Preventive medicine最新文献_第8页

Life course weight transitions from birth to childhood to midlife and risk of cardiovascular diseases and its subtypes 从出生到童年再到中年的生命历程中体重变化与心血管疾病及其亚型的风险。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-03 DOI: 10.1016/j.ypmed.2024.108060

Xiaoyi Wang , Qi Wang , Meiling Li , Yanqing Zhao , Qixiang Song , Chunying Fu , Wenting Hao , Dongshan Zhu

Background and aims

Evidence on weight transitions across life stages and cardiovascular diseases (CVDs) is limited. We aimed to explore weight transition patterns from birth to childhood to midlife and risk of incident CVDs.

Methods

A total of 193,905 participants from the UK Biobank were included. Weight at birth, childhood, and midlife were collected at baseline (2006–2010). CVD outcomes were collected at year 2022. We constructed 27 transition patterns from birth to age 10 years to midlife. Cox proportional hazard models yielded hazard ratios (HRs) and 95% confidence intervals (CI) between weight transition patterns and CVDs. Mediation analyses were performed. Rate advancement periods (RAP) were also calculated.

Results

Several weight transition patterns were clearly linked to risk of CVDs, including “Low birth weight → high weight at age 10 years → obesity at midlife” (HR 2.64, 95% CI 2.24–3.11), “Low birth weight → low weight at age 10 years → obesity at midlife” (2.27, 1.93–2.66), “High birth weight → low weight at age 10 years → obesity at midlife” (2.29, 1.96–2.67), and “High birth weight → high weight at age 10 years → obesity at midlife” (2.14, 1.89–2.42), which showed even stronger association with HF. RAPs of these patterns were 8.3–10.6 years for CVD and 10.0–13.1 for HF. 50% of the association between birth weight and CVDs was mediated by weight at midlife.

Conclusions

Our findings highlight the importance of weight management throughout the life course in reducing the risk of CVDs, especially maintaining a heathy weight at midlife.

背景和目的：有关不同生命阶段体重变化和心血管疾病（CVDs）的证据有限。我们旨在探索从出生到童年再到中年的体重变化模式以及心血管疾病的发病风险：方法：共纳入英国生物库中的 193905 名参与者。在基线期（2006-2010 年）收集了出生时、儿童期和中年期的体重。心血管疾病结果收集于 2022 年。我们构建了从出生到 10 岁再到中年的 27 种过渡模式。Cox 比例危险模型得出了体重转变模式与心血管疾病之间的危险比 (HR) 和 95% 置信区间 (CI)。还进行了中介分析。此外，还计算了心血管疾病发病率上升期（RAP）：结果：有几种体重转变模式与心血管疾病风险明显相关，包括 "出生时体重低→10 岁时体重高→中年时肥胖"（HR 2.64，95% CI 2.24-3.11）、"出生时体重低→10 岁时体重低→中年时肥胖"（HR 2.27，1.93-2.66）、"出生时体重高→10 岁时体重低→中年时肥胖"（2.29，1.96-2.67）和 "出生时体重高→10 岁时体重高→中年时肥胖"（2.14，1.89-2.42），这些模式与心房颤动的关联性更强。就心血管疾病而言，这些模式的RAP为8.3-10.6年，就心房颤动而言，这些模式的RAP为10.0-13.1年。出生体重与心血管疾病之间的关联有50%是由中年时的体重介导的：我们的研究结果强调了在整个生命过程中控制体重对降低心血管疾病风险的重要性，尤其是在中年时保持健康的体重。

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引用次数: 0

U.S. postsecondary students' health and academic outcomes: A comprehensive scoping review 美国中学后学生的健康和学习成绩：综合范围审查。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-03 DOI: 10.1016/j.ypmed.2024.108059

Objective

The relationship between postsecondary students' health and academic outcomes may have important implications for their collegiate experience and their future prospects. Yet a comprehensive summary of the evidence examining this potential connection does not presently exist. Seeking to fill this gap, this study reviewed the extant literature on postsecondary students' academic outcomes and health across multiple domains.

Methods

Using an established methodological framework, a scoping review was conducted to identify and summarize the attributes of all peer-reviewed research performed in the U.S. and published between 2008 and 2019 that examined the relationship between postsecondary students' health and academic outcomes.

