Preventive medicine最新文献_第9页

Maintaining healthy lifestyle behaviours in the era of social media: Challenges and solutions 在社交媒体时代保持健康的生活方式：挑战和解决方案

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-08-24 DOI: 10.1016/j.ypmed.2025.108395

Jean-Philippe Chaput , Allana G. LeBlanc

Objective

To examine the dual role of social media in influencing lifestyle behaviours relevant to chronic disease prevention and to propose strategies that align digital environments with public health objectives.

Methods

This commentary synthesizes recent evidence on the associations between social media use and health behaviours, including physical activity, nutrition, sleep, and sedentary time. It draws on research from public health, behavioural science, and digital media studies to highlight both risks and opportunities.

Results

Evidence shows that prolonged and unregulated social media engagement contributes to increased sedentary time, sleep disruption, poor dietary choices, exposure to targeted marketing of unhealthy products, unrealistic body ideals, and health misinformation. Conversely, social media can be harnessed to promote behaviour change through scalable interventions such as social support, self-monitoring, and goal setting.

Conclusions

Addressing the challenges posed by social media requires coordinated, multi-level strategies. These include redesigning digital environments with health-promoting defaults, regulating harmful commercial exposures, leveraging platforms for evidence-based health promotion, strengthening digital literacy, and introducing school-based smartphone restrictions. Aligning platform design and governance with public health goals is essential to mitigating risks, supporting healthy behaviours, and improving population health outcomes.

目的研究社交媒体在影响与慢性病预防相关的生活方式行为方面的双重作用，并提出使数字环境与公共卫生目标保持一致的战略。这篇评论综合了最近关于社交媒体使用与健康行为（包括身体活动、营养、睡眠和久坐时间）之间关系的证据。它借鉴了公共卫生、行为科学和数字媒体研究方面的研究，以突出风险和机遇。结果有证据表明，长时间和不受监管的社交媒体参与会导致久坐时间增加、睡眠中断、不良饮食选择、接触不健康产品的定向营销、不切实际的身体理想和健康错误信息。相反，社交媒体可以通过社会支持、自我监控和目标设定等可扩展的干预措施来促进行为改变。应对社交媒体带来的挑战需要协调的、多层次的战略。这些措施包括重新设计具有促进健康默认值的数字环境，规范有害的商业暴露，利用基于证据的健康促进平台，加强数字素养，以及引入基于学校的智能手机限制。使平台设计和治理与公共卫生目标保持一致，对于减轻风险、支持健康行为和改善人口健康结果至关重要。

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引用次数: 0

Association between midlife intake of ultra-processed foods and later-life subjective cognitive complaints: Evidence from the new York University women's health study 中年摄入超加工食品与晚年主观认知抱怨之间的关系：来自纽约大学妇女健康研究的证据

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-08-21 DOI: 10.1016/j.ypmed.2025.108390

Kejia Zhang , Fen Wu , Tess V. Clendenen , Yelena Afanasyeva , Yian Gu , Karen L. Koenig , Anne Zeleniuch-Jacquotte , Yu Chen

Objective

Research into risk factors for subjective cognitive complaints (SCCs) may offer insight into the etiology and prevention of Alzheimer's disease. Ultra-processed foods (UPFs) contain food additives that improve palatability and processed raw materials. Evidence is limited on the role of mid-life UPF intake in the development of late-life SCCs.

Methods

We included 5119 participants who responded to the 2018 or 2020 follow-up of the New York University Women's Health Study, a prospective cohort of 14,274 women recruited in New York City, United States, in 1985–91. Data on diet were collected at baseline using a validated modified Block food frequency questionnaire. Energy-adjusted total intake of UPFs and subgroups of UPFs, defined following the nova guidelines, were estimated using the residual method.

Results

The odds ratios (ORs) and 95 % confidence intervals (CIs) for reporting ≥2 SCCs were 1.15 (0.94–1.39), 1.06 (0.87–1.30), 1.20 (0.99–1.46), and 1.24 (1.02–1.51) for women in the 2nd, 3rd, 4th, and 5th quintiles of energy-adjusted UPF intake, respectively, compared to those in the bottom quintile (p-trend = 0.02). The associations were similar in sensitivity analyses using Multiple Imputation and Inverse Probability Weighting to account for potential selection bias.

