Pub Date : 2025-07-23DOI: 10.1016/j.ypmed.2025.108373
Javeria Akhter , Javed Iqbal , Syed Muhammad Ali
{"title":"Beyond biomarkers: Underexplored considerations in standardized research electronic cigarette trials for people with HIV who smoke","authors":"Javeria Akhter , Javed Iqbal , Syed Muhammad Ali","doi":"10.1016/j.ypmed.2025.108373","DOIUrl":"10.1016/j.ypmed.2025.108373","url":null,"abstract":"","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"201 ","pages":"Article 108373"},"PeriodicalIF":3.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718333","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}
Pub Date : 2025-07-23DOI: 10.1016/j.ypmed.2025.108375
Vivian Romero , Elise Rivera
Objective
Co-creation, a collaborative process of engaging with stakeholders to define complex problems and design solutions that are contextually relevant to stakeholders' needs, has gained traction in public health and preventive medicine to address “wicked problems” through meaningful engagement with stakeholders. The way in which co-creation approaches are used and/or described in public health are not always entirely clear. How might we enhance co-creation processes to improve health? The objective of this commentary is to argue for the integration of human-centred design thinking (HCDT) to direct co-creation processes by defining its framework and use of empathetic perspectives and iterative problem framing.
Methods
This commentary defines human-centred design thinking HCDT as a framework for co-creation with an emphasis on divergent and convergent thinking and introduces designer mindsets. The role of empathy and problem framing is explored using examples from the field.
Results
This commentary argues for the added value of applying HCDT as an approach to co-creation in public health and provides tools associated with this process that can complement traditional co-creation processes, such as the Double Diamond model, HCDT field guides with detailed and established activities, “designerly ways of knowing”, empathy mapping, and problem reframing.
Conclusions
By integrating HCDT into co-creation processes, we can foster deeper empathetic responses and problem framing through collaboration.
{"title":"Human-centred design thinking as a co-creation process: A commentary","authors":"Vivian Romero , Elise Rivera","doi":"10.1016/j.ypmed.2025.108375","DOIUrl":"10.1016/j.ypmed.2025.108375","url":null,"abstract":"<div><h3>Objective</h3><div>Co-creation, a collaborative process of engaging with stakeholders to define complex problems and design solutions that are contextually relevant to stakeholders' needs, has gained traction in public health and preventive medicine to address “wicked problems” through meaningful engagement with stakeholders. The way in which co-creation approaches are used and/or described in public health are not always entirely clear. How might we enhance co-creation processes to improve health? The objective of this commentary is to argue for the integration of human-centred design thinking (HCDT) to direct co-creation processes by defining its framework and use of empathetic perspectives and iterative problem framing.</div></div><div><h3>Methods</h3><div>This commentary defines human-centred design thinking HCDT as a framework for co-creation with an emphasis on divergent and convergent thinking and introduces designer mindsets. The role of empathy and problem framing is explored using examples from the field.</div></div><div><h3>Results</h3><div>This commentary argues for the added value of applying HCDT as an approach to co-creation in public health and provides tools associated with this process that can complement traditional co-creation processes, such as the Double Diamond model, HCDT field guides with detailed and established activities, “designerly ways of knowing”, empathy mapping, and problem reframing.</div></div><div><h3>Conclusions</h3><div>By integrating HCDT into co-creation processes, we can foster deeper empathetic responses and problem framing through collaboration.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"199 ","pages":"Article 108375"},"PeriodicalIF":4.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712949","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}
Pub Date : 2025-07-21DOI: 10.1016/j.ypmed.2025.108362
Ridwan J. Said , Dana Mowls Carroll , Xianghua Luo , Jiayi Hu , Qing Cao , Katelyn M. Tessier , Lorna Bittencourt , Dorothy K. Hatsukami , the Center for Evaluation of Nicotine in Cigarettes (CENIC)
Objective
To examine whether the impact of a nicotine reduction standard (NRS) varies by socio-demographics.
Methods
Secondary analysis of a 12-week trial (2018–2022) with 438 people who smoke (PWS) comparing very low nicotine content (VLNC) vs. normal nicotine content (NNC) cigarettes. Moderation by education, race, and age on cigarettes per day (CPD), smoke-free days, and biomarkers (CEMA, NNAL) was assessed using interaction models.
Results
For race and education, interaction tests for moderation were not significant (ps > 0.05). In subgroup analyses, VLNC condition reduced CPD and biomarkers and increased smoke-free days with the following exception: no difference in CEMA was observed by condition among those of lower education (Geometric mean ratio [GMR] = 0.72, 95 % confidence interval [CI] = 0.39, 1.33). For age, multiple interaction tests were significant. In subgroup analyses, older but not younger adults, had no VLNC vs. NNC differences for CEMA (GMR: 0.85 [CI = 0.51, 1.41] vs 0.47 [CI = 0.35, 0.62]) or smoke-free days (rate ratio: 1.85 [CI = 0.63, 5.55] vs 5.85 [CI = 3.12, 10.89]).
Conclusion
Age and potentially education moderate NRS effects among PWS.
Policy implications
Targeted support for older adults and those with lower education may maximize NRS benefits.
