AJPM focus最新文献

{"title":"Uptake of Pneumococcal Vaccines Among U.S. Adults After 2022 Update to Recommendations","authors":"Ahuva Averin MPP ,&nbsp;Jeffrey Vietri PhD ,&nbsp;Adriano Arguedas Mohs MD ,&nbsp;Sarah J. Willis PhD, MPH ,&nbsp;Alexander Lonshteyn PhD ,&nbsp;Derek Weycker PhD","doi":"10.1016/j.focus.2025.100384","DOIUrl":"10.1016/j.focus.2025.100384","url":null,"abstract":"<div><h3>Introduction</h3><div>Updated recommendations for adult pneumococcal vaccination in the U.S. (publication date: January 27, 2022) incorporated 2 new vaccines (15- and 20-valent pneumococcal conjugate vaccines), removed 13-valent pneumococcal conjugate vaccine, and called for pneumococcal conjugate vaccine use among immunocompetent adults aged 19–64 years with certain medical conditions. This study assessed uptake of recommendations and disparities in uptake across subgroups of adults.</div></div><div><h3>Methods</h3><div>A retrospective cohort design and data from Optum’s deidentified Clinformatics Data Mart Database were employed. Study population comprised all adults aged ≥65 years and adults aged 19–64 years with ≥1 chronic (at-risk) or immunocompromising (high-risk) condition. Vaccine uptake (including 23-valent pneumococcal polysaccharide vaccine) was estimated using the Kaplan–Meier method.</div></div><div><h3>Results</h3><div>During 21-month follow-up period, 13.2% of adults (<em>n</em>=6.8 million) received pneumococcal vaccine, mostly 20-valent pneumococcal conjugate vaccine (9.6%). By age/risk conditions, 20-valent pneumococcal conjugate vaccine uptake was highest among adults aged 65–66 years (23.8%) and at-risk/high-risk adults aged 60–64 years (12.1%) and lowest among at-risk/high-risk adults aged 19–49 years (4.7%). By immunization history, 20-valent pneumococcal conjugate vaccine uptake was highest among adults with a history of 23-valent pneumococcal polysaccharide vaccine uptake only (15.1%) or 13-valent pneumococcal conjugate vaccine uptake only (10.6%) and lowest among those without prior pneumococcal vaccination (8.7%) or with a history of 13-valent pneumococcal conjugate vaccine + 23-valent pneumococcal polysaccharide vaccine uptake (7.9%).</div></div><div><h3>Conclusions</h3><div>Fewer than ∼1 in 7 U.S. adults received 20-valent pneumococcal conjugate vaccine in the first 21 months after the updated recommendations. Uptake was lower among at-risk/high-risk adults aged &lt;60 years, adults aged ≥75 years, and adults without prior pneumococcal vaccination. Routine evaluation of vaccination status by providers and additional strategies to increase uptake of recommend vaccines are warranted.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 5","pages":"Article 100384"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multi-Institutional Evaluation of Billing for Tobacco-Cessation Services: Opportunities to Improve Quality and Enhance Revenue Capture","authors":"Edward Anselm MD ,&nbsp;Derek J. Baughman MD ,&nbsp;Marcus Rauhut MS ,&nbsp;Taylor Martin DO, MPH ,&nbsp;Ishan Mahajan ,&nbsp;Allison B. McCoy PhD","doi":"10.1016/j.focus.2025.100379","DOIUrl":"10.1016/j.focus.2025.100379","url":null,"abstract":"<div><div>A recent paper identified significant gaps in billing for tobacco-cessation services for a multihospital health system. Underbilling can reflect poor billing practices, low rates of tobacco-cessation counseling, or a combination of both. The study design was applied to 2 academic medical centers. Deidentified data from the electronic medical records systems were used to identify adult tobacco users and their insurance coverage for patients who had visits to primary care clinics. The proportion of office visits where cessation services were billed was calculated. An economic evaluation of the missed counseling opportunities was based on insurance type and a fee-for-service-payment model. Billing of cessation services is consistently below 2% across the medical centers studied, suggesting substantial opportunities to improve quality and increase revenue. The prevalence of tobacco use in the patient populations studied was significantly lower than reported for that state by the Centers for Disease Control and Prevention.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 5","pages":"Article 100379"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duration of Breastfeeding in Infancy and Levels of Central Adiposity and Systemic Inflammation in Early Middle Adulthood","authors":"Thomas W. McDade PhD ,&nbsp;Jessica A. Polos PhD ,&nbsp;Kiarri N. Kershaw PhD ,&nbsp;Taylor W. Hargrove PhD ,&nbsp;Stephanie M. Koning PhD","doi":"10.1016/j.focus.2025.100375","DOIUrl":"10.1016/j.focus.2025.100375","url":null,"abstract":"<div><h3>Introduction</h3><div>Overweight, obesity, and systemic inflammation contribute to chronic degenerative diseases that are major public health burdens associated with aging. This longitudinal cohort study investigates whether the duration of breastfeeding in infancy predicts waist circumference and chronic systemic inflammation in early middle adulthood.