首页 > 最新文献

American Journal of Preventive Medicine最新文献

英文 中文
Nonfatal Firearm Injury and Subsequent Emergency Department Utilization Among Nonelderly Adults 非老年成年人非致命性枪伤及其后的急诊使用情况。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-02-01 DOI: 10.1016/j.amepre.2024.10.005
Theodoros Giannouchos PhD, MSc, MPharm , Hye-Chung Kum PhD, MS, MSW , Hannah Rochford PhD, MPH

Introduction

The mortality, long-term morbidity, and exacerbated healthcare needs due to firearm injury in the U.S. are significant and growing. However, the relationship between exposure to a nonfatal firearm injury and long-term emergency department (ED) utilization is poorly understood. This study estimates the association between exposure to a nonfatal firearm injury and ED utilization in the subsequent year.

Methods

Using all-payer ED data among nonelderly adults in Georgia and New York, all ED visits for nonfatal firearm injuries from 2017 to 2018 were identified. Sociodemographic, clinical, and contextual characteristics between nonfatal firearm injury ED patients and the broader population of ED users were compared. ED utilization in the year following a nonfatal firearm injury relative to ED use in the year before and compared with ED use by a propensity score matched control group was examined using Poisson and negative binomial multivariable regressions. Analyses were performed in 2024.

Results

Nonfatal firearm injury ED patients were disproportionately male, younger, non-Hispanic Black, uninsured, and residents of areas with low median income and high firearm ownership. Compared to a matched control group, multivariable analyses indicated that nonfatal firearm injury ED patients had significantly higher risks of having hospital admissions through the ED (aRR: 1.42), all-cause injury-related ED visits (aRR: 1.47), nonfirearm injury-related ED visits (aRR: 1.26), and additional nonfatal firearm injury-related ED visits (aRR: 325.45) in the subsequent year (p<0.001 for all). About one in every eight ED users with a firearm-related injury at index also sought ED care for another nonfatal firearm injury within 1 year.

Conclusions

Nonfatal firearm-related injuries contribute to preventable harm, health inequity, and increased ED utilization.
导言:在美国,枪支伤害造成的死亡率、长期发病率和医疗需求不断增加。然而,人们对非致命性枪支伤害与长期使用急诊室之间的关系知之甚少。本研究估算了非致命性枪支伤害与随后一年急诊室使用率之间的关系:利用佐治亚州和纽约州非老年人的全付费 ED 数据,确定了 2017-2018 年期间所有非致命性枪支伤害的 ED 就诊情况。比较了非致命性枪支伤害急诊室患者与更广泛的急诊室使用者之间的社会人口、临床和环境特征。利用泊松和负二项多变量回归法,研究了非致命性枪支伤害发生后一年的急诊室使用率与前一年的急诊室使用率的比较,以及与倾向得分匹配对照组的急诊室使用率的比较。分析于 2024 年进行:非致命性枪支伤害急诊室患者中男性比例偏高、年龄偏小、非西班牙裔黑人、无保险、居住在中位数收入较低且枪支拥有率较高的地区。与匹配对照组相比,多变量分析表明,非致命性枪支伤害急诊室患者在随后一年中通过急诊室入院(aRR:1.42)、全因伤害相关急诊室就诊(aRR:1.47)、非枪支伤害相关急诊室就诊(aRR:1.26)以及非致命性枪支伤害相关急诊室额外就诊(aRR:325.45)的风险明显更高(p结论:与枪支有关的非致命伤害会造成可预防的伤害、健康不公平和急诊室使用率的增加。
{"title":"Nonfatal Firearm Injury and Subsequent Emergency Department Utilization Among Nonelderly Adults","authors":"Theodoros Giannouchos PhD, MSc, MPharm ,&nbsp;Hye-Chung Kum PhD, MS, MSW ,&nbsp;Hannah Rochford PhD, MPH","doi":"10.1016/j.amepre.2024.10.005","DOIUrl":"10.1016/j.amepre.2024.10.005","url":null,"abstract":"<div><h3>Introduction</h3><div>The mortality, long-term morbidity, and exacerbated healthcare needs due to firearm injury in the U.S. are significant and growing. However, the relationship between exposure to a nonfatal firearm injury and long-term emergency department (ED) utilization is poorly understood. This study estimates the association between exposure to a nonfatal firearm injury and ED utilization in the subsequent year.</div></div><div><h3>Methods</h3><div>Using all-payer ED data among nonelderly adults in Georgia and New York, all ED visits for nonfatal firearm injuries from 2017 to 2018 were identified. Sociodemographic, clinical, and contextual characteristics between nonfatal firearm injury ED patients and the broader population of ED users were compared. ED utilization in the year following a nonfatal firearm injury relative to ED use in the year before and compared with ED use by a propensity score matched control group was examined using Poisson and negative binomial multivariable regressions. Analyses were performed in 2024.</div></div><div><h3>Results</h3><div>Nonfatal firearm injury ED patients were disproportionately male, younger, non-Hispanic Black, uninsured, and residents of areas with low median income and high firearm ownership. Compared to a matched control group, multivariable analyses indicated that nonfatal firearm injury ED patients had significantly higher risks of having hospital admissions through the ED (aRR: 1.42), all-cause injury-related ED visits (aRR: 1.47), nonfirearm injury-related ED visits (aRR: 1.26), and additional nonfatal firearm injury-related ED visits (aRR: 325.45) in the subsequent year (<em>p</em>&lt;0.001 for all). About one in every eight ED users with a firearm-related injury at index also sought ED care for another nonfatal firearm injury within 1 year.</div></div><div><h3>Conclusions</h3><div>Nonfatal firearm-related injuries contribute to preventable harm, health inequity, and increased ED utilization.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 281-288"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Physical Activity Paradox in Low Muscle Mass in Middle-Aged and Older Adults 中老年人肌肉质量低的体育锻炼悖论。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-02-01 DOI: 10.1016/j.amepre.2024.10.015
Bokun Kim PhD , Yosuke Osuka PhD , Yoshiro Okubo PhD , Xiaoguang Zhao PhD , Gwon-min Kim PhD , Sechang Oh PhD

Introduction

Physical activity is widely accepted as a therapeutic approach to age-related muscle mass loss. However, it is unclear whether all physical activity domains benefit muscle mass maintenance. This study investigated the association between low muscle mass and domain-specific physical activity, including leisure-time and occupational moderate-to-vigorous physical activity (MVPA).

