Preventive Medicine Reports最新文献

Reimagining primary health care: a historical and contemporary scoping review of community-based primary health care models and innovations 重塑初级卫生保健：基于社区的初级卫生保健模式和创新的历史和当代范围审查

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.pmedr.2026.103390

Sanjaya Acharya , Shiva Raj Mishra , Lorenz von Seidlein , Bipin Adhikari , Daniel M. Parker

Objectives

Community-based primary health care (CBPHC) has long underpinned health service delivery in resource-limited settings. However, demographic shifts, increasing chronic disease burdens, and digital transformations challenge its sustainability. This review synthesizes historical and contemporary evidence on CBPHC to assess effectiveness, identify limitations, and outline future directions toward universal health coverage (UHC).

Methods

Using the Arksey and O'Malley framework, we conducted a scoping review of global literature from 1975 to 2025 across PubMed, Scopus, Web of Science, Google Scholar, and grey sources. Data were thematically analyzed into categories capturing evolution, achievements, challenges, and future directions.

Results

A total of 134 documents were reviewed. CBPHC improved access to essential services, particularly maternal and child health, infectious disease control, and health promotion. Programs led by community health workers and volunteers strengthened systems but faced persistent barriers such as attrition, limited funding, and weak integration. Case studies from Nepal, Ethiopia, Brazil, and Rwanda showed improved maternal and child outcomes and pandemic preparedness and resilience. Emerging challenges include syndemics, demographic shifts, and urbanization.

Conclusions

CBPHC remains vital for advancing universal health coverage. Its sustainability depends on evolving into a diagonally integrated, people-centered, and digitally enabled model supported by equitable investment in governance, workforce training, and community engagement.

长期以来，社区初级卫生保健（CBPHC）一直是资源有限地区卫生服务提供的基础。然而，人口结构变化、慢性病负担增加以及数字化转型对其可持续性构成挑战。本综述综合了CBPHC的历史和当代证据，以评估有效性，确定局限性，并概述全民健康覆盖（UHC）的未来方向。方法使用Arksey和O'Malley框架，我们对1975年至2025年PubMed、Scopus、Web of Science、b谷歌Scholar和灰色来源的全球文献进行了范围审查。数据按主题进行分析，分为进化、成就、挑战和未来方向。结果共审阅文献134份。CBPHC改善了获得基本服务的机会，特别是孕产妇和儿童保健、传染病控制和健康促进。由社区卫生工作者和志愿者领导的项目加强了系统，但面临着人员流失、资金有限和整合不力等持续障碍。尼泊尔、埃塞俄比亚、巴西和卢旺达的案例研究表明，孕产妇和儿童的成果有所改善，大流行病的防范和复原力有所提高。新出现的挑战包括传染病、人口结构变化和城市化。结论基层基层医疗保健对推进全民健康覆盖至关重要。其可持续性取决于发展成为对角线一体化、以人为本、数字化的模式，并得到治理、劳动力培训和社区参与方面的公平投资的支持。

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引用次数: 0

Improvements in glycosylated hemoglobin A1c and blood pressure as measured through electronic health records across four produce prescription projects in the northeastern and Western United States 通过美国东北部和西部四个农产品处方项目的电子健康记录测量糖化血红蛋白A1c和血压的改善

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.pmedr.2026.103394

Victoria A. Zigmont , James P. Marriott , Elise Mitchell , Hilary Seligman , Amy L. Yaroch , Christina Nadolne , Julia Caldwell , Hester Parker , Christopher R. Long

Objective: We examined changes in glycosylated hemoglobin A1c (HbA1c) and blood pressure among 2218 participants in four produce prescription programs (PRx) across nine clinics in the northeastern and western United States.

Methods: PRx enrolled participants with food insecurity and/or diet-related chronic disease conditions between 2023 and 2024. This multi-site, single cohort study used paired t-tests to examine changes in HbA1c and blood pressure after program participation. Blood sugar control category at baseline and hypertension category at baseline were examined to understand changes among categories.

Results: For all participants, a clinically and statistically significant decline in HbA1c was observed (mean = −0.5; 95% CI: −0.6, −0.5). Participants with >9% baseline HbA1c experienced the largest decreases (1.9 units). Both systolic blood pressure (SBP) (mean = −1.77) and diastolic blood pressure (DBP) (mean = −2.03) decreased significantly. Decreases in blood pressure were most substantial for participants with stage two hypertension at baseline; SBP decreased by 10.7 mmHg and DBP decreased by 5.7 mmHg.

