AJPM focus最新文献

{"title":"Adolescent Exposure to Food and Alcohol Advertising on TV in the U.S., 2013–2022","authors":"Lisa M. Powell PhD ,&nbsp;Julien Leider MA ,&nbsp;Rebecca M. Schermbeck MPH, MS, RD ,&nbsp;Jennifer L. Harris PhD, MBA","doi":"10.1016/j.focus.2025.100430","DOIUrl":"10.1016/j.focus.2025.100430","url":null,"abstract":"<div><h3>Introduction</h3><div>Reducing adolescent consumption of unhealthy foods and alcohol is a primary public health objective. Youth exposure to food and alcohol marketing is associated with increased consumption. This study measured changes in adolescents’ exposure to food-related and alcohol TV advertising from 2013 to 2022 and the nutrition quality of advertised food and beverage products.</div></div><div><h3>Methods</h3><div>This repeated cross-sectional study assessed U.S. TV ratings data on advertising exposure among adolescents aged 12–17 years (including separate ratings for Black and White adolescents) from The Nielsen Company for 2013, 2014, 2015, 2018, and 2022. For food and beverage product advertisements, nutrient content information was used to identify products high in nutrients to limit.</div></div><div><h3>Results</h3><div>Adolescents’ exposure to food-related advertising declined from 2013 to 2022 by 83.8%, from 5,983 to 969 TV advertisements per year. Exposure to alcohol advertising also fell substantially over this period but to a lesser extent—down by 70.6% with 95 advertisements seen per year in 2022. The percentage of food and beverage advertisements seen for products high in nutrients to limit fell modestly from 77.5% in 2013 to 69.0% in 2022. The proportion of food and beverage products high in sugar fell from 51.6% to 40.6%, whereas the proportion of products high in sodium increased from 19.3% to 25.1%. Similar changes in exposure were observed between White and Black adolescents; thus, the racial gap in marketing exposure persisted.</div></div><div><h3>Conclusions</h3><div>Adolescents’ exposure to TV advertising for food-related products and alcohol fell substantially over the last decade, yet adolescents still see almost 1,100 of such advertisements annually, primarily for unhealthy products. This suggests that current voluntary industry self-regulatory standards are insufficient to fully reduce youth exposure to harmful marketing, which may require broader mandatory policies that limit their total exposure to food-related and alcohol advertising.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 6","pages":"Article 100430"},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363542","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":"Emergency Department Utilization for Acute Myocardial Infarction, U.S., May–September 2018–2023","authors":"Essi M. Havor PhD ,&nbsp;LaTonia C. Richardson PhD ,&nbsp;Omoye E. Imoisili MD ,&nbsp;Fátima Coronado MD ,&nbsp;Sandra L. Jackson PhD ,&nbsp;Abigail L. Gates MSPH ,&nbsp;Lakshmi Radhakrishnan MPH ,&nbsp;Ambarish Vaidyanathan PhD ,&nbsp;Fleetwood Loustalot PhD ,&nbsp;Angela M. Thompson-Paul PhD ,&nbsp;Rebecca C. Woodruff PhD","doi":"10.1016/j.focus.2025.100426","DOIUrl":"10.1016/j.focus.2025.100426","url":null,"abstract":"<div><h3>Introduction</h3><div>Exposure to extreme heat and wildfire-related hazards, such as poor air quality, can increase the risk of acute cardiovascular events. This study assessed whether acute myocardial infarction–related emergency department visits increased in 2023—a year of increased heat and wildfire smoke exposure in the U.S.—compared with visits in the 5 preceding years combined.</div></div><div><h3>Methods</h3><div>This serial cross-sectional study identified acute myocardial infarction–related emergency department visits among adults aged ≥18 years from National Syndromic Surveillance Program data using discharge diagnosis codes. Daily mean acute myocardial infarction–related emergency department visit rates per 100,000 all-cause emergency department visits during May–September 2023 were compared with those during May–September 2018–2022 for adults overall and by subgroup.</div></div><div><h3>Results</h3><div>During May–September 2023, the daily acute myocardial infarction–related emergency department visit rate (699.5 acute myocardial infarction–related emergency department visits per 100,000) was 16.5% (95% CI=14.8, 18.2) higher than the rate in 2018–2022 (600.4 acute myocardial infarction–related emergency department visits per 100,000). Overall, acute myocardial infarction–related emergency department visit rates increased across age groups, in both sexes, and in most HHS regions. HHS Regions 2 and 4 reported the largest relative increases in acute myocardial infarction–related emergency department visit rate (27.0% [95% CI=22.9, 31.4] and 30.0% [95% CI=27.7, 32.5], respectively).