Preventive medicine最新文献_第7页

Conceptualizing vaccine champions from an implementation science perspective: Findings from a national survey of primary care health professionals 从实施科学的角度理解疫苗拥护者：全国初级保健专业人员调查的结果。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-17 DOI: 10.1016/j.ypmed.2024.108104

Kathryn L. Kennedy , Melissa B. Gilkey , Tara L. Queen , Jennifer A. Heisler-MacKinnon , Bennett Hanson , Wei Yi Kong , Micaela K. Brewington , Brigid K. Grabert

Objective

Clinical champions are healthcare professionals who help their colleagues improve the delivery of evidence-based care. Because little is known about champions working in the context of adolescent vaccination, we sought to identify vaccine champion roles among primary care health professionals (PCHPs).

Methods

In 2022, we surveyed 2527 US PCHPs who serve adolescents. The survey assessed the extent to which respondents identified as vaccine champions and the activities they performed. Guided by the Consolidated Framework for Implementation Research, we used these data to categorize PCHPs as: champions who led projects to increase vaccination rates (“implementation leaders”); facilitating champions who more generally shared vaccination data, information, and encouragement (“facilitators”); or non-champions. We used multinomial logistic regression to identify correlates of being a leader or facilitator as opposed to a non-champion.

Results

About one-fifth (21%) of PCHPs were implementation leaders, one-quarter (25%) were facilitators, and the remainder (54%) were non-champions. Leaders were more common among PCHPs with medium or high versus low practice experience (31% and 36% versus 20%, both p < .01) and adolescent patient volume (29% and 39% versus 17%, both p < .01). Being a facilitator was also associated with higher practice experience and patient volume. Leaders and facilitators reported a similar number of barriers to their work (mean = 1.8 and 1.9, respectively), with time and competing quality metrics being most common.

Conclusions

Our findings suggest that both implementation leaders and facilitators are common vaccine champions in adolescent primary care. These champions are more often found among PCHPs with higher experience and patient volume.

目的：临床拥护者是帮助同事改善循证医疗服务的医疗保健专业人员。由于对青少年疫苗接种工作中的带头人知之甚少，我们试图确定初级保健医疗专业人员（PCHPs）中的疫苗带头人角色：2022 年，我们对 2527 名为青少年提供服务的美国初级保健专业人员进行了调查。调查评估了受访者认定自己为疫苗卫士的程度以及他们所开展的活动。在 "实施研究综合框架 "的指导下，我们利用这些数据将公立医疗机构分为：领导提高疫苗接种率项目的拥护者（"实施领导者"）；更广泛地分享疫苗接种数据、信息和鼓励的促进拥护者（"促进者"）；或非拥护者。我们使用多项式逻辑回归来确定领导者或促进者与非倡导者之间的相关性：约五分之一（21%）的初级保健中心是实施领导者，四分之一（25%）是促进者，其余（54%）为非领导者。在具有中度或高度实践经验的初级保健中心中，领导者的比例要高于低实践经验的初级保健中心（31% 和 36% 对 20%，均为 p 结论：我们的研究结果表明，在青少年初级保健中，实施领导者和促进者都是常见的疫苗倡导者。在经验丰富、患者数量较多的初级保健医生中，这些倡导者更为常见。

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引用次数: 0

Unraveling the role of BMI and blood markers in the relationship between plant-based diets and osteoporosis: A prospective cohort study 揭示体重指数和血液指标在植物性饮食与骨质疏松症之间关系中的作用：一项前瞻性队列研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-14 DOI: 10.1016/j.ypmed.2024.108103

Yi Zheng , Jiacheng Wang , Yucan Li , Yawen Wang , Chen Suo , Yanfeng Jiang , Li Jin , Kelin Xu , Xingdong Chen

Background

The potential adverse effects of plant-based diets on bone health have raised significant concern, while the prospective evidence is limited. This study aimed to evaluate the association between plant-based diet indexes and incident osteoporosis while exploring the underlying mechanisms involved in this relationship.

Methods

The analysis included 202,063 UK Biobank participants conducted between 2006 and 2022. Plant-based diet indexes (hPDI and uPDI) were calculated using the 24-h dietary questionnaire. Cox proportional risk regression and mediation analysis were used to explore the associations of plant-based diet indexes with osteoporosis, estimating the contribution of BMI and blood markers.