{"title":"Secondary analysis of a randomized clinical trial of very low nicotine cigarettes: Outcomes across social and demographic groups","authors":"Ridwan J. Said , Dana Mowls Carroll , Xianghua Luo , Jiayi Hu , Qing Cao , Katelyn M. Tessier , Lorna Bittencourt , Dorothy K. Hatsukami , the Center for Evaluation of Nicotine in Cigarettes (CENIC)","doi":"10.1016/j.ypmed.2025.108362","DOIUrl":"10.1016/j.ypmed.2025.108362","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether the impact of a nicotine reduction standard (NRS) varies by socio-demographics.</div></div><div><h3>Methods</h3><div>Secondary analysis of a 12-week trial (2018–2022) with 438 people who smoke (PWS) comparing very low nicotine content (VLNC) vs. normal nicotine content (NNC) cigarettes. Moderation by education, race, and age on cigarettes per day (CPD), smoke-free days, and biomarkers (CEMA, NNAL) was assessed using interaction models.</div></div><div><h3>Results</h3><div>For race and education, interaction tests for moderation were not significant (ps > 0.05). In subgroup analyses, VLNC condition reduced CPD and biomarkers and increased smoke-free days with the following exception: no difference in CEMA was observed by condition among those of lower education (Geometric mean ratio [GMR] = 0.72, 95 % confidence interval [CI] = 0.39, 1.33). For age, multiple interaction tests were significant. In subgroup analyses, older but not younger adults, had no VLNC vs. NNC differences for CEMA (GMR: 0.85 [CI = 0.51, 1.41] vs 0.47 [CI = 0.35, 0.62]) or smoke-free days (rate ratio: 1.85 [CI = 0.63, 5.55] vs 5.85 [CI = 3.12, 10.89]).</div></div><div><h3>Conclusion</h3><div>Age and potentially education moderate NRS effects among PWS.</div></div><div><h3>Policy implications</h3><div>Targeted support for older adults and those with lower education may maximize NRS benefits.</div><div><strong>Trial registration:</strong> NCT03272685.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"201 ","pages":"Article 108362"},"PeriodicalIF":3.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699257","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}
Pub Date : 2025-07-21DOI: 10.1016/j.ypmed.2025.108363
Ruyu Sun , Tingzhong Yang , Menmen Wang , Xinxin Ying , Lu Li , Weifang Zhang
Objective
Pregnancy planning is a critical opportunity to enhance preconception health. “Beiyun,” a culturally rooted concept in China, encompasses traditional and modern practices for preparing for pregnancy. This study used the comprehensive idea of “Beiyun” to examine the mechanisms of pregnancy planning behavior among women and men through an integrated individual-couple analysis based on the Behavior Cognition – Social Influence Theory.
Methods
Using multistage stratified sampling, we recruited reproductive-aged individuals in Zhejiang, China between July and September 2023. A cross-sectional survey collected data on pregnancy planning behavior. Analyses were conducted at both individual (Study 1, all participants) and couple levels (Study 2, coupled participants) using path analysis, specifically employing the actor-partner interdependence model in Study 2.
Results
Study 1 included 1086 women and 905 men, with 57.6 % and 67.7 % reporting pregnancy planning, respectively. Study 2 comprised 458 heterosexual couples. At the individual level, perceived susceptibility (women: β = 0.09, p = 0.01; men: β = 0.09, p = 0.04) and behavioral norms (women: β = 0.37, p < 0.01; men: β = 0.45, p < 0.01) were significantly associated with planning behavior. Couple-level analysis revealed that women's pregnancy planning was associated with their perceived susceptibility (β = 0.13, p = 0.02), behavioral norms (β = 0.29, p < 0.01), and their partner's behavioral norms (β = 0.30, p < 0.01), while men's behavior was associated with their norms (β = 0.35, p < 0.01) and partner's perceived susceptibility (β = 0.13, p = 0.03).
Conclusions
This study yielded new insights into pregnancy planning behavior, highlighting the role of individual factors and partner dynamics. Future interventions should enhance risk awareness among women and shape behavioral norms in men, considering partner dynamics in public health campaigns.