Methods

This study included 27,357 middle-aged and older individuals (≥40 years) whose data were collected from 2014 to 2022 and analyzed in 2024. Low muscle mass was defined as a muscle mass index 2 SDs below the sex-specific average of 9,426 young individuals (aged 20–39 years). Leisure-time and occupational MVPA were assessed using the Global Physical Activity Questionnaire and categorized as 0 min/wk, 1–149 min/wk, and ≥150 min/wk. Logistic regression analysis focused on all participants, and additional analyses stratified by sex, age, sedentary time, and transfer time were performed.

Results

For leisure-time MVPA, participants with 1–149 min/wk and ≥150 min/wk had significantly lower odds of low muscle mass compared to those with no MVPA, with ORs of 0.795 (95% CI=0.691, 0.914) and 0.740 (95% CI=0.649, 0.843), respectively (p<0.01 for both). No significant association was found between occupational MVPA and low muscle mass. These findings were consistent across different strata of sex, age, sedentary time, and transfer time.

Conclusions

Leisure-time MVPA is inversely associated with low muscle mass, whereas occupational MVPA shows no association, highlighting the importance of dynamic movements of sufficient intensity and recuperation time in maintaining muscle mass.
导言:体力活动(PA)作为一种治疗与年龄有关的肌肉质量下降的方法已被广泛接受。然而,目前还不清楚是否所有的体力活动都有利于肌肉质量的保持。本研究调查了低肌肉质量与特定领域体育锻炼(包括业余时间和职业性中强度体育锻炼(MVPA))之间的关系:这项研究纳入了 27357 名中老年人(≥40 岁),从 2014 年至 2022 年收集了他们的数据,并于 2024 年对这些数据进行了分析。低肌肉质量的定义是肌肉质量指数比9426名年轻人(20-39岁)的性别平均值低两个标准差。休闲和职业 MVPA 采用全球体力活动调查问卷进行评估,分为 0 分钟/周、1-149 分钟/周和≥150 分钟/周。逻辑回归分析主要针对所有参与者,并根据性别、年龄、久坐时间和转移时间进行了分层分析:结果:就闲暇时间 MVPA 而言,与没有进行 MVPA 的参与者相比,每周 1-149 分钟和≥150 分钟的参与者出现低肌肉质量的几率明显较低,OR 值分别为 0.795(95% CI:0.691, 0.914)和 0.740(95% CI:0.649, 0.843)(p结论:休闲时间的 MVPA 与低肌肉质量成反比,而职业 MVPA 与低肌肉质量没有关系,这突显了足够强度的动态运动和休整时间对保持肌肉质量的重要性。
{"title":"The Physical Activity Paradox in Low Muscle Mass in Middle-Aged and Older Adults","authors":"Bokun Kim PhD ,&nbsp;Yosuke Osuka PhD ,&nbsp;Yoshiro Okubo PhD ,&nbsp;Xiaoguang Zhao PhD ,&nbsp;Gwon-min Kim PhD ,&nbsp;Sechang Oh PhD","doi":"10.1016/j.amepre.2024.10.015","DOIUrl":"10.1016/j.amepre.2024.10.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Physical activity is widely accepted as a therapeutic approach to age-related muscle mass loss. However, it is unclear whether all physical activity domains benefit muscle mass maintenance. This study investigated the association between low muscle mass and domain-specific physical activity, including leisure-time and occupational moderate-to-vigorous physical activity (MVPA).</div></div><div><h3>Methods</h3><div>This study included 27,357 middle-aged and older individuals (≥40 years) whose data were collected from 2014 to 2022 and analyzed in 2024. Low muscle mass was defined as a muscle mass index 2 SDs below the sex-specific average of 9,426 young individuals (aged 20–39 years). Leisure-time and occupational MVPA were assessed using the Global Physical Activity Questionnaire and categorized as 0 min/wk, 1–149 min/wk, and ≥150 min/wk. Logistic regression analysis focused on all participants, and additional analyses stratified by sex, age, sedentary time, and transfer time were performed.</div></div><div><h3>Results</h3><div>For leisure-time MVPA, participants with 1–149 min/wk and ≥150 min/wk had significantly lower odds of low muscle mass compared to those with no MVPA, with ORs of 0.795 (95% CI=0.691, 0.914) and 0.740 (95% CI=0.649, 0.843), respectively (<em>p</em>&lt;0.01 for both). No significant association was found between occupational MVPA and low muscle mass. These findings were consistent across different strata of sex, age, sedentary time, and transfer time.</div></div><div><h3>Conclusions</h3><div>Leisure-time MVPA is inversely associated with low muscle mass, whereas occupational MVPA shows no association, highlighting the importance of dynamic movements of sufficient intensity and recuperation time in maintaining muscle mass.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 348-356"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548765","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
Appalachian Primary Care Patients’ Quit Readiness and Tobacco Treatment Receipt 阿巴拉契亚初级保健患者的戒烟准备和烟草治疗接受情况。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-02-01 DOI: 10.1016/j.amepre.2024.09.017
Jessica L. Burris PhD , Abigayle R. Feather BS , Asal Pilehvari PhD , Sarah Cooper MPH , Amie M. Ashcraft PhD, MPH , Roger Anderson PhD , Amy Ferketich PhD

Introduction

Healthcare providers should facilitate smoking cessation, and primary care is an ideal setting for delivering this evidence-based care. This study's objective was to describe readiness to quit smoking combustible cigarettes among adult Appalachian primary care patients and determine their providers’ implementation of an established tobacco treatment model.

Methods

As part of a randomized clinical trial, 298 providers in 10 health systems across 4 states received tobacco treatment training. Periodically between January 2022 and June 2023, anonymous surveys were distributed to patients after primary care visits. The survey included questions about demographics, visit type, smoking status, readiness to quit, and provider behavior related to tobacco treatment implementation. In 2023, descriptive statistics, bivariate tests and logistic regression models were conducted.

Results

Among 1,242 survey respondents, 34.1% reported current smoking. Among those who reported current smoking, 13.9% expressed readiness to quit within the next 30 days and 15.3% reported readiness in 1–6 months while 36.7% indicated “never” wanting to quit. Nearly all providers asked respondents about smoking status (96.9%) and advised them to quit (89.8%); fewer providers engaged in cessation assistance by discussing behavioral counseling, discussing medication options, and/or prescribing medication (25.1%–64.6% across behaviors). Provider behavior was most consistently associated with patient age and visit type.

