Preventive medicine最新文献_第8页

Newborn pulse oximetry screening coverage in a nationwide complex survey sample: An assessment of a congenital heart disease early detection program at the regional level in Brazil 全国性复杂调查样本中的新生儿脉搏血氧仪筛查覆盖率：对巴西地区一级先天性心脏病早期检测计划的评估。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-18 DOI: 10.1016/j.ypmed.2024.108141

Arn Migowski , Gustavo Tavares Lameiro da Costa , Helena Cramer Veiga Rey

Objectives

To estimate the coverage of newborn pulse oximetry screening (POS) in Brazil, as well as identifies associated factors and the proportion of positive screening results.

Methods

Coverage was estimated based on the most recent National Health Survey (2019). Adjusted marginal prevalence ratios were estimated via poisson regression model with robust variance.

Results

The POS coverage was 66.3 % (95 %CI: 65.5–67.1; N = 3,140,023) and was higher in children born in privately funded hospitals (PFHs) than in the Unified Health System (SUS): 78.1 % (76.7–79.5) versus 61.1 % (60.2–62.1). In the North region, the POS coverage in PFHs (64.9 %, 59.7–70.1) was lower than that in the South (82.5 %, 79.4–85.6) and the Southeast (81.5 %, 79.3–83.6); it was even lower in SUS in the North (44.0 %; 42.4–45.6). After a federal ordinance providing financial resources to postscreening diagnostic, the screening coverage in SUS increased from 57.6 % (56.2–59.1) to 64.6 % (63.3–65.9). The proportion of positive screening tests was 9.2 % (8.9–9.5) in SUS and 7.8 % (7.3–8.3) in PFHs, of which 40.8 % (40.5–41.1) underwent complementary exams in SUS and 57.2 % (56.7–57.7) in PFHs. In the multivariate model, the main independent predictors of POS were the coverage of other newborn screening tests.

Conclusions

Inequalities were found between major regions and healthcare systems. Government financial incentives have reduced this inequality, although the percentage of postscreening complementary exams remains insufficient and unequal. The main independent predictors of screening prevalence were those related to the organization of health services.

目的估算巴西新生儿脉搏氧饱和度筛查（POS）的覆盖率，并确定相关因素和筛查结果呈阳性的比例：方法：根据最新的国家健康调查（2019 年）估算覆盖率。通过带有稳健方差的泊松回归模型估算调整后的边际患病率：POS覆盖率为66.3%（95%CI：65.5-67.1；N=3,140,023），在私人资助医院（PFHs）出生的儿童中，POS覆盖率高于统一卫生系统（SUS）：78.1%（76.7-79.5%）对 61.1%（60.2-62.1%）。在北部地区，PFHs 的 POS 覆盖率（64.9%，59.7-70.1%）低于南部地区（82.5%，79.4-85.6%）和东南部地区（81.5%，79.3-83.6%）；在北部地区的统一卫生系统中，POS 覆盖率甚至更低（44.0%；42.4-45.6%）。在一项为筛查后诊断提供财政资源的联邦法令颁布后，统一卫生系统的筛查覆盖率从 57.6%（56.2-59.1%）上升到 64.6%（63.3-65.9%）。筛查结果呈阳性的比例在统一卫生系统为 9.2%（8.9-9.5），在私人家庭医疗机构为 7.8%（7.3-8.3），其中在统一卫生系统接受辅助检查的比例为 40.8%（40.5-41.1），在私人家庭医疗机构为 57.2%（56.7-57.7）。在多变量模型中，POS 的主要独立预测因素是其他新生儿筛查项目的覆盖率：结论：主要地区和医疗系统之间存在不平等。政府的财政激励措施减少了这种不平等，但筛查后补充检查的比例仍然不足且不平等。筛查普及率的主要独立预测因素与医疗服务组织有关。

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引用次数: 0

Interventions to promote colorectal cancer screening among people with a family history of colorectal cancer: A scoping review 在有大肠癌家族史的人群中推广大肠癌筛查的干预措施：范围综述。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-12 DOI: 10.1016/j.ypmed.2024.108137

Tun Firzara Abdul Malik , Hooi Chin Beh , Christine Shamala Selvaraj , Christian David Mallen , Chirk Jenn Ng , Yew Kong Lee

Background

The global incidence of colorectal cancer (CRC) is rising, with people having a family history of CRC (PFH-CRC) facing double the risk compared to the average-risk population. Despite this, CRC screening uptake among PFH-CRC remains low. There is a lack of systematic mapping of interventions promoting CRC screening in this high-risk population.

