememgini Elo-Eghosa , Wei Li , Mohammad Ebrahimi Kalan , Nan Hu , Olatokunbo Osibogun","doi":"10.1016/j.ypmed.2024.108181","DOIUrl":"10.1016/j.ypmed.2024.108181","url":null,"abstract":"<div><h3>Background</h3><div>Premature atherosclerotic cardiovascular disease (ASCVD) is increasing in young adults (<55 years old). While research suggests females who smoke cigarettes have a higher risk of ASCVD than males, studies on the impact of exclusive e-cigarette and dual use on premature ASCVD are limited. This study investigated the association between tobacco use and self-reported premature ASCVD and explored potential sex differences.</div></div><div><h3>Methods</h3><div>Using pooled data from 480,317 adults (ages 18–54; ∼50 % female) from the 2020–2022 Behavioral Risk Factor Surveillance System from the United States, logistic regression models assessed associations between cigarette and e-cigarette use patterns and self-reported premature ASCVD. Tobacco use categories were defined as: non-use, former use (cigarettes, e-cigarettes), and current use (cigarettes, e-cigarettes) and dual use. Self-reported premature ASCVD was defined as self-reported angina or coronary heart disease, heart attack, or stroke. Weighted analyses were conducted for the overall sample and stratified by sex.</div></div><div><h3>Results</h3><div>After controlling for potential confounders, former exclusive cigarette (adjusted OR: 1.47 [95 % CI 1.29, 1.67]), current exclusive cigarette (1.68 [1.47–1.94]) and current dual (2.03 [1.69–2.44]) use were associated with higher odds of self-reported premature ASCVD. There was no significant association for e-cigarette use. Sex-specific analyses revealed similar patterns but the magnitude of these associations varied between males and females.</div></div><div><h3>Conclusion</h3><div>Both sexes showed higher odds of self-reported premature ASCVD for dual and exclusive cigarette use. Although the cross-sectional design precludes causal inferences, the findings suggest comprehensive tobacco cessation programs tailored to diverse use patterns are needed to reduce the burden of premature ASCVD.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108181"},"PeriodicalIF":4.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668964","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}
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