AJPM focus最新文献

{"title":"Cardiovascular Risk Profile Among Reproductive-Aged Women in the U.S.: The Behavioral Risk Factor Surveillance System, 2015–2020","authors":"Ellen Boakye MD, MPH ,&nbsp;Chigolum P. Oyeka MD, MPH ,&nbsp;Yaa A. Kwapong MD, MPH ,&nbsp;Faith E. Metlock BSN ,&nbsp;Sadiya S. Khan MD, MSc ,&nbsp;Mamas A. Mamas MBBCh ,&nbsp;Amanda M. Perak MD, MS ,&nbsp;Pamela S. Douglas MD ,&nbsp;Michael C. Honigberg MD, MPP ,&nbsp;Khurram Nasir MD, MPH, MSc ,&nbsp;Michael J. Blaha MD, MPH ,&nbsp;Garima Sharma MD","doi":"10.1016/j.focus.2024.100210","DOIUrl":"10.1016/j.focus.2024.100210","url":null,"abstract":"<div><h3>Introduction</h3><p>Suboptimal cardiovascular health is associated with adverse pregnancy outcomes and long-term cardiovascular risk. The authors examined trends in cardiovascular risk factors and correlates of suboptimal cardiovascular risk profiles among reproductive-aged U.S. women.</p></div><div><h3>Methods</h3><p>With data from 335,959 women in the Behavioral Risk Factor Surveillance System (2015–2020), the authors conducted serial cross-sectional analysis among nonpregnant reproductive-aged women (18–44 years) without cardiovascular disease who self-reported information on 8 cardiovascular risk factors selected on the basis of Life's Essential 8 metrics. The authors estimated the prevalence of each risk factor and suboptimal cardiovascular risk profile (≥2 risk factors) and examined trends overall and by age and race/ethnicity. Using multivariable Poisson regression, the authors assessed the sociodemographic correlates of suboptimal cardiovascular risk profile.</p></div><div><h3>Results</h3><p>The weighted prevalence of women aged &lt;35 years was approximately 64% in each survey year. The prevalence of suboptimal cardiovascular risk profile increased modestly from 72.4% (71.6%–73.3%) in 2015 to 75.9% (75.0%–76.7%) in 2019 (<em>p</em>&lt;0.001). This increase was mainly driven by increases in overweight/obesity (53.1%–58.4%; <em>p</em>&lt;0.001). Between 2015 and 2019, significant increases in suboptimal cardiovascular risk profile were observed among non-Hispanic White (69.8%–72.6%; <em>p</em>&lt;0.001) and Hispanic (75.1%–80.3%; <em>p</em>&lt;0.001) women but not among non-Hispanic Black (82.7%–83.7%; <em>p</em>=0.48) or Asian (68.1%–73.2%; <em>p</em>=0.09) women. Older age, rural residence, and non-Hispanic Black and Hispanic race and ethnicity were associated with a higher prevalence of suboptimal cardiovascular risk profile.</p></div><div><h3>Conclusions</h3><p>There has been a modest but significant increase in suboptimal cardiovascular risk profile among U.S. women of reproductive age. Urgent preventive efforts are needed to reverse this trend and improve cardiovascular health, particularly among subgroups at increased risk, to mitigate its implications.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000294/pdfft?md5=64f7ae06e39e6148ec090913bb541e9e&pid=1-s2.0-S2773065424000294-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140469958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Do Anger and Impulsivity Impact Fast-Food Consumption in Transitional Age Youth?","authors":"Alejandro D. Meruelo MD, PhD ,&nbsp;Ty Brumback PhD ,&nbsp;William E. Pelham III PhD ,&nbsp;Natasha E. Wade PhD ,&nbsp;Michael L. Thomas PhD ,&nbsp;Emil F. Coccaro MD ,&nbsp;Kate B. Nooner PhD ,&nbsp;Sandra A. Brown PhD ,&nbsp;Susan F. Tapert PhD ,&nbsp;Sylvie Mrug PhD","doi":"10.1016/j.focus.2024.100208","DOIUrl":"https://doi.org/10.1016/j.focus.2024.100208","url":null,"abstract":"<div><h3>Introduction</h3><p>Consumption of fast food has been linked to psychiatric distress, violent behaviors, and impulsivity in adolescents. The relationship between eating fast food, anger, and impulsivity has not been widely investigated. The National Consortium on Alcohol and Neurodevelopment in Adolescence community-based cohort consists of 831 youth, half at elevated risk factors for substance use disorders during adolescence, followed annually.</p></div><div><h3>Methods</h3><p>Impulsivity using Urgency, Premeditation, Perseverance, and Sensation Seeking Impulsive Behavior scale from annual assessments was examined in relation to self-reported fast-food consumption frequency and mobile application questions of anger. This study tested the hypotheses that youth anger may be predicted by fast-food consumption frequency and impulsivity using multiple regression, in addition to whether adolescent fast-food consumption frequency may be predicted by anger and impulsivity.