Objective

We conducted a scoping review to identify the types of interventions targeting PFH-CRC, their effectiveness in increasing CRC screening uptake, and the elements associated with the outcomes.

Methods

The Joanna Briggs Institute methodology for scoping review was followed. The search for eligible articles was conducted from the inception of each database until 17 July 2024 in PubMed, EMBASE, CINAHL, Cochrane, PsycINFO and Web of Science with no restrictions on language.

Results

Thirty studies from 1995 to 2023 across 13 countries were included; mostly from high-income countries. There was considerable variability in study design, intervention characteristics, and screening outcomes. Eleven studies used theoretical frameworks in intervention development. Fourteen studies reported statistically significant increases in screening uptake among PFH-CRC, most using complex, multiple-component interventions. Tailored print materials and patient navigation more consistently demonstrated increased screening uptake, while counselling yielded mixed results.

Conclusion

Interventions for promoting CRC screening uptake in PFH-CRC commonly incorporate print material, patient navigation and counselling, often combined into complex interventions. Future research should include more implementation studies to translate these interventions into real-world settings. Additionally, there are gaps in research from low- and middle-income countries, highlighting the need for further research in these resource-limited settings.

背景：全球结直肠癌（CRC）发病率呈上升趋势，有 CRC 家族史的人（PFH-CRC）面临的风险是平均风险人群的两倍。尽管如此，有家族史的人接受 CRC 筛查的比例仍然很低。在这一高风险人群中，缺乏促进 CRC 筛查的干预措施的系统性规划：我们进行了一项范围综述，以确定针对 PFH-CRC 的干预措施类型、其在提高 CRC 筛查接受率方面的有效性以及与结果相关的要素：方法：采用乔安娜-布里格斯研究所（Joanna Briggs Institute）的方法进行范围界定研究。在PubMed、EMBASE、CINAHL、Cochrane、PsycINFO和Web of Science等数据库中搜索符合条件的文章，搜索时间从每个数据库的开始时间起至2024年7月17日，语言不限：共纳入了 13 个国家从 1995 年到 2023 年的 30 项研究，其中大部分来自高收入国家。研究设计、干预特点和筛查结果存在很大差异。有 11 项研究在制定干预措施时使用了理论框架。有 14 项研究报告称，PFH-CRC 的筛查率在统计学上有了显著提高，其中大多数研究采用了复杂的多成分干预措施。量身定制的印刷材料和患者导航更一致地表明筛查接受率有所提高，而咨询的结果则好坏参半：结论：促进PFH-CRC接受CRC筛查的干预措施通常包括印刷材料、患者指导和咨询，通常结合成复杂的干预措施。未来的研究应包括更多的实施研究，以便将这些干预措施应用到实际环境中。此外，中低收入国家的研究还存在空白，这凸显了在这些资源有限的环境中开展进一步研究的必要性。

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引用次数: 0

Association between physical activity and the N-terminal pro-brain natriuretic peptide in a middle-aged Japanese population: The interaction with alcohol consumption, 2005–2006 日本中年人群中体育锻炼与 N 端前脑钠肽之间的关系：与饮酒量的相互作用，2005-2006 年

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-11 DOI: 10.1016/j.ypmed.2024.108138

Yuichiro Nishida , Megumi Hara , Naoto Taguchi , Kazuyo Nakamura , Hinako Nanri , Takeshi Imaizumi , Tatsuhiko Sakamoto , Chisato Shimanoe , Mikako Horita , Takuma Furukawa , Chiharu Iwasaka , Koichi Shinchi , Yasuki Higaki , Keitaro Tanaka

Objective

Higher N-terminal pro-brain natriuretic peptide (NT-proBNP) levels are a strong risk factor for cardiovascular disease. The current study aimed to clarify the cross-sectional association of physical activity (PA) with NT-proBNP and to identify the interaction of PA with alcohol consumption or cigarette smoking in middle-aged individuals.

Methods

The study included 4613 individuals (1824 men and 2789 women) (November 2005–November 2006). Total PA, steps, light-intensity PA (LPA), and moderate-to-vigorous-intensity PA (MVPA) were assessed using accelerometer. Serum NT-proBNP levels were measured. Cross-sectional associations of total PA and steps with NT-proBNP were analyzed using multiple regression with adjustment for potential confounders. The isotemporal substitution model was used to assess activity intensity-specific association. The interaction between PA and alcohol consumption or smoking was also examined.