Results

We found the highest quintile for hPDI (HR = 1.16; 95% CI: 1.05 to 1.28) and uPDI (HR = 1.15; 95% CI: 1.05 to 1.26) were associated with an increased risk of osteoporosis. BMI was identified as an important mediator in the association between hPDI and osteoporosis, with mediation proportions of 46.17%. For blood markers, the mediating (suppressing) effects of C-reactive protein, alkaline phosphatase, and insulin-like growth factor-1 on the association between uPDI (hPDI) and osteoporosis were significant, ranging from 5.63%–16.87% (4.57%–6.22%).

Conclusion

Adherence to a plant-based diet is associated with a higher risk of osteoporosis, with BMI and blood markers potentially contributing to this relationship. Notably, even a healthy plant-based diet necessitates attention to weight management to mitigate its impact on bone loss. These findings emphasize the importance of personalized dietary recommendations and lifestyle interventions to decrease the risk of osteoporosis.

背景：植物性饮食对骨骼健康的潜在不利影响引起了人们的极大关注，但前瞻性证据却很有限。本研究旨在评估植物性膳食指数与骨质疏松症发病率之间的关系，同时探索这种关系的内在机制：分析对象包括 2006 年至 2022 年间的 202,063 名英国生物库参与者。采用 24 小时膳食调查问卷计算植物性膳食指数（hPDI 和 uPDI）。我们使用 Cox 比例风险回归和中介分析来探讨植物性膳食指数与骨质疏松症的关系，并估计了体重指数和血液指标的贡献：我们发现，hPDI（HR = 1.16；95% CI：1.05 至 1.28）和 uPDI（HR = 1.15；95% CI：1.05 至 1.26）的最高五分位数与骨质疏松症风险增加有关。在 hPDI 与骨质疏松症的关系中，BMI 被认为是一个重要的中介因素，其中介比例为 46.17%。在血液标志物方面，C反应蛋白、碱性磷酸酶和胰岛素样生长因子-1对uPDI（hPDI）与骨质疏松症之间关系的中介（抑制）作用显著，介于5.63%-16.87%（4.57%-6.22%）之间：结论：坚持以植物为基础的饮食与较高的骨质疏松症风险有关，体重指数和血液指标可能是造成这种关系的原因。值得注意的是，即使是健康的植物性饮食也需要注意体重管理，以减轻其对骨质流失的影响。这些发现强调了个性化饮食建议和生活方式干预对降低骨质疏松症风险的重要性。

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引用次数: 0

Age, sex, and pre-arrest comorbidities shape the risk trajectory of sudden cardiac death— Patterns highlighted by population data in Taiwan 年龄、性别和猝死前的合并症决定了心脏性猝死的风险轨迹--台湾的人口数据凸显了这一模式。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-14 DOI: 10.1016/j.ypmed.2024.108102

Chih-Wei Sung , Hua-Chih Chang , Cheng-Yi Fan , Chi-Hsin Chen , Edward Pei-Chuan Huang , Likwang Chen

Objectives

Few reports have indicated the secular trend in the sudden cardiac death (SCD) incidence and pre-arrest comorbidities. This study aimed to comprehensively analyze the trend of SCD incidence and its association with pre-arrest comorbidities.

Methods

This population-based cohort study analyzed Taiwan's National Health Insurance (NHI) research database and identified SCD incidents by inspecting data from all emergency department visits from 2011 to 2018. The inclusion criteria were ICD-9:427.5 or 427.41, or ICD-10:I46.9, I46.8, or I46.2. Pre-existing comorbidities were confirmed based on medication use. Multivariable logistic regression was adopted with covariates age, sex, and pre-existing comorbidities.

Results

This study reviewed a total of 184,164,969 person-year records, and identified 92,138 SCD incidents. From 2011 to 2018, the SCD incidence rate increased from 36.3 to 55.4 per 100,000 enrollees in Taiwan. The top five pre-arrest comorbidities were stable, while the prevalence of chronic kidney disease rose significantly. Compared to those aged 20–29, enrollees aged >65 years had significantly higher odds of SCD (aOR:27.30, 95% CI:26.05–28.61). Higher odds of SCD were noted in the enrollees who had a seizure (aOR:2.24, 95% CI:2.12–2.38), parkinsonism (aOR:1.81, 95% CI:1.73–1.89), psychological disorders (aOR:1.59, 95% CI:1.56–1.62), diabetes mellitus (aOR:1.44, 95% CI:1.41–1.46), heart diseases (aOR:1.41, 95% CI:1.38–1.44).