Results

The search strategy resulted in 12,488 articles. After deduplication, initial screening, and full review of relevant articles to determine eligibility, 264 articles were included in the final review. The most frequently examined health domains were mental health and substance use. Grade point average (GPA) was the most common academic measure investigated. Most studies took place at single institutions among undergraduate students, and several studies focused on specific student sub-populations. Almost all study results indicated that healthier behavior or optimal health status was associated with better academic outcomes or did not negatively impact academic success.

Conclusions

This study serves as a first step in understanding the scope of existing research examining the connection between postsecondary students' health and academic outcomes. A substantial literature base was found; however, several gaps were identified including the need for more cohort studies, national studies, examination of graduate students, and a focus on academic outcomes beyond GPA.

目的：中学生的健康状况与学习成绩之间的关系可能会对他们的大学生活和未来前景产生重要影响。然而，目前还没有对研究这种潜在联系的证据进行全面总结。为了填补这一空白，本研究综述了有关中学生学业成绩和健康状况的多个领域的现有文献：方法：采用既定的方法框架，对 2008 年至 2019 年期间在美国发表的所有经同行评审的研究进行了范围界定，并总结了这些研究的属性，这些研究考察了中学生的健康与学业成绩之间的关系：通过搜索策略，共搜索到 12,488 篇文章。经过去重、初步筛选和对相关文章进行全面审查以确定是否符合条件后，264 篇文章被纳入最终审查。最常研究的健康领域是心理健康和药物使用。平均学分绩点（GPA）是最常见的学业衡量标准。大多数研究都是在单一院校的本科生中进行的，有几项研究侧重于特定的学生亚群。几乎所有的研究结果都表明，更健康的行为或最佳的健康状况与更好的学业成绩有关，或不会对学业成功产生负面影响：本研究是了解现有研究范围的第一步，这些研究探讨了中学生健康与学业成绩之间的联系。研究发现了大量的文献基础，但也发现了一些不足之处，包括需要更多的队列研究、全国性研究、对研究生的研究以及对 GPA 以外的学业成绩的关注。

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引用次数: 0

Epidemiology of drug arrests in the United States: Evidence from the national survey on drug use and health, 2015–2019 美国毒品逮捕的流行病学：来自 2015-2019 年全国毒品使用和健康调查的证据。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-07-03 DOI: 10.1016/j.ypmed.2024.108058

Saba Rouhani , Lingzi Luo , Himani Byregowda , Nicholas Weaver , Ju Nyeong Park

Objective

Following changes to drug criminalization policies, we re-examine the epidemiology of drug arrests among people who use drugs (PWUD) in the U.S.

Methods

Serial cross-sectional data from the National Survey on Drug Use and Health (2015–2019) were utilized. Past-year illicit drug use (excluding cannabis) and drug arrests were described by year, area of residence, drug use characteristics and participant demographics. Adjusted associations between race and drug arrest were estimated using multivariable logistic regression.

Results

Past-year illicit drug use remained consistent over time and was highest among non-Hispanic (NH) white respondents. Of those reporting past-year illicit drug use (n = 25,429), prevalence of drug arrests remained stable over time overall and in metro areas while increasing in non-metro areas. Arrests were elevated among NH Black participants and those with lower income, unemployment, housing transience, non-metro area residence, polysubstance use, history of drug injection, substance use dependence and past-year drug selling. Adjusted odds of drug arrest remained significantly higher among NH Black individuals [aOR 1.92, 95% CI 1.30, 2.84].

Conclusion

Despite recent shifts away from punitive drug policies, we detected no reduction in drug arrests nationally and increasing prevalence in non-metro areas. Despite reporting the lowest level of illicit substance use and drug selling, NH Black individuals had significantly increased odds of arrest across years. Findings highlight the need for further examination of policy implementation and policing practices in different settings, with more research focused non-metro areas, to address enduring structural racism in drug enforcement and its consequences for health.