Conclusions: These data provide needed estimates of biomarker improvement during participation in heterogeneous real-world PRx, reinforcing the generalizable potential for positive health impact from improved access to fresh fruits and vegetables. Further research is needed to understand program impacts relative to standard care.

目的：我们研究了美国东北部和西部9个诊所的4个药品处方项目（PRx）的2218名参与者的糖化血红蛋白A1c （HbA1c）和血压的变化。方法：在2023年至2024年期间，PRx招募了患有食品不安全和/或饮食相关慢性疾病的参与者。这项多地点、单队列研究使用配对t检验来检查参与项目后HbA1c和血压的变化。检查基线血糖控制类别和基线高血压类别，了解类别之间的变化。结果：所有参与者的HbA1c均出现临床和统计学意义上的显著下降（平均值= - 0.5;95% CI: - 0.6, - 0.5）。基线HbA1c为9%的受试者降幅最大（1.9个单位）。收缩压（SBP）（平均= - 1.77）和舒张压（DBP）（平均= - 2.03）均显著降低。在基线时，2期高血压患者的血压下降最为显著；收缩压下降10.7 mmHg，舒张压下降5.7 mmHg。结论：这些数据提供了参与异质性现实世界PRx期间生物标志物改善的必要估计，加强了从改善获取新鲜水果和蔬菜中获得积极健康影响的可推广潜力。需要进一步的研究来了解项目相对于标准护理的影响。

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引用次数: 0

Rural-urban differences in perceived social and built environments and associations with physical activity among youth in the United States 美国青年感知社会和建筑环境的城乡差异及其与体育活动的关联

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.pmedr.2026.103400

Christopher D. Pfledderer , Emma J. Mullane , Denver M.Y. Brown , Ethan T. Hunt , Kevin Lanza , Ashleigh Johnson

Objective

To examine rural-urban differences in perceived social and built environment characteristics and assess associations with the frequency of meeting physical activity guidelines among United States youth.

Methods

We used data from the 2022-2023 National Survey of Children’s Health, a nationally representative sample of United States children and adolescents. Weighted cumulative logit models were used to determine associations between parental perceptions of social/built environments and number of days youth met physical activity guidelines, stratified by rural-urban status.

Results

The total sample included 55,551 (Representative N=41,792,444, 11.9 ± 3.5 years, 48% female) youth. Positive perceptions of neighborhood support were associated with higher odds of meeting physical activity guidelines (OR:1.43; 95% CI:1.32,1.54) as were perceptions of school safety (OR:1.29; 95% CI:1.08,1.54). Access to neighborhood amenities was associated with higher odds of meeting guidelines (OR:1.18; 95% CI:1.05,1.34). For rural youth, neighborhood support (OR:1.62; 95% CI: 1.34,1.95) and neighborhood amenities (OR:1.26; 95% CI:1.05,1.52) were positively associated with odds of meeting guidelines. For urban youth, neighborhood support (OR:1.40; 95% CI:1.29,1.53) and school safety (OR:1.31; 95% CI:1.07,1.59) were positively associated with odds of meeting guidelines.

Conclusions

Perceived social/built environmental factors are associated with youth physical activity, although associations differ by urbanicity.

目的研究美国青年在感知社会和建成环境特征方面的城乡差异，并评估其与满足体育活动指南的频率之间的关系。方法我们使用的数据来自2022-2023年全国儿童健康调查，这是一个具有全国代表性的美国儿童和青少年样本。使用加权累积logit模型来确定父母对社会/建筑环境的看法与青少年符合体育活动指南的天数之间的关联，并按城乡状况分层。结果共纳入青年55,551例（代表性N=41,792,444例，年龄11.9±3.5岁，女性48%）。对社区支持的积极看法与更高的符合体育活动指南的几率相关（OR:1.43; 95% CI:1.32,1.54），对学校安全的看法也是如此（OR:1.29; 95% CI:1.08,1.54）。使用社区设施与较高的符合指南的几率相关（OR:1.18; 95% CI:1.05,1.34）。对于农村青年，社区支持（OR:1.62; 95% CI: 1.34,1.95）和社区便利（OR:1.26; 95% CI:1.05,1.52）与满足指南的几率呈正相关。对于城市青年，社区支持（OR:1.40; 95% CI:1.29,1.53）和学校安全（OR:1.31; 95% CI:1.07,1.59）与满足指南的几率呈正相关。结论感知到的社会/建筑环境因素与青少年体育活动有关，尽管其相关性因城市而异。