Conclusions

Higher UPF intakes in midlife were associated with higher odds of late-life SCCs in women.

目的研究主观认知主诉（SCCs）的危险因素，为阿尔茨海默病的病因和预防提供新的思路。超加工食品（upf）含有食品添加剂，可改善适口性和加工原料。关于中年UPF摄入在晚期SCCs发展中的作用的证据有限。方法：我们纳入了5119名参与者，他们对纽约大学女性健康研究的2018年或2020年随访做出了回应，这是一个1985-91年在美国纽约市招募的14274名女性的前瞻性队列。饮食数据在基线时使用经过验证的改良Block食物频率问卷收集。根据nova指南定义的upf和upf亚组的能量调整总摄入量使用残差法进行估计。结果能量调节UPF摄入第二、三、四、五分位数女性报告≥2个SCCs的优势比（ORs）和95%可信区间（ci）分别为1.15（0.94-1.39）、1.06（0.87-1.30）、1.20（0.99-1.46）和1.24(1.02-1.51)，与最低五分位数女性相比（p趋势= 0.02）。在使用多重输入和逆概率加权来解释潜在的选择偏差的敏感性分析中，这些关联是相似的。结论较高的UPF摄入量与女性晚年SCCs的发生率相关。

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引用次数: 0

Inequities in food security by sexual orientation in the United States 美国性取向导致的食品安全不平等

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-08-20 DOI: 10.1016/j.ypmed.2025.108391

Alexandra Balshi , John P. Dempsey , Hannah R. Thompson , Mary W. Montgomery

Objective

To determine if sexual minority (gay, lesbian, bisexual, or another [LGB+] sexual orientation) identity independently contributes to food insecurity while accounting for other social drivers of health (SDoH) like race, education, employment, supplemental nutrition assistance program (SNAP) participation, and mental illness.

Methods

We performed multivariate logistic regression of 2019–2023 National Health Interview Surveys to determine any relationship between LGB+ identity and 30-day food security scale responses.

Results

We included 130,656 participants, representing 235,728,318 Americans by weighted sampling. Among those eligible, there was no difference in SNAP utilization between LGB+ and heterosexual individuals (odds ratio: 1.12, 95 % confidence interval: 0.97–1.30). However, LGB+ individuals had 1.53 times higher odds of very low food security (95 % confidence interval: 1.31–1.79) even after adjusting for SDoH and mental illness.

Conclusion

Despite similar SNAP enrollment, LGB+ individuals remain disproportionately food insecure, suggesting that structural or systemic barriers not addressed through federal food assistance programs contribute to elevated risk.

目的确定性少数群体（男同性恋、女同性恋、双性恋或其他[LGB+]性取向）身份是否独立导致粮食不安全，同时考虑种族、教育、就业、补充营养援助计划（SNAP）参与和精神疾病等其他社会健康驱动因素。方法对2019-2023年全国健康访谈调查进行多元logistic回归，以确定LGB+身份与30天食品安全量表反应之间的关系。结果我们通过加权抽样纳入130,656名参与者，代表235,728,318名美国人。在符合条件的人群中，LGB+和异性恋个体在SNAP使用方面没有差异（优势比：1.12,95%可信区间：0.97-1.30）。然而，即使在调整了SDoH和精神疾病之后，LGB+个体的食物安全非常低的几率（95%置信区间：1.31-1.79）高出1.53倍。尽管有类似的SNAP招募，LGB+个体仍然不成比例地保持粮食不安全，这表明没有通过联邦食品援助计划解决的结构性或系统性障碍导致风险升高。

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引用次数: 0

Electronic cigarettes and pregnancy: A social media content analysis 电子烟与怀孕：一项社交媒体内容分析。

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-08-13 DOI: 10.1016/j.ypmed.2025.108387

Grace Kong, Rachel R. Ouellette, Amanda de la Noval, Christina N. Kyriakos, Vanessa Ponte, Elise E. DeVito

Objective

Electronic cigarette (e-cigarette) use during pregnancy is a polarizing and complex public health topic. We examined social media content on e-cigarette use during pregnancy.

