Preventive medicine最新文献_第3页

U.S. national trends in cervical cancer screening by sexual orientation and race/ethnicity in cisgender women 美国国家趋势宫颈癌筛查的性取向和种族/民族的顺性别妇女。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.ypmed.2025.108223

Kelley Baumann , Caryn E. Peterson , Stacie Geller , Saria Awadalla , Hunter K. Holt

Introduction

Changes in up-to-date cervical cancer screening (CCS) over time by sexual orientation and race/ethnicity were estimated to identify trends in screening disparities.

Methods

This 2024 retrospective, cross-sectional analysis of National Health Interview Survey data (years 2013, 2015, 2019 and 2021) included 40,818 cisgender women aged 21–65 without hysterectomy. Joinpoint analysis was performed to calculate the annual percent change (APC) of up-to-date CCS from 2013 to 2021. Logistic regression (years 2019 and 2021) was used to describe the relationship between up-to-date screening and sexual orientation, race/ethnicity, and the interaction thereof.

Results

The adjusted odds of up-to-date CCS were 22 % lower for lesbian, gay, and/or bisexual (LGB) compared to heterosexual women (OR = 0.78, p = 0.01). Up-to-date CCS fell significantly from 80.50 % in 2013 to 75.00 % in 2021 for heterosexual respondents (APC = -0.97 %, p < 0.01), but was stable across years for LGB respondents. Up-to-date CCS decreased for Hispanic (APC = -1.52, p < 01) and non-Hispanic White only heterosexual women (APC = -0.63, p = 0.02). It also decreased for non-Hispanic Black/African American only LGB women (APC = -2.67, p < 0.01) falling from 85.22 % in 2013 to 67.91 % in 2021. By multiplicative interaction, LGB Hispanic women were more up-to-date than their heterosexual counterparts (p = 0.05).

Conclusions

In 2021 there were approximately 19.72 million women aged 21–65 who were not up-to-date with CCS. 1.76 million LGB women were not up-to-date for CCS, and a greater proportion of these women identified as non-Hispanic Black/African American. CCS must be improved for all cisgender women, and specific attention should be given to those who identify as LGB and/or Black/African American.

引言：最新宫颈癌筛查（CCS）随着时间的推移，性取向和种族/民族的变化进行了估计，以确定筛查差异的趋势。方法：对全国健康访谈调查数据（2013年、2015年、2019年和2021年）进行回顾性、横断面分析，包括40,818名21-65岁未切除子宫的顺性别女性。采用连接点分析计算了2013年至2021年最新CCS的年变化百分比（APC）。使用逻辑回归（2019年和2021年）来描述最新筛查与性取向、种族/民族之间的关系及其相互作用。结果：与异性恋女性相比，女同性恋、男同性恋和/或双性恋（LGB）的最新CCS调整几率低22% % （or = 0.78,p = 0.01）。异性恋受访者的最新CCS从2013年的80.50 %显著下降到2021年的75.00 % （APC = -0.97 %,p ）。结论：2021年，大约有1972万21-65岁的女性没有最新的CCS。176万LGB女性没有更新CCS，这些女性中更大比例是非西班牙裔黑人/非洲裔美国人。CCS必须针对所有顺性女性进行改进，并应特别关注那些自认为是LGB和/或黑人/非裔美国人的女性。

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引用次数: 0

Association between physical activity-related metabolic signature and cardiometabolic diseases and multimorbidity: A cohort study from UK biobank 身体活动相关代谢特征与心脏代谢疾病和多发病之间的关联：来自英国生物银行的队列研究

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.ypmed.2024.108211

Jiacheng Wang , Yi Zheng , Yanfeng Jiang , Chen Suo , Tiejun Zhang , Xingdong Chen , Kelin Xu

Objective

Physical activity has protective effects on cardiometabolic diseases (CMDs), but the role of metabolism related to physical activity in this process is unclear.

Methods

In the prospective cohort study from UK Biobank between 2006 and 2022, participants free of CMDs at baseline were included (n = 73,990). We identified physical activity-related metabolites and constructed metabolic signature using linear regression and elastic net regression. Association between physical activity, metabolic signature, and CMDs (type 2 diabetes [T2D], coronary heart disease [CHD], and stroke) were explored using Cox and mediation analyses. Interactions between the metabolic signature and genetic susceptibility (categorized into “low” and “high” based on the median of polygenic risk scores) were assessed by additive hazard models and relative excess risk due to interaction (RERI). Multi-state models evaluated the association between metabolic signature and disease progression.