</p></div><div><h3>Results</h3><p>Among youth, higher anger levels and impulsivity predicted greater frequency of fast-food consumption, and greater fast-food consumption frequency and impulsivity predicted higher anger levels.</p></div><div><h3>Conclusions</h3><p>This study's longitudinal findings are consistent with those of other studies that have found fast-food consumption and anger associated with impulsivity and also reveal a bidirectional link between anger and fast-food consumption. These results may point attention to food selection considerations for those at risk of anger and poorer psychiatric outcomes.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000270/pdfft?md5=ec022578f4472ce99e7a065ca68367da&pid=1-s2.0-S2773065424000270-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140187219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Historical Redlining With BMI and Waist Circumference in Coronary Artery Risk Development in Young Adults","authors":"Andrea S. Richardson MPH, PhD ,&nbsp;Tamara Dubowitz ScD ,&nbsp;Kirsten M.M. Beyer PhD ,&nbsp;Yuhong Zhou PhD ,&nbsp;Kiarri N. Kershaw PhD ,&nbsp;Waverly Duck PhD ,&nbsp;Feifei Ye PhD ,&nbsp;Robin Beckman MPH ,&nbsp;Penny Gordon-Larsen PhD ,&nbsp;James M. Shikany DrPH ,&nbsp;Catarina Kiefe MD, PhD","doi":"10.1016/j.focus.2024.100209","DOIUrl":"https://doi.org/10.1016/j.focus.2024.100209","url":null,"abstract":"<div><h3>Introduction</h3><p>Historical maps of racialized evaluation of mortgage lending risk (i.e., redlined neighborhoods) have been linked to adverse health outcomes. Little research has examined whether living in historically redlined neighborhoods is associated with obesity, differentially by race or gender.</p></div><div><h3>Methods</h3><p>This is a cross-sectional study to examine whether living in historically redlined neighborhoods is associated with BMI and waist circumference among Black and White adults in 1985–1986. Participants’ addresses were linked to the 1930s Home Owners’ Loan Corporation maps that evaluated mortgage lending risk across neighborhoods. The authors used multilevel linear regression models clustered on Census tract, adjusted for confounders to estimate main effects, and stratified, and interaction models by (1) race, (2) gender, and (3) race by gender with redlining differentially for Black versus White adults and men versus women. To better understand strata differences, they compared Census tract–level median household income across race and gender groups within Home Owners’ Loan Corporation grade.</p></div><div><h3>Results</h3><p>Black adults (<em>n</em>=2,103) were more likely than White adults (<em>n</em>=1,767) to live in historically rated hazardous areas and to have higher BMI and waist circumference. Redlining and race and redlining and gender interactions for BMI and waist circumference were statistically significant (<em>p</em>&lt;0.10). However, in stratified analyses, the only statistically significant associations were among White participants. White participants living in historically rated hazardous areas had lower BMI (<span><math><mrow><mi>β</mi><mo>=</mo><mspace></mspace><mo>−</mo><mn>0.63</mn></mrow></math></span> [95% CI= −1.11, −0.15]) and lower waist circumference (<span><math><mrow><mi>β</mi><mo>=</mo><mspace></mspace><mo>−</mo><mn>1.50</mn></mrow></math></span> [95% CI= −2.62, −0.38]) than those living in declining areas. Within each Home Owners’ Loan Corporation grade, residents in White participants’ neighborhoods had higher incomes than those living in Black participants’ neighborhoods (<em>p</em>&lt;0.0001). The difference was largest within historically redlined areas. Covariate associations differed for men, women, Black, and White adults, explaining the difference between the interaction and the stratified models. Race by redlining interaction did not vary by gender.</p></div><div><h3>Conclusions</h3><p>White adults may have benefitted from historical redlining, which may have reinforced neighborhood processes that generated racial inequality in BMI and waist circumference 50 years later.