</div></div><div><h3>Conclusions</h3><div>Acute myocardial infarction–related emergency department visit rates were higher in May–September 2023 than in May–September 2018–2022. Near real-time surveillance data can be leveraged to monitor emergency department visits for acute cardiovascular conditions across different time periods to inform clinical and public health practices.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100426"},"PeriodicalIF":0.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419244","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":"The Relationship Between Receipt of Opioid Settlement Funds and Reductions in Opioid Overdose Deaths in the U.S.","authors":"Ryan K. McBain PhD ,&nbsp;Jonathan H. Cantor PhD ,&nbsp;Aaron Kofner MS ,&nbsp;Zoe Lindenfeld PhD ,&nbsp;David Powell PhD","doi":"10.1016/j.focus.2025.100424","DOIUrl":"10.1016/j.focus.2025.100424","url":null,"abstract":"<div><h3>Introduction</h3><div>The ongoing distribution of funds from the national settlement agreements with opioid distributors and manufacturers presents a unique opportunity to mitigate the morbidity and mortality associated with opioid use. In this study, the authors examine whether larger per-capita settlement disbursements correspond to greater reductions in opioid-related overdose deaths since then and the extent to which states with higher baseline opioid-related overdose death rates receive greater per-capita settlement disbursements.</div></div><div><h3>Methods</h3><div>Using national data on opioid settlement disbursements from the Kaiser Family Foundation and overdose deaths from the Centers for Disease Control and Prevention, the authors estimated an event study using a Poisson regression to compare trends in overdose deaths during the predisbursement period (2017–2021) with those observed in the postdisbursement period (2022–2023). The authors then quantified the magnitude of settlement disbursements in 2022–2023 relative to opioid-related overdose death rates in the 5 preceding years.</div></div><div><h3>Results</h3><div>Each additional per-capita dollar of settlement funds was associated with a 0.99% larger decline in opioid-related overdose deaths in 2022 (95% CI= −1.90%, −0.08%; <em>p</em>=0.03) and a 2.46% decline in 2023 (95% CI= −4.17%, −0.75%; <em>p</em>=0.01). The authors also found a significant association between opioid-related overdose death rates in the 5 years prior to disbursements and the magnitude of per-capita disbursements (2022–2023). Each additional opioid-related overdose death per 100,000 residents was associated with a $0.87 greater per-capita disbursement (95% CI=$0.43, $1.31; <em>p</em>&lt;0.001).</div></div><div><h3>Conclusions</h3><div>This study provides valuable initial evidence that settlement disbursements are being directed toward states with higher baseline opioid-related overdose death rates, and the size of the disbursements is associated with early reductions in these death rates.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 6","pages":"Article 100424"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268256","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":"Hardship-Free Households Are Associated With Optimal Caregiver and Child Health","authors":"Richard Sheward MPP ,&nbsp;Stephanie Ettinger de Cuba PhD, MPH ,&nbsp;Diana B. Cutts MD ,&nbsp;Deborah A. Frank MD ,&nbsp;Ana Poblacion PhD, MSc ,&nbsp;Eduardo Ochoa Jr. MD, FAAP ,&nbsp;Félice Lê-Scherban PhD, MPH ,&nbsp;Maureen M. Black PhD ,&nbsp;Sharon M. Coleman MSPT, MPH ,&nbsp;Timothy C. Heeren PhD ,&nbsp;Megan Sandel MD, MPH","doi":"10.1016/j.focus.2025.100422","DOIUrl":"10.1016/j.focus.2025.100422","url":null,"abstract":"<div><h3>Introduction</h3><div>Families living with low incomes experience a higher risk of material hardships associated with poor health. To understand the potentially protective role of hardship-free households, the authors examined associations between the absence of material hardships among families with low incomes and child health and healthcare utilization and caregiver health outcomes.</div></div><div><h3>Methods</h3><div>Researchers interviewed a sentinel sample of caregivers of publicly insured children aged &lt;4 years in hospital settings in 5 U.S. cities (2012–2017). Exposure to material hardships (food insecurity, housing instability, healthcare hardship, and energy insecurity) was categorized as 0, 1, or ≥2 hardships. Outcome measures included child health (overall and oral health), anthropometrics, developmental risk, lifetime hospitalizations, composite well-child measure, caregiver health, and depressive symptoms. Multivariable logistic regression models examined the associations between hardships and child and caregiver health.