Pub Date : 2024-05-16DOI: 10.1016/j.focus.2024.100241
Allison B. Robbins MD , Mimi R. Borrelli MBBS, PhD , Fatima N. Mirza MD, MPH , Nicole A. Negbenebor MD , Helena M. Kuhn MD , Tiffany J. Libby MD
Introduction
Indoor tanning is a major modifiable risk factor in the development of both melanoma and nonmelanoma skin cancers. Investigation of behavior-altering interventions is an area of active research. As with other preventive measures, screening of high-risk populations can be an important aspect of a multimodality public health intervention. This study sought to further the limited understanding of indoor tanning screening practices in the primary care setting.
Methods
Physicians practicing within the scope of primary care in the northeast were surveyed in 2022 on practice patterns around the frequency of indoor tanning screening, barriers encountered with implementing screening, and actions taken with a positive screen. Research methodology adhered to the Joanna Briggs Institute critical appraisal checklist.
Results
Of 26 primary care physicians, only 7.7% routinely screened for indoor tanning. Barriers identified included time limitations (76.9%) and prioritization of other health concerns (96.2%). All primary care physicians (100%) reacted to reports of indoor tanning with an intervention, most commonly counseling on the risks of indoor tanning (92.6%).
Conclusions
This data suggest that screening for indoor tanning use could be improved. The authors recommend the incorporation of a standardized screening question regarding indoor tanning in intake forms.
{"title":"Assessing the Feasibility and Effectiveness of Screening for Indoor Tanning in the Primary Care Setting: A Report of Preliminary Findings","authors":"Allison B. Robbins MD , Mimi R. Borrelli MBBS, PhD , Fatima N. Mirza MD, MPH , Nicole A. Negbenebor MD , Helena M. Kuhn MD , Tiffany J. Libby MD","doi":"10.1016/j.focus.2024.100241","DOIUrl":"10.1016/j.focus.2024.100241","url":null,"abstract":"<div><h3>Introduction</h3><p>Indoor tanning is a major modifiable risk factor in the development of both melanoma and nonmelanoma skin cancers. Investigation of behavior-altering interventions is an area of active research. As with other preventive measures, screening of high-risk populations can be an important aspect of a multimodality public health intervention. This study sought to further the limited understanding of indoor tanning screening practices in the primary care setting.</p></div><div><h3>Methods</h3><p>Physicians practicing within the scope of primary care in the northeast were surveyed in 2022 on practice patterns around the frequency of indoor tanning screening, barriers encountered with implementing screening, and actions taken with a positive screen. Research methodology adhered to the Joanna Briggs Institute critical appraisal checklist.</p></div><div><h3>Results</h3><p>Of 26 primary care physicians, only 7.7% routinely screened for indoor tanning. Barriers identified included time limitations (76.9%) and prioritization of other health concerns (96.2%). All primary care physicians (100%) reacted to reports of indoor tanning with an intervention, most commonly counseling on the risks of indoor tanning (92.6%).</p></div><div><h3>Conclusions</h3><p>This data suggest that screening for indoor tanning use could be improved. The authors recommend the incorporation of a standardized screening question regarding indoor tanning in intake forms.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000592/pdfft?md5=7e2159162c70101148476ad1e08d33de&pid=1-s2.0-S2773065424000592-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141031780","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}
Pub Date : 2024-05-16DOI: 10.1016/j.focus.2024.100242
Kavita Mosalpuria PhD , Elise V. Bailey BS , Hyunkyu Ko PhD , Eric J. Hansen BS , Fernando A. Wilson PhD
Introduction
Veterans commonly experience both poor health and employment difficulty. However, the research examining potential relationships between chronic physical and mental health conditions and employment in veterans has important limitations. This study examines those potential relationships using large-scale, nationally representative data. The authors' hypothesis was that veterans experiencing these conditions would be less likely to be employed than veterans without the conditions and, further, that there may be differences in these relationships when comparing male veterans with female veterans.
Methods
The study team conducted a pooled cross-sectional analysis of nationally representative data from the 2004–2019 administrations of the Medical Expenditures Panel Survey, which had items addressing health conditions, employment, and military experience. The authors assessed the relationship between health conditions and employment using multivariate logistic regression. Control variables included demographics, SES, family size, and survey year.
Results
Veterans experiencing diabetes, high blood pressure, stroke, emphysema, arthritis, serious hearing loss, poor self-reported mental health, poor self-reported health, depression, or psychological distress were less likely to be employed than veterans without those conditions, even after adjusting for potential confounding factors. Veterans with diabetes had 25% lesser odds of being employed than veterans without the condition (95% CI=0.65, 0.85). Veterans with increased likelihood of depression had 35% lesser odds of being employed than veterans without depression (95% CI=0.52, 0.81).
Conclusions
This study adds evidence to the understanding of the role of chronic health conditions in employment status of veterans. The results support arguments for programs that aid veterans with both their health and their employment.