Conclusions

Nearly one third of Appalachian patients who smoke reported readiness to quit within 6 months and nearly all received advice to quit from their provider. Patients would benefit from more intensive tobacco treatment delivery in primary care settings, with a focus on assisting with quit attempts.
简介:医疗服务提供者应促进戒烟,而初级保健是提供这种循证医疗服务的理想场所。本研究的目的是描述阿巴拉契亚初级保健成年患者戒除可燃卷烟的准备情况,并确定医疗服务提供者实施既定烟草治疗模式的情况:作为随机临床试验的一部分,四个州 10 个医疗系统的 298 名医疗服务提供者接受了烟草治疗培训。2022 年 1 月至 2023 年 6 月期间,定期在初级保健就诊后向患者发放匿名调查问卷。调查内容包括人口统计学、就诊类型、吸烟状况、戒烟意愿以及医疗服务提供者与烟草治疗实施相关的行为。2023 年,我们进行了描述性统计、双变量检验和逻辑回归模型:在1242名调查对象中,34.1%的人表示目前正在吸烟。在目前吸烟的受访者中,13.9% 表示准备在未来 30 天内戒烟,15.3% 表示准备在 1-6 个月内戒烟,36.7% 表示 "从未 "想戒烟。几乎所有的医疗服务提供者都询问了受访者的吸烟情况(96.9%),并建议他们戒烟(89.8%);通过讨论行为咨询、讨论药物选择和/或开具药物处方来提供戒烟帮助的医疗服务提供者较少(25.1%-64.6%)。医疗服务提供者的行为与患者年龄和就诊类型的关系最为密切:近三分之一的阿巴拉契亚吸烟患者表示准备在 6 个月内戒烟,几乎所有患者都接受了医疗服务提供者的戒烟建议。在初级医疗机构提供更深入的烟草治疗,重点帮助患者尝试戒烟,将使患者受益匪浅。
{"title":"Appalachian Primary Care Patients’ Quit Readiness and Tobacco Treatment Receipt","authors":"Jessica L. Burris PhD ,&nbsp;Abigayle R. Feather BS ,&nbsp;Asal Pilehvari PhD ,&nbsp;Sarah Cooper MPH ,&nbsp;Amie M. Ashcraft PhD, MPH ,&nbsp;Roger Anderson PhD ,&nbsp;Amy Ferketich PhD","doi":"10.1016/j.amepre.2024.09.017","DOIUrl":"10.1016/j.amepre.2024.09.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Healthcare providers should facilitate smoking cessation, and primary care is an ideal setting for delivering this evidence-based care. This study's objective was to describe readiness to quit smoking combustible cigarettes among adult Appalachian primary care patients and determine their providers’ implementation of an established tobacco treatment model.</div></div><div><h3>Methods</h3><div>As part of a randomized clinical trial, 298 providers in 10 health systems across 4 states received tobacco treatment training. Periodically between January 2022 and June 2023, anonymous surveys were distributed to patients after primary care visits. The survey included questions about demographics, visit type, smoking status, readiness to quit, and provider behavior related to tobacco treatment implementation. In 2023, descriptive statistics, bivariate tests and logistic regression models were conducted.</div></div><div><h3>Results</h3><div>Among 1,242 survey respondents, 34.1% reported current smoking. Among those who reported current smoking, 13.9% expressed readiness to quit within the next 30 days and 15.3% reported readiness in 1–6 months while 36.7% indicated “never” wanting to quit. Nearly all providers asked respondents about smoking status (96.9%) and advised them to quit (89.8%); fewer providers engaged in cessation assistance by discussing behavioral counseling, discussing medication options, and/or prescribing medication (25.1%–64.6% across behaviors). Provider behavior was most consistently associated with patient age and visit type.</div></div><div><h3>Conclusions</h3><div>Nearly one third of Appalachian patients who smoke reported readiness to quit within 6 months and nearly all received advice to quit from their provider. Patients would benefit from more intensive tobacco treatment delivery in primary care settings, with a focus on assisting with quit attempts.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 396-401"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331831","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
Disparities in Tobacco Smoking and Risk of Cardiovascular Disease in People With Low Socioeconomic Status or Serious Psychological Distress: A Simulation Analysis 社会经济地位低下或有严重心理困扰的人群吸烟与心血管疾病风险的差异:模拟分析。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-02-01 DOI: 10.1016/j.amepre.2024.10.008
Boram Lee PhD , Linzy V. Rosen BA , Nora M. Mulroy BA , Yiqi Qian MPH , Fatma M. Shebl MD, PhD , Jessica E. Becker MD, MPH , Emily P. Hyle MD, MSc , Douglas E. Levy PhD , Krishna P. Reddy MD, MS

Introduction

High tobacco smoking prevalence in people with low SES or serious psychological distress in the U.S. may increase cardiovascular disease risk among these marginalized subpopulations. The authors estimate how smoking disparities contribute to cardiovascular disease disparities.

Methods

Using the Simulation of Tobacco and Nicotine Outcomes and Policy model, a validated microsimulation model of tobacco use and clinical outcomes, the authors used 2004–2019 data from the National Health Interview Survey to first compare 20-year cumulative cardiovascular disease incidence for people aged 40 years by sex, smoking status, and marginalized subpopulation membership. Second, the authors simulated the marginalized subpopulations with representative age, sex, and smoking status distributions to estimate 20-year cumulative cardiovascular disease incidence under status quo and counterfactual scenarios. In the counterfactual scenario, smoking prevalence and trends in the low SES and serious psychological distress subpopulations match those in the higher SES and non-SPD subpopulations, respectively.

Results

The model-projected impact of smoking on 20-year cumulative cardiovascular disease incidence is considerably larger than the impact of low SES or serious psychological distress; for example, among males aged 40 years, cumulative cardiovascular disease incidence is 28.3% for low SES people who currently smoke, 13.0% for low SES people who never smoke, and 26.2% for higher SES people who currently smoke. In the second analysis, in the status quo scenario, model-projected 20-year cumulative cardiovascular disease incidence is 19.3% for low SES and 22.1% for serious psychological distress; in the counterfactual scenario, it is 18.1% for low SES and 19.6% for serious psychological distress.