Methods

We content analyzed 170 TikTok posts about e-cigarettes and pregnancy in 2023. We coded message valence (anti-, pro-, mixed/unclear/neutral), messenger characteristics (age, gender, pregnancy status, healthcare provider status, e-cigarette and cigarette use), geographic origin, and engagement metrics (likes, favorites, shares, downloads, comments, followers). We assessed whether engagement and message valence differed by messenger and post characteristics using Chi-Square and Kruskal-Wallis tests.

Results

Posts included 55 % (n = 93) anti-, 32.4 % (n = 55) mixed/unclear/neutral, and 12.9 % (n = 22) pro-e-cigarette use during pregnancy messages. Messenger characteristics included 90.6 % (n = 144) female, 53.5 % (n = 85) 18 to 30 years old, 40.9 % (n = 65) pregnant, 7.5 % (n = 12) healthcare providers. Geographic origin included 66.5 % (n = 113) from the United States and 22.9 % (n = 39) from the United Kingdom. Engagement was high, with some videos receiving over 2 million “plays” and 500 thousand “likes.” Posts by healthcare providers and messengers over 45 years old had more followers (ps < 0.001). Posts with messengers who quit e-cigarettes, from the US, and 18–45 years old were more likely to contain anti-e-cigarette content, whereas posts from the United Kingdom were more likely to have pro-e-cigarette content (ps ≤ 0.001).

Conclusions

A wide range of content on e-cigarette use and pregnancy was observed on TikTok. Future research is needed to understand how pregnant individuals navigate this content. Healthcare providers may be effective messengers for promoting e-cigarette cessation during pregnancy on social media.

目的：孕期使用电子烟是一个两极分化且复杂的公共卫生话题。我们研究了怀孕期间使用电子烟的社交媒体内容。方法：我们对2023年TikTok上170篇关于电子烟和怀孕的帖子进行了内容分析。我们对信息的价值（反对、支持、混合/不明确/中立）、信息特征（年龄、性别、怀孕状况、医疗服务提供者状况、电子烟和香烟使用）、地理来源和参与指标（喜欢、收藏、分享、下载、评论、关注者）进行了编码。我们使用卡方检验和Kruskal-Wallis检验来评估参与和信息效价是否因信使和帖子特征而不同。结果:文章包括55 % (n = 93)反,32.4 % (n = 55)混合/不清楚/中性,和12.9 % (n = 22)怀孕期间pro-e-cigarette使用消息。信使特征包括90.6 % (n = 144)女,53.5 % (n = 85)18到30 岁40.9 % (n = 65)怀孕了,7.5 % (n = 12)卫生保健提供者。地理来源包括66.5 % （n = 113）来自美国，22.9 % （n = 39）来自英国。用户参与度很高，一些视频获得了超过200万次“播放”和50万次“赞”。结论：在TikTok上观察到有关电子烟使用和怀孕的广泛内容。未来的研究需要了解孕妇如何浏览这些内容。医疗保健提供者可能是在社交媒体上宣传怀孕期间戒烟电子烟的有效信使。

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引用次数: 0

Adverse childhood experiences, resilience, and substance use during early pregnancy 不良的童年经历、恢复力和怀孕早期的药物使用。

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-08-13 DOI: 10.1016/j.ypmed.2025.108388

Kelly C. Young-Wolff , Mariah S. Wood , Sara R. Adams , Monique B. Does , Deborah Ansley , Carley Castellanos , Maria T. Koshy , Carey R. Watson

Objective

Adverse childhood experiences (ACEs) are common risk factors for unhealthy behaviors and poor health outcomes throughout the life course, but their relationship with prenatal substance use is understudied. This retrospective cohort study included 44,284 patients with pregnancies between January 1, 2022, and June 28, 2024, in a large healthcare system in Northern California, United States of America with universal screening for ACEs, resilience, and substance use during early pregnancy.

Methods

Multivariable regression models examined the relationship between ACEs and prenatal substance use and tested whether resilience moderated these associations.