目的：随着毒品刑事定罪政策的变化，我们重新研究了美国吸毒者（PWUD）中的毒品逮捕流行病学：随着毒品刑事定罪政策的变化，我们重新研究了美国吸毒者（PWUD）中毒品逮捕的流行病学：我们利用了《全国毒品使用与健康调查》（2015-2019 年）中的序列横截面数据。按照年份、居住地区、毒品使用特征和参与者人口统计学特征对上一年的非法药物使用（不包括大麻）和毒品被捕情况进行了描述。使用多变量逻辑回归估算了种族与吸毒被捕之间的调整关联：过去一年的非法药物使用情况在过去一段时间内保持一致，非西班牙裔（NH）白人受访者的非法药物使用率最高。在报告上一年非法药物使用情况的受访者（n = 25,429）中，吸毒被捕率在总体上和大都会地区保持稳定，而在非大都会地区则有所上升。在新罕布什尔州的黑人参与者中，以及在收入较低、失业、住房不稳定、居住在非都会区、使用多种药物、有药物注射史、药物使用依赖性和过去一年有毒品销售的参与者中，被捕率较高。调整后，新罕布什尔州黑人吸毒被捕的几率仍然明显较高[aOR 1.92, 95% CI 1.30, 2.84]：尽管近来惩罚性毒品政策有所改变，但我们发现全国范围内的毒品被捕率并没有下降，而非大都会地区的毒品被捕率却在上升。尽管报告的非法药物使用和毒品销售水平最低，但新罕布什尔州黑人在不同年份被捕的几率显著增加。研究结果突出表明，有必要进一步检查不同环境下的政策执行情况和警务实践，并将更多的研究重点放在非都会区，以解决缉毒执法中持久存在的结构性种族主义及其对健康的影响。

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引用次数: 0

Associations of educational and marketing messages with beliefs about nicotine and reduced nicotine cigarettes 教育和营销信息与尼古丁和低尼古丁香烟信念的关联。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-06-27 DOI: 10.1016/j.ypmed.2024.108056

Melissa Mercincavage , Olivia A. Wackowski , Andrea C. Johnson , William J. Young , Andy S.L. Tan , Cristine D. Delnevo , Andrew A. Strasser , Andrea C. Villanti

Introduction

Widespread misperceptions about nicotine may have unintended effects on public health. We examined associations between existing messages about nicotine or tobacco and beliefs about nicotine and reduced nicotine cigarettes (RNC).

Methods

2962 U.S. 18–45-year-olds were randomized in a May 2022 web-based survey to view one of 26 text-based messages about tobacco or nicotine from three sources: ongoing research (n = 8), messages authorized by FDA for VLN cigarettes (n = 6), and FDA's “From Plant to Product to Puff” campaign (n = 12); six messages from FDA's campaign did not reference nicotine and were treated as the reference source. Analyses examined associations between messages, grouped by source and individually, with beliefs about nicotine and RNC addictiveness and harms.

Results

Relative to FDA messages that did not reference nicotine, all message sources were associated with greater odds of a correct belief about nicotine (Odds Ratios [ORs] = 1.40–1.87, p's < 0.01); VLN messages were associated with greater correct beliefs about RNC addictiveness (b = 0.23, p < .05). No campaign produced greater correct beliefs about RNC harms. At the individual level, only five messages were associated with a correct belief about nicotine (ORs = 2.12–2.56, p-values < .01), and one with correct beliefs about RNC harms (b = 1.09, p < .05), vs. the reference message.

Conclusions

Few existing messages improved understanding of the risks of nicotine separately from the risks of combustible products. Communication research is needed to promote greater public understanding of nicotine while minimizing unintended effects on nicotine and tobacco use.

导言：对尼古丁的普遍误解可能会对公众健康产生意想不到的影响。我们研究了现有尼古丁或烟草信息与尼古丁和减尼古丁香烟（RNC）观念之间的关联。方法：在 2022 年 5 月的一项网络调查中，2962 名 18-45 岁的美国人被随机抽取，从以下三种来源的 26 条关于烟草或尼古丁的文字信息中选择一条进行浏览：正在进行的研究（n = 8）、FDA 授权的 VLN 卷烟信息（n = 6）以及 FDA 的 "从植物到产品再到烟草 "活动（n = 12）；FDA 活动中的 6 条信息未提及尼古丁，被视为参考来源。分析研究了按来源分组和单独分析的信息与尼古丁、RNC成瘾性和危害的信念之间的关联：结果：与未提及尼古丁的 FDA 信息相比，所有信息来源都与尼古丁的正确认知几率有关（Odds Ratios [ORs] = 1.40-1.87，P's 结论：现有信息很少能提高人们对尼古丁的认识：现有的信息很少能提高人们对尼古丁风险和可燃产品风险的理解。需要开展传播研究，以促进公众对尼古丁的进一步了解，同时尽量减少对尼古丁和烟草使用的意外影响。

