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Author Reply to Letter to the Editor Regarding “Accuracy of Online Artificial Intelligence Models in Primary Care Settings” 作者就 "在线人工智能模型在基层医疗机构中的准确性 "致编辑的回信
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-18 DOI: 10.1016/j.amepre.2024.03.016
Richard M. Wardrop III MD, PhD, Andrei Brateanu MD, Joseph Kassab MD, MS
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引用次数: 0
ACPM Member Spotlight—Eric Deussing, MD, MPH, FACPM ACPM 会员聚焦-Eric Deussing,医学博士,公共卫生硕士,FACPM
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-18 DOI: 10.1016/j.amepre.2024.04.005
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引用次数: 0
Letter to the Editor Regarding “Accuracy of Online Artificial Intelligence Models in Primary Care Settings” 致编辑的信,内容涉及 "在线人工智能模型在基层医疗机构中的准确性"。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-18 DOI: 10.1016/j.amepre.2024.03.017
Wenjuan Yang MS, Guoliang Shi BS
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引用次数: 0
Patient-Provider Communication and Access, Use, and Financial Burden of Care 患者与医疗服务提供者之间的沟通以及医疗服务的获取、使用和经济负担。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-14 DOI: 10.1016/j.amepre.2024.07.004
Sungchul Park PhD , David D. Kim PhD

Introduction

Effective patient-provider communication is a critical component of optimal patient care, but its potential impact on the delivery of healthcare services remains unclear. This study examines the association of patient-provider communication with access to care, healthcare utilization, and financial burden of care.

Methods

Using the 2013–2021 Medical Expenditure Panel Survey longitudinal data, the level of patient-provider communication was measured across four domains (attentive listening, clear explanation, respectfulness, and time allocation) as a primary independent variable, categorized into low, moderate, and high. A lagged dependent model was employed to examine the associations of patient-provider communication at baseline with subsequent access to care, healthcare utilization, and financial burden of care, controlling for baseline sample characteristics and outcomes measured at the baseline. Analysis was conducted in February 2024.

Results

Among 28,955 analytic samples (representing 709,547,678 U.S. adults), 5.3%, 50.2%, and 44.3% reported low, moderate, and high levels of patient-provider communication. Marginalized populations, including racial/ethnic minorities, those with low education and income, and those lacking insurance, were more likely to report low patient-provider communication. Compared with adults with high patient-provider communication, those with low patient-provider communication were more likely to encounter difficulties in accessing medical care (2.6 percentage points; 95% CI: 1.2–3.9), experience delays in obtaining necessary medical care (2.8 percentage points; 1.3–4.4), have emergency room visits (4.2 percentage points; 1.9–6.4), and face difficulties paying medical bills (4.0 percentage points; 2.2–5.8) in the subsequent year.