{"title":"Chronic Physical and Mental Health Conditions Associated With Employment Status in Veterans","authors":"Kavita Mosalpuria PhD , Elise V. Bailey BS , Hyunkyu Ko PhD , Eric J. Hansen BS , Fernando A. Wilson PhD","doi":"10.1016/j.focus.2024.100242","DOIUrl":"10.1016/j.focus.2024.100242","url":null,"abstract":"<div><h3>Introduction</h3><p>Veterans commonly experience both poor health and employment difficulty. However, the research examining potential relationships between chronic physical and mental health conditions and employment in veterans has important limitations. This study examines those potential relationships using large-scale, nationally representative data. The authors' hypothesis was that veterans experiencing these conditions would be less likely to be employed than veterans without the conditions and, further, that there may be differences in these relationships when comparing male veterans with female veterans.</p></div><div><h3>Methods</h3><p>The study team conducted a pooled cross-sectional analysis of nationally representative data from the 2004–2019 administrations of the Medical Expenditures Panel Survey, which had items addressing health conditions, employment, and military experience. The authors assessed the relationship between health conditions and employment using multivariate logistic regression. Control variables included demographics, SES, family size, and survey year.</p></div><div><h3>Results</h3><p>Veterans experiencing diabetes, high blood pressure, stroke, emphysema, arthritis, serious hearing loss, poor self-reported mental health, poor self-reported health, depression, or psychological distress were less likely to be employed than veterans without those conditions, even after adjusting for potential confounding factors. Veterans with diabetes had 25% lesser odds of being employed than veterans without the condition (95% CI=0.65, 0.85). Veterans with increased likelihood of depression had 35% lesser odds of being employed than veterans without depression (95% CI=0.52, 0.81).</p></div><div><h3>Conclusions</h3><p>This study adds evidence to the understanding of the role of chronic health conditions in employment status of veterans. The results support arguments for programs that aid veterans with both their health and their employment.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000609/pdfft?md5=fed345d5f384d0fb965fb0f7f2882253&pid=1-s2.0-S2773065424000609-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141047262","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}
Pub Date : 2024-05-09DOI: 10.1016/j.focus.2024.100234
Anastasia V. Warmington RN, MSc , Dawn M.E. Bowdish PhD , Diana Sherifali RN, PhD, CDE , Deborah M. Sloboda PhD
Introduction
Pregnancy complications, including high maternal BMI, are associated with altered early development and child health outcomes. A growing body of work links the prenatal environment, specifically maternal BMI, with respiratory infections in offspring. In this rapid review, the authors review the literature supporting the hypothesis that high maternal BMI during pregnancy is associated with childhood respiratory infection incidence.
Methods
The authors employed systematic search criteria in known databases—EMBASE, EMCARE, MEDLINE, CINAHL, and PsychINFO—searching from inception to January 2023. Included were primary research studies that involved (1) human pregnancy, (2) pregravid or gestational overweight or obesity, and (3) childhood respiratory infection with or without hospitalization.
Results
Only 7 population-based cohort studies met the criteria, investigating maternal BMI as an exposure and childhood respiratory infection as an outcome (age 6 months to 18 years). Therefore, the authors conducted a qualitative analysis, and outcomes were reported. The authors found that >85% of the albeit few published studies support the hypothesis that maternal BMI may have independent and profound consequences on respiratory infection risk across childhood.
Discussion
This area of research needs large-scale, well-controlled studies to better understand the relationship between maternal BMI and childhood respiratory infection. Possible resources such as cohort catalogs and combined databases are discussed. These findings add to the growing evidence that early environmental factors influence lifelong respiratory health. By incorporating a life course approach to infectious disease risk, policy makers can put this research to work and target health vulnerabilities before they arise.
{"title":"A Scoping Review of the Relationship Between Maternal BMI and Offspring Incidence of Respiratory Infection: Where Do We Go From Here?","authors":"Anastasia V. Warmington RN, MSc , Dawn M.E. Bowdish PhD , Diana Sherifali RN, PhD, CDE , Deborah M. Sloboda PhD","doi":"10.1016/j.focus.2024.100234","DOIUrl":"10.1016/j.focus.2024.100234","url":null,"abstract":"<div><h3>Introduction</h3><p>Pregnancy complications, including high maternal BMI, are associated with altered early development and child health outcomes. A growing body of work links the prenatal environment, specifically maternal BMI, with respiratory infections in offspring. In this rapid review, the authors review the literature supporting the hypothesis that high maternal BMI during pregnancy is associated with childhood respiratory infection incidence.</p></div><div><h3>Methods</h3><p>The authors employed systematic search criteria in known databases—EMBASE, EMCARE, MEDLINE, CINAHL, and PsychINFO—searching from inception to January 2023. Included were primary research studies that involved (1) human pregnancy, (2) pregravid or gestational overweight or obesity, and (3) childhood respiratory infection with or without hospitalization.</p></div><div><h3>Results</h3><p>Only 7 population-based cohort studies met the criteria, investigating maternal BMI as an exposure and childhood respiratory infection as an outcome (age 6 months to 18 years). Therefore, the authors conducted a qualitative analysis, and outcomes were reported. The authors found that >85% of the albeit few published studies support the hypothesis that maternal BMI may have independent and profound consequences on respiratory infection risk across childhood.</p></div><div><h3>Discussion</h3><p>This area of research needs large-scale, well-controlled studies to better understand the relationship between maternal BMI and childhood respiratory infection. Possible resources such as cohort catalogs and combined databases are discussed. These findings add to the growing evidence that early environmental factors influence lifelong respiratory health. By incorporating a life course approach to infectious disease risk, policy makers can put this research to work and target health vulnerabilities before they arise.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277306542400052X/pdfft?md5=e05db879b90bdd5fcadd435c402695ac&pid=1-s2.0-S277306542400052X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141053870","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}
This study aimed to clarify the relationship between psychological factors (goal orientation and desire for approval from others) and the severity of sports injuries experienced by young Japanese athletes.