目的妊娠计划是提高孕前健康的重要机会。“备孕”是一个植根于中国文化的概念，包含了传统和现代的备孕做法。本研究以行为认知-社会影响理论为基础，运用“北云”的综合思想，通过个体-夫妻的综合分析，探讨男女计划生育行为的机制。方法采用多阶段分层抽样方法，于2023年7月至9月在中国浙江省招募育龄个体。一项横断面调查收集了有关怀孕计划行为的数据。使用通径分析在个体（研究1，所有参与者）和夫妻（研究2，耦合参与者）水平上进行了分析，特别是在研究2中采用了行动者-伴侣相互依赖模型。结果研究1纳入1086名女性和905名男性，分别有57.6%和67.7%的人有妊娠计划。研究2包括458对异性恋夫妇。在个体水平上，感知易感性(女性：β = 0.09, p = 0.01；男人:β= 0.09,p = 0.04)和行为规范(女性:β= 0.37,p & lt;0.01;男性：β = 0.45, p <；0.01)与计划行为显著相关。夫妻水平分析显示，女性的妊娠计划与其感知易感性（β = 0.13, p = 0.02）、行为规范(β = 0.29, p <；0.01)，以及伴侣的行为规范(β = 0.30, p <；0.01)，而男性的行为与他们的规范相关(β = 0.35, p <；0.01)和伴侣感知易感性（β = 0.13, p = 0.03）。结论本研究对怀孕计划行为有了新的认识，突出了个体因素和伴侣动态的作用。未来的干预措施应提高妇女的风险意识，并影响男子的行为规范，同时考虑到公共卫生运动中的伙伴动态。
{"title":"Associations between behavior cognition–social influence and pregnancy planning behavior in China: An integrated individual-couple analysis","authors":"Ruyu Sun , Tingzhong Yang , Menmen Wang , Xinxin Ying , Lu Li , Weifang Zhang","doi":"10.1016/j.ypmed.2025.108363","DOIUrl":"10.1016/j.ypmed.2025.108363","url":null,"abstract":"<div><h3>Objective</h3><div>Pregnancy planning is a critical opportunity to enhance preconception health. “Beiyun,” a culturally rooted concept in China, encompasses traditional and modern practices for preparing for pregnancy. This study used the comprehensive idea of “Beiyun” to examine the mechanisms of pregnancy planning behavior among women and men through an integrated individual-couple analysis based on the Behavior Cognition – Social Influence Theory.</div></div><div><h3>Methods</h3><div>Using multistage stratified sampling, we recruited reproductive-aged individuals in Zhejiang, China between July and September 2023. A cross-sectional survey collected data on pregnancy planning behavior. Analyses were conducted at both individual (Study 1, all participants) and couple levels (Study 2, coupled participants) using path analysis, specifically employing the actor-partner interdependence model in Study 2.</div></div><div><h3>Results</h3><div>Study 1 included 1086 women and 905 men, with 57.6 % and 67.7 % reporting pregnancy planning, respectively. Study 2 comprised 458 heterosexual couples. At the individual level, perceived susceptibility (women: <em>β</em> = 0.09, <em>p</em> = 0.01; men: <em>β</em> = 0.09, <em>p</em> = 0.04) and behavioral norms (women: <em>β</em> = 0.37, <em>p</em> < 0.01; men: <em>β</em> = 0.45, <em>p</em> < 0.01) were significantly associated with planning behavior. Couple-level analysis revealed that women's pregnancy planning was associated with their perceived susceptibility (<em>β</em> = 0.13, <em>p</em> = 0.02), behavioral norms (<em>β</em> = 0.29, <em>p</em> < 0.01), and their partner's behavioral norms (<em>β</em> = 0.30, <em>p</em> < 0.01), while men's behavior was associated with their norms (<em>β</em> = 0.35, <em>p</em> < 0.01) and partner's perceived susceptibility (<em>β</em> = 0.13, <em>p</em> = 0.03).</div></div><div><h3>Conclusions</h3><div>This study yielded new insights into pregnancy planning behavior, highlighting the role of individual factors and partner dynamics. Future interventions should enhance risk awareness among women and shape behavioral norms in men, considering partner dynamics in public health campaigns.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"199 ","pages":"Article 108363"},"PeriodicalIF":4.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696730","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}
Pub Date : 2025-07-20DOI: 10.1016/j.ypmed.2025.108361
Sophie J.A. Jooren , Heike H. Garritsen , Sigrid Troelstra , Willeke van Dijk , Maria W.J. Jansen , Marc C. Willemsen , Jeroen Bommelé
Objective
Although smoke-free outdoor environments are increasingly implemented to reduce adolescent smoking and de-normalize the behaviour, compliance is often low. To better understand compliance of people who smoke, we conducted a realist review.
Methods
A realist review, a type of literature review, uses existing evidence to make a program theory, outlining mechanisms and contexts, that provides an explanatory analysis of compliance of people who smoke with outdoor smoke-free environments. The search was conducted in PubMed, Web of Science, Embase, and PsycINFO. Studies were included that had been published from January 1, 2000, to September 1, 2023. Twenty-five peer-reviewed English-language articles were included. Evidence was extracted about contexts and mechanisms that influence the compliance of smokers.
Results
Compliance with smoke-free outdoor environments increases if people who smoke accept the policy, have sufficient knowledge and when the policy affects their motivation to quit smoking. However, these mechanisms may be hindered by feelings of people who smoke, such as low confidence in the policy's effectiveness and enforcement, feelings of stigma, and a lack of understanding. The context in which these environments are implemented, such as communication about the smoke-free policy, the stop-smoking facilities, the presence of ashtrays and designated smoking areas, and the size of the environment, influences mechanisms and compliance.
Conclusions
To increase acceptance and clarity of smoke-free policies, we recommend implementing smoke-free outdoor policies without designated smoking areas or ashtrays while actively promoting public awareness. To avoid stigmatisation, accessible cessation support is key. Lastly, proper enforcement training is essential.