Results

We found 58 metabolites were related to physical activity, of which 17 were used to construct metabolic signature. The metabolic signature was associated with reduced risk of T2D (HR = 0.13[0.10–0.16]), CHD (HR = 0.40[0.34–0.47]), and stroke (HR = 0.67[0.53–0.86]), and mediated 40.56 % of the association between physical activity and T2D. The metabolic signature exhibited additive interactions with genetic risk for T2D (RERI = 1.57[1.09–2.05]) and CHD (RERI = 0.27[0.05–0.49]). Finally, the metabolic signature was associated with a reduced risk of transition from CMD to CMM (HR = 0.58[0.42–0.81]).

Conclusion

Physical activity-related metabolic signature is linked to reduced risks of CMDs and CMM. We once again emphasize the importance of physical activity for CMDs prevention from a metabolic perspective, especially for individuals at high genetic risk.

目的：体育锻炼对心血管代谢疾病（CMDs）具有保护作用，但与体育锻炼相关的代谢在这一过程中的作用尚不清楚。方法：在2006年至2022年期间来自UK Biobank的前瞻性队列研究中，纳入基线时无cmd的参与者（n = 73,990）。我们利用线性回归和弹性网络回归确定了与体育活动相关的代谢物，并构建了代谢特征。采用Cox和中介分析探讨了体力活动、代谢特征和CMDs（2型糖尿病[T2D]、冠心病[CHD]和卒中）之间的关系。代谢特征和遗传易感性之间的相互作用（根据多基因风险评分的中位数分为“低”和“高”）通过加性危害模型和相互作用的相对超额风险（RERI）进行评估。多状态模型评估了代谢特征与疾病进展之间的关系。结果：我们发现58种代谢物与体力活动相关，其中17种用于构建代谢特征。代谢特征与降低T2D （HR = 0.13[0.10-0.16]）、冠心病（HR = 0.40[0.34-0.47]）和卒中（HR = 0.67[0.53-0.86]）的风险相关，并介导了体力活动与T2D之间40.56 %的关联。代谢特征与T2D （rei = 1.57[1.09-2.05]）和冠心病（rei = 0.27[0.05-0.49]）的遗传风险存在叠加性相互作用。最后，代谢特征与从CMD转变为CMM的风险降低有关（HR = 0.58[0.42-0.81]）。结论：体育活动相关的代谢特征与CMDs和CMM的风险降低有关。我们再次强调，从代谢的角度来看，体育活动对于预防慢性阻塞性肺病的重要性，特别是对于具有高遗传风险的个体。

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引用次数: 0

Relationship between self-rated health, physical frailty, and incidence of disability among Japanese community-dwelling older adults: A longitudinal prospective cohort study 日本社区老年人自评健康、身体虚弱和残疾发生率之间的关系：一项纵向前瞻性队列研究

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.ypmed.2024.108210

Ryo Yamaguchi , Keitaro Makino , Osamu Katayama , Daiki Yamagiwa , Hiroyuki Shimada

Objective

Poor self-rated health (SRH) and physical frailty are both significant predictors of disability in older adults, but their joint association on health outcomes remain unclear. This study aimed to examine the relationship between SRH, physical frailty, and incidence of disability among community-dwelling older adults.

Methods

This longitudinal cohort study included 2838 older adults aged 65 years or older (mean age, 73.1 ± 5.9 years) living in Takahama, Japan, who participated in the baseline assessment from September 2015 to February 2017. Participants were followed prospectively until June 2021. SRH was assessed on a four-point scale, and frailty was evaluated using the Japanese version of the Cardiovascular Health Study criteria. Participants were categorized into four groups based on SRH (Good or Poor) and frailty status (Robust or Frail). Cox proportional hazard models were used to assess the association between these categories and the incidence of disability over a 5-year follow-up.

Results

During the median follow-up of 60 months, 349 of the 2838 participants developed a disability. The risk of disability was significantly higher in the Poor/Robust (HR 1.64, 95 % CI 1.20–2.25), Good/Frail (HR 2.58, 95 % CI 1.91–3.49), and Poor/Frail (HR 2.03, 95 % CI 1.37–3.01) groups than in the Good/Robust reference group.

Conclusions

Frail older adults who report good health were associated with the risk of disability, suggesting that discrepancies between subjective and objective health assessments may lead to adverse outcomes. Recognizing and addressing these discrepancies is crucial to promote successful aging.