Conclusions

The incidence of SCD steadily increased in Taiwan from 2011 to 2018. Hypertension, diabetes mellitus, heart disease, psychological disorders, and arthritis were major pre-arrest comorbidities. Age is the most important risk factor for SCD. Further large-scaled population-based study that investigated in diverse ethnicities from countries in addition to Asians would be warranted.

目的：很少有报告指出心脏性猝死（SCD）发病率与猝死前合并症的长期趋势。本研究旨在全面分析 SCD 发病率的趋势及其与猝死前合并症的关系：这项基于人群的队列研究分析了台湾的国民健康保险（NHI）研究数据库，并通过检查2011年至2018年期间所有急诊科就诊数据确定了SCD事件。纳入标准为ICD-9:427.5或427.41，或ICD-10:I46.9、I46.8或I46.2。根据用药情况确认是否存在既往合并症。采用多变量逻辑回归法，辅以年龄、性别和既往合并症：本研究共查阅了 184 164 969 人年记录，发现了 92 138 例 SCD 事件。从2011年到2018年，台湾每10万名参保者的SCD发病率从36.3上升到55.4。发病前的五大合并症保持稳定，而慢性肾病的发病率则显著上升。与 20-29 岁的参保者相比，年龄大于 65 岁的参保者发生 SCD 的几率明显更高（aOR:27.30, 95% CI:26.05-28.61）。患有癫痫发作（aOR:2.24，95% CI:2.12-2.38）、帕金森病（aOR:1.81，95% CI:1.73-1.89）、心理障碍（aOR:1.59，95% CI:1.56-1.62）、糖尿病（aOR:1.44，95% CI:1.41-1.46）和心脏病（aOR:1.41，95% CI:1.38-1.44）的参保者发生 SCD 的几率更高：从2011年到2018年，SCD的发病率在台湾稳步上升。高血压、糖尿病、心脏病、心理障碍和关节炎是发病前的主要合并症。年龄是 SCD 最重要的风险因素。除了亚洲人之外，还需要对不同国家的不同种族进行进一步的大规模人群研究。

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引用次数: 0

The effect of gestational diabetes mellitus on postnatal mother-infant bonding: Findings from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study 妊娠糖尿病对产后母婴关系的影响：东北医疗大型数据库项目出生和三代队列研究的结果。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-14 DOI: 10.1016/j.ypmed.2024.108101

Madeleine Benton , Mami Ishikuro , Taku Obara , Aoi Noda , Keiko Murakami , Shinichi Kuriyama , Khalida Ismail

Purpose

Gestational diabetes mellitus (GDM) is a common complication of pregnancy and is associated with considerable psychological burden for women. In qualitative research, women with GDM describe increased awareness about their bonding with their infant, potentially resulting from the highly medicalised nature of the condition. The primary aim was to examine quantitatively whether GDM was associated with lower mother-infant bonding in the postnatal period.

Methods

Data were analysed from 10,419 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017 in Japan. GDM status was collected from hospital records and measured using the oral glucose tolerance test. Mother-infant bonding was assessed using the Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) at one-month postpartum, higher scores representing lower bonding. Data were analysed in SAS using multiple regression adjusting for relevant confounders.

Results

GDM did not appear to be associated with worse mother-infant bonding scores at one-month postpartum. There was a non-significant unadjusted trend in the mean mother-infant bonding scores (1.43(SD=1.11) versus (1.75(SD1.71)), and the proportion with bonding disorder (n = 4 (4.12%) versus n = 969 (9.39%)) in the GDM versus non GDM group respectively, indicating higher self-reported bonding in the GDM group. This remained not statistically significant in the adjusted analyses.

Conclusions

We observed the reverse of our hypothesis, that there was a trend for women with GDM to self-report higher bonding compared to non-GDM women. There is need to replicate this finding in cohorts specifically designed to measure GDM-specific psychological distress.