</div></div><div><h3>Results</h3><div>Among 16,320 families, 41.0% experienced 0 hardships, 28.2% experienced 1 hardship, and 30.8% experienced ≥2 hardships. After covariate control, children from hardship-free households experienced lower adjusted odds of lifetime hospitalizations, fair/poor health, fair/poor oral health, developmental risk, and higher odds of wellness than children from household that experienced ≥2 hardships, and caregivers had lower odds of fair/poor health and depressive symptoms. Children and their caregivers from households with 1 hardship showed lower adjusted odds of lifetime hospitalizations, fair/poor health, fair/poor oral health, and higher odds of wellness than those from household that experienced ≥2 hardships, and caregivers had lower odds of fair/poor health and depressive symptoms.</div></div><div><h3>Conclusions</h3><div>Living without material hardships may contribute to positive physical and developmental/behavioral health among children and caregivers. Findings support the importance of policies to decrease material hardships among families with low incomes.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100422"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145323663","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":"Racialized Black–White Economic Segregation and Major Chain Yoga Studio Locations in Major U.S. Metropolitan Areas","authors":"Kevin Y. Xu MD, MPH ,&nbsp;Ruth Ling BA ,&nbsp;Devin E. Banks PhD ,&nbsp;Benson S. Ku MD, PhD","doi":"10.1016/j.focus.2025.100417","DOIUrl":"10.1016/j.focus.2025.100417","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite yoga’s benefits and popularity, there is concern for racial inequities in yoga access and participation that have not been empirically studied at the population level. Against this background, the objective of this study was to examine the geographic distribution of major chain yoga franchises in relation to racialized Black–White economic segregation across the U.S.</div></div><div><h3>Methods</h3><div>The authors extracted census tracts and 5-digit ZIP codes (ZIP5) for &gt;500 major chain yoga franchises in the U.S. and estimated the Index of Concentration at the Extremes (ICE_{Race[Black–White]-Income}), a measure of racialized Black–White economic segregation. ICE_{Race(Black–White)-Income} is a continuous variable ranging from −1 to +1, categorized into quintiles (−1=maximum deprivation; +1=maximum privilege).</div></div><div><h3>Results</h3><div>Study findings revealed that &lt;10% of studios were situated in census tracts and ZIP5s with a proportion of Black residents exceeding 13%. Less than 25% of studios were situated in census tracts and ZIP5s with household incomes below the 2022 national median ($74,580). Across all census tracts and ZIP5s, the mean value for ICE_{Race(Black–White)-Income} fell in the highest quintile for racialized Black–White economic segregation (ICE_{Race[Black–White]-Income}=0.37).</div></div><div><h3>Conclusions</h3><div>Major yoga franchises are situated in census tracts and ZIP codes that fall within the highest quintile of racialized Black–White economic segregation in the U.S.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 6","pages":"Article 100417"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268253","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":"Association of SARS-CoV-2 Serology Test Result and COVID-19 Vaccination in Adults: A Multisite Cohort Study","authors":"Jason M. Glanz PhD ,&nbsp;Darryl E. Palmer-Toy MD, PhD ,&nbsp;Komal J. Narwaney PhD ,&nbsp;Jennifer C. Barrow MSPH ,&nbsp;Katia J. Bruxvoort PhD ,&nbsp;Courtney R. Kraus MSPH ,&nbsp;Jason A. Lyons MA ,&nbsp;Ingrid A. Binswanger MD, MPH","doi":"10.1016/j.focus.2025.100423","DOIUrl":"10.1016/j.focus.2025.100423","url":null,"abstract":"<div><h3>Introduction</h3><div>Although the utility of SARS-CoV-2 serology testing is limited, individuals may have used serology test results to inform COVID-19 vaccination decisions during the pandemic. Serology test results may have changed individuals’ perceived susceptibility to SARS-CoV2 infection, leading to risk compensation behavior. Understanding how serology results as a measure of perceived susceptibility influence COVID-19 vaccination decisions could inform future interventions to increase adult vaccine acceptance. This study examined the association between SARS-CoV-2 serology (antibody) test results and COVID-19 vaccination uptake.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included adults who received ≥1 serology test between January 1, 2021, and February 28, 2023. The date of the first serology test represented Day 0, and vaccination uptake was followed for 30 days. Individuals could have multiple serology tests, and person-time follow-up was enumerated across tests. The main exposure was the SARS-CoV-2 serology test result. Receipt of COVID-19 vaccination (BNT162b2 or mRNA-1273) was analyzed using Cox proportional hazards regression, controlling for age, sex, race/ethnicity, tobacco use, and comorbidities.</div></div><div><h3>Results</h3><div>Within a cohort of 28,610 adults, there were 28,820 serology test results. Approximately 38% (<em>n</em>=10,802) of the cohort had at least 1 positive serology result. Among negative tests, the COVID-19 vaccination rate was 1,489 per 1,000 person-years of follow-up; among positive tests, the rate was 829 vaccinations per 1,000 person-years. A negative serology test result was positively associated with COVID-19 vaccination (adjusted hazard ratio=1.58; 95% CI=1.45, 1.72).