Conclusions

Interventions focused on reducing smoking disparities could substantially reduce cardiovascular disease in marginalized subpopulations.
导言:在美国,社会经济地位低或有严重心理困扰(SPD)的人群吸烟率较高,这可能会增加这些边缘化亚人群患心血管疾病(CVD)的风险。我们估算了吸烟差异是如何导致心血管疾病差异的:使用烟草和尼古丁结果与政策模拟模型(一个经过验证的烟草使用和临床结果微观模拟模型),我们利用 2004-2019 年全国健康访谈调查的数据,首先比较了 40 岁人群 20 年累计心血管疾病发病率(按性别、吸烟状况和边缘化亚人群成员划分)。其次,我们模拟了具有代表性的年龄、性别和吸烟状况分布的边缘化亚人群,以估计现状和反事实情景下的 20 年累积心血管疾病发病率。在反事实情景下,低社会经济地位亚人群和SPD亚人群的吸烟率和趋势分别与高社会经济地位亚人群和非SPD亚人群的吸烟率和趋势一致:模型预测的吸烟对 20 年累积心血管疾病发病率的影响远远大于低社会经济地位或 SPD 的影响;例如,在 40 岁男性中,目前吸烟的低社会经济地位人群累积心血管疾病发病率为 28.3%,从不吸烟的低社会经济地位人群累积心血管疾病发病率为 13.0%,目前吸烟的高社会经济地位人群累积心血管疾病发病率为 26.2%。在第二项分析中,在维持现状的情况下,模型预测的 20 年累积心血管疾病发病率在低社会经济地位人群中为 19.3%,在高社会经济地位人群中为 22.1%;在反事实情况下,低社会经济地位人群的发病率为 18.1%,高社会经济地位人群的发病率为 19.6%:结论:以缩小吸烟差距为重点的干预措施可大幅降低边缘化亚人群的心血管疾病发病率。
{"title":"Disparities in Tobacco Smoking and Risk of Cardiovascular Disease in People With Low Socioeconomic Status or Serious Psychological Distress: A Simulation Analysis","authors":"Boram Lee PhD ,&nbsp;Linzy V. Rosen BA ,&nbsp;Nora M. Mulroy BA ,&nbsp;Yiqi Qian MPH ,&nbsp;Fatma M. Shebl MD, PhD ,&nbsp;Jessica E. Becker MD, MPH ,&nbsp;Emily P. Hyle MD, MSc ,&nbsp;Douglas E. Levy PhD ,&nbsp;Krishna P. Reddy MD, MS","doi":"10.1016/j.amepre.2024.10.008","DOIUrl":"10.1016/j.amepre.2024.10.008","url":null,"abstract":"<div><h3>Introduction</h3><div>High tobacco smoking prevalence in people with low SES or serious psychological distress in the U.S. may increase cardiovascular disease risk among these marginalized subpopulations. The authors estimate how smoking disparities contribute to cardiovascular disease disparities.</div></div><div><h3>Methods</h3><div>Using the Simulation of Tobacco and Nicotine Outcomes and Policy model, a validated microsimulation model of tobacco use and clinical outcomes, the authors used 2004–2019 data from the National Health Interview Survey to first compare 20-year cumulative cardiovascular disease incidence for people aged 40 years by sex, smoking status, and marginalized subpopulation membership. Second, the authors simulated the marginalized subpopulations with representative age, sex, and smoking status distributions to estimate 20-year cumulative cardiovascular disease incidence under status quo and counterfactual scenarios. In the counterfactual scenario, smoking prevalence and trends in the low SES and serious psychological distress subpopulations match those in the higher SES and non-SPD subpopulations, respectively.</div></div><div><h3>Results</h3><div>The model-projected impact of smoking on 20-year cumulative cardiovascular disease incidence is considerably larger than the impact of low SES or serious psychological distress; for example, among males aged 40 years, cumulative cardiovascular disease incidence is 28.3% for low SES people who currently smoke, 13.0% for low SES people who never smoke, and 26.2% for higher SES people who currently smoke. In the second analysis, in the status quo scenario, model-projected 20-year cumulative cardiovascular disease incidence is 19.3% for low SES and 22.1% for serious psychological distress; in the counterfactual scenario, it is 18.1% for low SES and 19.6% for serious psychological distress.</div></div><div><h3>Conclusions</h3><div>Interventions focused on reducing smoking disparities could substantially reduce cardiovascular disease in marginalized subpopulations.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 402-407"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479931","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
Content Is King but Ignored in the Debate on Screentime and Adolescent Health 内容为王,但在关于屏幕时间和青少年健康的辩论中却被忽视了。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-02-01 DOI: 10.1016/j.amepre.2024.10.010
Jon-Patrick Allem PhD
{"title":"Content Is King but Ignored in the Debate on Screentime and Adolescent Health","authors":"Jon-Patrick Allem PhD","doi":"10.1016/j.amepre.2024.10.010","DOIUrl":"10.1016/j.amepre.2024.10.010","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 415-417"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gun Ownership for Safety/Protection and Unsecured Firearm Storage Practices: Suicide Risk and Prevention Among U.S. Army Servicemembers 为安全/保护而拥有枪支以及不安全的枪支存放做法:美国陆军军人的自杀风险与预防》。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-02-01 DOI: 10.1016/j.amepre.2024.10.011
Catherine L. Dempsey PhD, MPH , David M. Benedek MD , Patricia T. Spangler PhD , James C. West MD , Robert M. Bossarte PhD , Matthew K. Nock PhD , Kelly L. Zuromski PhD , Matthew W. Georg MPH , Jingning Ao MPH , Katy Haller MSPH , Deborah M. Probe MA , Robert J. Ursano MD

Introduction

Year 2021 had the highest number firearm suicide deaths in U.S. history, with veterans representing 62.4% of firearm suicide deaths. The study objective is to understand motivations for firearm ownership, storage practices, history of mental health disorders and suicide risk in servicemembers, as reported by family members.

Methods

Data were obtained from a case-control psychological autopsy study of 135 suicide decedents in the U.S. Army compared to a probability sample of 255 living controls, who are also service members weighted to be representative of the Army. Next-of-kin and Army supervisor informants participated in structured interviews and assessed reasons for firearm ownership, and storage practices. The military medical record provided lifetime mental health history of suicide decedents. A subsample of 123 personal firearm owners (n=31 cases and n=92 living controls) addressed the study objectives. Multivariable logistic regression analyses were constructed to examine predictors of unsecured firearm storage practices.