目的：较差的自评健康（SRH）和身体虚弱都是老年人残疾的重要预测因素，但它们与健康结局的联合关系尚不清楚。本研究旨在探讨居住在社区的老年人的SRH、身体虚弱和残疾发生率之间的关系。方法：本纵向队列研究纳入2838名年龄在65岁 以上的老年人（平均年龄73.1 ± 5.9 岁），居住在日本高滨，于2015年9月至2017年2月参加基线评估。参与者的前瞻性随访将持续到2021年6月。SRH采用四分制进行评估，脆弱性采用日本版心血管健康研究标准进行评估。参与者根据SRH（好或差）和虚弱状态（强壮或虚弱）分为四组。使用Cox比例风险模型评估这些类别与5年随访期间残疾发生率之间的关系。结果：在中位随访60 个月期间，2838名参与者中有349人出现残疾。致残风险在差/健壮组（HR 1.64, 95 % CI 1.20-2.25）、好/虚弱组（HR 2.58, 95 % CI 1.91-3.49）和差/虚弱组（HR 2.03, 95 % CI 1.37-3.01）显著高于好/健壮参照组。结论：报告健康状况良好的体弱老年人与残疾风险相关，表明主观和客观健康评估之间的差异可能导致不良结果。认识和解决这些差异是促进成功老龄化的关键。

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引用次数: 0

Illicit drug use among adolescents and young adults with impairments in the US: A cross-sectional analysis of the National Survey on Drug Use And Health 美国有缺陷的青少年和青壮年的非法药物使用情况：全国药物使用和健康调查的横断面分析。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.ypmed.2025.108222

Justin A. Haegele , Samantha M. Ross-Cypcar , Jeanette M. Garcia

Objective

The purpose of this cross-sectional analysis is to compare the degree to which adolescents and adults with and without impairments in the US engage in illicit drug use.

Methods

This cross-sectional study utilized data from the 2022 National Survey of Drug Use and Health. Impairment status (mobility, cognitive, hearing, vision, self-care, and communication impairments), illicit drug use (cocaine, crack, heroin, hallucinogens, LSD, ecstasy and molly, inhalants, and methamphetamine), and demographic variables were measured using self-report. Weighted prevalence estimates for illicit drug use across each category were provided. Group differences in drug prevalence between individuals with and without impairments were examined, then logistic regressions estimated crude and adjusted odds of drug use among impairment groups by age. Prevalence of use and age of first time use for illicit drugs were explored across impairment type.

Results

The sample comprised of 35,921 individuals, with an estimate of 12.9 % experiencing at least one impairment. Among emerging adults, hallucinogens were the highest reported used drug in the past year, with a significantly higher percentage of those with impairments (12.8 %, 95 % CI: 1.5, 9.6), compared to adults without impairments (7.1 %, 95 % CI: 6.3, 8.0), reporting recent use. Individuals with impairments (mean = 16.2 years) were significantly younger when they first tried an illicit drug compared to peers (mean = 18.1 years).

Conclusions

Overall, individuals with impairments were more than twice as likely to engage in illicit drug use compared to counterparts. People with impairments were younger, on average, when they first tried any illicit drugs.

目的：本横断面分析的目的是比较美国有和没有障碍的青少年和成年人参与非法药物使用的程度。方法：本横断面研究利用了2022年全国药物使用与健康调查的数据。损害状况（活动能力、认知、听力、视力、自我保健和沟通障碍）、非法药物使用（可卡因、快克、海洛因、致幻剂、LSD、摇头丸和莫利、吸入剂和甲基苯丙胺）和人口统计学变量采用自我报告进行测量。提供了每一类非法药物使用的加权流行率估计数。检查有和无损伤个体之间药物流行率的组间差异，然后按年龄进行逻辑回归估计损伤组中药物使用的原始和调整的几率。探讨了不同损害类型的非法药物使用率和首次使用年龄。结果：样本由35,921人组成，估计有12.9 %经历至少一种损伤。在新兴成人中，致幻剂是过去一年中报告使用最多的药物，与没有损伤的成年人（7.1 %,95 % CI: 6.3, 8.0）相比，有损伤的成年人（12.8 %,95 % CI: 1.5, 9.6）报告最近使用致幻剂的比例明显更高。与同龄人（平均 = 18.1 岁）相比，有缺陷的个体（平均 = 16.2 岁）首次尝试非法药物时明显更年轻。结论：总体而言，有障碍的个体从事非法药物使用的可能性是同类个体的两倍多。平均而言，有障碍的人第一次尝试非法药物的年龄更小。

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引用次数: 0

Positive association of large alcohol intake per occasion with vision-threatening severe diabetic retinopathy or diabetic macular edema in Japanese men with type 2 diabetes

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.ypmed.2025.108220

Masahiko Yamamoto , Kazuya Fujihara , Hiruma Hasebe , Yuta Yaguchi , Takaho Yamada , Satoru Kodama , Shiro Tanaka , Hirohito Sone

Objective

Differing from the overall consumption of alcohol, whether consuming large quantities of alcohol per drinking occasion is associated with higher risk of developing severe diabetic retinopathy remains unknown.