</div></div><div><h3>Conclusions</h3><div>SARS-CoV-2 serology results appear to influence vaccination behavior. Future interventions could target perceived illness susceptibility to increase vaccine acceptance.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 6","pages":"Article 100423"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333278","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":"Blasting Off Again: An Observational Study on Substance Use Content Exposure in Pokémon Twitch Streams","authors":"Matthew C. Nali BA ,&nbsp;Meng Zhen Larsen BA, BS ,&nbsp;Tim K. Mackey MAS, PhD","doi":"10.1016/j.focus.2025.100413","DOIUrl":"10.1016/j.focus.2025.100413","url":null,"abstract":"<div><h3>Introduction</h3><div>The Pokémon franchise has an array of media (i.e., TV series, movies, merchandise, and Trading Card Game) that has attracted global youth and adults since its creation in 1996. Specifically, users have been known to discuss, promote, and purchase Pokémon Trading Card Game on the livestreaming platform Twitch. However, Pokémon Trading Card Game livestreaming content may also include potentially harmful content for youth and adolescents, such as depictions of substance use. Hence, the objective of this study was to assess whether popular Twitch Pokémon Trading Card Game content and influencers promote substance use topics and behavior.</div></div><div><h3>Methods</h3><div>This study was conducted in 3 phases: (1) data mining on 2 Twitch data aggregation websites (Sullygnome.com and TwitchTracker.com) within the Pokémon Trading Card Game category; (2) data filtering using keywords through a snowball sampling strategy on the title of a Twitch stream; and (3) content coding using the WHO protocol on Internet Monitoring of Marketing of Unhealthy Products to Children and Adolescents for influencer and microinfluencer substance use marketing, including depictions of substance use or promotion of products on the streamer’s profile. The authors also conducted an assessment of any underage moderation for Twitch livestreams.</div></div><div><h3>Results</h3><div>A total of 1,025 highly active Pokémon Trading Card Game streamers were recruited and analyzed. The use and promotion of substance use in the form of alcohol, cannabis, or tobacco was detected in 25.07% (<em>n</em>=257) of these Pokémon Trading Card Game Twitch streamers. Frequent substance use detected was alcohol (90.27%, <em>n</em>=232), followed by polysubstance use (6.61%, <em>n</em>=17), cannabis (<em>n</em>=6, 2.33%), and tobacco (<em>n</em>=2, 0.78%). Content coding detected 3 general themes, with behavioral being the most observed. This included behavioral content of substance use for the specific reason of casual use (46.06%, <em>n</em>=228) and for intoxication (26.26%, <em>n</em>=130). In addition, close to three quarters (72.76%, <em>n</em>=187) of streamers’ accounts did not prohibit underage access to account content or livestreams.</div></div><div><h3>Conclusions</h3><div>In this study, the authors detected Twitch streamers violating Twitch community guidelines that may have exposed millions of youths and young adults in the Pokémon Trading Card Game category to different depictions of substance use. Although Twitch prohibits monetary gain in exchange for posting substance use content, the apparent lack of enforcement of Twitch community guidelines and the absence of age verification means that youth who enjoy Pokémon Trading Card Game content may also be exposed to content actively promoting substance use behaviors.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 6","pages":"Article 100413"},"PeriodicalIF":0.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268257","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":"Impact of Vaccination-Differentiated Public Health and Social Measures on Vaccine Uptake Among the Vaccine Hesitant","authors":"En Jie Tan MD ,&nbsp;Cheryl Chong MD ,&nbsp;Alex Yap BS ,&nbsp;Calvin Chiew MD ,&nbsp;Sharon Tan BDS ,&nbsp;Yuhan Yang ,&nbsp;Kelvin Tan PhD ,&nbsp;David Lye FRCP ,&nbsp;Alex Cook PhD ,&nbsp;Vernon Lee PhD","doi":"10.1016/j.focus.2025.100419","DOIUrl":"10.1016/j.focus.2025.100419","url":null,"abstract":"<div><h3>Introduction</h3><div>Vaccine hesitancy poses a hurdle toward achieving high population-level immunity and reducing disease transmission. One policy response adopted during the COVID-19 vaccination campaign was the implementation of vaccination-differentiated public health and social measures. This paper aims to evaluate the impact of vaccination-differentiated public health and social measures on COVID-19 vaccination rates in Singapore, with a specific focus on vaccine-hesitant persons.