Results

Total PA was independently and inversely associated with NT-proBNP in the entire sample (P = 0.04). The inverse association of substituting LPA with MVPA for NT-proBNP was clearer in men than in women (P_interaction = 0.04). Inverse associations of total PA or steps with NT-proBNP were clearer in heavy drinkers than in moderate drinkers and non-drinkers in the entire sample (P_interaction < 0.05). In men, the inverse association of substituting LPA with MVPA for NT-proBNP was also clearer in heavy drinkers (P_interaction = 0.02). No interactions of PA with smoking were detected.

Conclusions

Higher total PA was associated with better NT-proBNP in middle-aged individuals. Additionally, the effect of substituting LPA with MVPA on NT-proBNP was greater in men than in women. Furthermore, the association between PA and NT-proBNP may be modified by alcohol consumption.

目的较高的 N 端前脑钠肽 (NT-proBNP) 水平是心血管疾病的一个重要风险因素。本研究旨在阐明体力活动（PA）与 NT-proBNP 的横断面关联，并确定中年人体力活动与饮酒或吸烟的相互作用。使用加速度计评估了总运动量、步数、轻度运动量（LPA）和中强度运动量（MVPA）。此外，还测量了血清 NT-proBNP 水平。使用多元回归分析了总 PA 和步数与 NT-proBNP 的横截面关系，并对潜在的混杂因素进行了调整。等时替代模型用于评估活动强度与NT-proBNP的相关性。结果在整个样本中，总 PA 与 NT-proBNP 呈独立的反比关系（P = 0.04）。用 MVPA 代替 LPA 与 NT-proBNP 的反向关系在男性中比在女性中更明显（P=0.04）。在整个样本中，重度饮酒者的总PA或步数与NT-proBNP的反向关系比中度饮酒者和不饮酒者更明显（Pinteraction < 0.05）。在男性中，用 MVPA 替代 LPA 与 NT-proBNP 的反向关系在大量饮酒者中也更为明显（Pinteraction = 0.02）。结论总 PA 越高，中年人的 NT-proBNP 越好。此外，男性用 MVPA 替代 LPA 对 NT-proBNP 的影响大于女性。此外，PA 与 NT-proBNP 之间的关系可能会因饮酒而改变。

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引用次数: 0

Perceptions of neighborhood disorder and gun carrying during adolescence: The indirect effect of exposure to violence 青少年时期对邻里关系混乱和持枪的看法：暴力事件的间接影响

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-07 DOI: 10.1016/j.ypmed.2024.108129

Joshua Rosenbaum, Anika Proctor, Samuel Agboola, Mason Myers, D'Andre Walker

Objective

As society strives to curb gun violence among adolescents, understanding the risk factors associated with gun carrying is of critical importance. The current study seeks to examine the relationship between perceived neighborhood disorder and adolescents' susceptibility to carrying a gun to school. More specifically, the aim of the current study was threefold: (1) to examine the direct relationship between perceived neighborhood disorder and exposure to violence, (2) to investigate the association between perceived neighborhood disorder and gun carrying, and (3) to test the mediating effect of exposure to violence on the relationship between perceived neighborhood disorder and gun carrying.

Methods

Data from waves I and II (1994–1996) of the National Longitudinal Study of Adolescent to Adult Health was analyzed (N = 11,887). Due to the binary nature of the mediating and dependent variables (i.e., exposure to violence and gun carrying) a series of logistic regression models were estimated.

Results

Our analyses revealed that perceived neighborhood disorder is positive and significantly associated with, both, exposure to violence and gun carrying. The relationship between perceived neighborhood disorder and gun carrying was fully mediated by exposure to violence.

Conclusions

While neighborhood disorder is a risk factor for gun carrying among youth, exposure to violence explains the relationship between perceived neighborhood disorder and carrying a gun to school. To reduce the prevalence of gun carrying and gun violence among the adolescent population, mental health resources should be provided to those who reside in communities with high levels of disorder and violence.

目标随着社会努力遏制青少年中的枪支暴力，了解与携带枪支相关的风险因素至关重要。本研究旨在探讨邻里关系混乱与青少年携带枪支上学的易感性之间的关系。更具体地说，本研究的目的有三：（1）研究感知到的邻里关系混乱与接触暴力之间的直接关系；（2）调查感知到的邻里关系混乱与携带枪支之间的关联；（3）检验接触暴力对感知到的邻里关系混乱与携带枪支之间关系的中介效应。方法分析了《全国青少年到成人健康纵向研究》第一和第二阶段（1994-1996 年）的数据（N = 11,887 人）。由于中介变量和因变量（即遭受暴力和携带枪支）的二元性质，我们对一系列逻辑回归模型进行了估计。结果我们的分析表明，邻里关系混乱与遭受暴力和携带枪支有显著的正相关。结论虽然邻里关系混乱是青少年携带枪支的一个风险因素，但暴力事件可以解释邻里关系混乱与携带枪支上学之间的关系。为了减少青少年携带枪支和枪支暴力的发生率，应该为那些居住在混乱和暴力程度较高的社区的青少年提供心理健康资源。