</div></div><div><h3>Methods</h3><div>Survey-weighted regression models were implemented with data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of adults (aged 33–44 years) with information on breastfeeding history as well as measures of waist circumference, C-reactive protein, and interleukin 6. Analyses focused on 3,417 and 3,570 participants with C-reactive protein and interleukin 6 measurements, respectively. Fixed-effects regression models were also used to analyze between-sibling differences in breastfeeding duration, waist circumference, and C-reactive protein/interleukin 6. C-reactive protein and interleukin 6 were quantified in serum with highly sensitive particle-enhanced nephelometric and electrochemiluminescent immunoassays, respectively.</div></div><div><h3>Results</h3><div>Longer duration of breastfeeding was associated with significantly lower waist circumference and lower C-reactive protein. Results were similar for interleukin 6 but statistically weaker. For individuals who were breastfed for 6–12 months and those not at all, marginal mean waist circumference was 94.8 cm (95% CI=92.5, 97.1) and 101.7 cm (95% CI=100.2, 103.2), respectively. Marginal mean C-reactive protein was 1.59 mg/L (95% CI=1.38, 1.84) versus 2.10 mg/L (95% CI=1.97, 2.24). Waist circumference mediated 57.3%–93.8% of the associations between breastfeeding duration and C-reactive protein, depending on duration category. Breastfeeding duration was negatively associated with waist circumference and inflammation in sibling comparisons, but estimates were imprecise and not statistically significant.</div></div><div><h3>Conclusions</h3><div>The convergence of obesogenic environments and low uptake of breastfeeding for cohorts born after the historical nadir of breastfeeding in the U.S. may contribute to epidemics of overweight/obesity and chronic inflammation that presage risk for chronic degenerative diseases of aging.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 5","pages":"Article 100375"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Associations Between Smoking Patterns and Employment Status Among a Nationally Representative Sample of U.S. Adults","authors":"Mirsada Serdarevic PhD ,&nbsp;Aro N. Choi MS ,&nbsp;David Gimeno Ruiz de Porras LPsy, MS, PhD ,&nbsp;Tracey E. Barnett PhD","doi":"10.1016/j.focus.2025.100376","DOIUrl":"10.1016/j.focus.2025.100376","url":null,"abstract":"<div><h3>Introduction</h3><div>Smoking is a leading preventable cause of death, with higher prevalence in certain occupations. Given the evolved work environment after COVID-19 and shifting tobacco use patterns, this study examines recent data to assess the associations between smoking status, employment status, and industry.</div></div><div><h3>Methods</h3><div>The authors analyzed data from the 2023 National Health Interview Survey. Participants were aged ≥18 years, and their employment status was classified as employed or unemployed on the basis of the prior week’s work; smoking status was classified as current, former, or never. The prevalence of employment and smoking was calculated. Weighted multinomial logistic regression was used to assess the associations between smoking status, employment status, and industry.</div></div><div><h3>Results</h3><div>Among the 26,442 adults (50.8% male, 63.6% non-Hispanic Whites, mean age of 49.3 years, 69.7% employed), 11.0% were current smokers, 23.4% were former smokers, and 65.6% were never smokers. Current smoking was highest in wholesale trade (20.5%), information (16.9%), and mining (15.9%) industries. After adjustment, unemployed individuals, particularly those unable to work owing to health reasons, had 93% higher odds of being current smokers (AOR=1.93; 95% CI=1.64, 2.28) and 35% higher odds of being former smokers (AOR=1.35; 95% CI=1.16, 1.58) than those who were employed.</div></div><div><h3>Conclusions</h3><div>This study highlights the current relationship between employment status, industry, and smoking behaviors in the U.S. Current smoking rates were highest in specific industries, underscoring the need for targeted interventions in these occupational settings. Tailored smoking cessation programs for high-risk industries and unemployed individuals, particularly those unable to work owing to health issues, are crucial. Public health policies should address the unique needs of both employed and unemployed populations to reduce smoking-related health disparities.