Methods

We examined whether the quantity per drinking occasion (QPO), including a large QPO, and the combinations of the frequency of alcohol consumption (FAC) and QPO were associated with higher risk of developing severe diabetic retinopathy or diabetic macular edema (DME) using adjusted Cox models. Severe diabetic retinopathy or DME was designated as a vision-threatening treatment-required diabetic eye disease (TRDED). For each man with type 2 diabetes who participated in this longitudinal retrospective cohort study, the date of the earliest health check-up during the inclusion period (April 2008 to August 2016) was set as the start date of follow-up.

Results

A TRDED was observed in 425 of 21,392 Japanese men aged 22–74 years with type 2 diabetes during a mean follow-up of 4.3 years (4.6/1000 person-years). Multivariable Cox analysis showed that a large QPO, defined as drinking three drinks or more per occasion, in low- (hazard ratio [HR], 4.76; 95 % CI, 2.06–10.97), intermediate- (HR, 1.58; 95 %CI, 1.001−2.50), and high-frequency categories (HR, 2.01; 95 % CI, 1.20–3.36) was significantly associated with elevated risks of TRDED.

Conclusions

In addition to the total amount of ethanol, these findings imply the necessity of avoiding the consumption of large amounts of alcohol on a single occasion to prevent severe diabetic retinopathy or DME.

{"title":"Positive association of large alcohol intake per occasion with vision-threatening severe diabetic retinopathy or diabetic macular edema in Japanese men with type 2 diabetes","authors":"Masahiko Yamamoto , Kazuya Fujihara , Hiruma Hasebe , Yuta Yaguchi , Takaho Yamada , Satoru Kodama , Shiro Tanaka , Hirohito Sone","doi":"10.1016/j.ypmed.2025.108220","DOIUrl":"10.1016/j.ypmed.2025.108220","url":null,"abstract":"<div><h3>Objective</h3><div>Differing from the overall consumption of alcohol, whether consuming large quantities of alcohol per drinking occasion is associated with higher risk of developing severe diabetic retinopathy remains unknown.</div></div><div><h3>Methods</h3><div>We examined whether the quantity per drinking occasion (QPO), including a large QPO, and the combinations of the frequency of alcohol consumption (FAC) and QPO were associated with higher risk of developing severe diabetic retinopathy or diabetic macular edema (DME) using adjusted Cox models. Severe diabetic retinopathy or DME was designated as a vision-threatening treatment-required diabetic eye disease (TRDED). For each man with type 2 diabetes who participated in this longitudinal retrospective cohort study, the date of the earliest health check-up during the inclusion period (April 2008 to August 2016) was set as the start date of follow-up.</div></div><div><h3>Results</h3><div>A TRDED was observed in 425 of 21,392 Japanese men aged 22–74 years with type 2 diabetes during a mean follow-up of 4.3 years (4.6/1000 person-years). Multivariable Cox analysis showed that a large QPO, defined as drinking three drinks or more per occasion, in low- (hazard ratio [HR], 4.76; 95 % CI, 2.06–10.97), intermediate- (HR, 1.58; 95 %CI, 1.001−2.50), and high-frequency categories (HR, 2.01; 95 % CI, 1.20–3.36) was significantly associated with elevated risks of TRDED.</div></div><div><h3>Conclusions</h3><div>In addition to the total amount of ethanol, these findings imply the necessity of avoiding the consumption of large amounts of alcohol on a single occasion to prevent severe diabetic retinopathy or DME.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"191 ","pages":"Article 108220"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033848","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}

引用次数: 0

Passive exposure to opioid crisis information and public attitudes: Effects on local policy support, discrimination, and stigma in a United States national survey 被动暴露于阿片类危机信息和公众态度：在美国全国调查中对当地政策支持、歧视和耻辱的影响。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.ypmed.2024.108212

Alex Kresovich , Mateusz Borowiecki , Phoebe A. Lamuda , Bruce G. Taylor , Sherry L. Emery , John Schneider , Harold A. Pollack

Objective

To examine associations between passive exposure to opioid crisis information and public attitudes toward opioid use disorder (OUD) policies and stigma among United States (US) adults.