目的：尽管越来越多地实施室外无烟环境以减少青少年吸烟并使其行为非常态化，但依从性往往很低。为了更好地了解吸烟者的依从性，我们进行了一项现实审查。方法：现实主义回顾，一种文献回顾，利用现有证据制定程序理论，概述机制和背景，为吸烟者对室外无烟环境的依从性提供解释性分析。在PubMed， Web of Science， Embase和PsycINFO中进行了搜索。研究纳入了2000年1月1日至2023年9月1日期间发表的研究。纳入了25篇同行评议的英文文章。提取了影响吸烟者依从性的背景和机制的证据。结果：当吸烟者接受政策，有足够的知识，当政策影响其戒烟动机时，对室外无烟环境的依从性增加。然而，这些机制可能会受到吸烟者的感受的阻碍，例如对政策的有效性和执行缺乏信心，污名感和缺乏理解。实施这些环境的背景，例如关于无烟政策的宣传、禁烟设施、烟灰缸和指定吸烟区的存在，以及环境的大小，都会影响机制和遵守情况。结论：为了提高公众对无烟政策的接受度和清晰度，我们建议在积极提高公众意识的同时，实施无指定吸烟区和烟灰缸的室外无烟政策。为避免污名化，获得戒烟支持是关键。最后，适当的执法培训是必不可少的。
{"title":"Compliance with smoke-free policies in outdoor settings: a realist review","authors":"Sophie J.A. Jooren , Heike H. Garritsen , Sigrid Troelstra , Willeke van Dijk , Maria W.J. Jansen , Marc C. Willemsen , Jeroen Bommelé","doi":"10.1016/j.ypmed.2025.108361","DOIUrl":"10.1016/j.ypmed.2025.108361","url":null,"abstract":"<div><h3>Objective</h3><div>Although smoke-free outdoor environments are increasingly implemented to reduce adolescent smoking and de-normalize the behaviour, compliance is often low. To better understand compliance of people who smoke, we conducted a realist review.</div></div><div><h3>Methods</h3><div>A realist review, a type of literature review, uses existing evidence to make a program theory, outlining mechanisms and contexts, that provides an explanatory analysis of compliance of people who smoke with outdoor smoke-free environments. The search was conducted in PubMed, Web of Science, Embase, and PsycINFO. Studies were included that had been published from January 1, 2000, to September 1, 2023. Twenty-five peer-reviewed English-language articles were included. Evidence was extracted about contexts and mechanisms that influence the compliance of smokers.</div></div><div><h3>Results</h3><div>Compliance with smoke-free outdoor environments increases if people who smoke accept the policy, have sufficient knowledge and when the policy affects their motivation to quit smoking. However, these mechanisms may be hindered by feelings of people who smoke, such as low confidence in the policy's effectiveness and enforcement, feelings of stigma, and a lack of understanding. The context in which these environments are implemented, such as communication about the smoke-free policy, the stop-smoking facilities, the presence of ashtrays and designated smoking areas, and the size of the environment, influences mechanisms and compliance.</div></div><div><h3>Conclusions</h3><div>To increase acceptance and clarity of smoke-free policies, we recommend implementing smoke-free outdoor policies without designated smoking areas or ashtrays while actively promoting public awareness. To avoid stigmatisation, accessible cessation support is key. Lastly, proper enforcement training is essential.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"199 ","pages":"Article 108361"},"PeriodicalIF":4.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691326","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}
Pub Date : 2025-07-16DOI: 10.1016/j.ypmed.2025.108360
Yifei Wang , Tianshan Dong , Bin Wang , Ping Zhang
Objective
To investigate the association between Life's Essential 8 (LE8) health behavior component score and mortality outcomes among individuals with Cardiovascular-kidney-metabolic (CKM) syndrome stages 0–3.
Methods
8067 U.S. adults from the National Health and Nutrition Examination Survey 2005–2018, aged 30–79 years with CKM syndrome stages 0–3, were analyzed. Mortality status was obtained via linkage to the National Death Index through December 31, 2019. Kaplan-Meier analysis, multivariable Cox regression, and restricted cubic splines (RCS) were used to examine associations between LE8 health behavior component score and mortality outcomes.
Results
CKM stages were distributed as follows: 7.8 % (stage 0), 21.0 % (stage 1), 64.0 % (stage 2), and 7.3 % (stage 3). Higher LE8 total score and health behavior component score were linked to reduction in all-cause mortality and cardiovascular mortality risk. RCS analysis showed a linear relationship between LE8 total score, health behavior component score and mortality outcomes. Interaction between health behavior component score and CKM syndrome stages was identified for all-cause mortality.
Conclusions
Higher LE8 health behavior component score is associated with reduced all-cause and cardiovascular mortality among population with CKM syndrome stages 0–3. These findings support the potential value of behavior-targeted interventions tailored to CKM syndrome stages.