Results

Family members reported safety/protection as the main reason for suicide decedents’ firearm ownership, which was significantly associated with unsecured firearm storage practices (OR=3.8, 95% CI, 1.65, 8.75, x2=9.88, p=0.0017). Ownership for safety/protection and lifetime history of Generalized Anxiety Disorder (GAD) from the military medical record (OR=3.65, 95% CI, 1.48–9.02, x2=7.89 p=0.0050) predicted unsecured storage.

Conclusions

Ownership for safety/protection and the presence of clinically significant anxiety predicted unsecured firearm storage practices. Future research examining motivations for gun ownership for safety/protection, anxiety, and unsecured storage practices may help target interventions to prevent suicide.
导言:2021 年是美国历史上枪支自杀死亡人数最多的一年,其中退伍军人占枪支自杀死亡人数的 62.4%。研究目的是根据家庭成员的报告,了解军人拥有枪支的动机、储存枪支的习惯、精神疾病史和自杀风险。数据来自一项病例对照心理尸检研究,该研究对美国陆军中 135 名自杀身亡者与 255 名在世对照者进行了概率抽样比较,后者也是军人,加权后具有陆军代表性。直系亲属和军队主管线人参加了结构化访谈,并评估了拥有枪支的原因和存放方式。军队医疗记录提供了自杀死者的精神健康史。123 名个人枪支所有者(n = 31 例和 n = 92 名在世对照者)的子样本符合研究目标。研究人员进行了多变量逻辑回归分析,以检查未安全存放枪支行为的预测因素:家庭成员报告称,安全/保护是自杀死者拥有枪支的主要原因,这与不安全的枪支存放方式有显著关联(OR = 3.8, 95% CI, 1.65, 8.75, x2 = 9.88, p = 0.0017)。出于安全/保护目的而拥有枪支以及从军队医疗记录中发现的终生广泛性焦虑症(GAD)病史(OR = 3.65,95% CI,1.48 - 9.02,x2 = 7.89,p = 0.0050)会导致枪支存放不安全:结论:为安全/保护而拥有枪支以及存在临床上严重的焦虑情绪会导致不安全的枪支储存行为。未来对出于安全/保护、焦虑和不安全储藏行为而拥有枪支的动机进行研究,可能有助于有针对性地采取干预措施来预防自杀。
{"title":"Gun Ownership for Safety/Protection and Unsecured Firearm Storage Practices: Suicide Risk and Prevention Among U.S. Army Servicemembers","authors":"Catherine L. Dempsey PhD, MPH ,&nbsp;David M. Benedek MD ,&nbsp;Patricia T. Spangler PhD ,&nbsp;James C. West MD ,&nbsp;Robert M. Bossarte PhD ,&nbsp;Matthew K. Nock PhD ,&nbsp;Kelly L. Zuromski PhD ,&nbsp;Matthew W. Georg MPH ,&nbsp;Jingning Ao MPH ,&nbsp;Katy Haller MSPH ,&nbsp;Deborah M. Probe MA ,&nbsp;Robert J. Ursano MD","doi":"10.1016/j.amepre.2024.10.011","DOIUrl":"10.1016/j.amepre.2024.10.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Year 2021 had the highest number firearm suicide deaths in U.S. history, with veterans representing 62.4% of firearm suicide deaths. The study objective is to understand motivations for firearm ownership, storage practices, history of mental health disorders and suicide risk in servicemembers, as reported by family members.</div></div><div><h3>Methods</h3><div>Data were obtained from a case-control psychological autopsy study of 135 suicide decedents in the U.S. Army compared to a probability sample of 255 living controls, who are also service members weighted to be representative of the Army. Next-of-kin and Army supervisor informants participated in structured interviews and assessed reasons for firearm ownership, and storage practices. The military medical record provided lifetime mental health history of suicide decedents. A subsample of 123 personal firearm owners (<em>n</em>=31 cases and <em>n</em>=92 living controls) addressed the study objectives. Multivariable logistic regression analyses were constructed to examine predictors of unsecured firearm storage practices.</div></div><div><h3>Results</h3><div>Family members reported safety/protection as the main reason for suicide decedents’ firearm ownership, which was significantly associated with unsecured firearm storage practices (OR=3.8, 95% CI, 1.65, 8.75, <em>x</em><sup>2</sup>=9.88, <em>p</em>=0.0017). Ownership for safety/protection and lifetime history of Generalized Anxiety Disorder (GAD) from the military medical record (OR=3.65, 95% CI, 1.48–9.02, <em>x</em><sup>2</sup>=7.89 <em>p</em>=0.0050) predicted unsecured storage.</div></div><div><h3>Conclusions</h3><div>Ownership for safety/protection and the presence of clinically significant anxiety predicted unsecured firearm storage practices. Future research examining motivations for gun ownership for safety/protection, anxiety, and unsecured storage practices may help target interventions to prevent suicide.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 311-319"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trends in Availability and Nutritional Profile of Meat-Based Versus Meat-Free Menu Items in 75 Large Chain Restaurants in the United States, 2013–2021 美国 75 家大型连锁餐厅 2013-2021 年肉类与无肉菜品的供应趋势和营养概况。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-02-01 DOI: 10.1016/j.amepre.2024.10.013
Anna C. Tucker , Megan P. Mueller , Lindsey Smith Taillie , Jason P. Block , Cindy W. Leung , Julia A. Wolfson

Introduction

Chain restaurants are ubiquitous in the U.S. While restaurants are increasingly promoting health- and climate-conscious menu options, few studies have examined whether restaurants are increasing availability of menu items with lower climate impact and whether these offerings are healthier. This study examines trends in the availability and nutritional profile of food items featuring different meat sources on menus at 75 large chain restaurants in the U.S. from 2013 to 2021.

Methods

Longitudinal data on menu items from 75 large U.S. chain restaurants from 2013 to 2021 were obtained from MenuStat.org, an online database of menu items from the largest-grossing restaurant chains in the U.S. Annual counts and proportions of food items featuring different meat sources were calculated overall, by food category, and by restaurant type. Differences in predicted mean calories between meat-based items and meat-free items were calculated (overall, by restaurant type, by year) using linear regression models with clustered standard errors.