Methods

A nationally representative survey of 6543 US adults was conducted from December 2023 to January 2024. Participants reported passive exposure to opioid crisis information from various sources. Outcome measures included preferences for national and local harm-reduction policies, discriminatory practices, carceral approaches, and OUD stigma. Multivariable regression analyses were performed, controlling for demographic factors.

Results

Over half (n = 3863, 59.4 %) of participants reported passive exposure to opioid crisis information. Exposure from medical professionals (b = 0.143, p = 0.001), family/friends (b = 0.118, p = 0.013), print media (b = 0.135, p = 0.019), and web searches (b = 0.164, p = 0.002) was associated with increased support for local harm-reduction policies. Social media exposure was negatively associated with support for discriminatory practices (b = −0.101, p = 0.043). Exposure from medical professionals was negatively associated with OUD stigma (b = −0.090, p = 0.014). No significant associations were found between information exposure and support for national harm-reduction policies or carceral approaches.

Conclusions

Despite widespread media coverage of the opioid crisis, passive information exposure was only associated with increased support for local, not national, harm-reduction policies. The modest exposure rate (59.4 %) suggests an attention gap between information availability and public engagement. The differential effectiveness of information channels suggests that communication strategies emphasizing community-level initiatives and leveraging specific sources like healthcare providers and interpersonal networks may be particularly important for building public support for evidence-based OUD prevention policies.

目的：研究美国成年人被动接触阿片类药物危机信息与公众对阿片类药物使用障碍（OUD）政策和耻辱感的态度之间的关系。方法：从2023年12月到2024年1月，对6543名美国成年人进行了一项具有全国代表性的调查。与会者报告了从各种来源被动接触阿片类药物危机信息的情况。结果测量包括对国家和地方减少伤害政策的偏好、歧视性做法、医疗方法和OUD污名。在控制人口统计学因素的情况下，进行多变量回归分析。结果：超过一半（n = 3863,59.4 %）的参与者报告被动暴露于阿片类药物危机信息。从医务人员接触(b = 0.143,p = 0.001),家人/朋友(b = 0.118,p = 0.013),印刷媒体(b = 0.135,p = 0.019),和网络搜索(b = 0.164,p = 0.002)与增加对地方减害政策的支持。社交媒体曝光与支持歧视行为呈负相关（b = -0.101,p = 0.043）。医务人员接触与OUD病耻感呈负相关（b = -0.090,p = 0.014）。未发现信息暴露与支持国家减少伤害政策或医疗方法之间存在显著关联。结论：尽管媒体对阿片类药物危机进行了广泛的报道，但被动的信息暴露只与对地方减少伤害政策的支持增加有关，而与国家减少伤害政策无关。适度的曝光率（59.4 %）表明信息可得性和公众参与之间存在注意差距。信息渠道的不同有效性表明，强调社区一级倡议和利用医疗保健提供者和人际网络等特定来源的沟通战略，对于建立公众对循证OUD预防政策的支持可能特别重要。

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引用次数: 0

Cholesterol screening by nativity status in pediatric patients receiving care in United States community-based clinics

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-01-30 DOI: 10.1016/j.ypmed.2025.108239

Jennifer A. Lucas , Miguel Marino , Steffani R. Bailey , Jorge Kaufmann , John Heintzman

Objective

Accumulation of cardiovascular risks begins early in life. Some experts recommend cholesterol screening for children aged nine to 11. Latinos living in the U.S. have a high burden of cardiovascular disease and risk factors, and this is further influenced by birthplace, yet information on early screening for cardiovascular disease in this group is sparse.

Methods

We used electronic health records from a national network including 771 community-based clinics across 21 states from 2012 to 2020, from 310,297 foreign-born Latino, US-born Latino, Latino with unknown birthplace, and non-Hispanic white patients aged nine to 17 years. Logistic regression including demographic and clinical covariates was conducted to estimate prevalence of cholesterol testing, stratified by obesity.

Results

Latino children, regardless of nativity status, had higher adjusted prevalence of cholesterol screening compared to non-Hispanic white children for those with and without obesity. The highest prevalence of screening among those with obesity was in foreign-born Latinos (34.8 %), and among those who were not obese, US-born Latinos had the highest screening prevalence (16.8 %).

Conclusions

Cholesterol screening was low overall in these community-based clinic patients but differed by ethnicity and nativity status. There is opportunity for further research on outcomes in Latino children to inform guidelines for early screening for cardiovascular health.