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引用次数: 0

Life-period associations of body mass index with adult carotid intima-media thickness: The Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study 体重指数与成人颈动脉内膜中层厚度的生命周期关联：博格卢萨心脏研究和芬兰年轻人心血管风险研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-06 DOI: 10.1016/j.ypmed.2024.108128

Jack T. Evans , Marie-Jeanne Buscot , Brooklyn J. Fraser , Markus Juonala , Yajun Guo , Camilo Fernandez , Mika Kähönen , Matthew A. Sabin , Matthew K. Armstrong , Jorma S.A. Viikari , Lydia A. Bazzano , Olli T. Raitakari , Costan G. Magnussen

Objective

Child and adult body mass index (BMI) associates with adult carotid artery intima-media thickness (cIMT). However, the relative contribution of BMI at different life-periods on adult cIMT has not been quantified. This study aimed to determine the life-course model that best explains the relative contribution of BMI at different life-periods (childhood, adolescence, and young-adulthood) on cIMT in adulthood.

Methods

BMI was calculated from direct measurements of height and weight at up to seven time-points from childhood to adulthood (1973–2007) among 2485 participants of the Cardiovascular Risk in Young Finns Study (YFS) and 1271 participants in the Bogalusa Heart Study (BHS). BMI measures at three ages representative of childhood (9-years), adolescence (18 years) and young-adulthood (30 years) life-periods were used. B-mode ultrasound was used to measure common cIMT in adulthood (>30 years). Associations were evaluated using the Bayesian relative life-course exposure model.

Results

In both cohorts, cumulative exposure to higher levels of BMI across the life-course was associated with greater cIMT. Of the examined life-periods, BMI in young-adulthood provided the greatest relative contribution towards the development of adult cIMT for YFS (49.9 %, 95 % CrI = 34–68 %) and white BHS participants (48.6 %, 95 % CrI = 9–86 %), whereas BMI in childhood had the greatest relative contribution for black BHS participants (54.0 %, 95 % CrI = 8–89 %).

Conclusion

Although our data suggest sensitive periods in the life-course where prevention and intervention aimed at reducing BMI might provide most benefit in limiting the effects of BMI on cIMT, maintaining lower BMI across the life-course appears to be optimal.

目的：儿童和成人的体重指数（BMI）与成人颈动脉内膜中层厚度（cIMT）有关。然而，不同生命周期的体重指数对成人 cIMT 的相对影响尚未量化。本研究旨在确定最能解释不同生命时期（童年、青春期和青年期）BMI 对成年期 cIMT 的相对影响的生命过程模型：芬兰青年心血管风险研究》（YFS）的 2485 名参与者和《博加卢萨心脏研究》（BHS）的 1271 名参与者在从童年到成年（1973-2007 年）多达七个时间点的身高和体重直接测量值计算出了体重指数。研究采用了儿童期（9 岁）、青少年期（18 岁）和青年期（30 岁）三个年龄段的 BMI 测量值。B 型超声波用于测量成年期（30 岁以上）的常见 cIMT。采用贝叶斯相对生命期暴露模型对相关性进行了评估：结果：在两个队列中，一生中累积暴露于较高水平的体重指数与较大的 cIMT 相关。在所研究的生命周期中，青年时期的 BMI 对 YFS（49.9%，95% CrI = 34-68%）和白人 BHS 参与者（48.6%，95% CrI = 9-86%）的成人 cIMT 发展的相对贡献最大，而童年时期的 BMI 对黑人 BHS 参与者的相对贡献最大（54.0%，95% CrI = 8-89%）：尽管我们的数据表明，在生命过程的敏感期，旨在降低体重指数的预防和干预措施可能会在限制体重指数对 cIMT 的影响方面带来最大益处，但在整个生命过程中保持较低的体重指数似乎是最佳选择。

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引用次数: 0

Association between life satisfaction, self-esteem, and health checkup participation: A population-based longitudinal study in South Korea 生活满意度、自尊与参加健康检查之间的关系：韩国一项基于人口的纵向研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-05 DOI: 10.1016/j.ypmed.2024.108127

Seong-Uk Baek , Jin-Ha Yoon

Objective

Previous studies have shown that background sociodemographic factors are associated with health checkup participation. However, little is known about the psychological determinants of health checkup participation in longitudinal studies. This study explored the psychological determinants of health checkup participation based on a longitudinal study in South Korea.