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 5","pages":"Article 100376"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediabetes Awareness Barriers and Enablers: National Health and Nutrition Examination Survey 2011–2020","authors":"Li Wang PhD ,&nbsp;Xingran Weng DrPH ,&nbsp;Jennifer L. Kraschnewski MD, MPH ,&nbsp;Ariana R. Pichardo-Lowden MD, MEd, MS","doi":"10.1016/j.focus.2025.100378","DOIUrl":"10.1016/j.focus.2025.100378","url":null,"abstract":"<div><h3>Introduction</h3><div>Prediabetes is prevalent and commonly progresses to diabetes when unaddressed. Prediabetes progression is preventable, yet prediabetes unawareness jeopardizes timely intervention. This study examines barriers and enablers of prediabetes awareness, and describes its influence on diet and physical activity.</div></div><div><h3>Methods</h3><div>We used the United States National Health and Nutrition Examination Survey 2011-2020 data to identify participants with prediabetes. Weighted logistic regression identified factors associated with prediabetes awareness. Weighted logistic and linear regression tested the effects of prediabetes awareness on lifestyle choices such as sugar, carbohydrate and calorie consumption, and physical activity.</div></div><div><h3>Results</h3><div>Of the 2,749 adult participants identified as having prediabetes, 84% were unaware of their condition. Having had a glucose testing in the previous three years before participating in the survey was the strongest independent contributor of prediabetes awareness (AOR: 3.97, 95% CI: 2.76-5.71, P&lt;0.0001). Prediabetes awareness was associated with weight loss intent (AOR: 1.63, 95% CI: 1.13-2.33, p&lt;0.01), but not with healthy lifestyle choices. Healthcare professionals’ advice was associated with increased exercise (AOR: 1.75, 95% CI: 1.31-2.33, p&lt;0.01), however, not with a change in diet.</div></div><div><h3>Conclusions</h3><div>Most participants were unaware of their prediabetes condition, regardless of social determinants of health and demographic factors. This suggests the need to promote prediabetes awareness across populations. Proactively evaluating and discussing results may help narrow the unawareness chasm. Lifestyle choices not being associated with prediabetes awareness suggests that mere awareness and medical advice are not enough for patients to embrace healthy behaviors.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 5","pages":"Article 100378"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board and Journal Information","authors":"","doi":"10.1016/S2773-0654(25)00057-4","DOIUrl":"10.1016/S2773-0654(25)00057-4","url":null,"abstract":"","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 3","pages":"Article 100369"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Communities Implementing the Communities That HEAL Intervention Have Significantly Lower Rates of High-Risk Opioid Prescribing and Dispensing?","authors":"Frances R. Levin MD ,&nbsp;Douglas R. Oyler PharmD ,&nbsp;Denise C. Babineau PhD ,&nbsp;Jennifer Villani PhD ,&nbsp;Redonna K. Chandler PhD ,&nbsp;Patricia R. Freeman PhD ,&nbsp;Daniel P. Alford MD, MPH ,&nbsp;Naleef Fareed PhD ,&nbsp;Nicole Mack MS ,&nbsp;Trang Q. Nguyen MD, DrPh ,&nbsp;Daniel M. Walker PhD ,&nbsp;Joella Adams PhD ,&nbsp;Trevor J. Baker MS ,&nbsp;Donna Beers MSN, RN-BC ,&nbsp;Shoshana N. Benjamin MPH ,&nbsp;Jennifer Bhuiyan PharmD ,&nbsp;Derek Blevins MD ,&nbsp;James L. David MS ,&nbsp;Netrali Dalvi MPH ,&nbsp;Lauren D’Costa BS ,&nbsp;Nabila El-Bassel PhD","doi":"10.1016/j.focus.2025.100371","DOIUrl":"10.1016/j.focus.2025.100371","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Prescription opioids can contribute to risk for opioid use disorder and overdoses. Improving prescription opioid safety is a critical component in reducing opioid risks. This report aims to determine whether communities randomized to the Communities That HEAL (CTH) intervention have significantly different rates of prescription opioid safety measures.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;A multisite, 2-arm, community-level, cluster randomized, unblinded, wait-list controlled comparison trial designed to assess the effectiveness of the CTH intervention in reducing opioid-related overdose deaths among community residents 18 years of age or older (adults).