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000282/pdfft?md5=be95d748e307f831c668eab49da4242b&pid=1-s2.0-S2773065424000282-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140341567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Association Between Social Needs and Care Gap Closure Among Older Adults Receiving Dental Care","authors":"David M. Mosen PhD, MPH ,&nbsp;Matthew P. Banegas PhD, MPH ,&nbsp;Daniel J. Pihlstrom DDS ,&nbsp;Erin M. Keast MPH ,&nbsp;John F. Dickerson PhD ,&nbsp;Jeffrey L. Fellows PhD","doi":"10.1016/j.focus.2024.100212","DOIUrl":"https://doi.org/10.1016/j.focus.2024.100212","url":null,"abstract":"<div><h3>Introduction</h3><p>The authors of this study sought to (1) describe the prevalence of social needs and (2) determine whether social needs were associated with closure of care gaps among patients aged ≥65 years seeking dental care.</p></div><div><h3>Methods</h3><p>In this retrospective cross-sectional study, the authors identified 754 Kaiser Permanente Northwest patients aged ≥65 years who completed an index dental visit; had at least 1 of 23 preventive care gaps (e.g., flu vaccination) or disease management care gaps (e.g., diabetes HbA1c screening test) documented in their medical record; and had completed a social needs assessment through survey evaluating financial strain, food insecurity, housing needs, social isolation, and transportation needs. The authors described the prevalence of social needs at the index visit and then used logistic regression to evaluate the association between the number of social needs (0, 1, ≥2) and closure of all care gaps over the following 60 days (yes versus no), adjusting for patient characteristics. Identification and closure of care gap were assessed through Kaiser Permanente Northwest's Panel Support Tool.</p></div><div><h3>Results</h3><p>Approximately 28% of patients reported ≥1 social needs. The prevalence of social needs was as follows: social isolation, 13.7%; financial strain, 11.3%; food insecurity, 7.7%; transportation needs, 5.4%; and housing needs, 3.3%. Those with 1 social need were more likely to close care gaps than those with no social needs (OR=1.82, 95% CI=1.17, 2.85). No significant association was found with care gap closure among those with ≥2 versus zero social needs.</p></div><div><h3>Conclusions</h3><p>The prevalence of social needs was nearly 30% among patients aged ≥65 years with dental and medical coverage. Patients with 1 social need were more likely than those with no social needs to close all care gaps after their visit.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000312/pdfft?md5=d5ee9e519bfd80b27313861d95d14e79&pid=1-s2.0-S2773065424000312-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Children's Perception of Food Marketing Across Digital Media Platforms","authors":"Jennifer E. Carroll PhD ,&nbsp;Jennifer A. Emond PhD ,&nbsp;Linda L. Griffin PhD ,&nbsp;Elizabeth R. Bertone-Johnson ScD ,&nbsp;Nicole A. VanKim PhD ,&nbsp;Susan R. Sturgeon DrPH","doi":"10.1016/j.focus.2024.100205","DOIUrl":"10.1016/j.focus.2024.100205","url":null,"abstract":"<div><h3>Introduction</h3><p>Exposure to food marketing increases the risk of poor diet. Children's perception and interpretation of food marketing across digital media platforms is understudied. Children aged 9–11 years are uniquely susceptible to food marketing because children may watch content alone, and it is unclear whether embedded ads are decipherable by children (e.g., social media influencers) and if children are receptive to advertisements.</p></div><div><h3>Methods</h3><p>The authors collected data from 21 child–parent dyads in 2022 to fill this gap. Children were interviewed about their food marketing exposure and media use and were asked to share their perspectives on food advertisements. Parents completed a survey for household digital devices, demographics, and perception of their child's food advertising knowledge.</p></div><div><h3>Results</h3><p>This study found that all children generally recognized direct food advertisements, could describe them with varying levels of confidence, and shared examples. Despite self-identifying ads and understanding the intent of advertising, many children are still receptive to advertisements on the basis of engaging content (e.g., liking the ads as entertainment, watching ads even when given the chance to skip the ad) and the food items marketed (e.g., liking the taste of foods).</p></div><div><h3>Conclusions</h3><p>These findings suggest that knowledge of advertisement exposure and intent of advertising are not sufficient to reduce receptiveness of unhealthy food ad exposure. Additional research on the potential impacts of embedded ads, such as through social media influencers, is needed to understand children's interaction with the current digital media landscape.