Annals of Epidemiology最新文献

{"title":"Cigarette smoking in relation to survival in Black women with ovarian cancer: Evidence from the African American Cancer Epidemiology Study (AACES)","authors":"Maxwell Akonde ,&nbsp;Anthony J. Alberg ,&nbsp;Courtney Johnson ,&nbsp;Elisa V. Bandera ,&nbsp;Lindsay J. Collin ,&nbsp;Michele L. Cote ,&nbsp;Theresa A. Hastert ,&nbsp;Lauren C. Peres ,&nbsp;Edward S. Peters ,&nbsp;Bo Qin ,&nbsp;Paul D. Terry ,&nbsp;Andrew B. Lawson ,&nbsp;Joellen M. Schildkraut","doi":"10.1016/j.annepidem.2025.02.011","DOIUrl":"10.1016/j.annepidem.2025.02.011","url":null,"abstract":"<div><h3>Background</h3><div>Numerous studies have documented the negative impact of cigarette smoking on ovarian cancer survival, but the participants in these prior studies were predominantly White women. In comparison, Black women experience significantly worse ovarian cancer survival, which may be due in part to dissimilar risk factor profiles or factors associated with survival. We therefore examined the association between cigarette smoking and survival in a cohort of Black women with ovarian cancer.</div></div><div><h3>Methods</h3><div>This study included participants in the multi-site population-based African American Cancer Epidemiology Study (AACES), a prospective cohort study of 592 Black women with epithelial ovarian cancer followed up for an average of 5.5 years. Cox proportional hazards models were fit to estimate the association between cigarette smoking status (current and former smoking vs. never smoking) and all-cause mortality adjusting for sociodemographic, lifestyle, and clinical factors.</div></div><div><h3>Results</h3><div>Compared with women who never smoked cigarettes, women who currently smoked cigarettes experienced worse, but not statistically significant, survival (HR 1.41; 95 % CI 0.95– 2.10), whereas women who had quit smoking had comparable survival (HR 1.06; 95 %CI 0.82–1.35). Among former smokers, the association among those who quit smoking within the past five years was of similar magnitude as for current smoking (HR 1.37; 95 % CI 0.97–1.94) but no risk was observed among those who quit for &gt; 5 years.</div></div><div><h3>Conclusion</h3><div>Black women with epithelial ovarian cancer who were current smokers experienced worse survival than those who never smoked cigarettes. Even though this association was not statistically significant, the magnitude of the association is similar to prior studies comprised predominantly of White women. Ensuring access to evidence-based smoking cessation strategies represents a potential avenue for reducing mortality in Black women with ovarian cancer.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"104 ","pages":"Pages 48-54"},"PeriodicalIF":3.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A framework for designing hybrid effectiveness-implementation trials for digital health interventions","authors":"Theresa E. Matson PhD, MPH ,&nbsp;Eric D.A. Hermes MD ,&nbsp;Aaron R. Lyon PhD ,&nbsp;Andrew Quanbeck PhD ,&nbsp;Stephen M. Schueller PhD ,&nbsp;Sarah M. Wilson PhD ,&nbsp;Joseph E. Glass PhD, MSW","doi":"10.1016/j.annepidem.2025.02.007","DOIUrl":"10.1016/j.annepidem.2025.02.007","url":null,"abstract":"<div><div>This article proposes methods for designing randomized controlled trials studying the implementation and effectiveness of digital interventions, meaning websites or applications (\"apps\") that patients use in healthcare. Deploying digital interventions for behavioral health differs from implementing traditional interventions such as medications or human-delivered therapy. Prior trial design guidance has ignored the existence of international governmental evidence standards, has paid insufficient attention to implementation reporting guidelines, and has not described methods for empirically testing the approach for organizing the delivery of digital interventions. This framework for designing hybrid effectiveness-implementation trials of digital behavioral health interventions helps researchers articulate research questions that matter to decision-makers and meaningfully contribute to implementation. The framework outlines three phases: 