Methods
A total of 560 young Japanese athletes (328 males and 232 females) aged 18–24 years completed an online survey in 2022–2023. A web questionnaire was used to investigate participants’ task and ego orientations, desire for approval from others (e.g., coaches and friends/families), and history of injury. The samples were then split into 3 groups on the basis of the rest duration due to the injury: noninjury group (0 days), mild-to-moderate injury group (1–27 days), and severe injury group (>28 days). Spearman's test examined a correlation between task and ego orientation scores among all samples. The Mann–Whitney U test was used to compare the scores between the severe injury and noninjury groups.
Result
A significant positive correlation was found between task and ego orientation scores from all samples (ρ=0.27, p<0.001). The severe injury group had significantly higher task orientation scores and desire for approval scores than the noninjury group (ρ=0.001, p<0.001).
Conclusions
Japanese young athletes with high task orientation and approval desire may be at risk of severe sports injuries requiring >4 weeks to return to sports. The goal orientation profiles should be interpreted with caution. Future research should examine contextual effects such as the perceived motivational climate, in addition to the goal orientation profiles.
{"title":"Goal Orientation and Desire for Approval Were Associated With Sports Injuries Among Young Japanese Athletes","authors":"Yukiko Kimotsuki MSc, PHN, RN , Issei Ogasawara PhD , Susumu Iwasaki PhD , Kanto Nagai PhD, MD , Kyohei Nishida PhD, MD , Noriyuki Kanzaki PhD, MD , Yuichi Hoshino PhD, MD , Takehiko Matsushita PhD, MD , Ryosuke Kuroda PhD, MD , Ryohei Uchida PhD, MD , Yasuhiro Take PhD, MD , Ken Nakata PhD, MD","doi":"10.1016/j.focus.2024.100236","DOIUrl":"10.1016/j.focus.2024.100236","url":null,"abstract":"<div><h3>Introduction</h3><p>This study aimed to clarify the relationship between psychological factors (goal orientation and desire for approval from others) and the severity of sports injuries experienced by young Japanese athletes.</p></div><div><h3>Methods</h3><p>A total of 560 young Japanese athletes (328 males and 232 females) aged 18–24 years completed an online survey in 2022–2023. A web questionnaire was used to investigate participants’ task and ego orientations, desire for approval from others (e.g., coaches and friends/families), and history of injury. The samples were then split into 3 groups on the basis of the rest duration due to the injury: noninjury group (0 days), mild-to-moderate injury group (1–27 days), and severe injury group (>28 days). Spearman's test examined a correlation between task and ego orientation scores among all samples. The Mann–Whitney <em>U</em> test was used to compare the scores between the severe injury and noninjury groups.</p></div><div><h3>Result</h3><p>A significant positive correlation was found between task and ego orientation scores from all samples (ρ=0.27, <em>p</em><0.001). The severe injury group had significantly higher task orientation scores and desire for approval scores than the noninjury group (ρ=0.001, <em>p</em><0.001).</p></div><div><h3>Conclusions</h3><p>Japanese young athletes with high task orientation and approval desire may be at risk of severe sports injuries requiring >4 weeks to return to sports. The goal orientation profiles should be interpreted with caution. Future research should examine contextual effects such as the perceived motivational climate, in addition to the goal orientation profiles.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000543/pdfft?md5=93dbccdec621f7a1d613bfb6c06ee306&pid=1-s2.0-S2773065424000543-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141028847","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}
Pub Date : 2024-05-07DOI: 10.1016/j.focus.2024.100232
Lilai Teum PharmD , Fallon Gokhman PharmD , Sophia Park PharmD , Daniel S. Budnitz MD, MPH , Joseph W. Aquilina MD , Edwin K. Kuffner MD
Introduction
Prescription and most over-the-counter medicines are required to have child-resistant packaging and/or labeled with instructions “Keep out of reach of children.” Although medication organizers are not required to have such design features or instructions, these could help prevent unsupervised ingestions by children. Commonly purchased medication organizers were evaluated for child-resistant design features and instructions for safe use to prevent unsupervised ingestions.
Methods
The 29 best-selling medication organizers on Amazon.com were identified, and product identifiers, design characteristics, and safety characteristics were recorded using a standardized instrument.
Results
Of the 29 medication organizers, none claimed to be child resistant. Only 31% provided a specific warning that the organizer was not child resistant on the packaging; only 41% communicated “Keep out of reach of children.” Most organizers (59%) provided neither a warning that the organizer was not child resistant nor instructions to store out of reach of children. The majority of organizers (79%) shared the following characteristics: plastic construction, rectangular shape, nonelectronic flip-top opening mechanisms, and 7-day usage.
Conclusions
Opportunities exist for manufacturers of medication organizers to improve child-resistant product design, provide information to help prevent unsupervised ingestions (directions to keep the device out of the reach of children), and help to reduce unsupervised ingestions.