{"title":"Cholesterol screening by nativity status in pediatric patients receiving care in United States community-based clinics","authors":"Jennifer A. Lucas , Miguel Marino , Steffani R. Bailey , Jorge Kaufmann , John Heintzman","doi":"10.1016/j.ypmed.2025.108239","DOIUrl":"10.1016/j.ypmed.2025.108239","url":null,"abstract":"<div><h3>Objective</h3><div>Accumulation of cardiovascular risks begins early in life. Some experts recommend cholesterol screening for children aged nine to 11. Latinos living in the U.S. have a high burden of cardiovascular disease and risk factors, and this is further influenced by birthplace, yet information on early screening for cardiovascular disease in this group is sparse.</div></div><div><h3>Methods</h3><div>We used electronic health records from a national network including 771 community-based clinics across 21 states from 2012 to 2020, from 310,297 foreign-born Latino, US-born Latino, Latino with unknown birthplace, and non-Hispanic white patients aged nine to 17 years. Logistic regression including demographic and clinical covariates was conducted to estimate prevalence of cholesterol testing, stratified by obesity.</div></div><div><h3>Results</h3><div>Latino children, regardless of nativity status, had higher adjusted prevalence of cholesterol screening compared to non-Hispanic white children for those with and without obesity. The highest prevalence of screening among those with obesity was in foreign-born Latinos (34.8 %), and among those who were not obese, US-born Latinos had the highest screening prevalence (16.8 %).</div></div><div><h3>Conclusions</h3><div>Cholesterol screening was low overall in these community-based clinic patients but differed by ethnicity and nativity status. There is opportunity for further research on outcomes in Latino children to inform guidelines for early screening for cardiovascular health.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"192 ","pages":"Article 108239"},"PeriodicalIF":4.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075291","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

Disparities in prenatal care utilization among racial/ethnic and nativity subgroups in the United States

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-01-30 DOI: 10.1016/j.ypmed.2025.108238

Choi Sugy , Pearl A. McElfish , Clare C. Brown

Objective

To evaluate disparities in prenatal care among granular (disaggregated) racial/ethnic subgroups overall and by nativity.

Methods

We analyzed singleton live births among United States (US) residents from the National Center for Health Statistics Birth Certificate Data (2018–2022) to evaluate first trimester prenatal care initiation and prenatal care adequacy using the Adequacy of Prenatal Care Utilization Index. We conducted multivariable logistic regressions and used marginal effects to assess adjusted differences among 7 broad racial/ethnic categories (e.g., Asian) and 16 disaggregated subgroups (e.g., Chinese). Disaggregated subgroups came from Asian, Native Hawaiian and Other Pacific Islander (NHPI) and Hispanic categories.

Results

Among the sample (n = 15,882,850), 78.4 % had first trimester prenatal care, and 76.2 % had adequate prenatal care. Adjusted rates of first trimester prenatal care ranged from 60.1 % among NHPI individuals to 82.5 % among White individuals, and prenatal care adequacy ranged from 54.3 % among NHPI individuals to 80.1 % among White individuals. Compared to US-born individuals, foreign-born individuals had lower first trimester care and prenatal care adequacy among most racial/ethnic broad categories and subgroups. The rates of both outcomes among each NHPI subgroup were lower than every other racial/ethnic subgroup evaluated.

Conclusions

Significant disparities in first trimester prenatal care initiation and adequacy exist based on race/ethnicity and nativity, with the largest disparities among NHPI individuals. These findings highlight the need for focused public health interventions to address disparities in prenatal care access and quality, ultimately promoting both infant and maternal health equity.

{"title":"Disparities in prenatal care utilization among racial/ethnic and nativity subgroups in the United States","authors":"Choi Sugy , Pearl A. McElfish , Clare C. Brown","doi":"10.1016/j.ypmed.2025.108238","DOIUrl":"10.1016/j.ypmed.2025.108238","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate disparities in prenatal care among granular (disaggregated) racial/ethnic subgroups overall and by nativity.</div></div><div><h3>Methods</h3><div>We analyzed singleton live births among United States (US) residents from the National Center for Health Statistics Birth Certificate Data (2018–2022) to evaluate first trimester prenatal care initiation and prenatal care adequacy using the Adequacy of Prenatal Care Utilization Index. We conducted multivariable logistic regressions and used marginal effects to assess adjusted differences among 7 broad racial/ethnic categories (e.g., Asian) and 16 disaggregated subgroups (e.g., Chinese). Disaggregated subgroups came from Asian, Native Hawaiian and Other Pacific Islander (NHPI) and Hispanic categories.</div></div><div><h3>Results</h3><div>Among the sample (<em>n</em> = 15,882,850), 78.4 % had first trimester prenatal care, and 76.2 % had adequate prenatal care. Adjusted rates of first trimester prenatal care ranged from 60.1 % among NHPI individuals to 82.5 % among White individuals, and prenatal care adequacy ranged from 54.3 % among NHPI individuals to 80.1 % among White individuals. Compared to US-born individuals, foreign-born individuals had lower first trimester care and prenatal care adequacy among most racial/ethnic broad categories and subgroups. The rates of both outcomes among each NHPI subgroup were lower than every other racial/ethnic subgroup evaluated.</div></div><div><h3>Conclusions</h3><div>Significant disparities in first trimester prenatal care initiation and adequacy exist based on race/ethnicity and nativity, with the largest disparities among NHPI individuals. These findings highlight the need for focused public health interventions to address disparities in prenatal care access and quality, ultimately promoting both infant and maternal health equity.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"192 ","pages":"Article 108238"},"PeriodicalIF":4.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075293","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