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting/Participants&lt;/h3&gt;&lt;div&gt;Sixty-seven (67) communities in Kentucky, Massachusetts, New York, and Ohio. “Participants” were communities in this study. Intervention: The Communities That Heal intervention consists of multiple dimensions: a coalition-driven community engagement process to select and support implementation of Evidence Based Practices; the Opioid-overdose Reduction Continuum of Care Approach, a compendium of Evidence Based Practices and technical assistance resources organized under overdose education and naloxone distribution, medication for Opioid Use Disorder, and prescription[DB1] opioid safety menus; and communication campaigns intended to reduce Opioid Use Disorder stigma and raise awareness and demand for naloxone and medication for Opioid Use Disorder [DB1] I pulled the intervention language from the body of the manuscript. Journal guidelines aske for no abbreviations in Abstract...so that is why everything is spelled out.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome(s) and Measure(s)&lt;/h3&gt;&lt;div&gt;The main outcome was the number of adults with new incident high-risk opioid prescribing episodes after at least a 45-day washout. Other outcomes included the number of opioid-naïve adults with new opioid prescriptions limited to a 7-day supply, number of adults who received opioid prescriptions from multiple prescribers or pharmacies, and number of locations providing drug take-back services. Outcomes were assessed from July 2021-June 2022.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;There was no statistically significant difference in the adjusted rates for new incident high-risk opioid prescribing per 100,000 adults during the comparison period between intervention (1094.48 (95% CI: [1063.15, 1126.74])) and wait-list control communities (1121.90 (95% CI: [1079.62, 1165.84])). The adjusted relative rate comparing intervention to wait-list control communities was 0.98 (95% CI: [0.93, 1.02]; p-value=0.296). Similarly, there were no statistically significant differences between intervention and wait-list control communities for the other outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions and Relevance&lt;/h3&gt;&lt;div&gt;Although no statistically significant differences were found in prescription opioid safety measures between study arms, improvement in these measures ","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 6","pages":"Article 100371"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Correlates of Firearm Screening and Counseling in Primary Care in Southeast Michigan","authors":"Joseph B. Ladines-Lim MD, PhD ,&nbsp;Magdalena Hecht MD ,&nbsp;Caleb Arthur MD ,&nbsp;Autumn Pu MD ,&nbsp;Melissa Ross MD ,&nbsp;Kayla Secrest MD ,&nbsp;Aaron Sifuentes MD ,&nbsp;Justin Litzner BS ,&nbsp;Jennifer Stojan MD, MHPE ,&nbsp;Michelle Degli Esposti PhD ,&nbsp;Jennifer Meddings MD, MSc","doi":"10.1016/j.focus.2025.100370","DOIUrl":"10.1016/j.focus.2025.100370","url":null,"abstract":"<div><h3>Introduction</h3><div>The American College of Physicians recommends firearm screening and safety counseling for high-risk patients, although frequency of practice is unclear. The authors evaluated the prevalence and correlates of firearm screening and counseling during health maintenance exams.</div></div><div><h3>Methods</h3><div>The authors performed a cross-sectional analysis of all health maintenance exams for patients aged ≥18 years at an academic center in Southeast Michigan from September 2021 to February 2022. Primary outcomes included documentation of attempted firearm screening and counseling after positive screens. Multinomial logistic regression models estimated the associations between primary outcomes and patient and clinician characteristics using multilevel modeling to account for interclinic variability.</div></div><div><h3>Results</h3><div>In 27,686 health maintenance exams across 17 clinic sites, attempted screening was documented in 99.8% of visits, principally through routine questionnaires, with positive, negative, or no responses in 15.2%, 48.0%, and 36.8%, respectively. One outlier clinic site documented attempted screening in only 0.9% of health maintenance exams and was excluded. Counseling occurred in 1.1% of positive screens; clinic sites accounted for 36.3% of variability. Counseling was less likely for females (AOR=0.65; 95% CI=0.51, 0.82), patients aged ≥65 years (AOR=0.31; 95% CI=0.21, 0.47), and Asian patients (AOR=0.31; 95% CI=0.16, 0.61) and more likely for internal medicine–pediatrics/family medicine clinicians than internal medicine clinicians (AOR=4.42; 95% CI=1.99, 9.82).</div></div><div><h3>Conclusions</h3><div>Clinicians documented attempted firearm screening in nearly all health maintenance exams but seldom counseling, which varied across sites and was linked to patient sociodemographic characteristics and clinician specialty as opposed to high-risk clinical features such as psychiatric disorder. Findings suggest that training and quality improvement efforts are needed to ensure appropriate risk-based counseling.