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引用次数: 0

Co-occurring conditions during pregnancy and hospitalizations in the first year postpartum among persons with opioid use disorder 阿片类药物使用失调症患者在怀孕期间的并发症和产后第一年的住院情况。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-06-26 DOI: 10.1016/j.ypmed.2024.108057

Jessica Frankeberger , Robert W.S. Coulter , Marian Jarlenski , Elizabeth E. Krans , Christina Mair

Introduction

Pregnant persons with opioid use disorder (OUD) face a multitude of comorbid conditions that may increase the risk of adverse drug and health outcomes. This study characterizes typologies of comorbidities among pregnant persons with OUD and assesses the associations of these typologies with hospitalizations in the first year postpartum.

Methods

A cohort of pregnant persons with OUD at delivery in 2018 were identified in a Pennsylvania statewide hospital dataset (n = 2055). Latent class analysis assessed 12 comorbid conditions including substance use disorders (SUDs), mental health conditions, and infections. Multivariable logistic regressions examined the association between comorbidity classes and hospitalizations (all-cause, OUD-specific, SUD-related, mental health-related) during early (0–42 days) and late (43–365 days) postpartum.

Results

A three-class model best fit the data. Classes included low comorbidities (56.9% of sample; low prevalence of co-occurring conditions), moderate polysubstance/depression (18.4%; some SUDs, all with depression), and high polysubstance/bipolar disorder (24.7%; highest probabilities of SUDs and bipolar disorder). Overall, 14% had at least one postpartum hospitalization. From 0 to 42 days postpartum, the moderate polysubstance/depression and high polysubstance/bipolar disorder classes had higher odds of all-cause and mental health-related hospitalization, compared to the low comorbidities class. From 43 to 365 days postpartum, the high polysubstance/bipolar disorder class had higher odds of all-cause hospitalizations, while both the high polysubstance/depression and moderate polysubstance/bipolar disorder classes had higher odds of SUD-related and mental health-related hospitalizations compared to the low comorbidities class.

Conclusions

Findings highlight the need for long-term, multidisciplinary healthcare delivery interventions to address comorbidities and prevent adverse postpartum outcomes.

导言：患有阿片类药物使用障碍（OUD）的孕妇面临多种并发症，这些并发症可能会增加不良用药和健康后果的风险。本研究描述了患有阿片类药物滥用症的孕妇的合并症类型，并评估了这些类型与产后第一年住院治疗的相关性：宾夕法尼亚州全州医院数据集（n = 2055）确定了 2018 年分娩时患有 OUD 的孕妇队列。潜类分析评估了 12 种合并症，包括药物使用障碍 (SUD)、精神健康状况和感染。多变量逻辑回归检验了合并症类别与产后早期（0-42 天）和晚期（43-365 天）住院（全因、OUD 特定、SUD 相关、精神健康相关）之间的关联：结果：三类模型最符合数据。其中包括低合并症（占样本的 56.9%；合并症发生率低）、中度多种药物/抑郁症（18.4%；部分合并药物依赖，全部合并抑郁症）和高度多种药物/双相情感障碍（24.7%；合并药物依赖和双相情感障碍的概率最高）。总体而言，14%的人至少有一次产后住院经历。在产后 0 到 42 天内，中度多药/抑郁和高度多药/躁郁症与低合并症相比，全因住院和精神健康相关住院的几率更高。从产后43天到365天，多药/躁狂症程度高的患者因各种原因住院的几率更高，而多药/抑郁程度高的患者和多药/躁狂症程度中等的患者与合并症低的患者相比，与药物滥用相关的住院几率和与精神健康相关的住院几率都更高：研究结果突出表明，有必要采取长期、多学科的医疗保健服务干预措施，以解决合并症问题并预防产后不良后果的发生。