Results

Pregnant individuals with a greater number of ACEs had lower resilience, were younger, more likely to be Black, Non-Hispanic White, or Hispanic, and live in an area with greater neighborhood deprivation. In adjusted models, compared to those without ACEs, those with ACEs had a higher adjusted prevalence of prenatal alcohol use, cannabis use, nicotine use, pharmaceutical opioid use, stimulant use, and multiple substance use. Low resilience was independently associated with an increased prevalence of prenatal substance use.

Conclusions

Results indicate that routine screening for ACEs may help identify pregnant individuals at risk for prenatal substance use, allowing for earlier linkage to resources and potentially improved maternal and child outcomes.

目的：不良童年经历（Adverse childhood experiences）是一生中不健康行为和不良健康结果的常见危险因素，但其与产前药物使用的关系尚不清楚。这项回顾性队列研究纳入了44284名在2022年1月1日至2024年6月28日期间怀孕的患者，这些患者来自美国北加州的一个大型医疗保健系统，对妊娠早期的不良童年经历、恢复能力和药物使用进行了普遍筛查。方法：多变量回归模型检验了不良童年经历与产前物质使用之间的关系，并测试了弹性是否调节了这些关联。结果：童年不良经历较多的孕妇适应力较低，年龄更小，更可能是黑人、非西班牙裔白人或西班牙裔，并且生活在更严重的邻里剥夺地区。在调整后的模型中，与没有不良童年经历的人相比，有不良童年经历的人在产前饮酒、大麻使用、尼古丁使用、阿片类药物使用、兴奋剂使用和多种物质使用方面的调整患病率更高。低恢复力与产前药物使用的流行率增加独立相关。结论：结果表明，对不良童年经历的常规筛查可能有助于识别有产前药物使用风险的孕妇，从而允许更早地与资源联系，并可能改善孕产妇和儿童的结局。

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引用次数: 0

Association between an active lifestyle and reduced incidence of obesity-related cancers in the Seguimiento Universidad de Navarra cohort Seguimiento university de Navarra队列中积极的生活方式与减少肥胖相关癌症发病率之间的关系

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-08-08 DOI: 10.1016/j.ypmed.2025.108386

Maite Bastyr-Diego , Maria Barbería-Latasa , Maria Olmedo , Alfredo Gea , Maira Bes-Rastrollo , Miguel Ángel Martínez-González , Estefania Toledo

Objective

To assess whether physical activity, sedentary behavior, and an active lifestyle score, combining physical activity and sedentary behavior, are associated with developing obesity-related cancers (ORCs).

Methods

From 1999 through 2022, a cohort of Spanish university graduates was followed using biennial questionnaires collecting data on sociodemographic characteristics, clinical diagnoses, and lifestyle factors. We used a previously validated questionnaire to assess physical and sedentary activities (television watching+sitting time), from which we estimated an eight-item active lifestyle score. Cancer incidence was confirmed with medical records and the National Death Index. Multivariable-adjusted hazard ratios (HRs) were estimated with Cox regression models.

Results

Higher adherence to the active lifestyle score nearly halved the risk of ORCs (HR high vs. low 0.45 (95 %CI 0.27–0.73)). The HR in quartile four (Q4) of leisure-time physical activity was 0.54 (95 %CI 0.37–0.80) compared to Q1. The HR per +1-point increase in the score was 0.88 (95 %CI 0.81–0.95). No significant association was observed between television watching and ORCs risk.

Conclusions

A higher active lifestyle score was associated with a decreased risk of ORCs. These findings may aid public health organizations in refining recommendations in ORC prevention to include interventions focused on combining increased physical activity and lowered sedentary behavior.