Methods

Data were retrieved from a nationwide, longitudinal panel study in South Korea, which included community-dwelling general adults, conducted from 2005 to 2022. Established scales for assessing life satisfaction and self-esteem were employed, and life satisfaction and self-esteem levels were categorized into four groups based on quartile values (lowest, low, high, and highest). Respondents reported whether they had undergone a health checkup in the past year. Fixed effects logistic regressions were fitted to determine within-individual associations between life satisfaction, self-esteem, and health checkup participation (n = 15,771; 171,943 observations). Odds ratios (OR) and 95 % confidence interval (CI) were determined.

Results

Compared with the lowest life satisfaction, the highest life satisfaction is associated with increased odds of health checkup participation (OR: 1.17, 95 % CI: 1.13–1.23). Compared to the lowest self-esteem level, the highest self-esteem level was positively associated with health checkup participation (OR, 1.14; 95 % CI: 1.10–1.18). The odds of participating in health checkups were also positively associated with age, income, and educational level.

Conclusion

Although the effect sizes were modest, high life satisfaction and self-esteem were associated with an increased likelihood of participating in health checkups.

目的以往的研究表明，背景社会人口因素与参加健康体检有关。然而，在纵向研究中，人们对参加健康体检的心理决定因素知之甚少。本研究以韩国的一项纵向研究为基础，探讨了参加健康体检的心理决定因素：研究数据来自于 2005 年至 2022 年在韩国开展的一项全国性纵向小组研究，研究对象包括居住在社区的普通成年人。研究采用了既定的生活满意度和自尊心评估量表，并根据四分位值（最低、低、高和最高）将生活满意度和自尊心水平分为四组。受访者报告了他们在过去一年中是否接受过健康检查。固定效应逻辑回归用于确定生活满意度、自尊和健康体检参与度之间的个体内部联系（n = 15,771; 171,943 个观察值）。结果表明：生活满意度最低的人，参加健康检查的比例较高，而生活满意度最高的人，参加健康检查的比例较低：结果：与最低生活满意度相比，最高生活满意度与参加健康体检的几率增加相关（OR：1.17，95 % CI：1.13-1.23）。与最低自尊水平相比，最高自尊水平与参加健康体检呈正相关（OR：1.14；95 % CI：1.10-1.18）。参加健康体检的几率与年龄、收入和教育水平也呈正相关：尽管影响大小不大，但生活满意度高和自尊心强与参加健康体检的可能性增加有关。

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引用次数: 0

Black college women's preventive health behaviors: Applications of a Black Feminist-Womanist research paradigm 黑人女大学生的预防保健行为：黑人女权主义-妇女主义研究范式的应用。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-02 DOI: 10.1016/j.ypmed.2024.108126

Juinell B. Williams , Angela J. Johnson , Michelle Ruiz , Lisa C. Campbell

Objective

The researchers applied Lindsay-Dennis' Black Feminist-Womanist research paradigm to Andersen's Behavioral Model for Health Service Use to guide initial research about Black American women's preventive health behaviors.

Methods

This article highlights this application, using interpretive phenomenological analysis for qualitative questions assessing how 40 Black college women define health and their experiences in health care. This was part of a larger convergent parallel mixed-methods approach in a 2022 cross-sectional online survey.

Results

Participants defined health as a concept involving health literacy, physical and mental health, and being free from health conditions or disease. Regarding health-related lived experiences, negative experiences were more frequently reported than positive experiences. However, many participants reported both positive and negative health care related experiences. Predisposing, enabling, and need factors were all present in qualitative responses.

Conclusions

This article highlights the fit of a Black Feminist-Womanist research paradigm to Andersen's model to better understand Black women's health experiences and illustrates ways that medical mistrust, health literacy, and past experiences with health care can influence health service use. Areas for future research on barriers and facilitators to preventive care and implications for reducing health disparities are also discussed.

目标：研究人员将 Lindsay-Dennis 的黑人女性主义-妇女主义研究范式应用于 Andersen 的健康服务使用行为模型，以指导有关美国黑人女性预防性健康行为的初步研究：本文重点介绍了这一应用，采用解释现象学分析法对 40 名黑人女大学生的定性问题进行评估，了解她们如何定义健康以及她们在医疗保健方面的经历。这是在 2022 年横断面在线调查中采用的更大范围的趋同平行混合方法的一部分：结果：参与者将健康定义为一个涉及健康知识、身体和心理健康以及远离健康状况或疾病的概念。关于与健康相关的生活经历，负面经历的报告多于正面经历。然而，许多参与者既报告了与医疗保健相关的积极经历，也报告了与医疗保健相关的消极经历。在定性回答中，倾向性因素、有利因素和需求因素都存在：本文强调了黑人女性主义-妇女主义研究范式与安徒生模型的契合，以更好地理解黑人妇女的健康经历，并说明了医疗不信任、健康素养和过去的医疗经历如何影响医疗服务的使用。此外，还讨论了有关预防性保健的障碍和促进因素的未来研究领域，以及对减少健康差异的影响。