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000245/pdfft?md5=273aa403b5b8268a891e301c01a52dae&pid=1-s2.0-S2773065424000245-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139875469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cohort Study of Downgraded Misdemeanor Convictions and Subsequent Violent Crime: Differences by Defendant Race and Ethnicity","authors":"Julia P. Schleimer MPH ,&nbsp;Miriam J. Haviland PhD, MSPH ,&nbsp;Amy Gallagher MPH ,&nbsp;Ayah Mustafa BS ,&nbsp;Rachel Ross MPH ,&nbsp;Garen Wintemute MD, MPH ,&nbsp;Deirdre Bowen JD, PhD ,&nbsp;Ali Rowhani-Rahbar MD, PhD, MPH","doi":"10.1016/j.focus.2024.100206","DOIUrl":"10.1016/j.focus.2024.100206","url":null,"abstract":"<div><h3>Introduction</h3><p>Criminal convictions may be imperfect markers of criminalized behavior, in part because of criminal legal system processes (e.g., plea bargaining). In this retrospective cohort study of individuals convicted of misdemeanors, authors compared the risk of subsequent criminal charges for a violent crime among those initially charged with a felony with that among those initially charged with only misdemeanors, overall and by defendant race and ethnicity.</p></div><div><h3>Methods</h3><p>The study population included individuals aged ≥18 years who were convicted of a misdemeanor in Washington Superior Courts from January 1, 2015 to December 31, 2019. Those with and without initial felony charges were age/gender matched in a 4:1 ratio. The primary outcome was the first subsequent violent crime charge in Washington Superior Courts through December 31, 2020. Data were analyzed with Fine–Gray hazard models from June 2022 to November 2023.</p></div><div><h3>Results</h3><p>There were 3,841 individuals with initial felony charges and 956 with initial misdemeanor charges only. Median follow-up was 2.4 years for both groups. During follow-up, there were 166 new violent crime charges. In multivariable models, White defendants with initial felony charges had a greater risk of subsequent violent crime charges (subdistribution hazard ratio=2.58; 95% CI=1.24, 5.36) than White defendants with initial misdemeanor charges only. Among Black and Hispanic/Latinx defendants, initial felony versus misdemeanor charges were not associated with subsequent violent crime charges (subdistribution hazard ratio=0.93; 95% CI=0.44, 1.97 among Black defendants; subdistribution hazard ratio=0.49; 95% CI=0.15, 1.57 among Hispanic/Latinx defendants).</p></div><div><h3>Conclusions</h3><p>Findings suggest differential associations between downgrading of felony charges to misdemeanor convictions and future violent crime charges by defendant race and ethnicity, with implications for inequitable collateral consequences of criminal convictions.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000257/pdfft?md5=046b4b03801ab667e9739e306d693e3f&pid=1-s2.0-S2773065424000257-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139884515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wastewater Surveillance for Xylazine in Kentucky","authors":"Chris Delcher PhD ,&nbsp;Dana Quesinberry JD, DrPH ,&nbsp;Soroosh Torabi PhD ,&nbsp;Scott Berry PhD ,&nbsp;James W. Keck MD ,&nbsp;Abhya Rani ,&nbsp;Bikram Subedi PhD","doi":"10.1016/j.focus.2024.100203","DOIUrl":"10.1016/j.focus.2024.100203","url":null,"abstract":"<div><h3>Introduction</h3><p>In the U.S., xylazine, the veterinary non-opioid sedative, has emerged as a major threat to people who use illicitly manufactured fentanyl and other drugs. The aim of this study was to compare wastewater detection of xylazine with other public health and safety surveillance data from 2019 to 2023 in Kentucky.</p></div><div><h3>Methods</h3><p>Wastewater samples from 5 rest areas, 2 truck weigh stations, and 4 wastewater treatment plants were tested for xylazine. Wastewater xylazine positivity rates were compared with xylazine-positive submission rates from the National Forensic Laboratory Information System and Kentucky's fatal overdoses in 6-month periods (Period 1=January–June; Period 2=July–December).