</div></div><div><h3>Methods</h3><div>An interrupted time series design with segmented linear regression was utilized to assess the impact of the announcement of each vaccination-differentiated public health and social measure on vaccine uptake rates among the vaccine-naive population. Newey-West standard errors with a 7-day lag were applied to address potential autocorrelation in the data. Covariates adjusted for included day of the week, daily numbers of COVID-19–related cases, deaths, hospitalizations, and patients in the intensive care unit.</div></div><div><h3>Results</h3><div>The study found a significant and positive effect of vaccination-differentiated public health and social measure announcements on the daily vaccine uptake rate among the vaccine-naive population, specifically for dining out and patronizing shopping malls. When stratified by age group, the significant and positive effect of the announcement of mall access vaccination-differentiated public health and social measures persisted across all age groups, and it only persisted for individuals aged 13–17, 25–34, and 35–49 years for the announcement of dining vaccination-differentiated public health and social measures.</div></div><div><h3>Conclusions</h3><div>Overall, the findings support the effectiveness of vaccination-differentiated public health and social measures in increasing vaccine uptake rates among vaccine-hesitant persons. However, the compelling evidence for complementary policies should also be considered.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100419"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365212","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":"Silent No More: Confronting Structural Gendered Racism and the Crisis of Abduction and Femicide of U.S. Black Women and Girls","authors":"Tiara C. Willie PhD, MA","doi":"10.1016/j.focus.2025.100421","DOIUrl":"10.1016/j.focus.2025.100421","url":null,"abstract":"","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 6","pages":"Article 100421"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222022","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":"Exploring the Characteristics Associated With Diabetes and Hypertension Performance in Community Health Centers","authors":"Amanda Gusovsky Chevalier PhD, MPH ,&nbsp;Daniel M. Walker PhD, MPH ,&nbsp;Ann Scheck McAlearney ScD, MS ,&nbsp;Kirsten Casey PhD ,&nbsp;Esther Olsen MS ,&nbsp;Maria F. Levis MPH ,&nbsp;Karleen F. Giannitrapani PhD, MPH, MD ,&nbsp;Laura Vaughan MD ,&nbsp;Latha Palaniappan MD, MS ,&nbsp;Alan Glaseroff MD ,&nbsp;Sara Singer PhD, MBA","doi":"10.1016/j.focus.2025.100418","DOIUrl":"10.1016/j.focus.2025.100418","url":null,"abstract":"<div><h3>Introduction</h3><div>Large portions of patients served at community health centers have diabetes or hypertension. This study aimed to identify the factors related to diabetes and hypertension performance among community health centers.</div></div><div><h3>Methods</h3><div>The authors estimated multivariable linear regression models to examine the association of characteristics (percentage of patients at high risk of cardiovascular events on statin therapy, female, overweight or obese, homeless, veterans, gender minorities, sexual orientation minorities, best served in a non-English language, or with diabetes or hypertension and log of revenue per patient) with diabetes (proportion of patients with HbA1c &gt;9.0) and hypertension (proportion of patients with high blood pressure) control. The sample included community health centers in the 2023 Uniform Data System data set.</div></div><div><h3>Results</h3><div>Variables significantly associated with lower diabetes control were percentage of patients who were unhoused (0.10; 95% CI=0.07, 0.13) and patients best served in a non-English language (0.03; 95% CI=0.01, 0.05); variables significantly associated with higher diabetes control were percentage of patients who were at high risk of cardiovascular events and on statin therapy (−0.17; 95% CI= −0.22, −0.12) and those who were veterans (−0.86; 95% CI= −1.12, −0.59); variables significantly associated with lower hypertension control were percentage of patients who were unhoused (0.06; 95% CI=0.03, 0.09) and patients who were hypertensive (0.10; 95% CI=0.04, 0.16) and log of revenue per patient (0.73; 95% CI=0.17, 1.30); and variables significantly associated with higher hypertension control were percentage of patients who were at high risk of cardiovascular events and on statin therapy (−0.35 95% CI= −0.39, −0.30), patients who were overweight or obese (−0.04; 95% CI= −0.07, −0.01), and veterans (−0.82; 95% CI= −1.08, −0.55).</div></div><div><h3>Conclusions</h3><div>Community health centers with higher proportions of unhoused patients may require extra support. Encouraging delivery of evidence-based care may help performance.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"5 1","pages":"Article 100418"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365215","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}