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引用次数: 0

Relationship between participation in projects of incentives to promote walking and healthy aging among the older population: A four-year longitudinal study 老年人参与鼓励步行项目与健康老龄化之间的关系：一项为期四年的纵向研究。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-02 DOI: 10.1016/j.ypmed.2024.108125

Gemmei Iizuka , Taishi Tsuji , Kazushige Ide , Katsunori Kondo

Objective

This study aimed to evaluate the association between the Yokohama Walking Point Program, which promotes walking through feedback on step counts and incentives, and the extension of healthy life expectancy.

Methods

A total of 4298 individuals aged over 65 years who responded to the 2013 and 2016 surveys and who were not certified as needing long-term care in 2016 were included in this study. The participants were categorized into “non-participation,” “participation without uploading,” and “participation with uploading” groups based on their involvement and uploading of pedometer data. The objective variable was the occurrence of long-term care certification and deaths over the subsequent four years. A modified Poisson regression model was applied, adjusting for 15 variables before project initiation.

Results

A total of 440 participants (10.2 %) were included in the “participation with uploading” group and 206 (4.8 %) in the “participation without uploading” group. Compared with “non-participation,” the risk ratio was 0.77 (95 % confidence interval (CI): 0.59–0.99) for “participation with uploading” and 1.02 (95 % CI: 0.75–1.38) for “participation without uploading”. In the sensitivity analysis censoring death as an inapplicable outcome and considering functional decline, participation with uploading showed a risk ratio of 0.79 (95 % CI: 0.60–1.04) for the likelihood of functional decline.

Conclusions

The use of pedometers and health point programs based on walking activity is associated with enhancing the health of older individuals participating in the program, representing a population-centric strategy targeting all citizens.

研究目的本研究旨在评估 "横滨步行点计划 "与延长健康预期寿命之间的关系：本研究共纳入了 4298 名 65 岁以上的老人，他们都对 2013 年和 2016 年的调查做出了回应，并且在 2016 年没有被证明需要长期护理。根据参与和上传计步器数据的情况，将参与者分为 "未参与 "组、"参与但未上传 "组和 "参与但上传 "组。客观变量是在随后四年中发生的长期护理认证和死亡事件。在项目启动前，对 15 个变量进行了调整，采用了修正的泊松回归模型：共有 440 名参与者（10.2%）被纳入 "参与并上传 "组，206 名参与者（4.8%）被纳入 "未参与并上传 "组。与 "未参与 "相比，"参与上传 "的风险比为 0.77（95% 置信区间（CI）：0.59-0.99），"参与未上传 "的风险比为 1.02（95% 置信区间（CI）：0.75-1.38）。在敏感性分析中，将死亡作为不适用的结果进行了删减，并考虑了功能衰退的因素，结果显示，参与并上传计步器对功能衰退可能性的风险比为 0.79（95 % CI：0.60-1.04）：使用计步器和以步行活动为基础的健康积分计划有助于提高参与计划的老年人的健康水平，是一项针对所有公民的以人口为中心的战略。

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引用次数: 0

Firearm violence and associated factors among young adults presenting to emergency departments in three cities: Baseline results from Project SPARK 三个城市急诊科就诊的年轻成年人中的枪支暴力及相关因素：SPARK 项目的基线结果。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-09-02 DOI: 10.1016/j.ypmed.2024.108124

Jason E. Goldstick , Patrick M. Carter , Lauren Whiteside , M. Kit Delgado , Philip Stallworth , Keara Sullivan , Maya Childs , Sarah Taga , Rebecca M. Cunningham

Objective

Recent shifts in U.S. violence dynamics call for updated violence epidemiology among general emergency department (ED) samples of young adults. Using baseline data from a multi-site longitudinal study of firearm violence prediction, we describe violence rates and associated factors.

Methods

Staff approached age 18–24 entrants to Level-1 trauma centers in three cities (Flint, Seattle, Philadelphia; 7/2021–5/2023). Consenting participants completed a survey including validated measures of violence experience, firearm-related behaviors, substance use, mental health symptoms, peer/parental/familial behaviors, community violence, and attitudes/norms. We described the sample and examined factors associated with firearm assault (victimization/aggression, including threats).