{"title":"Co-occurring conditions during pregnancy and hospitalizations in the first year postpartum among persons with opioid use disorder","authors":"Jessica Frankeberger , Robert W.S. Coulter , Marian Jarlenski , Elizabeth E. Krans , Christina Mair","doi":"10.1016/j.ypmed.2024.108057","DOIUrl":"10.1016/j.ypmed.2024.108057","url":null,"abstract":"<div><h3>Introduction</h3><p>Pregnant persons with opioid use disorder (OUD) face a multitude of comorbid conditions that may increase the risk of adverse drug and health outcomes. This study characterizes typologies of comorbidities among pregnant persons with OUD and assesses the associations of these typologies with hospitalizations in the first year postpartum.</p></div><div><h3>Methods</h3><p>A cohort of pregnant persons with OUD at delivery in 2018 were identified in a Pennsylvania statewide hospital dataset (<em>n</em> = 2055). Latent class analysis assessed 12 comorbid conditions including substance use disorders (SUDs), mental health conditions, and infections. Multivariable logistic regressions examined the association between comorbidity classes and hospitalizations (all-cause, OUD-specific, SUD-related, mental health-related) during early (0–42 days) and late (43–365 days) postpartum.</p></div><div><h3>Results</h3><p>A three-class model best fit the data. Classes included <em>low comorbidities</em> (56.9% of sample; low prevalence of co-occurring conditions), <em>moderate polysubstance/depression</em> (18.4%; some SUDs, all with depression), and <em>high polysubstance/bipolar disorder</em> (24.7%; highest probabilities of SUDs and bipolar disorder). Overall, 14% had at least one postpartum hospitalization. From 0 to 42 days postpartum, the moderate polysubstance/depression and high polysubstance/bipolar disorder classes had higher odds of all-cause and mental health-related hospitalization, compared to the low comorbidities class. From 43 to 365 days postpartum, the high polysubstance/bipolar disorder class had higher odds of all-cause hospitalizations, while both the high polysubstance/depression and moderate polysubstance/bipolar disorder classes had higher odds of SUD-related and mental health-related hospitalizations compared to the low comorbidities class.</p></div><div><h3>Conclusions</h3><p>Findings highlight the need for long-term, multidisciplinary healthcare delivery interventions to address comorbidities and prevent adverse postpartum outcomes.</p></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470328","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

Systemic inflammation response index is associated with increased all-cause and cardiovascular mortality in US adults with rheumatoid arthritis 全身炎症反应指数与美国成年类风湿性关节炎患者全因死亡率和心血管死亡率的增加有关。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-06-24 DOI: 10.1016/j.ypmed.2024.108055

Wei Wang , Wei Yao , Wanyun Tang , Yuhao Li , Qiaomei Lv , Wenbo Ding

Background

Rheumatoid arthritis (RA) stands as a persistent systemic inflammatory autoimmune condition. Despite this understanding, the precise impact of the systemic inflammation response index (SIRI) on the prognosis of RA patients remains elusive. This study aims to elucidate the correlation between the inflammatory biomarker SIRI and both all-cause mortality and cardiovascular mortality among RA patients.

Methods

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2020, a retrospective analysis was conducted. Survival data were depicted through Kaplan-Meier survival curves, while the relationship between SIRI and all-cause or cardiovascular mortality in RA patients was scrutinized via multivariable Cox proportional hazards regression analysis and restricted cubic spline plots. Furthermore, subgroup analysis and mediation analysis were also performed.

Results

This study encompassed 2656 RA patients with a comprehensive 20-year follow-up, during which 935 all-cause deaths and 273 deaths attributed to cardiovascular disease were recorded. We observed a nonlinear positive correlation between SIRI with both all-cause and cardiovascular mortality in RA patients. Notably, at a SIRI level of 1.12, the hazard ratio reached 1, indicating a shift from low to high mortality risk. Furthermore, mediation analysis revealed that 12.6% of the association between RA and mortality risk was mediated through SIRI. Subgroup analysis indicated a more pronounced association between SIRI and mortality in female patients or those with a high BMI.

Conclusion

This study underscores a non-linear positive correlation between the biomarker SIRI and both all-cause mortality and cardiovascular mortality in RA patients.