{"title":"A Pilot Study Assessing Common Medication Organizers for Child-Resistant Features","authors":"Lilai Teum PharmD , Fallon Gokhman PharmD , Sophia Park PharmD , Daniel S. Budnitz MD, MPH , Joseph W. Aquilina MD , Edwin K. Kuffner MD","doi":"10.1016/j.focus.2024.100232","DOIUrl":"10.1016/j.focus.2024.100232","url":null,"abstract":"<div><h3>Introduction</h3><p>Prescription and most over-the-counter medicines are required to have child-resistant packaging and/or labeled with instructions “Keep out of reach of children.” Although medication organizers are not required to have such design features or instructions, these could help prevent unsupervised ingestions by children. Commonly purchased medication organizers were evaluated for child-resistant design features and instructions for safe use to prevent unsupervised ingestions.</p></div><div><h3>Methods</h3><p>The 29 best-selling medication organizers on Amazon.com were identified, and product identifiers, design characteristics, and safety characteristics were recorded using a standardized instrument.</p></div><div><h3>Results</h3><p>Of the 29 medication organizers, none claimed to be child resistant. Only 31% provided a specific warning that the organizer was not child resistant on the packaging; only 41% communicated “Keep out of reach of children.” Most organizers (59%) provided neither a warning that the organizer was not child resistant nor instructions to store out of reach of children. The majority of organizers (79%) shared the following characteristics: plastic construction, rectangular shape, nonelectronic flip-top opening mechanisms, and 7-day usage.</p></div><div><h3>Conclusions</h3><p>Opportunities exist for manufacturers of medication organizers to improve child-resistant product design, provide information to help prevent unsupervised ingestions (directions to keep the device out of the reach of children), and help to reduce unsupervised ingestions.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000506/pdfft?md5=062b44bd2fe016387bcd9ad06eea2b1e&pid=1-s2.0-S2773065424000506-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141031402","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}
Pub Date : 2024-05-07DOI: 10.1016/j.focus.2024.100235
Debra K. Kellstedt DrPH , Courtney S. Suess PhD , Jay E. Maddock PhD
Introduction
Time spent in nature provides myriad physical and mental health benefits for both adults and children. Despite these benefits, most people spend too little time in nature to realize the maximal effect. Different types of childhood experiences may have differential influence on adult time in nature. This study assessed the influences of different kinds of childhood outdoor experiences on time spent in nature as an adult. The first aim was to utilize 20 childhood nature experience items to construct summative scales. The second aim was to examine the influence of each scale and other factors on adult time in nature.
Methods
A 2-factor scale measuring wild and domesticated childhood nature experiences was developed using principal and confirmatory factor analyses. An online study of 2,109 American adults was conducted. Multiple linear regression examined the influences of the 2 childhood nature experiences scales, attitude and self-efficacy scales, and sex and age covariates on adult time spent in nature.
Results
Significant predictors of adult time in nature were wild childhood nature experiences (β=0.279, p<0.001), positive attitudes about nature (β=0.12, p<0.05), negative attitudes about nature (β= −0.23, p<0.001), and self-efficacy (β=0.71, p<0.001).
Conclusions
Wild childhood nature experiences (e.g., camping, hiking, and fishing) that include skill building, that are immersive and engaging, and that involve opportunity for social interaction may translate better into adult nature activities. Programs that introduce and support wild experiences may increase lifelong time spent in nature.
{"title":"Influences of Outdoor Experiences During Childhood on Time Spent in Nature as an Adult","authors":"Debra K. Kellstedt DrPH , Courtney S. Suess PhD , Jay E. Maddock PhD","doi":"10.1016/j.focus.2024.100235","DOIUrl":"10.1016/j.focus.2024.100235","url":null,"abstract":"<div><h3>Introduction</h3><p>Time spent in nature provides myriad physical and mental health benefits for both adults and children. Despite these benefits, most people spend too little time in nature to realize the maximal effect. Different types of childhood experiences may have differential influence on adult time in nature. This study assessed the influences of different kinds of childhood outdoor experiences on time spent in nature as an adult. The first aim was to utilize 20 childhood nature experience items to construct summative scales. The second aim was to examine the influence of each scale and other factors on adult time in nature.</p></div><div><h3>Methods</h3><p>A 2-factor scale measuring wild and domesticated childhood nature experiences was developed using principal and confirmatory factor analyses. An online study of 2,109 American adults was conducted. Multiple linear regression examined the influences of the 2 childhood nature experiences scales, attitude and self-efficacy scales, and sex and age covariates on adult time spent in nature.</p></div><div><h3>Results</h3><p>Significant predictors of adult time in nature were wild childhood nature experiences (β=0.279, <em>p</em><0.001), positive attitudes about nature (β=0.12, <em>p</em><0.05), negative attitudes about nature (β= −0.23, <em>p</em><0.001), and self-efficacy (β=0.71, <em>p</em><0.001).</p></div><div><h3>Conclusions</h3><p>Wild childhood nature experiences (e.g., camping, hiking, and fishing) that include skill building, that are immersive and engaging, and that involve opportunity for social interaction may translate better into adult nature activities. Programs that introduce and support wild experiences may increase lifelong time spent in nature.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000531/pdfft?md5=ecc32e989d95c190c5eb73439293fc82&pid=1-s2.0-S2773065424000531-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141028342","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}
Pub Date : 2024-05-07DOI: 10.1016/j.focus.2024.100233
Michelle S. Rockwell PhD, RD , Adam J. Funk BS , Alison N. Huffstetler MD , Gabriela Villalobos MSW , Jacqueline B. Britz MD, MSPH , Benjamin Webel BA , Alicia Richards MS , John W. Epling MD, MSEd , Roy T. Sabo PhD , Alex H. Krist MD, MPH
Introduction
Unhealthy alcohol use increases the risk for and exacerbation of chronic health conditions. As such, screening, prevention, and management of unhealthy alcohol use is especially critical to improving health outcomes for patients with multiple chronic health conditions. It is unclear to what extent multiple chronic condition status is a barrier to screening for unhealthy alcohol use in the primary care setting. The authors hypothesized that patients with multiple chronic conditions would be at lower odds of being screened for unhealthy alcohol use than patients without multiple chronic conditions.