Results

Across sites, 1506 participants enrolled (41.7. % Black; 33.6 % White; 61.4. % female). Half of participants self-reported past-six-month violent victimization and/or aggression; non-partner violence, and violent victimization were most common. Over half of participants self-reported high-risk substance use, and over half screened positive for post-traumatic stress disorder, depression, and/or anxiety. About 14.4 % self-reported past-six-month firearm assault, and 5.9 % self-reported firearm violence (excluding threats). Adjusted analysis showed community violence exposure was most strongly associated with firearm assault; each one-point-increase corresponded to a 13.7 % (95 %CI: 10.4 %–16.9 %) absolute increase in firearm assault prevalence. Drug misuse, mental health symptoms, firearm carrying, retaliatory attitudes, prosocial attitudes, and family conflict were also associated with firearm assault.

Conclusions

Violence, including firearm assault, is common among young adults entering urban EDs, and is associated with several psychosocial factors. High rates of substance use and mental health symptoms underscore this as a high-need population. Leveraging this information could help tailor interventions and optimize resource allocation.

目的：美国暴力动态的最新变化要求对普通急诊科（ED）青壮年样本中的暴力流行病学进行更新。我们利用枪支暴力预测多站点纵向研究的基线数据，描述了暴力发生率及相关因素：工作人员与三个城市（弗林特、西雅图、费城；2021 年 7 月至 2023 年 5 月）的一级创伤中心的 18-24 岁入院者进行了接触。征得同意的参与者完成了一项调查，其中包括暴力经历、枪支相关行为、药物使用、精神健康症状、同伴/父母/家庭行为、社区暴力以及态度/规范等方面的有效测量。我们对样本进行了描述，并研究了与枪支攻击（受害/攻击，包括威胁）相关的因素：在各个地点，共有 1506 名参与者（40.9% 为黑人；34.3% 为白人；60.1% 为女性）。半数参与者自我报告了过去六个月的暴力伤害和/或侵犯行为；非伴侣暴力和暴力伤害最为常见。半数以上的参与者自述曾使用高风险药物，半数以上的参与者在创伤后应激障碍、抑郁和/或焦虑症筛查中呈阳性。约有 14.4% 的人自述在过去六个月中遭受过枪支攻击，5.9% 的人自述遭受过枪支暴力（不包括威胁）。调整后的分析表明，社区暴力风险与持枪攻击行为的关系最为密切；每增加一个点，持枪攻击行为的发生率就会绝对增加 13.7%（95%CI：10.4%-16.9%）。药物滥用、精神健康症状、携带枪支、报复态度、亲社会态度和家庭冲突也与持枪伤人有关：暴力（包括持枪伤人）在进入城市急诊室的年轻成年人中很常见，并与多种社会心理因素有关。高比率的药物使用和精神健康症状突出表明这是一个高需求人群。利用这些信息有助于调整干预措施和优化资源分配。

{"title":"Firearm violence and associated factors among young adults presenting to emergency departments in three cities: Baseline results from Project SPARK","authors":"Jason E. Goldstick , Patrick M. Carter , Lauren Whiteside , M. Kit Delgado , Philip Stallworth , Keara Sullivan , Maya Childs , Sarah Taga , Rebecca M. Cunningham","doi":"10.1016/j.ypmed.2024.108124","DOIUrl":"10.1016/j.ypmed.2024.108124","url":null,"abstract":"<div><h3>Objective</h3><p>Recent shifts in U.S. violence dynamics call for updated violence epidemiology among general emergency department (ED) samples of young adults. Using baseline data from a multi-site longitudinal study of firearm violence prediction, we describe violence rates and associated factors.</p></div><div><h3>Methods</h3><p>Staff approached age 18–24 entrants to Level-1 trauma centers in three cities (Flint, Seattle, Philadelphia; 7/2021–5/2023). Consenting participants completed a survey including validated measures of violence experience, firearm-related behaviors, substance use, mental health symptoms, peer/parental/familial behaviors, community violence, and attitudes/norms. We described the sample and examined factors associated with firearm assault (victimization/aggression, including threats).</p></div><div><h3>Results</h3><p>Across sites, 1506 participants enrolled (41.7. % Black; 33.6 % White; 61.4. % female). Half of participants self-reported past-six-month violent victimization and/or aggression; non-partner violence, and violent victimization were most common. Over half of participants self-reported high-risk substance use, and over half screened positive for post-traumatic stress disorder, depression, and/or anxiety. About 14.4 % self-reported past-six-month firearm assault, and 5.9 % self-reported firearm violence (excluding threats). Adjusted analysis showed community violence exposure was most strongly associated with firearm assault; each one-point-increase corresponded to a 13.7 % (95 %CI: 10.4 %–16.9 %) absolute increase in firearm assault prevalence. Drug misuse, mental health symptoms, firearm carrying, retaliatory attitudes, prosocial attitudes, and family conflict were also associated with firearm assault.</p></div><div><h3>Conclusions</h3><p>Violence, including firearm assault, is common among young adults entering urban EDs, and is associated with several psychosocial factors. High rates of substance use and mental health symptoms underscore this as a high-need population. Leveraging this information could help tailor interventions and optimize resource allocation.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"189 ","pages":"Article 108124"},"PeriodicalIF":4.3,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133575","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