背景：类风湿性关节炎（RA）是一种持续性全身炎症性自身免疫疾病。尽管如此，全身炎症反应指数（SIRI）对类风湿性关节炎患者预后的确切影响仍然难以捉摸。本研究旨在阐明炎症生物标志物 SIRI 与 RA 患者全因死亡率和心血管死亡率之间的相关性：方法：利用美国国家健康与营养调查（NHANES）1999 年至 2020 年的数据进行回顾性分析。生存数据通过 Kaplan-Meier 生存曲线进行描述，SIRI 与 RA 患者全因或心血管死亡率之间的关系则通过多变量 Cox 比例危险回归分析和限制性立方样条图进行研究。此外，还进行了亚组分析和中介分析：本研究共对2656名RA患者进行了长达20年的全面随访，期间共记录了935例全因死亡和273例心血管疾病死亡。我们观察到，SIRI 与 RA 患者的全因死亡率和心血管死亡率之间存在非线性正相关。值得注意的是，当 SIRI 达到 1.12 时，危险比达到 1，表明死亡风险从低向高转移。此外，中介分析显示，12.6%的RA与死亡风险之间的关联是通过SIRI中介的。亚组分析表明，女性患者或体重指数高的患者的SIRI与死亡率之间的关系更为明显：本研究强调了生物标志物SIRI与RA患者全因死亡率和心血管死亡率之间的非线性正相关。

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引用次数: 0

Examining U.S. disparities in smoking among rural versus urban women of reproductive age: 2002–2019 研究美国农村与城市育龄妇女在吸烟方面的差异：2002-2019 年。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-06-22 DOI: 10.1016/j.ypmed.2024.108054

Stephen T. Higgins , Tyler Erath , Fang-Fang Chen

Objective

This study is part of a programmatic investigation of rural disparities in cigarette smoking examining disparities in smoking prevalence and for the first-time quit ratios among adult women of reproductive age (18–44 years), a highly vulnerable population due to risk for multigenerational adverse effects.

Methods

Data came from 18 years (2002–2019) of the U.S. National Survey on Drug Use and Health (NSDUH) among women (n = 280,626) categorized by rural-urban residence, pregnancy status, using weighted logistic regression models testing time trends and controlling for well-established sociodemographic predictors of smoking (race/ethnicity, education, income). Concerns regarding changes in survey methods used before 2002 and after 2019 precluded inclusion of earlier and more recent survey years in the present study.

Results

Overall smoking prevalence across years was greater in rural than urban residents (adjusted odds ratio [AOR] = 1.11; 95%CI, 1.07–1.15; P < .001) including those not-pregnant (AOR = 1.10; 1.07–1.14; P < .001) and pregnant (AOR = 1.29; 1.09–1.52; P < .001). Overall quit ratios across years were lower in rural than urban residents (AOR = 0.93; 0.87–0.99; P < .001) including those not-pregnant (AOR = 0.93; 0.88–1.00, P = .035) and pregnant (AOR = 0.78; 0.62–0.99; P = .039). Interactions of rural versus urban residence with study years for prevalence and quit ratios overall and by pregnancy status are detailed in the main text.

Conclusions

These results support a longstanding and robust rural disparity in smoking prevalence among women of reproductive age including those currently pregnant and provides novel evidence that differences in smoking cessation contribute to this disparity further underscoring a need for greater access to evidence-based tobacco control and regulatory interventions in rural regions.

研究目的本研究是对农村地区吸烟差异进行的一项计划性调查的一部分，调查对象为育龄成年女性（18-44 岁）中吸烟率和首次戒烟率的差异：数据来自美国全国药物使用和健康调查（NSDUH）18 年（2002-2019 年）的数据，按城乡居住地和怀孕状况对妇女（n = 280,626 人）进行分类，使用加权逻辑回归模型检验时间趋势，并控制已确立的吸烟社会人口预测因素（种族/民族、教育、收入）。考虑到 2002 年之前和 2019 年之后调查方法的变化，本研究未将较早和较近的调查年份纳入其中：结果：农村居民在不同年份的总体吸烟率高于城市居民（调整后的几率比 [AOR] = 1.11；95%CI，1.07-1.15；P 结论：这些结果支持了农村居民吸烟率的长期稳健增长：这些结果表明，农村育龄妇女（包括怀孕妇女）的吸烟率长期存在巨大差异，并提供了新的证据表明，戒烟方面的差异导致了这种差异，这进一步强调了农村地区需要更多的循证烟草控制和监管干预措施。

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引用次数: 0

Telework and 24-hour movement behaviours among adults living in Canada during the COVID-19 pandemic 科维德-19 大流行期间加拿大成年人的远程工作和 24 小时移动行为。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-06-22 DOI: 10.1016/j.ypmed.2024.108053

Stephanie A. Prince , Aviroop Biswas , Marisol T. Betancourt , Stephanie Toigo , Karen C. Roberts , Rachel C. Colley , Shawn Brule , Jean-Philippe Chaput , Justin J. Lang

Objective

To assess the association between work location and movement behaviours (physical activity [PA], screen time, sleep) and adherence to the Canadian 24-Hour Movement Guidelines (24-H Guidelines) among Canadian workers during the COVID-19 pandemic.