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引用次数: 0

Comments on “Learning needs and experiences of hospital nurses in genetic medicine in a rural area of Japan: A cross-sectional questionnaire survey in Oita prefecture” 《日本农村地区医院护士遗传医学学习需求与经验：大分县横断面问卷调查》评论

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.pmedr.2026.103399

Hawkar A. Nasralla , Hussein Mustafa Hamasalih , Fahmi H. Kakamad

引用次数: 0

On being a doctor and caregiver: Tertiary preventive (palliative) care during crisis times in Iran 作为一名医生和护理人员：伊朗危机时期的三级预防（姑息治疗）护理

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.pmedr.2026.103379

Fatemeh Zarghami

Objective

This personal reflection, as a doctor, public health professional, and gerontologist, on the dying of my father with terminal cancer, provides insight into the gaps in tertiary preventive care (palliation at the end of life) during Covid-19 period in Iran.

Methods

The reflection is based on the author's lived experience as a family caregiver during the final months of her father's life during Covid-19 time in Iran.

Results

This narrative situates challenges within Iran's fragmented health system, where palliative care is neither routinely integrated nor systematically funded—exacerbated by sanctions and pandemic-related disruptions. Despite these gaps, Iran offers relatively accessible and affordable essential health services for much of its population. It explores how structural barriers limited access to palliative services and calls for ‘dying preparedness’ as a public health priority. This narrative discusses that the collaborative efforts of families and health care professionals need to be systematically integrated into health care system.

Conclusions

The paper argues that system-level preparedness for end-of-life care is essential to honor patient wishes, reduce caregiver burden. This preparedness supports families through unavoidable deaths—particularly in low- and middle-income countries with no formal hospice infrastructure.

目的作为一名医生、公共卫生专业人员和老年病学专家，对我父亲因癌症晚期去世的个人反思，有助于深入了解伊朗在2019冠状病毒病期间三级预防保健（临终姑息治疗）方面的差距。方法该反思基于提交人在伊朗Covid-19期间父亲生命最后几个月作为家庭照顾者的生活经历。这种说法反映了伊朗支离破碎的卫生系统所面临的挑战，在伊朗，姑息治疗既没有常规整合，也没有系统地得到资助，制裁和与大流行相关的中断加剧了这种情况。尽管存在这些差距，但伊朗为其大部分人口提供了相对容易获得和负担得起的基本卫生服务。它探讨了结构性障碍如何限制获得姑息治疗服务，并呼吁将“临终准备”作为公共卫生优先事项。本叙述讨论了家庭和卫生保健专业人员的合作努力需要系统地整合到卫生保健系统中。结论系统层面的临终关怀准备对于尊重患者意愿、减轻护理人员负担至关重要。这种准备可以帮助家庭度过不可避免的死亡，特别是在没有正式临终关怀基础设施的低收入和中等收入国家。

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引用次数: 0

HPV detection in first void urine and cervicovaginal samples: comparative study and analysis of associated factors in women from tunja, colombia 首次空尿和宫颈阴道样本中HPV检测：哥伦比亚tunja妇女相关因素的比较研究和分析

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.pmedr.2026.103393

Lorenzo Hernando Salamanca Neita , Elizabeth Guío Mahecha , Mónica Gabriela Huertas Valero , Johana Marín Suárez , Juan Pablo Carvajal Rojas , Gloria Eugenia Camargo Villalba , Laura Ximena Ramírez López

Objective

To compare Human Papillomavirus (HPV) detection in first-void urine (FVU) and cervicovaginal samples and to analyze factors associated with cervicovaginal HPV infection among women in Tunja, Colombia.

Methods

A cross-sectional study was conducted among 161 women aged 20–65 years residing in Tunja, Colombia. Samples and data were collected between September and November 2022 in a clinical laboratory. Cervicovaginal and FVU samples were obtained for HPV genotyping using the INNO-LiPA HPV Genotyping Extra II kit. Concordance, sensitivity, specificity, and associations with sociodemographic and gynecological variables were evaluated. Crude and adjusted odds ratios (OR) were estimated using logistic regression.