Financial incentives for physical activity in adults: Systematic review and meta-analysis update 促进成人体育锻炼的经济激励措施：系统回顾和荟萃分析更新。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-01-25 DOI: 10.1016/j.ypmed.2025.108237

Babac Salmani , Harry Prapavessis , Leigh M. Vanderloo , Marc S. Mitchell

Objective

To update the evidence on the effects of financial incentives (FI) on physical activity (PA) in adults.

Methods

A systematic search of nine databases (Medline, EMBASE, PsychINFO, Scopus, Web of Science, CINAHL, EconLit, SPORTDiscus, and Cochrane) was conducted to identify randomised controlled trials (RCTs) and pilot RCTs published between June 1, 2018 and March 31, 2024 examining FI-for-PA interventions. ‘Vote counting’ and random-effects meta-analyses assessed short- (<6 months) and long-term (≥6 months) FI effects, as well as impact during follow-up (incentive withdrawal). Meta-regressions examined moderator effects.

Results

Twenty-nine studies (n = 21 RCT, n = 8 pilot RCTs; median FI size = $1.19 USD/day) involving 9604 participants were included (60.8 % female, mean age = 42.7 years). 17 of 21 studies reported positive short-term effects. 5 of 5 and 3 of 8 studies, respectively, reported positive long-term and follow-up effects. Among the 15 studies included in daily step count meta-analyses (most commonly reported PA outcome), FI had a moderate effect during short-term interventions (standardized mean difference [SMD] [95 % CI] = 0.52 [0.25–0.78], p < 0.001) and a small effect in follow-up (SMD [95 % CI] = 0.20 [0.01–0.40], p = 0.04). Too few long-term studies reported daily step count to conduct pooled analyses (n = 1). Meta-regressions suggest study length, incentive size, wearable device-use, and goal setting moderate FI effects (p < 0.05).

Conclusions

Twenty-nine studies were identified over a 6-year span. Short-term FI interventions increase PA. The impact on daily step count is clinically significant (≥1000 steps/day). Key contextual factors moderate effects. Evidence is limited regarding long-term and follow-up effects.

{"title":"Financial incentives for physical activity in adults: Systematic review and meta-analysis update","authors":"Babac Salmani , Harry Prapavessis , Leigh M. Vanderloo , Marc S. Mitchell","doi":"10.1016/j.ypmed.2025.108237","DOIUrl":"10.1016/j.ypmed.2025.108237","url":null,"abstract":"<div><h3>Objective</h3><div>To update the evidence on the effects of financial incentives (FI) on physical activity (PA) in adults.</div></div><div><h3>Methods</h3><div>A systematic search of nine databases (Medline, EMBASE, PsychINFO, Scopus, Web of Science, CINAHL, EconLit, SPORTDiscus, and Cochrane) was conducted to identify randomised controlled trials (RCTs) and pilot RCTs published between June 1, 2018 and March 31, 2024 examining FI-for-PA interventions. ‘Vote counting’ and random-effects meta-analyses assessed short- (<6 months) and long-term (≥6 months) FI effects, as well as impact during follow-up (incentive withdrawal). Meta-regressions examined moderator effects.</div></div><div><h3>Results</h3><div>Twenty-nine studies (<em>n</em> = 21 RCT, <em>n</em> = 8 pilot RCTs; median FI size = $1.19 USD/day) involving 9604 participants were included (60.8 % female, mean age = 42.7 years). 17 of 21 studies reported positive short-term effects. 5 of 5 and 3 of 8 studies, respectively, reported positive long-term and follow-up effects. Among the 15 studies included in daily step count meta-analyses (most commonly reported PA outcome), FI had a moderate effect during short-term interventions (standardized mean difference [SMD] [95 % CI] = 0.52 [0.25–0.78], <em>p</em> < 0.001) and a small effect in follow-up (SMD [95 % CI] = 0.20 [0.01–0.40], <em>p</em> = 0.04). Too few long-term studies reported daily step count to conduct pooled analyses (<em>n</em> = 1). Meta-regressions suggest study length, incentive size, wearable device-use, and goal setting moderate FI effects (<em>p</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>Twenty-nine studies were identified over a 6-year span. Short-term FI interventions increase PA. The impact on daily step count is clinically significant (≥1000 steps/day). Key contextual factors moderate effects. Evidence is limited regarding long-term and follow-up effects.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"192 ","pages":"Article 108237"},"PeriodicalIF":4.3,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053299","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}