Methods
The authors performed a secondary analysis of electronic health record data for patients from 67 primary care practices in Virginia (2020–2023). Using the Center for Medicare and Medicaid Services’ chronic disease framework, they classified patients by multiple chronic condition status: no multiple chronic conditions, physical multiple chronic conditions, mental health multiple chronic conditions, and physical and mental health multiple chronic conditions. They used multiple logistic regressions with an added practice-level random effect to analyze the relationship between multiple chronic condition status and the odds of receiving an alcohol-related assessment, of being screened for unhealthy alcohol use with a U.S. Preventive Services Task Force–recommended instrument, and of screening positive for unhealthy alcohol use within the past 2 years.
Results
Within a final cohort of n=11,789, a total of 6,796 patients (58%) had multiple chronic conditions (29% physical multiple chronic conditions, 4% mental health multiple chronic conditions, and 25% physical and mental health multiple chronic conditions). In all, 69% of patients were screened for unhealthy alcohol use, whereas 16% were screened with a U.S. Preventive Services Task Force–recommended instrument, and 7% screened positive for unhealthy alcohol use. Patients with physical and mental health multiple chronic conditions had 0.9 times lower odds of receiving any screening for unhealthy alcohol use than those with no multiple chronic conditions (95% CI=0.8, 1.0; p=0.0240), whereas patients with only physical multiple chronic conditions or only mental health multiple chronic conditions had similar odds. There was no difference in the odds of being screened with a U.S. Preventive Services Task Force–recommended instrument on the basis of multiple chronic condition status. Patients with mental health multiple chronic conditions and physical and mental health multiple chronic conditions had 1.8 and 1.5 times greater odds of screening positive for unhealthy alcohol use, respectively (95% CI=1.3, 2.7; p=0.0014 and 95% CI=1.2, 1.8; p=0.0003).
Conclusions
Although patients with chronic mental health conditions were more likely to screen positive for unhealthy alc
{"title":"Screening for Unhealthy Alcohol Use Among Patients With Multiple Chronic Conditions in Primary Care","authors":"Michelle S. Rockwell PhD, RD , Adam J. Funk BS , Alison N. Huffstetler MD , Gabriela Villalobos MSW , Jacqueline B. Britz MD, MSPH , Benjamin Webel BA , Alicia Richards MS , John W. Epling MD, MSEd , Roy T. Sabo PhD , Alex H. Krist MD, MPH","doi":"10.1016/j.focus.2024.100233","DOIUrl":"10.1016/j.focus.2024.100233","url":null,"abstract":"<div><h3>Introduction</h3><p>Unhealthy alcohol use increases the risk for and exacerbation of chronic health conditions. As such, screening, prevention, and management of unhealthy alcohol use is especially critical to improving health outcomes for patients with multiple chronic health conditions. It is unclear to what extent multiple chronic condition status is a barrier to screening for unhealthy alcohol use in the primary care setting. The authors hypothesized that patients with multiple chronic conditions would be at lower odds of being screened for unhealthy alcohol use than patients without multiple chronic conditions.</p></div><div><h3>Methods</h3><p>The authors performed a secondary analysis of electronic health record data for patients from 67 primary care practices in Virginia (2020–2023). Using the Center for Medicare and Medicaid Services’ chronic disease framework, they classified patients by multiple chronic condition status: no multiple chronic conditions, physical multiple chronic conditions, mental health multiple chronic conditions, and physical and mental health multiple chronic conditions. They used multiple logistic regressions with an added practice-level random effect to analyze the relationship between multiple chronic condition status and the odds of receiving an alcohol-related assessment, of being screened for unhealthy alcohol use with a U.S. Preventive Services Task Force–recommended instrument, and of screening positive for unhealthy alcohol use within the past 2 years.</p></div><div><h3>Results</h3><p>Within a final cohort of <em>n</em>=11,789, a total of 6,796 patients (58%) had multiple chronic conditions (29% physical multiple chronic conditions, 4% mental health multiple chronic conditions, and 25% physical and mental health multiple chronic conditions). In all, 69% of patients were screened for unhealthy alcohol use, whereas 16% were screened with a U.S. Preventive Services Task Force–recommended instrument, and 7% screened positive for unhealthy alcohol use. Patients with physical and mental health multiple chronic conditions had 0.9 times lower odds of receiving any screening for unhealthy alcohol use than those with no multiple chronic conditions (95% CI=0.8, 1.0; <em>p</em>=0.0240), whereas patients with only physical multiple chronic conditions or only mental health multiple chronic conditions had similar odds. There was no difference in the odds of being screened with a U.S. Preventive Services Task Force–recommended instrument on the basis of multiple chronic condition status. Patients with mental health multiple chronic conditions and physical and mental health multiple chronic conditions had 1.8 and 1.5 times greater odds of screening positive for unhealthy alcohol use, respectively (95% CI=1.3, 2.7; <em>p</em>=0.0014 and 95% CI=1.2, 1.8; <em>p</em>=0.0003).</p></div><div><h3>Conclusions</h3><p>Although patients with chronic mental health conditions were more likely to screen positive for unhealthy alc","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000518/pdfft?md5=55ff4a9eb5045455e208787fdbfa7294&pid=1-s2.0-S2773065424000518-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141025057","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}
Pub Date : 2024-05-06DOI: 10.1016/j.focus.2024.100231
John James F. Parker MD, MS , Craig F. Garfield MD, MAPP , Clarissa D. Simon PhD, MPH , Laura A. Colangelo MS , Michael P. Bancks PhD, MPH , Norrina B. Allen PhD, MPH
Introduction
Emerging literature links fatherhood to men's health but lacks comprehensive assessment of health outcomes, especially among multiethnic populations. This study's objective was to evaluate the associations of fatherhood (age at onset and status) with cardiovascular health scores, incident cardiovascular disease, cardiovascular disease death, and all-cause mortality, examining differences by race/ethnicity.