目的：评估身体活动、久坐行为和积极生活方式评分（结合身体活动和久坐行为）是否与肥胖相关癌症（ORCs）的发生有关。方法：从1999年到2022年，对一组西班牙大学毕业生进行了两年一次的问卷调查，收集了社会人口统计学特征、临床诊断和生活方式因素的数据。我们使用先前验证过的问卷来评估身体和久坐不动的活动（看电视+坐着的时间），从中我们估计了8项积极生活方式的得分。癌症发病率通过医疗记录和国家死亡指数得到确认。采用Cox回归模型估计多变量校正风险比（hr）。结果：坚持积极生活方式得分越高，发生ORCs的风险几乎减半（HR高比低0.45(95 %CI 0.27-0.73)）。与Q1相比，第四分位数（Q4）的休闲时间身体活动的HR为0.54（95 %CI 0.37-0.80）。每增加1分，HR为0.88（95 %CI 0.81-0.95）。没有观察到电视观看与ORCs风险之间的显著关联。结论：积极生活方式评分的增加与ORCs风险的降低相关。这些发现可能有助于公共卫生组织完善ORC预防建议，包括集中于增加体育活动和减少久坐行为的干预措施。

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引用次数: 0

The heterogeneity of youth at risk of prediabetes and diabetes: A latent class analysis of a United States national sample 青少年糖尿病前期和糖尿病风险的异质性：美国国家样本的潜在分类分析。

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-08-07 DOI: 10.1016/j.ypmed.2025.108384

Catherine McDonough , Yan Chak Li , Gaurav Pandey , Nita Vangeepuram , Bian Liu

Objective

Prediabetes and diabetes are complex conditions associated with interrelated factors from multiple domains, including lifestyle, health, and sociodemographic status. We aimed to identify youth subgroups with co-occurring features from these domains to inform prevention and intervention efforts.

Methods

We analyzed data from 1278 adolescents (ages 12–17 years) from the 2011–2018 United States National Health and Nutrition Examination Surveys. Prediabetes/diabetes was defined using hemoglobin A1c (≥5.7 mg/dL) and/or fasting plasma glucose (≥100 mg/dL). We applied latent class analysis of physical activity, diet quality, screen time, and body mass index (BMI) identified subgroups adjusting for sociodemographic factors. Associations between latent class membership and prediabetes/diabetes were assessed using survey-weighted logistic regression.

Results

Four classes emerged: High BMI and unhealthy lifestyle (37.5 %), Healthy BMI and physically active (24.7 %), Healthy BMI and lifestyle (16.0 %), and Average BMI and lifestyle (21.8 %). Compared to youth in the High BMI and unhealthy lifestyle class, youth in the other three classes all had lower odds of prediabetes/diabetes, where the adjusted odds ratio was 0.56 (95 % CI: 0.33–0.95) for youth of the Healthy BMI and active class, 0.46 (95 % CI: 0.21–1.01) for youth in the Healthy BMI and lifestyle class, and 0.68 (95 % CI: 0.42–1.10) for youth in the Average BMI and lifestyle class.

Conclusions

The latent class analysis revealed four youth subgroups with different lifestyle, health, and sociodemographic characteristics, and youth prediabetes/diabetes status was associated with the latent class membership. The results suggest potential heterogeneous interventions over one-size-fits-all approaches to mitigate prediabetes/diabetes risk among youth.

目的：前驱糖尿病和糖尿病是一种复杂的疾病，与生活方式、健康状况和社会人口状况等多个领域的相互关联因素有关。我们的目的是确定具有这些领域共同发生特征的青年亚群体，为预防和干预工作提供信息。方法：我们分析了2011-2018年美国国家健康与营养检查调查中1278名青少年（12-17 岁）的数据。糖尿病前期/糖尿病的定义是血红蛋白A1c（≥5.7 mg/dL）和/或空腹血糖（≥100 mg/dL）。我们对身体活动、饮食质量、屏幕时间和身体质量指数（BMI）进行了潜在分类分析，确定了经社会人口因素调整后的亚组。使用调查加权逻辑回归评估潜在类别成员与前驱糖尿病/糖尿病之间的关联。结果分为高BMI与不健康生活方式（37.5% %）、健康BMI与运动（25.3% %）、健康BMI与生活方式（16.0% %）和平均BMI与生活方式（21.8% %）4类。与高BMI和不健康生活方式组的年轻人相比，其他三个组的年轻人患前驱糖尿病/糖尿病的几率都较低，其中健康BMI和活跃组的校正比值比为0.56(95 % CI: 0.33-0.95)，健康BMI和生活方式组的校正比值比为0.46(95 % CI: 0.21-1.01)，平均BMI和生活方式组的校正比值比为0.68（95 % CI: 0.42-1.10）。结论：潜在阶级分析揭示了四个具有不同生活方式、健康和社会人口学特征的青年亚组，青年糖尿病前期/糖尿病状态与潜在阶级成员相关。结果表明，在一刀切的方法中，潜在的异质性干预措施可以减轻青少年糖尿病前期/糖尿病风险。