1) frame effectiveness and implementation questions in terms of the digital intervention components, types of clinical support for the digital intervention, and specific strategies for implementing the digital intervention; 2) define and delineate actors, activities, action targets, dose, temporality, and outcomes to maximize inference and reproducibility; and 3) specify trial design features used for hybrid classification. We illustrate the utility of this framework with two effectiveness-implementation studies of digital interventions for substance use. This framework can help researchers decide on appropriate methodology and help decision-makers apply findings.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"104 ","pages":"Pages 35-47"},"PeriodicalIF":3.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-space characteristics of emergency medical service attendance and layperson naloxone administration during non-fatal opioid overdoses in Rhode Island: A retrospective, event-level analysis","authors":"Joseph G. Rosen ,&nbsp;Melissa Basta ,&nbsp;Kristen St. John ,&nbsp;Benjamin D. Hallowell ,&nbsp;Maxwell S. Krieger ,&nbsp;Lila Flavin ,&nbsp;Ju Nyeong Park","doi":"10.1016/j.annepidem.2025.02.009","DOIUrl":"10.1016/j.annepidem.2025.02.009","url":null,"abstract":"<div><h3>Purpose</h3><div>As the opioid overdose crisis worsens in the United States (U.S.), emerging scholarship has uncovered time-and-place variations in substance use and overdose response efforts in community settings. Building on this work, we characterized spatio-temporal attributes of naloxone administration during non-fatal opioid overdoses attended by laypersons and emergency medical services (EMS) over a three-year period.</div></div><div><h3>Methods</h3><div>Leveraging EMS encounter data across Rhode Island between January 2020 and December 2022, we quantified hour-by-hour variations in EMS deployment locations for non-fatal opioid-involved overdoses among adults (aged 18 + years). We used multivariable Poisson regression with robust standard errors to identify spatio-temporal patterns in EMS-attended overdoses by location type and evidence of layperson naloxone administration during these events.</div></div><div><h3>Results</h3><div>Of the 5377 EMS non-fatal opioid overdose encounters, most occurred in residential housing (61.1 %) and outdoor public spaces (19.3 %). We identified substantial time-space variations in non-fatal overdoses, with EMS deployments to residential housing clustering in non-daylight hours (5:00PM-8:59AM) and to outdoor public spaces in daylight hours (9:00AM-8:59PM). Documented naloxone intervention by laypersons prior to EMS arrival was uncommon (10.6 %) but was most pronounced in overdoses occurring in residential housing and the early afternoon (1:00PM-4:59PM).</div></div><div><h3>Conclusions</h3><div>Despite the clustering of non-fatal opioid overdoses in housing environments, we identified substantial within-location variations in overdose-related EMS encounters over time and place.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"103 ","pages":"Pages 55-60"},"PeriodicalIF":3.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis use & female infertility: A cross sectional analysis of the National Health and Nutrition Examination Survey, 2013–2018","authors":"Megha Arora BS ,&nbsp;Sarah K. Dzubay BS ,&nbsp;Aine Huntington MPH ,&nbsp;Kristin C. Prewitt MD, MPH ,&nbsp;Sarah B. Andrea PhD, MPH","doi":"10.1016/j.annepidem.2025.02.008","DOIUrl":"10.1016/j.annepidem.2025.02.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite growing prevalence of cannabis use in the U.S., literature describing the impact of cannabis use on fertility is limited. This study investigates the association between frequency of cannabis use and female infertility.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis of frequency of cannabis use and infertility (inability to conceive within a year) using the 2013–2018 National Health and Nutrition Examination Study (NHANES) for women aged 20–49. Multivariable logistic regression models adjusting for sociodemographics, health status, and other substance use were utilized to estimate adjusted odds ratios (aOR), 95 % confidence intervals (CI), and assess results by age of regular use initiation and marital status.