目的：妊娠期糖尿病（GDM）是一种常见的妊娠并发症，给妇女带来了相当大的心理负担。在定性研究中，患有 GDM 的妇女描述了她们与婴儿之间的亲子关系意识的增强，这可能是由于该疾病的高度医学化所导致的。本研究的主要目的是定量研究 GDM 是否与产后母婴亲子关系较差有关：分析了2013年至2017年期间参加日本东北医疗大型数据库项目出生和三代队列研究的10419名妇女的数据。从医院记录中收集 GDM 状态，并使用口服葡萄糖耐量试验进行测量。使用日文版母婴结合量表（MIBS-J）评估产后一个月的母婴结合情况，得分越高代表结合程度越低。采用多元回归法对数据进行了分析，并对相关混杂因素进行了调整：GDM似乎与产后一个月母婴亲子关系评分较差无关。GDM组和非GDM组的母婴亲子关系平均得分和亲子关系障碍比例（n = 4 (4.12%)对n = 969 (9.39%)）在未经调整的情况下分别呈不显著趋势，表明GDM组的自我报告亲子关系较高，但在调整后的分析中仍无统计学意义：我们观察到与我们的假设相反的趋势，即与非 GDM 妇女相比，GDM 妇女自我报告的亲子关系更高。有必要在专门测量 GDM 特异性心理困扰的队列中重复这一发现。

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引用次数: 0

Association between obesity phenotypes and dietary patterns: A two-step cluster analysis based on the China multi-ethnic cohort study 肥胖表型与膳食模式之间的关系：基于中国多民族队列研究的两步聚类分析。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-13 DOI: 10.1016/j.ypmed.2024.108100

Yuxin Hu, Yuxin Zhang, Jianqin Zhong, Yuan Wang, Enhui Zhou, Feng Hong

Objective

This study aimed to explore obesity phenotypes and investigate their association with dietary patterns.

Methods

Data were obtained from the baseline survey conducted in the China Multi-Ethnic Cohort Study from July 2018 to August 2019. All participants with a body mass index of at least 24 kg/m² were enrolled and underwent a questionnaire survey, physical examination, and clinical laboratory tests. A two-step cluster analysis was employed to classify the participants into phenotypes. Dietary information was collected using the food frequency questionnaire, and principal component analysis was conducted to identify distinct dietary patterns.

Results

We analyzed the data of 8757 participants. They were categorized based on demographic characteristics, biochemical indicators, and anthropometric measurements into two distinct clusters identified as metabolically healthy obesity and metabolically unhealthy obesity (MUO). Key predictors included serum uric acid, sex, and diastolic blood pressure. Subgroup analysis by sex identified three distinct clusters within both male and female participants. The MUO group had the highest prevalence of a range of chronic noncommunicable diseases. The analysis uncovered three unique dietary patterns among participants classified as the premium protein, rice-oil-red meat, and oil-salt patterns. Notably, the MUO subgroup demonstrated significantly higher factor scores for both the rice-oil-red meat and oil-salt patterns.

Conclusions

Obesity phenotypes are closely related to metabolic and demographic characteristics, with serum uric acid being a significant factor in categorizing the metabolic states of obesity. The rice-oil-red meat and oil-salt patterns may be related to the metabolic status of individuals with obesity.

研究目的本研究旨在探索肥胖表型并研究其与膳食模式的关联：数据来自 2018 年 7 月至 2019 年 8 月进行的中国多民族队列研究基线调查。所有体重指数不低于 24 kg/m2 的参与者都被纳入其中，并接受了问卷调查、体格检查和临床实验室检测。研究采用两步聚类分析法对参与者进行表型分类。通过食物频率问卷收集饮食信息，并进行主成分分析以确定不同的饮食模式：我们分析了 8757 名参与者的数据。结果：我们对 8757 名参与者的数据进行了分析，根据人口统计学特征、生化指标和人体测量数据，将他们分为代谢健康型肥胖和代谢不健康型肥胖（MUO）两类。主要预测因素包括血清尿酸、性别和舒张压。按性别进行的分组分析在男性和女性参与者中发现了三个不同的组群。MUO组在一系列慢性非传染性疾病中发病率最高。分析发现，参与者有三种独特的膳食模式，分别为优质蛋白模式、米油红肉模式和油盐模式。值得注意的是，MUO 亚组的米油红肉和油盐模式的因子得分明显更高：结论：肥胖表型与代谢和人口特征密切相关，血清尿酸是划分肥胖代谢状态的重要因素。米-油-红肉和油-盐模式可能与肥胖症患者的代谢状态有关。

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引用次数: 0

A produce prescription program for patients with low incomes in North Carolina resulted in increased produce purchases 北卡罗来纳州为低收入患者实施的农产品处方计划增加了农产品的购买量。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-11 DOI: 10.1016/j.ypmed.2024.108097

Amy E. Lo , Neal Curran , Sierra Mullen , Shu Wen Ng

Objectives

To assess if participation in a North Carolina produce prescription program for Supplemental Nutrition Assistance Program (SNAP) participants with diet-sensitive health conditions (SuperSNAP) is associated with changes in purchase composition and spending source.

