Preventing Chronic Disease最新文献

Introduction: Whether using nutrition facts labels (NFLs) leads to adherence to higher-quality dietary patterns - such as the Dietary Approaches to Stop Hypertension (DASH) diet, which is associated with lower risk of chronic diseases - is unclear. We investigated whether people aged 21 to 64 years who use NFLs were more likely to adhere to the DASH dietary pattern.

Methods: We analyzed data from the nationally representative, cross-sectional Israeli National Health and Nutrition Survey for Adults from 2014-2016. Adherence to the DASH diet was determined from a single 24-hour dietary recall using a DASH score calculated on the basis of adherence to 9 nutrient targets. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% CIs for DASH accordance (DASH score ≥4.5 [accordant] vs DASH score <4.5 [nonaccordant]) and for each separate nutrient target of the DASH diet.

Results: The data set comprised 2,579 participants (NFL users, n = 931 [36.1%]). Of the NFL users, 299 (32.1%) were classified as DASH accordant, compared with 339 (20.6%) of the non-NFL users. After adjusting for potential confounders, the OR for DASH adherence among NFL users was 1.52 (95% CI, 1.20-1.93) compared with non-NFL users. Compared with non-NFL users, NFL users' odds of meeting individual DASH nutrient targets were 1.30 (95% CI, 1.06-1.59) for protein; 1.46 (95% CI, 1.17-1.81) for dietary fiber; 1.48 (95% CI, 1.18-1.85) for magnesium; 1.38 (95% CI, 1.12-1.70) for calcium; and 1.60 (95% CI, 1.30-1.97) for potassium. Age, female sex, and performing recommended physical activity were associated with DASH adherence.

Conclusion: These results highlight the importance of nutrition education and awareness, as well as the potential role of NFLs in promoting healthier dietary habits.

Introduction: Recent literature suggests blood pressure variability (BPV) is an independent risk factor for cardiovascular disease (CVD). Ours is the first study to assess the prognostic value of the intraindividual SD of systolic blood pressure (SBPSD) and diastolic blood pressure (DBPSD) in American Indians.

Methods: We computed BPV for 3,352 American Indians who had 8 nonurgent visit-to-visit blood pressure checks according to their electronic health records, and linked those measurements with Strong Heart Study cohort data. We used Cox proportional hazards models to determine whether the risk of all-cause mortality, CVD mortality, or major adverse cardiovascular events (MACE), was different for SBPSD and DBPSD quartiles, while controlling for covariates.

Results: Mean participant age was 54.5 years (SD = 17.3), 66% were female, mean SBPSD was 13.47 (SD = 5.71), and mean DBPSD was 8.05 (SD = 3.02). Over the 20-year follow-up, 45.4% died, 14.6% experienced CVD-related mortality, and 20.8% experienced MACE. Compared with the lowest SBPSD quartile (quartile 1), the risk of all-cause mortality was 35% higher for the highest quartile (quartile 4), while controlling for covariates (HR = 1.35; 95% CI, 1.13-1.61). The risk of CVD mortality and MACE was higher for quartile 4 SBPSD compared with quartile 1 (CVD mortality, HR = 1.81, 95% CI, 1.29-2.53; MACE HR = 1.39, 95 % CI, 1.07-1.80). The risk for quartile 4 DBPSD was not significant for these outcomes (all-cause mortality, HR = 1.15, 95% CI, 0.97-1.36; CVD mortality, HR=1.22, 95% CI, 0.91-1.65; MACE, HR = 1.11, 95% CI, 0.87-1.40).

Conclusion: Our study identified SBPSD as a significant risk factor for all-cause mortality, cardiovascular mortality, and MACE, whereas DBPSD in our cohort of American Indian subjects was not a significant risk factor after adjustment for covariates.

Introduction: Arthritis is a common chronic disease, affecting an estimated 53.2 million adults (21.2%) in the US. "Arthritis" is a general term, describing over 100 conditions with different etiologies, pathogeneses, symptoms, and treatments. Few studies have examined the prevalence and distribution of arthritis subtypes in the US.

Methods: We used National Health and Nutrition Examination Survey data from 2017 to March 2020 to estimate the prevalence of arthritis subtypes overall and by sociodemographic characteristics.

Results: The overall prevalence of any type of diagnosed arthritis among US adults aged 20 years or older in this study was 27.9% (67.1 million). Among adults with diagnosed arthritis, osteoarthritis (49.6%, 33.2 million) was the most common arthritis subtype, followed by rheumatoid arthritis (15.8%, 10.6 million) and psoriatic arthritis (1.4%, 1.0 million). More than 1 in 10 reported some other type of unlisted arthritis (11.5%, 7.7 million), and 1 in 5 did not know their arthritis subtype (21.6%, 14.4 million). Prevalence of not knowing arthritis type was approximately 1 in 4 for adults identifying as non-Hispanic Black (26.7%) or other Hispanic (29.5%) and for adults who reported low family income (26.7%) and was approximately 1 in 3 for adults identifying as Mexican American (31.9%), having less than a high school education (31.8%), or not having health insurance (36.1%).