Methods

Using cross-sectional data from the 2021 Canadian Community Health Survey (n = 10,913 working adults 18–75 years), primary work location was categorized as: worked outside the home at a fixed location (fixed workplace), worked at home (telework), and worked outside the home at no fixed location (non-fixed workplace). Recreational, transportation and occupational/household PA, as well as leisure screen time and sleep duration were self-reported. Logistic regression assessed associations between work location and adherence to movement behaviour recommendations, adjusting for covariates.

Results

Compared to a fixed workplace, those teleworking reported more recreational PA (21.1 vs 17.0 min/day, p < 0.0001) and sleep (7.2 vs 7.1 h/night, p = 0.026) and were more likely to meet sleep duration recommendations (adjusted odds ratio [aOR] = 1.28, 95% CI: 1.08–1.51) and the 24-H Guidelines (aOR = 1.25, 95% CI: 1.04–1.51). Compared to fixed workplaces, those at non-fixed workplaces reported more occupational PA (62.7 vs 32.8 min/day, p < 0.0001) and less leisure screen time (2.5 vs 2.7 h/day, p = 0.021), and were more likely to meet the PA recommendation (aOR = 1.46, 95% CI: 1.15–1.85) and the 24-H Guidelines (aOR = 1.38, 95% CI: 1.09–1.75).

Conclusions

Results suggest that adherence to the 24-H Guidelines varies by work location, and work location should be considered when developing strategies to promote healthy movement behaviours. Future studies could explore hybrid work arrangements, and longitudinal study designs.

目的评估工作地点与运动行为（身体活动[PA]、屏幕时间、睡眠）之间的关系，以及在科威德-19大流行期间加拿大工人遵守《加拿大24小时运动指南》（24-H指南）的情况：利用 2021 年加拿大社区健康调查的横截面数据（n = 10,913 名 18-75 岁的工作成年人），将主要工作地点分为：在固定地点外出工作（固定工作场所）、在家工作（远程工作）和无固定地点外出工作（非固定工作场所）。娱乐、交通和职业/家庭活动量以及休闲屏幕时间和睡眠时间均为自我报告。逻辑回归评估了工作地点与坚持运动行为建议之间的关系，并对协变量进行了调整：结果：与固定工作场所相比，远程工作的人报告了更多的娱乐性 PA（21.1 分钟/天 vs 17.0 分钟/天，p 结论：结果表明，在远程工作的人中，有更多的人坚持运动行为建议：结果表明，工作地点不同，对《24 小时指南》的遵守程度也不同，因此在制定促进健康运动行为的策略时应考虑工作地点。未来的研究可以探索混合工作安排和纵向研究设计。

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引用次数: 0

Implementing an advanced team-based care model in a federally qualified health center (FQHC): Assessing implementation facilitators and challenges 在联邦合格医疗中心（FQHC）实施先进的团队护理模式：评估实施的促进因素和挑战。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-06-20 DOI: 10.1016/j.ypmed.2024.108044

Aesha K. Patel , Emily Stiehl , Natalie Siegel , Jeffrey Panzer , Chloe Edmiston , Emily Deis , Betsy Q. Cliff

Objective

The objective of this paper is to assess implementation facilitators and challenges for advanced team-based care (aTBC) in a federally qualified health center (FQHC). In aTBC, care team coordinators room patients, perform vitals and agenda setting during patient intake, and remain present alongside providers during patient visits.

Methods

The authors conducted a qualitative post-hoc analysis of the aTBC implementation using data from several sources. They used content analysis to code items as facilitators or challenges and thematic analysis to group those into larger themes. Finally, they applied a priori codes from the revised consolidated framework for implementation research (CFIR) to organize the facilitators and barriers into subdomains.

Results

The existing evidence-base around aTBC, the FQHC's ability to pilot and adapt it, and strong implementation leads were key facilitating factors. Challenges included an external shock (i.e., the COVID-19 pandemic), aTBC complexity, and uncertainty about whether success required implementation of the full model versus easier-to-integrate smaller components.