Methods

This study used loyalty-card transaction data (October 2019–April 2022). We applied a linear mixed-effects model with overlap weights to perform a difference-indifferences analysis of purchases by SuperSNAP program enrollees compared to the control group.

Results

The sample included 1440 SuperSNAP shoppers and 45,851 control shoppers. Compared to shoppers only on SNAP, SuperSNAP shoppers spent $82.98 (95% CI (75.6, 90.3), p-value <0.001) more per month, $76.09 (95% CI (69.4, 82.8), pvalue <0.001) of which were spent strictly on food and beverage products. Among SuperSNAP shoppers, out of the $40 SuperSNAP benefit each month, an estimated $34.86 (95% CI (33.9, 35.8), p-value <0.001) of it was spent on fruits and vegetables.

Conclusions

This study shows the promise of targeted produce prescription programs for SNAP participants in encouraging shifts in purchase composition.

目标：评估参与北卡罗来纳州为有饮食敏感健康问题的补充营养援助计划（SNAP）参与者提供的农产品处方计划（SuperSNAP）是否与购买构成和消费来源的变化有关：本研究使用会员卡交易数据（2019 年 10 月至 2022 年 4 月）。我们采用了带有重叠权重的线性混合效应模型，对超级SNAP计划参加者与对照组的购买情况进行了差异分析：样本包括 1440 名超级无偿援助计划购物者和 45851 名对照组购物者。与仅使用 SNAP 的购物者相比，超级无农食品计划购物者花费了 82.98 美元（95% CI (75.6, 90.3)，P 值）：这项研究表明，为 SNAP 参与者提供有针对性的农产品处方计划有望促进购买构成的转变。

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引用次数: 0

Association of immigrant status with self-rated health in Spain: 2014–2020 西班牙移民身份与自我健康评价的关系：2014-2020 年。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-11 DOI: 10.1016/j.ypmed.2024.108096

Luisa N. Borrell , Nerea Lanborena , Sara Yago-González , Julia Díez Escudero , Elena Rodriguez-Alvarez

Objective

To examine inequalities in self-rated health between immigrant and native populations in 2014 and 2020, and whether these inequalities vary by sex/gender and social support.

Methods

This cross-sectional study used information from adults aged ≥18 years who participated in the European Health Interview Survey in Spain in 2014 and 2020. Self-rated health was specified as good or bad/poor. Immigration status and length of stay were considered to specify the exposure. Poisson regression was used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) in each survey. Interaction terms between immigration status and survey; and immigration status, survey, and sex/gender or social support were tested.

Results

The adjusted analyses showed that when compared with Spanish native adults, immigrants with 6–15 years residing in Spain had a 1.34 (95%CI:1.18, 1.53) greater probability of rating their health as bad/poor in 2014. This probability was 1.48 (95%CI:1.28, 1.75) in 2020. No heterogeneity was observed for the associations of immigrant status/length of stay with self-rated health for sex/gender or social support in either survey (p-interactions for sex/gender: 0.41 and social support: 0.71).

Conclusion

Given the growth of the immigrant population in Spain and the importance of immigration as a social determinant of health, these findings call attention to a deeper examination of inequalities, with the aim of identifying potential factors leading to bad/poor rating of health over time.