Conclusion: Understanding arthritis type is important for improving treatment, self-management, and health outcomes associated with arthritis. Improving organizational and personal health literacy are potential strategies that may reduce the prevalence of not knowing arthritis type.

Introduction: Increasing walking for transportation is a strategy to integrate physical activity into daily life. We examined reported environmental, access, and individual reasons for not walking to places near home among US adults, by sociodemographic characteristics and geographic location.

Methods: We used data from the 2022 SummerStyles survey on 3,967 US adults aged 18 years or older. We calculated prevalence of reporting 11 selected reasons for not walking to places within 10 minutes of home, overall and by sex, race or ethnicity, age, education, income, US census region, and metropolitan residence (an area with at least 1 urban area of ≥50,000 inhabitants) versus nonmetropolitan residence. We used Bonferroni-corrected pairwise comparisons and orthogonal polynomial contrasts (ordered groups) to compare prevalence by subgroup.

Results: Overall, 79.0% of respondents identified at least 1 reason for not walking to places near home (within 10 minutes). Commonly reported reasons were hot and humid conditions (36.0%), no places to walk within 10 minutes (24.9%), a preference for driving (22.1%), and inconvenience (21.5%). The reasons varied significantly across sociodemographic and geographic subgroups. The prevalence of reporting none of the listed reasons was higher among males than females, higher among non-Hispanic Black and non-Hispanic Asian adults than non-Hispanic White adults, and higher among adults from the Northeast versus the South.

Conclusion: Eight of 10 US adults reported at least 1 environmental, access, or individual reason for not walking to places near home. Designing communities to make walking for transportation more accessible, convenient, and desirable may help address the leading reasons reported, which may support adults in adding more physical activity to their daily lives.

The intake of sugar-sweetened beverages (SSBs) is a public health concern. Evidence-based behavior-change interventions can facilitate reductions in intake. Understanding maintenance of reductions after an initial intervention period is essential. In a cluster randomized controlled trial of 12 middle schools in Appalachia, we examined the 19-month maintenance effects of a 6-month school-based SSB reduction intervention tailored for middle school students and caregivers and demonstrated to be effective. Relative to their control counterparts, intervention students maintained significant reductions in SSB intake, while intervention caregivers did not show sustained effects. This study offers valuable insights into the long-term effect of school-based behavioral interventions designed to reduce intake of SSBs.

The preservice education of public health professionals often includes thorough, community-engaged learning experiences. One critical element of public health work is program evaluation - an essential function for supporting evidence-based practice. However, the literature on how to prepare future public health professionals to integrate community-engaged evaluation work is lean, although lessons may be learned from the literature on service-learning. Analyzing students' reflections in their "key learning experience" essays from an introductory program evaluation course incorporating service-learning may address this gap, helping educators identify the most effective elements of their course design and implementation. This illustrative evaluation used existing educational frameworks grounded in andragogic principles and significant learning experiences to deductively analyze 146 graduate students' reflections on their service-learning course experience. Deductive analysis suggested that community engagement is a key element of students' learning experience. Sixty-two (42.5%) student reflections were about community engagement, whereas 84 (57.5%) were about other topics the students found memorable. A program evaluation course that integrates service-learning may be a viable vehicle for teaching public health students about community engagement.

Community engagement is a pivotal public health tool for addressing population health challenges and advancing health equity. Community-academic partnerships that use community-engaged approaches can prioritize community strengths and ensure that resources and interventions match local needs. In 2021-2022, a community-academic partnership, guided by the principles of community engagement, collaborated with residents of Milwaukee's Near West Side (NWS) to identify strengths and assets and prioritize actions to improve health and quality of life. To inform the development of a planned community resource center, residents were invited for group concept mapping (GCM). GCM includes idea generation, sorting and rating, and developing cluster maps. Residents (N = 165) generated 71 unique ideas in response to the question, "To make the Near West Side a healthier community we need _____." Residents sorted ideas into clusters based on conceptual similarity and prioritized the importance of each. Data were managed with The Concept System Global MAX Software. By using the 71 ideas, a cluster map with 9 domains best fit the data. Domains were high-quality and affordable housing, community-engaged public safety, health and wellness services, strong and inclusive neighborhoods, investments in young people, public infrastructure, sustainable businesses, alternative modes of transportation, and vibrant social spaces. Eight of the 9 domains were highly rated for importance. These domains became focus areas for our partnership's efforts to advance health and well-being in NWS. Our work highlights the significance of projects incorporating community engagement principles within the context of a community-academic partnership to generate mutually beneficial solutions that are strength-based and aligned with partners' priorities.