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引用次数: 0

Food insufficiency and difficulty affording expenses after the end of Supplemental Nutrition Assistance Program emergency allotments in the United States among households with and without children 在美国有孩子和没有孩子的家庭中，在补充营养援助计划紧急拨款结束后，食物不足和负担费用困难

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-08-07 DOI: 10.1016/j.ypmed.2025.108385

Anna E. Austin , Stephanie Ettinger de Cuba , Courtney N. Maierhofer , Rebecca B. Naumann , May Chen , Kayla N. Anderson , Paul R. Shafer

Objective

Emergency allotments were issued in the Supplemental Nutrition Assistance Program (SNAP), the largest program addressing food insecurity in the United States, during the COVID-19 pandemic. These emergency allotments temporarily increased the amount of monthly food purchasing assistance received by SNAP-participating households. Our aim was to examine the association of the end of SNAP emergency allotments with food insufficiency and difficulty affording expenses, overall and among households with and without children.

Methods

We used March 2021–April 2022 Household Pulse Survey data from respondents in four states that ended emergency allotments in August 2021 (“earlier ender” states) and eight states that ended emergency allotments after the end of the study period (comparison states). We conducted difference-in-differences analyses to compare changes in the risk of food insufficiency and difficulty affording expenses from before to after the end of emergency allotments in August 2021 between SNAP-participating households in “earlier ender” states and comparison states.

Results

Earlier ending of SNAP emergency allotments was associated with a 5.0 percentage point increase in the risk of food insufficiency (risk difference (RD) = 0.05, 95 % confidence interval (CI) 0.03, 0.07) and an 8.0 percentage point increase in the risk of difficulty affording expenses (RD = 0.08, 95 % CI 0.06, 0.09). The increase in the risk of food insufficiency was slightly larger for households with children (RD = 0.06, 95 % CI 0.03, 0.09) than households without children (RD = 0.04, 95 % CI 0.00, 0.08).

Conclusions

SNAP benefit reductions after the end of emergency allotments were associated with difficulty affording food and household expenses among households with and without children.

在2019冠状病毒病大流行期间，补充营养援助计划（SNAP）是解决美国粮食不安全问题的最大计划，并发放了紧急拨款。这些紧急拨款暂时增加了参与该计划的家庭每月获得的粮食购买援助数额。我们的目的是研究SNAP紧急拨款结束与食物不足和负担费用困难之间的关系，无论是在总体上还是在有孩子和没有孩子的家庭中。我们使用了2021年3月至2022年4月来自四个在2021年8月结束紧急拨款的州（“提前结束”州）和八个在研究期结束后结束紧急拨款的州（比较州）的受访者的家庭脉搏调查数据。我们进行了差异中差异分析，以比较2021年8月“提前结束”州和比较州参与snap的家庭在紧急拨款结束前后食物不足风险和支付费用困难方面的变化。结果提前结束SNAP紧急拨款与食物不足风险增加5.0个百分点(风险差（RD) = 0.05, 95%置信区间（CI） 0.03, 0.07）和负担费用困难风险增加8.0个百分点（RD = 0.08, 95% CI 0.06, 0.09）相关。有孩子的家庭食物不足风险的增加略大于没有孩子的家庭（RD = 0.04, 95% CI 0.00, 0.08）（RD = 0.06, 95% CI 0.03, 0.09）。结论：在紧急分配结束后，snap福利减少与有孩子和没有孩子的家庭难以负担食物和家庭开支有关。