Methods
The study sample included men from Multi-Ethnic Study of Atherosclerosis, prospective cohort study that enrolled adults aged 45–84 years without known cardiovascular disease at baseline. Cardiovascular health was defined using the American Heart Association's Life's Essential 8 scores (0–100), excluding sleep (cardiovascular health score).
Results
In this sample of 2,814 men, mean age at cardiovascular health assessment was 62.2 years, 82% were fathers, 24% self-identified as Black, 13% self-identified Chinese, 22% self-identified Hispanic, and 41% self-identified White. Fathers who were aged <20 years and 20–24 years at their oldest child's birth had worse overall cardiovascular health than fathers who were aged >35 years (adjusted mean score of 61.1 vs 64.7 [p=0.01] and 61.0 vs 64.7 [p<0.001], respectively). Fathers had worse overall cardiovascular health (adjusted mean score of 63.2 vs 64.7, p=0.03) and more nicotine exposure (63.1 vs 66.6, p=0.04) than nonfathers. In age-adjusted models, fathers overall (hazard ratio=0.82; 95% CI=0.69, 0.98) and Black fathers (hazard ratio=0.73; 95% CI=0.53, 0.999) had a lower rate of all-cause mortality rate than nonfathers, but these associations were no longer significant in fully adjusted models.
Conclusions
Fatherhood is a social determinant of health, and understanding its influence may provide opportunities to improve men's health, particularly among men of color.
导言：越来越多的文献将父亲身份与男性健康联系起来，但缺乏对健康结果的全面评估，尤其是在多种族人群中。本研究的目的是评估父爱（开始年龄和状态）与心血管健康评分、心血管疾病、心血管疾病死亡和全因死亡率之间的关系，并研究不同种族/族裔之间的差异。结果 在 2814 名男性样本中，接受心血管健康评估时的平均年龄为 62.2 岁，82% 为人父，24% 自认为是黑人，13% 自认为是华人，22% 自认为是西班牙裔，41% 自认为是白人。与 35 岁的父亲相比，最大孩子出生时年龄为 20 岁和 20-24 岁的父亲的整体心血管健康状况较差（调整后的平均得分分别为 61.1 vs 64.7 [p=0.01] 和 61.0 vs 64.7 [p<0.001]）。与非父亲相比，父亲的整体心血管健康状况更差（调整后的平均得分为 63.2 vs 64.7，p=0.03），尼古丁暴露更多（63.1 vs 66.6，p=0.04）。在年龄调整模型中，父亲总体（危险比=0.82；95% CI=0.69，0.98）和黑人父亲（危险比=0.73；95% CI=0.53，0.999）的全因死亡率低于非父亲，但这些关联在完全调整模型中不再显著。
{"title":"Fatherhood and Cardiovascular Health, Disease, and Mortality: Associations From the Multi-Ethnic Study of Atherosclerosis","authors":"John James F. Parker MD, MS , Craig F. Garfield MD, MAPP , Clarissa D. Simon PhD, MPH , Laura A. Colangelo MS , Michael P. Bancks PhD, MPH , Norrina B. Allen PhD, MPH","doi":"10.1016/j.focus.2024.100231","DOIUrl":"10.1016/j.focus.2024.100231","url":null,"abstract":"<div><h3>Introduction</h3><p>Emerging literature links fatherhood to men's health but lacks comprehensive assessment of health outcomes, especially among multiethnic populations. This study's objective was to evaluate the associations of fatherhood (age at onset and status) with cardiovascular health scores, incident cardiovascular disease, cardiovascular disease death, and all-cause mortality, examining differences by race/ethnicity.</p></div><div><h3>Methods</h3><p>The study sample included men from Multi-Ethnic Study of Atherosclerosis, prospective cohort study that enrolled adults aged 45–84 years without known cardiovascular disease at baseline. Cardiovascular health was defined using the American Heart Association's Life's Essential 8 scores (0–100), excluding sleep (cardiovascular health score).</p></div><div><h3>Results</h3><p>In this sample of 2,814 men, mean age at cardiovascular health assessment was 62.2 years, 82% were fathers, 24% self-identified as Black, 13% self-identified Chinese, 22% self-identified Hispanic, and 41% self-identified White. Fathers who were aged <20 years and 20–24 years at their oldest child's birth had worse overall cardiovascular health than fathers who were aged >35 years (adjusted mean score of 61.1 vs 64.7 [<em>p</em>=0.01] and 61.0 vs 64.7 [<em>p</em><0.001], respectively). Fathers had worse overall cardiovascular health (adjusted mean score of 63.2 vs 64.7, <em>p</em>=0.03) and more nicotine exposure (63.1 vs 66.6, <em>p</em>=0.04) than nonfathers. In age-adjusted models, fathers overall (hazard ratio=0.82; 95% CI=0.69, 0.98) and Black fathers (hazard ratio=0.73; 95% CI=0.53, 0.999) had a lower rate of all-cause mortality rate than nonfathers, but these associations were no longer significant in fully adjusted models.</p></div><div><h3>Conclusions</h3><p>Fatherhood is a social determinant of health, and understanding its influence may provide opportunities to improve men's health, particularly among men of color.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277306542400049X/pdfft?md5=2b3aebf4f9995366e514d60025878cd6&pid=1-s2.0-S277306542400049X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141049900","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}
Pub Date : 2024-04-19DOI: 10.1016/j.focus.2024.100230
Huabin Luo PhD , Bei Wu PhD , Yanyan Wu PhD , Mark E. Moss DDS, PhD
Introduction
National data on dental caries and dental service use among immigrant children in U.S. are limited. It is not known whether race/ethnicity would interact with immigration status to increase these disparities. Using a nationally representative sample, this study assessed the interaction effects of immigrant generation status and race/ethnicity on dental caries and dental visits among children in the U.S.
Methods