</p></div><div><h3>Results</h3><p>Xylazine was detected in 61.6% (424 of 688) of daily wastewater samples from roadway sites/wastewater treatment plants. For roadways, detection increased from 55% (Period 1, 2021) to 94% (Period 1, 2023), and wastewater treatment plants had an overall detection of 25.8% (<em>n</em>=66 samples, Periods 1 and 2, 2022). Increasing roadway positivity corresponded to trends in National Forensic Laboratory Information System xylazine-positive submission rates: from 0.19 per 1,000 submissions (Period 1, 2019) to 2.9 per 1,000 (Period 2, 2022, latest available). No deaths from xylazine were reported publicly in Kentucky, although this study's authors identified 1–4 deaths (true count suppressed) in the overdose surveillance system, which, in back-of-the-envelope comparisons with other states, is far fewer than expected.</p></div><div><h3>Conclusions</h3><p>Wastewater signals indicate broad geographic exposure to xylazine in Kentucky, yet health outcomes data suggest otherwise. These findings may inform regional, national, and international efforts to incorporate wastewater-based drug surveillance. Harm-reduction activities along roadways and other suitable locations may be needed.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000221/pdfft?md5=e0e45691477f8f3c321f1dc14382915a&pid=1-s2.0-S2773065424000221-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139879838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of a Global Pandemic on Young Adult Sedentary Behavior and Physical Activity","authors":"Brett D. Baker PhD,&nbsp;Darla M. Castelli PhD","doi":"10.1016/j.focus.2024.100202","DOIUrl":"10.1016/j.focus.2024.100202","url":null,"abstract":"<div><h3>Introduction</h3><p>The novel COVID-19 disease detected in 2019 widely affected individuals’ social movements, likely disrupting the ability to participate in leisure-related physical activity. Because of this, participation in sedentary behavior is thought to have increased. The purpose of this study was to determine how the COVID-19 pandemic affected U.S. young adult physical activity and sedentary behavior.</p></div><div><h3>Methods</h3><p>A total of 333 U.S. young adults (aged between 18 and 30 years) completed an online, comprehensive questionnaire during the early parts of COVID-19. Wilcoxon signed-rank tests were used to determine the change in time spent in physical activity and sedentary behavior during COVID-19 compared with that before COVID-19.</p></div><div><h3>Results</h3><p>There was a significant decrease in physical activity minutes (<em>p</em>&lt;0.0001) and a significant increase in sedentary behavior (<em>p</em>&lt;0.005) during COVID-19 compared with that before COVID-19. Significant differences were found by stratifying the data by sex and relationship status. Although both males and females reduced their physical activity, only males significantly increased their time in sedentary behavior during COVID-19 compared with that before COVID-19 (<em>p</em>&lt;0.05). Furthermore, married young adults significantly reduced their physical activity during COVID-19 (<em>p</em>&lt;0.001), whereas single individuals did not. Single young adults saw significant increases in sedentary behavior during COVID-19 (<em>p</em>&lt;0.005), whereas married individuals did not exhibit any change in sedentary behavior.</p></div><div><h3>Conclusions</h3><p>Stay-at-home orders enforced in the U.S. during the summer of 2020 led to increases in sedentary behavior and decreases in physical activity, particularly among males and single young adults. Future studies should determine whether these behavior changes persist.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277306542400021X/pdfft?md5=770497e7a04386ba7719aa2373864afb&pid=1-s2.0-S277306542400021X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139893067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pivoting COVID-19 Resources for an Equitable Mpox Vaccine Response in Louisiana","authors":"Arundhati Bakshi PhD ,&nbsp;John McClure BS ,&nbsp;Theresa Sokol MPH ,&nbsp;Lee Mendoza PhD ,&nbsp;Arun Adhikari PhD ,&nbsp;Nancy Zhao MPH ,&nbsp;Suryatapa Kar MPH ,&nbsp;Jimmy Gale BS ,&nbsp;Javone Davis Charles MPH ,&nbsp;Kyle Freese PhD, MPH ,&nbsp;Ousswa Kudia MPH ,&nbsp;Sara Brown MPH","doi":"10.1016/j.focus.2024.100204","DOIUrl":"10.1016/j.focus.2024.100204","url":null,"abstract":"<div><h3>Introduction</h3><p>The first case of mpox in Louisiana was identified 2 months ahead of Southern Decadence Festival in New Orleans, the largest LGBTQ+ Pride festival in the South. With mpox case numbers reflecting racial disparities, the objective was to mount an equitable vaccination response.