Conclusions

Encouraging effective patient-provider communication is essential for advancing patient-centered care and mitigating health inequities.
介绍:有效的医患沟通是优化患者护理的重要组成部分,但其对提供医疗服务的潜在影响尚不清楚。本研究探讨了患者与医护人员沟通与获得医疗服务、医疗服务利用率以及医疗服务经济负担之间的关系:方法:利用 2013-2021 年医疗支出小组调查的纵向数据,从四个方面(用心倾听、清晰解释、尊重和时间分配)衡量患者与医护人员的沟通水平,并将其作为主要自变量,分为低、中、高三个等级。在控制基线样本特征和基线测量结果的前提下,我们采用了一个滞后因果关系模型来检验基线时患者与医疗服务提供者的沟通与后续医疗服务的获得、医疗服务的使用和医疗服务的经济负担之间的关系。分析于 2024 年 2 月进行:在 28,955 个分析样本(代表 709,547,678 名美国成年人)中,5.3%、50.2% 和 44.3% 的样本报告了患者与医护人员沟通的低度、中度和高度水平。边缘化人群,包括少数种族/族裔、低学历和低收入人群以及没有保险的人群,更有可能报告患者与医疗服务提供者沟通水平低。与患者-医患沟通程度高的成年人相比,患者-医患沟通程度低的成年人在随后一年中更有可能在获得医疗护理方面遇到困难(2.6 个百分点;95% CI:1.2-3.9),在获得必要的医疗护理方面遇到延误(2.8 个百分点;1.3-4.4),在急诊室就诊(4.2 个百分点;1.9-6.4),以及在支付医疗账单方面遇到困难(4.0 个百分点;2.2-5.8):鼓励患者与医疗服务提供者进行有效沟通对于促进以患者为中心的医疗服务和减少医疗不公平现象至关重要。
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引用次数: 0
Chronic Disease Epidemiology, Prevention, and Control, 5th Edition 慢性病流行病学、预防与控制》第 5 版
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-14 DOI: 10.1016/j.amepre.2024.06.010
Gary D. Gilmore MPH, PhD, MCHES
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引用次数: 0
ACPM Position Statement: Air Pollution and Environmental Justice ACPM 立场声明:空气污染与环境正义。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-14 DOI: 10.1016/j.amepre.2024.07.003
Randall J. Freeman MD, MPH, MBA, MTM&H, FACOEM, FACPM , Leith J. States MD, MPH, MBA, FACPM , Stephen A. Lewandowski PhD, MS, CPE , Darrell E. Singer MD, MPH, FACPM , Sayalee N. Patankar AB , David W. Niebuhr MD, MPH, MSc, FACPM, FAAFP
The American Lung Association's “State of the Air” 2023 report reveals almost 36% of Americans live with unhealthy levels of air pollution. Studies link air pollution with acute respiratory symptoms and exacerbation of respiratory and cardiovascular diseases. Differential air pollution exposures between white and nonwhite communities are significant components of environmental injustices. Even during the coronavirus disease 2019 (COVID-19) lockdown, when the United States experienced significant decreases in polluting activities, these differences persisted. The American College of Preventive Medicine's Science and Translation Committee conducted a nonsystematic literature review to explore initiatives addressing air pollution as a key component of environmental justice, the state of the science regarding health impacts, and evidence supporting mitigations to reduce those impacts. We recommend advocacy for cleaner energy sources and increasing green space; and increasing research, surveillance, and education and training on linkages between air pollutants and health. We recommend preventive medicine physicians raise awareness about increased risks of cardiovascular disease, cancer, asthma, and reduced lung function with air pollution exposure. Preventive medicine physicians may also educate patients and other practitioners about exposures, and how “conventional” disease prevention strategies may have unintended consequences; and influence healthcare leaders to improve efficiency and reduce emissions. We also recommend physicians utilize social determinants of health Z-Codes to capture environmental factors. Private payers should incorporate pollution exposure data into social determinants of health risk adjustments for Medicare Advantage programs. Medicaid agencies should develop provider recommendations for pediatric populations, and states should finance in-home interventions for asthma.
美国肺脏协会的《2023 年空气状况》报告显示,近 36% 的美国人生活在不健康的空气污染环境中。研究表明,空气污染与急性呼吸道症状以及呼吸道和心血管疾病的恶化有关。白人和非白人社区之间的空气污染暴露差异是环境不公正的重要组成部分。即使在 COVID-19 封锁期间,美国的污染活动显著减少,但这些差异依然存在。美国预防医学院科学与翻译委员会进行了一项非系统性文献回顾,以探讨作为环境正义关键组成部分的空气污染应对措施、有关健康影响的科学现状,以及支持减轻这些影响的证据。我们建议倡导使用更清洁的能源,增加绿地面积;加强对空气污染物与健康之间联系的研究、监测、教育和培训。我们建议预防医学医生提高人们对空气污染会增加心血管疾病、癌症、哮喘和肺功能下降风险的认识。预防医学科医生还可以教育患者和其他从业人员,让他们了解空气污染暴露,以及 "传统 "疾病预防策略如何可能产生意想不到的后果;并影响医疗保健领导者提高效率和减少排放。我们还建议医生利用健康的社会决定因素 (SDOH) Z 代码来捕捉环境因素。私人支付机构应将污染暴露数据纳入医疗保险优势计划的 SDOH 风险调整中。医疗补助(Medicaid)机构应制定针对儿科人群的医疗服务提供者建议,各州应资助针对哮喘的居家干预措施。
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引用次数: 0
Transactional Sex, HIV, and Bacterial STIs Among U.S. Men Who have Sex with Men 美国男男性行为者中的性交易、艾滋病毒和细菌性性传播感染。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-11 DOI: 10.1016/j.amepre.2024.07.002
Kaitlyn Atkins PhD , John M. Wiginton PhD , Thomas Carpino MPH , Travis H. Sanchez DVM , Sarah M. Murray PhD , Stefan D. Baral MD