Data were from the 2020 and 2021 National Survey of Children's Health. All data were self-reported by parents/guardians. The 2 outcomes were (1) dental caries (yes/no) in the past 12 months and (2) preventive dental visits (yes/no) in the past 12 months. Racial/ethnic groups included non-Hispanic White, Black, Hispanics, and Asian Americans. The analytical sample included 66,167 children aged 2–17 years, including 1,243 first-generation immigrant children; 11,017 second-generation immigrant children; and 53,907 nonimmigrant children. Study authors ran separate multiple logistic regression models for the 2 outcome variables. All analyses accounted for the survey design of National Survey of Children's Health.
Results
First-generation immigrant children were more likely to have dental caries than nonimmigrant children (AOR=1.44). The interaction of race/ethnicity and immigrant generation status was significant (p=0.04) in the preventive dental visits model, indicating increased challenges in getting dental visits among minority immigrant children in comparison with that among non-Hispanic White immigrant children, especially among first-generation immigrant children of Asian Americans (AOR=0.41) and non-Hispanic Black immigrant children (AOR=0.37).
Conclusions
First-generation immigrant children were less likely to see a dentist and more likely to have dental caries than nonimmigrants. Moreover, first-generation immigrant children from minority racial/ethnic groups were the least likely to seek dental services. To further reduce disparities in oral health and dental use among children in the U.S., culturally sensitive health promotion is warranted to improve oral health literacy and reduce barriers to dental care for immigrants, especially immigrant children of the minority groups.
{"title":"Dental Caries and Preventive Dental Visits Among Children in the U.S.: The Impact of Race/Ethnicity and Immigration","authors":"Huabin Luo PhD , Bei Wu PhD , Yanyan Wu PhD , Mark E. Moss DDS, PhD","doi":"10.1016/j.focus.2024.100230","DOIUrl":"10.1016/j.focus.2024.100230","url":null,"abstract":"<div><h3>Introduction</h3><p>National data on dental caries and dental service use among immigrant children in U.S. are limited. It is not known whether race/ethnicity would interact with immigration status to increase these disparities. Using a nationally representative sample, this study assessed the interaction effects of immigrant generation status and race/ethnicity on dental caries and dental visits among children in the U.S.</p></div><div><h3>Methods</h3><p>Data were from the 2020 and 2021 National Survey of Children's Health. All data were self-reported by parents/guardians. The 2 outcomes were (1) dental caries (yes/no) in the past 12 months and (2) preventive dental visits (yes/no) in the past 12 months. Racial/ethnic groups included non-Hispanic White, Black, Hispanics, and Asian Americans. The analytical sample included 66,167 children aged 2–17 years, including 1,243 first-generation immigrant children; 11,017 second-generation immigrant children; and 53,907 nonimmigrant children. Study authors ran separate multiple logistic regression models for the 2 outcome variables. All analyses accounted for the survey design of National Survey of Children's Health.</p></div><div><h3>Results</h3><p>First-generation immigrant children were more likely to have dental caries than nonimmigrant children (AOR=1.44). The interaction of race/ethnicity and immigrant generation status was significant (<em>p</em>=0.04) in the preventive dental visits model, indicating increased challenges in getting dental visits among minority immigrant children in comparison with that among non-Hispanic White immigrant children, especially among first-generation immigrant children of Asian Americans (AOR=0.41) and non-Hispanic Black immigrant children (AOR=0.37).</p></div><div><h3>Conclusions</h3><p>First-generation immigrant children were less likely to see a dentist and more likely to have dental caries than nonimmigrants. Moreover, first-generation immigrant children from minority racial/ethnic groups were the least likely to seek dental services. To further reduce disparities in oral health and dental use among children in the U.S., culturally sensitive health promotion is warranted to improve oral health literacy and reduce barriers to dental care for immigrants, especially immigrant children of the minority groups.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000488/pdfft?md5=0fc31555d65ce334d5c028b417aff150&pid=1-s2.0-S2773065424000488-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786375","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}
Pub Date : 2024-04-10DOI: 10.1016/j.focus.2024.100229
Gilly A. Hendrie PhD , Kim Anastasiou PhD , Emily Brindal PhD , Bonnie Wiggins MMktg , Danielle L. Baird BNutrDiet (Hons) , Brittany J. Johnson PhD , Lucinda K. Bell PhD , Claire Gardner MNutrDiet , Jennifer C. Arguelles BNutrDiet , Amber Kelaart MHSM , David N. Cox PhD , Rebecca K. Golley PhD
Introduction
Dietary guidelines worldwide emphasize the importance of consuming vegetables as part of a healthy diet. Despite this, translating this information into messages for consumers that change behavior has been difficult. There have been population-level social marketing campaigns as well as several smaller campaigns directed specifically toward children, which have demonstrated small increases in consumption. However, achieving meaningful and sustained increases in children's vegetable consumption remains a challenge. This article describes the process of synthesizing the published literature and translating these findings to inform the development of 7 best practice guidelines to increase children's vegetable intake.