{"title":"The association between life's essential 8 health behavior component score and all-cause and cardiovascular mortality among U.S. adults with cardiovascular-kidney-metabolic syndrome stages 0–3","authors":"Yifei Wang , Tianshan Dong , Bin Wang , Ping Zhang","doi":"10.1016/j.ypmed.2025.108360","DOIUrl":"10.1016/j.ypmed.2025.108360","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between Life's Essential 8 (LE8) health behavior component score and mortality outcomes among individuals with Cardiovascular-kidney-metabolic (CKM) syndrome stages 0–3.</div></div><div><h3>Methods</h3><div>8067 U.S. adults from the National Health and Nutrition Examination Survey 2005–2018, aged 30–79 years with CKM syndrome stages 0–3, were analyzed. Mortality status was obtained via linkage to the National Death Index through December 31, 2019. Kaplan-Meier analysis, multivariable Cox regression, and restricted cubic splines (RCS) were used to examine associations between LE8 health behavior component score and mortality outcomes.</div></div><div><h3>Results</h3><div>CKM stages were distributed as follows: 7.8 % (stage 0), 21.0 % (stage 1), 64.0 % (stage 2), and 7.3 % (stage 3). Higher LE8 total score and health behavior component score were linked to reduction in all-cause mortality and cardiovascular mortality risk. RCS analysis showed a linear relationship between LE8 total score, health behavior component score and mortality outcomes. Interaction between health behavior component score and CKM syndrome stages was identified for all-cause mortality.</div></div><div><h3>Conclusions</h3><div>Higher LE8 health behavior component score is associated with reduced all-cause and cardiovascular mortality among population with CKM syndrome stages 0–3. These findings support the potential value of behavior-targeted interventions tailored to CKM syndrome stages.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108360"},"PeriodicalIF":3.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659997","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}
Pub Date : 2025-07-11DOI: 10.1016/j.ypmed.2025.108358
Saba Rouhani , Eteri Machavariani , Anna-Michelle McSorley , Therese L. Todd , Jonathan Purtle
Objective
To estimate willingness to call the police in an emergency among US adults to inform policies addressing emergency response and help-seeking.
Methods
We utilized cross-sectional data from a web-based 2023 Survey of Racism and Health of (N = 5059) adults in 12 Northeastern and Mid-Atlantic states and D.C. We estimated odds of willingness to call the police as a function of gender, race/ethnicity, and lifetime diagnosis with a behavioral health (substance use or mental health) condition using unadjusted and adjusted logistic regression.
Results
Most of the sample (80 %) reported willingness to call the police in an emergency. Dds were observed among Black (aOR 0.33; 95 % CI 0.27–0.41), American Indian/Native American (aOR 0.43; 95 % CI 0.27, 0.70), and Multiracial (aOR 0.36; 95 % CI 0.25–0.52) compared to White respondents, and those with behavioral health diagnoses (aOR 0.73; 95 % CI 0.61, 0.88). Women (aOR 1.23; 95 % CI 1.05, 1.43) and older adults (Age 55+: aOR 4.62; 95 % CI 3.70, 5.80) reported higher willingness to call the police.
Conclusions
Findings highlight subpopulations for whom the police may not be a viable source of emergency response, particularly individuals who are racially minoritized and/or have behavioral health conditions. This has implications for alternative response programs which rely on 911 dispatch to triage calls and highlights a need for targeted messaging and alternative mechanisms to call for service in communities with police mistrust.
目的评估美国成年人在紧急情况下报警的意愿，以告知应对紧急情况和寻求帮助的政策。方法：我们利用了基于网络的2023年种族主义和健康调查（N = 5059）成年人的横断面数据，这些成年人来自东北部和大西洋中部的12个州和华盛顿特区。我们使用未调整和调整的逻辑回归估计了愿意报警的几率，这是性别、种族/民族和行为健康（物质使用或精神健康）状况终生诊断的函数。结果大多数受访者（80%）表示在紧急情况下愿意报警。黑种人中存在Dds (aOR 0.33；95% CI 0.27-0.41)，美洲印第安人/美洲原住民(aOR 0.43；95% CI 0.27, 0.70)和多种族(aOR 0.36；95% CI 0.25-0.52)，与白人受访者和行为健康诊断者相比(aOR 0.73；95% ci 0.61, 0.88)。女性(aOR 1.23；95% CI 1.05, 1.43)和老年人(55岁以上：aOR 4.62；95% （CI 3.70, 5.80）的人报告说，他们更愿意报警。结论：调查结果强调了警察可能不是应急响应的可行来源的亚人群，特别是少数种族和/或有行为健康问题的个人。这对依赖911调度来分类呼叫的替代响应方案具有启示意义，并突出了在警察不信任的社区中需要有针对性的信息传递和替代机制来呼叫服务。
{"title":"Disparities in willingness to call the police in a 2023 survey of US adults: Implications for alternative crisis response programs","authors":"Saba Rouhani , Eteri Machavariani , Anna-Michelle McSorley , Therese L. Todd , Jonathan Purtle","doi":"10.1016/j.ypmed.2025.108358","DOIUrl":"10.1016/j.ypmed.2025.108358","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate willingness to call the police in an emergency among US adults to inform policies addressing emergency response and help-seeking.</div></div><div><h3>Methods</h3><div>We utilized cross-sectional data from a web-based 2023 Survey of Racism and Health of (<em>N</em> = 5059) adults in 12 Northeastern and Mid-Atlantic states and D.C. We estimated odds of willingness to call the police as a function of gender, race/ethnicity, and lifetime diagnosis with a behavioral health (substance use or mental health) condition using unadjusted and adjusted logistic regression.</div></div><div><h3>Results</h3><div>Most of the sample (80 %) reported willingness to call the police in an emergency. Dds were observed among Black (aOR 0.33; 95 % CI 0.27–0.41), American Indian/Native American (aOR 0.43; 95 % CI 0.27, 0.70), and Multiracial (aOR 0.36; 95 % CI 0.25–0.52) compared to White respondents, and those with behavioral health diagnoses (aOR 0.73; 95 % CI 0.61, 0.88). Women (aOR 1.23; 95 % CI 1.05, 1.43) and older adults (Age 55+: aOR 4.62; 95 % CI 3.70, 5.80) reported higher willingness to call the police.</div></div><div><h3>Conclusions</h3><div>Findings highlight subpopulations for whom the police may not be a viable source of emergency response, particularly individuals who are racially minoritized and/or have behavioral health conditions. This has implications for alternative response programs which rely on 911 dispatch to triage calls and highlights a need for targeted messaging and alternative mechanisms to call for service in communities with police mistrust.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108358"},"PeriodicalIF":4.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623794","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}
Pub Date : 2025-07-11DOI: 10.1016/j.ypmed.2025.108359
Stephen T. Higgins , Tyler G. Erath , Fang Fang Chen , Michael J. DeSarno
Objective
This study investigated rural disparities in cigarette smoking among U.S. women by age (18–65+ years) across survey years (2002−2022).