Results

HPV prevalence was 29.19% in cervicovaginal samples and 32.91% in urine samples. Genotypes 52 and 68 were the most frequent in both sample types. Concordance between tests was weak (kappa = 0.39). Sensitivity and specificity of urine-based detection were 61.70% and 78.94%, respectively. In the multivariable model, only pregnancy history remained independently associated with cervicovaginal HPV infection.

Conclusions

HPV infection prevalence was moderate, with high-risk genotypes detected in both sample types. The history of pregnancy was the only independent factor associated with cervicovaginal HPV infection. HPV detection in urine showed limited diagnostic performance, highlighting the need to optimize urine screening strategies.

目的比较首次空尿（FVU）和宫颈阴道样本中人乳头瘤病毒（HPV）的检测情况，分析哥伦比亚Tunja地区妇女宫颈阴道HPV感染的相关因素。方法对居住在哥伦比亚Tunja的161名年龄在20 ~ 65岁的女性进行横断面研究。样本和数据于2022年9月至11月在临床实验室收集。使用ino - lipa HPV基因分型Extra II试剂盒获得宫颈阴道和FVU样本进行HPV基因分型。评估一致性、敏感性、特异性以及与社会人口学和妇科变量的关联。使用逻辑回归估计粗比值比和调整比值比（OR）。结果宫颈阴道标本中shpv患病率为29.19%，尿液标本中shpv患病率为32.91%。基因型52和68在两种样本类型中最常见。试验间一致性较弱（kappa = 0.39）。尿法检测的敏感性和特异性分别为61.70%和78.94%。在多变量模型中，只有妊娠史仍然与宫颈阴道HPV感染独立相关。结论shpv感染流行程度中等，两种样本均存在高危基因型。妊娠史是与宫颈阴道HPV感染相关的唯一独立因素。尿中HPV检测显示有限的诊断性能，突出了优化尿液筛查策略的必要性。

{"title":"HPV detection in first void urine and cervicovaginal samples: comparative study and analysis of associated factors in women from tunja, colombia","authors":"Lorenzo Hernando Salamanca Neita , Elizabeth Guío Mahecha , Mónica Gabriela Huertas Valero , Johana Marín Suárez , Juan Pablo Carvajal Rojas , Gloria Eugenia Camargo Villalba , Laura Ximena Ramírez López","doi":"10.1016/j.pmedr.2026.103393","DOIUrl":"10.1016/j.pmedr.2026.103393","url":null,"abstract":"<div><h3>Objective</h3><div>To compare Human Papillomavirus (HPV) detection in first-void urine (FVU) and cervicovaginal samples and to analyze factors associated with cervicovaginal HPV infection among women in Tunja, Colombia.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among 161 women aged 20–65 years residing in Tunja, Colombia. Samples and data were collected between September and November 2022 in a clinical laboratory. Cervicovaginal and FVU samples were obtained for HPV genotyping using the INNO-LiPA HPV Genotyping Extra II kit. Concordance, sensitivity, specificity, and associations with sociodemographic and gynecological variables were evaluated. Crude and adjusted odds ratios (OR) were estimated using logistic regression.</div></div><div><h3>Results</h3><div>HPV prevalence was 29.19% in cervicovaginal samples and 32.91% in urine samples. Genotypes 52 and 68 were the most frequent in both sample types. Concordance between tests was weak (kappa = 0.39). Sensitivity and specificity of urine-based detection were 61.70% and 78.94%, respectively. In the multivariable model, only pregnancy history remained independently associated with cervicovaginal HPV infection.</div></div><div><h3>Conclusions</h3><div>HPV infection prevalence was moderate, with high-risk genotypes detected in both sample types. The history of pregnancy was the only independent factor associated with cervicovaginal HPV infection. HPV detection in urine showed limited diagnostic performance, highlighting the need to optimize urine screening strategies.</div></div>","PeriodicalId":38066,"journal":{"name":"Preventive Medicine Reports","volume":"62 ","pages":"Article 103393"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Adherence to heart rate-based intensity parameters predicts cardiovascular response to 12-weeks of aerobic cycling training in sedentary older adults 坚持以心率为基础的强度参数预测久坐的老年人进行12周有氧自行车训练后的心血管反应

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.pmedr.2026.103388

Tom S. Novak , Caroline Quan , Keith McGregor , Kevin Mammino , Medina Bello , Joe R. Nocera

Objectives

Exercise improves cardiovascular health in older adults, yet variability in responsiveness remains. This study tested if prescribed exercise intensity adherence predicts individual differences in cardiovascular fitness gains following an intervention.