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 6","pages":"Article 100370"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional Educational Intervention in Users With Psychiatric Disorders Living in Supported Housing: A Pilot Study","authors":"Giulia Picardo MD ,&nbsp;Clara Donnoli RN, MSN ,&nbsp;Maria Rosaria Barbera MSc ,&nbsp;Marina Agostini MSc ,&nbsp;Giuseppe Ducci MD ,&nbsp;Giuseppe Liotta PhD","doi":"10.1016/j.focus.2025.100368","DOIUrl":"10.1016/j.focus.2025.100368","url":null,"abstract":"<div><h3>Introduction</h3><div>The pilot data analysis assessed the weight and eating habits of users in Supported Housing (SH) across six Rome districts, verifying the feasibility of a nutritional education intervention.</div></div><div><h3>Methods</h3><div>The study team conducted a quantitative, quasi-experimental study. The cohort consisted of 92 users living in 57 houses, categorized by age, sex, and diagnosis. The intervention carried out between October 2021 and January 2022 consisted of 2 phases, an educational session on the food pyramid and national dietary guidelines for staff assisting users and an education intervention to promote healthier lifestyle choices to the users.</div></div><div><h3>Results</h3><div>Results reported an average BMI of 28 kg/m² (SD = ±5.74) categorizing users as belonging in average to the overweight BMI class. Adherence to the Mediterranean diet based on the Del Balzo and Savastano1 questionnaire was overall scarce (90.1%). The educational intervention positively impacted 90.3% of users who demonstrated an increase in consumption of fruit and vegetables and a decrease in consumption of fried food and soft drinks. A weight decrease was experienced by 43.4% (13/30) of the cohort. Average weight loss, in the group who lost weight, was 7.6kg (SD = ±6.93).</div></div><div><h3>Conclusions</h3><div>The study suggests the feasibility and potential impact of public health initiatives addressing obesity in the population with psychiatric disorders.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 6","pages":"Article 100368"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Produce Prescription Program Grounded in Community Connection Improves Fruit Intake in Hawaiʻi","authors":"Monica K. Esquivel PhD, RDN ,&nbsp;Cherese Shelton BS ,&nbsp;Alicia Higa BS ,&nbsp;Hyeong Jun Ahn PhD ,&nbsp;May Okhiro MD, MS","doi":"10.1016/j.focus.2025.100365","DOIUrl":"10.1016/j.focus.2025.100365","url":null,"abstract":"<div><h3>Introduction</h3><div>In Hawai‘i, 50% of Native Hawaiian and Pacific Islander children live in a household experiencing food insecurity. Individuals from food insecure households experience increased risk for chronic health conditions that may be alleviated with healthy food. Wellness for Native Hawaiian and Pacific Islander populations can be achieved through the Pilinahā framework, comprising connection to self; community; past, present, and future; and land. The Keiki (child) Produce Prescription Program was designed to address the Pilinahā framework through a 6-month intervention that provided pediatric participants with vouchers totaling $50 per month to exchange for local, fresh fruits and vegetables from the farmers market along with nutrition education kits.</div></div><div><h3>Methods</h3><div>The community-designed intervention connected pediatric patients from a large federally qualified health center with the community farmers’ market. Eligibility consisted of children aged 2–17 years who screened positive for a nutrition-related chronic disease or food insecurity. Baseline survey and 6-month data collected included sociodemographic data, household food security, and fruit and vegetable consumption. Monthly voucher redemption was tracked.</div></div><div><h3>Results</h3><div>One hundred and twenty-one participants enrolled, 90 participants redeemed vouchers for 6 months, and 75 (62%) completed 6-month survey data. Participants redeemed $210 (70%) in vouchers on average. Children’s fruit consumption increased by 1.0 cups per day (p=0.014), whereas parent fruit consumption increased by 1.2 cups per day (<em>p</em>=0.0001). No changes to household food security or total fruit and vegetable consumption were observed.</div></div><div><h3>Conclusions</h3><div>The Keiki Produce Prescription Program improved fruit intake among households with children. High levels of program participation and completion reinforce the importance of community-engaged approaches to program development. Rigorous testing through RCTs and increasing engagement with nutrition education are recommended for future studies.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 5","pages":"Article 100365"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}