Results

Availability and calorie content of meat-based versus meat-free items were generally stable over time. Availability of chicken-containing items increased and there was an absolute reduction in the availability of beef-containing menu items (p-trends<0.001). Total calories and calories from protein, unsaturated fat, and saturated fat were lower among meat-free items versus meat-based items. However, calories from sugar were higher for meat-free items.

Conclusions

While meat-free items had fewer calories and some aspects of nutritional profile were more favorable, the availability of meat-free menu items has not increased in large chain restaurants, suggesting limited improvement on reducing climate impact.
导言:在美国,连锁餐馆无处不在。虽然餐馆越来越多地推广注重健康和气候的菜单选择,但很少有研究探讨餐馆是否增加了对气候影响较小的菜单项目,以及这些项目是否更健康。本研究探讨了 2013-2021 年间美国 75 家大型连锁餐厅菜单上不同肉类来源食品的供应趋势和营养状况:本研究从 MenuStat.org 网站获取了美国 75 家大型连锁餐厅 2013-2021 年菜单菜品的纵向数据,MenuStat.org 是一个在线数据库,收录了美国收入最高的连锁餐厅的菜单菜品。我们按食品类别和餐厅类型计算了不同肉类来源食品的年度总数量和比例。使用带有聚类标准误差的线性回归模型计算了肉类食品和无肉食品之间的预测平均卡路里差异(总体、按餐厅类型、按年份):肉类食品与无肉类食品的供应量和卡路里含量随着时间的推移基本保持稳定。含鸡肉菜品的供应量有所增加,含牛肉菜品的供应量绝对减少(P-趋势结论):虽然无肉菜品的热量更低,营养成分的某些方面也更有利,但大型连锁餐厅的无肉菜品供应量并未增加,这表明在减少气候影响方面的改善有限。
{"title":"Trends in Availability and Nutritional Profile of Meat-Based Versus Meat-Free Menu Items in 75 Large Chain Restaurants in the United States, 2013–2021","authors":"Anna C. Tucker ,&nbsp;Megan P. Mueller ,&nbsp;Lindsey Smith Taillie ,&nbsp;Jason P. Block ,&nbsp;Cindy W. Leung ,&nbsp;Julia A. Wolfson","doi":"10.1016/j.amepre.2024.10.013","DOIUrl":"10.1016/j.amepre.2024.10.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Chain restaurants are ubiquitous in the U.S. While restaurants are increasingly promoting health- and climate-conscious menu options, few studies have examined whether restaurants are increasing availability of menu items with lower climate impact and whether these offerings are healthier. This study examines trends in the availability and nutritional profile of food items featuring different meat sources on menus at 75 large chain restaurants in the U.S. from 2013 to 2021.</div></div><div><h3>Methods</h3><div>Longitudinal data on menu items from 75 large U.S. chain restaurants from 2013 to 2021 were obtained from MenuStat.org, an online database of menu items from the largest-grossing restaurant chains in the U.S. Annual counts and proportions of food items featuring different meat sources were calculated overall, by food category, and by restaurant type. Differences in predicted mean calories between meat-based items and meat-free items were calculated (overall, by restaurant type, by year) using linear regression models with clustered standard errors.</div></div><div><h3>Results</h3><div>Availability and calorie content of meat-based versus meat-free items were generally stable over time. Availability of chicken-containing items increased and there was an absolute reduction in the availability of beef-containing menu items (<em>p</em>-trends&lt;0.001). Total calories and calories from protein, unsaturated fat, and saturated fat were lower among meat-free items versus meat-based items. However, calories from sugar were higher for meat-free items.</div></div><div><h3>Conclusions</h3><div>While meat-free items had fewer calories and some aspects of nutritional profile were more favorable, the availability of meat-free menu items has not increased in large chain restaurants, suggesting limited improvement on reducing climate impact.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 327-335"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512408","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
Loneliness, Discrimination, Stress, and Type 2 Diabetes Risk in Young Adults 年轻人的孤独感、歧视、压力和 2 型糖尿病风险。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-02-01 DOI: 10.1016/j.amepre.2024.09.019
Caleb Harrison BS , Maya I. Ragavan MD, MPH, MS , Margaret F. Zupa MD, MS , Xu Qin PhD , Vicki S. Helgeson PhD , Mary Ellen Vajravelu MD, MSHP

Introduction

The aim of this study was to determine the associations between type 2 diabetes or prediabetes and loneliness and related social experiences in young adults, a population at increasingly high risk of type 2 diabetes.

Methods

This was a cross-sectional analysis using data from adults aged 18–35 years enrolled in the All of Us Research Program. Exposures included loneliness, social support, discrimination, neighborhood social cohesion, and stress, measured by standardized surveys. The main outcome was type 2 diabetes or prediabetes by self-report or linked health record. Logistic regression determined the odds of type 2 diabetes/prediabetes for each survey measure, adjusting for age, sex, race or ethnicity, income, and family history. Latent class analysis evaluated clustering of social experiences. Data were collected from 2018 to 2022 and analyzed in May 2023–June 2024.

Results

The cohort included 14,217 young adults (aged 28.2 ± 4.4 years, 73.1% [n=10,391] women, 64.1% [n=9,111] White, 10.6% [n=1,506] Hispanic, 5.7% [n=806] Black, and 9.1% [n=1,299] multiracial). Overall, 5.5% (n=777) had either prediabetes or type 2 diabetes. The 2 highest loneliness quartiles were associated with increased odds of prediabetes/type 2 diabetes (Q3: OR=1.42 [95% CI=1.15, 1.76] and Q4: OR=1.78 [95% CI=1.45, 2.19]). Greater stress and discrimination and lower social support and neighborhood social cohesion were also associated with increased odds of prediabetes/type 2 diabetes. Latent class analysis revealed 3 distinct phenotypes, with elevated odds of prediabetes/type 2 diabetes in the 2 with the most adverse social profiles (OR=2.32 [95% CI=1.89, 2.84] and OR=1.28 [95% CI=1.04, 1.58]).