Methods

From 2017 to 2022, nineteen sedentary older adults (69.78 ± 6.47 years) completed a 12-week aerobic cycling program in the Exercise Research Laboratory at the Atlanta VA Hospital. Participants trained 3× weekly, progressing from 20 to 45 min per session. Target intensity, expressed as percent heart rate reserve (HRR), increased from 50% to 80%. Cardiovascular fitness (

\dot{V} O

_2max) was estimated pre- and post-intervention using the YMCA submaximal test. Attendance reflected the proportion of completed sessions. Intensity-based adherence was derived from the ratio of median HR to prescribed HR across sessions, modeled over time, and expressed as change from session 1 to 36.

Results

Estimated

\dot{V} O

_2max increased significantly (21.51 ± 8.77 to 25.80 ± 9.42 ml/kg/min, p < .001). Attendance exceeded 90% and did not predict estimated

\dot{V} O

_2max change, whereas HR adherence to prescribed intensity significantly predicted improvement (R² = 0.42, p = .01).

Conclusions

Cardiovascular adaptations in older adults relate more strongly to prescribed HR adherence than attendance. Objective, trajectory-based adherence metrics may refine exercise prescriptions and improve prediction of individual responsiveness.

目的：运动可以改善老年人的心血管健康，但其反应性仍存在差异。这项研究测试了是否坚持规定的运动强度可以预测干预后心血管健康增加的个体差异。方法2017年至2022年，19名久坐老年人（69.78±6.47岁）在亚特兰大VA医院运动研究实验室完成了为期12周的有氧自行车项目。参与者每周训练3次，每次从20分钟到45分钟不等。目标强度，以百分比心率储备（HRR）表示，从50%增加到80%。心血管适应度（V˙O2max）在干预前和干预后通过YMCA次极大试验进行评估。出席率反映了完成会议的比例。以强度为基础的依从性来源于各疗程中HR与处方HR的比值，并随时间建模，表示为从第1期到第36期的变化。结果V˙O2max估测值显著升高（21.51±8.77 ~ 25.80±9.42 ml/kg/min, p < 0.001）。出勤率超过90%并不能预测估计的V˙O2max变化，而坚持规定强度的HR显著预测改善（R2 = 0.42, p = 0.01）。结论：老年人的心血管适应性与处方HR依从性的关系比出席率的关系更强。客观的，基于运动轨迹的依从性指标可以改进运动处方，提高对个体反应性的预测。

{"title":"Adherence to heart rate-based intensity parameters predicts cardiovascular response to 12-weeks of aerobic cycling training in sedentary older adults","authors":"Tom S. Novak , Caroline Quan , Keith McGregor , Kevin Mammino , Medina Bello , Joe R. Nocera","doi":"10.1016/j.pmedr.2026.103388","DOIUrl":"10.1016/j.pmedr.2026.103388","url":null,"abstract":"<div><h3>Objectives</h3><div>Exercise improves cardiovascular health in older adults, yet variability in responsiveness remains. This study tested if prescribed exercise intensity adherence predicts individual differences in cardiovascular fitness gains following an intervention.</div></div><div><h3>Methods</h3><div>From 2017 to 2022, nineteen sedentary older adults (69.78 ± 6.47 years) completed a 12-week aerobic cycling program in the Exercise Research Laboratory at the Atlanta VA Hospital. Participants trained 3× weekly, progressing from 20 to 45 min per session. Target intensity, expressed as percent heart rate reserve (HRR), increased from 50% to 80%. Cardiovascular fitness (<span><math><mover><mi>V</mi><mo>˙</mo></mover><mi>O</mi></math></span><sub>2max</sub>) was estimated pre- and post-intervention using the YMCA submaximal test. Attendance reflected the proportion of completed sessions. Intensity-based adherence was derived from the ratio of median HR to prescribed HR across sessions, modeled over time, and expressed as change from session 1 to 36.</div></div><div><h3>Results</h3><div>Estimated <span><math><mover><mi>V</mi><mo>˙</mo></mover><mi>O</mi></math></span><sub>2max</sub> increased significantly (21.51 ± 8.77 to 25.80 ± 9.42 ml/kg/min, <em>p</em> < .001). Attendance exceeded 90% and did not predict estimated <span><math><mover><mi>V</mi><mo>˙</mo></mover><mi>O</mi></math></span><sub>2max</sub> change, whereas HR adherence to prescribed intensity significantly predicted improvement (R<sup>2</sup> = 0.42, <em>p</em> = .01).</div></div><div><h3>Conclusions</h3><div>Cardiovascular adaptations in older adults relate more strongly to prescribed HR adherence than attendance. Objective, trajectory-based adherence metrics may refine exercise prescriptions and improve prediction of individual responsiveness.</div></div>","PeriodicalId":38066,"journal":{"name":"Preventive Medicine Reports","volume":"62 ","pages":"Article 103388"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Psychometric validation of the food and nutrition literacy scale (Escala de Literacia da Alimentação e Nutrição – E-LAN) among Portuguese youth 葡萄牙青年食品和营养素养量表(e -LAN)的心理测量验证