</div></div><div><h3>Results</h3><div>Of the 3167 women included, 12.4 % reported infertility. Infertility prevalence was 10.6 % among those with irregular cannabis use and 15.4 % among those with regular use. Compared to never use, women with regular use had 53 % greater odds of infertility (aOR: 1.53; 95 % CI: 0.91, 2.55) and women with irregular use had 17 % lower odds of infertility (aOR: 0.83; 95 % CI: 0.54, 1.27), without statistical significance. Associations were robust to age of initiation of use and marital status.</div></div><div><h3>Conclusions</h3><div>Our results suggest a possible modest association between regular cannabis use and infertility, adding to a growing body of evidence which can inform professional society recommendations and patient counseling.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"104 ","pages":"Pages 1-7"},"PeriodicalIF":3.3,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ischemic heart disease among South Asians with ischaemic stroke in three countries across two continents: the BRAINS study","authors":"Gie Ken-Dror ,&nbsp;Prianka Sureshkumar ,&nbsp;Thang S. Han ,&nbsp;Sapna D Sharma ,&nbsp;Padmavathy N. Sylaja ,&nbsp;Fahmi Yousef Khan ,&nbsp;Kameshwar Prasad ,&nbsp;Pankaj Sharma","doi":"10.1016/j.annepidem.2025.02.006","DOIUrl":"10.1016/j.annepidem.2025.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Ischaemic heart disease (IHD) and cardiometabolic risk factors have been extensively investigated in those of European descent, yet they are more common among South Asians who make up around 20% of the world’s population. We explored the differences in IHD and cumulative metabolic profile in South Asians with stroke living in the UK, India and Qatar, compared with white British stroke patients.</div></div><div><h3>Methods</h3><div>The study included first-ever ischemic stroke white British patients and South Asians living in UK, India and Qatar from the ongoing large Bio-Repository of DNA in Stroke (BRAINS) international hospital-based stroke study.</div></div><div><h3>Results</h3><div>We analysed 4359 patients of which 1575 were white British (WB) UK residents, 1135 British South Asians (BSA), 1084 South Asians in India (ISA), and 565 South Asians in Qatar (QSA). Stroke patients from BSA and ISA background had a 9.5% (95%CI: 6.2-12.9, <em>P</em>&lt;0.001) and 15.8% (95%CI: 13.1–28.9, <em>P</em>&lt;0.001) higher prevalence of IHD respectively, compared to WB patients. Adjusting for traditional stroke risk factors, BSA patients continued to display an increased association of IHD compared to WB patients: OR=1.59 (95%CI: 1.25–2.02, <em>P</em>&lt;0.001). Among South Asian ethnicity, compared to ISA, BSA had an almost twice the association of IHD: OR=1.83 (95%CI: 1.37-2.45, <em>P</em>&lt;0.001). The OR for the presence of 2, or ≥3 cumulative cardiometabolic risk factors was 2.55 (95%CI: 2.02–3.23, <em>P</em>&lt;0.001), and 3.86 (95%CI: 3.02–4.95, <em>P</em>&lt;0.001) for South Asians (ISA, BSA, QSA) compared to WB patients, respectively.</div></div><div><h3>Conclusion</h3><div>South Asian ischaemic stroke immigrants have a higher prevalence of IHD as well as more cumulative cardiometabolic risk factors compared to those who remain on the subcontinent. Countries with large immigrant South Asian populations should focus public health campaigns to mitigate their high cardiometabolic risk profiles.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"103 ","pages":"Pages 48-54"},"PeriodicalIF":3.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of traumatic brain injury among adults and children","authors":"Dana Waltzman PhD ,&nbsp;Lindsey I. Black MPH ,&nbsp;Jill Daugherty PhD ,&nbsp;Alexis B. Peterson PhD ,&nbsp;Benjamin Zablotsky PhD","doi":"10.1016/j.annepidem.2025.02.005","DOIUrl":"10.1016/j.annepidem.2025.02.