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引用次数: 0

Corrigendum to “Reducing perceived barriers to scaling up overdose education and naloxone distribution and medications for opioid use disorder in the United States in the HEALing (Helping End Addiction Long-Term®) communities study” [Preventive Medicine Volume 185 (2024) 108034] “在美国康复（帮助结束长期成瘾®）社区研究中，减少对扩大过量教育和纳洛酮分布和阿片类药物使用障碍的感知障碍”[预防医学卷185(2024)108034]的勘误。

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-08-07 DOI: 10.1016/j.ypmed.2025.108383

Hannah K. Knudsen , Daniel M. Walker , Nicole Mack , Elizabeth N. Kinnard , Timothy R. Huerta , LaShawn Glasgow , Louisa Gilbert , Bryan R. Garner , Anindita Dasgupta , Redonna Chandler , Sharon L. Walsh , Yjuliana Tin , Sylvia Tan , Joel Sprunger , Linda Sprague Martinez , Pamela Salsberry , Merielle Saucier , Maria Rudorf , Sandra Rodriguez , Carrie B. Oser , Mari-Lynn Drainoni

引用次数: 0

Changes in health behaviors and risk of cardiovascular disease among midlife and aging municipal employees with and without metabolic risk factors: A register-linkage cohort study in Finland 芬兰有或没有代谢危险因素的中老年市政雇员健康行为和心血管疾病风险的变化：一项登记连锁队列研究

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-08-05 DOI: 10.1016/j.ypmed.2025.108379

Jaakko Harkko , Olli Pietiläinen , Pekka Jousilahti , Antti Etholén , Luka Vähäsarja , Eero Teppo , Novartis Foundation AI4HealthyCities Group, Tea Lallukka

Objective

To investigate associations between changes in health behaviors and cardiovascular disease (CVD) risk among municipal employees, stratified by baseline metabolic risk factors (hypertension, hypercholesterolemia, obesity, diabetes).

Methods

We followed 4470 municipal employees in Helsinki, Finland (74 % women; median age 56.1 years) for an average of 11 years (2007–2022) to assess incident CVD. Survival curves estimated median survival differences, and hazard ratios (HRs) evaluated CVD risk related to changes in smoking, physical activity, alcohol consumption, diet, and sleep.

Results

During the follow-up, 1879 (42 %) individuals developed CVD. Among those without metabolic risk factors, improvement in health behavior score was linked to reduced CVD risk and an 8.1-year longer median survival (HR = 0.59, 95 % CI = 0.41–0.86). Across metabolic risk-factor groups, the most considerable reductions were observed in the transition from physical inactivity to activity among individuals with hypertension (HR = 0.66, 95 % CI = 0.49–0.87), diabetes (HR = 0.51, 95 % CI = 0.30–0.87), and obesity (HR = 0.63, 95 % CI = 0.43–0.93).

Conclusions

Changes in health behaviors were associated with CVD risk, varying by metabolic factors. Findings support targeted interventions to promote behavior change, particularly increasing physical activity in those with metabolic risks.

目的：通过基线代谢危险因素（高血压、高胆固醇血症、肥胖、糖尿病）分层，探讨市政职工健康行为变化与心血管疾病（CVD）风险的关系。方法：对芬兰赫尔辛基4470名市政雇员进行随访(74% 为女性；中位年龄56.1 岁)，平均11 岁（2007-2022年）来评估心血管疾病的发生率。生存曲线估计中位生存差异，风险比（hr）评估与吸烟、体育活动、饮酒、饮食和睡眠变化相关的心血管疾病风险。结果：随访期间，1879人（42 %）发生心血管疾病。在没有代谢危险因素的患者中，健康行为评分的改善与心血管疾病风险降低和中位生存期延长8.1年相关（HR = 0.59,95% % CI = 0.41-0.86）。在代谢危险因素组,最可观的减少从缺乏身体活动过渡到活动中观察高血压患者中(HR = 0.66,95 CI  % = 0.49 - -0.87)、糖尿病(HR = 0.51,95 CI  % = 0.30 - -0.87),和肥胖(HR = 0.63,95 CI  % = 0.43 - -0.93)。结论：健康行为的改变与CVD风险相关，且随代谢因素的变化而变化。研究结果支持有针对性的干预措施，以促进行为改变，特别是增加有代谢风险的人的身体活动。

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