Introduction

Men who have sex with men (MSM) and are engaged in transactional sex (MSM-TS) experience complex social and structural vulnerabilities that increase their HIV risk. This study aimed to estimate the prevalence of TS and associations between TS and sexually transmitted infection (STI) outcomes among cisgender MSM in the U.S.

Methods

Using 2017–2021 data from an online survey of U.S. MSM, characteristics of MSM-TS were summarized, and adjusted prevalence ratios (aPRs) calculated for the associations between past-year TS and bacterial STI diagnosis, HIV status, and either antiretroviral or pre-exposure prophylaxis use. Analyses were conducted in 2023.

Results

TS prevalence was 3.7% (n=1,848/49,539). Compared to other MSM, MSM-TS more commonly reported homelessness, being uninsured, condomless anal sex with partners of any HIV status and condomless anal sex with serodifferent partners, and illicit drug use. TS was associated with increased HIV (aPR 1.44, 95% CI 1.25–1.66) and bacterial STI prevalence (aPR 2.40, 95% CI=2.09–2.52) and lower antiretroviral therapy use (among MSM living with HIV; PR 0.92, 95% CI=0.87–0.97).

Conclusions

Structural and behavioral risks converged among U.S. MSM engaging in TS leading to greater HIV and bacterial STI prevalence in this group. HIV interventions for U.S. MSM-TS should address individual as well as structural risks, including poverty and housing instability.
导言:男男性行为者(MSM)和从事性交易的男性(MSM-TS)经历了复杂的社会和结构脆弱性,这增加了他们感染 HIV 的风险。本研究旨在估算美国顺性别 MSM 中交易性行为的发生率以及交易性行为与性传播感染(STI)结果之间的关联:利用美国 MSM 在线调查的 2017-2021 年数据,总结了 MSM-TS 的特征,并计算了上一年 TS 与细菌性 STI 诊断、HIV 感染状况以及抗逆转录病毒疗法或暴露前预防疗法 (PrEP) 使用之间的调整患病率比 (aPR)。分析于 2023 年进行:TS 患病率为 3.7%(n=1,848/49,539)。与其他 MSM 相比,MSM-TS 更常报告无家可归、无保险、与任何 HIV 感染状况的伴侣进行无套肛交 (CAS)、与血清不同的伴侣进行 CAS 以及使用非法药物。TS 与 HIV 感染率(aPR 1.44,95% CI 1.25-1.66)和细菌性 STI 感染率(aPR 2.40,95% CI=2.09-2.52)增加以及抗逆转录病毒疗法使用率降低(在感染 HIV 的 MSM 中;PR 0.92,95% CI=0.87-0.97)有关:从事性传播感染的美国男男性行为者的结构性风险和行为风险趋于一致,导致该群体中艾滋病毒和细菌性传播感染的发病率更高。针对美国 MSM-TS 的 HIV 干预措施应解决个人和结构性风险,包括贫困和住房不稳定。
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引用次数: 0
Intoxicating Cannabis Products in Vape Shops: United States, 2023 Vape 商店中的有毒大麻产品:美国,2023 年。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-11 DOI: 10.1016/j.amepre.2024.07.001
Matthew E. Rossheim PhD , Cassidy R. LoParco PhD , Kayla K. Tillett MPH , Ryan D. Treffers JD , Melvin D. Livingston PhD , Carla J. Berg PhD

Introduction

Since 2020, many types of intoxicating cannabis products have entered the U.S. market. Hemp-derived intoxicating cannabis products, including hexahydrocannabinol and delta-8 tetrahydrocannabinol, pose concerns regarding their youth-oriented marketing, potency, and health effects. Some states have attempted to ban, restrict, or regulate their sale. However, the effectiveness of these laws and their enforcement is unclear. This study provides insights into the retail landscape of intoxicating cannabis products sold across the U.S.