引用次数: 0

Ethnic belonging and chronic disease in Indigenous populations in Canada

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-01-22 DOI: 10.1016/j.ypmed.2025.108236

Zekai Lu, Eran Shor, Samuelle Fortin

Objectives

Indigenous peoples in Canada endure health inequalities and cultural erosion due to colonial legacies. This study examines the relationship between ethnic belonging and chronic disease patterns among three Indigenous groups: First Nations, Inuit, and Métis.

Methods

We analyzed data from the 2017 Indigenous Peoples Survey of Canada, performing latent class analysis to identify distinct classes among 12 chronic disease indicators. We used multinomial logistic regression to examine the relationship between ethnic belonging and subtypes of chronic diseases, also employing average marginal effects to interpret heterogeneity. All analyses incorporated complex survey weights to ensure national representativeness.

Results

The final sample comprised 19,621 individuals. Four distinct subgroups were identified: Relatively Healthy, Physical Illness, Mental Illness, and Severe Illness groups. Descriptive statistics revealed that up to 35.0 % of the Indigenous population is in a suboptimal health state. Regression outcomes demonstrated that a strong sense of cultural belonging significantly reduces the odds of both Mental Illness (OR = 0.82, 95 % CI [0.76,0.88]) and Severe Illness (OR = 0.92, 95 % CI [0.84,0.99]). Heterogeneity analyses revealed that the positive association between belonging and health outcomes was stronger in the adult age group, among men, and within First Nations and Inuit groups.

Conclusion

This study underscores the critical role of ethnic belonging in enhancing health among Indigenous populations, particularly in reducing odds associated with mental and severe health conditions. Policies and community practices should focus on strengthening Indigenous peoples' community belonging and cultural connections.

{"title":"Ethnic belonging and chronic disease in Indigenous populations in Canada","authors":"Zekai Lu, Eran Shor, Samuelle Fortin","doi":"10.1016/j.ypmed.2025.108236","DOIUrl":"10.1016/j.ypmed.2025.108236","url":null,"abstract":"<div><h3>Objectives</h3><div>Indigenous peoples in Canada endure health inequalities and cultural erosion due to colonial legacies. This study examines the relationship between ethnic belonging and chronic disease patterns among three Indigenous groups: First Nations, Inuit, and Métis.</div></div><div><h3>Methods</h3><div>We analyzed data from the 2017 Indigenous Peoples Survey of Canada, performing latent class analysis to identify distinct classes among 12 chronic disease indicators. We used multinomial logistic regression to examine the relationship between ethnic belonging and subtypes of chronic diseases, also employing average marginal effects to interpret heterogeneity. All analyses incorporated complex survey weights to ensure national representativeness.</div></div><div><h3>Results</h3><div>The final sample comprised 19,621 individuals. Four distinct subgroups were identified: <em>Relatively Healthy</em>, <em>Physical Illness</em>, <em>Mental Illness</em>, and <em>Severe Illness</em> groups. Descriptive statistics revealed that up to 35.0 % of the Indigenous population is in a suboptimal health state. Regression outcomes demonstrated that a strong sense of cultural belonging significantly reduces the odds of both <em>Mental Illness</em> (OR = 0.82, 95 % CI [0.76,0.88]) and <em>Severe Illness</em> (OR = 0.92, 95 % CI [0.84,0.99]). Heterogeneity analyses revealed that the positive association between belonging and health outcomes was stronger in the adult age group, among men, and within First Nations and Inuit groups.</div></div><div><h3>Conclusion</h3><div>This study underscores the critical role of ethnic belonging in enhancing health among Indigenous populations, particularly in reducing odds associated with mental and severe health conditions. Policies and community practices should focus on strengthening Indigenous peoples' community belonging and cultural connections.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"192 ","pages":"Article 108236"},"PeriodicalIF":4.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041027","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}

引用次数: 0