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Surveillance of traumatic brain injury (TBI) in the United States has historically relied on healthcare administrative datasets, but these sources likely underestimate the true burden of TBI. Surveys that ask individuals to self- or proxy-report their experiences with their injuries are an alternative source for surveillance. This paper provides results from a large national survey that ascertained TBI among sampled adults and children.</div></div><div><h3>Methods</h3><div>Data from the 2023 National Health Interview Survey, a nationally representative household survey of the civilian non-institutionalized US population, were examined. Descriptive and bivariate statistics of demographic and injury characteristics of children and adults who sustained a TBI in the past 12 months were calculated.</div></div><div><h3>Results</h3><div>Analyses reveal that 3.0 % (n = 9757,000) of Americans (3.3 % of adults and 2.2 % of children (aged ≤17 years)) reported a TBI in the past year. Among children who sustained a TBI in the past year, over half (55.5 %) sustained their TBI during a sport or recreational activity, and 62.4 % were evaluated by a medical professional. The prevalence of TBI and injury characteristics varied by select demographics.</div></div><div><h3>Conclusion</h3><div>These findings demonstrate that TBI affects a large number of Americans and highlight the value of TBI surveillance through nationally representative surveys, providing a broad picture of prevalence, healthcare utilization, and setting of injury.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"103 ","pages":"Pages 40-47"},"PeriodicalIF":3.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer and Chronic Disease Comorbidity in Incarcerated Individuals in the United States, Survey of Prison Inmates 2016","authors":"Alyssa Watson ,&nbsp;Mary Beth Terry","doi":"10.1016/j.annepidem.2025.02.002","DOIUrl":"10.1016/j.annepidem.2025.02.002","url":null,"abstract":"<div><h3>Purpose</h3><div>There are limited studies examining the cancer and chronic disease comorbidity in individuals who are incarcerated in the United States.</div></div><div><h3>Methods</h3><div>We used the weighted analysis of 20,064 individuals from the 2016 Survey of Prison Inmates in state correctional facilities across 50 states, to examine cancers and other reported comorbid chronic conditions or diseases.</div></div><div><h3>Results</h3><div>45 % of 20,064 individuals reported living with at least one chronic disease. The proportion of individuals currently having cancer was 1.23 % while 4.82 % reported ever being diagnosed with cancer by a medical professional. Incarcerated individuals with any chronic condition or diseases reported a higher risk of currently having cancer after adjusting for smoking, time incarcerated and age (OR, 2.18; 95 % CI, 1.43–3.31) compared to individuals not reporting having any chronic diseases.</div></div><div><h3>Conclusions</h3><div>There is a high burden of chronic diseases in individuals who are incarcerated, and these common chronic conditions are associated with currently having cancer even after adjusting for key risk factors for cancer like prior smoking and age. Efforts to reduce the high prevalence of chronic disease and improve cancer screening policies are necessary to improve the health of individuals who are incarcerated.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"105 ","pages":"Pages 15-19"},"PeriodicalIF":3.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher prevalence of long COVID observed in cancer survivors: Insights from a US nationwide survey","authors":"Lingchen Wang,&nbsp;Wei Yang Ph.D., M.D.","doi":"10.1016/j.annepidem.2025.02.004","DOIUrl":"10.1016/j.annepidem.2025.02.004","url":null,"abstract":"<div><h3>Background</h3><div>Cancer and cancer treatments can weaken the body's immune system, making cancer patients particularly vulnerable to COVID-19. While evidence suggests that cancer patients may be at increased risk for severe outcomes after COVID-19 infection, there is a lack of population-based studies comparing long COVID prevalence between cancer survivors and non-cancer individuals.