Methods, data source
Data came from the National Survey on Drug Use and Health. Women were categorized by rural-urban residence and age. We examined associations between residence, age, and time on current-smoking prevalence and quit ratios in two-year bins using weighted logistic-regression adjusting for race/ethnicity, education, annual income.
Results
Effects of residence on current-smoking prevalence interacted with time (t[df = 430,180] = 4.51, P < .001), with reductions over time among urban (AOR = 0.95, 95 %CI: 0.94–0.96, P < .001) but not rural residents (AOR = 0.99, 95 %CI: 0.98–1.01, P = .66). Residence interacted with age (t[df = 430,180] = −4.90, P < .001), with greater smoking among rural women in younger (AORs≥1.23, 95 %CI: 1.01–1.44, Ps ≤ 0.008), but not older age brackets (AORs ≤1.04, 95 %CI: 0.74–1.35, Ps ≥ 0.688). Rural residence predicted lower odds of quitting smoking (AOR = 0.80, 95 %CI: 0.71–0.91, P < .001).
Conclusions
There is a growing disparity in smoking prevalence that disproportionately impacts rural women ages 18–49 years raising concerns about multigenerational adverse effects as this demographic is most likely to be pregnant or parenting young children. There is also a rural disparity in quitting smoking across age groups underscoring a need for greater access to smoking-cessation services among rural women.
{"title":"Examining rural disparities in cigarette smoking among U.S. women by chronological age: 2002–2022","authors":"Stephen T. Higgins , Tyler G. Erath , Fang Fang Chen , Michael J. DeSarno","doi":"10.1016/j.ypmed.2025.108359","DOIUrl":"10.1016/j.ypmed.2025.108359","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigated rural disparities in cigarette smoking among U.S. women by age (18–65+ years) across survey years (2002−2022).</div></div><div><h3>Methods, data source</h3><div>Data came from the National Survey on Drug Use and Health. Women were categorized by rural-urban residence and age. We examined associations between residence, age, and time on current-smoking prevalence and quit ratios in two-year bins using weighted logistic-regression adjusting for race/ethnicity, education, annual income.</div></div><div><h3>Results</h3><div>Effects of residence on current-smoking prevalence interacted with time (t[df = 430,180] = 4.51, <em>P</em> < .001), with reductions over time among urban (AOR = 0.95, 95 %CI: 0.94–0.96, P < .001) but not rural residents (AOR = 0.99, 95 %CI: 0.98–1.01, <em>P</em> = .66). Residence interacted with age (t[df = 430,180] = −4.90, <em>P</em> < .001), with greater smoking among rural women in younger (AORs≥1.23, 95 %CI: 1.01–1.44, Ps ≤ 0.008), but not older age brackets (AORs ≤1.04, 95 %CI: 0.74–1.35, Ps ≥ <u>0</u>.688). Rural residence predicted lower odds of quitting smoking (AOR = 0.80, 95 %CI: 0.71–0.91, <em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div>There is a growing disparity in smoking prevalence that disproportionately impacts rural women ages 18–49 years raising concerns about multigenerational adverse effects as this demographic is most likely to be pregnant or parenting young children. There is also a rural disparity in quitting smoking across age groups underscoring a need for greater access to smoking-cessation services among rural women.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"201 ","pages":"Article 108359"},"PeriodicalIF":3.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626968","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}
Pub Date : 2025-07-09DOI: 10.1016/j.ypmed.2025.108357
Zoë Szewczyk , Bronwyn McGill , Philip Clare , Karen Lee , Sandra Davidson , Sarah Yeun-Sim Jeong , Adrian Bauman , Blythe J. O'Hara
Objective
The Get Healthy Service (GHS) is a free telephone and online health coaching service for adults delivered across New South Wales, Australia, since 2009. The GHS was first evaluated over 10 years ago and was shown to be effective. Using recent data, we investigated characteristics conducive to program completion and whether program impact has been sustained at scale.