Methods

In November–December 2023, researchers systematically identified, called, and completed brief surveys with 520 U.S. vape shops: (n=10 per state, n=10 in District of Columbia, n=10 in Puerto Rico). The survey assessed the availability of 6 commonly sold intoxicating cannabis products. Data were analyzed by regulatory context. Analyses were conducted in 2024.

Results

A total of 74% of vape shops sold any intoxicating cannabis products. Intoxicating cannabis products were sold in 43% of shops in states with delta-8 tetrahydrocannabinol bans, 53% in states with substantial regulations (intended to support safe use), 90% in states with significant restrictions (intended to limit potency/availability), and 92% in states with limited/no regulations. Intoxicating cannabis products were sold in vape shops in each state except Washington and Alaska, both of which banned hemp-derived intoxicating cannabis products and had active retail of legalized nonmedical cannabis.

Conclusions

Taking licensed dispensaries into consideration, intoxicating cannabis products can be purchased in retail stores located in all 50 states; Washington, District of Columbia; and Puerto Rico. Intoxicating cannabis products are widely available in vape shops, even in most states with relevant bans/restrictions. Enhanced laws, surveillance, and enforcement are needed. The 2024 Farm Bill and state laws should explicitly prohibit hemp-derived intoxicating cannabis products.
导言:自 2020 年以来,多种类型的醉人大麻产品 (ICP) 进入了美国市场。大麻衍生的 ICP(包括六氢大麻酚 (HHC) 和δ-8 四氢大麻酚 (THC))因其面向年轻人的营销、药效和对健康的影响而备受关注。一些州已尝试禁止、限制或监管其销售。然而,这些法律的有效性及其执行情况尚不明确。目前的研究为了解全美 ICPs 的零售情况提供了参考:2023 年 11 月至 12 月,研究人员系统地确定、召集并完成了对美国 520 家汽水店的简短调查:(每个州 10 家,哥伦比亚特区 10 家,波多黎各 10 家)。调查评估了 6 种常用 ICP 的供应情况。数据按监管环境进行分析。分析于 2024 年进行:74%的汽水店出售任何 ICPs。在禁止使用δ-8四氢大麻酚的州,43%的商店出售 ICPs;在有严格规定(旨在支持安全使用)的州,53%的商店出售 ICPs;在有严格限制(旨在限制药效/可用性)的州,90%的商店出售 ICPs;在有限制/无规定的州,92%的商店出售 ICPs。除华盛顿州和阿拉斯加州外,其他各州的吸食店都出售 ICP,这两个州都禁止大麻衍生 ICP,并积极零售合法化的非医用大麻:考虑到持证药房的情况,所有 50 个州、华盛顿特区和波多黎各的零售店都可以购买到 ICP。即使在大多数有相关禁令/限制的州,也可以在汽疗店广泛购买到 ICP。需要加强法律、监督和执法。2024 年农业法案》和各州法律应明确禁止大麻衍生的 ICP。
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引用次数: 0
Social Determinants of Health Research at NIMHD: An Analysis of Studies Funded During 2019–2023 NIMHD 的健康社会决定因素研究:2019-2023 年资助的研究分析。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-05 DOI: 10.1016/j.amepre.2024.06.027

Introduction

Social determinants of health (SDOH) contribute to differences in health outcomes and exacerbate health disparities. This study characterizes the National Institute on Minority Health and Health Disparities’ (NIMHD) portfolio of funded grants in SDOH research, identifies gaps, and provides suggestions for future research.

Methods

Using the National Institutes of Health's SDOH Research, Condition, and Disease Categorization, research projects funded from 2019 to 2023 were identified and linked with NIMHD's internal coding system to extract in-depth study characteristics, including sociodemographics of study participants, disease and condition focus, and alignment with strategic priorities. Natural Language Processing methods were used to categorize projects into five Healthy People 2030 SDOH domains.