Conclusions

Loneliness and related experiences are strongly associated with type 2 diabetes and prediabetes in young adults. Whether these factors could be leveraged to reduce type 2 diabetes risk should be investigated.
简介本研究旨在确定2型糖尿病(T2D)或糖尿病前期与年轻人(T2D高危人群)的孤独感及相关社会经历之间的关系:这是一项横断面分析,使用的数据来自参加 "我们所有人研究计划 "的 18-35 岁成年人。暴露因素包括孤独感、社会支持、歧视、邻里社会凝聚力和压力,均通过标准化调查进行测量。主要结果是通过自我报告或链接健康记录得出的 T2D 或糖尿病前期。逻辑回归确定了每项调查测量的 T2D/糖尿病前期几率,并对年龄、性别、种族或民族、收入和家族史进行了调整。潜类分析(LCA)评估了社会经历的聚类。数据收集时间为 2018-2022 年,分析时间为 2023 年 5 月至 2024 年 6 月:队列包括 14217 名年轻成年人(28.2 ± 4.4 岁;70.3%(n=9792)为女性;64.1%(n=9111)为白人,10.6%(n=1506)为西班牙裔,5.7%(n=806)为黑人,9.1%(n=1299)为多种族)。总体而言,5.5%(n=777)的人患有糖尿病前期或 T2D。孤独感最高的两个四分位数与糖尿病前期/T2D 的几率增加有关(Q3:OR 1.42 [95% CI 1.15-1.76];Q4:1.75 [95% CI 1.43-2.16])。较大的压力和歧视以及较低的社会支持和邻里社会凝聚力也与糖尿病前期/T2D 的几率增加有关。LCA显示了三种不同的表型,其中社会状况最差的两种表型的糖尿病前期/T2D几率更高(OR 2.32 [95% CI 1.89-2.84]和OR 1.28 [95% CI 1.04-1.58]):结论:孤独感和相关经历与年轻人的 T2D 和糖尿病前期密切相关。结论:孤独感和相关经历与年轻人的终末期糖尿病和糖尿病前期密切相关,是否可以利用这些因素来降低终末期糖尿病的风险值得研究。
{"title":"Loneliness, Discrimination, Stress, and Type 2 Diabetes Risk in Young Adults","authors":"Caleb Harrison BS ,&nbsp;Maya I. Ragavan MD, MPH, MS ,&nbsp;Margaret F. Zupa MD, MS ,&nbsp;Xu Qin PhD ,&nbsp;Vicki S. Helgeson PhD ,&nbsp;Mary Ellen Vajravelu MD, MSHP","doi":"10.1016/j.amepre.2024.09.019","DOIUrl":"10.1016/j.amepre.2024.09.019","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to determine the associations between type 2 diabetes or prediabetes and loneliness and related social experiences in young adults, a population at increasingly high risk of type 2 diabetes.</div></div><div><h3>Methods</h3><div>This was a cross-sectional analysis using data from adults aged 18–35 years enrolled in the All of Us Research Program. Exposures included loneliness, social support, discrimination, neighborhood social cohesion, and stress, measured by standardized surveys. The main outcome was type 2 diabetes or prediabetes by self-report or linked health record. Logistic regression determined the odds of type 2 diabetes/prediabetes for each survey measure, adjusting for age, sex, race or ethnicity, income, and family history. Latent class analysis evaluated clustering of social experiences. Data were collected from 2018 to 2022 and analyzed in May 2023–June 2024.</div></div><div><h3>Results</h3><div>The cohort included 14,217 young adults (aged 28.2 ± 4.4 years, 73.1% [<em>n</em>=10,391] women, 64.1% [<em>n</em>=9,111] White, 10.6% [<em>n</em>=1,506] Hispanic, 5.7% [<em>n</em>=806] Black, and 9.1% [<em>n</em>=1,299] multiracial). Overall, 5.5% (<em>n</em>=777) had either prediabetes or type 2 diabetes. The 2 highest loneliness quartiles were associated with increased odds of prediabetes/type 2 diabetes (Q3: OR=1.42 [95% CI=1.15, 1.76] and Q4: OR=1.78 [95% CI=1.45, 2.19]). Greater stress and discrimination and lower social support and neighborhood social cohesion were also associated with increased odds of prediabetes/type 2 diabetes. Latent class analysis revealed 3 distinct phenotypes, with elevated odds of prediabetes/type 2 diabetes in the 2 with the most adverse social profiles (OR=2.32 [95% CI=1.89, 2.84] and OR=1.28 [95% CI=1.04, 1.58]).</div></div><div><h3>Conclusions</h3><div>Loneliness and related experiences are strongly associated with type 2 diabetes and prediabetes in young adults. Whether these factors could be leveraged to reduce type 2 diabetes risk should be investigated.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 217-226"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Electronic Adolescent Substance Use Screening: Focus on Implementation is Needed 青少年药物使用电子筛查:需要注重实施。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-02-01 DOI: 10.1016/j.amepre.2024.10.018
Amy M. Yule MD , Alyssa Levin-Scherz MD , Julianna Brody-Fialkin LICSW, MPH , Dana S. Rubin MD, MSW , Caroline J. Kistin MD, MPH
{"title":"Electronic Adolescent Substance Use Screening: Focus on Implementation is Needed","authors":"Amy M. Yule MD ,&nbsp;Alyssa Levin-Scherz MD ,&nbsp;Julianna Brody-Fialkin LICSW, MPH ,&nbsp;Dana S. Rubin MD, MSW ,&nbsp;Caroline J. Kistin MD, MPH","doi":"10.1016/j.amepre.2024.10.018","DOIUrl":"10.1016/j.amepre.2024.10.018","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 418-421"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559319","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
Quitline-Based Young Adult Vaping Cessation: A Randomized Clinical Trial Examining NRT and mHealth 基于戒烟线的年轻人戒烟:一项检查NRT和移动健康的随机临床试验。
IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-02-01 DOI: 10.1016/j.amepre.2024.10.019
Katrina A. Vickerman PhD , Kelly M. Carpenter PhD , Kristina Mullis PhD , Abigail B. Shoben PhD , Julianna Nemeth PhD , Elizabeth Mayers MS , Elizabeth G. Klein PhD, MPH

Introduction

Broad-reaching, effective e-cigarette cessation interventions are needed.

Study Design

This remote, randomized clinical trial tested a mHealth program and nicotine replacement therapy (NRT) for young adult vaping cessation.

Setting/Participants

Social media was used from 2021 to 2022 to recruit 508 young adults (aged 18–24 years) in the U.S. who exclusively and regularly (20+ days of last 30) used e-cigarettes and were interested in quitting.

Intervention

All were offered 2 coaching calls and needed to complete the first call for full study enrollment. Participants were randomized to one of 4 groups in the 2×2 design: mailed NRT (8 weeks versus none) and/or mHealth (yes versus no; stand-alone text program including links to videos and online content).