The association between precarious employment and stress among working aged individuals in the United States 美国老年劳动者就业不稳定与压力之间的关系。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-08-30 DOI: 10.1016/j.ypmed.2024.108123

Vanessa M. Oddo , Sherif Mabrouk , Sarah B. Andrea , Emily Q. Ahonen , Megan R. Winkler , Emilia F. Vignola , Anjum Hajat

Objective

Precarious employment is a plausible stressor, which may adversely affect health. We investigated the association between multidimensional precarious employment and perceived and biological stress in the U.S.

Methods

We used data from waves 4 (2008–2009) and 5 (2016–2018) of the National Longitudinal Study of Adolescent to Adult Health. Eight indicators were mapped to five dimensions of precarious employment to create a continuous score (PES, range: 0–5): material rewards, working-time arrangements, stability, workers' rights, and interpersonal relationships. Perceived stress was constructed from the four-item Cohen's perceived stress score (PSS; range: 0–16; wave 4). We measured biological stress in waves 4 and 5 via C-reactive protein (CRP). Given variability in CRP collection between waves, we treated wave 4 and 5 as cross-sectional. We employed adjusted linear regression models to estimate whether the PES was associated with the PSS in wave 4 (n = 11,510) and CRP in waves 4 (n = 10,343) and 5 (n = 3452).

Result

Individuals were aged 28 and 37 years on average in wave 4 and 5, respectively. Half were female and most identified as non-Hispanic (NH)-White (∼73 %), followed by NH-Black (∼14 %), Hispanic (∼9 %) and NH-other (∼4 %). Average PES was inversely related to education. The PSS averaged 8.1 (Interquartile Range [IQR] = 7.0,9.0). Average CRP was 4.4 mg/L (IQR = 0.8,5.0) in wave 4 and 3.6 mg/L (IQR = 0.8,4.2) in wave 5. The PES was associated with perceived stress ( $β$ =0.06; 95 % CI = 0.01,0.10) and CRP in wave 5 ( $β$ =0.34; 95 % CI = 0.07,0.62).

Conclusions

Given the deleterious effects of stress on health, policies to reduce precarious employment warrant consideration.

目的：不稳定就业是一种合理的压力源，可能会对健康产生不利影响。我们调查了美国多维度不稳定就业与感知压力和生理压力之间的关联：我们使用了全国青少年到成人健康纵向研究第 4 波（2008-2009 年）和第 5 波（2016-2018 年）的数据。八项指标被映射到不稳定就业的五个维度，从而得出连续得分（PES，范围：0-5）：物质奖励、工作时间安排、稳定性、工人权利和人际关系。感知压力由四项科恩感知压力评分（PSS；范围：0-16；第 4 波）构成。我们通过 C 反应蛋白（CRP）测量第 4 波和第 5 波的生物压力。考虑到不同波次之间 CRP 采集结果的差异，我们将第 4 波和第 5 波视为横断面。我们采用调整线性回归模型来估计 PES 是否与第 4 波的 PSS（n = 11,510 人）以及第 4 波（n = 10,343 人）和第 5 波（n = 3452 人）的 CRP 相关：第 4 次和第 5 次调查的平均年龄分别为 28 岁和 37 岁。半数为女性，大多数为非西班牙裔白人（约占 73%），其次是非西班牙裔黑人（约占 14%）、西班牙裔（约占 9%）和非西班牙裔其他族裔（约占 4%）。平均 PES 与教育程度成反比。PSS 平均为 8.1（四分位数间距 [IQR] = 7.0,9.0）。第 4 波的平均 CRP 为 4.4 毫克/升（IQR = 0.8,5.0），第 5 波为 3.6 毫克/升（IQR = 0.8,4.2）。PES与感知压力（β=0.06；95 % CI = 0.01,0.10）和第5波CRP（β=0.34；95 % CI = 0.10,0.62）相关：鉴于压力对健康的有害影响，减少不稳定就业的政策值得考虑。

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引用次数: 0