目的研究 2014 年和 2020 年移民和本地人口在自我健康评价方面的不平等，以及这些不平等是否因性别和社会支持而异：这项横断面研究使用了 2014 年和 2020 年参加西班牙欧洲健康访谈调查的 18 岁以上成年人的信息。自评健康状况分为好或坏/差。移民身份和逗留时间被视为暴露的具体条件。泊松回归用于估算每次调查中的流行率 (PR) 和 95% 置信区间 (CI)。测试了移民身份与调查之间的交互项，以及移民身份、调查、性别或社会支持之间的交互项：调整后的分析结果显示，与西班牙本地成年人相比，在西班牙居住 6-15 年的移民在 2014 年将自己的健康状况评为不良/差的概率要高出 1.34（95%CI：1.18，1.53）。同样，2020 年在西班牙居住 6-15 年的移民的健康状况被评为不良/差的概率为 1.48（95%CI:1.28, 1.75）。在这两项调查中，均未观察到移民身份/居留时间与性别或社会支持的自我健康评价之间存在异质性（性别/社会支持的交互作用为 0.41，而性别/社会支持的交互作用为 0.71）：鉴于西班牙移民人口的增长以及移民作为健康的社会决定因素的重要性，这些研究结果呼吁人们关注对不平等现象进行更深入的研究，目的是找出随着时间的推移导致不良/差健康评价的潜在因素。

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引用次数: 0

The effectiveness of internet-based group behavioural interventions on lifestyle modifications: A systematic review 基于互联网的群体行为干预对改变生活方式的有效性：系统综述。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-10 DOI: 10.1016/j.ypmed.2024.108099

Amanual Getnet Mersha , Jamie Bryant , Kade Booth , Levi Watson , Michelle Kennedy

Objectives

To examine the effectiveness of internet-based group interventions incorporating social support elements in addressing behaviours related to smoking, nutrition, alcohol consumption, physical activity, and obesity.

Methods

A literature search was undertaken in six databases from inception to April 2024. Articles were eligible if they reported on group-based online interventions targeting smoking, nutrition, alcohol consumption, physical activity, and obesity, and included interactive features aimed at promoting social engagement and support. Two reviewers independently screened and assessed the quality of articles using Joanna Briggs Institute Critical Appraisal tools. A narrative analysis was used to synthesize and interpret the data to understand the effects of online interventions on lifestyle modifications.

Results

A total of 4063 citations underwent screening, resulting in 32 articles being deemed eligible and included in this review. Most studies examined physical activity (n = 14), followed by obesity (n = 7) and smoking (n = 6), Most studies were conducted in the USA (n = 14) and Australia (n = 11). Websites were the most utilised mode of intervention delivery (n = 11), followed by Facebook (n = 7) and mobile apps (n = 5). Group-based internet interventions were effective in improving smoking cessation, increasing physical activity and addressing obesity. However, there is insufficient data to determine their effect on promoting healthy nutrition and reducing alcohol intake.

Conclusion

Group-based interventions delivered on the internet are effective in changing various health behaviours. This approach can offer large scale and cost-effective means to deliver behavioural interventions. However, the long-term effects and strategies for maintaining the behaviour changes are lacking, underscoring the need for further research.

目的研究基于互联网、包含社会支持元素的团体干预措施在解决吸烟、营养、饮酒、体育锻炼和肥胖相关行为方面的有效性：方法：从开始到 2024 年 4 月，在六个数据库中进行了文献检索。如果文章报道了针对吸烟、营养、饮酒、体育锻炼和肥胖的基于小组的在线干预，并包含旨在促进社会参与和支持的互动功能，则符合条件。两名审稿人使用乔安娜-布里格斯研究所的批判性评估工具独立筛选和评估文章质量。采用叙事分析法对数据进行综合和解释，以了解在线干预对改变生活方式的影响：共有 4063 条引文经过筛选，32 篇文章被认为符合条件并纳入本综述。大多数研究涉及体育锻炼（14 篇），其次是肥胖（7 篇）和吸烟（6 篇），大多数研究在美国（14 篇）和澳大利亚（11 篇）进行。网站是使用最多的干预方式（11 项），其次是 Facebook（7 项）和移动应用程序（5 项）。以小组为基础的互联网干预在改善戒烟、增加体育锻炼和解决肥胖问题方面效果显著。然而，目前还没有足够的数据来确定其对促进健康营养和减少酒精摄入量的效果：结论：在互联网上开展以小组为基础的干预活动对改变各种健康行为很有效。这种方法可以提供大规模和具有成本效益的行为干预手段。然而，目前还缺乏长期效果和维持行为改变的策略，因此需要进一步研究。