Conclusions

FQHCs that wish to implement aTBC models need strong champions and internal structures for piloting, adapting, and disseminating interventions. FQHC leaders must think strategically about how to build support and demonstrate success to improve an FQHC's chances of expanding and sustaining aTBC.

目的：本文旨在评估联邦合格医疗中心（FQHC）实施高级团队护理（aTBC）的促进因素和挑战。在 aTBC 中，护理团队协调员为患者安排房间，在患者入院时进行生命体征测量和议程设置，并在患者就诊时与医疗服务提供者一起在场：作者利用多个来源的数据对 aTBC 的实施情况进行了事后定性分析。他们使用内容分析法将项目编码为促进因素或挑战，并使用主题分析法将这些项目归纳为更大的主题。最后，他们运用修订后的实施研究综合框架（CFIR）中的先验代码，将促进因素和障碍组织成子领域：结果：TBC 的现有证据基础、FQHC 的试点和调整能力以及强有力的实施领导是关键的促进因素。挑战包括外部冲击（即 COVID-19 大流行）、aTBC 的复杂性，以及不确定成功是否需要实施完整的模式，还是更容易整合的较小组成部分：希望实施 aTBC 模式的 FQHC 需要强有力的支持者和内部机构来试点、调整和推广干预措施。联邦定点医疗保健机构的领导者必须从战略角度考虑如何建立支持和展示成功，以提高联邦定点医疗保健机构扩大和维持传统治疗方法的机会。

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引用次数: 0

Patterns and drivers of disparities in pediatric asthma outcomes among Medicaid-enrolled children living in subsidized housing in NYC 居住在纽约市补贴住房中的享受医疗补助的儿童患小儿哮喘的模式和原因。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2024-06-20 DOI: 10.1016/j.ypmed.2024.108023

Andrea R. Titus , Kelly Terlizzi , Sarah Conderino , Lan N. Ðoàn , Byoungjun Kim , Lorna E. Thorpe

Objective

There are persistent disparities in pediatric asthma morbidity in the U.S. We linked claims data with information on neighborhood-level risk factors to explore drivers of asthma disparities among Medicaid-enrolled children in New York City subsidized housing.

Methods

We constructed a cohort of Medicaid-enrolled children living in public or other subsidized housing, based on residential address, in NYC between 2016 and 2019 (n = 108,969). We examined claims-derived asthma prevalence across age and racial and ethnic groups, integrating census tract-level information and using the Bayesian Improved Surname Geocoding (BISG) algorithm to address high rates of missing data in self-reported race and ethnicity. We used inverse probability weighting (IPW) to explore the extent to which disparities persisted when exposure to asthma risk factors – related to the built environment, neighborhood poverty, and air quality – were balanced across groups. This analysis was conducted in 2022–2023.

Results

Claims-derived asthma prevalence was highest among children <7 years at baseline and among non-Hispanic Black and Hispanic children. For example, among children aged 3–6 years at baseline, claims-derived prevalence was 17.3% and 18.1% among non-Hispanic Black and Hispanic children, respectively, compared to 9.3% and 9.0% among non-Hispanic White and non-Hispanic Asian American/Pacific Islander children. Using IPW to balance exposure to asthma risk factors across racial and ethnic groups attenuated, but did not eliminate, disparities in asthma prevalence.

Conclusions

We found high asthma burden among children living in subsidized housing. Modifiable place-based characteristics may be important contributors to pediatric asthma disparities.

目的：我们将理赔数据与邻里层面的风险因素信息联系起来，以探讨纽约市补贴住房中的医疗补助参保儿童的哮喘差异驱动因素：我们构建了一个队列，其中包括 2016 年至 2019 年期间居住在纽约市公共或其他补贴住房中的医疗补助参保儿童，以居住地址为依据（n = 108969）。我们研究了不同年龄段、种族和民族群体的索赔衍生哮喘患病率，整合了人口普查区级信息，并使用贝叶斯改进姓氏地理编码（BISG）算法来解决自我报告的种族和民族数据缺失率高的问题。我们使用反概率加权法（IPW）来探讨当暴露于哮喘风险因素（与建筑环境、邻里贫困和空气质量有关）的程度在各组间保持平衡时，差异的持续程度。该分析于 2022-2023 年进行：儿童的哮喘发病率最高：我们发现居住在补贴住房中的儿童的哮喘负担很重。可改变的地方特征可能是造成儿科哮喘差异的重要因素。

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引用次数: 0