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.pmedr.2026.103392

Maria João Batalha , Camila Rosinha , Catarina Amaro , Mariana Couto , Mariana Fidalgo , Sara Simões Dias

Objectives

Psychometric Validation of the Escala de Literacia da Alimentação e Nutrição (E-LAN), addressing the current lack of validated instruments for assessing food and nutrition literacy among portuguese youth.

Study design

Cross-sectional.

Methods

The study was conducted in a school setting in the western region of central Portugal between April 10 and 12, 2024, using a convenience sample of children aged 10–12 years. The E-LAN comprises 49 items (42 Likert-scale and 7 multiple-choice) across seven subscales assessing cognitive and skills domains. Reliability was examined using Cronbach's α, and confirmatory factor analysis (CFA) was performed to evaluate the internal structure, using χ²/df, AGFI, CFI, TLI, and RMSEA as fit indices.

Results

The initial scale showed good internal consistency (Cronbach's α = 0.875). Four items were removed due to low item-total correlations and factor loadings. The revised 38-item version demonstrated improved reliability (Cronbach's α = 0.889), acceptable inter-item correlations, and good model fit (χ²/df = 1.45; AGFI = 0.91; CFI = 0.93; TLI = 0.91; RMSEA = 0.06).

Conclusions

The E-LAN is a concise, reliable, and valid tool for assessing food and nutrition literacy among portuguese youth, supporting its use in public health research and interventions.

目的：对食品营养 (e - lan)进行心理计量学验证，解决目前缺乏评估葡萄牙青年食品和营养素养的有效工具的问题。研究designCross-sectional。方法本研究于2024年4月10日至12日在葡萄牙中部西部地区的一所学校进行，使用了10 - 12岁的儿童作为方便样本。E-LAN包括七个子量表的49个项目（42个李克特量表和7个选择题），评估认知和技能领域。采用Cronbach’s α检验信度，采用验证性因子分析（CFA）评价内部结构，拟合指标采用χ2/df、AGFI、CFI、TLI和RMSEA。结果初始量表具有良好的内部一致性（Cronbach’s α = 0.875）。由于低项目总量相关性和因素负荷，四个项目被删除。修订后的38个条目的版本证明了提高的信度（Cronbach's α = 0.889），可接受的条目间相关性和良好的模型拟合（χ2/df = 1.45; AGFI = 0.91; CFI = 0.93; TLI = 0.91; RMSEA = 0.06）。结论E-LAN是一种简明、可靠、有效的评估葡萄牙青年食物和营养素养的工具，支持其在公共卫生研究和干预中的应用。

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引用次数: 0

Contraceptive care for patients with bigger bodies in the US: Evaluation of a provider training intervention 美国大体型患者的避孕护理：对提供者培训干预的评估

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2026-01-19 DOI: 10.1016/j.pmedr.2026.103389

Yasaman Zia , Alejandra Alvarez , Christina Pineda , Connie Folse , Jen Robinson , Alison Edelman , Suzan Goodman , Cynthia C. Harper

Objective

Weight stigma is widespread in healthcare. Few studies have assessed contraceptive counseling approaches for patients with bigger bodies. We aimed to assess the impact of a training program on changes in counseling knowledge for those delivering care in the US to patients with bigger bodies.

Methods

From January 2024 to January 2025, we surveyed attendees of Continuing Medical Education (CME)-accredited training on delivering contraceptive care to patients with bigger bodies to assess clinical knowledge change.

Results

Most providers lacked knowledge on contraceptive options and emergency contraception dosing and options for patients with bigger bodies at baseline. We found improved knowledge of clinical recommendations for contraceptive care for this population, improved emergency contraception counseling, and enhanced sensitivity in clinical practices both immediately-post and at 3-month post-training.