Methods
This evaluation used data collected during program delivery between December 2017 and May 2023. Descriptive and inferential analysis was used to measure program completion, and pre-post health risk behaviour change.
Results
Of 53,566 participants enrolled in the GHS, 34 % completed the program. Multivariable analyses showed that men, people aged 50+ years, and those who did not identify as Aboriginal were more likely to complete the program. Program completers showed increased physical activity (43.5 mins/week; 95 % CI 40.55, 46.49), fruit intake (IRR 1.011; 95 % CI 1.08, 1.14) and vegetable intake (IRR 1.3; 95 % CI 1.27, 1.32); improvements in their BMI score (−0.51 kg/m2; 95 % CI -0.56, −0.45) and waist circumference (−2.74 cm; 95 % CI -2.96, −2.52); and improvements in sweet drink and takeaway food consumption. Compared to earlier evaluations, the impact of the GHS on health risk behaviours had decreased.
Conclusions
Since its launch almost 15 years ago, GHS continues to confer improved anthropometric and lifestyle risk factors in adults, however the magnitude of effect has decreased since earlier evaluations. Efforts to sustain and improve the impact of the program, particularly amongst participants from most disadvantaged backgrounds, is needed.
目标健康服务（GHS）是自2009年以来在澳大利亚新南威尔士州为成年人提供的免费电话和在线健康指导服务。全球统一制度在10多年前首次得到评估，并证明是有效的。利用最近的数据，我们调查了有利于项目完成的特征，以及项目的影响是否在规模上持续。该评估使用了2017年12月至2023年5月期间项目交付期间收集的数据。采用描述性和推断性分析来衡量规划完成情况和前后健康风险行为的改变。结果在53566名参加GHS的参与者中，34%的人完成了该计划。多变量分析显示，男性、50岁以上的人以及不认为自己是原住民的人更有可能完成这个项目。计划完成者的身体活动增加(每周43.5分钟；95% CI 40.55, 46.49)，水果摄入量(IRR 1.011；95% CI 1.08, 1.14)和蔬菜摄入量(IRR 1.3；95% ci 1.27, 1.32)；BMI评分改善(- 0.51 kg/m2；95% CI -0.56, - 0.45)和腰围(- 2.74 cm；95% ci -2.96,−2.52)；甜味饮料和外卖食品的消费也有所改善。与以前的评估相比，全球统一制度对健康风险行为的影响有所下降。自近15年前推出以来，GHS继续改善成人的人体测量和生活方式风险因素，然而，与早期评估相比，影响程度有所下降。需要努力维持和提高该方案的影响，特别是对来自最弱势背景的参与者的影响。
{"title":"Sustainable chronic disease prevention at scale: Evaluation of the Get Healthy Service, a telephone and online coaching service","authors":"Zoë Szewczyk , Bronwyn McGill , Philip Clare , Karen Lee , Sandra Davidson , Sarah Yeun-Sim Jeong , Adrian Bauman , Blythe J. O'Hara","doi":"10.1016/j.ypmed.2025.108357","DOIUrl":"10.1016/j.ypmed.2025.108357","url":null,"abstract":"<div><h3>Objective</h3><div>The Get Healthy Service (GHS) is a free telephone and online health coaching service for adults delivered across New South Wales, Australia, since 2009. The GHS was first evaluated over 10 years ago and was shown to be effective. Using recent data, we investigated characteristics conducive to program completion and whether program impact has been sustained at scale.</div></div><div><h3>Methods</h3><div>This evaluation used data collected during program delivery between December 2017 and May 2023. Descriptive and inferential analysis was used to measure program completion, and pre-post health risk behaviour change.</div></div><div><h3>Results</h3><div>Of 53,566 participants enrolled in the GHS, 34 % completed the program. Multivariable analyses showed that men, people aged 50+ years, and those who did not identify as Aboriginal were more likely to complete the program. Program completers showed increased physical activity (43.5 mins/week; 95 % CI 40.55, 46.49), fruit intake (IRR 1.011; 95 % CI 1.08, 1.14) and vegetable intake (IRR 1.3; 95 % CI 1.27, 1.32); improvements in their BMI score (−0.51 kg/m<sup>2</sup>; 95 % CI -0.56, −0.45) and waist circumference (−2.74 cm; 95 % CI -2.96, −2.52); and improvements in sweet drink and takeaway food consumption. Compared to earlier evaluations, the impact of the GHS on health risk behaviours had decreased.</div></div><div><h3>Conclusions</h3><div>Since its launch almost 15 years ago, GHS continues to confer improved anthropometric and lifestyle risk factors in adults, however the magnitude of effect has decreased since earlier evaluations. Efforts to sustain and improve the impact of the program, particularly amongst participants from most disadvantaged backgrounds, is needed.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108357"},"PeriodicalIF":4.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611546","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}
Pub Date : 2025-07-08DOI: 10.1016/j.ypmed.2025.108356
Melissa Pearman Fenton , Kaitlyn Swacil , Catherine Woodstock Striley , Linda Bauer Cottler , Milton Eder , Irvin PeDro Cohen , Catalina Lopez-Quintero
Objective
We examined sociodemographic factors associated with barriers to healthcare utilization (HCU) among a national sample of adults engaging in heavy drinking behavior (HDB).