</p></div><div><h3>Methods</h3><p>The Louisiana Department of Health rapidly pivoted its COVID-19 resources and strategies—specifically, using vaccine strike teams and mobile events, in-state vaccine redistribution through centralized warehousing and shipping support, and community partnerships—to now control mpox transmission. Here, the authors have evaluated state-based Immunization Information System data to examine whether the vaccination response was geographically and racially equitable. Geographic equity was measured by taking into account vaccine availability as well as uptake in areas with high Social Vulnerability Index.</p></div><div><h3>Results</h3><p>A total of 113 providers were enrolled in the vaccination program, and 96 mobile vaccination events were held in locations frequented by at-risk populations. Racial disparities among vaccine recipients decreased over time, and vaccine availability and uptake were equitable in areas with high Social Vulnerability Indices. However, Black, female, and Hispanic/Latinx patients had significantly higher risk of not completing the 2-dose series than their counterparts.</p></div><div><h3>Conclusions</h3><p>The mpox vaccination response in Louisiana was geographically equitable, though some demographic disparities remained.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100204"},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000233/pdfft?md5=48a906fe898e76eb4e7c53e8d8ed210c&pid=1-s2.0-S2773065424000233-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139833054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neighborhood Environment and Poor Maternal Glycemic Control–Associated Complications of Gestational Diabetes Mellitus","authors":"Leela V. Thomas PhD ,&nbsp;Claudine T. Jurkovitz MD, MPH ,&nbsp;Zugui Zhang PhD, FAHA ,&nbsp;Mitchell R. Fawcett MBA ,&nbsp;M. James Lenhard MD, FACP, FACE","doi":"10.1016/j.focus.2024.100201","DOIUrl":"10.1016/j.focus.2024.100201","url":null,"abstract":"<div><h3>Introduction</h3><p>Risk of complications due to gestational diabetes mellitus is increasing in the U.S., particularly among individuals from racial minorities. Research has focused largely on clinical interventions to prevent complications, rarely on individuals’ residential environments. This retrospective cohort study aims to examine the association between individuals’ neighborhoods and complications of gestational diabetes mellitus.</p></div><div><h3>Methods</h3><p>Demographic and clinical data were extracted from electronic health records and linked to American Community Survey data from the U.S. Census Bureau for 2,047 individuals who had 2,164 deliveries in 2014–2018. Data were analyzed in 2021–2022 using Wilcoxon rank sum test and chi-square test for bivariate analyses and logistic regression for analysis of independent effects. All census tract–based variables used in the model were dichotomized at the median.</p></div><div><h3>Results</h3><p>Bivariate analysis showed that the average percentage of adults earning &lt;$35,000 was higher in neighborhoods where individuals with complications were living than in neighborhoods where individuals without complications were living (30.40%±12.05 vs 28.94%±11.71, <em>p</em>=0.0145). Individuals who lived in areas with ≥8.9% of residents aged &gt;25 years with less than high school diploma had a higher likelihood of complications than those who lived in areas with &lt;8.9% of such residents (33.43% vs 29.02%, <em>p</em>=0.0272). Individuals who lived in neighborhoods that had ≥1.8% of households receiving public assistance were more likely to have complications than those who lived in areas where &lt;1.8% of households received public assistance (33.33% vs 28.97%, <em>p</em>=0.0287). Logistic regression revealed that the odds of deliveries with complications were 44% higher for individuals with obesity (OR=1.44; 95% CI=1.17, 1.77), 35% greater for individuals residing in neighborhoods with higher percentages of households living below the poverty level (OR=1.35; 95% CI=1.09, 1.66), and 28% lower for individuals from neighborhoods where a higher percentage of households had no vehicles available for transportation to work (OR=0.72; 95% CI=0.59, 0.89).</p></div><div><h3>Conclusions</h3><p>Clinical interventions in concert with environmental changes could contribute to preventing maternal and neonatal complications of gestational diabetes mellitus.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000208/pdfft?md5=c683a679c6cf02145c5f31bf36852f46&pid=1-s2.0-S2773065424000208-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139824394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}