Conclusions

Patients with bigger bodies deserve accurate clinical information and comprehensive access to contraception. To provide person-centered care for patients with bigger bodies, this training increased knowledge of how to deliver contraceptive care for this population.

目的体重耻辱感在医疗保健中很普遍。很少有研究对体型较大的患者的避孕咨询方法进行评估。我们的目的是评估培训项目对在美国为体型较大的患者提供护理的咨询知识变化的影响。方法从2024年1月至2025年1月，对参加继续医学教育（CME）认可的大体型患者避孕护理培训的人员进行调查，评估临床知识的变化。结果大多数医疗服务提供者缺乏关于避孕选择和紧急避孕剂量的知识，以及基线时体重较大的患者的选择。我们发现，这一人群对临床避孕护理建议的了解有所改善，紧急避孕咨询有所改善，培训后立即和培训后3个月临床实践的敏感性都有所提高。结论体型较大的患者应获得准确的临床信息和全面的避孕措施。为了为体型较大的患者提供以人为本的护理，这一培训增加了如何为这一人群提供避孕护理的知识。

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引用次数: 0

Childhood adversity and self-rated health disparities by citizenship in middle-aged-and-older Latino adults in California 加州中老年拉丁裔成年人的童年逆境和自评健康差异

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventive Medicine Reports

Pub Date : 2026-01-16 DOI: 10.1016/j.pmedr.2026.103387

Alein Y. Haro-Ramos , Julio Fernando Salas , Josefina Flores Morales

Objectives

We assessed the association between adverse childhood experiences (ACEs) and fair/poor self-rated health (SRH), and whether citizenship modifies it among Latinos aged ≥50 years.

Methods

Latinos aged ≥50 from the 2021–2022 California Health Interview Survey (n = 5493) were included. Weighted log-binomial generalized linear models estimated prevalence ratios (PRs) of the associations between ACEs, citizenship, and fair/poor SRH, including interaction terms to assess effect modification on multiplicative and additive scales.

Results

High ACE exposure (≥4) was associated with a higher fair/poor SRH prevalence (PR = 1.38, 95% CI:1.21, 1.57) relative to low ACEs. Immigrant Latinos had higher fair/poor SRH prevalence than U.S.-born Latinos, strongest among noncitizens (PR = 2.19, 95% CI:1.86, 2.57). Multiplicative interaction by citizenship was statistically significant; however, the relative association between high ACEs and fair/poor SRH was smaller among immigrant Latinos than U.S.-born Latinos. On the additive scale, high ACEs corresponded to meaningful absolute increases in fair/poor SRH across all groups (U.S.-born: +14 percentage points; naturalized: +6; noncitizens: +12).

Conclusions

High ACE exposure is consistently associated with poorer SRH among Latinos aged ≥50, but citizenship shapes how this risk is expressed. Evaluating both additive and multiplicative scales clarifies that smaller relative effects among noncitizens coexist with substantial absolute health burdens.

目的：我们评估不良童年经历（ace）与公平/不良自评健康（SRH）之间的关系，以及在年龄≥50岁的拉丁美洲人中，公民身份是否会改变这种关系。方法纳入2021-2022年加州健康访谈调查中年龄≥50岁的拉丁裔（n = 5493）。加权对数二项广义线性模型估计了ace、公民身份和公平/不良SRH之间关联的患病率比率（pr），包括相互作用项，以评估乘法和加法尺度上的影响修改。结果与低ACE相比，高ACE暴露（≥4）与较高的一般/不良SRH患病率相关（PR = 1.38, 95% CI:1.21, 1.57）。拉美裔移民比美国出生的拉美裔人有更高的公平/贫困性生殖疾病患病率，在非公民中最为明显（PR = 2.19, 95% CI:1.86, 2.57）。公民身份的乘法交互作用具有统计学意义；然而，拉美裔移民与美国出生的拉美裔相比，高ace与公平/贫穷的SRH之间的相对关联较小。在累加尺度上，高ace对应于所有群体中公平/贫穷SRH的有意义的绝对增长（美国出生：+14个百分点；归化：+6个百分点；非公民：+12个百分点）。结论：在≥50岁的拉美裔人群中，高ACE暴露始终与较差的SRH相关，但公民身份决定了这种风险的表达方式。对累加性和乘法尺度的评估表明，在非公民中，较小的相对影响与巨大的绝对健康负担并存。

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引用次数: 0