{"title":"The effectiveness of internet-based group behavioural interventions on lifestyle modifications: A systematic review","authors":"Amanual Getnet Mersha , Jamie Bryant , Kade Booth , Levi Watson , Michelle Kennedy","doi":"10.1016/j.ypmed.2024.108099","DOIUrl":"10.1016/j.ypmed.2024.108099","url":null,"abstract":"<div><h3>Objectives</h3><p>To examine the effectiveness of internet-based group interventions incorporating social support elements in addressing behaviours related to smoking, nutrition, alcohol consumption, physical activity, and obesity.</p></div><div><h3>Methods</h3><p>A literature search was undertaken in six databases from inception to April 2024. Articles were eligible if they reported on group-based online interventions targeting smoking, nutrition, alcohol consumption, physical activity, and obesity, and included interactive features aimed at promoting social engagement and support. Two reviewers independently screened and assessed the quality of articles using Joanna Briggs Institute Critical Appraisal tools. A narrative analysis was used to synthesize and interpret the data to understand the effects of online interventions on lifestyle modifications.</p></div><div><h3>Results</h3><p>A total of 4063 citations underwent screening, resulting in 32 articles being deemed eligible and included in this review. Most studies examined physical activity (<em>n</em> = 14), followed by obesity (<em>n</em> = 7) and smoking (<em>n</em> = 6), Most studies were conducted in the USA (n = 14) and Australia (<em>n</em> = 11). Websites were the most utilised mode of intervention delivery (n = 11), followed by Facebook (<em>n</em> = 7) and mobile apps (<em>n</em> = 5). Group-based internet interventions were effective in improving smoking cessation, increasing physical activity and addressing obesity. However, there is insufficient data to determine their effect on promoting healthy nutrition and reducing alcohol intake.</p></div><div><h3>Conclusion</h3><p>Group-based interventions delivered on the internet are effective in changing various health behaviours. This approach can offer large scale and cost-effective means to deliver behavioural interventions. However, the long-term effects and strategies for maintaining the behaviour changes are lacking, underscoring the need for further research.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"186 ","pages":"Article 108099"},"PeriodicalIF":4.3,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971648","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

Longitudinal screening adherence in the Australian National Bowel Cancer Screening Program from 2006 to 2022 2006 年至 2022 年澳大利亚国家肠癌筛查计划的纵向筛查坚持率。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-08 DOI: 10.1016/j.ypmed.2024.108095

Joachim Worthington , Anna Kelly , Jie-Bin Lew , Han Ge , Caitlin Vasica , Kate Broun , Karen Canfell , Eleonora Feletto

Objective

Australia's National Bowel Cancer Screening Program (NBCSP) offers two-yearly screening to 50–74-year-olds for the prevention and early detection of colorectal cancer (CRC). Internationally, detailed reporting of participation across multiple screening rounds – also known as longitudinal adherence – is becoming more common, but remains limited in Australia. We described the longitudinal screening adherence of individuals by age and sex invited to the NBCSP at least once, and quantified longitudinal adherence among individuals who received four NBCSP invitations.

Methods

We obtained aggregate national data for individuals who received at least one NBCSP invitation between 1 August 2006 and 31 March 2022. We described screening adherence patterns including longitudinal adherence among individuals who received four invitations, and evaluated prior longitudinal adherence and adherence at most recent invitation as predictors of future participation.

Results

Over the study period, 8.5 million individuals were invited to screen in the NBCSP; 51.9% of these individuals screened at least once. Of the >2.5 million individuals who received four invitations, 23.3% consistently screened, 38.3% never screened, and 38.3% inconsistently screened. The longitudinal adherence at the fourth invitation round for individuals who previously returned none, one, two, or three of their previous three invitations was 9.5%, 37.4%, 70.1% and 88.8%, respectively. Both longitudinal adherence and adherence at the most recent invitation were significant predictors of future participation.

Conclusion

Our study is the first detailed report of longitudinal adherence to the NBCSP in >2 screening rounds. These insights into long-term behaviours can inform planning for interventions to improve screening participation.