Methods
A sample of 3257 participants from the All of Us program (2018–2022 Controlled Tier Dataset-v7) who reported HDB (i.e., six or more drinks on one occasion, at least weekly) was selected to examine the associations between socio-demographic factors and barriers to HCU (i.e., structural, competing social roles, attitudinal, and financial barriers). Multiple logistic regressions estimated adjusted Odds Ratios (aOR) for the associations of interest.
Results
Financial barriers (23.64 %) were the most common of the four barriers, followed by attitudinal (18.27 %), competing social roles (15.66 %), and structural (13.36 %) barriers. Females were more likely than males to report competing social roles (or = 1.56, 95 %CI = 1.28,1.90), attitudinal (aOR = 1.41, 95 %CI = 1.17,1.70), and financial (or = 1.41, 95 %CI = 1.19,1.68) barriers. Lower income (aOR = 6.71, 95 %CI = 4.77,9.56), and Non-Hispanic Black/African Americans (aOR = 1.39, 95 %CI = 1.04,1.85) showed higher odds of reporting structural barriers.
Conclusions
As many as one in four individuals who engage in HDB experience at least one HCU barrier, particularly women, those with low-incomes, and Non-Hispanic Black/African Americans. The findings highlight the need for implementation of evidence-based strategies among the identified populations to reduce HCU barriers, and ultimately, alcohol-related disparities.
目的：在全国有重度饮酒行为（HDB）的成年人样本中，研究与医疗保健利用障碍（HCU）相关的社会人口学因素。方法选择来自All of Us项目（2018-2022 Controlled Tier Dataset-v7）的3257名报告HDB（即一次饮酒6次或更多，至少每周一次）的参与者作为样本，研究社会人口因素与HCU障碍（即结构性、竞争的社会角色、态度和财务障碍）之间的关系。多重逻辑回归估计了相关因素的调整优势比（aOR）。结果经济障碍占23.64%，其次是态度障碍（18.27%）、社会角色竞争障碍（15.66%）和结构障碍（13.36%）。女性比男性更有可能报告竞争性的社会角色（or = 1.56, 95% CI = 1.28,1.90），态度（or = 1.41, 95% CI = 1.17,1.70）和财务（or = 1.41, 95% CI = 1.19,1.68）障碍。低收入（aOR = 6.71, 95% CI = 4.77,9.56）和非西班牙裔黑人/非裔美国人（aOR = 1.39, 95% CI = 1.04,1.85）报告结构性障碍的几率更高。多达四分之一的HDB参与者至少经历过一次HCU障碍，尤其是女性、低收入者和非西班牙裔黑人/非洲裔美国人。研究结果强调需要在确定的人群中实施基于证据的战略，以减少HCU障碍，并最终减少与酒精相关的差异。
{"title":"Barriers to healthcare utilization among adults engaging in heavy drinking: Results from the all of us research program","authors":"Melissa Pearman Fenton , Kaitlyn Swacil , Catherine Woodstock Striley , Linda Bauer Cottler , Milton Eder , Irvin PeDro Cohen , Catalina Lopez-Quintero","doi":"10.1016/j.ypmed.2025.108356","DOIUrl":"10.1016/j.ypmed.2025.108356","url":null,"abstract":"<div><h3>Objective</h3><div>We examined sociodemographic factors associated with barriers to healthcare utilization (HCU) among a national sample of adults engaging in heavy drinking behavior (HDB).</div></div><div><h3>Methods</h3><div>A sample of 3257 participants from the <em>All of Us</em> program (2018–2022 Controlled Tier Dataset-v7) who reported HDB (i.e., six or more drinks on one occasion, at least weekly) was selected to examine the associations between socio-demographic factors and barriers to HCU (i.e., structural, competing social roles, attitudinal, and financial barriers). Multiple logistic regressions estimated adjusted Odds Ratios (aOR) for the associations of interest.</div></div><div><h3>Results</h3><div>Financial barriers (23.64 %) were the most common of the four barriers, followed by attitudinal (18.27 %), competing social roles (15.66 %), and structural (13.36 %) barriers. Females were more likely than males to report competing social roles (or = 1.56, 95 %CI = 1.28,1.90), attitudinal (aOR = 1.41, 95 %CI = 1.17,1.70), and financial (or = 1.41, 95 %CI = 1.19,1.68) barriers. Lower income (aOR = 6.71, 95 %CI = 4.77,9.56), and Non-Hispanic Black/African Americans (aOR = 1.39, 95 %CI = 1.04,1.85) showed higher odds of reporting structural barriers.</div></div><div><h3>Conclusions</h3><div>As many as one in four individuals who engage in HDB experience at least one HCU barrier, particularly women, those with low-incomes, and Non-Hispanic Black/African Americans. The findings highlight the need for implementation of evidence-based strategies among the identified populations to reduce HCU barriers, and ultimately, alcohol-related disparities.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108356"},"PeriodicalIF":4.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604233","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}
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