</div></div><div><h3>Methods</h3><div>We utilized data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), analyzing a sample of 120,658 U.S. adults who had tested positive for COVID-19. Long COVID was defined as the presence of COVID-19 symptoms lasting three months or longer. The weighted prevalence of long COVID was compared between cancer survivors and non-cancer individuals. Crude and adjusted odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated. Multiple imputation was employed to address missing data on COVID-19 vaccination.</div></div><div><h3>Results</h3><div>Among 17,362 cancer survivors who tested positive for COVID-19, 4009 reported having long COVID (weighted prevalence = 24.0 %), compared to a weighted prevalence of 21.6 % in non-cancer individuals (p &lt; 0.001). After controlling for covariates and accounting for the complex sampling design, the adjusted OR was 1.17 (95 % CI = 1.06–1.30, p = 0.002). In participants under 45 years old, cancer survivors had a notably higher prevalence of long COVID compared to non-cancer individuals (32.1 % vs. 21.3 %, p &lt; 0.001), with an adjusted OR of 1.33 (95 % CI = 1.07–1.66, p = 0.012). In participants aged 45 and above, the prevalence difference was not significant (22.7 % vs. 21.9 %, p = 0.324), with an adjusted OR of 1.14 (95 % CI = 1.02–1.27, p = 0.024). Regarding the association of COVID-19 vaccination with long COVID, four or more doses were linked to a significant reduced odds of long COVID among cancer survivors (adjusted OR=0.55, 95 %CI = 0.34–0.88, p = 0.013).</div></div><div><h3>Conclusions</h3><div>Cancer survivors are observed to have higher odds of developing long COVID, particularly younger survivors. The association of COVID-19 vaccination with long COVID varies between cancer survivors and non-cancer individuals, with cancer survivors requiring more doses to achieve significant reduction in the odds of long COVID.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"103 ","pages":"Pages 30-39"},"PeriodicalIF":3.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Youden index and Tjur’s R2 in 2 × 2 tables","authors":"Linard Hoessly","doi":"10.1016/j.annepidem.2025.01.012","DOIUrl":"10.1016/j.annepidem.2025.01.012","url":null,"abstract":"<div><div>We refer to a recent paper by Hughes and show that despite similarities in the rough form between Tjurs <span><math><msup><mrow><mi>R</mi></mrow><mrow><mn>2</mn></mrow></msup></math></span> coefficient of discrimination and Youden index for assessing diagnostic test performance on <span><math><mrow><mn>2</mn><mo>×</mo><mn>2</mn></mrow></math></span> contingency tables, the two functions are different.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"103 ","pages":"Pages 28-29"},"PeriodicalIF":3.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse childhood experiences and firearm storage patterns","authors":"Alexander Testa ,&nbsp;Karyn Fu ,&nbsp;Dylan B. Jackson ,&nbsp;Daniel C. Semenza ,&nbsp;Sandra McKay","doi":"10.1016/j.annepidem.2025.02.001","DOIUrl":"10.1016/j.annepidem.2025.02.001","url":null,"abstract":"<div><div>This study investigates the relationship between adverse childhood experiences (ACEs) and firearm storage practices among adults in firearm-owning households using data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS) across Nevada, New Jersey, Oregon, and Virginia. Findings from multiple logistic regression analyses reveal that relative to respondents with 0 ACEs, 2–3 ACEs (Adjusted Odds Ratio [aOR] = 1.48, 95 % Confidence Interval [CI] = 1.12–1.97, <em>p</em> = .007) and 4 + ACEs (aOR = 1.60, 95 % CI = 1.19–2.16, <em>p</em> = .002) were associated with a higher likelihood of storing a firearm loaded versus unloaded. Among individual ACE items, household alcoholism (aOR = 1.36, 95 % CI = 1.08–1.71, <em>p</em> = .008), household incarceration (aOR = 1.67, 95 % CI = 1.18–2.36, <em>p</em> = .004), parental divorce/separation (aOR = 1.37, 95 % CI = 1.09–1.72, <em>p</em> = .007) were associated with higher odds of storing a firearm loaded. These findings underscore the need for tailored public health interventions that address the lasting impacts of childhood adversity on health and safety practices in adulthood.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"103 ","pages":"Pages 16-20"},"PeriodicalIF":3.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}