Results

The resulting sample included 675 unique research projects. Most projects included racial and ethnic minority groups (89%), followed by people with lower socioeconomic status (33%), underserved rural communities (16%), and sexual and gender minority groups (13%). Most projects focused on the Etiology of health disparities (61%), followed by Interventions (54%), and Methods and Measurement (39%). Of the Healthy People 2030 domains, Social and Community Context had the greatest representation (61%) whereas Education Access and Quality had the least (6%). Variation in research project characteristics across SDOH domains is also presented.

Conclusions

This study documents characteristics of SDOH research funded by NIMHD and explores how they differ across Healthy People 2030 SDOH domains. Findings highlight how study characteristics and foci align with strategic priorities and suggest opportunities for future research.
导言:健康的社会决定因素(SDOH)导致了健康结果的差异并加剧了健康差距。本研究描述了美国国立少数民族健康与健康差异研究所(NIMHD)在 SDOH 研究方面的资助项目组合,找出了差距,并为今后的研究提出了建议:方法:利用美国国立卫生研究院(National Institutes of Health)的SDOH研究、状况和疾病分类,确定了2019年至2023年资助的研究项目,并与NIMHD的内部编码系统相连接,以提取深入的研究特征,包括研究参与者的社会人口学特征、疾病和状况重点,以及与战略重点的一致性。使用自然语言处理方法将项目归类为五个 "健康2030 "SDOH 领域:结果:结果样本包括 675 个独特的研究项目。大多数项目包括少数种族和少数族裔群体(89%),其次是社会经济地位较低者(33%)、服务不足的农村社区(16%)以及性和性别少数群体(13%)。大多数项目侧重于健康差异的病因(61%),其次是干预措施(54%)以及方法和测量(39%)。在 "健康人类 2030 "领域中,社会和社区背景的代表性最高(61%),而教育机会和教育质量的代表性最低(6%)。此外,还介绍了不同 SDOH 领域的研究项目特点的差异:本研究记录了由 NIMHD 资助的 SDOH 研究的特点,并探讨了这些特点在 "健康 2030 "SDOH 领域中的差异。研究结果强调了研究特点和重点如何与战略重点保持一致,并提出了未来研究的机会。
{"title":"Social Determinants of Health Research at NIMHD: An Analysis of Studies Funded During 2019–2023","authors":"","doi":"10.1016/j.amepre.2024.06.027","DOIUrl":"10.1016/j.amepre.2024.06.027","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Social determinants of health (SDOH) contribute to differences in health outcomes and exacerbate </span>health disparities. This study characterizes the National Institute on Minority Health and Health Disparities’ (NIMHD) portfolio of funded grants in SDOH research, identifies gaps, and provides suggestions for future research.</div></div><div><h3>Methods</h3><div>Using the National Institutes of Health's SDOH Research, Condition, and Disease Categorization, research projects funded from 2019 to 2023 were identified and linked with NIMHD's internal coding system to extract in-depth study characteristics, including sociodemographics of study participants, disease and condition focus, and alignment with strategic priorities. Natural Language Processing methods were used to categorize projects into five <em>Healthy People 2030</em> SDOH domains.</div></div><div><h3>Results</h3><div><span>The resulting sample included 675 unique research projects. Most projects included racial and ethnic minority groups (89%), followed by people with lower socioeconomic status (33%), underserved rural communities (16%), and sexual and gender minority groups (13%). Most projects focused on the Etiology of health disparities (61%), followed by Interventions (54%), and Methods and Measurement (39%). Of the </span><em>Healthy People 2030</em> domains, Social and Community Context had the greatest representation (61%) whereas Education Access and Quality had the least (6%). Variation in research project characteristics across SDOH domains is also presented.</div></div><div><h3>Conclusions</h3><div>This study documents characteristics of SDOH research funded by NIMHD and explores how they differ across <em>Healthy People 2030</em> SDOH domains. Findings highlight how study characteristics and foci align with strategic priorities and suggest opportunities for future research.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"67 5","pages":"Pages 713-721"},"PeriodicalIF":4.3,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trends in Awareness of the Causal Link Between HPV and Cervical Cancer in the US: 2013 to 2022 美国对 HPV 与宫颈癌之间因果关系的认识趋势:2013 年至 2022 年。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-05 DOI: 10.1016/j.amepre.2024.06.025
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引用次数: 0
期刊
American Journal of Preventive Medicine
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