Main Outcome Measures

Self-reported 7-day point prevalence vaping abstinence at 3 months.

Results

A total of 981 participants were eligible and randomized; 508 (52%) fully enrolled by completing the first call. Enrolled participants were 71% female, 31% non-White, and 78% vaped daily. Overall, 74% completed the 3-month survey. Overall, 83% in the mailed NRT groups and 24% in the no-mailed NRT groups self-reported NRT use. Intent-to-treat 7-day point prevalence abstinence rates (missing assumed vaping) were 41% for calls only, 43% for Calls+mHealth, 48% for Calls+NRT, and 48% for Calls+NRT+mHealth. There were no statistically significant differences for mailed NRT (versus no-mailed NRT; OR=1.3; 95% CI=0.91, 1.84; p=0.14) or mHealth (versus no mHealth; OR=1.04; 95% CI=0.73, 1.47; p=0.84).

Conclusions

This quitline-delivered intervention was successful at helping young adults quit vaping, with almost half abstinent after 3 months. Higher than anticipated quit rates reduced power to identify significant group differences. Mailed NRT and mHealth did not significantly improve quit rates, in the context of an active control of a 2-call coaching program. Future research is needed to examine the independent effects of coaching calls, NRT, and mHealth in a fully-powered randomized control trial.

Trial Registration

clinicaltrials.gov NCT04974580.
需要广泛有效的电子烟戒烟干预措施。研究设计:这项远程随机临床试验测试了移动健康计划和尼古丁替代疗法(NRT)对年轻人戒烟的作用。背景/参与者:从2021年到2022年,使用社交媒体在美国招募508名年轻人(18-24岁),他们专门并定期(过去30天中的20多天)使用电子烟,并有兴趣戒烟。干预:所有人都被提供了2个辅导电话,并需要完成第一个电话以进行完整的研究登记。在2×2设计中,参与者被随机分为四组:邮寄NRT(8周vs无)和/或移动健康(是vs否;独立的文本程序,包括链接到视频和在线内容)。主要结果测量:自我报告的7天点流行电子烟戒烟3个月。结果:共有981名参与者符合条件并随机分配;508人(52%)通过完成第一次电话登记。登记的参与者中71%为女性,31%为非白人,78%为每天吸电子烟。总体而言,74%的人完成了为期3个月的调查。总的来说,83%的邮寄NRT组和24%的未邮寄NRT组自我报告使用了NRT。意向治疗的7天点患病率戒断率(假设没有抽电子烟),仅通话组为41%,通话+移动健康组为43%,通话+NRT组为48%,通话+NRT+移动健康组为48%。邮寄的NRT与未邮寄的NRT没有统计学上的显著差异;或= 1.3;95% ci =0.91, 1.84;p=0.14)或移动健康(相对于没有移动健康;或= 1.04;95% ci =0.73, 1.47;p = 0.84)。结论:这种戒烟热线提供的干预措施成功地帮助年轻人戒掉了电子烟,3个月后几乎有一半的人戒掉了电子烟。高于预期的戒烟率降低了识别显著组间差异的能力。邮寄NRT和移动健康并没有显著提高戒烟率,在积极控制2电话教练计划的背景下。未来的研究需要在一项全功率随机对照试验中检验教练电话、NRT和移动健康的独立影响。试验注册:clinicaltrials.gov NCT04974580。
{"title":"Quitline-Based Young Adult Vaping Cessation: A Randomized Clinical Trial Examining NRT and mHealth","authors":"Katrina A. Vickerman PhD ,&nbsp;Kelly M. Carpenter PhD ,&nbsp;Kristina Mullis PhD ,&nbsp;Abigail B. Shoben PhD ,&nbsp;Julianna Nemeth PhD ,&nbsp;Elizabeth Mayers MS ,&nbsp;Elizabeth G. Klein PhD, MPH","doi":"10.1016/j.amepre.2024.10.019","DOIUrl":"10.1016/j.amepre.2024.10.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Broad-reaching, effective e-cigarette cessation interventions are needed.</div></div><div><h3>Study Design</h3><div>This remote, randomized clinical trial tested a mHealth program and nicotine replacement therapy (NRT) for young adult vaping cessation.</div></div><div><h3>Setting/Participants</h3><div>Social media was used from 2021 to 2022 to recruit 508 young adults (aged 18–24 years) in the U.S. who exclusively and regularly (20+ days of last 30) used e-cigarettes and were interested in quitting.</div></div><div><h3>Intervention</h3><div>All were offered 2 coaching calls and needed to complete the first call for full study enrollment. Participants were randomized to one of 4 groups in the 2×2 design: mailed NRT (8 weeks versus none) and/or mHealth (yes versus no; stand-alone text program including links to videos and online content).</div></div><div><h3>Main Outcome Measures</h3><div>Self-reported 7-day point prevalence vaping abstinence at 3 months.</div></div><div><h3>Results</h3><div>A total of 981 participants were eligible and randomized; 508 (52%) fully enrolled by completing the first call. Enrolled participants were 71% female, 31% non-White, and 78% vaped daily. Overall, 74% completed the 3-month survey. Overall, 83% in the mailed NRT groups and 24% in the no-mailed NRT groups self-reported NRT use. Intent-to-treat 7-day point prevalence abstinence rates (missing assumed vaping) were 41% for calls only, 43% for Calls+mHealth, 48% for Calls+NRT, and 48% for Calls+NRT+mHealth. There were no statistically significant differences for mailed NRT (versus no-mailed NRT; OR=1.3; 95% CI=0.91, 1.84; <em>p</em>=0.14) or mHealth (versus no mHealth; OR=1.04; 95% CI=0.73, 1.47; <em>p</em>=0.84).</div></div><div><h3>Conclusions</h3><div>This quitline-delivered intervention was successful at helping young adults quit vaping, with almost half abstinent after 3 months. Higher than anticipated quit rates reduced power to identify significant group differences. Mailed NRT and mHealth did not significantly improve quit rates, in the context of an active control of a 2-call coaching program. Future research is needed to examine the independent effects of coaching calls, NRT, and mHealth in a fully-powered randomized control trial.</div></div><div><h3>Trial Registration</h3><div>clinicaltrials.gov NCT04974580.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"68 2","pages":"Pages 366-376"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
American Journal of Preventive Medicine
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1