Methods
The first step in this process was a systematic review of scientific literature to identify the components of interventions that were associated with successfully increasing vegetable intake. The synthesis of effective intervention components was guided by the Behavior Change Wheel. These scientific findings were translated to guidelines for best practice. This process involved a team of nutrition and behavioral researchers and nutrition practitioners translating the science into actionable advice that could be adopted by a range of stakeholders. The 6 selected stakeholders included long daycare centers, after-hours school care providers, primary schools, industry groups and growers, researchers, and government policy makers. Stakeholders were involved in the development process through surveys and interviews to understand their requirements for resources to support adoption of the best practice guidelines within each setting and within the context of existing practice.
Results
The guidelines center on coordination of effort, with a focus on components such as planning, environmental restructuring, barrier reduction, feedback, and monitoring. In consultation with key stakeholders, a range of resources were developed for each setting to support the implementation of best practice, with the aim of achieving meaningful increases in intake. The resources and tools have been made available at http://www.vegkit.com.au.
Conclusions
The translation of knowledge into practice is not traditionally included as part of the research process. Therefore, combining the process of reviewing the science and translating the evidence to stakeholder resources to influence practice in 1 research study is novel, and the study could be used to guide future research translation activities within and beyond the field of public health nutrition.
{"title":"Increasing Children's Vegetable Consumption: Translating a Review of the Evidence Base to Develop Best Practice Guidelines","authors":"Gilly A. Hendrie PhD , Kim Anastasiou PhD , Emily Brindal PhD , Bonnie Wiggins MMktg , Danielle L. Baird BNutrDiet (Hons) , Brittany J. Johnson PhD , Lucinda K. Bell PhD , Claire Gardner MNutrDiet , Jennifer C. Arguelles BNutrDiet , Amber Kelaart MHSM , David N. Cox PhD , Rebecca K. Golley PhD","doi":"10.1016/j.focus.2024.100229","DOIUrl":"10.1016/j.focus.2024.100229","url":null,"abstract":"<div><h3>Introduction</h3><p>Dietary guidelines worldwide emphasize the importance of consuming vegetables as part of a healthy diet. Despite this, translating this information into messages for consumers that change behavior has been difficult. There have been population-level social marketing campaigns as well as several smaller campaigns directed specifically toward children, which have demonstrated small increases in consumption. However, achieving meaningful and sustained increases in children's vegetable consumption remains a challenge. This article describes the process of synthesizing the published literature and translating these findings to inform the development of 7 best practice guidelines to increase children's vegetable intake.</p></div><div><h3>Methods</h3><p>The first step in this process was a systematic review of scientific literature to identify the components of interventions that were associated with successfully increasing vegetable intake. The synthesis of effective intervention components was guided by the Behavior Change Wheel. These scientific findings were translated to guidelines for best practice. This process involved a team of nutrition and behavioral researchers and nutrition practitioners translating the science into actionable advice that could be adopted by a range of stakeholders. The 6 selected stakeholders included long daycare centers, after-hours school care providers, primary schools, industry groups and growers, researchers, and government policy makers. Stakeholders were involved in the development process through surveys and interviews to understand their requirements for resources to support adoption of the best practice guidelines within each setting and within the context of existing practice.</p></div><div><h3>Results</h3><p>The guidelines center on coordination of effort, with a focus on components such as planning, environmental restructuring, barrier reduction, feedback, and monitoring. In consultation with key stakeholders, a range of resources were developed for each setting to support the implementation of best practice, with the aim of achieving meaningful increases in intake. The resources and tools have been made available at http://www.vegkit.com.au.</p></div><div><h3>Conclusions</h3><p>The translation of knowledge into practice is not traditionally included as part of the research process. Therefore, combining the process of reviewing the science and translating the evidence to stakeholder resources to influence practice in 1 research study is novel, and the study could be used to guide future research translation activities within and beyond the field of public health nutrition.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000476/pdfft?md5=880e83b9036ffe1b8af2d138abe51855&pid=1-s2.0-S2773065424000476-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759383","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}
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