目的：澳大利亚国家肠癌筛查计划（NBCSP）每两年为 50-74 岁的人群提供一次筛查，以预防和早期发现结肠直肠癌（CRC）。在国际上，详细报告多轮筛查的参与情况（也称为纵向依从性）正变得越来越普遍，但在澳大利亚仍然很有限。我们按年龄和性别描述了至少一次受邀参加 NBCSP 的个人的纵向筛查坚持情况，并量化了收到四次 NBCSP 邀请的个人的纵向坚持情况：我们获得了 2006 年 8 月 1 日至 2022 年 3 月 31 日期间至少收到过一次 NBCSP 邀请的个人的全国汇总数据。我们描述了筛查依从性模式，包括收到四次邀请的个人的纵向依从性，并评估了之前的纵向依从性和最近一次邀请时的依从性作为未来参与的预测因素：在研究期间，NBCSP 邀请了 850 万人进行筛查；其中 51.9% 的人至少筛查了一次。在收到四次邀请的超过 250 万人中，23.3% 的人坚持筛查，38.3% 的人从未筛查，38.3% 的人筛查不一致。在第四轮邀请中，之前三次邀请均未返回、返回一次、两次或三次的个人的纵向坚持率分别为 9.5%、37.4%、70.1% 和 88.8%。纵向依从性和最近一次邀请时的依从性都是未来参与的重要预测因素：我们的研究首次详细报告了在超过两轮筛查中对 NBCSP 的纵向坚持情况。这些对长期行为的洞察可为规划干预措施以提高筛查参与率提供参考。

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引用次数: 0

Modifiable risk factors mediating the impact of educational inequality on heart failure: A Mendelian randomization study 教育不平等对心力衰竭影响的可调节风险因素：孟德尔随机研究

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-08 DOI: 10.1016/j.ypmed.2024.108098

Yijiang Zhou , Runze Ye , Xiaogang Guo

Background

Heart failure (HF) is a rapidly growing global disease burden with high mortality rates. We aimed to utilize mendelian randomization (MR) analyses to investigate the association between educational attainment (EA) and HF, and to evaluate the contribution of modifiable risk factors as mediators.

Methods

We applied a two-sample MR approach based on the largest genome-wide association studies (GWAS) to investigate the causal relationship between EA and HF. Data collection was conducted in July 2023. We then conducted mediation analyses to explore whether body mass index (BMI), blood pressure, and type 2 diabetes mellitus (T2DM) mediate the effect of EA on HF, and utilized multivariable MR to estimate the proportion of mediation attributed to these factors.

Results

Genetically predicted 3.4 years of additional education was associated with a decrease in the risk of HF (OR 0.76 for each 3.4 years of schooling; 95% CI 0.72, 0.81). BMI, T2DM, systolic blood pressure, and diastolic blood pressure mediated 40.82% (95% CI: 28.86%, 52.77%), 18.00% (95% CI: 12.10%, 23.90%), 11.60% (95% CI: 7.63%, 15.56%), and 7.80% (95% CI: 4.63%, 10.96%) of the EA-HF association, respectively. All risk factors combined were estimated to mediate 63.81% (95% CI: 45.91%, 81.71%) of the effect of EA on HF.

Conclusion

Higher EA has a protective effect against the risk of HF, and potential mechanisms may include regulation of BMI, blood pressure, and blood glucose. Further research is needed to understand whether interventions targeting these factors could influence the association between EA and HF risk.

背景：心力衰竭（HF）是一种迅速增长的全球性疾病，死亡率很高。我们旨在利用亡羊补牢式随机分析（MR）研究教育程度（EA）与心力衰竭之间的关联，并评估可改变的风险因素作为中介的贡献：我们采用基于最大规模全基因组关联研究（GWAS）的双样本 MR 方法来研究 EA 与 HF 之间的因果关系。数据收集于 2023 年 7 月进行。然后，我们进行了中介分析，以探讨体重指数（BMI）、血压和2型糖尿病（T2DM）是否中介了EA对HF的影响，并利用多变量MR估算了这些因素的中介比例：结果：根据基因预测，额外接受 3.4 年教育可降低罹患心房颤动的风险（每接受 3.4 年教育的 OR 为 0.76；95% CI 为 0.72，0.81）。BMI、T2DM、收缩压和舒张压分别介导了40.82%（95% CI：28.86%，52.77%）、18.00%（95% CI：12.10%，23.90%）、11.60%（95% CI：7.63%，15.56%）和7.80%（95% CI：4.63%，10.96%）的EA-HF关联。据估计，所有风险因素加在一起介导了 EA 对 HF 影响的 63.81% (95% CI: 45.91%, 81.71%)：结论：较高的 EA 对心房颤动风险具有保护作用，其潜在机制可能包括对体重指数、血压和血糖的调节。要了解针对这些因素的干预措施是否会影响 EA 与高血脂风险之间的关联，还需要进一步的研究。

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引用次数: 0